Category Archives: Alcohol Dependence

Weekly Review of Consistency for management of Depression!

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.

What you should know about dual diagnosis?

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

What is dual diagnosis?

Dual Diagnosis means that two or more independent disorders exist in the same individual. Specifically, for our purposes, when I speak of dual diagnosis, I am referring to mood disorder and alcohol abuse or drug dependence. Each exists independently of one another and yet each makes the other worse. Both are biological and psycho-social disorders with similar symptoms. They are lifelong disorders, which cause the person to be prone to relapse. Both require integrated treatment that includes psychiatric treatment, medication, psychotherapy, education, symptom management and additional supportive treatment such as Intensive outpatient (IOP), group therapy and Alcoholics Anonymous as needed.

Mood disorders and alcohol and substance abuse do not interact well. In fact, each makes the other worse, especially when one is using and/or not taking medication as prescribed. One must manage both disorders simultaneously and treatment must be a collaborative effort with the level and the array of services necessary to maintain stability, sobriety and consistency.

It is helpful to think of someone you know who is diabetic and what it means to be a diabetic. Mood disorders may not be as visible as sitting in a wheelchair, but you do have a disability. Mood Disorders, addiction and diabetes are comparable in many ways. Each is a lifelong, biological problem that requires daily attention, education and support.

Medication, when taken as prescribed, stabilize each condition but knowledge and training play a very important role in healthy functioning. The comparisons demonstrate that mental disorders, like other physical handicaps, can become manageable handicaps; not the global disability it is for some. It is a result of genetics, an imbalance in the chemistry of the brain. No one is at fault, and no one is to blame. Management of a Mood disorder may well be a lifelong pursuit.

  • Manage both disorders simultaneously.
  • Take medication as prescribed by your doctor.
  • Use coping skills, ie., cardio, socialization, hobbies.
  • Limit or abstain from alcohol use.
  • Your ability to maintain sobriety and manage your mood determines. the level of support needed.
  • Each failure requires an increased level of support, esp around alcohol or substances.

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.

What are the causes of relapse to symptoms of depression

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

What causes relapse?  

The causes of relapse to active symptoms of mood disorder have been well documented over the years. It’s no surprise that these reflect the relapse warning signs listed below.
They are:
• Medication non-compliance (Not taking the medication as prescribed).
• Alcohol and substance use and abuse.
• Little or no sleep.
• Lack of social support, isolation.

Non-compliance with medication and alcohol or substance use or abuse are by far the leading causes of relapse to symptoms. These are self-explanatory. However, little or no sleep and lack of social support also need to be addressed.

Alcohol and/or substance abuse will cause relapse to active symptoms of depression, panic and anxiety. If you are not an alcoholic, I recommend no more than 2 drinks twice per week but never in back to back days. If you mood dips in the days following you should consider abstinence.

Sleep is an important issue for most with mood disorders. People with Bipolar disorders usually report that they don’t need much sleep. They have a tendency to play with their sleep/wake cycle. They like the euphoric hypomanic feeling that lack of sleep creates. It is very much like the moth and the flame. There is an attraction to the high that one gets when they are sleep deprived. Unfortunately, you can take anyone in the world and keep them awake for two, three or four days, they will become actively psychotic. For people with a mood disorder, sleep is a mental health issue.

Social support is also very much a part of maintaining good mental health. Even if one is compliant with medication and not using or abusing alcohol and drugs, social isolation can create considerable stress and ultimately cause a relapse to symptoms. It is imperative that people with mental disorders, have an avenue to combat their tendency to isolate and withdraw from people. I encourage my clients to maintain regular social contact. This contact creates reality testing. We don’t think of socialization as reality testing but it is. For example: You have an argument with your spouse; you call a friend and say here is what happened. What do you think? You get feedback on your situation and behavior. That is reality testing. Lack of social support may result in an inability to test the accuracy of what one is feeling or experiencing. This is obviously a very important component of maintaining good mental health.

