What is Paranoid Personality Disorder (F60.0)?

By David Joel Miller.

There’s more than one kind of paranoia.

Fearfulness

Paranoia.
Photo courtesy of Pixabay.com

When you hear the word paranoid, most people think of the expression “paranoid schizophrenic.” Paranoia can be a part of several mental illnesses. Among the mental illnesses that include paranoia as a symptom Paranoid Personality Disorder is the most common. According to the DSM-5, estimates for the prevalence of Paranoid Personality Disorder range between 2.3% and 4.4 %. The estimate for all types of schizophrenia is between 0.3% and 0.7%. Since there are several types of schizophrenia, my rough estimate tells me Paranoid Personality Disorder is probably 10 times as common as paranoid schizophrenia.

Paranoia can also be a part of several other mental illnesses including, depression, bipolar disorder with psychotic features, other psychotic disorders, delusional disorder persecutory type. Suspicion and even paranoia may also be features cognitive dementia and substance use disorders.

There is also a condition known as “Subclinical paranoia” in which the person has milder forms of trust issues, suspicion, or paranoia. Symptoms that may cause them problems, but doesn’t quite meet all the criteria to be diagnosed as a specific mental illness. Professionals are beginning to believe that paranoia can exist on a continuum from occasional mild symptoms to the more persistent and serious symptoms that we see in those people diagnosed with Paranoid Personality Disorder.

Many cases of paranoid personality disorder do not get diagnosed. People with this disorder, whether in a mild form or more serious one, distrust others and believe people are out to harm them. As a result of these beliefs, they tend to avoid others, professionals in particular. Those with paranoid personality disorder are likely to only be diagnosed when they are involuntarily hospitalized for mental health issues or forced to be seen by professional because of criminal or legal issues.

How is Paranoid Personality Disorder diagnosed?

To receive the diagnosis of Paranoid Personality Disorder someone would need to exhibit the presence of at least four symptoms from a list of 7 possible symptoms. These symptoms involve suspiciousness, trust issues, beliefs that others are deliberately trying to harm them. The DSM calls for the symptoms to begin by early adulthood and happen in multiple contexts. This leaves us with a gray area in diagnosing paranoid symptoms which develop in senior citizens.

It’s easy to see that there can be a large mathematical number of combinations of having or not having the seven symptoms. My math tells me that there are over 5000 possible combinations of these symptoms with 840 of those combinations meeting criteria for a diagnosis of Paranoid Personality Disorder. Since we don’t have laboratory tests such as blood tests or x-rays to detect the symptoms, they are evaluated using symptom check-lists either from the patient’s reports or observations by others. Depending on how the client describes their feelings and the mood of the therapist’s that day it’s easy to call a particular symptom either in or out resulting in fuzzy diagnoses.

Many of these possible symptoms can vary in intensity. Deciding if someone has 3, 4, or 5 symptoms present can be very much a judgment call. Using more objective screening tools and checklists result in a large number of people who show some symptoms, but not enough to make the cut off for having Paranoid Personality Disorder. One commonly used instrument is the 20-question questionnaire, Paranoia Scale by Fenigstein and Vanable. Results from this scale vary from very low, occasional, symptoms of paranoid to extremely high and constant levels. In future posts, I want to talk about those people who fall in the middle of the score range on the paranoid scale, enough that they frequently experience trust issues and suspicion but don’t quite meet the cut off to be diagnosed with Paranoid Personality Disorder.

What are the 7 symptoms that may be present in Paranoid Personality Disorder?

  1. Being suspicious without good reason that others are trying to harm them, lie to them or take advantage of them. The presumption here is that the person can’t accurately perceive the actions of others. It can be difficult for the professional to determine whether these beliefs about others actions are accurate.
  2. They spend a lot of time thinking about their beliefs that others are not trustworthy, disloyal or have bad intentions.
  3. They do not trust anyone and avoid talking about their fears because of a belief that others will use what they say against them.
  4. They interpret normal, everyday events as threats or personal attacks.
  5. Holds onto the perceived attacks, may have grudges and be unwilling to forgive even accidental injuries because they believe others are deliberately trying to harm them.
  6. Gets angry and fights back because they believe others are attacking their character or reputation. The things they’re angry about most other observers don’t see as intentional attacks.
  7. Have unjustified suspicions that their regular sexual partner is unfaithful.

