Category: OCD

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

These articles about OCD (Obsessive-compulsive disorder) are offered to increase understanding and reduce stigma. OCD is a long lasting disorder where a person has recurring, repetitive thoughts and then related compelling behaviors or actions they feel inner pressure to take and repeat over and over…

The Obsessions are thoughts or images that illicit anxiety such as:

Fear of germs or contamination
Unwanted, forbidden, or taboo thoughts involving religion, sex, or harm
Aggressive thoughts toward others or self
Wanting things to be symmetrical or else in perfect order

Compulsions that follow the thoughts

In response to those obsessive, intrusive thoughts, a person feels pressure within to repetitively take these actions, or perform these behaviors. These behaviors may be

Hand washing or extreme and excessive cleaning
Arranging things or putting them in a specific order
Repetitiously checking something, like the door knob to ensure it’s locked or that the oven or iron are off. Over and over and over.
Compulsively counting and recounting

Now, we all know that checking things, or counting, or handwashing are normal behaviors we all do, but it’s different for someone with OCD. This person:

Can’t control his thoughts or behaviors, even if he can tell that what he’s doing is excessive.
He still spends at least an hour a day doing these things. Sometimes far more.
He doesn’t experience any pleasure from these thoughts or behaviors. However, the thoughts produce anxiety, and performing the behaviors may offer a small relief from it.
These behaviors create troubling problems in his daily life

A troubling symptom that affects some people with OCD:

A tic disorder can affect this person in some cases, and can be a motor tic or a vocal tic. In the case of motor tics, the affected person may shrug his shoulders repeatedly, or make a facial grimace, blink his eyes, or jerk his head or shoulder. In each case these are repetitive actions.

Vocal tics include throat clearing, sniffing, and grunting.

All of these symptoms may come and go, may re-emerge in the presence of stress, and may seem normal to children and some adults. However, most adults understand that their behavior is abnormal but feel helpless to control it.

Neuroscience researchers work to find relief for these distressing symptoms.

Because of promising outcomes with IV ketamine combined with mixed results at other times, more studies are being performed.

Cause and Risk Factors

While causes of OCD are unknown, risk factors include genetics, brain structure and functioning, and environment.

As you read these articles about OCD, consider the symptoms and treatments available and we hope you’ll share your understanding with others who suffer.

What Your Friend With OCD Needs from You

Wonder how to help someone with OCD?

Think about what your friend with OCD needs from you…

Obsessive Compulsive Disorder, or OCD, is a condition where intrusive thoughts occur in your mind over and over again. You don’t want to have these thoughts or ideas…but you can’t stop them by sheer will.

To make it worse, they’re often disturbing or upsetting.

Compulsions follow the disturbing and repetitive thoughts…and you feel driven to act them out over and over again. When you act out these compulsions, your hope is that they’ll drive away the obsessions.

Unfortunately, as hard as you try to drive away those obsessive thoughts with your compulsive and repetitive behaviors…they just don’t go away. In fact, they become stronger. More compelling… even overwhelming.

Eventually the overwhelming and compulsive behaviors become so demanding and cause such anxiety and are so time consuming…

Well, it all becomes a vicious cycle.

Some people with obsessive compulsive disorder are driven only by obsessions. Others by only compulsions. But most are driven by the obsessive – compulsive cycle of both. And it can occur as often in men as in women, and in children as often as adults.

People with OCD weren’t born with these symptoms. In spite of extensive research, the cause is still pretty much unknown…although there seems to be a genetic connection in families for the tendency. And it may begin following a severe strep infection in children, or an accumulation of stressors in adults.

Regardless of the cause, what’s important is the role you play, as someone who cares about anyone who seems to suffer with OCD.

What Does Your Friend with OCD Need From You?

Let’s talk about some ways you can support her. If you’re not alert to the behaviors you see, and what’s causing them, it may be easy to fall into criticism and judgment, teasing or ridiculing, which honestly, just makes things worse for them.

For instance, you may begin noticing behaviors or habits that are frustrating to you, but are actually “signals” of OCD. Things like spending way too long in the bathroom, continually showing up late, or constantly asking questions about themselves that are steeped in self-judgment, and needing continual reassurance.

