What is Separation Anxiety Disorder (F93.0)?

By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

What is

What is Separation Anxiety Disorder (F93.0)?
Photo courtesy of Pixabay.

Separation Anxiety Disorder used to be strictly a children’s condition.

In the past Separation Anxiety Disorder was listed in the section of the Diagnostic and Statistical Manual (DSM) under the category of Disorders First Diagnosed in Infancy, Childhood, and Adolescence.  Recently in the reorganization of the DSM, this disorder was moved to the chapter on anxiety disorders.

Increasingly we recognize that there are adults who suffer from Separation Anxiety Disorder.  In children, if they have the symptoms for four weeks or more, that meets the criteria.  But when we see this disorder in adults we expected it to last at least six months.  This is a disorder which may come and go throughout the lifespan.  It is likely to begin after, or to be triggered by, stressful events.

Separation Anxiety Disorder is about a fear of losing the major attachment figure.

In Separation Anxiety Disorder there is a fear of leaving home or being separated from a major attachment figure.  This is very different from people who are simply afraid of going out of the house, being around crowds, or meeting strangers.  In Separation Anxiety Disorder it is the fear of losing that significant person which causes them extreme distress.

This fear is clearly far more than life circumstances would warrant.  People with this disorder need to know where that important person is it all times.  And they may have an excessive need to stay in constant contact with their major attachment figure.  These people may be given to constantly texting, and may become quite upset if they’re communications are not immediately responded to.

You may also fear being taken away.

Separation Anxiety Disorder is also the fear that something will take you away from that major attachment feature.  People with this disorder worry about an illness, kidnapping, or being forcibly taken from a major attachment figure. Some people with this disorder are unable to be in a room by themselves.

Separation Anxiety Disorder can make you refuse to leave home.

The classic example of this is the child who is terrified of leaving their mother to go to kindergarten on the first day of school.  In normal children, if we expect them to get over this fear after a few days.  But in those with Separation Anxiety Disorder that fear continues for long periods of time. We may continue to see this behavior as children get older.  They may have frequent illnesses which keep them at home with their important attachment figure.

Like most other anxiety disorders, Separation Anxiety Disorder typically begins in childhood, but it may well continue throughout adult life.  In diagnosing this disorder the professional looks at the developmental stage of a person to see if what they are going through is appropriate.

Some adults are so afraid of leaving their significant family members that they are unable to venture out into society alone.  They will only be willing to go outside the house, to the store or an appointment, if that major attachment figure accompanies them.

That huge fear of being alone maybe Separation Anxiety Disorder.

An abiding characteristic of Separation Anxiety Disorder is the extreme level of fear of being alone.  Any time this person is separated from their major attachment figure, they become anxious and may even become terrified.

In children, the attachment figure is likely to be their parents or caregiver.  In adulthood people with this disorder are likely to become very anxious when separated from their spouse, partner, or their children.

If that important person is not home, then you can’t sleep.

People with Separation Anxiety Disorder find that they are unable to sleep when the major attachment figure is not in the house.  They may stay up all night on those occasions when that person they’re attached to needs to be gone overnight.

The person with Separation Anxiety Disorder will have a constant need for reassurance.  This need may result in frequent phone calls or other efforts to contact the attachment figure who is not there.  This constant need for reassurance may begin to interfere with their partner’s ability to work.

Separation Anxiety Disorder causes nightmares about being separated.

In this disorder, the content of the nightmare is that the important person will be taken from you or you from them and that you will never ever be able to see them again. These nightmares can be recurrent and play a role in maintaining the other symptoms.

Separation Anxiety Disorder can make you physically ill.

Symptoms of this disorder can look just like a physical illness.  These symptoms may include headaches, inability to eat, nausea, or even vomiting if there’s a chance that you’ll be separated from this major attachment figure in your life.

People with Separation Anxiety Disorder are likely to be described by others as needy and insecure.

There is help for Separation Anxiety Disorder.

While this condition often begins in childhood and may continue well into adulthood, someone with this issue does not have to continue to suffer.  There are treatments available.  If you or someone you love suffers from this condition, consider getting professional help.

More on this and other anxiety disorders see:  Anxiety

FYI These “What is” sometimes “What are” posts are my efforts to explain terms commonly used in Mental Health, Clinical Counseling, Substance Use Disorder Counseling, Psychology, Life Coaching, and related disciplines in a plain language way. Many are based on the new DSM-5, some of the older posts were based on the DSM-IV-TR, both published by the APA. For the more technical versions please consult the DSM or other appropriate references.

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

For videos, see: Counselorssoapbox YouTube Video Channel

What is Selective Mutism (F94.0)?

By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Selective Mutism is the failure to speak at times when speech is necessary.

What is

What is Selective Mutism (F94.0)?
Photo courtesy of Pixabay.

Selective Mutism is an interesting disorder. It is one of the less common anxiety disorders and one which commonly first appears in childhood.  This disorder often co-occurs with Social Anxiety Disorder.  As with all the anxiety disorders, Selective Mutism may continue well into adulthood.

Selective Mutism is not the inability to speak or the willful refusal to speak.  Selective Mutism occurs when someone chooses not to speak in a particular situation even when not speaking may cause them difficult.  Children with this condition will avoid starting a conversation with other children.  When spoken to they will fail to respond.

