Category Archives: Alcohol Dependence

What are the causes of relapse to symptoms of depression

By James E. DelGenio MS, LCPC

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://psychologytoday.com
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.

The Family Institute at Northwestern University

James DelGenio LCPC is a senior staff therapist who offers 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 dependence.

Locations include Millennium Park (Michigan Avenue), and WestchesterTeletherapy anywhere 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://psychologytoday.com
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.

Symptoms of Bipolar Mood Disorders and how to cope.

Symptoms of Bipolar mood disorders James E. DelGenio LCPC

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.

Why depression and alcohol just don’t go together?

James E. DelGenio MS, LCPC

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://psychologytoday.com
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.

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
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.

Mood disorders and alcohol don’t mix!

By James E. DelGenio MS, LCPC

When you have a mood disorder, the use of alcohol may be the same as abuse!

Where mood disorders are concerned use may very well be the same as abuse!  Alcohol impairs functioning and it affects thinking, behavior and relationships.  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.

Alcohol also “washes out” and therefore may negate the usefulness of the medication.  Remember, it takes four to six weeks to get the medication to a therapeutic level.  When you drink you affect that level. In addition, one should never use alcohol or substances when taking 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, check with your Dr. 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 and can lead to drug/alcohol dependence.
  • Conflict often related to alcohol use and mood disorders.
  • Two drinks, beer or wine only; never back to back days, no more then twice per week with doctor approval.
  • 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 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   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.

What are the Symptoms of Bipolar Depression?

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

Symptoms of Bipolar Disorder

Bipolar Disorder formerly known as manic depressive disorder is a mood disorder in which people may have mixed episodes of mania and depression. This is a biological problem and will most likely require medication.

The biggest problem with managing this diagnosis is missing the high of mania. It is very much like a mouth to a flame. It is a very appealing state of mind but a very dangerous flirtation risking the stability of your mental health.

If you check even one or two of these symptoms, you should consider getting an evaluation by a psychiatrist and/or therapist. See how many of these symptoms listed below describe you.

__        Rapid mood fluctuations.

__        Feeling high, euphoric or having inflated self-esteem.

__        Irritability, hostility, anger.

__        Aggressive or risky behavior.

__        Pressured, fast speech, more talkative than usual.

__        Racing thoughts, skidding from subject to subject.

__        Delusions of grandeur, grandiose beliefs or behavior.

__        Poor judgment, lack of insight, false beliefs.

__        Poor self-control.

__        Little or no need for sleep.

__        Increased activity, sexual drive and impassivity including spending.

__        Easily distracted, poor concentration, short term memory issues.

__        Alcohol and substance abuse.

__        Bizarre dress and appearance.

__        Thoughts of suicide, homicide.

The above symptoms of depression and bipolar mood disorders are widely accepted. Since these disorders have a biological basis; a psychiatrist manages the medication while the therapist provides treatment and support. The therapist support often includes psychoeducation, symptom reduction and management, increased coping skills and management of other day to day stress such as job loss, school failure and relationship issues.

There is also an increased risk of substance abuse, dependence and alcohol issues.  Seventy to 90% of those diagnosed with a bipolar disorder also have alcohol and drug dependence. Research suggests that just casual use of alcohol with a bipolar issue may result in dependence over time.

There are two types of bipolar disorders. They are Bipolar I and Bipolar II. Bipolar I is considered the more severe of the two disorders and has more extreme episodes of mania or depression. It may also have psychotic features such as delusions and paranoia. This generally includes being out of touch with reality.

Bipolar II is characterized by milder swings of mania and depression and may have less serious effect on daily routine, relationships or employment. Both bipolar 1 and bipolar ll need ongoing treatment and medication to manage the symptoms well.

  • Most common symptoms of bipolar disorders are feeling high, risky behavior, rapid mood fluctuations and hostility.
  • Denial is a common symptom of bipolar disorder.
  • Bipolar disorders require psychiatric medication (typically a mood stabilizer), psychoeducation, ongoing therapy and additional supports when alcohol and substance dependence are also issues.
  • Alcohol and drug use should be avoided with this diagnosis.

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
http://psychologytoday.com
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.

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.