Tag Archives: Emotions

Bipolar – misdiagnosed or missing diagnosis?

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

Person with masks

Bipolar.
Photo courtesy of Pixabay.com

Diagnosing Bipolar Disorder.

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

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

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

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

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

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

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

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

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

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

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

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

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

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

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

Story Bureau.

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

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

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

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

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

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

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

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

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

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

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

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

For videos, see: Counselorssoapbox YouTube Video Channel

10 ways to get emotional help without money

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

Counseling.
Photo courtesy of Pixabay.com

Can’t pay for therapy?

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

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

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

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

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

1. Read the internet

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

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

2. Read self-help books.

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

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

3. Self-help groups.

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

4. Colleges and schools

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

5. Community-based resources

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

6. Ask therapists and counselors about sliding fee arraignments

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

7.  Consider group therapy

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

8. Substance abuse facilities

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

9. Think about your priorities.

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

10. Consider Religious counseling.

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

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

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

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

Story Bureau.

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

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

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

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

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

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

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

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

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

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

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

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

For videos, see: Counselorssoapbox YouTube Video Channel

12 ways to Sabotage New Year’s resolutions

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

the future

Living the Future
Photo courtesy of Pixabay.com

There are hundreds of articles out there about how to keep New Year’s resolutions. This isn’t one of them. This is about getting out of the ones you already made.

Lots of people make New Year’s resolutions, we feel we have to. But then the next morning we wish we had never said that. Here are some easy ways to make sure that your New Year’s resolution ends up in the dust and ensure that no one blames you for not living up to your promises.

1. Set huge impossible large goals. Despite not exercising for the last  60 years or so and having given up my photograph efforts in the late 1970s, this year I plan to make a film chronicling my success at winning twelve different gold medals in sports I had not previously played. Who could blame me for not keeping that one? The key here is to not plan to do anything, just plan to somehow have achieved the goal without effort.

2. Do not write down your goals or tell anyone. Writing things down leaves evidence. You might be tempted to look at your goals during the year. If you can’t remember what you planned to do how can it be your fault? Telling someone only expands the conspiracy. If you don’t tell, they won’t ask. People who blab their resolutions fell obliged to work on them.

3. Hang out with the losers. If you hang out with successful people you might emulate them. Want to avoid weight loss? Hang out at the donut shop or a buffet; better yet look up a donut buffet.

4. Resolve to change someone else. This is a favorite one that works every time. Plan to change your children or your spouse. Who could blame you if your family does not change? It was certainly your ex’s fault or maybe the fault of those rotten kids, wherever they are these days.

5. Embrace boredom. If it is fun don’t do it. Make resolutions to do boring, painful things not something you might actually get to like if you tried it. Nothing will squash a resolution faster than a good reason to avoid it in the first place.

6. Bet the farm on this one. If you are going to not do something, don’t do something big. Make your resolution so huge that your family might end up homeless if you did not carry through. Who could argue with you giving up your dream for the safety of your family? Doing a series of small things might actually be doable and then you would be stuck with a string of successes. Nothing ends your streak of failures like a small unsuspected success.

7. Test yourself constantly. This works well for alcoholics, who test themselves by buying alcohol and hanging out in bars. If your resolution had to do with food, go shopping and fill the house with your favorite foods. Then check the cupboard or the fridge often just to reassure yourself you have not eaten them – yet. Test yourself often enough you are sure to fail.

8. Don’t worry about being emotional. Watch sad movies and cry. Pick lots of fights. Argue with everyone you can. After an emotional day like that, you are sure to not have the energy needed to work on any stupid resolution. Happiness is incompatible with failure. Laughter can ruin a well thought out sorry-for-yourself binge. Stay moody.

9. Stop sleeping. Stay up all night every night and then sleep all day. Worry about your exercise plan, make a list of things you can’t buy. Lack of sleep will make you irrational but who can blame a half-crazed person for shopping online all night.

