Tag Archives: Bipolar

Treatments for Depression and Dysthymia

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

Depression.
Photo courtesy of Pixabay.com

What are the available treatments for Depression?

So you have symptoms of depression. Is it Major Depressive Disorder, Dysthymia, or an adjustment disorder? First, I recommend you see a professional and make sure you have the problem you think you have. Remember this is a general description of the treatments available; I can’t diagnose or treat you over the internet. If you need treatment this is not a do it yourself project, see a professional.

The first stop should probably be a medical doctor – Primary Care Physicians.

Some mental illnesses look like psychical problems and vice versa. Most people who commit suicide have been to see a primary care doctor in the 30 days before they attempt. When you feel bad it is natural to think there is something medically wrong with you. Most people are surprised to find out they are depressed or have Dysthymia.

Many doctors will spot Major Depression; sometimes they identify other mental illnesses. They can be especially helpful in ruling out things like brain tumors or heart problems. If you do have a medical illness, treating that issue will often reduce or eliminate the problem, but not always. You could have a physical issue and a mental illness.

More than half of all the psychiatric medication prescribed is prescribed by primary care doctors. If you get a prescription for antidepressants and you didn’t really need them, most of the articles I have read say taking them won’t hurt you. It just may not help. But if you do have serious depression the meds alone are rarely enough. If you don’t change your circumstances or your thinking, eventually the meds may stop working. The medication will help you work on your problems; the meds won’t solve problems for you.

We hope doctors take seriously the presentations and if after checking the person out they decide this is more likely a psychiatric problem than a physical one, they may try you on an anti-depressant. If that does not help, most likely they will make a referral for you to see another professional.

In my experience medication is absolutely essential for someone with psychosis. It is highly recommended for anyone with Bipolar Disorder. People with Major Depression respond well to medication but need therapy or the meds stop being helpful after a while. The research seems to tell us that meds are not all that helpful for Dysthymia.

The primary care doctor may refer you to see a psychiatrist.

Psychiatrists specialize in treating mental illnesses. They have lots of knowledge about psychiatric medication; they know which meds could make a physical problem you have, like high blood pressure, worse. They also know about new medications and can prescribe medication a primary doctor would not want to prescribe. For psychosis or Bipolar Disorder, a psychiatrist is highly recommended.

A psychiatrist will probably not be enough. They are trained to prescribe medication. Few if any will have the time or the inclination to spend more than a few minutes with you. Ten or fifteen-minute med check appointments are the rule. If you need someone to help you deal with your problems day-to-day, the psychiatrist will probably refer you to a counselor or therapist.

What treatments will a counselor use that the doctor didn’t?

In a previous post, I wrote about the differences between Therapists, Counselors, and Social workers. What is important to you, if you have depression, is finding someone, preferably knowledgeable and licensed, who knows how to help you with your problem.  The therapist will probably use one of the theoretical approaches below.

Cognitive Behavioral Therapy (CBT.)

This is my preferred method for treating Depression and a lot of other things. Not all therapists use this but there is a whole lot of research data to recommend this approach.

CBT is based on the idea that a change in thinking can change your feelings; a change in feelings will change your behavior. This works in reverse also, so if you begin to make small changes in your behavior, your feelings will start to change, and eventually, your thinking will change. A change in thinking will result in a change in the neurochemicals in your brain.

In CBT the therapist helps you see your problems from different viewpoints, helps you perform experiments or do homework and in effect, they coach you through becoming able to change yourself. This is sometimes called getting a “new pair of glasses” or simply cleaning the glasses you have.

If you are looking out at the world through dirty glasses, then, of course, the world will look dirty and gray.

Dialectic Behavioral Therapy (DBT) is a close cousin to CBT.

DBT adds skills training to the CBT. It can include mindfulness techniques, meditation, relaxation, or any other calming skill. Other skills can be included as needed. My understanding of this approach is sometimes we get so caught up in the problem or the crisis of the day that we forget to work on learning the skills to have a better life. DBT combines the change-your-thinking part with the learn-a-new-skill part.

DBT is especially helpful if you have multiple problems, several mental illnesses, or a personality disorder on top of your depression.

Narrative Therapy can help you think about things differently.

Most of us have a “story” we tell ourselves about who we are. If you keep telling yourself you are a failure, you will become one. Some of us bought into negative “stories” about ourselves as children and we keep retelling these. A narrative therapist helps you write a new story and tell it. If you tell your new story enough, parts of it start coming true.

Psychodynamic or “Client-Centered” therapy.

I hear the most complaints about these approaches. This is the therapist who lets you talk and says nothing much in return. I recognize some people have a lot of stuff they need to tell about childhood and that sometimes just talking it out is helpful, but it frustrates me and a lot of clients to have to be in pain that long.

This is most likely to be helpful if you have lots of unfinished business from childhood. Victims of abuse or molestation may need to move more slowly and take more time to get things out.

Groups can be very helpful.

Groups are like “way powerful” when it comes to recovering from depression. Groups run by a profession are at the top of the list, but self-help groups can be very helpful also. In person, groups are the best, but online groups are useful also. Groups are hard to find sometimes but worth the search.

