Category: Ketamine

Articles About Ketamine from Lori Calabrese, MD | The Ketamine Blog

Breakthrough anesthesia medicine proves life-changing for many who suffer from severe mood disorders.

In the last several years, a medicine began to emerge as a remarkable treatment for mood disorders. It was developed and FDA approved for anesthesia around 1970. Over 25 years later… it began to show its colossal hidden ability. What sort of ability? The power to relieve depression and other psychiatric disorders in a most dynamic way. Disorders like PTSD, bipolar depression, postpartum depression, addiction, social anxiety, and even eating disorders respond to this extraordinary treatment that involves a series of IV infusions. And perhaps the most remarkable of all, ketamine infusions can erase suicidal thinking in a few short hours. These articles about ketamine treatment are presented here to dispel stigma about psychiatric conditions and to give hope about treating them.

Early Testing was Cautious

Researchers tested it with trepidation 10-20 years ago. Then each study built upon the last. Their work revealed more insights about what actually causes depression, and how to treat it effectively. Never before has a medicine helped relieve symptoms in such a wide variety of people and their symptoms.

Researchers Still Learning All Ketamine Can Do

Ketamine works in multiple areas and systems of the brain. It improves the function of mechanisms that have been impaired by the stress of depression and anxiety. It helps the G proteins that pile up on lipid rafts in the cell membrane slide to off. This equips them so they can do their job enhancing signal transmission.

It also turns on the mRNA switch which in turn flips on DNA to build up brain-derived-neurotrophic-factor (BDNF). BDNF then causes synapse connections between neurons to proliferate in turbo mode, transforming and replenishing the connections between brain cells all around the brain, lighting it up with information, cognition, creativity, and insight.

There’s more that it accomplishes, like tamping down the cell bursting in the lateral habenula so you can experience the reward of pleasant moments. We don’t know what researchers haven’t discovered yet, but we look forward to hearing what’s next.

Ketamine Does More Than Bring Relief, It’s Transforming

The results of IV ketamine treatment are transformative. Those who have been weighted under a blanket of lethargic apathy and despair typically find they feel better and better after treatment. They often find they have the energy and motivation to dive into tasks they couldn’t face in recent memory.

More patients with treatment resistant conditions respond to ketamine than any other medicine available. It may sound odd, but the patients it helps the most are those who suffer the most from severe disorders. With continued research, neuroscience researchers and psychiatrists are learning methods of administration that help more and more patients enjoy a rapid and robust response,.

As a result, these individuals enjoy renewed hope. They express amazement at their energy for life and work, and an overall transformation in what they enjoy and are able to accomplish. They report a more balanced and joyful outlook, and the desire to rebuild and strengthen their relationships.

Ketamine is NOT for Everyone

With all the good IV ketamine treatment accomplishes, some people still don’t respond to it at all. The percentage of people who don’t respond is comparatively small, and we need to see more studies that can help explain why.

Why Ketamine Sometimes Doesn’t Work

There are others who have a significant response initially, then the response fades. One reason for that may be they have a deficiency of certain components in their blood. They may have a low folate level, or low testosterone, and some other deficiencies. In cases like this, sometimes replacing those nutrients helps that patient respond to ketamine treatment and experience resilience again. There are even cases where a patient’s blood levels are normal but the levels of certain components in their cerebral spinal fluid is low. By replacing that deficiency, the patient is able to enjoy a very positive and robust response to ketamine treatment.

Neuroscience is gaining knowledge by leaps and bounds in the 21st century. We hope to see more and more medicines that work as well as ketamine for those who have not yet been helped.

These articles about ketamine expand on those things we learn from neuroscience research in the labs, as well as those things we learn from research in our practice.

True Recovery From Trauma and How to Find Restoration

Trauma: Don’t Beat Yourself Up – Allow Your Loved Ones to Lift You UP

Have you been through something traumatic …? Maybe you’re a combat veteran, a first responder, or a victim of severe domestic abuse. It might have been a car wreck, or the unexpected sudden loss of someone you love. Fixed beliefs you form about that traumatic experience can insulate you from working through the scars you feel. If you tell yourself you “shouldn’t” be reacting to the incident, it keeps sitting deep inside you…haunting…but not healing.

Truth be told, you were traumatized. By rape. Infidelity. Fire. Hurricane.

What matters is that it traumatized you.

No one but you knows what has shaken you to your core. And continues to keep you shaken. But no one needs to. This was your experience. And YOU need to heal.

People are individuals and don’t react the same to the same stimulus. One combat veteran finishes his tour and goes back home, gets a job, and proceeds to build his “after-combat life.”

It’s not that he’s not shaken. But his reaction to all that happened may not have shattered him like the next guy. People go through divorce. One ex-wife gets thoroughly angry and surges forward like a steam engine to overcome the heartbreak she feels about her husband’s infidelity. But another one may be so shattered, so disillusioned she can’t work, can’t function, and trembles or vomits when she sees her errant ex-husband or drives by their favorite restaurant.

Sometimes It’s Appropriate to Let Yourself Feel Loss

But then, there’s another reaction. This is you if you’re the abandoned spouse who’s so empathic toward others and their pain that when you’re in pain you just try to ignore your sorrow when you see others who seem to be suffering more.

Sadly, you validate the pain and sorrow of others, and dismiss your own. The result is that you can’t validate your own grief like you would for someone else to help them heal. Sound familiar…?

Hey, Loss is Traumatic: It’s Not a Competition

If a woman loses her husband in a car wreck, and watched him die, she has reason to be heartbroken and deeply shaken. The fact that another woman lost her infant child in a sweeping illness does not trump the widow’s pain.

Both woman have lost a treasured loved one through horrifying circumstances. Both women felt helpless. There is no measuring stick to compare the loss of a husband with loss of a child. Both losses are terrible, and life-altering. In both cases, the women hurt terribly. Both were traumatic.

And both women need support, kindness, a listening ear, and patience. Both may certainly need counseling at some point to help them restore their desire to live and go forward. They’re not in any sort of contest with each other.

In fact, they’re each faced with shock and grief. And people do have to find their way through these very difficult times of life. Often they come through such times as a natural process. Other times it requires treatment.

But either way, the loss is devastating. And each person who suffers terrible loss is justified to feel traumatized…to grieve. To be supported. And to recover.

Let’s look at another perspective.

When a Traumatized Person Who’s Evaluated For PTSD, Is Not Given that Diagnosis…

Does it mean he or she wasn’t traumatized…? Or that the shock or pain of it wasn’t that serious?

NO.

There are certain criteria required for a PTSD diagnosis. Every person is different and responds to painful or traumatic experiences individually. Your pain, loss, grief, and trauma are real and valid.

Don’t let a label or diagnosis invalidate what you’re going through.

Some people, after a deeply traumatic experience, are actually diagnosed with PTSD. Most aren’t. What’s more, there can be other diagnoses after you endure something like this. If it’s not PTSD, it may be depression, or it might be panic disorder, or substance abuse, or an eating disorder.

Or…it might be that you’re sorting through all the complicated effects of grief, shock, and pain that can accompany a traumatic event or experience. To achieve true recovery from trauma requires that you be honest with yourself, as well as patient.

Let’s set labels aside.

If you’re suffering, that’s all anyone needs to know. And your suffering is valid. As time goes by, after a few years, if you’re still suffering the same symptoms you suffered immediately after the event…or even during the event …. then it might be time to see a psychiatrist to find out how to help you move forward.

Because a life-altering event isn’t something you just get over. It’s a part of who you become…every major life event is. But if the way you feel about it is preventing you from living your life and productively contributing to your job or hobbies you enjoy, it may be that an intervention can help you get your life back.

True Recovery From Trauma

Mental and emotional health isn’t defined by a lack of difficulty or upheaval, but by the skills you learn as you live to cope and recover from those challenges and difficulties that happen.

Resilience … takes time to develop.

And…even if your ability to cope needs a little nudge or a leg-up, you’re still learning and building your life skills. And you’ll continue.

The Secret of the Phoenix

There will be fires and wars in life. Betrayals and shocks. But if your goal is to learn to rise from the ashes, you’ll likely gain strength and resilience through the processes you endure, and the storms you weather.

Even so, if you find that the results of trauma in your life have interfered dramatically in your ability to move forward — whether you have PTSD, general anxiety disorder, panic disorder, severe depression, bipolar disorder, substance use disorder, and especially if you have suicidal thoughts — call us.

At Innovative Psychiatry we specialize in helping people who haven’t gotten better with other treatments.

And the most powerful tool we’ve found among the novel, advanced treatments we offer is ketamine treatment. Sometimes in the process of grief, or in processing trauma, you can get sort of stuck, unable to progress forward into a healthier place. Ketamine treatment has proven over 50 years its safety with adults and children.

The extraordinary actions of ketamine treatment can rebuild the structures in your brain that stress and trauma break down. It’s like it restores your tool box so you can rebuild your life. And it can be a huge help in your true recovery from trauma.

Learn about how to choose the best ketamine clinic, or best psychiatrist who offers ketamine treatment, and be your own best advocate. You deserve to live well and enjoy a restored life.

To the restoration of your best self,

Lori Calabrese, MD

July 30, 2018
The Truth About Bipolar II Disorder: How To Get Your Life Back

You Can Know if You Suffer From Bipolar II Disorder

and What You and Your Doctor Can Do About It

Clara is a 27-year-old artist whose talent has opened opportunities for her she never dreamed possible. She’s published books of her original poetry and children’s stories she wrote and illustrated herself. She paints watercolors of children playing amid lovely floral backgrounds … and sells them through a local gallery.

Clara’s light-hearted artistry belies her deeply analytical and moody personality. She says she paints the world the way she wishes it was, rather than the way she sees it.

She experiences long periods of sorrow…self-criticism…shame. Then sometimes, out of the blue, she’ll feel more normal again — and she’ll rush around to buy groceries, clean up her place, and have lunch with friends…until that brief “normal” period is replaced by that all-too-familiar sinking feeling again.

Clara was diagnosed with bipolar II disorder. Most of the time she labors under the leaded blanket of bipolar depression…and occasionally she’ll feel better for a few days. Her “hypomanic” periods are really just about what “normal” would be like for someone who wasn’t ill.

She can’t believe this isn’t just depression.

The Good Times Roll…and Then They Plunge…

Then, there’s Ben. He’s 33 and works in the IT department of a large hardware company. He’s been promoted regularly due to his innate ability to problem-solve software “puzzles.” Ben finds that there are periods when he’s particularly astute, and can work long hours relishing in the challenges before him. At these times, he gets by on little sleep — and feels fine with only 4-5 hours a night.

