All posts by James DelGenio

Individual, Family, and Couples Counselor with over forty years of experience as therapist, author, and continuing education provider.

Manage your Mood or It will Manage You!

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

How to Manage your Mood.

This material will not resolve all the issues associated with mood disorders without professional intervention. My goal here is to begin the process of identification and education. I want to help familiarize you with symptoms, terminology, facts, and related issues. I would also like to aid you in managing and coping with your disorder and to help you minimize the impact that it has on your daily life and relationships.

Historically, mood disorders have been prevalent in a large segment of the American population. The National Institute of Mental Health estimates that about one in seven people in the United States have a diagnosis of mental disorder. So ultimately, if you have a mood disorder you are not alone. Surely, you or someone you know, and love struggles with a mood disorder. Together, we will explore ways to bring your life back to balance.

In all, I have over 40 years of experience as a clinician, speaker and continuing education provider. I’ve seen a lot of issues, counseled a lot of people, and helped people cope with some of the most severe mental health issues out there. I certainly haven’t seen it all, and I’ve learned enough after 40 years to know that I haven’t and never will.  What I have seen are mood disorders and marital conflicts of all kinds. And yes, there are ways to better manage your life and your marriage.  I will share tools to manage your symptoms and improve your relationships.

There are common symptoms and issues associated with a diagnosis of mood disorder. I will use these common themes and present useful tools to help guide one toward their goals.

Many symptoms of depression and other mood disorders are commonly associated with marital and family conflict, sleep issues, irritability, anxiety, panic, OCD, social dysfunction, and alcohol and substance abuse or dependence. These symptoms may vary from person to person as the specific diagnosis indicates but essentially the management issues remain the same. One needs to: accept that there is an issue, learn to identify symptoms as such, learn coping skills which will ultimately improve many of your communication and relationship issues.  

However, you have come to this piece, there is no doubt you are dealing with issues in your life for which you need help. We all experience issues in life that are difficult – that is a part of life’s journey. There is simply no way to avoid stress in society today. Seek professional help! You will need to understand your disorder and its impacts on your life. Then you will need to learn the tools to manage it consistently. This will minimize the impact that a mood disorder has on your life and relationships, especially your marriage and family.

It is my hope and wish that you will gain a better understanding of your disorder, learn some management skills and begin the journey toward wellness because if you don’t manage it, it will manage you!

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   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.

What are the Symptoms of Bipolar Depression?

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

Symptoms of Bipolar Disorder

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

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

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

__        Rapid mood fluctuations.

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

__        Irritability, hostility, anger.

__        Aggressive or risky behavior.

__        Pressured, fast speech, more talkative than usual.

__        Racing thoughts, skidding from subject to subject.

__        Delusions of grandeur, grandiose beliefs or behavior.

__        Poor judgment, lack of insight, false beliefs.

__        Poor self-control.

__        Little or no need for sleep.

__        Increased activity, sexual drive and impassivity including spending.

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

__        Alcohol and substance abuse.

__        Bizarre dress and appearance.

__        Thoughts of suicide, homicide.

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

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

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

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

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

Zoom!

Now I can work via zoom with anyone, anywhere in the country and it may still be covered by BCBS Insurance. Check with your BCBS representative.  Call James E. DelGenio MS, LCPC, Senior Staff Therapist at The Family Institute at Northwestern University, 847-733-4300 Ext 638.

http://manageyourmood.net
http://family-institute.org
http://psychologytoday.com
http://takenotelessons.com   Highly effective online, one on one, SAT, ACT, GRE, standardized test preparation, via face time or skype.

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

Symptoms of Depression and other mood disorders

James E. DelGenio MS, LCPC

Symptoms of clinical depression & symptoms of situational depression.

If left untreated, symptoms of depression, anxiety and panic may worsen and severely disrupt one’s life. These symptoms can cause untold suffering and possibly lead to hospitalization, strained relationships, divorce or even suicide. Recognizing the symptoms of a mood disorder is often the biggest hurdle to the diagnosis and treatment. I will list commonly recognized symptoms; see how many apply to you. Typically, if you recognize more than two or three from the checklist below you should consider getting an evaluation by a licensed professional.

