Category Archives: Substance Dependence

Alcohol Dependence, Anxiety Panic Grief Depression, Bipolar Mood Disorders, Coping skills, Couples, Divorce, Glossary of terms, Marital Family Issues, Premarital Issues, Relationships, Substance Dependence

The Family Institute at Northwestern University

Leave a comment

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 Westchester.  Teletherapy 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.

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

Symptoms of Bipolar Mood Disorders and how to cope.

1 Comment

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.

Bipolar Mood Disorders, Coping skills, Glossary of terms, Substance Dependence

What are the Leading Causes of Relapse to Symptoms of Depression?

20 Comments

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

The Leading Causes of Relapse to Symptoms.

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.

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 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://jamesdelgenio.com
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.

Anxiety Panic Grief Depression, Bipolar Mood Disorders, Substance Dependence

How to be well when you have a mood disorder?

1 Comment

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

How to be well when you have a mood disorder?
Coping with a mood disorders is no easy task!  It takes professional support, medication when necessary, psycho-education and experience to manage the debilitating symptoms. With the necessary supports and monitoring, persons with mood disorders can learn to have long-term stability and consistency.
I have also found that it takes an average of about one year to reach those goals. In addition, many people will need some level of support on and off for their entire lives. The bottom line is you can’t do it alone. You need a psychiatrist to manage your medication, if necessary and a therapist to provide ongoing support.

Ten Steps to Wellness
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 definitely a tough one. In order 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.

2) No caffeine, substance 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 consuming two cups per day, 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 often. It’s just one glass. It’s not like I’m an alcoholic.”
The second leading cause of relapse to symptoms is alcohol and substance use. Some doctors and even therapists say that it is alright to have one or two drinks if you have no alcohol abuse or dependence issues. I still question this because alcohol and pot are depressants. Why would you take a depressant when you are depressed under any circumstance?
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. 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!
There is a definitely a negative correlation between the use of alcohol or drugs and a mood disorder. The increased chance of dependence and risk of relapse to the symptoms of your mood disorder are just not worth it. Connect the dots! The bottom line 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 is 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 plus years 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 feel like doing 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!
● Don’t do it for a grade
● Do it because you are interested in it
● Do it to help manage (structure) your symptoms and your free time
● Do it to be more social

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, 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 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 carrier. 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, 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.

Bipolar Mood Disorders, Substance Dependence

Denial  is the biggest obstacle to being well when you have a mood disorder.

3 Comments

James E. DelGenio MS, LCPC   Licensed Clinical Professional Counselor

What is the biggest obstacle to managing depression?

Denial is the biggest obstacle to management and recovery of a mood disorder or alcohol and substance dependence.  Through self-deception, rationalization, justification, and excuse making, a person can deny that they have a problem when everyone around them sees that the problem is obvious.

Denial usual takes place around several key issues. They are: acceptance of the disorder, the use of medication in helping manage the disorder and the detrimental role of alcohol and substances on achieving wellness.

When clinical depression is the disorder; it is biological. It is genetic in origin. One can usually trace it in family history. It may be a grandparent, parent, uncle or cousin, even if it was never formally diagnosed, the history is typically there. No matter how much one tries to pull themselves up by their bootstraps and try harder, they will not make a significant impact on managing their symptoms. Even a skilled Cognitive Behavioral Therapy (CBT) therapist, employing cognitive behavioral techniques will not make a significant difference in the management of the disorder.

This means that medication is indicated. Some women, generally more men will initially refuse medication. I often hear, “I won’t take medication.” I describe my view and experience in general terms. If that is not enough to convince them, I will agree to cognitive behavioral therapy for period of time. If there is still no impact on symptom management through clearly defined goals, I revisit the medication issue to encourage an appointment with a psychiatrist.

Ultimately, it’s your life!  You can be a victim of your disorder or you can choose to manage it. Lets not make life more difficult then it already is. Try the medication for six months and see if it helps.   At least go hear what the doctor has to say.

This is also true around the use of alcohol and recreational drugs such a marijuana. Remember, alcohol is a depressant. When you are already depressed why make it worse. Initially it helps but then it slams you in the days that follow. That is why it is known as self medicating.

Some clients, again mostly men will refuse to consider stopping the use of marijuana. Yet the reason they have initiated treatment is panic and anxiety. Duh! Though not addictive per se, marijuana is habit forming psychologically. Prolonged daily use may cause anxiety and panic for those with a mood disorder. Take medication or stop using. I encourage both.

Though denial can be an issue for both men and women, I have found that men especially do not want to admit that they have a problem. They are generally more resistant to seeking help, taking medication or facing dependence.

In my practice, I recognize that this is a trust issue. If I feel that this will be an issue, I will put the referral for a medication evaluation off for a time while building a therapeutic relationship. I also address this resistance as most therapists do by comparing mood disorders with other physical disabilities such as diabetes or epilepsy. All are physical issues with a genetic origin which affects thinking and behavior. If your doctor told you, “I’m sorry to inform you that you are diabetic like your father was”, you would not like it but would likely be willing to take insulin injections.

