Category Archives: Mental Health

Treatments for Depression and Dysthymia

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

Depression.
Photo courtesy of Pixabay.com

What are the available treatments for Depression?

So you have symptoms of depression. Is it Major Depressive Disorder, Dysthymia, or an adjustment disorder? First, I recommend you see a professional and make sure you have the problem you think you have. Remember this is a general description of the treatments available; I can’t diagnose or treat you over the internet. If you need treatment this is not a do it yourself project, see a professional.

The first stop should probably be a medical doctor – Primary Care Physicians.

Some mental illnesses look like psychical problems and vice versa. Most people who commit suicide have been to see a primary care doctor in the 30 days before they attempt. When you feel bad it is natural to think there is something medically wrong with you. Most people are surprised to find out they are depressed or have Dysthymia.

Many doctors will spot Major Depression; sometimes they identify other mental illnesses. They can be especially helpful in ruling out things like brain tumors or heart problems. If you do have a medical illness, treating that issue will often reduce or eliminate the problem, but not always. You could have a physical issue and a mental illness.

More than half of all the psychiatric medication prescribed is prescribed by primary care doctors. If you get a prescription for antidepressants and you didn’t really need them, most of the articles I have read say taking them won’t hurt you. It just may not help. But if you do have serious depression the meds alone are rarely enough. If you don’t change your circumstances or your thinking, eventually the meds may stop working. The medication will help you work on your problems; the meds won’t solve problems for you.

We hope doctors take seriously the presentations and if after checking the person out they decide this is more likely a psychiatric problem than a physical one, they may try you on an anti-depressant. If that does not help, most likely they will make a referral for you to see another professional.

In my experience medication is absolutely essential for someone with psychosis. It is highly recommended for anyone with Bipolar Disorder. People with Major Depression respond well to medication but need therapy or the meds stop being helpful after a while. The research seems to tell us that meds are not all that helpful for Dysthymia.

The primary care doctor may refer you to see a psychiatrist.

Psychiatrists specialize in treating mental illnesses. They have lots of knowledge about psychiatric medication; they know which meds could make a physical problem you have, like high blood pressure, worse. They also know about new medications and can prescribe medication a primary doctor would not want to prescribe. For psychosis or Bipolar Disorder, a psychiatrist is highly recommended.

A psychiatrist will probably not be enough. They are trained to prescribe medication. Few if any will have the time or the inclination to spend more than a few minutes with you. Ten or fifteen-minute med check appointments are the rule. If you need someone to help you deal with your problems day-to-day, the psychiatrist will probably refer you to a counselor or therapist.

What treatments will a counselor use that the doctor didn’t?

In a previous post, I wrote about the differences between Therapists, Counselors, and Social workers. What is important to you, if you have depression, is finding someone, preferably knowledgeable and licensed, who knows how to help you with your problem.  The therapist will probably use one of the theoretical approaches below.

Cognitive Behavioral Therapy (CBT.)

This is my preferred method for treating Depression and a lot of other things. Not all therapists use this but there is a whole lot of research data to recommend this approach.

CBT is based on the idea that a change in thinking can change your feelings; a change in feelings will change your behavior. This works in reverse also, so if you begin to make small changes in your behavior, your feelings will start to change, and eventually, your thinking will change. A change in thinking will result in a change in the neurochemicals in your brain.

In CBT the therapist helps you see your problems from different viewpoints, helps you perform experiments or do homework and in effect, they coach you through becoming able to change yourself. This is sometimes called getting a “new pair of glasses” or simply cleaning the glasses you have.

If you are looking out at the world through dirty glasses, then, of course, the world will look dirty and gray.

Dialectic Behavioral Therapy (DBT) is a close cousin to CBT.

DBT adds skills training to the CBT. It can include mindfulness techniques, meditation, relaxation, or any other calming skill. Other skills can be included as needed. My understanding of this approach is sometimes we get so caught up in the problem or the crisis of the day that we forget to work on learning the skills to have a better life. DBT combines the change-your-thinking part with the learn-a-new-skill part.

DBT is especially helpful if you have multiple problems, several mental illnesses, or a personality disorder on top of your depression.

Narrative Therapy can help you think about things differently.

Most of us have a “story” we tell ourselves about who we are. If you keep telling yourself you are a failure, you will become one. Some of us bought into negative “stories” about ourselves as children and we keep retelling these. A narrative therapist helps you write a new story and tell it. If you tell your new story enough, parts of it start coming true.