Zoom!   Now I can work via Zoom with anyone, anywhere in the country and it may 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.  I am currently doing Zoom only.

http://manageyourmood.net
http://family-institute.org
http://takenotelessons.com   Effective on line, one on one, SAT, ACT, GRE, standardized 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.

Issues to discuss before Marriage. What you will learn in premarital counseling?

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

Premarital Counseling is a really good idea! 

Premarital counseling can help ensure that you and your partner have a strong, healthy relationship. This will give you a better chance for a stable and satisfying marriage. Premarital counseling can also help you identify weaknesses that may become larger problems during marriage. Good marriages don’t happen by accident. Many issues can be resolved prior to marriage with the help of a therapist. Common issues addressed may include work, finances, lifestyle, spending habits, credit card balances, student loans, savings, retirement planning, roles and responsibilities, children, parenting, in-laws, and leisure and fun. Marriage requires an understanding of yourself, your future spouse, and the tools and skills you need to make it work.

Does your significant other have a Mood Disorder?
Some moodiness is a part of everyone’s life; sometimes we feel happy, other times we are sad; some days we have lots of energy, while at other times we may be fatigued and unmotivated. When mood changes interfere with your ability to function, work or go to school, when they harm your relationships significantly, when they cause you to miss sleep, abuse drugs, or behave in ways you later regret, or when they lead to risky behaviors, thoughts of suicide, or losing touch with reality, your mood requires professional attention.

If this sounds like you’re intended. All is not lost. The key factor in this decision is Denial. If your partner tends to deny issues now, do you really think it is going to get better later?
I find that most premarital couples are well aware of their intended’s mood and alcohol/substance issues. My main questions are as follows:
Is he/she:
• Willing to seek help?
• In need of psycho-education and symptom management?
• Willing to take medication, if prescribed?
• Willing to honestly address alcohol and substance abuse issues?
• Willing to see a therapist for relationship issues and support?
It’s not going to get better if your intended is in denial. Get out while you still can!

Civility and Respect
Work on resolving conflicts in a civil and respectful way. Lack of civility and respect will eventually be the undoing of any relationship. It is possible to argue, resolve conflicts, and agree to disagree in a respectful manner. In order to do this, all couples need rules of engagement for conflict. It is important that couples express how they feel, but this needs to be done in a very caring and respectful manner. This definitely means there should be civility and respect when conflict occurs. That means no hitting (of course), no yelling, no swearing, no screaming or name calling or sarcasm. I encourage you to look at yourself and your relationship with your intended. Are you holding onto resentments? If so, you will need a therapist to help resolve this and teach you how to fight with civility and respect.

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

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.

Symptoms of Bipolar Mood Disorders and how to cope.

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

Negative rumination i.e. negative thoughts on repeat often cause conflict in relationships.  Physical distraction of any kind will help some, i.e. cardio work, chores, walking, hobbies. If these don’t help you will need to consider medication.

Overwhelmed with anxiety, panic, depression. This causes lack of motivation and loss of interest.  Need for medication is a must.

Changes in the sleep wake cycle esp. little or no sleep.  Could be heading for a manic episode. Often caused by non-compliance with the medication or alcohol use and abuse.

Isolation and withdrawal from friends and family.  We all need social contacts for good mental health. Look at the pandemic!

Alcohol use or abuse. Either way alcohol and mood disorders do not mix. Alcohol is a depressant and it will increase your anxiety. Don’t drink; you will feel better!

Little or no impulse control; Risky behavior, such as sex, reckless driving.

Uncontrolled spending w/o regard for ability to pay.

Racing thoughts and speech, grandiosity, invincibility.

Verbally abusive to others.  Conflictual relationships. Never permit physical abuse; report it. Get out!  Go to a shelter but get out.

Denial, No need for help or medication! Can’t trust your own thoughts. Need reality testing with friends and family to get past denial.

Hopelessness, thoughts of suicide.

Medication is as necessary as insulin is to a diabetic.  It’s just genetics with faulty chemistry.