Selective Mutism gets noticed when children begin to attend school.

Children with Selective Mutism do poorly in school because they do not respond verbally to the teacher and do not read out loud.  Those with this disorder may use other ways of communicating rather than speaking.  Sometimes they will point, grunt, or used personally significant gestures.  They may also be willing to engage in social activities when speech is not required.

Children with Selective Mutism are able to speak normally at home with their parents or primary caregivers.  They may be unwilling to speak in the presence of close relatives including cousins, aunts and uncles, and grandparents.

Risk factors for Selective Mutism.

Children who are shy are at extra risk to develop this disorder.  Having parents who are withdrawn or growing up in a socially isolated environment may also be risk factors.  It is possible that having overprotective or controlling parents increases this risk.  There’s some evidence that children with this disorder have difficulty understanding the things that are said to them.  Having Social Anxiety Disorder or a family history of it may also increase the risks.

Other problems may accompany Selective Mutism.

People with Selective Mutism also frequently are shy and experience social embarrassment.  They may be isolated and withdrawn.  Children with Selective Mutism may be clingy and become easily upset.  They may also exhibit temper tantrums and oppositional behavior.

Having this disorder early in life and not getting treatment for it puts the child at extra risk for poor development and failure to learn needed social skills.

Things that are excluded from a Selective Mutism diagnosis.

To get this diagnosis, this condition of not speaking even when you need to speak must go on for a month or more.  If the thing keeping you from speaking is the result of not knowing the English language or being bilingual in some way, this is not a case of Selective Mutism.

Also excluded from the definition of Selective Mutism are things related to speech fluency.  If the person involved is experiencing an episode of hearing voices, if being psychotic, or a schizophrenia-like condition, this also is outside the definition of Selective Mutism.

FYI These “What is” sometimes “What are” posts are my efforts to explain terms commonly used in Mental Health, Clinical Counseling, Substance Use Disorder Counseling, Psychology, Life Coaching, and related disciplines in a plain language way. Many are based on the new DSM-5, some of the older posts were based on the DSM-IV-TR, both published by the APA. For the more technical versions please consult the DSM or other appropriate references.

More “What is” posts will be found at What is.

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

For videos, see: Counselorssoapbox YouTube Video Channel

What is Reactive Attachment Disorder (RAD) F94.1?

By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

What is

What is Reactive Attachment Disorder (RAD) F94.1?
Photo courtesy of Pixabay.

Reactive Attachment Disorder begins early in life.

Reactive Attachment Disorder (RAD) is one of those disorders which was moved in the DSM-5.

It used to be included in the chapter on Disorders First Diagnosed in Infancy, Childhood, and Adolescence.

RAD now appears in the chapter on Trauma- and Stressor-Related Disorders.

Reactive Attachment Disorder is the result of deficiencies in early life care.

Reactive Attachment Disorder is an internalizing disorder. A related disorder called Disinhibited Social Engagement Disorder involves externalizing behaviors.  Both conditions are thought to be caused by poor caregiving early in life. RAD involves a consistent pattern of shutting down, withdrawing, and inhibiting emotions. This disorder starts before age five and is rarely given after that age.

While this is a diagnosis primarily applied to very young children, in working with adults we often see conditions that probably began as Reactive Attachment Disorder.  A common statement is that they “just don’t get close to others.” This condition involves an inability to regulate emotion and unexplained anger, both issues we frequently see in adults who came from dysfunctional homes.

With children, we usually know that the symptoms are caused by neglect and poor parenting.  With adults, similar symptoms show up as depression, chronic sadness, anxiety disorders, or even personality disorders.  Our understanding of reactive attachment disorder is pretty much an all or nothing condition.  I can’t help wonder about the effects which varying degrees of neglect or failure to meet the child’s emotional needs might be causing.

Reactive Attachment Disorder involves a consistent behavioral pattern.

Most of the Trauma- and Stressor-Related Disorders are related to anxiety and obsessive-compulsive disorders and are fear-based. Reactive Attachment Disorder is about shutting down and internalizing. In Reactive Attachment Disorder, there is chronic sadness, depression, and loss of pleasure.  There may also be accompanying anger, aggression, and dissociation. This involves a lot of withdrawal and inhibited emotion.

Reactive Attachment Disorder involves social and emotional problems.

Children with RAD are unresponsive to others.  They’re rarely happy or positive.  RAD involves frequent irritation, sadness and sometimes being afraid. Children with this disorder often react to adult caregivers in a negative way for no apparent reason. These patterns of poor relationships with adults continue even when caregivers change.

In adults, we see similar patterns with those people who get diagnosed with Persistent Depressive Disorder.  They often say they do not ever remember being happy.  What we often don’t know is if this person really had deficient care as a child or if they had a temperament which makes them difficult to parent.  Sick, or irritable temperamental children are harder to parent and more likely to be abused or neglected.

Extremely deficient care results in Reactive Attachment Disorder.

Characteristics of this less-than-adequate care include emotional needs not being met, frequent changes in caregivers, and being raised in impersonal institutionalize settings.  Mostly this deficient care results in poor relationships with caregivers and other adults, but it may also affect peer relationships.

Sometimes other things look like Reactive Attachment Disorder.

