Category Archives: Mental Health

Things you need to stop worrying about

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

Man worrying,

Some things you do not need to worry about.
Photo courtesy of Pixabay.com

Worrying about the wrong things is keeping you stuck.

Some things may be worth worrying about. Especially if that worry will spur you to take action and change something.

There are a whole lot of things that consume people’s time in worry that really should not be on your list of things to worry about.

Chuck these topics of worry for a happier more productive life.

1. Stop worrying about what others think about you.

The more you do the more people will find to criticize you about. What others think about you is none of your business. Do things because you think they are right, do them because they please you and because this is what you chose to do. Let others opinions go.

2. Stop worrying that you are not good enough.

You are however you are. Accept yourself as you are and then go on to make the best of who and what you are. You are plenty good enough for you. If there is room for improvement focus on the things you would like to be better and let go of the thoughts that you are not yet all you want to be.

You are and will be throughout your life a work in progress, not a finished person.

3. Stop worrying about what you “should” do.

That list of “should’s” left over from childhood is holding you back. Do not do things because others said you should. If you think it is right do it. Do only those things that are right for you.

Do what you are doing. Do it to the best of your ability and in a fair and honest way but never sweat whether the thing you have chosen to do is what you “should” be doing.

While doing one thing do not worry about other things you should be doing. Stay focused on the moment or quit and change what you are doing.

You are always doing what you are doing now.

4. Do not worry that people do not agree with you.

There are always people who will disagree no matter who you are or what you will do. New, innovative things arise because someone does something that others never thought of doing.

You will not be able to make everyone happy. Start by making yourself happy. Consider the consequences of who will disagree with you and why, but the final authority on you is you.

5. Do not worry about someone else’s issues.

You can only change you. If someone else has issues then they need to be willing to change. You can offer support if they chose to change but you are not in charge of others’ lives and they are not in control of yours.

Focus on your own issues, those things you can and should be working on, and offer others the same option.

6. Stop trying to get someone to do what you want.

You can waste a lot of time on manipulation and trying to control others. Work on being the kind of person others would want to work with rather than trying to make them do things your way.

Your way may be good for you but it might not be what someone else needs. Especially stay focused on the results you want rather than on making others do things the way you would do them.

7. Don’t worry that you do not have enough education

Plenty of people have accomplished great things with minimal education. People frequently use a lack of formal education as an excuse for not doing anything.

Do what you can with the training you have. Practical experience is a great teacher. Get more education if this is a requirement for a field you want to work in. You are never too old for more learning. Many people have to retrain multiple times for new careers. People with one degree decide that field is not a fit for them and change occupations.

Make the most of what you know and learn something new each day. You will be amazed at how far you can go.

8. Do not worry about your looks.

Make the most of what you have but always stay focused on who you are inside and what you can do. Sure in some fields a certain look is valued. But there are plenty of stories about how a person who is driven to succeed made it even though they did not fit the normal look.

A quick glance around any large employer will show you that there are lots of people working there that have less than perfect looks.

9. Do not think that you can’t face a problem.

Most problems have to be faced one way or another. Even if you run you have had an encounter with that problem. Run once and you may have to run the rest of your life. Problems do not disappear when you run from them. Many problems shrink as soon as you begin to take actions to work on them.

10. Avoid rehashing what you should have done.

The past is gone. Worrying about what you should have done prevents you from doing in the only time you ever really have – the now.

Keep doing. Accept that some things will work out. You will have some regrets and along the way, you will accomplish some things you can be proud of.

11. Stop thinking that you are not doing enough.

Do what you can. Make an honest effort. That is enough. If you can do more do it. Time spent worrying that you are not doing enough is time not spent working or relaxing. Self-care, time not working, is a part of keeping yourself productive.

12. Do not worry that you are doing too much.

If you are highly productive give yourself credit. If this is wearing you out cut back. Practice saying “No.” If you need to do this because of a boss or a position you hold then relax and stop worrying about it.

Do not concern yourself that you are doing more and someone else is doing less. You are not them and they are not you.

13. Stop worrying about things that are out of your control.

Plan for the unexpected. Work to mitigate the effects of disasters and the unexpected but worrying about them wastes time trying to control the uncontrollable when you should be making the most of the opportunities at hand.

Worrying about the unexpected wears you out and accomplishes nothing.

14. Do not worry that you are going to fast.

Some things take more time than others. Some people move and work at a fast pace. If you are making too many mistakes slow down. Work at the pace that is best for you.

15. Stop thinking that you made a mistake.

If you made mistakes, correct the ones that you can. If it can’t be corrected learn from it. Most mistakes are small things in the long run. What is the lesson you needed to learn? The more you try to accomplish the greater the risk that some things will not work out. Do not think of these less than perfect outcomes as mistakes. They are learning opportunities.