Long blocks of time doing anything… with no explanation for what was going on… simple chores that turn into prolonged undertakings… and doing the same thing over and over and over…

If you see behaviors like these, coupled with irritability and an unwillingness to talk about it, be assured this isn’t about you or your friendship.

Something painful is happening with your friend. While it may appear to you initially that she’s being weird, or that she has a wacko personality…she may be suffering from OCD.

And if she is, she needs support and acceptance from you. If she feels you blame her … or you’re critical of her…anxiety will just skyrocket and her symptoms will likely get worse.

What Symptoms Look Like

She may have obsessions that center around a common theme…like fear of contamination or dirt, or maybe about everything around her being orderly and symmetrical … or maybe fear of harming herself or others.

Those obsessions are likely to result in compulsive acts such as not wanting to touch things that have been touched by others. Maybe she wonders if she forgot to lock the door or turn off the iron…

And she may feel mounting pressure to return to the house and check that the door’s locked and the iron unplugged. “Would you stop it?? We’re late already…!” isn’t the response that will calm things down and get you back on schedule. Instead, reassuring her that the schedule can be adjusted and it’s time together that matters is a much more productive response.

Easy Tasks are Tougher for Her

Taking a shower and dressing for a quick brunch may involve 5-6 hours, while you wait for her to emerge. Remind yourself that she’s not treating you disrespectfully nor is she intending to be inconsiderate.

She may or may not even realize what’s happening that takes her so much time …and she may not realize so much time has passed either.

Also know that any change, even what seems like a good change, can stir up anxiety for her. And if you’re counting on her to carry her weight, such as in a move or cleaning the house, you’ll both end up miserable.

More important than her equal share, is that she feels accepted, understood, and reassured. She’s likely already beating herself up. She probably has NO idea why each task takes her so long. Your friend with OCD needs your reassurance at times like this.

She needs your help to cut herself some slack. “It’s no surprise you’re feeling stressed, or that your symptoms are worse right now…you’re going through a lot of change. Be patient with yourself, and give yourself time. This will subside — like it always does.”

Give Her Credit for Improvement

For anyone who doesn’t suffer from OCD, small tasks seem rather insignificant. But for your friend, shortening the length of her shower time by 5 minutes, or washing her hands one less time, can require an enormous amount of work, and fighting through gargantuan anxiety.

Resist the temptation to compare her to you…but instead applaud her efforts and results. The gratification of those small victories can be so motivating to continue making progress.

You’re Friends First

In the midst of all the OCD centered interaction, remember your friendship comes first. You are individuals first.

If you had thin hair, and she helped you with products to thicken it, that would not become the center of your friendship. But just one of many ways you connect and support each other.

And just as she wouldn’t focus every conversation around your hair, you mustn’t allow too many conversations to be focused around her OCD symptoms. Just as you wouldn’t play “mother hen” to any other friend, this friend also needs time to herself and respect as an individual. And you need the same.

What your friend with OCD needs from you is recognition of her best traits, as well as support for her struggles. After all, that’s how friendship works, isn’t it?

OCD is often treated with antidepressants and medications that reduce anxiety, but the results haven’t been stellar. However, an advanced treatment option is yielding some bright hope for those who suffer with this disorder.

IV ketamine treatment treats OCD symptoms by rebuilding synapses and strengthening signaling throughout the brain. It also reduces anxiety, depression, suicidal thoughts, and relieves PTSD.

At Innovative Psychiatry, we consistently see 80% recovery in treatment-resistant cases of depression, anxiety, PTSD, and obsessive-compulsive disorder.

If you or someone you care about is someone who suffers from OCD symptoms, call us. We’re here to help you with advanced treatment options like IV ketamine treatment and Transcranial Magnetic Stimulation.

Even though our practice is closed to new patients seeking medication management or therapy…we’re just too full…we are scheduling patients who want to see if advanced treatment options like ketamine treatment might be right for them.

We look forward to working with you for the better.