Sometimes children with Autism or developmental delays exhibit symptoms that can look like Reactive Attachment Disorder. In young children, it is important to be sure the problems were caused by poor caregiving.  In adults, we see behaviors that we suspect began as Reactive Attachment Disorder, but without a prior diagnosis, we can’t be sure. RAD may affect many other developmental areas.

Some cautions.

As with the other things we are calling a mental illness this RAD needs to interfere with the ability to work, or in children, go to school, relationships, or other enjoyable activities or cause personal distress. Otherwise, there may be issues, but the diagnoses will not be given. If the only time this happens is when someone is under the influence of drugs or medicines or because of some other physical or medical problem these problems would need to be more than the situation otherwise warrants. These other issues may need treating first, then if there are still symptoms, the diagnosis will be given.

Treatment for Reactive Attachment Disorder.

For children, getting into a situation with a caring, responsible, caregiver, can make all the difference.  For adults with problems now, which may or may not be the result of early childhood experiences, there are several therapies which may be helpful.

It is imperative that children who have Reactive Attachment Disorder get treatment early to prevent lifelong difficulties.  Adults who struggle with emotional difficulties may find that they still have early childhood issues that need to be addressed before their adult problems will resolve.

FYI These “What is” sometimes “What are” posts are my efforts to explain terms commonly used in Mental Health, Clinical Counseling, Substance Use Disorder Counseling, Psychology, Life Coaching, and related disciplines in a plain language way. Many are based on the new DSM-5; some of the older posts were based on the DSM-IV-TR, both published by the APA. For the more technical versions please consult the DSM or other appropriate references.

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

For videos, see: Counselorssoapbox YouTube Video Channel

Things that will make you anxious.

By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Anxiety provoking.

Anxiety.
Photo courtesy of Pixabay.com

How many of these things make you anxious?

If you are high in anxiety and your life is full of stress, some of the things you have surrounding you may be adding to the tension and pressure you are struggling with. Take an inventory of these worry-producing factors and see which ones are part of your life. Consider cutting back on or eliminating things that are fueling your anxiety and stress and see if your life does not become far more pleasant.

Unsupportive relationships increase anxiety.

Having people in your life who like, respect, and support you as a person and friend can be protective when it comes to anxiety and stress. Having to spend a lot of time around those who are uncooperative wears you out and leads to that stressed-out feeling. Consider taking a look at your relationships and decide which ones add to your well-being and which ones need to be curtailed.

Judgmental people surrounding you increase anxiety.

People who are constantly judging you rather than accepting you are guaranteed to increase your anxiety. If you keep getting the message that you do not measure up to others standards, take a look at yourself. Improve what you can and distance yourself from those you will never be able to please no matter what.

Having to constantly be on guard to do and say just the right thing is exhausting. Having people in your life who can accept the real you lets you relax and recharge.

Not getting enough sleep results in anxious days and stressed out nights.

Do not start thinking that sleep is time wasted. Those hours asleep each night help your brain clear the mental wreckage from the day before. Your brain burns a lot of calories each day and that mental exercise creates waste. You need some sleep for the brain to repair.

Chronically sleep-deprived people become grouchy, have difficulty thinking, getting along with others, and begin to make mistakes. When thinking is hard you can easily become overwhelmed and anxious. Increase your sleep to reduce your anxiety and fears.

Your diet is emotionally burning you out.

Poor diet results in trying to run your body on less than adequate fuel. Make sure you get enough to eat. Look to improve your diet in small ways. You do not need to become a healthy diet fascist to learn to eat better.

A healthy balanced diet needs to include plenty of water and less in the way of sugar. Look for ways to make small sustainable changes that help you have the energy to cope with life. When you feel healthy you can better cope with stress.

If exercise has become a spectator sport anxiety increases.

Make sure your body is capable of responding when the challenge comes. Get up and move around. Sever that connection between fear and moving. Dance, walk, play to keep the body used to beneficial movement. Not being fit increases the stress when you do have to move for a reason.

Forgetting to breathe expands anxiety.

When the body is deprived of oxygen it sends out distress messages. Most people only breathe deeply when they are already in a panic. Learn to control your breathing rather than letting anxiety take your breath to unknown places.

Having a job, not a life purpose stresses you out.

If you do your work with a purpose it rewards you twice, once when you enjoy what you do and again when they pay you for having done what gives you pleasure. People who have to endure the workday become progressively more worn out.

Seek out work that gives your life meaning. Look for something you can feel proud you do. Make your daily occupation a means to an end not the end of your existence.

Living to meet other’s expectations increases anxiety.

If you are mostly motivated by trying to please others you will find it difficult to please yourself. Do each daily task as if you were the boss and do it well enough that you would be happy with an employee that worked this hard.

Being on the lookout for what could go wrong magnifies anxiety.

Do you spend most of your day looking for what might go wrong? If you are on the constant lookout for problems you will find them. In that process, you may miss the possible solutions and the happy moments between the problems.

All you do is work, too many miles without downtime adds to anxiety.

If life becomes a grind then it will grind you down. Some people love what they do and it energizes them but other people work to exhaustion and spend their off time worrying about work and teetering on collapse.

You spend more time in the past and the future than in now.

The more time you spend visiting the past and the future the more anxious or depressed you may become. People who anticipate the future with dread, looking for what might go wrong, grow more anxiety than accomplishments.

