Fear and anxiety not the same thing.

By David Joel Miller.

Confusing fear and anxiety cause you emotional pain.

When is fear real?

Fear, Anxiety, and Worry.
Photo courtesy of Pixabay.com

Many people are high in anxiety. They report that they are afraid of a great many things. To conquer anxiety, you need to learn the difference between the things you are afraid of, the ones you really should be afraid of, and the things that make you anxious for very personal reasons.

Recent research suggests that we may have been getting two different things confused.  While fear and anxiety may look a lot alike, the kind of behavior we do to defend ourselves, the circuits in the brain for these two things are quite different.

Fear is about an immediate danger.

Defensive behaviors are controlled in the human brain stem. The brainstem controls automatic reactions to things. It’s the part of the brain that keeps your heart beating when you fall asleep. Many fears are hardwired into the brainstem and function to protect humans from harm.

If you are too close to the edge of a cliff, and about to fall off, fear kicks in and tells you to step back. For most people avoiding falling off a cliff or from another high place keeps them from getting injured or even killed.

If you’re out in the wilderness, it is a good thing to be afraid of bears and lions, tigers and other wild animals. Most primates are instinctively afraid of snakes. Some steaks are poisonous and can kill you. Having an automatic fear eliminates the need to study the snake in front of you to determine if it’s poisonous. Experts, those who work with snakes on a regular basis, learn the difference between poisonous and non-poisonous snakes. Avoiding snakes, especially the poisonous ones, can save your life.

Anxiety is about distant possible dangers.

While fear is about a current immediate danger, anxiety is about future. The majority of things that anxious people worry about are things that are unlikely to happen. Often anxiety is related to rumination.

The part of the brain that appears to be involved in anxiety are the structures that should be used for thinking and planning as well as memory. People who are high in anxiety will attempt to improve results and keep themselves safe by trying to imagine all the things that could possibly go wrong.

The more you sit and try to think of things that might go wrong in the future, the more things you’ll find to be anxious about. It turns out that most of the things that we worry about will never happen. Anxiety is about trying to predict low probability events.

Planning for the future and for contingencies is a good thing. But if you find that you are spending a large amount of time trying to foresee everything that could possibly go wrong, you have moved from planning to trying to be a fortune teller.

The more you try to be perfect and never make a mistake, to create a life in which nothing can ever possibly go wrong, the more you will worry. Unfortunately, the belief that you can somehow protect yourself from every possible catastrophe turns out not to be true.

Whenever you find that you’re worrying about something and it’s making you anxious, the first question to ask yourself is how close am I to this potential danger? Is this something that could happen in the next minute? The second question you should be asking yourself is how likely is this bad outcome to be.

Ask yourself do you want to give up 99% of your life to avoid the things that have a 1% chance of happening. Living, and having good things happen in your life, requires doing lots of things. Unless you really love your anxiety, consider adding more spontaneous, exciting things to your life. Try more things and pay special attention to the things that go well not the few things that don’t turn out the way you want them to occur.

Learning the difference between realistic fears and the high anxiety that worrying brings can result in a much happier life.

Want to sign up for my mailing list?

Get the latest updates on my books, due out later this year by signing up for my newsletter. Newsletter subscribers will also be notified about live training opportunities and free or discounted books. Sign up here – 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 the about the author page. For information about my other writing work beyond this blog check out my Google+ page or the Facebook author’s page, up under David Joel Miller. Posts to the “books, trainings, and classes” category will tell you about those activities. If you are in the Fresno California area, information about my private practice is at counselorfresno.com. A list of books I have read and can recommend is over at Recommended Books

Advertisements

Lessons Anxiety teaches you.

By David Joel Miller.

What are your fears teaching you?

Anxiety and Fear

Lessons Anxiety teaches you.
Jimee, Jackie, Tom & Asha

Are you someone who suffers from high anxiety?  Have you learned the lessons that your anxiety is trying to teach you?  Anxiety can be a kind of bully, trying to scare you away from anything new and keeping you from the parts of life that might be beneficial. Or anxiety can become a good teacher and help you learn life lessons.

Below is the list of some lessons that anxiety might be able to teach you and ways that you could develop those lessons.

Just because it scares you does not make it dangerous.

A well-functioning anxiety system helps you identify risks and warns you of danger.  Some people’s anxiety system is turned up way too high.  Overly sensitive anxiety systems give off warning sounds and flashing lights even when the danger is minimal.

An important lesson you should learn from your experiences with anxiety is that not everything that makes you fearful or scares you is in fact, that dangerous.  Learn that your anxiety is a source of information, not an absolute life ruler.

It is OK to feel scared.

Some people believe they should never feel scared.  One of the lessons about anxiety it is important to learn is that it is possible to feel scared and still have nothing bad happened.  Let anxiety teach you this lesson.  Just because you’re scared does not mean that anything terrible or awful will necessarily happen to you

It is OK to feel what you feel.

