Tag Archives: dual diagnosis

5 Reasons Mental Illness and drug use hangout together.

Posted on by
Reply

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

sign

No Drugs.
Photo courtesy of Pixabay.com

Why do so many people have both Substance Use Disorders and a Mental Illness?

Having multiple problems is so common today that we are surprised when someone shows up looking for help for one and only one problem. People who have a mental illness often abuse drugs or alcohol. People with a Substance abuse disorder frequently have one or more mental illnesses.

The overlap is so common we have come to expect that someone who has one life problem is at risk to develop another. When people have more than one problem it is hard to recover from one unless the other gets treated.

The old method was to ask the mentally ill to give up drugs and alcohol, stay clean 30 days, and then they could get help for their mental illness. Substance abuse clients were told to go get their depression or anxiety treated and then come back for drug treatment. The result was people with multiple problems who were ping-ponged back and forth between providers and many never got the help they needed.

The newer approach is to treat multiple problems all at once and improvements in one life area help recovery in other areas. So why are mental health problems so very common among those with substance use disorders? Here are some of those reasons.

A prior Mental illness puts you at risk to abuse substances.

Having a mental health problem puts you at risk to use substances to cope with your issue. Someone with anxiety finds that alcohol or drugs help them get past the anxiety and be more outgoing. The more of a drug they do the better they feel. Before long this use is out of control and becomes first a habit and then an addiction.

A person with Post Traumatic Stress Disorder will find that chemicals, alcohol or drugs, numb the symptom. Some people drink to forget the depression. All of these uses of chemicals to cope with a mental health issue could fit under the idea of self-medication. Using drugs and alcohol can help the person cope for a while, but since this is an unsafe coping strategy eventually the person’s solution becomes a second problem.

Common stressors and environments increase risks for both.

Living in poor neighborhoods increases the risk that you will have life difficulties. More crime more mental health issues and more drug and alcohol abuse in your neighborhood. Poverty is depressing and substances are a way to cope, temporarily, with poverty and unemployment.

Substances change your brain and induce mental health disorders.

People try drugs for all sorts of reasons. Many people have had the experience of a hangover. After that experience, a common treatment for the hangover is the hair of the dog that bit you, more alcohol.

Substance use progresses from experimentation to habitual use. The more of a drug someone uses the more their brain chemistry changes. At some point, not a planned occurrence, this habit becomes a mental need, a psychological addiction to the substance. Eventually, this progresses to a psychical addiction, a chemical dependency.

Excessive substance abuse results in long-term changes in the functioning of the brain. Depression, anxiety, or even psychosis may develop as a result of using, being under the influence, and withdrawing from substances.

Life experiences from either increase the risk of the other problem.

People with serious mental illnesses are more likely to be the victim of crime than the perpetrator. Being mentally ill makes you vulnerable. Having a mental illness increases the risk that you will be unemployed, have a psychical illness, and die at an earlier age. All of these are risk factors for substance abuse.

The life experiences that drug users have, poor neighborhoods, crime, and poverty are all risk factors for poor mental health. The drug-using experience increases the risk of traumatic experiences. Rapes, robberies, assaults, and incarcerations all can accompany substance use disorders.

The experience of having a substance use disorder increases the risk of a mental illness. Trying to live with a mental illness increases the risk that you will abuse substances.

Giving up a drug of choice is painful.

For most substance abusers their drug of choice becomes their best friend. Women come and go but Sherry is always waiting in the bottle for you. A man may leave you but Jose and Jack will always be in the bottle when you need them.

Crystal is always ready for your next date with the pipe.

People become closer to their drug of choice than to their family or friends. Giving up drugs or alcohol means losing that best friend. This loss of a friend and support system can leave the substance user alone with no coping mechanism and at high risk to develop a mental health problem or return to active use.

Hope that these 5 ideas will help to explain why having both a substance use disorder and a mental illness at the same time is so very common. If you or someone you know has one or both of these issues help is available. If that person has both conditions, look for a treatment provider who is comfortable with working on both issues at the

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, Drugs and Mental Illnesses

Posted on by
Reply

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

Drugs.