16. Avoid worrying about money.

Worrying about money does make more of it. Somehow those with little money get by and those with a lot never seem to have enough. If you have money problems work on ways to spend less, stretch what you have further, and make more.

Worrying is wasted effort. Learn all you can about money and finances. Do not be misled into thinking that if you just had more money your troubles would disappear. You would still have problems they would just be different problems.

17. Avoid the thought that there is something wrong with you.

You are fine just the way you are. If you have medical or psychiatric concerns see a doctor or a therapist. If you have legal or financial issues see a professional in that field.

Learn to accept yourself the way you are and then work on becoming a better more skilled person.

18. Don’t worry that you do not have the best things.

People who judge you based on the things you have are shallow people. Judging yourself that way will make you shallow. The more you have, the farther away the goal of having the “best things” moves.

There is no end to the things people think they need and then tomorrow those things are passé.

Anyone out there jealous of my collection of 8 track cassettes and 8-inch floppy diskettes?

19. Stop thinking that your opinion is wrong.

You have the right to your opinion. You also have the right to sometimes be wrong. Accept that no one is right all the time.

When making decisions and taking actions consider the possibility that you could be wrong. When you get new information or situations change reconsider your opinion.

Do not beat yourself up for having had an incorrect opinion and especially do not waste time on worrying that today’s opinion may be tomorrow’s error.

20. Stop worrying that people are taking advantage of you.

Be careful in your dealings. Do not assume others have your best interest at heart. Make sure you do things because you want to and they are right for you.

Once you make those decisions do not worry if someone else is getting something out of your interaction.

Reserve the right to periodically reevaluate things and change relationships as needed. Worrying will not protect you from being taken advantage of. Careful research and good advice will help here.

21. Do not worry that others are better than you.

There will always be someone better than everyone else. Records only stand so long and then someone breaks them.

You can’t be the best at everything. You may not be the best at anything. Work on being the best you can be and accept that if you approve of yourself then what you do will be good enough.

22. Don’t worry that you are out of time.

Time keeps moving forward. Make the best of what you have and then let it go. Worry that you are out of time waists some of the precious time you do have.

23. The things you want will never happen.

If they did happen then you would only want more. Some things we want do happen and some do not. In retrospect, as we grow older, some of the things we wanted in the past we become glad never happened.

There are 23 different things that you could worry about, but why would you? Stop worrying about as many of these things as you can and see if your life does not become happier and more productive.

Are there other things you have found that you no longer need to worry about?

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

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

Story Bureau.

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

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

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

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

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

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

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

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

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

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

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

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

For videos, see: Counselorssoapbox YouTube Video Channel

The link between Smoking and Depression

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

Full ashtray

Smoking cigarettes.
Photo courtesy of Pixabay.com

Smoking may be the cause not the result of depression.

People who smoke are far more likely to become depressed than nonsmokers. About 40% of smokers suffer from a mood disorder, largely depression, while the rate in the whole population is typically in the range of 2% to 10% in any one year.

The connections between tobacco smoking and mental health issues may be even more severe than was previously thought. The connections are not limited to depression or related mood disorders.

One recent study took another look at the National Epidemiologic Study on Alcohol and Related Conditions, a large nationwide survey of mental health and addiction issues.  (P. A. Cavazos-Rehg, N. Breslau, D. Hatsukami, M. J. Krauss, E. L. Spitznagel, R. A. Grucza, P. Salyer, S. M. Hartz, L. J. Bierut. Smoking cessation is associated with lower rates of mood/anxiety and alcohol use disorders. Psychological Medicine, 2014; 1 DOI: 10.1017/S0033291713003206)

This study surveyed 35,000 people; about 4,800 of those were daily smokers. The study participants were resurveyed 3 years later. Smokers in this study appear to have significantly higher rates of mental health issues.

Half of all smokers reported having “Alcohol problems” While 24% reported some form of drug use problem.

Over the course of the three-year period between studies, some people quit smoking. Among those who quit smoking the rates of mental health and substance abuse problems declined, while those who continued to smoke continued to have higher rates of mental health and substance use disorders.

This challenges the conventional wisdom that in treating serious mental health or substance abuse issues the issue of tobacco smoking can be left for a later time.

Chemical use of many kinds is known to impact mental health. Excessive alcohol use results in depression. Many practitioners have been reluctant to treat someone for depression while they are still drinking alcohol.

Recently professionals in the mental health and substance abuse field have moved to thinking that substance use issues and mental health issues so thoroughly interact that both problems need to be treated simultaneously.

