Tag Archives: Mental disorder

Can you avoid prison by saying your suicidal?

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

Alcatraz prison

Prison?
Photo courtesy of Pixabay.com

If you say you are suicidal will you stay out of prison? How about jail?

Nice try! Not likely!

People try all sorts of things to get out of going to prison. While saying you are suicidal may slow the process down a wee bit it won’t prevent it.

Jails and prisons have psychiatric units. They can put people on suicide watch. So just because you say you are suicidal will not prevent you serving a prison term.

People often confuse some very different ideas and the result is that they think things are one way when they are not. Here are the different concepts, very oversimplified. All of these, for the record, is very different from the popular conception of “crazy.”

Not guilty by reason of insanity.

This may get you off from the prison term but you may not be happy with the way it goes. Not guilty by reason of insanity means that at the time you committed the crime you did not understand that what you were doing was wrong. This is way beyond seriously and persistent mental illness and has nothing much to do with saying you want to kill yourself.

People who get this verdict go to a long-term psychiatric facility. You do not just stay for your 5 or 10. You stay until some psychiatrist is willing to risk his license on saying that you will not do this thing again and that you now have learned the difference between right and wrong.

I hear from clients who have been in these places that had they been up to going back to prison they might have chosen the prison.

Involuntary psychiatric hold.

There are three reasons you get placed on an involuntary hold. You say you will kill yourself, you threaten to kill someone else and we believe you or when we give you food and clothing you can’t figure out what to do with this stuff.

This involuntary hold usually gets you sent to a local mental hospital. These are not long-term facilities by any means.

You stay here for, in my state, up to 72 hours for evaluation and then at the discretion of the psychiatrist you might get put on a longer hold. For most people, this stay lasts a week to two. A stay beyond that is rare. Not the 72 hours is an “up to
” number. Lots of people get released in a lot less than 72 hours.

The objective here is to give you meds, get you stable and then send you somewhere else.

So if by some chance you convince someone you are going to harm yourself, you will get to stay here long enough for the meds to kick in and you to stop caring about what happens. At that point off you go to the prison unit.

While a prisoner is at this kind of hospital there will probably be one full-time guard watching them. They watch you all the time, everywhere. This gets annoying enough some about-to-be-sentenced people make sudden recoveries.

Seriously and persistently mentally ill.

If you can convince the powers that be that you have a long-term mental health problem you will get sent to a prison with a psychiatric unit at which you may be required to take your meds. You may have the right to say no, but the prison can go before a judge and get a court order to medicate you against your will. Also refusing meds results in a lot of reductions in privileges and options.

Should you say you are suicidal to get out of jail?

My advice to whoever sent this question in is if you really are suicidal say so. But if you are not, do not try this dodge. The result could be more time and having to do things you do not want to do. You also run the risk of getting a label hung on you and face discrimination from the other prisoners. Who wants to do their whole time labeled a J-cat unless you really do need the meds.

Give it up. You did the crime, do the time and then consider doing something to rehabilitate yourself.

Staying connected with David Joel Miller

Three 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.

Sasquatch. Wandering through a hole in time, they encounter Sasquatch. Can they survive? The guests had come to Meditation Mountain to find themselves. Trapped in the Menhirs during a sudden desert storm, two guests move through a porthole in time and encounter long extinct monsters. They want to get back to their own time, but the Sasquatch intends to kill them.

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

Books are now available on Amazon, Kobo, iBooks, Barnes & Noble, and many other online stores.

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. If you are in the Fresno California area, information about my private practice is at counselorfresno.com.

How do you tell them you have a mental illness?

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

Mental Health or Mental Illness

Mental Health or Mental Illness?
Photo courtesy of Pixabay.com

How do you tell someone you have a mental illness?

Should you tell people about your mental illness? When and how? Is there a stigma around having a mental illness? You bet there is!

That stigma impacts your decision about when to self-disclose and to whom. Whether to tell others about your mental illness is one of the tougher decisions anyone in recovery will have to make.

