Youth Mental Health First Aid – ALGEE imposter

Posted on December 20, 2013 by David Joel Miller

Counselorssoapbox.com

Really? Do I look that much like ALGEE?

By David Joel Miller.

Algee Look-Alike

Just back from a Youth Mental Health First Aid Training. One of the other trainers took this picture and tried to assert that somehow I look like a relative of ALGEE. Really? Do I look that much like a koala bear?

For those of you not familiar with Algee or Mental Health First Aid (MHFA) let me catch you up.

Mental Health First Aid is this cool program that started in Australia and is now available in America. It is sponsored by the National Council for Community Behavioral Healthcare.

MHFA

The goal of the program is to teach as many people as possible to recognize when someone is having a mental health problem. You can also learn some skills to be helpful and to get this person the help they need.

The program is not designed for professionals; after all, by the time someone gets to us, we already know they have problems. MHFA is designed to be used just like Medical First Aid in being helpful when there are no professionals around or until you can get help for the person experiencing mental health issues.

The training runs 8 information-packed hours and is conducted by certified trainers all over America and in many other countries as well. I have been an MHFA trainer in the Adult course for a number of years.

Youth Mental Health First Aid is not meant to be a training for young people but rather a course for adults who work with young people. The goal is to help adults who work with or around young people to better recognize and respond to emerging problems in the hope that early detection and assistance efforts may help prevent some mental health issues and may help to reduce the severity of others.

The Mental Health First Aid website has a list of certified trainers and scheduled upcoming trainings. Check there for possible trainings in your area. You are also welcome to contact me about trainings, I may be doing in the future.

While Algee and I may have some superficial resemblances I do not believe that we are in any way related. We are however both interested in helping to reduce the stigma around mental illness and to help people to cope with all of life’s problems.

How about you? Are you interested in becoming a Mental Health First Aider?

Could you use some help? (counselorssoapbox.com)
Why are we so afraid of feelings? (madeleinemaya.wordpress.com)
Have You Considered Taking The Mental Health First Aid Course? (cottonwooddetucson.com)
Mental Health First Aid Training – Islington (islingtonblogs.typepad.com)
Mental Health Monsters – Depression and Anxiety (counselorssoapbox.com)

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

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

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

For videos, see: Counselorssoapbox YouTube Video Channel

Winter Blues (SAD) Prevention and Treatment

Posted on December 19, 2013 by David Joel Miller

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

Winter.
Photo courtesy of Pixabay.com

Treatments for Winter Blues.

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

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

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

Light therapy for seasonal affective disorder.

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

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

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

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

Medication seasonal depression.

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

Therapy can reduce seasonal depression.

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

Self-care reduces the impact of seasonal affective disorder.

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

Combination Therapy

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

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

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

Sad – Risk factors.

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

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

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

For videos, see: Counselorssoapbox YouTube Video Channel

Winter Blues (SAD) Risk Factors

Posted on December 18, 2013 by David Joel Miller

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

Winter.
Photo courtesy of Pixabay.com

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

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

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

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

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

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

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

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

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

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

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

Risk factors for Seasonal Affective Disorder.

The amount of daylight affects mood.

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

Genetics can increase your winter blues risk.

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

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

Eye color may be connected to seasonal affective disorder.

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

Thinking errors increase all kinds of depression.

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

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

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

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

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

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

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

For videos, see: Counselorssoapbox YouTube Video Channel

Reactive Attachment Disorder is now a Trauma and Stressor-Related Disorder

Posted on December 11, 2013 by David Joel Miller

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

Stress and Trauma.
Photo courtesy of Pixabay.com

Reactive Attainment is related to Stress and Trauma but how?

We know children can be affected by reactive attachments but now we are wondering if it might underlie some problems of adults. We know what happens to you growing up can shape and affect you for the rest of your life, how much might reactive attachment disorder be contributing to adult mental health issues?

Reactive Attachment Disorder (RAD) used to be a problem relegated to a special section on childhood issues; it has been moved to the Stress and Trauma section of the new DSM-5. Two things to consider – the way in which this childhood problem may be affecting adults and how might this be another case of how much is it affecting adults rather than a simple yes or no question.

