Persistent Depressive Disorder – PDD (F34.1)

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

What is

What is Persistent Depressive Disorder?
Photo courtesy of pixabay.

What if you don’t ever remember being happy?

Persistent Depressive Disorder – PDD (F34.1) is new to the DSM-5. The DSM is the book professionals use to identify mental illnesses. This diagnosis is the result of merging Dysthymia and another group of symptoms which was being researched as Chronic Major Depression. Some other variations on the depressive theme were being called Minor Depressive Disorder, which did not get recognized as such but kind of fits here.

While we may label these conditions as chronic or minor, there is nothing minor about them if you are someone who has this condition?

The defining characteristic of Persistent Depressive Disorder – PDD, is a pervasive sadness that just won’t go away. People who have this condition are always sad or unhappy. They may describe themselves as “always down” or having the blues. While this can cause a lot of impairment, people who have PDD come to think of their chronic sadness as “Just the way I am.”

It is estimated that about two percent of the U. S. population has PDD. Many people with PDD also experience a substance use disorder. There is also an overlap between PDD and Cluster B and Cluster C personality disorders, both of which, to my way of thinking, may have their roots in negative childhood experiences.

Persistent Depressive Disorder (PDD) is more disabling than Major Depressive Disorder.

PDD has been identified on brain scans and seems to affect at least four separate brain regions. PDD is long-lasting, at least two years, often more. During this time someone with PDD may also experience an episode of Major Depressive Disorder. While the major depressive episode may come and go the PDD often remains relatively constant. Because of this constant feature, people with PDD may not be able to ever feel really happy and their functioning, day-to-day, is more impacted than those with Major Depressive Disorder only.

Persistent Depressive Disorder (PDD) is chameleon-like.

Chronic unending depression has a lot of variations. This disorder can exhibit itself a great many ways. As a result, there are eighteen separate specifiers that can and should be added after the F43.1 These specifiers are not exclusive, so one person may also get several specifiers added to the Persistent Depressive Disorder (PDD) diagnosis.

Specifiers include with:

Anxious distress – anxiety commonly co-occurs with depression.

Mixed features

Melancholy features

Atypical features

Mood-congruent psychotic features

Mood-incongruent psychotic features

Peripartum features

In partial remission

In full remission

Early onset – before 21

Late onset – at or after age 21

Pure dysthymia syndrome

Persistent major depressive episode

Intermittent major depressive episode, currently with MDD

Intermittent major depressive episode, currently without MDD

Mild

Moderate

Severe

The symptoms of Persistent Depressive Disorder.

To qualify for PDD a person should have the following symptoms:

  1. Felt depressed or down, or had others see them this way, most of the day, most days, over a two-year period.
  2. Had at least two of the following six symptoms. These symptoms should be caused by emotions not by dieting or working long hours, etc.
  3. Change in appetite either up or down.
  4. Changes in sleep either too much or too little.
  5. Felt low in energy or fatigued a lot.
  6. Low self-esteem.
  7. Difficulty deciding things or poor concentration.
  8. Hopeless.
  9. Most of the usual exclusions. This has to be causing problems with work, school, relationships, should interfere with important activities or upset the client. It should not overlap Bipolar Disorder or Psychotic Disorder but may overlap Major Depressive Disorder. These symptoms should not be the result of medical or substance use issues.
  10. These symptoms have been constant and not gone away for two months or more over the required two-year period.

Be careful with the PDD label.

Calling Persistent Depressive Disorder by the label PDD could be problematic. In the past, we had another PDD – Pervasive Developmental Delay which is now recognized as a part of the Autism Spectrum. Persistent Depressive Disorder – PDD is about depression and has nothing to do with Autism. Be careful in reading articles that if they use the label PDD you know which of these two they are talking about. From here on I will call Persistent Depressive Disorder – PDD.

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

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

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

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 Disruptive Mood Dysregulation Disorder?

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

What is Disruptive Mood Dysregulation Disorder?
Photo courtesy of Pixabay.com

Maybe that child does not have Bipolar Disorder?

Disruptive Mood Dysregulation Disorder F34.8 was added to the new DSM-5 (Diagnostic and Statistical Manual of Mental Disorders) partially because way too many children were getting diagnoses of Bipolar Disorder. Most of these children grew up and never had an episode of mania or hypomania, the one thing that is required for a Bipolar Diagnosis.

