Shouldn’t evolution end mental illness?

Posted on by
Reply

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

Confused brain

Mental illness.
Photo courtesy of Pixabay.com

Why are there so very many different genes involved in mental health?

Clearly, there were lots of lifeforms on the earth in the past that are no longer around. Without getting sidetracked here by the whole question of evolution or creation or some variant of the two, one still has to wonder how all those things which are calling mental illnesses arose. And why do mental illnesses still exist?

Every additional study I read tells me that someone has identified a gene they believe may be involved in creating or exacerbating a condition we are calling a mental illness. If they haven’t found that gene then they are suggesting one must exist and remains to be found.

This raises the question: “Why are there so many of these mutations?”

That makes me wonder if all these conditions we are calling mental illnesses are of recent origin or did they at some time in the past have some evolutionary advantage. If mental illness did not serve some purpose in the past, why does it still exist?

Ancient literature, the Bible, and other writings mention things like alcoholism, drunkenness, and some people with impaired reality testing who would in past times have been described as “mad.”  This was Mad as in insane or mentally ill not mad as in uncontrolled anger.

Shouldn’t natural selection be reducing not increasing the number of mental illnesses?

We know that mental illness shortens the lifespan, the mentally ill live fewer years than those without a diagnosable illness. Over time there should be fewer and fewer of the mentally ill left to reproduce. That would make some sense unless there was at some time, current or past, some advantage to what we now call a mental illness.

Humans now live longer and in larger clusters.

Some authors have suggested that many of the diseases we are now most concerned about, heart conditions, cancers, and diabetes are largely the result of humans living longer than before. When the average lifespan was 30 or 40 years, few people lived long enough to get those old-people diseases. See Sapolsky’s “Why Zebras Don’t Get Ulcers” for more on this topic.

So people live longer now and they also are living more and more in large industrial cities. Crowding of the sort that happens in cities can cause stress and changes in behavior. Is it possible that humans are mentally and emotionally un-adapted to live in large city masses?

There has been an avalanche of children getting mental health diagnosis.

We used to think that childhood was essentially a happy time and then you grew up and had to work. Only back then most children did not grow up, they died. So the more we look at the childhood prevalence of things we call emotional disturbances the more of these things we find. ADHD in elementary school girls is up 600 percent. Depression is more common than expected in children. Suicide rates of children are occurring in younger children and becoming more common.

Are mental illnesses ancient survival mechanisms?

What if some of those things we call mental illness helped people survive in the times when most people lived in rural areas, forests and jungles even, and some of these things use to be good things, but they are no longer as helpful in modern industrial situations.

How could some anger be a good thing?

Anger and its link to the fight or flight responses in the brain appear to occur in all the animals with a brain stem. For creatures of any kind that primitive response to threat can keep you alive in times of hunger when you need to fight for the food. Getting angry and fighting can also keep you from becoming that food.

Killing to preserve your life and your food supply makes sense when you live in the woods and that is a mountain lion out to eat you. That same anger mechanism is less helpful when someone cuts in line in front of you at the supermarket. Get angry and hit someone there and you may be the one getting carted off to jail or the psych hospital.

Why do bipolar people reproduce?

One of the characteristics of bipolar disorder is hyper-sexuality. This same driven sexual behavior can be seen in drug addicts also. Sexual “acting out” as it gets called, can get people with bipolar disorder in trouble with their family and their mates.

People, most of them, who are faithful to their mates get more sex on a regular basis and they tend to live longer than those who have lots of sexual partners. For someone in extreme danger who might get eaten at any moment being hypersexual may not improve your survival but that increased number of offspring may have helped humans expand their population at the expense of other animals.

What is good for the population as a whole is not always good for the individual person and vice versa.

Could depression have been an asset in the past?

Some of the characteristics of depression, the atypical type, are eating everything in sight and then sleeping as much as possible. This is a great strategy if you live in an ice age cave where food is unreliable and you need to conserve energy.

Eating everything in sight and sleeping all day does not work so well when you have a job to go to every day.

The point I am making is that many of the things we think of as “mental illness” may have been functional in the past. Some of these things that are getting labeled illnesses are more “maladaptations.” Even the bears don’t get to hibernate the way they used to.

ADHD may have saved lives.

One of the characteristics of this thing we are calling ADHD is restlessness and hyperactivity. This is useful if you need to outrun run a lion. The more you run around the stronger your legs get. Being fast on your feet keeps you from getting eaten or killed in some situations.