The Family Institute at Northwestern University

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

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

Offering Teletherapy anywhere in IL via zoom.  HIPPA approved and accepted by BCBS PPO Insurance.

TFI is a unique not-for-profit organization that is leading the way in all facets to strengthen and heal families from all walks of life through clinical service, education and research. No other institution brings together such a concentration of knowledge, expertise and academic credentials to help improve the lives of people in the Chicago area and around the globe.

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 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://takenotelessons.com   Highly effective on line 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.

Why depression and alcohol just don’t go together?

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

Why are mood disorders and alcoholism often found in the same individual?
The answers here are not completely understood. Some doctors have told me that the sites in the brain that are affected by mood disorders are the same sites affected by addiction. Regardless of the chemistry, research has shown that just casual use of alcohol by a person with a mood disorder may eventually result in abuse or dependence. If you have a severe mood disorder, you shouldn’t have any!

At least see how drinking affects your mood in the 3 days that follow alcohol use. Track it; give yourself a mood score from one to 10, ten being the best. Maybe you can limit alcohol use to one or two drinks twice per week and see if that helps. If you see in charting your mood that it does effect you negatively, than you shouldn’t have any. The consequences are just not worth it. If you can’t stick to two twice a week, you may need alcohol treatment.

Zoom! Now I can work via zoom with anyone, anywhere in the country and it may still be 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://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.

What are the Benefits of Premarital Counseling?

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

The Benefits of Premarital Counseling.

Premarital counseling can help ensure that you and your partner have a strong, healthy relationship. This will give you a better chance for a stable and satisfying marriage. Premarital counseling can also help you identify weaknesses that may become larger problems during marriage. Good marriages don’t happen by accident. Many issues can be resolved prior to marriage with the help of a therapist. Common issues addressed may include: mental health issues, work, finances, drug and alcohol use, lifestyle, spending habits, credit card balances, student loans, savings, retirement planning, roles and responsibilities, children, parenting, in-laws, and leisure and fun. Marriage requires an understanding of yourself, your future spouse, and the tools and skills you need to make it work.

Does your significant other have a Mood Disorder?
Some moodiness is a part of everyone’s life; sometimes we feel happy, other times we are sad; some days we have lots of energy, while at other times we may be fatigued and unmotivated. When mood changes interfere with your ability to function, work or go to school, when they harm your relationships significantly, when they cause you to miss sleep, abuse drugs, or behave in ways you later regret, or when they lead to risky behaviors, thoughts of suicide, or losing touch with reality, your mood requires professional attention.

If this sounds like you’re intended. All is not lost. The key factor in this decision is Denial. If your partner tends to deny issues now, do you really think it is going to get better later?

I find that most premarital couples are well aware of their intended’s mood and alcohol/substance issues. My main questions are as follows:
Is he/she:
• Willing to seek help?
• In need of psycho-education?
• Willing to take medication, if prescribed?
• Willing to honestly address alcohol and substance abuse issues?
• Willing to see a therapist for relationship issues and support?

Rules of Engagement
All couples need rules for fighting. The most important rule is civility and respect. This, of course, means no hitting or throwing ever. If there is physical violence, you must call the police. Beyond that essential rules are no screaming, swearing, or name calling ever. This is destructive and may lead to your undoing as a couple. Couples need to work on resolving conflicts in their relationship with civility and respect so that bitterness and resentments can not build. It is possible to argue, resolve conflicts, and agree to disagree. In order to do this, all couples need rules of engagement for conflict. Establish your rules!

Finances and Spending
One of the biggest causes of problems in relationships is differences in values and goals and habits when it comes to money, and especially communication about money issues. That old saying is true …. money can’t buy you love, but it sure can tear it apart.

This makes a discussion of finances necessary before marriage. Learn how to talk about money, and align your financial goals such as retirement, savings, spending, debt, and disposable income. If you can do those two things, you’ve done more than most couples, and you’ve done a lot to start your relationship off on solid ground.