Are you one of those people who was taught that you shouldn’t feel whatever it is that you are feeling?  A valuable lesson that anxiety and many of our other feelings has to teach us is that humans use feelings as a source of information.  Information is neither good nor bad in and of itself.  Was is important is for you to feel what you’re feeling, decide what that means, and then decide what you wanted to do with that information.

Feelings can be your friends.

Feelings are not automatically your enemies.  They can be your friends.  Sometimes anxiety and fear are friends warning you of danger.  What you need to decide is how real and how important that danger it is.  Every so often the danger is very real and very imminent.  During those times you will need to do something about it.  Other times your anxiety is detecting something new and unfamiliar and you’ll need to learn how you are going to respond to that new and novel situation.

Walking towards fear makes it shrink.

Fear is a natural-born bully.  Fear wants to have its way.  The more you give in to your fear the larger the fear grows.  Many things that look scary and are fearful at first sight become far less scary as you begin to do them.

If you walk towards something that scares you, what you will often find is that it is far scarier from a distance than once you get up close.

The first time is always the scariest.

Many people are afraid of something new that they’ve never experienced, but once they’ve tried it for that very first time that may discover that they enjoy it.  Don’t let your fears and your anxieties keep you from trying something that might turn out to be a great deal of fun.

Scary experiences create lasting memories.

Despite the fact that many people avoid things that make them anxious or scare them, most of us are also fascinated by the scary.  Scary movies draw large audiences.  Haunted houses are perennial Halloween favorites.

Because of the heightened level of hormones in the body during scary events the brain thinks that it is important to remember these times.  In thinking about the times that some event made you anxious it is important to remember the times that despite the anxiety those things turned out very well.

You can’t be calm and scared at the same time.

Ever notice when there’s a loud noise everyone turns to look at it and ignores everything else that is happening?  Anxiety and fear are like that.  They distract your attention from what else is going on at the same time.

One way of reducing anxieties impact on you is to learn ways to calm yourself.  Stress reduction techniques like deep breathing, mindfulness, and meditation can all be very helpful in reducing your anxiety.  What you will quickly learn, if you try these techniques, is that it’s not possible to be calm, relaxed and scared at the very same time.

Learn to make this fundamental rule of emotions work for you.  Opposite sets of emotions don’t like to live together.  It’s difficult to laugh when you are sad.  People don’t seem to be able to be both excited and relaxed at the same time.  If you have found that your anxiety has gotten out of control, a quick way to reduce that anxiety, if is to learn ways to self-sooth and calm yourself.

The more skills you have the more you can handle.

In all aspects of life it is important to develop a good set of skills.  While initially it may be uncomfortable to work with strong emotions such as anxiety, the more you do this work the better you get at it.  Repeatedly putting yourself in situations that create a small amount of anxiety, which you discover you are able to handle, can result in increasing your ability to handle increasingly difficult anxiety provoking situations.

Whenever the size of your comfort zone, if you spend too much time cramped inside it, that comfort zone will prevent your personal growth.  Gradually work on stretching out that comfort zone.  Before long you will have the skills to handle situations they used to seem impossible.

When you do good self-care less overwhelms you.

Another lesson than anxiety will teach you is the importance of good self-care.  With poor self-care it’s easy to get stressed out and have everything overwhelmed you.  When you concentrate on taking good care of yourself you will be able to handle situations that you never thought possible.

You will handle most things better than you thought you would.

It’s normal to be very scared before something that you have never experienced. What surprises so many of us is how often we are able to handle far more than we ever believed possible.  Anxiety teaches you that you are capable of much more than you would have believed had you not been in those anxiety provoking situations.

Most of the things we worry about turn out better than we thought.

Many people discover that the majority of things they have worried about turn out better than they expected.  It is a human failing to expect the worst.  Let your anxiety teach you that many good things can happen.

You almost always have more options than you think.

One bad habit that makes anxiety far worse than it needs to be is artificially limiting your options.  Often we only see a couple of alternatives.  Make sure that you look for other options.  People will tell themselves they have to get something done by a deadline or they’re going to lose their job. Only seeing those two options results in not making use of the many more options that might have resulted in a better outcome.  Besides not finishing the report or getting fired, you may also have the options of discussing the deadline with your boss or requesting additional help in completing the project on time.

If you make anxiety your friend you may find that it’s a wonderful teacher.

Want to sign up for my mailing list?

Get the latest updates on my books, due out later this year by signing up for my newsletter. Newsletter subscribers will also be notified about live training opportunities and free or discounted books. Sign up here – 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 the about the author page. For information about my other writing work beyond this blog check out my Google+ page or the Facebook author’s page, up under David Joel Miller. Posts to the “books, trainings and classes” category will tell you about those activities. If you are in the Fresno California area, information about my private practice is at counselorfresno.com. A list of books I have read and can recommend is over at Recommended Books

Is it Anxiety, Stress or PTSD?

By David Joel Miller.

Just how stressed out are you?