Psychodynamic or “Client-Centered” therapy.

I hear the most complaints about these approaches. This is the therapist who lets you talk and says nothing much in return. I recognize some people have a lot of stuff they need to tell about childhood and that sometimes just talking it out is helpful, but it frustrates me and a lot of clients to have to be in pain that long.

This is most likely to be helpful if you have lots of unfinished business from childhood. Victims of abuse or molestation may need to move more slowly and take more time to get things out.

Groups can be very helpful.

Groups are like “way powerful” when it comes to recovering from depression. Groups run by a profession are at the top of the list, but self-help groups can be very helpful also. In person, groups are the best, but online groups are useful also. Groups are hard to find sometimes but worth the search.

“Alternative recovery methods”

Hobbies, religious groups, gyms exercise programs all have their place. Having a good support group or finding a support group is also important. Some people say nutrition was helpful.

Fad treatments worry me. The nutritional supplement or spiritual retreat of the week helps some people, but mostly they end up back at the doctor or the counselor’s office in a few weeks when the weekend collides with the real work week.

Electro Convulsive or Shock Therapy (ECT)

I am not a fan of Electroshock therapy as it has large risks. It is called Convulsive for a reason.

It has helped some people who had found no other help, but the risks are high enough that I suggest you try all the other options first. This is used ONLY with extremely severe Major Depressive Disorder. It is not recommended for Dysthymia, Adjustment Disorder, or milder depressions.

Some clinicians, me included, wonder if ECT should ever be used.

There are some thoughts on possible treatments for depression and Dysthymia, questions as always, are welcome.

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

Dysthymic Disorder –chronic sadness untreated

Posted on by
24

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

Depressed person

Depression.
Photo courtesy of Pixabay.com

Dysthymic Disorder, a forgotten Mood Disorder.

Mood disorders are separated into two groups, Depressive Disorders, and Bipolar Disorders.

Major Depressive Disorder gets all the press while it’s craftier and more insidious cousin Dysthymia gets almost none.

In Dysthymia the person feels pessimistic and “down in the dumps” but the condition is not yet severe enough to be recognized as full-fledged Major Depressive Disorder. In children, this disorder is likely to be missed or to be misdiagnosed as a learning disability, attention problem, or poor behavior.

In adults, we call these people pessimists or grumpy old men. People often have been suffering from dysthymia for so long they come to believe this is simply the way they are. They think the sadness is a part of their personality, and don’t know that dysthymia is a treatable condition. They can’t imagine feeling happy as others do.

Diagnosable Dysthymia is a long-term overall sadness that interferes with having a happy life. As a Cognitive Behavioral Therapist, I am sure a faulty belief system either creates or perpetuates this disorder.

Dysthymia is not an occasional “BAD HAIR DAY.’ It involves someone who, while not always depressed, is sad and down more of the days each week than not. It is also not just a rough patch in the road. We may all have weeks or even months of tough times that make us sad. People with Dysthymia have at least two straight years of mostly sad, depressed days but somehow they keep trudging on. If they would just give in and stop trying they might get the diagnosis of Major Depressive Disorder.

For kids, we reduce the two-year requirement to one year, if the child can avoid the “ADHD, heavy meds, hits someone and become a bad kid” trap.  In kids, the mood is more likely to be irritable all the time than obviously sad or depressed. Kids show pain by being irritable. They may also become pessimistic and stop trying to complete their work. Their grades drop and their sad mood leads to missed school days and few friends.

This is a chronic condition and without treatment, it rarely goes away. About half the time Dysthymia deepens and becomes Major Depressive Disorder. The combination of both is sometimes referred to as Double Depression and even when the Major depression lifts the person may still have the overall sad mood of dysthymia. This makes it important that they get treated not just for the Major Depression but for the Dysthymia also.

Just being down, depressed, or irritable for two years is not enough to get you this diagnosis. This disorder will also probably not get you disability, as people with Dysthymia keep trying and are able to go to school or work even when they hate life and are chronically unhappy.

People with Dysthymia will also have features similar to Major Depressive Disorder in being rather Melancholy or having atypical symptoms. They either eat-and-sleep like bears hibernating for the winter or they can’t eat and can’t sleep.

One common characteristic of people who have dysthymia is low self-esteem. They don’t have much self-confidence and they don’t think they can accomplish much; as a result, they give up trying. This can be the result of a difficult childhood, bullying, or simply a lack of having had the experience of succeeding at little things in life.

