Category: Depression

Articles about Depression by Lori Calabrese, MD | The Ketamine Blog

The World Health Organization asserts that depression causes more disability worldwide than any other illness. In addition to standing alone as a disabling disorder, it also worsens other illnesses from diabetes, liver disease, heart disease, and brain injuries. We present these articles about depression to show the many ways this disorder is expressed, ways to treat it, and to dispel stigma caused by lack of information.

Causes

Depression and stress create a self-defeating cycle. Prolonged stress prunes the synapses, the dendrites attached to them, and the dendritic spines, reducing the network necessary for optimal signaling in the brain. Consequently, thinking slows and outlook darkens. In addition, creativity all but disappears. Depression follows this process, imposing yet more stress on the these all-important signaling structures.

Other structures in the brain enter the process. These structures in turn malfunction and make the symptoms worse. The lateral habenula, the amygdala, the thalamus, and the hippocampus each play a role in depression. By the same token, depression impacts them, too.

Treatment

Only about a third of people who suffer with depression find relief with traditional antidepressants. These medicines increase neurotransmitters in the brain and eventually increase neuron growth. But the actions of these medicines delay the process and these patients improve slowly. Sometimes, if the first trial with a medication doesn’t help, a different one or combination can help another one third or so of those who didn’t feel better after the first trial. Unfortunately, 33% of people suffering from depression find no relief from these medications. Until recently, they were left with little or no hope of relief for the rest of their lives.

Benefits of Ketamine Treatment

However, ketamine treatment is a novel and advanced treatment that has changed the prognosis for those treatment-resistant patients. Ketamine switches the mRNA to “On” which turns on the DNA to turboboost the brain-derived-neurotrophic-factor (BDNF) that proliferates neuronal growth along with synapses, dendrites, and dendritic spines which play such a vital role in improving signaling throughout the brain.

Another benefit of ketamine is how rapidly it causes the G proteins to slide off the lipid rafts in the cell membrane. This allows them to get back to work enhancing signals. It also causes the cell bursting in the lateral habenula to be dampened. Another process that allows you to experience a sense of reward – and feel better – when something good happens. Basically, ketamine treatment goes to work to help you feel better fast.

Then you enjoy clearer thinking and more creativity. Also a rewarding and upbeat outlook filled with light and joy. Add to that the improved initiative, increased motivation, and hope that makes life worth living again. This remarkable outcome occurs in 65-70% of treatment-resistant patients in general, and much more than that when the treatment is highly personalized. And the results are rapid and robust. Extraordinary.

As you read these articles about depression, keep in mind that there is always hope. Researchers continue to work to find more aspects ketamine’s effects on the brain that can impact the outcome.

  • How Ketamine Can Put Your College Student Out Front Again

    How Ketamine Can Put Your College Student Out Front Again

    Start your college student out front with treatment for depression with IV ketamine.

    Ethan was in his second semester of his first year in college. The new had worn off, and the classes were getting harder. He hadn’t had to work that hard to do well in high school and being challenged felt more like being overwhelmed. He studied hard for chemistry, but he really struggled to get a handle on it. Instead of A’s he was making B’s and C’s in that class and was feeling stupid for the first time in his life. He had never worked at a job before now, but had to work 20 hours a week doing something he hated…making cold calls to alumni to raise funds. It was part of his financial aid. To make things worse, his social anxiety was kicking up with all the stress, making those calls torture. Ethan wasn’t starting as a college student out front, unfortunately.

    Help your college student out front again with ketamine for depression.

    His friendships were few, because forming connections took so much energy and he felt more and more depleted. HIs roommate was a nightmare…clearly someone who needed some sort of treatment. 

    The guy would hide behind the door and jump out screaming at him when he walked in the room. Bizarre was an understatement. Rather than a place of rest and refuge, his dorm room was a torture chamber except when his roommate went home for the weekend. Relief was hard to find, and the stress just kept building.

    As time passed, Ethan’s anxiety kept rising. Test anxiety, social anxiety, and worry grew and billowed, choking his ability to function. Worse and worse. He had expected to do well, but his stressors were preventing him from being a college student out front of the crowd.

    When he reached the breaking point, he would stay in bed and skip classes as well as work. A day in bed in a dark room seemed to give him the courage to face another day…until it didn’t.

    His grades began to decline.

    The worse his grades, the more guilty he felt. He didn’t want to face his parents with what had happened this semester. He began drinking to relieve the guilt. It wasn’t partying because he had too much anxiety to face a crowd. He had never used alcohol before, because he’d always had his mind on performing well in school. But that wasn’t happening anymore. He didn’t know what to do.

    A student feels lost when they aren't ahead in class.

    Realizing he was going to fail the semester if he didn’t take action, Ethan went to the campus counseling center and talked to a therapist. He told him the trouble he was having with everything. He asked what could be done about his record when he was too anxious and depressed to function, much less improve his grades.

    The therapist recommended a leave of absence to give him time for treatment and therapy so he could function again and improve his grades.

    She also gave him a card for a therapist, and another one for a psychiatric practice that offers ketamine treatment.  And she encouraged him to spend some time with his parents to talk through all that had happened, and determine the best steps to take.

    Anxiety disorder is the most common disorder in college students, and generalized anxiety disorder is often diagnosed during college. It exhibits itself often as worry that won’t stop, and can often be accompanied by social anxiety or panic attacks. Add to that the prevalence of depression which often accompanies untreated anxiety, and you can see the very real risk to college students for things to fall apart caused by the new stressors they face. 

    You can set your college student out front when you treat depression with IV ketamine.

    Suicidal thinking, planning, and attempts threaten college students — and suicide is the third leading cause of death for young adults.

    Eating disorders are also high on the list of disorders threatening college students. ADHD and autism often get identified for the first time are also prevalent. Sometimes psychotic symptoms begin.

    All these challenges face a growing number of young adults between ages 17 and 25. Since college students aren’t known for seeking help, many end up being placed on suspension without effective treatment. In addition, the prevalence of disorders sometimes clogs the healthcare system in universities. 

    But when parents and students identify symptoms of depression, anxiety, PTSD, and suicidal thinking, they can receive IV ketamine treatment and in most cases find relief and even remission.

    By treating mood disorders you can set your college student out front.

    IV ketamine doesn’t resolve everything, but for these conditions it can give you your life back. Initiative, motivation, clarity of thinking, hope… freedom from feeling overwhelmed and confidence can set your college students on firm ground for embracing challenges. If you have social anxiety it can be transformative for you.

    It doesn’t work for everyone, but IV ketamine can be transformative for many.

    The key to understanding why college students may be overcome with anxiety, depression, PTSD, and suicidal thoughts is stress. Their increased stressors wear down the synaptic connections between brain cells that are the pathways for signals throughout the brain. When those pathways wear down, signals can’t be sent, and thoughts become less prolific…dull…dark.   

    IV ketamine treatment turns on mRNA which switches DNA to ON to turbo boost  brain-derived-neurotrophic-factor. BDNF restores and proliferates those synapses creating strong and broad pathways for messages, filling your mind with problem solving, creativity, and hope.

    Put your college student out front with IV ketamine for depression.

    If your student is struggling with anxiety, depression, PTSD, or suicidal thinking, call us.

    We offer IV ketamine treatment so he can experience freedom from fear, lifting of depression, relief from PTSD, and the end of suicidal thinking. If he’s had difficulty with academic demands, ketamine can put your college student out front again.

    Let us help your student excel like he used to.

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

    To the restoration of your best self,

  • Promote Optimism and Slash Depression with IV Ketamine

    Promote Optimism and Slash Depression with IV Ketamine

    Ketamine can promote optimism and slash depression for you.

    Jayne believed in being realistic. She didn’t notice that her “realistic” outlook leaned toward pessimism. When someone said, “Don’t be such a pessimist!” she would respond, “My realistic outlook has served me well.” She didn’t want her head in the clouds. When something bad happened, she thought about how it was punishment of her for her failures. The more she thought about it, the more hopeless and worthless she felt. Eventually, she felt like she was drowning in her own worthlessness …and that there was no hope of improvement. This wasn’t realism, it was pessimism and hopelessness. Self flogging. Despair. Jayne had no idea she could actually promote optimism and slash depression with the help of IV ketamine.