Stressed

Feeling stressed out?
Photo courtesy of Pixabay.com

Everyone experiences a little stress in their day-to-day life.  Having anxiety in your life is considered just a part of modern life.  But sometimes that stress and anxiety overwhelm people.  The things that get called trauma come in all shapes and sizes.  Many times these traumas resolve in a short period of time.  Traumas that don’t resolve, that hang on for long periods of time and interrupt your daily life, can turn into a serious mental illness such as an anxiety disorder a stress related disorder or even Posttraumatic Stress Disorder.

If you’re struggling with difficulties, anxieties, stress or even some traumatic events it is helpful to know just what kind of problem you’re dealing with.  Some things will sort themselves out on their own.  Other times anxiety, stress, and trauma need professional help.  Here are some of the problems that you might be experiencing and some thoughts about how to tell the different problems apart.

Stress.

Stress is that reaction the body has to challenges from the environment.  Stress can be small and repeated or large and dramatic.  Even good things can be stressful.  That first day on a new job can be full of stress even when you really want that job.  Many people get sick the first week on a new job.  Weddings or the birth of a baby can be stressful also, even when these have been something you have looked forward to.

Most of the time people have stress and it goes away.  But over time people can accumulate a great deal of stress, and this can result in physical, emotional and mental illnesses.  One very important life skill is learning how to manage and reduce stress.  Take a look at the other posts on counselorssoapbox.com about stress and stress management.

Animals get stressed and so do people.

Humans are not the only creatures to get stressed.  Animals in the wild can have a very stressful life.  Sapolsky wrote a very interesting book called Why Zebras Don’t Get Ulcers.”  The main difference between humans and animals seems to be how they adjust to stress after it has come and gone.  Animals who were stressed returned to a low-stress state very quickly.  Humans get stressed and years later they are still experiencing that stress.  For humans, this accumulation of stress over time can result in chronic illnesses.

Anxiety.

Anxiety is a normal human response.  But when it gets out of control it can become a disease.  If you’re in a dangerous situation, anxiety and even fear can help you stay safe.  If the volume on your anxiety is turned up too high, it can cause you to overreact to many everyday situations.  Sometimes people have what they call anxiety attacks.  For a brief period of time, they feel excessive anxiety but eventually, these anxieties attacks subside.

When this high anxiety continues too long and begins to interfere with your daily life, your job, or your relationships, it is excessive and may be diagnosed as an anxiety disorder.  There are a number of different recognized Anxiety disorders depending on the particular features of your anxiety.

Post-Traumatic Stress Disorder or PTSD.

Post-traumatic Stress Disorder or PTSD is a diagnosable mental illness.  Sometimes in life people experience overwhelming traumatic experiences.  They may witness a violent death, a tornado, hurricane, or other natural disasters.  In these events, the person may fear that they or someone close to them is going to die.

This condition was originally identified in the veterans returning from war zones.  It has since been identified in civilian populations who have been exposed to traumatic events and feared for their lives.

As a result of this trauma, people begin to develop difficulties functioning.  Some people will struggle with these problems for short period of time a month or so.  Other people will very quickly return to normal function.  In some cases, as a result of these traumatic experiences, people will continue to have symptoms for years afterward.  These continuing symptoms may be PTSD.

Complex trauma.

Repeated traumatization becomes more difficult to heal from.  There has been a good deal of research and writing about a condition that is sometimes called complex trauma.  While it’s not an official diagnosis, is helpful for many people to think about it this way.  Someone may be able to experience a trauma and recover from it.  If that same person experiences the same trauma repeatedly, each time it becomes more difficult to recover.

If you are struggling with anxiety, stress or PTSD consider getting professional help.

Want to sign up for my mailing list?

Get the latest updates on my books, due out later this year by signing up for my newsletter. Newsletter subscribers will also be notified about live training opportunities and free or discounted books. Sign up here – 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 the about the author page. For information about my other writing work beyond this blog check out my Google+ page or the Facebook author’s page, up under David Joel Miller. Posts to the “books, trainings and classes” category will tell you about those activities. If you are in the Fresno California area, information about my private practice is at counselorfresno.com. A list of books I have read and can recommend is over at Recommended Books

Getting past the fear.

By David Joel Miller.

Ways to overcome your fears and anxiety.

What do you fear

Fear
Photo courtesy of Pixabay.com

Fear and anxiety are terrible roommates. They can take over your life and make you miserable. Anxiety is like some nasty monster lurking about your life controlling your destiny. Fear is a bully whispering in your ear all manner of negativity. The more you try to ignore your fears, pacify them by avoiding all the scary things, the more they take over your life.

If you have decided that you are tired of letting your fears and anxieties control your life then now is the time to get this relationship with your fears under control. Like an annoying relative, you may not be able to cut your anxieties out of your life altogether, but you can set up some new rules and take back control of your life. Here are some ways to tame the anxiety monster.

Accept the fear, recognize it is in the room.

Hiding from your fears will not make them go away. Neither will trying to run away. You can’t get rid of fear by hiding. Drugs, alcohol or other distracting behaviors will only make matters worse.

