Lori Calabrese, MD

Author: Lori Calabrese, M.D.

IV Ketamine for PTSD Symptoms from Severe Abuse Trauma

Celeste quivered in the dark recesses of the closet… trying to breathe ever so quietly. She didn’t want to alert her husband to her hiding place. His violent assaults had become more and more severe…she could feel her eye throbbing and her lip swelling, but the worst was the soreness in her neck. He had almost crushed her airway this time. She knew if he found her he might finish her off. So she tried to breathe without making a sound. It was hard. She was terrified — and knew that this kind of severe abuse trauma leads to PTSD, but she couldn’t worry about that now.

Then, unexpectedly the closet door opened.

She froze.

Cam pushed the hanging clothes aside and peered into the darkness. She prayed he wouldn’t see her.

Then, with horror, she felt his hand close around her ankle, and he jerked her out of her hiding place by her leg. Her head bumped the wall as she was dragged out. She screamed.

He dragged her to the cat’s litter box and holding her hands behind her back he forced dirty litter into her mouth and down her throat. Celeste choked and coughed. Then gagged. She scrambled to get her feet under her so she could run, but he tackled her and forced her to the floor. He wrapped his arm around her neck and she could feel her airway closing off. She closed her eyes and tried to relax.

She went limp.

Cam loosened his hold to see what was going on. She took advantage of that split second he was off-guard, then twisted and kicked him in the stomach with all her strength. She spotted her keys on the table and pushed to her feet as she ran for the front door, grabbing the keys on the way. Out the door, into her car, she started it and threw it into gear. Celeste took off with tires squealing.

She looked in the rearview mirror. There was no sign of him.

She turned at one corner, then the next, trying to disappear. Then she turned her car toward the highway.

Celeste drove and drove, trying to calm down, but she was still shaking. The scenes of the morning played over and over in her mind. Terror that he would find her, pull up behind her on the road, kept her rigid with fear. She knew this kind of severe abuse trauma wasn’t normal in a relationship. She just couldn’t find a way to escape it, until now.

She exited at a random exit, and drove west until she reached another highway, then got on it and kept driving. Thank God there was gas in the tank.

He mustn’t find her.

After 2 hours of driving, she finally began to become calmer. With no where else to go, she called her Mom’s cell phone.

The sound of her mother’s voice made her tear up and her voice wavered.

“Mom, I’ve left him. Can I come to your house?”

“Of course, honey!! Where are you?”

“I’m not sure…I’ve been driving. I thought he was going to kill me this time…”

“Oh Celeste, honey, how horrible! I’ll help you. I’ll do whatever. I’m so glad you’re taking a stand to save yourself. Would it help if I met you somewhere?”

“No, Mom. I just want to come to you and be in a safe place. I need to park my car in the garage so if he drives by he won’t know I’m there.”

“Ok. That makes sense. Stay on the phone with me and talk while you drive so you don’t feel alone.”

“Yes, that’s a good idea.”

In 45 minutes, Celeste pulled into her mom’s driveway.

She saw the garage open, so she pulled in and her mom, Jill, was there when she got out of the car. They closed the garage door and went into the house and locked all the doors.

Over the next few weeks, Celeste cried, slept, ate, and slept some more. For the first time, she described to her mom the violence, fear, confusion, and terror that had been her life for the last two years. All of the severe abuse trauma seemed to engulf her.

Her mom had encouraged her to file a report with the police the day after she arrived, so they’d have pictures of her black eye, swollen lip and cheek, and bruised neck and chest.

It was hard. She loved him, or so she thought. She had not told anyone about the violence… to protect him. Letting go of that protection and loyalty – to take care of herself – was extremely difficult.

She didn’t want him to continue hurting her, but she didn’t want to hurt him, either.

Still, she saw his car drive by the house a few times over the next few weeks. She hired a lawyer to help her with a restraining order, and she never went anywhere alone.

She felt so vulnerable.

Celeste found herself jumping at unexpected sounds, loud noises, voices when she didn’t realize someone was nearby. When she ran into an old friend in a grocery store, the friend hugged her and patted her back. She froze, broke out in sweat and began to shake.

She slept very little, lying in her bed tense and wide awake, and plagued by a rapid cycle of thoughts, memories, fears. When she did fall asleep, she had nightmares of Cam and soon woke up again.

She knew in her head she was living in a safe place now, but Cam seemed all-powerful to her, and she expected he could turn up anywhere at anytime…and she believed he’d kill her.

She found she was too terrified, more and more, to step outside the house. Walking to the mailbox to collect the mail made her feel terribly vulnerable, so she stopped doing it. Trips to the grocery store became too threatening, so she stayed home. Severe abuse trauma choked her when she considered leaving.

After awhile, she found she only felt safe in her bedroom.

So she stayed there. All the time.

Her mom watched her emotional state deteriorate more and more. She brought meals to her room, gave her plenty of time to herself, and sat with her on her bed sometimes to talk and offer moral support.

Finally, Jill got on her laptop and searched for an understanding of the symptoms she saw in Celeste. The hypervigilance, tension, and insomnia… her reaction to being touched, patted, or spoken to… her fear of leaving the house, then her room.

She felt gut punched and choked all over again. Apparently, 2 years of trauma had taken a toll.

PTSD from severe abuse trauma seemed the best explanation.

Jill talked to her about it and what she learned. She bought a book about it for Jill to read in hopes it would help her understand herself and her fears.

She also learned there was an effective treatment for PTSD using IV ketamine treatment.

IV Ketamine for PTSD

She read one article after another that explained neuroscience studies about how IV ketamine treatment can bring remission to symptoms of PTSD. The jumpiness, the panic, the fear and anxiety, the depression.

After printing off a pile of articles, she went to her daughter and told her what she’d found. She told her she was also searching for a place where Celeste could receive ketamine treatment.

Celeste started scanning the articles, writing notes in the margins as she read.

She began to feel hope that life could be better.

The idea that she didn’t have to live in a prison of fear and panic opened a window in her mind and light and fresh air streamed in.

She learned about how the stress of severe abuse trauma wears down the synapses or connections between brain cells, called neurons. That the neurons rely on those connections to send signals around the brain, communicating from one region to another. When those connections are lost, the signals can no longer be transmitted, and depression grows.

Cognition, courage, creativity, and hope all rely on those connections. The result is poor concentration, fear, panic, despair, and hopelessness… a cluster of PTSD symptoms. A cluster in general.

Celeste asked her mom to help her find a psychiatrist who treat her with IV ketamine treatment.

IV Ketamine Treatment

With her mom’s help, they found a practice within a couple hours drive and called to make an appointment.

There were other clinics closer to her home that offered ketamine treatment, but she wanted a prominent psychiatrist who understood her condition and could guide her as she received treatment. It felt safer.

After the first three infusions which were 3 days apart, Celeste couldn’t really feel any difference, and she began to worry. She read more articles about how long it should take to feel better, went online, started panicking that it wasn’t going to work….and then learned that everyone is different. Some feel a little better the first day, others after a couple treatments, others later than that… so she told herself to be calm and patient. It was hard to hold on to hope.

After the 5th treatment, it was as if a light began to turn on inside her. She felt slightly less nervous, less fearful, less panicky.

After that, with each treatment, she felt better and better. After 8 treatments, she felt remarkably better and noticed in the following couple weeks the improvement continued.

She decided to attend a therapy group of others who had suffered from PTSD. And it helped for awhile, then she didn’t feel as well as she had.

Sometimes a booster is the ticket

About a month after her last treatment, she seemed to be feeling shaky again, as the severe abuse trauma seemed to begin to surface again. So she called for a booster infusion. Once again, after that she improved dramatically again until she felt more like her old self than she had in a number of years.

Cam was arrested for assault, evidence was collected, and the case was built with her help and numerous visits to the D.A. Without ketamine, she could not have left the house, much less gone to his office for meetings to build the case.

As it happened, Cam was sentenced to 3 years in prison, which gave Celeste time to rebuild her life to some degree. But most importantly, she could live in peace with her surroundings, and her emotions.

The panic attacks subsided, her hope grew, and she decided to go back to school to get her law degree so she could help people who have been through what she had.

She could breathe again, and she looked forward with joy.

Do you know someone who suffers from PTSD?

IV ketamine treatment can do wonderful work in your brain cells and their synapses to soothe PTSD symptoms. In fact, it can help you achieve remission.

If you’ve been diagnosed with PTSD, or can identify with Celeste’s symptoms, and nothing you’ve tried has helped, call us.

One of the most effective treatments for PTSD today is IV ketamine treatment. We’ve been watching people like you recover from PTSD symptoms for years with the IV ketamine treatment we provide.

If you’ve been through severe trauma and fear has made your life feel like a prison, let us help you receive this remarkable treatment, so you can find freedom from the symptoms that keep you from living the life you deserve.

We’re all about helping you move forward with joy.

To the restoration of your best self,

June 26, 2023
How Your Ketogenic Diet Transforms Bipolar Disorder

We’ve looked at how your ketogenic diet transforms depression. But what about bipolar disorder, one of the most severe psychiatric conditions? Surely, an illness so complex can’t be treated with something so mild and routine as a change in diet? Sound absurd? Well, it’s not only NOT absurd, it’s a neuroscience-backed intervention that’s changing lives for the better.

