Tag Archives: Depression

Bipolar – misdiagnosed or missing diagnosis?

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18

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

Person with masks

Bipolar.
Photo courtesy of Pixabay.com

Diagnosing Bipolar Disorder.

Why is it so hard for people with Bipolar Disorder to get diagnosed and treated? For mental and emotional problems, the sooner the diagnosis, the sooner the treatment begins, the less the suffering. The more entrenched the illness the longer and more difficult the recovery. We continue to have difficulty with Bipolar Disorder. Why?

Almost 70% of people with a Bipolar Diagnosis had another diagnosis first. On average they get four other diagnoses before the Bipolar one. Usually, somewhere along the line, they are diagnosed with Major Depressive Disorder, given an anti-depressant. At this point, on an antidepressant, 40% of clients with Bipolar experience an episode of mania or hypomania. Antidepressants given to people with Bipolar disorder also increase the likelihood they will become rapid cyclers.

Our understanding of this condition has changed over the years. To be honest the mental health profession’s understanding of most illnesses has changed a lot over the years. We used to call Bipolar Disorder by another name – Manic Depressive disorder. Clients continue to come into facilities and tell us that they have Manic Depressive Disorder and Bipolar, not understanding that both are the same thing, just a new name.

Currently, there are two principle camps in this debate – those who think too many people are being diagnosed with Bipolar Disorder and those who think that professionals are missing a lot of Bipolar Disorder. The controversy goes back to the first efforts at classifying anything, the lumpers, and the splitters. Some people would like a different name for every possible type of dog; other people are content to consider them all dogs, the same with mental illnesses. So what difference does it make? It could make a lot of difference.

Ira Glick, up at Stanford wrote an article a while back called Undiagnosed Bipolar Disorder: New Syndromes and New Treatments. This is not a really new article but it is important as we think about how the diagnosis is likely to change in the next few years when the DSM-5 comes out. Glick suggests that the true rate of Bipolar may be as much more than what is being diagnosed. We used to expect Bipolar Disorder to run 1% to 2 % of the population; recently it has been diagnosed closer to 7%.

We are starting to think of this condition as a spectrum disorder. So there is a range of symptoms and the ones with less noticeable symptoms are not getting diagnosed.

Does it matter if some mild cases are getting missed and not treated? Yes, it matters and the clients with the less prominent symptoms are not necessarily milder cases. Currently, we separate cases into Bipolar I and Bipolar II.  People who have Bipolar II don’t have pronounced episodes of mania. They do have other significant differences.

People with Bipolar II have way more unemployment. They get divorced more often; have more thoughts of suicide and more suicide attempts. This one disorder, according to Glick, accounts for more suicide attempts than any other mental illness, excluding personality disorders. This is a big problem since Bipolar II looks like Major Depression until the mania or hypomania kicks in.

Many people who eventually get the Bipolar Diagnosis are first seen by their primary care physician. Primary care doctors treat more than half of all the depression and anxiety. There are a lot of medical problems that are especially problematic for people with Bipolar Disorder. People with bipolar disorder are more likely to have migraines, diabetes, or obesity.

Medications for people with Bipolar are especially problematic. People with Bipolar II get antidepressants till they have a manic episode then they may get all sorts of meds. People with Bipolar I have the more pronounced psychosis and may get all kinds of heavy-duty antipsychotics. Sometimes people with depression have distorted thinking and we see psychosis. Sometimes the psychosis in Bipolar II looks a lot like Schizophrenia, Schizoaffective disorder, and a lot of other things.

We are also not sure how much of all this is a result of genetics and how much is learning. Some authors have talked about how personality traits, those supposed unchanging characteristic ways of behaving may be related to Bipolar Disorder.

In fact, there is some question as to which mental health issues are district illnesses and which are symptoms. A cough is easy to notice but what causes the cough can vary a lot from person to person.

Despite all the issues with diagnosis, Bipolar disorder in all its forms causes a significant amount of suffering. It is also a difficult disorder to manage for the client and for the professional. If there is a chance you or someone you know has this disorder get a professional evaluation. If you have Bipolar disorder become a knowledgeable client, and don’t give up hope, the treatment options continue to improve.

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 Inside and Outside of Relapse triggers.

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10

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

Relapse

Relapse.
Photo courtesy of Pixabay.com

Relapse triggers, either internal or external, are those things that set off cravings in a recovering person. The failure to do maintenance steps in the process of change increase the risk of giving into triggers.

External triggers are the things outside ourselves that place us at risk to resume old behaviors and give up on the progress of recovery. Shorthand ways of understanding these triggers are people, places, and things.

