Learning to Pay Attention

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

Attention sign

Attention sign.
Photo courtesy of Pixabay.com

Paying attention is important.

Sometimes staying focused is vital. We were all told repeatedly to pay attention. Some people have been told they have an attention deficit.

Were you ever taught how to pay better attention?

Better attention is a skill you can learn. If you have ADHD there are skills you can develop that may not cure your condition but they can go a long way to getting your attention defects under control.

Try these ideas to increase your ability to pay attention.

1. What is the goal of paying attention to this information? Why might it be useful or fun to know this?

It is hard to pay attention if you can’t see a use or benefit to knowing this information. Learning and attention are emotional. If you like the topic you can learn it. Don’t have any interest in the subject? Then you will need a really good reason for your brain to bother to pay attention.

2. What do you need to focus on right now?

Every minute of every day there is all manner of things that are vying for your attention. At any given moment you need to make the decision. “What do I need to focus on right now?” If your mind wanders, do not beat yourself up. Just gently pull that mind back to the thing it needs to focus on right now.

Practice focusing your attention and it will improve.

3. Prioritize – make a list.

Writing out a list and then checking things off as you do them can help keep you organized and your mind working on one thing at a time. Get overwhelmed trying to focus on a lot of things and you will hop from channel to channel without getting the gist of anything.

4. Clear the mind of things you do not need to remember right now – mind dumps.

If you are trying to hold onto an idea or thought that you will need later, you use up some of the mental capacity you will need to be able to pay attention right now.

Have things you need to do after work? Write out a list and put it in your purse or pocket. Now you have only one thing to remember, the list, not all those things you need to do later. The fewer things in short-term mental storage the more capacity to pay attention to new things in the right now.

5. Do the big things first.

If you start with the small things you can spend all day jumping from thing to thing and at the end of the day you will still have those big things to do.

Start with the big thing first and when you reach breakpoints you can easily do those small things.

6. Break big projects into smaller parts.

If you try to build the whole house all at once you can leave out things. Break the project up into small components. Focus on one part at a time. A written list helps to make sure you did not leave anything out. If as you work on this big project you think of more steps, add them to the list. Do not keep stopping one thing to work on another. Jumping from one part to another is a sure way to undermine your ability to pay attention to any part of the project.

7. Single-task.

Multi-tasking is a myth. It may work when you need to hurry through things and none of them need any real attention or accuracy but the more you try to multitask the worse your attention to any one part becomes.

8. Cut out the distractions.

You know the things that distract you. Try to find ways to eliminate or reduce these distractions. When I am writing the sound of voices distract me. I keep wondering what is being said. I wear headphones and have some nondescript instrumental music playing. This works for me to reduce the distractions. The headphones work by the way even if there is no music playing.

Find what works for you to reduce distractions. Turn off your phone if you can or move it to mute. Shut down the email or the social media while you work. Tell others around you that you need to concentrate so please stop talking. Do whatever works for you within the laws and the social setting.

9. Create a work kit or place.

If you can have a set place for your work do so. If you need to move from place to place create a box or bag that includes all the things you will need. Do not have to run back and forth to find pens, pencils or paper, Keep some of all these things in your bag. Even you computer users may need a small pad of paper and a pen in that computer case for the time you need to make yourself a note or when the power is off.

10. Add more steps to the list as needed – skip the things you can’t do for now.

As you are working on your project or your list, there will be things you can’t do right now. Do not dwell on those things. Skip this and move on to the next thing. Having that thing on your list eliminates the need to remember to do it later.

11. Do focus sets – 10-minute blocks and repeat.

Chunking, doing things in small short blocks, and then taking even a micro-break can help improve focus. In teaching, I find I need to move around the front of the room every so often to keep the students listening. As a student, I found that even shifting my position in my seat could help me refocus my attention. A leg that is falling asleep takes precedence over most lectures.

