Tag Archives: Depression

Support Groups for people with PTSD or Complex Trauma.

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

Group.
Photo courtesy of Pixabay.com

Anyone know of support groups for people with PTSD?

This question came in from a reader. They were specifically asking about local support groups here in Fresno. I did not come up with much and so I thought I would offer a few suggestions and then ask those of you out there if anyone else knows of any other resources.

Unfortunately, most of my suggestions may not help the person who asked the question, the resources are limited.

1. Try on-line groups.

I am familiar with some groups or communities on the internet. More and more the specialized groups are becoming self-help or peer-run groups on the internet.

One, in particular, is Trauma and Dissociation which is a Google+ community. You have to have a google+ account to access this but opening an account is easy and free.

You can also try the WordPress Blog: http://traumaanddissociation.wordpress.com/

2. Larger insurance providers may have something to offer if you have private insurance. Kaiser for one has offered some groups. Can anyone add to that list?

3. Your insurance provider may be able to refer you to a private therapist and some of them specialize in PTSD an even smaller number may offer group formats.

4. If you are in substance abuse recovery some A.A. and N. A. groups, while not specifically devoted to people with PTSD can be supportive places for people in substance use recovery who have PTSD or another mental health issues also. Check out the group and make sure you feel comfortable with them before divulging the details of things other than the official topic.

5. VA has some groups and more likely to come in the future as so many veterans are returning from multiple deployments with PTSD and the related MST (Military Sexual Trauma.)

6. Those people who are receiving services through their local Community Mental Health Department should check with them for available groups. In Fresno County, if you have no insurance there are county-run programs for those on Medi-Cal and those with no or very low-income.

It remains to be seen if these groups will be expanded. Personally, I think specialty groups for people with specific issues can be especially powerful. I anticipate that as more people become eligible for services in the government-run systems we will increase the number of groups run by both peers and professionals.

Any other suggestions?

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 your lover an addiction?

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

Couple

Relationship.
Photo courtesy of Pixabay.com

When your lover is an addiction it is not a healthy relationship.

Human lovers may be with you for a lifetime or they can come and go – but that addiction is always there for you. Some people have love or sex addictions. They can’t stand the thought of being alone or not having a partner. They settle for a bad relationship in preference to being alone. They can’t seem to develop a healthy relationship with themselves.

If your lover is Gambling, alcohol, or drugs you know that your addiction will be waiting for you, demanding your devotion as human partners come and go.

The love of your life may be shopping or the go-in-debt-at-home channel. It may be hoarding useless things. Most any activity can become an addiction if you can’t stop thinking about it and eventually you lose control and have to do it one more time, whether you wanted to or not.

Clearly, drugs and their older sneakier cousin, Alcohol, win the contest for addictions that can take control of you.

Most people with addictions become closer to their addiction, often a drug of choice than to the humans in their life. Somehow we hold on to that love for that addiction even when it begins to treat us badly.

I have seen a number of people stuck in bad relationships with other humans. Eventually, most of them have had enough. They either come for counseling and try to change their relationship, or they decide to leave the other person. Occasionally someone hangs on even though they know that this is not a good relationship. They hang on because the prospect of letting go feels worse to them than the pain of staying.

It is even worse when the partner you are leaving is an addiction.

People who give up their addiction are letting go of their best friend, their lover, and their full-time life companion.

They tell me that partners come and go but that “Crystal” is always there for them. Women may reject you but “Sherry” is there in the bottle waiting for you. And your drug of choice, it always changes the way you feel. Until it begins abusing you.

Having had a long-term relationship with a drug of choice results in a lot of grief and loss issues when you finally decide to give her up.

While you are grieving over your lost partner, Whisky or Beer, wine or Meth, everywhere you go there are people trying to get you two back together again.

Your friends, they all know “Crystal” and “Sherry” and they tell you – have just one more for old-time sake. Even the stores are out to get you with their reminders of your lost love. The beer is stacked up by the door and the milk is at the end of the wine aisle.

Like any other lost love when you are trying to get over an addiction everywhere you go there are reminders.

Do not give up. Going back to an addiction is not a way to find happiness. Eventually, the grief will pass and you will find a new happier life waiting for you.

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

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

Story Bureau.

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

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

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

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

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

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

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

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

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

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

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

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

For videos, see: Counselorssoapbox YouTube Video Channel

Can you focus your mind?