    When things were difficult, Jayne would spiral in her thoughts about her own failures. She felt she would never be able to create solutions because of her own worthlessness. Surely her family would be much better off if she were gone. She felt like a dead weight they had to carry. She could see no value in herself. Her focus on her failures —rather than understanding the wonderful value she had to those who loved her — blinded her.

    Ben saw that IV ketamine would promote optimism and slash depression for his wife.

    Her husband, Ben, read about IV ketamine treatment in a magazine. He decided to research it more deeply on his laptop. He learned it could dispel hopelessness and replace it with hope and a bright outlook.

    Ben talked to Jayne about it at length, and she agreed to meet with a doctor who could give her IV ketamine treatment. She understood there would be at least 6 infusions, maybe more.

    Her thoughts of suicide dissipated after the first treatment. That was a relief. After the second treatment, she began to feel initiative. She got things done. It made her feel better about herself. After the third, hope began to seep in. By the time she had her 7th infusion, she felt joy and pleasure…and began to believe in herself. Her outlook was surprisingly optimistic, after years of pessimism. 

    Jayne was so grateful to her husband for seeking answers and finding a treatment she didn’t realize she needed. She felt transformed.

    Worthlessness, hopelessness, and pessimism are negative beliefs that characterize major depressive disorder and the depression that is part of bipolar disorder. These beliefs and feelings color the outlook and perception, and influence the way you interpret experiences and events in your life.

    IV ketamine can promote optimism and slash depression.

    They cause a negative view of yourself, everyone around you, and your future. Healthy people tend to have a stubbornly optimistic view of life. There is a stark contrast between the two.

    Beliefs about the likelihood of future outcomes are regularly “updated” after new and interesting experiences. This most often happens after a positive experience in healthy people, and most often occurs after a negative experience in depressed people.

    These updating experiences change the way they expect a new situation will turn out.  If he’s healthy, he’s most likely to expect good things to follow. But if he’s depressed, he’s likely to ignore positive updating experiences and overfocus on negative ones. He’s likely to derive a pessimistic view and just expect that bad things that continue to happen.  

    This way of looking at life tends to maintain depressive symptoms, just as a healthy outlook serves to maintain optimism.

    IV ketamine has demonstrated a rapid antidepressant effect that peaks in 24 hours. It promotes optimism and slashes depression.

    We know that ketamine alters the belief updating process. It alters the mechanism you use to update your beliefs when exposed to new experiences and information. This is what happens in healthy people.

    But if you have treatment resistant depression, it hasn’t been so clear when and how ketamine can impact your belief updating, and it’s important that we understand that.

    So a team led by Hugo Bottamanne, M.D. conducted an incredibly elegant study recently to show how IV ketamine affects belief-updating. Because if ketamine can shift belief-updating to be more positive than negative in patients with treatment resistant depression, it can prolong a healthy outlook. Published in JAMA Psychiatry September 2022, the study worked with 26 patients with treatment resistant depression, and 30 who were healthy, who served as the control group.

    The participants received three ketamine infusions and during this treatment period, they were asked to make educated guesses as to the likelihood they’d experience certain adverse events. The details of it all are quite complex.

    On an ordinary day, IV ketamine can promote optimism and slash depression for you.

    If they expected it was likely that a catastrophe would happen to them, they had a pessimistic outlook. (Of course, right?) If they expected it was unlilkely a catastrophe would happen to them, they had a more optimistic outlook. (At baseline, they expected the worst.)

    Belief Updating Goes Positive

    But even after just one ketamine infusion, the depressed participants showed a strong shift in their thinking from pessimistic to optimistic. Their natural depression-related bias (leaning more towards the negative) actually shifted towards imagining positive outcomes in a significant and measurable way. One treatment. This accounts, in part, for why they started to feel better within just 4 hours of their infusion.

    It just happened. Without trying too hard. Without having to work at reframing anything.

    Just like it happens in our own patients.

    It’s so exciting to see this studied in such a careful way, because it underscores and begins to explain how it is you can actually feel your depression lift. It’s because, in part, your thinking automatically changes and you lean in more towards the positive.

    Ketamine promotes optimistic thinking…and hope. The mechanisms that promote pessimistic, depressed, and hopeless thinking can be reversed by ketamine.

    Don’t just take my word for it (although I say it all the time). This latest research now shows it. We are all about bringing you innovative treatments, and helping you understand the brain science, the mechanisms, and the evidence base that underlies them. So that you can change your mind.

    For the better.

    The way you think has a strong impact on your outlook and state of mind. Ketamine can instill hope and a positive outlook for the future.

    If you feel your realistic thinking (or, let’s just say, your pessimistic thinking) is contributing to depression, and if nothing has helped, call us.

    IV ketamine can promote optimism and slash depression, giving you hope and joy for the future.

    We want to help you experience how bright your life can be.

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

    To the restoration of your best self,

  • Did You Know Alcohol & Substance Misuse Increase Suicide Risk?

    Did You Know Alcohol & Substance Misuse Increase Suicide Risk?

    Alcohol and substance misuse increase risk of suicide.

    Tom woke up, his head pounding, and he ached all over. The dark cloud that followed him everywhere was back. The partying last night gave him a brief reprieve, but it was over. He slowly dragged himself out of bed and thought about how disappointing it was that he woke up. He didn’t realize he was playing with fire, or that alcohol and substance misuse increase suicide risk.

    He just wanted relief.

    The nagging wish to stop living like this wrapped itself around him and through him to his core. It wasn’t the booze and pills that he wanted to be free of. It was the darkness, the pit, the vacant emptiness, the ache.

    A lifetyle of over indulging increases risk of suicide.

    His lifestyle of repeatedly over indulging, getting high, and oblivion was the one thing that gave him minutes of relief. 

    Minutes when he felt good for a change.

    Tom drank a couple mugs of coffee to try to clear his head, took a shower, and headed to his job. He had a degree in business management, but since the depression and anxiety had gotten so much worse, it flattened his ambition. He was just hanging on. Trying to get through the day. In fact, he held on to get through the hour…the slow, dragging minutes.

    By lunchtime he didn’t know if he could get through the day, but he needed this paycheck. So he had to endure…and thought about what he would do after work to feel better. He started planning in his head to occupy his mind. That was a whole lot better than just slogging through work.

    That night, Tom met up with friends he sometimes partied with. He contributed a bottle of bourbon, malt whiskey, and a case of beer he put on ice. The other two friends brought more of the same, plus some pills. 

    Alcohol and substance misuse increase risk of suicide.

    Tom hated the morning after. He always did. But the whole purpose was to construct relief. Respite from his misery. And this time was no different. He wanted to drown his pain. So he popped pills, guzzled beer and slammed shots with abandon.

    However, this time he didn’t wake up with his head pounding. The “blackout” that followed all that he swallowed pulled him into a coma. One of his friends woke up from his own stupor and couldn’t wake Tom or his other friend. He called 911.

    Their friend was pronounced dead at the scene, and Tom was rushed to the hospital where emergency personnel fought for his life. 

    After 2 weeks in the ICU, Tom began to gain consciousness. They told him his alcohol poisoning was nearly fatal, which was really hard for him to grasp. But it was even worse realizing his friend William had died that night.

    Were they trying to end their lives? Had they tried to die before and — since it hadn’t happened — did they think they were indestructible? Was it really “partying” or was it flirting with death, in hopes of escaping their misery..?

    These are questions that surround the growing numbers of people who misuse alcohol and substances… and die as a result.  Do they realize that alcohol and substance misuse increase suicide risk?

    Is an overdose suicide or an accident?

    Self medicating depression symptoms increases risk of suicide.