Ruminating about things, not let things go increases anxiety.

Rumination is that habit humans have of just not being ready to let anything go. You worry you obsess and then you worry some more. If most of your thoughts are about things that need worry, your life has been taken over by the anxiety monster and you are doing his bidding.

Taking things way too seriously grows anxiety.

Is everything in your life deadly serious? Do you need to be right about everything? Then you have lost your perspective and are ripe to be absorbed in your anxiety. In terms of humans history, not much that happens in most of our lives will matter next week let alone next year. But your effort into the things that will really matter.

For more on this topic see:      Anxiety

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

For videos, see: Counselorssoapbox YouTube Video Channel

How to scare an anxious person.

By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Anxiety provoking.

Anxiety.
Photo courtesy of Pixabay.com

How many of these things scare you?

People who are high in anxiety are easily frightened. A great many things can scare someone with high anxiety.

Unfortunately, it is often the person who is high in anxiety who is scaring themselves. How many of these thoughts do you entertain that result in feeding your anxiety monster until he is out of control?

Threaten them. 50% chance of an earthquake in the next few years.

Lots of bad things MAY happen. Particularly in the realm of nature and the environment. That earthquakes, hurricanes, tornadoes, and other weather phenomena may happen, does not guarantee they will.

Even in those places where these catastrophic events take place the chances that you and yours will get through unharmed are better than the chances you will be injured. Don’t waste a lot of effort considering low probability events when there are high probability events around the corner.

Does the chance something may happen, justify your using up space in your brain worrying about what may happen at some point off in the future. Eventually we humans all die but happy people live their life based on positive beliefs.

Asking “what if” questions will scare you.

Putting doubt in your head is a proven method to increase anxiety. Ruminating about the future is a sure-fire way to crank up your anxiety. Ask repeatedly “what if” questions about the future and you will discover plenty of possibilities to go wrong.

Attitude towards waiting, traffic jams, lines, being late, can increase anxiety.

For people high in anxiety any waiting is anxiety-provoking. Where someone with less anxiety might interpret the wait is a chance to relax and de-stress the anxious person will use the time to worry about what might happen, how this is not the way things are “supposed” to go. Anxious people can catastrophize about any delay in plans.

Remind yourself everyone is watching. Public speaking, presentations, inspections.

There are lots of situations in life where people might be watching you. Giving a bad talk or presentation might get you noticed in an unfavorable light.

The best remedy for that kind of unfavorable attention is to know what you are talking about and to thoroughly prepare that talk. Most of the time you will find that people are paying far less attention to you than you might wish. Even worse than doing a poor presentation, for the person who speaks a lot, is giving a good one and having no one notice.

One thing you will discover if you investigate what others think about you is that most of the time, those other people are far too preoccupied with their own lives to notice what you did or did not do.

Tell them to “dress appropriately.”

Fuzzy directions can create immense anxiety. Planning to be on time only works if you know what is “on time” for the particular function you will be attending. What is appropriate for one situation and a group of people can be very inappropriate for another.

The best way to quiet this fear is to do your homework or ask what is the proper time or attire.

Ask if they noticed that mole, rash, lump, itch.

You can spend countless hours of frantic involvement with your worries as you go over every inch of your body looking for imperfections to diagnose. Stop stressing and head to the doctor. They should be able to tell you what that mark is and put your mind to rest.

You are not wrong to ask a friend about some new mark you see on their body, just do it in a gentle way knowing that the high anxiety person may anxious themselves beyond belief at your question.

Have them work in a place with sudden unexplained noises.

Someone with high anxiety is always on the lookout for sudden unexplained events, noises, and movement. Put that person on a worksite that has random unexplained sights and sounds and by the end of the day, they are ready to become the proverbial basket case.

Worse than ending up in that sort of environment by chance is the person with high anxiety who ignores their mental health needs and takes on an unsuitable job or those anxious people who are living in a situation with those random, sight, and sound triggers.

Wait till the last minute, for appointments, gas, or essentials.

If you are a high anxiety person you know how unnerving last-minute changes of plans can be. You have planned things out in advance to prevent unexpected occurrences and suddenly plans get changed with possible “catastrophic” results.

If you have to live or work with an anxious person, plan ahead to avoid these last-minute emergencies. Stopping for gas on the way to the appointment may be no problem for you but the high anxiety person will come unglued at the thought that you may run out of gas or that you might be late for that appointment and then they would not be seen by the doctor and their cancer would go undiagnosed and they might die as a result —- See how that anxiety train picks up speed as they ruminate about unforeseen plan changes?

Take them for a drive along the cliff when the river floods.

There are a number of things that trigger anxiety so commonly these items made it into the most recent Diagnostic and Statistical Manual of Mental Disorders (DSM-5) in the section on specific phobias. While people can be specifically afraid of these things they can also be triggers for high anxiety even when the person with the fear attack is unaware of the phobia.

The list of Specific Phobias includes animals, nature, blood and surgery, close or confined places, choking, vomiting, and even costumed creatures.

If you have a person with anxiety in your life, try to avoid doing these things and triggering that person’s anxiety. If you are an anxious person, how many of these things are you creating for yourself, and are you willing to try some counseling to get past those anxiety triggers?

