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.

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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.

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.

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.

Could you start over after a trauma?

By David Joel Miller.

David Joel Miller Books

David Joel Miller Books

Ninety-nine cent Kindle book sale.

The Kindle Edition of my latest book, a novel about a man forced to recover from an incredible trauma, is on sale right now for just ninety-nine cents.

Casino Robbery.

The robbers wanted more than money; they planned to kill Arthur’s fiancé and her boss.

Arthur Mitchell was trying to start his life over with a fiancé and a new job. That all ends

Photo of Casino Robbery book

Casino Robbery.

when the casino robbers shoot Arthur, kill his fiancée, and her boss. Arthur would like to forget that horrible day, but the traumatic nightmares and constant reminders won’t let him, and someone is still out to get him. When he tries to start over by running a rural thrift store, someone knocks him unconscious, vandalize the store, and finally tries to kill him. His only chance to find peace is to figure out what the killers want from him and why.

Casino Robbery is a novel that explores the world of a man with PTSD who has to cope with his symptoms to solve the mystery and create a new life.

The Kindle Edition can be ordered now for just 99 cents!

Casino Robbery is also available in paperback.

Bumps on the Road of Life

Don’t forget about my first book.

Bumps on the Road of Life is now available in Kindle format. It was released 11/13/17. The paperback version is also available. Look at the description below. Thank you, to those who have already ordered paperback copies or the Kindle Edition.

Bumps on the Road of Life

Your cruising along the road of life and then wham, something knocks you in the ditch.

Bumps on the Road of Life.

Bumps on the Road of Life.
By David Joel Miller

Sometimes you get your life going again quickly. Other times you may stay off track and in the ditch for a considerable time. If you have gone through a divorce, break up or lost a job you may have found your life off track. Professionals call those problems caused by life-altering events “Adjustment Disorders.” Bumps on the Road of Life is the story of Adjustment Disorders, how they get people off track and how to get your life out of the ditch.

Bumps on the Road of Life

Please visit my Amazon Author Page – David Joel Miller

if you purchased either of my books, reviews are appreciated.

I sincerely hope you all enjoy reading my book as much as I enjoyed writing them. If you do, I would greatly appreciate a short review on Amazon or your favorite book website. Reviews are crucial for any author, and even just a line or two can make a huge difference.

Thanks again for reading this blog, pardon the short digression, next time we will return to another post about mental health, substance use disorders, and having a happy successful life.

David Joel Miller.

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

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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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.

Lessons Depression teaches you.

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

Depressed person

Depression.
Photo courtesy of Pixabay.com

Are you learning from your issues?

People who are able to learn from their problems do better in the future.  Whether you have an episode of  – Major Depressive Disorder, Persistent Depressive Disorder or some other type of anxiety or depression it is important to learn the lessons from that experience.  People who learn lessons from their issues seem to develop the skill of resiliency and they recover more quickly from future difficulties.  Below are some of the lessons that your depression may be able to teach you.

Sleep is more important than hard work.

One characteristic of depression is changes in sleep.  You may be sleeping far more than before or far less.  Not getting enough sleep puts you at risk to develop or worsen your depression.  Chronically getting too little sleep is one risk factor for episodes of depression and bipolar disorder.  If you’re losing sleep in order to work more or longer, that loss of sleep may impair your judgment and eventually undermine the progress you are making in your work.

You need to take care of yourself.

Just taking good care of yourself will not automatically prevent depression, but part of the process of recovering from depression is learning to take better care of yourself.  Depression teaches you the importance of good preventive self-care.

Taking care of you is not being selfish.

Another lesson depression can teach you is that in order to do for others you need to first take care of yourself.  You will find that taking care of yourself is not the same thing as being selfish.  Make self-care a priority to reduce the risks of future episodes of depression.

No one is perfect.

Depression can teach you that no one is perfect, there are plenty of improvement opportunities in every life.  Being too hard on yourself can easily put you in a negative frame of mind.  Trying to be perfect is setting yourself up for failure.  Learn to accept yourself just as you are.  Having this excepting frame of mind will help to inoculate you against future episodes of depression.

Sick people can do sick things.

Sometimes depression is a reaction to the hurtful things other people do to you.  Depression can teach you that other people can sometimes do very painful things.  Being a recipient of people’s negativity does not mean that you were at fault.  Sometimes people blame themselves for things that others have done when in fact that other person is a very sick person.  If someone has done something deliberately to harm you this does not mean you were at fault.

Stuff can’t make you happy.

It’s easy to slip into the trap of thinking if you just had more, bigger and prettier things, that then you would be happy.  Depression doesn’t care how much stuff you have.  Depression can teach you that experiences and relationships are far more important than material things.

Giving up on things can be a victory.

Persistence and dedication are virtues.  Sometimes we continue to try for far too long. Learning when to let go of something that is no longer making you happy is an important step in recovery.  Hanging on to lost causes is a sure way to increase your sadness and depression

It is OK to feel badly.

One lesson depression teaches is that sometimes it is OK to just feel the way you feel.  It is possible to feel badly and simply accept that feeling.  Just because something is hurtful, or painful does not mean that it needs to destroy you.

Feelings can be your friends.

Feelings, both good and bad can be your friends.  Feelings provide you with information.  They can tell you that things are good for you, or that they are bad for you.  Just because you feel badly you do not have to fall apart.

Your experiences made you who you are.

Living through feelings, good and bad, can be painful, but it ends up teaching you valuable lessons.  Your life experiences have made you who you are.  You can stay stuck in the past asking why things had to happen, or you can make peace with what happened and accept that this has become a part of who you are.

You need to measure your accomplishments, not the errors.

Most people have had many accomplishments.  Everyone who tries has some things that don’t work out the way they were planned.  If you only keep score of your errors you’ll run up a very large score.  When all you do was look at your faults it to be very discouraging.  Make sure you give yourself credit for the things you have accomplished.  It is likely that you accomplished far more things than you are aware of.  Depression likes to obscure your view of the positive things in life.

Friends will either buoy you up or pull you down.

Depression can tell you a lot about friends.  Some will help pull you up, others drag you down.  Let depression teach you about the characteristics of your friends.  Work on getting rid of friends who are negative.  A good support system can help you recover from any adversity.  Depression teaches you the value of good friends and encourages you to expand your support system.

What you tell yourself comes to be.

Words are powerful.  The things you tell yourself tend to come true.  Tell yourself that you can’t and you won’t be able to.  Tell yourself that somehow you will find a way to get past this and things go better.

How to really be grateful.

When everything is going well we forget to be grateful.  Depression teaches you to pay attention to the good things that happen in your life.  Sometimes we can become so discouraged by the things we don’t have, we lose the pleasure from the very many things we do have.  Recovery from depression can help you put all the parts of your life into proper perspective.

What lessons have you learned from your issues?

Take some time and consider what your personal issues may have taught you.  Have your life’s struggles make you stronger and more resilient or have you ignored the lessons they were trying to teach you?

Staying connected with David Joel Miller

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. A list of books I have read and can recommend is over at Recommended Books. If you are in the Fresno California area, information about my private practice is at counselorfresno.com.