Tag Archives: Counseling

Why are so many children being diagnosed Bipolar?

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

Person with masks

Bipolar.
Photo courtesy of Pixabay.com

Early Onset Bipolar Disorder.

Bipolar diagnoses in children have increased 40 fold in the ten-year period from 2000 to 2010.

What is behind the increasing number of children and teens who are being diagnosed with Bipolar Disorder?

We are learning more about the risk factors for early-onset all the time. Still, as we learn about what may be causing this increase in the number of cases of early-onset Bipolar Disorder, the picture of how to treat or prevent early life Bipolar Disorder is getting less clear.

If we could detect symptoms of Bipolar Disorder early, presumably we should be able to treat those symptoms and reduce the incidence of Bipolar Disorder or at least reduce the severity of the disorder.

Unfortunately, there is often a lag of ten years or more from the first symptoms until the child has a manic or hypomanic episode that qualifies them for a diagnosis of Bipolar.

I have written in past blog posts about how many of the things that cause people to think of someone as Bipolar are in fact not necessarily symptoms of the disorder. Being moody does not make you Bipolar.

What does help define the Bipolar condition is the ability to sleep only a few or no hours per night and still have plenty of energy. That along with excessive energy, being driven to do things, and being impulsive are the hallmark features of Bipolar Disorder.

Here are some of the possible causes of the increasing number of Bipolar diagnoses in children.

1. Taking Stimulant ADHD meds or antidepressants can set off a manic or hypomanic episode.

One huge risk factor for developing a Manic or hypomanic episode, the key factor in a Bipolar Disorder diagnosis is having taken either a stimulant or antidepressant medication.

Having been treated with a stimulant ADHD med seems to correlate with developing mania. Not all children treated for ADHD develop Bipolar and not all people with a Bipolar Disorder diagnosis were first diagnosed with ADHD but the overlap is disturbing.

In one study of adolescents with Bipolar Disorder, 98% had been diagnosed with ADHD and treated with stimulant meds first.

This points to the need for psychiatric diagnosis to be reviewed by psychiatrists and in children by a child psychiatrist.

2. Abusing substances increases the risk of developing Bipolar disorder.

Over 40 % of children who receive the Bipolar Disorder diagnosis have been abusing substances. In their lifetime, 60% of all people with Bipolar Disorder will develop a substance use disorder.

This is not limited to just stimulant drugs. There is a high overlap between Bipolar Disorder and alcohol abuse as well as developing problems with excessive use of Marijuana.

3. Being the victim of physical or sexual abuse or neglect.

Abuse or neglect increases the risk of developing Bipolar disorder. This also accounts for the difficulty in many cases of distinguishing between Bipolar disorder and Borderline Personality Disorder. It is possible for people to have both illnesses.

There is also an overlap between trauma-induced problems, stress disorders like PTSD, dissociation and the like, and Bipolar Disorder. We would like to think the boundaries between genetic disorders and those that are the result of life experiences that were easy to find. In practice those lines are blurry.

4. Poor diet and lack of exercise are risk factors for Bipolar Disorder.

Poor diet, particularly diets deficient in some vitamins and minerals can increase the risk of getting a Bipolar diagnosis. Hard here to tell which came first. People with depression or mania, both symptoms of Bipolar Disorder neglect their diet. Poor diet increases the risk and around the circle goes.

Lack of adequate exercise has resulted in an explosion in weight-related problems. There is the thought that this lack of exercise and poor diet is also contributing to the increased prevalence of Bipolar Disorder.

5. Genetics is a Bipolar Disorder risk factor.

If you have one parent with Bipolar Disorder the risk you will develop Bipolar Disorder is 33%. Two parents with Bipolar Disorder and the risk goes up to 70%.  Add to that the difficulty that parents who have an emotional problem have in parenting and you can see how the interplay of genetics and environment increases the risk dramatically of your grow up with a Bipolar, substance-abusing parent.

6.  A changing environment may make Bipolar Disorder more noticeable.

Some of the characteristics that we today call Bipolar Disorder would have had survival benefits in the past. Fast processing speed and jumping to conclusions might save your life in the woods but can get you into trouble in the classroom.

People with milder varieties of bipolar disorder enjoy the hypomania – for a while. Even full-on Mania can be fun until those impulsive decisions get you into trouble. Bipolar Disorders are often associated with overspending, excessive sexual activity, and substance abuse. All things that damage relationships and can cost you your job.