Symptoms of depression, panic and anxiety checklist: Note the symptoms that apply to you.
__ Lack of pleasure, loss of interest and energy
__ Lack of goal-directed behavior, lack of motivation, lethargy
__ Lack of insight into one’s own behavior
__ Inability to structure time, poor concentration
__ Anger, hostility, irritability
__ Strained relationships, marital conflict, loss of friends
__ Withdrawal, isolation, would rather be alone
__ Difficulty in getting along with people
__ Sleeping too much or too little
__ Anxiety, worry, sadness, low mood
__ False beliefs, 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 or gain
__ Crisis prone, police involvement
__ Low sex drive
__ Thoughts of suicide, homicide

Zoom!
Now I can work via zoom with anyone, anywhere in the country and it may currently 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    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.

How can family help a loved one with depression?

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://psychologytoday.com
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.

The Family Institute at Northwestern University.

James E. DelGenio LCPC   Senior Staff Therapist                                              

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://jamesdelgenio.com
http://family-institute.org
http://psychologytoday.com
http://takenotelessons.com   Highly effective on line one on one, SAT, ACT, GRE, standardized test preparation, via face time or skype.

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

Homework for couples

James E, DelGenio MS, LCPC

Homework for couples.

As a cognitive behavioral therapist, I assign homework between sessions to the couples I counsel. Homework will not solve conflict, communication or resentment issues. Those issues need to be addressed in session. Homework will, however, help and typically addresses the following:

Civility and Respect
This one is a must. Civility and respect is the foundation of your relationship. When a couple loses civility and respect, their relationship is in serious trouble. They feel distant and as a result intimacy suffers. There is never a good reason to scream, swear, name call, or act out like mooning your spouse. If you have gotten into these habits, you may need professional help to get it under control. It will take some time; it is a process – but if you work at it and strive for consistency you can regain civility and respect. As in any process, owning your errors is important. Don’t hesitate to acknowledge it if you say something that is not civil or respectful. Say, “I am sorry I should not have said that.” and mean it. All couples need rules of engagement for conflict. You can never allow yourself to lose control. It is the foundation of your relationship. You can’t build a house without a good foundation. Couples can’t permit yelling, screaming, swearing and name calling to undermine their relationship.

Call Time Out
When conflict becomes too intense and one or both of you are in danger of losing civility and respect, call a time out. The words time out will become a signal for both of you to settle down. Never follow your spouse when they are trying to retreat from the conflict. Standing outside the bathroom door and continuing the discussion is out of bounds. If you decide to go for a walk or to a movie, say so your spouse knows when you are coming back. It is cruel to just walk out without regard for the other’s feelings. The rule of time out is you must get back to the discussion within 24 hours. Far too often couples will just let the issue go unresolved, swept under the rug. This creates resentment and distance. Hopefully, after a day to reflect, you will be able to discuss the issue calmly. If not, hold the issue for the next therapy session.

Reduce Alcohol/Drug Use
Many fights occur when too much alcohol has been consumed. Alcohol reduces inhibitions making it easier to allow yourself to lose control. If you are drinking daily, you may have a problem. Denial is a huge part of alcoholism. I typically say, can you stop drinking for a week, a month? Note: If you are a binge drinker, you still are an alcoholic. If you make excuses and refuse the challenge, you have an alcohol problem. There is no good reason one should be drinking on a daily basis. When alcohol is at the basis of conflict, you have to stick to two drinks twice a week. If you can’t, you need professional help!

Date Night
A night out alone is a common suggestion among both therapists and self-help books. As I have said, couples lose their way because of all that life throws at them. Don’t forget to nurture the relationship by spending time together alone. This does not have to be a big money issue. Many people with financial stress will simply go out for coffee or ice cream. I find it a statement of the current economic times and somewhat sad that couples will go out after therapy because they can’t afford a babysitter twice in one week.