“Alternative recovery methods”

Hobbies, religious groups, gyms exercise programs all have their place. Having a good support group or finding a support group is also important. Some people say nutrition was helpful.

Fad treatments worry me. The nutritional supplement or spiritual retreat of the week helps some people, but mostly they end up back at the doctor or the counselor’s office in a few weeks when the weekend collides with the real work week.

Electro Convulsive or Shock Therapy (ECT)

I am not a fan of Electroshock therapy as it has large risks. It is called Convulsive for a reason.

It has helped some people who had found no other help, but the risks are high enough that I suggest you try all the other options first. This is used ONLY with extremely severe Major Depressive Disorder. It is not recommended for Dysthymia, Adjustment Disorder, or milder depressions.

Some clinicians, me included, wonder if ECT should ever be used.

There are some thoughts on possible treatments for depression and Dysthymia, questions as always, are welcome.

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

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

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

For videos, see: Counselorssoapbox YouTube Video Channel

Bipolar Disorder, Alcoholism and Addiction

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

Bipolar.
Photo courtesy of Pixabay.com

HUGE connection between Bipolar Disorder and Substance Disorders.

There are so many connections between having Bipolar Disorder and having a Substance Use Disorder. In treatment facilities that screen for mental illness, it is not uncommon for Bipolar to be the single most common co-occurring mental illness. Anti-social disorders are common in court order referrals and sometimes you might see a lot of clients with PTSD but most often it is the combination of Bipolar Disorder and a Substance Use Disorder that really stands out.

Drugs and alcohol can mask psychiatric symptoms, can create them and both intoxication and withdrawal can look like mental illness, but the combination of Bipolar Disorder and a substance use disorder is so common it is an expectation.

Bipolar Disorder coexists with substance abuse more often than with all the Depressions put together. All mood disorders other than Bipolar Disorder are sometimes labeled unipolar depression to separate them from the bipolar condition.

The overlap between these two conditions is huge. The Epidemiological Catchment Area Study reported that more than 60% of people with Bipolar also had a substance use disorder.

Alcohol was the drug of choice for both people with Bipolar Disorder and unipolar depression.

Because many people with Bipolar Disorder report liking the mania or hypomania they most often go undetected and untreated for long periods of time. Most of the time they come in for treatment because of an episode of depression. Many also escape detection until they have legal consequences that send them to a treatment program.

Most people who finally do arrive at the diagnosis of Bipolar Disorder have seen five or more health care professionals and have spent ten or more years on the process before getting diagnosed with Bipolar Disorder.

The extreme fluctuations in mood in Bipolar Disorder interact with drugs and alcohol. The reported rate of Bipolar Disorder is 1-2 % though it seems likely that many subclinical cases go undetected for prolonged periods of time.

Cyclothymia is another diagnosis related to Bipolar Disorder that has low highs and not so low lows. It is sometimes described as on the bipolar spectrum. For a full diagnosis of Cyclothymia, you need to have had the condition for at least two years.

This disorder is rarely diagnosed and treated as it does not cause the huge impairment or legal consequences of the more severe forms of Bipolar Disorder. People with Cyclothymia have periods of feeling better and stop treatment. They only come in when depressed and hide the hypomania well. In my own clinical experience, this condition is probably vastly underdiagnosed.

When we talk about having a substance use disorder most people will respond that they are not drug addicts or alcoholics. There are forms of the disease of addiction that stop short of physical addiction but result in ruined lives, broken relationships, and periods of time incarcerated.

The hallmarks of a substance use disorder are:

Obsessions – you can’t stop thinking about it.

Cravings – repeated urges to use

Loss of control – using more and more often than planned.

Increased tolerance – Needing more to get the same high or getting less of a result from the same amount of drug.

Withdrawal effects when you run out of the drug.

Psychological addiction or dependence occurs long before physical addiction.

Bipolar Disorder may have existed before the substance abuse but did not get diagnosed because there had been no severe mania. Some people with Bipolar begin using to cover up the symptoms or to help themselves cope. We think of this as “self-medicating.

Drugs and alcohol may increase the risk of developing Bipolar Disorder.

People with Bipolar disorder and substance abuse issues are hospitalized more often and for longer. They are more likely to have rapid cycling Bipolar Disorder and to have developed the symptoms at a younger age. They are also much more likely to have mixed episodes of both mania and depression at the same time.

Co-occurring Bipolar Disorder and substance abuse are much more resistant to treatment and people with both conditions at the same time are far more likely to drop out of or fail to complete treatment.

Alcoholism is more often a result of having Bipolar Disorder rather than a risk factor and those with alcohol as their primary drug of choice do better in treatment than many other co-occurring disorders.

Further complicating this picture we should know that any alcoholic with or without a mental illness is likely to have severe mood swings. Alcohol withdrawal and alcohol intoxication can mimic many mental illnesses and it can take some period of sobriety before a baseline for diagnoses is clear.

Alcohol and illicit drug use will also interfere with getting the medication right resulting in many med changes that might otherwise not have been needed.