How does Paranoid Personality Disorder disrupt lives?

People with Paranoid Personality Disorder assume that others are out to get them. Sometimes these thoughts are totally unreasonable but other times there a matter of opinion or even experience. If someone has harmed you in the past, it’s not unreasonable to be on the lookout for other people seeking to harm you.

If your partner has cheated on you before, it’s hard to trust them again. Sometimes the mistrust makes sense but other times the injured spouse develops a persistent sort of paranoid jealousy, and no amount of checking will convince them that their partner is faithful.

People with varying levels of paranoid thoughts spend a lot of time doubting and worrying about whether the people around them are trustworthy and loyal. When you’re high in paranoia, you find it difficult to believe you can trust anyone.

Paranoia makes it harder to trust others and makes you reluctant to share personal information with others for fear they will use that information against you. They may be reluctant to answer personal questions and when asked to fill out forms may refuse to give answers to some questions saying that these things are “nobody’s business.” This high level of distrust leads them to believe that accidents were deliberate and that routine jokes were meant as personal criticism. The paranoid person is likely to take compliments as veiled insults.

There are some other characteristics of paranoia which aren’t included in the diagnostic criteria but are listed as associated features. It’s really hard to get along with people who have even moderate levels of suspicion and distrust. People who are high in paranoia are likely to be control freaks and have difficulty getting along with others.

Paranoid Personality Disorder is part of the “Cluster A Personality Disorders.” It’s common for people who are diagnosed with one of the Cluster A personality disorders to also have symptoms of several other personality disorders from this group.

Not everyone with trust issues gets diagnosed with Paranoid Personality Disorder.

As with the other things we are calling a mental illness this needs to interfere with your ability to work or go to school, your relationships, your enjoyable activities or cause you personal distress. Otherwise, you may have the issues, but you will not get the diagnoses if this is not causing you a problem. If the only time this happens is when you are under the influence of drugs or medicines, or because of some other physical or medical problem, this fear needs to be more than your situation would warrant. These other issue needs treating first; then if you still have symptoms, you could get this diagnosis.

In upcoming posts, we will look at the overlap between paranoia and substance use disorders, some possible causes for paranoia, some of the milder variations of fearfulness and trust issues as well as ways to reduce the impact of your trust issues on your ability to have a satisfactory life.

FYI These “What is” sometimes “What are” posts are my efforts to explain terms commonly used in Mental Health, Clinical Counseling, Substance Use Disorder Counseling, Psychology, Life Coaching and related disciplines in a plain language way. Many are based on the new DSM-5; some of the older posts were based on the DSM-IV-TR, both published by the APA. For the more technical versions, please consult the DSM or other appropriate references.

See Recommended Books.     More “What is” posts will be found at “What is.”

Staying connected with David Joel Miller

Two David Joel Miller Books are available now!

Bumps on the Road of Life.

You can recover. You are cruising along the road of life and then wham, something knocks you in the ditch. If you have gone through a divorce, breakup, or lost a job, your life may have gotten off track. 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 that explores the world of a man with PTSD who must cope with his symptoms to solve a mystery and create a new life.

Other books are due out soon; 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 my writing projects, speaking and teaching, along with comments on recent news in the field of counseling – 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 the about the author page or my Facebook author’s page, David Joel Miller. 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.

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Overthinking takes you nowhere.

By David Joel Miller.

Thinking the same thoughts over and over does not lead to insight.

Overthinking

Overthinking.
Photo courtesy of Pixabay.com

In overthinking you get stuck on thinking the same thoughts over and over. To gain insight, you need to think about things from a different perspective. Take a break from your problems, sleep on it overnight, have some fun, and your problem is likely to look different the next time you think about it.

Overthinking is sometimes described as racing thoughts. These racing thoughts are different from the kind of out of control thoughts described in Bipolar Disorder. Overthinking is related to anxiety disorders in that these thoughts look like a hamster in his wheel, running as fast as he can around and around in the same place. In overthinking your thoughts take you nowhere but they do increase your anxiety. The racing thoughts of bipolar take you farther and farther into grandiose beliefs and urges.