The research supports the idea that a particular type of childhood depression was not getting the treatment it deserved. As a result, a lot of children were getting diagnoses they should not have had. Bipolar is only one of these possible incorrect diagnoses.

Some of the prominent symptoms of Disruptive Mood Dysregulation Disorder (DMDD) are temper tantrums and chronic irritability. These symptoms are quite different from the pressured uncontrollable behavior seen in Bipolar. DMDD has also been misdiagnosed as several other psychiatric disorders in the past.

One reason this has been getting noticed is that children who have a particular group of symptoms now recognized as DMDD rarely grow up to have Bipolar Disorder or behavioral disorders. What they develop as they grow are significant levels of depression and anxiety.

Disruptive Mood Dysregulation Disorder (DMDD) is similar to depression.

DMDD shares some characteristics with other forms of Depression. In both DMDD and the other depressions, there are mood issues, sadness, feeling empty, or being chronically irritable. These mood issues result in changes to the body, physical symptoms, as well as changes in thinking and behavior. The result is that the person with DMDD or depression can’t function well even when they want to. DMDD is now found in the DSM chapter on depression. For many with adult depression, their issues all started in childhood with DMDD.

What are the symptoms of Disruptive Mood Dysregulation Disorder (DMDD?)

Disruptive Mood Dysregulation Disorder (DMDD) results in temper tantrums.

Children with Disruptive Mood Dysregulation can’t respond to frustration appropriately. The result of this lack of frustration tolerance is frequent temper tantrums or outbursts. These outbursts may be expressed verbally, or behaviorally. The defining characteristic of these temper outbursts is that they are excessive for the child’s developmental stage.

Even when this child is not having temper tantrums they are almost always in an angry or irritable mood. This angry irritable mood should be something that others can readily see by observing the child.

Age of onset of Disruptive Mood Dysregulation Disorder (DMDD.)

DMDD is only diagnosed if the symptoms first appear between the age of 6 and 18. The expectation is that the symptoms of depression seen with DMDD are inconsistent with the person’s developmental level. This is an issue of not being able to regulate your emotions.

Before age six we expect young or school-age children to have difficulty regulating emotions and to react with sadness, irritability, or temper tantrums when frustrated. Young children may become frustrated and not able to exercise self-control no matter what the encouragement or punishment they receive.

Even if this disorder does not get recognized and diagnosed until later teen years the child must have had these symptoms before age ten. This separates DMDD from things that may be typical of adolescents during the teenage years.

Frequency and duration of Disruptive Mood Dysregulation Disorder (DMDD.)

On average, a child with DMDD should be having three or more episodes of mood dysregulation per week. This separates out the child who has occasional difficulties in response to a stressor from those who just can’t regulate emotions and are triggered more easily than they should be given their age.

These temper outbursts and mood dysregulation should go on most of the time for a year or more. This is no passing phase. Even if there are brief periods when the irritable angry mood is not present these periods of better mood should not last for more than three months.

Mood dysregulation happens in more than one place.

For us to think this child’s issue is a disorder we would expect the symptoms to appear in more than one setting, school, home, organized activates, and so forth. In at least one of these settings, probably more, the outbursts are expected to be severe.

If there is mania it is not Disruptive Mood Dysregulation Disorder (DMDD.)

For a small group of children, there will be symptoms of mania or hypomania. If that is present then yes Bipolar Disorder is more appropriate and they are likely to develop more severe bipolar symptoms over time. Early treatment for childhood Bipolar Disorder can reduce the severity and impact of the disease but only if we are getting the diagnosis correctly.

One other difference between Disruptive Mood Dysregulation Disorder (DMDD) and Bipolar is the way symptoms fluctuate. DMDD fluctuates in response to frustration. Bipolar symptoms come and go as a function of time.

Other Disruptive Mood Dysregulation Disorder (DMDD) issues.

DMDD has a lot of co-morbidity with other disorders. Children with DMDD are at increased risk of abusing a substance and developing a substance use disorder (SUD.) And yes, we see SUD in elementary school children.

Because girls tend to internalize problems, while boys externalize, there is likely to be a bias in the diagnosis of Disruptive Mood Dysregulation Disorder (DMDD.) Only time will tell if this turns out to be another label for young boys.