Reactive Attachment is a serious problem for very young children as any Child Protective services worker will tell you. We have a fairly good idea of what causes it and some methods of treating it but the long-term consequences seem to get lost when the child reaches the school years and beyond.

Working with adults I see some of these characteristics from time to time. I do not want to minimize the problem in children nor do I think every adult problem should get blamed on childhood experiences. Just the same there are these tendencies we see in adults and I can’t help wondering how many of those adult problems had their roots in childhood experiences.

First the 7 criteria for Reactive Attachment Disorder (very roughly paraphrased from the DSM-5) and along the way some thoughts on how other adult issues may be like this one and may be different from RAD. For the full, precise set of characteristics and diagnostic criteria see the DSM-5.

1. The child is always or almost always is inhibited and withdrawn. They do not go to adults for comfort and when the adult tries they do not appear to be comforted.

2. Low or no social interaction with others, and does not look happy or like they are enjoying themselves. Lots of sadness, irritability, and fear for no good reason.

3. The child has been neglected and did not get their needs met by adults in their life. Parents could not or did not meet the child’s needs or the child moved from caregiver to caregiver so much no pattern of care got off the ground. Group settings with too few adults per child can also cause this.

4. We think the lack of care caused the problem. (This can be the tricky one as we may not know what this person’s care was like way back when.)

5. This is not Autism or something like autism (The DSM lists ways to tell these apart.)

6. This started before age 5.

7. The child is developmentally at least 9 months old.

Now if you got all that you should have a picture of what this neglected (maybe also abused) child might look like. This kid could be a very difficult child to raise. The just sit there and look at you.

Most kids we expect to be cute. Give them a toy to play with and they smile. Hug them and they hug you back. Not the child with RAD. This kid cries for no reason and does not stop when you hold them. They never smile and they are always irritable. They jump at the slightest sound and then refuse your touch when you try to comfort them. Getting the picture?

Now the criteria wants us to see and know all this before 5 years and know that the neglect (or abuse) caused this.

What would this child look like in ten or twenty years as they grow up and for some reason first appear in the mental health system?

What might these symptoms look like if it was not an all or nothing situation? Say the parents worked all the time and the child had to fend for themselves. They moved around a lot and had no friends or close family members?

As this person ages, they might live in various group homes. The caregiver would keep changing. They would develop trust issues. They might believe that you can’t rely on others because they will leave you.

In the teen years, this child might, still angry, irritable, anxious, act out, and get in trouble. These would be the children that blow foster home placements or move from group home to group home. Even if they lived with some family member, grandma or aunt, they would never really get close to that person and eventually, they would “hook up with” a member of the opposite sex and have some more little ones.

Not able to feel cared for they might not be able to care for their own children and they might abuse or neglect the next generation.

While Reactive attachment is an extreme case I think by now you might see how low caregiver contact, abuse, neglect, or frequent changes in living situations could produce some of these characteristics to a greater or lesser degree as the child grows to adulthood.

Not knowing or feeling loved is at the core of these problems.

We may well have been underestimating the effects of lifespan issues in our evaluation of adult mental and emotional issues.

People can and do recover from almost all forms of mental and emotional disorders, but recovery from Reactive Attachment Disorder is a difficult process.

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

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

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

For videos, see: Counselorssoapbox YouTube Video Channel

What kind of person are you? Can people really change?

Posted on December 9, 2013 by David Joel Miller

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

Change.
Photo courtesy of Pixabay.com

Are people just that way or can they change?

There are certain things about you and about others around you that are just the way people are. There are other things that change with time, with the situation, and with who you decide to be. The trick is to know what about you is just you and what things are possible to change.

There is a world of difference between being an “angry person” and being angry right now.

Some people think that they are always angry, sad, and so on and this provides a rationale for not trying to change. It also can be an excuse for bad behavior.

Someone in your life gets angry, says or does hurtful things, and then later says “that is just the way I am, you know I get angry a lot, deal with it.” It is hard to take that over the long haul. Being always full of negative emotions drives others away.

You may have said that yourself about certain characteristics you see in yourself or others see in you. But is this true or is change possible?

Spoiler alert – I believe people can and do change. They recover from what others have done to them and from what they have done. That change is often not easy and changing may have a price.

One way of understanding this is that who you are and who you can become is the difference between states and traits.

A trait is presumably a stable characteristic.

