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.

  • School’s Starting: How’s Your Teen Now? Watch for Anger, Depression, Anxiety

    School’s Starting: How’s Your Teen Now? Watch for Anger, Depression, Anxiety

    School is starting for the 2020-21 school year, whether remotely or on campus. 

    Never before have these students started a new school year during a pandemic. It’s been over 100 years since the last one, and few of those students are still alive. But these students, yours and mine, are pioneers now.  School’s starting, how’s your teen coping with what lies ahead? They’re facing a new school year with social distancing, mask wearing, frequent hand washing… and they’re also facing new subjects, anxiety about whether the pressure will be too much, whether they’re up for the task… and they’re concerned about socializing.

    Some have already started.  The desks are six feet apart, they’re wearing masks.  And they feel uncertain. Shy… afraid they’ll do something wrong. Others are afraid of the long hours at their desks… Because those need movement and stimulation.  They’re afraid of consequences.

    Some of our students will take whatever changes they face in stride. Those are the adaptable ones. But others won’t.. because change causes them to suffer anxiety. 

    While, as a parent,  you may be eagerly awaiting school to start so you can get those kids back into school, since you may have had them home since March.

    But, make sure you’re in tune with them. Listen to their fears and don’t dismiss them. No matter how you feel about what’s happening in the world, your teen may not be equipped to handle the early adjustments of this new experience.

    Because here’s the thing… stress, especially long term continuous stress, can lead to circuitry damage in their brain cells…and that damage can result in depression. 

    Stress Damages. In Fact, It Can Kill.

    In a teen, depression doesn’t usually come with a label written across their forehead.  

    It may look like anger or rebellion. It may look like laziness. It may look like stubbornness.

    And symptoms like these are actually depression, PTSD, bipolar depression, substance abuse, social anxiety, suicidal thoughts…  and if it is, it may need treatment.

    Because these conditions create their own fallout, like poor grades, inappropriate behavior, non-compliance…

    Then, without proper and EFFECTIVE treatment, the condition can deteriorate to criminal behavior…or even suicide.

    Suicide is the 3rd cause of death among teens. 

    Did you know?

    If your teen talks about wanting to die, listen.

    Adolescents are emotional, their hormones rage, and they sometimes seem to be all over the map. 

    But listen to them with respect. 

    Because you need to watch… since school’s starting: How’s your teen doing?

    Parents of teens who have ended their own lives will be the first to say that dismissing these claims was a mistake. But in retrospect they realized their child had been crying for help for a long time.

    Is a “cry for help” really just manipulation?

    No…a cry for help is a plea for HELP. And what seems to you to be a solvable, transient struggle – or growing pains – to your teen may seem like the end of the world. 

    Don’t let it be. 

    Now, it can get tricky.

    If your adolescent has never been diagnosed with a disorder, you may not realize his disorder is escalating.  A fellow psychiatrist tells the story of seeing a 14 year-old he’d known since he was born as a family friend.

    During the intake evaluation, he finds out the boy has been deeply subdued, without joy, extremely shy, and having difficulty making himself participate in school work.  He looks at the parents and asks, Why am I just now hearing about this??

    Truth be told, if the boy’s parents had perceived psychiatric care in the same category as dental care, he would have. But, they’d never dealt with a disorder in the family before and didn’t know how to identify it. They tried more structure, more emotional support, more consequences… until one evening they found him in the fetal position in the shadows…and realized they needed help.

    Your heart goes out to that fellow. 

    And it goes out to his parents, too.

    Because they loved him and wanted him to be happy. They just didn’t recognize the signs.

    What about you?

    School's starting: how's your teen

     And what about your teen?

    Would you know the signs if your teen displayed the need for help?

    Are you sure?  His life may depend on it.  

    So think about this:

    Has your son or daughter suffered a severe loss like a crippling humiliation,  a lost relationship, or death of someone close…?

    What about substances like drugs or alcohol…?

    Has he or she been depressed for a long time? Has treatment helped?  Because if it hasn’t, it’s the same as no treatment at all.

    Has he or she ever been abused physically, emotionally, or verbally? Are you sure?

    Does he or she suffer from a dual diagnosis, like bipolar depression and substance use disorder, or depression and anxiety, or PTSD and alcohol use disorder..?

    Has there ever been a suicide attempt before?

    Has there been an arrest before?

    These are all risk factors for potential suicide attempt or completion.  Any of these indicate the need for special care.

    Further, if your teen talks about death, or feeling rotten inside, or hopeless, or worthless… is withdrawn, sullen, and talks about violence, or wanting to die, reach out for help.

    The National Suicide Prevention Lifeline 1-800-273-TALK (8255)

    At Innovative Psychiatry, we offer ketamine treatment every week. Specifically, if you’ve tried other antidepressant medication trials for at least a few months each, and have experienced no relief, ketamine treatment can help you achieve remission when other medicines didn’t come close.

    Ketamine Suicidality

    And if you endure suicidal thoughts and visuals, ketamine can erase those thoughts in a few short hours…maybe less.

    In this era of psychiatric treatment, you just don’t have to endure without treatment… or with treatment that doesn’t work.

    So… like I said, school’s starting: How’s your teen doing now?

    We treat adolescents and adults, age 14 and up with ketamine treatment when it’s appropriate, and celebrate with our patients as they complete treatment and walk out with the joy of a life of freedom of symptoms.

    While ketamine treatment doesn’t affect everyone this way, it does do this for most. And there are other ground breaking treatments you can try if you’re one of those rare people not transformed by ketamine.

    Thankfully, we no longer live in the Dark Ages even our grandparents did when it comes to psychiatric care. There is hope now. Wholeness. Remission.

    If you struggle with symptoms like we’ve talked about here, call us.

    We want to help you glide through the challenges ahead with resilience.

    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,

    We can all help prevent suicide. The National Suicide Prevention Lifeline provides 24/7, free and confidential support for people in distress, as well as prevention and crisis resources for you or your loved ones.

    The National Suicide Prevention Lifeline 1-800-273-TALK (8255)

    The Veterans Crisis Line and Military Crisis Line 1-800-273-8255 Press 1

    Crisis Text Line: 741-741 Free text hotline 24/7

  • Does Psychiatric Treatment Suffocate Creativity in the 21st Century?

    Does Psychiatric Treatment Suffocate Creativity in the 21st Century?

    Have you avoided treatment fearing it would subdue your talent?

    This is a very real concern for some intelligent, talented people who suffer from certain disorders. The idea that suffering yields brilliant satire, beautiful music, heartbreaking poetry, and dazzling art that enrich mankind. It’s been a subject of controversy for eons. But is it true? If your treatment suffocates creativity, you can do something about that.

    We speculate about the connection between artistic genius and depression or bipolar disorder. Theories emerged that Vincent Van Gogh’s severe depression. He suffered serious bouts of anxiety, and possibly suffered from bipolar disorder.

    He self-medicated with alcohol… Of course, no medical treatment was available for his symptoms. 

    Ludwig von Beethoven stands as another historic creative genius we celebrate who suffered from bipolar disorder. Were his enthralling symphonies created by his illness?  

    Franz Haydn, his teacher and fellow composer, had remarkable words for him as he was getting to know him. “”You will accomplish more than has ever been accomplished,” he said. “You’ll have thoughts that no other has had. You will never sacrifice a beautiful idea to a tyrannical rule, and in that you will be right…”

    He was brilliant…there’s no question. And some would argue that brilliance and bipolar disorder sometimes go together. And he grew deaf. A tragedy for a musical genius. His behaviors as reported by his peers may have been indicative of depression. Maybe bipolar disorder.

    Still can you imagine his frustration at not hearing his own music?

    We must remember that our belief in the presence of a diagnosis of these figures in history is conjecture. That we’re basing our views on what we read about them, what their contemporaries said about them. And we try to piece together the puzzle pieces.