12. Push through to the goal.

It is tempting to stop one thing and do another but if you are close to the end and there is the chance you could finish one thing now, try pushing through to the end and then crossing this off your list. One less thing to remember to get back to improves your ability to concentrate on the other things going on in your life.

There are my suggestions for exercising your attention paying brain muscles. What have you found that helps you stay focused?

Staying connected with David Joel Miller

Two David Joel Miller Books are available now!

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.

Casino Robbery is a novel about a man with PTSD who must cope with his symptoms to solve a mystery and create a new life.

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

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

Want the latest on news from recoveryland, the field of counseling, my writing projects, speaking and teaching? Please sign up for my newsletter at – Newsletter. I promise not to share your email or to send you spam, and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse, and Co-occurring disorders see my Facebook author’s page, davidjoelmillerwriter. A list of books I have read and can recommend is over at Recommended Books. If you are in the Fresno California area, information about my private practice is at counselorfresno.com.

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Which border is Borderline Intellectual Functioning on?

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

Crossing the border.
Photo courtesy of Pixabay.com

What is Borderline Intellectual Functioning?

Borderline Intellectual Functioning (BIF) is one of several totally unrelated conditions which are officially or unofficially called borderline only because they are on the edge or junction of some other condition. BIF is in no way related to Borderline Personality Disorder.

Borderline Intellectual Functioning is a designation for some individuals who find it hard to learn some information. It sometimes gets confused and mixed up with several types of ADHD or the older label ADD.

The definition of BIF is totally determined by the person’s IQ score. Stay with me here as I explain this. I will give you the exact numbers as we go.

There is also a lot of prejudice about anyone with a low I.Q. score even though some low I.Q. scoring people are extremely talented in areas that are not captured on an I.Q. test.

When discussing I.Q scores we need to be very careful. First, they do NOT mean what many people think they mean and since they are mathematical numbers being somehow attached to non-mathematical people we need to talk some statistic-number-stuff to explain this one. I will keep the number stuff extra simple.

The companies that make the tests try to improve the test over time but there is only so much you can do in trying to give a test that somehow is meant, to sum up, a person’s abilities. We believe that  I. Q. is made up, not of one single ability, but a whole host of talents. Verbal and mathematical talents are easy to capture with a written test, musical, artistic and athletic talents may not show up so much.

There is also evidence of something called E. Q. (Emotional intelligence.) We all know someone who is very bright in school but is no good with people and there are those individuals who are good with people or animals but can’t pass a written test.

Many, but not all I. Q. and related tests, are biased towards how many words you know. Want to score well on a lot of ability tests – learn all the words you can.

The scores are designed to measure how someone’s test score compares to other people. We still can’t find any “normal” people to compare others to so we create an imaginary “normal” person by averaging all the scores we get and saying that average (or mean or mode) is somehow the “normal” person.

I.Q. tests are set up so that the “average” score is 100. Theoretically, if you test enough people the most common score is 100. But scores vary an awful lot. So is someone with a 99 really less smart than someone who scores a 101? Not very much.

If you take this kind of test many times you will get many scores. So some days you, one single individual will be “smarter” than on others.

One day the average person scores a 95. We could call that below normal. The next day they get a 105 and are above average. So we learn to use ranges of scores, not just the number.

Turns out that the largest group of people will score between 85 and 115 on most tests. (For the math people the standard deviation here is 15.) This group will contain just under 70% of all humans.

We consider this whole range of people 85-115 more or less the same. Since scores of one person may move up or down 5 points from day-to-day we need to look at the people just outside that range.

So are people above 115 really smart, geniuses maybe? Not that often. It may be easier for someone with an I.Q of 125 to get A’s in school but we all have heard of very bright people who fail school and less smart people who study really hard and get good grades.

For most purposes, we don’t see a lot of differences in individuals till we get out to two standard deviations. People who score between 70 and 130 all fall within the “average” group. This group covers about 97.5 % of all people. Only those below 70 and above 130, start to get extra special labels.

