All posts by James DelGenio

Individual, Family, and Couples Counselor with over forty years of experience as therapist, author, and continuing education provider.
Anxiety Panic Grief Depression, Bipolar Mood Disorders, Coping skills, Couples, Glossary of terms, Relationships

James E. DelGenio offers Tele-therapy with BCBS PPO Insurance accepted

39 Comments

By: James E. DelGenio MS, LCPC
Senior Staff Therapist
The Family Institute at Northwestern University

James DelGenio LCPC is a senior staff therapist who offers teletherapy and accepts BCBS PPO Insurance.  Teletherapy is HIPAA approved via Zoom.com 

His services include Individual and family counseling, marital and premarital counseling, and treatment of mood disorders and dependence.

Locations:  Teletherapy anywhere via zoom.  HIPAA approved and accepted by BCBS PPO Insurance.

As a practicing Psychotherapist for over 40 years, I employ a variety of clinical approaches including Cognitive Behavioral Therapy (CBT) in the treatment of couples, families and individuals.

Individual Practice: Assessment and treatment of anxiety, stress, panic, trauma, anger, grief, depression, mood disorders, mental illness and alcohol/substance abuse.

Marriage and Family Practice: Lack of intimacy, infidelity, poor communication, conflict over finances, lack of trust, parenting and behavior issues, premarital and divorce issues.

Specialization: Treatment of couples, depression and its impact on relationships and the family.

Zoom!

Now I can work via Zoom with anyone, anywhere in the country and it is covered by BCBS Insurance. Check with your BCBS representative for more information.  Call James E. DelGenio MS, LCPC, Senior Staff Therapist at The Family Institute at Northwestern University, 847-733-4300 Ext 638.

http://manageyourmood.net
http://family-institute.org

Disclaimer: This material is meant to be used in conjunction with psychiatric treatment, medication, if necessary, and supportive therapy. Always share this material and your questions about this material with your doctor and therapist.

Uncategorized

What are relapse warning signs of depression?

Leave a comment

By: James E. DelGenio MS, LCPC
Senior Staff Therapist
The Family Institute at Northwestern University

Relapse Warning Signs of reoccurring Depression

Be aware of relapse warning signs and symptoms. When one is taking medication as prescribed by the doctor, symptoms are largely under control and the client is stable. The reappearance of certain symptoms is an indication that the medication may need to be adjusted, reevaluated or changed. These symptoms may also be an indication that the medication is no longer being taken as prescribed or alcohol and substance use is interfering with the effectiveness of the medication.

These symptoms include:
• Thoughts about hurting oneself or others
• Changes in one’s sleep/wake cycle, especially little or no sleep
• Inability to concentrate, rapid speech, skidding from subject to subject
• Rapid mood fluctuations, mania, or depression
• Poor judgment, risky behavior, or lack of insight into one’s own behavior

These symptoms are reflected by poor daily functioning, lack of motivation, loss of interest and conflict. These are considered to be active symptoms and usually are caused by non-compliance with medication and use of alcohol or drugs. In many instances, the medication may need to be changed or the dosage adjusted by the doctor. This may also reflect the need for family members to monitor medication compliance and alcohol/drug usage. Relapse warning signs should be reported to the doctor and therapist immediately. Don’t wait!

Zoom!

Now I can work via Zoom with anyone, anywhere in the Illinois and it may still be covered by BCBS Insurance. Check with your BCBS representative.

Call James E. DelGenio MS, LCPC, Senior Staff Therapist at The Family Institute at Northwestern University, 847-733-4300 Ext 638.

http://manageyourmood.net
http://family-institute.org

Disclaimer: This material is meant to be used in conjunction with psychiatric treatment, medication, if necessary, and supportive therapy. Always share this material and your questions about this material with your doctor and therapist.

Alcohol Dependence, Bipolar Mood Disorders, Substance Dependence

The use of alcohol can be the same as abuse when you have depression.

2 Comments

By: James E. DelGenio MS, LCPC
Senior Staff Therapist,
The Family Institute at Northwestern University

Mood disorders and alcohol just don’t go together.

