Category: PTSD

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

Our purpose in offering these articles about PTSD is to reduce stigma. It’s also to help the reader better understand the causes and symptoms of PTSD. Better understanding helps each of us to offer support to those in our lives who need understanding for episodes they’re unable to prevent.

Post-traumatic-stress-disorder (PTSD) occurs following a terrifying experience, in some people. It prevents the sufferer from recovering after witnessing a traumatic event. PTSD can last for months or years. In addition, memories of the event can trigger extreme physical and emotional reactions.

Symptoms of PTSD

The scars that remain from active combat or other traumas cause recurring memories that seem as real as when they first happened. Originally known as “shell shock, PTSD was thought to be exclusive to soldiers returning from battle. But over time, it became clear that PTSD was a disorder anyone could develop who’d been through a traumatic experience.

When someone suffers from PTSD can have recurring flashbacks of the terror they experienced during the traumatic event, as well as intense nightmares. They may feel afraid, or intensely frightened, whether there is anything presently threatening or not. It’s as though their “fight-flight” response malfunctions, and a small stimulus can bring all the horror of the initial experience back instantly.

PTSD affects around 8 million people a year in the US. These people who suffer have been far too often misunderstood and misjudged for their reactions.

Articles About PTSD Treatment

Talk therapy

The most widely used treatment for PTSD is talk therapy. By talking through the traumatic memories, as well as those moments that seem to trigger the flashbacks, the individual can sometimes learn a healthier response to the trigger.

Medications

Medicines are used in some cases to help patients cope with their anxiety and anger in the face of an unrelated situation that stimulates the reaction, i.e., a trigger. Since adrenalin is a hormone that’s released in overabundance with each trigger point, addressing the individual’s hormonal reactions sometimes improves relief.

IV Ketamine infusions

This treatment makes a remarkable difference in many cases of PTSD. The Veterans Administration works with IV ketamine to treat PTSD in combat veterans, and has for years with excellent results. And IV ketamine shows remarkable outcomes for people with a wide variety of PTSD causes. PTSD from major disasters, to domestic violence, assault, battery, and rape, to catastrophic illnesses, transportation accidents, and other disastrous injuries.

IV ketamine isn’t for everyone. No treatment is. But chances are it will help you enjoy a dramatic relief from symptoms of PTSD.

More studies show IV ketamine infusions can also prevent PTSD in combat military and first responders. Extraordinary.

By offering these articles about PTSD, we hope to increase understanding and compassion for those who suffer, and drive back stigma with factual information.

Keep reading…

Reach Out for Ketamine… to Get Better… and Make 2020 Your Best Year Yet

This is the first Monday of the New Year…so how do you start a new year?

With resolutions? A diet? Maybe more exercise? Lots of people do. But what about you? What if you don’t have an appetite…? Might be hard to stick to a diet more than a couple days… and what if you haven’t slept in days…and you’re exhausted… who cares about the new year and any good intentions? When you feel crummy, the beginning of the year seems like just more of the same ol’ misery. Maybe you wonder, why try? You’ve been so depressed, with so much anxiety, and have felt so alone, so vacant, for so looong, it seems futile to try something new… BUT. What if there really IS an answer that could sweep away your misery and you could finally feel like the best you you’ve ever been…? I know, you probably think that sounds impossible. But wait a sec…this is the 21st century, my friend. Treatments have improved. Or a better way to put it, there’s now a treatment that’s a game changer. But it won’t come to you. You’ll have to reach out for ketamine so you can get better now. You’ll have to do something…because this treatment won’t magically show up in your living room. So why not do it now?

IV Ketamine Treatment – The Game Changer for Psychiatric Disorders

Of course, I’m talking about the treatment that came out of the woodwork the last decade. The one that started as a trusted anesthesia medicine listed on the World Health Organization (WHO) List of Essential Medicines. The one that’s been so safe for 50 years that it’s been used in surgical settings for people of all ages across the globe, and also in surgical settings for pets of all sizes.

Like most exceptional medicines that are designed for sedation and/or pain relief, it’s been abused by people on the street and in the club scene for its dissociative side effects. As a result, it’s sometimes been misunderstood as a result.

But under psychiatric supervision, it’s nothing less than extraordinary in its effect on people whose disorder has not responded to traditional medications. Which is one of its many endearing charms.

Why wait any longer? Why not reach out for ketamine now and start this new decade on far better footing..? Stick your neck out and make the call for treatment now because you deserve the chance to live a fulfilling life, free of symptoms that keep your life shackled.

Ketamine Treatment Relieves a Broad Variety of Disorder Symptoms

It happened last week, and it shocked me. Someone asked me about the best treatments for depression, anxiety, and PTSD. As I began to talk about treatments, I saw a blank look on his face when I mentioned ketamine infusions. He’d never heard about them…! And I realized that though this medicine is always in my radar, there are countless people who know nothing about what it can do.

Someone who suffers from unrelenting and severe depression, bipolar depression, PTSD, OCD, social anxiety, substance use disorder, alcohol use disorders – and sometimes eating disorders like Anorexia Nervosa – can achieve remission with IV ketamine treatment.

IV ketamine treatment can be a bit tepid in relieving symptoms for those with milder cases. But, let me quickly say that when you feel bad, it doesn’t feel mild. And that’s why we have criteria to help us measure the severity of each case.

Just knowing how severe it is – or not – can guide us in how to treat it. When we see someone who has suffered with symptoms for years in spite of multiple medication trials, in spite of other treatments, who has also been hospitalized for symptoms, and may have attempted suicide multiple times, we realize this patient has suffered severely for a very long time. And patients like this usually experience a dramatic remission after IV ketamine treatment.

Not always. But usually…

IV ketamine treatment doesn’t work like this for everyone… sadly, not even for everyone who’s severely ill. But it has a remarkably fast and vigorously thorough effect on a very high percentage of patients… higher than any other office treatment for these disorders.

And that’s not all.

Freedom from the Doldrums

You know how it is with depression that hangs over you…month after month and year after year… even if you have a few days that are a bit better…and you can actually smile some…as soon as someone says something that hits a nerve – you plunge again…back into the pits. It’s like you have nothing to fight with, like a tightrope performer with no net. So even a lighter feeling for a few days is temporary and you know it. You can feel how fragile it is.

But with IV ketamine treatment, that fragile-ness seems to evaporate. You get offended by the guy at the party who ALWAYS has his foot in his mouth, and it burns you up. But the nosedive you expect floats away, as you think through that guy’s words and realize your peace is too important to jeopardize… and ::::poof!:::: you move on. And it’s forgotten.