People are one of the biggest reasons people relapse. There is a huge temptation to look up old friends. Often the only thing that you have in common with an old friend is a history of using drugs or drinking. Sometimes there was a history of other dysfunctional activities, codependency, or abusive relationships. If the people you had around you in the past supported your addiction or if they were not affirming, or made you feel bad about yourself, being around them can take you back there. Avoiding people who are bad for you is not being selfish.it is being self-caring. In early recovery it is suggested you not make a change you can’t take back like changing jobs or relationships. Surround yourself with people who support your recovery.

Places are another important external trigger to pay attention to. Alcoholics need to avoid bars; drug addicts should avoid dope houses. But there are other places to avoid. People with relationship issues should avoid revisiting places they used to go with a partner who is no longer in your life. Should someone on a diet visit a candy store? I wouldn’t recommend it. Think about places that you may need to avoid if you want to be secure in your recovery. Is there a family member or former friend who triggers your issues?

Things can also reignite thoughts of returning to an old lifestyle. Music can be a powerful memory trigger, so can some smells. People with relationship issues, sometimes we call these people love-addicts, find it hard to let a relationship go. They keep the old moments out. They think about the things they did together. One last call to see how that person is doing is likely to set off a new round of problems. Carrying lots of cash can trigger some people, especially gambling addicts and former drug dealers. Sometimes it is a pipe or a lighter you find hard to get rid of. Is there something that reminds you of your issue but which you find hard to give up?

Internal triggers are the other part of the equation. The things going on inside our bodies and our minds are also relapse triggers. The word HALT standing for, Hungry, Angry, Lonely, and Tired is used as a reminder of those triggers.

Hunger, thirst, and many other physical sensations can make you feel restless, irritable, and unleash the cravings. Negative emotions are powerful relapse triggers. Feeling anger fear or resentment, any number of negative emotions can cause someone to catch a case of “who cares.” Loneliness sends people back to their disorder quickly. Being tired is likely to upset recovery also. All of these internal triggers have to do with not taking care of ourselves. It is a short hop from not taking care of yourself to thinking you don’t deserve care, after that why should you hang on? Why not go back to the old life? People who don’t provide good self-care don’t encourage others to care for them. They start believing they don’t deserve to be treated well and then they stop treating themselves well.

Another way of understanding internal and external triggers is to look at the two main causes of relapse, romances, and finances. Romances are all about your feelings, feelings of loving and being loved, self-worth, and self-esteem. Finances, mostly money, is the ultimate thing. Lack of money can sap our will to change. Having a lot of money makes some people feel they are invincible; the rules don’t apply to them. Pay attention to the healthiness of your relationships with things and with people. When one of these relationships gets out of balance, your life is headed out of balance.

These are only some of the things that might cause you to relapse. We each have our own triggers. What are yours? Knowing your triggers and how to defuse them strengthens your recovery.

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

10 ways to get emotional help without money

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

Counseling.
Photo courtesy of Pixabay.com

Can’t pay for therapy?

The times you need help the most are likely to be the times you are least able to pay. People with emotional problems often have other problems, no job or a low-paying one, physical health problems, housing issues. If you had those other problems wouldn’t you be depressed or anxious?

Now if this is an emergency, if you or someone close to you is thinking of suicide, has a drug overdose or other critical problem, please call your local emergency number. In my area, we have 911 services and every night many people call that number and end up in hospitals where they can be linked to help. People who chose to not call emergency services can walk into an emergency room and seek services. These days emergency rooms across America are filling with people with mental and emotional problems, people with nowhere else to go.

We continue to hope that the services for the people in need will match the need. So far it isn’t happening. The recent downturn in the economy has resulted in strained budgets and budget cuts. Mental health and substance abuse dollars keep shrinking at the very time the need is growing.

The first place to start of course is your local mental health facility. If you qualify for services they are likely to be covered or offered at extremely low rates. These days the need is so great most public facilities are limited to serving only those with the most severe need, people who are suicidal or have hallucinations. Even if you don’t qualify for ongoing therapy, you may be able to get emergency services or they may be able to refer you to free or low-cost services.

So if you are someone who has fallen through the cracks, who needs counseling or therapy but has no insurance, doesn’t qualify for services or your diagnosis does not meet the “medical necessity” for services, how do you get help? Here are a few suggestions, some are more available than others, and some are more painful than others but if you need help and haven’t been getting it these are things you might try.

1. Read the internet

Especially read blogs and sites about recovery. The internet can be had for little or no cost. These days’ even homeless people have email. Most libraries let people use computers for some amount of time. This has brought information to everyone. It has also caused problems. Not all sources of information are helpful. Watch out for sites that are sponsored by a company that wants to sell you something.

