Not identifying feelings makes you depressed.

Man with feelings

Managing feelings.
Photo courtesy of Pixabay.com

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

Feelings illiteracy results in misidentifying your feelings.

In childhood, most of us learn a great many things. One thing a lot of people don’t learn about is feelings. Mostly we are taught to think logically. When you do feel unpleasant emotions, people are often told to ignore them. The result of all this lack of learning about feelings is a condition called emotional illiteracy.

What is feelings illiteracy?

While it’s not an official diagnosis inability to understand feelings as a factor in a great many mental health issues, it begins with not being able to recognize what it is you are feeling. Feelings illiteracy also means that you can’t identify what other people are feeling. People who lack feelings illiteracy can be extremely sensitive and perceive things others do and say as about them. Feelings illiteracy can lead to a lack of emotional intimacy when you can’t leave feelings, your efforts to be assertive to become aggressive, hostile, and bullying. Feelings illiteracy can lead to insecurity, anxiety, and being continually on guard in the world that feels frightening and hostile.

It’s challenging to manage emotions when you don’t know what they are.

If you’ve never learned to identify what you feel, you may misidentify them. Many people when asked how they feel will tell me they feel good; they feel bad; they feel angry. That’s the limit of their ability to identify feelings. When they feel insecure or threatened, many people respond by feeling angry rather than identifying what is making them feel anxious.

It’s common for some folks to interpret feeling lonely as a feeling of rejection and as a result, they withdraw from others rather than seek out more friendships or to improve their existing relationships.

Emotionally illiterate people blame their feelings on others.

You don’t know much about feelings and can identify what you’re feeling it’s tempting to believe that other people create those feelings inside you. If you feel bad, someone must’ve done something wrong. If you don’t feel happy, then someone must’ve withheld that happiness from you. As people become more emotionally literate, they come to recognize that they are responsible for how they feel.

Feelings illiteracy matters most when times are hard.

Wouldn’t it be nice if life was always smooth sailing? Well probably not, life without variations in feelings could become very dull. The times when feelings become most important is when we are struggling. How can you overcome a challenge if you don’t know what that challenge is? Recognizing that you’re feeling stressed improves your ability to cope with that stress.

It’s not unusual for adults to have the emotional literacy of a preschool child.

Teens who can’t identify feelings experience stress as depression.

Under stress, it’s common to misidentify emotions. If the only label you have for feelings is bad, you may not be able to tell the difference between the discomfort of stress and the more severe condition of chronic depression. One significant study found that teens who couldn’t identify various types of negative emotions were very prone to interpret their stress as depression.

The response that you use to feelings depends on identifying the feeling.

If you’re feeling irritated, you may want to find out why rather than respond with a default response of anger. The way you should react to guilt should be quite different than the way you respond to failure or rejection. Feeling restless doesn’t have to be in the negative; it can spur you to do something different. But you can’t fashion the correct response unless you can identify the feeling.

It’s easier to identify physical health than emotional health.

A great deal of material on the Internet these days is devoted to staying physically healthy. We can identify when we are overweight, have diabetes, experience high blood pressure, are having headaches, not getting enough sleep, or having some other physical health problems.

When it comes to poor emotional health, most people can identify the symptoms they have early enough to do anything about them. If you’re coughing and cannot go to work, you’ll probably call a doctor. If you too depressed to get out of bed or too anxious to leave the house most people are more likely to accept these problems is just the way they are because they can identify what they’re experiencing as anxiety or sadness.

Feelings illiteracy is an important component of emotional intelligence.

If you can’t recognize your feelings will have a great deal of difficulty empathizing with how other people are feeling. There are many occupations which allow you to work without interacting with other people. Your feelings can give you important information about the nature of those interactions. Being able to tell how the other person is feeling will facilitate and improve the relationship.

How would you know if you were emotionally literate?

The characteristics of feelings literacy or being emotionally literate include the ability to recognize what you’re feeling when you’re feeling it. You need to be able to put a name to that feeling. Identifying the feeling would allow you to decide what you want to do with that feeling. You should be able to manage your emotions. Emotional literacy involves the skills to repair emotional problems. Emotional literacy is a fluid skill in the more emotionally literate you become, the more you’re able to integrate all of these qualities of emotional literacy.

