Lori Calabrese, MD

Author: Lori Calabrese, M.D.

  • Pandemic Anxiety Depletes Bandwidth You Need to Cope With Stress of Living

    Pandemic Anxiety Depletes Bandwidth You Need to Cope With Stress of Living

    We’re all weary of hearing about COVID and mask wearing precautions. Aren’t we?

    About the negative impact of isolation. And while we see improvement on the horizon through wide spread vaccinations, there are still imminent risks, and new cases as well as deaths every day. Those risks add to your daily stress in ways you may not realize. Pandemic anxiety depletes your bandwidth for coping with daily living. The story of Carolee and Jacob illuminates the kinds of stressors that can go on behind closed doors…

    Carolee and Jacob walked the two blocks to the grocery story to pick up food for dinner. They were discussing a news story they’d read on the internet about how some states are lifting mandates for COVID precautions, like wearing masks, social distancing, and use of hand sanitizer. They liked walking to their neighborhood store when they could, just for fresh air and exercise.

    Since they passed a number of people on the sidewalk as they walked, they always wore masks, even when they were outside.

    Carolee expressed her frustration that those particular states were lifting the requirements, in spite of the fact that each governor had strongly encouraged citizens to continue to use precautions on their own.  

    Of course, there will be those who step up and “discipline themselves” and maintain the precautions. But she knew there would be so many… so so many…who would not. Her frustration and disgust exploded.

    “WHY?????  Why would they drop this requirement before we’re ready for it?  People aren’t going to do the right thing. They’re going to just be glad to be rid of it all and do what they want to do for fun!  And the cases will start growing…and more will die… and….”

    You Can’t Control Everyone… Just Yourself, Right?

    Jacob squeezed her hand and tried to soothe her. “Carolee, you know there are already so many who don’t follow the rules. But you and I can only do what’s best for us…Don’t you think it’s futile to struggle about everyone else, when it’s something we have no control over?  It’s really not worth you getting wound up and shaken about something you can’t control…is it?

    “It’s about bandwidth, Carolee. The amount of information your brain can receive…like per second. We’re flooded with so much more to consider about every detail of life than we’ve ever had to. This pandemic anxiety depletes the bandwidth we need just to get through every minute, every hour. We have to find ways to tamp down our own response to things, so we have more energy for everything else.”

    Jacob knew that Carolee hadn’t been sleeping well lately. She seemed to wake up frequently, sometimes walking through the house wringing her hands.  Sometimes just pacing. Staring out the window. Standing out on the patio.

    They’d talked several times about how the COVID-19 variants were spreading, asking questions about whether the new vaccines would be effective with the variants… About how long they were waiting on the list to get their own vaccines. Each time they talked, they agreed to let it go, for their own peace of mind.

    But that was easier said than done.

    To make matters worse, Jacob was feeling more and more worn down by the stress of the pandemic, his work responsibilities, and Carolee’s meltdowns.  He knew she would get past them, but he found himself worrying about her more and more. He needed to find a way to relax. In addition to Carolee, Jacob sure needed some relief.

    Worry. Worry. Then worry some more.

    Life was already full when COVID-19 came along. People were already stressed with daily responsibilities to job, family, faith organizations, maintenance of home and car, children and their struggles.

    When the pandemic appeared on the horizon like a vast dark cloud of pestilence, it pervaded everything.  Those aspects of life that were so routine and required little attention, came to require acute attention often overloaded with a sense of panic with fear of doing it wrong. 

    A psychiatrist wrote in Psychiatric Times about the fear and guilt she experienced when she stopped by the bank for cash only to find the drive-through banking not yet open. So she wrestled with herself about whether to go inside the lobby or park and wait  an hour for the drive-through to open. She went inside, but worried about whether she had been exposed to COVID-19 and  who she might expose through the day as a result. She worried about it all far more than she normally would have.

    Kate Murphy, a NYT journalist, made the point that your brain is overburdened by this pandemic. That things you normally relegate to your brain’s autopilot now require serious thought and risk analysis. And…as a result, you have less bandwidth for higher order thinking.  

    Less bandwidth.

    Isn’t it true?

    And those pandemic anxiety reactions eat up bandwidth.

    If you’ve depleted yourself through a panicky reaction to forgetting your mask when you MUST buy groceries, or driving through for a meal but your hand sanitizer is empty…how can you eat without sanitizing your hands?? Or you’re trying to cope with working from home and the kids are jumping out of their skins from cabin fever??

    What do you do when you keep hitting your thumb with a hammer?

    Those bandwidth-eating reactions are similar to hitting your thumb with a hammer, over and over and over…  because more and more damage is done. You can hardly cope with everything else when your thumb is screaming in pain, you know? You just have to step away from the hammer!!

    Then, if you’ve already been taking medication for anxiety, and the exponential expansion of anxiety caused by the pandemic sends your worry and panic through the roof, well, you have difficulties you hardly know how to manage.

    There was a time before the pandemic was anticipated, that worrying about little things blew up into worrying about disasters in your mind, and as your  grandma would say, “Honey, you’re borrowing trouble and making a mountain out of a molehill.”

    But now, the ongoing stream of changes and increased risks you face everyday can result in outright panic for some, and on a lesser scale, confusion and exhaustion…and dread. This pandemic anxiety just depletes your bandwidth for life.

    You probably know people who have contracted COVID-19. You may have seen some who experienced extremely mild symptoms, if any at all. Still, you may also know someone who experienced serious or extremely severe symptoms. Maybe you know people who have died.

    If you’ve known more than 1 person who has died, your anxiety about death may have filled you with alarm. Alarm about masks, about social distancing, about making sure OTHERS are doing what they’re supposed to be doing.

    And what’s more upsetting than people who won’t comply?? You just have to step away from that hammer…

    The more traumatic your experience has been, the more anxiety you may feel about the risks. On the other hand, if you have not known anyone who was hospitalized from COVID-19, exposure may not seem like a great risk to you at all.

    Unique Pandemic Trauma and Loss Requires More Bandwidth

    Either way, you need to be grounded. To let the world take care of the big solutions while you manage the challenges of your daily life. To help with that, take daily walks – wearing your mask! — but get out in the fresh air and sunshine. Take a friend or family member along and talk. Take care of YOU. Then look after your family.

    Pandemic anxiety depletes your bandwidth for your own life. Right now, you need all the energy and mental clarity you can get just to get through life, day by day.

    Because YOUR life needs to go on.

    Still, if your medications and fresh air and exercise don’t help at all, then you may need help getting your symptoms of depression, bipolar depression, PTSD, and suicidal thoughts under control. Then maybe… you should consider IV ketamine infusions.

    Since IV ketamine treatment is at the front lines transforming people when nothing else has helped, it may be an obvious next step for you. And receiving these infusions is a relaxing and comfortable experience. With your remission as our goal, your dose will be titrated according to your individual response during each infusion.

    Pandemic anxiety depletes bandwidth for coping with COVID, but you'll not be exposed to viruses in our office. You're safe here.

    At Innovative Psychiatry, we’re working every day to respond to the call for helping people who are against the wall in this pandemic. If your own bandwidth for coping with the demands of COVID on top of the demands of your life is growing slim, you’re not alone. A vast mob of stressed out, overwhelmed, exhausted, and depressed people surround you. You have to decide what to do about it, if your efforts toward exercise, fresh air, and medication have become futile.

    In that process, it could be that the results of stress have depleted your ability to cope anymore. You may need to reboot. You may need a remodeling project in your synapses to increase your synaptic plasticity. To relieve your symptoms of depression, PTSD, or suicidal thinking. To give you fresh bandwidth.

    For your safety, we’ve installed state-of-the-art technology that utterly removes and destroys COVID-19 and viruses and pathogens from the air and surfaces. So you don’t have to spend bandwidth on your safety, when getting treated is so important for you. Just one more thing to lighten your load. You have enough on your mind.

    If this sounds like you, and you’d like to discuss IV ketamine treatment, call us.

    This pandemic has been hard for everyone. You’re not alone. And we’re here to help.

    We look forward to talking with you and working together for your relief.

    Lori Calabrese, M.D. is on the front end of the race to stop PTSD in its tracks using IV ketamine treatment.