Meet and Greet
Meet and greet is another way to address the lack of affection that many spouses feel. Touch is very important. This is not sexual touching. This is simply affection. Offer a hug and kiss when you leave and when you return. The responsibility is on both of you to find one another and do this when one of you walks in the door or leaves for work. Reaching out and holding hands when walking or just watching TV is also a way to address lack of affection.

Parent as a Team
Children learn quickly who to go to get what they want. Sometimes tension between parents is picked up on by the children and they will take sides. As I say, “the walls have ears.” Even when you don’t think they hear your arguments more than likely they do. I have had children tell me, “I listen to their arguments through the heating vent in my room.” A daughter will often side with mom. The result is when dad tells the daughter to get ready for bed, she ignores him. He gets upset and mom steps in often creating even more conflict between mom and dad. Mom needs to back dad and of course vice versa. “Do what your father says”. When mom is angry at dad anyway due to unresolved marital issues, mom unconsciously gets satisfaction from the child’s disrespect toward dad. This will continue for a while until marital issues are addressed and parents recognize how they undermine the others authority, and the child sees that they are consistently parenting as a team. Parents need to support one another in family meetings to address disrespect to the other parent. This is a common issue addressed under family meetings below.

“I feel” Statements
Inability to express feeling is a major issue in many relationships. One of the hardest things for many men to do is to get in touch with feelings. I find that many men have difficulty expressing their feelings at all let alone civilly and respectfully. Yet, lack of expression of feelings is a major cause of marital discontent. Opening up is critical for a good relationship. In addition, expressing feelings out loud appropriately helps dissipate negative feelings. Women, especially it seems, need to know what their man is feeling in order to feel connected and consequently warm and fuzzy in the bedroom. Men are more R rated; they don’t like to talk. Women say about 6,000 words per day: men only 2,000. I believe that good communication is romance, and that communication is needed for marital success. For most women and many men, it is that expression which makes a couple feel connected. I encourage “I feel” statements….” because.” It may at times still be a confrontational statement but much less so than when you begin statements with “you always “. First of all, never say never and always. When you have something difficult to say be nose to nose with your arms around the person. Say, “I feel” and it will more likely be perceived less defensively than things are said from across the room or behind a closed door.

No History Lessons and no skidding off current issues
Stay on the present issue. Many couples allow their conflicts to skid into the past. When this happens there is rarely a resolution to the current issue. This can create hostility and resentment. When you find yourself fighting about where you squeeze the toothpaste tube (he squeezes in the middle you squeeze on the end) obviously you are not addressing the real issues.

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 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 with your doctor and therapist.

Seasonal Affective Disorder (SAD)

James E. DelGenio MS, LCPC

What is Seasonal Affective Disorder?

SAD as it is known by many, is a type of depression related to the dark gloom of fall and winter with shorter days and less sunlight. SAD is exacerbated by a decrease in activity level that is generally created in the cold winter months. The symptoms are largely the same but not as severe as for other depressive disorders including poor sleep and fatigue, crying spells, irritability, poor concentration, weight gain and loss of sex drive. In some severe cases, seasonal affective disorder can also be associated with thoughts of suicide.

Though symptoms usually improve in the summer, many people have found relief from the use of full spectrum lighting in their homes. These lights come in a variety of shapes and sizes and can be easily found on the internet. Probably the least expensive of these is the 27-watt full spectrum CFL bulb which can be placed strategically in fixtures and lamps throughout one’s residence. These are effective when used on a daily basis. Sometimes, however, these lights are simply not enough. In these cases, many of my clients have found relief by taking an antidepressant for a period of time and by increasing the level of physical exercise especially cardio work.

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 847-733-4300 Ext 638.

http://manageyourmood.net
http://family-institute.org
http://psychologytoday.com Find a therapist
http://takenotelessons.com   Highly effective SAT, ACT, GRE, standardized test preparation and much more.

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

Psychiatric Treatment – Help the Doctor Help You

James E. DelGenio MS, LCPC

How to prepare for your psychiatry appointment?

Help the doctor help you to avoid relapse to active symptoms of depression, anxiety or panic.  The Psychiatrist is an integral part of the treatment team. S/he needs your honest input to best help you. If any of the following are problematic, report them to the doctor. Write things down so you are prepared for your appointment.

