What is an Alcohol Use Disorder?

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

Liquor

Alcoholic beverages.
Photo courtesy of Pixabay.com

How is Alcohol Use Disorder different from Alcoholism?

Used to be a time when doctors treated medical issues, Therapists treated mental illness, Social services treated poverty-related issues, and – well – no one exactly wanted to do anything with drug addicts and alcoholics. Times are changing.

Turns out that no matter where you are and who you work with there is a good chance that people around you are being affected by chemicals, alcohol in particular, long before they reach the “alcoholic” or “Chemically Dependent” stage.

In Drug and Alcohol counseling we used to spend a lot of time debating what made you an alcoholic or addict. Turns out the lines are fuzzy. One estimate is that 90% of alcoholics have full-time jobs. Some people do not drink that often. Half the adult U. S. population did not drink in the last thirty days.

Even if you only drink once a year, say for New Year, if you have gotten into fights while drinking, gotten DUI’s several times, then your only drink once a year is not of much import. If when you drink, bad things happen, then you have an Alcohol Use Disorder. The DSM uses the expression “Problematic Pattern of Alcohol Use.”

What we discovered was that it was not so much what you drink or when you drink that matters when it comes to Alcohol Use Disorders, it is what happens when you drink that is significant.

The Symptoms of Alcohol Use Disorder.

The new DSM-5 has switched to the use of the term “Alcohol Use Disorder” to indicate someone whose use of alcohol is causing them problems whether they are “Alcoholic” or not and lists 11 criteria for Alcohol Use being a problem. Here is my plain language version of those Criteria.

  1. Once you start drinking you drink more than you planned on and/ or keep drinking longer than planned.
  2. You keep trying to cut down on your drinking. In other Alcoholism texts, this is also described as efforts to control your drinking or to quit drinking. See, people do not try to cut down, control, or quit drinking unless it is a problem.
  3. Drinking eats up a lot of your time.
  4. You have cravings for alcohol when you are not drinking.
  5. Drinking gets in the way of work, school, home life, or recreation. A real Alcoholic cuts out this other stuff so they can concentrate on their drinking.
  6. You know that when you drink bad stuff happens but you keep drinking anyway.
  7. You start cutting out other parts of your life to spend more time drinking.
  8. You try to get away with drinking even when you know it makes the situation dangerous.
  9. You keep drinking even though you now realize it is causing you problems.
  10. Your body starts building up tolerance. (See post “What is Tolerance” in the “What is” section.)
  11. You experience “withdrawal” when you stop drinking and the blood alcohol level starts dropping. (See post “What is Withdrawal” in the “What is” section.)

These problems with Alcohol can come in mild, moderate or severe. Mild Alcohol Use Disorder would have 2-3 of these symptoms, Moderate has 4-5 symptoms and severe has 6 or more.

If you or someone you know is exhibiting these symptoms think about treatment and or self-help groups. The sooner Alcohol Use Disorder gets treated the better the life prognosis. While sooner is better it is never too late to get treatment for an alcohol use disorder as long as you are alive.

Terms and their meaning can differ with the profession using them. The literature from the Rehab or AOD (Alcohol and Other Drug) field may be very different from that in the mental health field. There is still a large gap between recovery programs, AOD professionals, and the terms and descriptions used in the DSM.

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

Ways to take back control of your life.

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

Control

Self-Control?
Photo courtesy of Pixabay.com

Taking control of your life is a choice, not an accident.

Do you ever feel that your life has gotten out of control? Would you like to find a way to get some of that control back? Here are some principles you need to apply to your life to get it back in your control. Some of these are easy, you just make the decision and then do it. Others are skills you need to learn and practice until they become automatic. Either way here are my tips for getting your life back in control.

Learn when to take advice.

When things are going out of control it can be hard to admit that you have lost it and need help. The first step in getting your life under control may be looking for and accepting the need to get some good sound advice.

This does not mean letting your family or friends tell you what to do. Have money problems, get financial advice. Have legal problems, get legal advice. Having career problems talk, with someone who has worked in your field for a while and who can offer you some sound advice.

If you are in recovery you might well find that your sponsor or mentor can share with you some personal experiences and a different viewpoint. A support or 12 step group cumulatively can offer you a better perspective than a single individual.

