What are Somatic Symptom and Related Disorders?

By David Joel Miller.

Your mind and your body are connected.

The Somatic Symptom and Related Disorders chapter in the DSM 5 covers a group of disorders in which both the body and the emotions play a role. A lot of people think of the mind and the body as two separate things. They would like to believe that if you are sick, that means there was something wrong in your body. Otherwise – your pain is all in your head. The truth is emotional problems can make you physically ill, and illnesses that originated the body can significantly impact your emotional health.

People with Somatic Symptom and Related Disorder are primarily seen medical settings, often by primary care physicians. They are less often seen in mental health settings, and then primarily because their doctor referred them. Some of these conditions are quite rare in the general population. If a condition affects one in 300 people, then there would be over 1,000,000 people in the U.S. with that condition.

Many emotional and mental disorders create physical symptoms in the body. Depression characteristically causes changes in sleep and appetite as well as loss of energy and motivation. Anxiety disorders can cause dizziness, sweating, light-headedness, shortness of breath and many other physical symptoms. Panic Disorder manifests with symptoms similar to a heart attack or respiratory failure.

This group of disorders displays significant physical or somatic symptoms. The pain and suffering of the body are readily apparent. In these conditions, there is also significant distress and impairment in your ability to work, create and maintain relationships, or enjoy other important areas of your life. People with Somatic Symptoms Disorders are very upset by their symptoms.

This family of diagnoses should not be used simply because the doctor has been unable to find a medical explanation for the condition. Somatic Symptoms Disorders also require a change in the way the patient sees their symptoms. What the doctor or therapist is looking for is the way in which the patient’s thoughts, feelings, and behaviors, are being altered because of the physical symptoms. Somatic Symptom Disorder, the most common among this family of disorders, is often present in combination with another diagnosed physical illness. When both conditions are present, it becomes more difficult to treat and may require the services of both a medical doctor and a therapist.

Risk factors for developing a Somatic Symptom Disorder.

Having a history of traumatic experiences in early life increases the risk for a Somatic Symptom Disorder. Stress is more than just a feeling. When under stress, hormones and neurotransmitters change. Living with high levels of stress hormones alters the functioning of the nervous system. Other risk factors include an increased sensitivity to pain, chronic pain, or living in an environment where no one listens to your needs unless your report physical pain.

Other disorders related to somatic symptoms.

Here is a short list of other disorders related to Somatic Symptom Disorder.

Illness Anxiety Disorder.

Conversion Disorder.

Facetious Disorder.

False Pregnancy (Pseudocyests)

Brief forms of Somatic Symptom Disorders.

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

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

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

Bumps on the Road of Life.

Your cruising along the road of life and then wham, something knocks you in the ditch.

Sometimes you get your life going again quickly. Other times you may stay off track and

Bumps on the Road of Life.

Bumps on the Road of Life.
By David Joel Miller

in the ditch for a considerable time. If you have gone through a divorce, break up or lost a job you may have found your life off track. Professionals call those problems caused by life-altering events “Adjustment Disorders.” Bumps on the Road of Life is the story of Adjustment Disorders, how they get people off track and how to get your life out of the ditch.

Bumps on the Road of life

Amazon Author Page – David Joel Miller

More to come as other books are completed.

Thanks to all my readers for all your support.

Want to sign up for my mailing list?

Get the latest updates on my books, due out later this year by signing up for my newsletter. Newsletter subscribers will also be notified about live training opportunities and free or discounted books. Sign up here – Newsletter. I promise not to share your email or to send you spam, and you can unsubscribe at any time.

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

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What is an Adjustment Like Disorder? (F43.9)

By David Joel Miller.

When is an adjustment disorder not an adjustment disorder?

What is? Series

What is an Adjustment Like Disorder?
Photo courtesy of Pixabay.com

Sometimes people have symptoms as a result of experiencing trauma or stress.  These difficulties are sufficiently severe that we think this person needs treatment but the exact group of symptoms they have doesn’t quite fit a listed disorder.  The new DSM – 5 solves this problem by creating another name for adjustment like disorders.