    September is National Suicide Prevention Month. Research has illuminated the complicated relationship between alcohol use disorder, substance use disorder…and suicidal thinking, suicide attempts, and suicide deaths. The purpose of National Suicidal Prevention Month is to inform society and equip you to recognize risk factors among your own friends, family, and coworkers.

    For a long time we’ve recognized that alcohol and substance use disorders are associated with suicide risk. And when substance use is combined with alcohol use, there is a much higher risk of fatalities by suicide.

    When you consider that alcohol and substances are widely used to self medicate symptoms that may not have been addressed and treated, it makes sense to treat the symptoms and talk openly about suicidal thoughts that can be stopped by IV ketamine.

    Alcohol and substance misuse are not the only risk factors for suicidal thinking or fatalities —but they can increase risk of suicide a hundred fold.

    A hundred fold greater risk. That’s staggering.

    When you identify these risk factors in the life of someone you care about, you can save a life by opening up conversation about suicidal behaviors and thoughts.

    IV ketamine can give you remission from depression and suicidal throughts.

    Talk about the symptoms that lead to self medication — because there is hope through treatment of those symptoms.

    And IV ketamine can stop suicidal thoughts in a few hours. And allow you time to seek the treatment that will make your life better.

    If you’re experiencing suicidal thoughts or plans, call 988, the National Suicide Hotline. 

    Someone who understands what you’re feeling is waiting to talk with you.

    If you’re plagued by thoughts of suicide and want to seek IV ketamine treatment to stop those thoughts, call us.

    IV ketamine can stop those thoughts in an afternoon, and buy you time to seek treatment and counseling for a more rewarding life.

    We’re here to help.

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

    To the restoration of your best self,

  • Anxiety, Panic, and Depression in Teens:  IV Ketamine Offers Hope

    Anxiety, Panic, and Depression in Teens: IV Ketamine Offers Hope

    Anxiety, panic disorder, and depression can be relieved with IV ketamine.

    Anxiety. Some people never struggle with it. A little bit of anxiety for them can be a motivator to study for a test, practice lines for a play, or learn math. Those who experience small spurts of anxiety can often perform very well. But when anxiety grows out of bounds it’s no longer motivating. When it explodes into fear, it can freeze you in place, making it extremely difficult to take care of things you need to do. That’s especially difficult for teens in school — including getting ready for college. And when issues crop up like anxiety, panic, and depression in teens, it can be just too much to manage.

    Emma’s Anxiety

    Take Emma. As a young child in her elementary school, she loved learning to read, working on group projects, and helping with the scenery for the class play. She wasn’t shy… but wasn’t outgoing either. She was just task oriented, good at things, and liked to excel.

    But as she got older, social anxiety crept in. Going into a full classroom if she was late made her feel like she would die a thousand deaths. (So she tried very hard to not be late.) The anxiety that built inside her about giving a report in front of the class or participating in group discussions or projects robbed her of the motivation to do a good job. She worried and worried about it and then, exhausted, just wanted to disappear.

    Some days she was so exhausted by it all that she just stayed home. Told her mom she had a sore throat or upset stomach.

    Anxiety, panic disorder, and depression can make it difficult for a teen to function in school.

    Then, when Emma was 15, she woke up one day and the anxiety about going to school overwhelmed her. She dropped to the floor crying and couldn’t move. Her mother came in to tell her to get dressed or she’d be late. But Emma couldn’t do anything. She felt frozen and helpless. She cried and cried harder, and told her mother she couldn’t do more than she was doing. Her mom was caught by surprise… but thought Emma was testing her boundaries. She was sick of the drama, tired of the hormones, and wanted Emma to just get up and go to school.

    But no matter what her mother said, Emma remained in a heap on the floor.

    Anyone who has had a weeping teen knows that you can lead a horse to water but you can’t make them drink. Her mom knew she could try to get her daughter dressed out the door, but she couldn’t force her to participate in school. She decided she better try a different approach.

    She asked her daughter what was wrong. Why was she crying? Emma took a long time to answer but finally said she didn’t know what was wrong. So she stayed home again and spent the day relaxing. Anxiety, panic disorder, and depression created a complex knot of overwhelm for this teenage girl.

    She took a mental health day.

    She took a lot of them.

    Eventually, Emma graduated from high school. She was so relieved to be away from that world that she was euphoric… and hoped she’d be ok now.

    Emma spent the summer doing things she enjoyed with her closest friend. She didn’t have a ton of friends since social anxiety caused her to stay to herself or with the friend she knew well. In August, it was time to move into the dorm at the college where she was scheduled to start. The last week she was home anxiety choked her. She wasn’t sure she could do this… so many people she didn’t know! How would she register? How could she move into a dorm with a stranger? Who would she eat with? 

    The fears spun in her mind faster and faster. She felt like she was frozen in a vault unable to communicate with anyone. Her parents tried to help her get ready and pack, though she couldn’t focus on it. They drove her to the campus and helped her carry her boxes to her dorm room.

    Then they drove away and she was alone.

    Anxiety interferes with life changes

    She froze where she stood. She was the first one in the room. And it was small. The terror of being in her room and facing her roommate was too much. She didn’t move. Emma worried that her roommate wouldn’t like her, and she’d have nowhere to escape to get away from her. She finally walked to the library to find a place she could be alone. It wasn’t long before she found a cool, dark corner where she could huddle. 

    Social anxiety, panic disorder, and depression can be relieved by IV ketamine treatment.

    After a couple hours there, Emma forced herself to go back to her dorm, and after standing outside the door for 20 minutes trying to get the courage to go in, she finally held up her card key, buzzed herself in, and walked in. She and her roommate introduced themselves but neither wanted to talk much.

    And so it began.

    Emma managed to go class, spent her weekends studying in her room or the library, and got through the semester. But once the next semester started, she was in trouble. Anxiety rose more and more until she couldn’t leave her dorm room.  She didn’t make it to many classes. 

    She stayed in her dark dorm room and slept instead of going to class. Emma slept all the time. Kids down the hall and acquaintances from her classes stopped by but she didn’t answer the door. She couldn’t face going outside and walking to class.  Couldn’t face other students. She’d gotten so far behind she felt too overwhelmed to fix it. And she was placed on academic probation. Now she had to tell her parents what was going on.

    Emma felt so much shame. Abject failure. But no idea what to do to turn this around. She felt like there was something wrong with her. She believed she was just weak. Inept. Worthless.

    Social anxiety, panic, and depression were a complex set of problems, on the heels of COVID, that proved too difficult to overcome.

    Reaching out for help

    She decided—finally—to talk to one of the campus counselors. Even though she had no idea what they could do, Emma knew she needed some sort of help.

    The counselor asked lots of in-depth questions about Emma and her history, her school life, and her family life. She got Emma to talk about what her thoughts were when she avoided class. Counseling on campus is short-term. So she gave Emma the name of a psychiatrist nearby who might be able to help.

    Emma called her parents and told them what she was going through, about her grades, and about the counselor. She cried — a lot. She asked her parents if they would help her see the psychiatrist. They agreed. 

    Her visit with the psychiatrist was enlightening. He told her that she had social anxiety, and depression—and probably panic disorder. He prescribed meds that day and she started taking them. But she felt tired, wasn’t sleeping well, and after a couple months she was still getting no relief. She felt no different. He tweaked her meds—a couple of times—and suggested a different therapist to see one-on-one for CBT (cognitive behavioral therapy) for anxiety… but she didn’t want to do that. Her social anxiety was too intense for her to tell her story. All over again.

    And then he told her that 30-40% of people with anxiety and/or depression aren’t helped by traditional medicines and treatments.

    She wished she’d known that before wasting so many months. 

    And he gave her the name of a psychiatrist who offered IV ketamine treatment.

    Really? How would she know if she was even legit?

    Emma called and made an appointment.

    But she felt no different after the first infusion. And started to worry—maybe this wasn’t going to work?—even though she knew that it could take a few infusions before her symptoms turned around. The dissociation was interestingweird but interesting. She hoped it would help.

