Coping in the coronavirus world.

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

Illustrate illness storm.

Coronavirus storm.
Photo courtesy of Pixabay.com

The coronavirus is changing the way we live our lives.

In my last post, I wrote about the macro issues, the big things we as a society need to grapple with as the coronavirus storm rages, people die, and our healthcare system strains to the breaking point. Today I wanted to share with you some of the micro issues, the challenges I faced in my own life, home, and relationships, as I try to cope with this changing situation. As you read this, please remember I am an old guy, born shortly after World War II and now in my seventies. Keeping up with new technology, changes in fashion, and an ever-evolving world has been a struggle for me even before the coronavirus. The changes now feel like a merry-go-round that has started to accelerate out of control.

What are my significant personal challenges?

Over the last two months, my life has changed more than I could ever imagine. I suspect it has for every one of you who is reading this blog. Now it a good time to share with all of you some of the changes I’ve been experiencing in my life and some thoughts for what the future holds.

Many counselors and therapists are reluctant to share about themselves. As my students, and probably most of you readers realize, I feel like I need to be more open and honest about my experiences. Here are a few of my experiences and observations on the way the coronavirus has changed my life.

Sheltering in place has changed everything.

I thought I had my schedule all worked out. Each week I have been spending part of one day at a local nonprofit doing clinical supervision. I had it down to a routine. Show up, run the group, sign the forms, and then go home. Because of the shelter in place order, the trainees and interns have had to learn to do therapy via telehealth. I’ve had to learn a whole new technology to do their supervision remotely. What had been a simple routine procedure has had a sharp learning curve.

Beyond the technical parts, every one of those therapists in training is also a person. It’s hard to think about your client when your life is in turmoil. The ever-present thought that by spending time in a small consulting room with the client, you’re putting your life in danger, must be reckoned with. Part of each training session now is devoted to having the therapist check-in and see how they are coping with the ominous threat of the coronavirus looming over them and their families.

Despite all the difficulties in shifting to an online way of life, I think the shelter in place was an enormously wise decision. I live in California, and we implemented the stay at home protocol early on. I also live in the Central Valley, a mostly rural and less densely populated area. Early action and sparse population have resulted in extremely low infection rates and even lower death rates. I have every reason to think the virus will get here eventually, but the slow spread has so far avoided overtaxing our medical system.

Shifting from teaching in-person classes to online classes has been traumatic.

I’ve been teaching classes at two different local colleges for over 12 years now. I had my system in place. I have created PowerPoints, quizzes, and tests; all the materials I need to run a class. Suddenly there were no in-person classes. The classes have all moved online. Fortunately, I’d taken a class and how to teach online courses back in the summer of 2016. My efforts to create videos for the counselorssoapbox YouTube Channel has turned out to be a significant blessing.

While it’s been a frantic pace of the last few weeks, I knew how to convert my lectures to videos and upload them to YouTube so that my students can watch them anytime they want from the relative safety of their home.

If only the transition had been that easy. This semester I’m teaching three separate classes. One is a 16-week long semester class. Another is an eight week, twice a week class. While the third class was a hybrid part in-class part online format, all three have a different start, midterm, and end date. Beyond that, the three classes are being conducted on two separate learning platforms. Over a couple of weeks, I’ve had to become considerably more familiar with both Moodle and Canvas.

Over the years, I’d accumulated quite a test bank of questions. It was easy to assort the questions, print out a copy, and make as many copies as needed for class. The process of turning these into online quizzes and tests turned out to be a whole lot more complicated.

Working from home requires confronting my age.

I’ve been retired from a full-time job for over two years now. Whenever I must enter my birthdate on anything, I am forced to recognize that I’m getting older. Despite having retired, I’ve been doing more part-time work and staying incredibly busy. Keeping busy and active, I suppose, is my way of avoiding admitting I’m not as young as I used to be.

Then, when I got the email from the college saying that anyone over a certain age was not to come on campus and I realized I was quite a few years past that age, I’ve been forced to admit to myself I’m now in that high risk older adult category. Furthermore, whatever I may think about taking risks with my own life, I have had to realize that I can’t take the risk of contracting something and bringing it home to others who are at an even higher risk.

I’ve had to transition my therapy clients to distance counseling.

A little over two months ago, I had never even considered using the technologies that today I use every day. I’ve had to learn to use Zoom, FaceTime, and several other online tools. Not only do I have to learn new technology, but I’ve also had to develop some new skills to do remote distance counseling. I remind myself that little over two years ago; I had to have one of my interns teach me how to answer a text message. And today I’m making videos and discussing them with people via Zoom, the process of technological change looks less like a gradual uphill climb and more like scaling a sheer vertical cliff.

Working from home has been exhausting.