Things will change whether you think about them or not.

Whether you think about it or not the weather will change. You can prepare for the weather but worrying about it will neither prevent the storm nor make it worse. Know that, regardless of what you think, the summers and winters will come. Overthinking steals your life.

The time you spend overthinking is time you are not doing.

Living is about the things you do, not the things you think about doing. The best way to prepare for the future is by living today. It’s easy to stay busy thinking about the past, worrying about the future, all the while avoiding taking action in the present.

Don’t believe everything you think.

Sometimes we take our own thinking as evidence for the truth of what we believe. IF something is making you anxious, you need to take a good look at it, and sometimes you need to listen to your gut. Consider however that just because something scares you that does not make it dangerous. Often our preconceived views of things turn out to be wrong. Be careful that you don’t jump to the conclusion and then because you think it; you look for evidence to support that view.

Don’t recruit others to overthink with you.

Group overthinking has been called co-rumination. If every time you get together with your friends, you go over and over the same problems in life, these relationships have moved from being supportive to keeping you stuck in your problems. You don’t need half a dozen people helping you think about how awful things are.

The more baggage you accumulate, the harder it is to move forward.

Do you have a lot of baggage from the past? Do you spend a lot of time taking it out, looking it over and then packing it up again to take it with you into the future? Constantly dwelling on the mistakes and the pain of the past keeps you stuck. Learn life’s lessons but be careful not to carry any more baggage into the future than is absolutely necessary.

Overthinking prevents you from making decisions.

The more you think about something, the harder it may be to decide. Unfortunately, not deciding and not acting are decisions. Don’t let overthinking make your decisions for you by preventing you from ever doing something which might benefit you.

Overthinking destroys your creativity.

Creativity is about new ways of looking at things and new ways of combining them. If you are stuck in overthinking and worry about what the right way to do something is, you will become afraid to take the chances necessary to be truly creative. Overthinking will tell you that there’s only one correct answer and you need to find that answer. Creativity will tell you that there are many possible solutions and the more open you are to those solutions the more creative you will become.

Overthinking tells you there’s only one way to do things.

The longer you think about things more likely you are to doubt each possibility. Overthinking by pointing out the pitfalls of potential decisions takes away your choices. If you want to be truly free, don’t let your worried mind tell you that you shouldn’t make the choices that appeal to you. Often when presented with a choice, our first thought is the correct one. People who are high in test anxiety often find the more they go over their answers and change them, the lower their test score goes. Don’t let overthinking talk you out of the choice that’s right for you.

New Book Bumps on the Road of Life is now available in Kindle format for preorder. It will be released on 11/13/17. The paperback version should be ready shortly.

Bumps on the Road of Life.

Your cruising along the road of life and then wham, something knocks you in the ditch. Sometimes you get your life going again quickly. Other time you may stay off track and in the ditch for a considerable time. If you have gone through a divorce, break up or lost a job you may have found your life off track. Professionals call those problems caused by life-altering events “Adjustment Disorders.” Bumps on the Road of Life is the story of Adjustment Disorders, how they get people off track and how to get your life out of the ditch.

Bumps on the Road of life

Amazon Author Page  – David Joel Miller

More to come as other books are completed.

Thanks to all my readers for all your support.

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For more about David Joel Miller and my work in the areas of mental health, substance abuse and Co-occurring disorders see the about the author page. For information about my other writing work beyond this blog check out my Google+ page or the Facebook author’s page, up under David Joel Miller. Posts to the “books, trainings and classes” category will tell you about those activities. If you are in the Fresno California area, information about my private practice is at counselorfresno.com. A list of books I have read and can recommend is over at Recommended Books

How to stop overthinking.

By David Joel Miller.

Overthinking is harmful to your mental health.