Drugs.
Photo courtesy of Pixabay.

How are alcohol and other drugs connected to mental and emotional problems?

There are clearly a large number of connections between drug and alcohol use and abuse and mental, emotional, and behavioral illness. The recognition of these connections has resulted in a growing emphasis on the relationships between drugs and alcohol and those conditions that we call Mental Illnesses.

This overlap, those times when someone has both a substance use disorder and a mental illness, was called first dual-diagnosis and more recently co-occurring disorders. The overlap is common but not total.

There are people with a mental illness that do not have a substance use disorder. There are also those with a substance use disorder that do not have a mental illness. Over time we have come to see that the overlap is so large that it is more common to see someone with both of these problems than not. The professionals in the field have come to think of co-occurring disorders as an expectation and not an exception.

This understanding that there are reasons for the overlap, or co-occurrence, of these two different disorders has spawned a lot of efforts to find effective treatments for people with multiple disorders. The advances in brain studies have resulted in a lot of research studies on the effects of various drugs and the brain. We now know more than ever before about how drugs and alcohol are affecting people’s thinking, feeling, and behavior.

Alcohol, the drinkable kind, has been around and in use longer than any other drug. We know more about this particular substance and its effect on the brain than probably any other chemical. I recently did a literature search for current scientific articles on the effects of alcohol on the brain and the search returned 28,834 articles. Other searches would, of course, have returned even more.

Given this huge and growing body of research, I thought I should spend some time and some blog posts reviewing some of this new knowledge. While I can’t read every study and surely will only be able to report on a few highlights, I want to tell you about some of the things we know and some of the things I think about the effects of drugs on the brain and on those things we call mental illness.

There are several sources of this new knowledge. These studies, beginning with the ones focused on alcohol come from the following areas.

1. Fetal Alcohol Spectrum Disorders.

Studies of children who have been exposed to Alcohol before birth show changes in the body, brain, learning, and behavior of those children. We used to think that only those children who were exposed to large amounts of alcohol developed problems. The more the research progressed the more we have concluded that any amount of alcohol consumed during pregnancy increased the risks to the child.

Just because a woman drank during pregnancy does not automatically mean that any problems her child has are the result of her drinking. Still, the link is so strong that most authorities now believe that there is no safe level of alcohol consumption for a woman who is or may become pregnant.

One result of the large overlap between substance use disorders and other mental illnesses is that a lot of people with a diagnosed disorder are at extra risk for risky sexual behavior and unplanned pregnancy. Parents with a disorder or two are more likely than others to produce an unplanned child.

2. Binge drinking.

The amount of damage drinking does to the body is correlated with the blood alcohol level. As a society, we have been looking at how much alcohol in the bloodstream is a safe level for someone to have and still drive.

Studies of the effects of various levels of alcohol on brain function have taught us a lot about the way in which increasing the level affects the person.

It looks certain that the higher the blood alcohol content the more the damage to the body and the brain. One drink a day all month may be theoretically safe but 30 drinks on one day is a very hazardous way to drink.

3. Alcohol affects the structure and functioning of the brain.

We have known for a long time that chronic alcoholics have a reduced brain volume. We are now seeing studies of the effects of alcohol on brain regions and on the production of neurotransmitters. One treatment for depression is to increase the levels of serotonin in the brain. This is done by slowing the natural breakdown of serotonin which is one way many antidepressants work.

We know that alcohol is altering these neurochemicals and so may be increasing the risk of developing a mental illness, may make one worse, or may mimic a disorder.

4. Chronic Alcoholics.

Studies of chronic alcoholics, how their brain works, and the changes that the brain undergoes have added to our understandings of what the alcohol may be doing to the other parts of the body and brain. Because alcohol totally mixes with water, and blood contains a lot of water, no part of the body avoids being damaged by drinking.

5. Developmental studies.

Studies of teens have suggested ways in which alcohol consumption may be affecting the development of the brain. The correlations between the amount that a teen drinks and the results of the rest of their lives, while not a proof of cause and effect, makes us think there are more connections than we previously realized.