The evidence continues to mount that there is a connection between tobacco use and both mental health issues and substance use disorders. It is becoming clear that ending tobacco use might have a significant impact on mental health.

Recently I have been hearing of studies in which the seriously mentally ill were taught smoking cessation and the results of their recovery from both issues were essentially the same as the general population.

If you are a smoker, quitting may well improve your mood and your mental health. If you are struggling with a mental health or substance use disorder there is no reason to put off quitting smoking and there are a growing number of reasons to think that quitting will make your other problems easier to manage.

Have you seen a connection between your smoking and other life problems?

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

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

Story Bureau.

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

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

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

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

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

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

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

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

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

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

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

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

For videos, see: Counselorssoapbox YouTube Video Channel

Hair Pulling is a mental illness- trichotillomania.

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

Anxiety provoking.

Anxiety.
Photo courtesy of Pixabay.com

Hair-Pulling Disorder – Trichotillomania.

Yes Hair-Pulling Disorder, the repetitive uncontrolled kind of hair pulling is a mental health issue. Humans are not the only creatures who resort to this kind of self-mutilation when under stress. Caged animals, especially birds do this when stressed also.

Hair-pulling Disorder sounds like an odd problem to have at first glance unless you or someone you know has had this disorder and then it takes on huge importance.

The way we understand this one has been changing. This is in flux and will take some time to sort out.

In the past, as reflected in the DSM-4 this was seen as a form of impulse control disorder. Much of the way it was treated in the past was behavioral. The focus was on the behavior and not the meaning or function it had for the person pulling the hair.

As an impulse control disorder, it was in with Pathological Gambling and Intermittent Explosive Disorder. Hair pulling was for sure different than compulsive gambling but most people who had to treat clients with this problem didn’t know what else to do with it.

In the new DSM-5, when all the professionals switch to the DSM-5, this disorder will move to the section on Obsessive-Compulsive Disorders. This will put it more in the class of disorders with Hoarding and Body Dysmorphic Disorder. We are seeing that obsessions and compulsions are more driven than chosen behaviors.

This change in thinking makes a whole lot of difference in how it might get treated and it makes even more of a change in how the person who has the problem might react to that treatment.

Behavioral treatment is focused on the behavior and interrupting that behavior. So grandma might have used a treatment that consisted of slapping that hand each time the young person reached for the hair. The idea was that stop the behavior and you had the problem cured.

If we see this as OCD behavior, then this is not something the person is consciously doing. The behavior is functioning to reduce tension and there is this overwhelming need to do it. This would not be something that the person thought about beforehand and no amount of slaps or yells will change anything.

You might as well yell at someone for yawning. Once they yawn it is over. Besides we think yawning is about physical sensations, not inappropriate behavior. Despite that feeling, we still can get annoyed at people who yawn and we all try to stifle the yawn from time to time.

But if you got smacked for each and every yawn eventually you might give up and just avoid the person slapping you or you might feel that you were a bad person for not being able to control this sensation and you could punish yourself in some way.

So if this is a form of OCD we would want to know what the function of the behavior was. What anxiety or tension is the person trying to relieve by hair pulling? Reduce that tension; treat the anxiety and the hair-pulling stops on its own.

Young women are ten times more likely to get this diagnosis than young men. We do not mind seeing young men with very little hair but a young girl with bald spots, that gets noticed.

People who have Hair-Pulling Disorder (Trichotillomania) are also at higher than average risk to do other self-injurious behaviors. Someone with the hair-pulling disorder might also pick at their skin excessively, technically called excoriation, or they might nail-bite excessively.

There are also likely to become depressed and or develop another anxiety disorder.

So if you or someone you know is finding their life messed up because they are constantly pulling out hair, they develop bald spots for which there is no known medical cause and when they try to stop find they can’t, consider professional treatment.

Yes, absolutely Hair-Pulling Disorder (Trichotillomania) is a real mental illness of the obsessive-compulsive disorder type.

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

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

Story Bureau.

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

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

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

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

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

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

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

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

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

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

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

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

For videos, see: Counselorssoapbox YouTube Video Channel

Drug kills your mental health before it kills your body.

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

Full ashtray

Smoking cigarettes.
Photo courtesy of Pixabay.com

Nicotine  – The killer drug.

Of all the drugs out there, legal or illegal one drug alone accounts for the bulk of the drug-related deaths each year. That drug is Nicotine and the predominant ways it gets into your body is by smoking or second-hand smoke.

We have known for 50 years or more that Tobacco and smoking were harmful to our physical health but we are only now seeing the extent of the connection between smoking and other societal problems such as mental illness and homelessness.