Being able to recognize when you need the advice of experts and experienced people and then using that advice is a practice that can help you get where you are going in life.

Decide when to steer your own course.

As much as you need to be able to accept needed advice there are times when you need to steer your own course. Don’t try to live your life headed to someone else’s dream. The job that was right for a family member may not be a good fit for you.

Spend some time getting clear about what your values are and then set some goals. If you let others be in control of your life you end up where they would go not where you wanted to be.

Learn to like yourself.

If you do not like yourself you make it hard for others to like you. We teach others how to treat us. You need to be your own best supporter and friend. Caring about you is not being selfish. It is being the captain of your own life.

Insecure adults who do not like the person they have become, contribute to the development of children who do not feel good about themselves and have low self-esteem.

You can’t please everyone – please yourself.

Trying too hard to please everyone leaves no one happy, especially you. Think carefully about what you want from life. Make sure you are not living someone else’s life. Do not be influenced by passing fads and fancies which come and go. Living well is timeless.

Doing what everyone else is doing creates a poor copy of others. Be yourself, be unique and you will create a life that you can be proud of.

Other people’s opinions of you matter very little.

You know in your heart if you are living your life. Do not be easily swayed by others. It is very reasonable to consider other people’s opinions but the final decision is yours. Do the thing you feel is right not the popular or expedient thing.

Learn when to say no.

One sure sign of an out of control life is someone who can’t say no. You need to decline offers and invitations that are not good for you. You should not be doing things only to please others. If you have to go along with things that make you uncomfortable for others to like you they are users, not friends.

Learn when to say yes.

Don’t let fear and reticence keep you from doing things that might do you some good. Many older people have reported that their great regrets in life were not the things they did but the things that they passed on that they now wish they had tried.

Do not let fear, timidity, or the opinions of the crowd keep you from the things that may bring joy to your life.

Keep your self-talk positive.

Negative self-talk creates a negative life. Don’t do that to yourself. Use positive self-talk. A good morning affirmation can set the whole day off on the right course. Tell yourself you can, you will, and that you deserve a good life and see what you create.

Get clear on your values.

There are lots of things you will be tempted to do. Ask yourself how this relates to your values. Do not do things that are objectionable to you just for the approval of those around you. Values determine how you will take this trip we call life.

Set some goals. Don’t be a victim.

Without goals, your life will wander aimlessly. Decide where you want to go, today and in the distant future. When it is done what do you want your life to be about? Set big goals then break them up into smaller sub-goals. Take the little steps each and every day and you will find you have traveled a long way in the right direction.

Be OK with disagreement.

You do not need everyone to agree with you. Accept that not everyone will agree with you. You do not need the agreement of the crowd to be good with yourself.  The more you stand for something, the more you accomplish, the more people will criticize you and disagree. Great people follow their own vision despite others urging them to take the easy path where no one criticizes.

Accept yourself warts and all.

Do not pretend to be more than you are. Accept yourself. However, you are is just fine. After accepting yourself think about those improvement opportunities. How you are is fine but how would you like to improve? Self-acceptance is the starting place on the path to being the best you can be.

Dream big.

If you set your sights low you end up in the dirt. Set high sites and even if you do not reach the moon you may well wind up in the sky.

Stop trying to be perfect and please everyone.

There are no perfect people. You cannot please everyone. Be the best you there is and do the best you can. Accept how you are and you will discover that you, not someone else, is in control of your destiny.

Get the bad, negative stuff, out of your life.

If you are controlled by addictions, bad habits or negativity get that self-limiting stuff out of your life. Addictions can take over control of your life. You won’t get back in control until you clear the negative influences out.

When will you get your life back under your control?

You may want to check out the other counselorssoapbox.com self-help posts.

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

Happy Easter.

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Happy Easter

Happy Easter.
Photo courtesy of Pixabay.com

What is a Specific Phobia?

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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 Drug Withdrawal?

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

Drugs.

Drugs.
Photo courtesy of Pixabay.

You’re more likely to have a drug withdrawal than you might think.

When people think of drug withdrawal the picture they see is the one of classic heroin withdrawal. Someone coming off heroin or other opiates does some “kicking” both drug wise and legs-wise. They also have diarrhea and “goosebumps.” Because opiates are pain relievers during withdrawals people can experience high levels of pain.