To the release of your best self,

Lori Calabrese, M.D.

December 11, 2017
Joie de Vivre with IV Ketamine Can Replace Last Resort Treatments

When Depression Doesn’t Get Better

When you’re sick of one more trial. One more dose increase. A new augmentation agent. Another cross taper…reducing dosage on one drug while increasing it with another… When you’re sick of just feeling so sick and tired and miserable. When you can’t stand the thought of gaining more weight. What then?

With the rising use of IV ketamine infusions for treatment-resistant mood disorders, more and more people who are sick of their symptoms are seriously stopping and thinking about their best course of action. Since oral antidepressants can take weeks – if not months – for their full benefits, people are looking at brain-targeted treatments that have faster results.

Life Threatening Symptoms

One reason is that the suicidal thinking that can occur with depression can be life-threatening. If you have thoughts that it would be a relief to be dead, or thoughts of killing yourself, waiting 2-3 months for oral medication to kick in and relieve these thoughts can be dangerous.

Another reason is that once you reach the point that you’re looking for alternatives to oral antidepressants, you’ve probably been depressed for months or years. And the longer it goes on, the more life-robbing it becomes.

Then, there are studies that show the longer someone suffers from a psychiatric mood disorder, the harder it is to get better. And the more medications you try . . . the less likely that another SSRI (selective serotonin reuptake inhibitor) or SNRI (serotonin-norepinephrine reuptake inhibitor) is going to help.

So you try a different class. You take one of the medications on reserve that we pull out when other things don’t work.

. . . And your symptoms slowly become “treatment-resistant” — even though you take what you’re supposed to take, do what you’re supposed to do. You keep every appointment, try to exercise, meditate in the morning. Sometimes nothing seems to make a difference. It’s exhausting even thinking about it.

These are all reasons to shift to a different treatment … an innovative one that can go above and beyond oral antidepressants.

Now wait just a minute… oral antidepressants help lots of people…!

Yes. They do. Millions.

Actually, 350 million people in the world are depressed.

16 million in the US.

4% of kids between ages 8-15 are, too.

Anxiety disorders are the most common mood disorder in the US — and 18% of adults suffer from anxiety disorders … almost 57,000,000 people.

Shocking, isn’t it?

Anxiety is the most widespread of all…

Every single one of these millions of people struggles and the struggle is real. Sometimes it’s just to get out of bed in the morning, sometimes it’s being paralyzed by a vague fear, sometimes it’s just to follow through and do what they know they should do — make the phone call, finish cleaning up the yard, deal with the paperwork. They can be pretty disabled by malfunctions in specific portions of their brain. Is it any wonder that so many take antidepressants hoping for relief that will allow them to function?

Most just want to be able to get back in the game.

Over 10% of Americans take antidepressants for depression and anxiety.

And we know that they’re really helpful for some people.

Just not all…not by a long shot.

Only HALF the Time

Jennifer Payne, M.D. is director of the Women’s Mood Disorders Center at The Johns Hopkins University School of Medicine — my alma mater. She says, “Even our best antidepressants work only about half the time.” And she goes on to say that the chance of success drops if the patient doesn’t respond to the first drug they try. In fact, the hope of recovery diminishes with each new antidepressant regimen that fails.

Their mood disorder slowly becomes “treatment-resistant,” even if they’re not. It’s for those who still suffer that we’re discussing options today.

Like IV ketamine, TMS, and ECT.

ECT – Its Troubling Side Effect

Until recently, after all the failed med trials, the gold standard for treatment-resistant depression was ECT, or Electroconvulsive Therapy. (The snazzier new term for it is Electrocortical Therapy. They took out the “convulsive” part.)

ECT has been in use in psychiatry for over 80 years, and it’s still available at hospitals for inpatient and outpatient treatment. Although it gets a bad rap in the popular press and in the media, it can be a lifesaving, effective treatment for severe depression and particularly for depression when psychotic symptoms are present — like hearing voices, or having delusional beliefs.