Symptoms of Disruptive Mood Dysregulation Disorder (DMDD) are likely to change as the child grows and matures. It will be interesting to see if children who receive the DMDD diagnosis go on to experience Major Depression or some other adult mental health issues. Hopefully, treatment for this disorder while the child is young can prevent lifelong problems.

As with the other things we are calling a mental illness DMDD needs to interfere with the child’s ability to go to school, their relationships, and enjoyable activities or cause them personal distress. Otherwise, they may have the issues but not get the diagnoses. If the only time this happens is when under the influence of drugs or medicines or because of some other physical or medical problem these symptoms need to be more than the situation would warrant. Other issues may need treating first, then if the child still has symptoms they could get this diagnosis.

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

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

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

Story Bureau.

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

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

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

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

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

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

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

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

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

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

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

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

For videos, see: Counselorssoapbox YouTube Video Channel

What operating system is installed in your brain?

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

Brain Apps

Brain Apps.
Photo courtesy of Pixabay.com

How is your brain programmed to handle life?

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

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

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

Here are the most common brain operating system problems.

Act out, behavioral solutions.

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

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

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

Stay inside your head, isolate.

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

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

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

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

Avoidance. Use drugs, don’t trust.

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

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

Don’t feel.

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

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

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

What are the rules? Tell me what to do.

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

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

File everything for future use. Hold onto the hurts.

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

Act on those feelings, impulsivity.

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

Beat your body into submission.

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

No Starter.

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

No brakes.

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

Not many functions. No vocabulary.

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

An executive function that decides what routine to use.

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

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

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

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

Story Bureau.

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

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

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

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

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

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

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

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

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

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

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

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

For videos, see: Counselorssoapbox YouTube Video Channel

What is a Specific Phobia?

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

What is

What is a Specific Phobia?
Photo courtesy of Pixabay.

There are lots of things you might be afraid of.

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

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

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

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

Coding Specific Phobia.

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

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

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

F40.230 Medical, blood

F40.231 Medical, injections

F40.232 Medical, other procedures

F40.233 Injuries

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

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

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

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

The treatment of choice for Specific phobias is systematic desensitization.

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

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

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

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

Story Bureau.

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

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

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

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

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

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

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

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

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

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

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

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

For videos, see: Counselorssoapbox YouTube Video Channel

com.

What is Bulimia Nervosa? (Was 307.51 now F50.2)

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

What is

What is Bulimia Nervosa? (Was 307.51 now F50.2)
Photo courtesy of Pixabay.

When eating and avoiding weight gain collide.

Bulimia Nervosa, Bulimia for short, is one of the feeding and eating disorders and is diagnosed about 4 times more often than Anorexia Nervosa according to the DSM-5. For the full description consult the DSM-5, what follows is my simple language version of this disorder and my experiences in seeing clients with these issues.

Women are ten times as likely to receive this diagnosis as men. Bulimia has three defining characteristics, “pigging out” and extreme measures to make up for that episode of excessive calorie intake as well as self-esteem or self-worth that is excessively based on weight and body type. These three characteristics make Bulimia sort of like Anorexia Nervosa on the one hand and Binge Eating Disorder on the other.

Pigging out is more than just liking to eat.

What makes the pigging-out or “binge eating” different in this disorder is the feeling of loss of control. In Bulimia, the client will eat far more than would be normal and do this in a relatively short time. The official definition sets this time limit more or less at 2 hours.

So binge eating is not snacking all day or having a big appetite. It is a loss of control over how much they eat and once they start the eating run it goes on until something interrupts the binge. Some have described these loss-of-control episodes as “spacing out” or dissociating. What they binge on can be very individual and can vary from episode to episode.

This loss of control is very similar to what we see in Substance Use Disorders. Turns out that about 30 % of those with Bulimia also develop a substance use disorder. Mostly this will be alcohol which is readily and legally available and can temporarily dissolve the guilt that comes from overeating. The other common drug of choice among many people with Bulimia is a stimulant use disorder. Start off on the “Jenny-Crank” diet to lose weight and you too may develop a Stimulant Use Disorder.

Once the guilt sets in you try to undo the binge.

