What is the difference between Melancholy and Atypical Depression?

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

Depressed person

Depression.
Photo courtesy of Pixabay.com

How are Melancholy depression, atypical depression, and major depressive disorder related?

When you read around on the internet, and in some books on the subject also, you will find a lot of different names for depression. Some of these are understood as separate disorders because in doing research or in the way these disorders affect clients they look like different but related conditions. Some of these terms are primarily descriptors, technically descriptors, for the most significant feature of the depression. Some of the terms you will read about elsewhere are more descriptions of the thing that may have caused or may be causing the depression.

Someday we may be able to run a precise test, brain scan or blood test and identify specific forms of depression. There has been a lot of promising research in this field and some huge claims about the ability to diagnose mental disorders by this or that test, but as of now most diagnosing is done by asking the patient questions, counting up symptoms and then if you have enough symptoms you get a disorder with a particular name.

Melancholy depression or atypical depression.

Melancholy depression and atypical depression are two “Specifiers” used to group cases of Major Depressive Disorder with similar features together for ease of reference. In the newer diagnostic book (DSM-5) there are 9 specifiers. These specifiers are somewhat changed from the older DSM-4 system. What follows is my oversimplified explanation, for the full text of the description you would need to look at the APA book DSM-5.

What is Melancholy Depression?

Almost total loss of pleasure. Stuff that used to make you happy now just does not interest you. If you are too depressed to think about sex or a hobby you used to love, chances are you have melancholic depression.

With Melancholic depression, nothing is likely to snap you out of it. You see a show that others say is funny but you can’t enjoy it and laughter is just too much work. If something good happens, it does not make you feel good even for a little while.

People with Melancholic depression have a noticeable down mood. They are despondent, hopeless or in despair. People with this form of major depression wake up way early and their depression is worse in the morning. They have changes in appetite and feel guilty.

This is the kind of depression that made its way into novels in the last century and may still be seen on soap operas. These literary efforts make this look like it is someone being dramatic or overacting. In the clinic, this is a real enough disorder and people with this condition are not faking it for attention.

Depression with atypical features specifier.

With atypical features, the depressed person can snap out of it a little for a while if something really good happens. They laugh at a joke, some of the time. Trouble is that the happy feeling is fleeting and disappears before they realize they just smiled.

With atypical features, the person has significant weight gain and or increased appetite. They are always tired and drag around. With this type of major depression, the image that should come to mind is a bear hibernating for the winter. They eat everything in sight and then sleep for hours. Upon waking they are too tired to walk around and after eating they return to sleep.

People with atypical features to their depression customarily have had a long-term pattern of feeling rejected. They are very sensitive to any hint of rejection, judgment or criticism and this often interferes with personal relationships, job, school or any other activity that involves getting along with others.

With Seasonal pattern depression specifiers.

Another specifier would be added if this person had the depression only at one particular time of year or at a transition between seasons. This requires the change of weather or seasons to be the trigger for the depression. If you work a summer or winter job and get laid off each year that is not seasonal depression. We know what caused it and the weather need not get blamed.

This type of depression is often called winter blues or it used to be called seasonal affective disorder before we split bipolar and depression into two very different groups of disorders.

Peripartum onset specific for depression.

The name of this specifier was changed and I think for good reason. This is the “thing” that used to get called postpartum depression. Turns out that lots of times this started out in the middle of the pregnancy. Starting before the birth of the baby is a bad sign as often this results in a more severe depressive episode.

Women who had postpartum depression now called Major depressive disorder with Peripartum onset found that with each succeeding pregnancy the depression gets worse.

With psychotic features turns into two specifiers.

What used to be major depressive disorder with psychotic features has been subdivided into two specifiers. One is Mood congruent psychotic features and the other is mood-incongruent psychotic features.

Catatonia.

This is that condition where a person stands frozen like a statue. It can be diagnosed separately without any depression but occasionally it appears as a specific type or specific form of major depressive disorder.

This is a quick, abbreviated, run down on some features of Major Depressive Disorder. If you or anyone you know has these symptoms seek professional help. Getting help is not giving in to your illness. Getting help early can keep depression from getting far worse and ruining your relationships, job or your happy life.

For more posts on depression:

Staying connected with David Joel Miller

Two David Joel Miller Books are available now!

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.

Casino Robbery is a novel about a man with PTSD who must cope with his symptoms to solve a mystery and create a new life.

