Do the mentality ill need to stay sick?

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

Mental health care is caught in a bind.

Mental Health or Mental Illness

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

What are we to do about the mentally ill? Our systems of care are stuck on the very sharp points of a modern dilemma. Most of those care systems are set up to care for the sick. We assume that there are two kinds of people, the “normal” ones and the mentally ill ones. Despite all the evidence that across the lifespan the two groups are largely indistinguishable, our programs are primarily focused on, sometimes restricted to, treating the ill.

We have systems in place to treat the sick. Often these programs are poorly funded and access is limited to only the most severely impaired. Despite their inadequacies programs do exist. Unfortunate our systems of care aren’t always prepared for people getting well.

The traditional mental health treatment paradigm consists of identifying a problem that could respond to our available treatments. Give them meds, give them therapy, manage their lives for them. Sometimes the system expects to cure them, a few of them, and send them away.

Only we know that paradigm stopped working in physical health a long time ago. Most health problems, mental or physical, do not get cured. They are chronic. You don’t get cured of diabetes, you get your symptoms under control. Then if you are no longer critically ill we need to move you out of the treatment facility.

Mental health systems only treat the ill.

Despite much evidence that people with mental health and substance abuse disorders recover, we insist that if they are to continue to see the doctor they need to remain sick. If their current care does not meet “medical necessity:” then they are not eligible for services. Keeping someone well, supporting their wellness is just not in the program.

Once you “flip out” and try to kill yourself or others you are eligible for help. Until that time no services for you.

Preventive medicine has not yet reached mental health.

Repeated studies have demonstrated that for every one dollar we spend on substance use treatment we save seven dollars in incarcerations and criminal justice costs. But until you commit a crime and do your time you are not eligible for rehab.

Strength-based recovery works so no one pays for it.

Treatment plans begin with current symptoms. The assessment form may start off with a history of the present illness, not what life problems has this person had to overcome and what strengths have they been using so far.

The biased assumption of this approach is that there is somehow something wrong with this person. The possibility that life and its stressors have overwhelmed you rarely comes into play.

If you want treatment you need to stay chronically ill.

Generally, once the symptoms subside the client gets discharged. The recommendation is when you feel like killing yourself again, call us. What is missing is what can we do to help you get well. If you want help you need to stay sick. Get too healthy and your encouragement gets withdrawn.

The system perpetuates itself by encouraging people to think that they cannot and shouldn’t get better. Disability rather than a temporary support has become an all-or-nothing program. Stay sick and we will help you. If you decide to get better you are on your own.

There are some exceptions To the stay-sick requirements.

I realize that there are some exceptions to this paradigm, that you need to be very, very mentally ill before you can get coverage for your mental health issues. Some non-profits try, a few governmental programs are designed to help people stay well and continue to have productive lives. But those few programs are the exceptions. They are constantly hampered because they need to find funding sources to pay for prevention and rehabilitation services. Most funding streams are only available to treat illness and to get help in these places you need to stay ill.

What is needed to improve mental health?

What is sorely needed in the mental health and the substance use disorder field is a seamless system of care. People need accesses to brief counseling when they are going through life’s difficulties before those problems derail their life.

We also need mental health systems that assume people will get better and can have a happy productive life. Those systems should be able to offer help and encouragement during the difficult times without requiring you to prove you are permanently mentally ill to qualify for treatment.

Most importantly, systems of care ought to emphasize helping people reach their own happy life goals rather than requiring them to stay sick if they want help. Episodic and preventative care needs to replace the current program of requiring people to prove they are seriously mentally ill and will promise to stay that way in order to receive help. Outcome measures need to focus less on how many severe symptoms you have and more on how you are progressing on having the best life possible.

Wellness and recovery needs to move from being a slogan to being a reality.

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.

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Hacks and Life-hacks.

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

Is this a hack?
Photo courtesy of Pixabay.com

The meaning of “Hack” has changed.

One of my younger colleagues was talking to me about the desirability of “hacks.” This word like so many others has changed its meaning, not because the dictionaries had it wrong, but because people started using the word differently and then the dictionaries are having to change their definitions to keep up with the way people use the word.

