Tag Archives: Depression

How is youth mental health treatment different from adults?

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

Crying child

Youth mental health.
Photo courtesy of Pixabay.com

What are the differences between youth and adult mental health treatment?

There are differences in the way a counselor might work with a child and how they might work with an adult. How to “treat” a mental health problem is a complicated subject. It needs several books to fully describe this, but let me focus here on just a few things that may influence how a professional might try to help with an emotional problem in a child.

The way a counselor works with clients is sometimes referred to as our “theoretical orientation.” How I see your issue determines how I might try to help you. I can’t speak for therapists of other theoretical orientations but I would describe my approach as largely Cognitive Behavioral Therapy, that with a dash of learning theory and occasionally a pinch of narrative therapy.

This stuff is largely “skills-based.” I figure that the client is trying the best they can but that there are things they may not know and if they knew them they could do better. I could try to tell them, sometimes that works but mostly they need some help it trying on new behaviors and seeing what works for them and what does not.

Lots of people have “stories” they tell themselves about them. By story I do not mean that this is either true or false, it just is the way that person explains themselves and their life.

That story might sound like “I am such a loser.” Or “I can’t do anything right.” Kids get one thing wrong and they may start saying that they are a failure. See how having a single story that describes you rather than the thing you were not able to do could color your life experiences?

So adults have more experiences in life and may have more ways of thinking of new stories for their life than a younger person. What I am saying is that I would try as much as possible to tailor my approach to the individual, not some specific category or label.

In career counseling, the approach would be very different in working with a person who had worked at lots of jobs and was just downsized than it might be with a client who was very young and had never had a job.

What are some considerations in creating a treatment for a specific client?

Age is only a small part of the picture.

I would want to know in addition to the client’s age something’s about their abilities and their life experiences. Age, I.Q, and developmental stages are all in the mix. So might things like learning disabilities, intellectual disabilities, and other developmental issues.

The approach for someone who has a form of Autism Spectrum Disorder might be different from a younger person who had a less severe challenge. The key, for me, is really getting to know the person and match my efforts to them rather than memorize a particular formula for a given age, I.Q. or disorder.  Here are some things a therapist might do as the child moves through the lifespan and becomes a young adult, a mature adult, and evenly an older adult.

1. Activities build relationships.

With adults, it is often possible to sit down and have a talk with them. The younger the child, the more the anxiety or the more “inside themselves” they are the more we need to work on forming a relationship.

One way to create that relationship is to do things with the client. (Yes even with a five-year-old I think of this person as a “client.”) How would I have wanted to be approached when I was that age? If I can’t remember ever being that age, I take a guess at what that might have been.

So the counselor might play a game, not to waste time but to get the client to feel comfortable. Even with very adult clients, I find they will say more about their lives when we are doing something than when they are sitting in a chair and I am cross-examining them.

2. Pictures versus words in therapy.

Very young people and some adults are better at seeing than describing, they just do not have the words to tell me their story. I ask them to draw me a picture. A rainbow tells me one thing and a tornado-like creature in black and red tells a very different story.

3. Skills training is important.

You need to practice skills if you want them to be there when you need them. Adults practice golf swings. Younger people may need to practice introducing themselves, making friends, and sharing appropriately. A whole lot of people tell me right up front they have an “anger management problem” they do not seem to understand that managing anger is a skill like most other things in life and you can learn that skill.

The younger or more impaired the person the more they need help in learning appropriate skills.

4. Involvement of your support system makes a difference.

With children or youths, I like to know the involvement of the support system. The more people on your side the better your chances. Some people have a parent or caregiver that can help the client through things. Other young clients have no one on their side.

Sometimes I am working on helping the caregiver to learn to help the youth and other times I am helping the client learn how to cope with their less-than-perfect caregiver.

There are a whole lot of specialized treatments for all sorts of mental, emotional, and behavioral problems that a child may experience. This post has not even begun to look at all those possibilities but I hope it has given you some small idea of the ways in which a professional counselor might be able to help a child or their caregiver through a child’s emotional problems.

If you work with children consider taking the Youth Mental Health First Aid training when it is offered in your area.

Related articles

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

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

Story Bureau.

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

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

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

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

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

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

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

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

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

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

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

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

For videos, see: Counselorssoapbox YouTube Video Channel

Are the mental health problems in children different?