That dramatic type of withdrawal is not the only kind you might have. Each drug you might take can have some effects when the level in your body, principally in your bloodstream, begins to drop.

Drug Withdrawal Defined.

Drug withdrawal is an identifiable illness or syndrome that happens when someone stops taking a drug or reduces the amount they are using significantly. The symptoms begin when the level of a drug in the blood drops. Withdrawal symptoms can vary in severity and each drug has its own pattern of withdrawal symptoms. An alternative name for withdrawal is Abstinence Syndrome.

In the early stages of drug use, withdrawal symptoms may be minimal and go unnoticed. Once the body has adjusted to having that drug present and made adaptations the symptoms become more pronounced. Symptoms may not be entirely physical. For some drugs the primary withdrawal symptoms are psychological.

Withdrawal symptoms make it harder to stop using drugs.

The more severe the withdrawal symptoms the more likely the user is to pick that drug back up to reduce those symptoms. A withdrawal symptom of drugs taken to reduce anxiety, prescribed or self-medicated ones, is an increase in anxiety. People who smoke marijuana to reduce anxiety report that the anxiety gets really bad after they discontinue smoking it. This results in a return to marijuana use.

Getting rid of withdrawal symptoms is a strong motivator to resume drug use again.

The DSM-5 lists withdrawal effects for eight of the eleven classes of substances.

I find it interesting that some drugs such as Inhalants and Hallucinogens have no withdrawal symptoms specified. We also have only one diagnosis and F code for the group of drugs, Sedative, Hypnotic or Anxiolytic Drugs. Withdrawal from these drugs can be different with different drugs. Stimulant Withdrawal is separated and has one code for Cocaine and another for Amphetamines and other stimulants. These DSM-5 codes are a rough sketch. For the full details consult the DSM-5 text. Also, note that there are well-defined withdrawal criteria for Cannabis (Marijuana) and Caffeine.

Alcohol Withdrawal (F10.239 or F10.232)

Caffeine Withdrawal (F15.93)

Cannabis (Marijuana) Withdrawal (F12.288)

Opioid Withdrawal (F11.23)

Sedative, Hypnotic or Anxiolytic Withdrawal (F13.239, F13.232)

Stimulant Withdrawal

Amphetamine or other stimulant (F15.23)

Cocaine Withdrawal (F14.23)

Tobacco Withdrawal (F17.203)

Other (or Unknown) Substance Withdrawal (F19.239)

For more on drugs and recovery see:

Drug Use, Abuse, and Addiction      Recovery

Terms and their meaning can differ with the profession using them. The literature from the Rehab or AOD (Alcohol and Other Drug) field may be very different from that in the mental health field. There is still a large gap between recovery programs, AOD professionals and the terms and descriptions used in the DSM.

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

17 Ways to Boost Your Self-esteem.

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

High self-essteem

Boost your self-confidence.
Photo courtesy of Pixabay.com

Common sense ways to increase your self-esteem.

Feeling badly about yourself? If you have low self-esteem this does not need to hold you back. There are many things you can do to crank up your belief that no matter where you have been or what your life has been like, you can move forward and accomplish good things. If “low self-esteem” has been getting in the way of having the life you want, here are seventeen ways to change your thinking and behavior and start creating a life you can be proud of.

1. Stop comparing.

Who you are is not some sort of contest. You do not need to be better than others to feel OK about yourself. One of the fastest routes to improved self-confidence is to accept yourself as you are and stop comparing yourself to others.

Most people have the bad habit of comparing up. You know that you do not look as good as someone on the red carpet. People with only a thousand connections on social media compare themselves to someone with 15,000 connections. More connections do not make you a better person. Life is not a popularity contest.

2. Hang out with confident people.

Hang out with insecure and non-affirming people and you become insecure. Want to be a winner? Hang with the winners. (No comparing now.) Associating with happy people and their happiness will rub off. You become, over time, like the people you hang with.

3. Build on your strengths.

Everyone has strengths. Find the things you are good at. Identify and name those strengths and then emphasizes those things that allow you to make use of your best qualities.