For every one person that dies of an illegal drug Nicotine kills 200 people. That is not an argument for legalizing other drugs. We have seen highly publicized drug deaths recently from illegal drugs. Heroin and prescribed Opiates can kill quickly and with alcohol in the bloodstream the overdose death rate sores.

Deaths from tobacco happen far more slowly. There is a gradual progression of a variety of diseases before the final death.

What we have been overlooking in all of this is the significant connection between mental illness, other drug addiction, and smoking. Mental health treatment providers have been slow to recognize the connection and slower yet to attempt any form of smoking cessation treatment with the mentally ill clients.

While in withdrawal from Nicotine clients can become agitated, restless, and harder to manage. Providers have suggested that they needed to work on the “bigger” issues of drug withdrawal, alcoholism, depression, and other mental disorders.

What has been missing from this approach is a clear view of the ways in which Nicotine may be causing and maintaining a mental illness.

Research studies have suggested that between 44% and 50% of all the cigarettes consumed in America are smoked by those with a mental, emotional, or behavioral health diagnosis (a DSM diagnosable condition.)  Researchers have detailed the efforts of the Tobacco companies to market to the mentally ill (Prochaska, Hall, & Bero, 2008; Lasser et al., 2000; Apollonio & Malone, 2005, cited in Wigand, 2009.)

One consequence of the heavy smoking by the mentally ill is that they commonly live twenty years less than those without a long-term mental illness.

Despite the apparent connection between Nicotine and the creation and maintenance of mental illness most providers have been reluctant to include smoking cessation in their programs.

This connection between smoking and mental health issues is particularly problematic among women. Jessup Et al. on their study of women smokers reported “Smokers had significantly higher rates of Post Traumatic Stress Disorder (PTSD), past year depression and anxiety, suicidality, past year substance abuse, and co-occurring disorders.

Jessup further reports that women who smoke two packs per day are more than twice as likely to suffer from Major Depression. Those with Post Traumatic Stress Disorder were 4-5 times more likely to be heavy smokers. In this study, smoking women were much more likely to be unemployed than nonsmokers and even if they lived with a partner the smokers were more likely to not have enough money to meet their basic needs.

The connection between smoking, drug, and alcohol use disorders, and mental illness has been reported in study after study.

Those disorders that seem to be highly correlated include substance use disorders, PTSD, Depression, Anxiety disorders, and Psychosis. There have been some suggestions that smoking has helped those with serious mental illness manage their symptoms, even though this is at the cost of a shortened lifespan. The research seems to report that smokers report more, not fewer, symptoms of mental illness. The “smoking solution” is making symptoms worse, not better.

This connection between smoking, mental illness, and a substance use disorder also resulted in increased rates of unemployment, no medical insurance, and a high need for treatment. Those at the highest need of physical health services were the least likely to be receiving those services other than through free programs or hospital emergency rooms.

Studies have also reported that smokers are twice as likely to have had recent thoughts of suicide as non-smokers.

One difficulty with adding smoking cessation treatment to substance abuse, mental health, and co-occurring treatment programs is that the majority of people in treatment are in the stage of change we call “precontemplative” meaning they had not even thought about quitting. For this group, the most effective intervention may be education about the connection between smoking and their other co-occurring issues.

We are hopeful that the expansion of health care will result in more services for those who have co-occurring disorders and that smoking cessation treatment may be included in those services.

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

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

Story Bureau.

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

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

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

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

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

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

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

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

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

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

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

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

For videos, see: Counselorssoapbox YouTube Video Channel

Emotional healing takes several tries

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

Emotional healing.
Photo courtesy of Pixabay.com

Emotional Healing.

Some pain and trauma are just too intense to get past the first time around.

Getting over things is a process. Some things need time to heal. It is hard for others to sit and watch you suffer but sometimes you just need that space to get past it. What you can’t do is pretend it never happened and hope the pain will go away.

People come for counseling and they expect the pain to end right away. It can’t always happen that way. We find that pain, from trauma or grief and loss, takes time, and repeated attempts to get better.

Clients who have suffered a severe loss, someone close to them has died, find it hard to talk about that person at first. In the beginning, it is mostly about the pain of the loss and the tears.

Over time, the process of recovery is like the way you might peel an onion. You strip away an outer layer and then you cry. Then as your tears dry you strip away another layer. Eventually, you reach the core.

In the early stages of grief, all you can feel is the pain. What can happen if you keep working on the process is that with time you can let the pain recede and begin to remember the good things, the treasured memories, you have of that person.

People mean well when they tell you to just get over it but what they often do not understand is that getting over it is a process, not a destination. Some things in life we never get over, not completely, but we can reach a place of peace with what happened.