    So, if you’ve experienced severe bipolar I disorder, you may relate to some of these recollections of tormented icons. Their symptoms may seem pretty familiar to you.

    Again, there was no effective treatment available to him at that time, so we can only wonder.

    To learn whether treatment suffocates creativity, we have to fast-forward to the most recent 30 years of psychiatric treatment…and even better, the last five.

    In the days when Prozac was such a breakthrough, and then Paxil, I remember someone describing the way she felt. She said it was like she was “coated in wax.” 

    The early SRIs, and later the SNRIs, provided so much help to depressed people that they were considered a breakthrough at the time. People would joke, “the city needs to add Prozac to the drinking water. It could quite possibly solve all of society’s problems!”

    With time, we learned that these medications made a dramatic difference in quality of life for about 33% of those who suffered, and with some tweaking, titrating, and blending, over time that number increased to 50-65%. 

    But, eventually, it turned out that these medications weren’t always as remarkable as they seemed.

    There were plenty of people who stopped taking the medications because of the side effects of weight gain, sexual dysfunction, and more.  Plenty of others continued to take them and gained the weight and lived with the reduced sexual drive for the sake of functioning in their lives.

    Of the creatives who took these medications, some claimed the medicine impeded their creativity, while others found that with a clear mind, they could create more effectively.

    Those with bipolar disorder often take a mood stabilizer like lithium or depakote, and may experience more stability. But many others need a variety of medications to yield a more stable mood. And many others with bipolar disorder don’t experience any real or lasting relief from these medications.

    Does Psychiatric Treatment Suffocate Creativity In All This?

    While it wasn’t uncommon to hear patients complain of dampened creativity while taking SRIs and SNRIs, that’s not the case across the board. 

    Some who are treated for severe depression are relieved to discover they are able to be creative again. Others, not so much. It varies between people and can also depend on the symptoms. 

    And creativity and bipolar disorder share some genetic links, as well as some deviations from typical ways of thinking. Creativity includes new thoughts, original ideas, and freshness in composition of art, music, construction, etc.

    Still, neuroscience research reveals that the most productive creativity in someone with bipolar disorder happens when that person is in a non-extreme state, or euthymic period, or a hypomanic period.

    So, what about the last 5 years?

    Ketamine Treatment Doesn’t Suffocate Creativity

    Not only is ketamine treatment effective in treating depression and bipolar depression in far more people than SRIs or SNRIs, but it can actually enhance creativity. It’s in a category all its own.

    Ketamine treatment’s extraordinarily rapid and robust effects can proliferate the brain cell connections and the communication between different parts of the brain. These benefits can expand so dramatically that you can, and likely will, find yourself in a remission that defies all logic. 

    A kind of remission that finds you catching up on all the chores you’ve avoided for the last several years, advancing your career in ways you’d never thought about before, building strong, healthy relationships, and having fun…I mean really having fun.

    You can wake up singing songs that may have followed you while you dreamed, dancing spontaneously while you get your coffee. You may find yourself immersed in joy.

    Of course, ketamine treatment doesn’t do all this for every single person treated with it, but these benefits are widespread and common. There are a handful of sufferers who don’t enjoy these outcomes, but the vast majority do.

    In this day and age, on the brink of life changing treatments for severe psychiatric suffering, you have the opportunity to enjoy singing, dancing, and loving. 

    Watch the Clouds Part and the Sun Radiate Into Your Life

    At Innovative Psychiatry, we celebrate with our patients as they taste of a brightness of life and a hope that had always alluded them before. We provide ketamine treatment in a pandemic-safe, cautious protocol that protects our patients and our staff. 

    With this exacerbated environment for increased depression related to the pandemic,  it’s more important than ever to give yourself the additional support of a treatment that can renew your emotional energy and your patience to cope. 

    Does psychiatric treatment suffocate creativity? No…it doesn’t have to.

    If you’ve feared treatment because you fear losing your creative edge, call us.

    We’re here to help you open your doors and windows to let the light of your gifts shine through.

    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,

  • Fallout From the Covid Pandemic May Not Be All Bad

    Fallout From the Covid Pandemic May Not Be All Bad

    As tough as these times have been, there have been some bright spots. 

    In fact, some people who have suffered terribly from symptoms of their disorders are actually stabilizing and improving. Feeling as though they’re less “disordered” and almost more normal than they’ve felt before. Can you imagine? In fact, as much as we’ve struggled with grief, loss, and frustration, as well as worsened conditions from disorders, fallout from the covid pandemic may not be all bad.

    It’s something of a phenomenon.

    On the other hand, it may just be common sense. For instance, for some who struggle with shame and increased anxiety because of social anxiety, to be allowed to remain at home, and visit with your doctor through telepsychiatry, the pressure to interact in a public setting among strangers is gone.

    On top of that, that telepsychiatry visit gives you a sense of closeness with your psychiatrist you may not feel in the office. Some people feel less intimidated, and are even more likely to ask the doctor how she’s doing.

    Some with agoraphobia may also feel more relaxed, since so many others they know are also safely locked up at home.  

    Even those under a dark cloud of depression, feel less like the “odd man out” because there are so many experiencing depression for the first time and are so alarmed, so baffled, and are looking for someone to talk to about it.

    On the other hand, for most of the rest of us, there are all sorts of ways the pandemic has affected us. And it’s been a burden.

    It might have been novel and interesting for the more optimistic the first month or two, but few still find it engaging now.

    The Difference Between Depression and Grief

    It’s important to understand that what you’re feeling may not be depression or anxiety at all. In fact, it may have nothing to do with any pathology, per se.

    The process you would naturally go through when you grieve the loss of what used to be… could be affecting you. You may be also grieving the loss of a loved one. But grief is a natural part of life, and it includes feelings that are painful and troubling. 

    Think of it like you’re adapting: a completely healthy way to adjust to new challenges. Feeling deep loss, then over time adjusting to that missing person or those elements in your life, and finding ways to live with it. 

    Because the fallout from the Covid pandemic may not be all bad at all…in spite of the things you miss.

    Do you miss eating at your favorite restaurant..?  The wonderful food, yes…but you can pick that up and take it home…no it’s the entire experience, isn’t it?  The way the wine tastes after they pour it, the wonderful service, the ambiance. Do you miss your children catching the bus each morning after breakfast, and the peace and quiet that settles over your home while you drink your coffee…? 

    It’s the little things.  And you miss them, and that’s ok.  While it’s not uncommon to get angry…(that’s the first stage of grieving, by the way)… it’s also not all that productive to get stuck there, is it? 

    So you look for ways to reduce the impact of it all by finding ways to help others, reaching out with kindness… and catching up on your reading. 

    We’re All In This Together and Fallout From the Covid Pandemic Can’t Keep Us from Getting Through To Brighter Days

    And it stands to reason—doesn’t it?—that you are experiencing different effects from the pandemic and its side effects than your neighbor, your co-worker, and your family members.

    If you’ve not been someone with a depressive disorder in the past, but you feel terrible right now, don’t panic. Because you’re walking your own path. You may be grieving the loss of life as you knew it up until December 2019… or…you may actually have been so devastated by these blows that you’ve developed a disorder and need treatment. 

    If you need it, you’ll get it. And if you need to try some experiences we’ve talked about before to nourish your resilience, strengthen your compassion, and improve your wellbeing…  well how much better is it if there really is something you can do yourself?

    On the other hand…

    But if you can’t lift your head above the din of stressors, then there are treatments like  ketamine treatment to  restore your resilience, so you in turn can show kindness and support to others.

    Which is why at Innovative Psychiatry we continue to be mask-wearing essential services for you, if you need us.

    If you find yourself despondent, hopeless, unable to see any way to function, call us.

    We provide ketamine treatment in a safe, protected environment so you can get a fresh breath of air, a sort of new lease on life, and the energy and initiative to make changes in your life you want to make.