With ECT, you’re given general anesthesia and an electric current is passed through your brain to create a generalized seizure that lasts 30-45 seconds under very controlled circumstances, with muscle relaxers. The seizure is “seen” on an EEG monitor but your body doesn’t shake or convulse — just a toe wiggles. Treatment begins in a hospital center after you’ve been admitted as an inpatient and continues three times a week until the depression lifts–sometimes after 4 or 6 or 12 treatments.

ECT may be continued on an outpatient basis and stretched out and administered on a maintenance schedule (sometimes as infrequently as once a quarter) to help preserve remission.

Sometimes, ECT is offered on an outpatient basis to patients who can safely remain at home with family support — but they usually can’t work or go to school or drive during the weeks of treatment.

Clinical studies show this treatment to be 50-80% effective in reducing depression symptoms, and in those cases the patient feels much better. Because of this, ECT has been the “go-to” treatment for those with treatment-resistant mood disorders for whom no antidepressant regimen was successful for many, many years.

But there’s a problem with ECT.

Despite all of the modern advances in the administration of this treatment, ECT can inhibit the ability to lay down new memories around the time period of the treatment, and it can cause irreversible memory loss in a “piece-y” kind of way.

Bits and pieces of memories are lost. Certain things or certain periods seem fuzzy. It’s frightening because it can involve both recent and remote memory.

Well, when you’re at the end of your rope, when it feels like there is no choice, maybe a little bit of fuzzy thinking or poor recall around the time of ECT doesn’t seem like such a big deal . . .

But if you want to go to a wedding, recall a client’s name or the details of a contract, have an important discussion with your wife (or your accountant), drive to your cousin’s summer place without having to use a GPS … then fuzzy thinking, poor recall, or no memory of it at all are incredibly BIG things. It’s to be able to engage in and savor the moments that you’re getting treatment in the first place.

Remember, ECT was the “go-to” alternative treatment for treatment-resistant mood disorders because there was no real alternative.

Until now.

Now, there are more options, like TMS and IV ketamine infusions.

TMS Offers A Strong Success Rate And It’s Non-Invasive

TMS, or Transcranial Magnetic Stimulation, is a non-invasive treatment option that’s become more and more prominent in recent years. It’s more expensive than meds, but it’s effective for treatment-resistant depression as well other mood disorders and other maladies.

It’s Non-invasive. Nothing enters your body.

In this case, you’re is seated in a comfortable reclining chair – fully awake – because there’s no need for sedation. A magnetic coil is placed over your left temporal lobe just over the dorsolateral prefrontal cortex … and it sends pulses through your scalp into brain centers just below the surface. The pulses stimulate brain cells to send signals deep into the brain to activate, restore, and bring balance to the areas of the brain that control mood and anxiety.

TMS can be effective in 55-75% of people with treatment-resistant depression and other mood disorders. Because it’s non-invasive, there is nothing that lingers in the body to create lasting side effects between treatments or in the long-term. The effect that’s sometimes reported is a headache in the area where the tap tap tapping is heard when the impulses are released. This subsides in a little while.

No memory loss.

Great success in reversing depression.

No need for hospitalization… no need to suspend driving… no need for a leave of absence from work or from school like with ECT — even outpatient ECT.

For so many reasons, and for so many people, TMS is a much better alternative than ECT, which has become a last resort.

But there’s more… and I’ve probably saved the best for last.

TMS is effective, comfortable, and safe.

But there’s another option that’s even more effective.

That’s IV ketamine treatment for depression and other mood disorders.

IV Ketamine Can Replace Last Resort Treatments

Ketamine infusions are best given IV to ensure safety and to guarantee bioavailability — so that 100% of your precise dose (down to a tenth of a milligram) quickly reaches the areas of the brain and can get right to work. Like ECT and TMS, it’s recommended for those who have first tried an oral antidepressant without improvement.

You’re seated in a comfortable reclining chair (or maybe stretched out on a leather sofa!) in relaxing surroundings during the infusion. This treatment is so fast and effective, many patients are feeling better by the time the infusion is over.

Ketamine also treats suicidal thinking, basically erasing suicidal thoughts within 4 hours. This life-saving feature makes it a most desired choice for those who are are suicidal.