So there are some brief thoughts about the connections between Bipolar disorder and substance abuse, especially alcohol abuse.

If you or someone you care about has a problem with drugs, alcohol, or may have a mental illness please encourage them to go for professional assessment and treatment.

Other articles about Bipolar Disorders and related conditions can be found at:

Bipolar or Major Depression?

Bipolar – misdiagnosed or missing diagnosis?

Am I Bipolar?

Bipolar doesn’t mean moody

Are you Hyperthymic?

New Bipolar Drug Trial

Bipolar Disorder Genetics research study – Come one come all

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

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

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

For videos, see: Counselorssoapbox YouTube Video Channel

Millions about to catch a mental illness – The DSM-5

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

Medical record

Diagnosis.
Photo courtesy of Pixabay.com

UPDATE – changes in the DSM-5

You can erase some of this post from your memory. Non-suicidal self-injury, Cutting did not make it and is stuck in the back – maybe section. During the process of updating the Diagnostic and Statistical Manual of Mental Disorders (DSM) from the DSM-IV to the DSM-5 a lot of things were proposed. Some of those suggested changes were instituted and others were left out. This post includes mostly ideas that did make it to the final DSM-5. Because these ideas were included in a lot of research articles and other blog posts I have left the post up but need to tell you that some of this information is now out of date.

Will you be cured or struck with a new mental illness next year?

The way we understand mental illness is about to change. When the DSM-5 is published about May of 2013, millions of people will find their mental health diagnosis suddenly shuffled. Several conditions that bring clients to therapy every day, that didn’t used to be disorders, will suddenly appear. Some old disorders will disappear or become merged with others. This happened before when Manic Depressive Disorder disappeared and the Bipolar Disorders in all their shades took its place.

We Counselors don’t write the book so we don’t get much say on these changes but in order to get our clients the help they need we have to play along with the changes the Psychiatrists make in the rule book. These new rules include the latest research and hopefully refine and improve the system we use to figure out what mental, emotional or behavior problems the client has.

The new book, DSM-5 is still under review but from the version on-line we can see a lot of the directions the new version will take. There is still time for some revisions to the new DSM, but most of these changes look pretty certain.  I have been reading the new version on-line trying to get myself mentally prepared for the changes. Here are some trends I see.

Anger becomes a Disease – sort of

We know that anger and the loss of control that comes with excess anger is a serious problem. There is a huge group of people who have been required to take an anger management class. So far anger has not been a diagnosis. We have tried to force the angry client into other existing diagnoses. Some people with anger are depressed, some are anxious some are just bad people, and so on.

Cognitive therapists have been saying for years, and I agree with this, that most anger management classes fail because they seek to teach clients how to control their anger after they are already angry. Having the person who is furious count to ten only delays the explosion. The time to intervene is teaching the client not to “anger themselves” in the first place. You read that right. Others do not “make us angry” we “anger ourselves” when they don’t do what we want them to.

So we need a specific diagnosis for people who anger themselves too much and then lose control.  With kids we were calling this “Disruptive Behavior Disorder” or “Oppositional Defiant Disorder” sometimes this means blaming them as in “bad kid” diagnoses. We need to try to find ways to help kids learn new approaches. With adults, they became “depressed or anti-social, or worse.

The new label for this problem will become “Disruptive Mood Dysregulation Disorder”

Cutting and Self Mutilation becomes a disorder.

Cutting and all the other self-mutilating behaviors are a huge problem. Parents call or bring their kids in because of this all the time. There are hundreds of books on the subject and lots of research that says this is a distinct, separate disorder. But up till the DSM-5 we had to shoehorn this into something else.

The confounding issue here is that most self mutilators do not want to die. This is most often not a suicide attempt. It is also most often, though not always, not an attention-seeking behavior. Self mutilators do it repeatedly and in places where others can’t see. They use this behavior to regulate emotions.

The confounding problem, self mutilators feel bad and sometimes they do decide to commit suicide.

This problem seems destined to soon become a disorder all on its own called “Non-suicidal Self Injury.”

In the future, you won’t outgrow your diagnosis

We have had separate names for the problems that children get. Sometimes the problem stays the same but every few years we change the diagnosis. We have had a whole chapter of problems that get first diagnosed in infancy, childhood, and adolescence.  This will go away. Yes, kids can be depressed. I have seen video footage of a new-born in the hospital who showed significant sadness when mom and dad stopped paying attention to him. So if parents were to neglect a child, could the child become depressed? Sure they could. The more the parents neglect the more depressed the child becomes.

So rather than separating childhood depression and anxiety, we can think of them as the same as grown-up mental illnesses only in children the symptoms may look a little different. When they are sad the child cries and dad drinks, two different behaviors but the same emotion.

Asperger’s is about to be cured.

Suddenly in one day, everyone with Asperger’s will stop having Asperger’s. The same thing will happen to Pervasive Developmental Disorder NOS. Don’t get too excited. Within minutes they will all have caught Autism.