Your mental health conduction is mostly confidential.

Generally, medical conditions are protected by confidentiality. Your doctor is not going to tell people about your condition unless this is a “reportable by law” condition. Even then the person at the communicable disease center is going to keep it confidential as much as possible.

It is a whole lot harder to keep your mental health condition a secret and once that information gets out it can change your relationships forever.

Ask people if they would be OK working at a desk next to someone with cancer and many will say yes. There was a time people with cancer were avoided for fear it might be contagious. We know more now about most diseases.

Many people would be willing to work with or next to someone with an HIV infection or AIDS.

When it comes to someone with a mental illness the picture changes.

Most people do not know much about mental illness and still think it might be contagious, or that the mentally ill are “crazy” and dangerous. Many people do not know what to do or how to react when they encounter someone having a mental health crisis. Here is a great program called Mental Health First Aid to help people know how to respond but this program has not been available to nearly enough people.

Even among professionals working in social service agencies, there is a sizable number who would not want to have a person with a mental illness working alongside them. We have talked so much about the problems of the mentally ill, the message that recovery from mental illness can and does happen has not even reached everyone working in social services agencies, let alone the general public.

We have a long way to go to defeat the stigma around having a mental illness.

One way stigma has gotten broken down is by having people in prominent positions tell the story of their struggles. This has been powerful for reducing stigma against AIDS, Homosexuality and a great many other conditions.

High profile people talking about their mental illnesses has not had nearly as much effect.

Some people who have talked publicly about their mental illness have said if they had known how much prejudice they would experience, they might not have been so open about their problems.

It is not just the mental health consumer who experiences discrimination. Their family members may be discriminated against or persecuted also. Some people do not want to have the mentally ill in their neighborhood even when they have a mentally ill member in their own family.

The result of this prejudice keeps the mentality ill hidden and forgotten and the families find they may need to pretend that no one in their family would be “crazy.”

The route forward for those who self-disclose mental illness does not look easy.

Sometimes the self-disclosure is inevitable. When you are in a relationship your partner needs to know. If you are on a job and have to take time off for treatment or end up in a hospital then your boss needs to know. You may have to tell your family also.

Some relatives, friends, and coworkers are more understanding than others. Some companies follow the letter of the law and look for other reasons to terminate a mentally ill person. Other employers follow the spirit of the law and recognize the contributions the mentally ill can make to this organization.

Mental Health is on a continuum.

It is important to note that even in writing this post I slipped into talking as if there are two groups, the mentally ill and the “normal.”

People who are knowledgeable in this area will tell us that the boundaries between these two groups are porous and that people move from being mentally ill to being mentally well. Some mentally well people will also discover they have a mental illness this year when they had never had one before.

Life stresses can impact most anyone’s emotional well-being.

The road to reducing prejudice around mental illness runs through the places of education. That education needs to take place well beyond the confines of professional training programs. We need more understanding of what mental and emotional illnesses are like and how they can be overcome in our schools, churches, and workplaces.

Along the way to stigma reduction each person with a mental illness, their friends and family will need to consider when and to whom they will self-disclose.

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.

Growing up mentally ill effects every part of your life

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

Confused brain

Mental illness.
Photo courtesy of Pixabay.com

The high cost of growing up with a mental illness.

Lots of attention has been focused on how the severely mentally ill may be different from others. Very little attention seems to be paid to how the experience of having a mental or emotional problem in early life changes who that person becomes.

The prevailing myth is that childhood is a happy time; life problems and the resulting emotional distress come later, the cost of growing up. We would like to hold onto this Peter Pan fiction despite the fact that more than a few of us have our own memories of childhood emotional or mental difficulties.

Who we become as an adult is shaped by our experiences and what we learn about the nature of the world we live in. The life events of the mentally or emotionally challenged child are significantly different from those others undergo. These early emotional experiences create the adult they will become.

The challenge of growing up with a mental illness changes every aspect of your experience. Those life experiences contribute more to who the mentally ill child becomes that the particular emotional illness they have.