This can apply to outside characteristics like hair and eye color and to inside qualities like anger or kindness. True you can dye your hair or wear contacts to change your eye color. These efforts to change yourself do not change the underlying you. Some people might say that these efforts fall under the heading of deception or telling lies.

These underlying qualities may change as you get older. One way of explaining this is called gene expression. So the gene that gave someone Black hair in their twenties may give them gray hair in their eighties. Emotional expressions that worked for you at 9 months old will probably not work so well at 90.

Are some people born with particular emotional temperaments? Could you just be born blue-eyed and sad, or brown-eyed and angry? If you were just born that way could you learn to control or regulate those feelings? (CBT therapy and neuroplasticity research tells us this is way more doable than we used to think.)

People are not born with only one feeling. So even the irritable baby who cries a lot sometimes smiles. Angry people have episodes when they are not angry or at least less angry. (Watch for a future post on Reactive Attachment Disorder which talks about the challenges of learning new ways of feeling if you did not learn them at an early age.)

What is causing those feelings to change as situations change?

It is possible for something to “cause” or “trigger” an emotional state. One question that I ask in counseling is “What makes you happy?” And then – “What makes you sad.” Some people can quickly give me lists.

People who say nothing makes me happy, that is a red flag they may have depression.

Research has shown us that the brain continues to grow and create new connections throughout the lifespan. If you learned to be sad or anxious very early in life you can learn new ways of feeling.

Granted if you learn one language as a child and then at eighty try to learn another it is much more difficult but the good part is that no matter what age most people can still learn new information.

Learning to regulate your emotions and to move from an angry state to a calm one is possible if you chose to learn this skill. In fact, you can learn to not get angry in the first place. This does not mean you let people walk all over you and just bite your tongue. You can learn other skills to reduce the causes of your anger also.

If your life is full of anger, anxiety, or sadness you can learn skills to reduce the impact of those feelings on you and to create a new happy life. The cost of this? Some effort on your part and the need to stop making others responsible for how you feel.

To change your emotional life you need to take charge and get to work on new emotional skills. More in upcoming posts on this topic.

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

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

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

For videos, see: Counselorssoapbox YouTube Video Channel

Change

Posted on December 8, 2013 by David Joel Miller

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

Time for a life change?
Photo courtesy of Pixabay.com

Ready for the changes?

Today is Sunday. For much of the world, Sunday is the first day of the week. December is well underway. Before long the year will come to an end and a new year will begin. Many people will take a look at their lives and their situation and decide the time for a change is coming soon.

When the New Year arrives there will be a time for making resolutions and setting goals but now as the year 2013 comes into its final phase it would behoove us all to look at ourselves and our lives and to look at the things we need to bring to an end.

Before there is room in your life for new things you may well find that you have to bring some old things to an end.

What things do you need to let go of before you can find the room for a better life in the year to come?

What would your life look like if as this year comes to a close you finally began the process of change?

What exactly is this elusive thing we all say we want but that escapes from our grasp so often?

What is change?

Change:

Become or make different

Substitute something else for or replace with something else

Pass or move from one state to another

Remove one thing (as in clothing) and put on another

Exchange one thing for another

Vary a routine

A fresh set of something

A transition from one thing or state to another

To become altered, undergo a transformation, or be partly or wholly altered

Definitions adapted from Encarta and The Century Dictionary 1889.

Some thoughts about change from Goodreads;

“Here’s to the crazy ones. The misfits. The rebels. The troublemakers. The round pegs in the square holes. The ones who see things differently. They’re not fond of rules. And they have no respect for the status quo. You can quote them, disagree with them, glorify or vilify them. About the only thing you can’t do is ignore them. Because they change things. They push the human race forward. And while some may see them as the crazy ones, we see genius. Because the people who are crazy enough to think they can change the world, are the ones who do.”

― Apple Inc.

“Yesterday I was clever, so I wanted to change the world. Today I am wise, so I am changing myself.”

― Rumi

“Everyone thinks of changing the world, but no one thinks of changing himself.”

― Leo Tolstoy

“Education is the most powerful weapon which you can use to change the world.”

― Nelson Mandela

“Do I contradict myself? Very well, then, I contradict myself; I am large — I contain multitudes.”

