Lori Calabrese, MD

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.

  • IV Ketamine for Teens ? Ya gotta be kidding me, right?

    IV Ketamine for Teens ? Ya gotta be kidding me, right?

    We’re not. We’re dead serious. We want to keep them alive.

    Maybe you have a teen like the ones we see. Maybe you are are one… like the ones we see. Or maybe you’re quiet. Kind. Smart. Everybody’s friend. Absolutely gorgeous. An athlete. A contender. Someone who’s had it all. Or maybe you’re NOT any of that. Maybe you’re a worrier, shy, awkward. Maybe you feel like you’re always messing up, like no one wants to be with you, like no one knows how to help you. Like you’re lost. Like you just don’t get it. How everybody else is goofing around, laughing, having fun while you just sit there, wondering how it ever happened that things got so screwed up, and that you got so messed up. Know anybody like that? If you do, or if that is you–or your teen, or your sister, or your best friend–listen up. You’re in the right place. Because there is IV ketamine for teens.

    Just when you think that nothing can help, know that we have help. We have the experience, and the guts and the compassion–and we had the foresight–to see the potential that ketamine infusions could offer adolescents who are just suffering.

    We knew it years ago, when we first started using IV ketamine for treatment resistant depression. Then bipolar depression. Suicidal thoughts. We saw it, and decided to really look at what happened to real people (who always have 50 million things going on, not just one rarified condition or syndrome. We looked at our own patients, in our own practice. We wanted to look at our own numbers, the truth of who gets better, how many get better, what does it take– (in terms of ketamine) — how much? how often?

    We stepped up, powered up, and wrote up a critical research report and published it in a peer reviewed journal about what happens for patients who come to see a psychiatrist to see if ketamine treatment can help–for their depression, it was back then–and find that it can stop hopelessness and suicidal thinking in an afternoon.

    The thing is, we saw years ago it could help adolescents… Adolescents who weren’t just needing to take a pill to get better. These didn’t get better with one pill, or two…or a combination of several. And when they didn’t get better, it was said they had treatment resistant depression.

    But treatment resistance is a funny thing. It used to be that it meant you’d tried 4 different meds, then it was dropped to 2 different meds, and now in this adolescent study, treatment resistance was defined as having been treated with one medication that didn’t work.

    We’re glad that the requirement was just one failed medication trial before they were given the opportunity to be treated with IV ketamine.

    Why?

    Because so much is happening in a teen’s life and it’s happening so fast. They’re rate of growth is so intense that a day, a week, a month, of loss causes too much loss. And when there is no resolution found, time can fly by in years, and a teen loses a major block of development they never can get back.

    IV ketamine for teens to put a stop to loss.

    So what losses can they afford? To miss a month…or a semester…of high school? Or college?? To drop out of basketball? Lose friends? Teens often don’t have the patience and tenacity for a friend who just doesn’t show up. Or one who is always down. Defeated.

    Adolescents need action. They need solutions that work quickly. They don’t have the time to wait for 4 different medicine trials that go on for weeks or months. There is just too much loss.

    That’s why IV ketamine is so important.

    When there’s no time to lose this is something that works fast.

    How much can your kid afford to lose …how much can you afford to lose?

    Hopefully we’ll able to have more and more data coming out so that our kids won’t have to suffer so long… so they get better faster. So we can treat them with what is most likely to work before trying something first that probably won’t.

    We do the best we know in this profession. But we need more studies and more information. And until we have it…well, like I said, we do the best we know.

    And we know this treatment has been in use to help adults of all ages for years. But what if you’re a teen? Teens get depressed, suffer social anxiety, even suffer from PTSD, suicidal thoughts, and bipolar depression. And when it’s treatment resistant, the unrelenting symptoms can interfere with your life, your development, and your hope. So we step forward and reach for IV ketamine for teens.

    A study was just published about treating these kids with IV ketamine, to see if it was truly effective and safe…more about that coming up. But get this:

    76% of this study group below had relief within 3 days of the ketamine infusion!

    Imagine what that would mean to a teen who’s suffering, hopeless, and giving up.

    So IV ketamine treatment has been effective in smashing those symptoms in thousands of people. But let’s look at this study especially for adolescents:

    IV Ketamine for Teens

    A team of researchers at Yale University led by Jennifer Dwyer, M.D., conducted a 4-week study using IV ketamine in teens with treatment-resistant depression recently published in the American Journal of Psychiatry. They selected 17 adolescents ages 13 to 17 who had been diagnosed  with major depressive disorder, or MDD. 

