Tag Archives: depression

Bipolar Mood Disorders

How to manage Bipolar Disorder and Denial?

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


Denial is the biggest obstacle to management and recovery of Bipolar Mood Disorder.

People with bipolar disorders, in particular, seem to have the most issues with denial and are, therefore, the most difficult people to treat from a therapist stand point. 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. This seems to be most common with Bipolar Disorders.

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 substance use or abuse in 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 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 reconsideration. Ultimately, it’s your life; you can be a victim of your disorder or you can choose to manage it. It doesn’t happen often but I have discontinued treatment and offered some referrals to other therapists who are willing to treat the disorder without the help of medication. Personally, I just can’t do it at least not for very long.

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

She initially presented with severe anger issues. She reported that she would lose control, even become violent. She was already on an antidepressant but it wasn’t helping. 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. She reported that her anger was out of control. In addition, she had no motivation and had difficulty getting out of bed. She was experiencing panic and anxiety and had thoughts of suicide.

Beth can’t do what her friends did almost every weekend. I encourage someone like this to track their alcohol and pot use in the 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.

Payment and Insurance:
Blue Cross and Blue Shield PPO insurance welcome. Cash, check, Visa, Master Card or American Express accepted.

Zoom

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

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

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

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

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

Mood disorders and alcohol don’t mix!

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

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 than 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://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.

Bipolar Mood Disorders, Relationships

Depression and high expressed emotion

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

Depression and high expressed emotion.

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

Case scenario: Mary is 39 years old, and she has a severe mood disorder. She was sitting on the couch while her husband was arguing with his business partner on the phone. As the conversation became more heated, she began to shake with anxiety.

If you have a mood disorder, just being in the presence of high expressed emotion can have severe effect on the individual listening. Now imagine if that emotion was directed at her! The point is when a spouse or family member has a mood disorder, high expressed emotion or lack of civility and respect even if it is not directed at the individual will have a detrimental effect and may even lead to active symptoms. All the more reason to be civil and respectful!

Zoom

Now I can work via zoom with anyone in the country and it will still be covered by BCBS Insurance. Call 847-733-4300 Ext 638.

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

Bipolar Mood Disorders, Marital Family Issues, Relationships

How can family help a loved one with depression?

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

How can family help a loved one with 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.
  2. Abusing alcohol, substances or medications not prescribed by a doctor.
  3. Severely depressed, irritable, threatens violence or has thoughts of suicide or dying.
  4. Exhibits behavior which may result in injury or harm to the individual, family or community.
  5. Experiencing of any relapse warning signs, especially no sleep.
  6. Experiencing panic attacks, uncontrolled anxiety or restlessness.
  7. Acting on dangerous impulses.
  8. 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 meds”. 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.

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://takenotelessons.com   Effective online, one on one, SAT, ACT, GRE, test preparation, via face time or skype.

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

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

What are the best coping skills for depression?

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

Distraction is the best coping skill for depression.

Socialization, Exercise, Hobbies, Chores

Socialization is an important coping skill. It is good to have fun. Have fun! People with mood disorders often become engrossed in the past, their illness, and problems. They tend to isolate and withdraw. That is just not healthy and is a common symptom of depression. You should have at least 3-4 social events each month.

Exercise (especially walking) is good for depression and anxiety and is a great distraction when one is experiencing symptoms. Research suggests that a brisk walk for 4o minutes (with your doctor’s approval) will lift your mood and reduce anxiety. Don’t wait to feel motivated. Lack of motivation is often a direct result of a mood disorder. If you wait to feel motivated, it may never happen. Walk or do cardio work at least 4 times per week. Pick your days and let the day of the week make the decision for you. This will help to avoid, “I don’t feel like it today; I’ll do it tomorrow.” Unfortunately, tomorrow never comes. Any physical activity is likely to be helpful.

Hobbies can also be an important coping skill. A hobby can serve as a distraction when you are feeling low or anxious. Go to a hobby shop and pick something. I have had a lot of people choose paint by number sets. It’s the perfect hobby. You can pick up a paint brush and distract yourself and put it down and walk away when you need to. I had one man become a very good artist after starting with just a paint by number set. So, go to the hobby shop and pick something!