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

Focus

Focus.
Photo courtesy of Pixabay.com

You can shift the focus of your eyes but what about your thoughts?

In old-school photography, every student had to learn selective focus. The goal was to keep one thing in clear focus while letting the other things in the scene blur out and become ambiguous.

If you had a person close to you, then you wanted their face clear and the things behind them, the background, to blur out. If you took a picture through a fence the goal was to get the things far away clear and the fence to blur until it disappeared.

Wouldn’t it be nice if we could shift the focus on our minds just like that camera?

Well, some people can do just that.

Often when we interact with others our minds go all over the place. We think about the room temperature and lighting, what we will do after this meeting, what we did yesterday.

We can be overwhelmed and the result is that we lose the ability to pay clear attention to the thing we are doing or the person who we are speaking with.

When we try to relax our minds can become troubled with that swarm of thoughts buzzing around in our head. Things to do, people to call, emails to answer. Did you pay that bill? Should you check Facebook or Twitter first?

Seeing everything at once can result in seeing nothing as your life flows by lost in the jumble of thoughts.

One skill they teach in “mindfulness” training is how to shift that focus of your thinking, how to pay attention to the things you want to attend to and let the rest go. This is a valuable skill to have. The ability to attend to one thing and let the other things blur out is not something we are all born with but a skill that can be developed.

I realize that this selective attention or mindfulness can be more difficult for people with certain disorders like ADHD, but with the constant flow of information overload, all of us are at risk of losing our mental focus if we do not learn to attend to one thing out of a swarm of thoughts in our heads.

Do you sometimes feel like a traffic cop trying to direct thousands of unruly thoughts traveling within your head?

This age we live in has more information available than ever before. There are constantly things to do and distractions everywhere. The thoughts, feelings, and sensations run back and forth in our minds.

Do you run after each and every thought like a school worker trying to corral a group of unruly children?

Sometimes it is nice to just observe the thoughts as they run through our minds, let them go, and shift our focus from all that is going on outside us to what is going on inside yourself.

Learning to shift your mind’s focus, attuned to one important idea at a time can reduce your stress and improve your creativity and productivity.

Give that shift of mind focus a try and see if it does not bring a whole lot of things into sharper focus.

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

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

Story Bureau.

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

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

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

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

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

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

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

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

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

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

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

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

For videos, see: Counselorssoapbox YouTube Video Channel

What does being sad say about you?

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

Sad child

Sad.
Photo courtesy of Pixabay.com

What do you tell yourself when you are sad?

Many of us can’t bear to let ourselves be sad. Not because the feeling is so unbearable but because we tell ourselves that if I feel that way there is something wrong with me. That insistence that we should not feel what we feel or that feelings are negative, can keep you from learning the lessons that feeling are trying to teach you.

Those things we tell ourselves to try to avoid feeling what we feel can keep us stuck in those negative feelings a lot longer than if you let yourself feel and then decided what you wanted to do about that feeling.

Do you tell yourself these things when you feel a sad emotion coming on?

1. If I am sad that means I am weak.

Sad or even depressed does not mean weak. Feeling sad means you are normal, especially if the sad is for what you see happening to others. Only a psychopath can see a child being harmed and not feel sad. So unless you are aspiring to become a psychopath let yourself feel sad when things happen that should make you sad.

Being sad is not weak, it is realistic. What you need to do is not stay stuck in the sadness but look for ways to be kind and compassionate to those that suffer.

That list of people who you need to be kind to – your name should be up at the top of the list of people deserving kindness.

2. Do you think being sad is pitiful?

Pity is a looking down on other’s emotions. Why are you looking down at yourself?

Be compassionate with yourself. Beating yourself up or telling yourself not to feel what you feel will undermine your ability to use feelings as a reliable guide to life events. It is not pitiful to be you.

3. If I let myself be sad I am a basket case.

It is not people who feel that end up in emotional trouble. People who try to hold things in eventually meltdown or they become dead inside.

Some feelings have to be felt before you can move on. If someone dies feel the grief. Be sad when sad things happen.

Do not let sad or your efforts to not feel sad take over your life.

4. Being sad makes me inferior.

Being sad is a normal human emotion. Everyone can and does feel sad some of the time. What matters is what you do with that feeling. Do you get sad when you should and then let it pass or do you get stuck there?