    That panicky feeling calmed a little after the second infusion later that week. Just a bit. But every little bit helped.

    A few days later, she went for the third infusion.  She felt just a bit better the next day. Not a lot. But a little.

    Social anxiety, panic disorder, and depression can go into remission with IV ketamine treatment.

    Then, on the day of the 4th infusion, she began to feel less and less anxious, less out of control of her life, less afraid. She could tell it was helping. With the 5th and 6th infusions, she felt better and better… but was still a little shaky as she tried to make arrangement for a new semester. The doctor suggested she come in for another one or two infusions. She was almost there.

    After 8 infusions, she wasn’t afraid anymore. The depression was gone. Emma had the courage to face the school officials and made a plan with the campus counselor about repairing the damage to her GPA… She embraced her responsibilities and met with tutors. She started spending time with her roommate (who turned out to be a really nice girl) and they actually became good friends. Emma was so much better that she felt normal.

    Anxiety and panic disorder can go together. We call that co-morbidity. (What a word, right?) In Emma’s case, her depression was another whole thing she suffered from. With so much going on, she couldn’t figure out how to function or manage her life.

    This is actually pretty common in teens and college students. New stressors—like starting high school or college—can trigger even more severe anxiety. It can bring on depression. And make your teen—or youshut down.

    It’s important for parents to talk with their preteens and teens about mental health symptoms, and seek help when symptoms interfere with daily living. Symptoms like anxiety can be easy to misinterpret or overlook, so it’s really valuable to talk about how they feel. If they learn to talk about their experiences as they go through challenges, it will be easier to identify problems that need to be addressed…and treated.

    It will be easier to develop resilience.

    And if unexpected symptoms emerge, you’ll be in a better place to help.

    If Emma’s experiences sound at all familiar — and if treatment isn’t making a dramatic difference — call us.

    We’re here to help you with innovative solutions—and to help you reach for remission.

    Let’s see if we can get your life back.

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

    To the restoration of your best self,

  • If Your Teen is Thinking of Suicide: Save Her with IV Ketamine

    If Your Teen is Thinking of Suicide: Save Her with IV Ketamine

    When your teen contemplates suicide, take it seriously and seek IV ketamine treatment.

    Shannon was 13 and woke up almost every morning disappointed to realize she was still alive. Her last thought before falling asleep was usually hoping, praying, she would not wake up in the morning. Her misery was difficult to describe but it involved every aspect of her life — parents and family, her school work, her friends, and her health. Shannon knew something was wrong. But didn’t know what IV ketamine could do. (When your teen is thinking of suicide, she may not even realize that’s where that could really go.) Her mom always said, “If everything and everyone around you seems wrong, maybe it’s time to look at yourself.”

    She did look at herself, and didn’t blame anyone else for her frame of mind. She didn’t intend to be creating trouble of any kind…she just felt so bad…so, so bad. Shannon felt like a failure at school, always hearing from her teachers that she was she was “not living up to her potential.” She couldn’t focus, didn’t have the drive to do her assignments or study. And coping with other kids at school every day was painful and exhausting. She had nothing to say, and people shunned her because they thought she was standoff-ish. 

    Shannon didn’t intend withdraw, but it was all she could do. Her social anxiety was cruel and crippled her efforts at connecting with anyone.

    She didn’t feel like her parents understood her, and her brother and sister never stopped ribbing her and poking at her.

    Her parents would have sit-down talks with her and try to whip up her motivation, her commitment to her “responsibilities” … and it just discouraged her all the more. It proved to her what a failure she was.

    They thought she would grow out of it, that time would just eventually give her a little boost, or that she would find a surge to enjoy life.

    So they waited.

    Shannon thought about dying often, but didn’t know if she had the courage to take action.

    Months and months of this without improvement led Shannon’s parents to find a therapist and psychiatrist for her, and they put all their hopes on this treatment. Over the next year, fruitless talk, prescribed medication, adjusted doses, and then new medication…. brought no improvement. 

    Shannon had lived with this despair, hopelessness, anxiety, and listlessness, as well as feeling utterly worthless, for years — and she just couldn’t do it anymore. It seemed pretty clear to her that the rest of her life would be like this. The only solution was to stop living.

    Then at school, a girl in her class told her she’d been in class with her for two years and noticed Shannon always seemed to carry a burden. Since she’d herself been deeply depressed, and had been a teen thinking of suicide, she thought she recognized it in Shannon.

    She said, “I just want you to know you’re not alone. I’ve been there.”

    Shannon told her she didn’t know why she felt so bad, and turned to walk away. The girl, Christy, rushed to catch up.

    “Do you ever feel like you want to die? I did, and I wonder if it’s the same for you,” Christy offered.

    “All the time,” Shannon responded.

    “Would you like to meet up after school? Maybe we could hang out…talk…?”

    When a teen contemplates suicide, it's vital to take it seriously and get ketamine.

    Shannon was hesitant. She didn’t really know Christy that well, though they’d been in classes together. She was afraid she wouldn’t have anything to say. It would take energy she didn’t really have. ….Still, Christy seemed to understand what she was going through. She pushed herself to accept.

    “Ok.”

    They met and walked to Christy’s car. She drove them to a cute little place that served frozen yogurt.

    They each got a cup and found a table. Before long, Shannon was talking about her situation and Christy listened, seeming to know how to ask the right questions.

    Finally Shannon asked, “How do you know so much about all this? You seem fine.”

    Christy told her about her own depression, how desperate she had felt, how hopeless. Then she read about a treatment that turned out to be her answer.

    “IV ketamine treatment.” It’s used for anesthesia, but in the last 10 or 15 years it’s become a pretty amazing treatment for depression. It’s not like the pills you’ve tried. Some people feel great after the first infusion. For others, it takes a few infusions before they feel better. In general, the treatment requires a series of infusions, 6 or 8 or so, maybe more, and it can transform the way you feel. It’s hard to describe, but my suicidal thoughts stopped — it was like poof! — and my depression completely lifted.

    “The reason I approached you, is because I know what it’s like to be deeply, dangerously depressed.  I know the thoughts you probably have, and I wanted you to know there is hope. If there is anything I can do to help, I will.”

    After Christy took Shannon home, Shannon talked to her parents. She told them about her talk with Christy and her desire to look into IV ketamine treatment. They all looked online for more information, to understand the risks and benefits.

    Christy had given Shannon the name of the doctor who had provided the treatment for her so Shannon gave it to her parents. Before bed, Shannon’s mom gently asked her if she had had any thoughts of dying. She thought maybe her teen is thinking of suicide.

    Shannon stared at her hands.

    Her mom told her that in her research of IV ketamine, she had learned that ketamine was especially good for suicidal thoughts. That it can actually erase those thoughts.

    “Shannon, honey, hang on. Tomorrow I’ll call and get you an appointment. Let’s see what this treatment can do. Will you hang on with me?”

    Shannon nodded.

    The next day, her mom made an emergency appointment and took Shannon in for a comprehensive consultation and she was able to get a ketamine infusion that same afternoon.

    Within a couple hours, Shannon’s suicidal thoughts stopped. The depression didn’t feel much better yet but the thoughts and images of killing herself were gone. They made appointments for the rest of the series of infusions.

    After the second infusion, Shannon thought she might feel slightly better. Still hopeless, despairing, and without energy, but she got out a book from English class and began to read an assignment.

    When your teen contemplates suicide, IV ketamine can stop suicidal thoughts fast.

    She hadn’t made any effort with school in months. Initiative, her mom thought. 

    Then, after the third infusion, she could tell she was feeling better. Like sparks of light were seeping through the darkness of the last few years. From that point, she continued to feel better and better. After her 7th infusion, she was laughing, talkative with her family, sometimes singing under her breath. And as time went by she just kept improving. She worked with her teachers and explained her story, and made arrangements to make up her missed work.

    Her parents were flabbergasted at the change they saw in her. She completed the year with A’s and B’s in every class, and enjoyed her school work… was motivated to excel.  She talked on the phone with friends… and even went on a few dates.