For the child with an emotional problem, all relationships are fundamentally altered. The cranky from birth child is hard to care for. Interactions with the caregiver depending on the extent of the child’s mental illness and the age at which the symptoms first develop. The problem child gets labeled and learns the role of Black sheep, the creator of the family’s dysfunction.

Peer relationships are likely to be distorted. The depressed or emotional child is more likely to be bullied and rejected by peers. They grow up alone, unaccepted and victimized.

Their symptoms call down the wrath of teachers and adult authority figures. They are more likely to be judged by their symptoms than for themselves.

As difficult as the teen years are for the “typical” teen they are extra difficult for a teen who is struggling with mental illness. They may find it difficult to establish supportive friendships and have fewer resources to draw on to navigate the developmental tasks of growing up.

When and if they develop an intimate partner relationship that connection will be heavily influenced by the person’s mental illness. They are more likely to enter relationships with other mentally ill partners or to become the victims of partners who take advantage of their weaknesses. Being involved in relationships with other mentally ill people adds a double strain to the process of establishing healthy relationships.

They also have more difficulty staying in school and finishing their education. As a result, career options are more limited and the emotionally challenged youth is more likely to be unemployed or underemployed.

The mentality ill leave home and school to become a permanent member of an unnoticed minority. Regardless of their race or ethnicity, the emotionally challenged child grows up to be a victim of discrimination.

The mentally ill child is often scapegoated and blamed for the family’s problems. Some of them have grown up as the caregivers of mentally ill parents.

They come to question who they are when they are depressed, when they are manic or when they experience other symptoms.  The question becomes which part of their experience and their behavior is them and which is the result of their illness.

They often experience adults who view their symptoms as a matter of choice rather than illness and who tell them to just snap out of it and act normal. They wonder why others can cope with life and they find it such a challenge.

Growing up mentally ill can result in feelings of self-doubt and negative beliefs about the self. They come to think that they can’t do anything right. Not liking themselves is common.

Even when they enter the system they are likely to be viewed as incompetent rather than uneducated. They are likely to be assigned case managers who see their job as permanently managing these people who form a drain on society’s resources.

The professional that believes in recovery and a full and happy life for the mentally ill has long been the exception rather than the standard.

The cumulative impact of these experiences can easily lead to an adult mentally ill person who has come to accept that they are somehow defective and unwanted. They become marginalized unable to work, dependent on scanty government and family handouts and convinced by years of learned helplessness that they would not be able to succeed if given the chance.

We as a society create these angry depressed and isolated adult mentally ill by our unwillingness to recognize and help these youths who are struggling to overcome an emotional issue.

What is critically needed is more emphasis on early detection and treatment of mental and emotional challenges. We also need social service systems that believe in recovery rather than permanently marginalizing the mentally or emotionally ill.

David Miller, LMFT, LPCC

Related articles

Staying connected with David Joel Miller

Three 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.

Sasquatch. Wandering through a hole in time, they encounter Sasquatch. Can they survive? The guests had come to Meditation Mountain to find themselves. Trapped in the Menhirs during a sudden desert storm, two guests move through a porthole in time and encounter long extinct monsters. They want to get back to their own time, but the Sasquatch intends to kill them.

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

Books are now available on Amazon, Kobo, iBooks, Barnes & Noble, and many other online stores.

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. If you are in the Fresno California area, information about my private practice is at counselorfresno.com.

How to turn anxiety into paranoia

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By David Joel Miller.

Grim Reaper

Paranoia.
Photo courtesy of Pixabay.

Some days it is a short trip from anxiety to paranoia.

The higher the volume is turned up on your anxiety control the greater the risk that this could lead to paranoia.

Some caveats here. In this context, I am not talking about one of the paranoia’s that are currently diagnosable as a mental illness. Most people say Paranoid-schizophrenia as if it was all one word. There are lots of people with schizophrenia that are not paranoid. There are also people who suffer from paranoid personality disorder who do not have schizophrenia.