    It’s a massive undertaking to find kids that don’t have 6 different things going on with them… a cluster of co-morbidities. Teens who have just one diagnosis are the only ones that fit into a study like this. Just finding the subjects for a study is hard.

    Each teen in the group had been failed by at least 1 antidepressant medication treatment, but overall the average of failed treatments among the group was 3.24. (That’s a lot!–a lot of trials, a lot of weeks and months waiting for medications to help and being disappointed when they didn’t.) The average length of the current depression episode for these teens was 21 months. Almost two years. Too long.

    This crossover study gave each teenager either IV ketamine 0.5mg/kg over 40mins, or IV midazolam 0.045mg/kg over 40 mins. 

    Then 2 weeks later, each teen received an infusion of the other medicine. 

    It’s important to understand that midazolam (which is from the Valium family) is often used as the “placebo” tested against ketamine because it provides an experience of deep relaxation, so at low doses it can be a bit difficult for the subjects to know which one they’re receiving. (Often, though, there are little clues and little differences between them so that they can tell.) But midazolam provides no antidepressant benefits.

    It turned out that 76% of the adolescents experienced at least a 50% or greater antidepressant response within 3 days following their ketamine infusion.  (Compare this for a second: with an oral antidepressant, only 35% get 50% better….after 6-8 weeks.)

    IV ketamine for teens prevents loss of important moments in their lives.

    Were there side effects during the infusion in the study? Of course. But minor. For example, adolescents who had received ketamine experienced an increase in blood pressure compared to the midazolam infusion, but within a few hours those effects subsided.

    Oh, the beauty of it.

    When you’ve struggled and hidden in sullen isolation, sometimes for years… and you don’t know whether to search for a solution or hide, it’s so darn hard. You’ve missed class, missed practice…because it was too hard.

    Until something happens… and you realize you only seem mad at others — and the world — because you feel so terrible.

    Because you’re depressed.

    And you also may be laboring under the weight of other disorders as well, like trauma, PTSD, OCD or social anxiety…ugghhhh. When all of these different symptoms or disorders cluster and tangle together, it’s so much harder to find relief.

    Then, after months or years of searching for help, you learn about IV ketamine treatment. 

    And you come back to yourself after treatment. Older and a bit wiser maybe, but joyful and creative again. Able to love again.

    This is the beautiful story about how IV ketamine can transform adolescents…and can restore their hope.

    For years, the use of ketamine treatment was up in the air. Respected doctors and neuroscientists were quick to offer their professional opinion… which was to wait. They said that ketamine had not been researched enough. There was not enough information to back it up…so they said.

    But now we know that IV ketamine can transform adolescents, adults, and even children. It can erase suicidal thoughts, and give you … a teen… the time you need to get the help you need to see things differently. To redefine what life can be for you. To rebuild your hope. You purpose. And to restore the energy you need to build friendships that are strong and healthy.

    We’ve waited a looong long time. Too long for some adolescents…

    Even though we need more studies and more questions answered, we have to be willing to step up and take care of our kids who have everything on the line. For them it could be a matter of hope vs despair…life and death.

    We live on that line all the time.

    For all of us. We choose life. We need to choose it for our kids, too.

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

    At Innovative Psychiatry, we find great joy in watching young promising people like you — who come to us without hope or confidence — tell us enthusiastically after their treatment how good they feel and how their life is getting better and better.

    And because this process, this treatment, is so important, we took steps to make our office a safe place for you. We have technology that destroys viruses and all kinds of germs in the air and on surfaces, so you can feel safe and protected from infection of any kind. Whether it’s COVID-19 or influenza, or strep…it all dies immediately. So you can be in the safest possible environment during this pandemic and focus on your treatment and getting better.

    If you’re an adolescent with symptoms of depression or anger, if you have tried antidepressants that haven’t helped, ask your Mom or Dad or someone who cares about you to call us.

    We want you to find your joy again. To find your freedom and your hope.

    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,

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

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

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

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

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

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

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

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

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

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

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

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

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

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

    But that was easier said than done.

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

    Worry. Worry. Then worry some more.

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

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

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

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

    Less bandwidth.

    Isn’t it true?

    And those pandemic anxiety reactions eat up bandwidth.

