Monday, December 22, 2008


Below is my wish to everyone. To print out, go to http//

May You Develop

* Frequent overwhelming periods of gratitude

* A tendency to react spontaneously rather than in
reaction to fears

* An increasing tendency to go with the flow and let
things happen

* A lessening inclination to interpret the actions of others

* A decreasing involvement in conflict

* A feeling of contentment and oneness with man
and nature

* An increasing tendency to enjoy each moment

* An increase in the ability to receive love from others,
as well as the ability to give it

* A lessening of the motivation to worry

* Frequent attacks of smiling

This looks nice on the fancy papers you can buy in office stores. You can also change the font to your liking.



Saturday, December 13, 2008

Holiday Inventory

The Holidays are difficult for many - missing lost ones, anniversaries of deaths around those times, dealing with job loss/financial difficulties, not being where you want to be in life, etc. Even when life is in the groove, many of us stress over finding the "perfect gift," dealing with difficult family members, and/or being unable to afford what we would like to do for our loved ones.

For many, the Holidays are just another day, without special meaning. For Christians, it is a time to celebrate the birth of Christ. Regardless if one believes in virgin births, etc., Christmas can be a time to aim to be born anew. This does NOT mean preaching to others or evangelizing. Rather, I take it to mean to look at yourself everyday and see what you think you can do better. Are you loving enough to your family and those around you? Do you make a point to treat others better (if there is a need)? How is your patience? Do stupid things needlessly upset you?

Of course, people of other or no faith tradition can also take inventory and work on themselves. My one remaining uncle proclaims himself to be an atheist. He is one of the most decent and loving people that I have had the privilege of knowing. All of us can work on being more loving and better people. For a very humorous reminder, revisit Bill Murray in Scrooged.

Take inventory on how you treat others, including yourself. Work on having more patience with self-centered or otherwise difficult people, rather than responding to them in kind. Contact family and friends who are overdue a call, visit, card, etc. Make a decision to work on your poor habits and to begin any changes that you know you should make. Not only be kind to others, but also be kind to yourself. In doing these things, we renew and deepen ourselves and our relationships. These things also help bring meaning and enjoyment to us and those around us.



Sunday, November 16, 2008

Mental Health Parity Law

Included as part of the recent financial rescue/bailout bill signed by President Bush, was the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act. This will end health insurance benefits inequity between mental health/substance use disorders and medical/surgical benefits for group health plans with more than 50 employees. This means that equity in coverage will apply to all financial requirements, including lifetime and annual dollar limits, deductibles, copayments, coinsurance, and out-of-pocket expenses, and to all treatment limitations, including frequency of treatment, number of visits, days of coverage and other similar limits.

The new law will go into effect on 1/1/10, in order to give insurance companies time to change their policies. Medicaire and Medicaid are exempt. Medicare co-payments for mental health services are currently at 50%, while medical co-payments are at 20%. However, a Medicare parity bill passed last summer, so in 2014, mental health co-payments will be reduced to 20%. This bill was vetoed by President Bush, but the Congress overwhelmingly overrode the veto.

Forty-three (43) states have enacted parity laws. While some of these laws provide for strong parity protections, most are not as comprehensive as the new federal law.

Parity will not effect the millions of Americans who are still uninsured.

Best wishes,


Friday, September 26, 2008

The How of Happiness (Pt 1)

There has been a relatively recent and growing movement referred to as "Positive Psychology." Much of this has grown from the work of Martin Seligmann, PhD author of Learned Optimism and other books. Historically, most psychology studies focused on depression and other problems. There was a movement beginning in the late 50's called "Humanistic Psychology." Positive Psychology focuses more on "everyday" people and giving them tools to beat negative thinking and living more fully, while Humanistic Psychology has focused more on "extraordinary people and topics such as self-actualizing and peak experiences.

The How of Happiness. A Scientific Approach to Getting the Life You Want by Dr. Sonja Lyubomirsky, PhD was published in 2007. Dr. Lyubomirsky is a researcher at Stanford University. The findings of her and others' researchers on happier people is summarized below:

1. "They devote a great amount of time to their family and friends, nurturing and enjoying these relationships.
2. They are comfortable expressing gratitude for all they have.
3. They are often the firs to offer helping hands to coworkers and passersby.
4. They practice optimism when imagining their futures.
5. They savor life's pleasures and try to live in the present moment.
6. They make physical exercise a weekly and even daily habit.
7. They are deeply committed to lifelong goals and ambitions (e.g., fighting fraud, building cabinets, or teaching their children their deeply held values).
8. Last but not least, the happiest people do have their share of stresses, crises, and even tragedies. They may become just as distressed and emotional in such circumstance as you or I, but their secret weapon is the poise and strength they show in oping in the face of challenge.

(pages 22 - 23)

An interesting and worthwhile read. Dr. Lyubomirsky also has a blog on happiness at

Best wishes,


Friday, September 5, 2008

Drugs vs. Therapy

As I touched on in my previous posting about depression, there are interesting studies comparing the treatments of medications and psychotherapy/counseling. One sees medication ads almost any tie you turn on the TV, look in a magazine, etc. Research proves that the advertising works. Increasing numbers of people are taking medications for depression, stress, etc. The number of people seeking counseling may be decreasing.

Many of the studies with depression, even severe depression, show them to be about equally effective. Therapy has been shown to have greater durability, with lower relapse rates following the end of treatment. There are also lower drop-out rates for therapy, due to medication side-effects. It is common practice for people to receive both treatments. One might think this to be more potent than either treatment by themselves. Some studies do support this, but other studies do not.

There is some evidence that therapy may be the better choice for those experiencing panic attacks. One study "found higher treatment effect sizes, lower attrition rates, and favorable cost profiles for talk therapy as compared to medication treatment for this disorder." There are fewer studies for panic than for depression. Therefore, one should be slower to declare a conclusion.