Overthinking

Overthinking.
Photo courtesy of Pixabay.com

People who do a lot of overthinking, sometimes called rumination, increase their anxiety and their sadness. Unchecked overthinking, far from being helpful, can result in worry and leads to mental health issues such as anxiety disorders and depression. In overthinking your mind becomes your adversary, not your ally. If your mind is constantly turning things over and over and is wearing you out or if you find your overthinking has begun to interfere with your sleep and your relationships, it’s time to do something to put a stop to that over thinking.

If you suffer from overthinking here are some ways to get off that destructive path.

Notice when you overthink.

Overthinking can become an insidious habit. Become aware of when you are feeling distressed or anxious. The first step in getting overthinking out of your life is to become aware of how frequently you are overthinking. Avoid the trap of overthinking your overthinking.

Practice thought stopping.

When a child is doing something, they shouldn’t, we tell them to “knock that off.” When your mind starts taking you into bad neighborhoods, tell that mind to “stop that.” Another technique for stopping negative thoughts is to shift your focus to something positive. Search your memory for the happiest event in your life or imagine a happy event. When your brain begins to overthink possible negative occurrences, tell it to move to the positive.

Focus on the things that are likely to happen.

Most worry and overthinking is the result of an excessive focus on things that might or could happen but are very unlikely. Don’t spend large amounts of time thinking about things that are unlikely to happen. Most of the things we worry about never happen. Overthinking low probability events distracts you from dealing with the things that need doing today to prevent problems in the future.

Become a happiness expert.

Overthinking makes you an expert on unhappiness. Having a laser focus on what could go wrong obscures your vision of what could go right. People who are high in anxiety and depression develop a cognitive bias towards the negative. They don’t see the positive in their lives, and when they do they discount it. Notice small positive events in your life. When something good happens, don’t blink right away. Continue to look at and think about those positive, happy occurrences.

Avoid perfection paralysis.

Frequently people who are high in overthinking consider themselves perfectionists. An excessive focus on a perfection can leave you paralyzed. Pursue excellence. Try to become the best person possible, but avoid an emphasis on absolute perfection. Whatever you achieve should be valued.

Accept yourself as you are.

Failure to accept yourself, as you are, leads to a lot of unhappiness. However, you are, is perfectly acceptable. Acceptance values how far you have come. If you spend all your time looking for flaws you will miss your unique, individual qualities. Acceptance of yourself, others as they are, and the world the way it is rather than insisting that people places and things must be the way you want them to be will increase your happiness and reduce your anxiety provoking overthinking.

Inventory what you have not what’s missing.

Our society today, with its emphasis on the lifestyles of the rich and famous, has resulted in a lot of people believing their life is missing something. Constantly thinking about what’s missing from your life robs you of the enjoyment of the things you do have. When your focus is on keeping up with the Trumps, you will never have enough. When you adopt an attitude of gratitude, you can enjoy the people and the things you do have rather than grieve over your lack of those things that others have.

Take the long view.

Overthinking takes the short view. The focus is on what’s lacking now, the problems of today. Ask yourself what difference today’s problem will make 20 years from now? How about 50 years from now? When you start focusing on where you want to be in the future the problems of today shrink and become insignificant.

Reframe the scary as exciting.

Before an athletic contest, teams try to psych themselves up. If you expect to be beaten badly, it will take all the energy out of your performance. Worry about failing a test is likely to result in lower scores. Go into life’s adventures expecting them to be exciting and regardless of what you do you can have fun. Focusing on the scary parts of life prevents you from ever-living.

Get into action.

A great way to overcome overthinking is to get into action. Stop ruminating about what could go wrong and start doing. Some of what you do today will be the great memories you will be storing up for the future.

Staying connected with David Joel Miller

Two David Joel Miller Books are available now!

Bumps on the Road of Life.

You can recover. Your cruising along the road of life and then wham, something knocks you in the ditch. If you have gone through a divorce, break up, or lost a job your life may have gotten off track. 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 that explores the world of a man with PTSD who must cope with his symptoms to solve a mystery and create a new life.

Other books are due out soon; 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 my writing projects, speaking and teaching, along with comments on recent news in the field of counseling – 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 the about the author page or my Facebook author’s page, David Joel Miller. 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 you overthink things?

By David Joel Miller.

The more you think about things, the worse you feel.