Read about recovery. Some writers are in lots of pain; their writing is therapeutic for them. I read those sites but I find it is good to limit readings about pain unless there are also posts about recovery. Read blogs that spread the cure, not posts that spread the disease. Also, avoid reading too many posts about diagnoses. Self-diagnosis is a trap even professionals can fall into. You need an objective professional person to make a good diagnosis. That said, if someone has given you a diagnosis, read about your condition. If the things you read don’t match what is happening to you, ask questions. Not all professionals agree on things and sometimes they get things wrong.

2. Read self-help books.

There are lots of self-help books out there. I wish I could give you a list of the best ones. I am working on that list but so far it is not ready. I asked colleagues for recommendations and at this point, no two therapists have recommended the same book or books. Read a self-help book that speaks to you. What you need to learn may be different from what someone else needs to learn. You can get self-help books for very little money. Libraries have them for loan. Some can be downloaded from the internet for free or at a low price. I have picked up some great ones at thrift stores for fifty cents to two dollars. If you find a great one please leave a comment here and share your find.

Avoid books that require you to be dependent on or give unquestioning loyalty to a person or group. A.A. literature says here are “suggestions” that have helped us. If you find a better way we wish you well. If you have to do things the author’s way chances are the book is designed to help him and not you.

3. Self-help groups.

The old standby of self-help groups are Alcoholics Anonymous (AA) and Narcotics Anonymous (NA). The success of A.A. has spawned over 200 self-help groups based on the twelve-step model. There are also specific groups for people with co-occurring or dual diagnosis issues. There are also some groups based on specific needs that do not involve the twelve steps. Please don’t be put off by the twelve step programs talk about a “higher power” even nonreligious people, atheists, and agnostics are welcomed and they often find there is something they can believe in if it is only the ability of the group to be helpful.

4. Colleges and schools

Many colleges have therapy available for students. These services are in addition to the department that does academic counseling. Check with the health services on campus if you are a student. Universities that offer counseling or therapy major often have clinics where new therapists under the supervision of experienced instructors, provide therapy services to members of the community. These university-sponsored programs have low-cost or reduced-cost options. School counselors can sometimes help with family issues, parenting, and child behavioral issues.

5. Community-based resources

Non-profit organizations are sometimes able to provide some services to people in the community who are otherwise unable to access services. Check with charitable organizations. Some areas have a 211 phone service that is able to provide social service referrals.

6. Ask therapists and counselors about sliding fee arraignments

Some practitioners are able to see clients for reduced fees. Don’t be afraid to ask, but expect to have to show proof of income.

7.  Consider group therapy

Group counseling is not second-rate services. Sometimes being in a group with others can be a powerful experience. Group fees can be significantly less than individual counseling. Some practitioners offer large group counseling at extremely low fees. In my area, there have been large groups run by professional therapists that were sponsored by churches or community-based organizations that were free. The therapist donates their time and the organization provides the space. The people who attend get free services that they would otherwise not be able to afford and the counselor often gets referrals for their private practice.

8. Substance abuse facilities

Substance abuse facilities often have outpatient groups that are extremely reasonable. They also may have free or low-cost groups for the family members of clients in substance abuse treatment.

9. Think about your priorities.

How much is your recovery worth? Many a time a person has told me they couldn’t afford therapy but they continue to pay hundreds of dollars each month for hair or nail appointments, home shopping, or their drug of choice. Is it true you can’t afford help or is it that you have not made your recovery much of a priority?

10. Consider Religious counseling.

Pastors, Rabbi’s Priest, Bishops, and other religious leaders often have training in Pastoral counseling in addition to their religious training. Seek out people who seem to care about you and about being of service.

If any of you know of other resources let me know so I can pass the information along. Till next time –

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

Maintenance is a part of change

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12

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

Changing your life

Time for a life change?
Photo courtesy of Pixabay.com

How do you stay changed?

How can maintenance be a part of change? Isn’t maintenance what you do, as needed after the successful results of change are obvious? No, not at all. Not including maintenance as a step in the change process is where many improvement projects, public and private get themselves into trouble. Let me give you a more visual example.

The other day I drove through an older part of town. This part of town, built throughout the Victorian era to the turn of the century was really something once. Today this part of town is a poor neighborhood. While there are still a few houses that reflect the old glory days most of them are getting run down now. A couple of houses are slated for demolition. What happened to those grand old houses? There was no earthquake or fire, nothing dramatic, just the slow process of decomposition.