When I first considered teaching an online class, I thought it would make my life so much easier. The amount of work that it has taken to prepare the curriculum and upload it to the various platforms has left me exhausted. Stress can be very tiring, even when it motivates you to produce something positive.

Sheltering in place increases isolation.

One of the things I loved about my busy mix of part-time jobs was that it got me out of the house and kept me socializing with a wide variety of friends, students, interns, and clients. I’ve come to feel that the coronavirus has made me a prisoner in my own home office.

One of my colleagues and I were in the graduate program together all those years ago and have made it a habit to keep in touch. We try to get together every month or two for lunch just to check in with each other. With the coronavirus lurking outside, and the restaurants we would generally eat at closed, that monthly lunch together isn’t likely to happen again for a long time.

This last week we had to improvise our monthly get together. We sat talking together over FaceTime while I ate my lunch. I suppose that, for me, is one of the visible aspects of this anxiety-producing situation. One after another, I have found ways to adapt. I continue to teach, albeit online. I still see clients via distance counseling technology. And while my physical contact with other humans has been extremely limited, we’ve created ways to stay in touch with those people who are most important to us.

That’s my story of adapting to the coronavirus threat.

While my life is different now, I’m slowly adapting to this new form of existence. Gradually I’m getting back to my writing. I’ve developed a whole new set of skills. Somehow, no matter what happens, we humans find a way to adapt.

How are you dealing with the changes the coronavirus forced upon you?

Please share a comment below or send me one through the contact me page. If you use the contact me form, please let me know if it’s okay for me to share your comment here on the blog. Take care of yourself and do everything you can to protect yourself and those who are close to you.

Staying connected with David Joel Miller

Six David Joel Miller Books are available now!

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: Some family secrets can be deadly.

What if your family secrets put you in danger?

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?

Casino Robbery is a novel about a man with PTSD who must cope with his symptoms to solve a mystery and create a new life.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Sasquatch. Wandering through a hole in time, they encounter Sasquatch. Can they survive?

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

Books are now available on Amazon.

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

For videos see: Counselorssoapbox YouTube Video Channel

Want the latest on news from recoveryland, the field of counseling, my writing projects, speaking, and teaching? Please sign up for my newsletter at – Newsletter. I promise not to share your email or to send you spam, and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse, and Co-occurring disorders, see my Facebook author’s page, davidjoelmillerwriter.

3 thoughts that create or worsen depression

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

Depressed person

Depression.
Photo courtesy of Pixabay.com

Your thinking may be the cause of your depression.

3 thoughts can create or worsen depression, even when life is going well for you. These three thoughts sometimes are referred to as the cognitive triad. One of the challenges people with depression experience is avoiding falling into thinking patterns that make the depression worse.

Have you ever thought “I’m no good?”

People who mentally run themselves down create depression. For a long time, there was a widespread perception that acknowledging your successes would give you a swell head. Parents avoided praising children. People thought they could motivate others by pointing out all their faults. The idea that verbally beating yourself up will make you work harder and accomplish more is a fallacy. Constantly criticizing yourself results in you defeat even before you’ve begun.

Criticizing yourself, saying you’re no good, and rehashing all your faults often overlaps with perfectionism. It’s wonderful to strive to be and do the best you can, but disqualifying your accomplishments because of one in perfection leads to paralysis and the inability to do anything.

Learn to recognize your accomplishments and build on them. No one is perfect. But focus on all the less-than-perfect things you’ve done in your life will keep you from accomplishing the many good things you might have done.

Several unhelpful thoughts can become habits that lead to this type of thinking. Do you routinely disqualify anything positive? Do you have a mental filter in place that allows you to see only the mistakes you make? Have you drifted into all or nothing thinking where you believe you’re either perfect or you’re worthless? If these unhelpful thoughts are fueling your depression work with a professional to eliminate them.

Do you often think that people are no good?

Every day we hear the news, and it’s full of stories of bad things happening. All that negativity isn’t offset by that one feel-good story they run at the end of the news. While bad things do happen every day, it’s also true that a great many good things happen too. Spotting terrible events is easy. Learning to recognize the good around you takes practice.

Every day all around us, people are doing good deeds. Those good deeds, those good things, are not as exciting as the stories of awful events. The human brain is often biased towards remembering the horrible things. If you lived in the woods or the jungle and you ate a berry which made you sick, your brain will remember that forever to protect you from eating something poisonous. If you find something that tastes good as you walk through the woods, your mind may not pay attention to that good thing. There’s no guarantee that the next time you come this way, there will be more of that good tasting fruit.

To reduce your depression, learn to look for the good in others.

Do you tell yourself it will never get better?