Today children need to stay put and not move to keep the teacher happy. That ancient part of the brain is telling them to run, play, and move fast. It may take a long time for the human brain to catch up with the move from the woods to the big city.

Just my speculation on how these things we call mental illnesses may at points in the past have been more adaptive than they are today.  What do you think about this?

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

Tranquility.

Posted on by
Reply

Sunday Inspiration    Post By David Joel Miller.

Tranquility.

Tranquility.

Tranquility.
Photo courtesy of Pixabay.com

Only the development of compassion and understanding for others can bring us the tranquility and happiness we all seek.”

― Dalai Lama XIV

“And when the night is cloudy there is still a light that shines on me, shine until tomorrow, let it be”

― The Beatles

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

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

Posted on by
3

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 Aftercare?

Posted on by
1

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

What is

What is Aftercare?
Photo courtesy of Pixabay.

How does aftercare relate to treatment?

Aftercare is continuing or follow-up care that is received after the initial intense round of treatment. This is common in counseling those with a substance use disorder. It should be more common for those with most types of mental illness also. Aftercare is intended to prevent a return to active symptoms of the disorder. In the case of substance use disorders, this means aftercare should reduce the risk of relapse.

This term probably originated back in the days when the 28-day rehab was common practice. You got your initial drug or alcohol treatment in a residential treatment center and then after that initial period, you went home. Remember that while medical treatment for physical health problems has been around for centuries, treatment for substance use disorders and mental illness are relatively new procedures.

It is easier staying clean and especially sober when you are in a residential program. It is possible to get drugs and alcohol into a rehab facility but many of the people who are there are really trying to quit and they will report that kind of thing. Programs try their hardest to keep drugs out, kind of like jails do.

What often happened when people left the program was that they ended up back in the same environment as before. Everywhere you go there are people using drugs, drinking, and so on. The temptation to revert to the old ways of behavior is tremendous. Think of the alcoholic in early recovery. Everywhere they go there is alcohol. Why even the grocery store is out to get them. You have to walk past the wine to get produce and the beer is in front of the meat case.

To help people who had done a residential drug treatment program stay sober aftercare of some kind is a big help. This may be as little as one time a week or it could be more. Some aftercare’s are even a meeting every night.

Having this ongoing connection to other clean and sober people helps keep the person focused on their recovery and reduced the temptation to do what others were doing and get high or drunk. If you hang out with sober people you are less likely to drink.

Recently we have seen this same aftercare advantage with those with a mental illness. You can go see a therapist, get and take meds but if at the end of a few weeks you go back to your old way of living and nothing changes then you can end up feeling the way you used to feel. The depression has returned.

Staying connected to meds and therapy longer reduces the risk of relapse. One study I read reported that those who stayed on antidepressant meds for two years had fewer relapses even after discontinuing the medications.

Whatever you do to change your life. Keep doing it after that initial change effort starts working. That is aftercare in practice. Maintaining your changes is the primary purpose of attending an aftercare program.

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.

You might also want to check out these other posts Drug Use, Abuse, and Addiction 

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

Has Negativity take over your life?

Posted on by
Reply

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

Negativity

Is Negativity taking over your life?
Photo courtesy of Pixabay.com

How can you tell that negativity has taken over your life?

Negativity is a trap. If you are around others who are negative they can sap you of all your strength. Your own negativity can undermine your life goals. Sometimes that negativity beast creeps in without you noticing. If negativity has taken up living in your family, your home, or in you, then you need to recognize it and banish it from your life.

Here are the top 14 ways to spot negativity camped out in your life.

1. You can’t stop worrying.

If you find that you are worrying all the time and about everything your world has turned negative. A little worry may protect you, but only if after considering the possible problems you take action. Constant ongoing rumination about what could go wrong is guaranteed to keep you living negatively.

2. Your life is run by should and have to’s.

A life ruled by the “should’s” and the “have-to’s” is a life drained of joy. Take another look at all these rules you are living by. Where did the “should’s” come from? Consider if you reached a point in your life where you have outgrown living by other’s rules.

3. You’re always on high alert – hypervigilant.

People who are ruled by negativity are often excessively jumpy. Do you startle at the least little noise? Do you frequently find that you have been startled by something that others would ignore? It is likely that you are on the high alert for the things that can go wrong in life.

This hyper-vigilance, rather than keeping you safe is misdirecting your attention away from the good and the beautiful to the scary and the negative. Work on becoming a happiness expert.