Your Ketogenic Diet Transforms

As you learn about metabolic interventions, you can understand why treating your metabolism can bring your disorder into balanced order.

For 100 years, the ketogenic diet has been a prominent and effective treatment for epilepsy. By reducing carbohydrates and providing high fat, it pushes your mitochondria to trade ketones for carbohydrates. This allows you to make energy efficiently in each cell in your body, including your brain. And ketones are the most therapeutic fuel for brain cells to use.

Literature Review at Stanford University

Shebani Sethi, M.D., worked with Brenda J. Yu, M.D., and Ruya S. Oz, M.D., to conduct a literature review on “current metabolic mechanisms of bipolar illness.” They specifically focused on how your ketogenic diet transforms you and repairs your metabolism and, in turn, symptoms.

In bipolar disorder, similar to epilepsy, you see a dysfunction in the production of energy. We directly replace carbohydrate fuel with ketones in the mitochondria of the cell. This improved metabolism seems to imitate the effects of medications used to stabilize mood. Amazing, isn’t it?

So many people with bipolar disorder turn out to be “treatment resistant” — meaning medications are not as effective for them as they should be. For them—and for others who just don’t want to go down the road of more medication—a better and more effective treatment is critically needed.

So, hope is spreading rapidly as the therapeutic effects of a ketogenic diet are being studied and used in the treatment of this disorder.

Ketogenic Diet Transforms

It’s remarkable, too, that improving energy production in brain cells is not the only way a ketogenic diet helps. It also strengthens the immune system and reduces inflammation, protects brain cells from oxidative stress, and reduces dysfunction in the pathways that cause changes in brain function.

By bringing order to these systems, symptoms can then follow course and restore balance and order to your cognition, mood, and wellbeing.

Oxidative Stress Damages Brain Cells

Let’s take oxidative stress, for example. When it persists over time, it can cause irreversible damage to brain cells. Several studies have demonstrated that oxidative stress is one underlying cause of bipolar disorder. Chronic cellular damage like this seems to cause gaps in transmission of signals in brain cells which can result in bipolar symptoms.

Ketones seem to play a role to protect these neurons, providing a buffer for the brain cells and relieving bipolar symptoms.

Keto Diet Helps Neurotransmitters

Another of many malfunctions in metabolism blamed for mood disorders and bipolar disorder is the levels of neurotransmitters that regulate mood, emotion, and cognition. How your ketogenic diet transforms your bipolar symptoms includes what it does to your neurotransmitters.

Dopamine is a good example. Since dopamine plays a role in arousal, reward, and motivation, you can see how it has an influence on your mood.

Failure in the function of dopamine transporters and receptors in the brain is another likely cause of bipolar disorder. When there is too much dopamine being activated, constantly stimulating brain cells, manic symptoms can happen. This can also lead to oxidative stress…and you see the vicious cycle that results.

And it’s not just dopamine. Serotonin is another neurotransmitter that helps regulate metabolism, emotion, and cognition. Your mood is directly affected by a neurotransmitter that regulates your metabolism! It’s not hard to connect the dots, is it? Straighten out your metabolism and improve your mood!

Then there’s 5-HT… believed to contribute to the depressive episodes of bipolar disorder … and it’s found in low levels in people with this disorder.

And that leads us to norepinephrine, that helps regulate cognition, motivation, and intellect. Low norepinephrine can cause depression symptoms, and can contribute to the low moods of bipolar disorder.

So how about what these neurotransmitters do?..or don’t do?

For brain cells to function properly, there has to be balance between “inhibitory” and “excitatory” neurotransmitters.

GABA and glutamate create balance in the glutamatergic system, and changes in either one can cause depression symptoms and anxiety. Too much stimulation of these receptors can lead to death of the brain cells.

Beneficial Condition: Ketosis

Ketosis, the condition a ketogenic diet leads to, can alter neurotransmitter levels. In one study, lab animals fed a ketogenic diet for 3 weeks showed no change in their levels of norepinephrine, dopamine, or 5-HT, however, there was an increase in the activity of dopamine, and of dopamine and serotonin in another study.

So ketosis helps regulate neurotransmitter function in improving the symptoms of bipolar disorder.

Extensive mechanisms impacted by ketogenic diet in bipolar disorder

There are too many to to describe here, but we just want to offer a few examples of brain cell metabolism impacted by the ketosis established with a low carbohydrate, high fat diet.

By improving mood, behavior, and cognition, this intervention for bipolar disorder can promote things like restful sleep, clearer thinking, stable mood and emotions and a rewarding life.

Drs. Sethi, Yu, and Oz presented a thorough review of studies conducted about how your ketogenic diet transforms bipolar disorder symptoms, but more studies are needed.

Meanwhile, they’ve demonstrated a reason to hope for those who suffer from bipolar symptoms, especially if medications have not helped or if side effects of medication have required an alternative treatment.

Do You Have Bipolar Disorder?

Have medications or other treatments been ineffective?

If you have been diagnosed with bipolar disorder, or another a serious psychiatric disorder, and you’re interested in exploring how a ketogenic diet can be used as treatment, call us.

Let’s meet and talk about options that may be available for you.

We’re here to offer treatments that just may bring the relief you need, and open a door to a rewarding life for you.

To the restoration of your best self,

June 17, 2023
Smash Bipolar Disorder With Ketogenic Psychiatry? You Bet!

Greg woke up in the morning roaring. He never knew when he woke up how he’d feel, or how he’d react. The combination of angst, explosive rage, heartache, and pain burst from him as he became alert, and it took a few moments before he could gather control of himself and hold it all in. At least he could stop roaring. He went to the bathroom, feeling like he had fire ants on his brain and wanted to scream. Someone had said that sensation was caused by the inflammation in his brain. He didn’t know what it was but it made his face turn red and made him want to scream as loud as he could. Ever since he’d been diagnosed with bipolar disorder he’d taken a wide variety of medications, and nothing seemed to help him feel better. He felt like he lived in a cruel torture chamber ALL the time. He wished for a way to just smash bipolar disorder and get it out of his system.

Treatment-Resistant Bipolar Disorder

In spite of all the medicines he tried, Greg didn’t feel like he could socialize much because of the danger of mood swings that would ignite explosive rage or plunge him into depression… or else he’d rave too much and make a “fool” of himself, as acquaintances said. He couldn’t help it, and it made him feel awful about himself.

He had rapid cycling bipolar disorder and his moods didn’t swing over time, they jarred him from one extreme to the other —and back — in a day. It kept his life in chaos and misery.

The remarks of friends, acquaintances, and even relatives were so derogatory, so humiliating, that he started to develop social anxiety so severe that he was afraid to socialize at all. But being cooped up in the house all the time felt like being locked in prison.

He yearned for fun, excitement, and acceptance. And at the same time he couldn’t trust himself to just “blend in.” How he wished he could smash bipolar disorder permanently.

After high school, he enrolled in college. When it was time for his first exam… he panicked. He couldn’t face it. His anxiety sky-rocketed and he secretly found the keys to his grandmother’s car and took it out in the middle of the night, picked up a couple friends and they hit the road.

His parents and grandmother panicked.

What had he done and where had he gone? They tried to reach him on his phone but he didn’t answer. Finally, late the next afternoon he called and told them he was in a neighboring state.

His mom tried to remain calm and reassuring to avoid triggering him into rage or panic.

“Greg, are you ok?”

“Yeah, I’m fine.”

“Is everyone with you ok?”

“Yeah, mom…really. We’re all ok.”

“Ok good, honey. You need to come home. We need to get Gram’s car back into her garage as soon as we can. Can you get on the road and start home?”

“Yeah.”

“Ok, good. Where are you?”

“I’m in Augusta, Maine.”

“Oh wow. Ok. As I look on the map, it looks like you’re about 4 hours away. So get on the road and we’ll start looking for you in about 3 1/2 to 4 hours or so. And Greg? No alcohol or anything, ok? You need to be safe. Please call me as you go through cities so I know you’re making good progress, ok?”

“Yes, Ok. I’ll be careful.”

Just another crisis that no one saw coming.

Five hours later, Greg pulled into Gram’s driveway. His mom, Chrissy, went outside to meet him and get the keys as quickly and calmly as she could. Miraculously the car seemed undamaged. Greg was ashamed and embarrassed. His mom knew she needed to be accepting (and calm) as she talked with him about what had happened. Greg wished he could smash bipolar disorder. He hated his unpredictable behavior.

Life with Greg had taught her how to handle crises.

The hard way. Whether it was a suicide attempt, or self-medicating with alcohol or substances, or just excited raving episodes, it was ALWAYS important to maintain a calm and kind presence. Greg would quickly escalate otherwise.

His dad loved him too, but Greg’s behavior made him mad. His desire to protect his family made it very difficult for him to be calm in the face of these crises, so he (wisely) let his wife handle the immediate interactions.

The problem was… how could they navigate this the rest of their lives? What would become of Greg after they were gone and not there to help him? Medicines were certainly not helping.

What could they do?

Steve, Greg’s dad, decided to do more research out of sheer desperation. He searched the internet for articles about bipolar disorder and treatments that might help. Something had to give. He loved his son and ached for him to have the ability and the power to live a rewarding life.