It’s a breath of fresh air. For some people, it feels like their first breath.

IV ketamine is typically given in the office as a series of six 40 minute infusions over about 2-3 weeks. And then you walk out … and go to dinner, get some sleep, and drive yourself to work the next morning or scoot off to class. There’s no hospitalization, no lost time. At Innovative Psychiatry, we schedule ketamine infusions in the evenings, so you don’t have to miss work or school. No one needs to know.

Like TMS, there are no side effects between infusions. There’s no memory loss. Period. That’s HUGE. During an infusion, you might experience mild nausea, so we just plan to avoid that altogether for you. There’s also a floaty, dissociative effect during an infusion — you should expect this. Most people find it very pleasant , not frightening, and it’s actually predictive of a good response to treatment.

Of course, there are other rare side effects of ketamine when it’s used in high doses in anesthesia. But we just don’t see them in our practice.

The effectiveness rate of IV ketamine infusions in our practice is 80%. That means that 80% of people who come in with treatment-resistant depression can get WELL. Depression symptoms disappear. For some people, maintenance infusions are used to maintain this wonderful, balanced, quality of life.

Joie de Vivre – the Joy of life.

If you’ve struggled to break out of the hollow, dismal, dark place of depression, consider this thrilling treatment. It can fill you with HOPE, then transform that hope to real, here-and-now, life-joy.

For us, it’s exciting to see people who have been so terribly ill come to life again. Live again. Love again.

The old days of suffering…without hope… are behind us.

There is hope for you, even if you haven’t been helped by antidepressants before.

Let’s meet and discuss new options.

To the recovery of your best self,

Lori Calabrese, M.D.

June 19, 2017
Breaking News: Another Way IV Ketamine SMASHES Depression

Another way IV Ketamine SMASHES depression

Sometimes news is so hot it sizzles.

It lures you away from whatever you’re into. It captivates you. And then — just face it — you think to yourself, with admiration, OMG. You say to yourself … whoever came up with that is brilliant. They nailed it.

Well, Mark Rasenik and his group from the University of Illinois Chicago College of Medicine nailed it. They presented absolutely breathtaking work in May at the SBP meeting — the Society of Biological Psychiatry. It’s the meeting where research is presented that is just so brilliantly conceived and executed that it’s mind-blowing.

Rasenik’s work is like that.

He and his group came in from left field with their brilliant discovery of a new way ketamine works which just might explain how and why it can begin to lift depressive symptoms in minutes.

Understand ketamine’s talents, then get creative

The goal was to learn what happens on a molecular level that causes IV ketamine’s fast depression relief. Because, of course, someone wants to design a drug just as effective as ketamine but without its side effects. This is the ever-loving quest for new drugs that wannabe like ketamine.

Now, we’ve talked before about how IV ketamine acts on synapses to stimulate them to grow, branch out, and flourish — multiplying the numbers of connections between neurons that send signals deep into the brain. We’ve also talked about neuroplasticity, and how it’s key to this process that causes the brain to change.

As new synaptic connections are built, and greater communication between brain cells develops, the brain gains the ability to see things in a different perspective, and your outlook becomes brighter and healthier. IV ketamine can jump start that process. Wait. No. It can turbo-charge it.

How to Get Those G’s Back to Work

So Rasenik and his team found that “g proteins” were packed on “lipid rafts” in the cell membrane with people who are depressed. In addition, their brain cell signaling is stifled, which may be the cause of that numbness depressed people experience.

If this is you, listen up. Numbness is no joke.

They’ve demonstrated that when SSRI antidepressants are used, they move g proteins from lipid rafts (I love that visual…like the G’s are languidly floating on a raft in the pool…taking time off being lazy) very gradually, and back into WORK mode. Which is how SSRI’s help some people who are depressed — but it takes weeks or months for relief.

You see, G proteins produce cyclic AMP, which is vital for the nerve cells to properly send their signals.

And, Rasenick and his team noted that the movement of the G proteins under the influence of SSRI antidepressants, was gradual … over a period of several days.

So, let’s take a breath here.