The increase in children receiving the diagnosis of Bipolar disorder will continue to result in more adults with those labels as these early life cases age. If your child is having problems consider family therapy to help everyone find simple solutions to these problems.

If you or someone you know has Bipolar Disorder or another emotional problem that might look like Bipolar Disorder consider getting help. Therapy can be effective in helping you to learn how to control your symptoms. Medication can also be useful in keeping your moods within bounds.

People can and do recover from the symptoms we call Bipolar Disorder.

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

Is money keeping you from getting emotional help?

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

Cash

Money.
Photo courtesy of Pixabay.com

Is the cost keeping you from getting help?

No doubt that therapy does cost and it would be easy to tell yourself that you can’t afford it. Most people who do check it out find that the costs of therapy can be a lot less than they thought and that the cost of avoiding it can be way more than what the therapy would have cost in the first place.

You may be surprised to find how affordable some kinds of counseling can be. Going for therapy may actually be cheaper than not going. There are some ways to get the cost of seeing a therapist down in the same way you can shop for other things and find ways to save. More on that later.

Some hypothetical examples may help explain this cost versus benefits problem.

The cost of relationship counseling.

A couple is having problems in their relationship. They try to fix this by going on a few date nights.  She gets her hair done. He buys tickets to a show and they go to dinner. During the date night, they get into an argument and go home mad at each other. The fight carries over and neither gets much sleep. They have spent a lot of money and their relationship is in worse shape than before.

Note in this example that the hairdresser’s hourly rate may well be higher than the psychotherapists. The auto mechanic and the guy who does your taxes all charge as much or more than the therapist. Also, dinner and tickets will easily cost more than a visit to the therapist.

Another couple, same problem, went away for the weekend to the coast or it could be the casino. Someone drank too much or gambled too much, they fought and the result is a lot of money spent and no improvement in the relationship.

When you compare the cost of therapy with a lot of the ways couples go about avoiding therapy the avoidance is a lot more expensive.

This is not to mention that the hourly rate of the divorce and child custody lawyers will top all the other professionals I have mentioned so far.

Why then do people avoid the work of repairing relationships or themselves and then have to spend the large sums for lawyers to end these relationships?

Counseling for substance problems.

Seeing a professional to explore your drinking and other substance use problems, to see why you are overdoing things and reduce or quit that behavior is a whole lot cheaper than the cost of the DUI. But people put off the cost of repairing themselves or their relationship until they hit the wall and are required to do a program or go to counseling in order to avoid jail or loss of their children.

How might you make therapy more affordable?

Often seeing a counselor for psychotherapy costs a lot less than people think. The days of going to your analyst weekly for years have been replaced by a lot of counselors that do very brief therapy.

The average client going to a private therapist goes for about 6 sessions. The usual and customary rate for these sessions depends on the therapist and also on what they pay for their office and other expenses. I have seen figures from $50 per hour to $200 per hour.

Figure the middle figure ($100 per hour) and would it be worth $600 to repair your marriage, avoid a DUI, or keep your child from getting expelled from school?

But there may be a bargain in the making. Some of you have health insurance. The cost to you, if your plan covers your problem, will be a co-pay of say $20 per session. That brings the cost of the typical therapy program down to $120. That sounds doable for a lot more of you.

Under the new laws, this started way before the current Affordable Health Care Act (Obama Care), private insurance companies are supposed to provide the same benefits for mental health and substance abuse that they do for physical health coverage. This is referred to as Parity.

So in the future, more people are going to find that they can see a therapist at very little out-of-pocket costs if they are just willing to pick one that is on their insurance company’s in-network list. This means that the therapist has signed a contract with the insurance company to see their clients.

But there is more, therapy may be FREE!

Many of you will have an EAP (Employee Assistance Plan) at work. This plan probably includes seeing a therapist – for FREE! I am on some of these panels and I like doing this kind of work.

The client comes in for marriage counseling, anger issues, or substance abuse. The EAP usually has a checklist of what we are going to work on. The client gets 5-6 or 12 sessions at NO CHARGE! We agree upfront to try in those few sessions to find a way to reduce this client’s issues to a manageable level.

What if you have no job, no health insurance, and no EAP? Say you also know that you cannot pay $600 cash without giving up eating. This means that you have no extra money for hair appointments or trips and nights out. (Otherwise, we are talking about your priorities and that you don’t want to spend money on therapy not that you really can’t.)

There is a bunch of ways that you can get very low or no-cost counseling.

For more on those kinds of services see the counselorssoapbox post –

10 ways to get emotional help without money

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 will happen if I go for therapy?