― Walt Whitman

“We are taught you must blame your father, your sisters, your brothers, the school, the teachers – but never blame yourself. It’s never your fault. But it’s always your fault, because if you wanted to change you’re the one who has got to change.”

― Katharine Hepburn, Me: Stories of My Life

Are you preparing for the changes that will come in the New Year?

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

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

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

For videos, see: Counselorssoapbox YouTube Video Channel

Wait and see makes mental illness worse.

Posted on December 5, 2013 by David Joel Miller

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

Youth mental health.
Photo courtesy of Pixabay.com

Have you been putting off getting help for an emotional problem?

Some problems go away on their own if you just let them be others do not. Mental illness or emotional issues are not problems that benefit from delaying treatment. The majority of mental illnesses begin much earlier than we thought. Half of all those who get diagnosed with a mental illness have those symptoms by age fourteen.

Three out of four people who will develop a mental or emotional illness will have symptoms by age 24.

As early as the end of the third grade, eight years of age, we can already identify students who are at high risk for mental illnesses, emotional problems, and a future of substance abuse, dropping out of school and ending up in jails and prisons.

The conventional wisdom has been that you should not give in to an emotional problem. The truth is that walking around on a broken leg makes the damage worse. The earlier that cancer is detected and treated the better the prognosis.

Early detection and treatment of mental, emotional, and behavior problems results in a reduction in illness severity and saves lives and futures.

A whole lot of mental and emotional disorders turn up in a severe enough condition to get diagnosed way earlier than we used to think. The myth of childhood being all happy times has not proved to be true for a lot of children.

That does not mean that parents caused all these early-onset mental or emotional problems. We are still a long way away from knowing precisely why one person gets an illness and another does not. Current theories tell us that most of this is the result of the interaction of risk factors and environmental factors. Every time a cell divides there is a risk of mutation. Genetics play a role. So too does early experiences and learning. Trauma can rewire the brain.

Whatever the cause, early identification and treatment is superior to the wait and see attitude.

So what disorders are most likely to show up and at what ages?

These are lifespan issues. Preschool children get seen by medical doctors, primarily for developmental issues. Failure to eat or eliminate as others or walking and talking issues get recognized early on.

By age 6 anxiety symptoms are noticeable. Some children outgrow the shyness; some get more withdrawn as they age. Hoping they will grow out of anxiety is a risky approach.

At age 11, Behavior disorders, acting out, disruptive behavior, and ADHD start getting diagnosed.

Beginning in the teen years, about age 13, mood disorders become more recognizable. Some of the children who were being given behavioral diagnosis get their code change to a mood issue as the symptoms of depression or Bipolar disorder become clearer.

Some small number of children will get their diagnosis changed from Depression to Bipolar once they have the first manic or hypomanic episode. No mania or near mania and they should not be getting labeled bipolar no matter how moody they are. Reduced need for sleep and pressured driven behaviors also point in the direction of bipolar disorders.

The number of people diagnosed with a mood disorders increases as people get older. The number of Anxiety disorders stays relatively constant regardless of the age of the person. Exceptions to this are the increase in stress-related diagnoses as a group ages.

The younger someone is when they first develop a mental illness the more severe it is likely to be, especially if their problem goes untreated.

The same mechanism applies to learning disabilities. If they can’t read at grade level in third grade the child will continue to fall farther and farther behind until one day they give up and discontinue their education.

Anxious children give up trying new things and retreat into more and more isolation. People with depression are likely to stop trying.

Having an early onset of an emotional problem also sets up a high risk of trying drugs and alcohol as ways to cope. The earlier someone starts abusing substances the more likely they are to develop a substance use disorder.

Identification and treatment of mental health problems in young people have been woefully inadequate. The average person with a serious mental illness has the illness ten years from the onset until they arrive at treatment. Many do not get treatment until they end up in jails, prisons, or other institutions.

The cost of undiagnosed and untreated mental and emotional disorders does not solely fall on the person with the mental illness.

The mentally ill have higher rates of unemployment and underemployment.

They are more likely to be arrested. They have unstable housing and frequent changes of address. Having a mental health diagnosis is associated with poorer physical health and a shortened lifespan. This trend becomes worse the longer the delay between the onset of the disorder and the treatment.

The mentally ill also have more emergency room visits.

