Tag Archives: co-occurring disorders

Depression Season – 8 Ways To Beat It.

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

Depressed person

Depression.
Photo courtesy of Pixabay.com

Beat the depression season.

We are coming up on depression season. Did you know it has its own season? Like the rainy season or strawberry season, there is a definite season for depression, and it is fast approaching. While there are lots of reasons people might get depressed for the holidays there are things you can do to prevent or reduce depression this time of year so please stay tuned to the end for the solutions.

You have seen or will see shortly see lots of stuff about Seasonal Affective Disorder (SAD). A great many people suffer from a specific disorder which causes them to get depressed this time of year. Some people with SAD are OK during the winter but get depressed in the summer. A few unlucky ones get depressed summer and winter. These issues mainly have to do with changes in the hours of daylight and the weather. That’s not the only reason people will be getting depressed soon.

People with mood disorders, those who experience depression or bipolar disorder, are at extra risk to fall into depression this time of year.  There are all kinds of reasons for people with mood disorders to have episodes of depression and this time of year has. The season has lots of stressors that may trigger a bout of depression. Sure seasonal changes are one reason but as severe as they may be, loss of light and cold weather are not the only reason people fall into depression this time of year.

One reason for a winter depression season, which I believe is significant, is the increased occurrence of colds and flu. When someone is under the weather, they get grumpy and want to be left alone. When humans are sick we tend to push others away. This is especially true of children. We see a lot of kids that were essentially well-behaved most of the year but suddenly during the winter months they get into fights with their caregivers and end up in emergency psychiatric facilities. Often these emergency admissions, in kids and in adults, will begin sniffling and sneeze within hours if not minutes of admission. They got into conflicts and were unable to manage their emotions in part because they were fighting off an illness.

There are a lot of family get-togethers during the fall holiday season. Events like these cause stress. Even good events can be stressful. But how often has a holiday get together ended in arguments and fights? What was supposed to be a happy get together has turned into a depressing occurrence?

Some people become especially depressed during the holiday season for the opposite reason, they have little or no family. That is not the way we picture a holiday get together. On T. V and in the store ads holiday meals are a large group of people all laughing around a table full of tempting food. Imagine eating a bowl of Top Ramen by yourself for your holiday meal? I am getting bummed out just writing about this.

Increased consumption of alcohol and drugs in the wintertime also results in an increase in depression. People with mental illnesses are at increased risk to use drugs and alcohol to try to feel better. They also smoke the majority of the cigarettes consumed in America. Add a full ashtray and an empty bottle of booze to that bleak alone Christmas table and see how the picture looks now.

People with substance abuse problems, of course, get really depressed, at the holidays or any other time for that matter. Alcohol is a depressant, plain, and simple. Lots of us missed school the day they taught that. So the more you drink the more depressed you will probably get. Remember the twenty percent heaviest drinkers will drink eighty percent of the alcohol this holiday. They will also get arrested the most and they are fifty-five times more likely to attempt suicide when drunk.

People who do stimulants such as Methamphetamine will not be happy for Christmas either. Stimulant abuse does not make for happy people, just “wired” people. And when those drugs wear off and the user crashes, add them to the depressed.

So it does not much matter whether you have one problem, two problems, or many. It is not important which came first, the mood disorder or drug use. Lots of people are at risk for a bout of depression, from mild to severe, this holiday season.

So what can you do to avoid or reduce depression during the holidays?

A few simple steps, these are especially important if you know you are at risk.

1. Avoid alcohol and abusing drugs.

2. If you take meds stay on them and take them as prescribed. If you experience a severe episode of depression you may need to talk to your doctor or psychiatrist about your medication needs.

3. Spend as much time as possible in brightly lit places. A few hours a day of sunlight is great if possible. And definitely, avoid dark gloomy places.

4. If you have a spiritual or religious faith, practice it like your life depends on it. If you have severe depression your life just might depend on it.

5. Do not stay at home alone. Find places to go and people to be around. This is an area where alcoholics, drug addicts, and other recovering people just may have an advantage if they chose to use it. All across this country and beyond, twelve-step groups will have increased meetings during the holiday season. Many have potluck dinners. Some groups will hold Alco-thons and marathon meetings, around the clock 24 hours meetings of recovering people who encourage and support each other. For more information check your appropriate fellowship on-line or call the local central office.