He loves to get with co-workers for a beer after 16 straight hours of fighting a problem together. He buys drinks for everyone, along with appetizers for the team. Then after a few hours of shut-eye, he’s ready to jump back in again.

However, those times come and go.

After a period of almost spectacular productivity, it’s as if someone blew out the candle. He begins to slow down…really slow down…more and more until it’s hard to rub two thoughts together. During these times he feels heavy, sluggish. He manages to go to work, but once there, he feels dull. And he chows down on chips, cookies, cokes, and pasta. Before long, he can no longer button his pants.

It’s so humiliating. His coworkers – the ones he bought rounds of drinks for 2 weeks ago – poke at him. Tease him. They really like him but don’t understand that he’s powerless to be different right now, and the aggressive ribbing just make his shame more intense.

He just wishes he could go to bed and sleep. He feels overwhelmed at his own failure. He’s convicted of his complete worthlessness.

His boss starts pushing, getting annoyed with his poor performance. Ben feels helpless. Powerless. And ashamed. Worthless.

Then, after a few months, just before his boss is about to lay him off, his energy comes back. Suddenly, he’s brilliant again, and in two weeks makes up for all the down time when he was so depressed.

Ben sees a psychiatrist for his condition, but the treatment hasn’t helped. The doctor diagnosed Ben with bipolar II disorder.

No One Understands: Their Lovable Friend Retreats in Pain

Kelsey is 29 and has a job as a lab tech in the community hospital. She’s fast and efficient in her job and loves it. She has a bright and sparkling personality most of the time. Her coworkers love socializing with her outside of work.

They all want to be her best friend.

But sometimes she withdraws…calls in sick for several days…and avoids answering the phone. She thinks she has the flu from all the aching in her back, arms, and legs. And being home in bed is a welcome relief from the pressures and chaos of the office. She needs rest, she tells herself, and she’ll be ok.

After a week of reprieve, she steels herself to face it all again, and is back at work on Monday morning. But she decides to see her doctor when she realizes she’s still not herself a week later.

After a thorough examination, and lots of questions, her family doctor tells her he believes she’s suffering from Major Depressive Disorder (or unipolar depression, as some call it), and prescribes an antidepressant to help her feel better.

The antidepressant is a SNRI (serotonin norepinephrine reuptake inhibitor) and he expects it to relieve the aching she experiences during these “down” times.

It takes a couple of months, but Kelsey does begin to feel better. She wakes up with more and more hope each day… feels less need to withdraw … and the aches and pains subside. Finally.

The Solution Becomes the Problem

But then something weird happens. About 5 weeks after beginning the SNRI, Kelsey notices herself talking more at work — and at social gatherings, too.

After she goes home she thinks back and realizes she did most of the talking herself…like a veritable Chatty Cathy. It’s embarrassing… what’s wrong with her? She dominated the entire evening! groan…

But she still has the energy for work again and that’s a great relief.

The next week, she deposits her paycheck, and goes shopping. First she decides on new sheets … then she thinks it would be nice to make all her linens match, so she chooses bright cheerful sheets, pillows, duvet cover, towels, bathmats.

The bag is humongous so she takes it to the car then goes back into the department store.

The store is having a sale, and it’s so exciting that she just happens to be there — what great deals! She spots dishes that match her bed and bath linens, then pots and pans.

On her way out she notices those shoes she’d seen in a haute couture magazine…and buys them! She works hard. This is her special reward.

Oh boy! she says to herself, How beautiful and cheerful my whole apartment will be with everything matching. She pulls out her debit card and pays for a full set of dishes complete with matching serving bowls and the matching set of cookware.

The clerk suggests she bring her car to the door so they can help her load it all up.

After loading, she calls a friend to meet her for lunch at the nearby Italian bistro, and off she goes feeling exhilarated.

Following a yummy lunch with her friend and lots of lively chatter, the waiter brings the check. Kelsey pulls out her debit card and offers it to the waiter. In short order the waiter returns.

“Ma’am, this card was declined… do you have another we can try?”

OH NO. In Kelsey’s enthusiasm, she didn’t think to subtract her purchases from her balance. She had spent her entire paycheck without even noticing.

She asks her friend to cover lunch with promises she would pay her right back. What choice did her friend have…? Kelsey knew her friend wouldn’t look at her the same way again. She was devastated…confused… her face flushed and she tried to hide it.

She also knew she should probably return all the stuff she bought. But she just didn’t want to.

What happened…?

Bipolar II Disorder Can Hide For Awhile

Sometimes, a person who’s diagnosed with unipolar depression can take an antidepressant … and manic symptoms emerge.

Kelsey’s relief from depression and physical pain led to a phenomenon that sometimes happens with persons who are depressed and take antidepressants.

Kelsey actually suffers from bipolar disorder, but was mistakenly diagnosed with unipolar depression and treated with an antidepressant because she had not had a manic episode at that point.

The antidepressant either triggered hypomania in Kelsey… or… this was her first hypomanic episode.

Either way, she unwittingly plunged into a crisis.

Bipolar III?

Many doctors call this Bipolar 3 Disorder, which isn’t a real diagnostic term…but more a nickname for the condition when someone with depression who’s never exhibited bipolar symptoms suddenly does upon beginning an antidepressant.

If you’re old enough, you may remember the popular talk show host, Jane Pauley from the Today Show. This was her experience. And in a televised interview, she referred to her condition as “bipolar III.”

Aside from labels, Kelsey needs to be watched carefully by her doctor who’ll cautiously treat the symptoms as they present themselves, evaluating her condition going forward. But that’s another article for another day.

Treatment for all the variations of mood disorders doesn’t line up in black and white categories, but in combinations and shades of gray and it’s important to find the one that best helps you personally.

Bipolar Disorder is a Spectrum Disorder

So, we’ve mentioned three people who share a bipolar diagnosis, but whose symptoms are not that much alike. The point is that bipolar disorder is a spectrum disorder and its diagnosis relies on the patient’s – and their family’s – observations and descriptions of symptoms.

When you suffer from bipolar I, the upswing symptoms tend to be more severe … harder to ignore…and the diagnosis is less difficult.

The distractibility is clear, the recklessness and impulsivity are OBVIOUS, the high energy and lack of sleep and grandiosity can slip quickly down a slippery slope. It’s mania through and through, and it can dig you into a hole, fast.

But bipolar II is more complicated to diagnose because your symptoms land in a variety of places on a symptom spectrum. And sometimes even the symptoms you expect to see aren’t really there… yet. And may never be.

The better you understand your symptoms and recognize them, the more you and your family can help your doctor arrive at the correct diagnosis and the best treatment for you.

How to Understand a Spectrum Disorder

In his book, Why Am I Still Depressed? Recognizing and Managing the Ups and Downs of Bipolar II and Soft Bipolar Disorder, Jim Phelps stresses the importance of gauging symptoms on a continuum, rather than checking them off an arbitrary list.

Because we’re human, and everyone has a little of something that can be a symptom in someone else.

You may know someone who has milder insomnia but somewhat pressured speech and …severe irritability. They tell you they have bipolar disorder. So you think that’s what bipolar looks like.

In your case, you may feel confident and clever at times, even at times engaging everyone at a dinner party. Still, behind closed doors you have periods of extreme agitation and impulsivity. Or maybe risky behaviors like spending sprees, speeding, or intense sexual behavior that isn’t your norm…?

It’s tempting to say things like, “Maria doesn’t have bipolar disorder. It must be something else causing her problems. Because my daughter has bipolar disorder, and Maria and my daughter don’t act the same way at all!”

Each Person is Unique – So Psychiatric Disorders Are Unique in Each Person

But the fact is that there aren’t absolutes, but rather varying degrees of various symptoms that interfere with a productive and fulfilling life. And that’s why we seek to treat these symptoms…because they interfere with your life and the way you want to live it.

At Innovative Psychiatry, we see people with bipolar disorder in all its varieties every day. And we work with you to help you feel better. Not to just improve, but to feel so much better you can finally live and enjoy the things that are important to you. You can build and strengthen your relationships. You can focus again to read what you want to read and do things you enjoy. And you can show up when and where you’re needed.

And if you’ve tried other treatments for your bipolar diagnosis that haven’t helped much at all, don’t give up. Chances are that ketamine treatment may be just what you need to feel balanced, motivated, and able to relax and enjoy the moments of your life.

The beauty of it in bipolar disorder is that it lifts depressive episodes quickly — so you can avoid the risks of switching into hypomania or mania that come with using an antidepressant for weeks … or months.

That is so worth it.

The Concept of Spectrum Disorders

We encourage you to read Dr. Phelps’ book to gain insights about your own condition. And some of my blogs. Try to understand the concept of a spectrum illness. Ask your doctor. Get a second opinion.

And if you’d like to see what life is like without phobias, panic attacks, social anxiety, bipolar depression, PTSD, OCD, and… worst of all… those thoughts of death and suicide, call us.

Because every person is different, and responds to medicines differently than every one else, there are no absolute guarantees. But given our success rate, chances are ketamine treatment can turn your life into one you enjoy living.

To the emerging of your best self,

Lori Calabrese, MD

July 23, 2018
Can Inflammation Cause Depression? It All Depends on Your Childhood

Neuro

Neuroscience Discoveries Show Inflammation Can Cause Depression – Especially If You Experienced Severe Stress in Early Childhood

Lillian was in second grade when her mom went to work full-time. For the first time in her life, she would get off the school bus and walk down the street to her house, pull out her key and unlock the door.

Lillian was intelligent and responsible. But when she opened the front door and walked into the dark house, she was scared. She’d creep to the couch, shaking as she turned on a lamp, and sit there until 5:30 when her parents got home.

She often cried during those hours.

Some people could adapt to that just fine. But for some, experiences like this can be traumatic.

Second grade, third grade, fourth grade…. Those long hours in that dark and empty house were a crucible of terror for this sensitive little girl. It didn’t help that her parents weren’t the “sensitive” types. They chuckled about her fear. They just didn’t get it.

A Child Silently Suffers

As little Lillian advanced to middle school and beyond, she suffered for years with undiagnosed depression. Not that her parents were aware. Quite to the contrary, they were proud of their talented and intelligent daughter. As long as she continued to perform, they were happy.

“I see you have an A- on your report card. What happened? Why wasn’t it an A?” Their idea about parenting was to expect the best of their children, and never praise anything short of that. They fully expected their high-achieving daughter to go to medical school, and they had no intention of threatening their bragging rights by supporting what they considered mediocre.

In fact, they expected her to become a pediatrician. That was the plan.

But Lillian, in spite of her high grades, wanted to ride horses, study animal husbandry, and write songs.