We know that “F” students typically drink at least twice as much per week as the “A” students.

We also know that heavy drinkers take longer to heal from injuries than nondrinkers.

6. Brain scans and mice studies on the effects of alcohol.

Brain scans typically capture only a moment in time. Mice studies are not proof that what we see in mice is what is happening in humans. But when the two agree it lends credence to the concept that alcohol is fundamentally altering the way in which brains and the nervous systems function.

7. Learning studies and functional studies.

There have been a lot of studies on how alcohol and other drugs have been affecting people’s memory, behavior, visual and special recognition, learning, and other specific brain functions.

Now that you know where the information is coming from let’s begin in future posts to look at why we think mental illness and substance use disorders so often occur together and then what are some of the specific effects of alcohol and other drugs on the body and the brain.

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

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

Story Bureau.

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

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

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

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

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

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

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

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

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

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

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

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

For videos, see: Counselorssoapbox YouTube Video Channel

First night of Drug and Alcohol Classes

Posted on by
Reply

By David Joel Miller.

Drugs.

Do drugs cause mania.
Photo courtesy of Pixabay.

Tonight is the first night of classes here at FCC.

One activity in my busy schedule that I thoroughly enjoy is the opportunity to teach Substance Abuse Counseling classes at Fresno City College.

The program here is accredited by the California Association of Drug and Alcohol Educators (CAADE) and leads students towards becoming registered and then certified drug and alcohol counselors.

The program includes 36-semester units of classes in Drug and Alcohol use disorders, recovery, and the work of counselors and social workers. A few students from the 4-year college show up in these classes because this program contains more information about Substance Use Disorders than most Masters or Ph.D. programs.

We see students in this class who want to be drug and alcohol counselors. There are often also social work majors, nursing students, criminal justice majors, and a smattering of people who are in early recovery and know they need more information on Substance Use Disorders to be able to decide what career is right for them.

All these majors are welcome. I try to emphasize that first night that no matter where they work there is a strong possibility that they will encounter people with substance use disorders. They will also if they see substance abusers see mixed in with those clients a lot of people who have emotional or mental health issues.

For those of you, who are not able to take classes of this nature, consider some reading on the topic of substance use disorders, (The A.A. big book is a good place to start.) Also, consider taking a Mental Health First Aid (MHFA) class if one is offered in your area. If there is not one close to you, encourage your local officials to get an MHFA training scheduled for your locale.

Teaching, while enjoyable takes a bit out of my time so the posts may come a little farther apart and the replies to your questions and comments will take a little longer but know that I values all your input and will get back to you all as quickly as I can.

Related articles
  • Are you a Functional Alcoholic? Do you know someone with an Alcohol Use Disorder? (counselorssoapbox.com)
  • How to control your drinking (counselorssoapbox.com)

    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?

Posted on by
4

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

Seasonal Anxiety?

Posted on by
2

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

Anxious woman

Seasonal anxiety?
Photo courtesy of Pixabay.

Is there seasonal anxiety?

Officially there is no diagnosis for any seasonal disorder, but the profession does recognize that there is a form of Major Depressive Disorder that is highly influenced by the seasons. We denote this by referring to it as Major Depressive Disorder with a seasonal pattern.

Researchers on a lot of other mental and emotional illnesses are reporting that they find seasonal patterns in their disorders also, so far no one seems to be considering these seasonal influences on disorders like Anxiety.

So what other effects might the weather and the change of seasons be having on Anxiety and other disorders?

People who regularly see their doctors and have their blood pressure checked are more likely to find that they have elevated blood pressure as a result of stress in the winter months than in the summer months.

Yes, we do get stressed out more in the winter than in those lazy days of summer even when we are well into our working lives.

Women, particularly those working as supervisors and in responsible positions, report more anxiety and stress during the winter months than in the summer. They also report more physical ailments at that time of year for which no medical problem is found. Researchers are apt to call those issues “Somatic symptoms even though actual physical illnesses can’t be ruled out.