10. Give up all friends. Nothing so ensures your failure at resolutions as being totally isolated from all human contact. Quit your job, fight with your spouse till they leave, and hang up on your friends. People who are all alone should not be expected to be a success at anything, right?

11. Don’t eat. Being really eat-a-bear hungry can make you grouchy enough to not only stop trying but to be able to tell anyone still talking to you to put that resolution where the moonshine doesn’t- whatever.

12. If you tried before and failed don’t try again. Some people keep trying. If they keep that up they risk an eventual success. Smokers have an edge here. Most need to try to quit five to seven times so they get to talk about their try’s three or four times before giving up. Be careful though if you try too many times you might just end up making that change.

Well, I hope that this was helpful to all of you who are trying to avoid carrying through on your New Year’s resolutions. You could use this at other times of the year for any other change you are avoiding. Despite all my good advice some of you will try to make and keep New Year’s resolutions. Those of you who are successful will probably have passed through the series of steps we call “Stages of Change.” I see some of my former students smiling at that. They knew I couldn’t slip by mentioning the “Stages of Change.”

Spoiler alert – In a future blog I plan to write about how it is that people who attempt changes really do go about doing it successfully. Some of you are anticipating me and are inferring that real change rarely comes from one time resolutions and may involve a series of steps which we counselors like to term “Stages of Change.” If you prefer making resolutions and then not keeping them, avoid those blog posts.

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

You are not playing enough. Neither are your children.

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

Children Playing.

Children Playing.
Photo courtesy of Pixabay.com

How often have you heard “Stop playing around?”

Is some adult’s voice from your past playing in your head right now as you think about that? Do you ever say that to your child or someone else? Well, knock that off.

The truth is we all need to play more and so do our kids. Now I am not talking about the high-pressure play of organized sports. We are hearing about a lot of kids getting injured playing competitive sports. That is not good for them and despite that delusion of our athletic prowess most of us older folks are not up to that stuff either. I am not thinking of the high dollar sports that are now a business and not fun. What I am suggesting is we all need to do more running and jumping, laughing, and having fun.

For a while we had a movement called the “new games” movement which said that games had become too formalized and rule-bound. People watched them instead of playing at them. So they started inventing new games with different rules. The fun was in trying something different.

Now some of you are saying we need to be serious, kids should learn the academics. No time for play in a well-organized society, except for a few professionals we watch occasionally. That would be all wrong. Kids who play around as children very often do better later in life than their serious compatriots. Let me tell you a story.

There was a school that assigned a teacher to a special education class. That class had such a reputation for not behaving that they were banned from the school-wide assemblies. But this teacher thought it wasn’t fair that her class couldn’t go and all the other classes got to. The other teachers made their class’s line up and march to the multiuse room for the assembly. They were certain that those special education kids could never stay in line long enough to get lined up. And if they were able to line up by some bundle of luck, they were sure to move around and disrupt the assembly. The newly assigned teacher had a different idea and she had a solution.

She did not march her class across the school in single file formation as the other teachers did. She had her class run, as fast as they could, laughing all the way, around the entire school grounds. Only when they had run as far as they could, did she line them up for the assembly. And the shock was, that after a good run those kids were better behaved than the other classes. The teacher was Violet Oaklander, and her book “Windows on Our Children” is a classic on the use of art and play as therapy. But there is more to the story of why play is good. We now know it is not only useful for treating children therapeutically. Play is also necessary for normal development.

Children’s unscripted play is important in developing skills that will increase learning in other areas and will be useful in later life. Play is useful for alerting, improving attention, and for helping people organize their thoughts. It is also calming for most people. Some adults are afraid that play might “wind kids up.” It may improve alertness; I wouldn’t recommend it just before bedtime. But before class, it is likely to improve performances not prevent it.

So if we have overactive disruptive students, what do some teachers do? They take away recess and keep the kid in. This is precisely the wrong approach. Please, no emails – you don’t understand – we need to maintain control. FYI, I teach also, I know the problem. But when students get restless then need more breaks and physical activity, not more amphetamine.