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

Crying child

Youth mental health.
Photo courtesy of Pixabay.com

Age impacts mental health.

A reader asked “You keep mentioning children in your posts, how are their problems like or different from adult mental illness?

There are some differences between the issues children have and adults, but my experiences tell me that there are a lot of similarities.

We used to have a separate section for “Disorders usually first diagnosed in Infancy, Childhood, and Adolescence, in the DSM-4. In the DSM-5 those disorders get moved around. One problem with the old approach was that many clinicians missed the “Usually” part. We tended to think of these problems as something children get and adult problems as something only adults got.

That just is not so.

Some of these early-onset problems get missed or continue to plague people throughout their lives. Stress-related issues are a good example of this. Reactive Attachment Disorder may be easy to see in a small child but the after-effects can result in a bunch of problems that in adults we usually call by other names.

Just like the child develops, the mental health problems of that child may develop and change with time.

Also, it is very possible for children to develop problems that we used to think were only the providence of adults. Remember that “Happy childhood” myth. There must have been a few people with happy childhoods but there were a lot of people who did not get their ration of that one.

So children can and do suffer from depression, anxiety, stress, trauma, and a host of other adult looking problems.

We currently believe, I think for good reason, that the earlier in life we recognize some of these problems and treat them the better the chance that the person will not grow up to have a severe emotional disorder. That treatment, by the way, need not be medication or prolonged therapy.

Lots of other things can help these children. Anger Management and Parenting classes for unprepared parents also help. So do supportive environments like quality preschool or even grandparents or other supportive adults.

A disclaimer here – my perspective on working with children may be a bit different from other clinicians. My work with children has been largely in crisis settings, these kids were brought in because they said they were suicidal or they were way out of control. The other groups of children I worked with were substance abusing or those brought in for an assessment because someone believed this child has a serious emotional problem or a serious mental illness.

My experiences were with a group of children that may be more seriously affected by society’s problems. As a result, some childhood problems were probably not represented and others were way over-represented.

The problems that bring children to the attention of professionals change as they get older. The 3-year-old who is not talking is a way different problem than a 17-year-old girl who has been abusing drugs and is now suicidal because she found out she is pregnant by her 24-year-old boyfriend.

Both may have been the victims of abuse or neglect, so these very different “symptoms” may stem from the same or similar roots.

As a child gets older the way we should be assessing and the way we treat this “child’s” issues should get more and more like the way we treat adults. Mental health has had problems here for years as I see it. Some clinicians continue to treat adult clients as if they were mentally retarded or little kids.

One day you are 17 and you get the “now little girl” treatment and the next day you are 18 and you get the “grow up” lecture.

One other thing to consider when talking about the difference between adults and youth mental health issues is how to tell the difference between normal adolescent issues and those problems that could be the beginnings of a serious mental health issue. Just being a teen is, in and of itself, not a diagnosis.

Recently I attended a training to get certified as a Youth Mental Health First Aid trainer. I can’t begin to cover all that info here. If the issue of how to recognize mental health problems in young people interests you, you might want to check out that training.

The question about how the treatment approaches may differ between a young person with a disorder and a person who has accumulated more years, presumably an adult, that topic needs a whole other post.

Till next time, David Miller, LMFT, LPCC

Related articles

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

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

Story Bureau.

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

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

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

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

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

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

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

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

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

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

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

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

For videos, see: Counselorssoapbox YouTube Video Channel

Why do so many substance users have mental illnesses?

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

Drugs.

Drugs.
Photo courtesy of Pixabay.

Why are co-occurring disorders so common?

We used to talk about addiction and think there were just a handful of people with that problem; we blamed them for their disorder. We now know that long before someone becomes addicted they can have serious problems in their relationships with substances. We now are talking about substance use disorders.

We talked for a long time about the “seriously and persistently mentally ill” as if they were somehow different from us. We now know that mental illness is on a continuum. Those emotional problems, depression, anxiety, stress-related issues, can overwhelm anyone.

Is it really that common to have both problems?  Why do we say now that co-occurring disorders are an expectation, not an exception?”

So far in my career as a therapist, I have worked with substance abusers. I have worked in locked psychiatric hospitals with those on an involuntary hold for wanting to kill themselves or others. I have also been able to work with adolescents in crisis.