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

Therapy

Therapy.
Photo courtesy of Pixabay.com

Therapy can be pretty scary if you don’t know what to expect.

Whether it is your first time seeing a therapist or just your first time seeing this particular one you are probably wondering what to expect. The process of seeking professional help for emotional, mental, or behavior problems can make you so anxious some people do not make it to the appointment. Some folks never make the call in the first place.

You probably have one set of concerns on your mind. You know why you are thinking about therapy or at least who told you to go for therapy. The therapist often does not know these things about you.

The therapist has a whole other set of worries on their mind. In the interest of demystifying the whole process, let me try to explain what is happening here and why. To do this we may need to do some head-hopping between your thoughts and what is going on in the therapist’s mind.

In larger practices, you may have to come in beforehand and fill out paperwork. That helps relieve some of the therapist’s anxieties but not yours. In smaller practices, this may all get done at the first visit.

The therapist will want to know who they are supposed to be treating. We call this the “unit of treatment.”

Sometimes the person in front of the therapist wants help for themselves. Sometimes they are here because a family member needs help or they need help coping with that other person. Just because a couple shows up does not mean they want marriage therapy. One may need help and the other is being supportive or they may need help telling the kids about the divorce.

So the therapist asks what brings you to therapy. Who will be receiving the counseling and what you want to accomplish by being in therapy?

Once the therapist knows who they are treating they need to go through a bunch of stuff we call “informed consent.” You may or may not care about this stuff but we care.

First, the therapist has to tell you about exceptions to confidentiality. Yes, therapists want to keep your secrets and most of the time most of them do. But there are those pesky exceptions to confidentiality, the things the law says the therapist is not allowed to keep to themselves.

Look back over the last year and the posts about exceptions to confidentiality and what secrets the therapist can and cannot keep are the perennial top read posts.  Shortlist is 1. Danger to self or suicidal, 2 Danger to others, homicidal 3 Gravely disabled, unable to feed and clothe yourself. 4. If you enter your mental status into the court record then the judge can order the therapist to testify about what you said. 5. If you sue the therapist and say they did a bad job, they get to show the judge and jury your record and what you said at the time.

The other thing the therapist is thinking about is how much will you be paying and who is paying the bill. By law, in most places, they must tell you if they take insurance or not and either way how much each session will cost you.

The next thing the therapist is likely to do is an “assessment” of some sort, they need to know what the problem is that they will be treating you for. This identified problem can change over time but your treatment should aim at changing something.

The client may come in saying they are having conflicts with their partner. Later in this first session, they might say they have an “anger management” problem. We want to know how bad that problem is and what might be causing it. In the course of the assessment, if they say that they and their partner fight a lot, the therapist wants to know if this is domestic violence. We also would be asking how much alcohol they drink and what drugs they use.

This is not about being judgmental. It is about seeing what the problems are and how it needs to be treated.

Therapists, especially those paid or reimbursed by insurance will also probably need to create a treatment plan for what they will do and how you and they will know if you are getting better.

Different schools of therapy may proceed differently through these items. Some therapists like to let you do most of the talking, to talk it out. They feel that you already know the answer but you have no one you trust to listen. Other professionals will be looking for things you need and make referrals. They may even give you homework assignments.

If you came in saying that the problem is you are depressed because of your poor relationship with your partner we probably will work on that for a while. Later on, you may find that this relationship is a copy of the one you had with your parents or your parents had with their partners. At that point, we might shift to working on things from childhood.  All the while, as the focus of the session shifts, the therapist is thinking and working on how do we connect this back to the depression. How can a better awareness of where your depression comes from help you reduce the things that are maintaining that depression?

Some problems have quick solutions. Others take a lot longer. Some people may need to stay in therapy for a long time to avoid getting worse and ending up in a psychiatric hospital. Whatever your needs, the therapist should be working towards a thing called termination, the time when you will not need to come to see them anymore.

Those are the things that are likely to happen in the first session. From there the process moves to finding ways to help you get the result you want.

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

Can therapy help if the problem is someone else?

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

Change

Change.
Photo courtesy of Pixabay.com

Sometimes the problem is others.

Lots of times the client sits in front of us and tells the counselor that they are sure that they are not the problem. In their view, the other person, the one not in the room, is the problem. They tell me that and then they ask me to help them.

Actually many times the counselor can help in this situation.

There are two obvious possibilities here. First, it is possible that the person who has come to the office is reacting to the problems of another. If you are married to a drug addict or your child is having problems you may be right in saying that the other person needs therapy.