In counseling, we find that to push the client to talk about things before they are ready can cause more trauma rather than aid healing. Some clients come for a while, go as far as they can, and then go off to live their lives for a while. Some find that they need to return to continue or finish the process. Others have the drive to get the painful part over with as soon as possible. You may find that the pain keeps reminding you that help is needed and you can’t let it go until you finish the project.

Either way, I hope that if you are feeling the pain of a loss, a death, a trauma, a life disappointment, that you will find someone to work with on this issue that helps you move through the pain by leading you along not by forcing you to go faster than you are ready to go.

Therapy should heal the emotions not create new wounds.

If you are only partway along in your healing process, keep moving forward and know that eventually, you can reach a point of finding the meaning in the loss. Not having someone now should not take all those happy memories from you. Having suffered a terrible trauma need not rob you of your future.

The road of recovery can be difficult, but recovery is worth the effort.

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

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

Story Bureau.

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

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

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

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

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

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

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

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

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

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

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

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

For videos, see: Counselorssoapbox YouTube Video Channel

Does smoking cause mental illness?

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

Does smoking cause mental illness?
Photo courtesy of Pixabay.com

The evidence is starting to pile up that smoking may be a cause of some mental illnesses.

We have known for some time now that the mentally ill were heavy smokers. Those with psychosis, schizophrenia, in particular, are frequently two pack a day or more smokers.

We also have seen studies that report from 44% to over 50% of the cigarettes consumed in America are consumed by those with a mental, emotional, or behavioral disorder. Alcoholics and Drug Addicts are frequently heavy smokers.

Fully one in three adult smokers has some form of mental illness.

What most researchers have been reluctant to conclude is that smoking may be the cause of some of these mental illnesses. That is beginning to change.

One problem with the past studies has been the way the samples were drawn. A survey of the population can tell you how many people have a mental illness and how many smoked, but not which caused which or were they both caused by some third factor like poverty or trauma.

One particularly convincing study was done in Norway (Petersen et al. 2008.) They have good data on who was treated for what and why. This study was able to follow a large sample of youth beginning at age 13 and lasting 13 years until they were 27. They looked at who smoked at age 13, when they started, and the results. They were also able to follow the person’s health and mental health treatment.

This longitudinal study allowed them to compare those who had a mental illness at age 13 with those who did not and those who smoked at age 13 with those who did not. Their data tells us that those with an early onset of mental illness were at high risk to become daily smokers with a nicotine dependency.

What was more startling was that those who had no mental health diagnosis at age 13 and smoked were more likely to develop a mental illness. Smoking appears to have preceded the development of the mental illness. Even more, evidence that a mental health issue is caused by not is the cause of, smoking was found in the effects of levels of nicotine dependency.

Those youth who were heavy smokers (nicotine-dependent) developed more mental health problems regardless of the age at which they first started smoking. Someone who became a heavy smoker at age 20 with no history of mental illness was at high risk to have a mental illness at age 27.

Further evidence of the connection between smoking tobacco and mental illness comes from a study from South Australia (Bowden et al., 2001) which found that the more severe the level of mental illness the more likely the person was to smoke. The most seriously mentally ill had a smoking rate in excess of 51%.

This leads to the inescapable conclusion that smoking increases the risk of developing a mental illness in addition to the physical ones we already knew about.

How might smoking be increasing these risks?

One way smoking may increase the risk of developing a mental illness is Nicotine’s effect on the serotonin regulation in the brain. Nicotine impairs the serotonin function of the brain. Low serotonin has been postulated to be a major factor in Major Depressive Disorder. Selective Serotonin Reuptake Inhibitors (SSRI’s) that slow the breakdown of Serotonin and thereby increase the levels of serotonin in the brain are commonly used to treat depression. One antidepressant is also currently being marketed to help people stop smoking.

But there is more.

Smoking reduces the levels of oxygen in the bloodstream and the brain. This reduced oxygen is a factor in the presence of chronic pain and now appears to also be a factor in increasing depression and anxiety.

Social factors may also account for some of the differences in depression in non-smokers versus smokers. With societies shift to preferring nonsmokers, there are restrictions on smoking in public places. Smokers are finding it harder to get jobs and to be able to get off duty during the workday to smoke.

Not having a job, having few social friends, and being socially undesirable all add to the reasons a smoker is more likely to be depressed than a nonsmoker.

In future posts, we will explore the connection between smoking and specific mental illnesses and look at how and when you should quit if you want to maximize your mental wellness.

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

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

Story Bureau.

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

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

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

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

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

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

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

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

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

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

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

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

For videos, see: Counselorssoapbox YouTube Video Channel

What is it like to have an invisible illness?