Staying connected with David Joel Miller

Six David Joel Miller Books are available now!

Dark Family Secrets: Some family secrets can be deadly.

What if your family secrets put you in danger?

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?

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

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

SasquatchWandering through a hole in time, they encounter Sasquatch. Can they survive?

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.

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

Books are now available on Amazon.

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

For videos see: Counselorssoapbox YouTube Video Channel

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

For more about David Joel Miller and my work in the areas of mental health, substance abuse, and Co-occurring disorders see my Facebook author’s page, davidjoelmillerwriter.

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Ways to improve your mood in minutes.

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

Unhappy emoticon

Unhappy.
Photo courtesy of Pixabay.com

Sometimes a low mood is a mental illness; sometimes it’s not.

Everyone has days when they’re feeling down. When that down feeling goes on too long, and it interferes with your life, it becomes a thing we know as clinical depression. Treatment for depression can involve three separate approaches, medication, counseling, and changes in thinking and behavior. For that occasional blue moon, medication is not recommended. Using chemicals to change the way you feel can result in a substance use disorder.

Talking to people whether you’re in counseling or have a support system is useful even when your down mood hasn’t reached a diagnosable mental illness. People who incorporate talking and active behavior reduce the risks of developing depression, and these tools can be used to prevent relapse if you have been treated for depression.

Being more active will improve your mood.

Exercise doesn’t have to be strenuous for you to receive benefit from it. Walking as little as 20 minutes a day can improve your outlook on life. More important than the intensity is the frequency. You can’t sit on the couch every day and then expect to make up for it by exercising all day on Saturday.

Getting into motion has lots of benefits. Many people report that they don’t feel like doing anything, but once they start moving, that sluggish feeling disappears.

Going outdoors makes you feel better.

Brighter light helps your mood, so does fresh air, and being in nature. If you’ve ever been to the mountains or the lake you probably felt better. Researchers believe that there are healing benefits for humans being around nature. The recommended dose of mother nature is at least two hours a week.

Connect with positive people to improve your mood.

Positive outlooks on life are contagious. Humans are social animals, and they tend to copy the people they spend the most time around. Pick your friends wisely. If you hang out with gloomy people, the joy leaves your life.

We all need a support system. It’s terrific if you have one person in your life you’re close with. But a support system needs to be more than one person. Having good Friends keeps you connected and prevents Loneliness.

Improve your self-care.

Get plenty of sleep on a regular basis even if you have to cut some things out of your life to do it. Eat healthy food and drink plenty of water. When you’re tired, hungry, or thirsty, your mood suffers, and you become irritable.

Scratch something hard off your to-do list.

When you have difficult tasks on your to-do list, don’t procrastinate. The longer that hard-to-do project sits on your to-do list, the more anxious or depressed you’re likely to become. Tackle that challenging project first, and as you see progress, towards your goal, you can take pride in your accomplishments.

Taking back your environment will make you feel better.

Straighten the things around you. Do a quick cleaning up project. Eliminate clutter. A little bit of rearranging can make you a lot more comfortable in your surroundings.

Do something for someone else.

Doing for others is a proven way to elevate your mood. Any time you spend doing for others is time you’re not thinking about your challenges.

Learn something new to build a sense of accomplishment.

The process of learning something can elevate your mood. Learn a new skill. Study something you’ve always wanted to know about.

Read a book to spark your imagination.

Lots of people watch TV or online videos. But there’s something about “reading” a book that has a lasting impact on people. Whether you read a physical paper book, read an electronic version, or listen to an audiobook, you will engage your imagination. Videos show you everything. Books suggest things, leaving you to fill in the details. Reading more can increase your creativity and make you feel better.

Acting as if you are happy makes you happier.

One way to break out of a down mood is to smile more. People who smile begin to feel happy. People who laugh more are more fun to be around.

Being happy makes you a better person.

Being happy is not selfish. It makes you an easier person to be around. Happy people are easier to get along with, more productive, and more likable.

Staying connected with David Joel Miller

Five David Joel Miller Books are available now!

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?

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

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

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

SasquatchWandering through a hole in time, they encounter Sasquatch. Can they survive?

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

Books are now available on Amazon.