    To the restoration of your best self,

  • Keep Your Eyes on AKT: It Might Explain How We Learn and Forget Fear

    Keep Your Eyes on AKT: It Might Explain How We Learn and Forget Fear

    You may hear people say, “Antidepressants and other psych meds just don’t do anything…”

    Some people say, “…placebos work better…” Oh please. But why do they say that?  Maybe their own experience with prescribed medicines was disappointing. So — of course — they’re disillusioned about these medicines. We get it. And we know that any given medicine that works for some people won’t help some others at all, or might even make them worse. Sooo… what’s up with that? Well, the answer isn’t simple. We do know that antidepressants,when first prescribed, only help about 30% of depressed people. We know that psych drugs help some people but not others and that men and women can experience depression and anxiety and fear differently. It’s a tangle to unravel it all. That’s why we’re so excited about new developments. We want to keep your eyes on AKT because it might explain how we learn and forget fear.

    Meet Jill and Greg to see how differences affect their well being and livelihood:

    Jill and Greg own a coffee shop together and are partners in life as well. They have a great balance of power, in the tasks they divide between them and the strengths they each bring. Greg is a people person, creative, funny, and efficient at both designing new drinks and training staff to make them just right. Jill is a numbers person, and sometimes comes off a little stiff and awkward, because she just doesn’t have Greg’s gift for setting people at ease. She also has some social anxiety going on.

    She does ordering from suppliers, closes out the books every night, and keeps a close eye on profit and loss. They’re a perfectly matched pair and love working together. That is, as long as they’re both at their best. With Greg building relationships with customers and vendors, and Jill keeping the financial end sound, they really do provide strength for the weakness of the other.
    Unfortunately, they both suffer from disorders that periodically causes some lost time at the shop. When that happens, the one who is doing OK ends up carrying a double load. And both of them struggle with anxiety… or basically fear on some level.

    Greg was diagnosed with bipolar II disorder when he was a teenager. Jill was diagnosed with depression in college. She’s a worrier. He just explodes sometimes—and refuses to call it anxiety. Greg takes medication for mood stability that also has an antidepressant effect. Jill takes an antidepressant that only sort of works. They probably both need medicines that reduce anxiety.

    In a perfect world…

    Since their coffee shop venture requires all hands on deck to run smoothly, Jill and Greg are eager to find the right meds for both of them to help stay in the game. They need to be able to go in to work—they can’t afford not to. It seems to Greg that since his medication helps him as much as it does, Jill should ask her doctor to prescribe the same for her. She’s a nervous wreck! However, she knows enough about changing meds that she can’t just jump on another medication just because it works for Greg. She’s tried that before. It didn’t work.

    At this point, Jill has tried five different antidepressants over the past few years, and has researched enough about IV ketamine treatment that she wants to talk to her doctor about whether she’s a candidate for it.

    Considering something new takes a little bit of courage. She wasn’t sure what her psychiatrist would say. A visit with her psychiatrist surprised her–he was cautious but supported her trying something that might help. Jill decided to pay for it out of savings, because her bouts of severe depression were taking a toll on the shop and their income.

    She arranged for treatment and began infusions. When the treatment was complete, she had received 8 infusions over about 3 weeks, and she felt like she had a new lease on life. Her ketamine infusions seemed to wake up her brain. And that got better and better day by day — even after she completed treatment. She found she enjoyed singing and dancing, and painting became her new passion. When they had a problem in the shop, she had so many more ideas for solving it. Working on the book work was no longer a drudgery–she enjoyed it and got more accomplished in a shorter time.

    Jill and Greg’s life became so much better at work and at play. Greg still had slumps when his meds weren’t quite holding him, but their life was so much better overall. They had read that ketamine treatment could help bipolar depression, too. Maybe the next time he went through a bad bout of that, Greg would talk to his doctor about it. To see if it was right for him—not just to copy Jill.

    Finding the right medicine for you is sometimes a long search. And medicine that works for you may not work for your sister…or your son. But it’s well worth the work researchers do to better understand why.

    A research study at the University of Colorado Boulder offers one fascinating revelation about why those differences between people and genders might exist.

    It has to do with a key protein kinase in the brain called AKT…which functions differently between males and females.

    They found presence of a certain form of AKT (called an isoform) in male mice can help the male let go of fear from a past painful experience–and form a new adaptive response to get around the old fear. Wait, what? Doesn’t that remind you of the way synaptic plasticity helps you adapt?

    Ok, you’re right…mice aren’t people and it doesn’t work quite that way…. but AKT is remarkably similar across mice and humans and this kind of translational research can begin to give us specific information to make our medicines and medical care more specific. Potentially even gender specific.

    So you’ll do well to keep your eye on AKT because so much is being learned about how we learn and how we forget fear.

    By figuring out the very complicated cascades involved in creating synaptic plasticity, we may be on the verge of figuring out how to shape and foster the neuroplasticity–for the better.

    We may be able to personalize medication therapies so that they don’t just broadly address a disease state, but so that they can be specific for the man or woman who needs them. 

    Charles Hoeffer, the principal investigator of this study, said it like this: “We need to stop hitting every ‘disorder’ with the same hammer.”  Well said! (Wish I had said that!)

    We’re always talking about personalizing treatment. About how important it is to provide treatment that fits the individual. Just as that’s true with all of the fine details involved in ketamine treatment, it’s also true with all of the medicines we prescribe.

    So… about AKT. 

    It turns out AKT plays a lead role in synaptic plasticity. We’ve talked about that too…  The idea that the connections between cells in the brain can change and adapt. They can change and adapt as a result of an experience. (This is why trauma can change us.) But — so importantly — these connections can also grow, change, and adapt as a result of the deeply emotional experiences, like the incredibly deep and awe-filled experiences you can have during a ketamine infusion. So many of our patients do. We’ve talked about how taking advantage of that process by scheduling psychotherapy 24 hours after a ketamine infusion can enhance the effectiveness of the infusion. 

    Why? Because therapy helps you think differently about something…and synaptic plasticity empowers those changes in thought. Many of our patients also find that journalling, creative writing, meditation and other activities help to integrate those experiences into their lives, find meaning in the experience, and move forward. Keep your eyes on AKT… there’s so much more to learn.

    AKT helps you create memories. Like a child touching his hand to a hot stove. To encode that memory so that he will be cautious in the future around hot burners, his brain needs to activate protein kinases like AKT.

    In fact, AKT is one of the first proteins to present itself to form a memory like that.

    There are 3 main variants, or isoforms, of AKT and they do different things and affect people in different ways (More on that in a sec!)

    AKT1 is important in encoding new experiences and allowing you to forget the old.

    AKT2 is often found in the astroglia…which are star-shaped brain cells.

    AKT3 seems to be important in brain growth and development. This one plays a positive role in mental health and wellbeing. 

    And when AKT1 and AKT2 are working together in the prefrontal cortex, they’re vital for learning, for memory … for dynamic change.

    Maybe like the kind of dynamic change that you want for yourself. So yes. So many different forms, working singly and sometimes together, in ways we are only now just beginning to understand for people suffering with psychiatric disorders.

    Now. To add another twist to this picture. In this study, researchers found a dramatic difference between genders regarding AKT. 

    They found that male laboratory animals whose AKT1 was functioning well, had far more ability to replace unwanted memories with new ones…than those who were missing AKT1. 
    Draw that out for a moment now…. and imagine men who’ve experienced the trauma of illness, or assault, or combat… and imagine for a moment that they’re given the opportunity to experience something new — maybe hopeful, blissful, awe-filled, like they might during a ketamine infusion — and then the excitement of realizing that a tiny little protein kinase like AKT1 may play a part in helping to encode that new feeling. Turn it into a new memory. Make the old traumas fade. (That’s called extinction learning.) Teeny little AKT1 helps with this. In males. 

    Incredible.

    There are endless little nuances in your brain that translate your experiences, encode them, and shape your synapses…and your individual functioning. And maybe your future possibilities.

    AKT is one to keep your eyes on for sure.

    We keep learning, keep researching, and keep doing all we can to help you get better.

    (Let’s just say we read all this stuff for fun–at nights, on the weekends, and at 5 am with a double shot of espresso.)

    And at this point, serial titrated IV ketamine infusions still do the best job we’ve seen in bringing relief to more people with treatment-resistant depression and anxiety than just about anything else available today.

    But ketamine treatment doesn’t work for absolutely everyone. Is it because of AKT or something different? We don’t know. Not yet. Researchers like the ones at Boulder are still searching to understand the nuances of dendritic growth and synaptic plasticity in order to refine our treatments–and discover better ones.

    At Innovative Psychiatry, ketamine treatment is provided in a virus-free environment.