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What is it like to have an invisible illness? It is hard for others to understand when you have depression, anxiety, Lupus or any of a host of other illnesses for which the symptoms are not clearly visible.

Just came across a post titled “The Spoon Theory” by Christine that explains this issue.

Hope you find this as informative as I did.

Ugly nose and face or Body Dysmorphic Disorder

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

Body dysmorphic disorder?
Photo courtesy of Pixabay.com

Can someone be too ugly to get a job or be loved?

There is a group of people in our society who believe very deeply that there is something wrong with their body which makes them so ugly that no employer will hire them and no other person could stand to be in a relationship with them. They often seek medical help to change their appearance but that help rarely results in them feeling acceptable.

There is a range of appearances. Some people are frankly better looking than others. We value celebrities based on their looks. So how far from that ideal level of beauty do you need to fall before you conclude that you are ugly and no one can possibly love or accept you?

Some people believe that they are ugly even when others around them cannot see the “flaw” that makes them believe they are undesirable. This belief that your body is flawed in some way, while others do not see the flaw is called Body Dysmorphic Disorder.

Body Dysmorphic Disorder can center on beliefs that any part of your body is defective but the most common things that are the focus of this belief are the skin, hair, and nose. Stomach, weight, breasts, or chest and eyes also cause significant numbers of people to feel bad about themselves.

Researchers believe that the prevalence of Body Dysmorphic Disorder is greatly underestimated. The number of people who suffer from this emotional problem is probably far greater than our statistics are reporting. Estimates of the number of people in the United States with Body Dysmorphic Disorder range from 2 million to in excess of 15 million people. The number of cases you see depends on where you look.

Most people with Body Dysmorphic Disorder do not come to mental health systems because of their excessive focus on their appearance. They often first present at a plastic surgeons office requesting an operation to change that part of them that they feel is making them ugly.

Annual expenditures for plastic surgery surpassed 10 billion dollars in 2008. This was an almost 900% increase over 1992 and this figure continues to grow. Unfortunately, people with Body Dysmorphic Disorder are most likely to feel that their operation was “botched” and as a result, sue the doctor or request a second or third operation. One study reported that 44% of plastic surgery patients were repeat clients. Some clearly were happy with the results and having more done but those with Body Dysmorphic Disorder are likely to undergo repeated operations because the problem lies in their thinking that they are ugly rather than in any particular objective problem with their looks.

So how does this Body Dysmorphic Disorder manifest in those who have the disorder? Suffers typically spend 3 to 5 hours per day looking at themselves in the mirror. They are highly sensitive to minor flaws in people and can spot defects in others readily. Many become housebound, afraid to go out and socialize because they believe that they are so ugly no one will like them. A deficit in social skills predisposes them to believe that their lack of friends and romantic partners is the result of their appearance rather than their lack of social skills.

Since those with Body Dysmorphic Disorder blame their lack of friends and jobs on their appearance they are unlikely to present for counseling or therapy. One way they enter treatment with a mental health professional is when their depression, anxiety, or other emotional problem brings them to the notice of the mental health system.

Almost half of those with Body Dysmorphic Disorder have been hospitalized in a psychiatric hospital. As many as 82% have had thoughts of suicide and one in four is likely to have attempted suicide. Most are young, single, and unemployed. They frequently have eating disorders, Obsessive Compulsive Disorder, or another psychiatric problem in addition to the Body Dysmorphic Disorder. Skin picking and religious or sexual preoccupation are also common. Many go on to develop Avoidant Personality Disorder.

They are also at risk to miss many days of work or school and many social events as a result of their feelings that they are physically ugly. Many of those with Body Dysmorphic Disorder drop out of school to avoid being seen by others.

Body Dysmorphic Disorder frequently begins in the early teen years and gets progressively worse. The mean age of onset of the Body Dysmorphic Disorder is between 14 and 16. Those with the disorder will cover their faces in various ways, spend excessive amounts on clothing or cosmetics or resort to extreme methods to try to alter their appearance.  Frequently those with Body Dysmorphic Disorder have been teased or bullied.

The mean age of onset of the Body Dysmorphic Disorder is between 14 and 16. The DSM-5 tells us that the most common age for onset of Body Dysmorphic Disorder is 12 to 13 years old.

This disorder is not restricted to females. Many young men develop the notion that they need to have huge bulging muscles to be acceptable and develop a related condition called Muscle Dysmorphic Disorder. Males are also at risk to believe that their genitals are too small resulting in avoiding dating and sexual relationships.

Those with Body Dysmorphic Disorder may also show up in weight loss groups where despite their low to normal body weight they will be focused on changing the shape of one part of their body that they see as defective.