In every one of these settings, the number of clients who had both issues was large. Why do the two problems so often exist in the same person? Here are some of the reasons that both disorders so often co-exist in the same person.

1. Two issues, substance use disorders, and a mental or emotional illness are relatively common in our society.

Far short of addiction there are plenty of people who attend DUI School, lose days of work, or get into arguments with their spouses as a direct result of substance misuse.

Most families have one or more person in them who has been so depressed or so anxious that they missed work or stopped participating in family and social activities.

2. Having a mental or emotional problem increases the risk of using and abusing substances.

People who are depressed or anxious often start drinking. At first, this works but over time the alcohol makes them more depressed and when it wears off they become more anxious.

The result of using substances to manage your emotions is that over time you need more and more and eventually, you develop a substance use problem.

Many people in substance abuse treatment will report emotional problems including being the victim of abuse or neglect before they developed the substance abuse problems.

The seriously mentally ill find the effects of smoking very soothing. They become heavy smokers. This increases the risk that they will develop health problems, end up homeless, and that their lifespan will be cut short.

3. Using or abusing substances increases the risk of developing a Mental illness.

Alcohol is a depressant. Not everyone who drinks becomes clinically depressed but some people do. The more you drink the more depressed you become. The more depressed you get the more you drink. This can be a rapid downward spiral.

There are connections between many other abused substances and developing mental illnesses. Stimulants increase the risk of psychosis and can increase sexual behaviors. The younger you are when you begin to smoke Marijuana the more likely you are to develop certain mental health issues.

I am not trying to take sides here on the “medical marijuana” debate, but note that smoking anything, dried lettuce or incense included, is bad for the lungs. There is also a developing body of research that says that CBD is better for medicinal use and THC is not. If you are smoking marijuana to “get high” you are at risk to develop problems with its use no matter what story you are telling others. (I think I wrote some posts on that one, note to self-see if those articles got posted.)

4. Substance abuse issues or mental and emotional problems results in a lifestyle where it becomes hard to get your basic needs met.

Both groups have an increased risk of homelessness. They are both at risk to become alienated from family and friends.

You have to do what you have to do.

The result of these lifestyle changes is that the substance abuser is likely to become depressed, anxious, or to be abused. The mentally ill person, to cope with their isolation or homelessness, may turn to alcohol or drugs to cope.

What you go through with either problem increases the risk that you will develop the other disorder.

5. There are emotional consequences to entering recovery.

The substance abuser often gets closer to their drug of choice than to others in their life. When they stop using or abusing they have to go through a grieving process that can be just as severe as a divorce or death in the family.

Users have told me that “women come and go but crystal is always there for me.” People let me down but (fill in the name of liquor here) is always waiting for me. Losing this one support can be a major obstacle in creating a new life.

People in recovery very much need a new support system.

The conclusion?

Having either a substance use disorder, or a mental-emotional problem, increase the risk of having the other. It is easy to get locked in a pattern when no one is supporting your recovery and your environment is supporting you staying sick. Change can be difficult but change – recovery is very much worth the effort.

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

Spiritual but not religious

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

Waterlily

Mindfulness and meditation.
Photo courtesy of Pixabay.com

What exactly does “Spiritual but not religious” mean?

A very large number of people here in America are describing themselves as “Spiritual, not religious.” There is a growing disconnect between religion and people’s day-to-day life.

As a result of this disconnect we are gaining some things, I hope, such as a wider appreciation of our differences, but we are also losing some things.

In secular programs, those run by government agencies, we try to accommodate people of all faiths and those with no faith. Sometimes this is a challenge. We have to ask people what their religious or spiritual belief is without implying that they need to have one or that the belief they have is not acceptable to the agency.

An example of accommodating faiths and other spiritual beliefs

There are a whole lot of people who are vegetarians, do not eat meat variety vegetarians, not because of religious or health reasons but because they view the killing animals for human food as morally wrong.

Our society seems to be doing a better job of accommodating this particular moral belief. More events are offering vegetarian meals.

It gets harder when we take into account that some faiths do not eat pork, some decline beef and some require particular diets as in kosher.

Beyond dietary restrictions, it gets progressively more difficult to accommodate other spiritual beliefs within our increasingly multicultural society.