Really high scores might get the label “genius.” But some of them still do some dumb things. It may be a lot easier for the person who has an I.Q. of 125 to do a book report and someone with a score of 90 may struggle on a math assignment or vice versa, but we think anyone in that range, with a good education, can do this stuff.

Now back to Borderline Intellectual Functioning. The definition of BIF is an I. Q. Score of 71-84. The person with this score is on the low end of what we would consider an “average” or “normal” person.

Telling someone they or their child has a low score on an I. Q. test is likely to upset them. They want us to do something.

Most of us understand when a kid is too small or skinny to be good at football. We accept that a really short kid will not do so well in basketball. Most of us get this. Except sometimes parents want their kid to be good at a sport so badly that they push this kid unmercifully to grow more and get taller. Don’t get me started on the long-term damage wanting your kid to be something they are not can do to that child.

Not very many parents want to accept that their kid has fewer math or spelling circuits in their brain. So when they get the results of the I.Q. test they want something to make their kid smarter. Lots of kids in the lower normal I.Q. score range get low grades, get discouraged and stop caring about school work. Then they get diagnosed with ADHD and given a stimulant medication. It may boost their test scores a little, for a while, but it does not make them develop a higher I.Q.

Many people with BIF do graduate from school, get jobs and have happy productive lives. The task for them is to find the other areas in life for which they have abilities and then accept that some school type things may be harder for them than for people with more skill in another area.

My belief is we need to stop telling our kids that they need to be on the football team and get straight A’s and begin to accept that everyone has different talents. What are your talents and what are you doing with them?

For more on the Mental Health treatment of Borderline intellectual functioning see the post on V codes.

There, I will climb down off my soapbox, — for now.

Did that help you understand Borderline Intellectual Functioning?

Staying connected with David Joel Miller

Three David Joel Miller Books are available now!

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.

Casino Robbery is a novel about a man with PTSD who must cope with his symptoms to solve a mystery and create a new life.

SasquatchWandering through a hole in time, they encounter Sasquatch. Can they survive? The guests had come to Meditation Mountain to find themselves. Trapped in the Menhirs during a sudden desert storm, two guests move through a porthole in time and encounter long extinct monsters. They want to get back to their own time, but the Sasquatch intends to kill them.

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

Books are now available on Amazon, Kobo, iBooks, Barnes & Noble, and many other online stores.

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

Want the latest on news from recoveryland, the field of counseling, my writing projects, speaking and teaching? Please sign up for my newsletter at – Newsletter. I promise not to share your email or to send you spam, and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse, and Co-occurring disorders see my Facebook author’s page, davidjoelmillerwriter. If you are in the Fresno California area, information about my private practice is at counselorfresno.com.

Tests for mental illness

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

Mental illness.
Photo courtesy of Pixabay.com

 

 

Have you been tested for Bipolar disorder or Schizophrenia?

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Staying connected with David Joel Miller

Two David Joel Miller Books are available now!

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.

Casino Robbery is a novel about a man with PTSD who must cope with his symptoms to solve a mystery and create a new life.

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

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

Want the latest on news from recoveryland, the field of counseling, my writing projects, speaking and teaching? Please sign up for my newsletter at – Newsletter. I promise not to share your email or to send you spam, and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse, and Co-occurring disorders see my Facebook author’s page, davidjoelmillerwriter. A list of books I have read and can recommend is over at Recommended Books. If you are in the Fresno California area, information about my private practice is at counselorfresno.com.

Blaming obese older parents.

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

Older people

Elderly couple.
Photo courtesy of Pixabay.com

Do overweight older parents produce kids with birth defects?

There have been a lot of articles recently telling us that older parents are more likely to have children with autism, schizophrenia and birth defects. Is this true? And if it is true how do we explain what is going on here. Clearly, not every older parent has a child with a mental illness or birth defects. Nor do all offspring from obese parents develop autism or schizophrenia, not by a long shot. But the studies suggest an increased risk here. What is really going on? Here is my oversimplified counselor – metaphor explanation.  For a more scientific explanation, you may want to talk with or read doctors and geneticists explanations.