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

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

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

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

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

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

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

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

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

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

    Unique Pandemic Trauma and Loss Requires More Bandwidth

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

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

    Because YOUR life needs to go on.

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

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

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

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

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

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

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

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

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

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

    To the restoration of your best self,

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

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

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

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

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

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

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

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

    In a perfect world…

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

    So… about AKT. 

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

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

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

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

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

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

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

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

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

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

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

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

    Incredible.

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

    AKT is one to keep your eyes on for sure.

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

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

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

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

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

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

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

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

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

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

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

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

    We’re here to help.

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

    To the restoration of your best self,

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

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

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

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

    Take Janeen and Carole, for example:

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

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

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

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

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

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

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

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

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

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

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

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

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

    So she didn’t. 

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

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

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

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

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

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

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

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

    Another Perspective on Stress

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

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

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

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

    And all this stress is dangerous. 

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

    We look forward to talking with you.

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

    To the restoration of your best self,

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

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

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

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

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

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

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

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

    But this year… Katie Bar the Door!!

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

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

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

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

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

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

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

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

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

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

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

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

    Call it seasonal affective disorder but ketamine can bring remission.

    Find Healthy Ways to Bring Light Into Your Life

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

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

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

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

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

    Is it the same for everyone?

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

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

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

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

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

    And when the clouds dump snow, make snow angels!

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

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

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

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

    Don’t wait.

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

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

    Your remission is what we live to help you achieve. 

    Life really can get better.

    Reach out for hope. 

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

    To the restoration of your best self,

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

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

    What makes it so hard?

    Anxiety and depression are so prominent in a pandemic.

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

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

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

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

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

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

    COVID Tragedies Can Trigger Anxiety and Depression

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

    The 1554 respondents were an average age of 49.5.

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

    Anxiety and depression have been prominent in Denmark, too.

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

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

    What Can You Do with This Information?

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

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

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

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

    Anxiety and depression so prevalent during pandemic

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

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

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

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

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

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

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

    To the restoration of your best self,

  • Discovery: A New Key to Ketamine’s Extraordinary Antidepressant Benefits

    Discovery: A New Key to Ketamine’s Extraordinary Antidepressant Benefits

    Ethan sat on his rock at the lake’s edge and stared across the water. He couldn’t help but wonder if it would ever be easier to get through a day.  Not really easy, per se. But what about functional? To just have stuff to do and to get it done. Routine, like other people.

    Ethan was so tired. Just didn’t feel the energy to do anything…and was deeply ashamed about it. He knew people thought he was just lazy. Maybe he was. He didn’t care about changing it, and felt so defeated. (There are so many people like this…who struggle, hopeless, and don’t know about ketamine’s extraordinary antidepressant benefits. Oh to get the word out!)

    Would he ever be able to actually think? He’d felt like a goober for so long. Years.  Really felt scrambled, it was so hard to read.  But he could read fine when he was a kid. What the heck??

    What was it like to feel loved?  To love and feel loved? Why was he so empty…and why did love seem to be beyond his reach?

    Why didn’t the antidepressants Ethan’s doctor had prescribed ever make a difference? Was medicine for this condition just worthless? Did it help anyone? Or was he just not doing his part somehow?  It seemed hopeless. And he felt worthless. What was the point anyway?

    Years of this empty futility had eroded Ethan’s endurance to keep trying. He could not for the life of him find a reason to live. Or a benefit to living.

    Someone tell Ethan about ketamine’s extraordinary antidepressant benefits…. and hurry.

    Ketamine's extraordinary antidepressant benefits can put joy and hope back in your heart.

    Is it Futile? Not With the Aid of Ketamine’s Extraordinary Antidepressant Benefits

    Depression and bipolar depression. What can help you feel like living? It turns out that 30% or so of depressed patients just find no real help with traditional antidepressants like SRIs. These medicines just don’t help enough people.

    When a second medicine is prescribed, if that doesn’t help either, well…we say that your case is treatment resistant. That doesn’t mean you’re treatment resistant, but that your depression medicine is failing to help you feel better and enjoy your life.

    But the good news is that small doses of IV ketamine – that is, doses smaller than might be used in anesthesia – can be remarkably effective for lifting depression systems and restoring your joy, your creative energy, and your hope.

    In fact, IV ketamine treatment can provide rapid and extraordinary relief of symptoms. And researchers have been trying to understand the WHY and the HOW of the underlying mechanism for years.