The other option is that the person who is telling the counselor the other person is the problem is mistaken. They have not recognized their role in creating and maintaining the occurrence they define as the issue.

The problem is you are here and the other person is not. It is hard to work on something or someone who is not there, hard but not impossible.

One way of looking at this is that this is a case of a problem in a relationship. Relationships involve one person doing something and the other person reacting or not reacting to the actions of the first person.

Both people in this relationship can be mentally healthy or they can both be seriously mentally ill. Either way, the issue that needs working on is not the individual but the way these two people are interacting. Add more people and you get a family, and as most of us suspect the majority of families are called dysfunctional by someone in them.

Think of this couple’s or family’s interactions as if it was a square dance. Each couple or family develops its own unique dance. Everyone does one thing first and then something else next. Your child does nothing, you yell, they ignore you and then you get upset and storm out and yell at your spouse, who now comes in and tells the kid to do what you said in the first place Now they kid does it, grumbling all the way and you not them become the bad person. It is you the “yeller” who is defined by the rest of the family as having an “anger management problem.”

Once the family develops a dance it becomes hard to change it. But like that square dance if one person in the square changes direction and does something different the whole square falls apart.

This time instead of yelling at your child, you turn off the electronics and then talk to them calmly. They ignore you, so now you calmly take away their entertainment. Something new has been introduced, you have changed the dance. This could end in all sorts of ways, some good and some not so good but the point is that by changing your dance steps you can force others to change theirs.

Now some of you are asking “What if the person who comes to the counseling room really is the person with the issue?”

The key here is that this person needs to understand two things.

1. What they are doing is not working.

2.  Changing others is hard work and requires them to change some of the things they have been doing.

So regardless of whose “fault”, it is. If someone in this family or couple starts the change process then the relationship will change. If you decide to try to change others by changing the way you relate to them, think this through or better yet talk this through with a professional.

Otherwise, you may change, the family may change and when you are all done you may decide you wished you had never started the change.

For tips on how to change others or more accurately induce them to change, look at the series of posts about getting someone else to change listed below.

The changing others series:

One way we get others to do more of what we want them to do and less of what we wish to avoid is a process called Behavioral Modification. Here are six posts on that topic.

Changing Others – Part One  

Changing others part two

Rewards gone wild – Changing Others Part 3

Why ignoring them doesn’t work – Or does it Part 4

Why Your Child Won’t Behave

NO, NO, NO – Learning NO!

For more on the process of change see the blog post series “What are the Stages of Change”

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 Happiness?

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

Happy children

Happy.
Photo courtesy of Pixabay.com

Would you know happiness if you felt it?

Happiness is the state of being Happy

Happy: feeling or showing pleasure, contentment, or joy, feeling satisfied that something is right or has been done right

“For every minute you are angry you lose sixty seconds of happiness.”

― Ralph Waldo Emerson

“People are just as happy as they make up their minds to be.”

― Abraham Lincoln

“Happiness is not something ready made. It comes from your own actions.”

― Dalai Lama XIV

“Count your age by friends, not years. Count your life by smiles, not tears.”

― John Lennon

“Happiness is a warm puppy.”

― Charles M. Schulz

Quotes from GoodReads

What really causes Mental illness?

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

Could you be mentally ill?

What Causes Mental Illness?

Why do some people get a mental illness and not others?

We have had a lot of theories of mental illness, over the years, most of which have not panned out. So what do we know or think we know at this point? Some things that were suggested as causes of mental illness in the past turned out to be only a little right and a lot wrong. Check past posts for the discussion of that part if you missed it.

Recent studies of the brain have added a lot to our knowledge of how the brain works and what is causing those processes. The picture while having more lines drawn in is far from clear.

Some people would like to think most of what we call mental health issues are the result of something wrong with the brain. Other people will argue that mental illness is caused by a person’s thinking or life experiences. Let’s try to sort this out.I believe the truth is yes to all three possible causes.

Is Mental illness a “brain disease?”

In some ways yes mental illness is a disease of the brain. But in other ways no, there is more to getting a mental illness than just something chemically wrong with the brain.

We believe that mental illness is a real illness. The principle impairments are in the area of the nervous system. So this is not something the person chooses to have or can just snap out of. Mental illness is, I think more complicated than just that statement.

Saying mental illness is a brain disease should not be taken to mean that the person was born with a defective brain. They are not subject to recall or reassignment because of some sort of human lemon law. Yes, some brains are born different, right from the start. Unfortunately thinking that abnormalities in the brain are the one and only cause of mental illness is way too simplistic.