All these costs impact the person with the mental illness, their friends, family, and society in general.

Whether we like it or not the cost of every person with an untreated mental illness is paid for by the portion of society who is not having an illness in that particular year.

Early identification and treatment of mental and emotional disorders result in a reduced amount of suffering and countless benefits to the mentally ill, their families, and society.

If you or someone you know seem to be having emotional or mental problems seek out help as soon as possible.

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

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

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

For videos, see: Counselorssoapbox YouTube Video Channel

What is Dissociation?

Posted on December 4, 2013 by David Joel Miller

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

Confusion.
Photo courtesy of Pixabay.com

Does Dissociation really happen? What causes it?

Personally, I think there is more misunderstanding around this condition than most other mental health issues. First off Dissociation is way more common than most people realize. It comes in varying intensities; much of it is mild and goes unrecognized, denied and undiagnosed.

Dissociation, particularly Dissociative Identity Disorder has so much stigma around it that when we see it in clinical practice, I believe most clinicians call it something else more acceptable, like stress or Posttraumatic Stress Disorder, and let it go at that. This leaves people with more severe cases of dissociation with less than adequate treatment.

My view is that milder forms of dissociation are a normal protective behavior for most vertebrates, humans included. Under stress, the brain stem engages the “F’s” and takes over the functions of the brain to ensure survival.

Dissociation in its milder forms is, as I understand it, a functional survival mechanism. It is a close cousin to daydreaming and alcoholic blackouts.

Some simple examples of Dissociation.

I am driving along, I am thinking about something I need to do tonight. In my mind, I am picturing a set of slides that I want to create for the PowerPoint. I realize all of a sudden that I am miles past my freeway exit and I have no memory of driving this way. My mind has blanked out.

At this point, I turn around, drive as fast as I can, and reach my destination. Do I tell everyone about my “zoning out?” Not a chance. I make some lame excuse about traffic and getting off work late.

Next example, more severe

A woman who was gang-raped in the past is walking around downtown. She sees some men who are wearing gang colors and look kind of like the men that assaulted her. She becomes frightened and crosses the street, she begins walking fast to get away. A few minutes later she slows down. Her panic is subsiding. She looks around and finds she is walking through a neighborhood and she has no idea where she is or how she got here.

So now we can see a mechanism by which someone who is upset might do actions like run away and be functioning essentially on autopilot. High levels of stress, like high levels of alcohol in blackouts, might shut off the connection between current functioning and memory.

Does that mean this woman has some form of Dissociative Disorder?

Maybe, maybe not. The new DSM-5 lists five major kinds of Dissociative Disorders plus some specifiers and or sub-types.

This woman, now upset because this past problem, memories of the rape, is messing up her life and also a lot worried because she ended up in a strange neighborhood with no memory of how she got there comes to see a therapist.

She begins to talk about her experience. She had an experience that brought back memories of her rape (Intrusive thoughts.) She tried to avoid things, ran away (avoidance, yes.) She has been anxious for several nights since and has lost sleep over this. Maybe even had a nightmare and this has been affecting her home life and her relationship.

At this point she gets assessed, a treatment plan created and treatment begins.

She was embarrassed so she left out the part about walking for a while and having no memory how she got there.

Her diagnosis – it’s likely to be Posttraumatic Stress Disorder.

In clinical settings, stress-related disorders get diagnosed a lot more than dissociative disorders. Sometimes it is a judgment call. Which disorder are this woman’s symptoms more like? But I think we professionals may be overlooking a lot of dissociative symptoms. The result may be that in outpatient settings we are under-diagnosing Dissociative Disorder and over-diagnosing PTSD.

In carefully controlled research the prevalence of Dissociative Disorders of all 5 types exceeded 5% of the population. That makes dissociation up to 17 times more common than Schizophrenia.

Dissociative Disorders are the next chapter over in the DSM-5 from stress-related disorders. We see a huge overlap between those two groups. There is also an overlap with Borderline Personality Disorder another misunderstood condition.

If we think of all these conditions as reasonable responses to stress given the person’s biology and experiences we can see how some of the things that occur to a person with dissociation make sense.

Dissociative Disorders are most commonly found in the aftermath of traumatic events. Some of the symptoms of dissociation are embarrassment, confusion, and a desire to hide the existence of your symptoms. If you are the victim of trauma and let on how much the trauma affected you, this might put you at risk to be revictimized.