4. You are afraid to let people know the real you.

In negativity land, people hide their real selves, constantly afraid that if others knew who they really were they would be rejected or attached. Hide the real you from others long enough and you may discover you have lost you.

5. You are always expecting the worse.

Are you the person who can always see the gray part of every cloud? Once negativity moves into your life it obscures every positive thing. If you are always looking for the negative you will find it. When the good things walk by, you will neglect to invite them in.

6. You are always looking for bad news.

People who have become slaves to negativity are always looking to see what other misery they can find. Misery not only loves company it goes out of its way to create it in every life. When you spend all your time looking for the bad news you are sending the good news down the block to visit someone else.

7. You are very sensitive to criticism.

If you are mistaken about something and someone points that out you can take this as helpful, you now know something you didn’t know before. Negative people think that if they do not know everything they are failures. Being wrong about a fact makes them a “wrong” person.

If criticisms are valid, then take it to heart and use this as an improvement opportunity. If it is incorrect let it go and find the home it needs to live in. Do not adopt every critical comment and make it a permanent part of your emotional family.

8. You can’t accept a compliment.

Related to being overly sensitive to criticism is the converse behavior, rejection compliments. If you are so negative you can’t allow a positive feeling in your life you will reject any compliment offered to you.

Rejecting compliments does not make you modest. Accepting compliments does not make you arrogant. Constantly rejecting other’s compliments does make you insufferable.

9. Everything is yes-but, no-but.

If you are one of these people who sneaks a yes-but or a no-but into every conversation what you are doing is making excuses for why you want things to stay in the negative realm.

10. Any change is undesirable.

Negative people are terrified of change. They will assert that no matter how horrific things are now if they were to change then things will only get worse. Intractable people are in love with their misery and afraid that they do not deserve for things to get better.

Which do you prefer, the misery you have now or the risk of taking an action and having your life become unpredictably happy?

11. You don’t try because you might fail.

Negativity tells you don’t try you might fail. Negativity lies to you. Not trying does not protect you from failure, it guarantees you will not accomplish anything. You miss all the shots you do not take.

12. Nothing gets you excited.

Live without passion is life in the negativity zone. Caring about something, anything brings positivity into your life.

13. You’re afraid of good news because something will go wrong.

Negativity tells you to be skeptical of anything positive because good things come to an end. Negative things in life can be dragged out for as long as you want them to last. Letting go is the first part of moving on.

14. You have stopped caring about others.

Negative people can’t care about others. People who genuinely care about others find themselves becoming less negative. One of the fastest ways of getting out of self-negativity is to do something for someone else.

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

When You Fall Get Back Up.

Posted on by
Reply

Sunday Inspiration    Post By David Joel Miller.

Falling down

When you fall get back up.
Photo courtesy of Pixabay.com

It’s about getting back up.

“There is no disgrace in being knocked down, there is only shame in not getting back up; never quit!”

― Ken Poirot

“We all make mistakes, have struggles, and even regret things in our past. But you are not your mistakes, you are not your struggles, and you are here NOW with the power to shape your day and your future.”

― Steve Maraboli, Unapologetically You: Reflections on Life and the Human Experience

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

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

Posted on by
2

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 Drug Tolerance?

Posted on by
2

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

Drugs.

Drugs.
Photo courtesy of Pixabay.

What does it mean to develop drug tolerance?

The term tolerance or to develop tolerance has been a common concept in substance use disorder treatment for a long time. Tolerance has one meaning in that context but can have a number of other meanings in the field of medicine or pharmacology. None of these types of tolerance have anything to do with the idea of acceptance of diversity the way the word tolerance is used in political or social contexts.

Tolerance in Drug Treatment.

In Alcohol and Drug Counseling and CD (Chemical Dependency), thinking Tolerance is one of the first signs that someone’s body is being altered by the use of chemicals. Tolerance for drugs, and in this context Alcohol is a drug, means needing more of a drug to get the same effect or getting a smaller effect if you use the same amount you had been using.

Tolerance, along with Withdrawal symptoms have long been the hallmarks of addiction. Recently, in recognition that people can and do develop tolerance for prescribed drugs, even those with low abuse potential, we have also begun adding the concept of cravings to the characteristics of a substance use disorder.

A simple example of tolerance to alcohol.

When someone first starts drinking one or two beers may have a significant effect on them. After years of practice, that person may need to drink 6 or even 12 beers a night to get the same buzz. Someone who drinks a lot and develops substantial tolerance may be able to talk coherently or even act “sober” after substantial consumption of alcohol. They may think they have learned to “handle their liquor.”

