Lori Calabrese, MD

Author: Lori Calabrese, M.D.

When Depression Medications Don’t Help

Treatment-resistant depression

When you’re depressed and taking an antidepressant, it may seem like it takes forever for it to work. While therapy, in addition to medication, can help… it may not be enough if you’re experiencing treatment-resistant depression. Some people find after many months with a medication that there’s no relief. If that’s the case, we can offer options that can make a dramatic difference. In addition to traditional antidepressant medications, there are new treatment options available.

1. Ketamine

Ketamine is an innovative, off-label treatment of depression, which has created a wave of scientific interest and excitement in psychiatry and is administered intravenously. Unlike traditional antidepressant medication, ketamine acts quickly and has few side effects. Many patients find that ketamine is a much better option when traditional medications don’t work for them.

Most patients find that their mood improves within hours of treatment instead of weeks or months. For those with major depressive disorder (MDD) or those contemplating suicide, fast treatment is crucial.

2. TMS

Transcranial magnetic stimulation (TMS) is another alternative to the treatment of depression. This is a non-invasive procedure that uses magnetic fields to stimulate the nerve cells in the brain and can lead to response and remission even when other treatments haven’t been effective.

During treatment, magnetic pulses are delivered to the specific section of your brain in charge of controlling your mood. It may activate regions of your brain that have been inactive due to depression, which improve your depression symptoms and allows you feel better.

Being depressed can take its toll on your life in many different ways. If you think you’re medication isn’t working, there is hope, and we are here to help you. IV ketamine and TMS may work even when other strategies don’t. To learn more, or to schedule an appointment, please contact our office at 860.648.9755.

To getting you back to your best self,
Lori Calabrese, MD

November 10, 2016
How to Stay Present Through Emotional Pain

Coping with emotional pain may leave you feeling like life is passing you by. It can be difficult to remain focused on the present while you’re dealing with emotional pain, but it’s crucial to do your best to live for each day. If you’re having trouble staying present through emotional pain, here are some tips to help.

1. Expose Your Fears

At some point, we’ve all experienced the fear of losing control. Many people feel as though they have to control their feelings and emotions during trying times, but you need to let this go. In order to fully heal from emotional pain, you need to relinquish control by exposing your fears.

2. Label Your Feelings

Recognizing and labeling your feelings is another way to stay present through emotional pain. This allows you to fully understand what you’re feeling and why you’ve having those feelings. It greatly enhances your mindfulness because you’re focusing on what you’re feeling at that exact moment.

3. Let It Out

Sometimes, you just need to sit down and have a good cry to release all the emotions you’ve been carrying. Crying is a sign of strength and not a sign of weakness so don’t be afraid to let your emotions run down your cheeks. After a good cry, you may find yourself feeling a little better and able to focus more on the present than before.

Dealing with emotional pain can be difficult but it’s important to remain focused on the present. Try your best not to let your emotional pain keep you from enjoying the little things life has to offer. To learn more about staying present through emotional pain, or to schedule an appointment, contact us at 860.648.9755.

To getting you back to your best self,
Lori Calabrese, MD

November 3, 2016
How to Cultivate a Positive Self Image

Having a positive self image is essential to your well-being, but how do you get and keep it? Sadly, we can easily slip into feeling that who we are is not good enough, but that’s simply not true. We are all unique and we are all good enough! Here are some ways to cultivate a positive self-image and increase your self-esteem.

Focus on Accomplishments

It’s easy to focus on the negative things that happened throughout the day but work on focusing on what you accomplished that day instead. Changing your mindset from negative to positive will have a profound impact on your mental health and your self-esteem. Give yourself the credit you deserve for the things you achieve each and every day and you will begin to recognize even little things as accomplishments. .

Think Positively

This goes hand-in-hand with focusing on your accomplishments because you’re changing your thoughts from negative to positive. Make a conscious effort to remove all negative and self-sabotaging thoughts from your mind. Breaking this habit is going to take some time, so be patient with yourself and recognize your efforts

Be Grateful

Expressing gratitude is a great way to cultivate a positive self-image. Even if you don’t particularly feel grateful, take some time to appreciate the blessings in your life. If it helps, write a weekly or daily gratitude list to help you look for the silver lining. Be kind and gracious to the people that you see today who have performed some small service for you.

Practice Self-Care

Nothing says you love yourself more than taking care of yourself. Eat a healthy diet, exercise regularly, get enough sleep, and always make time for rest and relaxation. There is nothing wrong with taking some time for you to do what you enjoy or just unplug for a while and take a break from the rest of the world.