People with dysthymia are often hypercritical of themselves, others, and the world in general. They may complain a lot and have difficulty having fun. This leads to low productivity and a lack of positive relationships with others.

People who failed a lot or who were never told that what they did was good enough are prone to Dysthymia. Lack of praise was supposed to make for more accomplishment. Some parents ask me why they should praise a child just for doing what they should be doing anyway? The answer is that without praise kids begin to think that no matter what they do, or how hard they try, it will never be good enough. Eventually, they stop trying.

People with Dysthymia don’t get much pleasure out of life. As a result, they avoid doing anything that might be stressful or involve a risk of failure. They become increasingly sad and withdrawn. They find it difficult to make decisions and to start or finish projects. No use in trying if “nothing is going to turn out all right anyway.”

This may be hard to spot, as people with dysthymia avoid social situations and lack of social support is a factor in perpetuating dysthymia. It is hard to make new friends when you are sad, feel bad about yourself, and don’t have a belief in your ability to succeed.

Families tend to share their mental illnesses. If one member of the family has depression, major or minor, then other members of that same family may have dysthymia. This suggests that there is either a hereditary risk factor for Dysthymia or an environmental risk factor. Families provide both.

Dysthymia is extremely common among alcoholics and substance abusers. People who are sad a lot are more likely to abuse substances and people who abuse substances have plenty of reasons to be sad. What brings these people to treatment is an out of control addiction or when the dysthymia becomes Major Depressive Disorder. Many people with Dysthymia have psychical illnesses and conditions also.

Dysthymia frequently starts in childhood and affects both functioning and development. It is important for a child’s healthy development that they know it is possible to succeed and achieve. Having good, positive, and close friends is also an antidote.

The elderly are at increased risk to develop Dysthymia as they lose family and friends, become more isolated, and may have difficulty providing self-care. Changes in appetite, fatigue, sleeping problems, and isolation can all be mistaken for the usual results of aging instead of being recognized as symptoms of Dysthymia or depression in the elderly.

Treatment for Dysthymia is possible and has been shown to be highly effective. Group counseling and support groups are helpful. Individual therapy and medication are useful, though medication appears to be less effective with Dysthymia than with Major Depressive Disorder.

Because of the chronic nature of Dysthymia and the high risk, this will turn into Major Depressive Disorder early treatment is important.

Related articles: Mood Disorders, Depressive Disorders,

Major Depressive Disorder, Bipolar Disorder or Depression?, Bipolar or moody?, Am I Bipolar?, Hyperthymia, Are you hyperthymic? 

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 the difference between depression and Major Depressive Disorder?

Posted on by
20

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

Depressed person

Depression.
Photo courtesy of Pixabay.com

Depression, Mood Disorder, or Major Depressive disorder?

Major Depressive Disorder is a specific diagnosable disorder listed in the DSM (Diagnostic and Statistical Manual of Mental Disorders.)  Sometimes we use the term imprecisely to refer to both the common-sense feeling of sadness and a series of specific mental disorders that we professionals call mood disorders.

The dictionary definition of depression is essentially sadness. In the mental health field, it means so much more.

The differences in mood or depressive disorders are largely a matter of certain specific features that the person has rather than saying anything about the cause. There are also some related conditions that are not currently official “depressive disorders” but for which depression is a feature.

Confused yet? It takes 4 years of college and two more of grad school to make it all this complicated.

Mood problems often occur in “episodes” so they can come and go with or without treatment. The episodes don’t get specific diagnoses, but they do get used to seeing if you have all the features of a specific diagnosis.

Now if you are depressed and suicidal, which specific mood disorder you have may not matter to you, but it matters a whole lot to the insurance person approving your treatment. Since not everyone agrees which things are severe enough to require treatment, the list fades in and out with time.

What makes depression into a Major Depressive Disorder rather than a garden-variety depression is a few key factors.

How long you been feeling that way?

To be major depression it should have lasted for more than 2 weeks AND there should be at least 4 other symptoms of impairment. The effort here is to separate normal life problems from an illness that needs treatment.

How has this affected you?

There needs to be some problem in your life over and above just being sad. Being over sad all the time but not quite getting bad enough to be diagnosed with Major Depressive Disorder is called Dysthymic Disorder.

So we look to see can you work? Do you have friends and family? Do you still do some things for fun? These things separate out the sad moods and the sad-for-a-reason from the sad-way-to-much-and-too-long that characterizes Major Depressive Disorder.