    At Innovative Psychiatry, we personalize treatment to fit you — all the complexity and all the wonderfulness of you! And we aim for remission. Not just response. That’s the reason we titrate your dose, duration of the infusion, and the number of infusions you need to help you discover — once again — your best self.

    When you struggle and suffer from the symptoms of disorders that can be tormenting and exhausting, getting treatment is paramount. And feeling safe is critical — so we have state-of-the-art technology that crushes 99.999% of all viruses and pathogens. During this pandemic we want to make things easy. We all need a little bit of easy.

    So now, reach out for IV ketamine treatment in a safe atmosphere where this treatment can help you live better, hope more, and enjoy the challenges and relationships in your life that give your life meaning.

    You can live a life of joy, fulfillment, accomplishment, and ongoing hope.

    If your meds have not been providing you relief from symptoms of depression, despair, PTSD, or suicidal thoughts…call us.

    Let’s talk about what you’ve tried that didn’t work. And if you’re a candidate for IV ketamine treatment, we can begin that.

    Even though ketamine treatment isn’t for everyone, it just might be a good fit for you.

    We’re here to help.

    Lori Calabrese, M.D. is on the front end of the race to stop PTSD in its tracks using IV ketamine treatment.

    To the restoration of your best self,

  • Every Body Deserves a Seat at the Table: Let’s Ensure They Have It

    Every Body Deserves a Seat at the Table: Let’s Ensure They Have It

    This is National Eating Disorder Awareness Week — NEDAwareness Week

    Every body deserves a seat at the table, every race, every color, every sexual orientation, and every new idea.

    People come in a wide variety, don’t they? No one more deserving than another. Whether there are differences in skin color, differences in gender, differences in sexual orientation, differences in religion…or differences in IDEAS. And no matter the differences, no matter the variety, every body deserves a seat at the table. We may speak of the table as a place to eat, or we may speak of the table as a place to exchange ideas. It happens that this week we’re talking about both. Because we want to think about how NEW ideas and NEW approaches can bring NEW FREEDOM to people with eating disorders.

    An eating disorder causes you to see food and yourself in a distorted way. A way that affects you both physically and mentally. That distortion creates distorted eating patterns. And those eating patterns can cause damage to your body and your mind… as well as your life expectancy. And of all the eating disorders, anorexia nervosa is the most dangerous. With its poor response to treatment, such persistence, such rigidity. It takes over. It’s exhausting. We need more effective treatment for anorexia.

    Eating disorders affect 32 million Americans. Twice as many women as men. Whether it’s bulimia, binge eating, anorexia nervosa, avoidant/restrictive eating disorder, or others, the need to raise awareness for support, education, and especially effective treatment, is paramount.

    And although we hate bad news, there’s more bad news. The death rate in women with anorexia is 10 times greater than in other women. One major reason is that the metabolic and medical problems caused by self-starvation can be critical, even fatal. And also because the desperation triggered by anorexia can lead to suicide… and often does.

    So let’s talk about what an eating disorder is…and what it isn’t.

    In general, a variety of biological, psychological, and sociocultural factors tangle together and lead to a disorder of this type. 

    The idea that eating disorders are a “girl’s disease” a disorder where a girl seeks her parents’ approval is false.  Archaic. Fiction. Can you say Old Wives’ Tale?? Similar to some other diseases, there is a biological basis for anorexia — and genetic studies identifying the first 8 genetic loci! — that is exacerbated by sociocultural and psychological/psychiatric components.

    And, by the way, let’s square off against the idea that eating disorders aren’t serious. They can, and often do, wreak havoc on you and the people who love you. They can interfere with your relationships, your livelihood, and your own sense of peace and self-respect. And they can tear down your health.

    We need to up our game if we want to erase this hold they have on us, and erase the shame and stigma they carry. We need to up our game if we want to make headway in treating the most deadly of these disorders — anorexia nervosa.

    Anorexia has the highest mortality rate of any psychiatric illness. (Or it did, until the opioid crisis recently claimed the lives of so many.) That mortality is caused by the medical consequences of binge eating, purging, starvation, over-exercising. And these consequences include heart attack, kidney failure, osteoporosis, electrolyte imbalance… and suicide.

    Because of the stigma attached to eating disorders, early diagnosis can be hard to achieve. And early diagnosis is important for effective treatment. Because these disorders can begin at any age. And last for years

    …and let’s get One Thing Straight Now:

    Eating disorders are NOT a matter of choice. They’re diseases governed by physiology and biology, with genetic, social, cultural, and psychological factors. Help remove the stigma associated with eating disorders, to make the world a safer place for everyone… because every body deserves a seat at the table.

    Stigma comes from ignorance. It’s the inclination to pour shame on anything not understood. And that shame can be crippling. It can force someone who suffers into hiding…isolation… when it’s light, enlightenment, and help that is so deeply needed.

    When you’ve been isolated in the throes of shame, (and you know you haven’t done anything to deserve it!) it’s hard…really hard...to come out. Sometimes it’s hard just coming outdoors, for Pete’s sake! But sometimes, it’s coming out with truth about yourself. About your sexual orientation, about your habits, or about the way you think…or eat. It makes you feel vulnerable… and like you’re making yourself a target for hatred, stigma, and judgment.

    Sometimes eating disorders live silently inside— and sometimes they can’t help but show themselves, and then the anguish, the anger, the frustration, and the way they take over your life becomes…unbearable. And stigma or not, you realize you just have to find help.

    And especially, if you suffer from Anorexia Nervosa.

    There is plenty of stigma about anorexia… and you may hear people toss the term around disrespectfully, because they don’t grasp the critical nature of the disease. If they suffered from it themselves, they would not speak hateful words in ignorance, because they, too, would be informed. But that’s the nature of the beast of stigma, isn’t it?

    The death rate in women with anorexia is 10 times the death rate in those who don’t suffer from it. But every body deserves a seat at the table, a chance to live well… and not die from the critical medical conditions caused by self-starvation.

    And again, remember that this self-starvation is not by choice, but is associated with genetic factors, and fueled by changes in the brain that happen in some women and men when they start to lose weight, get energized, and begin to exercise compulsively. And we recognize that there are a host of other factors that can contribute to a slow spiral, a continuous weight lose, the emergence of anxiety, fear, and rigid rules.

    Every body deserves a seat at the table.
    But sadly, the most distinctive and cruel of the symptoms of anorexia is the “anorexia voice.” A voice talking to you, controlling you, commanding you, every minute of every day, telling you what to eat, what not to eat, when to exercise, when to feel guilty, and on and on and on it goes.

    Treatment is effective only when “the voice” can be silenced, and you are free to make choices you want to make. About food, about love, about activity… about hope. 

    So what can be done?

    Sometimes if you have a new idea, it takes courage to offer it up — like Conflict Zone: A Play on Eating Disorder Recovery, a live-streamed one woman show with a compelling storyline about the lived experience of recovering from an eating disorder kicking off NEDAwareness Week — but it could be brilliant.  It could deeply resonate.  It could breed a whole new movement fueled by hope.

    And while it may draw stigma and resistance from those who don’t understand the idea, those who need what the idea could provide grab onto that thread of hope.

    We’ve had the opportunity to work with a few other researchers to write up and publish a case report that incorporated a specially designed modified ketogenic diet combined with ketamine infusions that resulted in complete remission of severe and enduring anorexia in a 29-year old woman who had been ill for 15 years. Striking. Striking that her remission is complete and sustained and has persisted now for over a year. (See our blog about Caroline). 

    The case report has taken off, generated a lot of interest (and a lot of controversy — as you might guess when we put a ketogenic diet and ketamine on the table). It’s nice to see the metrics climb, the interest rise, to see the hope bud in people with anorexia who’ve lost hope of ever beating it… and to see the sparks fly in the imagination of the scientists, doctors, therapists and dietitians who try to help them. Our case report was recommended by Drs. Miletta and Horvath in Faculty Opinions as a New Finding, Interesting Hypothesis and Technical Advance, and written up in a lovely Faculty Opinions blog.

    So… we’re now following up with a small clinical trial involving more subjects which is registered on ClinicalTrials.gov. Because we need an N greater than 1. We need to see if what worked will work for more people with chronic anorexia. This next step will give us more information about the effectiveness of our new sequenced approach in the treatment of anorexia.

    As you can imagine, we’re cautiously excited to see what we can learn. And we’re hoping to see more and more studies to support novel treatments for anorexia.  