As an old guy, this changing my vocabulary and changing my metaphors so as to be understandable to the younger generation is a challenge. Mentions of Milton Berle get mostly dumb stares these days. The word hack, for me, is especially challenging.

I am familiar with Lifehacking sites, I even subscribe to their email. It is just that I had no idea how many other areas of life were getting hacked these days.

Hack used to be something else.

Hacks used to be cabs you called to take you somewhere. In that sense, I can see the use of the term life hack. These little tips are meant to help you get from where you are to somewhere else, quickly or more easily.

A “Hack” also used to be someone who did things in an unprofessional or half-hearted way. Calling a journalist a “hack” as in writing an uninformed or factually incorrect story was one of the worst things you could say about a member of the third estate. Hack writers were thought of as being unoriginal and mediocre. In that sense, I would not want a hack writing my life hacks.

There is also hacking into computers, as in unauthorized entry and hacking things up with an ax, neither of which seems to be related to those other definitions of hack.

Today Hacks, life or otherwise, have become accepted as short, useful ways to do things better, faster and more easily. In an era when there is far more skimming than reading going on via the internet, using hacks makes sense. Skimming used to be a bad thing as in taking money out of the till which involved stealing or cheating on your taxes, but today skimming is grabbing the cream off the top of the article without reading every word. See the old guy is catching on.

Henceforth counselorssoapbox.com will be embracing Hacks, – sometimes.

As we look more at how to improve life, wellness, and recovery, and less at diseases and disorders, looks like Hacks have their place. It also appears that a number of the posts on counselorssoapbox.com in the past were in fact “hacks.” How to improve your memory, how to be happy, and so on.  I would also include recovery tips in this category. So life hacks will now get their own category.

What about relationship hacks?

Not sure. Some of you youngsters need to let me know how far this hack thing should extend. Do we need friend hacks, memory hacks, etc or can we just lump them all together as life hacks? For now, just an added link to the posts that feature hacks and you can sort through them or look in the other categories for hacks.

Here is the link to the counselorssoapbox.com life hacks.

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.

Suicide – Addiction Proclamations.

Proclamation, Proclamation so many Proclamations.

Town crier proclamation.
Photo courtesy of Pixabay.com

By David Joel Miller.

Two very special proclamations came across my desk on the very same day this week. The president has proclaimed September as National Alcohol and Drug Addiction Recovery Month.

Here in Fresno County, California, our Board of Supervisors has declared September 7 through September 13th as Suicide Prevention Week. I suspect that lots of other jurisdictions are issuing proclamations for Suicide Prevention Week what with The World Suicide Prevention Day coming up on September 10th.

Why does Suicide Prevention Day and Week share the attention with Addiction Month?

Turns out there are a lot of connections between addiction, alcoholism, and suicide. Addiction, suicide, and mental health issues all co-exist and these are challenges that many people are reluctant to talk about. As uncomfortable as having these conversations may be they are topics we all need to think about and be prepared to discuss with those we come in contact with.

Most people are uneasy with the topic of suicide. Professionals get special training in how to talk with clients about their urges to self-harm and their thoughts of suicide. Even with that training, there are counselors who feel uncomfortable asking the simple questions like “Are you thinking of killing yourself?”

No one should ever feel uncomfortable with this question. If you have concerns about someone ask away. Just make sure you ask in a caring non-judgmental way. I see no evidence that asking someone if they are thinking about a suicidal act will put the idea in that person’s head. Many people who have started to think of suicide as a solution to their problems are just waiting for someone to care enough to ask.

Learning about mental illness, suicide prevention and substance use disorders.

At some point in your life, you will encounter a person with a mental health challenge, an addiction or possible you will cross paths with a suicidal person. What should you do? One important thing to do is to prepare for those possibilities now. An excellent source of information on mental health issues is the Mental Health First Aid course.

Certified Mental Health First Aid instructors are available across the United States and most of the rest of the world. Consider taking the class or better yet get your group to sponsor trainings in your area. If you need more information please feel free to leave a comment or contact me.