Major Depressive Disorder is also separated into “single episodes” and “recurrent.” The first time someone has Major Depression we look more for causes. If they have repeat performances of depression we look at this as likely to be something produced by the person, either biologically or thinking wise.

Depressive Episodes, hence Major Depressive Disorder can also be “graded” into mild, moderate, and severe. For the treating professional this helps plan treatment. For the insurance company, it helps them known how big a bill they are getting for this treatment.

Sometimes the depression gets so bad that the brain starts making up stories. This looks a lot like the psychosis in Schizophrenia but it only happens to some people and then only when they are severely depressed.  This is called with (or without) psychosis depending on whether you have or do not have psychosis.

People who have Major Depressive Disorder do not all look or act the same. Some people become so depressed they have trouble moving. This is called Catatonia which is also associated with sleep paralysis.

The old fashion name for depression was melancholy. This is typically very severe in the morning but gets better as the day moves forward. People with this variety also wake up early. They don’t feel like eating and they either sit unable to summon up the energy to do anything, or they pace aimlessly about.  Often they also feel guilty about everything and hate to bother people.

People with atypical features are more like bears hibernating for the winter. They are hungry when awake and they sleep day and night but are still tired.  They are likely to feel that people are rejecting them and don’t what them around. People with atypical features can brighten a little for a while if you dangle something they like in front of them, but this improved mood doesn’t last long.

Postpartum Depression is also a recognized type. This is easy to understand in women soon after the birth of a child, due to the changes in the hormones in the woman’s body. It can also be seen in men especially after the birth of the first child as there is a change in the primary relationship. The fairy tale is over. Some men become excited about fatherhood, others feel like they have lost a lover.

There is also a seasonal pattern associated with depression. Sometimes this is referred to as Seasonal Affective disorder or “winter blues.”  This pattern can occur in the summer or at the spring and fall changes of weather, but those changes are more likely to be associated with Bipolar Disorder than Major Depressive Disorder.

For more on related conditions check the categories list to the right of the posts or watch for words to turn blue indicating they have been linked to other posts about this topic. My plan is to add links as quickly as I can finish the posts on these other topics.

Feel free to leave comments or email me about your questions. While I can’t provide therapy or counseling over the internet, you need to come to see me in the office for that, I will be glad to try to answer questions of general interest.

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

Tests for mental illness

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

Mental illness.
Photo courtesy of Pixabay.com

Have you been tested for Bipolar disorder or Schizophrenia?

More and more people come in and want to be tested or have their family member tested for a specific mental illness.

We wish there was a specific test, maybe a blood test, someone could do, and then we could look at the lab report and say yes, you have Depression with a touch of ADHD. Unfortunately, it doesn’t work that way.

Mental health diagnosis or mental illness if you prefer that term. is arrived at by piling up symptoms and looking at the time you have had them to see what pattern of mental, emotional, and behavioral problems the client has been experiencing.

Not everyone with the same symptoms might have exactly the same disorder. Let’s illustrate this process with a physical disorder. If you are coughing and you go to the doctor and he diagnosed you with “Major Cough Disorder.” This may have been caused by a cold, asthma, or a touch of Tuberculosis. While you might take some cough drops to reduce the symptoms of the cough, regardless of the cause of the cough, you would want a different treatment for Tuberculosis or Asthma over the long run.

Treating the tuberculosis cough with a cough drop could make the problem worse by letting the bacteria get a hold and as a result, shorten your life.

With a Mental illness, we go the other way. We give everyone with the symptom more or less the same diagnosis regardless of what caused the symptoms. Does it matter if you are depressed because your spouse died or because you lost your job? What if you got depressed over time because your life was just not going the way you had hoped?

For each of these causes, we would diagnose depression and prescribe eventually the same treatment regardless of the cause. So you would get an anti-depressant medication and talk therapy. If you were grieving over a loss we would let you have a period of time to grieve, say 90 days and after that, if you were still grieving we would want you to get on with life.

Parents want their kids tested for ADHD. That should be simple from one point of view. The child does not pay attention when the adult wants them to. The child does not do their work – Ipso-presto they had ADHD. Not so fast loony breath.

If we look only at the symptom then yeah, sure, all kids have ADHD some of the time when they don’t pay as much attention as the adult wants them to. But it matters a whole lot if they are not paying attention because they are being bullied on the way home or if mom and dad fought all night last night or is everything in their life fine and when they try they just can’t focus.