    Every body deserves a seat at the table for ketogenic diet and IV ketamine for remission.

    At Innovative Psychiatry, we’re so pleased to see people with severe treatment resistant depression, bipolar depression, social anxiety, PTSD, and suicidal thoughts achieve remission with serial titrated ketamine infusions. 

    When you consider that the first paper published using ketamine for the treatment of a psychiatric disorder was using ketamine infusions for the treatment of anorexia — unbelievable but true!– more than 20 years ago, it’s WAY past time for people with anorexia to have truly effective treatment options to help them achieve remission.  Every body deserves a seat at the table.

    As our clinical trial launches, we remain right here, in the office, with boots on the ground, and continue to treat all of our patients for the symptoms that interfere with their lives.

    If you suffer from depression symptoms, PTSD, social anxiety, or suicidal thinking, and medications haven’t helped, call us. You are welcome at our table.

    We work to help you get the treatment that will help you with your symptoms and give you the freedom to live a rewarding life. In addition, we also work with our colleagues over the phone, email, and at conferences to learn all we can to better help you find remission. And, we pursue research opportunities to increase the medical knowledge available to all of us. For you.

    Because every body deserves a seat at the table, including you!

    We want to see you build a fulfilling life. That’s our heart in all we do.

    So please call and let’s work together.

    Lori Calabrese, M.D. is on the front end of the race to stop PTSD in its tracks using IV ketamine treatment.

    To the restoration of your best self,

  • Case Report Featured in Faculty Opinions

    Case Report Featured in Faculty Opinions

    See the Faculty Opinions and Recommendations featured in Faculty Opinions HERE

    Our work was was also featured in Faculty Opinions Blog — such a great piece with wonderful interviews with Barbara Scolnick MD and Caroline! Jump in and read it HERE

    Read our full case report in Frontiers in Psychiatry HERE

  • Don’t Let Stressors You Can’t Control Hurt YOU: Add Resilience

    Don’t Let Stressors You Can’t Control Hurt YOU: Add Resilience

    Turns Out Winter 2021 Hasn’t Run Out of Stressors to Throw at You Yet…

    People like you have been finding ways to adapt and endure this historical and very strange year. Never think that major factors in society, and in science, and in government, have no effect on you and your personal life. In fact, the ongoing onslaught of external pressures can take a serious toll. In fact, the toll can be so subtle you don’t realize it’s happening. If you find yourself sinking into what feels like quick sand, stop and take action. You don’t have to go down for the count. Stressors you can’t control don’t have to control you or even hurt you. But without intervention, you may find it all gets to be too much.

    Take Janeen and Carole, for example:

    Janeen and Carole were neighbors and had been friends for years. They enjoyed shopping together, stopping for coffee and pastries, or splurging on Italian food at their favorite white cloth restaurant. They were both upbeat single empty nesters and reveled in their freedom once their grown children built lives of their own.

    Carole was the more practical of the two, and Janeen was the more spontaneous, but oh, they had such fun together.

    As the pandemic emerged, and as surprising as it was, they didn’t expect it to have that much of an impact on their lives because they were both already so content doing things at home — together or individually. And they did, whether it was a craft project, or constructing a puzzle, or playing cards.

    However, with the spread of the pandemic, they each knew more and more people who became ill from it. Of course, Janeen and Carole were diligent with all the precautions including masks, gloves, hand sanitizer, and social distancing. Still, they knew someone who was critically ill with the coronavirus, and while she survived, it was pretty scary.

    Then Janeen learned that a life long friend of her family had died in the hospital from COVID. 

    Three weeks later, the brother of her co-worker also died. Both losses hit her hard. Then a cousin also died. Of course, they were reading about someone well-known who also died every day or two. The losses of dear people in this pandemic were unexpected and heartbreaking.

    You know that feeling when something so alarming happens that you hear about it in the news…but you never think it will happen to anyone you know..? Exactly. The alarming aspects of this disaster were getting too close to home for these friends. And in spite of the upbeat friendship Janeen and Carole shared, they discovered stressors you can’t control weren’t as easy to push aside when they plunder your personal life and those you hold dear.

    That Last Straw that Can Break a Camel’s Back…

    Finally, Carole’s sister Greta called and the tone of the conversation turned sour, then bitter…until her sister attacked her utterly unexpectedly. She attacked her political beliefs, her faith, and her family. By the time Carole ended the call, she was shocked and deeply wounded. Devastated. She felt betrayed at the deepest level. Carole trusted her sister. She respected her opinions and felt support from her so fundamentally, that she had always been confident they would never treat each other with disrespect. 

    Carole told herself her sister was just having a bad day. Or maybe the stressors of everything happening were wearing down Greta, too..? At any rate, Carole felt silly that she was so hurt by the things her sister said. She’d never been one to be so touchy with her family, to have her feelings on her cuff.

    But… for Carole, it was as if the clouds had covered the sun. The shades on her life had been drawn. And the light that had normally shone on her days disappeared. Carole didn’t understand what was happening to her. But the color in life had turned shades of gray.

    There was no reason to take her sister’s verbal assault so personally. But still, her outlook deteriorated. She couldn’t seem to help it.

    She read on the internet that depression seemed to be on the rise with COVID…and she wondered if that was happening to her for some inexplicable reason. It was as if she had lost her zest for life. As the days and weeks passed,  she realized she didn’t really care what her sister did…or what Janeen did. She felt so deflated she didn’t want to get out of bed. 

    So she didn’t. 

    Carole’s highly energized and determined personality went limp. Sad. Empty. 

    As days, weeks, and months passed, Carole knew she had become withdrawn. But she didn’t care. Nothing seemed to matter.

    Eventually, she realized she didn’t see any reason to keep living. Her children were living their own lives now, and she was no longer needed. She thought sometimes about how the end of life would come for her. Would she just not wake up one day?

    Or develop a catastrophic disease?  Then she realized she didn’t really have to wait…

    So she wondered how hard it would be to just put a STOP to her life.  To be released from the phenomenal stress she’d lived with.

    The more those thoughts built in her mind, the more reasonable they sounded to her.

    Janeen checked on her regularly, but Carole tried to end those contacts quickly. She just didn’t want to talk, visit, or exert any energy at all. She wished she could just sort of fade away.

    Above all, though, she knew she didn’t want to do anything that caused her family pain… Still, she continued to think about it…

    Another Perspective on Stress

    We talk about stress. How it can defeat otherwise unsinkable people. How it can reduce immunity and how it can contribute to disorders like depression, panic disorder, PTSD, alcohol use disorder, bipolar depression, social anxiety disorder, and suicidal thoughts. Stressors you can’t control are so much more difficult than those you can. And the helplessness that accompanies them does its own damage.

    When we look back in history to extremely stressful situations, we see how severe stressors can lead to suicide in masses of people. For instance, the stock market crash of 1929 for example, illustrates how extreme stress contributed to psychiatric crises for countless people.

    This winter — 2021 — has been a “perfect storm” of circumstances with the combination of the COVID-19 pandemic, flu season, the COVID variants, remote learning at home for kids, remote working from home, (where stressed parents try to do their job while supervising their children in the same space) and now a historical series of severe arctic storms sweeping from coast to coast, with snow, sleet, and ice causing life threatening traffic pileups, a break down in transportation of goods and services, preventing communities from having what they need… plus a presidential election and an impeachment.

    This is proving to be the most stressful, crisis-ridden winter this nation has seen in a very long time. And everyone is facing stressors they can’t control.

    And all this stress is dangerous. 

    Some people have taken every precaution to try to maintain health and safety, and to help contain the fallout of each of these crises.  Others have all but thumbed their noses at the need for precaution, and so many others have fallen somewhere in between. 

    Most people are relatively resilient, and will weather whatever is thrown across their path. But if major stressors are tossed at them day after day, week after week, month after month…eventually they’ll need some sort of relief…a break to recover.

    In this particular winter of 2020/2021, we may find ourselves isolated or quarantined. But we still need that break. We need to reach out for relief.

    By building a network of people we look forward to talking and laughing with online. Or writing for self-fulfillment and to draw interaction from others, or cooking meals and delivering them to neighbors nearby. 

    Stressors you can't control can hurt without resilience. Ketamine treatment restores.
    We all need to give. We all need to receive. And we all need feedback.  When we give, receive, and participate in feedback…well, those are stressors we can control…so they help.
    When the things we need as humans are accessible and balanced in our lives, it’s easier to maintain a certain equilibrium. 