Unwitting Parents Tear Down Resilience

This isn’t the first time parents’ dreams for their child remained unrealized. Neither was it the first time a budding teenaged girl felt misunderstood.

When Lillian and her friend dressed to go to an 8th grade dance, before they walked out the door, her mom said, “Lillian, you need to cut your hair. It looks shaggy. And you need to lose weight in your hips. They’re too big!”

The lithe but discouraged girl looked at her shoes… wishing she could be swallowed up by a hole. How could she face the 8th grade boys when she felt so ugly?

Experiences like these accumulated through her teens. Once she was married and gave birth to her first child, the depression grew more severe. It became worse and worse until she stayed in bed most of the days…unable to function to care for her children.

Finally, she was admitted to a community psychiatric hospital. The depression that had plagued her during her formative years escalated to full blown disability. And she improved only marginally from that hospitalization. There would be many to follow.

But why?

Can Inflammation Cause Depression if You Suffered Early Childhood Stress?

An article by Carmine Pariante, MD, PhD published in Psychiatric Times in May, points out some of the ways research is revealing patients with depression have increases in their inflammatory system. Elevated levels of “cytokines” which are substances, like interferon, interleukin, and some of the growth factors, secreted by the immune system indicate inflammatory activity.

Even so, what’s interesting is that not all people who suffer from depression also suffer from inflammation.

They found through a series of studies between 2009 and 2017 that excessive stress early in life, as well as the stress of lower socioeconomic status and cardiovascular risk factors, can lead to inflammation. But of these factors, early life stress was by far the largest correlate to inflammation.

Can Inflammation Cause Depression?

In recent years, we’ve been able to even connect the dots of inflammation in adults who were exposed in the womb to their mothers’ perinatal depression. The link was so significant that researchers were able to make the connection that stress in the womb is linked to inflammation in adults, with or without depression symptoms.

Stress in the womb is a risk factor for inflammation in adults!

Then they took it a step further…

Several studies revealed that certain genetic variations lead to depression symptoms…but only in those who suffered early life stress.

Then things got even more interesting.

Can inflammation cause depression?

Since omega 3 fatty acids fight inflammation, the researchers found that patients with low levels of DHA and EPA had more inflammation. So they speculated that when the levels of DHA and EPA are low, that condition would cause inflammation-induced depression.

DHA is the nutrient added to many infant formulas that’s also found in breast milk. DHA and EPA are long chain omega 3 fatty acids that account for 97% of the omega 3 fatty acids in the brain. They’re vital for optimum brain function and development.

And the researchers were right. They performed a clinical trial with patients who had these low levels…dosed them with EPA and DHA… and found it prevented or delayed onset of this type of depression.

This discovery showed them that patients with low levels of EPA and DHA omega 3’s can be treated with nutrients to restore these reserves and potentially prevent the inevitable depression that can follow.

Personalized Medical Care Means Faster and More Effective Treatment

This innovative discovery empowers us with one way to provide personalized interventions for depressed patients based on their individual cause of depression.

They also found that of those with low omega 3 levels, only those who experienced early life stress became depressed. Others with low omega 3 levels showed inflammation without depression.

What’s more, those who experienced stress in the womb due to their mother’s depression during pregnancy, showed inflammation and depression in adulthood.

Certainly, not everyone who is depressed shows those inflammation markers in their lab work.

But for those who do, we can provide more effective and novel treatments to help them recover.

If they don’t need an antidepressant, but do need dosing of EPA and DHA, and if that intervention will restore their emotional balance, how much better to treat the real fundamental problem.

More Neuroscience Research is Needed

Neuroscience researchers continue to uncover mysteries as they work to find solutions for your suffering. I would like to see studies involving depressed patients who fit these categories treated with IV ketamine infusions.

Is it possible that the patients who don’t seem to readily respond to ketamine treatment are actually those low in EPA and DHA?

On the other hand, would these patients respond to ketamine treatment without doses of EPA and DHA?

So many more studies are needed. In fact, the more we learn, the more we realize what the questions are!

At Innovative Psychiatry, we continually seek novel and effective treatments for you if you suffer from treatment-resistant psychiatric disorders.

Personalized treatment drives us with each patient.

We work hard to find out how to help you get better, based on what factors led to or contributed to your symptoms.

From ketamine treatment to strengthening your microbiome to adding nutrients to your diet and more… we want you well.

Let’s work together to help you get better, so you can enjoy and build a fulfilling and rewarding life. Call us.

To the blooming of your best self,

Lori Calabrese, MD

July 16, 2018
Anxiety and Panic Disorder: Can This Condition Be Quelled?

Anxiety and Panic Disorder – A Tormenting Presence

“Am I going to die? I feel like I’m dying…”

“No, you’re going to get through this. You’re having a panic attack. Just keep looking in my eyes and holding my hand. These feelings are going to pass in a few minutes. Hold on…” The emergency department nurse reassured the shaken young man.

He looked to be in his mid-twenties, a handsome, dark-haired guy with a 5 o’clock shadow getting ahead of itself.

“What’s happening to me? Am I dying …?”

“No. This is fear. It’s a real feeling…but it’s not an accurate assessment of what’s happening. You’re doing fine. This feeling is going to pass. Hold my hand…”

“How do you know I’m not dying…? It feels like I’m dying…”

The nurse ached for him. “I’ve seen this before. This is a feeling you’re experiencing. It’s a panic attack. Do you have a pet at home?”

“Yes, I have a dog.”

“What’s his name…?”

“Barkley. Do you think I’m dying now? Just tell me the truth.”

“No…you aren’t dying. Your pulse is a little faster than usual but it’s regular and your blood pressure is sta-“

He cut her off…

“Are you sure…?? Why am I sweating? Because I feel like I’m dying…”

“I know you do. It’s hard to feel like this. But you’re ok. This feeling is going to pass. Do you have any children?”

“Yes, I have a little boy. Will you please tell him I always loved him very much?”

Panic Attacks Can Take Many Forms

Sometimes you may scream and cry; sometimes you may feel frozen and unable to move, sometimes you might just talk about the feelings of imminent death or impending doom like our friend Tom in the Emergency Department.

If you’ve never had one, here’s how to imagine it:

Think how you’d feel if you came upon a grizzly bear in the woods. You might be frozen with fear or feel overwhelmed with your imminent death… or you might just break into a sweat — or a scream…

“Tom, you’re going to be able to tell him that yourself in just a little while. What grade is he in…?”

“He’s in second grade. Are you sure this is a feeling? Because…it feels like it’s real. I wish I had spent more time just playing with him. He doesn’t deserve this.”

“Tom, just make the decision now that you’ll spend more time with him. You’ll have plenty of opportunities. What would you like to do more with him…?

“Oh anything. Basketball, soccer, playing at the park… He deserves more… I might be feeling a little better…. Is that possible?”

The nurse sighs in relief. “That’s great to hear. I gave you some medicine to help you relax. I’m glad you’re feeling better…it’s going to get better and better now… “

“Oh, I hope you’re right. I thought I was dying…”

Tom has never seen a psychiatrist. No one in his family has. But there’s high blood pressure, heart problems, an uncle with diabetes.

He checks again. “You’re sure I’m not going to die…?”

Anxiety is a bear, but panic attacks are dragons.

Panic attacks come when you least expect them, and in full force. If this happens to you often … even regularly … you may have panic disorder.

Traditionally, anxiety and panic attacks have been treated with anxiolytics, or medicines that cause symptoms of anxiety to diminish.

And also antidepressants – both SRI (serotonin reuptake Inhibitors) and SNRI (serotonin norepinephrine reuptake inhibitors) varieties. And when they work, well…they’re a Godsend.

But far too often they don’t help. Even after trying 2 or 3 different prescriptions, increasing the doses, adding augmentation agents like buspirone.

Sometimes the side effects of the medicines are just too much. Maybe they’ve made you tired all the time, or interrupted your sleep. Maybe you’ve gained weight. Developed chronic GI side effects. Found that your libido is non-existant or that you’ve developed other sexual side effects.

Then what?

Some people are able to get the panic under control with a combination of SRI or SNRI antidepressants combined with Cognitive Behavioral Therapy (CBT).

If your doctor has tried antidepressants, anxiolytics, and even mood stabilizers in an attempt to help you get better, but no combination has worked… then it may be time to consider more novel advanced treatments.

Things like Transcranial Magnetic Stimulation (TMS) or ketamine treatment.

Novel Advanced Treatments To Consider for Anxiety and Panic Disorder

Sound weird?

These treatments aren’t weird…they’re very 21st century.

Transcranial Magnetic Stimulation (TMS)

TMS uses a magnetic coil placed over your head, that sends pulses deep into the brain. These pulses stimulate your brain cells to become healthier and function properly.

As a result, you begin to feel better and better during the 3rd or 4th week. It doesn’t work fast…but it works well in about 70-75% of people. TMS requires appointments five days a week for roughly 4-6 weeks. And there are treatment protocols for anxiety disorders that are quite effective.

Ketamine Treatment for Anxiety and Panic Disorder…?

Ketamine was developed in a laboratory in the 1960’s as an anesthetic. And it’s been used in the operating room for over 50 years. It’s effective and has proven itself as a safe medicine when used for that purpose.

Then, several years ago, ketamine began to be tested for depression. And it’s made a huge difference for many of those who received it. There have been some bumps along the way, as we’ve learned about how to help its benefits last, and which routes allow the most wonderful outcomes.

Now, in 2018, ketamine is receiving increasing respect as the most extraordinary antidepressant neuroscience has seen in the last 50 years.

What’s more, it’s being tested in laboratories and clinical practices, and we’re finding ketamine’s benefits are widely experienced by people who suffer with a host of different psychiatric disorders.

Things like major depression, postpartum depression, treatment-resistant severe depression. Also anxiety…generalized anxiety disorder, social anxiety, and panic disorder.

Add to that PTSD, OCD, and suicidal thoughts.

This medicine is life changing.

But let’s talk about panic disorder and a case study from 2016 that indicates that ketamine might be useful for it. Because right now, panic disorder lacks extensive studies using ketamine. More studies are needed to validate the results some doctors are seeing regularly in the office.

In the case study, Ms. A suffered deeply from panic disorder, agoraphobia, generalized anxiety disorder, and major depressive disorder.

For far too long, she’d been unable to leave the house or use public transportation, and felt unable to learn to drive because of her anxiety. Panic attacks at least every week caused her to believe that she’d never be able to manage the anxiety that ruled her life.