The same thought process regarding antidepressants or mood stabilizing medication should apply with a diagnosis of mood disorder. There really is very little difference! Until you can accept your issues and play the hand you were dealt by genetics, environment and personality traits, you will be unlikely to manage your life well.

This will affect your marriage, relationships, employment and your ability to cope with day to day life. There is no soft way to peddle this. A psychiatric evaluation will determine if medication is appropriate. Medication does the first 50% and is considered the foundation. Once on the right medication at the right dose, symptom management with a skilled therapist will likely be more successful. Once this is addressed, we are more likely to resolve relationship issues through individual, family or couples counseling.

Case Scenario
 Case Scenario: Denial or Acceptance – Mary
Mary is a twenty something year old female who enjoys partying with friends. Her friends can drink, smoke pot and stay out until 4 am without major negative impact on their life. Mary cannot. Her partying has also made her medication ineffective.

She initially presented with anger issues.  In addition, she had no motivation and had difficulty getting out of bed. She was experiencing panic and anxiety and had thoughts of suicide. The symptoms of clinical depression including her lack of motivation, poor sleep, poor concentration and tendency to withdraw and isolate have come to a head.

Mary can’t do what her friends did almost every weekend. I encourage someone like this to track their mood in the 3 days after to see if this can help her connect the dots. It’s tough when your friends can do it but you can’t. I always remind my clients that they do have a disability that they need to manage. This makes them different, not bad, just different. However, if she makes the connection then it becomes a choice, a choice to be a victim of her disorder or a choice to be well. You’re only to blame if you ignore it. Then you need to be held accountable.

Zoom!
Now for the first time, I can work zoom time with anyone, anywhere in the country and it may be covered by BCBS Insurance. Check with your BCBS carrier for details.  Call Jim at 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, 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.

Bipolar Mood Disorders, Glossary of terms, Substance Dependence

Psychiatric visit reporting form

2 Comments

James E. DelGenio MS, LCPC

Doctor reporting form. Help the Doctor help you!

Copy and present this to the doctor at each visit. This list is not all inclusive; report anything which may be useful for your treatment. Call 911 in case of emergency or with difficulty breathing!

Name: ___________________________________  Date: ________________

Indicate areas (“X”) in which you feel you need training and education:
1.__ Depression, Mood Disorder, Serious MI
2.__ Use of Psychiatric Medication
3.__ Alcohol, Drug Abuse and Addiction
4.__ Medication Side Effects
5.__ Adverse Reactions
6.__ Dual Diagnosis – MI & Alcohol/Substance Abuse
7.__ Storage of Medication, Safe Guarding Medication
8.__ Medical Emergencies
9.__ Questions About Medications
10.__ Other____________________________________________________________________________________

Do you take your medication daily as prescribed?  __ Yes __ No
Have the benefits & purpose of medication been explained?   __ Yes __ No  Is additional training needed?  __ Yes __ No                                                                      Do you use alcohol and substances?  __Yes  __ No                                                                                                                Comments___________________________________________________________________

Fill in all boxes below with one of the following codes
NA = Not applicable, no problem noted
U = Unable to determine
X = Problem noted, see comments
S = Symptoms

Common Issues, Symptoms & Possible Medication Side Effects.  In case of an emergency or severe reaction call 911.
__ Mood, stability,
__ Swelling
__ Constipation,
__ Diarrhea
__ Anxiety, panic
__ Muscle cramps
__ Headache
__ Suicidal, homicidal thoughts, or plans (call 911)
__ Restlessness, inability to sit still, pacing
__ Abnormal eye movements
__ Dry mouth
__ Tremor
__ Blurred vision
__ Sexual dysfunction
__ Relationship issues, conflict
__ Menstrual problems
__ Urinary retention
__ Depression, mood swings
__ Anger, irritability, hostility
__ Appetite loss, increased appetite
__ Involuntary weight changes
__ Employment issues
__ Poor concentration
__ Poor short term memory
__ Social isolation, withdrawal
__ Eye photo-sensitivity
__ Poor Concentration
__ Hearing voices
__ Poor daily functioning
__ Skin photo-sensitivity
__ Sleep/wake cycle, poor sleep, no sleep
__ Difficulty swallowing or breathing, (call 911)
__ Negative rumination, (negative thoughts on repeat in your head)
__ Skin rash
__ Nausea, vomiting

Comments,_________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Additional comments and concerns: Include: (1) Alcohol and drug use (2) Medication compliance (3) Suicidal or homicidal thoughts or plan (4) Other issues, reactions, side effects or Questions?

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 for cash quote.  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.

Alcohol Dependence, Bipolar Mood Disorders, Substance Dependence

What you should know about dual diagnosis?

Leave a comment

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.

Alcohol Dependence, Anxiety Panic Grief Depression, Bipolar Mood Disorders, Relationships, Substance Dependence

Mood disorders and alcohol don’t mix!

Leave a comment

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.

Alcohol Dependence, Anxiety Panic Grief Depression, Bipolar Mood Disorders, Substance Dependence

What are the Symptoms of Bipolar Depression?

6 Comments

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.

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

Weekly Review of Consistency for management of Depression!

53 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.