One reason may be the resilience ketamine builds. You’re able to adapt and quickly recover from the offenses that happen and you have the power to just snap back and be ok. It’s amazing…in fact, it’s priceless.

So, reaching out may require that you talk to yourself. Maybe you’ll need to “psych yourself up,” but when you do whatever you need to do, and reach out for ketamine treatment, you’ll find yourself surprised at all that happens for you.

Neuroplasticity + Psychotherapy = Peace & Joy in life

Then, to point out yet another talent of this treatment, researchers and therapists have learned that because of the neuroplasticity ketamine creates in your brain circuitry, psychotherapy can be much more effective about 24 hours after an infusion.

At Innovative Psychiatry, we love working with your psychiatrist and therapist to help make that benefit available to you with scheduled infusions coordinated with your therapy appointment 24 hours later.

But, the fact is, that none of this can be available to you unless you reach out. It requires that you call us. Let us coordinate with your healthcare team.

You’re probably thinking, How Can I Do THAT? I Can’t Seem to Get Out of Bed??!!

And there’s the rub.

There is more help available for your tormentous symptoms than has ever been seen by your parents or grandparents or great grandparents…

But the biggest obstacle between you and having a healthy, balanced, rewarding life is actually a characteristic of your illness. To get to that rewarding life (you may have all but given up on,) you have to do something you may not think you can do. And here it is…

PUSH through.

…and make the call.

And you know how you can do that..?

By grabbing on to HOPE.

The drowning man has to take hold of the rope. If he’s passive and tries nothing, he’ll drown.

The mountain climber who loses his footing and careens over the cliff has to reach out and GRAB – something. A rock…a rope…a bush…?

Once you reach out, it gets easier. We step in. You’ll still have to show up, but each time it will probably get easier and easier. And as ketamine goes to work in your brain cells – the systems and circuits and structures – surging hope and strength and resilience will billow from within you.

It doesn’t happen all at once the very first minute…

Maybe it just trickles at first, but then the trickles become waves, and the joy and initiative surges, and you find you’re CAPABLE of doing things you want to do, that you’d all but forgotten about.

For some it’s during the first infusion…for some it’s after the second one. For others it’s after the third… and in some cases it’s even after the fourth.

Your family may notice the changes in you before you do. You may show unexpected initiative before you FEEL all that much better. (Miranda, are you actually folding clothes? Unbelievable!)

Reach Out for Ketamine!

More than likely, you’ve heard of ketamine treatment. Maybe you dismissed it, because you’ve heard of it as “Special K” or thought it was just a horse tranquilizer. You think it all sounds bizarre, or the creepy kind of experimental treatment that happens in somebody’s garage.

If so, maybe it’s time you do your own homework? The National Institute of Health funds extensive research about ketamine treatment because it’s so extraordinary.

Esteemed neuroscience researchers around the world submit their research to peer-reviewed medical journals. Conferences of psychiatrists, neurologists, neuroscientists, and physicians in other fields are hosted in major cities like Oxford (UK), NYC, Austin, San Francisco, and more. And this has been going on for years.

IV ketamine treatment is the most effective medicine for psychiatric disorders we’ve ever seen. It’s not FDA approved because no one wants to pay for FDA trials if they can’t make a profit off a patent. And..ketamine is too old…there’s no patent to be had.

So, we lobby for it to be covered by insurance companies, anyway. And until then, you have to pay for this treatment out-of-pocket. However, there is medical financing available everywhere. And your resurrected life, your ability to pursue your dreams, build strong, healthy relationships, and enjoy your hobbies on your terms…isn’t all that worth a small loan? To be able to live again?

Reach Out for Ketamine and Get Better for 2020

This is a new year, and a new decade. Right now, this week, is the perfect time to turn the tables on misery, take hold of your hope, and reach out to get better.

Tell yourself that it’s your turn to get better. And that you’re not going to give in to excuses. That you want to live better, healthier, and more balanced. That you want your life to BE better. Give Hope the benefit of the doubt.

This step can turn your entire life around for the better. But you’re the one who has to take it.

Because it’s not right for everyone. We need to be sure you’re a candidate. And we’ll evaluate that first.

So…you may say, What if it doesn’t work for me?

Well…we say, What if it does??

The likelihood it will transform your life is much stronger than the likelihood it won’t work for you. Much stronger.

Do you really want another decade to crawl by while you’re trapped in the misery and despair of this disorder?

Reach out for Hope and for a better life in 2020 and beyond.

We’ll walk you through the process, answer your questions, and make it as easy for you as we possibly can. We’re here waiting for you to call us because we want to see you enjoying a full life.

Reach out for ketamine and grab onto HOPE.

To the restoration of your best self,

January 6, 2020
Who’s Affected by Severe Chronic Depression?

Just think about it. How far reaching is this one condition?

Sure people talk about being depressed with a casual tone. You get the feeling they feel crummy…but it seems to be their response to circumstances. And when circumstances change, they seem to forget they felt bad. But when you think about who’s affected by severe chronic depression, you think of people who don’t have the energy to get up in the morning. You think about people who are trapped in substance abuse and have grown to hate themselves. You think about people who are just tired. Of everything.

Let’s take a closer look at the people affected by severe chronic depression. Who are they?

Gary is one.

Gary worked hard his entire life. He worked tirelessly to help others improve their lives. He worked to inspire and comfort. But, when you’re in the business of helping people enjoy richer, more meaningful lives, there are always those few who spurn your efforts, and even come back to crush you, if they can. And sometimes it’s the one you believed in the most.

In Gary’s case, there were two of them. They robbed his house when he was away for the evening. Then, spread false stories attacking his integrity. And Gary was cut to the heart. After being robbed and betrayed, he was hurt, angry, disheartened. In fact he was shattered.

Even though he’d always been optimistic, and bounced back after disappointments, this time he utterly lost his footing. Shock and devastation swarmed around and within him. He lost his bearings…and withdrew into the quiet safety of his house.

He found himself acting strangely, behaving in ways he never had before.

Months went by. He ordered food from Amazon and avoided any human contact if at all possible. He didn’t answer the door, and friends gave up, one by one, and became absorbed with their own lives.

A relative helped him get in to see a doctor finally. He was diagnosed with Bipolar II Disorder. The doctor prescribed a medicine to help prevent the hypomanic episodes, but the depression and withdrawal didn’t improve much. Years went by and he settled into a routine of leaving the house maybe once a week. His warm, inviting personality became subdued and cautious.

Something needed to give. To help free him from the box he’d built around himself.