Her psychiatrist prescribed substantial doses of escitalopram and an intense regimen of electroconvulsive therapy treatments. Then she added 400mg of lamotrigine combined with 30 intensive sessions of CBT. In other words, Ms. A was receiving aggressive treatment. And…

All of this helped to reduce her suicidal thinking and mood improved.

But her anxiety didn’t improve. She remained home-bound because of her fear of leaving and having a panic attack.

Then, 6 or 7 months later, she was seen in the emergency department of her local hospital for severe pain in her neck. An MRI showed she had 2 herniated discs in her spine, so in the ER, she got IV ketamine to treat the pain.

One infusion. For pain.

Symptoms of Panic Disorder, Agoraphobia, and Major Depression IMPROVED

And in the weeks following her ER visit, her anxiety symptoms improved. (This is really pretty cool.)

She felt like shopping at the department store, started a business with a friend, volunteered at a market in her community. Her mood was positive and “normal” for at least 10 weeks. Her doctors attributed it to ketamine — although of course there are a dozen other possible factors.

Still.

We see patients who present to us with all kinds of complex symptoms and often panic disorder is just one of the many that bring them to our office. And we see the pit in their stomachs go away. The anxiety lift. The worry diminish. In each case, one at a time. The stories are too complex and too varied to see them as anything more than case reports right now.

So we need to see researchers conduct more studies. When we treat a patient for another disorder, or when a patient is treated with ketamine for severe pain, and their anxiety and panic disorder symptoms fade away at the same time, we’re the first to smile with them. Then they keep smiling all the way home … and all the way back into their day to day lives.

But we need researchers to do their gold standard, double-blind, placebo controlled studies to rule out variables that may enter into the mix in the office, and to verify ketamine is demonstrating effectiveness for this disorder.

There are backup studies for ketamine and social anxiety … another anxiety disorder. We see extensive positive outcomes in treating PTSD with ketamine, an anxiety disorder that often includes panic attacks.

We need to see more studies for ketamine and panic disorder.

At Innovative Psychiatry, we’re seeing patients with anxiety and panic disorder getting better every week and every month. We want to see you get better, too. If you suffer from panic attacks, anxiety, and any other disorders, call us.You can feel so much better. And we want that for you.

To the healing of your best self,

Lori Calabrese, M.D.

July 9, 2018
Remission by Ketamine Treatment: How You Can Hold On to the Benefits

IV Ketamine is a Most Extraordinary Medicine

Here Are Some Ways to Hold On to Its Benefits

This ONE medicine can relieve a wide array of psychiatric disorders. Remission by ketamine treatment is at center stage of the mental health world.

The same medicine that lifts depression and restores creativity, initiative, and hope, also stops suicidal thinking in 4 hours or less and relieves social anxiety.. and, oh yes, OCD. It restores balance in bipolar disorder, and dramatically reduces cravings in substance use disorders…it helps PTSD heal and may also prevent PTSD in first responders.

Ketamine isn’t just an anesthesia medicine any more.

It’s changing lives and taking the world by storm.

It can restore your power to enjoy the beauty of a yellow warbler as it sings among the cherry blossoms. Remember when you felt nothing…? A void. Empty. Isolated. But remission with ketamine treatment changes everything.

You’ve never seen a medicine like this. While pharmaceutical companies are testing other forms of the ketamine molecule, or other molecules similar to ketamine, there is so much more to be learned about ketamine itself!

These other molecules don’t rival ketamine in effectiveness — well, actually, nobody’s doing head to head comparisons.

Because ketamine itself has become the gold standard. Its broad reach and widespread actions relieve suffering in so many different disorders that for so many it has become hope in a jar.

Who could have ever dreamed the day would come when a few infusions could lift a new mother right out of postpartum depression and empower her to bond and enjoy her newborn…? Those heartbreaking stories you hear in the news … can be averted.

Think what ketamine could have done for Vincent Van Gogh if ketamine treatment had been available in his world. Of course, it was unheard of, but it could have saved not only his ear…but his life.

Because it’s saving lives.

Remission by Ketamine Treatment: Antidote for Psychiatric Misery

The terrible anguish that depressed persons suffer has an antidote now. Six treatments (or a couple more) and you can live again, create again, enjoy people again, come out of the terror of darkness again.

You can feel love, hope, initiative, motivation, and creativity. In the morning, you can spring out of bed, and sustain energy and productivity all through the day. Enjoy the taste of a flavorful tomato right off the vine. Tackle long forgotten projects again, complete them, and look at your work with deep satisfaction.

You no longer have to be trapped in a vacuum, unable to connect, lost in the shadows of your mind. You don’t have to fear your own reactions to unexpected noises, or insensitive comments someone drops in your presence.

Feel whole again, find out you can have self-control, and build a life you’re proud of. For many who suffer with depression anxiety that just won’t cut them a break, such a concept is an elusive dream.

But it’s time for us to take a step further, and learn more.

For instance, what factors influence how effective ketamine treatment is for you?

Infrastructure for Optimal Wellbeing

Without question, one factor is simply all those unknowns. Because we’re learning daily about what ketamine can do, as well as the unique genetic, environmental, and other factors that may prevent one brain from responding to ketamine when the next one responds so dramatically. There are factors we just don’t know or understand yet.

We have so much to investigate and learn.

But there are some factors we do recognize.

For instance, it appears that there are environmental factors and personal ones, too, that may determine how long a series of ketamine infusions will benefit you.

Remission is Most Enduring when Your Personal Infrastructure Is in Place

When we speak of infrastructure, we’re referring to all the things in your life that play a part in your outlook and productivity. Things like your attitude, your response to stress or conflict, your nutrition.

To get the most out of ketamine treatment, it helps to do the work to learn and practice healthier reactions and responses, so you don’t pull the same old problems in after you.

It helps if you’ve learned to practice self-love along with respect for others. To manage your anger, and avoid the pitfalls of co-dependency. It helps to feed your microbiome to help maintain your emotional balance.

Because even if ketamine’s wonderful repair work brings you to peace, if you haven’t done repair work in your thinking, your attitude, your outlook, your view of yourself…as well as your view of others… the destructive habits that may have crept in with the misery of your disorder in the first place will slowly tear down the work your ketamine treatment accomplished in your brain.

Not what you want.

You could, then, get a booster infusion to refresh the good repair.

On the other hand, if you’re actively participating in therapy to help you change your attitude and outlook, as well as your responses to the things that happen in your life, you may find your outlook stabilizes after you reach remission… and lasts.

This, of course, is not to say that if remission doesn’t last, it’s your fault. It’s not. There are far too many factors involved in what you’ve experienced to blame your symptoms on any one thing, especially something within your control.

But consider this.

Choices You Make Can Strengthen Remission

If a stressful life has found you reacting and angry in response to small frustrations, or if you’ve been in a toxic relationship where you know you’re being abused and exploited, and stressors like these aren’t changed, you can see why you’d become more and more worn down and stressed…even despondent…all over again.

But let’s say you found the courage to leave that destructive relationship…or you figured out how to change the way you perceive small frustrations so you’re able to be unruffled by them (and ketamine can help you accomplish these things)…you can see how the peace and emotional health in your life would benefit. Don’t you think..?

That’s the thing about ketamine. It can do its part to restore those brain structures that have been worn down and broken by stress, but it can’t force you to get some distance from those factors.

That’s a step you must take … and ketamine treatment can help you get there.

Hard Decisions Lead to Better Living

Here at Innovative Psychiatry we’ve seen this happen in our patients time and again. Sometimes, a patient reaches remission and has a new lease on life. But in a month or two she’s so disappointed because she thinks the ketamine treatment has “worn off.”

However, rather than the treatment wearing off, it’s far more likely that new damage is happening because of her unchanged thinking or environment. When our patient understood the impact of those things, and she entered counseling, her need for booster or refresher infusions seemed to disappear. We have seen this process in many patients.

Many patients have been able to enjoy remission for over 2 years once they learned to make healthy changes in their lives.

There really are things you can do – with ketamine’s help – to maintain the joy of remission by ketamine treatment.

Medical Skill with Ketamine Treatment Can Turn B- Results to A+ Results

Another important factor in achieving and maintaining remission seems to unmistakably be tied to the methods used in administering this medicine. The outstanding and life-saving benefits of ketamine treatment have changed the way the world views depression, social anxiety, bipolar disorder, PTSD, OCD, substance abuse disorders, eating disorders…and suicidal thinking.

But, to get the most out of your ketamine infusion, in addition to building your infrastructure, you need to choose a psychiatrist who is most skilled in administering ketamine to your best advantage.

We use precision infusion pumps, state-of-the-art monitoring equipment, and we’re adept at titrating dose, rate, and frequency to achieve optimal outcomes.

Our goal for you is remission of your symptoms with ketamine treatment.

There’s no question that ketamine treatment can renew your hope if you or your loved one suffers with stubborn symptoms.

Know that you can feel better, live better, and restore what your symptoms have taken from you. You can find your real and best self, and enjoy the world you’re in.

If you suffer from symptoms that medicines and treatments haven’t helped, call us. We can help you turn your emotional and mental chaos into order through ketamine treatment. You can enjoy new hope and purpose for your life.

To the realization of your best self,

Lori Calabrese, MD

June 18, 2018
The Heartbreak of Suicide: You and Ketamine Can Help

The Heartbreak of Suicide – What Can We Do?

Each day last week,122 people in the United States took their lives by suicide. We want to talk about Kate Spade … and you. And how the heartbreak of suicide is stealing our loved ones. And what we can do to change that.

By now, most of us have read that Kate Spade died by suicide this past week. This is too important to ignore as if it’s just another news story. Yes, Kate Spade was an icon and many have cherished her distinctive purses, bags, and wallets.

But this isn’t about her products. This is about her.

And others who suffer like she did.

Quietly. In silence… and despair.

All sorts of reports have swept through the news without sensitivity to Kate Spade and her family. A note published publicly by her husband expressed his horror that a note allegedly by Kate to her daughter was published by sensationalistic news media without his consent.

Traditional Depression Treatment Fails Sometimes…Then What?

The bottom line is that when suffering from a psychiatric disorder ends in death by suicide, the public considers that death the business of mankind in general… regardless of the suffering of the family.

It turns out, Kate suffered from depression and anxiety for the last six years before her death. She was engaged in intense psychiatric care regularly. But she wasn’t getting better.

Her family and close friends wanted to help, tried to help, but she probably reached the point that just talking about her struggles wasn’t changing anything… maybe she laughed it off when her best friend expressed concern. Maybe she looked fine. Sounded fine.

Psychiatric Disorders Can Be Hard on Relationships

She and her husband lived in separate apartments the last 10 months, but near each other so their daughter could easily go back and forth between them. The three of them continued to share meals, and vacations.