Some people do this as a way of protecting themselves from disappointment when bad things happen. This approach can bias the brain even more towards negative, depressing thoughts. If you lose hope, of course, you’ll become depressed. Every day all around us some people are succeeding. Learn to look for the positive and your brain will become better at recognizing it when it does happen.

One of the secrets to becoming a happier person is to become a happiness expert. Seek out happiness and learn to recognize it when it walks past you. Whenever you have any of these three negative thoughts or to challenge them. Tell yourself you are okay the way you are. There are still good people in this world. And most importantly, don’t give up hope that the future may be better than the past.

Feeling helpless and hopeless are the chief ingredients in maintaining depression. Look for the hope in every situation. If you reach the state of being helpless and hopeless, seek help. Professional counselors or therapists can often see the good in you and the potential for growth when all you can see is darkness.

Staying connected with David Joel Miller

Six David Joel Miller Books are available now!

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: Some family secrets can be deadly.

What if your family secrets put you in danger?

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?

Casino Robbery is a novel about a man with PTSD who must cope with his symptoms to solve a mystery and create a new life.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Sasquatch. Wandering through a hole in time, they encounter Sasquatch. Can they survive?

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

Books are now available on Amazon.

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

For videos see: Counselorssoapbox YouTube Video Channel

Want the latest on news from recoveryland, the field of counseling, my writing projects, speaking, and teaching? Please sign up for my newsletter at – Newsletter. I promise not to share your email or to send you spam, and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse, and Co-occurring disorders, see my Facebook author’s page, davidjoelmillerwriter.

Are unhelpful thoughts causing you problems?

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

Woman thinking

Unhelpful Negative Thoughts.
Photo courtesy of Pixabay.com

What are unhelpful thoughts?

Unhelpful thoughts are part of some people’s self-talk. What you tell yourself often enough becomes automatic thoughts. Becoming aware of the negative messages you’re giving your brain and challenging those messages is a part of the process of change that we call Cognitive Behavioral Therapy.

In the early days of Cognitive Behavioral Therapy (CBT,) researchers and theoreticians noticed a connection between the kind of automatic thoughts or self-talk that some people engaged in and the development of severe mental illnesses, particularly depression and anxiety. Originally these kinds of thoughts were described as irrational thoughts or dysfunctional thoughts. Those labels seem to me to be judgmental. Recently I’ve noticed therapists using the term unhelpful thoughts, and I believe that’s a much better way to describe these automatic thoughts.

Most of these unhelpful thoughts are the result of one or more informal logical fallacies. When you think unhelpful thoughts, they seem true to you, but when an outside observer looks at the evidence, these unhelpful thoughts don’t hold up. These categories of unhelpful thoughts may be called by different names, but here is my version.

All-or-nothing thinking is unhelpful.

This unhelpful thought involves looking at things in black-or-white or yes-or-no categories. For the person with all-or-nothing thinking, there is no middle ground. They tell themselves, “I must be perfect, or I’m a failure.” This type of thinking has led to an increase in depression and even suicide attempts at some of the prestigious colleges where students fall into the trap of believing there only two grades and A or a Not-A. This is a form of perfectionism in which one flaw makes the person worthless. While striving for self-improvement is worthwhile, believing that you must be perfect or you’re no good, will undermine your self-esteem and lead to depression.

Overgeneralization from a negative experience is an unhelpful thought.

This unhelpful thought involves the belief that one negative experience predicts the future. The person tells themselves, “I didn’t get hired for this job. I’ll never get any job.” If you get turned down for a date, you tell yourself no one will ever like me, and I will be alone the left rest of my life.

Having a negative mental filter creates unhelpful thoughts.

Someone with a negative mental filter never sees their accomplishments but only their mistakes. The student who gets one question wrong on a test believes that that means they’re stupid despite the overwhelming number of correct answers.

A person with a negative mental filter fails to get a promotion or is turned down for a raise, and they believe that means they are no good at their jobs and are at risk of being fired.

Discounting the positive is a common unhelpful thought.

Someone with this unhelpful thought might apply for a job and get hired, but rather than believing this is because they were a good candidate, they will tell themselves they only got hired because nobody better applied. No matter how many successes this person has; they only remember their failures and expect to fail the next time they attempt something.

Mind reading is a very unhelpful way of thinking.

People who practice mind-reading believe that when someone doesn’t return a phone call, this means that that person hates them. The mind reader is continually telling themselves that something terrible is about to happen. Since they always predict the worst, they see the worst in every person and situation they encounter. Expecting your partner to be a mind reader is an unhelpful thought that comes up often in couples counseling.

Jumping to dire conclusions is an unhelpful thought.