To work, provide for himself, maybe someday marry and have a family. None of that seemed possible at this point. Surely his diagnosis wasn’t a death sentence. Surely there was some hope somewhere. He wanted to smash bipolar disorder and free him of it, but how?

He found articles about alternative treatments, but nothing resonated. And then he found an article about research at Stanford University with Shebani Sethi, MD, that made the connection between severe psychiatric disorders, like bipolar disorder and schizophrenia, and metabolic illness. The article showed studies that used interventions like a ketogenic diet and low carbohydrates to treat these disorders.

He learned about the effectiveness of feeding ketones to brain cell mitochondria instead of carbohydrates and how that calmed and balanced brain function, drastically improving symptoms, increasing energy in the muscles of the body, and calming mania and explosive rage. With improved cognitive function, the patients were able to begin building rewarding lives.

So he googled “metabolic psychiatry” and a host of articles came up. He found a great video and podcast called Metabolic Mind which discusses psychiatric disorders and metabolic illnesses that could be treated with nutritional ketosis — a ketogenic diet used in metabolic psychiatry —combined with exercise and other lifestyle changes.

And it turns out that the Baszucki Group is committed to directing resources towards the greater good — and they have already funded new research related to the use of metabolic approaches in psychiatry. Their reason? Matt, Jan and David Baszucki’s son, had experienced radical improvement from bipolar disorder through these interventions, after several medicines didn’t help. The Baszucki family smashed bipolar disorder and helped their son become free. Actually, they crushed it.

Steve let out a deep and relieving sigh.

There was hope.

He searched and found a metabolic psychiatry practice which offered metabolic psychiatry treatment, so he called to make an appointment for Greg, and was excited to see that he and Chrissy could be involved.

After an extensive eval by the team, Greg began an individualized ketogenic metabolic therapy (not keto by YouTube) and they immediately started to adjust his diet according to the plan that the registered dietitian-nutritionist designed for him. There were lots of touchpoints. He was encouraged to participate in the walks and talks that the practice led several times a week, take in the gorgeous woodlands and scenery — with mountain laurel exploding in bloom! — breathe fresh air, and relax. He learned that therapeutic ketosis and exercise help fuel his mitochondria with ketones which would help improve his metabolism and the symptoms of his bipolar disorder.

And so it happened they smashed bipolar disorder.

Greg felt better and better, less volatile, more at ease, over the coming months. Within days, he felt sharper, clear and calm… within weeks they were seeing a real change in all of his symptoms. The calmer his mind was, the more hope he gained.

Four months later, he enrolled in a single course in college to see if he could handle it. He was amazed at the spike in cognition he experienced, and how the brain fog he’d suffered from for years was gone.

The course work was laborious, and required focused effort, but the more he did, the more he got engaged, the better he comprehended it all, and the more triumphant he felt. When it got hard, he didn’t feel panic. What a relief! He was beginning to feel like this must be what it’s like to be on top of your game. Could it be?

He decided to take a somewhat lighter load over the next few semesters, and throw in a summer class here and there, to avoid too much stress. After all, he had time. What was important was being successful — no matter how slow he needed to go.

Greg is well on his way to getting a BA in Literature and a teaching certificate. He continues to build confidence in his stability and health every season.

His parents have been present for every award, every achievement, and rejoice with him every step of the way.

The seemingly unreachable dream of a rewarding life is building and coming into being. Finally. He continues to maintain his therapeutic lifestyle to keep himself stable. He never wants to risk going back to the suffering he had known before.

You can achieve a fulfilling and rewarding life, too.

Do you suffer from a mood disorder or anxiety that just seems treatment-resistant?

If you’re sick of the way that you feel, sick of meds that don’t help enough, or sick of trying one medication after another, call us.

Through the discoveries of metabolic psychiatry, like ketogenic interventions, we can help you smash bipolar disorder and feel better, live better, and enjoy the rewards you yearn for in your life.

To the restoration of your best self,

June 12, 2023
Turning On Neurogenesis: The Head is Part of the Body

We’ve talked about our avoidance of the term “mental Illness” through the years, because it misrepresents psychiatric disorders. We’re now going a step further to emphasize that the head is part of the body, and that the key to treating these disorders may very well lie in the metabolism of the whole body. We’re going to be talking about the ins and outs of “metabolic psychiatry” in our quest to get more help for more people. A growing wealth of research is demonstrating the connection between the state of mitochondria in the body’s cells as a direct link to the state of a person’s mind. Studies are demonstrating that we can change the productivity of the mitochondria through diet — specifically therapeutic nutritional ketosis — and lifestyle changes. As a result, at Innovative Psychiatry, we’re expanding our practice to offer these developments to you.

Sound shocking? This idea that eating differently could impact psychiatric symptoms? That upgrading your food choices could not just reduce but stop symptoms that have plagued you for months… or years?

Granted, it might sound a bit far-fetched at first. But the more you understand about cells all over your body and how one group of cells affects another, the more sense it will make.

Therapeutic Nutritional Ketosis

We’ve seen this concept demonstrated in our work with anorexia nervosa, where after a period of therapeutic nutritional ketosis, we used IV ketamine treatment. We saw it work, replicated the approach with impressive results in a small pilot study that we published, presented at the International Conference on Eating Disorders in Washington DC, and discussed with Brett Scher, MD of Metabolic Mind on a video broadcast.

Working always with the premise that the head is part of the body, we’re seeing that using therapeutic nutritional ketosis can be effective in many other illnesses and disorders as well.

We know that stress wears down and prunes the dendrites and dendritic spines of neuron cells in the brain, and we also know this causes a dampening effect and a decrease of signals sent across the brain. Fewer signals result in less activity, less communication, less creativity, and less resilience. This can result in depression, mood switching, anxiety, and other disorders. We know that we want to see an increase in neurons, dendrites, and dendritic spines.

More circuits = more healthy signals, creativity, communication between areas of the brain, and resilience.

We also know that aging neurons tend to become dormant and less likely to send signals or reproduce themselves. For your mind and body to stay youthful and healthy, you need your cells to be functioning at their best. They need to reproduce themselves in an ongoing manner. When they don’t, dysfunction results. For example, dementia can develop.

Stem Cells Restore Specialized Neuron Cells

The cool thing about stem cells is that they can reproduce themselves over and over and over, continuously proliferating. They can also cause their new cells to develop specialized functions as needed. But when neuron cells age, what can we do to get them to proliferate new ones?

Think of stem cells as the unprocessed, built-in construction material of the body, and in this case, for the mind. When conditions are optimal, they reproduce to form all the other cells that specialize to perform specific roles.

But how to get conditions so optimal in a living, breathing, aging body? Because, as we’ve said, aging cells don’t reproduce that well.

A team of researchers led by Jean-Claude Martinou and Marlen Knobloch at two Swiss universities, discovered that these neurons can be increased in the adult brain. Remember, the head is part of the body. There are parts of the brain that contain quiet, non-active neural cells that are actually stem cells. Still, neuroscientists haven’t understood how to get these stem cells to increase in number.

These researchers discovered just how an aspect of metabolism enables these neural stem cells to overcome their dormant state and become active again. And when they’re active, they can regenerate. It’s all wrapped up in the mitochondria.

Mitochondria Regulation

You may know that the energy factory in the cell is the mitochondria. This special part of the cell contributes a variety of vital services, and your body flourishes as the mitochondria flourishes. The researchers discovered that the mitochondria contribute to regulating how much these neural stem cells are activated.

A protein complex in the mitochondria called the pyruvate transporter actually influences the possible roles a cell can fulfill.

This gets a bit complex, but here’s the crunch. When researchers know and understand that metabolic pathways separate active cells from dormant cells, these researchers can wake up the dormant cells by changing their metabolism in the mitochondria.

Let’s say that again.

Changing the direction of metabolic pathways can improve the activity state of neural stem cells and in doing that, the neural stem cells can generate more and more new neuron cells. In a word: neurogenesis.

Since the head is part of the body, producing new neurons can reverse the symptoms of depression and other disorders.

We’re going to be talking more about cell metabolism, mitochondria, and how to impact mitochondria with nutrients to generate and proliferate neurogenesis… brain cell production.

More To Learn…

In coming weeks, we’re going to talk about using nutrients to improve your frame of mind and psychiatric symptoms. Therapeutic nutritional ketosis is all about upgrading your food choices to optimize your cell metabolism, kick up your brain energy, and tamp down your anxiety to help you get better. That’s the therapeutic part. And that’s what’s at the heart of what we offer with the metabolic psychiatry program we offer.

We were on the cutting edge when we first offered ketamine treatment, and it has since emerged as a rapid, effective, office-based psychiatric treatment, now helping thousands upon thousands of people with psychiatric disorders around the world.

A New 21st Century Breakthrough

Now we’ve added another 21st century transformative treatment to our practice: metabolic psychiatry using therapeutic nutritional ketosis and other lifestyle approaches in a unique wrap-around approach.

At Innovative Psychiatry, we’re utilizing breakthrough transformative treatments for your improved health and wellbeing.