Kate and her husband Andy had been together for 35 years and the love between them was strong… enduring. But Andy says now they just needed a break to work out their problems…divorce was never considered.

If you’ve known severe depression and anxiety, you know that the depression can be suffocating…the anxiety crippling. And for some, as the depression worsens, the anxiety becomes more intense.

The longer depression goes untreated, the more likely it seems that phobias, panic attacks, and other forms of anxiety can emerge that can leave you feeling unable to function in your life like you used to.

People like to speculate. They’ll tell you maybe it’s not depression. Maybe it’s bipolar disorder.

Kate’s husband has been adamant that she suffered from depression and anxiety for the last six years, and that she’d been in psychiatric treatment for the last five.

And that’s the tragedy.

When you know you’re suffering from a psychiatric disorder, and your doctor provides the best treatment he knows to offer, what if it doesn’t help?

What do you do?

The Heartbreak of Suicide

For decades, this has been the situation with up to 50% of patients suffering with depression. They take medications year in and year out. But they don’t work…or maybe they don’t work well enough. So they try to keep going through their routine until they just can’t anymore. At some point they occasionally mention death… or dying…or funerals…

And they try and try to buck up, keep enduring…until they just can’t anymore.

Their thoughts fill with the idea of relief that would follow the end of life. They resist as long as they can. Sometimes, they succumb.

And someone finds them, after it’s too late to help.

For all of our lifetime, when medications and therapy didn’t make a real difference for a suffering person, doctors have sometimes just said, “I’ve done all I know to do.” It sounds so horrible. Like that’s it. There’s nothing else.

Others suggest trying yet another and another new medication or therapy. When hope just keeps being deferred indefinitely…well, we get heartsick…and can give up.

There’s Hope That Rises Above Traditional Treatment

But here’s the tragedy for Kate Spade, and others like her.

We’ve never had ketamine treatment before the last several years. But we have it now. She suffered for 6 years without relief.

What about you? Untreated depression and anxiety can slowly erode your relationships, your confidence, and your hope.

Does your doctor know about the effectiveness of ketamine treatment, or how to provide it with the best, most effective methods…?

She had made a fortune with her Kate Spade brand in partnership with her husband over the years. So she didn’t miss her chance for effective treatment because of cost. She had the resources to pay for the best treatment.

We see people like her all the time here at Innovative Psychiatry. People at the top of their game who suffer from an array of psychiatric disorders … and need treatment so they can continue contributing to their world, engaging with their families, enjoying their lives.

We can wish Kate had known about ketamine treatment. We can wish her life had been restored, her relationships with family and friends strengthened because she had the energy to invest in and build them again. Because she no longer feared that openness would harm her brand.

But for Kate Spade, sadly it’s too late for that.

Still, stop and think.

So Many Suffer in Silence Until They Can’t Stand It Another Day

How many people across the US died by suicide last week…? 122 each day. One of them happened Friday, when beloved celebrity chef Anthony Bourdain also died this way. How many more…?

We have to ask how many of those deaths could have been prevented if everyone knew about ketamine’s effective treatment that takes the pain away?

How many people in our world still don’t know that treatment actually IS available that can give them their lives back…restore their joy, their motivation, their well-being? That can stop suicidal thinking. Quickly.

We can work together to share this reality with everyone we know so no one else has to die without hope.

We must work together to help people who suffer like Kate suffered find help. And hope. We must talk about psychiatric symptoms without shame. As freely as we talk about back pain, migraines, cancer.

If a friend talks about death…about dying…even off the cuff…even laughing about it…

What do you think?

Oh, weird… wonder why she’s talking about this right now…embarrassing…

I hope not.

But the stigma is right there. Along with shame.

What if I’m overreacting..?

Overreacting to a possible call for help is not life-threatening….but ignoring the situation just may be.

You can reach out. You can confide in your friend about something you’ve been through that was embarrassing. Lower the wall. You can ask if there’s anything you can do. You can share things you’ve read, like this blog for instance.

Brain and Behavior Institute published this statement by Dr. Jeffrey Borenstein on Friday:

“If you are concerned about a loved one, you should express your concern. Some people have the misconception that asking a person about suicide will increase the risk, but in reality asking does not increase the risk of suicide, but can save a life.”

And you can provide your friend with the Suicide Hotline and encourage her to call you or call this number if she ever feels serious about it:

If you or someone you know is in crisis, call the U.S. National Suicide Prevention Lifeline at 800-273-8255, text TALK to 741741 or visit SpeakingOfSuicide.com/resources for additional resources.

Ketamine treatment can stop suicidal thinking in 4 hours or less. Tell your friends and loved ones.

Ketamine Treatment Ends Suicidal Thinking in 4 Hours or Less!

The heartbreak of suicide can be prevented.

It’s true that ketamine treatment isn’t for everyone…but it’s effective for most, and even some of those who seem to not respond at first have a delayed response…and are living their lives with joy several months later. Ketamine is so remarkable, it deserves a chance to show you what it can do.

And you deserve the chance to experience the rapid and robust action of ketamine in your brain, relieving your symptoms.

If you suffer from a psychiatric disorder, or if you know someone who does, read the articles linked to this one and inform yourself. It’s no longer necessary to suffer under the burden of a seemingly untreatable disorder.

At Innovative Psychiatry, we offer a variety of novel, advanced options to reach the source of your disorder and help you get better. We’re not interested in treatment that just takes the edge off…

When you’re in pain, you’re in pain. A little reduction in symptoms really doesn’t help that much. You need to feel good. You need to feel well.

Please call us. Let us help you get better.

May the husband and daughter of Kate Spade, as well as her family and friends, be comforted and find peace. Our hearts weep for you.

And if you find your thoughts filled with images of death and dying…call us. We can help lift this terrible burden from you to help you rebuild a happier, more fulfilling life.

To the healing and restoration of your best self,

Lori Calabrese, MD

June 11, 2018
Post-Traumatic Stress Disorder (PTSD) Can Strike Anyone – A College Kid’s Story

Twenty One Years Old. Enjoying campus life with her friends. Working toward her degree …and her dreams…

Then, a soreness in her mouth… and a trip to the doctor.

CANCER.

“Squamous cell carcinoma of the tongue,” the doctor said.

What??!!?

She’d never heard of such a thing. What could have caused this? How did it happen? Where did it come from…??

When you’re young, with all your hopes and dreams ahead of you, you don’t have the life experience to cope with such a devastating blow. So it’s not really about coping…it’s about taking action.

Fight now.

…process later.

The oncologist promised Nicole, a beautiful, intelligent college student, a full recovery but she would have to endure a horrifically aggressive treatment. There was nothing to do but just close her eyes and dive in.

For starters, she did some quick research. First step was a shocking surgery…removal of 75% of her tongue. Traumatic experience for anyone… But for a college kid? How could she ever feel normal again…?

She also learned that to truly eradicate this invader, she needed to add chemo to the radiation treatment. She wasn’t taking any chances.

Only two weeks to recover from a disfiguring surgery, then radiation and chemotherapy had to begin. A move with her mom into the Ronald McDonald House to be close to treatments, and another surgery to insert a feeding tube into her stomach. Terrible pain like she’d never known.

But it had to be done. The radiation treatments would destroy her ability to swallow, so they had to prepare for nutritional formula to feed her through the treatment process ahead. The pain was excruciating. But then chemo began.

Within 3 weeks, Nicole had lost her ability to swallow, and was hospitalized. She’d lost 35 lbs. of her 130 lb. frame. From the beginning, she had researched to understand the most thorough way to fight this rare cancer, in hopes that she could endure treatments and eventually be completely DONE with it all.

She kept her eye focused on the goal: to SURVIVE…and to get back to normal…and to her life.

After Traumatic Cancer Treatment You Can’t Go Back – Only Forward

When the treatment was finally completed, she was discharged and she moved home again. A 6-hour drive to get home, then a party with her friends that night to celebrate her return to her life.

Finally…it was OVER!!!

…or was it..??

Sometimes, you can be so strong and face the most terrible experiences, the worst life-threatening trauma, and pat yourself on the back for all you’ve endured. But then, out of nowhere, about the time you think you can relax and get back to your life, the other shoe drops.

Not with a thud…but with a crashing, devastating explosion…and ripples that affect every aspect of your life.

Severe Insomnia Sets the Stage for Worse Things to Come

First, came the insomnia. We’ve all heard about insomnia…when someone has trouble sleeping. But, have you ever gone for 5 or 6 days without sleep…? I mean NO SLEEP for day after day and night after night? Unless you’ve experienced this yourself, you can’t imagine what happens in your brain under this type of duress.

It’s used for torture in some third world prisons.

Then, let’s say you finally fall into a sleep but only sleep a couple hours…then it starts again. Day after day after day. You feel like you’ll go off the deep end.

The relentless stress builds and builds.

Tears Give Way to an Eating Disorder

One day, Nicole and her mom went to the mall to buy some clothes for Spring. They were excited about doing something fun and sort of “normal” again. But, when Nicole stepped out of the car, she broke into tears…and tears gave way to sobs. Hard sobbing without relief… She couldn’t breathe. She couldn’t move.

All she could do was sob and sob, wondering even at the time what was happening to her. Eventually, her mom called her dad to come get them and take them home.

That day marked the beginning of 11 years of flashbacks, extreme reactions, embarrassing meltdowns, and crippled emotions. She thought the nightmare was over when she finished her treatments, but a new nightmare was just beginning…

Nicole started back to school in the fall, and everywhere she went people told her how great she looked. (She knew she didn’t look great. She was “scary” skinny…) But more and more she heard it all the time.

Were they just glad to see her back in school…? Or did they really think she looked better than she used to…? She decided to stay ultra thin, to make sure she kept looking “great.”

Before long, she was sneaking out of the house early in the morning to go to the gym, counting calories, and weighing four times a day. After feeling so profoundly out of control with the cancer, she’d found something she could control. And…she liked it.

Working out daily, walking when driving would be more convenient, cutting calories… and hardly sleeping. All of which continued until she graduated with her degree.

Happily, her boyfriend proposed the day of her graduation, and they moved from Pennsylvania to Virginia. She’d been given a clean bill of health by her doctor… she was cancer-free. It seemed everything was going to be ok.

Post-Traumatic Stress Disorder (PTSD) Persists

But it turned out that the cancer was the easier foe to conquer. The fallout afterwards, which in time she was told was PTSD, was a much harder beast to vanquish.

A victim in a hospital scene on TV, the smell of an alcohol swab, or the mention of x-rays or medical procedures would make her freeze. Unable to breathe, choking in terrible panic, screaming for help, time and again… she felt like she was dying.