During intake processes, we are supposed to ask about the client’s race or ethnicity. An increasing number of clients are finding it difficult to answer that question. Some people are reporting 5 or more different ethnicities in their background.

When talking with clients I try to make it a practice to ask about their spiritual or religious beliefs.

Say the client reports that they are African-American. This tells me nothing about their spiritual beliefs. We need to try to stay open to all manner of possibilities.

More and more people are finding it impossible to answer questions about their faith. We have to tread lightly here. I do not want to imply that they need to have a faith or that any particular faith is preferred, but I do not want to completely disregard their spiritual practices in designing their treatment.

Those few who do answer are resorting to one of two responses. I am a Christian or Spiritual But Not Religious. Most who say Christian do not self-identify with any particular denomination. They are not Catholic; they are not Protestant and so on. Some few report attending Non-denominational churches.

Most who self-describe as Christians are reporting, at least in my experience that they do not attend any particular church.

A very large number are reporting as Spiritual but not religious.

So why does all this matter? From a practical standpoint those who self-identify as believing something do better in treatment than those who have no faith. This benefit includes those who self-identify as Atheists if they also report some particular higher law or principle, say right and wrong, that helps them guide their life and is reassuring in times of stress.

One of the gains from this spirituality moment has been sets of values that people take with them day by day in all areas of their lives. I am suspicious of any faith that requires you to be a believer for a couple of hours each week, while in a particular building, but you are free to spend the rest of the week on raping, pillaging, and burning.

One of the things we are losing as a result of this increased emphasis on spirituality and the disconnect from religion is the loss of meaningful shared rituals.

Rituals give meaning to things that would otherwise be everyday actions.

Rituals are not solely the providence of the religious world. Court proceedings, with that robe, the bailiff, and the ritualized language, make the whole process seem more meaningful and as a result, are intended to increase respect for the law and the workings of the court. The ritual gives the process meaning. Occasionally the system debases the meaning when they do not follow the principles of justice these rituals imply.

Graduation ceremonies are a ritual we can all share to make the transition to another life stage. Marriages used to be a way to make the transition from being two separate dating people; to one committed couple. We still have the ritual despite the loss of meaning that a wedding has after having the parties have several children.

Funerals are also a ritual we all share that helps us negotiate the loss of a person who had some meaning in our life.

In places where there is one dominant faith, rituals are shared by virtue of people’s participation in that faith. With the decline of active participation in a particular religion and an increase in self-identified Spiritual But Not Religious, what has been missing are the rituals that used to accompany life events.

Creating new rituals.

People in recovery have resorted to creating new rituals that may help them to share the emotions and resolve the changes in status without invoking a particular religion.

Addicts may write a “Goodbye Letter” to their drug of choice. There are traditions of sponsorship that may replace the “rite” of confession in certain religions. People celebrate the anniversary of their embarking on the road of recovery.

One remaining challenge has been how to create meaningful shared rituals that do not impinge on people’s particular religious faith and allow full participation in the ritual.

Whatever your spiritual or religious tradition, here is wishing you the best possible life.

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 this the year you are going to change?

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

Changing your life

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

You know you need something to change but what and how?

Lots of New Year’s resolutions. There are every year. But one year from now will be 2015 and just like last time around when we get to New Year’s 2015 some few people will have changed their lives and the majority will be stuck in the same rut they are in now.

Change is hard. Change is easy. You will change whether you want to or not. You will get happier, prouder, and more self-confident or you will get progressively more weighted down by your problems and cares. You will change, eventually. The only questions are the direction in which you will change and when that change will occur.

Intentional change is hard because it takes effort. It can be scary. Change is often uncomfortable if not downright painful. Change means entering the unknown and the things we know are less anxiety-provoking than stepping off in action and making those first tentative moves into the unknown.

Unplanned change is easy. Do nothing and you will change. We get older, no effort required. If we fail to save for retirement we have to cut back on our standard of living. The process of life says that you will change or you begin to decline.

Most of us, when we speak of change are looking for that huge dramatic shift. One day you are poor and then you will win the lottery and be rich. Lasting change does not happen that way.

Yes, some people win the lottery or make a good investment or open a business that succeeds but along the way those things rather than changing that person’s life, are the catalysts that force them to change.