6. Make use of your support system. Call someone you care about. Call someone who cares about you. If you have no support system – see point 5 above.

7. Plan to do something for someone else. Any minute you are thinking about someone else is a moment you are not worrying about yourself.

8. Don’t hesitate to call or seek professional help. They are lots of local helplines. Please use them. The time to look up those numbers, like the time to develop a support system, is before you need them.

Hope you all avoid the depression season and have 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

You are not playing enough. Neither are your children.

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

Children Playing.

Children Playing.
Photo courtesy of Pixabay.com

How often have you heard “Stop playing around?”

Is some adult’s voice from your past playing in your head right now as you think about that? Do you ever say that to your child or someone else? Well, knock that off.

The truth is we all need to play more and so do our kids. Now I am not talking about the high-pressure play of organized sports. We are hearing about a lot of kids getting injured playing competitive sports. That is not good for them and despite that delusion of our athletic prowess most of us older folks are not up to that stuff either. I am not thinking of the high dollar sports that are now a business and not fun. What I am suggesting is we all need to do more running and jumping, laughing, and having fun.

For a while we had a movement called the “new games” movement which said that games had become too formalized and rule-bound. People watched them instead of playing at them. So they started inventing new games with different rules. The fun was in trying something different.

Now some of you are saying we need to be serious, kids should learn the academics. No time for play in a well-organized society, except for a few professionals we watch occasionally. That would be all wrong. Kids who play around as children very often do better later in life than their serious compatriots. Let me tell you a story.

There was a school that assigned a teacher to a special education class. That class had such a reputation for not behaving that they were banned from the school-wide assemblies. But this teacher thought it wasn’t fair that her class couldn’t go and all the other classes got to. The other teachers made their class’s line up and march to the multiuse room for the assembly. They were certain that those special education kids could never stay in line long enough to get lined up. And if they were able to line up by some bundle of luck, they were sure to move around and disrupt the assembly. The newly assigned teacher had a different idea and she had a solution.

She did not march her class across the school in single file formation as the other teachers did. She had her class run, as fast as they could, laughing all the way, around the entire school grounds. Only when they had run as far as they could, did she line them up for the assembly. And the shock was, that after a good run those kids were better behaved than the other classes. The teacher was Violet Oaklander, and her book “Windows on Our Children” is a classic on the use of art and play as therapy. But there is more to the story of why play is good. We now know it is not only useful for treating children therapeutically. Play is also necessary for normal development.

Children’s unscripted play is important in developing skills that will increase learning in other areas and will be useful in later life. Play is useful for alerting, improving attention, and for helping people organize their thoughts. It is also calming for most people. Some adults are afraid that play might “wind kids up.” It may improve alertness; I wouldn’t recommend it just before bedtime. But before class, it is likely to improve performances not prevent it.

So if we have overactive disruptive students, what do some teachers do? They take away recess and keep the kid in. This is precisely the wrong approach. Please, no emails – you don’t understand – we need to maintain control. FYI, I teach also, I know the problem. But when students get restless then need more breaks and physical activity, not more amphetamine.

What else does play accomplish? Old fashion imaginative play also improves the ability to make use of the senses. It improves balance, fine motor skills needed for writing and the list goes on and on. There are also play activities that improve the auditory and visual senses, just the skills needed for effective learning.

The list of skills that might be improved by active play is too long for me to include here. Even video games when used in moderation, have some benefit in improving hand-eye coordination. Remembering I am not a big fan of robotic video game playing. I have seen too many video game addicts.

But Folks that’s not all!

Play improves the ability to bounce back from life’s stress and trauma. Various play activities have been shown to improve recovery and resilience. There is more to the topic of resilience and the ability to bounce back than just play. One of these days I plan to write more about why some people are able to bounce back from all the bumps in life’s road and others don’t seem to have those skills. I was researching the topic of resiliency and recovery when I came upon all the reports of the benefits of more play.

Hum – just might be a book lurking in that topic. Stay tuned for more on the resiliency angle.

So I hope you have gotten the message. Get out there and play some more. And encourage your kids to play more also. You might even get radical and try playing with your kids.

Is anyone reading this? What do you think about the topic of the need for more play?