Chores can also be a great distraction. Many people with depression are overwhelmed by the thought of cleaning their entire living space. Again, use the pick a day method and choose one or two chores per day. Do your chores and exercise on the days you have picked to do them. Try to have at least one social activity per week. Plan to have fun. Adding structure to your life addresses many common symptoms of a mood disorder but especially lack of motivation.

If these distraction techniques don’t work, you may need to consider medication such as an anti-depressant. Talk with your doctor soon.

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.

Uncategorized

The Family Institute at Northwestern University.

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

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.

The services include: Individual and family counseling, child and adolescent services, marital and premarital counseling, mental health counseling, psychological testing and more…

Locations: Evanston, Millennium Park (Chicago), Northbrook, Westchester and Naperville, IL

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://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.

Anxiety Panic Grief Depression, Bipolar Mood Disorders, Coping skills

Have Anxiety? Learn a simple relaxation technique!

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

Learn how to relax!

Most people experience tension; knowing how to relieve that tension can help prevent or reduce anxiety, headaches, back pain, high blood pressure, and a number of other stress related symptoms.

Listed below are some simple techniques for reducing anxiety that gets in the way of your happiness.

Position: Find a comfortable chair, preferably a reclliner or chair with an ottoman and a headrest where you will not be disturbed for at least 10 minutes. Loosen any tight clothing you may be wearing. Assume a comfortable position; let your hands rest comfortable at your sides. Open your mouth slightly, let your lower jaw hang loose, drop your shoulders, let your chest collapse and your stomach stick out. Breathe slowly and smoothly. Close your eyes; do not fall asleep; do not cross your arms or legs.

Breathing: Inhale through your nose, exhale through your mouth. Become aware of your breathing. Allow your exhale to be slow and easy. As you breathe out, say the word “ one” to yourself. Repeat this for several minutes, thinking “one” on each exhale. Imagine that each slow exhale the tension is leaving your body. When you finish, sit quietly for a few minutes at first with your eyes closed before you get up.

Imagery: When you close your eyes, clear your mind. Go off on a mental trip to a pleasant peaceful place where you feel relaxed, safe, and free of worries or concerns. Stay there several minutes and savor the experience. You can imagine this trip to you restful retreat whenever you feel tense or anxious. It is your private tranquilizer.

Here are some ways to install relaxation practice in your daily routine:

1) Make your daily relaxation practice a ritual; select two regular times each day for about ten minutes at a time and stick to your plan.
2) For instant relaxation remind yourself by sticking a colored dot on your watch so each time you see it you will be reminded to relax.

Note: Using any relaxation technique takes practice; the more you practice the better you will get at this natural form of tension reduction. It is a safe, effective, drugless way to relax. Try it!

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 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.

Anxiety Panic Grief Depression, Bipolar Mood Disorders, Glossary of terms, Severe mental illness

How to be well when you have a mood disorder?

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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 disorder is no easy task!  It takes professional support, education and experience to manage the debilitating symptoms.  In my practice, I have found that if I can provide a structured program which includes education and training to:

  1. Remain stable
  2. Learn coping skills
  3. Learn to overcome social dysfunction
  4. Have a network of friends and supports
  5. Thrive in a job or school

I have also found that it takes an average of about 1 year to reach those goals, while some people may never reach all five.  In addition, most people will always need some level of support their entire lives.  The bottom line is you can’t do it alone!  You need a doctor and therapist who can collaborate regarding treatment.  I have listed below the 10 elements necessary to cope with a mood disorder. See Disclaimer at the end of this article.

1)  Take the medication as prescribed by your doctor.

Not all my clients require medication but when coping skills and symptom management don’t make a significant impact on symptoms, it’s time to consider medication. This is a tough one.  No one likes to have to take medication, possibly every day for the rest of your life. Moderate to severe mood disorders will require medication for symptom management. It’s all about body chemistry, therefore, it’s no one’s fault.  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.