    While there are some actions that have emerged to illuminate this process, more information is coming available. We’ve talked of the lateral habenula and the synapses in the brain many times.

    New Research Unlocks a Ketamine Secret

    Ketamine’s extraordinary antidepressant benefits are the talk of the decade. But ketamine’s secrets have only slowly been coming to light.

    And just last month, research was published in Nature Research that shows that the ketamine  and the ketamine metabolite hydroxynorketamine provide their antidepressant effects when mTORC1kinase is activated in the cell. 

    This research shows one of the things mTORC1 does is to turn on mRNA which initiates special binding proteins 4E-BP1 and 4E-BP2. 

    Actually, these binding proteins get lots of the credit for ketamine’s antidepressant benefits…as well as that hippocampal synaptic plasticity that promotes so much healing.

    Remember that mRNA also turns on DNA to turbo boost brain-derived-neurotrophic-factor proliferating a dense growth of synapses.

    It turns out that these same binding proteins are necessary for ketamine’s benefits in the lateral habenula as well. You may remember also how ketamine moves those G-proteins off the lipid rafts to get signals moving fast!

    Ketamine is a powerful medicine. We don’t know why it isn’t effective for 100% of people who need it, or 100% of people who suffer from depression, bipolar depression, PTSD, and other conditions. We’re still researching and learning.

    But we do know that IV ketamine treatment in the form of serial expertly titrated infusions is effective for more treatment resistant depressed people than any other medicine currently known. 

    And the odds are excellent that it will help you achieve remission.

    Ketamine's extraordinary antidepressant benefits give you a spring in your step like this guy as he strolls and whistles.

    Imagine having a heart full of joy and courage, along with the determination to build a fulfilling life, and the initiative to develop healthy rewarding relationships.  

    Just imagine.

    Imagine really caring. About anything…about everything that matters. 

    Imagine hope.

    Ketamine’s Secret Unlocks Joy and Hope

    At Innovative Psychiatry, we cultivate hope… and joy… through expertise in titration, dose, and frequency of life-changing ketamine infusions. We have world class expertise in helping people get better.

    We also have a safe environment in the presence of COVID-19 pandemic. 

    Talk about world-class. We have transformed our offices into a coronavirus killing machine.  Units in each room that destroy and remove the virus…in fact all viruses….from the air, and a spectacular spray/fog that destroys all viruses – including COVID-19 – from all surfaces. 99.9999% is ALL.  

    You’re safe here. To be treated, restored, and empowered to live the life you want to work for. Your life. Your dream.

    If you have labored and struggled under the burden of treatment resistant depression, bipolar depression, PTSD, substance use disorders, and suicidal thinking, call us.

    And if you feel unsure, read the posts linked through this one. There is so much information, and hope.

    We’re here to listen, and to help.

    You’re the reason we do what we do. So call us.

    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,

  • Strong Support System Can Protect You From COVID-Related Depression

    Strong Support System Can Protect You From COVID-Related Depression

    HAPPY NEW YEAR! Here’s our hope for you that you’ll find ways to make 2021 a more fulfilling and rewarding year for you and your family.

    Let’s talk about the difference in between  isolation, solace, and quarantine. People need people, and the pandemic has created an atmosphere where it’s hard to tell if you’re just enjoying solace, or if your isolating yourself and pulling back from socializing in a way that builds the habit of avoiding social interaction. And there there is quarantine, where you isolate yourself to avoid spread of COVID-19 after being exposed to it. But a strong support system can protect you from depression symptoms caused by isolation.

    In the hustle bustle world of daily activity in a non-pandemic world, it can be difficult to find peace and quiet for an hour. That works fine for some people, who soak up quiet and refuel in a quiet atmosphere of solace.

    You know who you are. Lovely quiet periods help you refuel, and give you energy to get back out there.

    There are also people who draw their energy from being with people, listening to and absorbing their energy. If you’re one of those, it can be really difficult to be stuck at home in silence all the time. Without outside stimulation, your battery can run down dead and flat. Both in your personality and your emotions.

    This is true even when there is no pandemic to deal with.

    However, in a pandemic it can get more complicated and put more people at risk for depression.

    We want to get a handle on what can make life better while we see the pandemic through to its resolution. Right?  We do!!

    Quarantine can cause isolation if it goes on too long, can’t it?