What else does play accomplish? Old fashion imaginative play also improves the ability to make use of the senses. It improves balance, fine motor skills needed for writing and the list goes on and on. There are also play activities that improve the auditory and visual senses, just the skills needed for effective learning.

The list of skills that might be improved by active play is too long for me to include here. Even video games when used in moderation, have some benefit in improving hand-eye coordination. Remembering I am not a big fan of robotic video game playing. I have seen too many video game addicts.

But Folks that’s not all!

Play improves the ability to bounce back from life’s stress and trauma. Various play activities have been shown to improve recovery and resilience. There is more to the topic of resilience and the ability to bounce back than just play. One of these days I plan to write more about why some people are able to bounce back from all the bumps in life’s road and others don’t seem to have those skills. I was researching the topic of resiliency and recovery when I came upon all the reports of the benefits of more play.

Hum – just might be a book lurking in that topic. Stay tuned for more on the resiliency angle.

So I hope you have gotten the message. Get out there and play some more. And encourage your kids to play more also. You might even get radical and try playing with your kids.

Is anyone reading this? What do you think about the topic of the need for more play?

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

Three-year-old judge decides right and wrong

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

child

Child.
Photo courtesy of Pixabay.com

6 ways to tell right from wrong.

Preschool kids seem to be so very good at telling what is right or fair. They tell us often enough – “That’s not fair!” So how come they so often do things that we say are wrong? Maybe we should appoint three-year old’s to the Supreme Court? Is the understanding of right and wrong something people are born with or do they learn it? And if they learn moral values, how do they learn it?

In the early grades the ways in which kids decide the difference between right and wrong starts to change, at least for some of them. It is important to understand how it is that people learn right from wrong. Why some don’t seem to learn might also be a good thing to find out.

People who study child development probably learned about some theories of how an understanding of right and wrong developed. Counselors are often taught about the stages of moral reasoning, in some developmental classes and then seem to promptly forget it once they start working with real clients. But isn’t right and wrong, and conflicts over how that should be decided one major reason we see clients in counseling?

Lawrence Kohlberg researched and wrote about moral development. So did Lickona who wrote a very readable book “Raising Good Children.” I would recommend it to any parent struggling to teach their child the difference between right and wrong. Somehow all this work is getting forgotten despite the constant reports of high crime and failure of discipline in the home and school. We spend a lot of time these days emphasizing math and science in schools, but less and less time in our homes and schools is spent on right and wrong. So how is a sense of right and wrong likely to develop? Let me give you a brief description of Lickona’s ideas as I remember them. For the full details you might want to look for the book but here is my short version of the 6 stages of moral reasoning as I understand them. Lickona numbers the stages zero to five. The fact that he arranges them this way does not mean everyone agrees that a lower numbered stage is, in fact, better than another stage with a larger number.

0. Getting what I want is fair!

This is the default way of deciding right and wrong. It’s not fair – I wanted ice cream and I didn’t get any. Some people seem to be able to go through their whole life thinking this way. They take what they want and that is fair to them. Some of them go to prison. Some learn to hide what they are doing. Some of these folks end up elected to public office or working on Wall Street. These folks make lawyers rich when they try to get out of trouble for doing what they want. If we don’t want more of these folks around we need to work on teaching kids the more advanced ways of deciding right from wrong, or we need to build more prisons.

1. The teacher said – the authority approach.

Some kids learn this at home before they go to school, for a variety of reasons. Most kids learn this in school. It starts by learning to do what the teacher says. Eventually, the appeal is to some higher authority like the principal. Some people get really legalistic. It says on the page — of the revenue code, that I can do this so it must be right. In some places, with statute law, if there is no law against it, you can do it. In most places in the United States, we have the common law which says you should use common sense unless there is a law otherwise. Then we have lots of layers of appeals courts because we are so short on common sense. We see lots of people who appeal to religious writings as their rule book, sometimes to good effect and sometimes to some awful results. The problem here is not especially with the particular religious writing, but some of the bizarre ways people can interpret those writings. The philosopher, Charles Shultz once reported, something to the effect that “There is nothing in the book of Leviticus that prohibits the wearing of contact lenses.” See how hard I am trying to be politically correct here?