Plenty of people have won the lottery and a few years later they are back to being poor. Anyone can spend like a millionaire but learning to manage money, to hold onto it, and grow it, that is a skill that takes work to develop.

Lots of us have that fairy-tale fantasy, someone will come along, usually a prince or princess, and they will make us happy. That kind of happiness only lasts a moment. Eventually, there are children, bills to pay, and illnesses to suffer through together. The majority of those fairy-tale couples end in divorce when the reality sets in.

Change does not come from the outside it comes from within. As you become emotionally healthier you attract healthier people into your life. If you want a better life, start by working on yourself. Will this make the people in your life suddenly treat you better? No. But as you improve yourself you will find that their opinion of you matters less.

If you want to be wealthier you need to practice the skills wealthier people use to manage their money. Be responsible and pay bills on time. That one late charge, it does not make much difference, but over your bill-paying lifetime, fifty or sixty years of monthly late charges, that amounts to a small fortune.

Increasing your income and reducing your expenses go a long way to changing your financial situation. But this will not happen overnight, not even in a month or a year. Over time the small changes you make add up.

Real lasting change in your life begins on the inside with changing yourself. Change your thoughts and actions and the world around you will begin to change.

Lasting change does not come about as a result of one huge event, it occurs in small incremental steps.

Couples often try to fix what is wrong in their relationship by taking a romantic “honeymoon” type trip, a week at the beach, or in Vegas. Temporarily they see an improvement in their relationship. Most often within a week or two of returning home, they are back to their pre-trip way of interacting and they are just as dissatisfied as before.

Couples who make real improvements in their relationship begin by making changes in the way they interact. Maintaining those changes takes time and practice to have a lasting effect. A good marriage therapist can help you learn and practice those skills.

Many of you have written and told me that you want to change something in your life. You are not happy with the way things are. You have tried to change your life but the change does not seem to take.

I realize that it is easier for professionals to tell someone how to change than it is to actually do the changing. Throughout this year I want to talk with you readers of this blog about how to make those changes you want in your life and how to maintain those changes once you make them.

Stay tuned for some information on the books I am working on. Some things need more words than a blog post can hold.

Much of the information on recovery comes from the extensive literature on drug and alcohol recovery. Alcoholics and Drug Addicts have been recovering for a long time. Some of that information has been applied to people with “co-occurring disorders,” both mental health issues and substance use disorders. What is still in short supply is information that emphasizes the way in which people with emotional and mental health issues recover.

I strongly believe that people with mental health challenges can and do recover. Recovery for them does not necessarily mean that they are cured as if they no longer had ever had that issue, but it does mean that people can have a meaningful life despite their challenges, whatever they chose to call those challenges.

Related articles

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

Alcohol hangover or emotional hangover?

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

Inebriated people.

Alcoholism.
Photo courtesy of Pixabay.

Why are you reading this post? Hangover?

This is New Year’s Day and you are reading blog posts? Why?

If you are reading this on the day it was published, then it is time for you to take another look at your life. Don’t get me wrong, I really appreciate my readers and am glad you are reading this whenever that happens to be.

Some of you are just sitting around and waiting for the games. There are enough sporting events on the television on this day to produce a self-induced coma.

Some of you had that dazed look and the splitting head when you got up today. Is that a hangover? Are you looking for hangover cures?

How much did you drink last night? What if you didn’t drink and have that hangover anyway?

If the problem is too much to drink last night I have a solution. Check all those other blogs for hangover cures, try a few and then come back and read my posts for the next week or so. By then your hangover will be gone – assuming you do not drink again.

See the most effective treatment for alcoholic hangovers is time – time, rest, and water to be precise. You could also try preventing hangovers, which is easier than curing them.

How do you prevent hangovers?

Do not drink to excess. Better yet do not drink at all. If you are the kind of person who does not like the feeling of being drunk then have one and let it go at that. But if you are the kind of person for whom one is a warm-up for the rest of the bottle or case then the only solution may just be that you do not drink in the first place.

Emotional hangovers.

Some of you feel like you have hangovers only you did not drink any alcohol. That is a similar but different problem. That is likely to be an emotional hangover. See an excess of negative emotions can result in some of those same or similar symptoms as the alcoholic fueled hangover.