People with depression and mood disorders often have problems with sleep.  I do not recommend using caffeine.  It interferes with the sleep/wake cycle.  I also don’t recommend working the night shift i.e., midnight to 8 AM.  It is too hard to get adjusted to a night shift and it also wreaks havoc with the sleep/wake cycle.  Tell your doctor or your therapist if you are not sleeping.

As far as alcohol and substance use, it is as simple as it is hard.  Don’t do it!  Mental illness alters reality.  Alcohol and substance abuse alter reality.  There are negative relationships among alcohol and drug use, addiction, mood disorder and relapse.  The bottom-line is USE CAN BE THE SAME AS ABUSE!  Don’t use, ever!  If you already have a problem, get professional help and go to your AA or NA meetings as often as it is necessary to maintain sobriety.

 Note: Some Doctors and even therapists say that it is OK to have 1 or 2 drinks once in a while on special occasions even if you are not an alcoholic.  I question this because alcohol is a depressant.  Why would you take a depressant when you are taking an anti-depressant?  I call this the Elvis (Presley) syndrome.  Reportedly, Elvis took uppers to counter act the downers, to counter act the uppers.  It eventually killed him.  If you do drink, I strongly recommend that it be infrequent and on special occasions only.  This should be one or two drinks at most, and I encourage you to monitor your mood in the following few days.  Look for increased depression, disturbing thoughts or anger and irritability.  This will tell you if you can have one or two or none.

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) Be social, outside of the family.

Depression tends to make people isolated and withdrawn.  People need contact with other people to remain grounded in reality.  Even family cannot take the place of social contact in its benefit concerning reality testing.  People with mood disorders cannot always trust what they feel, see or hear.  They need to “check it out” with other people.

We all use our friends to test reality; you just don’t think of it in that way.  For example, you call up your friend and say, “Do you know what happened today?  I had an argument …  She said… I said …” Who do you think was right?”  It’s over simplified but you get the idea.  People need other people for many reasons.  For people with a mood disorder, reality testing or “checking it out” is just one of them.  I recommend at least two social activities per month with people other than family.

5)  Be active.

People with mood disorders tend to be sedentary.  They need to walk and get exercise as much or more than any of us.  I recommend taking a brisk walk, weather permitting, at least 4 times per week for 40 minutes.  Pick your days and stick to them as much as you can.  It is widely accepted today that walking (cardio work) reduces anxiety and improves your mood so get out there and walk.

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

6)  Plan to have fun.

When you were a child, it didn’t take much to have fun. You simply go outside and find some other kids and the party is on so to speak.  As an adult, we need to plan to have fun.  For example, if you had a boring weekend you might say to your spouse, “This was a lousy weekend.  Next week we need to plan to get together with …”   Get the idea?  People with mood disorders tend to become consumed with their symptoms.  Planning is a very important part of meeting your social goals.

7)  Work on a hobby daily.

A hobby is a wonderful way to cope and help structure your day.  When no one else is around or when you are experiencing negative thoughts, feeling low or just plain bored a hobby fills the bill.  The key word here is coping.  People often complain about too much free time and yet they will say, “I don’t have a hobby,” but they will sit for hours ruminating about their symptoms.  That is just not healthy.  So, don’t tell me why you can’t work on a hobby.  Tell me what hobby you are going to choose and get to work.  Hobbies should be worked on at least 1/2 hour any time you are having difficulty coping with your symptoms. I have seen some do paint by number as an easy way to distract themselves. The nice thing is you can pick it up and put it down and walk away.

8) Do your chores on assigned days.

Chores are a great way to distract yourself from your symptoms. 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. Make a cleaning schedule and stick to it. 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. Tape it on your refrigerator or someplace where you will see it every day, and then, stick to your cleaning schedule.  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.

This is not about how you feel.  If you felt good, you wouldn’t need this stuff.  If it’s Monday and you are scheduled to vacuum – do it.    It is a coping skill, and it also gives you the added benefit of a healthy environment in which to live.

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.

9)  Get at least 5 to 7 hours of sleep per night.