For more on this topic see:   Anxiety

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

For videos, see: Counselorssoapbox YouTube Video Channel

Is it Anxiety, Stress or PTSD?

By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Stress person

Stress.
Photo courtesy of Pixabay.com

Just how stressed out are you?

Everyone experiences a little stress in their day-to-day life.  Having anxiety in your life is considered just a part of modern life.  But sometimes that stress and anxiety overwhelm people.  The things that get called trauma come in all shapes and sizes.  Many times these traumas resolve in a short period of time.  Traumas that don’t resolve, that hang on for long periods of time and interrupt your daily life, can turn into a serious mental illness such as an anxiety disorder a stress-related disorder, or even Posttraumatic Stress Disorder.

If you’re struggling with difficulties, anxieties, stress, or even some traumatic events it is helpful to know just what kind of problem you’re dealing with.  Some things will sort themselves out on their own.  Other times anxiety, stress, and trauma need professional help.  Here are some of the problems that you might be experiencing and some thoughts about how to tell the different problems apart.

Stress.

Stress is the reaction the body has to challenges from the environment.  Stress can be small and repeated or large and dramatic.  Even good things can be stressful.  That first day on a new job can be full of stress even when you really want that job.  Many people get sick the first week on a new job.  Weddings or the birth of a baby can be stressful also, even when these have been something you have looked forward to.

Most of the time people have stress and it goes away.  But over time people can accumulate a great deal of stress, and this can result in physical, emotional, and mental illnesses.  One very important life skill is learning how to manage and reduce stress.  Take a look at the other posts on counselorssoapbox.com about stress and stress management.

Animals get stressed and so do people.

Humans are not the only creatures to get stressed.  Animals in the wild can have a very stressful life.  Sapolsky wrote a very interesting book called Why Zebras Don’t Get Ulcers.”  The main difference between humans and animals seems to be how they adjust to stress after it has come and gone.  Animals who were stressed returned to a low-stress state very quickly.  Humans get stressed and years later they are still experiencing that stress.  For humans, this accumulation of stress over time can result in chronic illnesses.

Anxiety.

Anxiety is a normal human response.  But when it gets out of control it can become a disease.  If you’re in a dangerous situation, anxiety and even fear can help you stay safe.  If the volume on your anxiety is turned up too high, it can cause you to overreact to many everyday situations.  Sometimes people have what they call anxiety attacks.  For a brief period of time, they feel excessive anxiety but eventually, these anxieties attacks subside.

When this high anxiety continues too long and begins to interfere with your daily life, your job, or your relationships, it is excessive and may be diagnosed as an anxiety disorder.  There are a number of different recognized Anxiety disorders depending on the particular features of your anxiety.

Post-Traumatic Stress Disorder or PTSD.

Post-traumatic Stress Disorder or PTSD is a diagnosable mental illness.  Sometimes in life people experience overwhelming traumatic experiences.  They may witness a violent death, a tornado, hurricane, or other natural disasters.  In these events, the person may fear that they or someone close to them is going to die.

This condition was originally identified in the veterans returning from war zones.  It has since been identified in civilian populations who have been exposed to traumatic events and feared for their lives.

As a result of this trauma, people begin to develop difficulties functioning.  Some people will struggle with these problems for a short period of time, a month or so.  Other people will very quickly return to normal function.  In some cases, as a result of these traumatic experiences, people will continue to have symptoms for years afterward.  These continuing symptoms may be PTSD.

Complex trauma.

Repeated traumatization becomes more difficult to heal from.  There has been a good deal of research and writing about a condition that is sometimes called complex trauma.  While it’s not an official diagnosis, is helpful for many people to think about it this way.  Someone may be able to experience a trauma and recover from it.  If that same person experiences the same trauma repeatedly, each time it becomes more difficult to recover.

If you are struggling with anxiety, stress or PTSD consider getting professional help.

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

For videos, see: Counselorssoapbox YouTube Video Channel

What operating system is installed in your brain?

By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Brain Apps

Brain Apps.
Photo courtesy of Pixabay.com

How is your brain programmed to handle life?

Most of us like to think that we have a lot of free will, we can make choices.  Psychology tells us that many of those choices we think we’re making are the result of programming, early life learning, which has created a default way in which we deal with life.

Sometimes it is helpful to think of these default operating systems as blueprints for living which we developed in childhood.  Many people find that the problems they deal with in adult life are things they learned between the ages of eight and eighteen which worked back then but do not work well as adults.

These default operating systems can sometimes work well and help us get through things.  Other times we find that there are flaws, fatal errors in our programming, which result in a less than ideal life. If you’re finding life isn’t going the way you thought it would, you may want to take a look at that programming and see if it doesn’t need an update.

Here are the most common brain operating system problems.

Act out, behavioral solutions.

For many people, this is the default setting.  When upset or angry they act out.  People who opt for the behavioral solution may become violent, throw things, yell at people, or swear.  In action-adventure movies, this is the way the hero frequently behaves.

Acting out and behavioral solutions are a typically male way of reacting.  In athletic competition, young men and women are encouraged to be aggressive.  Outside of athletic competition, these behaviors are unacceptable.

In school, many boys get in trouble for this and may be suspended or expelled.  Later on in life using behavioral solutions to life’s problems may get you arrested, put in jail or result in prison time.  Developing the skill to think it over before using a behavioral solution is an important part of the developmental process.