Overthinking

Overthinking.
Photo courtesy of Pixabay.com

Overthinking, sometimes described as rumination, is a common feature of several emotional problems, especially anxiety disorders. These constant thoughts can leave you both physically and emotionally exhausted. At times, you may feel as though your thoughts are racing away without you. Because you think these thoughts so often and they are so upsetting, you may begin to believe that the things you think about are very real possibilities.

Overthinking what might happen in the future increases your anxiety. Overthinking your past, beyond the point of learning from your mistakes, can result in depression. Don’t fall into the trap of believing that going over and over the same issue in your mind, in the same way, will result in additional insight. Overthinking increases self-doubt. The over-anxious brain is constantly on the lookout for threats and magnifies the smallest risk to terrifying proportions. Here are some of the common causes of overthinking.

Overthinking is about judging yourself too much.

Overthinkers judge themselves more harshly than they judge others. Self-evaluation, looking at both the things you do well and the things that you could improve on can be helpful. If your self-evaluation does not move beyond repeatedly reviewing less-than-perfect behaviors, you are judging yourself too harshly. Using the same scale to judge yourself that you use to judge others can reduce excessive self-criticism and prevent overthinking.

Comparing up causes overthinking.

Overthinkers always compare themselves to others who are better looking, more successful or seem more important. Constantly comparing yourself to others who have more or accomplish more, results in discounting everything you have accomplished. Rather than comparing yourself to someone you admire and feeling you are inferior, look for ways to learn from what they do and improve your performance.

Focusing on the negative increases your anxiety.

When you constantly look for the negative, that’s what you will find. Avoid focusing on what’s wrong in your life. Look for opportunities to improve yourself and the life you’re living. Spend less time thinking about what’s wrong and more time focused on the actions you need to take to reach your goals. Overthinkers look for the negative and disregard the positive.

Too much attention to other people’s opinion is harmful.

If you constantly are focused on other people’s opinions of you, your self-doubt increases. Everyone will have an opinion about your life. Sometimes it’s helpful to seek out advice and information from teachers or mentors. Too much attention to other people’s opinions results in you not having an opinion of your own. Be very careful whose opinion of you receives your attention. You are living a real life, and the person whose opinion matters most is yours.

Not knowing who you are creates confusion.

Not having a clear picture of who you are, results in a great deal of confusion and uncertain. Be careful not to be simply a reflection of other people’s opinions. Get clear on your values, your goals, and the person you want to become. Learning about yourself is one of the most important tasks you will undertake in your life.

Believing mistakes mean you are flawed undermines your self-confidence.

Focusing only on your mistakes put you on the path to overthinking, self-doubt and anxiety. Don’t fall into the trap of believing that you must be perfect to have value. All humans make mistakes. Cut yourself some slack. Accept that making mistakes is a necessary part of learning, growing and becoming who you can be. Learn from life experiences but don’t judge yourself harshly. Looking only at your mistakes leads to a very negative, biased, opinion about your self-worth.

Being overly judgmental of others creates uncertainty.

Avoid judging others using a stretched yardstick. If you expect an unreasonably high standard from others, you will find that you are unable to measure up to the standard you have set. The more judgmental you are of the people you meet, the more difficult it will become for you to feel good about yourself. Humans are not infallible computers, but then computers frequently make mistakes also. Avoid expecting impossibly high standards from yourself or others. Accept that you like all other humans are a work in progress.

Work on making overthinking a thing of the past. If you’re overthinking has gotten out of control, consider working with a counselor or therapist to get your thoughts back on a helpful path.

Staying connected with David Joel Miller

Two David Joel Miller Books are available now!

Bumps on the Road of Life.

You can recover. Your cruising along the road of life and then wham, something knocks you in the ditch. If you have gone through a divorce, break up, or lost a job your life may have gotten off track. 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 that explores the world of a man with PTSD who must cope with his symptoms to solve a mystery and create a new life.

Other books are due out soon; 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 my writing projects, speaking and teaching, along with comments on recent news in the field of counseling – 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 the about the author page or my Facebook author’s page, David Joel Miller. 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.

Are you a Co-ruminator?

By David Joel Miller

What is Co-rumination and how does it affect you?