Other Specified Trauma- and Stressor-Related Disorders (F43.9)

This designation gives us five more ways to categorize problems of everyday living which were caused by stressors or trauma but do not quite neatly fit the defined adjustment disorders.  Below are the five reasons you might get an adjustment like disorder diagnosis.

1. You had a stressor but your problems did not begin until more than three months after the stressor.

2. The problems continue for more than six months even though the stressor has ended but your symptoms have not turned into another diagnosis.

3. You were having an “ataque de nervious.” This particular condition is listed in the back of the DSM – 5 under cultural concepts of distress. While not recognized in the United States as a mental disorder, this particular group of symptoms is widely recognized in Spanish-speaking countries.

4. Another cultural syndrome. There are a number of cultural syndromes that are recognized in a particular geographic or ethnic area.  The cultural syndromes are understood as an inability to cope with a particular stressor.

5. Persistent Complex Bereavement Disorder. This condition is listed in an appendix to the DSM under conditions for further study.  Since it didn’t make the list of official diagnoses, researchers needed a way to code it.  The result is this condition ended up here under adjustment like disorders.

I don’t think I’ve ever seen an adjustment like disorder listed in the person’s chart nor have I ever use this particular diagnoses myself.  But when I saw it was right there in the DSM-5 I just couldn’t resist letting you all know about this.  Maybe this illustrates how learning to diagnose mental illnesses is both an imprecise science and an area for continuing learning.

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

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

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

For more on this topic see Adjustment Disorders in the Trauma- and Stressor-Related Disorders category.

Want to sign up for my mailing list?

Get the latest updates on my books, due out later this year by signing up for my newsletter. Newsletter subscribers will also be notified about live training opportunities and free or discounted books. Sign up here – Newsletter. I promise not to share your email or to send you spam and you can unsubscribe at any time.

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

What are the six types of Adjustment Disorders?

By David Joel Miller.

Adjustment Disorders include six types or specifiers.

What is? Series

What is an adjustment disorder specifier?
Photo courtesy of Pixabay.com

In another post, I wrote about adjustment disorders. You might want to take a look at that post.  You will find it in the trauma- and stressor-related disorders category. But to briefly recap, an adjustment disorder is a time when you experience stress and that amount of stress is more than you can handle.

The kind of things that you might find stressful, and how that stress might affect you, can vary a great deal from one person to another.  Adjustment Disorder can be very chameleon like, changing from person to person and from time to time. As a result of this variation and in order to help find the correct treatment for each person, professionals use six different specifiers for various presentations of adjustment disorder.  Listed below are the six specifiers or sub-types of adjustment disorder that are listed in the new DSM – 5.

Adjustment Disorder with Depressed Mood (F43.21).

Sometimes in addition to having difficulty coping with a stressor, as a result of this life problem, people develop depression.  If this goes on long enough or is severe enough they might eventually get a diagnosis of Major Depressive Disorder.  But until that happens treatment will mainly focus on the stressor and the depression that stressors is causing.

Adjustment Disorder with Anxiety (F43.22).

Sometimes the primary symptom that people experience when they are going through stress is an increase in their anxiety.  If this increase in anxiety is related to a specific stressor, is more severe than we expect or goes on too long, Adjustment Disorder with Anxiety is the likely problem.

Adjustment Disorder with both Depression and Anxiety (F43.23).

Anxiety and depression frequently happen to people at the same time.  If this stressor has produced both depression and anxiety, then this specifier should be added.

Adjustment Disorder with Conduct Problems (F43.24).

Sometimes the principle way we know that stress has affected somebody is that they begin to act in inappropriate ways.  This diagnosis with this specifier is most commonly seen in children who rather than show their symptoms as anxiety or depression, begin to act out.

