What is a friend?

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

Friendship.

Friendship.
Photo courtesy of Pixabay.com

How do you identify a friend?

Friend, according to the Century Dictionary of 1889 is:

One who is attached to another by feelings of personal regard and preference.

One who entertains for another sentiment which leads him to seek their company and study to promote their welfare.

One not hostile, an ally.

One who is favorable.

Encarta says a friend is:

Someone with whom you are emotionally close

Someone who trusts and is fond of another

Somebody who thinks well of or is on good terms with somebody else

“Friendship is born at that moment when one person says to another: “What! You too? I thought that no one but myself . . .””
― C.S. LewisThe Four Loves

“A friend is someone who knows all about you and still loves you.”
― Elbert Hubbard

“Good friends, good books, and a sleepy conscience: this is the ideal life.”
― Mark Twain

“It is not a lack of love, but a lack of friendship that makes unhappy marriages.”
― Friedrich Nietzsche

“It’s the friends you can call up at 4 a.m. that matter.”
― Marlene Dietrich

Quotes from Goodreads

What is kindness?

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

Do you know kindness when you see it?

Encarta says Kindness is:

An act that shows consideration and caring

The practice of being or the tendency to be sympathetic and compassionate

The Century Dictionary, 1889 has a lot more definitions:

Good will, Benevolence

Tender feeling, affection, love

Fitness, agreeableness

“Be kind, for everyone you meet is fighting a harder battle.”  ― Plato

“My religion is very simple. My religion is kindness.”  ― Dalai Lama XIV

“Three things in human life are important: the first is to be kind; the second is to be kind; and the third is to be kind.”  ― Henry James

“Kindness is a language which the deaf can hear and the blind can see.”  ― Mark Twain

Have you been kind today?

What is honor?

What is Honor?

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

Honor.
Photo courtesy of Pixabay.com

Who and what do you honor?

Honor is:

Respect blended with reverence.

Esteem due to worth or exalted merit

High respect and esteem

A controlling sense of what is right

Highest courage and loyalty

From the Century Dictionary, 1889

“I am not bound to win, but I am bound to be true. I am not bound to

succeed, but I am bound to live up to what light I have.”

― Abraham Lincoln

“It is not titles that honour men, but men that honour titles.”

― Niccolò Machiavelli

“We should keep the dead before our eyes, and honor them as though still living”

― Confucius

– Quotes from GoodReads

What is Happiness?

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

Happy children

Happy.
Photo courtesy of Pixabay.com

Would you know happiness if you felt it?

Happiness is the state of being Happy

Happy: feeling or showing pleasure, contentment, or joy, feeling satisfied that something is right or has been done right

“For every minute you are angry you lose sixty seconds of happiness.”

― Ralph Waldo Emerson

“People are just as happy as they make up their minds to be.”

― Abraham Lincoln

“Happiness is not something ready made. It comes from your own actions.”

― Dalai Lama XIV

“Count your age by friends, not years. Count your life by smiles, not tears.”

― John Lennon

“Happiness is a warm puppy.”

― Charles M. Schulz

Quotes from GoodReads

What is an addiction?

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

Hands with pills

Addiction.
Photo courtesy of Pixabay

How many addictions are there?

More and more things seem to be getting labeled as addictions.  This mushrooming of addictions has resulted in a lot of skepticism about whether all these items are real addictions or just excuses by people who do too much of one thing or another.

The mental health professions don’t typically use the word addiction. We use other terms to help explain why what is commonly called an addiction may look so different in different people.

Let’s explore this problem by starting with the best known of all addictions, drug addiction, and then see what other things might qualify as addictions.

Drug addiction.

Most drugs, legal and illegal, result in two specific reactions in the body, tolerance, and withdrawal. Tolerance means that over time your body builds up a resistance to the drug so that it takes more and more of the same drug to get the same effect.

Physically addicting drugs all result in tolerance in the body.

Withdrawal is the phenomenon of symptoms that occur when the level of the drug in the bloodstream begins to drop. As many an alcoholic knows if you can keep the level of alcohol in the bloodstream up, you can hold off the hangover for a while. Eventually, you fall asleep or more precisely pass out, and then the blood alcohol level drops.

The drop in the level of drug in the bloodstream, not the absolute level is what is causing the withdrawal symptoms, sometimes also referred to as “abstinence syndrome.”

When someone has been abusing drugs, including alcohol, we take them to a detox. They go through a lot of symptoms, some very unpleasant, as the drugs leave their system. So after 3 days or so, defiantly in a week, almost all drugs (except marijuana) are out of the system.

The carvings problem.