A characteristic of Bulimia is the use of unhealthy ways of offsetting the excess calories consumed on the binge.  Those with Bulimia may force themselves to vomit to get rid of the over-full feeling and to lose weight. They also can try laxatives, water pills (diuretics), and extreme episodes of fasting. Those fasts by the way often end with another binge.

In Bulimia, self-worth is based on weight.

All this pigging-out style overeating and then trying to make up by extreme measures is hard on the self-esteem and self-confidence. Those with Bulimia base their self-esteem and self-worth on their weight and or body. So when they put on weight, they feel bad about themselves.

Bulimia is not something that just happens during Thanksgiving week.

To be defined as Bulimia we expect this person’s dance with overeating to go on for say three months or more and they will probably be binging at least once per week. In Bulimia the revolving pattern is binge, feel bad about yourself, and then do the extreme measures to keep the weight off. The recurring story the person with Bulimia tells themselves is that if they were just thinner they would feel better about themselves and others would like them more. Unfortunately, the only way to discharge the anxiety around food is with another binge and purge.

Which eating disorder is which?

Bulimia is separated from Anorexia mostly by the person’s body weight. In Anorexia they weigh significantly less than they should and are trying to stay that way or lose even more. In Bulimia, the person weighs about normal or even a little beyond but they are defiantly not obese. In Bulimia, the main difference is that they binge and then feel they have to do extreme measures to compensate. In Binge Eating Disorder there is still the binging and the feeling bad but no compensating behaviors.

For more on this and related topics see – Feeding and Eating Disorders.

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

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

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

Story Bureau.

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

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

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

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

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

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

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

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

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

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

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

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

For videos, see: Counselorssoapbox YouTube Video Channel

What is Social Anxiety Disorder (Social Phobia.)

By David Joel Miller.

What is

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

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

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

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

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

The symptoms of Social Anxiety Disorder.

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

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

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

Performance Anxiety is a special case of Social Anxiety Disorder.

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

Children with Social Anxiety Disorder.

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

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

With Social Anxiety Disorder you can run or suffer.

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

Social Anxiety Disorder is neither brief nor temporary.

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

Treatment for Social Anxiety Disorder.

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

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

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

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

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

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

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

Story Bureau.

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

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

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

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

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

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

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

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

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

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

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

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

For videos, see: Counselorssoapbox YouTube Video Channel

Generalized Anxiety Disorder. (GAD Was 300.02 now F41.1)

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

Anxiety provoking.

Anxiety.
Photo courtesy of Pixabay.com

In Generalized Anxiety Disorder, everything is scary.

The key feature of Generalized Anxiety Disorder (GAD) is that in this disorder the worry-weed just keeps growing. Worry in GAD is all out of proportion. Clients with this problem worry the majority of their time. While you need to have been worrying for at least six months to get this diagnosis, most people with GAD have been worrying far longer. It is common to hear from someone with GAD that they have been worrying all their lives or that they can’t remember a time before they began worrying.

Generalized Anxiety Disorder is a relatively common disorder despite being very disabling for so many. In any given year here in the U. S., it is estimated 3 million people will receive this diagnosis. Cumulatively this amounts to between 27 and 35 million people who are estimated to be living with GAD.

Generalized Anxiety Disorder can begin at any age but many people first realized they were worriers or over-anxious in childhood or adolescence. There used to be a diagnosis for over-anxious children but that one got merged into the GAD diagnosis. While Generalized Anxiety Disorder can strike at any age and often stays with you, your whole life what people will worry about changes as you age.

Common worry themes in GAD are punctuality, natural disasters, being a victim of crime, and the need to do things perfectly and be perfect. With all these worries it is common for someone with Generalized Anxiety Disorder to seek reassurance. If they adopt rituals to keep themselves safe it can be a short hop to OCD or a related disorder.

What separates GAD from other anxiety disorders is the length of the list of things you worry about. People with GAD worry about many things most or all the time, not simply a few things occasionally. Someone with Generalized Anxiety Disorder is frequently apprehensive about what might happen and they tend to expect the worse. The anxiety bully whispers in their ear (figuratively) that something bad is about to happen and over time they come to believe these thoughts.

In GAD it is not that they hear these thoughts, as in an auditory hallucination, but the thoughts can take on a life of their own and they start believing that if they think this thought it must be true. One characteristic of GAD is the loss of control over the worry. It happens whether you want or need to worry or not.