You do not need to be less feeling and more numb than others to think of yourself as acceptable.

It is not the feeling sad that defines you, it is what you do with that emotion once it has visited you.

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

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

Story Bureau.

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

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

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

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

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

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

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

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

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

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

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

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

For videos, see: Counselorssoapbox YouTube Video Channel

How do you avoid healing?

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

Calm waters.

Calm.
Photo courtesy of Pixabay.com

Do you avoid something that would be good for you?

You walk right up to the thing that might help you heal and you turn away. Each of us has our own special ways of avoiding the healing process. We tell ourselves lies, listing to the lies from our disorder, or avoid the things that might make us better.

Do you know the prescription for what ails you but you use tricks to avoid taking that medicine?         Do you use any of these methods to avoid healing?

1. When you start to feel you reach for drugs and alcohol?

Early on in the process drugs and especially alcohol look like the solution. How often have you heard someone say they needed a drink to deal with an unpleasant emotion?

What happens more often than not is that the chemical you use only temporarily blocks the feelings. When the drug wears off the feelings return worse than ever. Eventually, alcohol or drugs do not take the feeling away.

At that point, your solution has become the problem. Now you have to keep drinking and using to forestall the crash that comes with withdrawal.

Your friend, the chemical, has turned on you.

Sometimes the best solution for unpleasant feelings is to feel them. A friend or professional can help with things a chemical cannot.

2. You don’t ask for your needs to be met.

People expect their friends and family to know what they need. I hear them say that if I have to ask you to do something then it does not count. This is just one more way of setting ourselves up to be disappointed and to blame our ills on others.

Unless you are the exception, you do not live with a mind reader and your partner, family or friend does not know what you want and need.

No one is inside your skin but you. Are you hungry? You need to say so. Are you lonely, tired or feeling unloved? Tell those around you what you need from them. They may not always be able to give it to you but you will get a lot more of your needs met if you just learn to ask for what you need.

3. You avoid conflicts by saying what they want you to say.

Sometimes saying nothing is a way to avoid conflict. Many of us need to learn to bite our tongue more often.

What is worse than saying nothing or saying too much is the habit some of us have of saying what we think others want us to say even when that is not what we want or mean.

If you have developed the habit of agreeing with people before you have had the chance to think about your needs you may avoid some conflict in the short run but you will sabotage your recovery.

4. Beat yourself up and shoot yourself in the foot.

Are you your own worse critic? Telling yourself you are bad, a failure, and the like is not going to make you do things better. Learn to give yourself encouragement and you are likely to make a lot more progress than if you beat yourself up.

That does not mean you should fail to address your shortcomings. Just do that by changing your actions not by calling yourself names.

Do you just find another self-destructive behavior to take the place of the pain? Lots of people do the old shoot yourself in the foot thing.

5. Your mind just leaves.

Daydreaming is the first cousin of dissociation. In extreme cases, this can be a diagnosable disorder. But short of that dissociation disorder, many people have ways of just letting their mind wander away.

Do you daydream rather than take action? Do you distract yourself with videos, online games, casinos, or other activities that allow you to avoid facing your problems?

Most problems do not disappear while we are out to lunch. A problem not dealt with is likely to grow.

Take a look at yourself and see if there are ways that you are avoiding taking the actions that you need to take and as a result, you are the one keeping yourself from healing from emotional pain.

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

Complex Trauma, Stress and PTSD

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

Words about PTSD

PTSD.
Photo courtesy of Pixabay.com

What is Complex Trauma and how is it connected to other emotional problems?

Most therapists recognize the existence of a “thing” that might be called Complex Trauma. We are pretty sure it exists. We see clients with it all the time.  Only it looks different in different people. Sometimes it looks like a stress disorder, sometimes it looks more like Post Traumatic Stress Disorder (PTSD) other times it looks a lot like depression or anxiety.

We, professionals, are just not sure what to call this thing and worse yet we are not all sure how to treat it.

This confusion is aggravated by the problem that there is was no diagnosis for this thing, this complex trauma monster, in the DSM-4. Worse yet, even with the increased attention to stress caused disorders in the new DSM-5 Complex trauma did not make the new book either.

The result is that we have a disorder that we all see in our clients but it looks different in a different light and we give it different names depending on who has this issue.