The bottom line here is, however, you see these complaints, stress, and anxiety are causing these women more problems in the winter than the rest of the year.

Anxiety disorder is worse in winter but Panic Disorder gets worse in the summer.

Several researchers into Panic Disorders have reported that panic disorder gets worse in the summer months. This appears to be related to the heat more than the hours of light.

Dehydration has been reported as a cause of this heat-related panic attack. Some people when out in public avoid drinking water because of the need to find restrooms. Don’t drink enough water and you get dehydrated which can trigger panic attacks.

One corollary to this was an article that reported more people in America are “Sunbirds” than “Snowbirds” that is more people go up north to escape the heat in the summer than go to the south in the winter to escape the snow in that northern tier of states.

There is a season to anxiety disorders and for most people, that season is throughout the wintertime.

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

Posted on by
2

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

8 Ways to make the holiday emotionally safe

Posted on by
Reply

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

Fall scene

Happy Holidays

Plan now to safeguard yourself in recovery.

The holidays can be stressful times. Recovery, from anxiety, trauma, alcohol or drugs is a precious thing and it takes a lot of work to reach for a recovered life. Keep your recovery and yourself safe this Holiday season by using these tips.

It is easy to get caught up in the “shoulds” and the “musts” and forget to look for the things that will be most helpful to you and your recovery.

Here are some helpful hints for getting through this time of year with your recovery unscathed.

1. Practice saying NO!

There can be a lot of pressure to do and say things that are not good for you. Work on setting healthy boundaries. Tell people no if they try to get you to do things that may be stressful and bad for your recovery.

Learn to tell yourself no also. There is always the temptation to overdo, run about too much, visit too many places, and try to do too much to make this a perfect holiday. Nothing will make the holidays perfect if your recovery unravels.

2. Too much of a good thing is a bad thing.

Even happy times can be stressful. This is especially true if you are recovering from depression, anxiety, or substance abuse. Do not let the good times wear you out and leave you vulnerable to relapse into your particular issue.

Happiness is not a sprint to get to the cookie jar first. A happy life is a long journey of relaxed enjoyment. Trying to put too much pleasure on your plate one day may leave you unable to do the things that might make you happy the next and beyond.

3. Avoid people and places that would undermine your recovery.

Some family is not healthy. Just because they are relatives does not mean you owe it to them to put yourself at risk. Avoid family members who may undermine your mental health. Take a supportive person with you if you will encounter negative people and be prepared to cut your visit short if the stress gets to you or you begin to be overtired.

4. Take exceptional care of yourself.

Get plenty of sleep. Lack of sleep one night can set up the downward spiral that will result in being too emotional wrung out to get up the next day. Overtired can lead to using substances to try to keep going. Cut your sleep short and you are setting yourself up for a relapse.

Drink plenty of water. This reduces the effects of other unhealthy exposures. Being very thirsty sets problem drinkers up to drink alcohol and places people with mental illnesses at risk to drink more than they planned.

Eat healthy food. Avoid excess sugar and take in those calories in moderation. It is a whole lot easier to pass up a few unhealthy treats than it will be to get back in shape in the New Year.

5. Make getting better job one.

Nothing is more important than your recovery. If you have started practices that are furthering your recovery do not put them aside over the holiday season.

Go to the gym, do your journaling, call supportive people. Keep up with your spiritual practice. Prayer and meditation are not tools that should be kept in the drawer this time of year. If you practice mindfulness and meditation make this a do first action.

6. Go for the safe choice first.

Avoid doing things that you “might” be able to handle. Avoid things that are risky and go always for the safe choice first.

Alcoholics should not drop by the bar just to say hi. Do not call people you know will be upsetting.

7. Reach out for help.

Call your support system. If you are a member of a particular fellowship make sure meetings are on your to-do list. Attend religious services if you find this supportive of your recovery.

Every recovering person needs a list of people who are supportive. Make those calls to other recovering people. Sometimes you will find that they needed to hear from you even more than you need to talk with them.