Stay inside your head, isolate.

A second response pattern which is often learned in childhood is to avoid problems by withdrawing and pulling inside.  Historically girls tended to use this strategy. When stressed they would often sit at their desks staring at their work.

The result of using the isolating, withdrawal strategy, is to avoid confrontations.  It may also result in you being considered less intelligent or incapable of doing the work.

High alert, stay in fear. Scan for the negative.

A certain amount of vigilance and anxiety can be protective.  Too much anxiety becomes a problem.  People who adopt a strategy of using high attention to avoid danger can become over-anxious.  This can result in hypervigilance.  People with hypervigilance often have an exaggerated startle response.  The door slams down the hall and they jump out of their seats.

Avoidance. Use drugs, don’t trust.

Another common way of dealing with problem situations is simply to avoid interacting with the situation.  Avoidance can be as simple as just don’t talk to or see someone who is upsetting.  Other common avoidance techniques are using alcohol, drugs, or another behavioral addiction.

Some people avoid painful situations simply by not interacting with others.  They may avoid friendships or close intimate relationships.  People who have been disappointed by others try to avoid additional disappointments by not putting their trust in other people.

Don’t feel.

In some family’s feelings are a banned substance.  The goal of not feeling was to avoid anything that would be upsetting.  In family’s like this people never talk about their pain or their hurt.  While this strategy may seem like a good way to avoid unpleasant emotions, it has some long-lasting negative effects.

If you grew up in a home which never dealt with feelings, you may be totally unprepared for the feelings that you do have.  People who never learned how to manage anger, pain, and sadness, are at high risk to be overwhelmed by these feelings when they do experience them.

People who have a history of not feeling are likely to also say that they have never experienced happiness.  In order to experience positive emotions, you also need to be able to experience the negative ones.  Consistently avoiding feelings can leave people feeling numb.

What are the rules? Tell me what to do.

When people don’t develop basic skills to make decisions, they may have a strong tendency to rely on extensive rules.  These people are often attracted to dogmatic leaders.  And they’re likely to be very legalistic.  You can easily spot these people.  They frequently can cite the exact rule that they believe applies to this situation.  What they find difficult to do is to function in situations where there are unclear rules or were new rules need to be made.

Rule users are also likely to try to impose their beliefs about what things should be like on other people.  They are likely to be intolerant of variation and nonconformity.

File everything for future use. Hold onto the hurts.

Another way of coping with life’s uncertainties is to never express how you feel about things.  People who adopt this strategy, often do a thing called gunny sacking.  When someone does something to bother or upset them they will hold onto that slight for later use.  They pick these little resentments up, one at a time, holding onto them for future use.  When the gunny sack gets full they unload the entire list of past resentments on the other person.

Act on those feelings, impulsivity.

Some people rather than using feelings as information feel compelled to do whatever those feelings urge them to do.  They become, in effect, slaves to those feelings.  Rather than taking ownership of their feelings, they believe that other people make them happy, make them sad, or make them angry.  Since they ascribe their feelings to another person, they also believe the other person is responsible for that feeling and for their actions.

Beat your body into submission.

Some people, when under stress, take it out on themselves.  They may engage in an excess of exercise or even in physical abuse.  These people are at high risk to become cutters or in other ways engage in self-injurious behavior.

No Starter.

Some people adopt a strategy of dealing with the risks of life but trying to avoid taking any risks.  They simply never begin anything and therefore never fail at anything.  The downside of this strategy is that by never starting anything they are never successful at anything.

No brakes.

Other people avoid the uncertainties of life by trying to never accept any feedback on their actions.  Once they begin on a course of action no matter how many difficulties they may encounter they continue going forward.  These are the people who find it impossible to admit they’ve made a mistake.

Not many functions. No vocabulary.

Some people’s brains are programmed for a limited number of functions.  They simply haven’t developed the skills necessary to do other things.  A lot of what humans do is symbolic.  We use words to talk about the feelings in our lives and what we want to do.  Some people lack the vocabulary to express the feelings they do have.

An executive function that decides what routine to use.

The most desirable and most effective operating system for humans is one that involves a great deal of executive function, the ability to think about, communicate about, and make decisions.  People with a good executive function are able to set a new course, stick to that course, and accomplish great things.

This is a brief description of possible human operating systems.  Many people probably use several of these methods on a daily basis.  Which of these mental operating systems have you developed?  Consider increasing the number of apps your brain has available for day-to-day life.

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

For videos, see: Counselorssoapbox YouTube Video Channel

How anxiety holds you back.

By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

How anxiety holds you back.
Photo courtesy of pixabay.

Ways your fears keep you from living.

Anxiety and his friends “The Pack of Fears” are sneaky. They try to tell you that they are protecting you from bad things happening. Anxiety and Fear are like an abusive controlling lover wanting all your attention. Anxiety’s constant insistence that you pay him all your attention prevents you from turning your gaze to positive, happy things.

When you listen to Anxiety a lot, he begins to think he can tell you anything. Remember that sometimes your fears are telling you lies. The key is to become a discriminating listener and discover when your fears are warning you of real danger and when they are just trying to keep you from doing something new.