4. Develop your undeveloped strengths.

Some strengths are developed, more or less, and others you still need to discover. Look for strengths and then practice them. Try out new things. You do not need to be great at every new thing you try. Some will not be your cup of coffee. But among those things you try, you may discover the strength that can build you a better life.

5. Study successful people.

Study those people who have overcome adversity and achieved noteworthy things. Read books about those who had great accomplishments. Those people’s journey can inspire you to be the best you can be.

6. Look for “improvement opportunities.”

Reframe every undesired outcome. When you try and do not reach your goal this is a chance to learn more and practice some new skills. No matter where you start out life requires all of us to keep working on our skills and on ourselves.

7. Work with a coach, counselor, or mentor.

No one is instinctively perfect. Most “naturals” got to be good by years of practice. Practice alone will not get you there. Not if you keep making the same mistakes over and over until they become automatic. You can’t see your own swing, but a coach can. An outside opinion, counselor, or peer can help you find more “improvement opportunities.”

8. Do good stuff.

The more positive things you do the better a person you become. Think of this as moral or karmic exercises. Good people do not become good by doing one great perfect task after a life of awful actions. Little random acts of kindness and positivity nurture a positive person.

9. Make positive self-talk the rule.

Calling yourself names will not make you work harder or build self-esteem. What you tell yourself your mind will try to make come true. Use positive affirmations, what you tell yourself becomes who you are. Remember to tell yourself you can and then go out and see how much you can do today.

10. Get acquainted with your feelings. Call them by their real names.

Feelings are not evil creatures to be banished. You fear is telling you something, so is your irritation. Learn to recognize and listen to what information those feelings are giving you, but do not let their voices drown out your thinking. If you are afraid examine this carefully. Is this really a dangerous situation or are your childlike feelings just needing reassurance that you are in control?

11. Life is about the journey, not the contests you win.

No one wins everything every time.  In life, there will be some second and third places and sometimes you may finish last. Those are not failures. Not being the best at something this time does not mean that you are flawed. Accept that life is about trying on new activities to see which fit you. You do not need to win every game to enjoy playing.

12. Enjoy being a beginner.

One way to cripple yourself self-esteem is to expect to be great at everything the first time. You learn a lot more by being the beginner and mentally observing yourself developing skills.

13. Be proud of your scars.

Victories come with a price. Sometimes that is pain, sometimes you have to fall down and get back up. Love yourself scars and all. You will have life experiences that are painful. You may not want to repeat some experiences but accept that they made you who you are.

14. Work hard at being you. Do not live to fulfill someone else’s dream.

Be sure that the yardstick you use to measure yourself is yours and not someone else’s. Better still toss those yardsticks and stop the measuring. Explore life and get acquainted with you. Live to be you not to fulfill someone else’s ambitions.

15. Stop hiding your mistakes.

Mistakes and imperfections do not diminish your value as a person. Don’t be afraid to look at your shortcomings and to admit them. Especially admit them to yourself. Looking at these less than perfect outcomes can help turn them into improvement opportunities.

16. Remember to love yourself.

You don’t take good care of things you don’t like and you shouldn’t be spending a lot of time with people who dislike you. You will spend the maximum part of your life with you. Make sure you grow to enjoy your company. Mostly that will happen when you stop criticizing you and begin to accept that however you are is perfectly fine.

17. Take good care of yourself, you deserve it.

This one got left for last. It could easily have been first on the list. Others will not treat you any better than you treat yourself. If you want to feel better about yourself start treating yourself better. You deserve to be treated well.

Self-worth is something you should have regardless of what you do. Remember you are a human being, not a human doing. You are more than the list of things you do.

There you have it, some of my suggestions for giving up self-judging and looking at yourself in a more positive way. Try these on and see if you don’t begin to feel just fine about yourself.

Check out the other counselorssoapbox.com posts on Self-esteem.

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

Today is Spring.

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Sunday Inspiration.   Post by David Joel Miller.

Spring.

Spring is here. Photo courtesy of Pixabay.com

Spring is here.
Photo courtesy of Pixabay.com

“It is spring again. The earth is like a child that knows poems by heart.”