Some people would separate “The Teacher said.” part, from the “The rule is.” Both are resorting to authority but one is putting your faith in a person and the other in some specific set of rules.

2. One hand washes the other.

This commonly heard, usually, in business, expression says right and wrong is something we trade.  We take turns. Most kids learn this on the playground really fast. If you don’t take turns with the ball you may not get to play at all. In Congress, this is called trading votes. You vote for my bill and I will vote for yours. It is pragmatic, gets things done. But is it the best way to determine right and wrong? We need to study this. Send me a million or so in federal money and I will be glad to work on this approach. At a million dollars a year we may need years of study. See how problematic trading one thing for another might be as a way to separate right from wrong?

3. I want you to like me.

So if I want you to like me I should do what you think is right. This is the “what will people think of me” approach. This type of social conformity can keep people acting in a socially positive manner – sometimes. The issue here is what people’s opinion do I care about? This goes to the discussion of peer pressure which I wrote about in an earlier blog. Take a look at that one – now if you want, it’s ok. I can wait here while you look.

You back? So you see that if my peers are good law-abiding people I probably will follow the law. But if my social circle includes convicts, murders, rapists, bankers, politicians, and other undesirables, I might decide that stealing your money was an acceptable thing to do, so long as I steal it using the same methods as my peers.

So using other people’s behavior as a guide to right and wrong may reduce the conflict we have in life, but it is no sure way to figure out right and wrong or to stay out of prison. Ask the group from Enron.

I may be a little hard on this stage. It is great to be a good son or daughter or a good parent. But that may not be enough, especially if you didn’t have good role models. This step in the development of morals is mostly about your relationships with people close to you.

4.  What is best for all of us?

This is the stage where people may do things that have personal costs because it is the thing that is best for our society. This stage of moral reasoning gets people to join the military or become volunteers. This is an altruistic stage, most of the time. It is also a way of moral reasoning that has been used to excuse some horrific atrocities.

Today in America we value diversity. Some of us do anyway. But can you see how someone in another place and time could do some awful things and justify it as “what is best for us?” Think genocide here. Could someone do that thinking it was what was best for their group? The difference between being a volunteer to work with the poor and trying to run a minority out-of-town hinges on who you define as us.

5. Some things are right just because they are right.

This is an easy one to explain in theory, until you are faced with the choice, then it is easy to default to an earlier stage of moral reasoning. Sometimes people are faced with things going on in their society that are just not right. And often it costs to do the right thing at these times and for sure there is nothing in it for you when you do the right thing at these times. This is about respecting everyone just because they are.

So there is my explanation of stages of moral reasoning as I understand them. Can you see how hard it is to figure out the right thing to do sometimes? Some parents are able to teach their children right from wrong despite all the influences around them to the contrary, but what about the other kids? It feels to me like we should spend more time in our society on the ways to determine right and wrong and less on some celebrity’s outrageous behavior. But that’s just my opinion. What do you think about how we learn to tell right from wrong?

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

Am I a quart low on serotonin?

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

Depressed person

Depression.
Photo courtesy of Pixabay.com

Low on Serotonin?

There has been a lot of talk about the way in which neurotransmitters affect the brain. Some of this has been helpful in understanding mental illness and some have not helped at all. On common expression has been that someone had a “chemical imbalance in the brain.” I wanted to talk about that and some other issues related to psychiatric medication in today’s blog. Please keep in mind that this is a highly simplified explanation. Remember I am a therapist and counselor, not a doctor so I need to find simple explanations for clients and myself without misleading them. If you have a background in biochemistry or research skip this blog now. If the doctor has told you to do or not do something please follow the doctor’s instructions or at the least talk with your doctor about these issues. The rest of you let me know if this helps explain things.