Adjustment Disorder with Disturbance of Emotions and Conduct (F43.25).

When stress overcomes a person’s ability to cope, we may see changes both in their behavior and in their feelings.  This is often the case in children and adolescents but may also be seen in adults with poor emotional regulation.

Adjustment Disorder Unspecified (F43.20).

When the counselor knows that the problem the client has is caused by their reaction to stress but none of the other sub-types quite seem to fit, this category may be used.

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

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

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

Want to sign up for my mailing list?

Get the latest updates on my books, due out later this year by signing up for my newsletter. Newsletter subscribers will also be notified about live training opportunities and free or discounted books. Sign up here – Newsletter. I promise not to share your email or to send you spam and you can unsubscribe at any time.

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

What is Separation Anxiety Disorder (F93.0)?

By David Joel Miller.

Separation Anxiety Disorder used to be strictly a children’s condition.

What is? Series

Separation Anxiety Disorder
Photo courtesy of Pixabay.com

In the past Separation Anxiety Disorder was listed in the section of the Diagnostic and Statistical Manual (DSM) under the category of Disorders First Diagnosed in Infancy, Childhood, and Adolescence.  Recently in the reorganization of the DSM, this disorder was moved to the chapter on anxiety disorders.

Increasingly we recognize that there are adults who suffer from Separation Anxiety Disorder.  In children, if they have the symptoms for four weeks or more, that meets criteria.  But when we see this disorder in adults we expected it to last at least six months.  This is a disorder which may come and go throughout the lifespan.  It is likely to begin after, or to be triggered by, stressful events.

Separation Anxiety Disorder is about a fear of losing the major attachment figure.

In Separation Anxiety Disorder there is a fear of leaving home or being separated from a major attachment figure.  This is very different from people who are simply afraid of going out of the house, being around crowds, or meeting strangers.  In Separation Anxiety Disorder it is the fear of losing that significant person which causes them extreme distress.

This fear is clearly far more than life circumstances would warrant.  People with this disorder need to know where that important person is it all times.  And they may have an excessive need to stay in constant contact with their major attachment figure.  These people may be given to constantly texting, and may become quite upset if they’re communications are not immediately responded to.

You may also fear being taken away.

Separation Anxiety Disorder is also the fear that something will take you away from that major attachment feature.  People with this disorder worry about an illness, kidnapping or being forcibly taken from a major attachment figure. Some people with this disorder are unable to be in a room by themselves.

Separation Anxiety Disorder can make you refuse to leave home.

The classic example of this is the child who is terrified of leaving their mother to go to kindergarten on the first day of school.  In normal children, if we expect them to get over this fear after a few days.  But in those with Separation Anxiety Disorder that fear continues for long periods of time. We may continue to see this behavior as children get older.  They may have frequent illnesses which keep them at home with their important attachment figure.

Like most other anxiety disorders, Separation Anxiety Disorder typically begins in childhood, but it may well continue throughout adult life.  In diagnosing this disorder the professional looks at the developmental stage of a person to see if what they are going through is appropriate.

Some adults are so afraid of leaving their significant family member that they are unable to venture out into society alone.  They will only be willing to go outside the house, to the store or an appointment, if that major attachment figure accompanies them.

That huge fear of being alone maybe Separation Anxiety Disorder.

An abiding characteristic of Separation Anxiety Disorder is the extreme level of fear of being alone.  Any time this person is separated from their major attachment figure, they become anxious and may even become terrified.

In children, the attachment figure is likely to be their parents or caregiver.  In adulthood people with this disorder are likely to become very anxious when separated from their spouse, partner or their children.

If that important person is not home, then you can’t sleep.

People with Separation Anxiety Disorder find that they are unable to sleep when the major attachment figure is not in the house.  They may stay up all night on those occasions when that person they’re attached to needs to be gone overnight.