    I hasten to say that ketamine treatment really doesn’t accomplish these things for absolutely everyone who receives it, simply because there isn’t any treatment that makes everyone well.

    Even so, its beneficial effects on most of those with treatment resistant depression is nothing short of extraordinary. So much so, that NO ONE should suffer indefinitely without remedy.

    There is hope.

    And joy.

    And the promise of a rewarding and fulfilling life.

    Let us help you take the next step to wellbeing and peace.

    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,

  • What If You’re Just Tired of Coronavirus??

    What If You’re Just Tired of Coronavirus??

    So… the pandemic continues…  

    Wearing a mask is adaptability in the pandemic and it's worth it for this woman.

    And millions of Americans are required to wear masks unless they’re at home with family. When you shop, there are yellow markers on the floor that show you where to stand in line to maintain social distancing… Certainly, this is a once-in-a-lifetime occurrence. Like the 100 year flood. We’ll never forget. Very few people in our midst have actually witnessed this before. Only those who lived during the Spanish flu in 1918 and are living today… and that’s about it. So, basically, only people older than 100. And as the conditions, precautions, and lockdowns become more restrictive, or less, or more again… you can find yourself disoriented, annoyed, and fearful. How do you cope? What if you’re just tired of coronavirus??

    Could you have imagined that 6 months ago, when news of the pandemic spread around the world, that by midsummer precautions would be reinstated again? 

    Well, you’re not alone. Most everyone shares your outlook. And by the way, some segments of this country has required masks outside of home since March.

    Keep reminding yourself…in the name of generosity and your own adaptability, that you’re not alone. Millions upon millions of people are in the same boat.

    So how do you do that…?  How do you maintain your sense of yourself, your identity, your good will and benevolence when you feel so worn down?

    Have you noticed in line at the grocery store, waiting 6 ft behind the person in front of you, how much more easily people around you seem to snap? To attack the poor girl at the register, who is dutifully wearing her mask? This girl didn’t create the pandemic, and yes she’s getting the brunt of everyone’s ill humor.

    So what can you do to nurture generosity and patience in this atmosphere?

    Honestly, what if you’re just tired of coronavirus?? Consider adaptability and resilience.

    Adaptability and Resilience in the Face of Hardship – Develops Your Patience and Confidence

    When faced with crises, you have choices. 

    You Can React and Let Your Tattered Emotions Lead…

    or you can respond from the resilience and patience you’ve cultivated in past crises.
    Adaptability in the pandemic or in nature can help you survive on a hike like this one.

    A tree that’s blown with hurricane force winds can bend and bend and bend.  If it snapped from the pressure, that would be the end of that tree. But by bending, the trunk of the tree is strengthened. It becomes stronger and more flexible.

    When you see a 200 year old oak tree, you can know that it’s seen lots of hardship, but it bends to the wind, it doesn’t allow itself to be drowned by flood or killed by drought. That tree has seen it all, yet it stands tall and strong, because it adapted.

    This tree has learned how to send its roots deep and wide to nourish its needs. It takes its challenges one at a time, tucks its chin and stands strong in the face of wind gusts and hurricanes, freezing temperatures, and blazing heat.

    Our beautiful oak doesn’t need to weather all the challenges that occur in ten years all it once. It stands, sways, bends, and replenishes itself, one challenge at a time.

    It uses its adaptability to be flexible in the face of hardship, then springs back to its normal state and prepares for the next one. Always standing strong and resilient. And with each season it grows a little stronger, a little more equipped to face harder assaults in the future.

    Adaptability means bending to accommodate the circumstances around you. And it’s vital because bending makes you stronger.

    These principles apply to countless crises, assaults, and hardships. Just like this beautiful old tree, you learn to nourish yourself, to put down roots deep and wide that will help you stand strong in the face of trouble, to reach for the sky with exercise and nutrition.

    You may be tired of coronavirus and all that goes with it, but if you think about it, things could be worse…a LOT worse. So nurture and nourish yourself, so you can give warmth and patience to others around you who are struggling too. Remember this isn’t permanent…it’s just right now.

    Simple, random acts of kindness and generosity can also beef up your own resilience and confidence.

    But to live to see another day can be a worthwhile goal in the thick of things.

    But What If I Can’t Think of a Creative Response? 

    What if I can’t imagine a better way to respond or feel?

    Just because you want to be calm, and respond wisely, doesn’t mean you have the power to do that. If you suffer from PTSD or depressive disorders the calm and wise response may be beyond reach.

    They say, “It’s not the strongest who survives, nor the most intelligent. But rather it’s the one who can best adapt to change.”

    To avoid the panic this woman feels, practice adaptability in the pandemic.

    And when you nurture resilience, and you’re flexible in the face of changing circumstances, you become stronger and you have more patience to offer the ones around you who are also tired of coronavirus.

    Which is where ketamine comes in.

    IV ketamine treatment can reduce stress and the damage it has caused in your synapses, in your hippocampus and amygdala. As the stress dissolves, and your synapses are rebuilt and become abundant and highly functional again, your ability to face a threat and make good decisions is remarkably improved.

    This new level of function reduces depression symptoms dramatically, to the point that you feel well. You have the needed energy to think of the needs of others and make decisions that benefit them. You have the creative thought to adapt in difficult circumstances, making them less distressing. In fact, you can enjoy the opportunities you find in the midst of them.

    And you can imagine…and enjoy.

    And if you have suicidal thoughts, or too many thoughts about dying, ketamine can stop those thoughts in a few hours. You could be an afternoon away from relief and hope.

    Ketamine Doesn’t Help Everyone – But It Can Transform Most People Who Reach Out for It

    At Innovative Psychiatry, every week we see people enjoy that relief, hope, and freedom because of their ketamine treatment. They marvel at the night and day change that replaces the depressive darkness and anxiety. 

    And as ketamine treatment restores their power to enjoy and imagine, they realize that instead of being tired of coronavirus, they have a renewed patience for taking it as it comes. And giving a leg-up to those around them.

    But, first, a word of caution: Ketamine treatment doesn’t have this robust effect on everyone who needs it. But no other treatment is currently available that relieves these symptoms so easily for as many. If you’re one of the ones whom ketamine doesn’t help, there are other treatments we can talk about. 

    Interestingly, ketamine treatment is often most effective on patients with the most severe symptoms. And that’s why we focus on patients who have not been helped by other medicines.

    Adaptability in the pandemic can allow you to maintain your joy in adversity like Carol here.

    So, if you struggle with anxiety disorders, PTSD, social anxiety, severe depression, substance use disorder, alcohol use disorder, or suicidal thoughts, and nothing else has helped, call us.

    Because letting ketamine improve your mood, your outlook, and your resilience also equips you with improved adaptability in other crises you face.

    We’re here to listen, and to help you find relief, even achieve remission, from these symptoms that impair your best life. 

    Ketamine can remove the obstacles that prevent you from pursuing happiness, building strong relationships, and investing motivation and initiative in your career. 

    You really can have a fruitful and rewarding life, and we’re here to help.

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

    To the restoration of your best self,

  • Ketamine Slashes Anhedonia in Treatment Resistant Bipolar Depression

    Ketamine Slashes Anhedonia in Treatment Resistant Bipolar Depression

    Depression shows its face in a lot of different ways:

    If you live in the misery of bipolar depression, anhedonia is right there, up close and personal.  So what is it? Anhedonia is the loss of interest or pleasure in things you used to enjoy. So you stop enjoying.  But if you can’t enjoy... life can taste like… sawdust. Bipolar depression is never fun. It’s interesting that those who suffer the type of depression that’s dominated by anxiety often have trouble sleeping…and tend to lose weight. While those who suffer from the type of depression dominated by lethargy tend to gain weight and sleep long hours…. like 19 hours straight. And anhedonia is right there, in your face, when you’re depressed. It can permeate your life and creep into conditions that sometimes tag along with depression and bipolar depression, like PTSD or substance abuse. And ketamine slashes anhedonia in these conditions.