Bipolar Disorder is another one parents want their kids tested for. One of the symptoms of bipolar is not sleeping or getting by on almost no sleep. Kids stay up all night a lot. Watching too much internet does not make you bipolar. (On second thought can I get a grant for a million-five to study that?)

This excess energy and lack of sleep are called mania or hypomania. A manic person looks a lot like someone on Methamphetamine but they get that way without the drug.

Kids also don’t get enough sleep because pound for pound elementary school kids take in more caffeine than adults. All that caffeine comes from the sodas they drink.  That much stimulant can make a five-year-old act like a drug addict on speed. Add many MG’s of an amphetamine salt to the caffeine and watch Johnny go like a cyclone. Expect that when he crashes he will get really irritable and hit someone while he is detoxing.

See why it is important to find out not just what behavioral symptom this child has but what else is going on in the family and in the kid’s head?

So as time passes and the facts come in the diagnosis might change, or not.

Also compounding this situation is the possibility that the client could have more than one problem. Could the Person with asthma catch a cold? Could they also catch Tuberculosis if exposed to the germ?

Someone could be depressed, have ADHD, and still take in too much caffeine or do drugs. This makes unraveling the diagnosis a problem sometimes even for a professional.

So till a reliable blood test come along for Bipolar Disorder, ADHD, and the rest, we will just have to limp along counting up the symptoms and looking for other possibilities to build the correct diagnosis up over time, and even then not every person responds to every treatment in the same way.

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 are the six kinds of hallucinations?

Posted on by
20

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

Auditory, Visual, Tactile, Olfactory, Gustatory and Proprioceptive Hallucinations.

Six types of Hallucinations.
Photo courtesy of pixabay.

Of the six types of hallucinations, one is a characteristic of mental illness, two are most commonly found coupled with drug use or abuse and the others are rare occurrences.

Auditory hallucinations:

Hearing voices is one of the commonly reported symptoms of psychosis. For perfectly normal people hearing all sorts of sounds and not being able to find a source is common. Mostly this happens at night or when there some sort of sensory deprivation. Many people have had the experience of thinking they heard someone calling their name only to look around and find no one there. But if someone has psychosis the sounds they hear occur when others are present who don’t hear them.

People with schizophrenia have described the progression of these sounds to me. No one pattern seems to be consistent but here is the way in which auditory hallucinations might develop.

In the early stages, the person might hear humming sounds. They may get their hearing checked and there is nothing wrong. Later on, the sounds become voices. But the voices are mumbling, the person can’t make out what they say. The voices may get louder over time.

There may be one voice or many. The voices can be men, women, or a group of people. Occasionally the voice will sound just like someone from the person’s past.

The voice may comment on them – say “you’re no good” or “you will never be anything.” The voice may tell them to do or not do something. The most troubling auditory hallucinations are the “command” hallucinations when the voice or voices tell the client to harm themselves or others.

Occasionally the voices may be experienced as good or helpful voices. Sometimes the person experiencing auditory hallucinations can’t tell the difference between their own thoughts and “voices” as their thoughts become more negative and persecutory.

An occasional “hear your name and no one is there” or “hear chains rattling in the night” can be written off, but voices that recur or say negative things about the person are a sign of a serious mental illness and they need immediate treatment.

Visual hallucinations:

Seeing wisps or shadows can happen from lack of sleep, low light levels, or other physical problems. Most of the more elaborate visual hallucinations are the result of drug use, intoxication or withdrawals. Seeing things when withdrawing from alcohol is life-threatening and needs immediate medical treatment.

A few people with mental illness only and no reports of substance abuse see things but most of the time if someone sees things they are doing drugs. Seeing things on drugs is so common that if the client knows that the drugs caused this we don’t diagnose it as a psychosis.

Three types of drugs cause visual hallucinations. Hallucinogens like LSD etc are a well-known cause. High levels of stimulants especially methamphetamine can cause Amphetamine-Induced Psychotic Disorder.  Collectively all the psychosis caused by stimulants is referred to as “Stimulant Psychosis.”

Meth users are familiar with “petting the shadow puppy” and being chased by the giant green meth monster.

Drug-induced visual hallucinations often persist even after the eyes are closed.

Alcoholic Delirium Tremens (D. T’s) also involve visual hallucinations.  This is life-threatening and is usually a lot more terrifying than the prosaic references to “pink elephants.”