If you have been listening to Anxiety and the chorus of Fear a lot, here are some of the ways they have been holding you back from having the happy, positive life you deserve.

There are no good surprises.

When you expect the worst and avoid unexpected things that might make you anxious you make unexpected pleasant possibilities impossible.  In the negative zone, people expect anything out of the ordinary to be bad and harmful. The result of this thinking is to never be in the places where pleasant surprises occur.

People who live in the positive zone allow new and unique things to occur in their lives and they are able to see the positive when unexpected things happen. Some of the happiest moments in life are the result of serendipitous pleasant occurrences, but you have to go where those happy moments are to experience them.

Your comfort zone limits who you become.

Since Anxiety wants you to stay close to home, the wall of fear grows high. You can’t experience things outside that wall and your world, over time, shrinks. The pleasures you might have discovered just beyond that wall of fears won’t become a part of your life as long as you stay behind the fear wall.

Flowers don’t grow well in the dark shade of negativity. The longer you stay inside your comfort zone prison the harder it becomes to escape. Over time the wall of fears grows higher and you can be crushed by the weight of those fears pressing in on you.

That fear wall can keep out all the things that might have made you smile and laugh. Fears keep you from getting in on things that could have made your life a joyful place.

Your dreams all become nightmares. You can only imagine bad things happening.

Since Anxiety tells you to expect the worst and prepare for the worst, you see only two things happening, the worst and the almost worst. If you can’t imagine wonderful, joyful things happening you can’t have big dreams for yourself.

With no dreams to pursue, life in that walled prison of fears becomes a lifetime sentence to suffer.

They protect you from the uncomfortable part of growth.

Developing your personal strengths and growth as a person requires emotional exercise. You need to stretch your abilities to develop as a person. Exercise can leave you with sore muscles sometimes. Fear will tell you not to participate in life because you might get hurt. Eventually, your muscles, physical, mental, and emotional ones, will become soft and underdeveloped.

People who exercise their bodies become healthier. Those who don’t grow flabby and weak. Same in the emotional realm. If you avoid learning the hard lessons in life by not trying, you will be ill-prepared for the inevitable bumps on the road of life.

Fear of bad experiences prevents the good ones.

The price you pay for trying to avoid confronting Anxiety and his gang of fears is that they keep you captive and away from living a happy productive life.  Your own doubts become one of life’s worst bullies.

If you have allowed Anxiety and Fear to hold you hostage and your life has become a prison walled off from happiness, isn’t it time you began to confront those fears and see just what bullies they are?

How are you going to stand up to Anxiety and banish the voices of fear?

For more on this topic see Emotions and Feelings. and  Anxiety

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

For videos, see: Counselorssoapbox YouTube Video Channel

What is a Specific Phobia?

By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

What is

What is a Specific Phobia?
Photo courtesy of Pixabay.

There are lots of things you might be afraid of.

Most Specific Phobias are easy to recognize when you see them. If you have one of these fears you may even wonder how this could get called a mental illness. The key, as far as diagnosing them goes, is that people with a specific phobia are far more afraid of the thing, object, or situation than the real danger might objectively warrant. But if you experience this particular fear there is no such thing as being objective about it.

About twenty-eight to thirty million Americans are believed to suffer from a specific phobia. This number may be low as some people can arrange their life to avoid ever having to experience the thing that scares them. If your job never requires flying that phobia may not come up.

Adults can tell you that this or that scares them. Children usually exhibit their fear through their behavior. The child may cry, scream, have a tantrum, freeze up, or be clingy. For all age groups we expect this very specific fear or phobia to have lasted for a while, customarily six months or more. This particular “thing” almost always triggers the same fear.

The list of things that get diagnosed using the DSM is lengthy and even this list is likely not totally inclusive. See Coding below for the new improved ICD-10 list.

Coding Specific Phobia.

Specific phobia used to all be coded in the DSM-4 as 300.29 now in the DSM-5 with the ICD-10 numbers the “objects” which could be things, animals, or situations, all get classified. Here is the list

F40.218 Animals as in snakes, mice, etc.

F40.228 Nature, storms, water, heights, etc.

F40.230 Medical, blood

F40.231 Medical, injections

F40.232 Medical, other procedures

F40.233 Injuries

F40.248 Situations, enclosed spaces, elevators, planes, etc.

F40.298 Other stuff, choking, vomiting, in children – cartoon characters or loud noises

Yes, it is possible for someone to have more than one specific phobia. If you do, the profession should list all the codes and “objects” that cause you significant anxiety. In clinician jargon, this is “stacking up” or listing multiple diagnoses. Specific phobia also often coexists with other disorders such as Depression, Anxiety, and OCD. There are rules in the DSM to tell clinicians, which disorder to diagnose, when to diagnose several disorders, and when to only diagnose one.

Seventy-five percent of those with Specific Phobia are afraid of more than one thing. The majority of all those with Specific Phobia have 3 or more fears that merit diagnoses. Typically these fears get stronger the closer you get to the thing that triggers your phobia. Just thinking about it can be a trigger. For example, people who need to fly but have a specific phobia of flying will begin to get anxious in the days before the flight every time they think about having to fly.

The treatment of choice for Specific phobias is systematic desensitization.

For some with specific phobia, the symptoms can be every bit as severe as those who experience panic attacks or panic disorder. See the “What is” posts on both of these for more on these topics.