    Now, here’s the problem. In bipolar depression, there is plenty of evidence that shows that the usual treatments for bipolar depression don’t relieve the anhedonia. In fact, they sometimes actually blunt the rewarding experience. We’ve talked about this in other articles, referring to the activity of cell bursting in the lateral habenula. 

    Let’s be frank. When you’re depressed, you want to feel better. NOT feeling isn’t good enough. You need to be able to enjoy.

    We talked about how important that is. To live a fulfilling and rewarding life includes enjoying. Because without any enjoyment, life is more of a drudgery…and you trudge through proverbial mud day in and day out.

    Who Says So??

    Peer reviewed studies have demonstrated that depressed patients with anhedonia have a poorer prognosis for recovery than depressed patients with no anhedonia. And anhedonia can also cause emotional blunting and even physical blunting, like inability to experience sexual pleasure or orgasm.

    A study published in the American Journal of Psychiatry demonstrated that when anhedonia is present in a major depressive episode, it can predict that suicide is likely to end that life.

    In 2014, there was no FDA approved treatment for anhedonia…and the suicide rate was climbing, and continued to climb and is still climbing. Currently, suicide is the 10th leading cause of death in the US.

    All that illustrates that “not enjoying anything’ isn’t as tepid as it may sound. It can actually be life-threatening.

    And in the meantime, in order to understand depression and bipolar depression, you do need to wrap your head around anhedonia.

    Ketamine Treatment Slashes Anhedonia in Bipolar Depression

    A neuroscience research team led by N. Lally that included Carlos Zarate and D.A. Luckenbaugh, looked at the effects of ketamine on anhedonia in Oct 2014. The study showed that ketamine causes rapid-acting anti-anhedonic effects in treatment-resistant bipolar depression. To go a step further, they found it it improves and relieves anhedonia independently of its antidepressive benefits.

    Over half of people diagnosed with treatment resistant bipolar depression suffer from serious anhedonia. And the researchers in this study demonstrated… and concluded….that ketamine treatment is vital for the treatment of anhedonia in patients with bipolar depression.

    We’ve talked before about how bipolar depression is characterized by an intensity that distinguishes it from major depressive disorder. And these researchers found that even when a patient with bipolar depression can laugh at a joke, or likes eating something sweet, he lacks the motivation to to go to the effort to get it for himself.

    So lack of motivation is embedded in anhedonia, and to restore motivation requires alleviating the anhedonia.

    But standard antidepressants aren’t always effective for anhedonia, at least there’s no proven evidence of it. So something had to give.

    And ketamine treatment seems to target regions in the brain that cause anhedonia. Not as part of its antidepressant benefits, but independently.

    We also know that IV ketamine also stops suicidal thoughts…and again it seems that it can do this independently from its antidepressant benefits.

    Is it any wonder so many are so excited about the restoration they’ve experienced after ketamine treatment?

    And what about you?

    Do you know what anhedonia is like from your own experience? Do you recognize the description of not enjoying things you used to enjoy…of having no motivation to drag yourself out of bed or to do anything?

    Ketamine treatment can be an ideal treatment for your symptoms, even when nothing else has worked — and sometimes, especially when nothing else has worked! — and can relieve depression by targeting a variety of areas in your brain, It’s almost as if it’s custom made just for you to dissolve your bipolar depression symptoms.

    I’m not saying ketamine treatment is a cure-all. Far from it. Depression and bipolar depression are complex disorders that require multifaceted treatment approaches. When anhedonia persists no matter what you do or try, you may want to consider ketamine treatment.

    Ketamine Slashes Anhedonia For You, Too

    At Innovative Psychiatry, we offer ketamine treatment for treatment resistant depression and bipolar depression. And our patients often tell us they’re amazed at the relief they experience and at how much easier it becomes to manage their lives after treatment.

    If you haven’t experienced relief, or even just partial relief, from the prescriptions you’ve taken…and you still don’t enjoy… call us.

    If you find yourself thinking about dying, or wish you didn’t have to wake up in the morning… reach out for help. Don’t go it alone. Call the National Suicide Prevention Lifeline at 1-800-273- TALK (1-800-273-8255) or in the US, text HOME to 741741 to connect with a crisis counselor at the Crisis Text Line.

    And learn about how we’re using IV ketamine infusions to help stop suicidal thinking in depression.

    You really can enjoy again…the fragrance of a flower, the energy to have fun, the motivation to accomplish your goals and build healthy relationships.

    Give yourself the chance to find out how good you can feel.

    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,

  • Bipolar Disorder Treatment for Depression and Suicidal Thinking

    Bipolar Disorder Treatment for Depression and Suicidal Thinking

    Treating bipolar disorder with all its comorbid symptoms can be a delicate process.

    Some people suffer tragically when all’s right with the world. The COVID-19 changes have made the last 5 months especially difficult for them. Those who suffer severely lack the medications and treatments to help them function during this period of isolation and quarantine.  For example, bipolar disorder treatment for depression, anxiety, and suicidal thoughts is all the harder in crises like these.

    Many people suffer with these symptoms when the world is balanced and functioning. However, during this period of crisis their difficulties torment them mercilessly.

    Bipolar disorder is one of the most severe psychiatric disorders, but unfortunately it has not received the most attention for studies, breakthroughs, and relief. Not even close.

    This serious disorder plays a significant role in the lives of people who live in shelters, in jail, or who commit suicide.

    To take it a step further, some doctors warn that no one should still be prescribing antidepressants for bipolar disorder.  

    I’m not one of them—but more on that in a bit.

    It’s true that depression is a terrible symptom of bipolar disorder. In most cases, it dominates many more of your days compared to mania or hypomania. And it’s vital to find a way to treat the depression while also avoiding the mania (or hypomania).

    Add to that the other conditions that often run hand in hand with mood disorders. Those that accompany the depression and mania — like severe anxiety, panic disorder, and OCD. Anxiety can appear as a cluster of conditions that vary in severity, with flares that occur willy-nilly. Boy, can they exacerbate each other! And boy, can a simple straightforward medication for an anxiety disorder suddenly make your mood disorder worse. And vice versa.

    If you or someone you care about has bipolar disorder, you know what I mean. The meds that are supposed to help can be hellish.

    Then, there’s another point to be aware of… 

    Bipolar Disorder Treatment for Depression, Anxiety, and Suicidal Thoughts …is Tricky

    An article in Psychiatric Times recommended we use evidence-based medications like lithium, quetiapine, lamotrigine, lurasidone, and cariprazine, and avoid antidepressants in people with bipolar disorder. And they have reasons for that.

    Those are excellent medicines. But what about when a patient doesn’t respond to any of them?  

    But people are individuals. And we design and personalize the treatment for each individual.

    For instance, when we find that patients with bipolar disorder also have severe anxiety disorders (panic disorder, OCD), the anxiety can be hard to address with therapy alone or occasional medications. Sometimes it’s just so bad that it needs to STOP. We can sometimes control these it best with a concurrent SRI — the current updated term for SSRI — to suppress panic attacks or OCD. 

    Why do that? Because some people with frequent unpredictable panic attacks just can’t function very well. Some people with OCD are tortured by it.

    Give them an SRI and it could go a long way towards suppressing all of that. But then … their mood can really go haywire. Rapid cycling can occur — and everything can spiral out of control.

    There is no one-size-fits-all for psychiatric treatment. Especially if you have bipolar disorder. And its friends. Anxiety? Agitation? Hyped-up energy? Frustration? Each symptom must be teased apart and treated carefully, without upsetting the other symptoms. Without upsetting the rest of your life.

    Because the fact is, bipolar depression can be severe,  unrelenting, and life-threatening. To expect someone with severe bipolar disorder to muscle through bipolar depression along with panic attacks, anxiety, OCD, being untreated, too, is cruel. While you’re waiting for the proposed mood stabilizing medicines to relieve the plethora of symptoms you suffer…when it never happens, it can feel pretty desperate. You can feel pretty hopeless.