These breakthrough treatments spell hope for you. If you’re among the 35-40% of depressed people for whom traditional antidepressant medications aren’t effective, these alternative — and effective — treatments can make all the difference for you, your life, and relationships.

If you suffer from severe depression, bipolar disorder, anxiety, or trauma… if you struggle with food or weight… if you want to optimize your health and begin to just feel good day after day, call us.

We can offer you innovative treatment that can reverse your symptoms, and explode your hope.

Come walk with us and give your best self access to the rewarding life you deserve.

To the restoration of your best self,

June 5, 2023
Devastating Divorce? You CAN Recover and Live Well Again

Jenn was stunned. She read the text message again, to be sure she had not misunderstood. Her husband of 13 years said, “I don’t want to be married anymore.” Her stomach knotted, she felt herself go pale. She was driving, so she pulled the car over for safety, because she couldn’t see what was in front of her. Shock, hurt, humiliation… her ears were ringing, her hands felt numb. It was as if her heart stopped. How could she love him so much and be cast aside like yesterday’s garbage? She lived to support him, comfort him, and bring joy to his life. Everything she was and had to give …well, he was spurning her heart… her value. To make matters worse, she had been through a devastating divorce once before. It couldn’t be happening again. It just couldn’t.

She didn’t WANT to start over. Jenn had invested her heart and soul to build their life together, to unite their blended family of teenagers, help them work through their anger, and feel a warm, secure place in their family. While her husband, Rick, slept for his job the next morning, she sat up and listened to teenagers who didn’t seem to get the urge to talk until it was pushing midnight.

Night after night.

It just seemed to be a fact of life with kids of this age. But it seemed to be all up to her.

With the late nights Rick was keeping, she knew this wasn’t out of the blue. She knew in her gut that the young woman with a child their family had been helping, supporting, and encouraging had become more than a charity case for him. Even though he wouldn’t admit it, this woman had become an obsession. Divorce was devastating.

And now he wanted to leave.

Jenn was devastated. Heart-broken. She had believed in their marriage, their communication, their shared commitment. She had believed they were both grateful for the other, and all they had accomplished in building their family and their future.

With her support, Rick had grown in his abilities in his job, and had received a string of awards, recognition, and promotions since they’d been married. He’d never known such success before, and expressed his awareness — told her often! —of the important role she played in his life.

What happened to that?

As days and weeks passed, she felt hollow, disillusioned, utterly flabbergasted. When she looked at herself through Rick’s eyes, she seemed to come up short. She seemed to have no value. Nothing to contribute that mattered. This devastating divorce was gutting her.

Jenn knew she had to find a place to live. She couldn’t bear to be in this house where all the memories of their love, their work together, their battles, and their triumphs oozed from the walls and furniture. She felt suffocated by it all.

This lady needed a break.

A safe place with fresh new associations … so she spent the days while he was at work packing her belonging and the household items that meant the most to her. Then found a house to rent and moved in with her boxes and a couple of blankets.

They could sort out the division of property through their lawyers, but she needed to not wait at home like a sitting duck for him to come and go at will with that woman in tow. Divorce was devastating. She had to be proactive … for her own survival.

Once her boxes were empty, she ordered a bed, a sofa, and a kitchen table to be delivered.

Then she sat in her new place, with her stuff all around. She cried. And sobbed.

And she wailed.

“So this is what it feels like when your heart is breaking,” she thought.

She felt her insides were tearing apart and exploding. The pain was unbearable. She knew she had to pull herself together, and see an attorney. But she didn’t want to. She didn’t want to do anything.

For the next week, she spent a lot of time in bed. Crying. Staring at the wall. Thinking of a thousand memories from the last 13 years. Thinking about Rick betraying her with someone else. This devastating divorce threatened to destroy her sanity, it seemed.

Not just anyone else. That young woman they had been “helping.”

Jenn may have looked idle on the outside to a bystander, but inside her head she was in utter chaos.

The pain. The rage. The betrayal.

White hot rage was so intense, she understood for the first time what it was like to want to kill somebody. She was alarmed by the intensity, and looked for ways to calm herself, and avoid contact with her husband or his “girlfriend” … shopping for groceries at a different grocery store, using different gas stations and restaurants, the best she could.

Then she saw the attorney and filed for divorce.

Her attorney could see she was struggling with more rage than she could cope with, as well as shattered self esteem. He recommended a psychotherapist he knew to be skilled in working with clients suffering from the trauma of divorce.

During her first session with the psychotherapist, the therapist spoke of her symptoms of depression and the trauma she had experienced. He gave her the name of a prominent psychiatrist who offered metabolic interventions to target her symptoms with therapeutic nutritional ketosis and exercise.

Jenn was traumatized alright.

She needed all the help she could get. So she called and made an appointment.

She also had to get a job, somehow. She hadn’t worked in years, and she didn’t know if she could think well enough at this point to produce something significant enough at a job and actually get paid. But she had to try. She called her boss from years ago, to see if the department had any openings.

A New Opportunity

Not only did they have an opening, but her old boss offered her a supervisory job, which paid more and would help her get on her feet.

So even though she felt emotionally crushed, Jenn started the job, and scheduled appointments with her therapist and the psychiatrist he recommended to her. It seemed it was all she could do to put one foot in front of the other — but instinctively she knew that if she didn’t push through and at least try, that she’d sink into a hole she might never escape. She couldn’t let this devastating divorce destroy her.

The psychiatrist talked about new understanding in the field of psychiatry that involved metabolic interventions to improve metabolism and brain function.

She said that those interventions could include a low carbohydrate/high good fat diet to fuel mitochondria in the cells, regular moderate exercise, psychotherapy to help her change her thinking to enhance her peace and help her heal, and ketamine treatment to enhance that change.

Keeping it simple, she described how providing the mitochondria with ketones, a more efficient fuel for cells, can bring balance and reduce the hyper-excitability — the hypervigilance — that trauma can create.

Overall, she explained that psychiatry was broadening its understanding about how psychiatric disorders—like neurological disorders—are related to alterations in energy processes at a cellular level. (Actually at an intracellular level–at the level of the mitochondria.) And that improving metabolism by upgrading your food choices changing can dramatically change your body, calm your brain, improve your frame of mind, and eliminate your symptoms. It’s Food as Medicine.

Getting your brain to run on diesel instead of gas can change everything.

And so they began.

Over the coming weeks and months, she noticed the brain fog, that had made it hard to think or focus, dissipated. Her mind became much sharper on running on ketones. Her thinking improved. Emotions (that had been so volatile) calmed, and she was able to respond more rationally as divorce proceedings moved forward.

Meanwhile, she was building a new life and a new sense of herself. She made new friends at work, and rediscovered her social skills by nurturing friendships she had enjoyed for years.

She continued her relationship with her therapist for a year and a half.

Feeling like a victim had plagued her when she and Rick first separated, but now she had forgiven herself for her own shortcomings, had let go of her resentment toward Rick, and saw herself as independent, capable, and worthy.

Life was moving forward.

Her thoughts came and went, but she embraced her freedom to choose or redirect them. To live… and love herself and others.

She had hope again, and so much to give when others she cared about struggled.

Can YOU relate to Jenn?

Has a great loss caused you to doubt yourself, your ability, and your worth? Life has its blows, and no one can avoid some of them. What you can do is to equip yourself to respond in ways that are good for you and your sense of yourself.

You can rebuild your self, your skills, and your confidence. You can have hope again.

If you suffer like Jenn did, and nothing you’ve tried has helped you move through it, call us.

We can help you get on your feet again with an intervention that jumpstarts your metabolism, kicks up your energy, and reduces the rapid-firing of anger and and anxiety using metabolic treatments like a ketogenic metabolic therapy.

It’s like getting your brain run on diesel instead of gas.

You can be your best self again, live well again… and enjoy your best life.

To the restoration of your best self,

May 22, 2023
Retirement: A New Beginning or Loss of Purpose in Life?

Joe woke up, looked at the ceiling, and sighed. Another day. What was he to do with this day? More of the same, most likely. Get up, drink coffee, read the paper, then watch daytime TV. He had been so excited to retire, to finally have the freedom to choose what he did with his days. To relax, read, travel…. But that wore off the first 3 months… and now it seemed the future loomed ahead endlessly. Retirement can cause loss of purpose in life, which can lead to depression.

Even Retirement Can Get Old

He had not expected this to get old so fast. After spending 36 years doing the same thing every day, he thought he would relish and savor the freedom to wake up without an alarm. To eat a leisurely breakfast. Enjoy a second cup of coffee.

After 7 months of this freewheeling lifestyle, he no longer showered every day. Why should he? He wasn’t going to see anybody. If he went fishing for hours in the sun he would clean up, because he knew he smelled pretty rank. But on a typical day hanging around the house, he didn’t smell that bad…and again, he rarely saw anyone.

It was certainly surprising to realize that all those decades of work had directed him as they did. He had specific things to work on — every day. The subject matter changed after each project was completed, and he had to admit, it was stimulating. Plus, he felt like he was making a difference in the lives of people on some level.

But now, he just sat around, taking up space, without any real goals in life.

Retirement seemed to be backfiring.

He was already tired of sitting in the quiet, reading book after book. Things he had longed to do, things he had seemed to have no time for, lost their luster now that he had an endless supply of time.