Why this change? Researchers have come to doubt this pigeonhole approach. The characteristics of lots of the mental illnesses we think of as separate conditions are in fact just varying degrees of symptoms of the same disorder. So rather than splitting hairs on which name we call this, we are going to think of this as a continuum and say all these people have more or less similar symptoms just some are more serious and profound than others.

So in the future, all these people will have one diagnosis but we will look at the way the symptoms affect the individual. We hope this is progress. One problem though. In the past, the treatment, especially who would pay for treatment, depended on the label. Schools, insurance companies, and regulators may need to figure this one out. How will they decide how severe your autism needs to be before someone will pay to get you treated? We think we know that the sooner this condition gets treated, even mild cases, the better the child will do throughout their whole life.

That’s enough of this for one post, more about the DSM-5 to come in the future.

Bottom line, the DSM-5 in mid-2013 will make some changes to the way we think about mental illnesses and possible the way they get treated.

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

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

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

For videos, see: Counselorssoapbox YouTube Video Channel

Five Axes Diagnosis Esoterica

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

Medical record

Diagnosis.
Photo courtesy of Pixabay.com

Five Axes Diagnosis Esoterica.

Update –

With the release of the DSM-5 using 5 axes may soon be a thing of the past.

Professionals will be looking for this information or most of it. We just won’t be separating it and reporting it this way. I left this post up for those who would like to see the way things used to be.

So in a previous post, we talked about some of the reasons clinicians might be reluctant to tell you about your diagnosis, how the diagnosis is based on the DSM-4 (soon to be the DSM-5) from the APA and how diagnosis are categories while people are on a continuum so sometimes people do not fit the diagnosis neatly. We left off with the ideas that there are 5 axis and that most people stop after knowing more or less their diagnosis on Axis one.

Axis One.

The DSM has over 400 diagnoses. Not just mental illnesses but all sorts of other problems that might take you in to see a counselor. They include mental illnesses, emotional and behavioral problems. This section covers about 750 pages of the DSM. My list below is VERY oversimplified

The major sections, not in order are things most of us have heard about:

1. Adjustment Disorders – life’s problems grown large.

2. Anxiety.

3. Mood disorders meaning Depression and Bipolar.

4. Psychosis, like Schizophrenia and Schizoaffective.

5. Disorders first seen in childhood – like ADHD, learning disorders, and Autism. (But NOT mental retardation!)

6. Sex, eating, and sleeping.

7. Substance abuse.

8. Dementia, physical stuff caused by emotions.

There is a section in the back where other codes, mostly the “V” codes are listed. “V” codes are largely about relationships like parent-child conflicts and partner conflicts. While counselors work in these areas many insurance plans to not pay to treat these things.

Axis Two.

The things we put on axis two are things that we used to think were untreatable – that is just the way you are stuff. This includes personality disorders and mental retardation, a strange mix. Both issues now have appropriate treatments.

Personality disorders are treated using therapies like DBT. Most women in prison are diagnosed with Borderline Personality Disorder. Sometimes in practice, the boundary between Borderline and Bipolar gets fuzzy.

Most men in prison get a diagnosis of Antisocial Personality Disorder. This is also generally treatable if the client wants to change.

Mental retardation can be treated using behavioral techniques as long as we have realistic expectations. The distinction between mental retardation and developmental delays can get fuzzy. Some people call all of these delays and avoid the politically sensitive issue of saying someone has mental retardation. It is also possible for someone with mental retardation to have an axis one problem like depression.

Axis Three

Did you know that medical conditions can cause symptoms that look like a mental illness? All good therapists like to have clients see a primary care doctor, specialists if needed, to make sure this the problem is not a brain tumor or hormone issue. Things like pregnancy, brain injury and poisoning all get confused with mental illness. In seniors, a lot of this dementia and cognitive decline is the result of the side effects of medications the senior is taking. Please, however, do not start or stop meds without talking with your doctor first. Ideally, your doctor and your therapist should be talking and on the same page if you have any medical conditions that may affect your mental state.

Axis Four – Psychosocial and environmental problems

Stressors for short. Not having friends or a family or having a poor relationship with them can cause lots of emotional problems. We also include people with social and educational problems. Being arrested or a victim of crime might get you an Axis Four diagnosis, as would not having medical care or living in poverty. We don’t always talk with clients about these issues as much as we should but these issues are at the core of client’s problems a lot of the time. Note that no matter how severe your unemployment problems are if you can’t qualify for an Axis One diagnosis like Depression you may have difficulty getting counseling for your employment or other problem.

If stressors are interacting with your mental health you might want to see a professional or clinician counselor who specializes in individual therapy centered on both these areas. In California, we call this specialty Licensed Professional Clinical Counselors (LPCC’s.)

Axis Five.

This is a summary scale. Imagine how hard it is, to sum up, a client’s whole life on a 0-100 scale. Imagine getting a pass-fail grade on your life. Imagine trying to grade someone’s life. Lots of other scales have been suggested for this. Insurance types like it because if your GAF number goes up it shows the therapy is working. This makes them happier about paying. Mostly we use this in making decisions about hospitalization or urgent care.