Where mood disorders are concerned use may very well be the same as abuse! Alcohol impairs functioning and it affects thinking, behavior and relationships. Alcohol and substances also affect thinking and behavior. Don’t do anything that would make you relapse to active symptoms.  It is known fact that alcohol and substance abuse make the symptoms of a mood disorder worse and vice versa.  Alcohol is a depressant; one drink at a family gathering may affect one’s mood for days. If you have depression, why would you exacerbate it by using alcohol?!  To me, continued alcohol use at this point would indicate that you are already alcohol dependent and are in need of professional help.

Alcohol also “washes out” and therefore may negate the usefulness of anti-depressant medication. Remember, it takes at least four to six weeks to get the medication to the prescribed therapeutic level in your body.  When you drink you affect that level. In addition, one should never use alcohol or substances when taking any prescription medication. This can be fatal.

It goes without saying that if you are an alcoholic, you can’t have any alcohol. If you are not an alcoholic, but you do have a mood disorder, check with your psychiatrist for approval of one or two drinks on very special occasions. In the days after, monitor yourself to see if it has affected your mood. If it does, use is the same as abuse!

  • Drugs and alcohol make mood disorders worse.
  • If the doctor approves of one or two drinks, monitor your mood in the days that follow.
  • If your mood is off, you need to consider abstinence from alcohol.

Zoom!
Now for the first time, I can work via Zoom with anyone, anywhere in the country and it may be covered by BCBS Insurance. Check with your BCBS carrier for details.  Call 847-733-4300 Ext 638 for more information.

http://jamesdelgenio.com
http://family-institute.or

Disclaimer: This material is meant to be used in conjunction with psychiatric treatment, medication, if necessary, and supportive therapy. Always share this material and your questions about this material with your doctor and therapist.

Uncategorized

How to become a good listener?

Leave a comment

By: James E. DelGenio MS, LCPC
Senior Staff Therapist
The Family Institute at Northwestern University

Be a good listener and improve your relationships.

Poor Communication
Many marital problems are rooted in poor communication. Effective communication between partners can be learned and developed.

When communication is poor and feelings go unsaid or unaddressed, the couple feels disconnected, even resentful. Over time, this leaves them feeling distant. Resentment creates further distance which in turn creates a lack of civility and respect and ultimately, a lack of intimacy.

Good communication is often oversimplified as just being romantic. It is not. Good communication involves the sharing of ideas and feelings. Good communication is made possible by means of trust, confidence, and mutual understanding.

Try to convey to your spouse the importance of expressing their feelings, even though they may think it’s silly. Explain how important it is to you and how it makes you feel. Explain to them how never knowing how they feel about this or that, confuses you and makes it more difficult for you to feel connected.

I encourage both men and women to use “I feel” statements. This allows the couple to say things that have in the past created conflict when sentences are started with: “You always” or “You never”. Never say never or always. This is also known as a history lesson into the past and therefore a minor conflict is never resolved and may even be magnified.

Stick to the topic
If you want to resolve an issue, stick to the topic at hand. That means no skidding. For example, “You don’t pick up after yourself”; “well you leave the bathroom a mess”. This is skidding. An issue is unlikely to be resolved when this occurs.

Active listening:
In order to show you are listening you need to reflect back to your spouse the content of what you heard. In other words, mirror what was said with emphasis on the feeling being projected. This shows the other that you are listening and also helps clarify the issue. Respond with empathy and don’t be defensive. Active listening also helps prevent bickering over nonsense that really isn’t relevant to a couples disconnect. The most obvious example of that was over 40 years ago. The couple I was seeing had a major argument over where they squeeze the toothpaste tube. She squeezed it on the end; he squeezed it in the middle. Obviously, their disconnect was not about the tooth paste. Sometimes all one wants is to be heard. Men often make the mistake of trying to solve the problem when all the wife wants is for him to listen. In this case, the wife needs to say it clearly, “I just need you to listen; please don’t try to solve the problem.” This will take practice but it will be worth it because your spouse will feel more connected to you.

Zoom!

Now I can work via zoom with anyone, anywhere in the country and it may still be covered by BCBS Insurance. Check with your BCBS carrier for details.