Fishing in the quiet. Walking in the quiet. How fickle I must be, he thought. It’s either feast or famine, but I’m never satisfied, it seems.

He began to think of the futility of life … the endless droning on of repetition and futility. He didn’t fully realize he had suffered a loss of purpose in life.

Why go on? What’s the point?

Joe needed stimulation

He also needed human connection.

One day when he was fishing, he saw a couple was fishing on the same shore a few yards away. He decided he might say hello. As he inched toward them between casts, he finally waved and called hello. They waved back and smiled. After all, it’s important to be quiet when you fish.

Still, Joe’s need for human interaction drove him to keep trying.

A few exchanges of niceties revealed it wasn’t going anywhere, so he packed up his tackle and the two fish he’d caught and headed for home.

Joe hadn’t always been alone. He had divorced a few years ago, and the loss hadn’t affected him as deeply at the time because he was absorbed in work. But he was realizing now it could be really helpful if he had a companion to talk to on a regular basis. He thought about the couple he had seen while he was fishing, and acknowledged they had something he didn’t. Companionship.

But there was more to it.

He realized he had lost his sense of purpose in life. That deeply felt inner direction to gives life a reason to go on.

He had taken for granted how his career had infused him with that priceless inner compass.

Joe had no idea what to do about it

Then one day, his daughter called. She was his wise and insightful child, and was pursuing a “calling” in psychotherapy, so she often read studies to gain more insight.

She told him about reading a book called, Brain Energy, and how she’d learned that mitochondria in the cells have a huge impact on how people feel and function. She explained that the mitochondria are the mechanism in the cells where energy is produced in every cell.

She talked about diet, and how a high fat, low carbohydrate diet can feed the mitochondria… ketones... for energy, replacing carbohydrates for fuel. The safest and most efficient way to do this is with a dietitian-designed therapeutic nutritional ketogenic diet. It’s called a ketogenic metabolic therapy.

And she talked about the importance of human connection, relationships that are meaningful and mutual. That his divorce from her mom had resulted in his being isolated, but she recognized symptoms of depression in him and suggested they talk about ways to restore relationships in his life.

On top of those things, she emphasized the vital importance of his loss of purpose in life. That certainly resonated with Joe. They talked about how he hadn’t realized how his job had infused him with purpose, and with the constraints of that gone, he seemed to have found himself adrift.

Treatment, diet, and relationships

“Dad, you’re going to need to take some assertive steps to create change for yourself. You need to get under the care of a good psychiatrist, in case you need meds. Plus you need to involve yourself in activities you believe in and can commit to, where you can contribute and make some kind of difference. And you need to make the effort to start building friendships you enjoy.

“And change your diet, Dad! All the chips and dip you love to eat with your beer need to be replaced with good fats like avocados, whole eggs, olive oil, nuts, yogurt, and salmon. Cook your salmon in olive oil…in fact, cook everything in olive oil. Add avocados to your meals. Skip the potatoes, bread, and rice. You’ll be amazed what a difference you’ll feel in your emotions and your body.”

Joe thought long and hard after his daughter hung up. He looked online for a psychiatrist and a registered dietician, and made appointments with one of each that he found.

The psychiatrist confirmed he was depressed. She explained the concept of metabolic psychiatry, and how metabolism plays a key role in psychiatric health. She confirmed everything his daughter had said. And she offered him a startlingly new approach with comprehensive metabolic assessment and treatment with a treatment team in her own office—not spread out and disjointed—with a registered dietitian, an expert in nutritional ketosis, and dozens of wrap-around supports for lifestyle changes including telehealth, in-person visits, digital apps, body composition analysis, labs, genetic testing, groups, nature walks, videos, recipes — ways to get energized, feel excited, get moving, shrink body fat, and find a new community of friends. There were dozens of Touchpoints.

Joe could see he was entering a new adventure. He began to feel hope.

He also made an appointment with a therapist she recommended.

And he cancelled his appointment with the dietician he had arranged to see on his own and made an appointment with the new one.

He began to see that the power to change his life was in his own hands. Loss of purpose in life didn’t have to be permanent. He felt the power to change.

While he waited for his dietician appointment, he decided to give away the potatoes, rice, chips, and bread as his daughter had suggested, and went to the store to buy salmon, olive oil, avocados, and eggs. No harm in starting to eat better while he waited to learn what the psychiatrist and dietitian and their team suggested in their collaborative metabolic program.

Then he searched online for opportunities to volunteer in his area. An organization that teaches English and reading skills to migrant children caught his eye.

“Now that’s a place I could make a real difference,” he said to himself.

He called to learn how to join the group, and set out the next day to offer his help.

Before long, he was being trained, then working directly with non-English speaking children who had bright hope in their eyes. During breaks he began to become acquainted with other volunteers and made arrangements to share a meal and go out to fish on the riverside with a few new friends.

Six months later, he called his daughter and told her all the changes he’d made, and how grateful he was to her for helping him find his way. He told her about his new friends, and his activities. And also mentioned one “special friend” who was becoming more and more important to him.

And he talked about the children, and how fulfilling it was to see their lives changing for the better. He knew he was helping them build a better future. He was so grateful for the new purpose in his life.

Have you retired or experienced some other highly stressful life event that left you floundering with a loss of purpose in life?

Finding a role that gives your life meaning, having rewarding relationships, taking care of yourself, and upgrading your food choices are all aspects of living well and enjoying your life.

Does it feel to you like life has become futile, without purpose, and without hope?

If you can relate to Joe and what he was going through, call us.

Loss of purpose can come from retiring, divorce, loss of a loved one, an empty nest, and other changes in circumstances. Recognize these blows can have a devastating effect on your life, and seek help.

We’re here to help you find your way back to a meaningful, rewarding life.

To the restoration of your best self,

May 15, 2023
When You Feel Alienated By Your Angry Child

Ben slammed the door with a resounding bang. “I’m outta here!!” He called over his shoulder as he charged down the street. Jill, his mom, felt defeated. She had tried so hard to be reasonable, caring, and sensitive to his mood. But apparently she had stepped on his toes, an error which had become a routine event lately. She didn’t understand why Ben was in such upheaval these days. She didn’t feel like she knew him anymore. Who are you and what have you done with my son?? she thought to herself. It’s tough when you feel alienated by your angry child.

It all started when he began high school. She and Ben had always been close, and shared a love of fishing, cooking, and watercolors. Since Ben was 10, they’d taken watercolor classes together and both had improved in their skill. Both of them had framed masterpieces hung around the house. And, since Friday night wasn’t a school night, they cooked dinner together as often as they could. They fished a couple times a month on weekends when weather permitted, and enjoyed coming home, cleaning the fish, and cooking it with corn on the cob and spinach salads.

But since Ben had started high school, it was as if he had no respect for her, no regard for her view points, or the boundaries she had always set. She felt so alienated by her angry child.

It hurt.

She knew that teens had conflict with their parents as they set out to find themselves, differentiate themselves as individuals from their parents. She knew that. But this seemed worse… more extreme somehow.

Scenes like this one, where he ran out banging the door and disappearing, were becoming more and more commonplace. But why?

Why was he so angry?

What was it that caused him to resent her so deeply?

After a year of his sullen withdrawal, his berating of her, and the complete absence of the bond they had always shared, the hurt she felt grew so overwhelming, that she began to withdraw, too. Her efforts to talk to him, listen to him, had proven futile.

Ben seemed to want nothing to do with her, and was not willing to express why he was so angry. Jill wracked her brain to figure out why.

After her husband had left, she had struggled from the pain, abandonment, and overall loss. For Ben’s sake, she had tried to rise above her pain and give him the happy childhood he deserved. Hence, the fishing, cooking, and art.

They enjoyed hiking together, camping near a river, and catching their dinner. So many wonderful memories were created in those years. Memories that also helped her move forward.

She knew Ben didn’t grasp her loss and grief… but she also knew she couldn’t grasp his. They both tried to understand, be compassionate and patient, and reach out for moments of joy.

It had worked, until the last year.

Jill’s gallant fight to rise above her grief finally began to crumble. Her own home felt like a war zone, and she was baffled as to why. Home was supposed to be a refuge from the harshness of the world, but hers had become a place where she was always on edge and isolated from love. Isolated and alienated by her angry child.

She had always tried to make it a refuge for Ben, and hadn’t anticipated “home” coming to this. Her loving effort to infuse joy into her son’s life just started to weaken. In the isolation she found herself in, disillusionment disintegrated into depression.

The pain of it was too much, and she felt herself giving up.

But she knew that Ben was in a vulnerable place in his life. He was a teenager and needed support and love and understanding to navigate all he was facing. But her energy for trying to help was waning. She didn’t know what to do to rise above all this. And she worried that other teenagers were his only input.

She could feel herself becoming numb…. not caring anymore about anything. Jill got on her laptop to explore what was happening to her, impairing her ability to show unconditional love to her son in his time of such need.

She tried googling the way she felt and what she could identify: isolation, loss, hurt, numbness, reduced energy… and a bucket of diseases came up. Jill instinctively knew that most of them weren’t relevant, but then she saw an article about the grieving process.

She recognized herself in the symptoms it described.