And thankfully something did …but we’ll get back to that in a moment.

And Who ELSE?

Dan is.

Dan had his first drink when he was 14, and was hanging out on a Saturday night with his brother’s friends. They were all 16 and 17, and after getting some six- and 12-packs of beer, they all went to the lake on a Saturday night and drank all they had. Some ended up vomiting, others passed out in the car. Dan did both. But he liked the way the beer made him feel, and he knew he’d be up for drinking more when he had the chance.

High school beer bashes led to frat party blow outs, and while he experimented with some other things when he had the chance, it was alcohol that became his “go-to” in good times and in bad.

At 42, he drank whenever he was free. He had managed to get through college with a degree and land a job that was steady, but nights and weekends were his time to reward himself — whether anyone was with him or not. He worked hard to earn the right to get smashed on Saturday night.

After marrying in his 20s…hoping for happily ever after… he found himself alone and single again in his 30s. So many fights about his drinking. She was just beautiful, and he was so proud to be seen out with her, but she was so critical.

Alcohol Addiction and Depression… A Dangerous Combination

Now in his 40s, Dan began to understand why. And he realized he was likely to spend his life alone and drunk, if something didn’t change. He’d actually tried to stop drinking but something always happened and he was back at it. He felt pretty defeated. It seemed to be bigger than he was.

Every day he dragged himself out of bed, and went to work. He was often hung over, but 25 years of this had helped him develop an armor that got him to work, helped him function well enough to not get fired, and then home again to repeat the habit of every other night of his life. He had come to hate his empty, dead-end life, and his empty, dead-end self.

Dan hadn’t enjoyed anything in his life in at least ten years. He endured, and barely existed. He had no purpose. No joy. He was the chair person for the Dan Hatred Club. It was hard to see any reason to keep living. He wondered how to stop without it hurting too much. He was convinced no one would notice if he was gone.

There’s more to Dan’s story.

And I want you to know what happened. A little later.

While it’s so true that many people are very ill, even disabled in some cases, with severe chronic depression, you can see that many have other illnesses that are complicated by depression.

Some people suffer with a complex combination of disorders, and diagnosis and treatment can be complicated, too. We talked about Gary and his traumatic experience, the depression and phobias that followed and led to his eventual confusing behaviors, and a Bipolar 2 diagnosis.

We talked about Dan, his early introduction to alcohol and the long term impact it had on his brain…and his life. How his drinking gave way to poor social function, and the inability to give his best to his marriage. Eventually he found himself in a self-destructive rut and didn’t know how to turn it around. Then the suicidal thoughts began.

So who else is devastated – and disrupted – by severe depression symptoms?

Cheryl is.

Cheryl is 26. She’d finished college and was working on her masters degree in forensic psychology when she found herself pregnant. She and her husband wanted children, but they weren’t sure when.

Still, she felt like she was carrying a miracle within her, and the couple set about learning all they could about pregnancy, their baby’s development, and child rearing. They wanted this to go perfectly. She would find a way to complete her masters degree. But she was determined to celebrate their child’s life.

Her pregnancy was hard at first, with morning sickness that seemed unrelenting. But around the 13th or 14th week she thought she might be feeling a bit better. She began to browse in baby stores, looking at the tiny clothes and trying to imagine her baby wearing them. Her clothes were also getting tighter, and she shopped to find some pants that were looser and more comfortable. It was all beginning to feel amazing, just thinking about this little person who was safely cradled and growing out of sight….but under her heart.

The weeks dragged by, and her excitement about her baby became almost too much at times. She and her husband began shopping for a bassinet, a crib…and a stroller. She learned about support meetings for breastfeeding mothers and attended as often as she could. There was so much to learn!

Weeks turned into months, and finally she was in her third trimester. Just 3 more months. Through her pregnancy her emotions were filled with excitement and joy. A sense of wonder seemed to give the whole world a glow.

Happy Times Preparing for Baby

She and her husband attended childbirth classes and toured the hospital. They practiced exercises and breathing patterns at home to try to truly equip themselves for the adventure of labor and delivery.

Then, when she was 41 weeks along, those Braxton-Hicks contractions everyone talked about began to get out of hand. Within a couple hours she was in the ER being checked out.

Finally, she was in labor.

Cheryl’s labor progressed normally the first 10 hours. Then, in spite of hard and nearly constant contractions she was no longer progressing. Her doctor confirmed his suspicions: the baby’s head was lodged at an angle in the pelvic region and couldn’t move forward. He called for a C-section.

Within 15 minutes she was wheeled into the operating room, and suddenly asleep. When she awoke, everything seemed strange. Then she remembered the labor, the baby, and oblivion.

Her husband was smiling and told her they have a beautiful baby girl. She felt too groggy to understand what he was saying. She blinked hard to try to clear her head. Her husband handed her a little bundle. She laid it in her lap. What was it?

As the fog cleared her head, her memory of the labor returned. Her new baby slept in her bundled blanket. And Cheryl put the pieces together. She had had a baby. She was sleepy because of emergency surgery. The baby couldn’t get out… But where was that baby?

Traumatic Birth Can Interfere with Bonding Between Mother and Child

She asked her husband, and he told her their baby was in her lap. But the bundle in her lap didn’t look like anyone she knew. It just didn’t feel real…somehow…

She felt no connection to this tiny human, in spite of her husband’s reassurance… She felt sure she would have recognized her own baby, right?

Cheryl found herself detached, stunned, disconnected from feeling like a mother. Her strange behavior puzzled her husband. Why didn’t she cuddle their beautiful baby girl? The nurses tried to help her breastfeed, but the baby only cried. Almost as if this baby girl could sense her mom’s disconnect.

Cheryl and her husband took their new baby home and named her Phoebe Mae. She desperately wanted to feel something good toward the baby. But, she didn’t. She couldn’t. All that anticipation for 9 months, and this is it? Endless exhaustion and sleepless nights? Where was the joy..?

Her behavior worried (and angered) her husband. He just didn’t understand his wife’s coldness. Was this damaging Phoebe? What damaged Cheryl to cause this?

Months went by and Cheryl had long since taken up bottle feeding Phoebe formula. Besides, her husband could help more easily this way.

Then, Phoebe’s first smile was for her daddy. And her first laugh, too. Cheryl felt a bit jealous that she stayed with her daughter all day and fed her and took her on walks, but she really only responded to her daddy.

“They’d both be better off if I was gone…”

Postpartum depression.

