Tag Archives: management

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, Marital Family Issues

Manage your Mood Disorder!

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

Mood disorders represent people experiencing mild to severe depressive disorders, bipolar disorders, panic, anxiety disorders, phobias, personality disorders and other disorders including alcohol or drug dependence.

Major research over the years has not completely explained one singular definitive cause of mood disorders. Generally, most consider a combination of bio-psycho-social factors including: family genetics, personality traits and stressful life events such as marital stress, financial issues, severe injury, chronic health issues or death of a relative or friend.

Strained relationships double the risk of triggering a mood disorder.

In the treatment of mood disorders, family conflict is present often enough that it be given symptom status.

It is estimated that up to 70% of the people who are currently diagnosed with a mood disorder also have alcohol and/or substance abuse issues. 

Casual use of alcohol or substances complicates treatment of depression/mood disorders and will likely result in a relapse to symptoms, alcohol and substance abuse and possibly hospitalization or suicide.

People with mood disorders who are long term casual alcohol users are very likely to develop alcohol dependence or addiction over the course of their lifetime. 

These two separate and distinct mood disorders (depression and addiction) complicate and exacerbate each other. For example, depressive symptoms can be a trigger for alcohol cravings.

Most patients benefit from combined psychotherapy, medication and an array of support services when dual diagnosis is present. Patients with chronic psychiatric illness are at risk for substance abuse and dependence.  Plans for comprehensive treatment of mental illness must include measures to prevent, detect, and treat substance abuse. Poor medication compliance and poor response to traditional substance abuse treatment have been associated with dual diagnosis. Substance abuse decreases compliance with treatment, compromises the efficacy of medication and thereby increases the risk of symptom exacerbation and relapse.

The National Center for Health Statistics (2006) show about half of marriages will result in divorce.  These statistics also show that stress and arguments over money are major contributors.

Social disability is a primary source of stress; it prevents patient’s developing the supportive relationships that could provide a buffering effect; thus, it is a potent predictor of symptom exacerbation.

Social support plays a critical role and is a necessary component if treatments are to improve the patient’s overall level of functioning, quality of life and compliance with treatment.

Mood disorders rank among the top 10 causes of worldwide disabilities. About 1 in 7 people in the USA have a mental disorder. Depression affects nearly seven percent of the population of American adults. Major depressive disorder is one of the most common mental disorders in the United States. Women are 50% more likely as men to experience depression over their lifetime. Major depressive disorders account for about 20 to 35% of all death by suicide. A major risk factor for suicide is a combination of depression and alcohol or substance abuse. Clients with a mood disorder and/or dual diagnosis (mood disorder and alcohol dependence) can be taught to manage their disorders, much as people learn to manage other physical handicaps such as diabetes or epilepsy.

As one can easily see from the above literature, mood disorders including alcoholism and addiction can have a tremendous impact on our life and relationships.  Given the research it is quite possible and even likely that either you or your spouse will experience a mood disorder at some time in your life time.  Even without these disorders, sometimes life just gets in the way of our relationships.  We can easily lose our connection to our spouse due to stressors such as finances, job stress, children’s activities, parenting issues, in-laws, health issues, and death of a relative or friend. These issues, in turn, can lead to poor communication, conflict, loss of civility and respect, apathy and infidelity which creates resentment and a feeling of distance from our spouse.  Now add the complications of alcohol abuse and addiction and we are guaranteed that issues will negatively impact our relationships, creating conflict and increase the possibility of divorce.

The goal here is to give people the knowledge and skills to overcome these issues when they occur.  Chances are they will occur at some point in our relationship. There is no Cinderella story; no happily ever after.  If we are going to have a healthy, happy relationship for life then we need to recognize that relationships take work and attention.  We can’t allow life to get in the way. My goal is to make couples more aware and hopefully prevent conflict and divorce. I want to give people the tools to deal with life stressors, mood disorders, addiction and the ability to withstand whatever life hands you.

Therefore, in upcoming Blogs I will address coping with mood and relationship disorders, alcohol/drug dependence and the other common issues that tend to get in the way of our relationships and marriage.

As a therapist, I also recognize that in some relationships, couples are past the point of working on their issues themselves without a skilled therapist to intervene. I recommend a Cognitive Behavioral Approach to treatment regardless of who the therapist is.

If you have questions, please don’t hesitate to contact me at 847-733-4300 Ext 638. I can address your relationship, mental health issues and provide support for your alcohol and substance abuse issues, if any.

BCBS 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

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.