Tag Archives: panic

What are essential elements of managing depression?

By James E. DelGenio MS, LCPC

Essential elements in managing your mood!
While a severe mood disorder and/or addiction may not be curable, their results need not be chronic dysfunction. You need not be a helpless victim of a debilitating illness. The frustrating pattern of wellness followed by relapse can be disrupted with proper psychiatric support, therapy and an array of supportive services which ultimately teaches the person about their disability and how to choose to be well.
The fundamental operating principle is that each person has the capacity and responsibility to maintain a state of recovery. Gladstone, DelGenio, Taussig, et al. (1984) have identified interrelated elements which will reduce relapse and bring the person to a higher level of functioning.
These components are:

Structure addresses the importance of your daily routine the management of symptoms including: medication management and compliance and the use of free time, physical activity, exercise, social activity and hobbies. Planning your day/week is key to management.

Psycho-education refers to the guided experiential learning that takes place in individual, couple or family therapy.

Ongoing treatment and support via the level of service necessary to maintain a state of wellness. This is a step-down approach which gradually reduces the frequency of individual therapy from weekly to as needed.
These are further defined below:

Structure
First, you must recognize the need for structure in combating your disorder. Initially, structure means securing an array of supports including an individual/family therapist and a psychiatrist. Add Alcoholics Anonymous (AA), Narcotics Anonymous (NA) or Smart Recovery meetings and professionally led alcohol and addiction groups for dependence or dual diagnosis. Most service providers are willing to collaborate with one another once written permission is obtained from the client. The collaborative support of the treatment team will create a common treatment plan. This will aid all providers to work in the same direction with common goals.
Once the treatment team is in order, the client learns the skills to combat the lack of structure in their daily life. This includes their medication management, i.e. taking the medication at the same time each day which will help ensure compliance. It also includes management of the sleep issues that mood disorders create. This means maintaining consistent sleep/wake habits. It is important to get up and get to bed at the same time each day.
In addition, many people are overwhelmed with common daily tasks such as grocery shopping, chores and laundry. These too can be structured by the day of the week and can become routine. I recommend that you spread out these tasks by picking various days of the week for each task. If it is Tuesday for instance, and that is the day you have picked to clean the kitchen, the day of the week makes the decision for you. This will help to address the lack of motivation which is so common among various mood disorders. The structure provided by this approach will hopefully be the foundation for success, permitting the person to achieve his or her individual capacity for stability and consistency.

Psycho-education aka Experiential Learning

In the early 1990s, my father-in-law had a heart attack. Fortunately, there was little damage to his heart. What was discovered, however, was that his blood sugar was elevated. He was diabetic. When he moved out of intensive care, they began to teach him how to cope with his newly discovered disability. He learned how to measure his blood sugar and how to give himself insulin injections. He was taught what he could eat and what he could not. He even learned what to do if he had a reaction to a particular food or his medication. When he was discharged from the hospital, a nurse visited him at home several times a week for several weeks just to make sure that what he had learned in the hospital, he continued at home. Through education and experiential learning, my father-in-law learned how to manage his diabetes. He learned to manage his disorder so well that eventually he was able to take oral medication and discontinue insulin injections.
In psychotherapy, psycho-education refers to teaching the person how to be well. The therapist will explore relationship issues, provide education about the disorder, symptoms, medication, relapse warning signs, and teach the coping skills necessary to maintain healthy functioning. I say, “This is not as obvious as if you are sitting in a wheelchair, but you do have a disability. You will need to learn how to manage it.”
Clearly, you will need a licensed therapist to assess and identify your disorder. The therapist will guide you through the experience and teach you how to cope with your symptoms. The goal of psycho-education is to help you maintain consistency in the management of your disorder. Without consistency in management of your moods, life will be a rollercoaster and much harder than it needs to be.
You may also be referred to a psychiatrist to confirm your diagnosis and possibly prescribe medication for you. Medication education is very much a part of psycho-education. Initially, if necessary, the doctor will discuss the reasons for and purpose of the use of medication. In the case of mild or situational depression, a psychiatrist may help you determine if medication may be appropriate for a limited time. Typically, the psychiatrist will give you the option of taking medication and encourage continued psychotherapy for daily management. Additional services and supports may be necessary if alcohol/substance abuse and dependence are related issues.