It hurts the mom, it hurts the baby, and it hurts the dad. The severe chronic depression that can occur after the baby’s birth is heartbreaking and interrupts bonding between mother and child.. sometimes retarding a child’s development.

Which brings up another point.

Who Else is Affected… or should I say, Overwhelmed ?

The family is.

Everyone who loves you. They worry, they try to help, they pitch in, they listen.

And try as they might, they’re helpless. And desperate for solutions. Your severe chronic depression breaks their hearts.

These few examples give only a glimpse of the complex symptom clusters any one person might suffer. There are so many more.

But IF, and only IF, you can safely and effectively reduce or even eliminate, the symptoms of depression, you may be able to see your life restored and functioning again.

Of course, traditional SRI and SNRI antidepressants play their role in helping people with depression feel better. Roughly a third to half of them…maybe a bit more. For those people, antidepressants are enough.

But for the rest, those who continue to suffer no matter what pills they take, there seems to be a need for more than reuptake inhibitors. These people need restored circuitry, new connections, fast and prolific signaling deep into their brain. They need restoration.

Maybe they need IV ketamine treatment.

Remember, there is no medicine for depression that is as fast working as ketamine. No other medicine is as widespread in its antidepressant benefits in the brain. And no other medicine helps as many people recover, even achieve remission, and build restored, rewarding and fulfilling lives like IV ketamine treatment can.

Plus, it’s safe.

Ketamine doesn’t cause long lasting side effects. The notorious effects most antidepressants display, like sexual dysfunction and weight gain, don’t exist with IV ketamine. Ketamine doesn’t raise or lower the blood levels of other medicines you’re taking. It just goes to work. And, hopefully for you, it accomplishes the transformative restoration it’s so famous for.

The World Health Organization includes ketamine on its List of Essential Medicines. Respected around the world in ORs, ERs, disaster areas, and war zones, ketamine isn’t new.

Remission Often Replaces Severe Chronic Depression at Innovative Psychiatry

Innovative Psychiatry in South Windsor, CT is the premier provider of safe, rapid, and effective IV ketamine treatment for depression and other psychiatric disorders in Connecticut. We were the first ketamine treatment center of Connecticut — in fact in our four state region. Because we treat the most severe cases of treatment resistant depression, bipolar depression, anxiety, PTSD, substance abuse disorders, and social anxiety. We were intent on finding treatment that turned these symptoms around.

How did IV ketamine treatment impact Gary, Dan, and Cheryl? Did they recover from their own severe chronic depression symptoms?

IV Ketamine Treatment Does Its Best Work When Symptoms of Severe Chronic Depression Seem Untreatable

Remember Gary?

And his boxed-in anxiety-filled existence? The same friend who helped him go to the doctor, also helped him access IV ketamine treatment.

After 7 infusions, Gary bloomed. The warm, outgoing, generous man who had served people in need all his life re-emerged. Gary’s confidence returned along with his energy to participate in the lives of people who needed his help.

His life became rewarding again, filled with activity and relationships. You might say his best self was restored.

Then there was Dan.

Dan was suicidal when a friend told him about IV ketamine treatment. He learned that ketamine not only relieved depression, but could be effective in helping break addiction. And… that it could stop suicidal thoughts in a few hours. Dan wanted to see what it could do for him. He felt like this was his last ditch effort. He didn’t want to die, exactly. But he didn’t want to live like this any more.

Well, he was not disappointed. The first half hour of the first infusion, those images of death and thoughts of dying disappeared. Almost like poof! gone. He emerged from the infusion smiling. That was a good start alright.

That night, he found he had no interest in a drink, so he skipped it. How about that, he thought to himself.

After the second infusion, he definitely felt less depressed. Improved. NOT great…but better. By the time he arrived for the 4th infusion he was feeling pretty good. Hopeful…motivated.

It’s been six months since his 6th infusion now, and Gary feels like he’s living. He’s stopped drinking completely, sees a few friends, met a terrific woman. His future looks bright.

And Cheryl…?

Well, Cheryl’s husband heard about ketamine for depression from a friend at work. He encouraged her to talk to her doctor about it. Her doctor said that effectively treating the depression could reverse her struggle with bonding.

When Phoebe was six months old, Cheryl received her first infusion. On the way home with her husband she could tell no difference. He encouraged her to keep an open mind. That he’d heard it could take awhile.

By the 4th infusion he noticed she was taking initiative in the kitchen, preparing a new recipe. She hadn’t done that since Phoebe was born. Then the next day she was sitting with Phoebe playing patty cake… and that night rocked her, kissing her on the forehead as she drifted off.

She was expressing joy more and more and laughing with Phoebe. By the end of the 6th infusion she didn’t feel perfect but she did feel happy. The doctor said it would get better and better.

Severe Stress Can Cause a Setback

Then Phoebe got sick. At 8 months she caught her first cold. Cheryl was up all night comforting her, sitting with her near the humidifier to help her breathe. This continued for 4 days until Phoebe started feeling better.

But the lack of sleep and strain took their toll. And Cheryl’s depression returned. Not as severe as it had been. But severe enough. A couple weeks later her husband asked her to call the doctor, who told her she may need another “booster” infusion. So she complied.

She felt much better again after the infusion, and Phoebe stayed well all summer. They had daily walks in the sunshine, and Cheryl and Phoebe both had rosy cheeks and and a tan.

The next time Phoebe got sick in the fall, the stress didn’t affect Cheryl adversely at all. She had the resilience to go without sleep as she cuddled her baby girl through the illness.

Before long, Phoebe turned a year old. Cheryl and her husband threw a big party for all their friends. It was a celebration of their little girl’s milestone, and for the joy Cheryl and her husband were enjoying again.

This Can Happen for You, Too

These stories all have happy endings. But low dose IV ketamine isn’t for everyone. Is there any medicine that is? Nope…not a one. But the response rate to ketamine treatment is remarkably high.

Still, that remarkably high response rate relies on skilled administration. Low dose IV ketamine treatment is not a one-size-fits-all treatment. It requires careful titration, identifying specific responses in the patient, and finding the sweet spot in dose and rate that yields the best outcome for each individual.

Unfortunately, many providers of ketamine don’t understand this, and give the same dose at the same rate to every patient, then schedule them to come in for regular maintenance infusions, indefinitely.

In other cases, they try a different dose with each successive infusion, because they don’t really understand how to achieve the therapeutic response.

Find Restoration from Severe Chronic Depression

Innovative Psychiatry is the premier provider of IV ketamine treatment in Connecticut for safe, effective treatment of depression and other psychiatric disorders. We offered the first ketamine treatment center of Connecticut for severe chronic depression and other disorders.