Her husband urged and even begged her to get help, but she refused. Going to the doctor — any doctor — might start the attacks. If she needed a chest x-ray, she just knew they’d find cancer. If her child needed to see the doctor, it was terrifying for her. Any buzzing noise took her back to that radiation machine years before. A routine scab on her husband’s ear, a swollen lymph node in her daughter’s throat, a sore finger…anything…. would trigger the panic attacks and the fear that she or her loved ones would have cancer and die.

Over the years, she and her husband brought 4 beautiful little girls into the world, two of which were twins. But the routine joys of pediatrician visits as children grow became the war zone for her flashbacks and terrors…

Until she sought treatment… and her life finally began to change.

But let’s get back to that in a bit. First, what is PTSD, and what can you do about it..?

What is Post-Traumatic Stress Disorder (PTSD)?

PTSD sometimes follows a traumatic or life-threatening event, with symptoms typically appearing in the first 3 months after it happened. However, in some cases symptoms may not show up for much longer…even years.

Your symptoms may be repeated, involuntary memories, flashbacks of the event that seem as real as the original incident did, efforts to avoid being reminded of the trauma, feeling detached or estranged from others, in addition to angry outbursts, irritability, and ongoing fear, terror, and shame. You can also become emotionally numb.

In Nicole’s case, she was able to finish her Bachelor’s degree, work at her job, and parent her little girls. But, functioning was really tough for her. In your case, you might be unable to function much at all.

For some people, the symptoms can subside over time, but in others, they can go on for years, or even a lifetime without treatment. The severe distress that’s caused by the horrific trauma may need psychiatric treatment.

Sometimes medicine and therapy help. But for some, it just doesn’t.

Nicole is doing better and better now. In hindsight, she wishes she had sought help sooner. She wishes anyone with these symptoms would go for help as quickly as they can.

But, since the treatment she needed required that she see a psychiatrist, and the thought of seeing a doctor triggered more panic attacks, it was really tough to cross that threshold.

At Innovative Psychiatry, Ketamine Treatment Gives Hope

At Innovative Psychiatry, we specialize in treatment-resistant psychiatric disorders. That means we specialize in helping people get better who didn’t get better with other medicines and treatments before.

We’ve had extraordinary results treating these special patients with ketamine treatment. Ketamine treatment has a way of rebuilding signaling systems in the brain that have been broken down by stress, anxiety, and depression.

When administered expertly, ketamine is even more effective than many people realize in treating depression, anxiety, PTSD, OCD, social anxiety, panic disorder, eating disorders, and suicidal thinking.

By rebuilding broken down synapse connections between the brain cells, enhancing signal transmission from the prefrontal cortex to deep in the brain, and proliferating the structures that provide those pathways, ketamine produces rapid and widespread improvement to the point that many patients declare themselves “well.”

June is National PTSD Month, and this month we want to show some of the types of PTSD, and help get the word out that there is effective and lasting treatment. And that you can have your life back again.

You can enjoy your job again, build your relationships with spouse, family, and friends again. Catch up on neglected projects and enjoy them. Get out and about and relish your days.

If you’re suffering, and nothing has helped, call us. Helping relieve stubborn psychiatric disorders is where we find our deepest fulfillment. We want to see you well. You’re not alone.

To the revitalizing of your best self,

Lori Calabrese, MD

June 4, 2018
Anorexia, Ketamine, and the Default Mode Network
Anorexia, Ketamine, and the Default Mode Network

Do you feel good about what you weigh? Or about how you look?

If you hesitated to answer, you’re not alone. If you answered No…or…I’m not sure… again, you’re not alone.

Survey Says: Majority Don’t Like the Way They Look

Allure, a magazine centered on beauty, surveyed 2,497 people nationwide, and found that 64% of people look at someone and the first thing they notice is how attractive they are. And 50% said they believed appearance defines us all… Really..?

Oh, and get this: 62% of both men and women said they believed they were more critical of their own appearance than others are of theirs.

So, being preoccupied with your appearance is not constrained by age or gender. It’s happening in the majority of the population. And who knows how many people surrounded the people in those percentages and criticized them for their weight, their appearance, or their appeal.

Is it any wonder that 30 million people in this country suffer from eating disorders?

30 MILLION !!!

Support for Your Eating Disorder

In the early 1970’s, a nurse named Viv tried to find support for the family of a critically ill patient in her hospital. She was unable to find ANYTHING to offer for connection or support for this patient and her family.

In the process of calling around, one healthcare professional after another told her that Anorexia Nervosa was such a rare disease, there probably weren’t even 2000 people with it in the entire U.S. They said she was wasting her time.

So she decided to research the situation for herself. After all, she was a nurse, and nurses can have some serious determination when it comes to helping their patients.

So she posted an ad in a newspaper…so seventies, right?…just a small block ad. The ad stated she was searching for others interested in information about eating disorders. Her town in Illinois had a population of about 30,000. It was no metropolis.

Well, within a few days she received 8 responses to that ad from people who’d been diagnosed with anorexia or another eating disorder, as well as family and friends who were concerned about a loved one.

But that was just the beginning.

Somehow, as fate would have it, a national magazine got wind of her story and published their own story about her. When that was published, she was flooded with a deluge of phone calls and letters from people all over wanting to learn more. She opened her home and established the first national helpline and referral service in the USA for people with eating disorders.

Viv founded ANAD, the National Association of Anorexia Nervosa and Associated Disorders, or ANAD.org.

That small group she started in her home took their training nationwide to establish professional support groups, helplines, and peer-to-peer support groups.

Anorexia, Ketamine, and the Default Mode Network: Mental Health Awareness Month

May is Mental Health Awareness Month, and this is the last post for this month, but going forward our posts will continue to address issues of mental health. Still, it seems fitting that we talk and share information about the deadliest of all psychiatric disorders — and that is eating disorders. Because somehow, it seems this is the quietest…least talked about … but deadliest… disorder of all.

No One is Testing Ketamine for Eating Disorders

Fact: there are currently 188 studies on anorexia nervosa listed in the National Institutes of Health databas, and not one of them is testing the effectiveness of ketamine combined with therapy … which we talked about last week. Plus, of the 489 studies on eating disorders, none incorporate ketamine treatment in any way.

Here’s what they ARE trying. Things like:
- Warm ginger foot soaks
- Zyprexa, an antipsychotic and mood stabilizer
- Duloxetine, an antidepressant
- Mobile phone apps
- Omega-3
- Deep Brain Stimulation
- Oxytocin
This is despite the high prevalence of suicidal thinking and actual suicide in anorexia. And despite the obsessive thoughts that ravage those who are restricting their food intake. Think about it.

If you suddenly imposed upon yourself that you were going to eat no more carbs… no potatoes, no bread, no sugar, no chocolate, no sweets, no ice cream…

What do you suppose would be on your mind constantly over the coming days…?

CARBOHYDRATES!

Every commercial on TV would seem to be about ice cream, cake, sugar, chocolate, bread … carbs! Every thought you have as you listen to your stomach growl…? French fries, fast food, donuts, dessert ….

Right??

When you deprive yourself, you obsess over how to end that deprivation. And if that’s as true of you as it is the rest of the human race, just imagine what it’s like for someone with an eating disorder.

When you’re sick with an eating disorder, you feel fat, see yourself as fat, and obsess over how to lose weight. And you restrict what you eat, and exercise excessively, or use laxatives or purging to prevent body fat at all costs. Even when you’re not doing anything, your mind is busy thinking, and your thoughts default to counting, criticizing, obsessing about fatness, thinness, calories, food…

Because of that… for anorexia, ketamine and its effects the default mode network could reveal a very effective treatment for eating disorders.

The condition of those with severe eating disorders is critical. Life-threatening – as in death – due to organ failure as well as suicide.

To take it a step further, studies involving the Default Mode Network that goes into play after ketamine infusions to make the most of cognitive behavioral therapy (CBT) are demonstrating some great results for other conditions.

Why isn’t anyone studying that for eating disorders??

The deadliest psychiatric disorder…!

When you look at just the handful of studies above, do you wonder why they’re so diverse…? Is that there’s so little we have to offer biologically

Don’t you wonder why researchers aren’t JUMPING on studying ketamine treatment for eating disorders every which way but Sunday?

SOMEONE SHOULD DO A STUDY!!

After all, this is exactly how research questions are formed and carried through to studies and trials in search of answers. This is how new ideas spark! And tried and true treatments become established and trusted.

So let’s think about this:

How might ketamine treatment provide the best and most thorough impact to help those with eating disorders?

A study comes to mind that might be extremely useful to consider. Sam Wilkinson and his group at Yale studied the effects of using ketamine treatment and cognitive behavioral therapy (CBT) together to prolong the anti-depressive effects of ketamine.

The study, which took place last year, arranged for depressed patients to undergo 12 CBT sessions over 10 weeks, while also receiving 2 ketamine infusions a week for two weeks.

The results indicated that remission from depression lasted longer in some than others, but in most
cases it lasted longer than it did with ketamine alone.

(Remember the blog about the first international Ketamine Conference in England in March? He discussed his data at that meeting!)

They used only 4 infusions instead of 6 — a protocol that may be a little underpowered in terms of getting depressive symptoms to completely remit in the first place. But people who achieve full remission early like that may be more likely to stay in remission…? We’ll see. Perhaps using CBT with strong early remitters allows a cleaner testof whether CBT prolongs remission after ketamine or not.

So let’s extend this for a moment to eating disorders.

The First Study with Ketamine for a Psychiatric Disorder

Jump back to 1998, and to I.H. Mills, who initiated studies in 1992 to establish eating disorders as compulsive disorders. Mills and his group were the first to study ketamine for treating the compulsiveness in eating disorders in 1998. Which, by the way, was the first study using ketamine to treat a psychiatric disorder ever.

So, I think somebody really should do a study…where 6 infusions of ketamine are used in patients with eating disorders and then 24 hours after each ketamine infusion (more about that in a second), the subject receives cognitive behavioral therapy. …. Or maybe 8 infusions interspersed with CBT, and then 4 more CBT sessions tacked on to the end…?

And what if the response was tracked not just by the usual rating scales for depression and OCD but by additional measures looking specifically at eating disorder symptoms and markers of improvement..

Thrilling to think about, isn’t it?

But they could take it even another step further.

Anorexia, Ketamine, and the Default Mode Network

They could exploit the Default Mode Network (DMN) in the brain for that study. If you remember, the Default Mode Network is a network of areas of the brain that work together to give your brain a restful state… where you complete a task you’re focused on, and instantly find yourself day dreaming… musing, reminiscing, worrying…or even obsessing about something negative about yourself, others, the past, or the future.