    Shannon and Christy became good friends, with their common history of depression and recovery. And together they reached out to other teens who were thinking of suicide.

    Teen suicide is the third leading cause of death in young people between the ages of 10 and 14. It’s the second leading cause of death in people aged 15 to 24. It’s extremely important to recognize signs of depression as well as signs of suicidal thinking in teens and take action.

    Because teens can be impulsive, suicide is a higher risk at this stage of life. The prefrontal cortex is not fully developed until the mid twenties, so executive decision making can be impaired. Teens may not think of the consequences of a decision that an adult over 30 is more likely to consider. 

    In addition, while depression is a serious risk factor for suicide, about half of those who commit suicide did not have symptoms of depression.

    Some people can seem fine, are productive and excelling in life, when they cause their own death. So it’s important to talk with your teen about suicide in an open and matter-of-fact manner. Check in with them often. 

    Be sure your family is familiar with the new hotline for suicide: 9-8-8.

    And know that IV ketamine treatment is available to help you recover. It’s not a fluke or a passing trend. (People might have thought that years ago when I first started providing this treatment.) Ketamine has been used for over 50 years safely. You may hear people disparage this amazing medicine as a horse tranquilizer, a psychedelic used on the streets as Special K, and other misnomers. The fact is that it’s been used in combat since the Vietnam war, is used for an anesthetic for humans and animals — and in the 21st century, it’s been studied and used effectively for depression, and other mood disorders. Like most good medicines for pain, ketamine has also been abused as a party drug for its dissociative properties.

    But make no mistake.

    When your teen contemplates suicide, IV ketamine can restore their joy for life.

    IV ketamine is one of the most, if not THE most, effective depression treatments available. It has a broad effect on the brain in the hippocampus, amygdala, the prefrontal cortex and the lateral habenula. It turns on mRNA which switches DNA to “ON” and triggers a proliferation of brain derived neurotrophic factor. This in turn acts like a compost to turbo boost the dendrites and dendritic spines on the brain neurons, to vastly multiply connections between brain cells, lighting up the brain with creative thought, bright emotions, hope, and confidence.

    When your teen is thinking of suicidewhen your child is thinking of suicide— you may recognize the signs… or you may not even dream they’re considering it because they appear so active and successful. Don’t be caught unawares. Encourage your kids to talk about their feelings. And know that a self-reliant successful person can be suicidal without showing signs.

    Our goal is to help those who feel trapped in their frame of mind and in suicidal thoughts. Ketamine can stop suicidal thinking even before depression lifts—and that’s ok. It can save a life. It can save your life.

    If you feel like Shannon, or worry about your own suicidal thoughts, call us.

    We’ll help you with the best ketamine treatment available to be free of those thoughts, and give you the time you need to pull in everything you need to get better.

    You’re not alone. We’re here to help.

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

    To the restoration of your best self,

  • Ketamine for Teenage Depression: How To Set Your Teen on Solid Ground

    Ketamine for Teenage Depression: How To Set Your Teen on Solid Ground

    Set your teen on solid ground with IV ketamine treatment.

    Brittney dressed for school and left for the bus. She waited 20 minutes then slipped back into the house and slid under the bed. And she waited. She couldn’t face school…. all the kids who she felt judged her. The sleepiness that made it impossible to pay attention in class. The expectations from teachers she couldn’t meet. What can set a teen on solid ground? Brittney didn’t know about ketamine for teenage depression, so she had no hope that anything would change.

    She wasn’t intending to do anything dishonest, she was just trying to survive. School was a problem she didn’t know how to solve. She had no energy or drive for homework, for the tension of being around people all day she had no rapport with. Every day, every day, every day…it never stopped. 

    She felt she would be trapped in this misery forever. So she found a safe place to avoid it.

    Under her bed there was no pressure. No tension from unfulfilled expectations. No students asking her intrusive questions. 

    “Are you on something? You always sleep in class… What do you do at night?”

    “No.”

    “Why do you always sleep?”

    “I don’t know.”

    She just couldn’t stay awake. And she didn’t want to, anyway. 

    When it was time to be arriving home from school, she slipped out of the house… And when the bus stopped she walked into her home by the front door, went upstairs and watched TV. Teen depression can drive them to do desperate things.

    Her mom came in. “Hi Brittney, how was your day?” “Fine.” 

    “Do you have homework?”

    “I finished it at school.”

    “Well, that’s good.”

    Her mother never suspected she was not going to school until the teacher’s conference. And it came out that she … a former “A” student… was failing from missed homework, absence from class, and missed tests.

    Talking with your child often can help set your teen on higher ground.

    After a long talk, and lots of tears, Brittney’s mom realized her daughter needed help. And that was the beginning of a long, painful road. Brittney wasn’t thumbing her nose at the system, she was trying to survive. Her mom racked her mind to find solutions, but didn’t know about ketamine for teenage depression.

    For years, we’ve been fighting a crisis of adolescent depression, bipolar depression, anhedonia, PTSD, social anxiety, substance and alcohol misuse, addiction, and suicide. As teens like Brittney drop out of adolescent society to withdraw into a seemingly safe, though dark place, they need someone to reach out and help.

    Someone who recognizes their misery and is willing to help them discover how to find freedom and joy. Because these symptoms aren’t a natural part of adolescence. Misery isn’t a required rite of passage … so if your teen is exhibiting a sullen withdrawal, they may very well need treatment rather than punishment.

    Because here’s the thing.

    Adolescence is a challenging time with hormone fluctuations, changes in self image, reduced energy associated with fast growth and less sleep, and the problems that arise from being suspended between childhood and adulthood.

    It’s no walk in the park to be a teenager, or the parent of one.

    But it’s not an illness. When you see symptoms of illness, that’s the time to seek help.

    And when it comes to illness… i.e., a psychiatric disorder…finding people who can help and a treatment that works can be easier said than done.

    Some teens want to see a therapist and some refuse. Some respond to oral medication and some don’t. If your teen can take a pill and feel better, function better, and get better, wonderful. But if he or she doesn’t respond, something else needs to be done. These are formative years when your teen is forming ideas about who he is and what he wants his future to hold.

    To let time go by without helping them feel their best is blocking that development. But it’s possible to help set your teen on solid ground.

    And for that, stop and consider IV ketamine treatment.

    Set your teen on higher ground with IV ketamine treatment for depression.

    Effective with a broad percentage of people, and responsible for helping so many more achieve remission, IV ketamine is a novel and advanced treatment that can be used for teens be used who suffer with psychiatric disorders like the ones we’ve talked about.

    There has never been a medication that helps everyone, but no medication we use has ever helped so many as quickly as IV ketamine has. It doesn’t help everyone — but in our practice, it does help most of those who need it. And when it helps, it can transform.

    If your teen struggles with anxiety about school, or social anxiety, or depression that hasn’t gotten better, or PTSD, IV ketamine treatment may be just the thing to relieve those symptoms and give him or her the chance to start the year on solid ground in high school or college

    It’s normal to be a little nervous about a new experience, but if your teen is depressed rather than excited about going to school, meeting new people, living in a dorm, and tackling harder classes, he or she may need the boost that IV ketamine for teenage depression can give.

    Receive your ketamine treatment in a comfy recliner to erase memory triggers of alcohol use.

    If you start now, you have time to benefit from a series of infusions before school starts.

    Back-to-school treatment to restore resilience and hope is far more important than back-to-school clothes shopping. Take advantage of 21st century neuroscience so that your teen (or you, if you’re a teen) can reap the benefits of IV ketamine treatment.

    Let us help you prepare your child for the challenges ahead. Call us now.

    Set your teen on solid ground and equip her to meet the demands.

    Sometimes it takes a village.

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

    To the restoration of your best self,

  • When You Need Resilience, IV Ketamine’s Got Your Back

    When You Need Resilience, IV Ketamine’s Got Your Back

    Chronic Illness Creates Physical Stress

    Janie has a chronic illness that causes her to be admitted to the hospital — often the ICU — relatively frequently. Her condition becomes urgent, throwing her electrolyte balance, her pH balance, and her other systems into disarray. Each time she’s admitted, she suffers dreadfully with overwhelming nausea, vomiting…. and her awareness dims. Janie needs resilience to get her through these times.