Call James E. DelGenio MS, LCPC, Senior Staff Therapist at The Family Institute at Northwestern University, 847-733-4300 Ext 638.

http://jamesdelgenio.com
http://family-institute.org
http://takenotelessons.com    Effective online, one on one, SAT, ACT, GRE, test preparation, via face time or skype.

Disclaimer: This material is meant to be used in conjunction with psychiatric treatment, medication, if necessary, and supportive therapy. Always share this material and your questions about this material with your doctor and therapist.

Anxiety Panic Grief Depression, Bipolar Mood Disorders, Glossary of terms

Five signs you are relapsing back into depression.

Leave a comment

By: James E. DelGenio MS, LCPC
Senior Staff Therapist,
The Family Institute at Northwestern University

1. Negative rumination. Negative thoughts that feel like they are on repeat, over and over again.

2. High anxiety.   Feeling like you want to jump out of your skin. Inability to relax.

3. Isolation and withdrawal. Prefer to be alone, avoiding people in general and friends. Failure to return calls from friends and family.

4. Sleep issues. Unable to get out of bed. Sleeping too much or too little.

3. Poor hygiene.   Not showering, brushing teeth, combing hair or wearing clean clothes.

4. Tearful. No particular reason for crying. Feeling low.

5. Poor concentration.  Inability to concentrate on the simplest of tasks.

6. Poor short term memory. This goes hand-in-hand with poor concentration.

These are known as active symptoms and usually indicate that the medication is not being taken as prescribed or that the medication needs to be adjusted or changed. Alcohol or drug use may also render the medication ineffective. Contact your doctor immediately.

Zoom!

Now I can work via zoom with anyone, anywhere in the country and it may still be covered by BCBS Insurance.  Check with your BCBS representative for more information.

Call James E. DelGenio MS, LCPC, Senior Staff Therapist at The Family Institute at Northwestern University, 847-733-4300 Ext 638.

http://manageyourmood.net
http://family-institute.org
http://psychologytoday.com

Disclaimer: This material is meant to be used in conjunction with psychiatric treatment, medication, if necessary, and supportive therapy.  Always share this material and your questions about this material with your doctor and therapist.

Couples, Marital Family Issues, Premarital Issues, Relationships

The Use of Home Work in Couples Counseling

3 Comments

By: James E. DelGenio MS, LCPC
Senior Staff Therapist
The Family Institute at Northwestern University

Homework for couples

As a cognitive behavioral therapist, I assign homework between sessions to the couples I counsel. Homework will not solve conflict, communication or resentment issues. Those issues need to be addressed in session. Home work will, however, help and typically addresses the following:

Civility and Respect
This one is a must. Civility and respect is the foundation of your relationship. When a couple loses civility and respect, their relationship is in serious trouble. They feel distant and as a result intimacy suffers. There is never a good reason to scream, swear, name call, or act out. If you have gotten into these habits you may need professional help to get it under control. It will take some time; it is a process – but if you work at it and strive for consistency you can regain civility and respect. As in any process, owning your errors is important. Don’t hesitate to acknowledge it if you say something that is not civil or respectful. Say, “I am sorry I should not have said that.” and mean it. All couples need rules of engagement for conflict. You can never allow yourself to lose control. It is the foundation of your relationship. You can’t build a house without a good foundation. Couples can’t permit yelling, screaming, swearing and name calling to undermine their relationship.

Call Time Out
When conflict becomes too intense and one or both of you are in danger of losing civility and respect, call a time out. The words time out will become a signal for both of you to settle down. Never follow your spouse when they are trying to retreat from the conflict. Standing outside the bathroom door and continuing the discussion is out of bounds. If you decide to go for a walk or to a movie, say so your spouse knows when you are coming back. It is cruel to just walk out without regard for the others feelings. The rule of time out is you must get back to the discussion within 24 hours. Far too often couples will just let the issue go unresolved, swept under the rug. This creates resentment and distance. Hopefully, after a day to reflect, you will be able to discuss the issue calmly. If not, hold the issue for the next therapy session.