If you did not sleep because you were passed out unconscious that is the alcohol, but if you were up all night and did not sleep because of worry, anxiety, or depression then that is an emotional hangover.

When drinking people forget to take care of themselves, they do not eat or drink non-alcoholic fluids in a healthy manner. People who have an emotional issue also neglect self-care and they experience those same worn out, tired and hung-over symptoms all without the alcohol.

Put the two together and you have a potentially life-threatening combination. Drinking while depressed is a recipe for self-harm.

Anger is a huge cause of emotional hangovers.

Anger is also an emotion that can take you places you wish you had not gone. Have you or someone you know ever become so angry they “lose control.” The next day was there a lot of emotional residue, the I-can’t-believe-I-said-the-whole-thing feeling?

Now if you drank too much last night or any other night, the solution seems clear, cut down or cut out the alcohol.

If you are having emotional hangovers isn’t the same solution possible?

If you have emotional hangovers, cut down or cut out the anger, reduce the level of depression or anxiety, and learn to manage your emotions in healthier ways.

I hear some of you saying I try but it is hard to change those emotions. Then for you, just like for the alcoholic it is time to make some far-reaching changes. If you have tried to control your emotions but they leave you with an emotional hangover then it is time to seek help.

Whether it is drugs, alcohol, anger, or any other emotional or mental health problem there is help available. That is unless you like the feeling of having a hangover.

Isn’t it time you reached out for help?

Over this year, here on counselorssoapbox.com, we will be looking at the ways in which you might finally make some life changes, No resolutions – just results. Are you ready for a change?

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

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

Story Bureau.

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

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

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

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

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

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

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

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

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

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

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

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

For videos, see: Counselorssoapbox YouTube Video Channel

Youth Mental Health First Aid – ALGEE imposter

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Counselorssoapbox.com

Really? Do I look that much like ALGEE?

By David Joel Miller.

Algee Look Alike

Algee Look-Alike

Just back from a Youth Mental Health First Aid Training. One of the other trainers took this picture and tried to assert that somehow I look like a relative of ALGEE. Really? Do I look that much like a koala bear?

For those of you not familiar with Algee or Mental Health First Aid (MHFA) let me catch you up.

Mental Health First Aid is this cool program that started in Australia and is now available in America. It is sponsored by the National Council for Community Behavioral Healthcare.

MHFA

MHFA

The goal of the program is to teach as many people as possible to recognize when someone is having a mental health problem. You can also learn some skills to be helpful and to get this person the help they need.

The program is not designed for professionals; after all, by the time someone gets to us, we already know they have problems. MHFA is designed to be used just like Medical First Aid in being helpful when there are no professionals around or until you can get help for the person experiencing mental health issues.

The training runs 8 information-packed hours and is conducted by certified trainers all over America and in many other countries as well. I have been an MHFA trainer in the Adult course for a number of years.

Youth Mental Health First Aid is not meant to be a training for young people but rather a course for adults who work with young people. The goal is to help adults who work with or around young people to better recognize and respond to emerging problems in the hope that early detection and assistance efforts may help prevent some mental health issues and may help to reduce the severity of others.

The Mental Health First Aid website has a list of certified trainers and scheduled upcoming trainings. Check there for possible trainings in your area. You are also welcome to contact me about trainings, I may be doing in the future.

While Algee and I may have some superficial resemblances I do not believe that we are in any way related. We are however both interested in helping to reduce the stigma around mental illness and to help people to cope with all of life’s problems.

How about you? Are you interested in becoming a Mental Health First Aider?

Related articles

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

Winter Blues (SAD) Prevention and Treatment

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

Winter

Winter.
Photo courtesy of Pixabay.com

Treatments for Winter Blues.

For some people, the Winter Blues is a mild transitory issue. You miss someone who is not there or you wish something were other than it is. But for some people, this becomes a severe emotional problem.

The Winter Blues sometimes is called Seasonal Affective Disorder or more precisely it is Major Depressive Disorder with seasonal features, a diagnosable mental illness.

There are a handful of treatments and the one that is right for you should be chosen in consultation with your doctor, psychiatrist, or therapist. Each treatment has its advantages and its limitations.

Light therapy for seasonal affective disorder.