Take a good look at this fear. What does it look like? How is this interfering with your life? Consider how your life would be different if you listen to the fear less. You can’t work on a problem until you recognize it.

Name the fear – what are you really afraid of?

Think about this fear. What is it really? Fear of flying? Or is it fear of crashing? Flying happens way more than crashing. Fear of snakes? Or fear of being bitten by a snake? Maybe even fear of being bitten by a poisonous snake. Snakes are not real interested in biting you, not unless you look like a meal. They will run if they get the chance. They may even hiss or rattle to scare you away. The biting happens when you don’t recognize the snake for what it is and wants until after the bite.

What does your fear really want from you? Is this outcome something you will accept rather than live the life you want?

Some fears are protective and some are not.

If someone is shooting at you be afraid and take cover. Fear, in that case, is trying to protect you. But if you hear a car door slams down the block and your fear sends you running for cover, this fear is far bigger than the real danger.

Just because it scares you does not mean there is a danger.

Being afraid of your shadow is more than an expression. Many of our fears and anxieties in adult life are fears left over from childhood when we were smaller and more helpless. Reevaluate those fears. Are they valid today in the world you are living in?

You may need an objective opinion to evaluate the risk.

When you are frightened the whole world looks scary. It can help to talk about your fears with an objective person. Sometimes you know already that your fear is excessive. It may even be keeping you from having a life, talking to a professional can help you get past the fear.

Being perfect is not possible.

Are you afraid to make a mistake? Are you worried that others will judge you and think you are incapable? Not taking action will guarantee the result you fear. There are no perfect people. Everyone makes mistakes. No one hits a home run every time or wins every contest. Letting fear keep you out of the game will prevent what could have been. You will not get 100% of the jobs you do not apply for.

Don’t go around collection others fears.

Fear, like misery, loves company. If you grew up in a fear filled home or live with someone who is full of fear then you may have been infected by others fears. If you are struggling with other people’s fears, return that fear creature and get the refund of your life back.

What would be better if you did not have this fear?

When you stay focused on the fear you miss out on the other possibilities. Ask yourself what would be better if you did not have that fear. Act as if that fear was already gone and as you move towards the thing you used to fear you will see it shrink. Anxieties bully people, tell that bully no.

Avoid comparing up.

One way to keep anxiety a part of life is to constantly compare yourself to someone who has more than you. This “comparing up” results in a lot of depression and anxiety. You are not as famous as that person you saw on the awards show. You do not have 152,000 friends on social media like that other person. If you keep comparing up you will start feeling bad about yourself and magnify your fear of not measuring up.

Collect successes.

Most people ignore their successes and collect the memories of their shortfalls. This is precisely the wrong approach. Make sure that you recognize your life’s good times. Pick those happy memories up and hold onto them. If you do not save successes you will lose count of them and then your inventory will look like all you have ever had were failures.

Sneak up on the fear. Systematic desensitization.

You can conquer that fear or anxiety using a process called systematic desensitization. I have written elsewhere about this process. The trick here is to approach the fear as close as you can and then hold that position. If you begin to experience feeling the fear and yet nothing bad happens the fear will move away. Keep this up and you can stretch your comfort zone and reduce the circle that fear stays in. Eventful that fear will come to serve you not the other way around. Working with a professional on this process can pay great rewards.

Build a fear-busting team. Support system.

Fears are much scarier when you have to face them alone. One of the best ways to tackle life’s problems is to develop a good support system. You need to surround yourself with people who can stand with you when you face this fear down.

Which of these fear busting tools are you going to try?

Want to sign up for my mailing list?

Get the latest updates on my books, due out later this year by signing up for my newsletter. Newsletter subscribers will also be notified about live training opportunities and free or discounted books. Sign up here – 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 the about the author page. For information about my other writing work beyond this blog check out my Google+ page or the Facebook author’s page, up under David Joel Miller. Posts to the “books, trainings and classes” category will tell you about those activities. If you are in the Fresno California area, information about my private practice is at counselorfresno.com. A list of books I have read and can recommend is over at Recommended Books

How Stress destroys your health.

By David Joel Miller.

Your body stores up stress and then makes you sick.

Stress makes you sick

Stressed Out
Photo courtesy of Pixabay.com

Most of us know the effects that stress can have on our mental health but few people notice that the way they feel emotionally is affecting their physical health. We use that same word “feel” for both sensations in the body and emotions we attribute to the mind. This leads to lots of confusion. Your mind, by which most people mean their thinking, is not all that separate from your body.

What you think about can take its toll on your physical health.

Physical symptoms are often the first indicators of a serious mental illness. It is smart to get your health checked out by a medical doctor. Having physical illnesses that are caused by stress or trauma does not mean you are going crazy and it sure does not mean that your problems are “all in your head.” Your body participates in everything your mind experiences.

When we say someone is a pain in the neck, take that literally. That unpleasant experience has caused your neck muscles to tighten. That person who makes you sick to your stomach really is affecting your digestion. So if you have seen a doctor and they can’t find anything medically wrong with you, consider getting some emotional help.