    But our human needs aren’t always easy to fulfill, and as stressors pile high upon us, we may need more to help us survive.

    We may need a treatment to help restore equilibrium. These are highly stressful times for many, many people for a multitude of reasons. While we need to lean into our support system and find it’s not in place, we may need extra support.

    Something that IV ketamine treatment excels at is resilience. And resilience chases away the clouds of disillusionment and despair. It helps you bounce back after disappointment and devastation. You may have an abundance of resilience already. But if you don’t, ketamine treatment can sure restore it and arm you for what you face when you’re confronted with stressors you can’t control.

    At Innovative Psychiatry, resilience is a remarkable and startling bloom we often see in our ketamine patients. After years of living in a slump, stripped of courage, patience, hope, purpose…to see the same person develop a bright and open countenance, to hear the laughter in his voice, the hope, the confidence…the warmth; to see a life changed so splendidly makes what we do so rewarding.

    While ketamine is not effective for everyone — we so wish it was! — its extraordinary impact is life-transforming for many. Neuroscience researchers continue to probe to find reasons for those it doesn’t help.

    We also have protocols to ensure your safety when you come to our office for treatment. With Novaerus units in each room that remove the coronavirus from the air you breathe, and surfaces treated by Steramist, which removes 99.999% of all the virus, bacteria, and dangerous pathogens from ALL surfaces, we are diligent about keeping our air clean. We all wear masks, and keep the door locked. We’ve made so many changes… and reinvent down to the smallest details.

    You can feel secure knowing that, so you can seek treatment for your depression, PTSD, social anxiety, and suicidal thinking symptoms without fear of COVID infection.

    When it seems that the things in life you could always trust seem to fall around you, and the dread of it wears down your ability to try anymore, you might want to call us.

    You might want to discuss your options for getting your resilience back.

    And if you do, we’ll do our best to help you navigate your way through the barrage.

    To find the best you to face the circumstances around you and the stressors you can’t control.

    We look forward to talking with you.

    Lori Calabrese, M.D. is on the front end of the race to stop PTSD in its tracks using IV ketamine treatment.

    To the restoration of your best self,

  • You Can Call It Seasonal Affective Disorder or Any Other Name, It’s Still Depression

    You Can Call It Seasonal Affective Disorder or Any Other Name, It’s Still Depression

    Across the country, extreme winter storms have descended upon us. Even in the Gulf states, short sleeve weather is suddenly shifting to snow. Temperatures are dropping from 70 degrees to 17 degrees.

    And the gray skies that bring snow, also contribute to Seasonal Affective Disorder. Gray on the outside can turn some people gray on the inside. And typically, about 5% American adults suffer depression symptoms this time of year only. These sufferers feel fine the other seasons of the year. But something about gray skies, less light, and snow trigger sadness. Which is why they call it SAD. Call it seasonal affective disorder or SAD or any other name. It still feels like depression.

    Symptoms include sadness, low energy, fatigue, weight gain or loss, and reduced interest in things they used to enjoy.  

    And specifically, symptoms begin in late fall…and subside in spring.

    Sound familiar? If you’ve ever suffered from depression, you probably recognize these symptoms. Because this disorder that’s associated only with winter is a seasonal depression.

    Some believe that the longer nights and shorter days interfere with your body’s internal clock. And that can result in changes in the brain. So using natural light and light boxes can help.

    But this year… Katie Bar the Door!!

    This year all bets are off. Due to the extra strain and anxiety caused by the COVID pandemic, plus the addition of flu season, the pandemic is causing anxiety and depression on its own. As the infection and death rate have grown, there is also SAD pulling people into darker places.

    Social distancing reduces social interaction. Increased stress arises from financial difficulties, employment layoffs and remote learning. That cooped up feeling from being inside the house all day…as well as heightened alert about health… These stressors can cause brain cell changes that can lead to depression. 

    It goes without saying that so much time in the house because of COVID means less exposure to natural sunlight.  You see where this is going.

    SAD +  COVID precautions + Flu season = Increased risk of depression and anxiety

    We’re not making light of the bombarding risks facing you this winter that threaten your wellbeing. On the contrary, recognize that this season holds a unique storm of confusing symptoms. These symptoms can emerge in your health and your wellbeing. 

    The symptoms can be from depression you’ve had all year, or the result of COVID’s strain, or if it only happens this time of year it could be from SAD…. That’s why they call it seasonal affective disorder.

    And being informed and familiar can help protect you from confusion and overwhelm if a tangle of symptoms should emerge in you or your family.

    There are things you can do. For SAD, light therapy is helpful for lots of people. 

    Symptoms of SAD intersect with symptoms of major depressive disorder, and some of the symptoms can also be found in cases of flu and COVID, like fatigue.

    So don’t be too unnerved if you find you have feelings of a deep dread, or increased agitation, or nervousness. If at all possible, this is not the time for controversial conversations about politics or religious differences. You may not realize the the underlying agitation or fear you feel may actually be stimulated by the pandemic and its restrictions, rather than the subject that seems so upsetting.

    Families have been thrown into upheaval and even split apart by this dread and agitation that only began since the COVID crisis. Keep your relationships shielded and safe.

    This is a great time for finding ways to reassure the people in your world, to find light-hearted discussions, and to maintain a sense of humor. This is a time for helping the people around you to maintain stability and get through this, rather than allowing controversy to up-end those already on shaky ground.

    Call it seasonal affective disorder but ketamine can bring remission.

    Find Healthy Ways to Bring Light Into Your Life

    Seek out healthy and productive ways of occupying your thoughts, and avoid those counter to your wellbeing, such as alcohol and substance use. Do your best to find ways to brighten your family and friends with online games, painting projects, sewing and knitting (not just for the ladies now… you guys are missing creative fun if you don’t try it!), and all the ideas you can come up with that will get everyone talking and laughing in front of the computer screen!  

    If you’ve experienced SAD in prior years, this year may be more severe, so seek natural light as often as possible… You can call it seasonal affective disorder or just depression… either way, there’s hope.

    And if you do have depression symptoms that don’t respond to medication, there’s hope. If the medication that has been effective for years has suddenly become ineffective over the past year, hang on. IV ketamine treatment just may make the difference you need.

    Ketamine treatment is a series of individually titrated infusions within a couple weeks. Ketamine has a remarkable ability to tamp down feelings of hopeless and despair, while building up the connections between brain cells proliferate a dense communication network.

    The result is a brightness of emotion, clearer thinking, restored energy for daily living, improved creativity, and the power to build healthy relationships. And…hope. It happens fast…and it can last.

    Is it the same for everyone?

    We have patients who may require a few more than the traditional six infusions, who recover so dramatically they haven’t needed more. That’s not to say those same patients might not eventually need another infusion eventually. They know to watch for the signs. 

    But sometimes people read articles and misunderstand about how ketamine treatment works. They think they have to keep getting infusions every couple months, or they read that ketamine treatment can’t really last.

    Broad assumptions should be avoided when it comes to treatment in the brain. Results vary among different people, and as we often remind our readers, ketamine doesn’t work for everyone.  But when it works, it can work dramatically well. And it can do a transformative work in most patients who are candidates for it.

    Whether You Call It Seasonal Affective Disorder or Something Else, You Might Want to See what Ketamine Treatment Can Do for You

    Call it seasonal affective disorder if depression only happens in winter, but ketamine can bring you joy.

    And when the clouds dump snow, make snow angels!

    At Innovative Psychiatry, we’ve witnessed such extraordinary outcomes with repeated and titrated IV ketamine that we offer it to the community to help more people get better and live rewarding lives. 

    We also invite our ketamine patients to ask their healthcare team to collaborate with us as we deliver the infusions and they can follow up with any needed therapies.

    Also, for the sake of safety, we have a protocol for patients who come to the office that involves special instructions, mask wearing, and special safety precautions.

    To this end, we’ve installed technology that destroys viruses including the COVID and flu viruses, as well as bacteria and molds in the air and on surfaces. This means that when we open the door for your appointment, you can come inside for treatment with confidence, knowing you’re safe.

    Don’t wait.

    You may call it seasonal affective disorder…or SAD… or major depression or other affective disorders, but if they’re not helped by medication, call us.

    This is a tough winter, and these intensive winter storms aren’t making it any easier. Reach out for resilience.

    Your remission is what we live to help you achieve. 

    Life really can get better.

    Reach out for hope. 

    Lori Calabrese, M.D. is on the front end of the race to stop PTSD in its tracks using IV ketamine treatment.