The Many Talents of IV Ketamine

We’ve talked about how IV ketamine stimulates neurons to flourish, grow branches, and become prolific with healthy connections for sending signals throughout the brain, especially into the deep brain structures like the hippocampus.

Now, Dr. Rasenick and his team have discovered that IV ketamine also gathers up the tools the nerve cells need so they actually can send signals throughout this new and bountiful network of connections, or synapses.

Those unemployed g proteins that were hanging out on the rafts, are pulled off the rafts and put to work to equip the brain cells to do their job.

And they work fast.

Remember how it takes several days for the g proteins to move off the rafts with an SSRI? Well, with IV ketamine, it happens in 15 minutes!!

So … do you see why ketamine acts so fast to remove suicidal thinking and depression?

I’m telling you, the more we know about IV ketamine, the more hope explodes with all of its potential.

Letting Go of OLD Ideas

There’s been a belief for years that ketamine’s one action was to block NMDA receptors. (Boy, does that seem like the dark ages now!) But ketamine is the only drug that blocks NMDA receptors AND moves g proteins off lipid rafts. It’s a double whammy, a one-two punch!

Once again, ketamine shows its highly targeted prowess in its assault on depression and its potential for assault on other psychiatric disorders.

In addition, ketamine and other compounds like it, improve glutamate levels, which SSRIs really don’t touch. When the processing of glutamate doesn’t function properly, that also contributes to depression.

So…wait a minute…that’s three actions ketamine uses to turn depression on its ear!

Oh, and the fourth: it turns on mRNA … to turn on DNA … to make more BDNF (Brain Derived Neurotrophic Factor) so that neurons grow new branches.

The Four Ways. Four different ways that ketamine smashes depression. This has brought a level of excitement into psychiatry like nothing else.

Someone should write a book.

A full 80% of those who are treated with IV ketamine infusions in our office respond, and many of those achieve complete remission of their symptoms. But, I’ve said before that it isn’t for everyone. If it’s not for you, we have other treatments like TMS to help you get better.

If you have symptoms of depression (chronic, recurrent, bipolar, postpartum), PTSD, and treatment-resistant OCD and have not been helped by anti-depressants, call or email us to arrange an appointment for a consultation. We’ll thoroughly check you out, and analyze what we learn, to determine the treatment most likely to truly help you feel better. I don’t mean to reduce your current symptoms, but to actually get well.

We’re Innovative Psychiatry. (Um, you’d have to be to translate lipid rafts and g proteins into treatment that works in your office … ) And we’ll work with you to find the best steps that will help you get well and live the life you want to live.

To the discovery of your best self,

Lori Calabrese, M.D.

June 8, 2017
Obsessive Compulsive Disorder Treatments Change the Game
Just because it feels natural…doesn’t mean it’s good for you

Macie is a 32 year-old administrative assistant who feels growing tension when she leaves the house. She opens and closes the door, locks it then unlocks it, and opens and closes it again to be sure it’s latched. Then locks it… and unlocks it. It doesn’t feel secure yet. So she repeats this ritual five times. For some reason, after the fifth cycle, she can finally leave. So she does.

She gets in the car, puts her key in the ignition, and starts it up. Then she turns it off, takes her key out, then reinserts it, and starts it up again. After three cycles, she’s ready to back her car out of the driveway.

These behavior patterns of repetitious cycles follow her through her day. For instance, when she goes to the restroom at work, she washes her hands, rinses them, and examines them. But they don’t feel very clean and the idea of the germs that are probably still there makes her shudder… so she sticks her hands back under the water, soaps them up, rubs them together and wrings them, rinses them, and turns off the water.

Nope…not there yet. It takes at least 3 more cycles like this before she can dry her hands and leave the restroom. She uses a paper towel to turn the doorknob.

People can be cruel.

Macie didn’t think much about these rituals until someone commented…someone else laughed… then became impatient waiting for all this to be completed. The comments of others began to wear on her…and she started to realize that maybe she was different than the others around her. And she felt ashamed.

She isn’t the fastest worker in her office, because of all these cycles that slow her down. But she has an eye for detail…and is great with spreadsheets. Meticulous, careful, accurate.