    When a family of 5 is exposed to the COVID-19 virus, and all test positive, they need to quarantine until they’ve been symptom free, according to CDC guidelines. But what can be done to help prevent the isolation that can lead to depression…?  Interaction is a big and important step.

    Online friendships are lifesavers during this time of isolation and quarantine. Family and friends in your support system can help protect you when discouragement threatens to cause depression.

    Here are two stories…about two different friends and how their outcomes compared in isolation vs. quarantine with online support.

    First meet Tamara. She’s 19 and was attending community college for her first semester when the COVID-19 pandemic emerged. 

    About 2 months into the semester, her school was closed and all classes were switched to remote online learning from home. Tamara was relieved at this because it’s natural for her to enjoy solitude, and looked forward to the peace and quiet and the chance to read voraciously without interruption.

    But there were some unexpected obstacles for Tamara. For one thing, as much as she loved to read, she struggled with algebra and chemistry. Quite honestly, in those subjects she’d always tried to get involved with study groups to help her grasp what she couldn’t seem to wrap her head around on her own.

    While study groups were available online, she didn’t benefit as much. However, she tried, and kept reaching out to various people in the group for help to understand the mysteries of those classes.

    So… she put in her time, worked on her assignments, and spent most of her free time reading books she enjoyed. 

    For the first 3 months, her freedom to enjoy the quiet and read one book after another was an indescribable luxury.

    However, because her mom had passed away a few years before this, she didn’t have her to talk to anymore. And talking to her dad didn’t go that smoothly. So she didn’t really have a true support group. Her only sibling was a brother who was in the Air Force, and his life was full.  She rarely heard from him.

    Long story short, Tamara was alone. Quite alone. 

    And the natural social interactions that had happened on campus before the pandemic weren’t available anymore.

    By the fourth month of the pandemic, she noticed she was losing her desire to have contact with anyone.  Online or in person.  She wore her mask and used hand sanitizer when she went to the pharmacy or grocery store…  But avoided eye contact.

    As Tamara moved into the summer months, she found she had far less energy she had before.  She didn’t want to leave her apartment. It became harder and harder to go to the mailbox. And she wasn’t really keeping up with friends anymore on facebook, text, or email.  

    Then someone stopped by and realized Tamara didn’t appear to be cleaning up her place — or even showering. She seemed shut down.

    Tamara was embarrassed, but honestly didn’t have the energy to do more than she was doing.  She was managing to keep her grades up in most of her classes, though Chemistry seemed a lost cause.

    Finally, her dad came by to see her.  He wore a mask and so did she, and they sat across the living room and tried to talk. Seeing her like this alarmed him. Dishes piled high in the sink, her own hygiene seemed to have lapsed…this wasn’t the Tamara he knew.  

    And he realized she was missing the support system that can protect against the threats of isolation and depression.

    So he asked her to let him help by getting her a telepsychiatry appointment.  That was actually a good solution, so she wouldn’t have to see anyone face to face…

    Now, meet Carolina. Carolina is 20, and knew Tamara in high school. They’d ended up at the same community college, but had not run into each other before classes closed for COVID-19. 

    Even though Carolina also enjoys solace, she has a nice group of friends to study with, and talk on her phone and text with. So even though she, too, has been home with remote online learning since a couple months after the semester started, she also has friends she talks to. 

    She doesn’t see them face to face, but they talk on FaceTime and Skype, as well as Marco Polo just so they can have live interaction. Carolina also lives at home with her family. Her parents are both working remotely from home, and her sister and three brothers are all learning remotely online.

    So, in spite of not seeing much of friends or relatives face to face, they meet up on Zoom, have a party, talk about their friends and their classes, music and the food they have delivered to their houses.  What’s tasty and what isn’t.

    If one of them is exposed to COVID-19 and then tests positive,  they all gather online to encourage and offer suggestions for managing it.

    The truth of it is that Carolina and her friends really haven’t struggled that much with feelings of depression. Maybe because they keep each other so engaged in daily living.  Somebody in the group always has a story to tell. All in all they offer each other a strong support system can protect against the damage that comes from too much isolation.

    Maybe it’s because their long term friendships have kept them all feeling more supported, resilient, and less vulnerable.

    It’s true that too much isolation can lead to depression symptoms in some people. And as we move into 2021, it’s a good idea to embrace the new year with a willingness to reach out to those who seem to lack support.  