The expression chemical imbalance is a bit misleading. The frequent use of that expression has resulted in a lot of people coming in and asking to be tested to see if they have a chemical imbalance and if so what chemical do they need more of.  They get quite upset when we say that we can’t do that kind of test. Here are some of the problems with that approach.

Thoughts in my brain and yours also, are carried from one nerve (brain) cell to another by chemicals. So when I think something, anything, my brain sends out chemicals to carry that message. Once the thought has come and gone the chemicals are broken down and reused or disposed of. So as fast as I can think of something my brain chemistry is changing.

Now different brains may make, transport, and use chemicals at varying rates but we all use chemicals to move thoughts. This is why talk therapies like Cognitive Behavior Therapy can help to change someone’s thinking which results in a change in their brain chemistry. Now medication can also help and research seems to show that doing both medication and therapy for your problems can result in changes that are more rapid and longer lasting than either treatment alone.

Most everyone has heard of anti-depressants. So they think that if I am short on a brain chemical I should be able to take a pill, replace the missing chemical, and – presto – I am cured. Wish it was that simple. Let me give you one exaggerated example of how an antidepressant might work.  The most well known and widely prescribed antidepressants right now are ones called SSRI. SSRI stands for Selective Serotonin Reuptake Inhibitors. This has resulted in a lot of people thinking that the reason they are depressed is a shortage of Serotonin. Let me try to explain how this works. You will need to unpack your imagination for this one.

I once drove a car that had a leaky radiator. At the time money was tight, still is a lot of the time but that is another story. So I kept putting water in the radiator. This is sort of like the way my brain might try to keep putting serotonin into use. But as fast as I filled the radiator the water kept leaking out. So my engine overheated. When I get low on Serotonin my brain overheats (not really don’t get the thermometer to check for depression) and then I get depressed.

So every few miles I had to find a place to stop and put water in the radiator and still it didn’t last long, kept overheating.

So this friend of mine tells me there is this thing you can get at the auto store that stops the radiator from leaking. I get some, put it in the radiator and the leak slows down. A second dose and the radiator stops leaking altogether, well almost stopped but at that point, I only have to put water in the radiator once a week, not every day.  So it wasn’t the amount of that stop leak stuff that mattered. I didn’t need to fill the radiator up with it. It just helped me get more use out of the water I had already put in my radiator.

The SSRI works that way on our brains. It doesn’t put more serotonin in the brain but it slows down the leak so we get more miles or smiles out of the serotonin we already have.

Now, let’s say for illustration purposes here, I am bragging to my friend about what a great job that stops leak stuff did and he doesn’t believe me. So I do a demonstration. I get my trusty old shotgun out. Point it at the radiator and let it rip. Now the radiator starts to leak again. So out comes a can of stop up the radiator stuff and I pour it in. Only this time the stuff doesn’t work. The radiator keeps right on leaking.

This is exactly what happens to the brains of people who are on SSRIs or other antidepressants and then they drink alcohol. Alcohol, remember, is a depressant substance. Why we so rarely call it a drug is beyond me, given that it causes more problems with abuse, dependence, and suicide than all the other drugs. But that is just the way it is.

So the point of this story is that the problem for most people is not that the brain is low on serotonin but that the things we do to our brains use up the serotonin way to fast.  A good diet, plenty of sleep, avoiding drugs, and alcohol can all help you produce more serotonin. So can changing your thinking because happy thoughts release more neurotransmitters into the brain. But calling this problem a chemical imbalance shouldn’t take away the responsibility to get our thinking and our living fixed.

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

Bipolar doesn’t mean moody

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

Person with masks

Bipolar.
Photo courtesy of Pixabay.com

Bipolar doesn’t mean moody.