The jumping to conclusions unhelpful thought takes you from the weather report saying it will rain tomorrow to canceling your camping trip because you’re sure there’s likely to be flooding and lightning might strike your camp.

People with this unhelpful thought process always expect the worst possible outcome. It won’t invest in a retirement account because the stock market might crash. They don’t want to go on a vacation because the plane might crash.

Emotional reasoning will mislead you.

Feelings can be a useful source of information, but not everything you feel is real. Just because something scares you does not mean it is dangerous. Feeling embarrassed about something you did doesn’t mean everyone else noticed and is judging you. Question whether your feelings are providing you accurate information, or are you assuming that because you feel something that makes it accurate?

Trying to live by a long list of absolute rules is unhelpful.

Holding yourself to a strict list of what you should and shouldn’t do and beating yourself up if you break any of the rules is a very unhelpful way of thinking. “I should never have said anything to her. I’m such an idiot.” Trying to live by an arbitrary list of “should’s” and “musts” can result in a lot of emotional problems.

Negative self-labeling is unhelpful.

If you make a mistake or your performance is less than you would like it to be, don’t call yourself stupid or clumsy. Telling yourself, you’re a failure, creates failure.

Trying to control things that are not in your control is unhelpful.

If you’re one of those people, who believes that everything that goes wrong is your fault, you have developed a very unhelpful way of thinking. Don’t try to control or protect other people by anticipating what could go wrong in their lives. You can plan, but don’t fall into the trap of thinking that your planning and worrying will somehow make everything come out the way you want it to.

What should you do if your life is full of unhelpful thoughts?

If you find that you fall into frequent use of these unhelpful thoughts, begin to challenge those anxiety-producing thoughts. Ask yourself what the evidence is that this thought is true. Get a second opinion from a friend. You may find self-help books based on Cognitive Behavioral Therapy, especially helpful. Consider working with the counselor or therapist. A good coach can help improve an athlete’s performance, and a good counselor can help you overcome the problem of frequent unhelpful thoughts.

Staying connected with David Joel Miller

Six David Joel Miller Books are available now!

Dark Family Secrets: Some family secrets can be deadly.

What if your family secrets put you in danger?

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?

Casino Robbery is a novel about a man with PTSD who must cope with his symptoms to solve a mystery and create a new life.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

SasquatchWandering through a hole in time, they encounter Sasquatch. Can they survive?

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.

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

Books are now available on Amazon.

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

For videos see: Counselorssoapbox YouTube Video Channel

Want the latest on news from recoveryland, the field of counseling, my writing projects, speaking, and teaching? Please sign up for my newsletter at – Newsletter. I promise not to share your email or to send you spam, and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse, and Co-occurring disorders, see my Facebook author’s page, davidjoelmillerwriter.

Can you prevent depression?

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

Depressed person

Depression.
Photo courtesy of Pixabay.com

Depression is no joke.

The World Health Organization has identified major depressive disorder as the most significant cause of disability worldwide. Even though depression is a significant source of disability most research on depression has focused on causes and treatment rather than ways to prevent depression or ways to prevent depressive relapses in those who have recovered from an episode of depression. A disease as common as major depression needs more focus on prevention.

Depression can be prevented.

All humans may suffer from some depressive symptoms from time to time, but if those symptoms become severe enough, you will be diagnosed with major depressive disorder. You should know that major depressive disorder rarely goes away on its own, untreated. There are certain lifestyle adjustments you can make which can reduce the likelihood you will get depression or once you have been treated; these techniques can reduce the risk that you will have subsequent episodes of depression. Researchers believe that up to half of all depression could be prevented. More than 30 randomized controlled trials have shown that depression can be prevented.

Preventing depression is different than treating depression.

When can depression be prevented?

You can experience depression at any time in your life, but there are certain times when you will be under stress, and the risks increase. Your quality of life will be much better if you focus on preventing depression rather than waiting until you experience a severe episode of depression.

There are two approaches to preventing depression. One is to try to avoid the first episode of major depressive disorder. The second approach is those efforts made by people who have recovered from a major depressive episode to prevent having a relapse into depression.

Your sleep affects your depression.

Changes in sleep are a symptom of depression. In melancholy depression, people can’t sleep and can’t eat. In atypical depression, people become like the bear ready to hibernate for the winter. They eat everything in sight and then sleep for abnormally long periods. If you have multiple days on end where you can’t sleep, or you feel chronically tired and can’t get out of bed in the morning despite sleeping for more than a healthy number of hours, you should be evaluated for major depressive disorder.

Better sleep requires more than simply more hours in bed.

It’s important to develop good sleep habits. The quality of your sleep matters. Aim for at least seven to eight hours of good restful sleep. Allocate enough hours each night for sleep. Give yourself an hour or two to wind down before bedtime. If you’re having difficulty sleeping because of emotional problems, talk over those problems with your support system or seek professional help.