    To the restoration of your best self,

  • Resilience: Key to Your Wellbeing Through COVID 2021 and Beyond

    Resilience: Key to Your Wellbeing Through COVID 2021 and Beyond

    Resilience is doing well when you shouldn’t be doing well.

    — Dr. Sood, executive director of the Global Center for Resiliency and Well-being.

    We’ve passed the 1-year mark of this pandemic, and it’s time to draw from our personal stores of personal strength to maintain our pace through the rest of the pandemic triumphantly. And the buzz word seems to be resilience. It’s the key to your wellbeing through COVID 2021 and beyond. Resilience means you bounce back from difficulty, recover, and more forward.

    We don’t know yet if we’ll see this pandemic wind down in 4 months, 6 months, 9 months or a year. But for your own wellbeing and that of your family, your co-workers, our economy, and our community, we must develop the power to hold steady and see this challenge through.

    The way we can do it is by developing and strengthening our resilience.

    Since resilience is vital to our life and ability to survive emotionally, financially, in our healthy relationships, our mental and physical health, as well as our ability to handle trauma and loss… even our basic happiness… Well, we need to build it up, don’t we?

    In fact, bolstering your resilience is probably the best thing you can do to prepare yourself for the challenges and changes you’ll face this year.

    So How Can You Strengthen Resilience?

    Each time you push past something that feels like a limit, you’re strengthening your resilience. Doing your sit-ups even though you’re not in the mood, getting up and dressing and leaving the house when you don’t feel like getting out of bed, choosing healthier foods like a salad when you’d rather have the smothered bacon fries…these are acts of resilience. They come from discipline and build resilience. 

    When you turn off the TV and get yourself out the door to volunteer to help others who need what you can give, your resilience grows.

    It’s choosing self -control. It’s choosing to not give up.  Things you do every day that build your inner reserves to call upon when the need arises.

    While it’s true that some people are born with more resilience than others, it’s still good to invest in developing it. And even people who have a lot of natural resilience tend to keep cultivating it.

    The challenge is to invest yourself to cultivate it when you never have before. Because by doing that, your ability to meet the challenges this year and next year will be far better than it was last year. 

    It’s worth the effort. 

    Motivation can power resilience. Getting up and doing those things you know you need to do can help you build the purpose so you can see the point of doing those things.

    Practicing jazz on the saxophone for the hundredth time may feel like monotony, but it’s building skill on your instrument, as well as resilience.

    How Do You Acquire Resilience?

    We acquire resilience from the inside out and from the outside in. What does this mean?

    Resilience comes from the rich stores inside you of self-love, self-worth, faith, hope, positivity, gratitude, courage, and conviction.

    Resilience that comes from the outside in draws upon our support system, your community of people who care about you and for whom you care, your family, your friends, and your co-workers you feel connected to.

    So it’s not hard to see how important it is that you choose that community carefully, guarding its impact on you, to help you build the inner strength and resilience you’ll need to draw from in difficult times. Because it’s the key to wellbeing through COVID 2021 and beyond.

    Neuroplasticity Is a Wonder that Improves Resilience

    As you know if you’ve been reading my posts awhile, neuroplasticity is the ability of brain cells to change or adapt. We’ve often talked about the neuroplasticity that ketamine treatment initiates.

    That’s something a normal healthy brain does to help you adapt through life.  But when you’re depressed, or affected by another disorder, that ability to change can become impaired.

    On the other hand, when you build your resilience, neuroplasticity can function as it should.

    The big obstacle is stress. We’ve talked about stress often, because it is so destructive to brain structures in the hippocampus, the prefrontal cortex, and the amygdala.

    And one of the most important things you can do to bolster your resilience is to reduce the stress in your life. Because when you reduce stress, and let some time go by in a more “de-stressed” state, the brain cells in these structures can return to their normal working condition.

    Then again, we also know that this stressed state can become severe enough that de-stressing isn’t enough to  restore healthy function.  Sometimes symptoms become so severe that suicidal thoughts begin to dominate your thoughts.

    That’s when you need an intervention. Sometimes, lots of interventions. In some cases, medication can help. But since it only helps a small percentage of patients, you may need to seek out new help, other strategies, or other treatments.

    When medications fail to bring you relief, and you’ve tried at least two different trials…you may want to find out if you’re a candidate for IV ketamine treatment. 

    That’s where we come in… because if you are a candidate, IV ketamine can be masterful at cranking up your neuroplasticity and your resilience.

    And transformation can be soon to follow.

    Resilience is the key to your wellbeing through COVID 2021 and beyond.

    At Innovative Psychiatry, we meet people who are depressed, anxious, and sick of it all to determine if ketamine treatment might help. Many walk out at the end resilient, joyful, and full of hope.

    Invest in resilience and build your inner joy to face what lies ahead. But if your efforts aren’t enough, and medications haven’t helped, call us.

    If you’re a good candidate for serial titrated IV ketamine treatment, it will be our pleasure to help you through that process.

    We also take your safety to heart in the midst of this pandemic and have invested in world class technology that removes COVID-19 causing virus from the air and surfaces in our offices. We use additional air sterilization processes that lay down microbarriers. And even with that presence, we still wear masks and ask that you wear them, too. We test ourselves and our staff with SARS-CoV2 PCR tests with a local DNA lab that gives us same day PCR results–incredible!–at least once a week. We also keep the door locked, to ensure that only those we’ve prescreened can enter. You can feel safe with us, and we know you need to feel safe so you can relax, receive treatment, and recover.

    Don’t hesitate. Let’s find out if IV ketamine treatment can help you get your traction back. Your resilience. Your life.

    We want to help.

    Lori Calabrese, M.D. is on the front end of the race to stop PTSD in its tracks using IV ketamine treatment.

    To the restoration of your best self,

  • A Few Words of Reassurance

    A Few Words of Reassurance

    Our Nation is in Crisis, but We’re Here to Help You Get Through This

    The current Coronavirus – COVID-19 pandemic has increased fear and intensified depression and other psychiatric symptoms for many. News about COVID-19 evolves daily – thank goodness! We’ve never appreciated more how medicine can move so fast, how scientists can work at breakneck speed, around the clock, around the world. We’re so fortunate – all of us — to have such extraordinarily dedicated scientists and doctors, who know so much, who put their lives on the line, who are learning more by the second. So that they can share it with us all. So that they can help our families.

    Let’s hold them in our hearts. Because their minds hold the key to this pandemic.

    We just need to hold on.

    It can feel terrifying. Overwhelming. Devastating. And it is creating a whole new kind of trauma, and a whole new level of fear and grief. But you don’t have to suffer alone.

    We Want to Help.

    At Innovative Psychiatry, we’re experts in relieving suffering. We’ve always been. And we’re here for you and responding to the needs of our patients while maintaining safety for patients and staff like. The U.S. Center for Disease Control (CDC) and the World Health Organization (WHO) are monitoring this crisis and offer guidelines for containing the virus. And they’re updated continuously as scientific information evolves.

    Please know that your safety and health are top of mind with us. Your physical, mental, and emotional health during this coronavirus crisis matters.

    Staying well has never been more a matter of life and death.

    So in compliance with CDC and WHO guidelines, we’re at the forefront to protect you and our staff.

    And we shared our own, early guidelines — what we’re doing in South Windsor, CT — nationally with our colleagues at ASKP3, the American Society for Ketamine Physicians, Psychotherapists, and Practitioners, while they were drafting their own.

    Everyone in Connecticut who is a non-essential worker was been asked to “Stay Safe, Stay Home.” By following this directive, you’re protecting others, as well as yourself, from the spread of the virus. And even though Connecticut and much of the country has opened up, the pandemic rages.

    And so we still recommend safety first, and we believe we’ve set the standard for a whole new level of safety and attention during ketamine treatment.

    Doctors are essential. 

    Our practice is essential. What we do is life-saving.

    And we continue it, especially now, with meticulous measures to give you the care you need, protect you, and protect ourselves.

    For Psychopharmacology Patients

    All psychopharmacology appointments are currently being conducted by telemedicine. If you need an appointment, please call us at 860-648-9755. We’ll explain the logistics of how telemedicine can work for you.

    We make it easy.

    For New and Current Ketamine Patients

    During such a time of stress and anxiety, the benefits of ketamine treatment can refresh, relieve symptoms, and bring you hope as you work through the challenges of staying at home for work, school, and family time.