A roof was torn off, the owner had not bothered to get it fixed and the rain had rotted out the lumber. Another has a porch that has fallen down. Lots of homes have not been painted in a while, broken windows are covered with cardboard, and sometimes there is an old blue tarp over the destruction. Realtors describe these homes as having “deferred maintenance.” Last time I talked with you about relapse as the result of the failure to do a maintenance step. Relapse is a sort of deferred maintenance.

What do we hear from people who relapsed on substances? You hear the story so often it starts to sound like a well-rehearsed poem. The recovering person says they, stopped going to meetings, stopped calling their sponsor, and started hanging out at the old spots. The dieter gets the goal pounds off and then eases up on the diet. The change has been a short-term project and now the deferral of maintenance starts. Eventually, when the change is completely reversed by the relapse the person starts to wonder when they tried to make that change in the first place.

We tell recovering people that whatever you did to get better, you need to keep doing it to stay recovered. Most people don’t want to accept the idea that what was needed was not a quick repair but an ongoing plan of preventative maintenance.

One important component of that relapse prevention plan is learning to provide good self-care. Having a good support system is also vital. People who have positive people in their life, people that want them to do well, are more likely to succeed. Never get to busy to call your support system. One study found that schizophrenics with a warm supportive person in the home with them cut their risk of ending up in a psychiatric hospital by almost 50%. People who attend AA drink less even if they don’t stop altogether. Many weight loss programs include a group component. Being surrounded by others who are also working on their own recovery is likely to strengthen your recovery.

Real lasting change has to include a commitment to a different lifestyle. This does not mean that every self-improvement plan needs to take over your life. If the changes you make are hard to do the chances are that you will stop doing them when the urgency is gone. Urgency is an often-overlooked factor. If your doctor tells you to lose twenty pounds or he can’t do a life-saving surgery, that is motivation. If the judge says to stay off drugs or you will go back to prison that is motivation. But if the diet is a lot of work to keep up it will probably be forgotten way too soon.

The end of this tale is that whatever got you better, diet, meetings, a religious practice, or time with friends, keep doing them. Don’t give up these positive things as you see results from your change efforts.

That is the story of my understanding of stages of change. In future blog posts, I want to talk more about relapse prevention and triggers. We should also talk more about the connection between depression, bipolar, and abuse of a couple of substances. There is a huge connection between mood disorders and substances and not always in the direction you might think. I also want to talk about why it seems there is so much controversy, especially among professionals about the diagnosis of bipolar disorder.

I read your comments and appreciate them. I also try to read as many blogs as I can that are written by recovering people of all types. The things you say remind me of things I need to talk about.

There is a lot of pain out there and we know how to help more than ever before – so why is it hard for people to find the help they need?  Why doesn’t therapy always work? What makes counseling helpful? I will give you my take on these issues and would appreciate yours.

I also want to talk to all of you, very soon, about how you might find help when you don’t have the money to pay for the help you need. Till then, here is wishing you all a happy life.

Other posts on this topic can be found at Pre-contemplation, Contemplation, Preparation, Early Action, Late Action, Maintenance, relapse, recovery, triggers, support system, more on support systems, Resiliency

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 Relapse a part of recovery?

Posted on by
11

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

Relapse

Relapse.
Photo courtesy of Pixabay.com

At some point, every recovery program has to tackle the issue of relapse. Why after losing all that weight do people suddenly put it back on? Do all alcoholics; sooner or later pick up a drink? Once you have depression you will always have recurrent bouts right? The way in which relapses are understood separates the Stages of change model from almost every other model of recovery. I have been told more than once that relapse is a part of recovery. I am not buying that! It doesn’t have to be that way.

So if relapse were a part of recovery, every person signing up for a self-improvement program should get out their calendar on day one and plan for their relapse. Doesn’t AA even say a relapse is a part of recovery? No, it doesn’t. The AA book says that a certain percentage of people get it the first time and don’t relapse. Bill W. estimated that percentage at 50%. In the early days, it appears that a lot of people who really wanted the program and stuck with it got it the first time around. He also said that there were some people, maybe 25% who tried a few times and eventually got it. The rest were better while they were in the program but kept going in and out. The stages of change model agrees with that thinking.

So why do people say that relapse is a part of recovery? Mostly, people say that because relapse happens a lot. And if relapse does happen, rather than giving up, the objective is to pick yourself up and try again. One article I read said smokers typically have to try to quit seven times. Now some people quit on the first try, a few people become nonsmokers in a few tries and there may be some people who just don’t seem to be able to quit. Any self-change is like that. It takes more than trying hard.

It is not the quitting of bad habits that is the problem. Some people quit drinking 5 or 6 times in one day. It is the staying quit that is harder. So how does someone make a change, give up a bad habit, make an improvement in their life, and then stay changed?

