Tag Archives: Counseling

How can family help one with depression?

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

What to do when your spouse has depression?

The role of the family in treatment is simply to monitor and report. The family should observe the patient’s behavior and report anything that may be important to the stable functioning and health of the patient. The patient should not be interfered with directly unless, of course, s/he is a danger to themselves or others. The family’s role in treatment is a collaborative effort in communication. The family should think of themselves as team members. We are all on the same team! Keeping secrets from the doctor or therapist interferes with treatment and may ultimately have serious consequences. Families should call their doctor, therapist immediately or 911 if the patient has any of the following behaviors or symptoms, especially if they are new, worse, or worry you.

Report when the patient is:

1. Not taking their medication as prescribed.

  1. Abusing alcohol, substances or medications not prescribed by a doctor.
  2. Severely depressed, irritable, threatens violence or has thoughts of suicide or dying.
  3. Exhibits behavior which may result in injury or harm to the individual, family or community.
  4. Experiencing of any relapse warning signs, especially no sleep.
  5. Experiencing panic attacks, uncontrolled anxiety or restlessness.
  6. Acting on dangerous impulses.
  7. Exhibits unusual behavior that is out-of-character for this individual.

Family should:

  1. Avoid placing blame or guilt.
  2. Avoid enabling. You are not responsible for the patient’s wellness. S/he is!
  3. Make regular opportunities to get away from each other. Have outside interests, hobbies and social activities.
  4. Get regular exercise (doctor permitting). Join a health club or walk at least 40 minutes on regularly scheduled days each week. In the winter if needed, use a treadmill or stationary bicycle.
  5. Learn all you can about mood disorders but do not try to be a therapist.

In most cases I have treated over the years, I have seen the client get annoyed with friends and family when they say, “You seem crabby, did you take your medication today”? The typical response is “just because I’m angry or upset doesn’t mean I’ve skipped my medications.” The way I see it, if you have a history of noncompliance, you don’t have the right to be angry when asked! Take the medication as prescribed so your family doesn’t worry about compliance or need to be intrusive in your life. They should be relatively assured that you are compliant with medication and treatment. Regardless, it is the responsibility of the family to ask because the consequences of not taking it as prescribed can lead to injury and possibly suicide.

  • Monitor and report on medication compliance.
  • Monitor and report on the use of alcohol and drugs.
  • Avoid over involvement unless the person poses a danger to himself or others.
  • Avoid trying to help motivate compliance with treatment.

Not in the Chicago Area! Now I can work via face time with anyone, anywhere in the country and it will still be covered by BCBS Insurance.

For those in the metropolitan Chicago area, I have offices in Millennium Park on Michigan Avenue, and near 22nd St and Wolf Road in Westchester. Call James E. DelGenio MS, LCPC, Senior Staff Therapist at The Family Institute at Northwestern University, 847-733-4300 Ext 638.

http://jimdelgenio.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.

Premarital Counseling is a really good idea!

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 psychoeducation 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 for more information.

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 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.