    People who suffer from bipolar disorder live at risk for ending their own lives. Their frustration with unrelenting symptoms, their shame over behaviors when their mania –or hypomania– is not controlled, and their impulsiveness during mixed states make effective treatment so important.

    The stakes are high.

    Sometimes an SRI can ease the panic attacks…or the OCD… without actually relieving the depression.

    And yet, what’s the alternative?

    For some patients, these medicines can help prevent hypomania or mania, and in some they also stabilize depression, too.  But when they don’t help the depressive symptoms, something more really does need to be done.  Pretty quickly.

    Ketamine Treatment Can Help with Bipolar Depression

    And ketamine treatment can relieve bipolar depression pretty quickly. It helps many patients whose depressive symptoms aren’t relieved by these mood stabilizing medicines or SRIs. But we use it carefully. Because ketamine infusions occasionally induce hypomania.

    At Innovative Psychiatry, we see people with bipolar disorder improve dramatically from ketamine treatment’s extraordinary antidepressant effects on their bipolar depression. By bringing relief with this treatment to the dangerous and overwhelming threat this condition causes, and by reversing the suicidal thoughts that can accompany it, mood stabilization can become easier.

    Bipolar disorder is not a walk in the park, but effective treatments and personalized, innovative psychiatric care can bring you joy, peace, and a rewarding life. 

    It’s what we do. It’s what we live for.

    We invite your healthcare team to work together with us to get you back to your best self. Please feel free to have them call.

    If you suffer from bipolar depression, call us.

    You actually can live very well with the right treatment 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,

  • Chronic Stress Pathology: IV Ketamine Kicks It to the Curb

    Chronic Stress Pathology: IV Ketamine Kicks It to the Curb

    Is depression common ..? 

    Is it something suffered only by the rare individual…? The World Health Organization says it’s the leading cause of disability.  Have you heard that? Not those rare people no one ever sees… but people all around you struggle to function, and paste on their “upbeat faces” … while feeling more alone than words can say. Likely as not, chronic stress pathology is at work wearing them down.

    And it’s not just depression. It’s bipolar depression, and generalized anxiety disorder, and PTSD, and social anxiety… These conditions are all different, and the way their symptoms present in each person can be really different.  

    But all these disorders also have something in common. Something called chronic stress pathology or CSP. They may have been triggered by a traumatic event, or a terrible loss, and just a constant nagging of unrelenting heaps of difficulty that wear away at your ability to cope.

    There’s something else they have in common. They tend to clump together …why?  Because of what happens in your brain. We call it comorbidity.

    We’ve often talked about how long and severe chronic stress prunes the dendrites and dendritic spines of the neurons in the prefrontal cortex and the hippocampus, breaking down synapses (or “synaptic connections”).

    Well …it turns out that there is a cascade of changes during these chronic stress situations that also increases brain derived neurotrophic factor or BDNF to increase synaptic connections in the amygdala and nucleus accumbens in another area of your brain.  The nucleus accumbens is part of the basal ganglia located near the hypothalamus.

    Oh dear…this is getting a bit tongue-twisting. 

    But get this: in one part of the brain, the synaptic connections are SHRINKING from chronic stress while in another area, they’re EXPLODING where they shouldn’t be.

    You heard right.

    This creates a vicious cycle that continuously drags you back into this disordered condition over and over…making it terribly difficult for you to recover. In the amygdala, the hippocampus, the prefontal cortex, and the nucleus accumbens, nerve connections (called neuronal connections) are being changed and damaged because of long term chronic stress.

    That condition may be major depression. It may be PTSD. It may be an anxiety disorder. But it goes on and on. And on.

    These Disorders are NOT a Chemical Imbalance

    You can see why the old idea — and people still talk about it like it’s a thing — that this is “a chemical imbalance”…is archaic, mistaken, and doesn’t even describe what’s going on at all. 

    We’re talking about dramatic changes in structures in your brain. Damage. Not just chemical changes.

    Misinformation Feeds Stigma… But Knowledge is Power

    This idea of chemical imbalances is leftover from 30 years ago, before neuroscience understood these structural changes and thought depression was the result of changes in serotonin alone….a neurotransmitter that turned out to be a only a component in the overall process.

    Ketamine Research has Taught Us So Much More… About Chronic Stress Pathology And Its Effects on Your Brain

    As we’ve talked about before, evidence has been accumulating for years showing that ketamine treatment can reverse the pruning of synaptic connections in the prefrontal cortex and hippocampus – caused by stress – by robustly increasing them — turning on your mRNA to switch on your DNA… and that releases BDNF. 

    And you know what BDNF does. It TURBO boosts those synaptic connections in those areas, which in effect turns the light on in the darkness. You feel better, function better. Your creativity flourishes. And you have the patience and capacity to build and repair your relationships. Hope surges and futility morphs into purpose.

    But you know what? We don’t talk very often about ketamine’s effect on the synapses in the amygdala and nucleus accumbens. There, it turns off the production of BDNF and reduces those connections there which helps to reduce your symptoms. 

    Chronic stress pathology wears you down when stress goes on too long.

    It also tamps down the cell bursting in the lateral habenula to help you relax and enjoy yourself. So you can revel in the fragrance of honeysuckle, and the aroma of burgers on the grill. 

    The fact is that chronic stress pathology is at the root of much of your suffering. Your body is intricately balanced, your emotions are influenced by a complicated series of changes in your gut through your microbiome, in your brain cells, as well as your muscles and organs.

    If you have a severely broken leg, the pain, repair, and convalescence of that injury can have a significant effect on your emotions. And symptoms of chronic stress, depression, and anxiety can make your muscles and joints ache.

    Which is why I’m on a mission to eradicate the term “mental illness.” Because your whole body is affected when something is malfunctioning in just one part of it. 

    For example, diabetes can predispose you to depression. And so can open heart surgery.  Your brain is part of your body…not a separate entity. And when one part of your body is affected, other parts are affected, too.

    So, the more we learn about our brains and bodies, the more we understand about the intricacies of how we function on every level.

    Now… what if you do have chronic stress pathology working against you?  What if you’ve been traumatized… or what if you’ve weathered a long, repetitive, unrelenting assault of stressors?

    Cheryl’s Story

    Cheryl did. Cheryl’s husband began complaining about the family’s budget..insisting they needed to make changes or there would be nothing to retire on. He finally became harsh about the need to find a less expensive house. Cheryl worked 60 hours a week…and the kids had needs, and schedules, and practices, and uniforms….  When could she look at houses..?  Or worse…when could she possibly pack?

    But since her husband Ben was so adamant about it, she tried to cooperate. She looked at houses during her lunch break, and after she dropped her sons off at practice.

    She stayed up late searching the internet for houses she could look at, but she and her husband couldn’t seem to find the time to look together.  Finally, she found one that could work, and Ben took a look on his lunch hour and agreed it was just fine. 

    Working late, marriage problems, and mom with cancer cause severe stress.

    After frantically packing every free minute for weeks…they closed on the house and moved. Cheryl was exhausted and the rooms packed with unopened boxes in the new house just made her want to cry.

    Then as soon as she moved, her mother asked her to go to the doctor with her. At the appointment, the doctor told her mother she had breast cancer. She explained the details, the treatment, and prognosis to both of them.

    When they got back in the car they cried together. 

    Cheryl knew her mother would need her extensively through this process. And she was committed to be at her side as much as she could.

    She rearranged her schedule, her children’s schedules, and approached her boss about shortening her work hours for the next several months.

    Unpacking the new house was a mountain to climb…and Cheryl kept wondering why Ben wasn’t on hand to help…

    And why was his job so demanding through all this, anyway??

    Then she found out…  Ben told her he wanted a divorce.