Let’s look at how the brain works, in a grossly oversimplified way, by comparing it to something most of us use every day.

How is your brain like a car?

You call the mechanic and tell him your car is not running, it no-goes.  He tells you to bring it in. You get it towed into the garage. The mechanic checks it, you’re right, it does not start. He tells you it is a lemon, worthless car, get a new one.

Wait a second, you drove this care in the past, it went then, why not now? The analogy here is why does someone seem normal at 12 and at 20 hear voices? Was there a brain bad all that time? Or did something change? How come someone who used to be happy gets depressed? Bad brain? I do not think so.

So the mechanic notices your tires are low, puts air in them, still, the car no-goes.  You check for gas, fill up the tank, but the car still does not run. With people, we do all the stuff that is supposed to make them stop being sad, but they still are depressed.

So the mechanic changes the battery, then the starter, finally the engine turns over. You get in the car and put her in gear and – the car goes nowhere. It still no-goes.

Down the line, you find that there is somewhere in the transmission and it slips or the rear end or drive shaft is bad. It could be lots of things.

The point is that the car has lots of parts – So does your brain.

So your brain has lots of parts and problems in one part may look sort of like problems in another part. Genetics may affect the structure or the functioning of various parts of your brain.

To date, we have identified over one hundred genetic mutations that appear to contribute to schizophrenia. No one mutation explains it and you can have varying amounts of these genes and still not get it. Take these 100 genetic mutations that may relate to schizophrenia and multiply that by 400 to 800 other mental health conditions and you see where this could go.

This is not, 100 times 400 by the way, but 100 times 399, times 398, and so on. One of you math guys can run the numbers if you want but you can see this is a HUGE number.

So a portion of the brain works too fast, too slow, is too large or small, or has wires connected incorrectly. This can all increase the risks that your brain will give results that are different from the results others get.

This may mean a mental illness or it could mean creativity or novel abilities. Sometimes the symptoms we call a mental illness can be connected to something else we call a talent. All very confusing.  Some of these personal differences, like fast thinking speed, may have been adaptive when your ancestors lived in the jungle and had to run from tigers but can get you in trouble if you jump to conclusions and hit someone who was just joking with you.

There are some skill differences in driving a stick shift and an automatic. You can learn to drive both but the skills are slightly different. Unfortunately, our educational system and a lot of the rest of our society is set up as if every brain ran the same way. (Read that as a possible cause of higher rates of ADHD in some schools and not in others.)

Notice that, to belabor this analogy, fluids do not work the same way in all parts of your car. Water is good in the radiator but may be bad if it is in your electrical system or your oil. Same with your brain.

Serotonin or Dopamine or other neurotransmitters may behave differently in various parts of the brain. So saying that the brain has too much or too little dopamine, may be wrong. Saying that there is too much or too little in a particular part of the brain might be closer to the truth but not there yet.

Thoughts change the brain.

Thoughts are moved from one nerve cell to another by chemicals we call neurotransmitters. Since thoughts are carried by chemicals, what you think changes your brain chemistry. That is a major factor behind the effectiveness of talk therapies.

Experiences can change the wiring of the brain. And of course, genetics can affect the shape, size, and efficiency of any number of thousands of parts of the brain.

So your genetics can predispose you to a particular mental illness, your environment can alter those neural circuits and your thoughts can add to or reduce the problems. No one thing is the whole answer but cumulatively they add up to a lot of ways the brain can be different in one way or another. Some of these differences we define as good and some we call mental illnesses.

Someone who has parents with a particular “high risk” gene who is under stress as a child, say abuse or neglect, or who does drugs or has tragedies in their life, all those things can add up to more than this particular brain can handle.

Conclusion:

There is no one thing that causes all cars to no go. There is also no one thing that causes the conditions that we are calling mental, emotional, and behavioral illness. Genetics, at birth and as the genes express themselves across the lifespan, coupled with life experiences and learning and add in beliefs about things or attitude and all together in varying amounts may be the cause of what we are calling mental illness.

Next stop, after a few other things get talked about,  coming soon – What is complex trauma and how does it rewire the brain?

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

Why are we so afraid of feelings?

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

Man with feelings

Managing feelings.
Photo courtesy of Pixabay.com

Fear of feelings?

You would think that feelings were on the banned substance list. So many people are avoiding them. Failure to feel what we feel is at the root of a lot of mental health problems. Still, people go to great lengths to not feel those feelings.