A brilliant group of researchers spear-headed by Meng Li of Magdeburg, has discovered through functional MRIs (fMRI) that the functional connectivity of the posterior cingulate gyrus (dPCC) changes after a ketamine infusion. This area is part of the DMN, and it is involved in more negative thought patterns. They see it change in the first hour after the infusion, but the change is much more dramatic after 24 hours. This change increases BDNF – remember what BDNF does?

This changes the glutamate at the NMDA receptors at the AMPA receptors, and the synapses or connections between the cells in the brain proliferate rapidly, budding and branching and quickly improving the communication and movement of signals throughout the brain.

At around 24 hours post-infusion, the functional connectivity of the dPCC is so greatly reduced that the DMN can use other parts of the brain to take over the resting thoughts. And that allows you to consider positive alternatives to the negative obsessing, worry, self-recriminations, and other negative thought patterns.

So when the DMN opens up 24 hours after a ketamine infusion, the neuroplasticity in the brain cells that ketamine sets in motion can help CBT to be much more effective. It’s a potential path to remission… and that’s what we want to find.

Not just for anorexia. For so much more.

May 2018 Mental Health Awareness Month

Mental Health Awareness Month has been a time of talking, listening, offering patience, and treating those we don’t understand with compassion. In psychiatry and neuroscience, we find more answers about psychiatric disorders to bring relief to more who suffer.

Including those who suffer in the shadows from disorders less understood.

If you’re someone who suffers from an eating disorder, and don’t know what to do, please call us. We’re looking for solutions, and we want to help you, too.

Innovative Psychiatry focuses on successfully treating the seemingly untreatable, most life-threatening psychiatric disorders. We get to see remarkably widespread response and remission in the patients we treat.

And we’re finding that ketamine treatment can smash through even the worst symptoms when administered properly. We’re thrilled when our patients feels restored and resilient. When they feel changed for the better.

When you walk into our office, you’ll be treated with respect, compassion, and support. For your infusion, we offer private, beautiful and relaxing environments.

And within about 6 infusions over 2-3 weeks, you can feel like your brain has been reset. You’ll feel joy…and hope. You’ll find you have more control over your life. And you’ll find you’ve rediscovered your best self. A new you?…more like the real you. Give us a call and let’s talk.

To the fresh emergence of your best self,

Lori Calabrese, M.D.
May 29, 2018
Ketamine for Anorexia? Don’t Let an Eating Disorder Be Your Default Mode
May is Mental Health Awareness Month

Eating Disorders Are Psychiatric Disorders

Surprised?

Anorexia nervosa, bulimia nervosa, binge eating disorder… The National Eating Disorder Association lists 10 conditions as eating disorders. And, it so happens that ketamine treatment can work wonders and restore your life.

Too many people who don’t have a family member suffering with an eating disorder find it easy to judge someone by their appearance alone.

Either she weighs too much, or she’s “disgustingly” too thin.

Either way, it’s because she’s self-indulgent, lazy, or doesn’t know how to eat right. Or so they think.

Eating Disorders Cause Prolonged Torment

But for those who suffer from eating disorders, the problem is far more complicated. And the last thing they need is criticism… or to be judged because of their appearance. Individuals with eating disorders already criticize themselves more than anyone else ever thought about doing.

In a moment we’ll talk about ketamine for anorexia, but first, let’s try to understand how these conditions develop.

Here’s an example of of a problem that seemed to start out innocently …

Picture yourself 14 and enjoying all the snacks at a sleep-over party with all your friends. After you begin to feel full, you slip off to the bathroom, poke your finger in the back of your throat and up it all comes. You rinse your mouth, and rejoin your friends. Easy.

Two hours later, you’ve been to the bathroom twice more… an observant friend asks if you’re ok? You laugh a little and just say, “I can’t gain any weight right now but the food looks so good. I just go in the bathroom and throw up, then I can eat more. Pretty cool, eh..?”

Seven years pass … and you have to fit into that little black dress for the awards presentation ceremony at your university. Your dad always told you to “demonstrate your discipline in the way you look.” That “you don’t get a second chance to make a first impression.” There have been so many celebratory dinners lately … and you’ve learned you can always fall back on a quick trip to the bathroom to keep things under control.

Five years later, the stress from performing in your new law firm has taken its toll. You’re snacking now, and not ever really eating at all. The drive within you to throw up is overpowering… and you’ve dropped 3 dress sizes.

Anorexia and Bulimia Are Disorders, Not Self-Indulgence

You feel fat, and hate what you see in the mirror… You’re running 5 miles after work every night, swimming 30 laps before work in the morning. You’re not sleeping, hating life, and hating yourself…

Then, your boyfriend finds you unconscious in the bathroom… and calls 911.

What happened…?

And why did it happen to you…?

Eating disorders have been plaguing people since long before any of us knew they were a “thing.” The first physician to identify anorexia was Dr. Richard Morton in England, in 1689. Bulimic behaviors weren’t identified until much later by Pierre Janet, a French doctor, in 1903. In other words … this isn’t a new problem.

Eating disorders are chemical changes in the brain, but they’re so much more than that. They’re a way that you use food and/or exercise to manage unmanageable circumstances in your life. When life seems so out of control, there has to be a way to get some control back … you know?

A Race to Stay Ahead of Compulsions

Even though an observer may judge your behaviors associated with food, for you, it’s rather logical. Because the underlying shame, self-hatred, and critical voices cause unbearable anxiety. And for you, the eating behaviors sort of help you cope with that. At first.

In spite of the early identifying discoveries of these disorders, effective treatments remained hard to find until the late 20th century. And, even now, in spite of the best therapies available, anorexia is the most deadly of all the psychiatric disorders.

What…? It is the most deadly psychiatric disorder.

In terms of psychiatric diagnoses, anorexia holds twice the risk of death as schizophrenia, and 3 times that of bipolar disorder.

Add to that, the risk of suicide is dangerously high. 20% of those who die from anorexia, die by suicide.

The Battle For Effective Treatment of Eating Disorders

Cognitive Behavioral Therapy (CBT) has proven to be the most effective treatment for the compulsive aspect of eating disorders like anorexia and bulimia. And there have been some improvements for those who received this therapy.

Still, 1 in 5 people with anorexia nervosa dies. That’s too many. As a psychiatrist, I want to see people recover and get well…

And that brings us to ketamine treatment.

Ketamine for Anorexia and Other Eating Disorders

In the 1990’s, many psychiatrists thought of eating disorders as a compulsive behavior disease, fueled by involuntary, frequent anorexic thoughts. Excitement of the hippocampus and glutamate-NMDA receptors can be blocked — to prevent recall of those anorexic thoughts — by ketamine, which blocks NMDA receptors.

Researchers developed a trial centered on ketamine’s potential effectiveness, combined with the use of nalmefeme, which is an opioid antagonist, or a compound that prevents the effects of opiate-like substances on the brain. This medicine doesn’t interfere with ketamine’s effects on the glutamate-NMDA receptors; it was added to keep patients awake.

An Early Trial: Ketamine for Anorexia and Other Eating Disorders – 1998

As early as 1998 — way before the early studies on using ketamine in depression — IV ketamine infusions were given to a group of 15 women with very severe, chronic anorexia. The patients chosen for the trial had been failed by other treatments they’d tried over the years.

It turns out that 9 of the 15 patients in the group achieved remission from anorexic thoughts and behaviors. They were given anywhere from 2-9 infusions of 20 mg/hr… which were long in duration – 10 hours – and repeated at intervals from 5 days to 3 weeks.

It was a little sporadic, but it worked rather well. And it was a first try at treating a psychiatric disorder with ketamine.

These participants reported a significant drop in their “compulsion” score, from 44 before they received the ketamine, to 27 after they received it.

The other 6 participants had no apparent response to the ketamine treatments. However, this took place before ketamine treatment was being used for depression and other psychiatric disorders. It’s been 20 years since that trial, and we’re now finding that some individuals seem to not respond to ketamine… initially.

Then, a few months down the road they experience extraordinary improvement … seemingly out of the blue.

We don’t yet understand what causes the delay. But it’s too bad those researchers didn’t follow up with the other six participants a couple months later. They might have been surprised by the results.

Help Spread Information and Awareness of Psychiatric Disorders

May is Mental Health Awareness Month. We’re all working together to openly talk with each other about our experiences with psychiatric disorders.

Many in our society have no idea that some people have a psychiatric disorder that causes the way they look and act. Anorexia, Bulimia, Binge Eating Disorder, Pica, Avoidant Restrictive Food Intake Disorder, Rumination Disorder, Orthorexia, Compulsive Exercise, Diabulimia, Night Eating Syndrome … are all eating disorders.

If you notice someone who seems to eat too much…or too little… resist the temptation to pass judgment. Chances are this is far more complicated than you realize.

Treat her or him with compassion, not criticism. Let this be a day where they can judge themselves less harshly.

And, if you struggle with behaviors you don’t understand, or with diagnoses that don’t respond to treatment, call us. Life is too short to be wasted criticizing yourself. Let us help you find the real you again.

Ketamine Treatment at Innovative Psychiatry

Ketamine treatment at Innovative Psychiatry is expertly provided in a beautiful and relaxing environment (complete with low lighting and a warm blanket to keep you comfortable). We continuously monitor your vital signs and your response during the infusion. With finely-tuned skill, we adapt and adjust your dose, rate, and the frequency of your ketamine treatment to cultivate the most outstanding results for you.

Ketamine treatment isn’t for everyone. There’s no psychiatric treatment that is. But even if you’ve tried other treatments without improvement, it’s very likely ketamine will help you in a dramatic way. It’s the most effective treatment available for many people whose symptoms seemed treatment-resistant.

Benefit from Extraordinary Outcomes from Ketamine for Anorexia and Other Mood Disorders

We see extraordinary outcomes from ketamine treatment for depression, anxiety, bipolar disorder, PTSD, OCD, suicidal thoughts, and other psychiatric illnesses that have not responded to prior treatments. Ketamine enhances neuroplasticity, and we desperately need fresh, updated studies of this treatment in anorexia and other eating disorders.

Schedule an appointment and see what can happen when ketamine goes to work to set your brain right by:
- - Turbo-charging BDNF
- - Abundantly proliferating synapses, dendrites, and dendritic spines among brain cells
- - Blocking glutamate at the NMDA receptor
- - Pushing the habenula to stop those depressing cell bursts
- - Dragging those G proteins off their lipid rafts in the cell membrane so they can rev up signal transmission…
Ketamine is a force to be contended with in a depressed and disordered brain.