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

Mindfulness on a full brain

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

Waterlily

Mindfulness and meditation.
Photo courtesy of Pixabay.com

What is all this mindfulness stuff?

And how can I possibly include that in with my cognitive behavior therapy?

Problem-solving in mental health as in life has always been pretty straightforward for me. If we are applying the wrong formula to a problem then we keep getting the wrong answer. Once we learn an improved formula all we need to do is turn the crank and out comes an answer.  Get a head change, a new way of seeing things and the problem changes from unsolvable to a manageable size. So we work on core schemas, automatic thoughts, irrational or dysfunctional beliefs. And we work on acceptance – radical acceptance. So the whole mindfulness thing troubled me—until-

There have been a lot of articles recently on mindfulness. Now I feel that this has its uses. Religious and spiritual practices have their place. And I am as much in favor of candles and herbal scents as the next person. All this has its time and place. And we know that if the client believes in something it will probably help. But do mindfulness techniques have a place in modern scientific, best practices, forms of treatment. Then I read some things that made me think.

Siegal has written and talked about mindfulness and recently I happened to read some things he had written on the subject. They made sense to me from a logical rational perspective.  Let me try to explain this as I get it and hope not to do too much violence to the science.

Scientists have discovered mirror neurons in the brain. Now if all they did was see someone else doing something and result in us knowing how to do the same thing that would be the end of it, one more way to learn stuff.  But these mirror neurons detect patterns that allow us to infer why someone is doing what they are doing. Learning these patterns makes our world a more secure and predictable place. This has a lot to do with understanding attachment theory.

If when we reach for more food at the table we get slapped – we learn to not reach but ask which may be a valuable learning experience for a young unsocialized child. But if the response varies depending on the amount of alcohol mom has consumed, what we may learn is the pattern that the world is a scary and inconsistent place. The pattern of asking may be adaptive and is quickly forgotten if we encounter a situation where it is not expected. The pattern of seeing the world as a frightening place is likely to last a lifetime.

So the mirror neurons help to explain how we learn basic core ways of relating to the world.

But there is more.

Mindfulness teaches the practice of paying attention to how we feel inside. As we come to recognize how we are feeling it becomes easier to recognize feelings in others. This is sometimes called the “expert” effect. If you are an expert on antiques you will spot them and probably will notice the cheap reproductions also. If you are not an antique expert you will see things you like or don’t like but lots of stuff will go unnoticed in the piles of other stuff. Same thing with feelings and empathy.

Seeing people express love will teach you the pattern of love.  But if the people you live with don’t show love or show it inconsistently then you may be unable to recognize the pattern and to replicate it. This does not mean that people whose early caregivers did not love them as much as they wanted will be unable to love. What it does mean is that it may be harder to recognize and express love in later life.

Lots of people in recovery, from drugs, alcohol, mental illness, or dysfunctional caregivers report they have difficulty with trust issues. Most came from situations where it was not safe to trust on a regular basis so they never learned the pattern.  Some recovering people have spent so much time being deceitful to cover up and continue their addiction they no longer recognize the truth when they hear it. Their mirror circuits have not had trust images to reflect back and incorporate into their catalog of patterns.

So how will mindfulness techniques help someone who has trust issues, attachment problems, or dysfunctional behaviors? How might these approaches help counselors in helping clients?

By becoming aware of our inner feelings and thoughts we can begin to dispute dysfunctional beliefs. We can learn new more functional patterns of meaning in life. We can recognize our feelings of anger, mistrust, and fear and test these feelings to see if they have a basis in reality. And we can learn from recognizing our own feelings to have empathy for others.

Counselors can especially benefit from mindfulness techniques by becoming better able to present an empathetic other who can participate in a corrective emotional experience with the client.

More to come as I research for that book I am writing on resilience.

Wishing you all the mindfulness you care to have. Hope to hear from some of 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

Three-year-old judge decides right and wrong

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

child

Child.
Photo courtesy of Pixabay.com

6 ways to tell right from wrong.

Preschool kids seem to be so very good at telling what is right or fair. They tell us often enough – “That’s not fair!” So how come they so often do things that we say are wrong? Maybe we should appoint three-year old’s to the Supreme Court? Is the understanding of right and wrong something people are born with or do they learn it? And if they learn moral values, how do they learn it?