I don’t ever remember telling a client their GAF because it does not much matter unless there is something that needs doing right now and in that case, I want to talk about what it is we need to do now.

So there we have it in two brief posts a very simplified look at the process of diagnoses.

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

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

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

For videos, see: Counselorssoapbox YouTube Video Channel

What is wrong with me?

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

What is wrong with me?
Photo courtesy of Pixabay.com

Ever wonder what is wrong with you?

Lots of clients ask me that question. Occasionally they want to know their diagnoses. Most of the time they are asking a whole lot more.

Discussing a diagnosis with a client is a controversial thing. Some clinicians feel that a diagnosis is a label and the client is a whole lot more than their label. What a client needs right now may have very little to do with their long-term diagnosis. Someone who has the symptoms of schizophrenia may come to see the counselor because they can’t get along with their spouse. The schizophrenia may make the situation more complicated but what they need right now is relationship counseling just like any other person. I see the point of avoiding labels but don’t always agree about withholding the diagnosis.

Other people tell me that knowing their diagnosis is empowering. If you can put a name on your problem and you know there are treatments for this problem, then you have some hope of recovery. If the professionals can’t tell you what is wrong you may start to think there is no hope for you. Alcoholics Anonymous encourages its members to admit they are alcoholics. If you know that you have this disease then you know what or do. Don’t drink! But if you think you have a “lack of control” or poor willpower you can keep on trying to control your drinking while racking up more DUI’s.

I take the approach that if the client asks me what the diagnosis is then I owe them an answer and an explanation. Personally, I don’t think “Why is it important for you to know that?” is an answer. It annoys me when clinicians do that. Lots of clients tell me it annoys them when their counselor says things like that. So how do therapists come up with these diagnoses that end up in the client’s charts?

A warning here. Diagnosis is not a do it yourself program. What I am saying here is meant as general information, not a personal assessment. That said, if you have questions ask your provider. If you don’t like the answer ask for a second opinion.

Some basics first. The way in which mental illness is diagnosed keeps changing as research and our understanding changes. There are also some gray areas in which the clinician needs to make a judgment call.

Diagnosis of mental illness is most often made by using a book called the DSM-4-TR. This stands for the “Diagnostic and Statistical Manual of Mental Disorders, fourth edition, text revision. The DSM-5 is due out soon but so far there is lots of disagreement about the changes that may be made. This book is published by the American Psychiatric Association (NOT the American Psychological Association type APA) so while we all have to go by their book, the psychiatrists get to write the book.

There are a lot of complicated rules about who gets to hand out Diagnoses and whether or not they need to be cosigned by a Psychiatrist. I won’t try to explain all that just now.

Therapists and counselors have to take at least one master’s level class, sometimes two in using the DSM and they get thousands of hours of supervised training while pursuing their license. You would think that would take all the guess-work out of diagnoses – it doesn’t. Let me explain why.

Diagnoses are categories. The client gets a named diagnosis like Depression. People don’t always come in nice discrete categories. Everyone gets sad or depressed sometimes. When is it severe enough that we say you have depression, not just normal sadness? We have 32 different shades of mood disorders (296.xx’s) plus specifiers for each and say 6 or more other flavors tucked away in other places. (Cyclothymic, Dysthymic, Adjustment Disorder with Depressed Mood etc.)  See why your psychiatrist might have a headache even before you get to their office? See why we might each have a few “favorite diagnosis” that we use more than others? But the problem doesn’t end there.

Let’s take one diagnosis category – Major Depressive Disorder.  To hand this one out the client must meet criteria A, B, C, D, and E. AND under criteria A there are 9 “Notes.” The client needs to have note one or two and at least four other of the noted characteristics. So we interview you and you sort of have note one but not note two. Then we see you have the three of the others, but we are just not sure if you have the fourth one or not. Now we have a problem.

If we say no to either of the maybe’s you are out. You do not have depression. But if we say yes to the two questionable calls you are in – you get the diagnosis. This makes me want to scream.

In research studies, they use “strict” criteria. Any doubt and they do not give out the diagnosis. In practice, if you come close and we think you need help and that you might get worse, then you are in. If you are suicidal, does it matter how many times a week you are able to feel pleasure or how much you sleep?

We should be done now but we are not. Not by a long shot. There is a hierarchy of diagnosis. Sometimes one diagnosis trumps another, sometimes not.  You can have depression and anxiety but not depression and Bipolar disorder.

Stop screaming.

Lots of people come in and tell me they have been diagnosed with Depression, Manic Depression, and Bipolar. I nod my head yes and let it go.

Bipolar is the new name for manic depression, the same thing, new name, mostly to confuse us. Bipolar may not be any better a name than manic depression. Both make it sound like you are either manic or depressed. Kay Redfield Jamison says, and I very much agree, that it is possible to have both at once, we call this mixed states. Some psychiatrists want to take it out of the next DSM. I think it needs to stay, but who am I to argue.

Why can’t you have depression and Bipolar? Because the description of bipolar includes having one manic or hypomanic episode! Most people start out diagnosed with depression but once you have even one teensy weensy bit of hypomanic episode we change the diagnosis to Bipolar.