The person with Separation Anxiety Disorder will have a constant need for reassurance.  This need may result in frequent phone calls or other efforts to contact the attachment figure who is not there.  This constant need for reassurance may begin to interfere with their partner’s ability to work.

Separation Anxiety Disorder causes nightmares about being separated.

In this disorder, the content of the nightmare is that the important person will be taken from you or you from them and that you will never ever be able to see them again. These nightmares can be recurrent and play a role in maintaining the other symptoms.

Separation Anxiety Disorder can make your physically ill.

Symptoms of this disorder can look just like a physical illness.  These symptoms may include headaches, inability to eat, nausea, or even vomiting if there’s a chance that you’ll be separated from this major attachment figure in your life.

People with Separation Anxiety Disorder are likely to be described by others as needy and insecure.

There is help for Separation Anxiety Disorder.

While this condition often begins in childhood and may continue well into adulthood, someone with this issue does not have to continue to suffer.  There are treatments available.  If you or someone you love suffers from this condition, consider getting professional help.

More on this and other anxiety disorders see:  Anxiety

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

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

Want to sign up for my mailing list?

Get the latest updates on my books, due out later this year by signing up for my newsletter. Newsletter subscribers will also be notified about live training opportunities and free or discounted books. Sign up here – Newsletter. I promise not to share your email or to send you spam and you can unsubscribe at any time.

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

What is Selective Mutism (F94.0)?

By David Joel Miller.

Selective Mutism is the failure to speak at times when speech is necessary.

Can't talk

No speech. Selective Mutism.
Photo courtesy of Pixabay.com

Selective Mutism is an interesting disorder. It is one of the less common anxiety disorders and one which commonly first appears in childhood.  This disorder often co-occurs with Social Anxiety Disorder.  As with all the anxiety disorders, Selective Mutism may continue well into adulthood.

Selective Mutism is not the inability to speak or the willful refusal to speak.  Selective Mutism occurs when someone chooses not to speak in a particular situation even when not speaking may cause them difficult.  Children with this condition will avoid starting a conversation with other children.  When spoken to they will fail to respond.

Selective Mutism gets noticed when children begin to attend school.

Children with Selective Mutism do poorly in school because they do not respond verbally to the teacher and do not read out loud.  Those with this disorder may use other ways of communicating rather than speaking.  Sometimes they will point, grunt or used personally significant gestures.  They may also be willing to engage in social activities when speech is not required.

Children with Selective Mutism are able to speak normally at home with their parents or primary caregivers.  They may be unwilling to speak in the presence of close relatives including cousins, aunts and uncles, and grandparents.

Risk factors for Selective Mutism.

Children who are shy are at extra risk to develop this disorder.  Having parents who are withdrawn or growing up in a socially isolated environment may also be risk factors.  It is possible that having overprotective or controlling parents increases this risk.  There’s some evidence that children with this disorder have difficulty understanding the things that are said to them.  Having Social Anxiety Disorder or a family history of it may also increase the risks.

Other problems may accompany Selective Mutism.

People was Selective Mutism also frequently are shy and experience social embarrassment.  They may be isolated and withdrawn.  Children with Selective Mutism may be clingy and become easily upset.  They many also exhibit temper tantrums and oppositional behavior.

Having this disorder early in life and not getting treatment for it puts the child at extra risk for poor development and failure to learn needed social skills.

Things that are excluded from a Selective Mutism diagnosis.

To get this diagnosis, this condition of not speaking even when you need to speak must go on for at a month or more.  If the thing keeping you from speaking is the result of not knowing the English language or being bilingual in some way, this is not a case of Selective Mutism.

Also excluded from the definition of Selective Mutism are things related to speech fluency.  If the person involved is experiencing an episode of hearing voices, if being psychotic, or a schizophrenia-like condition, this also is outside the definition of Selective Mutism.

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

More “What is” posts will be found at What is.

Want to sign up for my mailing list?

