Do people really need to stay on anti-psychotic medications over the long haul?

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

Drugs

Medications.
Photo courtesy of Pixabay.com

Are psychiatric meds for life?

The conventional wisdom has been that one you were put on an anti-psychotic you were going to be on it for life. People who stopped taking their meds were at high risk for a relapse.

Now comes a blog post, from no other than the director of the National Institute of Mental Health, reporting that we may have been wrong about this.

You can read the full director’s report at the link below.

http://www.nimh.nih.gov/about/director/2013/antipsychotics-taking-the-long-view.shtml

Please do not read my post or even the Director of NIMH and stop taking your meds. Talk to your doctor first.

But consider that meds and meds alone may not be what you or others with a mental illness really need.

You might also want to talk a look at Aaron Becks book on cognitive therapy and schizophrenia. The link is below.

Schizophrenia: Cognitive Theory, Research, and Therapy

“Counselorssoapbox is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to amazon.com.” We recommend only books we think are good and maybe occasionally make a buck.

So as with all other treatments, one size, one method is not the right approach for everyone.

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 to turn anxiety into paranoia

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.

SasquatchWandering 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

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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 my Facebook author’s page, davidjoelmillerwriter. If you are in the Fresno California area, information about my private practice is at counselorfresno.com.

Blaming obese older parents.

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

Older people

Elderly couple.
Photo courtesy of Pixabay.com

Do overweight older parents produce kids with birth defects?

There have been a lot of articles recently telling us that older parents are more likely to have children with autism, schizophrenia and birth defects. Is this true? And if it is true how do we explain what is going on here. Clearly, not every older parent has a child with a mental illness or birth defects. Nor do all offspring from obese parents develop autism or schizophrenia, not by a long shot. But the studies suggest an increased risk here. What is really going on? Here is my oversimplified counselor – metaphor explanation.  For a more scientific explanation, you may want to talk with or read doctors and geneticists explanations.

My grandmother would be horrified with the thought that there could be such a thing as a baby or a mother being too fat. In her time skinny babies died a lot more than plump babies. Skinny mothers died more often too.

She was right about that, as far as it goes. Women who are significantly underweight from poverty, illness, or an eating disorder are more likely to have a miscarriage, a low birth weight baby or a child with birth defects. Not eating as a result of anxiety or depression can cause these problems also. But too skinny mothers are not the major source of problems. Not in this century anyway.

Grandma also had lots of aunts and cousins who had very large families. Women had children starting as young as they could and kept it up as long as they were fertile. That was before birth control. She just might have been right about baby’s needing to have some weight on their bones to survive. But there were some things grandma didn’t know.

Grandma wasn’t near as concerned about the age of the parents either. Older men marrying a very young woman was the norm and for good reasons. In colonial days there were forty sometimes fifty or more men for every woman. So the day that a woman began to have her period the men started calling on this marriage prospect. Lots of women married much older men because the men were financially secure. They married older men and then outlived them and married again.

Men remarried a whole lot more then than now also. People didn’t need to divorce then, their partners kept dying.

Women used to be a lot more delicate than they are now. They died in childbirth and they died every spring of the milk sickness. There were also food shortages and epidemics. Skinny people died a lot. Hence the belief that fat was healthy. Now we know that is not the whole story.

We have long suspected that the father’s age was a factor in some things like schizophrenia or autism. This became more of a theory as there were plenty of young men and fewer old men on their third fourth or fifth wife. Women did not use to have so many children late in life. Now with birth control, postponing children and fertility treatments there are, percentage-wise, more children born to older mothers. That has started us wondering if the mother’s age matters also.

Grandma would have said that healthy kids and long life were in the genes. She would have been partially right.

Genes are not the whole answer! The same gene can do different things at different times in your life. So there are genes and there is gene expression, how the gene acts when in a certain time and place. Think of this as manners for genes.

My genes gave me that nice dark hair when I was young. Somewhere along the way, they decided I was old enough I needed to look the part so now they give me gray hair. I am pretending they are not turning the gray to white. The Same gene for hair color but different age and different hair color. If I had a child at this age they could inherit the dark black hair of my youth but I am stuck with the old man color for no better reason than that I am getting – well older.

Now no cell is made to last forever. Cells like people need to reproduce. I hear that cells replace themselves every seven years. For argument’s sake let’s say that this is true. Why do cell mutilations keep happening? Why do cells have birth defects?

Think of this as the “copier theory of cells.” Every time a cell reproduces it makes a copy of its self. Have you ever made a copy and then when you can’t find the original had to make a copy of a copy? The more generations the copy goes through the more chance it will be fuzzy and someone will read it wrong. Older cells may get fuzzy also. The more copies the more chance for changes – mutations to creep in. Some of those changes in humans may be good things, adaptive changes. But most gene changes cause birth defects.