Teens talking about problems

Teens Talking
Photo courtesy of Pixabay.com

Having friends, positive ones, can be very helpful for your mental health, wellness and recovery. Talking about your problems can be beneficial. This talking through your life problems is a major part of what counselors and therapist do when they use the “talking cure.’ Unfortunately not all talking over your problems is helpful.

We know that rumination, that constant reviewing, and hanging on to your problems, can make things worse. Focus on past difficulties over and over and you are likely to perpetuate your depression. Review repeatedly those things that might happen in the future and you can crank up the levels of anxiety you feel.

One especially problematic form of rumination is when one person enlists another to help them ruminate over their problems. So how can you tell if the time you spend with a friend or supporter is helping you work through and understand your problems or is this repeated discussion making things worse?

One definition of co-rumination is the excessive sharing of problems with peers. It has been seen and studied in those with poor relationships with caregivers and attachment disorders. Those who have been abused or traumatized are more likely to co-ruminate but anyone can become a co-ruminator.

Those who co-ruminate develop more not less mental health issues.

Sharing your problems with someone else should help you feel better, not worse. Co-rumination is not just a matter of talking about your problems with someone else. It also is about how frequently, intensely and how much time you spend on sharing those problems.

If the time you spend talking with someone about your life problems does not seem to make you feel better than you may be engaged in a process called co-ruminations.

Here are some ways you can tell if the time spent discussing problems is co-rumination.

You and a friend frequently talk about your problems.

If the bulk of the time you and this friend spend together is talking about the problems of one or both of you then you are drifting into a co-rumination mode. Ask yourself do you ever talk about happy things? Do you have anything in common other than your discussion of problems? Do you talk about the same problems over and over?

Good friends can help each other through things. But if all you have in common is the problems then this is not much of a relationship.

What happens if you run out of problems to talk about? Do you share your day or do you revisit some past problem saturated conversation?

Co-rumination is talking about the same problems over and over.

If you find you are stuck on one problem and every conversation returns to that problem then this is co-rumination. Some co-ruminators take turns discussing their problems. You know before the conversation starts that when your turn comes you will be expected to revisit the problem you two always talk about.

Should you ever try to move the conversation forward to some new topic you can count on your partner in co-rumination to remind you of the time your problem occurred.

You encourage each other to talk about problems.

Do you frequently ask your friend questions about their problems? If every conversation turns into revisiting problems you are engaged in co-rumination. Certainly, it is good to have a friend you know will listen when you have a problem but be cautious if all they ever want to hear about are your problems. Good friends also share happy times.

You focus on negative feelings and what is wrong with you.

If the only topics of conversation becomes what is wrong, you are not supporting each other in being well. You and your friend should be able to switch to a dissuasion of what is going well in your life. Too much focus on the negative will make you increasingly depressed or anxious and you will find it harder to have any positive thoughts.

Talk about what something meant not what happened.

Co-ruminating talk is heavy on why and how-come questions. It is not about revisiting the story and what happened but involves trying to figure out what is wrong with you that these things keep happening. Co-rumination is heavy on blame talk and whose fault things are and short on ways to cope and move forward.

Co-rumination can be a group activity.

While co-rumination most often happens when two best friends begin to spend all their time together going over and over their respective problems it can become a group activity. Especially among teen or preteen girls. In that life stage, we see groups whose primary activity together and on social media is endlessly rehashing each other’s problems.

If all the posts on your social media page are about your problems and your friend’s problems, you have a problem sustaining relationships.

More posts on this topic are under the category Rumination.  Anxiety and Depression.

Staying connected with David Joel Miller

Two David Joel Miller Books are available now!

Bumps on the Road of Life.

You can recover. Your cruising along the road of life and then wham, something knocks you in the ditch. If you have gone through a divorce, break up, or lost a job your life may have gotten off track. 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 that explores the world of a man with PTSD who must cope with his symptoms to solve a mystery and create a new life.

Other books are due out soon; 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 my writing projects, speaking and teaching, along with comments on recent news in the field of counseling – 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 the about the author page or my Facebook author’s page, David Joel Miller. 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.