Smoking is connected to depression.

Depressed people are more likely to begin to smoke, have difficulty quitting, and if they do stop depressed people are more likely to start again. This relationship is bidirectional. Smoking increases the risk you will become depressed. Smoking has been connected to a number of mental health problems. Not having to go through the daily process of taking doses of nicotine and then rapidly withdrawing can increase your emotional stability and reduce the risk of depression.

Increase positive emotions to avoid depression relapses.

Learn to be a happiness expert. Preventing depression includes expanding positive experiences in your life. The more happy, positive feelings you have the less room there is in your emotional life for depression. Magnify the positive to minimize the negative.

Decreasing negative emotions lowers the risk of depressions returned.

Try to rid your life of negative emotions. Too much anger can wear you out emotionally. Loneliness, especially the kind of loneliness that comes from poor quality relationships, quickly needs to depression.

Avoid alcohol to sidestep depression.

Alcohol is a depressant. Even a little bit of alcohol can dampen your mood. If you have a history of alcohol use disorder is probably not safe to drink alcohol. If you’ve recovered from depression drinking alcohol may lead to relapse. If you are recovering or have recovered from depression, why risk a relapse of depression by consuming alcohol?

Continuing treatment for depression longer can prevent relapses.

If you have taken medication for depression don’t discontinue it the minute you feel better. Always consult with your doctor before discontinuing or changing medication. Stopping medication too soon increases the risk of a depression relapse.

Continuing to participate in Cognitive behavioral therapy after the immediate crisis also reduces relapses into depression. If you have done other things to treat your depression continue those life improvement practices also. Staying in treatment a little longer can be very helpful in preventing relapses of depression.

Staying connected with David Joel Miller

Four David Joel Miller Books are available now!

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.

Casino Robbery is a novel about a man with PTSD who must cope with his symptoms to solve a mystery and create a new life.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

SasquatchWandering through a hole in time, they encounter Sasquatch. Can they survive?

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

Books are now available on Amazon, Kobo, iBooks, Barnes & Noble, and many other online stores.

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

For videos see: Counselorssoapbox YouTube Video Channel

Want the latest on news from recoveryland, the field of counseling, my writing projects, speaking and teaching? Please sign up for my newsletter at – Newsletter. I promise not to share your email or to send you spam, and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse, and Co-occurring disorders see my Facebook author’s page, davidjoelmillerwriter.

Eight ways depression gets overlooked in adults.

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

Older people

Elderly couple.
Photo courtesy of Pixabay.com

As people age, the ways they show depression changes.

In mature adults, depression can often be overlooked. As people age, the symptoms of depression change and treatable depression is likely to be dismissed as just a part of the normal process of aging. Younger people commonly express their sadness by crying. Among older adults, depression is more likely to manifest as withdrawal, hopelessness, loss of appetite, and apathy.

Symptoms of depression in mature people are often misinterpreted as aches and pains. Depressed people of all ages are likely to self-medicate emotional problems by using pain relievers. Untreated depression in older adults can lead to their failure to take care of their physical needs. Failure to recognize and treat depression among older adults can make the course of their physical illnesses worse and can result in an increased risk of suicide.

Gerontologists have recognized many ways in which depression in older adults can be overlooked. Here are eight ways depression often goes unnoticed in older adults.

1. Joint and back pain can be symptoms of depression.

Joint and back pain can be symptoms of depression, or they can lead to depression. One study found that the more joints that are in pain, the more likely the person is to have depression. If someone has joint pain or back pain, they need to see a medical doctor and get that pain treated, but they also need to be screened for depression. Pain can be depressing, but depression can make the pain feel worse.

2. Cognitive impairment may be depression rather than aging.

Problems with memory and thinking among older adults may well be the results of depression rather than age-related disorders. A lack of motivation, apathy, is a characteristic feature of depression. Depression leads to confusion about your options and what to do. The longer the depression goes untreated, the higher the risks it will be dismissed as cognitive impairment due to aging.

3. Chest pain can be made worse by depression.

Having a heart condition or chest pain can lead to depression. People with depression are likely to experience those pains more acutely. While you shouldn’t neglect medical treatment for chest pain, an older adult who has chest pain should also be screened for possible depression and treated for depression if it’s present. Having depression leads to poor compliance with the doctor’s instructions, not taking medication as prescribed, and a poor prognosis.

4. Irritability is a common symptom of depression.

Regardless of age, when you don’t feel well, you’re more likely to be irritable and push people away. Among older adults with depression, irritability is such a common symptom; it is almost universal. If you find that you’re becoming more irritable as you age considered getting professional help for possible mental health issues.