Three psychiatric diagnoses (ADHD, Bipolar, and Schizophrenia) have left the scientific literature and taken up residency in the media and in everyday conversation. The problem with these usages is it devalues the term and pretty soon it is being misused more often than it is used correctly. Bipolar is one of those terms.

Kids report that their peers call them or others “Bipolar.” We hear about it on talk shows. Sometimes parents call their children or their partner Bipolar with no clear idea what the term means. Children are being diagnosed with bipolar disorder at younger and younger ages. Early diagnosis and treatment is a good thing; it may reduce a lifetime of suffering. Referring every kid in first grade who is irritable for a bipolar evaluation is probably not warranted.

Lots of parents want their child “tested” for bipolar disorder. I wish there was a simple test, say blood or urine that would detect the disorder. There may be physical signs or markers, but so far no one seems to be able to detect bipolar disorder other than by a psychological evaluation that involves descriptions of mood and behavior. When many parents want to know if their child is bipolar, what they really mean is the child is irritable or difficult and they need help.

People refer to others who are moody as Bipolar. Bipolar disorder does not mean moody! Some people are naturally moody others get moody when something upsets them. Lack of sleep makes most anyone moody and grouchy. Not everyone with sleep disturbances has bipolar disorder by any stretch of the imagination.

When we talk about bipolar disorder we are talking about a condition, not a person. A person may have bipolar disorder that does not make them “bipolar.”

So what is Bipolar – really? It used to be called Manic Depressive disorder. I see client questionnaires where they report they have family histories of both manic-depressive disorder and Bipolar. I won’t go into the politics behind the name change but it is important to note two things. Bipolar is a mood disorder so it is in the same “family” or chapter as Depression and other mood disorders. The second characteristic is that for the problem to be bipolar it must include Mania or its cousin Hypomania.

Update – In the DSM-5 they did away with the term “mood disorders.” More and more professionals are thinking that Bipolar and Major Depressive Disorder are for-sure two separate things. You may have periods of depression for a while before the mania but we need to be careful to separate the Bipolar from the Major depression.

So what is mania? I won’t repeat the whole DSM-4-TR criteria here if you want that please go to the source. But a couple of things that separate mania and therefore bipolar disorder are important. For some clients, this looks like someone on Meth – without the drugs. This is not a little bit thing that comes and goes. When it occurs the person is debilitated.

Mania involves a period of time where the client’s behavior is elevated, expansive, or irritable. In short, they are “off the hook” and this is not deliberate but uncontrollable. During this time frame, they have a bunch of behaviors that are far too excessive. The DSM lists 7 characteristics and the person should have the majority of these symptoms. Not sleeping and not needing to sleep is a red flag. They are up all night doing things and they don’t even feel tired. They are likely to show grandiosity and excessive self-esteem. They talk faster than those around them can listen and they think faster than they can talk. But the thoughts may make sense only to the person with bipolar disorder. They are likely to get “stuck” on things, too much work, buying sprees, excessive sexual activity, and other risk-taking activities.

Since mania is seductive, who wouldn’t like to be able to have fun twenty-four hours a day and not need to sleep, during manic episodes the client with bipolar may be strongly attracted to stimulant drugs like methamphetamine and cocaine. Alcohol abuse is also common which increases the crash when the manic episode ends. And it always ends.

Most people who truly have bipolar disorder are first diagnosed with depression. One indicator that makes me suspicious is when a depressed client takes an anti-depressant and recovers suddenly and now is “better than ever.” A manic episode is about to occur.

So far talking about Bipolar disorder, with its depressive and manic symptoms makes it sound like the person runs from manic (which is not happy by the way) to depressed. That’s not the whole story. Kay Redfield Jamison writes about what we might call mixed states. It is possible, probably more common than we might think, to have both mania and depression at the same time. Think of the shifting moods like a tire on your car. When it is parked we could mark one side of the tire and call that the back, the other would be the front. But once the tire starts to move you don’t drive on the front or the back but the whole tire. So the person with bipolar may experience a mixture of depression and mania at the same time.