We hear lots of advice about ways to avoid feelings, think logically, pull yourself together don’t let yourself feel that. The forces of logic have won the day and henceforth feelings are banned.

But we know in our gut that sometimes feelings are telling us the truth when our head wants to mislead us.

Some people grew up in homes where their feelings were invalidated. You said you were sad and you were told you are not sad, you don’t even know what sad is. If you feel that way you are being weak or selfish or some other terrible thing.

Numbing out the feelings.

So you avoided feelings, any and all feelings, and eventually, you became numb, chronically unhappy, or unable to feel any real joy. In your flight from feelings, you may have left a lot of love, friendship, and compassion behind. You may have resorted to drugs or alcohol or other addictions to avoid feeling what you were feeling.

Feelings have been blackballed, put on the most wanted list, and hunted down and exterminated whenever possible. We have become so very afraid that someone will get angry, depressed, or anxious and then something bad will happen. So we tell them to pull themselves together, forget that feeling and think logically.

Logical thinking, the scientific method has resulted in a lot of technological advances. We have more stuff than ever before in the history of the world. Stuff exists now that science fiction writers fantasized about just a few short years ago.

What we haven’t accomplished is any real reduction in pain or unhappiness. We have more pain-killing drugs but no less pain. We have more antidepressants but we have more depression than ever. We teach people to be more rational and there are crimes of passion on every corner.

In this process of avoiding being carried away with excesses of feelings, we have lost the ability to use feelings for the intended purpose.

Your feelings brain.

When we talk about using our brains, what is left out of the equation is just how much of our nervous system lies outside our heads. All those nerve cells, the ones surrounding your stomach, and the ones in your neck, they are trying to tell you things also.

Those expressions, someone is a pain in the neck, or that makes me sick to my stomach, those expressions are full of truth. Those bodily sensations are conveying information to the rest of our beings that we just may need to know.

Those other “thoughts” the ones in our feeling systems ought to get more attention. That skill we call intuition may just be those emotional memories of things in the past that are useful for actions in the present.

By avoiding our feelings for so long we have lost the ability to regulate those emotions. When we do feel something, like sadness, we can easily become overwhelmed.

When feelings are strangers we come to fear their presence. So many of us will do anything, drink, drug, numb out to avoid feeling what it is we are feeling. We become afraid that feelings are enemies out to destroy us rather than old friends here to tell us something.

One huge step in recovery is to learn that we can feel feelings, happiness or sadness, excitement, or anxiety without becoming overwhelmed and carried away. Having a feeling is not the same thing as being taken over by that feeling. Joy does not have to lead to an excessive celebration and sadness or anxiety need not lead to another relapse or flight.

One group of therapists talks about the need to learn distress tolerance. I can feel bad some of the time and that is OK. I will not cease to exist because I feel sad or anxious. It is possible to feel unpleasant feelings, ask what that feeling has to tell us, and then, like so many other thoughts, let that feeling move on.

Not every happy feeling calls for action, a celebration of excess that might lead to a relapse into drug use, overspending or inappropriate sexual activities.

It is possible to feel feelings and let them serve and inform us rather than being controlled by what we feel.

How do you feel about your feelings?

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 an Alcoholics Anonymous (A.A.) meeting like?

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

AA big book

Alcoholics Anonymous big book.

What happens at an A. A. Meeting?

This should be an easy question. It’s not. Let me explain what an A. A. meeting is and how very different these meetings can be.

While most people think of Alcoholics Anonymous as meetings you go to, it all started with a book titled aptly enough “Alcoholics Anonymous.” Back then there were few A. A. meetings. Most people learned about Alcoholics Anonymous from buying and reading the book.

Reading the book “Alcoholics Anonymous.”

I continue to recommend that people read the book whether or not they elect to attend meetings.

Over time more and more meetings have sprung up, mostly meetings of people who had read the book and wanted to learn more or get help in participating in the A. A. program of recovery.

With all these groups starting up, they each had to develop their own set of rules. There got to be so many rules that at one point Bill W. one of the two co-founders, said if they followed all those rules, even he could not be a member. The result was that each group or meeting could figure out their own way of doing things as long as their rules did not conflict with the 12 Steps and the Twelve Traditions.

Today there are a whole lot of very different A. A. meetings. Most groups have their meeting times listed and included in schedules and you can find those schedules online or in print form.

Meetings can be categorized by what the program for a meeting will be, who is able to attend, where the meeting is held, and so on. There are also designations for rules for particular meetings.

Types of A. A. meetings.

They can also be categorized by what is on the program at that particular meeting. First the rule types and then the program types.