Tactile hallucinations

These involve feeling things on your skin and body that aren’t there. These are almost exclusively drug-induced.

Alcoholics may report the sensation of snakes crawling over their legs, mostly associated with restless leg syndrome.

Stimulant abusers are all familiar with Meth or cocaine bugs. They feel these sensations so often and scratch so much the characteristic scabs appear.

Olfactory hallucinations

Some people smell dead people, even before the people die. This makes good horror flick material but in real life, olfactory hallucinations are a lot rarer than auditory or visual hallucinations.

Smelling things that are not there and hypersensitivity to smells may have a physical cause or more rarely it may be a mental illness.

Gustatory hallucinations

This one makes me think I need a doctor, sometimes for the client, sometimes for me. If the client thinks they taste metal or poison this may be a medical issue, side effect of meds. Some clients have delusions of being poisoned and anything can taste like poison to them.

This is also a relatively rare issue in my experience.

Proprioceptive hallucinations:

This was covered under the category of sleep paralysis. These sensations of floating, flying, out-of-body experiences, and other dissociative movement events are most likely when in bed before and after sleeping.  They have also been reported under the influence of anesthetics and other hospital-related incidents.  There are some historical references to this type of hallucination being caused by certain herbs and potions but most likely it is the result of sleep disruptions. I can think of no mental illness that features these sorts of hallucinations.

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

Morning Question # 9 Is Substance abuse or mental illness first?

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

Hands with pills

Addiction.
Photo courtesy of Pixabay

Does Substance abuse or mental illness occur first?

Both can be first, depends on the person. People who have early symptoms of mental illness are at high risk of developing substance abuse disorders. People who begin abusing substances early in life are more likely to develop mental illness. It may be hard for many people to remember a time before they had one or the other so it is hard to tell sometimes. I like to start by asking how old someone was when they first began to use drugs and alcohol and then ask what life was like before the drugs or alcohol. Some people can’t remember a time before one or both.

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

Morning Question # 8 – Which personality Disorders can’t read other people?

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

personality disorder

Personality Disorder?
Photo courtesy of Pixabay.com

Which Personality Disorders can’t read other people?

None really. The closest would be Schizoid Personality Disorder, they can read people they just don’t care for people, any people. They are the classic hermits and loners.

I think you are asking about the Autism Spectrum. Autism, Asperger’s, and Pervasive Developmental Disorder NOS. Next year with the DSM-5 these will all become part of a new label Autism Spectrum Disorders. People with these disorders or varying degrees of this disorder have difficulty reading other people.

When shown pictures of people’s faces they can’t tell the angry person from the calm person. They also have difficulty reading lots of non-verbal clues. So they don’t understand when someone likes them and wants to talk or is bored and wishes they would go away. This creates all sorts of social problems.

One new treatment approach consists of teaching them all about nonverbal clues to behavior. More on this treatment coming up in a future post.

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

Morning Question #6 – Could a father’s meth use cause Schizoaffective Disorder?

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

Drugs

Stimulant drugs.
Photo courtesy of Pixabay.com

Schizoaffective Disorder and Meth use.

Schizoaffective Disorder is an unusual condition, though I think it is underdiagnosed. Think about traveling through a swamp full of lots of muck but here and there are some small islands of land. Sometimes you have one foot on land, sometimes two, and other times none. People with Schizoaffective Disorder can have episodes of psychosis, episodes of depression, or Bipolar disorder, sometimes both and sometimes neither. Depending on who sees them and when they are seen the diagnosis can change all over the place.

Mental Health conditions do not seem to be caused by any one gene. Most likely they are caused by the interaction of many genes, risk factors, environmental influences, and so on. Dad doing drugs is not likely to have caused that. Sometimes dad was doing drugs because he had a mental illness or there was a history of some disorder in the family that put him at risk.

Mom’s drug use during pregnancy is another matter. The more she uses the bigger the problem. The day she uses can determine what part of the baby was developing that day and what was affected. Mom’s drug use can result in mental retardation or learning disabilities but so far I have not seen any research out there that says the parent’s drug use before the child was born changed the child’s genes and caused a mental illness. If someone has seen that please leave a comment.

The parent’s drug use after the baby is born?

There are all kinds of research that says growing up in the home with a substance abuser can affect a child’s mental health.

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 sleep paralysis cause or is it caused by mental illness?

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Sleep paralysis

Sleep paralysis.
Photo courtesy of pixabay.

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

More on Sleep paralysis.