Anxiety makes you sick in so many ways.

By David Joel Miller.

Lots of illness, is it anxiety telling you to be sick?

Stress causes illness

Anxiety makes you sick
Photo courtesy of Pixabay.com

Many mental illnesses have very real physical symptoms. Those symptoms of depression and anxiety are not just in your head. Stress puts your body through some very debilitating changes. Having an anxiety disorder can look like a physical illness. If Anxiety goes on too long, those chemicals your nervous system is throwing out can lead to some long-term physical illnesses.

The mind-body connection does not just work in one direction. Physical illnesses can cause emotional problems. Emotional problems unrecognized and untreated can contribute to many physical illnesses. If you have any of the following psychical problems check first with your doctor. If that doctor can’t find a physical cause, consider working with a mental health professional to reduce your stress or treat your anxiety and depression.

Getting mental health help does not mean you are “crazy” or are losing your mind. Not getting help is you cheating yourself out of something that could do you some good.

Because anxiety symptoms mimic physical health symptoms when in doubt see your physician.

Anxiety causes sleep disturbances.

Being anxious interferes with your sleep and poor sleep contributes to physical illnesses. If you are lying awake at night turning problems over and over in your mind, a process called rumination, your anxiety is out of control and needs treatment.

Anxiety causes your mind to race.

Mind racing interferes with work and with relationships. You mind leaves on its own and there is no space in your head left for the things you need to be thinking about. Mind racing from anxiety is very different from the inattention in Attention Deficit Hyperactivity Disorder (ADHD) or the impulsive thoughts in Bipolar Disorder. In anxiety disorders, the racing mind is about what has happened and what might happen and how terrible it would be if those things were to happen.

Anxiety leads to indecision.

Anxiety uses up so much of your brain that there is not much “computing capacity” left for other decisions. People who are high in anxiety find it hard to make decisions and remember everyday items. This leads some to question if they are developing Alzheimer’s or dementia.

With Anxiety, you may find it hard to breathe.

People with high levels of anxiety tend to breathe from the upper chest, almost the throat area rather from way down deep near the diaphragm. The symptoms of this altered breathing are easy to recognize. They remind me of the dog that is out of breath and pants fast and shallow. Healthy breathing puts air in the bloodstream, anxious breathing, hyperventilating, leaves you worse off.

Anxiety leaves you light-headed.

That strange disoriented feeling, where you feel light-headed and out of things may be the result of excess anxiety. The changes in breathing described above contribute to these feelings of light-headedness.

In “Anxiety Attacks” the heart races. Having sudden episodes of anxiety is common if you are in a dangerous situation or under stress. When these events get severe they get diagnosed as Panic Disorder, a recognized mental illness.

These feelings of chest palpitations result in people with anxiety symptoms ending up in the emergency room. The first few times the symptoms of a panic attack can resemble a heart attack. You need a doctor to check you out to be sure. People who have frequent panic attacks come to recognize the difference as they have been through this before. Unless you are sure, it is wise to get this checked out. One sure way to tell the difference is to try slow breathing and hold your breath for a few seconds between breaths. As the breaths slow down the symptoms should subside if this is a panic attack.

Anxiety prevents swallowing.

Anxiety can constrict your throat and make it hard to swallow. That feeling of choking that can happen before anything has entered your mouth likely is anxiety. Fear of something bad happening can create the same symptoms you feared.

Anxiety kicks in the flight mode.

High levels of anxiety prepare you to run, There may be trembling in the legs like a car revving up to take off. You may develop the restless feeling and want to run. Some people report jelly-like legs. Sweating and shivering may also be caused by anxiety.

Anxiety disturbs your appetite.

Some experience this as a loss of appetite, others feel nauseous and unable to eat. You might also have feelings of wanting to throw up. All of these digestive interfering results of anxiety are the body’s ways of lightening the load and diverting blood from the stomach to prepare you to flee. If you really do need to run, all well and good. But if you, like many other people in modern life, have more anxiety than you need, these digestive irritations can do harm to your digestive system over time.