Reduce Alcohol/Drug Use
Many fights occur when too much alcohol has been consumed. Alcohol reduces inhibitions making it easier to allow yourself to lose control. If you are drinking daily, you may have a problem. Denial is a huge part of alcoholism. I typically say, Can you stop drinking for a week or two month (for binge alcoholics). If you make excuses and refuse the challenge, you have an alcohol problem. There is no good reason one should be drinking on a daily basis

Date Night
A night out alone is a common suggestion among both therapists and self-help books. As I have said, couples lose their way because of all that life throws at them. Don’t forget to nurture the relationship by spending time together alone. This does not have to be a big money issue. Many people with financial stress will simply go out for coffee or ice cream. I find it a statement of the current economic times and somewhat sad that couples will go out after therapy because they can’t afford a babysitter twice in one week.

Meet and Greet
Meet and Greet is another way to address the lack of affection that many spouses feel. Touch is very important. This is not sexual touching. This is simply affection. Offer a hug and kiss when you leave and when you return. The responsibility is on both of you to find one another and do this when one of you walks in the door or leaves for work. Reaching out and holding hands when walking or just watching TV is also a way to address lack of affection.

Parent as a Team
Children learn quickly who to go to get what they want. Sometimes tension between parents is picked up on by the children and they will take sides. As I say, “the walls have ears.” Even when you don’t think they hear your arguments more than likely they do. I have had children tell me, “I listen to their arguments through the heating vent in my room.” A daughter will often side with mom. The result is when dad tells the daughter to get ready for bed, she ignores him. He gets upset and mom steps in often creating even more conflict between mom and dad. Mom needs to back dad and of course vice versa. “Do what your father says”. When mom is angry at dad anyway due to unresolved marital issues, mom unconsciously gets satisfaction from the child’s disrespect toward dad. This will continue for a while until marital issues are addressed and parents recognize how they undermine the others authority and the child sees that they are consistently parenting as a team . Parents need to support one another in family meetings to address disrespect to the other parent. This is a common issue addressed under family meetings below.

“I feel” Statements
Inability to express feeling is a major issue in many relationships. One of the hardest things for many men to do is to get in touch with feelings. I find that many men have difficulty expressing their feelings at all let alone civilly and respectfully. Yet, lack of expression of feelings is a major cause of marital discontent. Opening up is critical for a good relationship. In addition, expressing feelings out loud appropriately helps dissipate negative feelings. Women, especially it seems, need to know what their man is feeling in order to feel connected and consequently warm and fuzzy in the bedroom. Men are more R rated; they don’t like to talk. Women say about 6,000 words per day; men only 2,000. I believe that good communication is romance and that communication is needed for marital success. For most women and many men, it is that expression which makes a couple feel connected. I encourage “I feel” statements….”because.” It may at times still be a confrontational statement but much less so than when you begin statements with “you always“. First of all, never say never and always. When you have something difficult to say be nose to nose with your arms around the person. Say, “I feel” and it will more likely be perceived less defensively then things are said from across the room or behind a closed door.

No History Lessons and no skidding off current issues
Stay on the present issue. Many couples allow their conflicts to skid into the past. When this happens there is rarely a resolution to the current issue. This can create hostility and resentment. When you find yourself fighting about where you squeeze the toothpaste tube (he squeezes in the middle you squeeze on the end) obviously you are not addressing the real issues.

Zoom!

Now I can work via zoom with anyone, anywhere in the country and it may still be covered by BCBS Insurance.  Check with your BCBS representative for more information.

Call James E. DelGenio MS, LCPC, Senior Staff Therapist at The Family Institute at Northwestern University, 847-733-4300 Ext 638.

http://manageyourmood.net
http://family-institute.org
http://psychologytoday.com
http://takenotelessons.com  Effective on line, one on one, SAT, ACT, GRE, test preparation, via face time or skype and much more!

Disclaimer: This material is meant to be used in conjunction with psychiatric treatment, medication, if necessary, and supportive therapy. Always share this material and your questions about this material with your doctor and therapist.

Couples, Marital Family Issues, Relationships

How to improve communication and cooperation in the family?

Leave a comment

By: James E. DelGenio MS, LCPC
Senior Staff Therapist,
The Family Institute at Northwestern University

Conduct family meetings to improve your relationship!
Once upon a time, families ate dinner together. There was no eating in front of the TV; no texting or answering the phone and no internet. This was a time when families discussed what was going on in the household i.e. news, upcoming events, behavior issues and general discussions. Dinner used to be the natural time for families to discuss their lives, upcoming events and issues of importance.