The stages of change model says that after all that effort, that process of change, there is one more thing you need to do to stay changed. See change is not a one-time thing. Real lasting change is an ongoing process. Why do people think that they can excessive like crazy, take off a few pounds, and then once they lose the weight they can stop the exercise?  How many days off Heroin before it would be safe to try some drugs again? The truth is that change is not a thing – it is a process. Once you make the change you have to keep doing the process to maintain the change.

The thing you need to do to stay changed is called maintenance. To stay changed you will need to do some maintenance. If you mow a lawn once will it grow back? So if it took an increase in exercise or an improvement in healthy eating to lose weight it will require you to keep doing that work to keep the weight off. The addicted person can’t just put down the substance; they need to keep doing the things that got them sober.  In the stages of change, relapse is not seen as something that is part of change it is understood as a failure to do the one remaining step in the process of change – doing maintenance.

Now, this is easier to see when we talk about weight loss or addiction but what about depression or bipolar disorder? With any of life’s problems, there are things that you can do to make the problem grow and other things that make the problem shrink. Taking good care of yourself is especially important for mental and emotional issues. So if taking good care of yourself makes you less depressed, what might happen if you stopped eating and sleeping well? Your depression might grow. The maintenance step is needed for holding onto any change you made, it is the best antidote to a relapse, whether that relapse is weight gain, addiction, or depression.

Next time we will talk about the last stage of change – maintenance. After that, I want to talk a bit about some related problems like triggers and finding help when you have few resources. Till then –

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

Stages of change – Late Action

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10

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

Change

Change.
Photo courtesy of Pixabay.com

Late Action – The change accelerates.

Last time we talked about how I might be full of enthusiasm as my self-improvement program gets going. In the weight loss example, I begin to exercise and maybe even get interested in nutrition and diet. Are deep-fried Twinkies a healthy diet? The diet guru says no. I eat low-fat and lots of greens. I hate greens but I eat them anyway. My efforts at change are taking shape and encouraged by my own persistence I may even expand my efforts.

On days when I can’t get to the gym, workdays, I start walking on my lunch hour. It is a mile around the park. If I walk fast I can make two trips and eat during my lunch period. I discover that if I bring a healthy lunch, a sandwich, and some low-fat yogurt, and I walk around the park fast, some days I lose weight. Even if I don’t actually lose weight, at least those days I do not gain any more. At this point, the intensity of my workouts is increasing. I am really getting into this.

In substance abuse recovery terms, the person involved may not only be attending meetings, but they also have a regular home group they go to every week, maybe even a fellowship they attend every night. Some people “get into service” meaning they make coffee, take out the trash, and so on. We get trainers, sponsors, and a support system. At this point, my change is beginning to be something I tell people about.

For people who have an emotional problem, like depression or anxiety, their recovery action might be seeing their therapist on a regular basis, improving self-care, or journaling. There is a huge connection between emotional issues and eating problems. One of the key issues a professional looks for in making a mental health diagnosis is changes in eating and sleep. Binge eating, overeating or not being able to eat, as well as sleeping too much or too little are all symptoms of problems. They can also be causes. More about that mind-body connection and the relationship between sleep, eating, and other life problems in a future blog.

So in late action, I am getting somewhere on my self-change program. Losing a few pounds, not drinking or drugging and I am no longer so depressed I don’t want to get out of bed. Everything should be going fine. Right?

Then what happens? Why do so many people successfully make a change only to return to the place they were before? Why do most weight loss programs, diet, and exercise, end in putting on more pounds than we lost? Why do so many people get a thirty-day sober chip only to drink again? And how is it that depression and anxiety return after a period of time?

I start wondering, am I fixed? Do I have to give up those quadruple thick burgers with the pound of fries? How long will I need to take these psych meds? Can’t I just have a donut or a glass of wine? What kind of wine goes best with donuts? My mind starts looking for ways out of the change process.

For substance abuse, we call this relapse. For depression or anxiety, we are starting to think in those terms also. For weight loss programs the part that we don’t like to talk about is why after losing twenty pounds, do I put it all back on and then some. Every time I have been on a diet I have needed to get new larger clothes.

This is the point where people start talking to us about maintenance plans.  You mean I can’t just crash diet off ten pounds and then I will be able to eat like other people? Can’t you AA folks just teach me to control my drinking? So my depression is gone. I will never feel that way again. Time to get back to the way things were before my self-improvement program. So next time let’s talk about putting the weight back on, the relapse, and the return of emotional problems.