Innovative Psychiatry offers you a most extraordinary psychiatric treatment, IV ketamine. Some people require booster infusions now and then for awhile, and others achieve remission with the initial six infusions.

Every brain is different, just as every person is different.

We can’t predict what it will be like for you, but we can promise to provide the most effective administration of this remarkable treatment that can be found anywhere.

Can you relate to Gary, Dan, or Cheryl..? Or maybe to their loved ones? If you have similar symptoms or variations of your own, that have not responded to the treatments you’ve tried, call us.

Like the people we’ve talked about here, you can have restored joy, renewed initiative and motivation, the energy to pursue your dreams, and to rebuild relationships.

We’re here to help. Let’s work together to help you live a fulfilling and rewarding life.

Lori Calabrese, M.D.

To the reinvigoration of your best self,

October 28, 2019
The Teen Suicide Epidemic – What You Can Do

Sam Chaney walked up to the quiet car in the dark.

It was a place by the lake frequented by teens for romantic interludes, or beer drinking. This car was dark. Silent. But running. He tapped on the window with a bit of anxiety. He’d just been reading about the teen suicide epidemic this morning.

“Hello – Metro police! Open the door please…”

Silence.

Tap tap tap…”Open up!”

Nothing.

Sam stepped back and looked at the car. Only then did he see the rags stuffed into the exhaust.

“Oh no….”

After trying to open the door, Sam used his baton to break the glass. The choking odor of exhaust wafted into his face. Carbon monoxide…

Inside the car he saw the lifeless bodies of four teenagers. One looked to be no older than 14.

Immediately he called for emergency personnel and then pulled each body out onto the ground in the fresh air.

One by one he checked their pulses. Nothing.

Instinctively, he did 15 chest compressions, then breathed twice into the mouth of each one. Then 15 more.

After the first one, he moved on to the next, then to the next. Their bodies were cold.

What is Causing the Teen Suicide Epidemic?

The suicide rate in teenagers has increased 56% since 2007. (Centers for Disease Control and Prevention) And even though the homicide rate in teens decreased 23% between 2007 and 2014, it increased again 18% between 2014 and 2017. Even so, the suicide rate has now surpassed the homicide rate in teenagers.

Suicide deaths in teens are also higher than accidental deaths such as transportation crashes or drug overdoses. These accidents represent the 3rd leading cause of death in people aged 10-24. But suicide has risen to the 2nd leading cause of death in teenagers.

Why??

We don’t really know. There are so many reasons. So many factors. Depression rates in children and teens have increased; in fact, they’ve increased across all age groups. Increased drug use has led to increased overdoses, too.

But a big factor seems to be embedded in the dramatic increase of social media use among this age group. This is a generation who has cut their teeth on facebook, instagram, and pinterest. Add to that Yelp, where they feel free to blast a restaurant with criticism every time they eat, just for the sport of it.

A Forum for Speaking One’s Mind – Uncensored and Unsupervised

In short, social media has allowed them to speak their mind, which isn’t necessarily bad. But to speak it without a filter aimed at diplomacy or compassion. We all know it’s easier to say something critical in writing than face to face. And during the teen years, insecurity is often considered hidden by cruelty to others.

Because of this un-squelched form of communication, privacy has taken a hit, too. A middle schooler catches someone in an awkward situation and sends the photo or video to his contact list. In seconds, a fragile, shy, insecure 13 year-old is publicly humiliated with nowhere to hide.

Darwin’s theory about the survival of the fittest is reduced to survival of the ones who dish out the most cruelty without falling prey to the same treatment.

For a child or teenager, the teen suicide epidemic seems daunting and intimidating. Her life experience or capacity to cope with such public shame is painfully limited, if not utterly lacking. And the under-developed prefrontal cortex in her brain prevents her ability to see such a crisis in the “big picture,” –that is, the idea that this too shall pass. Impulsivity can then win out …with a decision so permanent that all that’s left is the grieving.

Far too many of the children and teens who have taken their lives, had been reporting bullying. When circumstances didn’t change, they seemed to feel it was left up to them to stand against the assaults and onslaughts by themselves. And eventually, they may have become weary.

Chronic Stress Causes Pruning of Signaling Structures = Depression

We know what chronic stress does to the circuitry in the brain. Eventually, the synapses break down, dendrites become pruned…and depression ensues.

So a depressed person is more vulnerable to suicidal thoughts…images… and even action.

And there’s another factor.

Too often, as teens become depressed, they grow silent. They withdraw.

At Herriman High School in Utah, a total of 6 students ended their lives in a single year.

After each successive death occurred, the teachers, administrative staff, and parents became increasingly desperate to do something to prevent more.

The students, as well, experienced increased anxiety, overwhelm, and concern that students around them were suffering but no one knew who was at risk.

Parents Seek Answers for the Teen Suicide Epidemic

Parents spoke of the need to teach their children to talk about their feelings, and how things are going, from an early age. The mother of a boy who died said that she had no idea her son was struggling. She just thought he was being a normal teenager. She said, “We need to give them the ability to talk! And I think we’ve missed that along the way.”

As a result, both students and administration initiated programs to help everyone cope with their own anxiety and grief, and to also encourage everyone to reach out to anyone who seemed to be alone, isolated, or struggling.

QPR

In this atmosphere of tragedy, communication became a key focus. Since the parents of some who died recalled that their child had seemed withdrawn, spending long hours alone and talking very little, the students and staff learned to watch for withdrawal in any student. They developed a code: QPR. Similar to CPR, QPR is specific for saving the life of someone who’s suicidal.

Photo by Rachel Lynette French on Unsplash

Q stands for Question. They realized that people who are struggling may wish they could talk to someone, but maybe they don’t know what to say. In fact, they may not realize they’re struggling as much as feeling “off.” So the strategy they developed is to be bold enough to ask questions.

“Hi, would you like to sit with us?”

“How are you…?”

“You don’t seem to be feeling very well. Do you want to talk about it?”

“Are you at a point that you’re going to harm yourself?”

For teenagers, who struggle to talk at all, this initiative requires a brutal bravery, but as they weigh the awkwardness against the loss of life, they find they can push past the nervousness, and just ask.

P stands for Persuade. It means pushing through your own feelings to focus on the feelings of another. Then persuading that person to trust you enough to accept your invitation…answer your questions…consider solutions…

R stands for Refer. Part of the P in Persuade includes persuading the person to accept help and treatment: the solutions. It means including parents, the school counselor, and outside psychiatric help, as well.