In the early grades the ways in which kids decide the difference between right and wrong starts to change, at least for some of them. It is important to understand how it is that people learn right from wrong. Why some don’t seem to learn might also be a good thing to find out.

People who study child development probably learned about some theories of how an understanding of right and wrong developed. Counselors are often taught about the stages of moral reasoning, in some developmental classes and then seem to promptly forget it once they start working with real clients. But isn’t right and wrong, and conflicts over how that should be decided one major reason we see clients in counseling?

Lawrence Kohlberg researched and wrote about moral development. So did Lickona who wrote a very readable book “Raising Good Children.” I would recommend it to any parent struggling to teach their child the difference between right and wrong. Somehow all this work is getting forgotten despite the constant reports of high crime and failure of discipline in the home and school. We spend a lot of time these days emphasizing math and science in schools, but less and less time in our homes and schools is spent on right and wrong. So how is a sense of right and wrong likely to develop? Let me give you a brief description of Lickona’s ideas as I remember them. For the full details you might want to look for the book but here is my short version of the 6 stages of moral reasoning as I understand them. Lickona numbers the stages zero to five. The fact that he arranges them this way does not mean everyone agrees that a lower numbered stage is, in fact, better than another stage with a larger number.

0. Getting what I want is fair!

This is the default way of deciding right and wrong. It’s not fair – I wanted ice cream and I didn’t get any. Some people seem to be able to go through their whole life thinking this way. They take what they want and that is fair to them. Some of them go to prison. Some learn to hide what they are doing. Some of these folks end up elected to public office or working on Wall Street. These folks make lawyers rich when they try to get out of trouble for doing what they want. If we don’t want more of these folks around we need to work on teaching kids the more advanced ways of deciding right from wrong, or we need to build more prisons.

1. The teacher said – the authority approach.

Some kids learn this at home before they go to school, for a variety of reasons. Most kids learn this in school. It starts by learning to do what the teacher says. Eventually, the appeal is to some higher authority like the principal. Some people get really legalistic. It says on the page — of the revenue code, that I can do this so it must be right. In some places, with statute law, if there is no law against it, you can do it. In most places in the United States, we have the common law which says you should use common sense unless there is a law otherwise. Then we have lots of layers of appeals courts because we are so short on common sense. We see lots of people who appeal to religious writings as their rule book, sometimes to good effect and sometimes to some awful results. The problem here is not especially with the particular religious writing, but some of the bizarre ways people can interpret those writings. The philosopher, Charles Shultz once reported, something to the effect that “There is nothing in the book of Leviticus that prohibits the wearing of contact lenses.” See how hard I am trying to be politically correct here?

Some people would separate “The Teacher said.” part, from the “The rule is.” Both are resorting to authority but one is putting your faith in a person and the other in some specific set of rules.

2. One hand washes the other.

This commonly heard, usually, in business, expression says right and wrong is something we trade.  We take turns. Most kids learn this on the playground really fast. If you don’t take turns with the ball you may not get to play at all. In Congress, this is called trading votes. You vote for my bill and I will vote for yours. It is pragmatic, gets things done. But is it the best way to determine right and wrong? We need to study this. Send me a million or so in federal money and I will be glad to work on this approach. At a million dollars a year we may need years of study. See how problematic trading one thing for another might be as a way to separate right from wrong?

3. I want you to like me.

So if I want you to like me I should do what you think is right. This is the “what will people think of me” approach. This type of social conformity can keep people acting in a socially positive manner – sometimes. The issue here is what people’s opinion do I care about? This goes to the discussion of peer pressure which I wrote about in an earlier blog. Take a look at that one – now if you want, it’s ok. I can wait here while you look.

You back? So you see that if my peers are good law-abiding people I probably will follow the law. But if my social circle includes convicts, murders, rapists, bankers, politicians, and other undesirables, I might decide that stealing your money was an acceptable thing to do, so long as I steal it using the same methods as my peers.

So using other people’s behavior as a guide to right and wrong may reduce the conflict we have in life, but it is no sure way to figure out right and wrong or to stay out of prison. Ask the group from Enron.