FYI These “What is” sometimes “What are” posts are my efforts to explain terms commonly used in Mental Health, Clinical Counseling, Substance Use Disorder Counseling, Psychology, Life Coaching, and related disciplines in a plain language way. Many are based on the new DSM-5, some of the older posts were based on the DSM-IV-TR, both published by the APA. For the more technical versions please consult the DSM or other appropriate references.

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

For videos, see: Counselorssoapbox YouTube Video Channel

com.

What is Social Anxiety Disorder (Social Phobia.)

By David Joel Miller.

What is

What is Social Anxiety Disorder (Social Phobia.)
Photo courtesy of Pixabay.

Social Anxiety Disorder (Social Phobia.) Was 300.23 now F40.10.

Social Anxiety Disorder sometimes called Social Phobia is far more common and debilitating here in the United States than is generally recognized. The most recent estimates are that in excess of seven percent or over 22 million Americans have Social Anxiety Disorder. The U.S rate runs 3 to 6 times the rate reported in other countries.

Fully three-fourths of those who will revive this diagnosis first have symptoms during childhood from the fourth to the tenth grade. This results in significantly lower graduation rates by those with Social Anxiety Disorder. Lifetime someone with Social Anxiety Disorder is more likely to be lower-income and socioeconomic status.

The rates of Social Anxiety Disorder are highest among those who are single, unmarried, or divorced. The disorder may be severe when young and single, become milder when the person is married, and reemerge when they are divorced. The typical person with this disorder waits from fifteen to twenty years before seeking treatment.

The symptoms of Social Anxiety Disorder.

People with Social Anxiety Disorder become extremely, excessively, anxious when they will be in social situations where they may be judged or evaluated by others. While you are only required to be anxious in one social situation to be diagnosed with Social Anxiety Disorder most people with this condition are anxious in many situations.

Someone with Social Anxiety Disorder will report that they can’t relax around others. They may hide achievements that would get them noticed, avoid attention, avoid eating in front of others, and when in social situations they will listen instead of speak.

Other ways this disorder will manifest include, avoid confrontations, preferring to work alone, being afraid to ask questions, avoiding social gatherings, parties, etc. They will underachieve to avoid attention, may drop out of school, or not apply for a job or promotion.

Performance Anxiety is a special case of Social Anxiety Disorder.

People who are in the public eye are at extra risk for Social Anxiety Disorder. Many people are afraid of public speaking, this will not count towards Social Anxiety Disorder if you do not normally need to speak in public. But if your job requires public speaking, or being on stage and when you do this you become extremely anxious then that would be considered a case of Social Anxiety Disorder.

Children with Social Anxiety Disorder.

For children, we do not count situations in which they become anxious in front of adults. Children who develop the disorder also need to be excessively anxious in front of their peers.

Children may try to avoid social anxiety by crying excessively, having tantrums, being clingy, or going mute.

With Social Anxiety Disorder you can run or suffer.

Most people with Social Anxiety Disorder will go to great lengths to avoid social interactions. Some attempt to stay at home with parents well into adulthood convinced that they simply can’t venture out around strangers. They may settle for living in poverty, staying in abusive or dysfunctional relationships rather than attempt to move outside their residence.

Social Anxiety Disorder is neither brief nor temporary.

When we talk about Social Anxiety Disorder we are expecting a problem that is ongoing not a brief temporary fear of a social situation. Typically this has lasted for six months or more. Though clinicians are encouraged to use some judgment here. If you come in asking for help after only five months and three weeks you should get the help despite it being less than six months. In this disorder, the fear also should be far more severe than the situation would merit. If the danger is real and severe, this is not Social Anxiety Disorder.

Treatment for Social Anxiety Disorder.

Treatment for Social Anxiety Disorder can be very effective if the client can get to the treatment. One promising development has been the use of distance counseling over the internet for those too anxious to travel to the counselor’s office. Treatment has been effective both in reducing the Anxiety symptoms and in shortening the duration of the disorder.

There are other things that kind of look like Social Anxiety Disorder.

Professionals need to look at a bunch of other things and make sure that they are not sticking this diagnosis on someone when another diagnosis would fit better. The DSM-5 lists fifteen things that need to be ruled out before deciding on Social Anxiety Disorder. At the top of that list? Social Anxiety Disorder needs to be more severe and cause way more problems than just normal shyness.

As with the other things we are calling a mental illness, Social Anxiety Disorder needs to interfere with your ability to work or go to school, your relationships, your enjoyable activities or cause you personal distress. Otherwise, you may have the issues but you will not get the diagnosis if this is a preference, not a problem. If the only time this happens is when under the influence of drugs or medicines or because of some other physical or medical problem this fear needs to be more than your situation would warrant. These other issue needs treating first, then if you still have symptoms you could get the Social Anxiety diagnosis.

FYI These “What is” sometimes “What are” posts are my efforts to explain terms commonly used in Mental Health, Clinical Counseling, Substance Use Disorder Counseling, Psychology, Life Coaching, and related disciplines in a plain language way. Many are based on the new DSM-5, some of the older posts were based on the DSM-IV-TR, both published by the APA. For the more technical versions please consult the DSM or other appropriate references.

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

For videos, see: Counselorssoapbox YouTube Video Channel