Ongoing treatment
Ongoing treatment refers to the lifelong nature of many mood disorders. Some call it recovery, but to me that implies cured. I prefer to call it maintenance and stability. It takes about a year, sometimes two to learn all that one needs to know and experience to master the symptoms of a mood disorder. As time goes on and stability is achieved, the focus of treatment becomes about consistency in managing the symptoms. Unfortunately, there are those who say, “I feel good; maybe I don’t need treatment or medication anymore.” As much as I try to warn against this, even predict that this day will come, there are those who have to see for themselves. I guess some people just have to learn the hard way. I hope you hear what I am saying and take the less difficult route.
If you do want to try discontinuing medication, please do it with your doctor’s guidance. Typically, you discontinue these medications the way you began them, i.e. gradually. Though antidepressants and mood stabilizers are not addictive medications, an abrupt discontinuation will create uncomfortable side effects and may even be dangerous. Many people refer to the symptoms of abrupt withdrawal from medication as flu like symptoms.
Major depression disorders and bipolar disorders have become more commonly accepted by society in general thanks in part to high profile actors and professional athletes who have disclosed their disorders to the public. Clinical depression and bipolar mood disorders are biological/genetic problems that you most likely inherited and are considered no different than the diagnosis of other medical conditions such as epilepsy. Other mood disorders may be just as debilitating if left untreated. Most will require psycho-education, medication, and ongoing treatment. These disorders are usually manifested in the teens and as late as mid-30s. Real changes come from within. With structure, psycho-education, and ongoing treatment, you can control your disorder.
The most effective way to achieve stability and consistency is through ongoing therapeutic support. Initially this means weekly visits to the therapist and monthly visits to the psychiatrist. As time goes on and the client gains mastery over his or her disorder, the time between visits is extended. You will know because there will be less to discuss. I have clients who I now see monthly or even quarterly. I have found the best long-term results are achieved with ongoing therapeutic support. Practically, this means that we gradually step down the frequency of therapy after you stabilize and begin to master your disorder. Sessions are gradually reduced from weekly to as needed. This is just to check in and remind people that because they don’t have active symptoms does not mean that they are cured. The goal is stability and consistency.
Recovery means management of an intermittent lifelong disorder with only minor interference in one’s life and relationships.

Not in the Chicago Area!

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

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://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.

About my free E-Book: Manage your Mood.

By James E. DelGenio MS, LCPC

Manage your mood (or it will manage you!)

The challenge in writing about mood disorders and the impact on relationships for the general public is that the best and most productive discussions are normally face-to-face. My goal then is to establish a rapport with you. It is just one reason why I have woven some of my personal life experiences into this work. As you will see, we all experience life’s ups and downs. Download the book by simply entering your email at manageyourmood.net. It’s free!

Convention Used in this Book
I am not going to fill your head with medical jargon, so relax. In a straightforward way, we will explore together:
• Mood disorder, what is it and what causes it?
• Symptoms of mood disorders.
• Impact on relationships
• What you need to know.
• How to manage symptoms and improve coping skills.
• How to begin the journey to be well.
• The role of family in treatment of a loved one.

We will also look at common marital and relationship issues.
• Common marital issues.
• Tips for addressing conflict in any relationship.
• Rules for conflict and engagement.
• Benefits of premarital counseling.

For your convenience, there are also some easy to use forms which will help you track your progress.
• Doctor reporting form.
• Weekly review of consistency to help structure your week.

What you will learn. Manage your mood disorder or it will manage you!
• Psycho-education, what you need to know.
• Coping skills and symptom management.
• Common relationship issues and tips.
• Inspiration to find the right balance and enjoyment in your life.
• It is no one’s fault unless you do nothing.
• Practical guidance and goal setting.