My grandmother would be horrified with the thought that there could be such a thing as a baby or a mother being too fat. In her time skinny babies died a lot more than plump babies. Skinny mothers died more often too.

She was right about that, as far as it goes. Women who are significantly underweight from poverty, illness, or an eating disorder are more likely to have a miscarriage, a low birth weight baby or a child with birth defects. Not eating as a result of anxiety or depression can cause these problems also. But too skinny mothers are not the major source of problems. Not in this century anyway.

Grandma also had lots of aunts and cousins who had very large families. Women had children starting as young as they could and kept it up as long as they were fertile. That was before birth control. She just might have been right about baby’s needing to have some weight on their bones to survive. But there were some things grandma didn’t know.

Grandma wasn’t near as concerned about the age of the parents either. Older men marrying a very young woman was the norm and for good reasons. In colonial days there were forty sometimes fifty or more men for every woman. So the day that a woman began to have her period the men started calling on this marriage prospect. Lots of women married much older men because the men were financially secure. They married older men and then outlived them and married again.

Men remarried a whole lot more then than now also. People didn’t need to divorce then, their partners kept dying.

Women used to be a lot more delicate than they are now. They died in childbirth and they died every spring of the milk sickness. There were also food shortages and epidemics. Skinny people died a lot. Hence the belief that fat was healthy. Now we know that is not the whole story.

We have long suspected that the father’s age was a factor in some things like schizophrenia or autism. This became more of a theory as there were plenty of young men and fewer old men on their third fourth or fifth wife. Women did not use to have so many children late in life. Now with birth control, postponing children and fertility treatments there are, percentage-wise, more children born to older mothers. That has started us wondering if the mother’s age matters also.

Grandma would have said that healthy kids and long life were in the genes. She would have been partially right.

Genes are not the whole answer! The same gene can do different things at different times in your life. So there are genes and there is gene expression, how the gene acts when in a certain time and place. Think of this as manners for genes.

My genes gave me that nice dark hair when I was young. Somewhere along the way, they decided I was old enough I needed to look the part so now they give me gray hair. I am pretending they are not turning the gray to white. The Same gene for hair color but different age and different hair color. If I had a child at this age they could inherit the dark black hair of my youth but I am stuck with the old man color for no better reason than that I am getting – well older.

Now no cell is made to last forever. Cells like people need to reproduce. I hear that cells replace themselves every seven years. For argument’s sake let’s say that this is true. Why do cell mutilations keep happening? Why do cells have birth defects?

Think of this as the “copier theory of cells.” Every time a cell reproduces it makes a copy of its self. Have you ever made a copy and then when you can’t find the original had to make a copy of a copy? The more generations the copy goes through the more chance it will be fuzzy and someone will read it wrong. Older cells may get fuzzy also. The more copies the more chance for changes – mutations to creep in. Some of those changes in humans may be good things, adaptive changes. But most gene changes cause birth defects.

So what does being overweight or drinking alcohol have to do with birth defects? Alcohol for the record causes more preventable birth defects than anything else. Why is this?

Ever seen someone mark up an original before copying it? Imagine with me an original with white-out on it and some highlighter marks. Now before this stuff can dry the person puts the original on the copier glass and makes their copy. That messy stuff gets all over the glass. Every copy we make now has all those marks on it. They are all hard to read.

So when there are chemicals in the parents’ bloodstream, like alcohol, the copies that get made are fuzzy. More alcohol and the copies get worse. We know alcohol and drugs blur the mother’s contribution to the child’s genes. We also suspect that some chemicals may blur the father’s contribution also.

We used to think that if the mother took in too few calories bad things happened to her and the potential baby. Excess calories were stored as fat in the mother. No harm to the baby there right? Not so fast.