Depression may also express itself in other negative emotions. Guilt, shame, fear, anxiety, and loss of hope all feelings that may be associated with depression.

5. Headaches, especially migraines, can be a sign of depression.

One large study found that among those people with migraines, more than half also had depression. This connection can run in either direction. We can’t be sure whether the headaches caused the depression or being depressed increases the chances of headaches and migraines. If headaches have begun to interfere with an older adult’s life, they should be screened for depression and anxiety disorders.

6. Digestive problems can be a sign of depression.

One of the core criteria symptoms for depression is changes in appetite. In younger people with depression, we usually see them either unable to eat or binge eating large amounts of food. In older adults, these changes in appetite may also be reflected in nausea, constipation, diarrhea, or other gastrointestinal upsets.

7. Changes in sleep patterns may be caused by depression.

There are two types of depression recognized, melancholy depression, and atypical depression. In melancholy depression, people can’t sleep or sleep poorly. In atypical depression, the person will be chronically tired and spend an increased amount of time in bed. Some changes in sleep are common across the lifespan. But if an older adult finds they are having trouble sleeping or sleeping a great deal more than usual, that change in sleep may be a result of an underlying depression.

8. Increased use of alcohol and drugs are connected to depression.

In the past, there’s been a tendency to excuse increased alcohol consumption among the elderly. They don’t need to work anymore and why shouldn’t they enjoy themselves? The truth is drinking to intoxication is not likely to be enjoyable. Depressed people tend to drink more, and alcohol is a depressant, making the heavy drinkers more depressed. Drinking to intoxication has been linked to a massive increase in the risk of suicide. For older adults, even a small amount of alcohol can make their physical health worse.

Historically, as people grew older, most of them, gave up their use of drugs. The baby boomer generation has tended to continue their use of drugs well into their retirement years. Escalating drug use can be a symptom of depression in older adults and can lead to creating and exacerbating physical health issues.

If you’re an adult moving to the older adult years, or you have a friend or family member in that age range, don’t overlook the signs of depression. Depression is not something you have to put up with as you age. Severe depression is a crippling disorder which is treatable by both medication and talk therapy. No one should have to suffer from depression in their “golden years.”

Staying connected with David Joel Miller

Three David Joel Miller Books are available now!

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.

Casino Robbery is a novel about a man with PTSD who must cope with his symptoms to solve a mystery and create a new life.

SasquatchWandering through a hole in time, they encounter Sasquatch. Can they survive? The guests had come to Meditation Mountain to find themselves. Trapped in the Menhirs during a sudden desert storm, two guests move through a porthole in time and encounter long extinct monsters. They want to get back to their own time, but the Sasquatch intends to kill them.

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

Books are now available on Amazon, Kobo, iBooks, Barnes & Noble, and many other online stores.

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Want the latest on news from recoveryland, the field of counseling, my writing projects, speaking and teaching? Please sign up for my newsletter at – Newsletter. I promise not to share your email or to send you spam, and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse, and Co-occurring disorders see my Facebook author’s page, davidjoelmillerwriter.

How lonely will you be?

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

Lonely person

Loneliness.
Photo courtesy of Pixabay.com

Will loneliness cause you problems?

Loneliness can result in significant emotional problems. While loneliness isn’t considered a specific mental illness, it plays a role in creating and worsening several mental health issues. Loneliness can undermine self-esteem by making people feel, empty, worthless and unwanted. Loneliness is both a cause of and a result of social isolation. If you are feeling lonely, you probably feel that you lack something in your life. Loneliness coupled with anxiety and depression increases your risk of feeling threatened and may result in paranoia.

In its milder forms, loneliness can be a motivator for you to seek out human contact. Stronger versions of loneliness result from feeling you have too few social connections or the relationships you have are one-sided and unhelpful.

Researchers have discovered strong connections between loneliness and depression. Lonely people are at an increased risk to think about suicide or to even attempt suicide. Lonely people are more likely to use and abuse drugs and alcohol resulting in alcoholism and addiction. The combination of substance use disorders, feeling lonely and depressed, and believing that others are rejecting you, increases the risk of violent behavior. Loneliness has also been linked to physical health problems and poor emotional development.

The very young and very old are at increased risk for feelings of loneliness. Particular life transition points also increase these risks.

Your thinking can make your loneliness better or worse.

How lonely you feel is less likely to be the result of how many friends you have or how much time you spend with others, and is more connected to your attitudes about the quantity and quality of your social connections.

Your feelings of loneliness are primarily the result of your beliefs about four separate factors. When you’re feeling lonely, it is important to look at both the facts and your beliefs in these areas. One way to reduce the feelings of loneliness is to develop the skills you need to change your situation. The other way to feel less lonely is to reconsider your beliefs about things. Often negative emotions are caused not by the situation, but by the beliefs you have about your circumstances.