This discussion is about people without those two diagnosable illnesses who have some feeling that looks like paranoia during the course of another illness or even without meeting criteria for a diagnosis. In other words, this is about the dictionary definition of paranoia not the DSM definition of a paranoid mental illness.

Yes, in my opinion, you can have paranoid thoughts and not have a mental illness with the word paranoia in it.

One definition of Paranoia is an unfounded, exaggerated or unreasonable distrust of others not based on facts. This is fear based and makes you question others motives.

Here is how a case of paranoia might begin.

You are very fearful, sensitive and worried about what others think of you. You have “trust issues” and are not sure if people are really your friends or might want to harm you.

People who have been victimized in the past are especially at risk for these kinds of trust issues and for good reason. They have been harmed by someone in the past and may feel that they were too trusting.

One day this anxious person, let’s call her Annid. This is one of those made up names contracted from her mother’s name Ann and her father’s name, David. I don’t know an Annid or an Ann and David combination so I think I am safe here.

One day Annid is walking down the street and she hears footsteps behind her. She walks faster but the footsteps are still there. She looks over her shoulder and there is someone there. Let’s make this person a man. She is afraid of men because she was attacked by a man in an alley. This would be even worse if the man who attacked her was a member of a particular race and the man behind her was the same race.

At the corner, she decides to cross the street to get away from this man. She notices out of the corner of her eye he stops at the corner to talk to another man. She is becoming more anxious.

When the light changes the second man turns and follows her across the street. She walks faster but every time she looks back there is a man back there. She is not sure if this is either of the two men she saw before but there is always one behind her.

Eventually, she ducks into a coffee place and has some coffee. She decides to wait a bit to get rid of those men who are following her. But when she leaves the coffee place there across the street are 5 or 6, men all standing together and one of them looks like that man who was following her. Same sports team shirt and everything.

At this point, convinced she is being followed by a gang of men she ducks back into the coffee place and calls a friend who comes to pick her up and take her home.

Unchecked this fear that men are following her can grow until she is unable to leave the house.

One problem for this woman is that no matter where in this town she may walk there may be a man walking behind her.

Is this an irrational fear? Maybe, maybe not. Having been the victim of an assault once there is proof that a man could assault her. Is this fear excessive? Probably. The chances that every man on the street is following her and plans to assault her are very low, most of the time.

The challenge for this person and other people with paranoid symptoms is to reasonably evaluate the situation, assess for danger and still keep this fear of another assault from keeping her a prisoner in her home.

Now so far in this example, I have said that Annid has a history of being a victim. What if she has never been victimized?

She might have had a friend who was assaulted or heard a story on T. V. about assaults in her town. If she had a preexisting anxiety disorder even if nothing had ever happened to her she might keep looking over her shoulder believing that constant vigilance will keep her safe. And if you keep looking for something you will begin to see it.

See how easy it is to turn a fear in your mind into a belief that there is a real danger. We have even had cases where someone believing they were in danger pulled out a gun and shot a person who just happened to be going in the same direction they were. Family members have killed other family members in the mistaken belief that there was an intruder in the house.

High levels of fear can create the situation in which everything becomes scary.

If you have anxiety issues or feel threatened and unsafe, consider getting professional assistance both in determining if this is a real threat and in learning to manage your anxiety or other issues before that emotional problem turns you into a paranoid person.

Staying connected with David Joel Miller

Three 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.

Sasquatch. Wandering through a hole in time, they encounter Sasquatch. Can they survive? The guests had come to Meditation Mountain to find themselves. Trapped in the Menhirs during a sudden desert storm, two guests move through a porthole in time and encounter long extinct monsters. They want to get back to their own time, but the Sasquatch intends to kill them.

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

Books are now available on Amazon, Kobo, iBooks, Barnes & Noble, and many other online stores.

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. If you are in the Fresno California area, information about my private practice is at counselorfresno.com.

Are they laughing at you again?