8. Do not push yourself.

Be kind and gentle with yourself. Do not overdo. Do not pile more and more on your plate and expect to get through the holiday season with your recovery intact.

Taking good care of yourself is not being selfish. Be the kind of friend you need. Be your own best friend.

Which of these things do you plan to do? What other techniques have you found that help keeps you safe and in recovery over the holidays?

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

Will the therapist say I am crazy and lock me up?

Posted on by
2

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

Psychiatric hospital.
Photo courtesy of pixabay.

Being locked up is a fear of some people coming to therapy.

The chances of this happening are very close to zero. The fact that you came in on your own means this is highly unlikely for many reasons.

This idea of the upset person who gets “put away” in a mental hospital, usually called an insane asylum, makes for great T. V or a good novel, but in real life that does not happen, at least not very much and particularly not here in the United States.

Here are the reasons why you are not going to get locked up just for going to see a counselor.

Professionals just do not think of mental illness that way anymore.

The old notion was that there were two kinds of people, normal and crazy. If that were true we would need to lock everyone up because I do not see any normal people in my world. Some people may be more normal or less normal than others, normal being a statistical concept. Being different does not make you crazy.

Mental illness is not the same thing as being crazy.

Mental illness is on a continuum, people get unwell, then they get sick, then they move back in the other direction as they recover. Most people have times in their life when they are anxious or depressed. If someone is shooting at you please get anxious. If a family member dies, I hope you get sad. Do not let that anxiety or depression control you for the rest of your life.

People we call mentally ill get stuck at that “too sad” or “too anxious” and do not seem to get back to a better place without help.

There is a big argument about why. Watch for an upcoming post on the causes of mental illness as I see them.

The therapist expects you to have some problems, so no they are not likely to think you are over the edge just because you came for a little emotional help.

There are only three special reasons you can be confined to a psychiatric hospital against your will.

Holds for involuntary psychiatric hospitalization in this area are only written if the client is a danger to themselves, a danger to others or they are so disabled they can’t feed themselves or clothe themselves. Being poor, or homeless, does not count. I hand you a cookie and you eat it, I offer you a sweater and you put it on, you pass this test.

If you say you are planning to kill yourself then you may be detained until those thoughts pass and you recant that thought. Professionals are suspicious if you were saying you would kill yourself to the police just a few minutes ago and now you are saying that you won’t.

Saying you have thoughts, usually will not get it. You need to also have a plan for when and how you will do it or a history of attempts or some other reason for the official placing you on an involuntary hold to believe this is something you might do.

Being under the influence of drugs or alcohol is a risk factor. People who binge drink or are drunk are 55 times more likely to attempt suicide than sober people. So if when drunk you say you are going to kill yourself and the police are called you may end up in a psychiatric hospital for a very short stay.

Say you are planning to kill someone else, say you also have a gun and you may end up in a hospital or a jail for a while longer. Even then the law just does not let the police or the psych hospital keep people who might someday hurt someone else all that long.

Once the person sobers up or changes their mind, the chances are that they will have to be released even if the police still think that this person may in the future hurt someone.

While this lets some people out who may harm others it also keeps a lot of people from being locked up just because they scare someone else.

The psych hospitals are pretty full and they charge a lot of money.

The hospitals do not want to keep anyone there one minute longer than they have too. The days of years in an asylum are over and gone. Most stays now are a week or less. Stays beyond 30 days are rare.

In crisis units, the stay around here is most often less than a day.

Yes, I know the involuntary hold says 72 hours, but in practice, not many people stay that long. That 72 hours or 3 days is a maximum, not a for-sure.

Most of the complaints I hear are that people were discharged from the hospital before they felt ready, not that they were kept too long.

As soon as someone appears able to cope with life they get let out even if they will need meds or therapy to be able to cope in the future.

Counselors, in most places, are not authorized to write involuntary holds.

Even if a counselor works for the government and writes holds in their day job, they are not able to write them in their private practice. So unless your treating professional is a psychiatrist with treating privileges at the hospital there is a low chance they have that little card that lets them write holds, especially one that would let them write the hold in their private office.