If the mother develops diabetes that high blood sugar could have an effect. So could all sorts of other hormones. So we think that the more overweight the mother the more the risks to the child. Now, remember risks do not equal disease. You can have a risk factor for a disorder and not get it. Strenuous excesses and severe dieting during pregnancy or when you are trying to get pregnant are not recommended. But the mother’s overall health, her efforts to keep her blood sugar under control and to avoid toxins, especially alcohol, just may increase the chances of a healthy child.

Being older or overweight may not be reasons to avoid having children but the increase in risk factors may explain why we are seeing more children born with certain mental and physical illnesses like autism, psychosis, and ADHD.

Staying connected with David Joel Miller

Two David Joel Miller Books are available now!

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.

Casino Robbery is a novel about a man with PTSD who must cope with his symptoms to solve a mystery and create a new life.

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

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

Want the latest on news from recoveryland, the field of counseling, my writing projects, speaking and teaching? Please sign up for my newsletter at – Newsletter. I promise not to share your email or to send you spam, and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse, and Co-occurring disorders see my Facebook author’s page, davidjoelmillerwriter. A list of books I have read and can recommend is over at Recommended Books. If you are in the Fresno California area, information about my private practice is at counselorfresno.com.

Trauma Steals Your Sleep

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

sleep

Child sleeping.
Photo courtesy of Pixabay.com

Trauma alters your sleep.

Trauma, especially the kind that produces Post Traumatic Stress Disorder (PTSD) alters the brain in a host of ways. One major result of trauma is a change in sleep patterns. Those changes in sleep result in a host of other mental and behavioral changes. Children who are abused or neglected or witness a traumatic event have problems sleeping. Rates of sleep disorders in abused children and adults with PTSD range from 50% to 90%. The majority of all people who experience trauma have a sleep disruption that causes other mental health problems.

While the trauma and the resulting change in sleep often go unreported, other changes in behavior get noticed. These issues frequently follow child victims of trauma into adulthood. Adult victims of trauma have the same types of outcomes and they or others may think they are just acting childish. There are reasons the brain changes and things that can be done about those changes.

Not everyone who witnesses a traumatic event develops PTSD- we know that. There is a whole area of study on the topic of resilience and why some people can bounce back and others become “traumatized.” Even people with very high resilience can develop PTSD if they experience enough trauma often enough. Children who are abused, molested or neglected are at high risk, so are women who are abused and anyone witnessing the horrors of modern warfare often enough is likely to develop PTSD.

One result of exposure to trauma is an increase in attention to things that look like the cause of the trauma. We call this hypervigilance and many times it is a good thing.

Say you walk into the street and are hit by a car. In the future, you will be much more careful. If it happens to you as a child you may grow up to be afraid to cross streets. You may even become fearful when your children need to walk to school and feel the need to go with them to keep them safe.

A woman who is beaten and raped by some men wearing a particular color of clothing, something gang related or a sports team’s logo, will be very careful when she sees that style of clothing again. This may keep her safe if she avoids dangerous situations. But sometimes the increased vigilance becomes a problem.

When someone becomes afraid to leave the house or to go where there are crowds because that feared person can’t be seen? What if they become afraid of all people? What if a dangerous person changes their clothing and they do not get recognized because that woman is looking out for only one clothing style? The vigilance is now turned up too high and focused on too little.

A child who is punished for a poor score on a test may try harder the next time. But if the punishment is excessive – if it turns to abuse – that child may do anything to avoid taking a test – for the rest of their life!

How does this excess vigilance, which started out to protect the person begin to rob them of sleep and undermine their mental health?

The human body and brain move through a series of sleep stages during the night. Some stages are deep and some are shallow. Most people reach a shallow stage and then fall back asleep. Not someone with PTSD.

Children with PTSD as a result of abuse have difficulty falling asleep. Their sleep is shallower all through the night because of the hypervigilance. They wake up many times during the night. When they wake up they become fearful. Is something dangerous about to happen? Was there a sound that woke them up?