Our understanding of Body Dysmorphic Disorder continues to change. In the DSM-4 Body Dysmorphic Disorder was included in the section on somatoform disorders, those disorders where emotions make you sick or make your illness worse. In the new DSM-5 Body Dysmorphic Disorder is included in the Obsessive-Compulsive disorders because of the time people with this disorder spend on concerns about their appearance.

There are effective treatments for Body Dysmorphic Disorder. The difficult part is getting those with the disorder to come for treatment. Since they firmly believe that their problems are the result of some physical defect they do not see how counseling can help them, and will often insist that they are not “crazy” or “mental.”

Treatment of other issues, depression, anxiety, and suicidal thoughts and actions are often the first step in engaging those with Body Dysmorphic Disorder in treatment. Cognitive Behavioral Therapy, Antidepressant medications, Narrative therapy, and skills training are all thought to be effective in treating Body Dysmorphic Disorder.

So if you or someone you know has no friends, no romantic partner, or no job and you think this may be because of looks, consider working with a counselor on your social skills, career counseling, and self-esteem before you conclude that the problem is your looks.

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

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

Story Bureau.

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

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

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

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

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

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

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

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

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

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

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

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

For videos, see: Counselorssoapbox YouTube Video Channel

Why do people act in Passive Aggressive ways?

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

Passive-aggressive.
Photo courtesy of Pixabay.com

Why must they act Passive Aggressive?

Passive Aggressive Personality Disorder used to be a recognized mental illness. Then in the DSM-4, it was reduced to a condition that may need more study, and most recently it has simply disappeared from our way of thinking of mental illnesses.

Remember that there are times when a person gets criticized for adopting this form of behavior, maybe even referred for psychiatric care and then other people may be praised for adopting some form of passive reaction to an injustice.

So let’s look at why some people may adopt Passive Aggressive Behavior and why we are no longer so sure that it should qualify as a mental illness.

There are legitimate reasons people do not just come out and say what they mean. There are also reasons people may choose to say nothing but fail to carry through on things they were told to do. Passive-Aggressive behavior can be the result of some of those reasons.

People become Passive Aggressive when they have no power or control.

Children, especially if they are in an abusive or non-loving home, may not feel they can say no to their parents. They get out of things, not by saying no or discussing things but by taking excessive time or doing things wrong. If they break enough dishes mom may stop asking them to do the dishes.

The same behavior makes sense in the boss and employee situation. Sometimes you can’t tell the boss no, so you just do not get around to doing things that would be a waste of time anyway. Not everyone does this. Some employees are very conscientious, but the worse the boss in terms of giving arbitrary orders and not allowing people to disagree the more likely this becomes.

Some people use Passive Aggressive behavior more often than others.

If you came from a family where it was not acceptable to disagree with the parents or worse yet where you were not supposed to have any feeling unless they were sanctioned by the adult, you are more likely to hide your anger and then express it in Passive Aggressive ways.

Mental health clinicians used to think that there were things we called “Personality Disorders” and the presumption was that people who had these were always like that and that they were hard to treat and never changed. These premises have recently been called into question. Turns out that people can change their behavior when the situation changes.

One other thing that cuts against the validity of there being such a thing as Passive-Aggressive Personality Disorder is that it is mostly used in situations where there is a weaker person who is unable to disagree with a stronger person or in a close situation like a marriage where sometimes we want to avoid both doing what the other person told us to do and also avoid making this into an argument.

One characteristic that has been used to differentiate Passive Aggressive behavior from something like passive nonviolence is the level of anger or hostility that the person using passive-aggressive behavior is experiencing.

When the non-doing stops being a way of avoiding conflict and becomes a way to harm someone else without having to accept the responsibility that hidden or veiled aggression can drive the most rational person to open hostility.

One aspect of Passive-aggressive behavior that has received a lot of attention is the times when it appears to be motivated by contrariness or oppositional motives. When a youth adopts the position that they will avoid doing whatever the adult asks them to do just for the sake of asserting that the adult cannot control them this can escalate to severe problems.

Frankly, much of what was getting called Passive-Aggressive Personality Disorder looks way more like Oppositional Defiant Disorder when we see it in youths.

Passive Aggressive Personality Disorder shared so many features in common with other personality disorders and with depression and anxiety most professionals only used it when a parent or spouse said that was what the client was doing.

Most of the things we have been thinking of as personality disorders include a lot of antagonism towards others. Sometimes this is because the person’s life experiences tell them that they will not be treated fairly if they openly disagree or resist the will of others.

So while you will still read about Passive-Aggressive people, mental health has largely concluded that this is not a mental illness but is a way that some people cope with not being able to express disagreement. In other words, Passive Aggressive behavior is a symptom of some other problem rather than being a particular treatable disease.