    When this happens, she’s under extreme physical stress.

    At the same time, Janie fights depression related to feelings of inadequacy because the hospitalizations that occur so often have interrupted the normal development of her life. Being sick has put her life on pause. She blames herself for not building a career, and considers herself “worthless” because of her lack of success in the business world.

    So Janie suffers from physical and emotional stress. Unbelievable stress. And expanding shame.

    Work Pressure Creates Mental Stress

    Brandon has a severely stressful job. As a manager in a fast-paced, intense environment, he is constantly bombarded with problems that need to be resolved. Things his team members are not in a position to solve themselves. The mental stress of this constant bombardment prevents him from having even a few minutes to recover. Brandon works from 8am to 10pm… and often through the weekend. Sometimes the bombardment continues far into the night. 

    He has very little time with his family, and wonders how long he can hold up under this prolonged onslaught of demands. The mental strain he experiences threatens to break him.

    Janie and Brandon need a heaping dose of resilience. We can think of resilience as the power to quickly bounce back and recover from extreme stress.

    Stress can be emotional, mental, or physical. All three types of stress can prune and wear down the synapses, or connections, between brain cells in the prefrontal cortex, the hippocampus, and the amygdala. According to research, the prefrontal cortex has heavy connections to the emotion-linked areas of the brain in people with a lot of resilience. 

    You NEED those connections.

    Resilience Can Diminish if Not Supported

    While it’s true that the prefrontal cortex is heavily connected to the emotions in a resilient person, non-stop stressors can still wear down those connections and resilience can wane. When your resilience is high, you have incredible flexibility of thought. But as your resilience diminishes, so does that flexibility. So does the synaptic plasticity that creates it.

    There is a plethora of neurotransmitters that play a part in resilience: norepinephrine, neuropeptide Y, galanin, corticotropin releasing hormone, dehydroepiandrosterone (DHEA), dehydroepiandrosterone sulfate (DHEA-S), dopamine, serotonin, abrineurin (BDNF), and allopregnanolone (ALLO). These neurotransmitters and proteins are an integral part of the networks that help create resilience.

    And here’s an important point: not only is your gut involved in your response to stress, but large parts of your brain are involved in your response to stressful stimuli. Are you resilient in your response to the stress you face? Resilient people use higher levels of brain power — as in 3 times the number of genes — than those who have less resilience.

    Think about that.

    Developing Resilience

    And how you develop resilience is influenced by your personality, your temperament, physical fitness, and your social support network. Do you see stress as a challenge or a threat….? It’s unclear how much of a role genetics play in developing resilience, but you can improve your ability to recover from stress by choosing an optimistic solution to problems, by honing a problem-solving outlook, by investing yourself in seeking what’s important to you in life and what brings meaning to it for you, by surrounding yourself with people who support and believe in you

    Pushing Yourself to Stretch Beyond Your Comfort Zone

    You can also develop your own confidence by pushing the envelope, and see how much you can accomplish under duress… without disrupting your peace of mind. And you can support and help others with their challenges…which helps them and puts your own life challenges into perspective. And, by the way, this keeps your brain engaged in life, projects, work, and pleasure.

    Can Janie or Brandon stretch? Can you?

    When Janie’s in the ICU, and barely conscious from her severe condition, she’s not in a position to apply these lessons to improve her resilience. But when she recovers—each time she recovers—it’s a good time to think about her outlook, her problem solving, and her optimism.

    The science of resilience helps you overcome difficulties .

    And when Brandon’s in the throes of one thing going wrong after another at work, he may not be able to think of anything but the pressures that pound him. But when he’s off, he can work on his outlook, his physical fitness, his purpose, and he can choose to surround himself with people who support him and believe in him.

    Sounds good, right?
    Except when it doesn’t work.

    When the onslaughts of stress are severe, they can wear down those connections between brain cells and reduce the neurotransmitters… and it may be just too overwhelming to build resilience.

    You may need help with that.

    IV Ketamine Can Restore Resilience

    IV ketamine can restore resilience. It can build up the connections between brain cells in the prefrontal cortex. It can give you the benefit of turbo charged BDNF to create dendritic growth and spark those connections. The more connections, or synapses, the more you can reach out and the world can reach in. The better you feel.

    Then you have the freedom to build your own inner thought life to support the resilience you’ve gained as a result of treatment. It’s a sort of “leg up” to better living and recovery ability.

    Do you have stressors that overwhelm you? Have you tried treatments or medications that haven’t helped?

    Call us

    When you come for ketamine treatment, you'll have a comfortable, quiet room to get the most from your treatment.

    IV ketamine treatment can set you on higher ground, so you can not only develop resilience but you can maintain it. So you can face difficulty with confidence.

    Let’s work together to equip you to thrive — not just cope — with the challenges you face.

    You have just one life. Make it a joyful one filled with hope and confidence.

    We’re here to help

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

    To the restoration of your best self,

  • Mothers of Babies, Teens, and Mothers of Senior Citizens… We Honor You!

    Mothers of Babies, Teens, and Mothers of Senior Citizens… We Honor You!

    Whether you’re expecting your first child or your kids are senior citizens themselves, your heart has been on your sleeve for the duration. Is there anything like being a mother? Whether you’re a. mother of a baby, a teen, or a mother of senior citizens, the worry never dissipates. They’re always on your mind.

    Here in the US, we celebrated Mother’s Day last weekend. But everyday is a celebration of this most wonderful – and sometimes not so wonderful – relationship. The rearing and loving of a human, who pops out of the womb with his own ideas, plans, intents, and decisions compares with nothing else in this world.

    But on the other end of mothering, when children are grown, is when the tables turn in a long, slow process as grown children come to face their mother is a human being, rather than the self sacrificing superhero she’s always been. And that’s a rich opportunity to really learn to know her. Some mothers live long enough to nurture as mothers of senior citizens… and sometimes their senior citizen children are focused on caring for their elderly mother. Turn about is fair play when it comes to your mom.

    Adam is 40…and says his mom really WAS a super hero. The things she accomplished, the things she did for him as a child. No one could ever keep up. But when she was diagnosed with cancer, she became weak and frail. Then she didn’t recognize him at one point, and he says her mortality confronted him like a fist to his midsection. And that’s no joke.

    Marcie Anne talks about how she herself was a realist.  Always was. So her mom’s romantic and poetic views of life seemed to hit her cross ways from the time she was very young…as in three. Now in her mid thirties, her realistic mind set is even stronger. She says if she had to name a time when she was really seeing her mother as she was, it was when Marcie Anne was between 20 and 22…during her mom’s painful divorce.

    She made the point that there’s nothing like watching a parent torn to their core during a crisis like that. 

    What about you?  Do you remember when you realized your mother wasn’t just someone in your life to serve you, but rather a feeling, vulnerable human being in her own right and that there are needs of hers you can meet?

    Perhaps your mother wasn’t healthy enough to be there for you, but rather caused you to suffer by imposing her needs and desires upon you. There are some mothers like that, and if yours is I’m sorry.

    That said, there are no mothers who are perfect, right? None who are never selfish, or who never make mistakes or disappoint you.

    If you’re a mother, you know the deep exhaustion and creativity that life requires of you…and at the same time the reward of watching these young humans grow is beyond description.

    If you, like me, have children by natural birth, adoption, fostering, or just serendipity, you know that the greatest rewards come when we give the most. And few occupations…or rather callings…can require the investment mothering does, or brings the returns.

    But we all know that sometimes mothers become ill and can’t give to their children as they wish to. It can be a catastrophic illness like cancer… or a psychiatric one like severe treatment resistant depression, PTSD, bipolar depression, substance use disorder, or suicidal thoughts that won’t stop.