What could happen is if you said you were going to kill yourself or others and you convinced the therapist that you were serious about this, he or she might call the police and get you detained until you change your mind.

There you have it. The things that bring most people to counseling are miles away from the things that might get you locked up in a psych hospital. Stop worrying about this and go get the help you need before you have to live your life in the place of unhappiness.

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

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

Story Bureau.

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

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

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

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

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

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

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

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

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

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

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

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

For videos, see: Counselorssoapbox YouTube Video Channel

Why are we so afraid of feelings?

Posted on by
2

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

Man with feelings

Managing feelings.
Photo courtesy of Pixabay.com

Fear of feelings?

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

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

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

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

Numbing out the feelings.

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

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

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

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

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

Your feelings brain.

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

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

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

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

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

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

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

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

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

How do you feel about your feelings?

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

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

Story Bureau.

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

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

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

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

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

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

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

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

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

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

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

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

For videos, see: Counselorssoapbox YouTube Video Channel

Healthy Habits available for adoption

Posted on by
Reply

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

Would you like to adopt some healthy habits?

One sign of mental illness or substance use disorders is living an unhealthy lifestyle. People with depression do not have the energy to take care of themselves. People who are ill do not have the strength to maintain healthy habits.

Even those who don’t consider themselves “in recovery” find that adopting healthier habits can increase the happiness of their life and reduce the risk of becoming emotionally unhealthy.

One thing I have noticed from my time around the tables and the therapy rooms is that illnesses and diseases take a back seat to discussions of healthy habits. People who are really struggling talk about how hard, impossible it is to take care of themselves. As people recover then begin to talk increasingly about self-care.

Some will say that better self-care promotes recovery and others say that as you recover you begin to pay more attention to your self-care. I suspect there is some of both.

So what things are you doing to take better care of yourself?

Some people feel so responsible for others that they find it hard to spend time, money or effort on self-care.

Taking good care of yourself is not being selfish!

Here are some major areas of self-care that I see clients engaging in as their recovery progresses.

A better, healthier diet is part of self-care.

When you are in your disorder preparing food and eating can be a chore. Depressed people either eat nothing or they eat most everything. Often their food choices are unhealthy. Substance abusers have similar disruptions in their eating. As people begin to recover they pay more attention to what they are eating and how this is affecting them. How is your diet supporting your emotional health and recovery?

Exercise and health maintenance are parts of recovery.

Recovering people often begin an exercise program. They think about seeing a doctor. They get their physical health problems treated.

After years of failure to take care of your body, working on your health can become a priority. Recovering people need to balance their physical recovery with their emotional and spiritual recoveries. It is easy to turn an exercise program or being health conscious into a new addiction. This may be a “better addiction” but it can take you down a wrong path and away from real lasting recovery.

It is important to tell yourself that no matter how much damage to your body your old lifestyle has caused, you are worth taking care of. Depression and inactivity take their toll. So do anxiety and addiction. See to it that you get the health part of your recovery in balance with the other portions.

Setting boundaries with others safeguards recovery.

Part of recovery is learning to say no, set healthy boundaries. As you treat yourself better you will no longer be able to abide by others treating you poorly.

You will also find that you are more able to treat others as they should be treated. You will begin to recognize and respect other’s boundaries.

Safe and comfortable housing promotes recovery.

When you are down and discouraged you stay where you can. Once in recovery, you home becomes important.

You may need help finding a safe place to stay, do not hesitate to use public programs and private resources. Be sure that you make your nest in a place that is supportive of your recovery, not a place of settling for something less than you deserve.

Do what you can to make where ever you stay “your place.”

Improving relationships promotes recovery.

Recovering people want a healthy relationship with their children, parents, and significant others. They also may need to reexamine friendships and try to strengthen healthy supportive relationships, mending breaches where possible, and sometimes they find that there are former associates that need to be let go.

Even if you do not think of yourself as a recovering person, adopting healthy lifestyle practices can improve the quality of your life.

What healthy lifestyle practices are you ready to adopt and take home?

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