I may be a little hard on this stage. It is great to be a good son or daughter or a good parent. But that may not be enough, especially if you didn’t have good role models. This step in the development of morals is mostly about your relationships with people close to you.

4.  What is best for all of us?

This is the stage where people may do things that have personal costs because it is the thing that is best for our society. This stage of moral reasoning gets people to join the military or become volunteers. This is an altruistic stage, most of the time. It is also a way of moral reasoning that has been used to excuse some horrific atrocities.

Today in America we value diversity. Some of us do anyway. But can you see how someone in another place and time could do some awful things and justify it as “what is best for us?” Think genocide here. Could someone do that thinking it was what was best for their group? The difference between being a volunteer to work with the poor and trying to run a minority out-of-town hinges on who you define as us.

5. Some things are right just because they are right.

This is an easy one to explain in theory, until you are faced with the choice, then it is easy to default to an earlier stage of moral reasoning. Sometimes people are faced with things going on in their society that are just not right. And often it costs to do the right thing at these times and for sure there is nothing in it for you when you do the right thing at these times. This is about respecting everyone just because they are.

So there is my explanation of stages of moral reasoning as I understand them. Can you see how hard it is to figure out the right thing to do sometimes? Some parents are able to teach their children right from wrong despite all the influences around them to the contrary, but what about the other kids? It feels to me like we should spend more time in our society on the ways to determine right and wrong and less on some celebrity’s outrageous behavior. But that’s just my opinion. What do you think about how we learn to tell right from wrong?

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

Am I a quart low on serotonin?

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

Depressed person

Depression.
Photo courtesy of Pixabay.com

Low on Serotonin?

There has been a lot of talk about the way in which neurotransmitters affect the brain. Some of this has been helpful in understanding mental illness and some have not helped at all. On common expression has been that someone had a “chemical imbalance in the brain.” I wanted to talk about that and some other issues related to psychiatric medication in today’s blog. Please keep in mind that this is a highly simplified explanation. Remember I am a therapist and counselor, not a doctor so I need to find simple explanations for clients and myself without misleading them. If you have a background in biochemistry or research skip this blog now. If the doctor has told you to do or not do something please follow the doctor’s instructions or at the least talk with your doctor about these issues. The rest of you let me know if this helps explain things.

The expression chemical imbalance is a bit misleading. The frequent use of that expression has resulted in a lot of people coming in and asking to be tested to see if they have a chemical imbalance and if so what chemical do they need more of.  They get quite upset when we say that we can’t do that kind of test. Here are some of the problems with that approach.

Thoughts in my brain and yours also, are carried from one nerve (brain) cell to another by chemicals. So when I think something, anything, my brain sends out chemicals to carry that message. Once the thought has come and gone the chemicals are broken down and reused or disposed of. So as fast as I can think of something my brain chemistry is changing.

Now different brains may make, transport, and use chemicals at varying rates but we all use chemicals to move thoughts. This is why talk therapies like Cognitive Behavior Therapy can help to change someone’s thinking which results in a change in their brain chemistry. Now medication can also help and research seems to show that doing both medication and therapy for your problems can result in changes that are more rapid and longer lasting than either treatment alone.

Most everyone has heard of anti-depressants. So they think that if I am short on a brain chemical I should be able to take a pill, replace the missing chemical, and – presto – I am cured. Wish it was that simple. Let me give you one exaggerated example of how an antidepressant might work.  The most well known and widely prescribed antidepressants right now are ones called SSRI. SSRI stands for Selective Serotonin Reuptake Inhibitors. This has resulted in a lot of people thinking that the reason they are depressed is a shortage of Serotonin. Let me try to explain how this works. You will need to unpack your imagination for this one.

I once drove a car that had a leaky radiator. At the time money was tight, still is a lot of the time but that is another story. So I kept putting water in the radiator. This is sort of like the way my brain might try to keep putting serotonin into use. But as fast as I filled the radiator the water kept leaking out. So my engine overheated. When I get low on Serotonin my brain overheats (not really don’t get the thermometer to check for depression) and then I get depressed.

So every few miles I had to find a place to stop and put water in the radiator and still it didn’t last long, kept overheating.