There is also a special Mental Health First Aid training for those who work with youth which trains you how to respond to a youth who is having mental health issues.

One other handy resource for a potentially suicidal person is the

National Suicide Prevention Lifeline – 1 (800) 273-8255 which has services available 24-7 and in both English and Spanish languages. Website: www.suicidepreventionlifeline.org

Your local 911 or emergency number is also a good resource in a crisis.

Why the connection between suicide prevention and addiction?

We find that those who drink heavily, binge drinkers, are about fifty-five times more likely to attempt suicide. Intravenous drug users are about fourteen times more likely than the general population to try to suicide. Other drug users? Any drug use disorder raises the risk of a suicide attempt by at least tenfold.

If you know someone who has a substance use disorder encourage them to get help and learn all you can about the impact that substance use disorders are having on our country.

People with an addiction can recover.

This month during National Alcohol and Drug Addiction Recovery Month it is important to emphasize how very possible it is to recover from an addiction, a mental illness or other emotional challenges. People do change, recover and go on to live happy productive lives no matter what the challenge is they have faced.

Today, this week, and all this month think about the problems we all face whether we know it or not, every day with addiction, substance use disorders and the possibility that someone close to you may start thinking that suicide is an option for them.

Maybe together we can all do just a little to help those who are feeling hopeless and helpless today.

Photo by Marcus Jeffrey 

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.

Can you spare a cup of hope?

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

Cup full of hope.
Photo courtesy of Pixabay.com

Do you have enough hope in you that you could share some?

Hope seems to be in short supply. People find it hard to hope. Hope is something that makes recovery possible. So what is someone to do who has lost hope? Maybe you can be that “cup of hope” this other person needs just now.

The quote “Can you spare a cup of sugar” goes back to a different time in our history. There was a time when people could go to their neighbors and ask for the loan of something that they needed at that moment. Asking the people around you for help seems to be less common these days. Help, like hope, seems to require you to pay a price nowadays.

Some people just are afraid to be involved with others. Connections are fraught with danger. So there are some of you who I know will not open your door. Not for a cup of sugar and certainly not to offer a neighbor some hope that things can get better. Has it really reached the point when offering up hope is a dangerous thing to do?

Sometimes we see people who need help and we wonder if helping them is something we should do. Giving an addict money may only add to their addiction. Giving them food may keep them alive today. But if you give someone hope then they may change their lives.

Hope is one of those commodities in short supply these days, like water in the desert. We are all wishing for the rain to end the drought but when will the showers of hope come?

Hope is one of those “core” values in a Wellness and Recovery Action Plan (WRAP.) Without some measure, a cup or a teaspoon full, of hope recovery fails to materialize. Sometimes all we can offer a struggling person is the “Hope that they will be able to cultivate a crop of Hope.”

Twelve-step groups talk about “sharing their experience, strength, and hope.”  People who have found recovery seem to have enough hope to spare. Hope comes from a well that never runs dry. The more of this hope thing you share the more you have. Without hope people perish, with hope, they thrive.

The seeds of hope are everywhere. What is lacking sometimes is a person to nurture them. Hope starts with a smile to someone who can’t smile. It grows in the attitude that someone believes this person is of value no matter what their current position. Judgment and disdain prune hope back.

Hope is the chance to find a job when you had come to believe you would never work again. Hope is seeing your family when you thought that connection was gone forever. Hope is a place to sleep for the homeless and a meal for the hungry.

For some hope is knowing that there is someone in your life who believes in you when you find it hard to believe in yourself.

In this country, one of the wealthiest on earth, it is hard to imagine that hope is in such short supply. How have so many lost their hope and see only the bad that can occur when every day there are miracles growing from the seeds of hope planted by caring people? Has hope become too precious and expensive for all of us to be able to share a “cup of hope” to those in need of an extra cup of hope?

Do you have enough hope that you can share some?

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.

Are you catching a mental illness?

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

Mental Health or Mental Illness

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

How would you know if you were becoming mentally or emotionally sick?