Students refer to QPR as a useful tool for fighting the teen suicide epidemic and also for the helplessness they’ve felt as they’ve heard the announcement of each student who died. They feel armed with a way to help stop the deaths, and to know they’re doing something.

Joining Forces to Save Lives

Just as this high school pulled together to close the gap between hurting teens and everyone else, we can do the same.

To approach those who seem to struggle and dare to get your hands dirty. Dare to ask the questions. Then listen. Then work together with them to help them get treatment and to be safe.

Lots of Help is Available

But start with a comprehensive psychiatric — find the best doctor you can to do the best job they can to pull together all the pieces, all the stressors, all the symptoms. To diagnose and to offer treatment — rapidly.

And to present options and reasonable choices for treatment, the evidence for each, and the speed of response: medications, different talk therapies, TMS, and IV ketamine.

Speed is critical if you’re trying to save a life.

IV Ketamine Treatment works fast to Restore Brain Circuitry

So often, anguish is missed. Overlooked. Or it just doesn’t lift even with the first or second (or third) thing you’ve tried.

We see the end-results of anguish every day when everything breaks down: depression, anxiety, self-loathing, withdrawl. Loss of interest. Loss of eye contact. You don’t even smile anymore. (Or when you do, it’s phony.)

If you feel like this, or if someone you love feels like this, if treatment isn’t working, know that there is hope. You can feel better, you can repair and rebuild the circuitry that will allow that. And it can happen fast.

We know, because we’ve published our own results in a peer-reviewed journal.

IV ketamine treatment specializes in rebuilding broken down dendrites and dendritic spines — it turns on mRNA to switch on DNA to turbo-boost Brain Derived Neurotrophic Factor (BDNF) and those dendrites and synapses just explode in new growth. Repairing and restoring the circuitry, and giving you joy, initiative, motivation, energy, … and hope.

Once repair gets underway, your brain can transmit signals along those repaired and restored pathways. Your brain lights up, and your eyes light up with it.

There are solutions.

And even if your insurance doesn’t cover this extraordinary treatment yet, there is financing to help you pay for it. And there are voices clamoring for it to be covered because it can stop suicidal thinking. It can turn around that trip to the ER and make it unnecessary. It can help avoid the need for hospitalization.

Not always. But most of the time.

If you’re interested in seeing whether IV ketamine treatment might be an option for you, call us.

We’ll work with you, your doctor, your therapist, and your family, to help you feel better, function better, and really enjoy the details of your life again. If it’s been a really long time since you felt that way, you’re probably going to be astounded. Because the longer you’ve been ill without relief, and the more severe your symptoms are, the better IV ketamine treatment may work for you. It’s funny that way. It’s a bit of a show-off.

Let us help you find yourself, your creativity, and your heart again.

To the restoration of your best self,

Lori Calabrese, M.D.

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

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

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

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

October 21, 2019
Get Your PUFAs Straight and Watch Your Mood Lift

We’re smack in the middle of a couple weeks focused on the quest for improved treatments for depression and anxiety.

This past Thursday was World Mental Health Day, dedicated to raising awareness for mental health …and this year’s efforts were focused on “40 seconds of action” to help reduce the risk of suicide. Because every 40 seconds, worldwide, we lose someone to suicide. And right on the heels of #WorldMentalHealthDay, we’re jumping into #OCDAwarenessWeek, which is promoted internationally each year by the International OCD Foundation during the second week of October. It’s an opportunity to LEARN about Obsessive-Compulsive Disorder and find ways to support those who live with it every day. And every discovery that researchers find lays the groundwork for improved wellbeing and fact-based treatment regimens. Like polyunsaturated fatty acids (PUFAs) in your brain. Let’s talk about how you can get your PUFAs straight and reduce the symptoms of depression.

BBRF Researchers Help You Get Your PUFAs Straight

The Brain and Behavior Research Foundation (BBRF) just released information about a new study that may explain why some people have more severe depression than others.

Led by M. Elizabeth Sublette, M.D., Ph.D., and J. John Mann, M.D., and published in the Journal of Affective Disorders, the study identified a relationship between polyunsaturated fatty acids (PUFAs), specialized proteins that transport serotonin (SERTs), and the severity of, as well as vulnerability to, depression.

This is a short excursion into only ONE aspect of the complexities of major depression and bipolar depression. But it’s important, and may give us something that we can do — actively, ourselves … every day — by modifying our diet. It’s back again–the importance of what we feed our brain. Not just diversifying our microbiome, ensuring we take in micronutrients, but choosing the best lipids to feed our brain health. Getting our fatty acids right.

See what you think of this…

BBRF Researchers Find New Discovery About Reducing Your Vulnerability to Depression

Using PET scans, researchers have found an intriguing relationship between certain types of polyunsaturated fatty acids (PUFAs) and the specialized protein transporters that move serotonin (SERT) to where it needs to be to do its job to reduce anxiety and improve your mood.

These are both ordinary, commonly seen components in the brain, but together, they seem to play a role in either causing depression… or at least causing you to be more vulnerable to it.

This study discovered a significant relationship tied to a certain PUFA known as arachidonic acid (AA). They identified a relationship between PUFAs and levels of that serotonin transporter, SERT, in the 6 most important areas of the brain. Plus, it showed how these two factors may influence the severity of depression.

The relationship is U-shaped, and inverted. It’s nonlinear. And that’s important.

Sounds complicated, I know. But here’s how they discovered this connection.

Study Subjects Stopped Their Medications for At Least 2 Weeks

The research team invited 21 adults, who were each in a full episode of major depression, to participate in the study. Each of these participants had refrained from any medication that affects serotonin levels or the biochemical system that produces arachidonic acid for at least 2 weeks.

A number of weeks before the PET scans, the team evaluated plasma levels of each participant for three specific PUFAs. DHA and EPA are both omega-3 fatty acids, and AA is an omega-6 fatty acid.

Measuring these three levels in six specific and key regions of the brain demonstrated their significance in depression.

Now get this:

In a healthy brain, SERTs are widely available in abundance throughout the brain so they can remove and recirculate those serotonin molecules from spaces where they can’t function.

For example, when they get stuck in spaces between the sending and receiving neurons after a signal has been sent. This is what happens: The SERTs take up the serotonin and return it to the sending cell. So it’s ready for the next message that needs to go out. Easy.

Now that’s what happens in a healthy brain.

However, a number of peer-reviewed studies have found that there’s a low availability of SERT in the brain of someone suffering from depression…or bipolar depression. The most commonly prescribed antidepressants, (SRIs), block the SERTs so the SERTs can’t move the serotonin out of those spaces where they’re stuck. This keeps serotonin available in the synapses between the neuron cells which promotes more signaling.