Although you were meant to love who you are, it’s understandable that you might not always feel that way. To learn more about cultivating a positive self-image, or to schedule an appointment, please call our office at 860.648.9755 .

To getting you back to your best self,
Lori Calabrese, MD

October 27, 2016
4 Ways to Ease Depression

If you’re battling depression, you know how debilitating it can be. It’s more than just feeling unhappy; it’s pervasive and it takes time to develop positive strategies to help lift your symptoms. While antidepressants and psychotherapy are the cornerstone of treatment, there are many tools that you use to help ease your depressive symptoms.

1. Journal

Journaling has a profound impact on your mood because it can work in two ways. You can write down all of your fears and worries to help ease and quiet your mind. You can also use journaling to remind you that things are never as bad as they may seem. Make a habit of jotting down a few things you’re grateful for each time you journal. Also try to make note of something positive that happened to you that day, no matter how insignificant you may think it is.

2. Exercise

Regular exercise isn’t only good for your physical health, it works wonders for your spirits. When you exercise, your body releases endorphins, which help improve your immune system and boost your mood and self-esteem. You should strive to get 20 minutes of cardio or weight work (something that gets you pumping) 5 times per week.

3. Stop Negative Self Talk

When you’re depressed, you may find that it’s easier to see things in a negative way instead of a positive one. You may blame yourself when things go awry because depression reinforces self-doubt. When your thoughts turn negative, get out your journal and jot down a few things you like about yourself. This will help you change your thought process and ease depression. Get on Twitter and follow Twitter handles that post motivational and inspiring quotes – there’s a bunch! They can give you a positive stream of hope and encouragement at the touch of a finger any time you need to nurture yourself.

4. Listen to Music

Music has healing powers that are often overlooked or easily dismissed. When you’re feeling depressed, turn on some upbeat music and you’ll notice that your mood can begin to improve.

While these things can help ease minor depression symptoms, you should consult your doctor if your symptoms persist or worsen. To learn more about innovative treatments for depression, or to schedule an appointment, please call us at 860.648.9755.

To getting you back to your best self,
Lori Calabrese, MD

October 19, 2016
The 3 Phases of Addiction

Addiction steals your joy, hijacks your plans, destroys your family and can ruin your life. It is more complicated than just overindulging in an activity or substance that boosts your mood and doesn’t want to let up. Addictions are psychiatric disorders that require treatment. In order to fully understand addiction, it’s important to understand the three phases.

Phase 1: Binge

When you take an addictive drug, or participate in any other addictive behavior, dopamine and other neurotransmitters are released, which then signal the brain that the person has received a reward. Over time, dopamine begins to be released in anticipation of the addictive behavior or drug. It is during this time that the brain associates the reward feeling with the drug or addictive behavior, which can create powerful cravings and prompt a binge.

Phase 2: Withdrawal

Your brain begins to reset the reward system, making it difficult to experience pleasure without the drug or addictive behavior. When you don’t participate in the addictive behavior or ingest the drug, the body begins going into withdrawal. It is during this time that you begin to do the drug or preferred activity simply to avoid the feelings of withdrawal.

Phase 3: Preoccupation

You become more and more obsessed with the drug or addictive behavior. Although you may be fully aware that the addiction is ruining your life, it’s all you can think about. You become unable to function without it and are always looking for the next fix.

Addiction isn’t limited to substances like drugs or alcohol can be devastating The brain reward and reset mechanisms that underlie binge, withdrawal and preoccupation can be used to understand a number of behaviors that can spiral out of control such as eating, shopping, internet use, and video gaming.

If you or someone you love is struggling with an addiction, we are here to help you. To learn more or to schedule an appointment, please call us at 860.648.9755.

To getting you back to your best self,
Lori Calabrese, MD

October 6, 2016
Post-Breastfeeding Blues

The time has come to start weaning your baby from the breast and you may be feeling a little sad. There are so many emotions that run through your body, especially when it comes to your child. If you are feeling a little blue as you stop breastfeeding, here are some things you need to know.

What Causes Changes in Mood?

While not much research has been conducted on post-breastfeeding mood changes, the consensus is that it is linked to hormonal changes in the body. When you’re weaning your baby off the breast, you experience a drop in prolactin and oxytocin levels. Prolactin is a hormone required for the production of milk but it also makes you feel calm and relaxed. Oxytocin is a hormone required for milk ejection and is often referred to as the love or cuddling hormone as it is associated with bonding and attachment. With the decrease of these two hormones, you’re likely to feel a bout of sadness.