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

Laughing.
Photo courtesy of Pixabay.com

Why are people watching you and laughing at you?

 

If I started off by suggesting that people were following you around and were out to get you most of my readers would think that this was paranoia and say “no not me.” But a great many of you are convinced that others are laughing at you a lot. I have to admit I have shared that thought also a few times.

Most people worry in social; situations. We want others to like us. Being liked and included has had evolutionary survival value. When the tribe likes you they share their food, shelter, and fire with you. If they don’t like you the result may be being banished to the jungle or forest. In some more rural cultures, the mentally ill are still sent out into the jungle to live. The attitude is better they get eaten than the healthy ones in the village.

The more sensitive and insecure you are the more likely you are to be constantly vigilant to see if you are being accepted. People with high anxiety are constantly monitoring the environment to see if others like them. There is a big problem with all this insecure monitoring.

That problem is called confirmatory bias.

If you think that people laugh at you a lot, as you are walking through the mall you hear a sudden burst of laughter. You look around and see a group of people all laughing and they are looking at you. That confirms it. A group of total strangers is laughing at you. Once you catch them at this, they all turn and walk rapidly away. At least that is what you think.

That is not what happened at all.

An independent observer who was sitting on the bench watching this unfold would have a different story. A group of people was standing around talking. Someone told a joke and they all laughed. At that point, someone walking through the mall stopped, turned and stood there staring at the group of people. They became nervous and looked back. When this stranger continued to stare they decided to get out of there before that crazy person did something and they walked as quickly as they could towards an exit.

See how this confirmatory bias works?

If you think that others are looking at you when you look around there will be some people looking at you. That confirms what you thought. All other evidence gets ignored as you are not currently looking for people who are ignoring you.

One hard thing for people who are anxious or depressed to do is to realize that most of the rest of the world is not motivated by you. Frankly, they are, most of the time, not laughing at you. They are in fact not even looking at you.

This bias comes from the belief that you somehow are responsible for what the rest of the world is feeling, that if they are sad or angry or hurt that it is somehow you doing and therefore your fault.

One thing I have learned from my time here on earth is that most people are way too interested in themselves to pay any real attention to what I am doing. A lot of times that I felt embarrassed or worried because a made a mistake there in public, it turns out no one noticed because they were all too preoccupied with themselves.

So next time you become nervous and think that others are looking at you because of something you did or said, consider that they may be looking at you because they are afraid you just noticed what they did.

One other thing I have learned? To not take my self so seriously. Sometimes I realize I did something that even I should laugh about.

Hope you are learning to accept yourself however you are and moving towards the happiest life possible.

Related articles

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.

If you go to the psychiatric hospital are you crazy? Involuntary holds

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

Former psychiatric hospital

Psychiatric hospital.
Photo courtesy of pixabay.

Why do people get hospitalized? Can I send my child or partner there?

 

There are a lot of misconceptions about going to a psychiatric hospital, who goes and why. In this post, I want to talk with you about some general information about what it means to be in or be sent to a psychiatric hospital.

This may vary from hospital to hospital and from jurisdiction to jurisdiction so for legal information check with the laws or a lawyer in your area.

It is not the people with the most serious mental illnesses that end up in the hospital. Our policies around this have changed a lot over the last century.

There was a time when people were sent to psychiatric hospitals for long periods of time. Stays of a year or more used to be common in the days before medication. Today most hospital stays are as short as possible. The use of medications has shortened stays considerable and so have patient rights laws.

There was a time when a man could put his wife away in a hospital and then get to spend more time with his girlfriend. Families would try to put away people who had a lot of money or were eccentric, to get control of their assets. There were a lot of abuses as a result of having others in the family say you were crazy and then hospitalizing you. Once people got into the hospital it used to be hard to get out. Not anymore.

There are two ways that you might get hospitalized, voluntary and involuntary.

Voluntary psychiatric hospitalization.