I want to thank DeeDee whose post suggested the idea for this post. Her post on the GAF got me started about how we keep the diagnosis a secret. It is now clear I will not get this all into one post. So watch for a future post in which we tackle the mysteries of five-axis diagnosis and other esoterica.

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

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

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

For videos, see: Counselorssoapbox YouTube Video Channel

Bipolar Disorder Genetics Research Study- Come one come all

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

Person with masks

Bipolar.
Photo courtesy of Pixabay.com

Here is another Bipolar research study that I thought was worth passing along.

This was announced last month but I just came across the post.  While it may not help anyone with their current symptoms these kinds of studies help us understand more about

This was announced last month but I just came across the post.  While it may not help anyone with their current symptoms these kinds of studies help us understand more about Bipolar disorder and other conditions that just look like bipolar but aren’t. Here is the full press announcement from the March 1, 2012, update from the NIMH partner’s email. Let me know what you think of these blog entries on Bipolar research programs. Are they helpful? Have you heard about this before? Feel free to leave a comment on the counselorssoapbox.com blog.

“Nationwide Recruitment: Bipolar Disorder Adult Research Study

Bipolar Disorder Genetics: A Collaborative Study

Individuals diagnosed with bipolar disorder may be eligible to participate in a research study at the NIH Clinical Center. The purpose of this study is to identify genes that may contribute to the development of bipolar disorder (manic depression), and related conditions. Bipolar disorder is a common and potentially life-threatening mood disorder. The tendency to develop bipolar disorder can be inherited, but this is poorly understood and probably involves multiple genes. This study will use genetic markers to map and identify genes that contribute to bipolar disorder.

Families and individuals who have the disorder are asked to contribute personal information and a blood sample to an anonymous national database. This information will aid scientists around the world who are working together to develop better treatments for this serious mood disorder.

To find out more information, please call 1-866-644-4363 or email kazubad@mail.nih.gov.

National Institute of Mental Health, National Institutes of Health, Department of Health and Human Services

For more information on research conducted by the National Institute of Mental Health in Bethesda, MD click here http://patientinfo.nimh.nih.gov.”

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

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

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

For videos, see: Counselorssoapbox YouTube Video Channel

New Bipolar drug trial

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Person with masks

Bipolar.
Photo courtesy of Pixabay.com

In past blog posts, I mentioned that one difference between people with Bipolar disorder and people with unipolar depression was the way that people with Bipolar Disorder sometimes react suddenly and dramatically to medications, especially anti-depressants. I came across this article on a new trial of drugs being conducted by the National Institute of Mental Health. Thought this might be of interest to some of you. But please folks, don’t try this at home. New drugs should only be tried after consulting with your current provider and medication should always be supervised by a medical professional. If any of you are involved in this trial or hear more about it let us know what you find out.

NATIONWIDE RECRUITMENT–BIPOLAR DISORDER RESEARCH STUDY: ANTIDEPRESSANT RAPID EFFECTS OF KETAMINE

Individuals who have been diagnosed with bipolar disorder may be able to participate in a trial designed to understand the causes of depression and rapid antidepressant response. Specifically, this study is testing whether ketamine, a drug that affects glutamate in the brain, will improve symptoms of depression within a matter of hours.

Individuals between 18 and 65 years of age who have been diagnosed with bipolar disorder and previously failed to respond to treatment may be eligible for an inpatient trial designed to bring about a rapid antidepressant effect. After completion of the study, the participant is transitioned back to a clinician in the community. In addition, all research participation is without cost and NIMH will cover all transportation costs from anywhere in the United States. Compensation is provided for study procedures. To find out more information, please call 1-877-MIND-NIH (1-877-646-3644) or email moodresearch@mail.nih.gov. For more information on research conducted by the National Institute of Mental Health in Bethesda, MD click here http://patientinfo.nimh.nih.gov.

The photo above is from Wikimedia and is not the drug they are talking about for the study. You will probably need to cut and paste the link above. Short post tonight but more is on the way. Until next time, have a happy life. David Miller, LMFT, NCC.

Finding happiness or misery

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Counselorssoapbox.com

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

You get what you look for. Sounds simple, but this basic principle has a huge impact on how happy we are. Take two couples one happy and the other miserable – what is the difference?

Couple one, let’s call then Bob and Sue, for no particular reason. Bob complains that Sue nags him. She never likes the tie he wears. Nothing he ever does is good enough. Sue is sure that Bob doesn’t love her. He never wants to spend time with her. He is always too busy with his job and his studies for his night class to spend time with her. Sue says the only time Bob does things around the house is when she nags him, he always puts off taking the garbage out until the last possible moment. She has to keep at him because he will put off taking out the trash until bedtime if she doesn’t keep on him.

The couple next door, let’s call them Juan and Ann, again for no special reason. Juan says he is so happy in his relationship. Ann is always trying to be helpful. She wants him to be successful and look his best. She is so helpful; she even makes suggestions for which tie will make him look his best. Ann tells me she is so happy to be with Juan. He works so hard to provide for the family. He is even taking a night class to help improve their income. Juan is so helpful around the house, Ann says, sometimes she has to remind him because he is so busy, but he always gets the trash out before he goes to bed.