    A really good idea.

    Everyone around you needs a support system right now. Some have it, others don’t really. But you can help with that online. 

    And there are also those who have been suffering under the weight of depression for a long time, and nothing has helped. Those who are sick and tired of feeling so hopeless, despondent, alienated, and drained.

    IV Ketamine Treatment Opens Doors of Hope

    For those, there is further hope in IV ketamine treatment. A series of 6 or maybe 8 infusions spread over a few short weeks, and expertly titrated to ensure you get the dose that’s right for you. Ketamine has blown the doors off depression treatment in the last ten years and especially the last 5. It’s reputation has grown from skeptical to celebrated in that time. Why?

    Because ketamine treatment does so much. In the brain-derived-neurotrophic-factor, the lateral habenula, the synapses, the G proteins heaped up on lipid rafts, the AMPA receptors and signals flying at high speed around your brain. For so many, ketamine can work so much better than the medications, therapy and treatments they have tried. It targets areas that were otherwise ignored before this.

    IV ketamine treatment can be extraordinary in its effectiveness to help you achieve remission.

    At Innovative Psychiatry, we’ve been so encouraged by the help ketamine offers that we’ve dedicated a section of our office for treating those who need to receive this breakthrough treatment. We’ve also responded to the concerns caused by COVID-19 by installing and using specialized technology that keeps the air and surfaces free of the virus that causes COVID-19, as well as the other viruses, bacteria, and molds that can threaten your health.

    While we’re not attempting to conquer the entire pandemic we are busily at work to help you get better, free of depression symptoms, in an environment where you feel — and are — safe.

    In spite of all the other challenges in the world, you can take them in hand best if you’re at your best. It helps so much if you’re strong, functioning, and creative to embrace today’s challenges. You need to be the best you, you can be. And a strong support system can protect you and help you build the resilience you need.

    We’re here to help with that, and to get you off to a much better start for the year.

    If you’ve been suffering, trudging, and feeling overwhelmed by daily living… if nothing much has helped, call us.

    We believe in what you can accomplish without depression symptoms holding you 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,

  • Does Mine Look Like His?? How Disorders Look Different in Different People

    Does Mine Look Like His?? How Disorders Look Different in Different People

    It can be alarming to see you brother try to navigate his way through a challenging diagnosis like depression or bipolar disorder. His symptoms may be alarming for you, and while you’re trying to be supportive, he may feel the world is crashing in. His dramatic reactions can be overwhelming, especially when you had a friend with bipolar disorder who had a volatile temper, it seemed, and seemed hypersexed, but she didn’t act like your brother is acting now. Surely they got his diagnosis wrong. But the doctor says that disorders look different in different people…at different times and under different circumstances.

    And it’s good to know.

    Charlotte might be a good example.

    Charlotte first began to show signs of less confidence and depression around the age of 6. She tried so hard to have a stiff upper lip, to invest her effort and perform well at school to please her parents, and to be industrious. Her parents were always so proud of her. But they didn’t recognize depression in herbecause she tried so hard.

    Now, Charlotte’s family already showed signs of psychiatric disorders in other members. Her mom had suffered from depression since childhood, her oldest brother had suffered from depression since he was 4. Plus, her other brother received a diagnosis of bipolar disorder. He had actually displayed symptoms since he was a young child. See the similarities?

    In addition, Charlotte’s uncle struggled with Narcissistic Personality Disorder. So did her grandfather.

    So much going on in Charlotte’s extended family. In fact, so much woven through the whole family.

    But in her case, her primary diagnosis turned out to be severe treatment-resistant bipolar disorder. Plus alcohol use disorder, social anxiety, and some phobias.  

    Happily, her bipolar depression, social anxiety, and alcohol use disorder, eventually improved dramatically. Some aspects reached remission after IV ketamine treatment.

    Sometimes depression or bipolar depression expresses itself as anger… even rage. Sometimes it can look like alcohol use disorder. In one person it may look like sadness and despair. In someone else, it may show up as disrespect for others. One person with bipolar disorder may seemed quiet, full of sorrow, and hopeless a lot of the time, but another might feel angry, disillusioned, and seeking revenge. How is it that the same disorder can present so differently? It can look different in different people and with different circumstances.

    Lots of people wonder about the same thing. Why does one person with depression act so angry?  Then someone else with depression suffers from quiet despair..? One eats carbohydrates in large amounts, and gains weight steadily. While another has no appetite and loses weight at an alarming rate?