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

For videos see: Counselorssoapbox YouTube Video Channel

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

For more about David Joel Miller and my work in the areas of mental health, substance abuse, and Co-occurring disorders see my Facebook author’s page, davidjoelmillerwriter.

Persistent Depressive Disorder – PDD (F34.1)

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

What is

What is Persistent Depressive Disorder?
Photo courtesy of pixabay.

What if you don’t ever remember being happy?

Persistent Depressive Disorder – PDD (F34.1) is new to the DSM-5. The DSM is the book professionals use to identify mental illnesses. This diagnosis is the result of merging Dysthymia and another group of symptoms which was being researched as Chronic Major Depression. Some other variations on the depressive theme were being called Minor Depressive Disorder, which did not get recognized as such but kind of fits here.

While we may label these conditions as chronic or minor, there is nothing minor about them if you are someone who has this condition?

The defining characteristic of Persistent Depressive Disorder – PDD, is a pervasive sadness that just won’t go away. People who have this condition are always sad or unhappy. They may describe themselves as “always down” or having the blues. While this can cause a lot of impairment, people who have PDD come to think of their chronic sadness as “Just the way I am.”

It is estimated that about two percent of the U. S. population has PDD. Many people with PDD also experience a substance use disorder. There is also an overlap between PDD and Cluster B and Cluster C personality disorders, both of which, to my way of thinking, may have their roots in negative childhood experiences.

Persistent Depressive Disorder (PDD) is more disabling than Major Depressive Disorder.

PDD has been identified on brain scans and seems to affect at least four separate brain regions. PDD is long-lasting, at least two years, often more. During this time someone with PDD may also experience an episode of Major Depressive Disorder. While the major depressive episode may come and go the PDD often remains relatively constant. Because of this constant feature, people with PDD may not be able to ever feel really happy and their functioning, day-to-day, is more impacted than those with Major Depressive Disorder only.

Persistent Depressive Disorder (PDD) is chameleon-like.

Chronic unending depression has a lot of variations. This disorder can exhibit itself a great many ways. As a result, there are eighteen separate specifiers that can and should be added after the F43.1 These specifiers are not exclusive, so one person may also get several specifiers added to the Persistent Depressive Disorder (PDD) diagnosis.

Specifiers include with:

Anxious distress – anxiety commonly co-occurs with depression.

Mixed features

Melancholy features

Atypical features

Mood-congruent psychotic features

Mood-incongruent psychotic features

Peripartum features

In partial remission

In full remission

Early onset – before 21

Late onset – at or after age 21

Pure dysthymia syndrome

Persistent major depressive episode

Intermittent major depressive episode, currently with MDD

Intermittent major depressive episode, currently without MDD

Mild

Moderate

Severe

The symptoms of Persistent Depressive Disorder.

To qualify for PDD a person should have the following symptoms:

  1. Felt depressed or down, or had others see them this way, most of the day, most days, over a two-year period.
  2. Had at least two of the following six symptoms. These symptoms should be caused by emotions not by dieting or working long hours, etc.
  3. Change in appetite either up or down.
  4. Changes in sleep either too much or too little.
  5. Felt low in energy or fatigued a lot.
  6. Low self-esteem.
  7. Difficulty deciding things or poor concentration.
  8. Hopeless.
  9. Most of the usual exclusions. This has to be causing problems with work, school, relationships, should interfere with important activities or upset the client. It should not overlap Bipolar Disorder or Psychotic Disorder but may overlap Major Depressive Disorder. These symptoms should not be the result of medical or substance use issues.
  10. These symptoms have been constant and not gone away for two months or more over the required two-year period.

Be careful with the PDD label.

Calling Persistent Depressive Disorder by the label PDD could be problematic. In the past, we had another PDD – Pervasive Developmental Delay which is now recognized as a part of the Autism Spectrum. Persistent Depressive Disorder – PDD is about depression and has nothing to do with Autism. Be careful in reading articles that if they use the label PDD you know which of these two they are talking about. From here on I will call Persistent Depressive Disorder – PDD.