We’re here to help you get well. It’s what we live for. Give us a call, reach out with a quick email, and let’s help you get better.

To the blooming of your best self,

Lori Calabrese, MD
May 21, 2018
Treating Postpartum Depression Requires Fast-Acting Medicine: Ketamine Treatment Restores

Postpartum Depression and Paternal Postpartum Depression

Mental Health Awareness Month is also

Maternal Depression Awareness Month

#BreaktheSilence

So let’s stamp out the stigma and talk about mothers and Postpartum Depression. Treating postpartum depression requires fast-acting treatments because there’s so much at stake. Pregnant and breastfeeding moms are targets for anxiety and depression for so many reasons — and are more vulnerable to developing anxiety and depression than at any other time in their lives.

Brain and Behavior Research published a study in the November 7, 2017 issue of Brain, Behavior, and Immunity about pregnancy.

They discovered that pregnancy and the postpartum period actually reduce the immune response in the brain. Which may explain why some women are more susceptible to anxiety and depression during this time.

Women with postpartum depression carry shame and anxiety about being a “good enough” mom to their babies.

Brain and Behavior Research displays this hashtag for May and I like it: #BreaktheSilence

So we’re going to break the silence about postpartum depression and continue to celebrate mothers today by talking about something too many moms go through.

Think about this for a moment:

Your friend is pregnant — which is a glorious time of joy for a mother … or is it?

You want to talk about her baby, shop for baby clothes with her, plan her shower. But she doesn’t seem to be responding like you thought she would. In the first few months, she’s noncommittal and has nothing much to say. In case something goes wrong. You hope it’s because she’s just tired and nauseous. Maybe her excitement will build when she feels the baby’s movement.

But the second trimester is anything but exciting for her. As her baby grows, you begin to see a vacancy of sorts in her eyes. She becomes more and more listless.

Your friend’s once bright and sparkling personality has dulled. She seems to just trudge through the days. Then, late one evening, you get a call from her husband. He says she’s screaming and crying that she can’t be a good mother … she’s terrified of going into labor.

Postpartum Depression, Panic Attacks, and Anxiety

In less than 20 minutes you arrive at her house and try to help her calm down. You listen, you reassure her…though she seems inconsolable…then finally sobs and sobs. The next morning she tells you she’s sorry for her outburst. But you know there’s more to this than “normal” pregnancy.

When her baby is born you’re sure the cloud over her will dissipate as she looks into the face of her beautiful child, and enjoys the wonder of this miracle.

But unfortunately, she hardly wants to even see the baby in the first few days. And finally, when she does, she holds the baby and stares vacantly into space. What can you do..?

What IS Postpartum Depression..?

Women with postpartum depression experience the symptoms of depression anyone with depression experiences. Symptoms such as listlessness, feelings of emptiness, loss of interest, muscular and skeletal aches and pains, reduced energy, hopelessness, and withdrawal, for starters.

But, the new mom also experiences other symptoms that are unique to her situation. She focuses on her baby, her ability (or feared inability) to care for him, or financially support him.

Women with postpartum depression can suffer with feelings of anxiety, panic attacks, feelings of extreme inadequacy, and overwhelming sadness.

Postpartum depression doesn’t always follow depression during pregnancy. But the likelihood a woman will experience postpartum depression is much higher if she was depressed during pregnancy.

In fact, 1 in 7 women are affected by postpartum depression, and fully 25% of cases of postpartum depression began during pregnancy.

But what about the other 75% of cases? What sets those off postpartum?

More Causes of Postpartum Depression

There’s quite a variety of things that contribute to postpartum depression. Things like severe financial distress or multiple births can be behind it. Family problems such as separation or abandonment by the baby’s father, which can include heartbreak and financial crisis together.

There’s also a sudden drop in estrogen and progesterone that can trigger it for some women. When the baby is in the NICU for a prolonged period of time, that can interfere with maternal-child bonding, and can result in depression in the mom.

But for many moms–moms with support, with resources, with help… it’s so frustrating. There’s nothing that seems to precipitate it and no one to blame. The depression comes out of nowhere.

Serious Consequences of Untreated Postpartum Depression

It’s during this early period after birth that mothers and babies bond. When that period is interrupted, it can cause a cascade of suffering in both mother and child. The cooing and cuddling a mother does with her newborn stimulates the growth of neurons and synapses in the brain.

When the newborn misses this opportunity, neurocognitive deficits can be the result.

Or in straight English, it can interfere with the baby’s memory, ability to think and process, and make decisions as she gets older. Because of this, it can reduce her academic performance, too.

If a mother is depressed during pregnancy, we believe this has a direct impact on the wellbeing of her baby. Researchers report these babies are sometimes born irritable, lethargic, and have sleeping and eating problems. They can grow to be slow learners who are underweight and emotionally unresponsive. And later in life show behavior problems like aggression.

The same is true of babies of moms with postpartum depression. These babies are more likely to have excessive crying, behavioral and emotional problems, and later Attention Deficit Hyperactive Disorder, or ADHD.

This Mom is Suffering

For the mother, if depression takes hold, not only does she miss the rewarding connection with her infant, and the hormones that help her “feel” like a “good mom” but she often tends to blame herself as a “bad mother.” More than likely she’ll think about all the ways she believes she’s failing her child, or causing damage. Sometime to the point of developing recurrent, intrusive, and unwanted thoughts about this — obsessive thoughts.

And those obsessive thoughts are fueled to be even more intense by depression.

Dads Get Postpartum Depression, Too

Then, there’s the dad. He can also be heavily affected by her postpartum depression. It’s common enough for the father to become depressed also that they have a name for that too: Paternal Postpartum Depression. In fact, new fathers are at increased risk of postpartum depression due to the immense changes they experience with the birth of a baby.

And if the new father has a history of mood disorder, his risks are even higher. Newborns and infants depend on the loving interaction with both parents to thrive. When that interaction is absent, the baby suffers.

Mom’s Depression Is Tough on Baby

A study was conducted where mothers of 3-month-old infants were told to imitate depression symptoms for 3 minutes. They did this by speaking in a monotone, maintaining an expressionless face, and avoiding touching the baby.

In only 3 minutes, the infants reacted to this change in their mother’s mood.

They turned away from their mothers, became irritable and distressed. Even after the 3 minutes of exposure to this change, when the mothers returned to their normal, nurturing demeanor, the babies remained upset for awhile, difficult to console.

Infants are extremely sensitive to their mom’s sadness, silence, and inattentiveness.

Sometime postpartum depression can spiral dangerously out of control — beyond depressive symptoms into mixed symptoms with agitation, or symptoms of psychosis with delusional beliefs or hallucinations. This is especially dangerous when delusional beliefs or auditory hallucinations are centered on the baby.

Treating Postpartum Depression

For all these reasons, it’s vital that the mom with postpartum depression be treated and relieved as soon as possible. If the mom is given oral antidepressants, it can be weeks or months before she experiences relief. And that critical period for bonding and nurturing for mom and baby can be interrupted while they wait for relief.

Ketamine treatment for depression, when administered according to best protocols, can bring relief in as little as a few hours, or within a couple of treatments.

It doesn’t take weeks to work.

This is a psychiatric treatment that’s been used very effectively for the most difficult-to-treat cases of depression, bipolar depression and anxiety. It’s often a treatment “AFTER everything else has failed.”

With postpartum moms and newborn babies, it can be a treatment “BEFORE everything else has failed.”

It can save you weeks … or months. It can prevent a missed-bonding opportunity for you and your baby. Quickly. Immediately. Hopefully this will minimize the damage that can arise from that, before it becomes established and fixed.

Has it been studied extensively in postpartum depression? No. Not yet.

But neither has anything else. The latest Cochrane Database review shows an impressive lack of significant new studies of antidepressants in postpartum depression over the past decade, despite all of the available antidepressants on the market. No real news, no new findings, no new recommendations.

Geez.

We have several postpartum moms who came to us for ketamine treatment after weeks of failed treatment with antidepressants and psychotherapy, and who responded strikingly to IV ketamine. Sometime, we add 1-2 more infusions or use a larger or smaller dosage at a faster or slower rate to get symptoms to remit entirely.

Double Blind Study Shows Safety and Effectiveness of Ketamine

What’s more, researchers conducted a double-blind study published in the Journal of Clinical and Diagnostic Research. They included 92 women scheduled for caesarean section, to determine the safety and effectiveness of using a combination of ketamine and propofol to manage pain after surgery. Researchers hoped to address the problem of pain that delayed initial breastfeeding after caesarean section. (Stay with me here — it’s relevant.)

In addition to pain, the nausea, vomiting, and shivering that occurs in more than half of women following C-section also interferes with breastfeeding, walking, and caring for the newborn.

Researchers divided the women into 4 groups, and treated each group with either propofol, ketamine, ketofol (a combination of ketamine and propofol) or a placebo.

Those who were treated for pain with the placebo required an average of 58 minutes before they were stable enough to breastfeed.

Those whose pain was treated with propofol alone required 42 minutes before they could breastfeed.

Ketamine was most effective for pain and required only 31 minutes. But there were some surgery-focused issues that propofol could resolve and ketamine couldn’t.

So, those who were treated with ketofol (a combination of propofol and ketamine) required only 25 minutes after surgery to breastfeed.

This study determined that the ketofol combination was most effective. And it also found ketamine and propofol are safe for infants through breastfeeding.

Ketamine is Safe – Plus – Postpartum Depression Puts Mother and Child at Risk

Ketamine has shown its safety in treating people from infants to adults as well as the elderly for 50 years. One of the greatest risks to a baby born to a mother with depression is the mom’s untreated depression. Other medications are being tested to find more medicines that act quickly like ketamine does. In the future, we may find that they can be used postpartum to bring a mom to remission quickly so she can bond with her baby.

At this point, ketamine is the safest and fastest-acting depression-smasher for women, or men, suffering from postpartum depression.

If you’re pregnant or postpartum and are finding no joy in your pregnancy or in your life with your baby, know that you can feel better.

Call us, and let’s talk about what can be done to help you find joy again in your baby’s, and your own, future.

And if you suffer from depression, anxiety, panic disorder, social anxiety, bipolar disorder, PTSD, OCD, suicidal thinking, or other feelings of hopelessness and despair, you can have hope again.

At Innovative Psychiatry, ketamine treatment is administered with state-of-the-art infusion pumps, protocols, and expertise with dosage and rate to result in the best outcome for you.

We’re here to help you find your life again. To enjoy your family and relationships, your new baby and your most enjoyable interests.

To the revealing of your best self,

Lori Calabrese, MD

May 13, 2018