If you go in voluntarily you need a lot of money. A single day could cost thousands of dollars. But just saying you want in will not get you a bed in most hospitals. A doctor needs to say that you have a psychiatric issue that would benefit from hospitalization.  Beds in psychiatric hospitals are at such a premium that you don’t get to stay just because you want to be in the hospital.

If you enter on a voluntary status you are entitled to leave anytime you want regardless of what the doctor says. There may be legal ways for the doctor to keep you by moving you to an involuntary hold but those laws get complicated.

Involuntary psychiatric hospitalization.

People are placed in the hospital involuntarily because they are in a crisis that cannot be resolved on an outpatient basis.

Involuntary holds vary from place to place. In most jurisdictions, there are three reasons you might be placed on an involuntary hold.

1. If you are suicidal.

If you are a danger to yourself, suicidal, you can be put on a hold and kept in the hospital in most places. You stay there until the thoughts of suicide are reduced enough that the treating psychiatrist no longer feels you are a serious threat to take your own life.

2. Are you Homicidal?

The second reason to involuntarily hospitalize you would be if you have a plan to kill a specific person and you will not back down on this. You will stay in the hospital as long as the staff thinks you still plan to kill someone.

This is sometimes referred to as a “danger to others.” This is easily misunderstood.

3. Are you gravely disabled?

If you have food, clothing, and shelter but can’t figure out how to use these things, we might need to hospitalize you to protect you. This person would be referred to as gravely disabled.

Someone may have a serious and persistent mental illness, they are very impaired, but if they can be maintained on an outpatient basis with meds or therapy. They may never end up in the hospital.

Someone who was just laid off or served with divorce papers may end up in the hospital because while upset or angry they think of hurting themselves or others. A few days in the hospital they change their mind and are sent home. They may never experience a recurrence of these feeling. We still recommend therapy for a while just to make sure they are OK.

The conclusions about involuntary commitments.

1. It is not always the most severely mentally ill that go to the hospital. It is the people who need to be protected from themselves and others that spend time on an involuntary hold.

2. Just because someone has a severe mental illness does not allow professionals to lock them away. They need to also be currently a danger to themselves or others or gravely disabled.

3. There are currently not many other options for monitoring someone who is mentally ill. They either meet criteria to be hospitalized or they don’t. If they do meet criteria they stay till they stop being a risk to themselves and others. If they don’t they can’t usually go to the hospital even if they want to.

4. Other options to make help more available to the mentally ill short of a return to full hospitalization are urgently needed.

There is so much more that needs to be said on this topic but I will close for now, but there will be more to follow.

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 the mentally ill feel? About feelings.

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

Man with feelings

Managing feelings.
Photo courtesy of Pixabay.com

Can you describe how the mentally ill feel?

This question actually comes up, both in person and as search terms. Despite the difficulty of answering such a general question, I will take a stab at this.

Speaking for any group of people is always problematic. I am an old white guy. So I should be able to tell you how old white guys feel right? Trying to speak for any group is beyond difficult. How old white guys feel would depend on whether that old white guy was a homeless veteran living alone under a bridge or a Wall Street executive who was paid millions for running a company last year that lost billions. I really can’t describe how all old white men might feel about anything.

But I will try to tell you how the mentally ill feel.

It might be easier to describe how the mentally ill do NOT feel, though that begs the question of how they do feel.

The mentally ill don’t feel happy. Occasionally they may feel mania. They may run without stopping and not need to sleep but even then they will probably tell you they are not really happy.

It is hard for positive emotions like happiness, contentment, and peace to co-exist with active symptoms of a mental illness.

One reason I feel so sure that I can describe the way the mentally ill feel is that they are so much like those of us who would like to think we are not suffering from a mental illness – not at this moment anyway.

In the course of any one year, 25 % of Americans will have symptoms of a mental illness so severe they should be diagnosed. Over half of all Americans will have at least one episode of a mental illness during their lifetime. So they will feel a lot like the rest of us – only more so.