    In situations like that, the best Mother’s Day gift just might be ketamine treatment. As much as you love and appreciate your mom, she may love and appreciate you even more. To help her get back her heart, her clear mind, her cognition, and to help her get the treatment that restores her hope, and relieves the symptoms of the disorder, lets her live and love again like her heart aches to do.

    At Innovative Psychiatry, we’re set up and equipped to help you receive the treatment you need to function well without depression, social anxiety, or alcohol misuse.

    So you’re free to enjoy your family and your life, and you have the energy to invest yourself in things that matter to you. Your life is to be lived, and ketamine treatment can help you live it.

    To Mothers Everywhere, Happy Mother’s Day–every day!

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

    To the restoration of your best self,

  • Breathtaking Ketamine2022: Ketamine and Related Compounds Conference, Oxford, UK April 4-6

    Breathtaking Ketamine2022: Ketamine and Related Compounds Conference, Oxford, UK April 4-6

    It’s coming, and we’ll be there!

    This conference, hosted by Rupert McShane, Consultant Psychiatrist and Associate Professor, Oxford, UK will be a stunning international hybrid event and the list of speakers reads like the Who’s Who of the field. This is, quite simply, the most important and prestigious conference on ketamine and related compounds for mood disorders and other psychiatric conditions this year.

    Period.

    And it’s not too late to sign up. Come in person, show up online. Listen and learn from the people who actually break fresh ground. If you are a patient, a study participant, a scientist, scholar, researcher, a doctor, therapist, psychiatrist, psychologist, anesthesiologist, a policy-maker, journalist, a stakeholder, investor, funder, or regulator…. clear your calendar.

    Don’t miss this opportunity.

    Experienced researchers and clinicians from all over the world are coming together in a unique forum to talk about… everything. Like what? Like practice-defining large randomized clinical trials, exciting preclinical studies shedding light on mechanism of action, the operation of ketamine clinics, the use of ketamine in the emergency room…. updates about new devices, new forms of administration, regulatory issues, exploration of novel compounds — the breadth and depth is pretty stunning, along with asynchronous presentations, and e-posters. There is so much more, so many more presentations that we can’t describe it all here, but if you are interested, you can be a part of it. You can join us. Stream us. You can be on the cutting edge.

    If you remember, the first Ketamine and Related Compounds Conference in Oxford, UK in 2018 proved to be monumental in the findings and research that was presented. Those were early days. Rupert was young. (We were all young–my goodness!) I was there presenting a poster on my earliest findings with using ketamine for suicidal thinking in my own practice. Real world research. Real world results. Later, I published a large retrospective analysis on using ketamine to stop suicidal thinking in the office.

    At that first conference in Oxford in 2018, we pointed out how diligently we work in psychiatry. And even more so in the emerging field of therapeutic ketamine for psychiatric conditions, to gather information.

    How we read the research, scour the published studies in the field, pore over data, gather and analyze the latest information. We keep up with whatever is happening. The science…. and the misinformation. (And wow, has there been misinformation: sensationalism, commercialization, pseudoscience, hucksters. Be careful out there.)  

    In those early years, when off-label ketamine treatment for treatment resistant depression was finding its way into real world practice, the common complaint was that there was too little research.

    Too little information. Too many unknowns. Not enough data. No clear protocols. Some said it was like the wild west out there.

    (Some say it still is.)

    But five years and one pandemic later — with war exploding in Ukrainedepression, isolation, suicide, trauma, and anxiety are skyrocketing.

    And despite an explosion of research on the mechanisms of action of ketamine, and the use of ketamine for suicidal thoughts, mood disorders, PTSD, alcohol and cocaine addiction….. even with all of that, there are still physicians and therapists who claim there is still too little research on ketamine and related compounds in psychiatry for them to recommend it.

    Here’s to bringing them (and you!) important, relevant, game-changing information…. data that is transforming our field, and that we hope will be able to change people’s lives.

    What a privilege it was to be in Oxford, UK at the beginning in 2018 exchanging ideas and learning from the world’s leading ketamine researchers, scientists, clinicians and thought leaders! Their work, and the work of many before them, has opened doors for thought-provoking and ground-breaking new treatments in psychiatry.

    Now, once again, Ketamine2022 and @Oxfordpsych is presenting the brightest and best international researchers and experienced clinicians on ketamine.

    Here are just a few (with big apologies because I can’t do them–and the rest of the best–justice.)

    Carlos Zarate from NIMH is kicking off the conference and is an undisputed leader in ketamine research for psychiatric disorders. He’ll speak on glutamatergic modulators and next generation antidepressants. What refreshing hope it brings to look forward to new medicines that will give depressed persons a chance to feel better again.

    Roger McIntyre from Toronto will address the real world evidence that supports long term treatment with ketamine, and how the face of depression has transformed in the wake of ketamine treatment. (And he’ll be engaged in what is sure to be a fascinating debate on whether current data in the field supports widespread therapeutic use of ketamine in psychiatry

    Jeff Becker and Jason Wallach will speak on a new subcutaneous delivery system they’ve been developing for ketamine. Look how far we’ve come!

    And then Jason Wallach comes back again (full of brilliance and passion!) to dive into dissociatives–NMDA receptor antagonism and structure/activity relationships.

    I’ll speak on the results from a brand new clinical trial my team and are are conducting using ketamine in the treatment of chronic anorexia — with a therapeutic ketogenic diet (yep! in anorexia) followed by a series of ketamine infusions. (The publication is in the review process, so this is the first sneak peak at the data.)

    Gerald Sanacora will present the closing talk, expounding on lessons learned during two decades of ketamine research.

    (Let’s just say Rupert knows how to keep people in their seats til the very end!)

    But there’s so much more in between!

    Lisa Monteggia is talking about the mechanism for rapid and prolonged antidepressant action. You don’t want to miss this!

    Chadi Abdallah will present data on PTSD treatment: a large randomized controlled trial (RCT) of ketamine in veterans. And how does ketamine affect the connectome? 

    Pouya Movahed Rad presents ECT vs ketamine: results of a 1 year randomized, open-label trial in resistant depression

    Emma Robinson will talk on Filling the Half Empty Glass, referring to ketamine and negative affective bias

    David Monks will speak on the results of a feasibility study using ketamine to prevent postpartum depression after a planned C-section

    Paul Glue will be talking about the Bedroc Study, using controlled release ketamine tablets for treatment-resistant depression

    Rebecca Price will speak on extending the benefit of a single ketamine infusion with automated neurocognitive training

    Robert Shoevers will present qualitative data on patient experiences with oral esketamine treatment

    Alison McInnes presents real world data from the Osmind data platform

    David Barbic’s presentation on Agitation in the ER: an RCT of ketamine vs midazolam

    Rod Machado-Vieira presents his work on kynurenine pathway and biomarkers of response to ketamine

    Terry Kelly breaks ground with a single, ascending dose study of R-ketamine

    Amanda Jones will give a sneak peak at AXS-95, a new oral NMDA receptor antagonist for major depression

    Dong Jing Fu will speak on long term efficacy data for esketamine

    Esther Hagai introduces an oral form of esketamine for daily at home use (all eyes on this one!) I bet it’ll generate a lot of interest

    Gisèle Pickering will talk about using ketamine pain and depression both in RCTs and in real world clinical practice

    Polymni Georgiou will present data on how CRF primes the antidepressant response to ketamine and its metabolites

    Fabrice Jollant presents the results from a French multicenter RCT using IV ketamine for severe suicidal ideation

    Joshua Rosenblatt will speak on whether all depression subtypes respond similarly to ketamine

    These descriptions barely scratch the surface. (Apologies to all!) The depth and breadth of the research that is about to be presented is, quite simply, extraordinary.

    Treatment of depression, bipolar depression, PTSD, social anxiety, substance use disorders, suicidal ideation has transformed this century. And transformed how we look at things (….like even flavonoids…. social media….. and neglect).

    So why do we do this?

    Why do we read journals, attend conferences, talk to each other on the phone, compare outcomes, present, and publish our own papers about the therapeutic use of ketamine?