So this friend of mine tells me there is this thing you can get at the auto store that stops the radiator from leaking. I get some, put it in the radiator and the leak slows down. A second dose and the radiator stops leaking altogether, well almost stopped but at that point, I only have to put water in the radiator once a week, not every day.  So it wasn’t the amount of that stop leak stuff that mattered. I didn’t need to fill the radiator up with it. It just helped me get more use out of the water I had already put in my radiator.

The SSRI works that way on our brains. It doesn’t put more serotonin in the brain but it slows down the leak so we get more miles or smiles out of the serotonin we already have.

Now, let’s say for illustration purposes here, I am bragging to my friend about what a great job that stops leak stuff did and he doesn’t believe me. So I do a demonstration. I get my trusty old shotgun out. Point it at the radiator and let it rip. Now the radiator starts to leak again. So out comes a can of stop up the radiator stuff and I pour it in. Only this time the stuff doesn’t work. The radiator keeps right on leaking.

This is exactly what happens to the brains of people who are on SSRIs or other antidepressants and then they drink alcohol. Alcohol, remember, is a depressant substance. Why we so rarely call it a drug is beyond me, given that it causes more problems with abuse, dependence, and suicide than all the other drugs. But that is just the way it is.

So the point of this story is that the problem for most people is not that the brain is low on serotonin but that the things we do to our brains use up the serotonin way to fast.  A good diet, plenty of sleep, avoiding drugs, and alcohol can all help you produce more serotonin. So can changing your thinking because happy thoughts release more neurotransmitters into the brain. But calling this problem a chemical imbalance shouldn’t take away the responsibility to get our thinking and our living fixed.

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

ADHD Cure- – Treat Parents

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

Sad child

ADHD?
Photo courtesy of Pixabay.com

Could we cure ADHD or depression in children, especially preschool children, by treating the parents?

Just read a report that concluded that the epidemic of ADHD in preschool children can be very effectively treated by training the parents in Parent Behavioral Therapy (PBT). This raised a lot of questions. Why the increase in ADHD? Why in Preschool children? And most importantly how could treating the parents – cure the children?

The Press Release about the report by the McMasters Center can be found here. 

The McMasters center report suggested a different way of viewing ADHD and the older ADD. As I understand their concept they are convinced there is one larger umbrella disorder – Disruptive Behavior Disorder meaning the kid is doing things or not doing things that cause the adults problems.  This more general description, which is a recognized diagnosis in the DSM-4-TR they then subdivide and refine into ADHD in all its varieties, Optional Defiant Disorder, and finally the most severe form Conduct Disorder.

This makes sense to me since most of the referrals for ADHD screening begin with things like – he won’t stay in his seat, is not doing his work, etc. These are complaints teachers and parents have, not things a child, especially a preschool child would complain about. Hence the child’s behavior disrupts an adult’s life and the diagnosis. They report that this disorder began with the label of “minimal brain damage” but when no one could find the specific brain damage we dropped that label.

Further, the study says that ADHD should be thought of as a spectrum disorder. So it might vary from no problem, through milder forms to “for sure you got it” forms. This like so many other mental illnesses are not a case of you got it or you don’t but rather how much of this disorder do you have. Also, there is no medical test for ADHD. We use screening tests and other ways of diagnosing this but the truth is who gets the diagnosis depends on who does the diagnosing.

So why an increase in ADHD cases in preschool children?

Calling them preschool children does not mean that they do not attend school. ADHD and related problems first began to be recognized about 1902 when most children on earth began to attend mandatory universal education.  Now a large number of children are attending preschool – hence lots of preschool-age children are attending school. The report on effective ADHD treatments included all children under six in the preschool group. They especially noted that at this age it is difficult to separate the effects of a condition like ADHD from normal maturation.

I think young children – by definition are immature, so we don’t diagnose “too young” as a condition unless they don’t act like we want them to then they have some kind of disruptive behavior disorder. Some countries in Europe have children wait until they are at least six to start school on the premise that before six they are too immature to benefit from school. In America, we go the other way and start them out at age two or three on the premise that the younger we start pushing them the sooner they will grow up.

So who gets diagnosed with ADHD?

Most new diagnoses of ADHD occur when children begin to attend some form of formal education and are asked to sit still and concentrate on things the adults want them to learn instead of the things kids want to learn. The majority of diagnoses are made between the ages of five and ten years of age. Diagnoses of ADHD after the sixth grade drop sharply and those first diagnosed after age eighteen are even rarer.