Children with disrupted sleep as a result of a past trauma are more likely to wet the bed. They are also more likely to get up and check the house to see if they are safe. They may sleepwalk. They may have sudden awakenings as a result of the smallest of noise and it may be hard to get to sleep again after the awakenings. They often have nightmares and sometimes night terrors when they awaken suddenly screaming in fear.

Now a lack of sleep at night makes the person with PTSD very tired the next day. They often get diagnosed with ADHD or Bipolar disorder. I question sometimes, with the clients I see, if a large amount of trauma they experienced in childhood did not cause the brain to grow and connections to form that resulted in the Bipolar condition. Since there is a genetic component to many mental illnesses, and children who have the genetic risk factor may also have parents who have a mental illness. This is not an argument for taking more children away from parents. What I am suggesting is that we need more early intervention. Kids who grow up with PTSD may have trouble being appropriate parents and the problem gets passed on before it is recognized.

During the REM sleep stage, memories are moved from short-term memory to long-term memory. Poor sleep can result in things that were learned one day being forgotten when the person gets up the next morning. Lack of sleep can also result in conditions that look like psychosis.  Staying awake too long by choice or from PTSD results in the brain making things up. Before long you can have problems telling if something is real or if you are dreaming it up. You may walk around all day more than half asleep.

People who are traumatized, with or without PTSD and who have a sleep disruption, as a result, are much more likely to abuse alcohol or drugs. In many drug treatment programs clients who report trauma in the past exceed 50%, sometimes the rate approaches 100%.

When the thoughts of the past keep you awake at night it appears to make sense to take something to help you sleep. Many people turn to Alcohol which does not make things better, it makes them worse.

As a person drinks more the body develops a tolerance to the alcohol. It takes more and more alcohol to knock the drinker out. Being unconscious is not the same thing as sleeping. This is one reason a person who drinks and passes out is so tired the next morning.

So there you have it. Trauma especially in large doses, the PTSD kind, results in poor sleep. The poor sleep results in lots of symptoms that look like other problems. The treatment of choice here is to work with someone who specializes in treating the Trauma or PTSD and at the same time make getting lots of good sleep a priority.

Staying connected with David Joel Miller

Two David Joel Miller Books are available now!

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.

Casino Robbery is a novel about a man with PTSD who must cope with his symptoms to solve a mystery and create a new life.

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

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

Want the latest on news from recoveryland, the field of counseling, my writing projects, speaking and teaching? Please sign up for my newsletter at – Newsletter. I promise not to share your email or to send you spam, and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse, and Co-occurring disorders see my Facebook author’s page, davidjoelmillerwriter. A list of books I have read and can recommend is over at Recommended Books. If you are in the Fresno California area, information about my private practice is at counselorfresno.com.

More depression these days?

 

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

Depressed person

Depression.
Photo courtesy of Pixabay.com

Is there more depression now than they used to be?

More anxiety? More ADHD or PTSD? In fact, could we say there are more diseases like cancer now than in the past? Is the increase in disorders the result of chemicals or toxins or something else?

Let me be radical and suggest something here. Now remember I am coming at this from a therapist’s, this therapist’s to be more precise, viewpoint. I am not a medical researcher and I do not have data to back up this viewpoint, though I can cite some authorities in those fields who seem to explain this issue.

There are probably less of most diseases than ever before! Does that surprise you?  What has changed is the salience of diseases. Salience is a new word, relatively. It first started being used in 1836. FYI the word allergy did not make the dictionaries till much later. Before 1900 presumably, no one had allergies because there was no word in the dictionary for this. Lots of people had hay fever though. So does changing the word for something change the number of people diagnosed with a condition, yes. Does changing a name alter the amount of human suffering, I think not. What about mental illnesses and depression in particular?

The ancient Greek writers talked about bile and humors. One color made you sad and depressed another make you overactive and impulsive. The descriptions remind me of depression and mania. I suspect there was a lot of depression during the great ice age but they didn’t blog about it.

