Organic Rule-outs: Five top-priority concerns

What to do first when your mental state is unacceptable to you

by Tom Cloyd, MS, MA – Counselor / Psychotherapist – Cedar City and St. George, Utah (435)-272-3332 – email: tc (AT) tomcloyd (DOT) com (please read about content licensing)

You have to start somewhere

This very brief article/handout has quite a history. For years I’ve been advising clients who are having a bad day not to consider psychological issues first, when they start trying to figure out what’s going on. Instead, I’m confident that the smart thing to do is to consider the concerns I list below – and to work to remove their influence in their present lives. Get through this brief list, and one can then appropriately consider psychological issues.

Doing things this way has always simply made sense to me. It also seems to work for my clients. I continue to give this sensible advice.

I also walk the talk: I use this material myself – for the same reason I advise clients to use it – it just works.

So…here’s how to get a good start on a bad day

Many mental health problem symptoms can be triggered by basic organic problems. There are five we should check for, in this order, because this reflects their approximate likelihood of being present:

1. Blood sugar deficits: Go too long without eating, and you’ll get low blood sugar. The effect is clear: low energy. You may also feel cold. You may shake a little, if you’re really depleted. Your thinking will happen more slowly and with more effort and less clarity. You may well feel unmistakably depressed.
2. Sleep deficit issues: Sleep-deprivation fatigue is a real problem for many people, and the problem seems to be getting worse every year. Lack of sleep degrades your ability to think, to make decisions, and to respond to your environment. It also will almost certainly depress your mood. It has been said to be responsible for as many auto accident deaths as drunk-driving.
3. Illness – ongoing or impending: Physical sickness can induce or trigger distinct changes in your state of mind. The effects are various. Depressed mood, low energy, confused thinking…and a few other mental problems, can all derive directly from being ill.
4. Drug side effects: Easy to forget, the wide range of known drug side effects are impressive, and some of these effects are mental. This problem can arise even with a drug you’ve been successfully taking for a long time, and without any change in dosage, if some key aspect of your metabolism has recently changed.
5. Brain injury: Other than in the case of a stroke which has gone undetected (and this is very possible with small, undramatic strokes), most people with brain injury know they have it. Drug or alcohol induced brain injury, however, can be present without having been identified by anyone, so this possibility must be considered as well. The effects may not show up for years. “Brain injury” is a broad term, and so are its effects.

If any of these organic problems are suspected or known to be impacting you, it is difficult to see past them to clearly identify a psychological problem. In addition, in many people, a physically caused problem in mood or perception can trigger an additional problem of purely psychological origin – a secondary reaction, to your awareness of your primary problem. The only way to reduce this problem to manageable simplicity is to address the physical (organic) problem first, getting rid of it as much as possible.

Realistically, a minority of individuals may not be able to completely remove an organic problem, and its effect on their mental state. What cannot be fully resolved must simply be managed like any other mental or physical vulnerability. Many people do this successfully. The first step toward this goal is to reduce the presence of these organic problems in your life as much as you can, when you know you are impacted by them.