Despite developing this tolerance if we were to put that person on a driving simulator they would fail the test. They may be able to make some compensations in their behavior to fool themselves and others but their brain’s reaction times and coordination are not fooled.

Drugs of abuse are not the only ones that build tolerance.

Many prescribed drugs need to be started at low doses until the body or brain “adjusts” to the new medication. Even drugs with little or no abuse potential still develop tolerance. As time passes that person’s dose will need to be increased because tolerance has developed.

One aspect of tolerance is that you might develop a tolerance to the side effects of a drug over time while not developing a tolerance to the medicinal effects. This explains the need to sometimes gradually increase the dose of these drugs until the level in the body reaches a “therapeutic level.”

Technically there are multiple types of tolerance.

In pharmacology texts or AOD counseling books with sections on pharmacology, they describe three types of tolerance. These are sometimes subdivided. In substance abuse counseling we also talk about “selective tolerance” the concept that it may be possible for the body to develop tolerance for some effects of a drug but not others. Personally, I think of “tolerance” as the body’s natural adaption to the presence of a specific chemical. Sometimes that developing tolerance can be beneficial and sometimes it is harmful.

Tolerance can develop slowly to some drugs and rapidly for others. For example tolerance to many hallucinogens develops from a single dose. Try to use that drug again tomorrow and it will have little or no effect.

Functional Tolerance involves changes in the body’s behavior.

Functional tolerance can be further subdivided into Acute and Protracted Tolerance. Acute involves changes to the body’s reaction to that one first dose of drugs over the time that dose is in the body. Protracted tolerance is a change in the results from the second or third dose on the same using occasion.

Acute Tolerance develops during a single use of a drug.

In Acute tolerance, the body responds more significantly as the level in the blood is rising. As long as it keeps going up the effect is maintained. Once the blood level drops the adverse effects kick in. With alcohol as long as the level in the blood is rising the hangover is held at bay. Regardless of how high the level, once it starts to drop, the withdrawal effect, the hangover with alcohol, kicks in.

Protracted Tolerance

The second type of functional tolerance called protracted tolerance is best demonstrated by stimulant drugs like cocaine. The first dose produces a strong effect but after that first dose, each subsequent one produces less and less of an effect.

Metabolic or Dispositional Tolerance is how long the drug lasts.

How rapidly the drug is metabolized and eliminated changes over time and also varies from drug to drug.  For many, but not all drugs, the more you take or do the faster your body metabolizes and eliminates that drug. Some drugs, LSD for example, develop metabolic tolerance very rapidly.  Other drugs like Alcohol maintain a pretty constant rate of metabolism while the tissues and nerves alter their response.

Behavioral or Learned Tolerance.

People who frequently consume alcohol learn to slow down their walk and alter their stance to hide that they are under the influence. Many other adaptions of behavior to compensate for frequently having a particular drug in your system are possible.

Selective Tolerance.

When you develop tolerance to some of a drug’s effects but not others this is called selective tolerance. Heavy coffee drinkers find it stimulating in the morning but may develop a tolerance to caffeine’s sleep preventing effects.

Reverse Tolerance.

This form of tolerance involves becoming sensitized to a particular drug or substance so each time you take that drug there is a stronger effect than the previous time.

Cross-Tolerance.

Cross-tolerance is when someone who has been using a particular drug will develop a tolerance to other similar drugs. Someone who drinks alcohol will develop a tolerance to Barbiturates or surgical anesthetics even though they have never had those drugs in the past.

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 and AOD professionals and the terms and descriptions used in the DSM.

Related posts: Drug Use, Abuse, and Addiction      Recovery

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

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

Getting your life unstuck.

Posted on by
Reply

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

Life stuck

Getting your life unstuck.
Photo courtesy of Pixabay.com

Ways to create a better life.

Have you ever felt like your life is stuck?

Time is passing and you are just standing still, going nowhere, and wishing that your life had more meaning and purpose?

Getting your life on track requires a shift in how you see and do things. Here are some ways you can start creating the life you want.

Inventory what you have not what is missing.

If you spend all your time looking at the things you want and do not yet have you can get discouraged easily. Make sure you count up all the things you have accomplished. Emphasize what you have and the shortages will seem less overwhelming.

Keep your eye on the future, not the past.

Let things go. Always looking over your shoulder at the “good old days” can result in losing the present. Bemoaning what you had that is no longer in your life can take the pleasure of those experiences from you. Value what has been a part of your life rather than sit and cry over what has gone. Don’t lose the joys when it is time for something or someone to leave your life.