Now Bob and Sue are sure that their neighbors are very nosy, always minding other people’s business. When the family came to visit that old busybody across the street came over and demanded to know who was there. Sometimes that woman brings over food in an effort to get into the house and spy on them. They have had to tell the neighbors several times to mind their own business. This town is so hostile. The other day one of the people up the street followed Sue all over the grocery store.

Juan and Ann report they feel so safe in their neighborhood. They have a neighborhood watch. One time when Ann’s parents came for a visit, Mrs. Smith across the street came over to check who was going into their house. She almost called the police on Ann’s family. Mrs. Smith brought over a cake she had baked for the family to enjoy. Ann and Juan feel so safe knowing that the people on their street will keep an eye on their house when they are not home. It is such a friendly town. Last week they went shopping and ran into Mrs. Smith in the market. She was going one way and Ann was going the other, they must have run into her ten times that day. They had a good laugh that they just couldn’t stay away from each other.

Why is the experience of these two couples, who live just a few houses apart so different? One couple loves their town and their marriage and the other is miserable. Two important happy life principles are at work here. First, the happy couple has a happy positive belief about the way they are, the way the world is, and how the future will turn out. This illustrates the principle that beliefs about things, not the things themselves create our feelings. But no matter what you believe, life experiences will impact your beliefs and feelings. Both couples have a bias in their thinking.

We call this bias confirmatory bias. If you think your spouse is uncaring or lazy you will watch the things they do and pick out the things that confirm your belief as proof you were right. It is a natural human tendency to look for things that will make us right and to ignore or discard the things that might force us to change our minds.

Happy couples see things their partner does and interpret them as positive. Unhappy couples can find plenty of proof that their partner is unloving and uncaring. Now we know there are bad relationships and uncaring or dishonest people out there. But if you enter a relationship expecting your partner to make you happy they are likely to. If you go into a relationship with the expectation your partner will mistreat you then you will find lots of “proof” for that also.

Much of our news fits this pattern also. Two people hear the same economic report, one sees things in the report to say that the economy is improving; the other person sees things to prove that the economy is getting worse.  Political speeches and debates especially demonstrate this principle. If you are strongly in favor of a candidate you will think they made a great speech. If you dislike that same candidate you will find something in the speech to seize upon and “prove” that person is unfit for public office. If you are wrong about a candidate for office you can complain about them until the next election. If you live with someone it is a bigger problem.

Sometimes it pays to challenge those beliefs. Is your spouse really being uncaring or unloving or do you look for the faults and miss the positive things they really did do for you?

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

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

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

For videos, see: Counselorssoapbox YouTube Video Channel

Wall Street is crazy!

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

Mental Health or Mental Illness

Mental Health or Mental Illness?
Photo courtesy of Pixabay.com

Have you noticed that Wall Street has gone crazy?

Not the prices or the up and down of the market, more the way they are talking. I used to think all the “loony tunes” were in Washington. Have they moved to Wall Street?

Have you noticed they keep stealing our words – depression, schizophrenia even bipolar have turned into market terms.

I noticed it the other day. I was looking for articles on Major Depressive Disorder. Every article I came up with was about the economy. Suddenly depression is about a slow economy and not about a mental illness. Who do they think they are fooling?

With the exception of the “Great Depression” of 1929 past economic slowdowns were not called depressions. Even that one got the term because of the widespread sadness in the country as a result of the economic slowdown.

I even got a nasty comment on my blog, which I did not approve thank you very much, from a broker who was upset that we called sadness – depression. He did not like the idea that people could be sad. Investments – yes. People – no.

I read about the “occupy movement.” I can understand why they might want to occupy some places. Anyone for occupying Hawaii? But really guys – why occupy Wall Street? Would you occupy a VD clinic? Aren’t you afraid of catching something while on Wall Street? Something for which there is no treatment?

Let me remind those financial types that business slowdowns used to be called “Commercial Revulsions.” Look it up on Wikipedia if you doubt me. The idea was that purchasers became repulsed by the goods offered for sale. If you have looked at some of the cheap, tacky stuff in your local “Walleye World Store” or the “Cheaper Than a Buck Place” you would know what I mean. Some of that stuff makes me sick. In fact, I got so “commercially revulsed” that I wanted to vomit.

After “Commercial Revulsion” some smart ad man went to calling these downturns “Panics” they had a whole bunch of “Panics” up until our financial leaders decided that having a biannual “Panic” might not be good for consumer confidence.

We called them recessions off and on but that designation got to be so watered down we were having annual rescissions every time some retailer did not make a profit projection. So this time around they decided to borrow some mental health terms to explain why so many people are out of work and sad. In therapy we call these problems “Adjustment Disorders,” so far Wall Street hasn’t stolen that name. They are not used to adjusting to anything that is not their way but give them time.