Sapolsky tells us that one reason for the increase of certain disorders is that we are living longer.  When the average lifespan of Americans was 40, most people did not live long enough for us to worry about cancer or Alzheimer’s. Many of our current physical health issues are the result of people living long enough to be diagnosed with diseases of old age. For the record, they may not have had Alzheimer’s way back when but my great-grandmother died of senile dementia. Not sure what the difference is but I want to live long enough to find out.

When half the people in town die one summer from black plague no one worries about the person who killed themselves as a result of depression.

Depression is a new name. In older books, they wrote about Melancholy (literally black bile.) But that disorder was usually reserved for the upper or aristocratic class. Poor people were too busy dying of dysentery and milk sickness to live long enough to be depressed.

If you read journals of the early American settlers you would find plenty of stories about suffering, just back then we all accepted suffering as inevitable, just part of Gods will. People began to distrust that bad things might be part of some higher powers plan and started thinking that we just might be able to reduce human suffering without challenging the power of the Almighty. Then we started looking for cures to conditions that might have been considered normal in the past.

Until this last century, we thought mental illness was incurable. There were only two choices, pray over them and hope or chain them to the wall. Then we discovered that there were medications that could turn previously “crazy” people into functioning members of society.  This discovery took mental illness out of the demon possession category and moved it over into the treatable illness category.

There are still some people, politicians mostly, that think that people with mental illnesses are faking it to get out of work and just need to snap out of their disorder.  Other times they will tell you that these people are really just criminals and need to be locked up. There are lazy people and there are criminals for sure, but that is a different group than the mentally ill, though sometimes a person can have two or three conditions.

For sure there are toxins and environmental hazards. Some of these things have increased the rates of specific illnesses. But I can’t blame them for depression or anxiety.

The last century was a turning point in the fight to control diseases. We began to use antibiotics, vaccines and now we have advanced diagnoses and treatment. The next century holds promise for the integration of the mental and emotional disorders into the mainstream of care. Let’s hope that the increased awareness and detection of mental health and substance abuse disorders increases society’s willingness to tackle these sources of human suffering.

So for the record, I don’t think there is significantly more depression or more of most other diseases. The numbers of people diagnosed with a particular illness do go up and down. But as we are able to see them, the diseases become more important. But isn’t ending suffering, both physical and mental a part of having a happy life?

Staying connected with David Joel Miller

Two David Joel Miller Books are available now!

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.

Casino Robbery is a novel about a man with PTSD who must cope with his symptoms to solve a mystery and create a new life.

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

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

Want the latest on news from recoveryland, the field of counseling, my writing projects, speaking and teaching? Please sign up for my newsletter at – Newsletter. I promise not to share your email or to send you spam, and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse, and Co-occurring disorders see my Facebook author’s page, davidjoelmillerwriter. A list of books I have read and can recommend is over at Recommended Books. If you are in the Fresno California area, information about my private practice is at counselorfresno.com.

Chemical imbalance?

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

Brain

Memory.
Photo courtesy of Pixabay.com

Some of the ways mental illness is described disturb me. Chemical imbalance and minimal brain damage are especially troublesome. This post is about the whole idea of mental illness being the result of a chemical imbalance. I can see how these ideas got their start and why they continue to be popular, but they can be way misleading also. Below is a very oversimplified explanation of this issue.

One reason these ideas gained popularity was that it explains why some people were not able to “just snap out of it” even when they tried. We began to believe that mental illness was not a choice or a moral flaw but an illness. And if it was an illness then we should be able to find treatments for it. We also started to think there were risk factors and protective factors. Not everyone with a particular gene gets a particular disorder even when the gene increases the risk.

