Tag Archives: Emotions

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

Stress

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

Stressed

Feeling stressed out?
Photo courtesy of Pixabay.com

Stress!

“Can you feel the stress in this room?”

The person next to me bent over and whispered in my ear. “Yes,” I replied. “I have never felt it this strongly,” they said.

Are you feeling it too?

These days people are collapsing under stress as never before. Fear is stalking us.

We are daily reminded of two wars – should we make that three – and counting? Housing prices continue to crumble; most homeowners are underwater if they haven’t lost their home to foreclosure already. Unemployment is up – stubbornly up. In my area, unemployment flirts with the 20% mark. Is it any wonder we are stressed?

The gridlock in Washington hasn’t reduced the stress level of anyone I know. Did I hear that right – politicians almost let us default on the NATIONAL DEBT! And the stock market makes my stomach hurt worse than any roller coaster I ever rode on. Consumer confidence is near the bottom. Did I read that right – one credit card company emailed me a warning – I did not owe them anything but they were warning me THEY didn’t have the money to lend me?

Are company presidents really bragging about the number of American jobs they have eliminated?  It is not just the low-skilled unemployed that are out of work. People with college degrees are unable to find jobs; some are running out of unemployment benefits. And the once safe place – government employment – has become a scary place as huge numbers of government employees at all levels are being laid off.

There was a time when the way to escape economic uncertainty was to go back to school, usually to college, and get a degree. A degree is still a wonderful thing, but occupations are changing so rapidly a degree is no guarantee of finding a job.

California has traditionally been the land of second chances. And third and fourth … But as the budgets shrink colleges everywhere are raising tuition, cutting classes, and capping enrollment  So even if someone chooses to go back to school there are no guarantees of admission, classes, or a career afterward. That is causing students a lot of stress.

Being a parent is even more stressful. Lots of kids are not finishing school. The numbers going to juvenile halls show no sign of declining. Teen pregnancies and drug use are everywhere you look. If parents had known the risks beforehand we might not have become parents.

It’s only adults that stress right? Kids don’t understand stress, right? They don’t know we are stressed, we are hiding it well. Wrong! The hospital emergency rooms are seeing those kids. I read on the internet, a study which said over the last ten years the number of children admitted to psychiatric hospitals has continued to rise. These are kids who say they want to commit suicide, kids who wish they were never born, or they wish that they were dead.

No, not every kid says that, but the numbers who do are rising. Kids who never before knew what homelessness meant are learning the hard way. Kids tell me they have moved 3 – 4 – 7 times or more because the family couldn’t pay the rent. Several families move in together in a house too small for one family.

Some kids get kicked out of school. I am seeing a wave of home-schooled; self-taught students who couldn’t be kept in the classroom anymore because of their behavior – or their parent’s behavior.

Lots of those kids who end up in contact with the official system, welfare, Child protective services, juvenile hall, where are their parents? They are in prison and jail. In our society, for a long time, one in three black men went to prison. But the numbers are changing now. More Hispanics, more women, and more white men are going to prison. Nowadays everyone gets a chance to do time.

Our prisons are overcrowded and soon we will have to start letting people out to make room for the new prisoners.

Some kids are looking forward to seeing their parents freshly released from prison; some are scared for the same reason.

It’s the drugs, right? We have been fighting the war on drugs so long, our battle flag is torn and covered in blood. More children and younger ones are trying drugs. Some are doing drugs with their parents; others are stealing their parent’s drugs.

And it’s not just the same old drugs, six new drugs, maybe more, have arrived on the streets of America in the last couple of years. Some of these drugs aren’t illegal yet. Most don’t show on the hospital screening tests. And the kids who tell me they are using drugs – they keep getting younger and younger.

And the drugs that hurt the most are not the rare illegal ones. They are not the ones that sneak in through the windows but the ones that we openly carry in the front door. Alcohol and Tobacco-related deaths account for over 95 percent of all drug-related deaths. Abused prescription drugs are in second place with all illegal drugs a distant third.

So what causes these children to succumb to all this stress?  Why do some parents cave in under the stress and others make it through? In the future, I will write more about my thoughts on withstanding stress, but now I would like to know –

What do you think?

How do you cope with stress?

How can those of us that are in the helping professions, counselors, therapists, doctors, nurses, and others – how can we help people to withstand these horrific levels of stress?

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