Smoking and non-smoking meetings.

In the old days, most meetings were smoking allowed. Back then you could tell a good meeting by the full ashtrays. Nowadays more meetings are non-smoking. They may be held in a place that does not allow smoking or the members may have decided to make their meeting a non-smoking one.

Open and closed meetings

There used to be more prejudice about people admitting they had a drinking problem, let alone saying they were alcoholics, so some meetings became closed meetings, meaning that they asked that only alcoholics attend those meetings.

The majority of meetings, especially the large ones, are open meetings that anyone who wants to go can attend. They do ask that if you share, you only talk about alcohol problems and your recovery from alcoholism. Sorry, no commercial pitches or religious and political solicitations are part of this program.

Men’s only or Women’s only meetings

I recommend to female clients that whenever possible they attend a few women’s only meetings. The point of meetings is to work on your recovery not to find a new partner.

Meetings and fellowships

Meetings customarily meet once per week at a particular time and place. They may use any room available; say a church meeting hall, a room at a school, or business. The meeting rents the room from the place and then has its own meeting. The A. A. group may meet at say the Methodist church on Friday night, but it is an A.A. meeting, not a Methodist meeting, so any faith, or those with no faith, are welcome to attend.

A fellowship is a group of meetings that goes in together and rents a room so that there are primarily A. A. meetings in that place. A fellowship might have a morning meeting each day, a noon meeting each day, and one or more evening meetings each day all in the same place.

Go to a fellowship for a few weeks and you will develop a group of clean and sober friends. I encourage clients to try out a fellowship as soon as possible. I also encourage them to try a number of meetings until they find the one that is right for them.

Different A. A. meetings will have different formats.

Speaker meetings

At a speaker meeting, one or a couple of people will get up and talk about their experiences in recovery.

Book studies

At a book study, a portion of the book is read and they people discuss what this means and how they might apply it to their recovery. Books would include the A. A. Big Book, 12 and 12; As Bill sees it, and so on. These meetings do not include reading from any religious books like the Bible or the Koran as that would make the meeting a religious meeting not an A. A. meeting.

Open participation meetings

At this meeting members, (remember you are a member if you decide you want to stop drinking) are encouraged to talk about what is on their mind as it applies to drinking, not drinking, and their recovery from alcoholism.

Meetings, by the way, are not therapy sessions. Sometimes it is hard to tell the difference but the focus of the meeting should be on your problems with alcohol and your efforts to not drink.

The Big Book suggests that people share “in a general way,” what they used to be like, what happened and what they are like now.

So there you have the types of meetings that you might choose to attend, but what will actually happen if you chose to go to an A. A. meeting? If you need to or want to attend a meeting, consider which meeting type you might like to attend or try out several and see what is best for you.

In a future post, I want to describe what the experience of attending an A. A. meeting might be like.

The posts I write about AA are from my perspective as a therapist and clinical counselor and do not necessarily reflect the views of A.A. World Services. For more on A.A. and their program of recovery check out the “A.A. Big Book” titled Alcoholics Anonymous at the links below or contact AA World Services at their website.

The Big Book of Alcoholics Anonymous

The classic text on Alcoholism, recovery this is the book that started off the whole 12 step phenomenon.

Alcoholics Anonymous from The Anonymous Press

One of the Kindle editions – At 99 cents this is such a bargain. This edition needed a separate listing. No Kindle reader? No Problem, if you have a computer you can download a free Kindle reader.

http://www.aa.org

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

The Blue Jay Mind – Do you have Mind Chatter

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

Blue Jay.
Photo courtesy of Pixabay.com

Do you have a Blue Jay Mind? Is your mind on overload?

Does your mind feel like it is full? Is your brain always rushing somewhere? Do you sometimes feel like your mind is having a traffic jam?

Have you ever sat outside, a park or the lake, when a flock of Blue Jays or other loud birds had a constant chattering conversation? Does your own mind sound like that sometimes? In meditation, they refer to this as a monkey mind. But we North Americans we don’t see monkeys except in the zoo.

Flocks of loud obnoxious birds; that we see a lot of.

Some days my mind sounds like that squabbling in the tree outside my window.

You know you are not fully crazy; these are not voices in your head. These things that overwhelm you are your own thoughts, but that does not make it any easier to keep that mind of yours under control.

An unquiet mind is an unruly companion.

Some days my brain is just plain full. Is yours? I tell people around me not to tell me one more thing that I need to remember. I say, only half-joking, that if I learn one more thing I will need to forget something I used to know and I am afraid that trying to remember what they are telling me may mean I will forget how to get home tonight.