This problem, this idea that multiple, complex trauma is different from single trauma and that the results of multiple traumas are not a case of two plus two equaling four is not new. With complex trauma two plus two maybe six or even seven.

We know this from reading books and articles on zoology. Humans are not the only creatures who suffer more from repeated traumatization. Other creatures can recover from a single large trauma but when subjected to repeated traumas they lose the ability to adjust.

Let me attempt to explain this problem by using a far-fetched analogy.

Complex Trauma is kind of like a hurricane or monsoon.

Most of us know what a hurricane is, sort of. The wind blows really hard. It damages things and knocks things down. A tree may blow over and smash your roof or the wind may break some windows and blow over some things breaking them. But that is not all.

With the wind comes a lot of rain. The rain fills up creeks and small rivers and then they overflow. Your house may get flooded.

That tree may miss your house when it falls and hit a power pole. That pole may start a fire and your house could burn down. If you live near the coast the tide from the ocean may become a tide surge and sweep your home away.

All of these things are the consequences of the hurricane, but the effect on you and the way your insurance company sees things may be very different depending on whether your house is damaged by a falling tree, flooded, swept away by the tide, or burns due to a falling power line.

Complex trauma is a lot like that. Different people are affected differently. Some get depressed, some get anxious, some people dissociate and others think of harming themselves or others. All of these possibilities and more are the result of the stress or trauma but each person experiences them slightly differently and they all may get different diagnoses.

A different diagnosis may result in a different treatment which means some people are way more responsive to a particular treatment.

We used to think that there was a discrete number of mental illnesses, two, neurosis, or psychoses. Then a hundred or so and in the DSM-4 about 400. Now we are thinking that if we keep splitting up these problems of living we are going to end up with one diagnosis per person. So we are trying to think more in terms of a continuum. Some people are only a tiny bit depressed occasionally and others are major depressed all the time.

This variation in features is also impacting the way professionals see and respond to stress-related problems.

Over the next few weeks as time and space permits, I want to talk more about complex trauma, how it develops and why it is sort of like PTSD, anxiety, and other named disorders, and why it is enough different from those other disorders that clinicians are developing specialized treatments for this issue.

People can and do recover from complex trauma so stay tuned and we will talk about the steps to recovery from this misunderstood disorder.

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

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

Story Bureau.

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

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

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

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

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

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

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

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

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

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

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

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

For videos, see: Counselorssoapbox YouTube Video Channel

What is kindness?

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

Do you know kindness when you see it?

Encarta says Kindness is:

An act that shows consideration and caring

The practice of being or the tendency to be sympathetic and compassionate

The Century Dictionary, 1889 has a lot more definitions:

Good will, Benevolence

Tender feeling, affection, love

Fitness, agreeableness

“Be kind, for everyone you meet is fighting a harder battle.”  ― Plato

“My religion is very simple. My religion is kindness.”  ― Dalai Lama XIV

“Three things in human life are important: the first is to be kind; the second is to be kind; and the third is to be kind.”  ― Henry James

“Kindness is a language which the deaf can hear and the blind can see.”  ― Mark Twain

Have you been kind today?

Why are so many children being diagnosed Bipolar?

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

Person with masks

Bipolar.
Photo courtesy of Pixabay.com

Early Onset Bipolar Disorder.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

5. Genetics is a Bipolar Disorder risk factor.

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

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

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

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

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

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

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

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

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

Story Bureau.

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

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

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

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

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

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

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

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

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

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

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

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

For videos, see: Counselorssoapbox YouTube Video Channel

Is money keeping you from getting emotional help?

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

Cash

Money.
Photo courtesy of Pixabay.com

Is the cost keeping you from getting help?

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

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

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

The cost of relationship counseling.

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

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

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

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

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

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

Counseling for substance problems.

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

How might you make therapy more affordable?

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

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

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

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

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

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

But there is more, therapy may be FREE!

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

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

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

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

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

10 ways to get emotional help without money

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

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

Story Bureau.

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

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

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

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

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

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

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

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

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

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

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

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

For videos, see: Counselorssoapbox YouTube Video Channel

What will happen if I go for therapy?

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

Therapy

Therapy.
Photo courtesy of Pixabay.com

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

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

Story Bureau.

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

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

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

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

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

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

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

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

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

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

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

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

For videos, see: Counselorssoapbox YouTube Video Channel