Report any changes in your symptoms to your doctor including:

1. Sleep patterns

2. Changes in Mood

3. Poor concentration, poor short-term memory

4. Disturbing thoughts of self-harm or harm to others

5. Drug and alcohol use/abuse

6. Medication side effects or allergic reactions

7. Social activity or isolation

8. Poor self-care

9. Physical activities, hobbies, chores

10. Poor money management

11. Unusual behavior

Psychiatric Medication

Psychiatric medication is useful in controlling symptoms of mood disorders. Mood disorders are considered bio-psycho-social disorders. They affect thinking and behavior and often times create relationship issues. Medication and medication management are essential in the management of the biology or the chemistry of the disorder. I consider this to be the foundation of treatment. It is difficult, if not impossible, to treat a severe mood disorder without medication. You can’t build a solid house without a good foundation. Medication provides that solid foundation.

Therapy addresses the psychosocial treatment issues including identification and management of symptoms, daily living skills, coping skills, and the relationship issues which often accompany these disorders.

Refusal to take medication is a common issue. I do on occasion have clients who refuse medication. In the past, I have said, “I will work with you to see if we can make an impact on your symptoms.” If we do, that’s great. If not, I will try to deal with the denial and the refusal of medication.

What if I told you that you are a diabetic and will have to be on insulin injections the rest of your life? Of course, most people wouldn’t like it, but chances are, they would take their medication. Why is medication for a mood disorder any different?

Let me remind you that alcohol is a drug and if you are drinking, you are self-medicating with a depressant. This may lead to alcoholism or substance abuse and addiction. Wouldn’t it be wiser, safer, and more productive to let a doctor prescribe the correct medication to help you get on the path to recovery?

Medication and Support

Many people remain on medication their entire lives. Some people with mild depression or situational depression are able to use medication intermittently for periods of stress that cause their depression to re-emerge. Others don’t want those periods of regression in their life, so they chose to just stay on the meds. I encourage clients to consult with their doctor for recommendations.

Therapeutic support may also be intermittent or as needed after a time. Depending on the severity of the disorder and how well a person learns to manage, I recommend that my clients check-in at least three or four times per year. This is especially common for couples whose disorders affect their marriage.

Unfortunately, some people with severe mood disorders may go in and out of the hospital their entire lives if they remain in denial. This is usually a result of non-compliance with treatment and medication, combined with alcohol and/or substance abuse. Mood disorders and addiction can be global disabilities or manageable handicaps. Which one will you choose?

The number one cause of regression and recurrence of symptoms is not taking medication as prescribed. This is not like having a headache. When you have an ordinary headache, you take two aspirin and twenty minutes later your headache is gone. In order for antidepressants or mood stabilizers to work effectively, the drug must maintain a certain level in the body. When that level is not maintained, debilitating symptoms reappear. These medications take four to six weeks to reach their peak level of effectiveness. When you miss doses of medication, drink or use drugs, you negatively affect that level.

Medication Side Effects and Allergic Reactions

All medications have side effects. Even aspirin can cause ringing in the ears if you take too much. The pharmacy must list all side effects, but that does not mean you will experience any or all of them. Most of the common psychiatric medications for depression and mood disorders have very few, if any, side effects after the first week or so. First, ask your doctor about allergic reactions and possible side effects and what to do in the event of a serious reaction. Severe allergic reactions typically include but are not limited to rash, hives, and swelling (of the tongue). Always read the medication information given to you by the pharmacist. He or she is also a good source of information on medications.

The most common and less serious side effects are typically nausea, diarrhea, blurred vision, sleepiness, insomnia, dizziness, or headache. These usually go away in the first week or two. If any side effect becomes severe or you simply have concerns, contact your doctor or go to the ER. Know the possible side effects and allergic reactions of your medications. You should always know the name of your medication, frequency, and the dosage in milligrams. Carry a card in your wallet that will tell emergency personnel exactly what you are taking. If you have questions or concerns, direct your questions to your doctor or pharmacist. Dial 911 or go to the emergency room for serious allergic reactions and side effects. Ultimately, the more you know, the safer you will be.