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

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

Story Bureau.

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

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

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

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

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

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

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

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

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

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

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

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

For videos, see: Counselorssoapbox YouTube Video Channel

Are you the Passive Aggressive type?

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

Couple fighting by not fighting

Passive-aggressive.
Photo courtesy of Pixabay.com

Who is the Passive-Aggressive?

There has been some discussion recently on the internet and elsewhere about people who are “Passive-Aggressive” how you deal with someone who is Passive-Aggressive and so forth.

What exactly is a “Passive-Aggressive Person” and how might this passive-aggressive personality be affecting you?

Turns out there are at least two somewhat different activities going by the name of Passive-Aggressive behavior.  On the subject of Passive-Aggressive Personality, psychology and mental health are not on the same page. There are not just separated and divorced on this one but living in different time zones.

Psychology has studied the way people may behave and do they have Passive characteristics or Aggressive characteristics. They used to think of these two as on opposite poles of the same axis.

Then it was suggested that some people combine both into a Passive-Aggressive style of dealing with conflicts. There were also some studies of whether these were stable traits, people did this all the time, or were these states, that the person might use a particular way of behaving in response to a specific situation and at one time but not another.

Mental health started looking at this as a potential mental illness, Passive-Aggressive Personality Disorder, which was causing problems in people’s social lives or in their work settings. The result of these two different perspectives is that the two fields came to differing views about Passive-Aggressive personality.

How did we get to a place where some professionals are writing about Passive-Aggressive people as if we all know what that is and why, while other groups have told us to drop the idea altogether?

Is a passive-aggressive person all bad or are there times when this is a useful way of behaving?

The idea that there are “Passive-Aggressive people” seems to have originated during World War Two when officers noticed, and then they complained, that they might give orders but the men just did not get around to doing what they were supposed to do. The result of this behavior was that the men got out of doing things and sometimes they communicated to a superior officer that they did not like that officer.

One example of this might be an officer who had the men dig a ditch one day and then had them fill it in the next. I suppose that the officer could argue that this is teaching discipline and is keeping the men active and fit, but the men soon caught on and found that there was no reason to put much effort into this ditch to nowhere.

This concept, of the person who is told to do something but then deliberately does it poorly or not at all, has also been applied to employees in the work setting. Some bosses like to think of themselves as generals or in other military terms. They talk about commanding their employees. You can make a good argument for the need of people in the military to carry out an order regardless of whether they agree with the order or not. It is harder to see why bosses give some orders that just make life harder for their employees and do not create any extra production.

The result of these irritating directives from management can be work slowdowns, stoppages, or people who just forget to do things. Sometimes it is hard to tell the difference. Some jobs take longer to do than planned. Sometimes people do forget. So the interpretation of “is this a Passive-Aggressive act” has to do with the motivations or intent of the employees, not with the resulting action or inaction.

This Passive-Aggressive idea was expanded to include children who did not do what adults asked. I still see this version in articles about our educational system. The student is told to move something but they drop and break it. Or they get the instructions wrong and go to the wrong place. Sometimes is as simple as them saying yes to doing something but then just sitting in their seat and doing nothing. The complaint by teachers is that the student may be saying yes but their actions are sabotaging the outcome.

One other place this is coming up, and here we are bordering on the mental health arena is in the field of marriage counseling.

One partner will refer to the other as passive-aggressive. Say the wife has a job interview the next day, she is busy getting ready and she asks the husband to stop at the grocery store on the way home.

He gets home late that night and reports he had a problem at work and “forgot” to stop at the store. This may lead to an argument and then either they eat leftovers or he goes to the local fast food for dinner. She is annoyed.

Next morning she goes to use the car for the job interview and finds that the gas tank is empty. She is now furious at him. Her conclusion is that he was late and left the gas tank empty to sabotage her efforts to get a job. Before long both partners may be “not doing” and “forgetting” to get their revenge on the other partner.

So from these examples, we can see why some people may do things that look Passive-Aggressive and that this can be really annoying if you are on the receiving end of this behavior.

This is also a hard thing to cope with because the person who is behaving in a Passive-Aggressive manner has all kinds of excuses for why they did not get things done or why they made a mistake.

Does that mean that someone who is acting in a Passive-Aggressive manner has a mental illness? Why do they do this and how can you get them to stop? And can Passive Aggressive behavior sometimes be a good thing, at least for the person who is using it?

Let’s take a look at all those issues in an upcoming post about the reasons people might adopt passive-aggressive behavior.

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

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

Story Bureau.

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

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

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

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

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

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

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

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

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

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

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

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

For videos, see: Counselorssoapbox YouTube Video Channel