Other posts on this topic can be found at Pre-contemplation, Contemplation, Preparation, Early Action, Late Action, Maintenance, relapse, recovery, triggers, support system, more on support systems, Resiliency

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

Stages of change – early action

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10

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

Change

Change.
Photo courtesy of Pixabay.com

Early Action – the beginning of visible change.

So here we are in that process of change at the point where we start to do some action steps. Up till now, we have had someone or something that created a reason to consider the need for change. No catalyst and probably most people would never embark on the journey. So we were pre-contemplative. Then we started thinking about the problem, gathering information. We called that contemplation. At some point, people get into preparation, join groups, buy books seek out resources. Still, no change has occurred, not real lasting change anyway. But now it is time for the do or die part, – getting into action.

Stage of change four – Early Action.

Some authors only have five stages of change and they have only one stage for action. I am separating action here into early and late stages as we find that the things people do at the beginning of their recovery process is often different from what they do later on. I got this formulation from Ken Minkhoff and Christine Cline at Zia Partners. You might want to check out their website and the Change Agent Movement they have spawned. The difference between early and late action is easier to see when people have multiple problems, like substance abuse and depression, this is a condition we call co-occurring disorders or complex clients. For someone with depression and a drug problem and a weight loss problem, in the beginning, all they may be able to do is get dressed and go somewhere. For them, this may be early action. Later they will be able to do more.

Now on with our story, first the weight loss example and then examples of other possible changes we might want to make.

So remember my story. I discovered others though I was gaining weight even though I hadn’t noticed. I weighed myself and gathering information and decided I needed to lose weight, maybe even change to some healthier habits. I joined a gym and bought some exercise videos maybe even some getting healthy books. Now I am at the point of starting to do something. I am ready to start exercising and eating healthier.

So at the gym, I seek out a trainer or a fellow member he shows me how to use the equipment, the routines, and the whole culture of healthy living. I like the hanging out and the talking about fitness, the exercises not so much but I do it anyway. Right now my goal is to lose that weight, get that old suit to button closed again, and generally shut up my friends who say I am fat.

At first, I wander around the gym. I try out a machine or two. I check out the weights to see what I can lift. I talk with people who show me how to do things. It amazed me how friendly some people at the gym where and how much they were willing to help a newcomer. The same things happen at AA or other self-help groups, people trying to help each other. In gyms and recovery centers there are professionals also, trainers or therapists, and counselors; they can be especially helpful.

So the workouts continue. The weight is coming off, a little anyway, and I am feeling better and better about myself. The scale still is not saying I have lost that much weight but I always suspected it of being out to get me. One thing I noticed was that even when I was not exercising at the gym, just wandering around, the whole time I was not eating. Even if I wasn’t losing weight I had stopped gaining.

If this were a substance abuse example the person would be going to AA meetings, getting a book, and a sponsor. They might start to share at meetings. There is an old adage that a closed mouth does not get feed so you need to talk as well as listening. Now just like the guy at the gym, the person at AA might still be having thoughts of drinking, but they start to notice that while they are at meetings, they are not drinking. If they can make it from meeting to meeting without drinking the periods of sobriety start getting longer.

Each different recovery group, AA, overeaters anonymous, gamblers anonymous, or weight watchers has its own culture. You need to find one that is comfortable for you. There are over 200 twelve-step groups now and hundreds more of peer and self-help groups. Some gyms program is about exercise and flexibility other groups are all about weight lifting and setting records. A group for cancer patients is not much help to an alcoholic unless they have cancer also. Find the group that is right for you.

Eventually I settle into a routine. I am doing the things I need to do to recover, but I am not there yet. I also am not sure I want to keep this up after I lose the weight. Here is where we start to hear the word maintenance and we also start to talk about relapse. The question becomes – is what I am currently doing enough or is there more. Many people quit drinking or take off the planned weight and then they are good with that. Others want a new healthy lifestyle. So what will it be for you?

So in my weight loss example, I have started an exercise routine, lost a few pounds, though the buttons on that suit are still tight. For a substance abuser, they have made it two or three days without their drug, maybe even three weeks. So now what? What will I do next? Next blog we can talk about how my weight loss or substance abuse recovery program may change as my action moves from a few times to a regular routine.

Other posts on this topic can be found at Pre-contemplation, Contemplation, Preparation, Early Action, Late Action, Maintenance, relapse, recovery, triggers, support system, more on support systems, Resiliency

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

How do people change? Preparation

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

Change

Change.
Photo courtesy of Pixabay.com

Stages of Change – Preparation.