As with the other things we are calling a mental illness this needs to interfere with your ability to work or go to school, your relationships, your enjoyable activities or cause you personal distress. Otherwise, you may have the issues but you will not get the diagnoses if this is a personal characteristic, not a problem. If the only time this happens is when you are under the influence of drugs or medicines or because of some other physical or medical problem these symptoms need to be more than your situation would warrant. These other issues may need treating first, then if you still have symptoms you could get this diagnosis.

FYI These “What is” sometimes “What are” posts are my efforts to explain terms commonly used in Mental Health, Clinical Counseling, Substance Use Disorder Counseling, Psychology, Life Coaching and related disciplines in a plain language way. Many are based on the new DSM-5; some of the older posts were based on the DSM-IV-TR, both published by the APA. For the more technical versions please consult the DSM or other appropriate references.

More “What is” posts will be found at “What is.”  and Depression  

Staying connected with David Joel Miller

Three David Joel Miller Books are available now!

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

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

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

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

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

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

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

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

Why counselorssoapbox by David Joel Miller

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

Counselorssoapbox.com

Who is this David Joel Miller and why is he writing a blog called counselorssoapbox?

Counselorssoapbox is a blog about recovery, wellness and having a happy life. Yes, you guessed it, I am David Joel Miller and I write this blog. It occurs to me though that I have not explained why I write this blog and why I called it counselorssoapbox.

Someone is snickering under their breath the words “for the money” If you were thinking that then you would be more delusional than I was when I started writing this blog. Not delusional in the psychiatric sense, but delusional in that I had no idea how much work writing a blog on a regular basis would be. As for this blog making money, I definitely will not be quitting my day job, or my night job for that matter, anytime soon.

My first exposure to all things psychological was, like many of you, a few classes in psychology. It was the sixties after all. I have since learned that psychology, the kind we study in high school or most colleges is only a distant relative of counseling and recovery. Clinical Psychology, that takes 6 years of college for a Ph.D. and then you can start looking for the answers to why life is the way it is.

My first exposure to counseling and therapy was as a client. I discovered school counselors could tell me what classes to take if I wanted to make the big bucks but none of them seemed to know how to be happy along the way. Eventually, I ended up seeing some therapists. I discovered that there were helpful therapists and unhelpful therapists.

Becoming a therapist was not in my original plan. I took the classes and became a Drug and alcohol counselor. Along the way, I learned a few things. One was that there was a lot of wisdom in those 12 step programs. The other was that my AOD (Alcohol and Other Drugs) clients all had families. If I wanted to be helpful to those families, especially the children and the significant others, then I needed more training.

Next stop was the classes in how to be a Marriage and Family Therapist. Originally here in California, this was called a Marriage, Family and Child Counselor. Marriage in this context means any two or more people who have a close, primary, usually sexual, relationship.

Over the years of trying to figure out who I was and what I wanted to be when I grow up, I discovered that having a job or at least a purpose in life was an immense part of being happy. The answer to the who and what question I am still working on, but at least now I know something about the how of being happy.

To help people with their job issues and substance use issues took me in the direction of Professional Clinician Counseling and today I have that license also. From there I drifted, more like jumped, into teaching and supervising other counselors and therapists. So now you know a little bit about me. More is on my “about me” page.

But I still haven’t told you “Why a blog named counselorssoapbox?”

Throughout my process of becoming a professional in this field I kept thinking about those times I had sat on the other side of the desk and what I had experienced. I decided I did not ever want to forget what it was like to be on the client side of the room.

In graduate school, they explained a lot of stuff to us but honestly, I did not feel like some of these professionals I had seen had explained things to me in the way they were supposed to be explained. I asked about confidentiality and never seemed to get a straight answer.

Therapists were often good listeners but if they knew the answers to the “how to have a happy life question” they wanted me to suffer through the process of finding them myself and they flat resisted giving me any answers to these questions.

Counselorssoapbox started off as a way for me to express my opinions about what worked and what didn’t in the therapy world. I wanted to demystify the therapy process and explain what I had learned. Those times I got a reader question and didn’t have the answer took me back to reading the research and looking for more ideas. Writing a blog meant I needed to keep reading, studying and living wellness and recovery. So I just took it one post at a time.

What quickly happened was you readers prodded me in a few directions. Counselorssoapbox received a lot of questions about the safety of counseling, confidentiality and what gets reported. I was surprised at the number of search terms that involved counselors having sex with clients. So I put up a link to the publication “Professional Counseling Never Includes Sex.”  That post and the link keep getting hits so there remains an interest in this topic.