Here are some of the physical signs and symptoms that you are under too much stress or that your feelings are signaling your body they need some attention.

Appetite changes reflect feelings.

Can’t eat? Constantly hungry? Changes in appetite that are not connected to physical activity and caloric needs are a common indicator of an emotional crisis. Changes in appetite along with a loss of pleasure are at the top of the list for symptoms of depression. Loss of appetite can signal an anxiety disorder. Relationship issues and all manner of other stresses change your appetite.

Sleep responds to emotions.

Sleep, too much or too little is another mental health indicator. Sleep changes are a feature of depression. Low need for sleep or not sleeping at all and having plenty of energy could be signs of Bipolar Disorder. Just because you have not been diagnosed with Bipolar in the past is no reason to ignore this. Many people have had only episodes of depression and the blues before that first big manic break.

Aches and pains can be from stress.

Stress impacts your nerves and your muscles. One study reported that more than half of those with Fibromyalgia also met criteria for PTSD. Living with lots of stress or trauma extracts a price from your nervous system. Do not wait till your nerves quit to get that stress under control. While thinking things away will not cure physical illnesses alone, what you do about that stress can affect the course of your physical illness.

Cravings signal something is going on in your feelings life.

Cravings for foods could be a nutritional deficiency but it could also be the warning sign of a depression coming. Craving for behaviors or chemicals are hallmarks of addiction. While most behavioral addictions have not yet made the list of recognized mental illness, counseling is helpful if you find yourself craving things that could be harmful to your health or your life.

Loneliness can cause or be caused by emotional issues.

Feeling lonely or emotionally needy is a sign that your feelings life is in need of help. You should not hesitate to get assistance for emotional cravings. Loneliness is a recognized cause of relapse for substance use disorders. What is often missed is that feelings of loneliness and neglect can be triggers for mental and emotional disorders.

Lowered resistance to colds and flu may have an emotional cause.

Depression, Trauma, and stressor-related disorders all lower your resistance to illness. Happy people have more resistance to physical illness and are more resilient to emotional let downs. If you are having trouble getting over a physical illness, take another look and see if your emotions need mending also.

Temperature regulation – sweating could be anxiety or panic disorder.

Sweating and poor temperature regulation has been connected to anxiety and stress related disorders. Learn deep breathing, meditation and mindfulness. Cut back on the high rumination diet and see if your body does not stop sweating things.

Out of willpower – procrastination? Is it caused by stress?

Lack of energy, low willpower and a general malaise are all signs of emotional disorders. Depression and anxiety are the chief suspects here but other mental disorder can result in low motivation and a lack of willpower.

Irritable – low blood sugar – the two are connected.

Low blood sugar makes people more irritable and leads to anger and conflict. The opposite connection can exist. Poor emotional regulation can play having with your efforts to regulate blood sugar and other hormones. Make sure you are taking care of your emotional health and see if that does not help you improve your physical health.

Panic happens more often when you are stressed.

Panic may be appropriate if they are shooting at you or if the lion is hunting you. Panic in the sense of a sudden mobilization of effort. But if you are having panic attacks on a regular basis, if the setting on your anxiety or panic meter is turned up way to high, your emotions are going to create a lot of physical symptoms that will not respond well to the doctor’s prescription of medication.

Is emotional stress having an impact on your physical health?

Anxiety

Depression

Emotions and Feelings.

Obsessive-Compulsive Disorders (OCD)

PTSD & Stress

Want to sign up for my mailing list?

Get the latest updates on my books, due out later this year by signing up for my newsletter. Newsletter subscribers will also be notified about live training opportunities and free or discounted books. Sign up here – 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 the about the author page. For information about my other writing work beyond this blog check out my Google+ page or the Facebook author’s page, up under David Joel Miller. Posts to the “books, trainings and classes” category will tell you about those activities. If you are in the Fresno California area, information about my private practice is at counselorfresno.com. A list of books I have read and can recommend is over at Recommended Books

Do people with problems not want to change?

By David Joel Miller.

Why do they say that people with problems want to be that way?

Disabilities

Not want help?
Photo courtesy of Pixabay.com

Lots of people, with varying problems and disabilities, seem to be dismissed with the expression that the reason for their problems is that they do not want to change. Is there any truth to these claims and why do we hear this so often?

First, let me give you a list of the things I have heard recently. Some of this comes from professionals, some from the news media and some from just average people. After the list let me tell you why I think we are hearing this more these days and lastly what we should be doing about this.

People with depression are using this illness to avoid doing anything.

Fat people don’t really want to lose weight.

There is no such thing as mental illness, those people just want to get on disability.

People who say they have anxiety are just trying to get other people to take care of them.

The homeless prefer to live out on the street.

Drug users do not quit because they want to use.

The unemployed are unemployed because they do not want to work.

There are many other forms of these statements, but mostly they seem to me to be ways of dismissing people with problems by blaming them for having those problems and then saying that they are unwilling to change.