And she learned that if the grief process becomes stalled for some reason, it can funnel into depression. She started reading more about depression, and realized it sounded like a fit for what was happening to her.

Then she looked for treatment for depression — and learned that medications are helpful to some people, but at least 30-40% get little to no benefit from medication, so alternative treatments are often required for real relief.

The most promising alternative treatment she found was IV ketamine treatment.

She found listings of psychiatrists in her area, so she cross-referenced psychiatrist with ketamine treatment and found someone who seemed to offer it.

During a consultation appointment, the doctor diagnosed her with major depressive disorder, and they talked about medicines and treatments. They agreed to see what ketamine treatment could do for her.

By her third infusion, she began to see things differently.

She talked to Ben about her treatment, and that she believed it was helping. She was able to approach him in a newer, better way and he responded. As they talked she learned he was being bullied at school — she didn’t know! — and had been teased about the relationship he had with his mom, and so he had just slowly withdrawn.

Poor guy. In his effort to defend himself against the bullies, he had stripped himself of his most loyal supporter.

This discussion seemed to improve their line of communication, though Ben remained guarded. But, it was a start.

Jill continued with her infusions, realizing that to be who she wanted to be for her son, she needed to take care of herself. The process of it all also helped her change the way she saw herself in her son’s life — to being a support person for the life he wanted to build, rather than an integral part of everything. And she began to feel hope that should wouldn’t always be alienated by her angry child.

She learned to let go, to some degree.

She received 8 infusions in all, and went back for booster infusions twice, a month apart. By this time, Jill was feeling resilient again, and that continued to grow. She found a way to talk with Ben about how he was feeling, in the face of what was going on at school.

Ben could see a huge improvement in his mom’s outlook and attitude, and he began to wonder if this treatment could help him, too. They talked about it, and made an appointment with the same doctor, who diagnosed depression and social anxiety, and told Ben that ketamine treatment might help a great deal.

But before they set up his infusion schedule, she impressed upon him and his mom that ketamine doesn’t help everyone. However, she believed there was every reason to hope it would help him. Still, they would have to see.

The evening after his first infusion, Ben admitted to his mom that he’d been having thoughts of suicide, but they seemed to be gone now. He had been too afraid to talk about it, but now that they were gone, that in itself was such a great relief.

He felt a subtle improvement with each infusion and by the 4th, he was feeling like smiling again. He joked with his mom on the way home, and they both laughed. How refreshing that was! She was getting inklings of a time when she would not feel alienated by her angry child. That her child wouldn’t always be angry, but could find peace.

Jill didn’t take it for granted.

She asked Ben about friends he had, anyone he actually enjoyed. He mentioned one friend he trusted. Jarrad. She suggested that he invite him for pizza, and if that went well, how about a camping/fishing trip?

By this time, Ben was feeling better, more confident, and less withdrawn. They set it up and they all had a great time.

As time went by, Ben and his mom had plenty of bumps in the road. Because, after all, he was busy in the process of growing up and becoming independent. But they were always able to talk, treat each other with respect, and truly want the best for each other.

Through the crucible of the year Ben was 15, Jill had learned about allowing him to set boundaries and she treated them with respect. In turn, he had learned that his mom had his back and respected the young adult who was emerging.

They had both suffered deep loss, but they learned, with the help of ketamine treatment, that life can move forward. And that it should.

What about you?

Do you find that the transitions your child goes through make you feel isolated? Have you experienced loss so profound it has interfered gravely with the course of your life? Your ability to function?

If you can identify with all that Ben or Jill went through, and nothing you’ve tried has helped, call us.

Life is hard. Not all the time, but sometimes it really is. And sometimes when it’s hard, the shock and loss can feel crippling.

But there’s help.

We’re here to help you cross the bridge from isolation and incapacitation to freedom, confidence, and hope.

Let us help you experience your best.

To the restoration of your best self,

May 8, 2023
The Metabolic Mind Video about Anorexia

We’ve talked before about our work with Caroline to help her recover from anorexia nervosa, and the subsequent pilot study with 5 women who had suffered from anorexia for many years. In both cases, we used a combination of a nutritional intervention that created therapeutic nutritional ketosis without weight loss and IV ketamine infusions to silence the anorexic voice. Recently, we participated in an interview on a video posted on twitter by Bret Scher, M.D., on a Metabolic Mind broadcast.

Dr. Scher interviewed three of the five of us who co-authored the pilot study: Barbara Scolnick, M.D., Guido Frank, M.D., Ph.D.

The idea behind the whole project was really sparked by Barbara Scolnick, MD. Barbara is Caroline’s aunt and had been searching for a way to help Caroline since she was a teenager.

Caroline began to suffer from the symptoms of anorexia when she was 14, and though her family helped her to get treatment, nothing worked. Even if she gained weight in treatment, she would lose it again once treatment was over. She had a drive to starve.

The “Anorexic Voice”

The problem was the need to silence the anorexic voice that mercilessly shamed and berated her for eating.

By the time Caroline was 30, she told her aunt she couldn’t live like this the rest of her life. Something had to change. She wanted help to find a way out of anorexia after suffering from it for 15 years. But, like most of those who suffer with anorexia, Caroline was afraid of food. The “voice” of anorexia convinced her that eating anything would make her disgusting and contemptible. So she had come to live on a few peanut m&m’s a day.

Barbara realized that the ketones Caroline’s body produced seemed to make Caroline feel good. At least at first. That the state of starvation felt “right” to Caroline. So Barbara first suggested Caroline take a dose of MCT oil daily to see if the ketones that came from it would help her.

Adding ketones to cells seemed to help

Caroline reported that, in fact, she did feel better as she took the MCT oil. The ketones were helping. She believed she was getting better. But not enough better. So Barbara and Caroline flew to see Beth, a registered dietitian Barbara had met a few years before in her search to understand what a therapeutic ketogenic diet might be able to do to help Caroline.

Beth taught Caroline about this way of eating small meals packed with nutritious fats to increase the load of ketones Caroline’s cells had at their disposal. And while Caroline started with small servings, she realized that this keto diet that made other people lose weight, did not make her lose weight. She said, “See? My body IS different!”

After some time eating these ketone producing meals – not a weight loss diet! – Caroline realized she was feeling even better still.

But there was a problem.

At times, while she was eating this way, she would say she was getting her old familiar “voice” back (the real Caroline). But the anorexic voice wasn’t fully gone.

So Barbara contacted me, to talk about adding IV ketamine infusions to Caroline’s therapy. By this time, Caroline’s weight was stable, but she was still plagued by the cruel, shaming anorexic voice. We hoped that the neuroplasticity that ketamine created would reduce the anorexic voice.

IV ketamine infusions

And so we started IV ketamine infusions. We were all learning together with her, as we sought to find a treatment that would work. In other words, a treatment that would erase the anorexic voice.

After the 3rd infusion, Caroline woke up the next morning and that shaming voice was silent. Gone!

She told me she didn’t think she needed any more ketamine, and felt like she had found a cure! But we did one more infusion for good measure.

Caroline felt elated!

And so were we.

After Caroline experienced such wonderful results, we began to talk about expanding this protocol with more people.

Caroline entered remission that lasted for months and months for the first time since she was 14. And she worked with us to design and carry out a pilot study as we sought to see if a small group of anorexia sufferers could experience similar results from therapeutic nutritional ketosis, and we followed that up with a series of ketamine infusions, like we did for her. Caroline’s support role for the participants turned out to be invaluable. Could we silence the anorexic voice?

Beth Zupec-Kania, the registered dietitian who specializes in ketogenic diet therapy, and who helped Caroline, designed a similar dietary intervention — like the one Caroline used — for the women in our pilot study. We carefully screened and chose 5 adult women who had suffered from anorexia for years, and were medically stable.

We invited them into a home setting, where we talked, prepared meals together, and ate together— 3 meals a day plus two snacks. All of the women helped prepare these ketogenic meals, and actually achieved ketosis by the end of the weekend… and it happened so gently and beautifully.

Then, they went home and continued it with peer coaching, to maintain ketosis without weight loss, for 4 to 8 weeks. At that point, they received a series of ketamine infusions.

Conquering Fear of Food

Keep in mind that fear of food, fear of eating because of the fear of gaining weight, is a primary characteristic of anorexia. So for these women to participate in a study that was very different from the “all good is good food” approach they’d had in treatment settings, they wanted assurance they wouldn’t gain weight from eating fat.

Fat is a four letter word for a lot of people with anorexia.

Because they had anorexia, we wanted to assure that they wouldn’t lose weight. We didn’t want it to backfire and kick up their anorexia.

That’s the beauty—and the challenge—of this dietary intervention: because the keto diet is famous for making people lose weight who WANT to lose weight, they were reassured that they would not gain. So they were willing to try this.

It wasn’t “a diet.” It was a ketogenic metabolic therapy — an approach used as a medical treatment— in this case, to reduce psychiatric symptoms associated with anorexia.

Happily, we got to witness wonderful outcomes from our work with these women. Then we wrote the paper together and published it. We’re so thrilled to have it out so that others can see our results, and spread the word about the continuing research that still needs to be done to bring this treatment safely to those who need it.

Through this experience with Caroline and the women in our pilot study, we’ve come to recognize that the core of this illness … that thing we target to bring to remission… is the “anorexic voice.”