Today, I find that families rarely eat together, missing the opportunity for family discussion. Child activities including little league, football, soccer, music lessons, dance lessons, and all kinds of after school activities have come to interfere in this essential family event. Families have become ships in the night passing one another as they head out the door. The idea of after school activity is potentially a good one: keep the kids busy and you will keep them out of trouble. However, what has been lost is the sense of family and the opportunity for good communication.

When I was a child, dinner time was always between 5 and 5:30pm. I had a lot of freedom but I also knew what was expected of me. In this case, it was “be home by 5pm” for dinner.

We would hear stories, news and discuss family issues. Today parents have become dependent on dual incomes in order to maintain the lifestyle they want to give their family. Now that the world economy has become more difficult and we have high unemployment and home foreclosures are rampant, parents are working two jobs just to make ends meet. They work late or have different schedules and their relationship suffers. They too, are ships passing in the night. Many couples today report they feel disconnected, their communication has suffered and, in turn, so has the level of intimacy they share. This will ultimately lead to bickering, conflict, infidelity and possibly divorce. How sad that an important family event has disappeared without realizing the major negative impact on the family. Even when couples do realize the problem, there is little that can be done since they are trying to stay afloat financially.

One way to reclaim some of that lost family communication time are family meetings, though some of my clients prefer to call them team meetings. I encourage families to gather at least once per week to discuss four areas. Ideally, this should be done at the same day and time each week. There should also be a pre-family meeting for mom and dad to discuss these issues and get on the same page for the meeting with the kids to ensure you are parenting as a team.  This is also an opportunity for mom and dad to discuss any issues they might be having.  It is also a great time to plan a date night.

The general topics to discuss are News, Compliments, Issues and Feedback. Here are some examples:
1. News: This is a chance to keep everyone up to date of all the family events coming up. The more informed everyone is, the more opportunities to share the scheduled load and the less stress for last minute – must do projects. “We are going to grandma’s house next weekend or Joey has a science project due and he will need craft paper”

2. Compliments and Gratitude: Express gratitude all around the family. Search for things your child is doing well, no matter how small and acknowledge it with a compliment. It will increase their sense of confidence and self-esteem. Show that you are excited and proud of them. “You did a nice job getting ready for school on time. You did better this week but there is still room for improvement. Let’s keep this goal another week or two.”

3. Issues: We live in an increasingly complex world that challenges us every day with a wide range of disturbing issues. By initiating conversations with your children, you will create an open environment and be able to address the tougher topics i.e. homework, curfew issues, chaotic morning or bedtime routine, alcohol and drug abuse. Hopefully, next week you will have compliments from improvement in this weeks issues.

Tip: don’t tackle too many issues at once; no more then one or two.

4. Feedback: Listen to your children and allow them the chance to express their concerns, complaints and express their feelings. You will learn more about your child if you open your ears and close your mouth.

I have found that both parents and children love this opportunity. The only concern is that as much as everyone in the house likes this, parents themselves have a difficult time being consistent. They often report that they were consistent initially but the process hasn’t been repeated in weeks. Be consistent! Family meetings are just one way to address the potentially poor communication within the family.

Zoom!

Now I can work via zoom with anyone, anywhere in the country and it may still be covered by BCBS Insurance. Check with your BCBS representative.

Call James E. DelGenio MS, LCPC, Senior Staff Therapist at The Family Institute at Northwestern University, 847-733-4300 Ext 638.

http://jamesdelgenio.com
http://family-institute.org
http://takenotelessons.com   Effective online, one on one, SAT, ACT, GRE, standardized test preparation, via face time or skype.

Disclaimer: This material is meant to be used in conjunction with psychiatric treatment, medication, if necessary, and supportive therapy. Always share this material and your questions about this material with your doctor and therapist.

Alcohol Dependence, Anxiety Panic Grief Depression, Bipolar Mood Disorders, Coping skills, Glossary of terms, Substance Dependence

Weekly Review of Consistency for management of Depression!