Her husband, Josh, learned long ago to be patient and tolerant. It didn’t take long for him to realize that pushing her, pressuring her to hurry up and get moving, only resulted in her anxiety shooting up, her tension doubling, and then . . . instead of 5 cycles to lock the door, she needed 12, and instead of 3 hand washings, she needed 9.

In short, heightened anxiety just made everything harder … and worse.

Why do some people act this way…?

Macie has Obsessive Compulsive Disorder, and only recently she realized it’s affecting her job, and her friendships.

Obsessive Compulsive Disorder is a combination of recurring, intrusive, unwanted or disturbing thoughts or ideas that cause a person to feel unsettled and distressed. Then, to relieve the misery they feel, they’re driven to perform a repetitive action. Behaviors like these — such as Macie’s hand washing or checking the door locks — tend to interfere with their daily functioning to a dramatic degree.

Now we’re not talking about someone who locks the door twice and goes on his way. The rituals referred to here are so numerous and compelling that people like Macie have a difficult time maintaining a job, or maintaining relationships, because of them. The pressure to keep going through the cycle until it feels right is so great that if the cycle is disrupted, it causes terrible stress and consternation.

You know that feeling you have when you’re on a road trip and the second day you can’t remember if you left food and water for the cat…? You don’t want to go back and start your trip over, but you also don’t want your cat to starve. It’s so troubling, and anxiety builds until you resolve the situation.

Well, multiply that distress by about 50, and you’ll have a glimpse of the distress Macie feels about failing to lock that door. Then imagine this happening all day long.

OCD is like having a huge nasty bully in your head

…that no one else can see

In Macie’s case, she knows in the back of her mind that the fears she has aren’t real…but logically knowing it doesn’t ease her distress. Because this is not a logical problem. It’s rooted in anxiety that doesn’t go away. Anxiety she doesn’t understand, and can’t explain away. So she continues with her routines as if they’re just part of everyday life. Every day.

For her…they actually are.

In many cases, someone with OCD doesn’t seek treatment until they’re fired from their job or lose a relationship with someone who ran out of patience. When sorrow mounts that’s caused by their OCD behaviors, they get ready to seek help.

Is OCD common?

About 1.2% of adults suffers from OCD, which can begin in childhood, adolescence, or adulthood. If you have parents or close family members with OCD, the risk of developing it is higher for you.

Also, if you have another psychiatric disorder, that also may increase your risk of developing this one, too.

And then there’s trauma. When a terrifying or profoundly distressing experience presents itself, it draws a reaction from you. Your reaction may be fear of it happening again, or disgust at the thought of it, or some other disturbing feeling. For some people after an experience like this, a pattern of coping goes into play. To keep the thought of it out of your mind, you do something that’s reassuring or distracting. The disturbing thought is often connected to the repetitive action.
- Fear of sickness from germs or chemicals => may result in feeling driven to clean incessantly, repetitively washing and washing your hands…even being afraid to touch people or objects others have touched.
- Fear of an intruder => may result in repetitive cycles of door locking and re-locking
- Fear of hitting someone with the car => may trigger the need to back up at stop signs, or pull off the road to check, or call the local hospitals
The point is that these distressing thoughts can compel the person who’s suffering to perform certain rituals, and those rituals can interfere with normal functioning in a productive life. In fact, they can be debilitating.

Is there treatment?

Yes, there are medications that bring relief in some cases. But of the patients who take medications, 40-60% receive partial relief or none at all. There are therapies like CBT and exposure therapy that sometimes help to ease the disturbing and intrusive thoughts, as well as the compulsions. But these treatments leave only about 10% of people with OCD successfully treated.

Which calls for innovative treatments.

Obsessive Compulsive Disorder Treatments

For this reason, we offer other options, like Transcranial Magnetic Stimulation, for patients who haven’t experienced relief from Obsessive Compulsive Disorder through medication and therapy. TMS is not systemic, so there are none of the side effects like you may experience with antidepressants.