― Rainer Maria Rilke

“It’s spring fever. That is what the name of it is. And when you’ve got it, you want—oh, you don’t quite know what it is you do want, but it just fairly makes your heart ache, you want it so!”

― Mark Twain

“Spring work is going on with joyful enthusiasm.”

― John Muir, The Wilderness World of John Muir

Today is the first day of spring. Officially, here on the west coast of the U. S., it started at 9:31 last night but it is hard to see spring after dark. Let’s hope this Spring is a good one for you.

Wanted to share some inspirational quotes with you.  Today seemed like a good time to do this. If any of these quotes strike a chord with you please share them.

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

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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 Caffeine Withdrawal?

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

What is

What is caffeine withdrawal?
Photo courtesy of Pixabay.

You can get sick when you stop caffeine.

There are five distinct symptoms that people often develop when they suddenly stop taking in caffeine, and yes those symptoms can get severe enough that the person reports they are sick. Caffeine withdrawal is extremely common. About 70% of those who try to permanently stop consuming caffeine experiencing this illness.

Caffeine is used more commonly than any other psychoactive drug. By psychoactive we are talking about a drug that changes the way you think, feel, and behave. Increasingly counselors in the substance use disorder field are looking at commonly used drugs like tobacco and caffeine and their impact on the client’s recovery from alcohol and other drugs.

Absolutely your body can get used to having caffeine in your system and there are physical withdrawal symptoms when you stop using caffeine. This problem is severe enough that in the DSM-5 it is a specific diagnosis Caffeine Withdrawal (F15.93.)

Caffeine use is more common than one might think. It is not just adults who are using caffeine and experiencing caffeine withdrawal. The DSM-5 reports that 85% of U. S. adults and CHILDREN use caffeine daily.

Drug and alcohol texts (Maisto, Galizio & Connors, 2015) report that worldwide 90% of the population uses caffeine. Aside from adults, the group receiving the highest daily dose are young preschool children. Caffeine is commonly found in sodas and energy drinks, both favored beverages among the very young. One has to wonder how this universal use of caffeine is affecting children’s thinking, feeling, and behavior.

Caffeine withdrawal sneaks up on you.

Many people are surprised when they experience caffeine withdrawal. The most likely times to have this disorder are when there is a sudden change in your routine. Weekends, vacation times, hospitalizations, travel, all are potential caffeine withdrawal experiences.

Caffeine withdrawal starts twelve to twenty-four hours after your last dose. The worst of the symptoms peak one or two days after you stop taking in the caffeine. Headaches from caffeine withdrawal have been reported up to three weeks after the last dose.

You do not have to be a daily or heavy caffeine consumer to experience caffeine withdrawal, though the more caffeine you take in each day the more likely you are to experience caffeine withdrawal. More important than your daily intake in the equation is how regularly you use caffeine and the suddenness of your stopping.

People experiencing caffeine withdrawal are likely to misattribute their symptoms and think it is the flu or another illness. The result is those withdrawing from caffeine use a lot more pain relievers than normal.

How do you know you have caffeine withdrawal?

To receive this diagnosis you need to have 60% or three of five of the possible symptoms, though each person may have a different group of symptoms. The hard part sometimes is to be sure all of these symptoms are the result of caffeine withdrawal and not some other issue.

One way to be sure your problem is caffeine withdrawal is to take in some more caffeine. That should work in an hour or less.

What are the five symptoms of caffeine withdrawal?

  1. Headaches
  2. Tired, fatigue, or drowsiness.
  3. Bad mood, unhappy, depressed, irritable. As a side note, people who consume a lot of caffeine can become very anxious.
  4. Concentration or attention issues.
  5. Is this a virus? Caffeine withdrawal can include muscle pain, nausea, and even vomiting that are characteristic of the flu.

As with all the other things that make it into the DSM, Caffeine intoxication only gets diagnosed if it interferes with your work, school, relationship with family and friends, causes you excessive discomfort, or makes you give up things you used to like to do. You also should not blame it on not having your coffee if this is better explained by another mental illness or the effects of another drug.

Terms and their meaning can differ with the profession using them. The literature from the Rehab or AOD (Alcohol and Other Drug) field may be very different from that in the mental health field. There is still a large gap between recovery programs, AOD professionals and the terms and descriptions used in the DSM.

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

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