One group of theories about winter blues has its cause as a reduction in the amount of sunlight that occurs during the winter. More light, so the thought goes, and you should be less depressed. The cause could be just the amount of light but it can also be changes in the way your body reacts to the light level so some people are way more sensitive to changes in light levels, light intensity, and the amount of sleep they get.

Just leaving on a few lights in the early morning or evening may help a few people but most light therapy involves special lights of high intensity which are close in color and intensity to normal daylight.

The drawbacks to light therapy, above and beyond the cost of special lights, are that to be effective you may need to devote a lot of time on a very regular basis to sitting in these lights. Most often this is done first thing in the morning.

If this works for you, and remember it does not work for everyone, the results will fade in 3 to 5 days if you stop sitting under the lights. Once you start light therapy plan on continuing it until the winter season is over.

Medication seasonal depression.

Some people react well and quickly to antidepressants. Not everyone gets the same benefits from the same meds. You need to work with your doctor on this and start early, take the meds as prescribed and keep them up until any chance of a relapse of your depression is passed.

Therapy can reduce seasonal depression.

People with seasonal features to their depression, Winter Blues, in particular, are prone to the same sort of thinking errors that people with other kinds of depression experience. Therapy to correct negative or unhelpful thinking can reduce Seasonal Affective Disorder.

Self-care reduces the impact of seasonal affective disorder.

More exercise, better diet, and being around a positive support system can help you avoid or reduce the symptoms of the Winter Blues. Relapse from this condition, like recovery from most issues, requires a program of relapse prevention that includes management of internal triggers like sleep, hunger, and emotions as well as management of your contact with outside things such as people and places. Work on staying healthy and being around healthy supportive people.

Combination Therapy

Any or all of the treatments above can be combined. Medication is most often combined with therapy and self-care. Having a strong support system is especially important if you experience Winter Blues.

If you are sad, down, or depressed this Holiday season, whether it is because of Winter Blues or some other reason, please take good care of yourself and reach out for help when you need it.

For more about SAD and the risk factors involved take a look at the post

Sad – Risk factors. 

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

Winter Blues (SAD) Risk Factors

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

Winter

Winter.
Photo courtesy of Pixabay.com

Winter Blues are a troublesome, recurrent form of Major Depressive Disorder.

Every year a select group of people seems to get a recurrent episode of Depression. These symptoms can start as early as age three or four and result in serious impairment. People do poorly in school; lose jobs and relationships as a result of having this disorder.

The major occurrences of this disorder are in the winter months. A few people get recurrent episodes of depression every summer, fewer yet have spring or fall recurrences of depression. The winter version of this disorder is particularly problematic.

We have a large number of theories about why this occurs and what the risk factors are for this disorder but so far treatments and prevention efforts are more hit and miss.

If you have had episodes of Winter Blues you know the havoc it can play with your life.

Technically Winter Blues are diagnosed as a variation of Major Depressive Disorder (MDD.) The specifier of seasonal features is added on to the principle diagnosis of MDD.

Winter Blues is characterized by what is called “atypical” features. The easiest way to describe this is that the person begins to hibernate like an animal preparing for a long winter.

As winter approaches the person with Winter Blues begins to sleep more and more. They increase their food consumption and begin to put on weight. Carbohydrate Cravings are likely to become pronounced. The person with Winter Blues is also likely to avoid others and begin to isolate.

Case studies tell us of a child who became so very different during the winter that for a time they thought this might be a developmental delay. His speech became difficult to understand and he appeared to stop learning. He was tested for autism and retardation.

Then for no apparent reason, he began to function more normally as spring approached. Over subsequent years he regressed each winter and then “bloomed” again as spring returned. One early theory was that he was getting sick in the winter, a common occurrence for a child. But in the year he was sick in the summer and had fewer illnesses the following winter he still improved in ability over the summer and relapsed in the winter. Eventually, at about age 6, this child was diagnosed with a significant form of depression that grew worse each year.

Another woman came for treatment one winter and reported that she was about to lose her job from poor job performance. She had repeatedly over the years done well each summer and received promotions, but in the winters she made mistakes, was disciplined and eventually at risk of losing her job. She was treated for MDD with seasonal features and responded well.

Risk factors for Seasonal Affective Disorder.

The amount of daylight affects mood.

The farther north you live the fewer the hours of daylight in winter. Less light triggers the hibernation response. Some people have it more difficult than others.