    “A divorce??  NOW?? IS THIS WHY YOU WANTED TO MOVE…??”

    Cheryl felt herself coming apart.. 

    There was nothing to do but keep moving. Her children needed her to be reliable through this. To be a safe haven…a comfort.  

    Her mother needed her support as she looked a life threatening condition in the face.

    Cheryl couldn’t think about how she felt…she had to keep going.

    But 8 months later, after the divorce was final and her mother’s treatments were complete… Cheryl couldn’t get out of bed.

    Over the weekend…Cheryl just felt like she was in a long dark tunnel.  She called in to work on Monday. Her sister came over and got the kids on a bus…

    Sometimes it’s just too much.

    Chronic stress pathology is the damage caused by long term unrelenting crises.

    And what about you?

    Have intense stressors piled up in your life and worn down your hope? Have you taken prescriptions that just didn’t help? 

    Do you feel like the crises just keep pelting you without mercy?

    Sometimes we’re subjected to repeated stressful assaults in life that we can’t control. But there is something you can do about your ability to cope with it. Reach out for IV ketamine treatment.

    At Innovative Psychiatry, we offer IV ketamine treatment expertly titrated and see resilience return to our patients every week. We also have published research that you can read about our results. We’re serious about what we do.

    Titrated Serial Ketamine Infusions Stop Outpatient Suicidality and Avert ER Visits and Hospitalizations. Lori Calabrese MD.

    Things have changed since the days of “chemical imbalance” thinking. (That’s so 20th century!) Neuroscience is making 21st century discoveries that offer better treatments than we’ve ever known before.

    And you get to take advantage of those advances.

    If you can relate to Cheryl and prescriptions haven’t helped, call us. If you have symptoms of PTSD, call us.

    Ketamine treatment can give you relief from the damage of chronic stress pathology.

    IV ketamine treatment can reverse the damage caused by chronic stress pathology. Chronic stress doesn’t always result in this damage, but it does all too often.

    And when you’re the one suffering, you need a solution. You need to cope. While ketamine doesn’t work like this for everyone, it does provide rapid, robust relief for most. And chances are, it will transform your life to allow joy, hope, and resilience.

    Give yourself the opportunity to live well again. To enjoy a fulfilling and rewarding life.

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

    To the restoration of your best self,

  • Ketamine In A Pandemic: New Depression and Anxiety Can Strike Anyone

    Ketamine In A Pandemic: New Depression and Anxiety Can Strike Anyone

    The sky grew darker as clouds morphed from white to gray, and created a solid ceiling over the city.

    It had rained off and on for days, and thunderstorms had filled the night skies with a threatening latticework of lightening. In an aggressive assault on the grayness, Evie stepped back from the window and decided to turn all the lights on. The quiet in her bungalow, the gray skies, and the silence felt like a blanket that she couldn’t seem to shake off. She turned on music and tried to dance around the living room, but that didn’t last. There had to be a way to ward off this expanding gloom. She’d heard about ketamine in a pandemic, because these symptoms can strike anyone…even if they’d never had them before. Could that be what’s going on?

    Dread crept up inside her, and she couldn’t understand why. Where was this coming from? She didn’t object to this isolation. It had given her the excuse to read more, which she’d salivated to do for years. She enjoyed her own company.

    So where was the dread coming from?

    It was as if things she normally would do as part of her routine just seemed too hard to do lately.

    A heaviness grew darker and heavier in her chest..?  Her stomach…?  What was it?

    Evie had always prided herself in her ability to snap back from disappointment, to face fearful situations and push through them. She just lived with her sleeves rolled up, ready to take on whatever life tossed her way.

    Her younger brother had never been so resilient. And unfortunately, she hadn’t been very supportive.  She just had never understood why he wouldn’t just shake it off. Call a friend, pitch in and help someone in need, walk in the sunshine…and get over it! 

    Now…she was eating her words.

    Isolation and Even Social Distancing Take a Toll on Your Emotions

    She strained her brain to understand what was causing this. Internet articles pointed out that being cooped up this for weeks or months was affecting people in a negative way. 

    But Evie liked being alone. She loved the quiet. The uninterrupted freedom to do what she enjoyed.

    And these articles also talked about fear. People were afraid. Sales of guns had skyrocketed, and ammo was sold out and on back order, as people have bought up more and more.

    She had to admit to herself…that THAT was scary. All sorts of people armed against unknown dangers…

    But seriously. She wasn’t afraid of looters or invasions.

    It seemed clear to her that it was just a matter of waiting this out.

    Ketamine in a Pandemic Can Relieve Anxiety and Depression in Someone Who’s Never Had It Before

    So what was wrong with her?? Why was she lying in bed and reading all day every day? Things had piled up. Her garden needed weeding. But the idea of doing it was overwhelming.

    Motivation, initiative… it seemed to have drained out of some proverbial hole in her bucket.

    When a knock came on her door…Evie didn’t answer it. She just stayed quiet and waited for whoever it was to go away. The same with her phone. She didn’t want to talk…not to anyone. 

    She remembered a few months ago, when she saw a map of the world that depicted the incidence of this COVID-19 virus in countries around the world. She was stunned to see how every country seemed to be red. The entire world!

    So if she had thought she could just get out of town and wait for this to blow over, she was fooling herself. There was no escape on the planet.

    Maybe that shock started this…this feeling of dread…

    Large Scale Change Increases Stress

    Then they closed the schools and restaurants and businesses. Then required mask wearing.

    You know that feeling that “it will never happen to me”…?  But this thing has happened to everyone. Everywhere.

    So was the dread from feeling trapped?  Evie thought about that. It might be the case with some people, but how could she feel trapped all snugged up in our home she loved doing things she enjoyed?

    She didn’t know what was wrong with her or what specifically caused it. She did know that she wasn’t herself. There had to be some serious thinking about her brother and so many others who suffer from symptoms like this. Who really couldn’t shake it off, like she couldn’t now.

    And she acknowledged it was a difficult place to be. That her brother had been very brave all these years to keep fighting to function when medication and therapy didn’t work for him. 

    She’d read enough to know that many people were being affected by these circumstances. Some, like Evie, had never felt this way before. 

    She promised herself she’d call a doctor to see if she could get treatment — as soon as she could scrape up the initiative to do it.

    Evie’s not alone, is she? 

    And this is why telepsychiatry has been so vital through these months. A new flood of people who never needed psychiatric treatment before have emerged…and need treatment.

    Ketamine in a Pandemic: Depression and Anxiety Can Strike Anyone in These Circumstances

    Then, there are those who’ve been receiving treatment with prescriptions that now don’t seem to be working anymore. And in isolation, these people are at higher risk because they’re alone, and feeling all the things Evie feels, but often the symptoms of suicidal thoughts have been added to the mix.

    Ketamine in a Pandemic for Depression and Anxiety Can Be A Lifesaver

    A team of medical researchers set out to try to  evaluate the psychiatric effects this global pandemic — and the restrictions that have been part of it — to better understand its impact on mental health in individuals around the world.

    They published the results of their survey.  One of the most remarkable outcomes was that 41% of adults showed they were more concerned about their increasing anxiety, than they were about their financial problems. That’s 2 in 5 adults.

    Two out of 5 in line at the grocery store. Two out of 5 in line at the gas station.

    Think about it.

    Also, 2/3 said they feel like they’ve lost control of their lives. Sound familiar?  And 56% say they find it difficult to manage their responsibilities amid this pandemic.

    So, yes.  You’re not alone. If you’ve been struggling with these things too, just recognize you’re not alone. You’re part of the “new normal.”

    Except that it doesn’t feel normal.  

    And it doesn’t mean you should keep struggling with these feelings of uncertainty, anxiety, and depression.

    Do call your doctor and talk about what you’re going through.

    And…if you’ve been taking prescription medicines, and find they aren’t helping, don’t lose hope.