No drug (alcohol) in the system, the hangover, or other withdrawal symptoms go away. In the case of heroin, the shakes, diarrhea, vomiting, goosebumps, and all the other classic symptoms of opiate withdrawal end, and the person, now with no detectable drugs in their system are discharged to go home.

The majority of all people who go through detox, somewhere over 90%, will relapse or use again in a month or so after the detox.

If the drugs are all out of their system why are they still exhibiting addictive behaviors?

The problem with addiction is not the chemical dependency in the body, as awful as that can be. The real problem of addiction is that it is a problem of the mind.

We might call this manifestation of addiction a psychological dependency on the drug to differentiate it from a physical addiction. Even when no drugs are in the body the cravings remain in the brain.

Behavioral Addictions.

So can people really be addicted to things like shopping, sex, or compulsive spending?

My belief is that these kinds of activities can also be addicting but are not automatically addiction.

Each activity produces thoughts, those thoughts move through the brain chemically. Change your thinking and your brain chemistry changes. Some experiences, falling in love, having sex, can produce chemical changes in the brain that can be like an addiction.

One key criterion for addiction is the loss of control, if you lose control of an activity you are approaching addiction land.

Continued use of a substance or continued repetition of a behavior despite negative consequences, loss of control over a behavior fits this pattern.

Hypothetical example.

A client says she is “addicted to poodles.” She has poodle skirts, poodle statues, and pictures all over her house. Her husband gripes about all these poodle things but they are still together after 25 years. She says she is “addicted to poodles.” I think she has an unusually large interest, even an obsession with poodles, but so far it does not sound like an addiction.

Let’s say she also has 25 live poodles in the one-room apartment and that she has spent all of their money on poodle stuff this month leaving them with no money for rent and food. Now has her poodle addiction crossed the line?

So while excessive involvement in many things might possibly reach the level of being an addiction the more strongly rewarding things like drugs, alcohol, sex or risk-taking (gambling) produce such high levels of chemicals in the brain that many people might become “Addicted” to these behaviors. Most people are not likely to develop an addiction to poodles. The internet on the other hand –

Let’s leave that for now.

So in many ways, I see addiction, to drugs or other things, as a special case of OCD. The person can’t stop thinking about the object of their addiction and with chemicals or behaviors like gambling once they start they lose control over the substance or the activity.

Most recently we are recognizing that it is possible to have a problem with a chemical or behavior way short of developing an addiction. We might call this a “Use Disorder” or with behaviors we might think of it as an impulse control problem.

However you see this, loss of control over a chemical or an activity can cause someone a lot of life problems and needs treatment.

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 secondary trauma?

Injury

Trauma.
Photo courtesy of Pixabay.

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

Can you be traumatized by something that did not happen to you?

Secondary trauma.

Secondary trauma is the traumatic result of watching someone else be injured or their life threatened.  It is just as real as if the incident happened to you and can last long after the incident is over.

One place where we saw a lot of secondary trauma, this might also go by the name of vicarious trauma, were the incidents of September 11th. Children who watched the planes fly into the towers over and over on Television became frightened even though the events were thousands of miles away. They believed, because of the repeated showings, that thousands of planes were hitting thousands of buildings and that any moment the planes might hit buildings in their neighborhood.

This points out that events do not need to happen to you to be traumatic.  Watching a close family member be injured or killed can be as traumatic as if it happened to you. One reason there seems to be more Post-traumatic Stress Disorder among military veterans is the number of horrific incidents they witness during a tour of duty.

Watching others you are close to being killed or injured has a traumatic effect on you even if you are far enough away to escape injury.

Humans are endowed with very vivid imaginations. This raises the question can people be traumatized by fictional things, things that never happened?

As we grow older our ability to distinguish reality from fiction should improve. Young children are not always able to tell the difference. Plenty of children develop fears, night terrors or long-term phobias because adults watch horror or other graphic entertainment. They allow the kids to watch along with them since the adults are not overly frightened they expect the child to be able to understand the difference.

Unfortunately many young children these days are not able to tell the real from the imaginary especially in video format where great effort has been expended to make the horror as realistic as possible.

So whether the trauma was real or imagined, whether it happened to you or someone you know and care about, those traumas can and do traumatize people. We call this trauma, secondary traumatization because the victim of the physical attack may not be the person who suffers the most or the longest.

If you have been traumatized by watching someone else be harmed, there is help available. If your child develops fears or phobias after watching a video, talk with them about reality and fiction. If the problems continue, get professional help.

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 CAADE?

By David Joel Miller.

Update 2/1/18

At this time CAADE and its counselor certification body ACCBC are unable to certify AOD counselors. ACCBC is pursuing the ability to certify counselors again.  More information to follow.