Genetics can increase your winter blues risk.

This has been suggested as a factor. It has been a long time since I read much on genetics. If this interests you, I recommend you look it up and not take my fuzzy understanding as the whole story. Here is what one study seems to say.

Variations in the 5-HTTLPR have been suggested as being a risk factor. Some people have long versions and some people have short versions of this gene. Some people inherit two short genes and other people have two long. One of each is also possible. People with two short genes are at extra risk for winter blues, people with two longs are more likely to have a melancholy form of depression.

Eye color may be connected to seasonal affective disorder.

People with blue eyes get more use out of the light. People with brown eyes have more difficulty in Northern latitudes in the winter.

Thinking errors increase all kinds of depression.

People who experience episodes of seasonal affective disorder are more likely to ruminate, assign negative meanings to things, and look for the negative.

Whatever the risk factor or the reason someone has recurrent episodes of depression with those seasonal features each winter, the good news is that there are treatments for this form of depression, just as there are treatments for most other mental and emotional disorders.

If you find yourself getting depressed as the winter progresses you do not have to just suffer through it. Please reach out for help.

Coming up soon a post on treatment and prevention of the winter blues.

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

Questions and comments – let me get back to you on that

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By David Joel Miller, Licensed Therapist, and Licensed Counselor.

Counseling questions

Counseling questions.
Photo courtesy of Pixabay.com

You have questions – you left comments.

Sorry about not getting to answer all those great questions. You, readers, have sent in a number of comments and questions, some on one site and some on another.  All those comments and questions deserve a decent response. I am finding that this time of year with finals, a three-day training, preparing for the next semester, and the general hecticness of the season, there has just not been time to get back to all of you as I had wished.

So I hope you will keep reading the posts as they are scheduled to appear and know that I will get back to your questions and comments as soon as I possibly can.

You should know that most of the posts on counselorssoapbox.com are written ahead of time and then scheduled to appear at a later date.

There have been lots of new developments in therapyland and in recoveryland also. I have been reading some new research and the way we see substance abuse, mental illness and recovery are all about to change.

Over the next year, I want to talk about all of these items and give the questions and comments the replies they deserve.

Here are just some of the things that remain on my to-write-about list.

1.  How treatment and recovery might apply to children and adolescents. Over my time working in the recovery field I have seen a lot of youngsters that need and deserve help. Working with adults I see issues that are clearly the result of childhood mental illness or substance abuse that went untreated.

2. The role of the internet and modern technology in mental health and recovery. I see both harms and help from these new technologies. We should talk about what might be helpful in treating and preventing emotional and substance abuse issues and what internet features may be promoting recovery.

3. The changing role and status of LPCC’s in delivering mental health and substance abuse treatment in California.

4. Affairs: This is not a new topic but it is a large, possibly the largest, reason couples come to see me in private practice. People have strong feelings about this. With more than half of all marriages ending in divorce and more than half of all people reporting they have had affairs we need to look at this issue and how you might recover from an affair – yours or your partners.

5. New developments in brain science. The last year has resulted in some intriguing new knowledge of the brain and how it works. This research has suggested some new ways that mental and emotional illnesses, as well as substance use disorders, can be treated. Not all of this new knowledge points to using more medication to treat problems. Research continues to point to the value of talk therapies in treating emotional issues.  While I am neither a medical doctor nor a researcher, as a counselor, therapist, and writer, I find these developments worth commenting on.

6. The major role of stress, adjustment, and dissociation in emotional problems. PTSD, complex trauma, and a host of other problems have received less attention than they require. We need to talk more about how stress affects people, how to manage stress, and how to heal from past stressful experiences.

One goal for the counselorssoapbox.com blog this year was to write and post 350 new articles. With those already scheduled to appear before the year-end, it is clear that we will reach this goal. This will bring the total of articles posted on counselorssoapbox.com to over 700 posts.

This coming year looks to be a busy one. I will be teaching more classes than last year, doing more trainings, and plan to get back to work on that book or books. Readers have asked questions about, change, recovery, resiliency, and how to create a happy life, which needs much longer discussions than a blog post. The books in progress will be a way to offer my views on those topics.

Thanks to all the readers, new and longtime, of counselorssoapbox.com.  Keep those questions and comments coming; it encourages me to keep writing.

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