But In A Depressed Brain…Well, You Need to Get Your PUFAs Straight

However, this team of researchers discovered something about those three PUFA levels they analyzed before the scans. Only AA actually affected the availability of SERTs across those six brain regions they viewed with PET scans.

In fact, they found that the lower the AA level a person had when evaluated before the scans, the greater that person’s SERT transporter level they saw in the PET scan.

Reduced AA level = More Transporters; and Therefore Improved Mood…?

This is so revealing. We need to get our PUFAs straight.

Because depression and bipolar depression are complex and are each affected by so many factors. We’ve learned so much about depression through observing ketamine’s actions in the brain. And while we no longer believe the key to depression treatment is as simple as increasing level of serotonin (or any other neurotransmitter), we do know that serotonin binding plays a strong role in freedom from depression or conversely, a vulnerability to it.

Of course, our BBRF research team called for more studies to verify these findings. They asked that other researchers carry them a few steps farther. We need more information about the science behind polyunsaturated fatty acid supplements in depression. How do we work with complex, inverted, U-shaped relationships?

Hopefully, we’ll be hearing more about the effect AA has on depression and vulnerability to it.

This may sound like a little thing …a small finding from a ton of research. But it’s a breakthrough. And when you add up all the individual breakthroughs, together they can result in your changed and improved life.

Get Your PUFAs Straight and Bring Depression To Its Knees

At Innovative Psychiatry we rejoice with our patients whose symptoms lift after IV ketamine treatment. These patients didn’t responded to traditional medications. We continue to use a myriad of medicines, treatments, and regimens to relieve symptoms. And we bring the latest research findings to our practice. But for most patients, nothing compares to IV ketamine’s restoration of resilience, creativity, and initiative. The results bring fresh perspective, fresh hope, and renewed relationships as people rebuild their lives with enthusiasm and clarity.

Let’s keep spreading the word that remission of symptoms can happen. It’s no longer a pipe dream.

If you… or maybe someone you love… aches for relief from trauma or depressive symptoms, call us.

We know others who suffered from the same kind of pain, vacant-ness, and despondency you do. We can help.

To the restoration of your best self,

Lori Calabrese, M.D.

October 14, 2019
APA IPS: Innovation and Collaboration Improve Access to Psychiatric Care

I just returned from the annual meeting of the American Psychiatric Association’s Institute for Psychiatric Services: Mental Health Services Conference, in NYC.

This conference was presented in collaboration with the World Psychiatric Association. The World Psychiatric Association represents 120,000 psychiatrists in 120 countries. The heart and focus was that innovation and collaboration improve access to psychiatric care. It’s easy to miss the numerous populations who struggle to get help. And need it so desperately.

What a wonderful gathering. This group convened for psychiatrists and all the allied professionals who work together in mental health. Social workers, therapists, psychologists, counselors, psychiatric nurses, and mental health workers on every level. With the theme, “Improving Access Through Innovation and Collaboration,” the sense of learning and sharing together was palpable.

An audible commitment pervaded the crowd who recognized not only the value, but the vital role each discipline plays to provide mental health care to those who need it. The President’s theme concept definitely found its mark. Innovation and collaboration improve access to psychiatric care for everyone.

Abundant Presentations

There were presentations about suicide, about issues for LGBTQ youth, about the mental health and well-being of physicians and medical students, about addiction, and about where opioid use and psychiatric disorders intersect. There was a round table discussion about the presence and needs of mental health sufferers in the criminal justice system, an area sorely in need of solutions.

One session informed about talking, and listening, to patients about marijuana and CBD, and provided information psychiatrists need to know for these discussions.

Poster Presentations on 3 Floors

Then there were poster presentations. Four separate sessions of them!

Poster presentations on the latest findings in a wide variety of current subjects. One presented the issues that come into play when a patient requests a hastened death. Heavy subject matter, without question. Another considered a case of delusions of persecution in someone suffering from migraine. Another reported on psychiatric needs in the refugee crisis. Still another described educating an underserved community about ADHD.

And there were several on suicidality, where I also presented my own findings in treating suicidal thinking with IV ketamine infusions.

The enthusiasm for my poster bubbled over. So many asking questions, wanting discussion and details. I wish I had had more time. But it was thrilling to see how much psychiatrists ache to have better treatment alternatives for their most vulnerable patients. I think many were captivated by the fact that out of this population we had no suicides, no suicide attempts — not even trips to the ER. No one needed to be hospitalized.

IV Ketamine Treatment Can Make Such a Difference

IV ketamine treatment really is a game changer. And it can be a life-saver. We’re learning — and have so much more to learn— about how infusion dose and dissociation play a huge role in the outcomes.

We read the literature. (It keeps us up at night!) And we trust the literature. And sometimes we allow the literature to even think for us… So it really helps when our colleagues try an approach we haven’t heard of especially if it turns out to be effective. It adds a tool to our tool belt.

When we go to conferences, one of the driving forces is that we’re always hoping to find another tool or two we can use to help our patients improve.

It was thrilling to me to talk with other psychiatrists who would like to learn more about how ketamine can help, and who want to make sure they know enough about it in real practice settings to begin to talk with their patients about if, when, and how much. We all want better tools, better responses, better results. We need to be careful, thoughtful. And bold enough to stay on the cutting edge.

Some were hand-picked by the President of APA

There were presidential presentations, which were arranged by Bruce Schwartz, M.D., President of the APA. He invited specific leaders to speak on pressing subject matter from their expertise and experience.

One highlight was the presidential presentation by the esteemed Charles Nemeroff, M.D., Ph.D. He’s Professor and Associate Chair for Research at the University of Texas Dell Medical School in Austin, TX. Dr. Nemeroff has published more than 1100 scientific reports focused on the pathophysiology of mood and anxiety, particularly in children of abuse and neglect.

Dr. Nemeroff’s presentation centered on personalized medicine in psychiatry. His point of view is that personalized medicine is advancing slowly, but as we move forward, the future for our patients shines brighter and brighter.

I see the importance of his words in my own practice, and with my own patients. There is always room for improvement. Now, more than ever, the stakes are high, and time is short.

The Tragedy of Inmates Who Need Treatment

Another presidential presentation that was deeply felt by many was a round table discussion. It was chaired by Althea Jeanne Stewart, M.D., regarding the disjoint between mental health needs and the criminal justice system.