That even though a patient with anorexia may go into residential treatment and begin to eat and gain weight, once they are home from treatment, they often loses the weight they have gained…because of the cruel anorexic voice.

To silence the anorexic “voice”

In Caroline’s case, it seemed the dietary intervention provided the ketones her brain needed and even hungered for, but it wasn’t enough until ketamine infusions silenced the voice. Still… can the voice be truly silenced without the therapeutic ketone dietary intervention? And what about our ketogenic metabolic therapy alone, without ketamine infusions? Can that work by itself as effectively as the combination did? We need studies that explore these and many more questions. And carefully controlled studies involving larger populations of people are also needed.

And these studies need to be conducted with strict supervision and care.

Dr. Frank pointed out that we don’t know what causes anorexia or depression, and the symptoms of both can overlap. In addition, anxiety plays a large role in anorexia.

But he emphasized that what you eat can change your brain. He is interested in dopamine. And neurotransmitters like dopamine can be normalized in the neurons by certain fats added to the diet. We can learn so much more by studies along this line.

I often tell my own patients that we all start out with big, beautiful neuronal trees, branched out in gorgeous canopies. These broad, luscious branches become continually pruned by stress, trauma, inflammatory processes, and anxiety. As this happens, we have symptoms of depression, anxiety, eating disorders, and more.

Neuroplasticity can help us find a way out.

If you can reduce inflammation through a therapeutic ketogenic diet, enhance GABA through a therapeutic ketogenic diet, provide emotional and metabolic support throughout this with per counseling and medical and psychiatric supervision… and put this together so that patients flourish metabolically, you might SPARK something that gets neuroplasticity going through BDNF (brain-derived-neurotrophic-factor). Then you may have real possibility for growth to happen. And that new dendritic growth can get myelinated by the lipids (healthy natural fats) that you’re eating on a ketogenic metabolic therapy that you weren’t eating before.

Don’t Try This At Home

We see enormous hope to silence the anorexic voice. But this protocol isn’t something to do on your own. Anorexia is a metabolically dangerous condition that must be managed very carefully. We need a foundation of extensive research to establish a safe protocol before this treatment is widely applied.

And we do hope to see this effective treatment for anorexia nervosa emerge through more research.

If you have symptoms of depression, anxiety, PTSD, or suicidal thoughts that aren’t being helped, call us.

We address brain energy and how therapeutic nutritional ketosis as well as IV ketamine treatment can help a variety of psychiatric conditions every day through the arms of our Metabolic Psychiatry and Ketamine treatments.

We’re on a mission to find new ways to help you get better and live your best life.

To the restoration of your best self,

April 24, 2023
Has Failure Made It Impossible to Enjoy Anything? Reset Now!

Blake turned over in bed. He lay on his back, staring at the ceiling. What would he do with his day, he wondered. Ever since his business failed…scratch that…ever since HE failed…his sense of purpose had evaporated. He had been humiliated by the death of his business. And worse than that, he’d been disillusioned. He had believed in what he was doing, and what his work could do to help people. His excitement had fueled his resolve, and he tended to spring out of bed every day eager for what would unfold. But after working at it tirelessly for seven years, it was devastating to watch it wither slowly until his clientele dried up and disappeared. He was burned out. He had fought panic and tried everything to infuse new life into his marketing, his client relationships, his products. To no avail. And now he couldn’t find the least bit of interest in trying to discover what’s next in his life. He’d failed. And he had forgotten how to care, how to motivate himself, or to do anything. His feelings of failure made it impossible to enjoy anything. Not even the colors of a sunset or the fragrance of a flower. Blake had forgotten how to enjoy. Period.

Failure and shame go hand in hand. He’d held his head high as he’d jetted around the country to meet with clients, check on customer service, and contribute to new breakthrough launches. But there came a point when interest in his services and products seemed to dry up. Wither…

And all his scrambling to save all he’d worked for, and all those who relied on him, had turned out to be futile.

He felt ignorant. Foolish. Inept.

How could he face people he knew?

Honestly, Blake wondered if there was any reason to even get out of bed most days.

Any reason at all.

But every day he stayed holed up in his apartment, just confirmed his overall failure. His worthlessness. It was impossible to enjoy anything, everything…whatever he could think of.

His mom texted him. But he made up some excuse.

HIs brother called, but he didn’t want to answer. He just didn’t feel like it. And he didn’t care what his brother thought of him. The days of trying to fulfill other people’s expectations were gone. Nothing mattered anymore. And that seemed sad, but it was just the way it was. He couldn’t help it.

He even got messages and emails from friends he’d made in the business. Ideas they had about how to revive the business.Their ideas were too little too late. They didn’t have the experience he had with the marketplace, and lacked the scope of perspective he’d developed through it all. They didn’t realize he’d already tried those things, and had seen just more failure.

Blake scanned the internet looking for possible jobs. He needed income from somewhere. But he just was so mentally dull and flat. The creativity that was surging when he started his business was gone. Blank. So he didn’t know if he could actually do much of a job. He didn’t feel very employable. Everything was impossible to enjoy or do.

And the energy he would need to for interviews, not to mention the horrid phobias that had emerged: fear and dread of leaving the house, of facing people, of going into new places… how could he overcome all that to find a job?

Months went by. The more time that passed, the more isolated he was… by his own doing. But it was taking a toll.

Blake was shut down — even locked down — emotionally.

Time to RESET

He needed to be able to push a button so he could reboot in some way. Where was the Reset Button in his life?

He was still trying to find a job, as his savings were dwindling. The longer he stayed cooped up in his place, the worse he felt. He began to feel panic rising inside him … that if he didn’t find a way to break out of this ‘state’ he was in, he might just die here.

After hours scanning the internet, Blake decided to break out of this isolation and contact his brother. He sent him a text and told him he needed to talk to someone…that the walls were closing in on him. It was hard to make contact. He didn’t enjoy it, but it was impossible to enjoy anything, anyway. It was still important. He had to do it.

His brother, Jared, was so pleased to hear from him. He invited him to come over, or he would be glad to come to Blake’s apartment.

Blake got himself into the shower, as hard as it was, and made himself clean up. Why was this so hard? He was overwhelmed at trying to clean up the mess of his house so he said he could go to Jared’s. That was better. He drove to Jared’s house and knocked on the door.

Jared wrapped his arms around his brother and hugged him gently but firmly. It was such a relief to see Blake reaching out. But for Blake, he was just going through the motions. He wished he could connect with Jared, but it was impossible to feel or enjoy anything at this point.

They talked for hours about Blake’s business, what happened, and what it was like to deal with the failure of it all. They also talked about the effect this long isolation and grief had had on Blake. Jared told his brother how much he had missed him. And suggested they put their heads together to find what might help Blake move forward again.

Brothers Search for Answers

As hours fled by, they explored employment, how to get help for the failure Blake felt, and what his lack of energy and fears might mean. He needed to function again!

Side by side, they scanned the internet for answers and realized that Blake seemed to have the symptoms of depression, and that maybe his fear and dread were signs of phobias. They learned that anxiety, fear, and phobias do sometimes accompany depression.

Beyond this, they soon hit a wall. They could see he had symptoms, and that the symptoms may be treatable, but realized he needed a doctor to take it from there. So they searched for a psychiatrist in their community with great reviews. It seemed the best way to learn what a doctor might be like was to read what his own patients had to say about him.

They settled on one whose reviews were, for the most part, amazing. There seemed to be one or two reviewers who complained, but all the rest were overwhelmed with the doctor’s attentiveness, willingness to listen, and symptom relief.

So Blake made an appointment.

Jared cleared his schedule for that day so he could go with him for moral support.

The doctor diagnosed major depressive disorder, and talked about possible medications. Then sent Blake home with a couple prescriptions, an antidepressant and something to ensure he could sleep.

After a couple months, the antidepressant wasn’t working, so Blake called the new doctor to talk about ketogenic psychiatry and what might help him improve. Something just had to give. It was still impossible to enjoy absolutely anything.

He felt like he was wasting his life.

After scheduling a consultation appointment, Blake went to see her. She took a thorough history, including his symptoms when they started, and what he had felt like when he was his best self. Then she explained ketogenic psychiatry, and what a ketogenic diet leading to therapeutic nutritional ketosis, could do for him.

Blake felt better and better, and in the days and weeks that followed he just kept improving. His hope was growing as he realized his creativity was returning, his energy was returning, and his thinking was clearing up more and more.

Within a couple weeks, he interviewed for a job that he thought he was well suited for, and was hired. Soon he was back at work, contributing in meetings, creating new ideas, and making friends.

Brothers Bond

He made a pact with Jared that they would meet for dinner one night a week, to keep rebuilding their relationship and to talk about obstacles they both faced. They also went together to visit their mom, and committed to do it more often.

Blake wanted to build a healthier infrastructure in his life to combat the isolation that had gotten him into so much trouble. And Jared saw the benefit for both of them in doing that.

Blake also started seeing a therapist to help him untangle the feelings of failure and worthlessness that plagued him after his business ended. He was feeling more resilient since starting the ketogenic diet, but wanted to improve the way he looked at his life to guard against that type of thinking in the future.