Mental Illness is a disease very much like diabetes. It takes insulin to manage diabetes; it takes psychiatric medication to manage severe depression and other mood disorders. Some say you just have to be tough. “You just have to pull yourself up by your bootstraps and try harder.” This is false and it won’t work. The only way to successfully manage a mood disorder is with education, medication, structure, ongoing treatment and support.

Always contact the doctor when faced with positive (active) symptoms. Do not self-medicate. A doctor never operates on himself or his own family. Don’t play doctor! Remember, the leading causes of relapse are medication non-compliance and drug and alcohol use. The doctor can’t possibly medicate you properly if he does not know honestly what the patient is or is not taking including alcohol or substance use!

Rule of thumb: Never lie or withhold information from your doctor or therapist.

It is extremely important to learn to make healthy choices. Sometimes people do not recognize that the choices they make may not be healthy. Once stable and consistent, some people simply need to check-in with their therapist a few times per year. Others need ongoing supportive therapy every two to four weeks to remain stable. The frequency will depend on the individual and how well one manages their disorder. Together with your doctor, therapist, and ancillary supports, if necessary for dual diagnosis, you can learn to manage your symptoms and cope with the day-to-day stress of depression, mood disorder, or dual diagnosis. This is the reason that ongoing support from your doctor and therapist is essential for management.

You should call your doctor, 911 or go to the hospital if you are experiencing medication side effects or an allergic reaction. If you have thoughts of hurting yourself or someone else call your doctor and therapist immediately. If you are actively considering hurting yourself, call 911, go to the emergency room, or call the National Suicide Prevention Helpline, 1-800-SUICIDE (1-800-784-2433).

The Leading Causes of Relapse

The causes of relapse to active symptoms of a mental 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.

Non-compliance with medication and alcohol or substance 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 may 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 or out of touch with reality. 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.

Relapse Warning Signs

Be aware of relapse warning signs and symptoms. When one is taking medication as prescribed by the doctor, symptoms are largely under control and the client is stable. The reappearance of certain symptoms is an indication that the medication may need to be adjusted, reevaluated or changed. These symptoms may also be an indication that the medication is no longer being taken as prescribed or alcohol and substance use is interfering with the effectiveness of the medication.

Relapse warning symptoms include:

  • Thoughts about hurting oneself or others
  • Changes in one’s sleep/wake cycle, especially little or no sleep
  • Inability to concentrate, rapid speech, skidding from subject to subject
  • Rapid mood fluctuations, mania, or depression
  • Poor judgment, risky behavior, or lack of insight into one’s own behavior

These symptoms are reflected by poor daily functioning, lack of motivation, loss of interest and conflict. These are considered to be active symptoms and usually are caused by non-compliance with medication and use of alcohol or drugs. In many instances, the medication may need to be changed or the dosage adjusted by the doctor. This may also reflect the need for family members to monitor medication compliance and alcohol/drug usage. Relapse warning signs should be reported to the doctor and therapist immediately. Don’t wait!

Zoom!

Now I can work via zoom with anyone, anywhere in the country and it will still be covered by BCBS Insurance.  Call James E. DelGenio MS, LCPC, Senior Staff Therapist at The Family Institute at Northwestern University, 847-733-4300 Ext 638.

http://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.

James E. DelGenio offers Tele-therapy with BCBS PPO Insurance accepted

The Family Institute at Northwestern University

James DelGenio LCPC is a senior staff therapist who offers teletherapy and accepts BCBS PPO Insurance.  Teletherapy is HIPAA approved via Zoom.com 

His services include Individual and family counseling, marital and premarital counseling, and treatment of mood disorders and dependence.

Locations:  Teletherapy anywhere via zoom.  HIPAA approved and accepted by BCBS PPO Insurance.

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 is 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 online one on one, SAT, ACT, GRE, standardized test preparation, via face time or skype.

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

Weekly Review of Consistency for management of Depression!

James E. DelGenio MS, LCPC

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.