So what does being overweight or drinking alcohol have to do with birth defects? Alcohol for the record causes more preventable birth defects than anything else. Why is this?

Ever seen someone mark up an original before copying it? Imagine with me an original with white-out on it and some highlighter marks. Now before this stuff can dry the person puts the original on the copier glass and makes their copy. That messy stuff gets all over the glass. Every copy we make now has all those marks on it. They are all hard to read.

So when there are chemicals in the parents’ bloodstream, like alcohol, the copies that get made are fuzzy. More alcohol and the copies get worse. We know alcohol and drugs blur the mother’s contribution to the child’s genes. We also suspect that some chemicals may blur the father’s contribution also.

We used to think that if the mother took in too few calories bad things happened to her and the potential baby. Excess calories were stored as fat in the mother. No harm to the baby there right? Not so fast.

If the mother develops diabetes that high blood sugar could have an effect. So could all sorts of other hormones. So we think that the more overweight the mother the more the risks to the child. Now, remember risks do not equal disease. You can have a risk factor for a disorder and not get it. Strenuous excesses and severe dieting during pregnancy or when you are trying to get pregnant are not recommended. But the mother’s overall health, her efforts to keep her blood sugar under control and to avoid toxins, especially alcohol, just may increase the chances of a healthy child.

Being older or overweight may not be reasons to avoid having children but the increase in risk factors may explain why we are seeing more children born with certain mental and physical illnesses like autism, psychosis, and ADHD.

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.

Not everyone who hears voices is psychotic

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

All radios

Not everyone who hears voices is psychotic.
Photo courtesy of Pixabay.com

Did you hear that?

People in our society tend to think that hearing voices means you are crazy. We tell stories about this and we laugh at jokes, sometimes not too nice stories and jokes. It makes some of us feel safer to think that those who hear voices are not like us. We say that, even when we have heard the voices.

The truth is that most people hear voices. Sometimes we count the voices towards a mental illness and sometimes we don’t. The counting makes something a problem and other things, not so much.

The majority of all teenagers hear and have heard voices. One author says as many as 70% of all teens hear voices. Don’t be so quick here.

Have you ever thought you heard someone calling your name, looked over your shoulder and saw no one there? Did you shrug it off? Did you pretend it didn’t happen? Some people think if they don’t admit they have symptoms then they are all right.

Truth is our brains sometimes try to help us out and sometimes they are wrong when they do it. You hear a sound. You can’t make it out. Your brain turns it into the closest thing to something it recognizes, tells you someone is calling your name. Sometimes it may only be your own thoughts but if you are concentrating on something you forget which is in your head and which is in your ear. Your brain makes up a story to help you out. Sometimes the brain is wrong.

Sometimes we get thoughts in our head. It is like someone is telling us to do this – no don’t. Some people interpret this as an angel on one shoulder and the devil on the other or maybe it was your conscience. For a moment the voices sound real. But when you try to get them to stop can you make them shut up? People with a psychosis like schizophrenia can’t make the voices stop when they try.

Ever see or hear a dead relative come back to talk with you? How about an angel or religious figure? One rule psychologists follow is if this thing you see or hear is religious in nature or if you are grieving then we tend to disregard that experience. It happens a lot, you should get over it on your own. If not seek help.

If the thing you see or hear is all good and encourages you to do well, we are not so worried here. Unless it bothers you or the voices get too loud for you to think. But if the voice in your head tells you to kill people or break laws, we think this may be a big problem.

Ever been lying in bed and thought you saw or heard something in the room? When you are about to fall asleep or if you are asleep and start to wake up, images and experiences from your dream world can get dragged into the conscious world. We have special names for this, hypnogogic and hypnopompic hallucinations. We don’t count those experiences as a mental illness either, not most of the time because most normal people have these.

I should also mention that most hallucinations involve hearing things. Most of the times when people see things it is drug or alcohol induced. People with mental illness usually hear things, at least in the early stages.

We should also mention here that auditory hallucinations caused by mental illness are about the rarest kind of mental illness. There is much more depression and anxiety out there than schizophrenia. Not all people with schizophrenia are paranoid and not all people with paranoia have schizophrenia. Not by a long shot.

So aren’t people with schizophrenia violent and scary. No, not really. People with a mental illness are no more likely to get violent than anyone else. If someone is hearing voices give them some room, don’t crowd them and for sure call for some professional help.

So don’t people who hear voices scare me? Not half as much as the person who just found out their spouse was cheating on them and now they have brought their gun to work to fix this situation.

There is a great training on what to do if you encounter someone with a mental health crisis.  That program is called Mental Health First Aid. Have I mentioned that before? Check my other posts for more info. This was just a quick look at the whole area of hallucinations and mental illness. If you or someone you know has a problem in these areas please seek out professional care.

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.