Plan to be in a good place.

Expect to have a good day. Plan on an excellent day and see if you do not attract more of them into your life. If you expect to have a bad day your brain will willingly create one for you.

Victims wait for things to happen to them, winners plan for the best while preparing for all eventualities.

Start doing more positive things.

Do more positive things and life becomes more positive. Do for others. Be of service. Do things you can be proud of and watch your self-esteem soar.

Say goodbye to unhelpful urges. – don’t give in.

One hallmark of addictions and dysfunctional behaviors are the cravings. Giving in to that desire may seem like the way to reduce the discomfort in the short-term but over the long-term resisting urges will grow your inner strength.

Rethink your life rules. Who says you have to be that way.

What you tell yourself about you becomes who you are. Tell yourself often enough that you can’t do something and you make it true. What are those unhelpful rules you find yourself living by? Who told you that you were just that way and needed to accept things the way they are?

Clean out the unhelpful activities.

Are there lots of busy activities that are filling up your time? It is not just garages, drawers, and closets that need spring cleanings. Our lives can fill up with habits and activates that result in a cluttered, stuck life. If you find yourself out of time each and every day to do those great things start cleaning out the unhelpful activities and make room for the future.

Get rid of toxic friends.

Good friends can help you build your life. Toxic friends poison your environment. Getting unstuck involves looking at your life and deciding what to keep and what to jettison. Unhelpful thoughts and draining friends need to go.

Stop worrying about what others think and say.  Make your own decisions.

Do the things you believe in, they matter. Other’s opinions shouldn’t matter. Decide what is right and act on that view. This doesn’t mean that you should be selfish. It does mean that you need to follow your dreams and live your life rather than curtailing your hopes and dreams to fit other’s preconceived beliefs about how you should be.

Be careful who you listen too.

Get good advice from those who want the best for you. There is lots of advice around. Much of it free, but beware those who tell you what to do because it benefits them. True experts can give you facts and options, not answers to how you should live. If you want to get that life of yours moving in a positive direction seek out a coach or mentor, work with a counselor. Look to see what changes in you will produce the changes you want in your life.

Be open to new experiences.

Everything in life does not need to go as planned. Opportunity does not always knock, not loudly anyway. Sometimes the greatest opportunities in life go to those who put themselves in new situations and learn as a result.

Let go of resentments. No more blame.

Whose fault things are matters far less than whose responsibility is it to change things. If you want to get going stop blaming others for steering you wrong. Take back control of your life’s steering wheel.

Emphasize experiences and people, not things.

Things wear out and break. The latest fashion goes out of fashion, but the things you experience are with you for a lifetime. You will forget about those things you bought but you will treasure the memories of what you did.

Tell doubt to shut up. Do not listen to that committee in your head.

There are always those thoughts in your head. “You should do this” and “what about that.” Ignore those limiting voices. Heed the conscience but not the chorus of doubts. Be careful about believing your own thoughts, not everything you think is true. Those voices in your head, sometimes they lie to you.

Start with small steps, one day, one hour at a time.

Do not put off life improvements until you have the time. You get 168 hours a week like everyone else. There will never be a week with more hours or a year with more days. Start now going where you want your life to go and a little at a time you will get there.

Do nothing and ten years from now you will still be where you are now, stuck! Do some small thing to improve that life each day and in ten years you can look back and marvel at how far you have come. Most great projects can be broken down into a series of small baby steps. Take them one step at a time and see where it gets you.

Ask instead of waiting for someone else to take the first step.

Don’t fall into the trap of thinking others should anticipate your wants. There are very few mind readers around in spite of the large number who think they can read minds. If you expect others to know what you want, if you wait to be asked, you may miss out. That other person may be wanting for you to say something first.

Look for supporters, not obstacles.

Do not focus on the people or things that could get in your way. Look for those people who will be allies in your progress. Build bridges, not walls. There are all kinds of things that could hold you back but as long as you look around for obstacles you will miss identifying those who could truly help you get where it is you want to go.

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 Valentine’s Day.

Posted on by
Reply

Sunday Inspiration    Post By David Joel Miller.

Valentine's Day

Happy Valentine’s Day.
Photo courtesy of Pixabay.com

Happy Valentine’s Day.

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

― Elbert Hubbard

“Being deeply loved by someone gives you strength, while loving someone deeply gives you courage.”

― Lao Tzu

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