    Reach out for ketamine treatment, which can restore your resilience in the face of all this. It can restore your initiative and motivation. Aren’t you glad that there is something that can help in times like these? Ketamine in a pandemic can bring remarkable relief for depression and anxiety that’s triggered by these restrictions.

    At Innovative Psychiatry, we’re providing ketamine treatment here in our office every week. We’ve instigated safety protocols that allow us to provide you the essential treatment you need to help you get through this stressful time.

    While the process of recovery from a global pandemic is more complicated and time consuming than we wish, you don’t have to live in misery. Ketamine treatment can restore your hope, your resilience, your initiative, and your confidence.

    And if hopelessness has been rising up inside you, stripping away your belief that things will ever get better, that’s a symptom. It’s not reality. And ketamine treatment can relieve those thoughts, and help you get your momentum back.

    We specialize in treating suicidal thoughts. In fact, we’ve done research which shows ketamine’s remarkable effectiveness with this symptom.

    If you suffer from the symptoms we’re talking about, call us.

    We’re here to help you find your best self again. We want you to enjoy your life and live well.

    You aren’t alone. You really aren’t.

    Reach out for help. Your best days could be just around the corner.

    To the rejuvenation of your best self,

    signature of Lori Calabrese, M.D.

    Lori Calabrese, M.D.

  • For the Depressed Mom: Ketamine Can Restore Your Joy

    For the Depressed Mom: Ketamine Can Restore Your Joy

    “Motherhood is a choice you make everyday, to put someone else’s happiness and well-being ahead of your own, to teach the hard lessons, to do the right thing even when you’re not sure what the right thing is…and to forgive yourself, over and over again, for doing everything wrong.” – Donna Ball, author of At Home on Ladybug Farm

    Let’s talk about moms.

    Yesterday was Mother’s Day, and if you were a mom yesterday, chances are, you’re still a mom today. We could talk about all the idealistic and billowing praises that are bestowed upon moms in greeting cards, but let’s don’t. Let’s talk about what it’s really like to be one. And if you’re a depressed mom, ketamine can restore your hope, your joy, and your stamina to help your children grow. More about that in a bit.

    Motherhood Is a Handful.

    With the best of intentions, you gather your kids together and tell them you’re all going on a camping trip. Together! But….there is so much to be done before you can all load the car. So in the spirit of pitching in and working for the common good, you assign each one a task that will help shorten the prep time.

    Then you focus on your own tasks which include packing food for meals. While you’re busy in the kitchen, you hear an unusual noise.

    Closer inspection reveals that your 10 year-old son is in the bathroom (which he was supposed to be cleaning) after putting his sleeping bag  by the front door, and has filled the sink with water.

    He’s floating a little boat on the water with his pet hamster in the boat which immediately jumps out of the boat, over to the counter and jumps down under the cabinet and disappears.

    Oh dear.  

    Now there’s a loose rodent in the house. Aaaarrrgghhhhh!!

    Feel your resilience waning..? If you find out you’re a depressed mom, ketamine can restore. Keep reading…

    Your son, who got bored cleaning the bathroom, had gotten distracted with his hamster. Now how to find the hamster?

    Kids are just kids. Full of surprises. It takes a sense of humor…

    When It Rains It Pours

    Meanwhile, you stop in the boys’ room and find your 7 year-old, who was supposed to clean his room after delivering his sleeping bag to the front door,  sitting among a pile of Little Golden books. Reading. (What joy!) But apparently he had to go through the entire bookshelf of 43 Little Golden  books to find the one he wanted to read. His floor is covered with books he’s tossed.

    After sternly instructing him to pick up all his books PRONTO! you realize you better check on your 21 month-old daughter. Distractions can pile up when you’re focusing on packing 3 meals a day for 4 days and you have a houseful of active children…you didn’t notice she wandered off.

    Turns out she’s in your bedroom. At first sight, you panic. Is that blood?  Her face is covered! What happened?? 

    Upon closer inspection after snatching her up in your arms, you see that it’s not blood. It’s lipstick. Her face is so covered with the stain of it, you know she’ll be raw by the time you get it even partially off.

    Then you look at your feet.  Your favorite white leather summer bag, and your butter soft cream-colored pumps, have both been painted with lipstick to match.  

    How thoughtful. Sigh.

    The fact that that was a brand new tube of lipstick is now beside the point.

    Calamities, Crises, and Catastrophes

    Then…sniff, sniff… what is that smell…?

    You head for the kitchen, baby girl on your hip, and the kitchen and living area are in a cloud of smoke…then BEEEEEEEEEEEEEP!!!!!!    The smoke alarms.

    Run to the stove. OH NO!! The eggs you put on to boil for sandwiches have boiled dry and are burning!!! 

    Move the pan off the burner. Turn off the burner. Open windows. Gather kids and go outside for fresh air.

    You collapse into a lawn chair and watch the kids playing happily in the yard. The classic comic escapades of Calvin and Hobbes comes to mind…

    Maybe you’ll just get chicken at the drive-through…?

    Add to all of this the challenges of quarantine in a global pandemic!  There aren’t words. But you do what you have to do, don’t you?

    Motherhood is providing a listening ear, helping with Cub Scouts and Brownies, fighting fevers in the wee hours, encouraging the discouraged, instilling hope, tutoring when homework overwhelms, instructing, providing structure, instilling values, creating celebrations, stretching the budget, inspiring creativity, keeping idle hands occupied, teaching self-reliance, comforting broken hearts, and so much more.

    And this is when you’re healthy, resilient, and stable.

    But what about when you’re not?

    What about when anxiety makes it impossible for you to participate in sports with your child, or Cub Scouts, Brownies, or Blue Birds? 

    The sheer dread you feel about leaving the house to take your child to these activities and interact with the parents makes it so difficult that you may make it a time or two, but eventually the energy required to push through all that dread and fear leads to missing meetings and practices…if not abandoning it altogether.

    To the Depressed Mom: Ketamine Can Restore Your Hope

    Then there’s the guilt you feel for failing to give your child every advantage.

    What about when PTSD creates such traumatic responses in you that you just can’t leave the house, and find your reactions are terrorizing your children…but you can’t make it stop..?  

    If you’re a mom with PTSD…or a depressed mom… ketamine can restore your resilience and your hope.

    A simple pat on the back when you attend a gathering, or a loud noise in the kitchen…even the deep voice of a stranger… can send you into such terror, sweating, and reactions that, you know, you just feel safer at home.

    Or when you just can’t get out of bed… so you get the children to watch TV, because you know at least they’re safe, but it nags at you because you know this isn’t a healthy, carefree way to spend childhood.

    But it’s the best you can do. 

    If you struggle with symptoms like these, and they interfere with the mom you want to be…and if the medicines prescribed by your doctor haven’t helped…  there’s hope.

    When you’re a depressed mom, ketamine can restore your joy.

    Ketamine treatment consists of 6 infusions, give or take, over the course of 2-3 weeks. It’s, hands down, the most effective, innovative treatment for severe depression, social anxiety, PTSD, bipolar depression, and alcohol use disorder.

    If you’ve been seeing your doctor and the medicines she’s prescribed have worked to reduce your symptoms, then you’re all set. 

    But did you know that at least a third of people who have these symptoms are not helped at all by prescription medicines?

    That’s where ketamine treatment comes in. It works in the brain in ways these prescribed medications don’t. And its remarkable, even extraordinary, and robust relief is transformative for most of those who receive it.

    Ketamine works in multiple ways and in multiple areas in the brain. And it’s fast. So, instead of having to wait weeks or months for a prescription to help you feel better, with ketamine treatment you can feel better in hours or days.

    Ketamine turns on mRNA so it will turn on DNA to turboboost BDNF — brain derived neurotrophic factor — that works like a rich compost to trigger the rapid and prolific growth of dendrites and dendritic spines in the neurons in your brain.