    There’s no question your life has been disrupted, but with patience and cooperation, you and your family can make this a productive time of closeness you’ll remember for a long time to come.

    Even so, for some, effort and cooperation isn’t enough. Anxiety can become so intense it’s crippling. Depression can rise like a high tide till you find you can hardly breathe…much less function. PTSD can become more threatening and volatile than ever…  unless you can get help. And isolation can make it next to impossible to stay indoors when you miss the support of your friends.

    For reasons like these, making ketamine treatment available now – of all times – is paramount.

    And offering IV ketamine treatment now with dedicated staff gives us greater flexibility and more opportunity to treat you.  It eliminates the possibility that you will have contact with nurses doing shifts in ERs and ICUs, or on the front-lines of exposure to COVID-19.

    We’ve changed our scheduling so that you avoid contact with other patients, and minimize contact with us. We’re serious about social distancing, and use it to protect you and ourselves. And we use extensive sterilization procedures, antiviral plasma cell technology in each treatment room to destroy airborne virus particles, as well as masks, faceshields and gloves. And… on top of that, we use VBEnviroCare services to sterilize our entire suite regularly (see this in action with our videos), and microbarrier shields on all surfaces.

    We’re serious about the air you breathe. And we want you to be able to finally breathe easy.

    In addition, we are proud to regularly test ourselves and all of our staff with weekly PCR tests for COVID-19 (the highest standard and the highest degree of reliability) using a local DNA lab which gives us same-day PCR results. (Who else does this? We care deeply for your safety — and for ours.)

    When we say we’re on the cutting edge, we mean it.

    There are no deliveries, and there’s no one who can just walk in. We lock the door to make sure. And we open it for you.

    But only after we’ve carefully screened you by phone the morning of your appointment for COVID-19, and again the moment you arrive. For protection of you, our incredibly wonderful staff, and ourselves.

    We’re here for you.

    If you need us, we’re here. And we’re still standing.

    And we’re just a phone call away at 860-648-9755.

    Lori Calabrese, M.D. is on the front end of the race to stop PTSD in its tracks using IV ketamine treatment.

    To the restoration of your best self,

  • Why Are Anxiety and Depression so Prominent in This COVID Pandemic?

    Why Are Anxiety and Depression so Prominent in This COVID Pandemic?

    What makes it so hard?

    Anxiety and depression are so prominent in a pandemic.

    Devon tuned into his department meeting. Another Zoom meeting. He was so tired of online meetings…the technical lapses, interruptions…  you can read people so much easier face to face. At the same time, he could sit in an easy chair for the meetings, so that wasn’t so bad. But no one seemed like themselves. Anxiety and depression are so prominent and have clearly taken their toll on his colleagues.

    Still, maybe there’s also a palpable energy in face-to-face meetings. He wasn’t sure if that was the problem or not, but Devon found it more and more difficult to focus, and to think creatively for his job. As the year had passed, he felt less and less capable and more like dead weight. 

    He kept asking himself what was wrong with him? Where were the sparks that flew when he dove into a problem?  Rather than sparks, Devon felt more like a dud.

    Then, he got the phone call about his next door neighbor’s son. Just like Devon’s family, his neighbor’s son was taking his high school classes at home, and online. At first, the young man Stewart, had stopped logging in to classes. Devon had heard this was becoming more and more of a problem in his community. 

    But, apparently Stewart was becoming more and more depressed. Devon just learned yesterday the boy had ended his life…right there at home.

    The grief settled over Devon like a black fog. This on top of the recent deaths from COVID-19 of two of his friends, 10 days apart. But Stewart was 15. His whole life was ahead of him. It was all too tragic.

    COVID Tragedies Can Trigger Anxiety and Depression

    He’d watched the boy grow up, playing with his own kids over the years. And it stirred up more worry about Devon’s own family. He and his wife had tried to keep a close eye on their children to be sure they logged in to school and did their work.

    But, they couldn’t be everywhere and they both worked online. But they tried. Still, life was becoming increasingly overwhelming. His heart went out to Stewart’s family. And he felt a low, sinister rumble of trepidation within himself. The dangers of the pandemic went far beyond the risk of getting sick with the virus. 

    The fear of becoming too depressed to function, or of his family succumbing to it, rose inside him till his  ears were buzzing.

    All in all, Devon knew he had to keep functioning, and presenting a solid, unified front with his wife. He also knew the danger of drowning in it all. When his meeting ended, he called a highly recommended psychiatrist for a consultation appointment. He wanted to be proactive, before it was too late to think straight.

    There’s just something about a pandemic that can make happy people depressed or relaxed people overwhelmed with anxiety.

    We’ve talked about it before. In the early months of COVID-19, that the circumstances that accompany a widespread environment like this can lead to your symptoms worsening. It can also lead to symptoms you never suffered before. Anxiety and depression are so prominent these days.

    Well, at this point, this global state of affairs has been causing stressors that aren’t new anymore. But they do go on and on and on….and on…

    And periodically, we need to stop and take a breath and ask how you’re doing?

    At this point, there have been 99,195,630 COVID-19 cases globally, with 2.1 million deaths. In the US, 25.2 million cases, and over 419 thousand deaths. The numbers are staggering. And the scale of this pandemic is difficult to grasp.

    These are people. Our teachers, our friends, our neighbors, our families. Grandparents. Parents. Our children.

    And…since we are a species with both mind and body, it stands to reason— doesn’t it? —that both our minds and our bodies are impacted by this. With anxiety about sickness, anxiety about isolation, anxiety about lifestyle change and lack of spontaneous freedom, it does stand to reason that the problems and stress factors would pile up and also lead to depression. Anxiety and depression are so prominent these days…and they often go together.

    We’ve watched a 1st wave of COVID spread, then a 2nd wave, then a 3rd…and it’s not over. The virus changes, mutates, and different strains have varying impacts. Some cause milder symptoms, some spread much faster, some cause more severe symptoms. It goes without saying that all this has affected you…and all of us,

    Most of us know people who have had the COVID-19 virus, and many of us have seen our friends and loved ones die because of it. This is a traumatic time that none of us will forget.

    Research Helps Us Understand the Impact of a Tragic and Stressful Experience

    A group of Danish researchers in Copenhagen and Aarhus, Denmark led by Søren Østergaard conducted a survey during each of those 3 waves to better understand the variation in psychological well-being regarding symptoms of anxiety and depression during this pandemic, among participants in Denmark. 

    Their results were relevant to the global community, even though severity of the disease hasn’t been equal everywhere.

    They reported results of the survey for wave 1 (March 31st to April 6th), wave 2 (April 22 – April 30th), and wave 3 (November 20 – December 8 … just last month.)

    The 1554 respondents were an average age of 49.5.

    There was a statistically significant decline in psychological well being from wave 2 to wave 3, especially with men. And during wave 3, worry, anxiety, and hopelessness decreased over those levels in wave 2, but feelings of guilt increased.

    Anxiety and depression have been prominent in Denmark, too.

    In a nutshell, these researchers ended the paper with the statement that by late November to early December, the psychological well being of the Danish population had fallen again to the level of March/April, when it had been at its lowest.

    Overall, they found that when COVID cases are high, and the measures to reduce the spread of the virus like quarantine, isolation, social distancing, and major lockdowns are the most widespread, there is a significant impairment of psychological wellbeing.

    What Can You Do with This Information?

    Setting aside the particulars of a study in Denmark, and focusing on right here in the US, we need to find ways to intervene in your own state of mind. Your own wellbeing.

    Gather online with friends and family to interact for online chess. Talk and laugh together. Watch your grand babies blow bubbles.  Share a spaghetti dinner, complete with candles, where each participant cooks at home then all connect and chat while eating.

    Social interaction is fundamental to your well being. When you share a meal on Zoom, you don’t have to wear a mask!

    Even so, if this ongoing pandemic seems to be having a serious impact with depression, social anxiety, hopelessness, even suicidal thinking, ketamine infusions may be able to turn that around and refresh your resilience. There is still hope.

    Anxiety and depression so prevalent during pandemic

    At Innovative Psychiatry,  we’re all about helping you get a leg-up to manage these challenging times, and meet the frustrations in your life with flexibility and peace. We offer IV ketamine treatment — after a thorough screening and evaluation — to those whom we determine are good candidates for ketamine’s extraordinary benefits. Ketamine treatment is not for everyone, because circumstances as well as the medical and psychiatric history of some patients indicate ketamine is not the right choice. However, it can be so helpful to so many…it can be transformative.