California Association for Drug and Alcohol Educators.

CAADE stands for the California Association for Drug and Alcohol Educators. The first organization meeting was held here in Fresno in 1982 and CAADE was formally organized in 1984. CAADE is a nonprofit 501(C) 3 corporation and supports the efforts to educate drug and alcohol counselors and further the standards of the drug and alcohol treatment profession.

CAADE is one of the credentialing organizations included in the State of California Department of Drug and Alcohol Programs directory. Their website notes that they serve some 40 colleges and universities in California, Arizona, and Nevada.

Over the last few years, I have had the honor and the privilege of teaching at Fresno City College in their Drug and Alcohol Counseling program.  This program consists of a 36 unit curriculum in substance abuse counseling and related subjects, making it one of the more rigorous substance abuse counseling programs available.

In 2012 CAADE formed the Addiction Counselor Certification Board of California (an official affiliate of CAADE). This division clarifies the separate functions of improving the education provided to prospective counselors and the registration and certification of counselors as meeting the standards expected in this counseling specialty.

For more on the CAADE program, colleges, and universities that teach this program, and the CAADE annual conventions please visit the CAADE website.

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

O.C.D. or Obsessive-Compulsive Personality Disorder?

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

What is the difference between OCD and Obsessive-Compulsive Personality Disorder?

Obsession

Obsession.
Photo courtesy of Pixabay.com

There are two different mental disorders that share the OCD designation. It seems odd that we have two disorders that share the OCD part of their labels. The way I read the DSM they are rather different disorders.

The result of this dual use of the OCD label is that the two conditions may be getting confused and that people with Obsessive-Compulsive Personality Disorder may not be getting diagnosed or treated the way they should be.

People with Obsessive-Compulsive Disorder have high levels of anxiety and they have rituals they feel compelled to perform that relieve the anxiety.

Think of obsession as not being able to stop thinking about something, in the case of OCD this thing they can’t stop thinking about is usually connected to some perceived danger. This is beyond just being over-anxious about a real danger. Like PTSD there are images that keep popping into the head. Having these thoughts upsets the person. The person with OCD knows these are their own thoughts and that the thoughts are excessive.

The compulsive part has to do with the inability to withstand the thought and the need to do something to relieve the tension. These obsessions are not things like avoiding the alligator, which might keep you safe. They involve things like washing of hands over and over, praying for a long period of time repeating phrases or counting.

The description of OCD reminds me of impulse control disorders like gambling or addiction and has some similarities to overeating disorders.

OCD is a more generalized condition than what you might see in someone who has difficulty controlling only one obsession or compulsion as in an alcoholic who keeps thinking about drinking until they give in and drink. In OCD the compulsions don’t have that direct a relationship.

That is a very over brief description of OCD from the DSM-4-TR.

For more on OCD and its treatment, I would refer you to another site here on WordPress called ocdtalk.

How is OCD different from Obsessive-Compulsive Personality Disorder?

This description of Obsessive-Compulsive Personality Disorder is taken from the proposal for the DSM-5 since it will become final very soon and Obsessive-Compulsive Personality Disorder is one of the personality disorders that the DSM-5 kept.

Obsessive-Compulsive Personality Disorder involves a SIGNIFICANT impairment in self-functioning. Someone with Obsessive-Compulsive Personality Disorder does not just have a few symptoms about one thing but that is the way they are all the time.

Someone with Obsessive-Compulsive Personality Disorder gets their self-worth, their sense of purpose in life from their work or productivity. They are compelled to do something all the time. They have overly high rigid standards and are “inflexible” about meeting these standards. This sounds like that old “black and white thinking” to me.

Someone with Obsessive-Compulsive Personality Disorder is overly moralistic or conscientious. As a result of these excessive standards, they may be unable to complete projects unless they can be done “correctly” or perfectly.

People with Obsessive-Compulsive Personality Disorder lack empathy for others and will put work or moral standards before relationships.

If you are not perfect the person with Obsessive-Compulsive Personality Disorder will not want you for a friend. If you think you are perfect then you may well have Obsessive-Compulsive Personality Disorder or another mental illness.

Other traits of a person with Obsessive-Compulsive Personality Disorder include rigid-compulsive perfectionism and negative “affect.” Meaning they are negative about everything all the time.

A person with Obsessive-Compulsive Personality Disorder is also likely to practice “perseveration” meaning they can’t let something go. They will keep trying to get something just right even after it no longer matters.

I get the picture here of someone who is very “puritanical.” I believe sitcoms call them “anal-retentive.”

People with Obsessive-Compulsive Personality Disorder do not end up in treatment very often, at least not for the personality disorder, but they do drive others around them to therapy.