There has also been some interest in particular diagnoses and their treatment. While I can’t do therapy by blog post I have tried to provide general information on mental health and illness. All sorts of how to have a happy, productive, successful life posts find their way onto the blog also. Whatever tips on having the best life possible I come across I try to share.

There you have it. The answers to the questions who is this David Joel Miller and why a blog called counselorssoapbox.

What’s next? I continue to work on some books, both fiction and nonfiction and I write more blog posts looking for all the things that seem worthy of sharing with you. So if there are questions or comments related to the fields of substance use disorders, mental health, and wellness or living a happy life, send them along. I will do my best to answer questions or send you to someone who can. Comments and information from you or others gets shared here also.

If you read this far an extra thanks. Talk with you again soon.

Staying connected with David Joel Miller

Two David Joel Miller Books are available now!

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

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

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

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

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

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

Do people with problems not want to change?

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

Need to change

Time for you to make a change?
Photo courtesy of Pixabay.com

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

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

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

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

Fat people don’t really want to lose weight.

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

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

The homeless prefer to live out on the street.

Drug users do not quit because they want to use.

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

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

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

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

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

Why do we blame those with problems for those problems?

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

Unemployment is rarely a choice.

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

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

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

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

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

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

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

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

Obesity is about more than just eating less.

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

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

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

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

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

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

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

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

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

Staying connected with David Joel Miller

Two David Joel Miller Books are available now!

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

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

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

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

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

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

PTSD or Acute Stress?

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

Words about PTSD

PTSD.
Photo courtesy of Pixabay.com

What’s the difference between PTSD and Acute Stress?

Stressed

Feeling stressed out?
Photo courtesy of Pixabay.com

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

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

Stress can harm you.

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

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

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

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

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

Trauma- and Stressor-Related Disorders.

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

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

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

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

What is Acute Stress Disorder and why is it important?

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

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

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

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

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

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

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

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

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

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

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

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

A warning

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

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

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

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

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

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

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

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

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

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

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

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

People may “space out.”

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

Acute Stress Disorder is time limited.

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

Having Acute Stress Disorder really matters.

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

Acute Stress Disorder is not something else.

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

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

One last thing to consider.

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

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

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

Staying connected with David Joel Miller

Two David Joel Miller Books are available now!

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

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

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

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

17 Ways to de-stress

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

Stressed

Feeling stressed out?
Photo courtesy of Pixabay.com

How do you manage stress?

Stress can overwhelm you at any time or anywhere – Here are some suggested ways to turn down the stress volume.

1. Breath.

Under stress, most of us forget to breathe. The result is fewer shorter breathes and the overwhelming sense of panic that can follow a lack of air in your lungs.

Slow your breathing down. Take deep breaths from the diaphragm. You should feel your stomach moving in and out. Short fast breaths from high up in your chest can increase the feelings of stress.

Breathe slowly and deeply, pause between breaths. Watch your stress move out each time you breathe out and pause before taking in that next deep breath.

2. Make friends with silence.

There is noise everywhere. We have our radios and our televisions, our iPad’s and other electronics all screaming away at once. Add on people talking at you all day long and a few people screaming for whatever reason and you are bound to feel the stress meter rise.

Think back to that last time you felt really relaxed and distressed. Maybe a vacation in the mountains or at the beach. One thing you are likely to remember about that time is how quiet it was.

Those voices in your head can get awfully loud some days. Learn to quiet your mind down and embrace the silence. I keep a set of headphones at my desk to minimize the noise. Soft nature sounds help, sometimes no sound at all helps even more to reduce my stress.

3. Say a positive affirmation.

Affirmations are those little saying you tell yourself that help you to cope. Don’t lie to yourself or the whole affirmation will backfire. Tell yourself that this may be stressful but you can handle it. This too shall pass or whatever other saying works for you to put this current stress in perspective.

4. Make a list of the good things in your life.

If you keep thinking about all the problems your life story gets soaked through with problems. Most of us have lots of positive things going on. Take those little sparkling moments and hold on to them.