Physical symptoms are very common with mental illnesses. This does not mean things are just “in your head.”  The increase in stress hormones results in physical signs and symptoms in the body. Adults will have at least three of the six symptoms below. Less than 3 probably mean that one or more of the other anxiety disorders would be a better fit for the problem than GAD. Here are the six physical and emotional problems, 3 of which should be present in GAD.

  1. Motor racing – Feeling keyed up or restless.
  2. Tired, worn-out, or fatigued for no good reason.
  3. The mind goes blank, can’t focus or concentrate.
  4. Grouchy, irritable.
  5. Muscle tension.
  6. Poor sleep, reduced, disturbed, or otherwise disrupted for no discernible reason.

Note that some of these symptoms are combinations of emotional and physical issues. This is why before giving someone a diagnosis a therapist always wants to be sure that you have recently seen a medical doctor and ruled out a medical condition. We also have to ask about drug and alcohol use, not because we want to pry, but because if you are doing drugs, especially stimulants, this may be causing or aggravating the anxiety.

An important consideration, for this to be Generalized Anxiety Disorder, is that the anxiety needs to be way out of proportion to the actual life risks. A significant part of your thinking brain will be used up on worry leaving less to use in actually living life.

Much of the worry in Generalized Anxiety Disorder can be directed towards what you “should be” doing as opposed to what you are actually doing. People with GAD are likely to have exaggerated startle responses. Most of us will jump if a gun goes off close by, or we probably should. Someone with GAD will jump when a car door slams on the next block.

If you or someone you know has symptoms of GAD, seek professional help. There are treatments that can reduce or eliminate the symptoms of Generalized Anxiety Disorder.

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

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

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

Story Bureau.

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

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

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

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

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

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

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

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

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

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

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

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

For videos, see: Counselorssoapbox YouTube Video Channel

What is Agoraphobia? (300.22, now F40.00)

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

What is

What is Agoraphobia?
Photo courtesy of Pixabay.

Agoraphobia is about fear.

Agoraphobia is often translated as “fear of the marketplace.” This disorder involves being overwhelmed when you encounter people outside your home or “nest.” People with this problem become fearful when they have to venture out. It is not required that the person actually leaves their house and experience the situation, just thinking about the possibility, and then having symptoms can qualify as Agoraphobia. For some people, these symptoms and their efforts to avoid feeling these feelings can result in their becoming home-bound.

This disorder has been associated with panic attacks and panic disorder. We used to diagnose this as Panic Disorder with or without Agoraphobia. The new trend, as dictated by the DSM-5, is to separate Panic Disorder from Agoraphobia as some people can have either one without the other, some people have both in which case they get both diagnoses put on their chart.

Current estimates are that between five and six million Americans have Agoraphobia. Somewhere between one-third and half of these also have panic attacks. Many do not receive treatment because they are too fearful to leave their homes and go for treatment. Agoraphobia is a major cause of disability with over one-third of those with Agoraphobia being home-bound and unable to work. There are treatments for Agoraphobia if you are able to access them.

Some people report that when they experience settings that would qualify them for the diagnosis of Agoraphobia they have “Anxiety Attacks.” Having a brief increase in Anxiety as in an “Anxiety Attack” can be a part of other illnesses such as any Anxiety disorder, trauma, and stressor-related disorders, depression, and so on.

To be Agoraphobia, by definition, you need to experience these fear-based symptoms in two or more specific situations. This helps separate the Agoraphobia condition from a narrower specific fear or phobia. These fears also need to be excessive or unrealistic. Fear of leaving the house does not count if you live in a war zone or a high crime neighborhood.

The 5 specific fears of Agoraphobia you asked?

  1. Being on public transportation.
  2. Open spaces.
  3. Closed or confined spaces.
  4. Standing in a line or being in a crowd.
  5. Being outside your home alone.

To get the diagnosis of Agoraphobia it is not enough that you just be scared or nervous in these situations. People with Agoraphobia avoids these and possibly related experiences. This interfering with the rest of your life is one of the hallmarks of a mental health issue that should get diagnosed and treated.

People with Agoraphobia also worry excessively that they may not be able to escape or won’t be able to get help in these situations. It is these two key characteristics, not being able to escape and the belief that something terrible will happen that make Agoraphobia so debilitating.