Another feature of Bipolar disorder that separates it from moodiness and depression is the tendency for the elevated thinking to become first delusional and then it may progress to include hallucinations. So the person with bipolar disorder is not only thinking odd thoughts but is very irritated with others that they don’t “get them.”

Hope this explanation got you thinking about Bipolar disorder. If you would like more information, check out the Depression and Bipolar Support Alliance.

As always your comments are welcome. If you like this blog spread the word. If not let me know what might improve it. Till next time.

David Miller, LMFT, LPCC

Don’t think about elephants

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

Elephant.
Photo courtesy of Pixabay.com

For the balance of the time you are reading this blog – please do not think about any elephants.

I know this may be difficult for some of you but whatever you do – do not think about the elephants.

No cheating now.

Do not think about African elephants.

Please do not think about those big gray Indian elephants.

It would be especially important to not think about circus elephants or pink elephants or even cartoon elephants like Dumbo.

So how did you do? Did you think about even one little elephant?

Most of you did think about an elephant, didn’t you?

This short exercise illustrates how difficult it is for a person who has a problem, any problem, to avoid the problem by not thinking about it. The very effort to not think about the problem immediately makes us think of – the thing we were trying to avoid.

Lots of people try to solve their other problems in the same way. Let’s not think about them. Substance abusers who try to not think about their drug of choice spend all their day with the thoughts of that drug running through their heads. Dieters have the same problem, the more they try to think about not overeating the more food intrudes on their thoughts.

So what should you do?

You can’t just sit and think about your problems either that is called brooding. The more you ruminate the more depressed and anxious you will become.

There are two approaches to solving the problem of constant unwanted thoughts.

Do something. Many problems grow the longer you avoid them. Sometimes this is described as – while you are inside hiding from the problem the difficulty is outside doing push-ups. The longer you avoid the trouble the large it looms. Financial problems and unhealthy lifestyles are the most likely to grow. The sooner you take action to cut spending, raise your income, take a second job or just accept that your dream house or toy is really out of reach the sooner you can begin making progress towards solving the problem.

The other approach, the one especially recommended for addictions and other habits that seem to own you is stop trying to not think about the bad habit and begin to focus wholeheartedly on positive things. What would your life be like without that elephant you have allowed to live in your living room? Focus on the new pattern or activity you want to replace the unwanted tendency.

How do you decide which method will be most successful?

If you do nothing will the issue you are avoiding eventually destroy you? Addictions will, a mounting debt will. Unhealthy lifestyles, like smoking, will eventually shorten or end your life. Doing nothing should never be an option.

Unhealthy habits like addictions can never be overcome by sitting passively and resisting the urges. As a counselor, I don’t try to take an unhealthy behavior away from someone, which leaves them empty and hurting. Instead, we try to find something desirable, worthy, and uplifting to replace the burden the client is trying to put down.

So, in the end, the best successes for changing your life and improving the self comes not from struggling to avoid something but from finding a new positive goal to move towards.

As many a twelve-stepper will tell you, the greatest progress towards recovery comes in the times when we seek to do something for someone else. Trying to be of services to others, thinking of how we might help them always takes us further away from our own defects of character.

Here is wishing you a happy journey towards whatever happy life goal you decide to pursue.

P. S. The picture is from Wikimedia Commons.

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

Great New Training on Mental Health

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Counselorssoapbox.com

Mental Health First Aid (MHFA) is a great new training. If you are not familiar with this training you should check it out. Designed for the non-professional, it teaches you how to react and how to be helpful if you encounter someone who is having a mental health crisis. Created in Australia the program has now come to the United States. The two-day, twelve-hour interactive class covers the major kinds of mental illnesses and how to help a friend, family member, or someone you might meet who is experiencing mental health problems. Sponsored by the Maryland Department of Health and Mental Hygiene, Missouri Department of Mental Health, and The National Council for Community Behavioral Healthcare there are now certified trainers throughout the United States.