Did that explain the difference? Feel free to leave a comment. I always feel compelled to reply.

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 Cyclothymia?

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

Person with masks

Bipolar.
Photo courtesy of Pixabay.com

Cyclothymia, Bipolar, and Substance Abuse.

Cyclothymia is generally seen as a milder, subclinical form of Bipolar disorder. If it is the milder form we would expect to see a lot more Cyclothymia than Bipolar disorder. We don’t. So why and what is Cyclothymia?

A person with Cyclothymia is considered to be “temperamental, moody, unpredictable inconsistent and unreliable” (DSM-4-TR.) Cyclothymia seems to also be related to or overlaps Borderline personality disorder. Genetic risk factors, as well as environment and learning, may all play a role in creating Cyclothymia.

Cyclothymia, per the DSM, is a disorder characterized by chronic mood swings that do not meet the criteria for Bipolar disorder. Most mental illnesses require that the person, in order to get the disorder must experience a specific number of symptoms from a list of symptoms.

To be Bipolar I disorder you must have had a manic episode. For Bipolar Two, there must be a hypomanic (near manic) episode. That means that the person in addition to having an episode of elevated mood for at least 4 days must also have 4 of 7 listed symptoms. What if they only have three symptoms or if they have five “almost” symptoms. The way we count symptoms and who does the counting makes a lot of difference.

Cyclothymia waves the 4-day rule but requires that the mood swings go on over at least two years. (We make that one year in children.)  So for over two years, the person needs to keep having episodes of depression and episodes of almost hypomania but never reaching the full criteria for depressive or hypomanic episodes.

My experience says that no diagnosis, no treatment, unless you have the money to pay and the motivation to push, like having an overly moody child. So rather than wait the whole year for a child or two years for an adult before treatment is begun, people with these almost hypomanic therefore almost Bipolar diagnoses end up with the label Bipolar NOS or Mood Disorder NOS.

The statistics seem to bear that out. Estimates of the prevalence of Cyclothymia run from 4 to 6 people per 10,000. Bipolar One and Two are in the range of 50 to 150 people per 10,000. Meaning that Cyclothymia despite being thought of as mild Bipolar is much rarer. Mostly Cyclothymia gets diagnosed in people who have suffered for a long time – the full two years before something happened that sent them to treatment.

The criteria say someone with Cyclothymia should be experiencing “almost” depression, mania, or hypomania most of the time over those two years. Those episodes should all be just short of the Bipolar or Major Depressive disorder diagnosis but should cause a lot of distress. There also cannot ever be two months when you don’t have mood swings or we don’t think you meet the criteria for Cyclothymia.

To be Cyclothymia you should never have had any psychosis, which includes both hallucinations and severe delusional symptoms. And these symptoms can’t be the result of a medical condition.

Medications and Drugs can cause this.

It is not just street drugs but medications, prescribed and over the counter medications, that can cause Hypomania. Failure to sleep has been reported to cause hypomania and some overlooked products can cause the lack of sleep that induces mania.

Stimulants can interfere with sleep and that includes most of the medications for ADHD. But there is a bigger worry in children.

I feel certain I have seen sleep disruptions and resulting mood disturbances in kids who take in excessive caffeine. Energy drinks are a problem in teens but the little ones, the preschoolers and the early-grade student are also at risk.

Most sodas contain not just obesity causing sugar but massive amounts (relative to body weight) of caffeine. That huge amount of caffeine per pound of bodyweight causes sleep disruption and sleep disturbances which may be causing mood swings and even inducing Bipolar disorder.

The DSM-5 will tighten up the exclusion for any Drug or medication-induced hypomania.

Environmental and learned factors

Some of these symptoms, the swings between depression and hypomania look a lot like what we see in children from abusive, neglectful, or deprived backgrounds. Adult children of Alcoholics report that one time they would do something and be praised or rewarded for a behavior, the next time they might get hit.

An inconsistent environment would encourage you to be depressed and anxious at times and when it was safe to possibly go overboard at seeking pleasure. So being sort of hypomanic could be adaptive in a dysfunctional environment.

Cognitive Behavioral therapy has been reported as effective in treating people diagnosed with Cyclothymia. This suggests to me that some of these symptoms are learned and that there are core beliefs or schemas supporting this fluctuating mood way-of-being.

There are a host of other factors that influence the expression of Cyclothymia. Sleep changes can trigger changes in mood but so can changes in eating. Social support systems and the level of stress all contribute to mood swings.