Get the latest updates on my books, due out later this year by signing up for my newsletter. Newsletter subscribers will also be notified about live training opportunities and free or discounted books. Sign up here – Newsletter. I promise not to share your email or to send you spam and you can unsubscribe at any time.

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

What is Reactive Attachment Disorder (RAD) F94.1?

By David Joel Miller.

Reactive Attachment Disorder begins early in life.

What is? Series

Reactive Attachment Disorder (RAD)
Photo courtesy of Pixabay.com

Reactive Attachment Disorder (RAD) is one of those disorders which was moved in the DSM-5.

It used to be included in the chapter on Disorders First Diagnosed in Infancy, Childhood, and Adolescence. RAD now appears in the chapter on Trauma- and Stressor-Related Disorders.

Reactive Attachment Disorder is the result of deficiencies in early life care.

Reactive Attachment Disorder is an internalizing disorder. A related disorder called Disinhibited Social Engagement Disorder involves externalizing behaviors.  Both conditions are thought to be caused by poor caregiving early in life. RAD involves a consistent pattern of shutting down, withdrawing and inhibiting emotions. This disorder starts before age five and is rarely given after that age.

While this is a diagnosis primarily applied to very young children, in working with adults we often see conditions that probably began as Reactive Attachment Disorder.  A common statement is that they “just don’t get close to others.” This condition involves an inability to regulate emotion and unexplained anger, both issues we frequently see in adults who came from dysfunctional homes.

With children, we usually know that the symptoms are caused by neglect and poor parenting.  With adults, similar symptoms show up as depression, chronic sadness, anxiety disorders or even personality disorders.  Our understanding of reactive attachment disorder is pretty much an all or nothing condition.  I can’t help wonder about the effects which varying degrees of neglect or failure to meet the child’s emotional needs might be causing.

Reactive Attachment Disorder involves a consistent behavioral pattern.

Most of the Trauma- and Stressor-Related Disorders are related to anxiety and obsessive compulsive disorders and are fear based. Reactive Attachment Disorder is about shutting down and internalizing. In Reactive Attachment Disorder, there is chronic sadness, depression, and loss of the pleasure.  There may also be accompanying anger, aggression, and dissociation. This involves a lot of withdrawal and inhibited emotion.

Reactive Attachment Disorder involves social and emotional problems.

Children with RAD are unresponsive to others.  They’re rarely happy or positive.  RAD involves frequent irritation, sadness and sometimes being afraid. Children with this disorder often react to adult caregivers in a negative way for no apparent reason. These patterns of poor relationships with adults continue even when caregivers change.

In adults, we see similar patterns with those people who get diagnosed with Persistent Depressive Disorder.  They often say they do not ever remember being happy.  What we often don’t know is if this person really had deficient care as a child or if they had a temperament which makes them difficult to parent.  Sick, or irritable temperamental children are harder to parent and more likely to be abused or neglected.

Extremely deficient care results in Reactive Attachment Disorder.

Characteristics of this less-than-adequate care include emotional needs not being met, frequent changes in caregivers, and being raised in impersonal institutionalize settings.  Mostly this deficient care results in poor relationships with caregivers and other adults, but it may also affect peer relationships.

Sometimes other things look like Reactive Attachment Disorder.

Sometimes children with Autism or developmental delays exhibit symptoms that can look like Reactive Attachment Disorder. In young children, it is important to be sure the problems were caused by poor caregiving.  In adults, we see behaviors that we suspect began as Reactive Attachment Disorder, but without a prior diagnosis, we can’t be sure. RAD may affect many other developmental areas.

Some cautions.

As with the other things we are calling a mental illness this RAD needs to interfere with the ability to work, or in children, go to school, relationships, or other enjoyable activities or cause personal distress. Otherwise, there may be issues, but the diagnoses will not be given. If the only time this happens is when someone is under the influence of drugs or medicines or because of some other physical or medical problem these problems would need to be more than the situation otherwise warrants. These other issue may need treating first, then if there are still symptoms, the diagnosis will be given.