Do you reach the point of cognitive overload and find that you are working harder and harder to remember less and less? You may be getting old; you may be losing some abilities. If so see your doctor.

There is a simpler explanation.

We only have so many cognitive resources at our command. My computer has just so much storage space and so does my mind.

What we all need to do is reserve some space in our heads for the things that really matter. Learn to simplify our minds and reduce our worries. Less stuff rattling around in our brains results in more calmness, more serenity.

The difficult part of this is to get your mind slowed down and cleared out when you need to. We all can become so accustomed to thinking, thinking, always thinking that for many people it is difficult to shut that mind off when the times come to give your mind a rest.

Some people find mindfulness and meditation training to be helpful to get that mind quiet. Other people need counseling or even medication.

If your mind is constantly racing, if your head is full of noise and most of it is your own thoughts seek help. Just listening to your own thoughts day after day can wear you out.

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

That’s not what’s wrong with you!

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

Problem and problem solving

Problem-solving.

Are you sure you really know what your problem is?

There has been a disturbing trend lately in the psychotherapy business. To hear some of my colleagues talk, clients do not have a clue what is wrong with them. Worse than that, if the client did know, they are convinced the client would lie to them.

I have to question these premises. First, some fictional examples may help.

A male client goes to see their therapist. The man says he and his wife are quarreling and he is afraid their marriage will end in divorce. The therapist does a full assessment and informs the client that his problem is not his relationship. His problem is he did not have a good attachment to his mother. He needs to work through all his childhood issues of wanting more from his mother than she gave him.

The client, not conscious of psychological principles, continues to insist that he and his mother got along just fine. The client says that it is possible that all men have mother issues they need to work out before they can properly relate to a woman. What does he know about psychological principles?

So the man undergoes a long examination of his childhood and his relationship with his mother. At the end, he sees how he was not really as close to his mother as he thought.

In the meantime, his wife leaves him and files for divorce. As much as it pains this man to lose the relationship with a woman he really loves and he is also sad about losing contact with his children because the wife has moved them to another state where she lives with her parents.

Still, the man now understands how his underdeveloped relationship with his mother has resulted in his attachment issues with women and he now understands why he will never be able to make a woman happy.

Sound far-fetched? I see things like this more often than you might guess.

Second example. A woman comes to see her therapist because she has been out of work for many months. She is discouraged and getting depressed because of her employment situation and her economic troubles. I am thinking either treatment for depression or help with career counseling, but the treating therapist tells me that would be wrong.

The problem here is that this client grew up in a home with an alcoholic parent. This has left all sorts of scars on the client and the client undergoes treatment for her anger towards that alcoholic parent. The client insists that she got over that stuff a long time ago but the therapist informs this client that she is sicker than she thinks and that she will never be happy again until she gets these childhood issues treated.

The client talks with this therapist for a number of sessions, still unconvinced that she has all that big a problem with her childhood. Eventually, the therapist tells the client that this client needs to stop lying about her hatred towards her father.

Clearly, anyone who grew up with an alcoholic parent has been scarred for life and will probably never be able to work again

By the way, these are fictional composite examples so do not go thinking you know the people I am talking about. You would be wrong.

Counter-transference.

The problems these vignettes illustrate are a phenomenon known as counter-transference. The counselor who has had issues in their childhood, or has others in their life with these issues, is insistent that the client must have the issues that the counselor sees and if the client disagrees then the counselor believes the client is lying.

It can also come from a theoretical orientation that asserts that all adult problems are the result of childhood events.

A more productive approach is for the treating professional to consider that some people who had mother problems or an alcoholic parent may be having problems today because of that past, but most people really have the problem they say they have.

I try, in my practice, to always accept that the problem is what the client says the problem is. This can save a lot of time by working on that issue first and then get back to the other stuff if that still needs doing.

I also find that it saves a lot of my time and the client’s time to avoid arguing with the client. If they tell me things I take it that they believe what they are telling me. They may be mistaken but most people really do believe what they are saying.

Certainly, there are times that clients might stretch the truth. Especially if they have something to gain, like child custody or disability. In those cases, where my results will go to another person or agency I ask a lot more questions. But if the purpose of the therapy is to help the client resolve issues or cope with life problems I find it is worth the effort to start from a place of believing the client.

Most of the time the problem that needs treating is the thing the client says brought them to my office in the first place. If your provider is insistent on treating you for their issue instead of yours consider getting a second opinion.

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