    This multiplies the synapse connections fast to send signals across your brain, and wake up your emotions. Creativity blooms, quick thinking, solid decision making, initiative, motivation, hope…and joy all come to life and transform your outlook and your productivity.

    And you can love life again. 

    You Don’t Have to Endure Suicidal Thoughts…You Really Don’t

    In addition, if you’ve been plagued by suicidal thoughts, it can stop those thoughts in a few hours. Then you can be free to invest in restoring your life, rebuilding your thoughts and infrastructure, and restructuring and strengthening your relationships.

    It may sound too good to be true…but if you’re a depressed mom, ketamine can restore the real you, the person who has dreams for yourself and your children, and wants to have the resilience to help them fulfill their dreams.

    At Innovative Psychiatry, we enjoy the privilege of watching people walk out with fresh joy and hope every week.

    If you’ve struggled with the kinds of symptoms we’ve talked about here, and medicines haven’t helped, call us.

    We’re here to help you live well again, to find your joy in life again.

    Ketamine doesn’t do this for every single person who receives it –of course not!– because there isn’t any medicine or treatment that helps everyone. But it does amazing things for most. There’s no other treatment currently available that brings relief and restoration so quickly for so many who are so symptomatic — in the privacy of a beautiful office, beginning that afternoon . . .

    Discouraged, Depressed Mom? Ketamine Can Restore Your Resilience

    You can sing again, experience joy welling up inside you, laugh with your children, and all the things you have wished you could do.

    Give yourself the opportunity to feel truly better. Spend this year enjoying your life and your family. We can help you get there.

    To the blooming of your best self, 

    signature of Lori Calabrese, M.D.

    Lori Calabrese, M.D.

  • Explore: Method to Differentiate Bipolar Depression vs Unipolar Depression

    Explore: Method to Differentiate Bipolar Depression vs Unipolar Depression

    As you may know, May is mental health month.

    IV ketamine can restore her joy whether it's bipolar depression vs unipolar depression.

    And as such, it’s a good time to talk about symptoms of mental health disorders, don’t you think? We want to increase understanding and dispel stigma which will help people who suffer gain better access to the help they need. Stigma is steeped in ignorance about something someone doesn’t understand. In addition, the global circumstances of these last few months have impacted the mental health status of so many. So let’s use this month to broaden understanding and better equip us to respond to ourselves and those around us. So here’s something to talk about: A new way to differentiate bipolar depression vs. unipolar depression may be emerging.

    Leading Cause of Disability

    The leading cause of disability in the world today is not heart disease or cancer…it’s depression. Depression is that common. We talk about severe depression and we talk about bipolar depression. When you see someone with either of these conditions, they may look rather similar from your vantage point, but they’re actually two distinctly different conditions.

    When we diagnose someone in this depressed state, it can be difficult to determine whether they suffer from major depression or bipolar depression, unless they have a history of mania or hypomania to determine the difference.

    Unipolar depression and bipolar depression don’t feel the same…but they do sort of look the same.

    Which is why a doctor asks whether you’ve had times when your mood was elevated, you felt energetic, hyperactive, maybe irritable, angry… and overly confident…all at the same time?

    For this reason, so many with bipolar disorder are first diagnosed with major depression, especially those with bipolar II disorder, since their symptoms include far more depression than hypomania.

    When you first see a psychiatrist about your depression, it’s important to be patient. Because some of your symptoms may not have emerged yet…and you may appear to have unipolar depression. Then later, mania or hypomania emerges, and your doctor may change your diagnosis to bipolar disorder, along with your prescriptions.

    Because of the challenge of diagnosing someone accurately who has a low mood, researchers have been seeking a means of using some sort of biological markers to determine scientifically the proper diagnosis and character of the depressive symptoms.

    This man is in pain but doesn't know if it's bipolar depression vs unipolar depression.

    Something that would differ in patients with unipolar depression from those with bipolar depression. Possibly brain activity. Or maybe proteins in the blood? Possibly genetics?

    Exploring Bipolar Depression vs Unipolar Depression

    An interesting study conducted by Brain and Behavior Foundation researchers, led by Mary Phillips, Ph.D., performed with a relatively small group of subjects, suggests a way your doctor might differentiate the two disorders clinically to aid in accurate diagnosis.

    Using functional magnetic resonance imaging (fMRI), full brain scans were conducted on a group that included 18 bipolar patients who were in bipolar depression, 23 depressed patients who’d been diagnosed with major depressive disorder (MDD), and another 23 who were healthy without a diagnosed disorder.

    It’s unfortunate that their study involved so few, and also that 90% of those with bipolar disorder were diagnosed with bipolar II disorder, leaving only 10% who had bipolar I disorder. A more evenly distributed group might have told us more.

    Even so, they did make some significant observations.

    The working memory system is used by the brain to maintain, manipulate, and update information that is associated with tasks that are presently at hand. When the networks of nerves in this system are damaged, learning – reasoning – and decision- making ability can be disabled.

    This is particularly true in those with mood disorders, like depression.

    So, the researchers gave each participant an easy task and a difficult one, while the participant was undergoing an fMRI brain scan. The design of the tests was to highlight that people form expectations about a task before they fulfill it.

    Bipolar depression vs unipolar depression can both be treated effectively with IV ketamine treatment.

    A person might feel the task will be easy, so there’s little stress in performing it. But if he expects the task to be difficult, his stress increases before he begins.

    It turned out, that there were patterns of neural (brain cell) activation in the medial and lateral areas of the prefrontal cortex, that were related to how easy or difficult a task would be.

    Mechanism Defends the Person with Bipolar Depression From Emotional Pain

    The researchers reported that people with bipolar disorder may actually block anticipation of a negative experience to avoid experiencing negative emotion while performing a task. That basically people with bipolar disorder seem to have a built in defensive mechanism to help protect them from negative emotions.

    So enlightening. People with unipolar depression don’t do this. They feel what they feel. But those with bipolar experience such damage from their negative emotions.

    As I said earlier, unipolar depression and bipolar depression may look similar to someone observing people suffering from these. But they feel different.

    Let’s add to that, that both of these disorders can often end in suicide, unfortunately. Even so, it’s more common in bipolar disorder.

    There are traditional medicines for people with these disorders. And those medicines do help a lot of people.

    But not all.

    For that reason it’s important to seek help until you find treatment that helps you feel better, function better, and live a rewarding life.

    IV Ketamine Doesn’t Differentiate Between Bipolar Depression vs Unipolar Depression – It’s an Extraordinary and Robust Depression Treatment

    At Innovative Psychiatry, we offer IV ketamine treatment to help you experience relief from severe depression that prescriptions haven’t helped…. And for bipolar depression that is unrelenting in spite of prescription medications.

    Bipolar depression vs unipolar depression for this woman is still crushing.

    IV ketamine treatment isn’t effective with mania or hypomania. But the mania or hypomania is easier to manage and treat without bipolar depression. This treatment can be exceptionally effective for both unipolar and bipolar depression. In fact, it can be utterly life-changing.

    And… in regard to the risks of suicidal thoughts, IV ketamine treatment can erase those thoughts in an afternoon. A few hours. And if you’re not plagued by thoughts of death and dying, you’re a great deal freer to work toward healing, restoration, and joy.

    In this current global crisis, suicides have been increasing, among those with disorders, healthcare workers, physicians, and more.

    IV ketamine can save lives by removing thoughts that lead to suicide.

    IV ketamine has given her joy instead of depression.

    If you suffer from bipolar depression or unipolar depression, and medications haven’t helped, call us.

    Let us help you find your joy again, and your hope. The current global crisis is temporary, but it has affected the outlook of millions. The good news is that joy can be restored, and hope can return. You can feel resilient, and equipped for what life has in store.

    We’re here for you, and we’re working within a safety protocol so you can be treated without fear.

    Better days are ahead.

    To the restoration of your best self,

    signature of Lori Calabrese, M.D.

    Lori Calabrese, M.D.

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