So why if obesity, homelessness, unemployment, loneliness, drug addiction and mental illness cause all that pain, do people seem to so strenuously avoid doing exactly the things that would change their situation? Doesn’t it look sometimes as if people with problems really do not want to change or they would?

Turns out that change is far harder most of the time than doing nothing.

I can see why society and people who work in the helping fields could start blaming the people with the problems for their lack of progress. As long as we can blame them we do not have to think that our programs and policies might be letting the suffering down. It is easier to think that the homeless like to be out there in the cold, the rain or the snow, than to really try to tackle those issues.

Why do we blame those with problems for those problems?

Turns out that change is hard for humans. We learn a certain way of coping and then we continue that coping style over and over. Even when we come to believe that what we are doing is not working, deciding to do something different and then carrying through on that decision is difficult. People in these situations sometimes have to give up everything they have to reach for something else. Here are some examples.

Unemployment is rarely a choice.

If I think that unemployment is caused by a lack of jobs, I might get scared I could end up out of work. If I can convince myself it is because they don’t want to work I can pretend it won’t happen to me.

For a huge stretch of time since World War II here in the United States, we have had growth and expanding employment. There have been ups and downs but overall more people work as time goes on. There was a time when any able-bodied person who wanted to work could find a job. Recently we have seen a trend, there are jobs available, but those jobs require advanced skills and are often in distant places.

Many who are unemployed lack the skills needed to get a good job, they may live in places with high unemployment and as a result become seriously depressed. When you are depressed doing anything can be at the limits of your abilities.

For the homeless shelters may mean giving up all you have.

If you are homeless, most of your friends and partners are homeless also. If you have a boyfriend or girlfriend you need to leave them behind. Your pet? That dog that kept you warm and comforted you on that cold night? That animal goes to the pound. There are few places a homeless person can take their partner or their pet.

While in the homeless shelter you need to be there in the early afternoon and leave in the early morning. Getting to and from the shelter takes up the whole day. Your life begins to revolve around being a recipient of a place to sleep.

When you have next to nothing you use what tools you can find to cope. Many homeless people drink to dull the pain, physical and emotional. Without an address, it is hard to get into medical or psychiatric services.

Homeless programs often require that the people they house stop alcohol and drug use altogether to get housed. It is easy to say that the homeless do not want housing and harder to recognize that they may not be willing to give up friends, relationships, pets or other coping mechanisms to fit into the requirements of a given program.

Obesity is about more than just eating less.

Once upon a time we idolize the person with some meat on their bones. When food was scarce the healthy, those who were not emaciated, made it through the winter to live another year. Then times change, food became instantly available, and the ideal change.

Weight loss has become big business. Despite a quizillion diet books and weight loss programs the rate of obesity in America continues to climb. Food is available on every corner. Fast food and food available 24 hours a day in any season. The result of this increased availability of food has not been better health but more unhealthy food.

Most dieters learn all too rapidly that the minute you relax your diet the weight returns and brings a few pounds of extra fat with it. With the weight gain comes physical ailments. Exercise is harder the more weight you need to lose. The modern solution? Surgery to reduce the body’s ability to hold and process food.

The mentally ill are likely to be told to just snap out of it.

For most people who have a mental illness snapping out of it is only slightly more difficult than growing a few inches because you should be taller.

When you have depression, severe major depression, getting out of bed in the morning is an all-day task. This is not laziness, it is horrific work to make yourself do something that you lack the ability to do.

If you have an anxiety disorder, the most common mental disorder in America, you are likely to be told to just not worry about it. If you go for treatment those of you who have social anxiety can look forward to spending hours in crowded waiting rooms with people you do not know and with whom you wish you did not have to spend time.

I know there are exceptions. Programs to treat anxiety that are small and personalized. But all too often treatment programs are organized to meet the needs of the system not the individual.

The truth is that those with problems no not always use programs, not because they like things the way they are but because they are being ask to do more than they are able to in order to access those helps that most of the rest of us take for granted. We need to stop blaming the sufferers for their illness and look for solutions that work rather than create more programs that fail the people they are designed to serve.

Want to sign up for my mailing list?

Get the latest updates on my books, due out later this year by signing up for my newsletter. Newsletter subscribers will also be notified about live training opportunities and free or discounted books. Sign up here – 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 the about the author page. For information about my other writing work beyond this blog check out my Google+ page or the Facebook author’s page, up under David Joel Miller. Posts to the “books, trainings and classes” category will tell you about those activities. If you are in the Fresno California area, information about my private practice is at counselorfresno.com. A list of books I have read and can recommend is over at Recommended Books

PTSD or Acute Stress?

By David Joel Miller

What’s the difference between PTSD and Acute Stress?

Stressed

Feeling stressed out?
Photo courtesy of Pixabay.com

PTSD, Post-Traumatic Stress Disorder has made the news a lot recently. This is a good thing. More recognition of PTSD should result in more treatment and less suffering from those who have PTSD. Stress caused problems may or may not be from a Trauma.