59 Comments

By: James E. DelGenio MS, LCPC
Senior Staff Therapist,
The Family Institute at Northwestern University

How to build structure for consistency in management of mood disorders!

This form helps you monitor your progress towards goals each week. Consistency is key when you have a mood disorder. People with mood disorders need planning and structure to help manage their symptoms. You can also track your marital/relationship goals if you choose. This tool helps track progress toward goals by adding structure to your week. Make multiple copies. Modify as needed; feel free to add or delete goals. Rate mood 1 through 10. Ten is best – 1 worst. Place copy on your refrigerator or someplace where you can check it daily. Mark the goals each day so that you can see the week in review. Note alcohol/drug use and your mood rating in the 3 days after use. Being consistent in your goals makes a huge difference in managing your mood. Try it!

Week of _________________

Goal:                                      Mon       Tues        Wed        Thurs        Fri        Sat       Sun
Medication compliance
Cardio/walking
Social activity
Hobbies
Chores
Date night
Civility and respect
Sleep # of hours
Drug, alcohol use
AA/NA meetings
Time out called
 Time out respected
Mood
Family meetings
Psychiatric appt

Note: Always consult with your doctor before starting any exercise program.

Zoom!  Now I can work via Zoom with anyone, anywhere in the country and it is currently covered by BCBS Insurance.  Call James E. DelGenio MS, LCPC, Senior Staff Therapist at The Family Institute at Northwestern University, 847-733-4300 Ext 638.

http://manageyourmood.net
http://family-institute.org
http://psychologytoday.com
http://takenotelessons.com    Highly effective online, one on one, SAT, ACT, GRE, test preparation, via face time or skype.

Disclaimer: This material is meant to be used in conjunction with psychiatric treatment, medication, if necessary, and supportive therapy. Always share this material and your questions about this material with your doctor and therapist.

Anxiety Panic Grief Depression, Severe mental illness

What you need to know about depression and high expressed emotion?

Leave a comment

By: James E. DelGenio MS, LCPC
Senior Staff Therapist
The Family Institute at Northwestern University

What is High Expressed Emotion?
High Expressed Emotion (EE) or lack of civility and respect are known to have a detrimental effect on marital and family relationships. The expression of negative emotions toward or even in the presence of a person with a mood disorder is a major contributor of relapse to active symptoms. Negative expressed emotion also includes critical comments, hostility and overly involved critical family toward a person with a mood disorder. High EE, as it is known, is easily internalized and is known to cause family conflict, risking relapse to active symptoms and abuse of alcohol and substances.

Case scenario: Mary is 39 years old, and she has a severe mood disorder. She was sitting on the couch while her husband was arguing with his business partner on the phone.  As the conversation became more heated, she began to shake with anxiety.  If you have a mood disorder, just being in the presence of high expressed emotion can have severe effects on the individual listening.  Now imagine if that emotion was directed at her!  The point is when a spouse or family member has a mood disorder, high expressed emotion or lack of civility and respect even if it is not directed at the individual will have a detrimental effect and may even lead to active symptoms. All the more reason to be civil and respectful! No yelling, screaming, name calling, ever.

Zoom

Now I can work via zoom with anyone, anywhere in the country and it may still be covered by BCBS Insurance. Check with your BCBS representative.

Call James E. DelGenio MS, LCPC, Senior Staff Therapist at The Family Institute at Northwestern University, 847-733-4300 Ext 638.

http://manageyourmood.net
http://family-institute.org

Disclaimer: This material is meant to be used in conjunction with psychiatric treatment, medication, if necessary, and supportive therapy. Always share this material and your questions about this material with your doctor and therapist.

Anxiety Panic Grief Depression, Bipolar Mood Disorders, Coping skills, Glossary of terms

How to be well when you have depression?

Leave a comment

By: James E. DelGenio MS, LCPC
Senior Staff Therapist,
The Family Institute at Northwestern University

Ten Steps to Better Mental Health

1. Take the medication as prescribed by your doctor.
• “I don’t miss often; maybe once per week.”

The number one cause of relapse to symptoms is medication non-compliance. This is a tough one. For psychiatric medication to be effective, it must be taken daily as prescribed. I consider compliance to be missing no more than 5 pills per year! Many people don’t like to take medication, especially if it means daily for life. Let’s take one step at a time and see what it’s like to function to your capacity for a year or two before you make decisions about the rest of your life.