IV Ketamine also shows great promise and success in treating OCD. Like TMS, IV Ketamine is a treatment that targets brain structures to bring relief to OCD symptoms.

Obsessive Compulsive Disorder treatments change the game.

We can learn more about what you need to feel better… LIVE better….through a thorough psychiatric evaluation. If you’ve suffered with the harrowing symptoms of OCD and have not experienced relief from the medications you’re taking, let us help match you to the solution best suited to you.

Helping you to find the life you ache to live is our highest, never-ending goal. Let’s join forces to find your solutions.

To the emerging of your best self,

Lori Calabrese, M.D.
June 1, 2017
Ketamine Reduces OCD Symptoms

Obsessive-compulsive disorder is a psychiatric disorder that causes repetitive behaviors, intrusive thoughts, and fear. The traditional treatment for OCD has been cognitive behavior therapy, drug therapy, or a combination. But Ketamine has shown promise in reducing OCD symptoms. The theory that ketamine reduces OCD has been studied and continues to be backed up by ongoing research.

Ketamine Reduces OCD Quickly and Affordably

A recent study was presented to the American Psychological Association (APA) during the annual meeting showing promising results of ketamine therapy to reduce OCD symptoms. This study included 10 unmedicated patients with OCD who were each given an infusion of 0.5mg of ketamine and 0.5mg of saline randomly.

During the first week, half of the patients responded to treatment. The patients who received ketamine in the first infusion were evaluated two weeks later; 40% responded to treatment.

Ketamine Reduces OCD in 40% of Patients who Were Studied

The theory is that ketamine infusions work through the glutamate system to rapidly decrease the symptoms of OCD. More research is necessary to fully understand the sustained effect of ketamine in the treatment of OCD. However, this study has shown promising results for future OCD treatment.

Call My Office to Hear More about How Ketamine Reduces OCD

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

May 26, 2016
3 Myths About OCD
Obsessive-compulsive disorder (OCD) is a psychiatric disorder that affects approximately 1 in 100 Americans each year. This disorder is often misunderstood and those suffering struggle with the stigma associated with it. This stigma can negatively impact all areas of life. It’s time to stop the stigma with these 3 myths about OCD.

1. Having OCD Means You’re a “Clean Freak” or “Germaphobe”

OCD manifests differently in different people, which means no two cases are necessarily the same. Only a portion of people with OCD have a fear of germs or have compulsions of keeping themselves and everything around them clean. There are many fears or obsessions associated with OCD so to say that being afraid of germs or liking to be clean is a sign of OCD is perpetuating stigma. Common fears in people with OCD include:
- Fear of certain numbers, colors, words, etc.
- Fear of committing a sin
- Fear of germs
- Fear of a loved one dying
In addition to these fears, those with OCD also cope with compulsive behaviors. Many of these behaviors are repetitive and include:
- Hand washing
- Tapping or touching objects
- Counting
- Repeating certain movements
- Hoarding
Each patient is different and will experience OCD differently. In addition, symptoms can change over time, with some disappearing and new ones popping up.

2. Having OCD Means You Love Being Neat and Organized

How many of you have heard someone say, “I have OCD” while tidying up or trying to stay organized? High levels of anxiety accompany OCD, so, while you may think that someone enjoys being organized, they’re really doing it to stave off anxiety. It’s not something they enjoy doing; it’s something they feel as though they have to do to feel better.

3. Having OCD Means You’re Weak and Uptight

If you don’t have a psychiatric disorder, it’s difficult to understand those who do because a healthy mind doesn’t work the same way. Those with OCD aren’t weak because they can’t stop compulsive behavior. Their brain is wired differently making it difficult or even impossible for them to change their behavior without treatment. Getting upset or frustrated with someone who has OCD isn’t beneficial to anyone and it may make him or her feel worse about him or herself.

It’s important to know the facts before speaking on a subject. We all have our opinions, but, oftentimes, it’s those very opinions that keep the stigma surrounding psychiatric disorders alive. It’s this stigma that often prevents people from seeking treatment for one reason or another.

To getting you back to your best self,
Lori Calabrese, MD
May 18, 2016