It may be surprising (including to many mental health professionals) that therapy can also be very helpful in the treatment of schizophrenia. An examination of many studies (a meta-analysis) "found that people treated with talk therapy in addition to medication were significantly better off than those treated with medication alone."

There are several other interesting findings from the huge muti-site research on depression. More effective therapists focus less on medications. Also, that the relationship with the psychiatrist is predictive of how helpful medication will be. There was a parallel with some behavior therapists, years ago. The parallel is that the medication or behavioral treatment are what is important and that the relationship is not. Behavior therapists have come to understand this. Some psychiatrists still have this lesson to be learned.

What can one conclude? First, that treatment works for most people. Second, the relationship with any mental health (and probably non mental health) providers is critical. Third, that the drug companies have great influence on what treatments people seek. This posting is not intended as anti-medication. I have encouraged numerous individuals to try medications for a variety of conditions. Rather, medications are not the only choice and sometimes the lesser choice. Lastly, if you are unhappy with your provider, try to make your complaints known to that person.

Best wishes,

For full report:

Sunday, August 24, 2008


Today I ran my first road race, a 5K (3.1 miles) in perhaps 4 or 5 years. I fully anticipated doing some walking. I surprised myself by managing to run the whole way. I further surprised myself by being able to pick up the pace the last 50 yards or so and passing several people. My time was 31:03 (a VERY pleasant surprise).

There are several points of this posting. All too often, we limit ourselves with negative expectations. It's a good idea to periodically push ourselves beyond what we think we can do. Someone said that if you have never failed, that you've never risked enough. I ran much of the race with Matt, a 80 year old man who started running at 50. Since then, he has run over 2000 races, including over 100 marathons! Matt, as well as several others were very encouraging to me when I commented on tiring. Runners generally are very encouraging to others. This is a good reminder for us to look to be more encouraging, more affirming, and treating others more often in positive ways. It also reminds us that inspiration is all around us. Sometimes we cannot see past the blinders of depression. Other times, we focus on looking for negatives, to affirm our notions that people, politicians, the world, etc. stink and will let you down. Better to be more positive towards others and to look for inspiration around us.

Best wishes,

Friday, August 22, 2008


My name is Dr. Mike Miller and I want to introduce you to my blog. The purposes are to give people a sense of who I am, as well as to write about what it means to be human, present some behavioral research findings, book reviews, and who knows what else! I hope that you will enjoy and benefit from the variety of postings that I am envisioning. Suggestions are welcome. Go to http://drmike to learn more about me, as well as to find self-help information and tips for most behavioral health concerns.

Best wishes,

Depression Patients’ Brain Circuitry Makes Them Vulnerable to Relapse

"Using brain imaging, NIMH researchers have produced direct evidence that people prone to depression -- even when they're feeling well -- have abnormal mood-regulating brain circuitry. This makes them vulnerable to relapse when levels of certain key brain chemical messengers plummet.

To test this directly and identify any brain circuit abnormalities, the researchers studied 15 un-medicated subjects in remission who had a history of depression by giving them a drug that temporarily depleted their brains of dopamine and norepinephrine.

These subjects experienced an increase in depression symptoms and a decrease in the ability to feel pleasure. PET scans showed that this was accompanied by an increase in activity in a depression-implicated brain circuit. By contrast, activity decreased or remained unchanged in the same brain circuit with depletion in 13 healthy participants who experienced only minor mood effects. Activity in specific brain structures in the circuit corresponded with a set of mood effects (see graphics below)."

This offers some evidence of why there is such a high relapse rate in depressed individuals. However, there are many studies that show while therapy and medications are about equally effective treatments, that there is a high relapse for those receiving meds only, if they discontinue the meds. Those receiving therapy, have a much lower relapse rate.

This is further evidence that depression is a bio-psycho-social disorder (generally has biological, psychological, and social factors) and that effective psychological interventions ALSO positively effect one's biology. The reality is that the psyche affects the soma, the psychological effects the biological, or the mental effects the physical. In other words, there is an endless loop where both effect the other.

Best wishes,

For full report:

Thursday, August 21, 2008

Look for the good in others

Yesterday, we took our son to the University of Toledo. The idea and then reality has been somewhat difficult to deal with. It seems that only yesterday (more like 15 years) that even when he was around people he knew, he would still be hugging my leg. I accept (and somewhat celebrate) his being able to leave is evidence that my wife and I have done a decent job and helped him become more independent and socially comfortable. Last year, he attended community college and lived at home. It was an excellent transition for him from High School. Part of my difficulties is that it is one more reminder of my own mortality.

Also yesterday, Congressperson Stephanie Tubbs Jones of Cleveland died from a brain aneurysm. She was 58 (3 years older than myself). She was such a positive person, almost always smiling a real (NOT politician) smile. Dennis Kucinich referred to her as his "sister." I felt that this proclamation was sincere. Even the Republicans were effusive about her positiveness and personality.

So what is to be learned from all of this? Once I turned 50, mortality became a more pressing reality to me. It is highly unlikely that I'll ever run 10 miles again, let alone any more 26 mile marathons. A long rulk (run/walk/run/walk...) anymore is 3 miles. I accept this and try to maintain some level of physical fitness. I also accept that mortality is part of the natural order. I think that we should try to emulate Stephanie Tubbs Jones, where we bring a positive energy, affirming nature, as well as looking out for the welfare of others, past our own family and friends. We don't know how much time we have, so it is imperative to work on this NOW. I have always liked and endorsed Gandhi's dictum to "Be the change that you want to see in the world," similar to other teachings from almost 2000 years ago. Look for the GOOD in others!

Best wishes,
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