In the last two blogs (Stages of Change – Pre-contemplation, Contemplation) we explored steps one and two of a model of change. Some of you will remember that I was using a weight loss example. The need to change could be weight loss but it might also be an addiction, job or career change, or a relationship event. So to recap past episodes of my little story, I go to a reunion, people tell me I have put on a lot of weight. At first, I deny this, and I argue about it. That stage of change is called pre-contemplation. Next, I do some thinking about it. I weigh myself, ask the advice of others and I do lots of thinking about it. Finally despite all my efforts to avoid having a problem I discovered that in fact, I do have a problem. Now I am faced with a choice.

At this point, I could just accept the fact that I am now FAT!  Accept and go on with my life maybe embrace the idea. Yes, I am fat and proud of it. Since I am fat why not be the best that I can be and let my fatness shine through. Some people accept their problem. Many alcoholics go on drinking until the bitter end. Or – as strange as this may seem to some people I could decide to make a change and face my problem. That brings us to the third stage of change.

Stage of change 3 – Preparation. Some authors call this determination.

So I decide to challenge my fatness or my joblessness or – could be any other problem. I get out the phone book and look up gyms. There is one right around the corner and I call them. Then for good measure, I call a few more. Most gyms have sales on new memberships around the first of every year. Three months for the price of two and so on. They know that lots of us will decide to exercise, get in shape, join a gym as part of our New Year’s resolution. They also know to get the cash now, because by February at the latest most of the new gym members will have stopped coming. But a few people will stay at it and next year they will be that slim trim self I want to be. So how do they do it?

So I go down and tour this gym. I like the place, friendly people and all, so I join. And I get ready. There is a sporting goods store in that shopping center and I go there and buy some new exercise clothing. Notice I still haven’t exercised much but my credit card at this point. But there is more.

I see a video sales and rental place in the center. I go in there and find some exercise videos. I am in whole hog. I buy three videos. Now I take them home and put them in the VCR.  (Update this to DVD or Blue Ray or Hollow-suite program as needed.) I pop a big bowl of popcorn put my feet up and sit and watch these three videos, faithfully for a week. I really like watching exercise videos. Not so sure about actually exercising though. See a problem here?

Pause this picture for a minute. Doesn’t this apply to most any planned change? People buy books, self-help, or AA books, and then they take them home and pile them on the table and balance a drink on them. Other people put that new self-help book under their pillow in the hope that by osmosis the book will change us while we sleep. Unfortunately, change requires more than preparation. Don’t misunderstand here. Getting a list of meetings for AA or weight loss places is good. Joining a gym is good also. But doesn’t it take more than preparation to make a change?

At some point, I need to stop preparing, use that determination, and actually do something. Next blog we will talk about that next fourth stage of change where the rubber meets the road, where we finally start doing some things that result in change. So if you still want to learn about stages of change stay tuned for the next blog post. If you have decided to stay the way you are or to change someone else, skip the next couple of posts and rejoin us for the episode after the change is over. Feel free to share your thoughts along the way.

Other posts on this topic can be found at Pre-contemplation, Contemplation, Preparation, Early Action, Late Action, Maintenance, relapse, recovery, triggers, support system, more on support systems, Resiliency

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

Stages of Change or how do we change? Pre-Contemplation

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

Change

Change.
Photo courtesy of Pixabay.com

Change.

In a previous blog, I wrote about New Year’s Resolutions and how to get out of them. Now occasionally someone argues with me on this and says – no – really – I do want to change. I like to hear that. We, counselors, and therapists are in the business of helping people to change. I like to think of this as the happy life business. Lots of what is here is written for counselors, but if you are interested in change for yourself or others, please read on and see how we think it is that people really change.

Most people who change are able to transform their life by a gradual process, not a one-time resolution. Now I know that there is such a thing as a religious or spiritual conversion and also that some people do make resolutions and as a result change. I would suggest that most of the time that conversion or resolution is part of a process of change. They may make a change of direction but the person needs to do some work on getting to the new behaviors they want.

Every year for New Year’s or other occasions millions of people make a resolution that they will change themselves. Some plan to lose weight, some want to stop smoking or give up drugs. Lots of things they might want to change. Come back a year later and most of them will still be the way they were when they made that resolution. But a few people will really have changed. Why is it that some people are able to carry through and make the change while most people can’t? What happened to the ones that succeeded? These questions resulted in some studies of how people change and at last three guys wrote a book on how all things get changed. The book was “Changing for Good” and the authors were Prochaska, Norcross, and DeClemente. As a result of this book and others, substance abuse counselors, and many therapists are taught the Stages of Change model and they use it to help clients understand how to change.

So here is an example I tell my classes of how someone might change.