And he moved forward in his life with a combination of confidence and humility — recognizing that he was human, and capable of so much. He made the decision to be a learner in life, instead of a perfectionist. And he learned about exercise and a ketogenic diet that actually would help his psychiatric health. He committed, also, to being his own best friend… instead of the cruel judge he had been.

And these steps will help you, too.

Within the realm of everything we offer in psychiatry, therapeutic nutritional ketosis and exercise could make all the difference for you, if it’s impossible for you to enjoy what you used to enjoy.

If you suffer from the kinds of symptoms Blake did, call us.

We have opened another another avenue for you with Metabolic Psychiatry. We can help you discover how to eat and move and enjoy so that you kick up your brain energy, correct your metabolism, shrink your body fat, and get back to your best self.

There is so much to psychiatric illness, but there is also so much more you can do to be healthy again.

We’re here to help you get there.

To the restoration of your best self,

March 20, 2023
It’s Never Too Late to Heal from Brokenness and Failure

Caryn lay in bed, looking around the room. She’d been here in this bed for months. The mess had piled up from doing so little, and her finding no initiative to get up and do anything. No energy, either emotionally or physically. She looked across the room at the pile of clutter collected on her desk. She’d never lived like this before. She liked a tidy house, but had just been enduring…surviving…for the past year. (How could she heal from the brokenness and failure that overwhelmed her?) Her closest friends had known her for many years, and knew this wasn’t like her. They instinctively knew something was wrong. She thought that surely she could get up and just start putting things away from the top of that dresser, but when she tried, she gave up in a few minutes. It was just too much.

She had a history of periods of depression, but Caryn had finally seen a psychiatrist when she was in her 40’s. After a few tries they’d found an antidepressant that helped. That one medicine had helped her feel like herself again, and supported her through the ups and downs of life. When a loved one had died, she was sad and she grieved a good while. But she still functioned. It wasn’t like the depressions that used to cut her off at the knees anymore… until now.

Antidepressant Just Stopped Working

But now, for whatever reason, the antidepressant had stopped working. She couldn’t sleep… but lay awake through the nights with her mind racing. All too often, she saw the sun rise, as she soaked in despair.

And she seemed to keep plunging deeper. Caryn lived alone, and the pandemic had isolated her in her house. She found herself revisiting memories from her life. She thought about a string of incidents that took place with various loved ones. Her sister, her children… her parents.

And though she’d always been a generally kind and understanding person, she wasn’t perfect. She knew that. But the excursions through her mountain of memories took her on deep dives into the depths of what occurred in those incidents. It seemed her insights were heightened and distorted, and she found herself privy to how her oversights and less than sensitive responses to people she truly cared about had caused them deep hurt.

She hadn’t realized at the time, but now all these mistakes came flooding in.

She couldn’t bear to think she had scarred people she loved. Could they heal from her mistakes? Could she heal from such brokenness…. Such failure? The more she thought about these incidents in the past, the darker she felt. Her energy for life seemed to drain away.

Her husband had left her when the children were growing up, and she had been devastated. When he left, her belief in herself – and her sense of worth – went with him. If she had been a valuable person, he would have wanted to be with her. At least, that seemed obvious to her at the time. She suffered that her poor children had had to grow up with only her as a parent.

When her children were born, she believed in herself and her talent as a wise and loving parent. But now those beliefs seemed to dismantle and disintegrate by the day, and she became increasingly more convinced that she had utterly failed them all.

The more she thought about it, the darker she became inside. And the darker her outlook, the more numb she felt.

Sometimes the memories of the business she had built flooded her. Talk about failure. Could she ever heal from it and the brokenness that had replaced it? She was on her game back then. She’d overcome her divorce grief to build a worthwhile business that performed an important service.

She had pushed through her fears and had developed a client list of Fortune 500 companies. She flew around the country solving IT problems, while managing a team of 24 contractors who did the same. Her company’s reputation for clean, fast, and brilliant solutions grew fast and she enjoyed a level of income and respect she’d never dreamed.

Then, the software her team supported became less popular after 12 years, and the need for their skills waned. They worked together to build new, more marketable, skills for the current market, but their expertise wasn’t as deep, and their reputation suffered. For four more years she held onto her business with white knuckles, until she had to close it.

She had been devastated. Stripped bare.

Now, the pandemic was subsiding.

But as she lay in bed, she felt like she would drown in the pain of those failures. Her sense of inadequacy, as she looked back over her life, overwhelmed her. It seemed impossible that she could heal from the brokenness of her failures and mistakes.

Broken dreams, shattered hope, splintered relationships. What a mess she’d made of her life.

Where could she go from here? What was left?

Caryn found herself wondering if this is how life ends. She felt isolated from people who loved her. It didn’t seem to her it would matter much to others if she just died. She thought of the expensive set of sharp cooking knives in the kitchen drawer. It would be so easy to end this.

Steeped in that thought, she was jarred back to the present with a knock at the door.

Her old friend, Renee, stood there with sacks of groceries. Caryn felt self-conscious about her appearance, but grateful for the food. Going to the grocery store was a rare occurrence for her. It was just too hard to get out.

“Caryn, how are you feeling?”

“I’m ok, Renee. Just not up to much.”

Renee responded, “I wanted to tell you that one of the teachers at school talked to me today about her husband, who has been struggling with depression for nearly a year. They heard about IV ketamine treatment and that it can lift depression dramatically. She said her husband went to a psychiatrist who offers this treatment combined with a special diet, and after a couple months her husband seems like his old self again.

“I wrote down the name of the doctor, in case you might like to research all this online.”

“That sounds very nice. I’m so glad for her husband. It’s hard for me to share the enthusiasm, but that could just be because I don’t feel enthusiasm about anything these days. I question whether I can ever heal from the brokenness and failure I feel. But I will look online to see what I can find. I appreciate you giving me the information.”

Renee put the groceries on her kitchen counter, hugged her, and left.

So Renee got back in bed and googled IV ketamine treatment, and the name of the doctor. She learned that depression isn’t just a “mental” illness, but an illness that affects the whole body.

It helped her understand why she didn’t feel like getting out of bed. Why her limbs felt heavy and without energy. Why her lack of energy felt mental, emotional, and physical. In fact, it was spiritual, too.

The idea that something was wrong in her whole body, and that there could be treatment for it, gave her the first glimmer of something akin to hope. Maybe…just maybe…she could get treatment that would help her feel alive again.

Was It Possible?

Caryn felt such a deep need to heal from her brokenness and failure, and had no idea if this treatment could help. But she called her daughter and son-in-law, and asked if she could stay with them a few weeks so they could help her get to her infusions. They welcomed her and promised to pitch in with driving her.

Then she called the doctor she’d learned about and made an appointment for an evaluation.

It was hard for her to shower, pack some clothes, and load the car. She spread the arrangements out over 2 days – she was moving slowly – then set off on the 2 hour drive to her daughter’s house.

Since she’d been in bed so long, she had very little stamina. But her daughter helped her get ready and drove her to each infusion appointment. In between they talked at length about improving her diet with foods rich in flavonoids, omega 3 fatty acids, and low carbs…as well as taking walks together each day to start building her stamina again.

With her daughter putting blueberries and strawberries in front of her each morning, and glazed salmon, cucumber, tomato, mozzarella and onion salad for lunch, and chicken piccata, avocados, and asparagus for dinner, Caryn began to notice a change.

She was feeling better.

They took short walks with the dog in the mornings and afternoons, then Caryn rested afterward.

She didn’t notice much change after the first three ketamine infusions, but after the fourth it seemed that a wall was coming down inside her. Hard to describe but she could feel it.

And light began to trickle into her consciousness replacing the darkness that had been her constant companion for so long. She was beginning to believe in the routine they had created, as she felt the bottomless pit inside her filling in more and more.

She’d been adrift, but now it felt as through a solidness was growing under her feet. Like she was less vulnerable. Less hollow.

Despair was fading.

In its stead she felt bits of hope at first, then more and more.

She began to believe she really could heal from all the brokenness and failure that had smothered her.

After a month with her daughter, Caryn hugged her and her son-in-law and thanked them for their help and support when she needed it so desperately, and assured them she was ready to go home.

Once home, she hired someone to come over and help her put things away and clean the house so she had a fresh start. After that, she had the clarity of mind and purpose to put things away again as she used them, so she could continue to enjoy the clean house. The miracle was that she could.

She gave herself rest breaks and times of solace when she needed it, but began to occasionally call up Renee and meet her for lunch. Then, she made time for another friend, too.

Recovery was a process, but IV ketamine and her daughter’s care had given her the tools to move forward.

And she was so grateful to be feeling so much better.

And what about you? What about your loved ones?

Can you identify with the things Caryn suffered?

Depression can come unexpectedly. And it can seem to swallow all of yourself.

But there’s hope.

If you’ve been hurt, disappointed, devastated by the actions of others… or yourself… and have been overwhelmed with despair, call us.

Don’t let failure and brokenness become life threatening for you. You can live again, relish joy again, and and build loving relationships again.

Let us help you find your way back to joy.

If you have thoughts of suicide or hurting yourself, call 988, the Suicide and Crisis Hotline. Talk to someone who can help.

To the restoration of your best self,

March 6, 2023

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