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

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

Want the latest on news from recoveryland, the field of counseling, my writing projects, speaking and teaching? Please sign up for my newsletter at – Newsletter. I promise not to share your email or to send you spam, and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse, and Co-occurring disorders see my Facebook author’s page, davidjoelmillerwriter. A list of books I have read and can recommend is over at Recommended Books. If you are in the Fresno California area, information about my private practice is at counselorfresno.com. Depression

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Seasonal Anxiety?

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

Anxious woman

Seasonal anxiety?
Photo courtesy of Pixabay.

Is there seasonal anxiety?

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

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

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

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

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

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

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

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

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

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

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

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

Staying connected with David Joel Miller

Two David Joel Miller Books are available now!

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.

Casino Robbery is a novel about a man with PTSD who must cope with his symptoms to solve a mystery and create a new life.

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

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

Want the latest on news from recoveryland, the field of counseling, my writing projects, speaking and teaching? Please sign up for my newsletter at – Newsletter. I promise not to share your email or to send you spam, and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse, and Co-occurring disorders see my Facebook author’s page, davidjoelmillerwriter. A list of books I have read and can recommend is over at Recommended Books. If you are in the Fresno California area, information about my private practice is at counselorfresno.com.

Winter Blues (SAD) Prevention and Treatment

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

Winter

Winter.
Photo courtesy of Pixabay.com

Treatments for Winter Blues.

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

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

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

Light therapy for seasonal affective disorder.

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

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

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

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

Medication seasonal depression.

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

Therapy can reduce seasonal depression.

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

Self-care reduces the impact of seasonal affective disorder.

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

Combination Therapy

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

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

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

Sad – Risk factors. 

Staying connected with David Joel Miller

Two David Joel Miller Books are available now!

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.

Casino Robbery is a novel about a man with PTSD who must cope with his symptoms to solve a mystery and create a new life.

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

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

Want the latest on news from recoveryland, the field of counseling, my writing projects, speaking and teaching? Please sign up for my newsletter at – Newsletter. I promise not to share your email or to send you spam, and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse, and Co-occurring disorders see my Facebook author’s page, davidjoelmillerwriter. A list of books I have read and can recommend is over at Recommended Books. If you are in the Fresno California area, information about my private practice is at counselorfresno.com.

Winter Blues (SAD) Risk Factors

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

Winter

Winter.
Photo courtesy of Pixabay.com

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

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

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

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

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

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

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

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

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

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

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

Risk factors for Seasonal Affective Disorder.

The amount of daylight affects mood.

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

Genetics can increase your winter blues risk.

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

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

Eye color may be connected to seasonal affective disorder.

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

Thinking errors increase all kinds of depression.

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

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

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

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

Staying connected with David Joel Miller

Two David Joel Miller Books are available now!

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.

Casino Robbery is a novel about a man with PTSD who must cope with his symptoms to solve a mystery and create a new life.

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

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

Want the latest on news from recoveryland, the field of counseling, my writing projects, speaking and teaching? Please sign up for my newsletter at – Newsletter. I promise not to share your email or to send you spam, and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse, and Co-occurring disorders see my Facebook author’s page, davidjoelmillerwriter. A list of books I have read and can recommend is over at Recommended Books. If you are in the Fresno California area, information about my private practice is at counselorfresno.com.

7 recovery tools you need

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

Tools.
Photo courtesy of Pixabay.com

You need all your recovery tools.

Each activity calls for their own special set of tools.  Most men have a bunch of tools in the garage, carpenters and mechanics have humongous collections of tools. Cooks, good ones and otherwise, all seem to have a variety of tools at their disposal.

Why then do recovering people think they can get by with one or very few tools?

Some counseling or medication may get your depression, anxiety or addictive behavior under control but what will you use to prevent a return of your symptoms?

Some people can get away from substances, alcohol or drugs, by just quitting. Unfortunately, they often find they are dry but not really recovered. We call that being a dry drunk.

Some people function in spite of their anxiety or depression. They will themselves forward until that stops working.

Others think that given a sudden religious experience they are now cured and will not need to work on their recovery anymore. I am not discounting religious or spiritual experiences as a source of recovery, but anyone with a successful recovery is apt to tell you that embedded in their religious or spiritual practice are some other recovery tools.

Here are some of the recovery tools you might consider including in your recovery toolbox.

Support system – Family and friends.

Peers in a recovery program, fellow church members, and friend’s relatives, all can be important parts of a recovering person’s support system. You need more than one kind of support to make this work.

The key is to find people who are positive support system members.

Members of a recovering person’s support system need to be encouraging, see the best in the recovering person. They also need to understand that it is the recovering person’s journey, not theirs.