As I stated earlier, sleep is very important to maintaining your mental health.  Too much sleep is not healthy.  No sleep is a quick ticket to a psychiatric hospital.  I could take just about anyone in the world; if I kept them awake long enough, they would lose touch with reality.  Lack of sleep usually indicates that the person is not taking their medication as prescribed.  Remember Goal # 1.  Take the medication as prescribed by your doctor.  If you’re still not sleeping, notify your doctor.  It only takes a few sleepless nights to lose touch with reality and relapse to severe symptoms.

10)  Make healthy choices!

This is my generic one.  This one may very well be different from person to person.  What is a healthy choice for one person may not be healthy for another.  For example, if you have a mood disorder, poor sleep and alcohol use are mental health issues.

Issue 1. Sleep

Typical response: “It’s not the caffeine.  I like coffee.  It doesn’t affect me.  I’ve always drank coffee.”  Whether it’s coffee, soda or tea, caffeine interferes with sleep.  It is the most obvious reason for poor sleep.  I would certainly recommend discontinuing caffeine before asking the doctor for a sleeping pill.  Avoid caffeine for one month and see if you don’t sleep better.

Issue 2. Alcohol

Typical response: “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.”

Alcohol is a depressant. It may affect your mood for days, even weeks.  Don’t deny the obvious.  This is just not a healthy choice.  So, remember, what is healthy for one person, may not be a healthy for you.  Make healthy choices!

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.

Bipolar Mood Disorders, Glossary of terms, Relationships

What are the symptoms of a mood disorder?

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

What is a mood disorder?

A Mood disorder is a generic term for people experiencing mild to severe depressive disorders, situational depression often associated with grief and loss, bipolar disorders, panic and anxiety disorders, phobias, personality disorders and other disorders which may include alcohol or drug abuse or dependence. Check the symptoms list below. If you have four or more related symptoms, discuss these symptoms with your doctor, psychiatrist and therapist.

Common symptoms of a mood disorder

__    Lack of pleasure, loss of interest and energy.
__    Lack of goal directed behavior.
__    Feeling down and depressed
__    Lack of motivation, lethargy.
__    Inability to structure time, poor concentration.
__    Anger, hostility, irritability, resentment.
__    Strained relationships, marital issues, divorce, loss of friends.
__    Withdrawal, isolation, would rather be alone.
__    Difficulty in coping with the past or stuck in the past.
__    Sleeping too much or too little.
__    Anxiety, panic, worry, sadness, tearful.
__    Negative thinking, rumination.
__    Feeling guilty, stressed or hopeless.
__    Poor self-care including hygiene and diet.
__    Aches, pains, dizziness, headaches, or stomach aches.
__    Unintentional weight loss, gain.
__    Crisis prone, police involvement.
__    Low sex drive.
__    Thoughts of suicide, homicide.

    • These disorders require education, psychiatric treatment and ongoing therapeutic support.
    • The key here is management of a disability.
    • You manage it or it will manage you!  How do you want to live your life?

Zoom!

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  847-733-4300 Ext 638.

http://manageyourmood.net
http://family-institute.org
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Disclaimer: This material is meant to be used in conjunction with psychiatric treatment, medication and supportive therapy. Always share this material and your questions about this material with your doctor and therapist.

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

Find the right medication for depression through genetic testing!

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

Medication with supportive psychotherapy is most effective treatment of clinical depression. Most people go to a psychiatrist for their disorder and get on medication and in a two or three month process they feel significantly better.  As a therapist with over 35 years of experience, I have also seen some that struggle to find the right medication at the right dose for their disorder. I have seen this process take as long as 18 months.  This leads to frustration and possibly discontinuing treatment. Now psychiatry can take some of the guesswork out of the medication process. Genetic testing through GeneSight 866-757-9204 can help you and your doctor find the right medication for your body chemistry.  Call GeneSight for more information.

Note: I have no relationship with GeneSight; I just hate to see the struggle to find the right medication at the right dose.

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://takenotelessons.com   Effective online, one on one, SAT, ACT, GRE, standardized test preparation, via face time or skype.

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