Some mornings I wake up a little out of sorts. Maybe a cough, maybe a headache or just a general feeling of tiredness. Am I getting a cold or flu or is this just a difficult morning? This is the allergy season, or maybe it is the cold and flu season, am I coming down with something? I hope not.

There is this morning routine, for me, it is mostly the same each day. Hit the bathroom, comb my teeth and brush my hair, no wait, that should be the other way around. Maybe just brush them both. Then I take my vitamins and an allergy pill and hope the headache or other symptoms will go away. Blowing my nose, that might help also. You get the idea of my routine? Lastly, I feed and water my cat and slow down long enough to pet her a few times.

But if, after a while, I am not feeling better, say after my morning coffee and some light breakfast. Now I am thinking maybe I am getting sick. If by mid-day I am still coughing sneezing and feeling tired something is surely wrong.

What would happen if I were developing a mental or emotional disorder? Would I know? Do you?

This does not mean that you could catch a mental illness from someone the way you might catch a cold. We know of no germ that will get you mentally ill. Hanging out with someone who has schizophrenia will not give it to you. Being around someone with Bipolar Disorder will not make you Bipolar. Being “stressed out” or living an unhealthy lifestyle, that may put you at added risk to develop a mental illness, however.

We believe that there are things that you might do to wear your body out and increase your risk of a physical illness, staying up to late, not enough sleep, poor diet and being in unhealthy surroundings all increase your risk of getting a cold. Taking good care of your physical body will reduce your risk of physical illnesses. But you might do everything right and still catch a cold. Same thing is true of depression, anxiety, stress-related disorders and a lot of other emotional and mental illnesses.

If I am sneezing, coughing, have headaches and so on I am thinking cold. There are certain signs and symptoms that should make me think maybe I am developing an emotional problem. Remember my daily routine above? The last thing I do before I start my day is feed, water, and pet the cat. If I forget to do this, or just do not feel like doing it one morning, this is, for me, a sign that I am not mentally at my best.

These signs and symptoms are different for everyone. How would you know if you are having a good day? How would you know if you are having a bad day?

Being a professionally trained person I know and could rattle off the symptoms of a number of mental disorders. For me, they are relatively easy to spot during an initial assessment interview. But let them happen to me personally and I may not notice these signs till it is way too late. Remember that mental health professionals are not immune to stress, anxiety, and depression. We should know tools to work on those things if they ever happen to us, but most professionals, like other people, don’t always spot those instances in ourselves until someone else notices them.

One thing that is very helpful is to take a look at your life, daily and maybe in longer increments. What do you do when feeling emotionally at your best and what are you like when you are getting less well?

By knowing what you are like on a good day and then what you are like when things are headed in the wrong direction you are in a better position to do something about those off days before they become stretches of mental illnesses.

If you want more information on this topic, how to get and stay mentally well. Take a look at the works of Mary Ellen Copeland. Her WRAP (Wellness and Recovery Action Planning) program includes lots of material on this and many other areas of life.

WRAP has come from the consumer movement. People who have had a diagnosed mental illness and have recovered. People who have been brave enough to talk about their recovery. This information has influenced the direction of professional treatment. Professionals like Kay Redfield-Jamison who have openly talked about having a mental illness have also impacted the view we take of treatment for mental illnesses.

There was a time when professionals thought that once you had a mental illness, that was it, your life now needed to be turned over to others to control. We know now that throughout the lifespan people can become less well or they can become more well and that there is this thing that we now call the wellness and recovery continuum.

My suggestion to those of you who have read this far is to educate yourself about mental health and wellness and see if there aren’t things you can do to improve your mental health no matter where you may be on that wellness and recovery continuum.

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.

Mental Illness or Mental Health?

By David Joel Miller.

Do people have a mental illness or are they in poor mental health?

Mental Health or Mental Illness

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

The language we use influences the way we think about things. Talking about mental illness or talking about mental health is a prime example of this issue. While the two expressions turn up in much of what is currently being called “Behavioral Health” literature the implication embedded in these two terms influence what we expect and how we react to the people being referred to.