When I first studied physiological psychology way back in the dark ages of the 1960’s we studied mostly electrical potential and structure of the brain. There were a total of two neurotransmitters that were of any importance in that class. Forty years later I took a class on the effects of drugs and alcohol on the body and the brain. In that class, the text reported there were over 200 neurotransmitters in the brain and that brain chemistry was way more important than anyone had thought until that time. The book also suggested that there were probably another 200 or so neurotransmitters that had yet to be identified and named. That number has grown since.

One thing this diversity of chemicals in the brain might explain is the way in which drugs of abuse might work. There is one theory called the “lock and key” theory that says that drugs of abuse while not the same chemical as a neurotransmitter are shaped just like one and so they fit in the receptors, the locks, in the brain and these chemicals make the same things happen that happen when neurotransmitters move only way more so.

We now know, or think we know, that messages in the brain are carried within a nerve cell, called a neuron, by electrical charges. But from one neuron to another they are carried chemically. The role of the neurotransmitters is to move messages about. But there are other chemicals present also and they do many other things. It is a complicated world inside our brains.

We discovered that a medication that changed the way a neurotransmitter, serotonin, for example, was made, moved around, broken down and recycled, could also impact mental illness symptoms. So the shorthand for this became that someone who had depression might have a shortage of serotonin. The expectation was that give this person a medication that increases serotonin and they should be cured. It has turned out to be more complicated than that.

The belief that a shortage or surplus of a neurotransmitter was causing a particular mental illness gave rise to the idea that in time we would be able to take a sample of the fluid in someone’s brain, decide which neurotransmitter or enzyme was out of balance and then by adding or subtracting neurotransmitters they could be cured. People still come into our office and want to be “tested” to find out which chemical in their brain is out of balance. So far this hasn’t worked out. Let me suggest why.

Thoughts are carried from nerve cell to nerve cell chemically. You have lots of thoughts, conscious and unconscious. Hunger is a thought, so is tired. We may feel these long before we know that consciously. A depressed person might have a happy though, might even laugh at a joke. The brain chemistry will change. They think about their depression or a bad experience their brain chemistry changes again. So the chemicals in the brain are constantly changing. We also find that changes in thinking can change your mood. That is the basis of conative therapies. Changes in muscles are also controlled by chemicals so that might explain why behavioral therapies work also. But psychiatric chemicals, like anti-depressants, do work also.

Another thing we are starting to read about in the popular accounts of scientific research is the way in which neurotransmitters may act differently in different structures of the brain. We also find that there is a lot more than one model of a neurotransmitter. If serotonin were like a car, say a sedan model, there would be two door and four door models and various colors. Turns out there are multiple varieties of neurotransmitters. So the more we learn about brain chemistry the more refined the medications become but the more questions there are that need answers.

Rather than being just a simple case of a chemical imbalance, it may be that some brains get more mileage out of one chemical than another. Some brains come with superchargers and need higher octane fuel and others stall on the same mix. Forgive the repeated use of the car analogy but it comes the closest of any I can think of as to why we can’t just test for a chemical imbalance and why some people respond well to a medication and other people do not.

So remember that it is not just a shortage of or surplus of a chemical that throws brains out of balance. The things you do and the thoughts you think also influence your brain chemistry. In future posts, I want to talk about minimal brain damage and the ways in which psychiatric medications like anti-depressants might be working. Remember this is coming from a therapist and counselors point of view. Before you make any changes in your medication, starting or stopping, please talk with your doctor. But in my world, it never seems to hurt if you add some counseling to the medication.

Staying connected with David Joel Miller

Two David Joel Miller Books are available now!

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.

Casino Robbery is a novel about a man with PTSD who must cope with his symptoms to solve a mystery and create a new life.

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

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

Want the latest on news from recoveryland, the field of counseling, my writing projects, speaking and teaching? Please sign up for my newsletter at – Newsletter. I promise not to share your email or to send you spam, and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse, and Co-occurring disorders see my Facebook author’s page, davidjoelmillerwriter. A list of books I have read and can recommend is over at Recommended Books. If you are in the Fresno California area, information about my private practice is at counselorfresno.com.