I therefore, recommend meeting with a financial planner to discuss issues such as spending, use of credit cards and financial goals. Goals should include the following: savings, pension contributions, retirement planning, debt, discretionary spending, school loans and the use of credit cards. How will you handle school loans and debt brought into the marriage? How much money can be spent without consulting the other. I usually recommend $100 to $300.

Family Ties and In-laws
A family is made up of many unique individuals, each with a range of thoughts and opinions on almost every subject and situation. Add to the mix extended family with their countless beliefs and personal opinions and there is no wonder there are disagreements from time to time. Conflict is simply the natural and healthy progression of any relationship

Some questions to explore – What sort of relationship do you have with your extended family? Are they local? Do they like your fiancée? Are they affectionate? Are they over-involved or critical? Have there been any major conflictual issues?

I suggest that couples begin to see themselves as their own family unit. When addressing family of origin, always say that “we” will have to discuss the event or holiday and that he or she should respond to their own family unit. This is especially true once children enter the picture. Now consider, if you want to see us come over………  This way the kids don’t have to get up open presents and get in the car! Now your doing what is best for family.

Religious Beliefs
This potentially contentious issue should always be discussed in premarital counseling. The first step is to seek a better understanding of your future spouse’s religious and spiritual background.
Topics to look into are:
• How to reconcile differing ideologies and practices
• How to observe and celebrate each other’s holidays
• How to raise children so that they are exposed to both partners’ traditions without being overwhelmed and/or confused
• How to integrate both extended families, especially during the wedding/holidays

Case Study:

Mark is not religious; Eileen is and expects to go to Church every week. What if they did marry and had children; would Mark go to Church then?
What if Mark is Catholic and Eileen is Jewish? Will one of you convert? Does it matter at all? What will the respective families say? That is a big question especially in regard to child rearing.

“What do you mean; you are not going to raise the baby Catholic? Jewish?” For some, the consequences of that decision may be long lasting or a deal breaker. It is clearly better to decide before marriage and tell both families about your decision. In discussions with the extended families, always use the phrase “we” have decided.

Children and Parenting
Do you want children? How many and when? Are there already children from previous relationships? Have you discussed blended family issues? What do you expect from your spouse regarding parenting/step parenting roles? When a problem arises, how does my partner communicate? What are the responsibilities of each parent in raising a child?

I strongly recommend that you have two to four years together as a couple before you have children. This time is critical, it gives you the opportunity to get to know one another as a married couple.

Children don’t bring you closer together; they create stress and sometimes distance especially if you and your intended are not on the same page regarding roles and responsibilities. And even more stress when ex’s and step in-laws are in the picture.

Blended families have a lot to discuss: the ex, custody issues, the in-laws, parenting, finances, loans, debt, child support, etc.. They especially need premarital counseling. I am surprised at how often these have not been fully addressed.

I believe that the children don’t come first; your relationship comes first. Now I know that is not true but if you divorce, it will be children that suffer most. Of course, my point is don’t forget to make time for your relationship after you have children. Planning for alone time or date night is a key component in addressing this issue. Take turns planning so the wife isn’t doing it all. But above all – Parent as a team! Be consistent with consequences. Discuss issues prior to discussing them with the children. What to say and how to say it.

Work, Lifestyle, Leisure and Fun
What sort of lifestyle do you want? Will you both continue to work when children are born? Do you have the same idea of what is fun? Where will you want to live?

Today most couples are comprised of two working parents. Couples want to maintain or improve the lifestyle they had going into the marriage. This is difficult in today’s economy and job market. For the first time in history, couples may not meet or exceed their parents’ lifestyle. The common expectations of employment today are long hours and work from home in the evening and on the weekend. This reduces quality time together. These forces necessitate compromise and making the most of the time you have together. Planning mutually enjoyable activities and social events and balanced with appropriate alone time is a key component in maintaining a strong relationship.

Final Thought
You may not feel you NEED premarital counseling, but it is still wise choice to consider. You may be on cloud nine with the impending marriage but counseling may help bring up and resolve some difficult topics. Better to discuss issues before marriage then with a divorce attorney later.

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 with your doctor and therapist.