The mental illness paradigm.

The older, traditional way of looking at the subject of mental illness was to assume that there were two types of people – the “normal” folk and then those other “mentally ill” people.

One implication of this concept was that people with a mental illness were not able to do things other people could do. The result was programs and policies that assumed those with a diagnosed mental illness would need lifetime help to manage their lives.

There was a time when those with a mental illness were lumped together with those who had significantly lower I.Q., once called the “mentally retarded” or “developmentally delayed.”

If we think in terms of mental issues being a disease or disorder then the first line of treatment as with physical illnesses, should be medication and surgery, the standard treatments of choice for physical illnesses and conditions.

Despite over half a century of treating mental illness with medication and surgery the number of people who are diagnosed with a mental illness continues to rise. Fewer seem to be getting cured but everyone now gets diagnosed.

The Mental Health option.

If we think in terms of mental health, then many other things follow. Many of the things we have been referring to as mental illnesses become a matter of degree rather than an illness that you have or do not have.

Something bad happens to you, you lose a family member or a job, you become sad, a normal human emotion, then eventually you should get over sadness no treatment needed. Should you become too sad or the sadness persist too long then the label and the corresponding treatment would change.

Sadness or grief becomes Major Depressive Disorder when it gets out of hand.

Another example – Anxiety.

We have a range of Anxiety disorders. Now anxiety is a close cousin to afraid or scared. So if people are shooting at you I think you should be scared and duck behind something. That scared, anxious, avoidance of things may save your life.

But should that anxiety begin to get out of control, every time you hear a car door slam or see someone on the street, if you become too anxious to leave your house, that is a problem.

Clearly, most of the things professionals diagnose as an anxiety disorder are much more severe than the things we consider normal but it is easy to see how the two overlap.

Wellness and recovery.

The concepts of wellness and recovery have challenged the way we think about this issue. If we allow that people can move back and forth on the continuum of mental health then there would be times when a particular person was mentally ill and other times when they were in better mental health.

Rather than thinking exclusively in terms of mental illness and diseases we should be thinking about mental health as similar to physical health. There are times we are in better health than at other times. Someone could have “poor mental health” and be in need of prevention or restorative services long before they reached the point of what we have been calling a mental illness.

The Mental Illness Violence dilemma.

The news has been full of accounts of people who became violent and harmed others. The common discussion revolves around whether they were “mentally ill” and why no one had detected their illness beforehand and prevented that violence.

What if that person had been in poor mental health for some time and then eventually their mental health deteriorated to the point it could have been diagnosed as what we are currently calling a mental illness?

Could an intervention have been conducted while this person was in the pre-mental-illness stage that would have prevented their condition from deteriorating to a mental and a behavioral issue?

If the mentally ill are somehow different from the normal people then no, no prevention is possible but if there is such a thing as mental health that gets better and then gets worse and then better again there are things that can be done to prevent relapses into active mental illness.

We have had that violence – mental illness connection wrong.

A little more on the mental illness violence connection. Those with a mental illness are far more likely to be the victim of crime rather than the perpetrator.

Most of those workplace and school shootings? Those were often the result of someone who appeared normal or close to it until they were fired from their job, served with divorce papers or found out their partner was cheating on them.

Remember, as reprehensible as it is that even one child died in a school shooting, each year for every child who dies in a school shooting, from ten to twenty children are shot at home by a biological parent who then shoots themselves.

Rather than having had a long-term diagnosable mental illness I believe there is good evidence that many of these violent incidents were the inability of this person to cope with an identifiable stressor. Their problem was not a long-term severe mental illness but their inability to cope with stress that pushed them into a poor mental health state.

Many have suggested that the mental illness is just the way they are not to blame them for their having a disorder. I agree that they are not to blame for having gotten a mental illness. I doubt that anyone chooses to be sick mentally or physically.  That does not mean that the mentally ill have no hope and need to resign themselves to always being too sick to function. Recovery can happen. We see it happen every day.

Throughout the year I want to talk more about some of the tools that can be used to keep yourself mentally healthy and to reduce the impact of illness when it does occur.