But remember, clinical depression is a lifelong illness and it’s all about a chemical imbalance. It is a biological problem first and foremost. It’s like being a diabetic: you must take the medication as prescribed in order to be well. You wouldn’t like it but you would take the insulin injection. This is just chemistry.

2. No caffeine, substance use/abuse, or alcohol.

• “It’s not the caffeine. I like coffee. It doesn’t affect me. I’ve always drank coffee.”

Whether it’s coffee, power drink, soda or tea, caffeine can interfere with sleep and create anxiety. It is the most obvious reason for poor sleep. With your doctor’s supervision to avoid anxiety and headaches, gradually reduce your daily caffeine use. Eventually, when you are caffeine free, I believe, you will feel and sleep better.

I would certainly recommend gradually reducing caffeine use before asking the doctor for a sleep aid. Caffeine may interfere with your sleep/wake cycle. As far as your mental health, I recommend keeping caffeine to a minimum and before noon.

I also don’t recommend working the night shift i.e., midnight to 8 AM. It is difficult for your body to adjust. For a person with a mood disorder, this is not recommended. The back and forth between day and night shifts and the social isolation are risky to one’s mental health. It also wreaks night havoc with the sleep/wake cycle. Lack of sleep for a client with a bipolar disorder may bring about rapid mood fluctuations and jeopardize stability. Tell your doctor or your therapist if you are not sleeping. Wouldn’t it be better to reduce the caffeine rather than take a habit-forming sleeping pill?

• “What? I can’t have a glass of wine with dinner? I don’t do it every day. It’s just one glass. It’s not like I’m an alcoholic.”

The second leading cause of relapse to symptoms of depression is alcohol and substance use. Some doctors and even therapists say that it is all right to have one or two drinks if you have no alcohol abuse or dependence issues. I still question this because alcohol is a depressant. Why would you take a depressant when you are already depressed?

Alcohol may affect your mood for days, even weeks. At least track your mood on the calendar after you have been drinking to see if it has made your symptoms worse. Especially monitor the first three few days of being alcohol free. As far as alcohol and substance use, it is as simple as it is hard. If it interferes with your life, your daily functioning, or your relationships, don’t do it! Need help! Contact your doctor.

There is a negative correlation between the use of alcohol or drugs and symptoms of a mood disorder. Their is an increased chance of dependence and risk (70% to 90%) of relapse to the symptoms of your mood disorder. The consequences are just not worth it. Connect the dots! Denial or not! The essential point here is that for many people USE IS THE SAME AS ABUSE!

I recommend you discuss this with your doctor. If you already know you have a problem, get into Rehab. It’s never too late to turn your life around. Get professional help and go to your Alcohol or Narcotics Anonymous meetings as often as it is necessary to maintain sobriety. Even if you are not dependent, alcohol or pot may not be a healthy choice for you. Don’t deny the obvious. So, remember, the healthy use of alcohol for one person, may not be a healthy for you. Make healthy choices!

3. Take care of your physical health.
Be sure to have annual dental and physical exams. Some medications require regular blood testing. Some physical ailments can cause depression. See your doctor regularly.

4. Exercise
People with mood disorders tend to be sedentary. They need to walk and get exercise as much or more than any of us. You don’t have to join a gym; all you need to do is take a brisk walk. You don’t have to run but you do have to hustle a little bit. Studies going back thirty years or more say that cardiovascular exercise lifts one’s mood and reduces anxiety. The more recent studies show that those old studies are true but the walk needs to be at least 40 minutes to get the full benefit toward lifting your mood and reducing anxiety.

Walk at least 4 times per week. I also recommend that you pick your days, otherwise you will say, “I don’t feel like it today; I’ll do it tomorrow.” Tomorrow comes and the same thing happens. If you make a schedule and stick to it (say, Monday, Wednesday, Friday, and Sunday), the day of the week makes the decision for you. “Oh darn, today is Monday. I have to walk.” Remember, depression affects one’s motivation; if you wait until you want to do it, it may never happen.