Treatment for Reactive Attachment Disorder.

For children, getting into a situation with a caring, responsible, caregiver can make all the difference.  For adults with problems now, which may or may not be the result of early childhood experiences, there are several therapies which may be helpful.

It is imperative that children who have Reactive Attachment Disorder get treatment early to prevent lifelong difficulties.  Adults who struggle with emotional difficulties may find that they still have early childhood issues that need to be addressed before their adult problems will resolve.

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

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

Want to sign up for my mailing list?

Get the latest updates on my books, due out later this year by signing up for my newsletter. Newsletter subscribers will also be notified about live training opportunities and free or discounted books. Sign up here – Newsletter. I promise not to share your email or to send you spam and you can unsubscribe at any time.

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

What is Amotivational Syndrome?

By David Joel Miller.

Have you lost your drive or your desire to do something?

unmotivated

Low Motivation.
Photo courtesy of Pixabay.com

Amotivational Syndrome is often connected with the smoking of marijuana.  This is something quite different from what we see in depression.  In depression, people lose the desire to do things they use to make them happy.  We call that loss of pleasure anhedonia.

In Amotivational Syndrome people seem to spend more time looking inward and contemplating things and less time actively doing them.  This syndrome was originally recognized in younger, marijuana smokers who were heavier daily users.

Does marijuana smoking cause loss of motivation?

Things that are, or were, associated with Amotivational Syndrome include the development of apathy and loss of ambition.  Heavy smokers just seem to become indifferent and stop caring about anything except smoking.  They seem to have fewer goals and decreased effectiveness.  Problems with attention and concentration have also been attributed to heavy marijuana smoking and Amotivational Syndrome.

Many of these characteristics are seen in daily, heavy, marijuana smokers.  What is unclear is whether the marijuana smoking causes this cluster of symptoms or whether those people who are low in motivation like to smoke marijuana.  At one point it was commonly accepted that some marijuana smokers are likely to suffer from Amotivational Syndrome.

Not all marijuana smokers are low in motivation.

Because of the many famous, popular people, who have been reported to be regular marijuana smokers, the connection between smoking marijuana and low motivation has come into question. It is unclear how common this condition is, or even if this is a valid syndrome.  Amotivational Syndrome has not been reported in countries other than the United States.  There’s some question whether Amotivational Syndrome is, in fact, a cultural rather than a mental condition.

Animals on marijuana don’t lose motivation.

Laboratory studies of both humans and animals have not found evidence of the Amotivational Syndrome for those using marijuana.  Amotivational Syndrome or loss of goals and direction has been found in many groups of young people who are not using marijuana on a regular basis.  This has led some writers to conclude that Amotivational Syndrome is a personality characteristic rather than the result of smoking marijuana.  It may be that those people with low motivation are attracted to using marijuana and other intoxicating substances.

One other possibility that has been suggested is that those people who are under the influence of drugs and alcohol or other substances may have low motivations to do anything while under the influence.  What we may be seeing in those people who were described as having Amotivational Syndrome may, in fact, be the effects of intoxication and withdrawal from marijuana or other substances.

As with the other things we are calling a mental illness or symptoms of a mental illness Amotivational Syndrome would need to interfere with your ability to work or go to school, your relationships, your enjoyable activities or cause you personal distress for it to be the focus of clinical attention. Otherwise, while you may have lost some motivation you will not be identified as someone needing clinical assistance.  If the only time you have low motivation is when you are under the influence of marijuana or another drug this would be diagnosed as drug intoxication.

For more on this and related topics see the other posts on counselorssoapbox.com under        Drug Use, Abuse, and Addiction

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

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

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Get the latest updates on my books, due out later this year by signing up for my newsletter. Newsletter subscribers will also be notified about live training opportunities and free or discounted books. Sign up here – Newsletter. I promise not to share your email or to send you spam and you can unsubscribe at any time.

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