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.

5 Reasons Mental Illness and drug use hangout together.

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

sign

No Drugs.
Photo courtesy of Pixabay.com

Why do so many people have both Substance Use Disorders and a Mental Illness?

Having multiple problems is so common today that we are surprised when someone shows up looking for help for one and only one problem. People who have a mental illness often abuse drugs or alcohol. People with a Substance abuse disorder frequently have one or more mental illnesses.

The overlap is so common we have come to expect that someone who has one life problem is at risk to develop another. When people have more than one problem it is hard to recover from one unless the other gets treated.

The old method was to ask the mentally ill to give up drugs and alcohol, stay clean 30 days and then they could get help for their mental illness. Substance abuse clients were told to go get their depression or anxiety treated and then come back for drug treatment. The result was people with multiple problems who were ping-ponged back and forth between providers and many never got the help they needed.

The newer approach is to treat multiple problems all at once and improvements in one life area help recovery in other areas. So why are mental health problems so very common among those with substance use disorders? Here are some of those reasons.

A prior Mental illness puts you at risk to abuse substances.

Having a mental health problem puts you at risk to use substances to cope with your issue. Someone with anxiety finds that alcohol or drugs help them get past the anxiety and be more outgoing. The more of a drug they do the better they feel. Before long this use is out of control and becomes first a habit and then an addiction.

A person with Post Traumatic Stress Disorder will find that chemicals, alcohol or drugs, numb the symptom. Some people drink to forget the depression. All of these uses of chemicals to cope with a mental health issue could fit under the idea of self-medication. Using drugs and alcohol can help the person cope for a while, but since this is an unsafe coping strategy eventually the person’s solution becomes a second problem.

Common stressors and environments increase risks for both.

Living in poor neighborhoods increase the risk that you will have life difficulties. More crime more mental health issues and more drug and alcohol abuse in your neighborhood. Poverty is depressing and substances are a way to cope, temporarily, with poverty and unemployment.

Substances change your brain and induce mental health disorders.

People try drugs for all sorts of reasons. Many people have had the experience of a hangover. After that experience, a common treatment for the hangover is the hair of the dog that bit you, more alcohol.

Substance use progresses from experimentation to habitual use. The more of a drug someone uses the more their brain chemistry changes. At some point, not a planned occurrence, this habit becomes a mental need, a psychological addiction to the substance. Eventually, this progresses to a psychical addiction, a chemical dependency.

Excessive substance abuse results in long-term changes in the functioning of the brain. Depression, anxiety or even psychosis may develop as a result of using, being under the influence and withdrawing from substances.

Life experiences from either increase the risk of the other problem.

People with serious mental illnesses are more likely to be the victim of crime than the perpetrator. Being mentally ill makes you vulnerable. Having a mental illness increases the risk that you will be unemployed, have a psychical illness and die at an earlier age. All of these are risk factors for substances abuse.

The life experiences that drug users have, poor neighborhoods, crime, and poverty are all risk factor for poor mental health. The drug using experience increases the risk for traumatic experiences. Rapes, robberies, assaults, and incarcerations all can accompany substance use disorders.

The experience of having a substance use disorder increases the risk for a mental illness. Trying to live with a mental illness increase the risk that you will abuse substances.

Giving up a drug of choice is painful.

For most substance abusers their drug of choice becomes their best friend. Women come and go but Sherry is always waiting in the bottle for you. A man may leave you but Jose and Jack will always be in the bottle when you need them.

Crystal is always ready for your next date with the pipe.

People become closer to their drug of choice than to their family or friends. Giving up drugs or alcohol means losing that best friend. This loss of a friend and support system can leave the substance user alone with no coping mechanism and at high risk to develop a mental health problem or return to active use.

Hope that these 5 ideas will help to explain why having both a substance use disorder and a mental illness at the same time is so very common. If you or someone you know has one or both of these issues help is available. If that person has both conditions, look for a treatment provider who is comfortable with working on both issues at the

Staying connected with David Joel Miller

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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.

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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. 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.