    Because people suffer. Because we want to know what else is being discovered to help more people. We want to see people get BETTER who’ve suffered without relief from severe treatment resistant depression, bipolar depression, social anxiety, PTSD, substance and alcohol use disorders, suicidal thinking, and eating disorders.

    We want to learn what works and why with ketamine and related compounds. And when it doesn’t work, why not?

    So we travel across the world in the midst of a pandemic to sit in a seat and listen and learn and share. Or we tune in to watch the conference online, never wanting to miss a thing.

    It’s because of all the researchers who study and publish their findings from every continent that we have such effective treatments in psychiatry now — one of the most groundbreaking being ketamine. Ketamine and other compounds have opened countless doors for patients who suffer.

    Jump in. We hope you can attend this breakthrough informative gathering, either in person or online.

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

    To the restoration of your best self,

  • Indicators for Postpartum Depression May Protect Moms and Babes

    Indicators for Postpartum Depression May Protect Moms and Babes

    In addition to the suffering a new mother experiences from postpartum depression, the baby is at risk for lower IQ, increased likelihood of ADHD, slower language development, and increased risk of behavior problems and other psychiatric disorders.

    Indicators for postpartum depression — or risk factors, as we might call them — can be identified and treated to possibly prevent this illness. Psychiatric history before pregnancy, psychiatric illness in the family, depression during pregnancy, along with environmental causes including a pandemic, adverse life events like trauma in a family member, or death in the family, and obstetrical outcomes, including baby’s health at birth, can all increase the risk that a mom could develop post-partum depression (PPD).

    Jill tried to enjoy her pregnancy during the early months of the COVID-19 pandemic. While she had many joyful moments, she also worried deeply about the impact of the pandemic on her baby, and whether she, her husband, or her baby would be infected with COVID. Fear that the coronavirus would cause some sort of damage to her unborn child if it invaded her womb.

    This was her first pregnancy, and she had no idea when she found out she was pregnant that a pandemic was coming. She was 3 months along when read about the pandemic. The news filled Jill with terror.

    Her husband, Jason, wasn’t himself. He was painfully fearful about the pandemic and vented about it all the time. Quite honestly, she wished she had a calm home and calm marriage while she was pregnant.  She’d had a tendency to get anxious for years, and little frustrations at work could really set her off with shortness of breath, sweaty palms, neck, and forehead. Her hands would tremble, and her knees would give way.  

    After a cool drink of water, and the calm reassuring chat with a friend, she could calm down. But until that happened, it was embarrassing.

    So when she started showing these same symptoms during pregnancy, she worried. Jill knew it wasn’t good for babies in utero to feel mom’s panic and tension. She worried her anxiety would impact her baby.

    Unfortunately, as the months went by, her anxiety and panic attacks grew worse. She just tried to keep her nose above water….  Then finally the baby was born.  

    Her doctor admitted her to the hospital to induce labor, and after hours of labor, she became more and more anxious. After she entered the transition phase of labor, the monitor revealed the baby was in distress. The nurse and doctor wheeled her to the delivery area. Their baby was born but was not breathing properly. 

    Jill and Jason felt panic and terror. The respiratory emergency team worked on the baby for 45 minutes then finally took him to the NICU. 

    After 24 hours, the baby was functioning well, and was pink all over. But it was such a traumatic experience for Jill and Jason, and they worried about the long term effect on their baby.

    When they got home it started. The baby cried hard all the time. Exhaustion prevented Jill from enjoying the baby. She was in what seemed a constant state of breastfeeding…without sleep, without peace… and though Jason would walk the baby for hours, Jill still couldn’t fall asleep.

    A visit to the doctor when the baby was nine months old resulted in the doctor explaining that her anxiety was sky high and so was her baby’s.

    The OBGYN referred them to a group therapy directed by a pediatrician. He encouraged a special schedule to retrain the baby to nurse longer and sleep longer.  Within a month the baby was sleeping at night. 

    Jason and Jill began to sleep.  They started to wake refreshed. They were both deeply shaken by the nine months they’d spent with a hysterical baby, and were only cautiously optimistic that it would last.

    Jill continued seeing her therapist by telepsychiatry sessions, and trauma from her childhood began to emerge.

    Jill is continuing in therapy, and learning more and more about the damage she incurred as an abused child

    Over time, she realized that the postpartum anxiety and depression emerged in the presence of stress, and when the stress eased, she found she had access to old wounds and could get help and heal. She learned a great deal during these sessions, and often deeply wept. Jason felt so enlightened, and was so grateful to see his wife healing. It’s a long process, and while she is steadily learning and healing, more continues to emerge.

    Authors of the PPD biomarkers study found that focusing on maternal mental health to treat and relieve illness resulted in mental and physical outcomes for everyone in the family.

    Indicators for postpartum depression present a useful method for noting a pregnant woman at high risk for PPD, and treating her symptoms proactively.

    To prevent PPD, it’s most effective if it is identified before symptoms emerge. That requires identifying the factors that can contribute to the onset of illness.

    Think about the fact that out of every 100 pregnant women, 10-15 will develop postpartum depression. Out of that group, if any of them have risk factors for postpartum depression — such as a history of psychiatric disorder, and are not taking medications — the risk of developing PPD is even higher. In addition, if there is a family history of psychiatric illness, as well as depression during pregnancy, there is a higher risk of PPD.

    Add to that environmental risk factors like socioeconomic status, adverse life events — including the impact of a pandemic, and obstetrical outcomes (like a baby not breathing at birth) or a preterm birth.

    Notice that we spoke of one indicator for postpartum depression being psychiatric illness without medication. One of the most effective treatments for depression and PPD is IV ketamine treatment. With its action to increase brain derived neurotrophic factor (BDNF) to rapidly trigger dendrites and dendritic spines to grow and flourish, and remodel synapses in the brain, ketamine can bring transformation, emotional energy, motivation and initiative, as well as joy to your life. With the renewed joy, you can find you enjoy your baby, and bonding can replace the exhausted, detached feeling you may have had with your baby.

    We must mention here that ketamine isn’t for everyone. It’s a treatment that helps some people dramatically, but not all — and like with so many treatments in medicine, we don’t yet understand why. IV ketamine treatment can bring many people with treatment resistant depression, including postpartum depression, into rapid and extraordinary remission. Chances are it can be transformative in your life.

    At Innovative Psychiatry, we often see women with indicators for postpartum depression achieve remission with IV ketamine treatment. It’s a joyous, hope-filled, new outlook on life and relationships that can give you the energy you need for your husband and children, and your baby. The ‘funny’ thing about ketamine is that it really seems to be most effective with those whose illness is the most severe. It seems to love to show its power in full transformations.

    When you come for ketamine infusions, we’ll meet you at the door and show you to your private treatment room where you can settle in and get comfortable on your recliner designed to help you relax most completely. You may bring your favorite relaxing music and a sweater to stay warm.

    When you come for ketamine treatment, you'll have a comfortable, quiet room to get the most from your treatment.

    You’ll notice an elegant white box inscribed with the word Novaerus sitting on the table. This technology is at work in every room of our practice to protect you from infection of any kind while you’re here. Using plasma cell technology, this process was developed by the Department of Defense and NASA for the Space Station to prevent infection there. It destroys all viruses — including COVID delta, lambda and mu — bacteria, and fungi in the air. (It can even lift Staph aureus from hard surfaces. Amazing!) And our plasma cell technology can keep you safe while you undergo treatment, even during this pandemic.

    This safety allows you to relax, not worry, and focus on your treatment, to get the most out of it.

    We’ve gone the extra mile to ensure you feel safe and free of risk regarding infection.

    Because you need to get better now…and not wait till the COVID pandemic finally comes to an end.

    If you recognize the indicators of postpartum depression in yourself, and you think they might have led to the way you’re feeling now, you can get better, feel like yourself again, and enjoy your new baby.

    Give yourself the extra boost you need to feel joy.

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

    To the restoration of your best self,

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