Writing out a list of things that are good, things you are grateful for, can put the rest of your life in perspective. This list, sometimes called a gratitude list, can be a reference guide when things get tough.

The very act of writing down positive things in your life reinforces those things. Thinking saves the thought briefly in one part of the brain. Writing stores these blessings in a second part of the brain. Sharing them out loud with a friend, stores them in a third part of the brain. The more of your brain that is full of happiness the less room there is for stress.

5. Stand more.

Stand and get the body moving. Stretch and relax those tense muscles. Tight muscles can be a result of stress but they can also be the cause of your body thinking that the stress is worse than it really is.

People who stand burn more calories than those who sit. Standing is a quick easy way to relax and reduce the stress of the moment.

6. Walk more.

Walking can be very effective in reducing depression. When the body shares the load the mind can get a rest. A quick walk to the end of the hall, the water cooler or the bathroom can refocus the mind and move the stress off the front burner.

7. Make prioritized lists.

The human brain has a limit on the number of things you can keep in conscious memory at any one time. The more you try to keep in the front of the mind the less space is available to work on the current task.

Writing down a “to-do list” can free up space in your brain to get this task done. It also reduces the anxiety you may be feeling that you might forget something.

Once the list is down on paper, prioritize those things. Do one big hard thing first and leave the long list of quick things for later when you may only have a few minutes left.

Check those items off your list as you do them and by the end of the day you may find that you are far more productive and less stressed than when you were spending all that time trying to remember all those things you needed to get done today.

8. Feel what you’re feeling.

Feelings are not the enemy. They can convey needed information. Feelings like human friends are not always right. Because something scares you does not mean it is dangerous. Listen to the feelings but then make informed decisions on how you will handle those feelings.

See the post Making Friends with Feelings

9. Look at things that make you happy.

If you run from place to place with no time to take in the joys of life you will only accumulate more stress. Slow down sometimes and notice the pleasant things. Take an extra second or two and taste the thing you are eating. Pause to notice those flowers growing outside your office.

Accumulating those brief doses of pleasure can make the rest of the day less stressful.

Ever stop to really look at the pictures your workplace put up in the hall?

10. Carry a worry stone

A worry stone, religious symbol or other personal object carried in your pocket can absorb a lot of that stress you are holding onto.

11. Make time for family and friends.

When you don’t have friends and family around you, then you are all alone. Seek out positive people for a role in your stress reduction plan.

12. A pet can help you reduce stress.

When no one else listens, when you feel all alone, that pet, a dog or cat, is waiting at the door when you come home. A pet is a great example of unconditional love.

13. Be an indoor explorer – look for new experiences.

Check out a new deli or other places to eat. Visit a new store or library. Keep an eye peeled for things you might try that you have never done. A local adult education or college class may offer all kinds of opportunities for new experiences.

There are lots of resources on the internet these days to allow you to take a class at a far off university or learn about something that interests you.

14. Develop a skill.

Is there a new skill you might develop? Something you always wanted to do but never got around to? Take the time to develop that skill and see where it takes you. Those breaks while you practice that skill reduce stress and challenge you to keep working on your self-improvement.

15. Do self-care.

The more stressed-out people get the less time they take for self-care. Do something nice for yourself. Look for ways to treat yourself well.

16. Practice your spirituality.

If you have a faith practice it. Religion or spirituality are comforting when times are tough. If you have a belief make sure that your actions are consistent with that belief. Pray, meditate or engage in other spiritual practices. Those moments of faith can get that stress volume down to a realistic size.

17. Express Yourself.

Write not because you have to but because you chose to. Draw if that interests you. Do this for yourself, not for the approval of others. Dance, pantomime or practice any other expressive skill.

There are my suggestions of 17 ways to reduce stress. Do you have other ways you have found to help you manage your stress?

Staying connected with David Joel Miller

Six David Joel Miller Books are available now!

Dark Family Secrets: Some family secrets can be deadly.

What if your family secrets put you in danger?

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?

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

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

SasquatchWandering through a hole in time, they encounter Sasquatch. Can they survive?

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.

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

Books are now available on Amazon.

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

For more about David Joel Miller and my work in the areas of mental health, substance abuse, and Co-occurring disorders see my Facebook author’s page, davidjoelmillerwriter.