    Which came first?  The chicken or the egg?  Disorders have a way of emerging and creating more difficulties. Depression can give way to phobias, weight gain, social anxiety…

    Bipolar depression may show up as raging anger at times, unrestrained sexuality at times, and terrible despair in one person. Then, in another person, it may look like self-harming, unlawful behavior, and substance use.

    One reason? It’s not uncommon for someone with depression or bipolar depression to also experience anxiety, phobias, hypersexuality, or substance use disorder, alongside the original diagnosis. As a result, you may have a friend or relative who displays a certain cluster of behaviors, and you form the idea that this is what bipolar looks like.

    Then, someone else you know is given the same diagnosis, and while they display erratic behavior, it’s nothing like the behavior of your friend.

    The same disorder can look really different in different people.

    So now you can meet Grayson.

    He was first diagnosed with ADHD, then bipolar depression, and finally obesity. 

    It would be natural to assume that his depression, bipolar depression, and ADHD were all linked to each other. Since some people who exhibit ADHD symptoms as school age children, are later diagnosed with bipolar disorder. And depending on the type of depression you have, you may find you eat high carbs, or you may find out you eat very little. 

    Here’s Grayson’s experience:

    In Grayson’s case, ADHD emerged first when he was a child. About 6 years later, bipolar disorder became a more pressing concern, which SEEMED to lead to obesity. When Grayson is experiencing bipolar depression he tends to eat more, sleep lots, and feel listless and without energy.

    Disorders look different in different people.  

    In Grayson’s family, his own son was diagnosed with ADHD at the age of 7. Then, as he grew he was diagnosed with severe depression.  Grayson’s grandmother has suffered from depression all her life. His uncle has struggled with ADHD but learned to manage it in adulthood. 

    So.

    We know that depression, and many other psychiatric disorders, run in families. And these family connections call for us to show compassion for our family members who suffer from their own individual disorders. 

    If you suffer from depression along with other disorders, and if your current treatment isn’t working, feel free to call us.  Or ask your health care team to call us.

    We welcome the opportunity to work in conjunction with your healthcare team to help you get better.

    At Innovative Psychiatry, it’s true that we see multiple family members who each live with diagnoses and co-morbidities, and it’s true they may sometimes share the same diagnosis … or they may not. Although your symptoms need not necessarily be labeled, they do need to be evaluated as part of your overall self. And then they can be addressed, as needed, with appropriate treatment.

    While IV ketamine treatment is not the appropriate treatment for all of the symptoms you experience, we can work with your health care team to try to help you experience your best self.

    Does IV ketamine treatment help everyone who tries it? Unfortunately, no. But it does help many achieve remission and build fulfilling lives.

    So do try to avoid stressful situations or tasks during this season.

    Do make decisions that are productive for your own health and the health of your family.

    And do call us if we can help you get better with better with IV ketamine treatment. Give yourself the best opportunity for a fulfilled 2021.

    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,

  • Fantasize This: A Stress-Free Family Holiday Month… Crazy? Maybe Not.

    Fantasize This: A Stress-Free Family Holiday Month… Crazy? Maybe Not.

    December is National Stress-Free Family Holiday Month. Don’t Laugh. It really is…

    OK, yes, I get it. It’s the holidays. In a pandemic. COVID-19 spread is skyrocketing. Finances are a struggle and it’s the holidays. Depression can peak this time of year. Everybody needs something and to go somewhere. And don’t forget Personal Protective Equipment. Did I mention it’s the holidays? Stress-free family holiday month? You gotta be kidding me.

    We’ve talked about stress before, and the pathology that contributes to it. And how stress contributes to the wearing down of brain structures like synapses that can cause more serious disorders. Like depression, bipolar depression, PTSD, social anxiety, to name a few. 

    When do you need to be stress-free more than now??

    Add to the holidays the risk of seasonal affective disorder, which for some people creates the symptoms of debilitating depression as the days become shorter, the skies are gray more often, and less light gets through.

    When you feel bad, your stress increases. And when your stress increases, you feel crummy.

    So how on earth do you make December a stress-free family holiday month? Especially now?

    One approach might be to consider that even though the pandemic may create stress, the pandemic can also give us the freedom to reduce our own stress.