    We provide a safe place for treatment. We now test our staff at least once each week to verify they are COVID free… We can also refer our patients to a local DNA lab that will do same day PCR testing for those patients who wish it. In addition, we installed technology that destroys the coronavirus and all viruses and bacteria in the air and on all surfaces fast.

    Our goal is to help you get better and to keep you safe.

    You have struggled, tried to break through, tried to carry the anxious and depressive symptoms that have weighed you down for a long, long time. We want to help you put that struggle in your past. So you can feel restored. So that you can be your best self. To have the energy, freedom, and hope to build your life again with creativity and joy…and to have the resilience to move from day to day and week to week.

    You needn’t postpone it any longer. Call us.

    We can answer your questions and sort out the possibilities together.

    Lori Calabrese, M.D. is on the front end of the race to stop PTSD in its tracks using IV ketamine treatment.

    To the restoration of your best self,

  • Repeated Ketamine Infusions Relieve PTSD Symptoms – New Study

    Repeated Ketamine Infusions Relieve PTSD Symptoms – New Study

    New study demonstrates that with repeated doses of IV ketamine, relief can last up to several weeks.

    A deep unfamiliar voice behind Sarah made her jump. In a flash, she turned and bolted down the stairs she’d been climbing, turned left, then left again, knocking into people in her path as she scrambled for a place to hide. A mad dash took her into the restroom, where she locked the door and turned off the lights to hide in the dark. Screams sounded as darkness enveloped the room. Her heart was pounding, sweat pouring from her scalp, down her face, her torso…her armpits. She willed her breathing to slow…so the man pursuing her would not hear her panting gasps. (Poor Sarah. She’s suffering… if only she knew what repeated ketamine infusions relieve…)

    Three women exploded out of their stalls complaining about the lights and searching for the switch. Sarah pushed past them to an empty stall and stood on the toilet seat with the door locked so her feet couldn’t be seen below the door.

    Sarah’s vision blurred as sweat poured into her eyes. With a quick swipe, she wiped the moisture from her eyes and forehead. And waited. Silently.

    By her watch, she saw time passing. She heard women come and go from the restroom…heard their quiet conversation…  but she waited, hands trembling.

    After 45 minutes crouched with feet on the toilet seat…Sarah began to feel calmer. It washed over her that she’d been hiding in a public restroom for close to an hour… and now she was late to work. 

    PTSD is Not Only Terrifying, It Seriously Interferes with Daily Living

    Again.

    Oh noooo.

    Reality settled in. After washing her hands without incident, she cautiously opened the door and saw nothing unusual outside the door. She began to realize that it had happened again. Like countless other times. The sound of that voice triggered her memory of the assault…and it was so real. Except it wasn’t. 

    She was surrounded in the trauma again. 

    And that was the problem. Yet again, she would clock in late and be reprimanded for it. There must be help to conquer the PTSD symptoms that had emerged after she was assaulted 2 years ago. She had to find peace. Sarah wanted her life back.
    Desperately.

    Repeated Ketamine Infusions Relieve PTSD Under Controlled Conditions

    PTSD can be so entrenched that it is very difficult to relieve — even with therapy, special trauma-based therapies, SRI’s, or a combination of approaches. Very early work with ketamine–and the brilliant neuroscientists behind those studies–showed ketamine could reduce PTSD symptoms.

    A recent study from the Icahn School of Medicine at Mt. Sinai published January 5, 2021 has made splashing news among ketamine researchers and clinicians as the first randomized, double blind, placebo-controlled trial of repeated ketamine infusions for chronic PTSD. Adriana Feder and her team deserve applause and admiration, and have just set the bar higher for ketamine clinical trials.

    It was brilliantly conceived, elegantly executed. Well done.

    Patients with chronic PTSD that had gone on for years, from a variety of traumas, were separated into two groups. One group received 6 ketamine infusions (3 times a week over 2 weeks); the other group received an infusion of midazolam, which was the “placebo” in the trial, but it is was an active placebo–it made them feel something but it wasn’t ketamine.

    Ok, now this is important: if you have PTSD, or if someone you love has PTSD, you want it to stop. That would be remission, and that would be ideal. But in the world of PTSD clinical research studies, researchers look for response, and response means a 30% decrease in your symptoms.

    That’s how response is defined, and that’s how it was defined for this study: 30% improvement. It doesn’t seem like a lot of improvement, does it? Unless your life is a nightmare. Then a 30% reduction is a lot of improvement.

    As it happened, 67% of those in the ketamine group responded after 6 infusions …  compared to only 20% of those getting the placebo study drug.

    A significant difference.

    And possibly even more exciting than that 67%, those who received ketamine infusions experienced significant improvements across 3 of the 4 PTSD symptom clusters: intrusions, avoidance, and negative alterations in cognitions and mood.

    So, Repeated Ketamine Infusions Relieve PTSD

    Dr. Feder and her team — and all of us, truly — are encouraged by this kind of outcome, and of course, call for more infusion studies using more infusions as well as trials using ketamine infusions combined with trauma-focused therapy. In fact, we can and are imagining all kinds of studies we’d like to see for PTSD — different infusion parameters, different infusion doses, titrated infusions, new medications, new therapies. The GREAT news is that relief for PTSD is under investigation and more effective treatment is on the horizon.

    Formal Studies Help to Establish Credibility

    Now, it’s important to note that for a study to be replicable, it’s required to use clear protocols and consistent dosing. In real world practice, we have the duty and the responsibility to treat each patient as an individual for the best possible outcome. Sometimes that means using a teeny, tiny dose, tinier that you would imagine; sometimes it means titrating the dose to get a better response.

    Medicine is a science and an art.

    Since we’ve learned that effective depression relief requires different treatment for different patients, and effective ketamine treatment often requires different ketamine doses for different patients (and different conditions), we might expect the same to be true for PTSD.

    The ketamine dose for each of the 6 infusions dose in this study was 0.5 mg/kg — the same dose used in the single-dose and early repeat-dose studies of treatment resistant depression.

    But we find clinically, and from our own published work, many patients with depression need higher doses to stop suicidal thoughts, to achieve remission, and to restore hope.

    By the way, notice that in the trial above, 67% of participants benefitted from ketamine infusions: they experienced a 30% drop in their symptoms. Ketamine is wonderful for those it helps — when it helps — but for reasons we don’t fully understand yet, it doesn’t help everyone. And it didn’t benefit everyone in the study. Ketamine is not a treatment that works for everyone. There isn’t anything that works for everyone.

    In real life practice, we can titrate. By that I mean that we use our expertise, in addition to evidence-based scientific results, to adjust the infusion dose during treatment (within certain parameters) to try to bring forth the most effective results for you.

    Because your treatment, of course, is about you. It’s all about you.

    New Studies, like this one with a Series of Ketamine Infusions for PTSD, build our Brain Trust about Ketamine so that We Can Provide More Relief to More People Who Need It

    One size may fit many, but not most, and one size never fits all.

    At Innovative Psychiatry, we treat PTSD with repeated titrated IV ketamine treatment. And we use our deep expertise with ketamine in psychiatry and in the treatment of trauma to give you the best possible results. We’re thrilled that randomized, controlled trials are now investigating this so carefully. Research underscores safety, efficacy, and credibility. The more researchers learn, the more we can help you.  

    If you’ve suffered with PTSD and other treatments and medications have not helped, repeated ketamine infusions may help remarkably. 

    And remember, until the COVID-19 pandemic has moved to another solar system (just kidding! — but wouldn’t that be great?),  we’re prepared to keep you safe when you’re here with us. We have the technology to keep the SARS-CoV-2 out of the air, and off of the surfaces in our office. We’re vaccinated, we’re tested regularly, we screen everyone. (And we keep the front door locked!) When you come for treatment, you can breathe easy. 

    We want you safe, and we want you relieved of PTSD and other symptoms.

    Because, like Sarah, you need a life that is free to develop. A life that’s not interrupted with unmanaged symptoms.

    And we want that life for you.

    So you can follow your own dreams, and build the life you want to build.

    If you suffer from PTSD and nothing has helped, call us.

    In fact, if you suffer from treatment resistant depression, bipolar depression, anxiety, suicidal thinking and nothing has helped, call us.

    Let us work with you to help you transform and enjoy your life.

    Lori Calabrese, M.D. is on the front end of the race to stop PTSD in its tracks using IV ketamine treatment.

    To the restoration of your best self,

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