Honest, support system people, there is nothing you can do to make someone use drugs or drink. Stop walking on eggshells. There is also nothing you can do to keep them clean, sober or happy. You can encourage but the journey is theirs.

What you can do is be there for them. Expect there to be struggles and take good care of you. Letting the recovering person get away with things is not the same as being supportive.

Peer support groups and sponsors help.

Peer groups, especially 12 step groups have a long history of being helpful in maintaining recovery.

Consumer groups, while harder to find, can be very effective as a form of support.

Having a sponsor can also be extremely helpful. Sponsorship the way it is practiced in many 12 step groups is a whole lot less mysterious than many outside the groups make it sound.

You find someone who has recovered by completing a process of recovery and you get them to spend some time with you telling you how they did it. In twelve-step groups the process they use is the 12 Steps, so you want a sponsor who has actually “worked” the steps.

Other supports – Pets and Professionals.

Why did I put pets and professional together? Should you see a counselor or get a dog? Or cat? I am hoping you try both.

Both these groups give you something called “unconditional positive regard.” Meaning they should be in your corner no matter what, liking you as a person even when they want you to change.

With pets, we call this unconditional love. The dog comes over and licks you no matter how you are doing. They will, however, want you to get up and play even when you are depressed.

Guess what, playing with that dog, taking them for a walk will help your depression. And it may also take your mind off those cravings.

Counseling is a recovery tool.

Both group and individual counseling can be very effective. Group because you can hear how others are going through the same things. The verdict on online groups is still out, I suspect that as a part of your recovery tools they could be helpful. Just make sure you don’t try to do any heavy cutting with a hammer or a spoon.

Medication can be very helpful.

Mostly medication is useful for mental health issues. So far we have not found a drug that makes you clean and sober. Some are used to help reduce or manage the cravings. Lots of people stop using street drugs and then discover that they have severe anxiety or depression. They just never noticed this while getting high. For these folks, some psych meds, correctly used can be helpful.

Some people tell me medication has saved their life. Once the doctor found the right meds they began to have a good life.

Others tell me or write on the blogs, that the meds were worse than the disorder. Be careful about stopping meds suddenly. There can be side effects and withdrawal symptoms. But if your meds are not working or are causing other problems that are intolerable, please talk with your doctor. There are lots of things that can be done most of the time.

Meds by themselves, in my not so humble opinion, are not the whole answer. No pill will solve all your life problems. The med may allow you to face life again, but you still need to do the recovery work.

You need all the recovery tools you can get.

Self-help –self-expression – journaling etc. pictures, collages, music.

Self-help books, Journaling and other ways of expressing yourself are helpful. If you find you can’t write in a journal, try drawing pictures or composing songs.

Jobs – Paid or volunteer.

Something about having something to do and somewhere to go that is a huge boost to your well-being. Has someone told you that for you, work is not an option? Do not be so sure about that. In the first stages of recovery, you may not be ready for a 40 hour a week job. Still, that should not keep you from doing something.

If you go to meetings, make and pour coffee. Take out the garbage. Volunteer to help someone else. Something as simple as calling another recovering person each day (or emailing, blog posting, etc.) can get you back in the life game.

Supportive relationships are a big help in recovery.

By relationships, I do not mean only the romantic or sexual kind. Invest time in working on all your relationships.

In another post, I talked about being sure that your relationships are healthy. If they are not, consider how you could work on them to make them healthier or do you need to end some unhealthy ones.

People who have healthy relationships, others that care about them and encourage them, are more likely to stay sober and much less likely to end up in a psychiatric hospital.

I need to wrap this up. Relationships could easily be the topic of many posts or even a whole blog.

So how many of these recovery tools are you using? Are there any other things that I missed that work for you?

Staying connected with David Joel Miller

Two David Joel Miller Books are available now!

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.

Casino Robbery is a novel about a man with PTSD who must cope with his symptoms to solve a mystery and create a new life.

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

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

Want the latest on news from recoveryland, the field of counseling, my writing projects, speaking and teaching? Please sign up for my newsletter at – Newsletter. I promise not to share your email or to send you spam, and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse, and Co-occurring disorders see my Facebook author’s page, davidjoelmillerwriter. A list of books I have read and can recommend is over at Recommended Books. If you are in the Fresno California area, information about my private practice is at counselorfresno.com.

More on how to be happy

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

Happy faces

Happiness.
Photo courtesy of Pixabay.com

What does happy look like?

Happy is one of those things we talk about, we all say we want it, but when it comes down to the directions on getting from here to happy, we are all fuzzy on just how you get there.

Does this look like happy?