What do you think about your friendships?

Loneliness is reduced more by having close, true friends, than by the number of casual friendships you have. It’s not how many friends you have, especially your social media friends, but how close you and your friends are.

True friendships should be reciprocal. You care about them, and they care about you. You should be willing to do for them, and they should be equally willing to do for you. If you find that your relationship is all about that other person, that you must do what they want to keep their friendship, that’s not a healthy, positive friendship.

It’s wonderful to have a BFF (best friend forever.) Having only one close friend limits the ability of your friendship to be supportive. No one will be able to devote every minute of their life to meeting your needs. If you call that one best friend constantly about your problems, you are likely to burn them out.

Recovery programs often recommend that you have at least five separate people in your support system. Your friends should have other people in their lives beside you. If you’re in a relationship where you can’t have other friends or where you resent the other people in their life, these are not healthy relationships.

Emotionally healthy people belong to a group of friends rather than being dependent on only one person. Having only one person to meet their emotional needs is a large issue for couples. When there are difficulties in your relationship, you will find it hard to turn to your partner for emotional support. It’s risky to turn to friends with whom you might be tempted to develop a close sexual relationship. For heterosexual people, this is the time you need to have friends of your own gender.

Are you isolated?

Feeling socially isolated causes loneliness. If you feel like you have no friends and no one you can talk to, this should prompt you to reach out and make connections. For some people, this means professional counseling, which can help in the short-term. In the long-term, you need to put yourself into situations where you can make friends, and need to learn the skills necessary for creating and maintaining friendships.

Is being alone a bad thing?

Your attitude towards solitude will magnify or reduce your feelings of loneliness. Ask yourself how you feel about spending time with you? Some people find that when they are alone, they don’t know what to do. Are you bored when there’s no one else around?

Being alone shouldn’t make you unhappy. Alone time is an opportunity to find out about yourself. Focusing on the negative will increase your loneliness. Feeling negative about being alone will cause the time to drag. Filling the alone time with things you enjoy doing turns loneliness into happiness.

Can Solitude be a good thing?

When you are alone, look for the positives. Your time alone should be an opportunity to get to know yourself better. Develop a friendship with yourself. Throughout your life, the one constant will be you. Everywhere you go, every minute of your life, you will be there. Work on enjoying the time you by yourself.

Life can get hectic at times. Sometimes it’s nice to get away from it all. If when you get that chance to get away from life’s hassles, you discover you’re getting lonely, consider developing a stronger friendship with yourself.

Other posts about feeling lonely will are found in the category – Loneliness.

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

Your “feeling bad” may be Dysphoria.

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

Unhappy

Dysphoric.
Photo courtesy of Pixabay.com

Dysphoria – the feeling bad problem.

Sometimes you just feel bad. Many times, people feel bad but can’t describe what that feeling is. Ask someone at random how they feel, and the most common answers will be, good, bad, or angry. Some of this stems from the bad reputation feelings have received. Many people go to great lengths to avoid any negative feelings. When you tried to avoid negative feelings, it’s no surprise that when you do feel bad, you have difficulty identifying that feeling and giving it a name.

You may have been labeled dysphoric without your knowledge.

If you have been to see a professional because you were “feeling bad” but you didn’t know the specific reason, the professional may have written down somewhere in your file that you were “dysphoric.”

When you’re under stress, the chemicals your nervous system produces are felt widely throughout your body. Panic attacks can feel like a heart attack. Depression can leave you exhausted, lacking the energy to get out of bed. A high percentage of clients who experienced these symptoms go to the medical doctor first. Which is not a bad idea. You need to rule out a medical issue. Sitting and talking to your counselor during your heart attack could be fatal.

Once your medical Doctor has ruled out immediate, life-threatening illnesses, you may be referred to see a psychiatrist, counselor, or therapist. Seeing a counselor does not mean you are crazy. What it tells us is that your nervous system has been sending out chemicals alerting the body to an emotional crisis. The result is an episode of dysphoria.

Is dysphoria a mental illness?

Dysphoria is a term that goes back to the days of Freud. Back then someone was either diagnosed with psychosis, that meant you were crazy, or neuroses which largely meant you were struggling with the problems of living. I have seen the term dysphoria in a lot of the older literature from the fields of psychology and psychoanalysis. Today professionals use the DSM-5 to diagnose mental illness. The DSM lists about 400 different varieties of mental illnesses. Dysphoria can be an underlying symptom of many of these illnesses, but it is not one specific disorder.