    Case in point:

    You can shop less. Agree with your family and friends that giving no gifts or else giving small token gifts is easier to manage this year.  You can reduce your shopping and wrapping by say…80%?  And use the time that’s left to do things you enjoy at home. And avoid exposure to others.
    Perhaps spend more quiet and quality time with your spouse and family. Playing cards and board games, or just talking and laughing together.
    You can bake together if you enjoy it.

    But you can definitely reduce the stress that goes with hustle and bustle.  You can make reasonable decisions to just pass up the hassles this year and give gifts next year.  

    Stressors Abound But Stress Doesn’t Have To

    While it’s true that US COVID-19 cases in the month of November — 4 million — actually doubled the number of cases in October, your risk of infection is pretty low if you stay quarantined and isolated a while longer. 

    Daily deaths from COVID-19 in the US are back up to the numbers back in April. On April 15, 2752 people died in a single day, the largest number of the pandemic…until this past Wednesday, when 2300 people died.

    COVID-19 is a serious risk, but that’s why you need to make good decisions that protect yourself.

    The more you stay inside, washing your hands, wearing a mask if anyone comes in, and finding ways to ENJOY yourself, the less risk you face of the COVID-19 virus spreading to you.

    And if you don’t feel afraid, the stress ratchets down. 

    If you don’t feel overwhelmed with more to do than you can every complete…well the stress ratchets down more.

    If you don’t have to prepare to host a houseful of company for 10 days…you got it: the stress ratchets down even more.

    Because one of the things that cause stress is fear. Another thing that causes it is exhaustion — mental and physical exhaustion.

    And illness causes it, too.

    Winter 2020 presents us with new options.  

    We can continue riding the treadmill in the midst of the storm…or we can just take a breath, and decide to make changes that help us — and our loved ones — enjoy improvements in life and relationships. And less risk of contracting the most contagious and potentially threatening virus we’ve seen in 100 years. 

    It won’t always be like this, will it?  This is temporary.  It may last a year or two.  But it is NOT permanent. 

    So let’s take care of ourselves and each other. 

    In doing that, we can make this a stress-free family holiday month.

    Another thought:

    Think back over the last 5-10 years before we’d ever heard of COVID-19.  During the hustle, bustle, and intense stress of December, can you remember thinking that somewhere along the way we’ve lost sight of what all this is about? That society — you and me — has gotten so caught up in the obligations at this time of year that we’ve forgotten how to enjoy ourselves and each other. To seize moments?

    That feeling of “stop the world…I wanna get off…”  Sound at all familiar?  Consider that this is your year for a reboot. Set new expectations, reduce expenses, invest less of yourself in “impressing” and more in “supporting” and “loving”…

    Meanwhile, if you suffer from severe symptoms of depression, bipolar depression, alcohol use disorder, substance use disorder, PTSD, social anxiety…maybe even anorexia….  then the stressors of the Winter 2020 season can only aggravate the symptoms.

    Some people whose symptoms were managed by oral antidepressants before COVID-19 and all the circumstances of this season, find the oral medications are no longer effective. In spite of medication adjustments and dosage changes.

    And some of these people are finding they want to reach out for ketamine treatment because nothing else is working anymore.

    If that sounds like you, just know you aren’t alone and that ketamine infusions may just make the difference. It has for so many others who have reached the point you have.

    Yes, there is still some people who are not helped by ketamine and we don’t understand why. But research continues to clarify the dose, response, and safety of ketamine treatment.

    At Innovative Psychiatry, we, too, are re-evaluating to find less stressful and safer means of helping you get better. We’re so gratified when we see patients who’ve suffered for years from treatment-resistant symptoms walk out of our offices with joy, relief, and hope following a series of ketamine infusions.

    It’s enough that there are as many stressors as there are these days, but our hope for you is a stress-free family holiday month in December 2020. This is a unique holiday season like we’ve never seen before…and one we’re unlikely to see again in our lifetime.

    And if you need ketamine treatment to achieve “stresslessness” at home… please do call us.

    It’s possible to make some strategic executive decisions to reduce the stress as well as exposure to others for yourself and your family…while using this time to rediscover meaningful experiences within your household.

    And by reducing stress in your home, life, and family…and receiving treatment for the misery of unmanaged symptoms, you and your family can enjoy a special and memorable December 2020 holiday month.

    We’re here and ready when you are, and wishing a happy holiday month for you.

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

    To the restoration of your best self,

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