One year I attend a reunion and I run into an old friend. He comments on how much weight I have gained since he saw me last. I tell him no, I weigh the same thing I did in High School, well almost, but I am not gaining weight. He shakes his head and changes the subject.

Later that evening I run into an old girlfriend. She tells me she almost didn’t recognize me. “You have gotten so BIG! She exclaims. She is just jealous I think. Look at that skinny little wimp she is with, bet he has an eating disorder or something. I am definitely not gained any weight. I do not have a problem. And even if I have gained a little weight, so what, why would I care, I have no plans to change me.

Later in the evening, someone else remarks about my weight. This suit does seem a little tight. The tight fit is what is making me look fat. Ever since I moved to the desert my clothes have been shrinking. Even the ones in the closet that I don’t wear seem smaller recently. Some of you are thinking here that I am in denial. Maybe so.  The stages of change model calls this Pre-contemplation.

Stage 1: Pre-Contemplation

At this point, I am not thinking about making a change. People around me see a problem but so far I don’t. Now you could argue with me at this point and insist I get on a diet and lose weight. Lots of spouses do that. But if I don’t yet see that I have a problem all your lecturing me about being in denial of my problem will only make me mad.

Substance abuse counselors in the old days used to spend a lot of time arguing with clients, trying to break down denial. So did weight loss and stop smoking professionals. And the result most of the time was that clients stopped listening. So the thing you might do if you were faced with someone who did not think he had a problem would be, provide them with information. If you are reading this and you are already thinking you might need to change something, then you are already past the first of the seven steps that lead to real lasting change.

Often people reach the point of needing to change because of some traumatic experience. Until something happens we don’t even think about the need for change. Lots of people are suddenly confronted with a problem, most try to find a way to avoid change. Divorces or breakups, job loss, forced career changes, arrests and incarceration, and even medical problems can all require people to consider the need for change in their life.

One client told me he did not have a problem. This is typical in pre-contemplation. He just likes to have fun. How can you argue with a fun-loving guy? His wife, soon to be ex, she thinks he has a problem. His last employer told him he had a problem. So did his parole agent and a judge or two. But he was sure he didn’t have a problem.

With any problem, it seems to be human nature to try to find a way to cope without having to change. So we go through all kinds of mental gymnastics to try to not have a problem. Addictions to drugs, alcohol, food, or other substance are especially prone to go unrecognized. Some people also spend lives in bad relationships, sometimes we call them co-dependent or enablers, sometimes they just say they love too much.

People also can become entangled in activities, the gamble till. There is no money left and then borrow or steal money to try to win it all back. Some people are addicted to the process of pulling the lever or turning cards. Other people are addicted to being in a relationship. They would rather be in a bad relationship than none at all. Sex can be an addiction also. Recently we are seeing a rash of problems caused by electronic media. People spend all their time and money on a pornography site, even when it starts to affect their health or their relationships. Some people become addicted to gaming or high adrenalin activities.

So how do you know if the thing you are involved in has moved from you just like to have fun to an out of control life? Counselors have three ways to decide if this is a problem or not.

1. Does it affect your job or income? Has this activity you like to do cause you to lose jobs or promotions? Does it get you in trouble at work? Has it negatively impacted your career? Then this might be a problem.

2. Has the activity you are doing interfered with your relationship with family and friends? Once you start losing friends this is a problem. Especially if you find you are making new friends who agree with you that you’re drinking or drugging is no problem and then they ask you to pay for their drug use. See an issue here?  If both your ex’s thought your fun activity was a problem that should give you a clue. And if your family starts avoiding you and doesn’t want you around anymore you may have a problem.

3. If what you have been doing is starting to bother you. If you feel sad all the time or experience guilt when you do that activity, then it just might be a problem. Professionals call this subjective distress. It is easy to see when it involves depression, anxiety, and loneliness.

One way to understand this is that if multiple people suggest to you that you have a problem, weight loss in this example, then maybe you should check it out and see what they are talking about. At that point, you are ready for the second step in the process of change.

Next time we will talk about our model’s second stage of change – Contemplation.

Other posts on this topic can be found at Pre-contemplation, Contemplation, Preparation, Early Action, Late Action, Maintenance, relapse, recovery, triggers, support system, more on support systems, Resiliency

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

Depression Season – 8 Ways To Beat It.

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

Depressed person

Depression.
Photo courtesy of Pixabay.com

Beat the depression season.

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

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

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

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

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

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

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

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

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

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

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

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

1. Avoid alcohol and abusing drugs.

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

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

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

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

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

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

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

Hope you all avoid the depression season and have the happy life you deserve.

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

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

Story Bureau.

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

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

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

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

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

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

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

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

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

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

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

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