This book does not replace treatment.

This book is designed to help you understand, control and maintain good mental health when dealing with mood and relationship issues. You can use this book to gain deeper understanding, but it is NOT a replacement for therapy. Many mood disorders require a psychiatrist to access the need for medication and a skilled therapist to guide one through the process of learning how to be well. If medication is a part of the treatment regimen, it often provides a very necessary foundation for the experiential learning done with the therapist. In some instances, without medication, treatment with a therapist will be less effective or possibly ineffective.

With or without the need for medication, guided experiential learning with a skilled therapist is essential for management of symptoms and their impact on your daily life and relationships. The therapist holds the client accountable by setting measurable goals and encouraging the practice of the appropriate management and coping skills. Since there is no taking a day off from management, weekly discussion with a therapist will help the client learn to identify issues, set and review goals and maintain stability. Only with weekly review of consistency with a skilled therapist will one learn true management of their disorder. As one gains mastery over their symptoms, frequency of treatment with the therapist may be stepped down. Eventually, treatment may be discontinued or simply reduced to as needed.

Note: Alcohol and substance dependence may require additional services and ongoing supports.

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.

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://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.

How to Cope with a mood disorder without Medication?

James E. DelGenio MS, LCPC

How to cope with a mood disorder.

It is good to have fun. Have fun! People with mood disorders often become engrossed in the past, consumed with depression and anxiety. They tend to have negative thoughts that just repeat over and over again. Learning to cope takes experiential learning with a CBT therapist.

Recreation and exercise

Recreation and exercise play a key role in management of symptoms. Especially cardio exercise such as walking is good maintenance of depression, anxiety and panic symptoms.  These are a great distraction when one is experiencing symptoms. Any physical activity is likely to be therapeutic.  Join a park district team, like softball or volley ball.  It’s a good social activity too!

Social activity

Regular social activity is important and healthy; get out with people at least 3 times per month. Consider joining the Park district, volunteering, church groups and activities, or working a shelter.  Find something!  Avoid alcohol.

Hobbies

Get a hobby!  Hobbies to consider? Try paint by number. It’s easy but it takes concentration.  Helps deal with negative thoughts and repeat that often accompany depression. You can also walk away easily by simply rinsing out the brush.  Plan 1/2 half hour per day.

Chores

Even chores can also help with distraction. Make a schedule of chores, and stick to it.  Monday is vacuming, Tuesday is laundry, etc.. This also helps keep your living environment healthy.

Distraction from symptoms is an important coping skill. The tendency to isolate and withdraw also need to be overcome. The Internet, video games, TV or reading, generally do not qualify as distraction for most individuals.

Planning is key because mood disorders require structure. If you are going to have a good weekend, you will need to plan ahead to meet your exercise and social goals.

Unfortunately, sometimes these are just not enough, therefore medication will need to be considered.

When to consider medication?

I am sorry to have to say this but moderate to severe mood disorders require medication to control the symptoms. It’s all about chemistry. If you are diabetic, you would take insulin; you wouldn’t like it but you would do it.  This is no different.  It is just a chemical imbalance.

When coping skills don’t work, you will need to reconsider seeing a doctor and getting on medication. Even with medication, however, you will still need to practice coping skills.  Medication does 6o% and coping skills do the rest.  In these instances, the medication becomes the foundation and will help the coping skills work effectively.

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 847- 733-4300 Ext 638.

James E. DelGenio MS, LCPC

http://jimdelgenio.com
http://family-institute.org
http://psychologytoday.com

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.

What are the symptoms of a mood disorder?

By: James E. DelGenio MS, LCPC

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

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 847-733-4300 Ext 638.
James E. DelGenio MS, LCPC

http://manageyourmood.net
http://family-institute.org
http://psychologytoday.com
http://takenotelessons.com   Effective face to face SAT ACT GRE preparation

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.