The rest of the world has similar prevalences of mental illness. What you call it may vary from place to place. What symptoms people may exhibit may vary from culture to culture, but most any of us can tell when people are not happy and when they are suffering from dis-happiness.

Mostly people with a mental illness feel flooded, overwhelmed with negative emotions. When they are anxious they feel really, really anxious. When they are sad they are down in the bottom of the hole sad. Their depression does not go away when they watch a sitcom. Their night of dark feelings is really, really black.

It would be reassuring to think that somehow the mentally ill are different from the rest of us. If only they somehow have a different temperament or had done something so wrong they deserved their misery.  But the truth be told, bad things can happen to good people and we all are at risk to have an experience that overwhelms us.

Sure once they develop mental illness they may act differently from the way they did when they were well. They will smoke more and maybe drink and drug more. They may lose the ability to care for themselves or to show up for work.

But tell the truth, if tomorrow you were to lose your job and your home, if your family and friends turned their back on you – wouldn’t you feel depressed, anxious and like giving up?

So for those of you who wonder how the mentally ill feel, take a look at how you feel when things go wrong and then you will know how you might feel if one day you woke up and discovered you had contracted a mental illness.

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

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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.

Do addict, mentally ill labels help or hurt?

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

Mental Health or Mental Illness

Mental Health or Mental Illness?
Photo courtesy of Pixabay.com

Do most people accept labels like “addict” or “mentally ill?”

The use of labels to identify clients keeps coming up. Does having a label, a name, for your problem help you find answers or does it stigmatize you?

The recovery movement often uses labels, usually self-applied to define the nature of their issue. Saying you are an Alcoholic helps you to understand the problem and what you need to do to overcome it. In this case, if you are really an alcoholic you should not drink.

In A.A. they don’t give out the labels. They present information and let people decide for themselves if the designation fits. This approach has a lot to recommend it.

Some people feel that giving out labels can be a barrier to recovery. If you say you are an addict then, of course, you will use drugs, the use of the label could be interpreted as a reason to stay in your problem rather than move towards a solution.

Personally, if I have a cough it makes a lot of difference to me whether I have an allergy or tuberculosis. I am frankly a lot suspicious of a doctor who wants me to take medication for my cough but does not want to tell me what is wrong with me for fear of labeling me.

People are not defined by their disorders. We should not refer to them as “the schizophrenic” or the “depressive.” We know that there are times the person with schizophrenia or another psychosis may not be experiencing symptoms or the symptoms may be milder. This sometimes is referred to as periods of lucidity. People with depression can get better.

Most people, in my experience, embrace these labels. They help define the challenge the person is facing. It is reassuring to know that you have treatable disorder rather than to think that you are crazy or that there is something so wrong with you and there is no hope. What most people find is that there are lots of other people who are struggling with the same illness.

As a professional, I feel I owe it to a client to tell them what I think they are struggling with. Knowing the problem can suggest solutions. I don’t find it useful to argue with clients overdiagnosis. Whenever possible we start by working on the things the client thinks are problems for them. Help them find a job and the depression just may go away.

Sometimes people put too much trust in a diagnosis. What if the person who gave you that one was wrong? Learn to use that information, their view of what you are struggling with, and go from there.

Now if you have been given medication, I recommend you take it as prescribed. If it is not working or you are experiencing side effects, talk with the prescribing doctor before you make a sudden change and please do not take a med only on the days you think you need it, unless the doctor prescribed it to be used that way.

Feel free to add other helpful things, like therapy, meditation and a strong support system to your medication. Medication can only take you so far. Working on your recovery includes learning and practicing the skills you will need to maintain that recovery.

So as far as diagnosis or labels go, if they help your recovery, use them. If your label is getting in the way of your recovery don’t worry about what it is called and focus on your recovery skills.

My view – for most people labeling the problem is helpful, labeling yourself is not. You are, after all, much more than any one problem you may be struggling with.

For more on this whole label-diagnosis thing see also the posts on:

What is wrong with me?

5 Axis diagnosis esoterica

Is it a medical problem or a mental health problem?

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.