No client has ever told me they felt dysphoric. But I’ve heard that they “feel bad” plenty of times. I have seen the word dysphoria on assessment forms several times, usually as a checkbox for a feeling the client might be having. As my students have heard, I think of a good assessment as more than just checking the boxes and filling out a form.

To help someone who is “feeling bad” the counselor needs to examine that feeling, identify the specific feelings involved and ideally match them up with a specific mental, emotional, or behavioral problem.

What exactly is dysphoria?

OxfordDictionaries defines dysphoria as “a state of unease or generalized dissatisfaction with life. The opposite of euphoria.” Some words are easiest to define by saying that they are the opposite of something else. Unfortunately defining dysphoria by saying it’s the opposite of euphoria is not much help.

The Century Dictionary and Cyclopedia, from 1889, gets us closer to a useful definition. I think this is an important point. When you are reading books which were written a long time ago, Freud and Jung, even the psychoanalysts who wrote before the DSM Four, it’s important to ask what the words meant to them. The English language has always been in a state of change.

The Century Dictionary and Cyclopedia defines dysphoria as; pain hard to be borne, anguish, impatience under affliction, a state of dissatisfaction, restlessness, fidgeting, or inquietude.

In Psychology dysphoria generally means one of 3 things.

Martin Seligman in his book What You Can Change and What You Can’t begins with the idea of dysphoria and then breaks it down into three specific negative emotions. I would highly recommend this book by the way. One point he makes here is that to date there is no medication which cures any mental illness. At the time he wrote this book; he listed 14 mental illnesses that could be effectively treated, cured, or greatly reduced, using specific forms of talk therapy. I’m inclined to think in the years since he wrote this book other therapies have proven effective for additional mental and emotional disorders.

Anxiety can look like a physical illness.

Anxiety disorders are the “great pretenders.” During episodes of anxiety, the thoughts in the brain mobilize the body for flight or flight activities. Anxiety reduces a lot of physical symptoms in your body and is frequently mistaken for a physical illness.

Professionals split anxiety disorders into a number of specific types. Most are temporarily manageable with medication, but when the medication wears off the anxiety returns worse than before. Therapy of several varieties, coupled with relaxation techniques and life skills training can greatly reduce the levels of anxiety.

Recently, trauma and stressor-related disorders such as PTSD were separated from the Anxiety Disorders. These problems have added symptoms such as nightmares and flashbacks. There are treatments for these disorders, but those treatments are very different from the ones used for anxiety.

Depression comes in many varieties.

Professionals categorize depression more by the physical symptoms you experience than by the cause of the depression. Some types of depression have a specific cause, and others don’t. Many of the symptoms of depression look like those of physical illness. Changes in appetite, eating either too much or too little, can all be part of depression. Changes in sleep are also an element of depression. Some people, when depressed, experience significant fatigue. Depressed people may take to bed and feel too tired to get up. Underlying depression is the loss of the ability to experience happiness. Some people can feel a few bursts of pleasure, but the temporary pleasant sensation quickly fades.

Anger and irritability are often components of dysphoria.

When someone doesn’t feel well, they are out of sorts, they become irritable and push others away. Some people feel “bad” and experience a lot of anger. Neither anger nor irritability is considered a specific mental illness, but they may be symptoms of several mental health challenges.

It would be wonderful if there were specific blood tests or x-rays that would determine that the physical symptoms you have are the result of dysphoria and could be identified as one specific mental illness. Unfortunately, it doesn’t work that way. First, you need to see a medical Doctor to rule out physical illness. Next, you would see a counselor who would talk to you about your symptoms. Based on the number and severity of symptoms you would get a specific diagnosis.

Treatment should be tailored to you and your particular symptoms. Therapy is not something the counselor should do to you. Therapy is something the counselor and client do together. As a result of counseling, you should learn skills and new ways of thinking that will help you manage dysphoric feelings and learn to increase the number of positive feelings you experience.

If you have been feeling bad, one or more of the dysphoric feelings, please consider getting help.

Staying connected with David Joel Miller.

David Joel Miller MS is a Licensed Marriage and Family Therapist (LMFT) and a Licensed Professional Clinical Counselor (LPCC.)  Mr. Miller provides supervision for beginning counselors and therapists and teaches at the local college in the Substance Abuse Counseling program.

Two David Joel Miller Books are available now!

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.

Casino Robbery is a novel about a man with PTSD who must cope with his symptoms to solve a mystery and create a new life.

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

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

Want the latest on news from recoveryland, the field of counseling, my writing projects, speaking and teaching? Please sign up for my newsletter at – Newsletter. I promise not to share your email or to send you spam, and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse, and Co-occurring disorders see my Facebook author’s page, davidjoelmillerwriter. If you are in the Fresno California area, information about my private practice is at counselorfresno.com.