People under stress will have gaps in their memory. People with dissociation may also not know they have those gaps until someone asks about something they can’t remember. This is referred to in the literature as “amnesia about the amnesia.”

Dissociative Disorders, all 5 of them according to the DSM-5, include both positive and negative symptoms. In the past the only other disorder that I remember being described that way was Schizophrenia, but as I think about them other disorders have both also.

Positive and negative symptoms do not mean they are good and bad. What this means is that people with a disorder lose the ability to do some things others can do. This loss is called negative symptoms.

They also develop symptoms that others do not have. These added symptoms are called positive symptoms.

Since I believe people can and do recover I think that these areas of altered functioning can vary in intensity and can get better or worse depending on time, traumas, conditions, and treatment. More on negative and positive symptoms in future posts.

Another area of concern in talking about dissociation is something called state or trait theory. Trait would imply that once you got it you always got it. So if you dissociate then you are a goner and who wants to believe that. But if dissociation is a state then you can move into and out of it.

One other cause of Dissociative symptoms are efforts to reprogram or expose someone to “thought reform.” This mental reprogramming, like brainwashing, results in a brain that at some level believes two contradictory things. Can you see how that brain could pop in and out of contact with others?

Last, despite all the press about extreme cases of dissociation and the recurrent belief that this is something that only happens to women, the research tells me it is, in fact, more common among men than women. I have some theories about why that might be but that like the rest of this needs to wait till another post.

Dissociative disorders vary from person to person and from time to time. Nothing I can say will fit everyone and there is a lot to be said for listening to the “lived experience” of those who have these disorders. More to come on this topic, but in the meantime what do all of you think about this?

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

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

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

For videos, see: Counselorssoapbox YouTube Video Channel

Does Multiple Personality Disorder really exist?

Posted on December 3, 2013 by David Joel Miller

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

What Causes DID Disorder?
Photo courtesy of Pixabay.com

Are Multiple Personality Disorder, Manic-Depressive Disorder, and Addiction real illnesses?

There have been some books, articles, and blog posts recently saying that many things we are calling illness either do not exist or if they do exist they are not really illnesses but choices people make.

Some of the arguments these people are making seem to have some merit on the face, but when I look deeper there are some serious flaws in this kind of reasoning. All good lies have some truth in them and so these misconceptions about illnesses take some sorting out. Most of these efforts to deny the existence of a particular illness are cases of – if I do not believe in this it can’t hurt me.

Let’s look at some examples of ways people try to deny the existence of mental disorders.

1. Change the name and the illness ceases to exist – Denial one.

“There is no such thing as Consumption. When people believed in consumption they got it and died. No one gets it now because we know it does not exist.”

You buying that?

Consumption is the old name for Tuberculosis. Yes, people still get T. B. and die from it. We do have medication to treat it, but if you take no meds, you still can die from this illness. Changing the name did not erase the disease.

What about Manic-Depressive Disorder? No such thing right?

Well, we changed the name of that one to Bipolar Disorder so in that sense there is no such thing as Manic Depressive Disease. No difference really in the condition. Still, a serious illness and still needs treating, but not in the strictly literal sense, there is no such thing as Manic Depressive disorder anymore at least not in the DSM.

Which brings us to Multiple Personality Disorder.

The name misled a lot of people into thinking that everyone who had this issue would look like Sybil. The truth is that there are lots of variations. The new name is “Dissociative Identity Disorder” so while technically, semantically, Multiple Personality Disorder no longer exists, there are still millions of people living with exactly these symptoms; we just call this condition by a new name.

Watch for an upcoming post on Dissociation Disorders. (Yes, there are more than one of these creatures.)

2. Second denial – There is no such thing as mental illness.

The argument runs – mental illness is not a “real disease” these are just people who think or behave differently from the rest of us and we want to force them to act and think like the rest of us.

A lot was made of this a few years back. Again in a strictly semantically way, this has some truth to it. Just enough truth to be misleading.

One definition of illness or disease is a process of an organism, bacteria, or virus, invading the body, and damaging cells. The proponents of this “no mental illness” idea argued that if mental illness was a real illness we should be able to find the bug that caused it and a drug that removed this infection from the body.