Here in California’s central valley, there are over a hundred certified trainers. Certified trainers in Fresno have put on numerous trainings over the last year. I became so enthusiastic about this program that I took the training and became a certified trainer. So far I and a co-facilitator have completed three trainings. All of our trainings were enjoyable to do and well attended. In the coming year, we plan to offer the training at least three more times. We are currently looking for a larger room or a sponsoring agency. If you want more information on my trainings please email me or watch this blog for posts on upcoming trainings.

If you are not near Fresno you can check the Mental Health First Aid USA website at http://www.mentalhealthfirstaid.org/cs/program_overview/ for a listing of courses in your area. The training comes with a detailed book for reference after the class. So whether we see you in one of our trainings here in Fresno, or you take it from another trainer, this is one class well worth taking.

Thanks to all of you who are reading this blog, subscribing, and passing it on.

David Joel Miller, LMFT, LPCC

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

Anxiety is like a cat!

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

Stray cat

Feral cat.
Photo courtesy of Pixabay.com

Anxiety is like a cat!

What exactly is anxiety? And what is an anxiety disorder?

Well to some people it looks like a kitten.

And to others, it looks like a lion.

A little anxiety can feel like a small cat rubbing on your leg, a bit of an annoyance but nothing you can’t handle. It can push you to try harder. It is the stage fright that keys up the performer to go all out and give the performance of their life.

For others, Anxiety is the lion that keeps you off the stage of life. It is a terrifying disorder that tries to eat you alive.

Anxiety disorders are the most common emotional problem in America. In any one year, approximately one in five Americans will have an episode of anxiety that is severe enough to interfere with their everyday functioning, an episode so severe they should go for treatment.

Dictionaries define anxiety as a feeling, worry, nervousness, agitation, fear, or apprehension. The symptoms can interfere with every system in the body. Anxiety symptoms are often mistaken for physical illnesses and send millions of people repeatedly to the doctor looking for a physical cause of an emotional problem.

Now if you have a physical problem, by all means, see your doctor. But if the problem keeps changing, if the doctor can’t find anything wrong with you, then the problem may be emotional. That does not mean the problem is “all in your head” it is there, but it is everywhere in your body also, and there are treatments for anxiety.

Robert Sapolsky wrote a really cool book, called “Why Zebras Don’t Get Ulcers” which explains how your fears can essentially hijack your body and show up by making you sick. I highly recommend this book to counselors and therapists who want to understand anxiety and want to help people with this problem. But what if you or your child is suffering from anxiety. And I do mean SUFFERING? What if you just want to get your life back?

There are ways to turn the volume down on anxiety, shrink that cat down to a manageable size. I am not saying to get rid of anxiety altogether. If there is a real live lion chasing you, or a gang banger with a gun, some fear and anxiety is a good thing. Under those circumstances, anxiety might save your life. If your fears are keeping you from having a life, what then?

A good counselor or therapist can help you shrink those fears. There are self-help books that help also. A good counselor can help you learn and practice skills to stop anxiety in its tracks. The difficulty here is they will probably see you an hour a week, now you got 167 hours to go before your next appointment. What now? This is where a good self-help book can help, especially if you talk it over with a professional and practice the skills. A book is also helpful if you need to help a child get over their anxiety.

One book that I find helpful for managing anxiety is Tamar Chansky’s book “Freeing Your Child from Anxiety: Powerful, Practical Solutions to Overcome Your Child’s Fears, Worries, and Phobias.  She has lots of good techniques for reducing and controlling anxiety. She does some creative things like using a “Fear Extinguisher” and a “Fear Thermometer” as well as some of the standbys like creating incompatible emotion states by using humor or relaxation to reduce anxiety.

So is anger a problem for you? How do you reduce or control your anger? And if you are a counselor and work with clients with anxiety – What do you find the most effective approach?

There will be more on this topic to come, and please feel free to comment on this or any other topic in my blog. Till next week. David Joel Miller, LMFT, LPCC.

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