With all these health-related symptoms there is a huge tendency for people to ask for, even demand, medication from their doctors. Anti-anxiety meds can be helpful in the short run but reducing the stress and anxiety-provoking situations in your life coupled with other anxiety reducing techniques will work in the long run without the risk of becoming medication dependent. People who combine medication and counseling intervention seem to get past the anxiety faster.

Do any of these symptoms of anxiety affect you? Have you seen the doctor? Have you found other methods to control or reduce your anxiety?

Staying connected with David Joel Miller

Two David Joel Miller Books are available now!

Bumps on the Road of Life.

You can recover. Your cruising along the road of life and then wham, something knocks you in the ditch. If you have gone through a divorce, break up, or lost a job your life may have gotten off track. 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 that explores the world of a man with PTSD who must cope with his symptoms to solve a mystery and create a new life.

Other books are due out soon; 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 my writing projects, speaking and teaching, along with comments on recent news in the field of counseling – 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 the about the author page or my Facebook author’s page, David Joel Miller. 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.

Can’t make up your mind? Indecision, rumination and depression.

By David Joel Miller.

Indecision, rumination, and depression.

Hard to choose

Can’t make a choice?
Photo courtesy of Pixabay.com

If you can’t make up your mind it may be because you are depressed. Indecision is a common result of depression and certain types of rumination ramp this symptom up.

When you are depressed it becomes incredibly difficult to decide. Even a little depression can make decisions difficult and a significant level of depression can make decision-making impossible. How you are thinking about things, especially rumination, makes this indecision worse.

Depression impairs decision-making.

Depressed people tend to rely on others to make their decisions for them. If you find you don’t trust yourself to make a decision and you expect someone else to decide for you, it is time to take a look at this.

Depressed people tend to brood about things, turn them over and over in their head. The thinking part bogs down. The tendency is to look for global abstract reasons. What is wrong with me? Why does this keep happening to me? What you need to be asking yourself is, how you are going to get this done.

Depressed people stop trusting themselves. They do not use their intuition; that gut level information based on experience. When depressed do you stop trusting your judgment and start over-thinking everything?

Many of the symptoms of depression involve reduced ability to make decisions. When depressed there is less rational reasoning coupled with low activity levels. Can’t do and can’t decide defines depression. There is also less information gathering going on. The result of all this avoiding making decisions and self-doubt is an increase in negative emotions. Increasing negative emotions creates more severe depression and so the cycle goes.

Indecision and low self-esteem.

Indecisiveness has been linked to low self-esteem. Can’t decide you feel bad about yourself. Feel bad about yourself you will find it hard to decide. The result if indecision is more procrastination. One culprit in this indecision, low self-esteem connection is that ancient enemy perfectionism.

Perfectionists have trouble deciding.

If you are one of those people who are trying to be perfect, a largely neurotic trait, you will never make it. The search for the perfect prevents what can be.

This human fallacy, the search for abstract universal answers, leads to the wrong conclusions. It is not “why do bad things happen to me” or anyone else. The questions you should be asking is what are you going to do now and how will you do it.

We should note here that researchers have concluded that not having a good vocabulary to describe what and how you are feeling can result in an increased risk of depression. You need to have words for the feelings to begin to work on the consequences.

Rumination does more than result in an increased risk of depression and more difficulty making decisions. Depressed people who do decide are less committed and more likely to have difficulty following through on the course of action they have decided on.

The solution to all this indecision, rumination, depression, resulting in more indecision trap?

Gather all the information you can. Make the best decision you can and then stick with it until contrary information comes in. Stop looking for global reasons and look for the facts in this specific instance.

If indecision is plaguing you or you feel like simple decisions are beyond your ability consider getting some professional help.

Staying connected with David Joel Miller

Two David Joel Miller Books are available now!

Bumps on the Road of Life.

You can recover. Your cruising along the road of life and then wham, something knocks you in the ditch. If you have gone through a divorce, break up, or lost a job your life may have gotten off track. 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 that explores the world of a man with PTSD who must cope with his symptoms to solve a mystery and create a new life.

Other books are due out soon; 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 my writing projects, speaking and teaching, along with comments on recent news in the field of counseling – 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 the about the author page or my Facebook author’s page, David Joel Miller. 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.