What hasn’t gotten as much notice and should have, is the role of Acute Stress Disorder in the events that knock people down and cause a lot of suffering. Acute Stress Disorder creates a lot of problems for a lot of people. Reactions to severe stress can cause long-term changes in people’s feelings and behaviors. Many of these changes go unrecognized and untreated. Acute Stress Disorder may be missed more often than it is diagnosed. More on that later in this blog post.

Stress can harm you.

We know stress is a problem a lot of the time, for a lot of people. Outside the field of mental health, there are lots of blog posts and books on stress, what it is and how to deal with it.  I have written posts about stress and managing it for those of you who have too much stress in your life even if it does not get you a diagnoses or disability.

Stress, plain simple stress, can break people down even if they never meet the criteria for a mental illness. Think of stress like this:

Remember those spectacular car crashes at those televised car races? Some of those crashes were the result of car parts (or drivers) under stress. All day, for hundreds of miles that car and that poor car part, ran hard and fast. The stress just kept coming, then suddenly that part breaks, that car goes all which way and the crash occurs.

Stress on people can be like that. Too much stress too long and the person develops mental health problems. Some of those problems need a day off, others become diagnosable illnesses. In the past, we tended to think of stress related disorders like Post-Traumatic Stress Disorder (PTSD) as close cousins to Anxiety. That has started to change.

Beginning soon mental health professionals will begin to use new coding systems. The DSM-5 or the newer ICD codes. In those systems, Stress and Trauma-Related Disorders get their own chapter. While Stressor-Related Disorders can cause anxiety and have some symptoms in common with anxiety disorders they also have some differences.

Trauma- and Stressor-Related Disorders.

From the day you are born till the day you die too much stress can cause you a problem. One key factor in Trauma- and Stressor-Related Disorders is that there has to be a specific thing that happened to you, the stressor. Trauma is the king of all stressors.

So these things do not just suddenly happen for no reason and they are presumably not something you are born with. This fuzzes up the expression that mental illness is a brain disorder, in that the cause of these disorders are things that happen to you.

If life events result in acquiring a mental illness, then events, as in therapy and learning, can be helpful in treating that disorder.  Much of the treatments for stressor-related disorders are cognitive type therapies.

Trauma and Stressor-Related Disorders also can have features that are similar, we might even say overlap, depression, anxiety, obsessive-compulsive and the often overlooked dissociation. Not every other mental illness is caused by stress or trauma. We just need to be aware that sometimes there can be connections. This similarity to other issues results in a lot of stress related disorders not being diagnosed until years later when the person is severely mentally ill or disabled.

What is Acute Stress Disorder and why is it important?

Acute Stress Disorder has two sets of “symptoms,” the things people experience that are a problem for them and the technical things professionals use to give out the diagnosis.

Some of the things you might experience as a result of having Acute Stress Disorder are also symptoms of other mental health issues or other mental illnesses. There are a variety of diagnoses that someone might get as a result of injuries they sustained due to stress.

These symptoms can impact your life in long-term ways. People may find their personality has changed.

Poor or no sleep is a cause for worry. Poor sleep now, predicts mental health issues down the road. In the aftermath of stressors, many people report that they do not sleep well. Some report bad dreams, nightmares or night terrors. A few days of bad sleep after you are stressed and you should get back to normal. If the sleep disturbance goes on for very long it starts to change your functioning and your life.

Panic attacks are common in the first month after a severe life stressor. The time period of thirty days becomes important when we try to separate Acute Stress Disorder from other problems. This panic attack may first be experienced immediately after a stressful incident and then go on to become Panic Disorder.

If you have been through a severely stressful incident it is not unusual for you to blame yourself for not expecting it, not doing something differently and not being able to prevent it. Rationally you should know that it may not have been possible to prevent what happened, but people commonly experience guilt or even shame over not being able to stop that trauma.

After a trauma, some people report that the happiness or joy has been sucked out of life. They stop caring about themselves or others. They may begin to take risks that they never took before. They drive too fast, gamble, take more sexual risks. Some trauma or stress survivors become angry, bitter and more argumentative. They get in more fights, verbally and physically. It is as if they have changed who they are and they no longer care.

If you knew about the traumatic experience you might understand why the changes in behavior occurred. If that trauma survivor kept the trauma a secret, and many do, you might think this was all bad behavior.

Trauma survivors, even those who do not go on to develop more serious mental health problems, may become confused or think they are losing their minds. They may get tested for or treated for concussions. They could have both a concussion and a longer term mental illness.

After a trauma or a crisis from the buildup of long-term stress, you may find it difficult to go back to places that remind you of the trauma. People become unable to go back to work, visit certain places or they avoid social situations.

How do professionals diagnose Acute Stress Disorder and why is that diagnosis so rare?

The official criteria for Acute Stress disorder are found in the DSM-5 or DSM-4-TR if your agency is still using that one. The DSM’s are published by the APA and you can order the full text from them. Here is my oversimplified plan language version of that criteria. I hope I do not make errors in this explanation.