The majority of those diagnosed are boys. In fact, boys in the primary grades are four times more likely to get the diagnoses than anyone else. In my own experience, the time children are more likely to get referred for assessment for ADHD is when they first start school, preschool, kindergarten, or first grade. The next big surge in referrals is between the third and fourth grade when there is a shift from learning to read to reading to learn, and the poor readers get really bored.

The number of adult cases is half of those in children, so either a lot of people outgrow this condition with or without treatment or it is not so much of a problem once you are out of required school.  Or maybe a lot of kids get the diagnosis because they are bugging someone in the position to make a diagnosis.

The poor, especially those on Medicaid are much more likely to be diagnosed, but the rich (higher Socio-economic status) are much more likely to receive medication. The poor are more likely to stop taking meds after one prescription. For much the same reasons the poor are much more likely to drop out of parenting education programs.

When meds work for someone it is wonderful, unfortunately, the only way to see if a med will work for you or your child is to try it and there are side effects to worry about. Note that any meds may have side effects but some are worse than others.

In very young children – under the age of six, treatment with a stimulant ADHD med is likely to reduce the ADHD symptoms, but it increases the depression and other mood symptoms. Or maybe the sadness was always there but it becomes more noticeable when the child is able to sit still. The meds also suppress growth, something that a forty-year-old who is overweight might hope for – but not something we want to see in a child under six. And there is another problem.

In one well-documented study children who took a placebo – a non-active pill – did almost as well on managing their ADHD as children who took the real med. When the meds were stopped, 97.5 % of the kids on ADHD meds did not have a relapse, pretty impressive. But of the kids on a placebo who were treated with nothing resembling a drug other than the pill form it was given in, well a full 88% of these non-medicated kids did not relapse either. The conclusion here could be that the thing that helped the kids was the extra attention involved in treatment, not the medication.

Now, why not just send all these kids for therapy? Well as much as that helps some kids, and remember I am a therapist, there is a limitation on therapy. We see the kid for one hour a week. What happens the other 167 hours? So when parents take a class in Parent Behavioral Therapy or work with the therapist on how to help their child, they are able to maintain the treatment all week not just in the therapy hour.

Now if your child is on meds, please do not suddenly take them off, talk to your child’s doctor or psychiatrist first. But for very young children consider approaches other than medication.

The moral of this story? The more we adults work on our skills the more we can help kids with ADHD, with or without medication. So if your child has ADHD or depression or any other emotional problem, consider participating in therapy and learning new skills that might help your child.

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

Are you a rat?

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

Truth or lie

Separating truth from lies is hard work.
Photo courtesy of Pixabay.com

Should you ever rat? When is it OK to tell on someone?

We tell kids to talk to the teacher if someone bullies them. We tell them no one likes a tattletale. Teenagers are vehement that it is never OK to tell on your friends. Parents of teens wish someone would tell them when their child is in danger. What things might your child be doing you would want to know about? What things do you hope your friends are keeping secret?

In a previous post, I wrote about the way in which kids will tell their friends and their friend’s parents about things they would never tell their own parents. When you hear those things, what should you keep to yourself, and what is so important you need to tell? Should we accept the rule that we should never rat? Should it be OK if our kids keep those things secret?

Wouldn’t it be nice if there were all or nothing rules for behavior in life? Some people try to make absolute rules, for themselves and for others. They are mighty sure what the right thing to do is until you call one of their actions into question.

Most of the time in life, things are on a continuum, from good to less good to a little bad to a lot bad. Telling a friend’s secret to someone else is on that continuum.

As a parent, I would want to know if my child was thinking of killing themselves. Wouldn’t you? Could your child feel good about themselves if their friend confided to them that they were suicidal and they did nothing? People who talk about suicide may want to be talked out of it, to be reassured that there is someone who cares enough to intervene and stop them. Would you want to be the kind of person who saved a life or the kind who let someone die?

How would you explain to the parents of a murdered child that you knew someone was going to kill their child but you didn’t want to tell? Could you live with yourself after that? How would you feel if your friend bullied someone and they killed themselves?

It is a good idea to talk with your child about morality and ethics before they have to make those tough decisions.