We also used to have lots of bubbles. Remember the South Sea Bubble? (See Wikipedia again.) I remember sales on Arizona swampland and Florida homesites that were underwater. Wait a minute did that just happen again? Is this a rerun? This time underwater means they owe more than the stuff is worth. Last time it meant there was seawater on your home site. Another way to fleece a –

They have also taken to calling some CEO’s and CFO’s schizophrenic because they can’t seem to make up their minds. There is more to schizophrenia than indecisiveness. There are auditory hallucinations and there are things we call negative symptoms. Come to think of it some of those Wall Street types must have been hearing voices all through the housing boom. And now they have started making me real negative. Still not sure they should get the diagnosis of schizophrenia though.

And when did bipolar get to mean moody? I wrote a post about that but still, some stock guy wants us to think that today’s up and down market price is a sign of bipolar.

Next week I expect to read about a stock with “Dissociative Identity Disorder” or a CEO who has an “attachment disorder.”

Could you Wall Street types leave our vocabulary alone?

Could it get any worse? I just e-searched for more depression articles. Our depression word has been hijacked by a group of meteorologists. There was a whole page of articles on “Tropical Depressions.” What is so sad about going to the tropics it would make a meteorologist depressed?

Until next time, safeguard your illness from theft and have the happiest life you can.

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

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

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

For videos, see: Counselorssoapbox YouTube Video Channel

.

Should you be happy?

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

Happy faces

Happiness.
Photo courtesy of Pixabay.com

Are you comfortable feeling happy?

There are lots of articles on the net and lots of blog posts about depression and anxiety, but not much being written these days about being happy. We can’t blame those people who are focused on their depression or anxiety for this state of affairs.

If you ask people what makes them happy, many people can’t answer that question. Most people have never even thought about what might make them happy. In therapy sessions, I often ask people to describe some basic emotions, things like happy, sad, afraid, or mad. Most people in crisis can’t tell what makes them feel the way they do. They just know they are in pain and turmoil.

When I ask them what would make them happy, they often sit and look at me for a long time without an answer. The question stumps them. They have never considered just what it would take to make them happy. Usually, the pain is so acute that just ending the pain is all they can think about.

Loss of pleasure is one of the symptoms of Major Depressive Disorder, that I know. Yes, sure, in my practice I work with many people who are so depressed or anxious that they can’t even think about happiness just now. What surprises me the most is that most of them have never stopped to think about what it would take to make them happy.  Many times they are not even sure they should be happy. What would you say if I asked you that question?

Do you deserve to be happy?

There are those people who hold the religious view that the time on earth is a trial and they expect to suffer. They tell me they expect to suffer. Unfortunately, they frequently mean that they want everyone else to suffer. I see their kids in therapy after the kid has given up on life and wants to die. Please, if suffering makes you happy, try to do it in a joyous manner and let those around you have the happy life they deserve.

Now I know there are lots of challenges in this world. There are families that live in poverty.  There are single parents struggling to provide for their families on one low paying income. Families have sick children. Sometimes one or both parents are ill. Sometimes awful things happen to these people. Some people suffer horrifically.

The surprise here is that sometimes in two houses, side by side, both undergoing hardships, one family is happy and the other is miserable. Why?

How is it that some people can go through life’s trials and still values their existence while another person will suffer terribly?

One major difference between those who walk through a trial and continue to be happy and those who are overwhelmed is the mental attitude they have. I know that this is so easy to say and so very hard to do. Fortunately, there are people who are willing to help you change your view of the world if you are willing to change. I am not just talking about professional counselors and therapists here, though that is their job in my opinion. There are also self-help groups, books, and support systems of friends. The key is to be willing to give up our attachment to suffering and to embrace the idea that it is possible to have a happy life.

There are at least three things that can move you towards a happy life.

1. Give up the notion that you need to suffer and embrace the idea that it is possible for you to be happy and that you deserve this happiness not because of what you do or have but simply because you are the one unique you. Embrace the quest for a happy life. A happy life is not all about pleasure. Drugs and things are not likely to make you happy.

2. Change your thinking. Most of us have a whole pack of must’s, should’s, and have-to’s that we hold onto. Being able to let go of things and move on is critical.

3. Nurture your resilience, that ability to bounce back. This is a real life. It has its ups and downs. I can guarantee that things will happen to you that you will not like. But then if you keep on track those good things will happen also. So if you keep looking at the failures you will grow them. Learn from life’s trials but grow from them also.

You and I both know that if you are down right now all this is hard to do. When you lose your job, end a relationship, become homeless, or are struggling with sickness it is easy to get down and depressed. It is easy to get into fear and worry. Look for help. Find someone that you can talk to that will understand and support you.

In future blog posts, I want to talk to you about all these issues and many more. As our country struggles with a great economic illness we seem to have neglected the mental and emotional health of our people. Do all you can to fight mental and emotional illness by carving out all the happy life you can. And share that happiness. Happiness shared is not diminished it is multiplied.

See also:

Finding happiness

How to be happy

Buying happiness

13 ways to make yourself miserable

Till next time. Wishing you the happy life you deserve.

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

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

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

For videos, see: Counselorssoapbox YouTube Video Channel