A warning

Self-diagnosis or diagnosing your family and friends is a risky behavior. If after reading all this you believe you or someone close to you has Acute Stress Disorder, another Trauma- and Stressor-Related Disorder or any other mental health problem, go see a professional and get it checked out. There are treatments available for all of these conditions and there is no need to suffer alone.

There are 5 things the professional needs to look at for Acute Stress Disorder

  1. Did you experience a really bad Traumatic Stressor Recently?

There is a “waiting period” of 3 days. Most people have difficulty for a few days after a serious trauma. Then there is the requirement that the problems you are having must last UP TO 30 days. This is a huge thing for Acute Stress Disorder. If your problems go on more than 30 days the name we call this (diagnostic code) changes to something more long-term like Post-Traumatic Stress Disorder (PTSD.)

The result of this time factor is that a whole lot of people who have this problem do not ever get diagnosed. In outpatient settings, it can take 30 days to get your insurance settled and to get in for an appointment. In hospital settings this diagnoses may be found more often using “strict criteria” but in most other places the results of trauma do not show up till years later and the issues then get called something other than Acute Stress Disorder.

  1. You must have at least 9 of 14 possible symptoms.

This leads to lots of ifs. Depending on who is doing the evaluating some things get counted and not others. Another problem is that trauma victims do not like to talk about their trauma. One symptom is avoiding reminders of the trauma and talking about it again is a reminder. So not having said they have a symptom can rule people out who did, in fact, meet criteria and do have Acute Stress Disorder.

I will not go through all the 14 criteria here, just a few of the big ones.

You can’t get the trauma or stressor out of your head.

This is sometimes called intrusive thoughts. You may also have dreams and things will trigger the memories so much you begin avoiding those emotional triggers. After the 30 days waiting period this may become PTSD.

From now on you are in a bad mood and can’t get out of it.

The happiness and joy get sucked out of your life. You are in a bad mood all the time for no apparent reason. Some people, kids, and men mostly, become irritable, angry and possibly violent. In my view, Acute Stress Disorder and its aftermath are involved in a lot of these unexpected violent incidents.

People may “space out.”

Researchers have noted that zoning out, technically called dissociation, is common, almost universal in the first three days after a trauma. If that dissociation continues after the third day we think it indicates Acute Stress Disorder. After thirty days that dissociation gets diagnosed as something else. I believe that there are more cases of dissociation than get recognized. Some are ignored and some gets another name like Psychosis NOS (not otherwise specified.)

Acute Stress Disorder is time limited.

Acute Stress Disorder must last more than three days and less than thirty. Beyond the thirty the name gets changed. Many people try their hardest to cope and do not report symptoms. They can’t work and go on disability for a while until that runs out. Some end up alone and homeless. They get angry, depressed or anxious and their relationships suffer. They develop panic attacks or obsessive-compulsive disorders. Some get other mental illness diagnoses.

Having Acute Stress Disorder really matters.

This disorder, like most things we call mental illness, really makes a difference in people’s lives. It interferes with their ability to work or go to school. Having Acute Stress disorder can interfere with or destroy relationships with family and friends. It causes the people who have it a lot of suffering even when they can’t express how or why they are suffering. It can also damage other important areas of your life, such as religious observances, hobbies and so forth.

Acute Stress Disorder is not something else.

Professionals are continually reminded to avoid putting the wrong label (diagnoses) on things. If you only have these symptoms because of a medical issue or because you are drunk or high when you have the symptoms then we do not say you have Acute Stress Disorder.

This does not mean that people with medical problems or who use drugs can’t get Acute Stress Disorder, we just want to be careful we do not get the diagnosis wrong and count as symptoms things that were not caused by the stressor.

One last thing to consider.

There are two other groups of mental health problems in the Trauma and Stressor-Related Disorder chapter. Attachments Disorders, those problems that begin in very early life and Adjustment Disorders, which are reactions to stress that may not be life threatening but have a huge impact on your mental health. These groups of life problems, sometimes, they rise to the level of a mental illness or a mental health problem.

I have written elsewhere about how Attachment Disorders and Adjustment Disorders can wreck someone’s life if not attended to. I am out of time and space here to talk about these other groups of Trauma and Stressor-Related Disorders.

Hope this post did not run too long. I do not think I have written a post of this length in the past but this seemed like a topic that needed more space and discussion.

Want to sign up for my mailing list?

Get the latest updates on my books, due out later this year by signing up for my newsletter. Newsletter subscribers will also be notified about live training opportunities and free or discounted books. Sign up here – 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 the about the author page. For information about my other writing work beyond this blog check out my Google+ page or the Facebook author’s page, up under David Joel Miller. Posts to the “books, trainings and classes” category will tell you about those activities. If you are in the Fresno California area, information about my private practice is at counselorfresno.com. A list of books I have read and can recommend is over at Recommended Books

If you may have Acute Stress Disorder or PTSD seek professional help.