It may well that you can’t get there from here. Maybe you need to first go somewhere else, like contentment and then you turn right or is it left? And yes happy is right around the corner from contentment.

Happy may well be the last street after acceptance and serenity.

Since happy is so hard to describe we might do better when we see it.

Here are a few photos that could start you on the road to becoming an expert on happy. Knowing what to look for couldn’t hurt. We all used to know what happy looked like once, even if we never actually felt that way.

Happy cat

Happy cat

 

Happy Cat. Maybe, this is a Zen master cat and has mastered no attachment, or maybe this cat just doesn’t care.

Not sure how we would know if a cat were happy. Maybe by the purring?

I asked my cat but she is ignoring me.

 

Happy child

Happy child
Photo courtesy of Flickr (Ben.Millett)

Happy child, yes that looks like happy.

There we have it. A Happy we can tell when we see it.

Children don’t try to hide happy the way some adults do. They haven’t forgotten what happy feels like yet.

 

Some people say they never feel happy.

Never feeling happy, that is some form of depression, somewhere between Persistent Depressive Disorder (The old dysthymia) and Major Depressive Disorder. It is the result of something that actually happened then that could be a stress issue, as in Adjustment Disorder with Depressed Mood.

We, professionals, have all sorts of descriptions for unhappy but nowhere, that I see, are their clinical descriptors for “too happy.”

We will just have to take the risk and try one more picture. Maybe that will help us recognize happy the next time it crops up.

There do you have it? Can you recognize happy the next time it greets you?

Staying connected with David Joel Miller

Two David Joel Miller Books are available now!

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.

Casino Robbery is a novel about a man with PTSD who must cope with his symptoms to solve a mystery and create a new life.

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

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

Want the latest on news from recoveryland, the field of counseling, my writing projects, speaking and teaching? Please sign up for my newsletter at – Newsletter. I promise not to share your email or to send you spam, and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse, and Co-occurring disorders see my Facebook author’s page, davidjoelmillerwriter. A list of books I have read and can recommend is over at Recommended Books. If you are in the Fresno California area, information about my private practice is at counselorfresno.com.

How do you find a counselor for Depression or Dysthymia?

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

Counseling questions

Counseling questions.
Photo courtesy of Pixabay.com

Looking for help for your depression.

Reader question, thought I should share this with all counselorssoapbox.com readers as you might miss it as an answer to an older post. This was a comment on the Dysthymia post.

“I have a question: How do you find a professional who specializes in the treatment of Dysthymia? Someone who is really good. Searching for such a person in Michigan. Medications, by the way, are a waste of time. They don’t work for me. Can you suggest someone for me? Thanks!”

Great question. Let me make some suggestions. I am out in California and do not know professionals back there in your area. But the process is likely the same everywhere.

1. If you have not done so see a medical doctor first, there are some medical conditions that can look like depression or Dysthymia.

2. If you have a history of substance abuse, alcohol or drugs, get that treated first or concurrently with the Dysthymia  Even after people stop using they still have the old thinking and it does not change without help.

3. Interview the counselor you are considering seeing.  Picking a therapist is kind of like dating, you may find the right person the first time, but you need to get to know them a little before you make the commitment.  Progress in therapy is all about the relationship.

4. Look for someone who treats depression. The process is very similar in treating Depression or Dysthymia  If the depression comes from a recent bad event this is more like adjustment disorder. If you are depressed because you lost your job you need someone who can work on career counseling. Dysthymia is generally more long-term and you may need to look at things you learned as a child that no longer are helpful. I prefer to work from a Cognitive Behavioral or Rational Emotive perspective. Narrative therapy can also work.

5. Avoid a counselor who advertises things that do not fit you. Men should generally avoid a therapist that advertises they use a “feminist” perspective. Don’t see a Muslim counselor if you are a Christian or vice versa. Most good counselors work with everyone and do not put that sort of thing in their advertising.

6. Expect to do a lot of work on yourself. A good therapist is like a good tour guide, they can tell you about the trail but you need to take the hike.

Staying connected with David Joel Miller

Two David Joel Miller Books are available now!

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.

Casino Robbery is a novel about a man with PTSD who must cope with his symptoms to solve a mystery and create a new life.

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

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

Want the latest on news from recoveryland, the field of counseling, my writing projects, speaking and teaching? Please sign up for my newsletter at – Newsletter. I promise not to share your email or to send you spam, and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse, and Co-occurring disorders see my Facebook author’s page, davidjoelmillerwriter. A list of books I have read and can recommend is over at Recommended Books. If you are in the Fresno California area, information about my private practice is at counselorfresno.com.