If a teen is endangering their life with drugs and drinking and driving do you owe it to them to talk to them about it? If they don’t want to stop and continue to endanger their life it is permissible to tell someone else who is in a position to stop them.

Every year we hear about a local teen that is killed by driving drunk, being a passenger of a drunk, or being hit by a drunk driver. Does not trying to stop that when you know about it make you a bad friend? Would you rather be a good friend who kept a dead friend’s secrets or a bad friend who saved their life?

Professional counselors and therapists have legal constraints on secrets. We can’t tell things we might like to such as having a client tell us about past crimes. The counseling relationship has a high level of trust and if we violate that trust we keep clients from coming for the help they need.

But there are other things that counselors are legally and ethically required to talk about, like intervening if a client plans to kill themselves or someone else. We also can intervene when someone does not know how to care for themselves even if they want to be left alone.

Knowing when to keep a secret and when you need to tell to protect that friend, others and society is one of the tasks people need to learn to be adults. A parent’s major job is to help their child grow up. That sometimes it is OK to tell is a lesson we all may need to learn.

P. S. I know that tame rats can, in fact, make good pets. I have no idea why we call people who tell on each other rats. Rats don’t tell on each other. At least I don’t think they do.

I know there are some of you who won’t agree with me on this, you are entitled to be wrong.

Still feel free to comment on this or any other blog and feel free to like, forward and recommend to your heart’s content. Till next time, David Miller LMFT, LPCC.

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

Don’t think about elephants

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

Elephant.
Photo courtesy of Pixabay.com

For the balance of the time you are reading this blog – please do not think about any elephants.

I know this may be difficult for some of you but whatever you do – do not think about the elephants.

No cheating now.

Do not think about African elephants.

Please do not think about those big gray Indian elephants.

It would be especially important to not think about circus elephants or pink elephants or even cartoon elephants like Dumbo.

So how did you do? Did you think about even one little elephant?

Most of you did think about an elephant, didn’t you?

This short exercise illustrates how difficult it is for a person who has a problem, any problem, to avoid the problem by not thinking about it. The very effort to not think about the problem immediately makes us think of – the thing we were trying to avoid.

Lots of people try to solve their other problems in the same way. Let’s not think about them. Substance abusers who try to not think about their drug of choice spend all their day with the thoughts of that drug running through their heads. Dieters have the same problem, the more they try to think about not overeating the more food intrudes on their thoughts.

So what should you do?

You can’t just sit and think about your problems either that is called brooding. The more you ruminate the more depressed and anxious you will become.

There are two approaches to solving the problem of constant unwanted thoughts.

Do something. Many problems grow the longer you avoid them. Sometimes this is described as – while you are inside hiding from the problem the difficulty is outside doing push-ups. The longer you avoid the trouble the large it looms. Financial problems and unhealthy lifestyles are the most likely to grow. The sooner you take action to cut spending, raise your income, take a second job or just accept that your dream house or toy is really out of reach the sooner you can begin making progress towards solving the problem.

The other approach, the one especially recommended for addictions and other habits that seem to own you is stop trying to not think about the bad habit and begin to focus wholeheartedly on positive things. What would your life be like without that elephant you have allowed to live in your living room? Focus on the new pattern or activity you want to replace the unwanted tendency.

How do you decide which method will be most successful?

If you do nothing will the issue you are avoiding eventually destroy you? Addictions will, a mounting debt will. Unhealthy lifestyles, like smoking, will eventually shorten or end your life. Doing nothing should never be an option.

Unhealthy habits like addictions can never be overcome by sitting passively and resisting the urges. As a counselor, I don’t try to take an unhealthy behavior away from someone, which leaves them empty and hurting. Instead, we try to find something desirable, worthy, and uplifting to replace the burden the client is trying to put down.

So, in the end, the best successes for changing your life and improving the self comes not from struggling to avoid something but from finding a new positive goal to move towards.

As many a twelve-stepper will tell you, the greatest progress towards recovery comes in the times when we seek to do something for someone else. Trying to be of services to others, thinking of how we might help them always takes us further away from our own defects of character.

Here is wishing you a happy journey towards whatever happy life goal you decide to pursue.

P. S. The picture is from Wikimedia Commons.

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