Remember this is written from a therapist’s point of view. If there is any chance that you or someone you know has a medical problem, have it checked out by a doctor first. But if the doctor finds nothing medically wrong with you that does not mean you are going crazy. It might mean that you can benefit from some counseling to help you better cope with stress.

Many people who experience sleep paralysis, hypnogogic hallucinations, or “exploding head syndrome,” think they are going crazy or fatally ill. Knowing that these are explainable phenomena and have simple treatment can reduce the concerns. Sleep Paralysis and many related sleep problems are often triggered by stress. More stress, good or bad stress, and the chances of an attack increases.

People who become fearful of another occurrence of Sleep Paralysis can “prime the pump” and increase the risks of a second bout in the same way people who experience panic attacks begin to worry about having another episode.

If clients describe these events as dreams the doctor is likely to reassure them that it is normal. Patients who explain these events as demons, spirits, or believe they actually saw a supernatural being are likely to be prescribed a psychiatric medication. Antipsychotics, antidepressants, and anti-anxiety medications (Benzodiazepines) are all believed to increase the incidence of Sleep Paralysis and Hypnogogic Hallucinations (Gangdev, 2004.)

Other things that have been reported to increase the risks of having an episode of Sleep Paralysis include being physically ill, such as having the flu, watching or experiencing emotionally upsetting events, such as having an argument.

If the paralysis or hallucinations only occur when going to sleep and waking up they are most likely sleep-related and not the result of a mental illness. Gangdev, in his article, asked the question: “It is possible that a small proportion of patients diagnosed with schizophrenia who experience hallucinations may actually be experiencing escaped REM-related dream activity during the wakeful state?”

There is a significant overlap between sleep paralysis and Narcolepsy. Narcolepsy includes not only sleep paralysis but hypnogogic and hypnopompic hallucinations, daytime sleepiness, and Cataplexy (sudden unexplained loss of muscle tone.)

Sleep Paralysis without any cataplexy or daytime sleepiness is not considered to be associated with Narcolepsy and is referred to as Isolated Sleep Paralysis (ISP.) Penn reported that 16 % of medical students reported at least one episode of sleep paralysis. That makes me think that long hours and sleep deprivation may be a major cause of many of these events.

Sleep Paralysis is far more common in African-Americans and in one study of Nigerian subjects more than half had experienced ISP. It is also common in Japanese Subjects.

People who have a Sleep Paralysis event find it helpful to get up move about and make sure they are fully awake before attempting to return to bed. People who do not get out of bed have an increased risk of having multiple episodes of sleep paralysis in the same night. Sleeping flat on your back looking up at the ceiling (supine position) is much more likely to cause a Sleep Paralysis experience than sleeping on your side.

Knowing that episodes of Sleep Paralysis and Hypnogogic Hallucinations are relatively common and most often harmless can help someone cope with these experiences.

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 are Personality Disorders?

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

What is

What are personality disorders?
Photo courtesy of Pixabay.

Update.

In the new DSM-5, the five-axis system was eliminated. Personality disorders are now included in the full list of mental, emotional, and behavioral disorders, just like any other mental health issue. I have left this post here, as originally posted because much of this information remains relevant. Not all of the changes we expected in the DSM-5 took place. For the current status take a look at some of the newer posts.

How many Personality Disorders are there?

Personality Disorders are a special class of mental illnesses that are considered different in kind and nature from other mental health problems. Mental illnesses in all their shades are recorded on Axis I. There are currently over 300 recognized Mental illnesses. Most mental illnesses have several standard treatments and if severe enough are likely to be covered by insurance or public funding. Not so with personality disorders.

Personality Disorders are kept separate. They are recorded on Axis II in a separate and small class of problems that just don’t seem to ever change or get better. They have long been considered like mental retardation, something we need to help with, but something that just won’t change. Personality Disorders are a short list, rarely over a dozen labels, though the list changes over time.

Personality Disorders are conditions in which the person to be diagnosed “deviates from expectations of their culture.” There are different. But that is not enough for the diagnosis to be imposed.

This pattern of “differentness” is “Pervasive and inflexible.” They stick to their irritating pattern no matter what. This pattern starts in adolescence or early adulthood and they just don’t change, “grow up” or “grow out of it.” So this pattern of differentness is “stable over time.” It is as if people with a personality disorder get stuck in one way of behaving and then can’t change their approach when they are in a different time or place.