Newer research on the brain is chipping away at this one. There are lots of changes that nerve cells undergo that cause a change in functioning. Thoughts and traumatic experiences can change the wiring and the chemistry of the brain.

Most mental issues are correctly referred to as “disorders” not technically diseases. The specific definition of a disorder is essentially something that causes you a thinking, feeling, or behavioral issue.

So if the emotional, mental, or behavior problem cause you to have impairment in Social functioning, (You can’t get along with family and or friends) occupational functioning (the ability to hold a job) of subjective distress (You say it bothers you) then we diagnose it as a mental disorder. The DSM-5 adds “other important area of functioning” I am still not sure what all that might be but if we find that we can give you the diagnosis also.

So while there does not appear to be any Dissociative Disorder germ, I still think that the effects of trauma can alter your emotions sufficiently that we can say you have a disorder.

3. Denial three – I do not believe in Dissociative Disorders so they do not exist.

I take this to be the funniest reason of all to pretend that disorders do not exist. Still, some people cling to the notion that there was no evolution or that the sun does, in fact, revolve around the earth.

Personally, I have taken to believing that Arizona does not exist. California just runs all the way to New Mexico. Those of you that think you live in Arizona knock that foolishness off and start sending your taxes my way.

People have denied the existence of addiction for years saying those people just chose to be that way. Some of them say the same thing about schizophrenia. Now the medical people are saying almost all medications including prescribed ones can cause tolerance and withdrawal so they all met the old definition for addiction.

We are getting around this one by eliminating addiction – it is no more. All of you that thought you knew someone with an addiction you were wrong – there is no such thing as addiction – We will, however, be treating a lot of people next year for substance use disorders and the key characteristic of that disorder will be a loss of control over their use of a substance.

See how this works.

4. Straw man argument.

The way this one goes is: When you talk about Multiple Personality Disorder or Dissociative Disorder what you really mean is –

They then proceed to spend the rest of their post arguing about things that you never said and wouldn’t have said, but it makes them feel better to win an argument even if they need to misrepresent what you think to win one.

Oh, my – another long post. So in the future let’s talk some more about all the things that we have been learning about stress, trauma, and dissociation.

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

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

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

For videos, see: Counselorssoapbox YouTube Video Channel

counselorssoapbox

Counseling, Therapy, Recovery and having a Happy Life

Tag Archives: Therapy

Top 10 Mental Health Blog posts of 2013

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Change

Ready for the changes?

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What is Dissociation?

Does Dissociation really happen? What causes it?

Some simple examples of Dissociation.

Does Multiple Personality Disorder really exist?

Are Multiple Personality Disorder, Manic-Depressive Disorder, and Addiction real illnesses?

1. Change the name and the illness ceases to exist – Denial one.

2. Second denial – There is no such thing as mental illness.

3. Denial three – I do not believe in Dissociative Disorders so they do not exist.

4. Straw man argument.

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Really? Do I look that much like ALGEE?

Related articles

Share this:

Treatments for Winter Blues.

Light therapy for seasonal affective disorder.

Medication seasonal depression.

Therapy can reduce seasonal depression.

Self-care reduces the impact of seasonal affective disorder.

Combination Therapy

Share this:

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

Risk factors for Seasonal Affective Disorder.

The amount of daylight affects mood.

Genetics can increase your winter blues risk.

Eye color may be connected to seasonal affective disorder.

Thinking errors increase all kinds of depression.

Share this:

Reactive Attainment is related to Stress and Trauma but how?

Share this:

Are people just that way or can they change?

A trait is presumably a stable characteristic.

Share this:

Ready for the changes?

Share this:

Have you been putting off getting help for an emotional problem?

So what disorders are most likely to show up and at what ages?

The mentally ill have higher rates of unemployment and underemployment.

The mentally ill also have more emergency room visits.

Share this:

Does Dissociation really happen? What causes it?

Some simple examples of Dissociation.

Share this:

Are Multiple Personality Disorder, Manic-Depressive Disorder, and Addiction real illnesses?

1. Change the name and the illness ceases to exist – Denial one.

2. Second denial – There is no such thing as mental illness.

3. Denial three – I do not believe in Dissociative Disorders so they do not exist.

4. Straw man argument.

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