Can This Lead to Depression?

It’s important to slowly wean your baby and yourself from breastfeeding to avoid an abrupt shift in hormone levels. If you suddenly stopped nursing, you could have adverse effects, which may lead to depression. If you have a family or personal history of depression, you may be more likely to experience it after weaning your baby.

It’s important to note that having the post-breastfeeding blues is different than having depression. You’re going to feel a sense of loss and sadness during weaning and that’s okay. However, if you find that it’s not getting better or it’s interfering with your ability to care for yourself or your child, call us today at 860.648.9755 to schedule an appointment.

To getting you back to your best self,
Lori Calabrese, MD

September 28, 2016
IV Ketamine Therapy for Postpartum Depression

Postpartum depression affects 1 in 7 women and can last for months if not treated. The symptoms of pervasive depressed mood, feelings of inadequacy and being overwhelmed are often accompanied by anxiety, irritability, inability to sleep despite exhaustion, inconsistent appetite, and intense isolation and guilt about experiencing these symptoms during what should be a joyful time. Some women have thoughts of harming themselves or intrusive thoughts of intentionally or unintentionally harming the baby.

Treatment for postpartum depression includes support for the mother and baby, omega 3 fatty acids, bright light therapy, and acupuncture. Data on the effectiveness of these is limited, but some women have found them helpful. Multiple studies have found that postpartum depression responds to psychotherapy and to traditional antidepressant medications. However, psychotherapy can take weeks or months to help ease symptoms; antidepressants often take weeks to work and are transmitted to the baby if the mom is breastfeeding.

Breastfeeding mothers with postpartum depression often agonize about whether or not to use antidepressants to treat their symptoms because they often don’t want to expose the baby to medication and don’t want to stop nursing in order to take a daily medication. Yet they need rapid and effective relief–for their own health and the health and development of their babies. Multiple studies show that untreated postpartum depression affects mother-baby interactions and are associated with lower cognitive functioning and adverse emotional development in the baby. In these instances, IV Ketamine Therapy for Postpartum Depression can help.

Explore IV Ketamine Therapy for Postpartum Depression Safely and Affordably

If you have postpartum depression or know someone who does, IV ketamine can treat it within hours without requiring that you stop breastfeeding.

IV ketamine is an extremely rapid, effective treatment for depression and 75-80% of patients respond quickly and dramatically to very low dose IV infusions. Although more research needs to be done, this makes IV ketamine therapy an exciting treatment option for postpartum depression, where getting better quickly is what every mom hopes for, and where restoring the health of the mother positively impacts the whole family. Mood, negativity, hopelessness, anxiety and distractibility can improve within hours, and hopelessness and suicidal thoughts can evaporate. A series of low dose infusions over about 2 weeks can result in dramatic and complete remission of symptoms.

Most women experience a mild floating feeling during the 45 minute infusion and lightheadedness, which clears within about 10 minutes. Although other side effects are possible, they are rare, and have not occurred in our postpartum patients. We are careful to discuss and review these in depth with our patients, as well as the breadth of research that supports the use of IV ketamine in the treatment of depression.

We Prioritize IV Ketamine Therapy for Postpartum Depression with Flexible Scheduling

We offer IV ketamine infusions, called IV Ketamine Therapy, for depression and for postpartum depression, and we make it a priority to see postpartum moms. We offer flexible scheduling in the late afternoon and evenings so that a breastfeeding mom can come in for her treatment and resume breastfeeding when the medication has cleared from her system so that her baby is not exposed to it. We carefully calculate the time that it takes for ketamine to clear and work with our patients to plan breastfeeding or pumping around their treatments.

This is dramatic and life-changing for new moms and their families and can be easily added to support, non-pharmacologic approaches and psychotherapy for the most robust and sustained result.

If you or a loved one would like to learn more about IV Ketamine Therapy for Postpartum Depression, please reach out to our office. We are here to help restore you back to your best self.

To getting you back to your best self,
Lori Calabrese, MD

September 18, 2016
3 Ways to Stop Repetitive Thoughts

Have you ever had fast, recurring thoughts about a particular topic that you just couldn’t shake? You may be experiencing repetitive thoughts, which is a common symptom of anxiety. Psychiatrists sometimes refer to these as “ruminative thoughts.” Here are 3 ways to stop them.

1. Write

When you find yourself having repetitive thoughts, stop for a minute and write them down. Getting your thoughts on paper frees up your mind, allowing you to feel less anxious. Writing actually engages your mind and helps to reduce the power of your repetitive thoughts. You don’t have to forget about these thoughts entirely. Writing them down allows you to revisit them when you’re mind isn’t moving so quickly.