Note: Always consult with your doctor before starting any exercise program.

5. Plan to have fun
It’s good to have fun; have fun! When my son was about four years old, I remember distinctly, it was a beautiful summer day. Our front door was open and he stood there and saw children outside playing. He said, “Dad, there are kids out there! Can I go out and play?”

My point is that when you are a child, all it takes is something as simple as finding other kids and the party is on! As an adult, it takes planning, especially if you have a mood disorder. You need to take time to plan to have fun. Join a bowling league, take a pottery class or cooking class, take ballroom dancing, or take a photography class at the local park district. Take an adult education class at your local community college or park district. It’s not about the grade so you can also skip the tests and homework. These are inexpensive and fun and a great way to meet your socialization goals!
• Do it to be more social.
• Don’t do it for a grade.
• Do it because you are interested in it.
• Do it to help manage your symptoms and to structure your free time.

6. Make time to nurture your relationship.
Line up sitters so you can have time alone with your spouse or significant other. This may feel awkward at first but keep it up anyway. Gentlemen, don’t let the wife be responsible for all the social and vacation planning. Do your share. Plan a date night. When you go to dinner, discuss your next date night, event, or do vacation planning. Don’t use the date night to discuss difficult issues. This is should be a fun time and a way to nurture your relationship. If you are going to have fun, you are going to have to plan ahead!

7. Be social
A common symptom of a mood disorder is social dysfunction or social isolation. Human beings are by nature social creatures, but unfortunately, a common symptom of mood disorders includes social isolation and/or withdrawal. Call a friend and make a lunch date. Have people over to play cards or watch a sporting event. If you don’t have a large social network, use the park district or local community college to meet people. Taking a class or joining the volleyball league at least gives you an opportunity to be with people and make a friend. While meeting strangers may seem intimidating, think of it this way: if you don’t know them to begin with, then you really have nothing to lose if things don’t work out. On the other hand, you never know when a stranger can turn into your new best friend, business partner, or love interest!

8. Hobbies
Try woodworking, paint by number, sewing, knitting, crossword puzzles, gardening, toy trains, arts and crafts, or whatever you choose! Go to a hobby shop and look around but pick something and stick to it. Work on your hobby several times per week or when you are feeling low, negative, or worrisome. It is quite possible you will enjoy the activity so much that you will forget about your symptoms for a while. Hobbies are a great way to distract yourself from troubling thoughts when one else is around.

9. Chores
Most any physical activity is a good distraction from your negative ruminating thoughts and symptoms. Chores are another way to distract yourself and give you a clean environment. When you have depression, the idea of cleaning the entire house or apartment can be overwhelming. Break your chores down into one or two chores each day. For example:
• Monday is vacuuming
• Tuesday is bathroom cleaning
• Wednesday is washing the floor
• Thursday is cleaning the kitchen
• Friday is changing the sheets and towels day
• Saturday is laundry day
• Sunday is a free day. It is your reward for doing your chores all week long.

Chores are a great way to distract yourself from your symptoms. Most any physical activity will help. Make a schedule and stick to it. Try to come up with your own list of distraction activities. The more things you try, the less likely you will be a victim of your disorder.

10. Make healthy choices
This is my generic one. This one may very well be different from person to person. A healthy choice for one person may not be healthy for you. If you have a mood disorder, poor sleep, too much caffeine, alcohol or drug use, and social isolation are mental health issues. Remember! You manage it, or it will manage you!

Zoom! Now I can work via Zoom with anyone, anywhere in the country and it is currently covered by BCBS Insurance. Check with your BCBS representative for more information.

Call James E. DelGenio MS, LCPC, Senior Staff Therapist at The Family Institute at Northwestern University, 847-733-4300 Ext 638.

http://jamesdelgenio.com
http://family-institute.org
http://takenotelessons.com    Highly effective online, one on one, SAT, ACT, GRE, standardized test preparation, via face time or skype.

Disclaimer: This material is meant to be used in conjunction with psychiatric treatment, medication, if necessary, and supportive therapy. Always share this material and your questions about this material with your doctor and therapist.