This differentness needs to also cause them problems getting along with other people, holding a job or make them unhappy to get the diagnosis. They are not just a little different some of the time but a lot different all the time.

Some people could care less if they have a personality disorder or not. But most people who have a Personality Disorder are suffering, want, and need help, no matter how we label or understand their problem.

Currently, there are ten recognized Personality Disorders in three groups or “clusters.” The DSM-5 due out next year probably will reduce that list to six personality disorders and a new “Personality Disorder Trait Specified.” Not sure what will happen to the people who have a disorder now when their diagnosis is abolished. Will they be declared cured? Or maybe we just give them a new mental illness to compensate them for their loss.

When I was in Grad School I though these personality disorders were interesting, did extra research, and even wrote some papers on the topic. I considered specializing in treating these disorders. But what I discovered is that most people with a personality disorder come to the therapist for Depression, Anxiety, and relationship problems just like anyone else. Also since these are “inflexible” patterns, only two of these disorders end up in treatment with any regularity.

Here are the clusters as they stand now with the included diagnosis. The descriptors are mine with my apologies to the APA. Clusters A and C first as Cluster B is the biggie.

Cluster A: These are the “Weird” people.

Paranoid Personality Disorder – They are scared all the time. Most are NOT Schizophrenic. We don’t see many of these people unless family or police call us as they are so afraid they never leave home. This diagnosis disappears with the DSM-5. Lots of luck on that one.

Schizoid Personality Disorder

Loners. They do not like being around other people even family. They don’t have or want friends. They would make great hermits. When the DSM-5 arrives they are all cured and free to head for a cave in the hills. Just watch out for the zoning enforcement people as those dudes like to talk.

Schizotypal Personality Disorder.

Odd, superstitious, and believe in signs, spirits, and the supernatural. They may not have friends outside the family or only one close partner. If they think about something that needs to be done, say doing the laundry and then you go do it, they will believe that their thought caused you to do it. They often dress in odd ways. This description has been applied to people who look like “witches” etc. The DSM has an exemption here if they belong to a group that agrees with their beliefs. For the record Modern “Witches” who call themselves Wiccan do not wear funny clothes all the time and do not qualify for the diagnosis of Schizotypal. This is more common than the last two Personality Disorders and stays in the new DSM-5.

Group C Scared People

Avoidant Personality Disorder – they would like friends they are just sure no one will like them and so they avoid people. They are also sure people will criticize them or put them down so they don’t try. This one stays.

Dependent Personality Disorder.

Needy, clingy afraid they will be abandoned. They always need help and what to be told and what to do. This diagnosis goes. Find yourself a dominant partner before your diagnosis is repealed or get help and become less needy.

Obsessive-Compulsive Personality Disorder.

This goes beyond everyday OCD. They want everyone else to do things just so. They are often stingy with money, needs to control everything and they have the rule book to do it. Often they cannot get anything done because their rules are so complex they can’t follow them. This one stays.

Cluster B personality disorders.

The people who cause others problems. Cluster B diagnoses are the most common diagnosis in prisons.

Antisocial Personality Disorder.

They disregard the rights of others and violate those rights. This is the number one diagnosis of men in prison. This one needs a whole post all by itself.

Borderline Personality Disorder – The main ingredient here is lots of pain. Unstable interpersonal relationships, poor self-image, unstable mood, often impulsive with a chaotic life. Most people who are diagnosed with Borderline Personality Disorder are women. This traditionally is the number one diagnosis of women in prison. Many women with this diagnosis have been victims of one kind or another at an early age. They did what they had to do to cope in a bad situation but now the way they cope is not working. There are some really good treatments for this, especially DBT, but it takes a time to heal.

Histrionic Personality Disorder.

Excessive emotionality and attention-seeking sometimes referred to uncomplimentary as “Drama Queens.” Not common in practices and we are doing away with this diagnosis when the DSM-5 comes out. Most of these folks have their own T. V. shows by now so they can pay for therapy even without a diagnosis.

Narcissistic Personality Disorder.

We’re keeping this one. Not sure why. First, we treat you for low self-esteem and then we tell you that you are Narcissistic. Most people who come for marriage counseling tell me their partner is Narcissistic.

This should be on a continuum. Is this a political season? How can we tell the Narcissists from the candidates? Don’t you need to be a lot Narcissistic to think you should be running the show? Does the top Narcissist get to run a Bank or Wall Street?

Running out of time and this post is going long. More on Personality Disorders to come. Do any of you have any thoughts on the topic?

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