Studies of Cyclothymia have the same defects as studies of other mood and anxiety disorders. People who act out and get arrested don’t get included in studies. Neither do people with drug or alcohol problems or those who are suicidal. Psychosis and delusions also get you kicked out of research. So those most likely to really be impaired by Cyclothymia are most likely to be excluded.

Information on Bipolar, Hyperthymia, Cyclothymia, Depression, and Other Mood disorders is scattered through this blog and I will continue to add to those posts. Check the categories list to the right. To make Bipolar Family posts easier to find there soon will be a separate post devoted to links on this blog and other places on the subjects of mood disorders.

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 Reactive Depression?

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

Depressed person

Depression.
Photo courtesy of Pixabay.com

Do you have Reactive Depression?

Reactive depression is one of those terms, like Manic-Depressive Disorder, that still gets used even though we have come up with new, presumably more precise names. The underlying assumption, which is often hiding here, is that if we could find ways to categorize the various mental, emotional and behavioral problems, we should be able to find precise treatments, medication, or therapy for your specific ailment. If only it was that simple.

The Reactive Depression terms meaning has changed over time. Most recently it was in use to describe times when a person became depressed as a result of a specific stressor. Say you lose your job, that loss might make you sad. A small amount of sadness for a while is normal. Staying a lot sad for a long time is excessive and so you are sort of depressed. In this view reactive depression is depression caused by your specific reaction to an identifiable event. That event might be a one-time thing or it might be repeated exposure to the same sorts of events. Some people have called this Situational Depression.

This is not the same thing as Posttraumatic Stress Disorder (PTSD.) A person with PTSD may or may not have depression but Depression is not part of the definition of PTSD. People with PTSD can’t get the thoughts of the event out of their heads. It is as if they are continually re-experiencing the trauma. Anything that reminds them of the trauma is upsetting and they will try to avoid things that trigger those reminders. PTSD usually disturbs sleep. Other symptoms include disturbing dreams, nightmares, trouble falling asleep and more trouble staying asleep. PTSD is an ANXIETY disorder as opposed to an Anxiety disorder. It also includes a lot of stress and trauma-related features.

There is another idea, similar to reactive depression, currently called Minor Depressive Disorder which is currently listed as a disorder listed for further study. While Reactive Depression is in response to something that happened to you, Minor Depressive Disorder is a sad or depressed period with some symptoms but it is just not as deep or severe a depression as a Major Depressive Disorder. So far neither of these ideas is an accepted diagnosis under the current text, the DSM-4-TR. Some of these ideas will change when the DSM-5 comes out but that is very controversial at this time.

There is another name and criteria set that we are currently using to cover both of these issues. We call this disorder or group of six disorders – Adjustment Disorders. There are good reasons why people might suffer from adjustment disorders and need treatment but still not have all the symptoms of Major Depressive Disorder or Bipolar Disorder.

In my experience, Adjustment Disorders result in more people in crisis than most of the other disorders. By definition, Adjustment Disorders should be time-limited. If it goes on too long after the event or if the symptoms continue to be severe or worsen, then the diagnosis will get increased to Major Depressive Disorder.

That does not mean that a Reactive Depression or Adjustment Disorder is not dangerous. People, who find out their partner is leaving them or has cheated or those who lose a job or house they love, can and sometimes do get violent towards themselves and others.

So let’s return to the person who just lost their job, or spouse or has a sick family member. Might that make them sad? Might they be scared and anxious? Hey, what if they got both depressed and anxious?

This is why we have diagnoses of Adjustment Disorder with Depressed Mood, with Anxiety, and with Anxiety and Depressed Mood. What else might happen?

Could a person who lost their spouse start drinking and get arrested?  Maybe a teen that fails a class or gets in trouble might run away from home or get mad and break windows? So one reaction to a problem, one adjustment difficulty, could be to behave in ways that make society disapprove of you. We would call that Adjustment Disorder with Disturbance of Conduct.

Think about this for a moment. That teen, might he be depressed, anxious, and act badly? What about his unemployed father who gets scared he won’t find another job, starts drinking, and gets into a fight. We call these sets of behavior Adjustment Disorder with Disturbance of Emotions and Conduct. Lots of names for the ways in which adjusting to a problem could affect someone.

If you have been counting that is only five diagnoses and I promised you six.

We always need a loophole. We call that Adjustment Disorder Unspecified when we can’t figure out which other one it is.

Regardless of the name the preferred treatment for these issues in counseling. Cognitive Behavioral Therapy or solution-focused counseling is recommended. The main direction of this kind of therapy is on problem-solving and changing the ways in which you think about your problems.

So whether you call it Reactive Depression, Minor Depression, or an Adjustment Disorder, the way we react to life’s stresses can result in crises that require and often bring people to counseling.

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