For this diagnosis to “fit” this intense fear can’t be just a one time or occasional occurrence. It has to happen most or all the time you encounter these situations.  People with Agoraphobia often insist on having a companion to reassure them when they leave the house and they can only endure these situations by ensuring intense fear.

Symptoms for Agoraphobia are a little wider than the psychical ones seen in Panic Disorder. Other possible symptoms would include the risk of having an embarrassing or incapacitating incident such as loss of control over bodily functions or falling, passing out, or getting lost. In the elderly, it is hard to separate real concerns from excessive ones that would count towards Agoraphobia.

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

For more on these topics see Anxiety Disorders,

Stress and Trauma-Related Disorders,

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

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

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

Story Bureau.

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

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

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

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

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

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

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

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

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

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

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

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

For videos, see: Counselorssoapbox YouTube Video Channel

What is Abnormal Psychology?

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

What is

What is Abnormal Psychology?
Photo courtesy of Pixabay.

How is Abnormal Psychology related to mental illness?

Abnormal Psychology used to be a chapter in psychology tests, sometimes it was a separate class. Personally, I am becoming increasingly uncomfortable with the whole idea of normal versus abnormal when it comes to psychology.

We used to think there were two kinds of people, normal and abnormal. Presumably the abnormal had something wrong with them and the rest of the people were just fine. The more we study people the more convinced we become that there is a very wide range of what is normal.

Wikipedia has an extended discussion of Abnormal Psychology, though as a note to students be careful with this article, it is not up to date on the recent changes taking place in the field of mental health. For example, the DSM-5 has eliminated the use of the five axes system.

The working definition Wikipedia is using, at least as of today, appears to be more in the realm of “unusual behavior” as opposed to what gets diagnosed as a mental or emotional illness. In psychology, there is this tendency to look at behaviors as either adaptive or maladaptive. In mental health, we think that “adaptive” may well be in the eye of the beholder.

Think back to that “bell-shaped curve.”  When people are so variable how are we to tell how abnormal is abnormal? I have written elsewhere about how along the way psychology and counseling, mental health, in particular, got a divorce. Rather than try to figure out whether atypical ways of thinking were “abnormal” we are looking at – does this different way of thinking help you, as in Steve Jobs or Bill Gates, or is this abnormality hurting you.

So the criteria for calling the behavior a mental illness is not that it’s an abnormality, but does this behavior, normal or not bother you, interfere with your working, school, or relationships, or does it interfere with other important areas of your life, like hobbies and so on.

The criteria for mental illness are about functioning and how do you feel about yourself. Those kinds of things. It is not about are you left-handed or extroverted.

People are not abnormal all the time about everything.

You can be very different about one thing and quite typical, I hesitate to use the word normal here, about other things. People can move around on this continuum we call recovery and wellness. So being abnormal about one thing, today, does not mean this abnormality applies to everything all the time. Even if it did, this is not necessarily a bad thing unless you think it is.

 Will studying Abnormal Psychology fix you?

Lots of students, typically first-year ones, find they are having emotional problems and they take a class in psychology, maybe become psychology majors, thinking this will “fix” them. They learn a lot of stuff but usually, none of this helps with the problems they are having.

Much of what you experience in life has to do with developmental stages. That high school to college transition can be a difficult time. Lots of stress, the competition to do well. There are also those things about getting into relationships, trying out drugs and alcohol, and figuring out who you are.

Some people get through, pass this hurdle, and some do not. Rarely does knowing that you are introverted or extroverted or exploring your thinking, knowing, perceiving, ENTI or other psychological theories help explain your depression or anxiety.

That normal think just does not always explain why some people do what they do. Really odd people become great successes and very normal people get angry about their partner’s behavior and show up at worksites with guns.

If you are feeling “different” consider talking with a professional who can explain what kinds of abnormal are OK and what kinds deserve treatment. No, you do not need to be crazy to get counseling. In fact, if you are having problems it makes sense to get help.

These “What is” sometimes “What are” posts are my efforts to explain terms commonly used in Mental Health, Clinical Counseling, Substance Use Disorder Counseling, Life Coaching, and related disciplines in a plain language way. For the more technical versions please consult the DSM or other appropriate references.

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

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

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

Story Bureau.

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

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

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

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

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

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

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

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

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

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

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

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

For videos, see: Counselorssoapbox YouTube Video Channel