2. Breathe

You may find that your breathing changes during your bouts of repetitive thoughts. When your mind is racing, be aware and work to slow your breathing. Slowly breathe in through your nose, counting to 3, and breathe out through your mouth, slowly counting to 5. You’ll start to notice that your mind and body will be more relaxed.

3. Focus

When your mind is racing, it may be difficult to focus on anything but your thoughts. However, it’s important to focus on the present especially during times like this. Focusing on the present allows you to accept what you can’t change and let it go. As much as you may like to, you can’t change the past so it only encourages your anxiety to constantly think about it.

Remember, it takes time to change old habits or develop new ones. Start slowly by choosing one of these tips to use the next time you find yourself dealing with repetitive thoughts. For more tips or to schedule an appointment, contact our office today.

To getting you back to your best self,
Lori Calabrese, MD

September 8, 2016
4 Strategies to Overcome Test Anxiety

It’s that time of year when thoughts turn to beginning a new school year and thinking about how things may go. As a student, you may already be experiencing some anxiety about taking tests. Take these last few weeks to master these 4 strategies to overcome text anxiety!

Plan Your Time

You have a lot of material to study in a short amount of time, and that could make anyone anxious. How are you going to remember it all? The best course of action here is to make and keep a study plan. List out the tasks you need to accomplish and then break them into smaller, more manageable sub-tasks. This will keep you from feeling overwhelmed, and will keep you on task and focused on the material you need to know.

Change Your Perspective

Sometimes a change in perspective is all we need. See the test as your friend instead of your enemy. Embrace it and you’ll notice that the stress you usually experience may be a thing of the past. Stop all negative self-talk and focus on what needs to be done.

Be Mindful

It’s important to take time to regroup and collect your thoughts throughout the day. Being mindful of right here, right now is a great way to decrease your stress and anxiety. If the test you’re studying for is in a week, your mind may be flooded with thoughts on how you’re going to pass, when to study, how you’re going to retain the information you’ve learned, and so on. The practice of mindfulness doesn’t take that away; it just brings your thoughts and focus back to the present.

Cover the Basics

The basics consist of taking care of your basic needs; diet, sleep, and exercise. Eating a balanced diet will keep your body fueled with the nutrition it needs to stay focused and ready for anything that comes your way. Getting enough sleep is also essential as it calms your mind and body, which decreases stress and anxiety. Lastly, exercise gives you more energy and decreases stress.

Education can be stressful for a number of reasons, but taking tests no longer has to be. Follow these 4 strategies to conquer test anxiety once and for all! For more information on conquering anxiety or to schedule an appointment, please contact our office today.

To getting you back to your best self,
Lori Calabrese, MD

August 4, 2016
4 Ways to Overcome Mental Exhaustion

Mental exhaustion often disguises itself as overwhelm and stress. If you’ve ever complained about not having enough time in the day, you may be suffering from mental exhaustion. Here are 4 ways to overcome it!

1. Relax

Relaxation is often elusive to many of us for one reason or another. It’s not enough to relax; you need to give yourself permission to relax. Don’t feel guilty about doing nothing. Your mind, body, and spirit need the rest so sit back and enjoy it!

2. Be Realistic

For many of us, our to do list is full of tasks we know we’re not going to accomplish that day. It’s time to start being realistic about how much you can get done during the day. Don’t overextend yourself with a full to do list. Leave some room for more enjoyable things, like taking a walk or reading.

3. Practice Prioritization

At the beginning of each day, choose the three tasks that must be completed that day. These are the most important tasks you should be focusing on, which help you prioritize your day. It’s also helpful to find more efficient ways of handling your tasks. For example, setting up your bills on auto-pay will take the stress off of you each month because you don’t have to manually pay them.

4. Seek Rest Opportunities

Rest opportunities are all around us but many of us are too exhausted to see them. While you’re waiting in line, try some mindfulness techniques or breathing exercises. Some mindfulness techniques include paying close attention to physical feelings, such as how your feet feel on the floor or in your shoes, how your shoulders feel (i.e. are they tense, back, hunched forward). These can be used in public, making it a perfect option while standing in line at the supermarket.

Relaxing your mind and recovering from mental exhaustion is essential for good mental health. It’s important to take time for yourself, even if it’s just 20 minutes a day, to help you unwind and feel better.

To getting you back to your best self,
Lori Calabrese, MD

July 12, 2016

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