If you’ve ever encountered the experience of an inmate with a disordered brain, you know— the pain and frustration these suffer, the frustration of staff, and the intense difficulties for everyone involved.

We must continue to confront these difficulties in our system, and do the hard work required to apply better solutions.

Innovation and Collaboration Improve Access to Care for All Patients

The theme for this year’s conference was a solid one. Ongoing innovation will yield more effective treatment. And in collaborating with a team of experts, more psychiatric patients will have the care they need. But one of the stakeholders is the insurance industry and the insurance companies who pay for care. We need them to realize that and innovative treatment like IV ketamine can stop suicidal thinking enough to reduce their dollar spend on ambulances, mobile crisis calls, ER visits for suicidal ideation and hospitalizations for people who fear they will harm themselves.

Because as we advance forward, our society will only benefit from a broader and larger population of people who are functioning well, and feeling well. Who can fill their positions, contribute their talent, raise their children, take care of their world. For that to happen requires accessible psychiatric care.

And in the case of outpatient care in the privacy of an office setting, extraordinary treatments like IV ketamine …could mean the difference between life and death.

We see it every week at Innovative Psychiatry. Not only life and death struggles, but life that’s rewarding. Full of hope. Where purpose, meaning, and reward replace despair. Where you have the energy and creativity to restore and strengthen your relationships. And where joy thrives.

We attend meetings to bring home more to help you find restoration. If you have severe symptoms of depression, bipolar depression, social anxiety, PTSD, substance use disorder, or postpartum disorder, call us. We’ll help you find out if IV ketamine treatment can help you heal and find joy and purpose in your life.

Lori Calabrese, M.D.

To the healing of your best self,

October 7, 2019
Cost of Ketamine Treatment: Is it Worth It?

“IV Ketamine treatment…? I can’t afford that.”

“Sure, I want to feel better. I’ve tried so many medicines and treatments. I don’t even know what it’s like to enjoy something, anything…or to feel happy. I don’t have the energy to even get out of bed half the time, much less get anything done. But…the cost of ketamine treatment is way out of reach for me. I don’t even know if it’s worth it?” That’s Ann Marie, out loud.

“When I go to work, my mind is plagued with images of people dying… or me dying. Dark, hopeless thoughts and pictures in my head. Sometimes gruesome…

“But we all know IV ketamine treatment is for people who’ve got money…. right?”

……….

This is what people say to themselves, and to their family…comments like this, or others similar…

And since IV ketamine treatment can restore your hope, your motivation, and initiative, you’re likely to be far more able to make those payments after you’ve benefitted from the treatment.

So, maybe they aren’t seeing the big picture… in fact, maybe you aren’t seeing it either. It’s something to think about.

Because, you know, you don’t have to have the free cash to pull the payment out of your wallet on the spot. You know that, right? Countless companies offer medical financing to pay for medicines and procedures over time. Advance Care Credit, United Medical Credit, and M-Lend are a few.

For example, have you thought about the benefits of investing in IV ketamine treatment ? Yes, there’s an initial investment, but have you thought about this..?

Discontinue Medications and Save $$

For one thing, you’ve likely been taking medications for your depression or other disorder for years…haven’t you? And even though they haven’t helped, you may still be taking them.

But, the beauty of ketamine is that it works independently of SRIs, SNRIs, anxiolytics, etc. So by investing in as few as 6 ketamine infusions, or a few more as needed, you may find you’re well enough to think about eventually tapering some of the add-ons that didn’t add anything.

Some of your medicines may not be expensive, but some may be pretty pricey. In some cases, people have found that IV ketamine treatment paid for itself in 3-6 months. Even when you have insurance, your treatment costs can be exorbitant. Now it seems like everyone has a huge deductible to pay before insurance even kicks in. How much money would you save if you were able to stop taking those …. add-ons that maybe aren’t adding anything? Well, that money could go toward paying for your IV ketamine infusions.

Then, there are those calls for extra appointments with your doctor when your symptoms flares.

Fewer Doctor Visits

If you’re not having symptoms, you may find you don’t need to see your doctor as often as you were when your symptoms were so persistent and so severe. What a relief that would be–if you didn’t need to call to be fit in for extra appointments when you took a dive, didn’t have to reach out to an answering service on the weekend. You’d probably prefer to spend that time and money doing things you enjoy, right?

Why pay for a parking garage and sit in a waiting room when you’d rather be hiking in the woods, or playing tennis, or shopping? When ketamine goes to work on your brain systems, and restores the circuitry there, you regain the power to enjoy. And if you’re enjoying yourself, it’s likely you may not feel the need to check in with your doctor nearly so often.

Add to that the expense and the hassle of lab work. Some medications require that regular lab work be done to monitor your liver, or your kidneys, or your blood sugar and your cholesterol.

To spend more of your time enjoying your life, your work, your hobbies, and your relationships is a far more fulfilling way to spend your time than having blood drawn in a lab on a Saturday…don’t you think?

And money spent on co-pays and fuel, as well as wages lost from missed work and days you take under your FMLA for symptom flares and doctors’ visits…well, those funds have such better uses when you feel really well. Baseball tickets, funnel cake, or…a picnic in the park!

Cost of Ketamine Treatment Improves the Quality of Your Life

But most of all, it’s the quality of your life. While the costs can be reclaimed in countless ways by a happier, healthier you as time goes on, can you put a price on your improved, deeply rewarding, utterly fulfilling new life?

James comes to mind. A patient of mine who couldn’t remember ever feeling happy, or having fun, or enjoying those little moments in his life. Ketamine worked for him. And now, he enjoys a fragrance he notices in the air, the way the meat responds to the fire when he’s cooking, the clear blue of a mountain spring.

Things he never noticed before because of the dark gray cloud that hung over him, suffocating him. He arranged financing for his treatment, and that monthly payment feels easy, because he lives every day the life he had wished for as long as he could remember.

And his life has bloomed, because he has the energy to step out and live. He has a family that’s growing and his mind is on his family’s future…in fact, he realizes his whole life is ahead of him. He invested himself and the cost of ketamine treatment was part of that.

Then, there’s Lisa. She grew up in a home where she never felt understood. She was sensitive, intelligent, and meticulous. Her parents were hard working, confident, and not so tuned-in. Not really understanding their daughter’s sensitive nature, they made a plan for her from earliest childhood. She would be a doctor, and would make them proud.

But Lisa’s heart turned to music, and she sang like an angel. From the time she was losing her front teeth, she could feel her parents’ pressure to be who they wanted her to be. She wanted so much for them to appreciate her for who she really was.

Lifelong Depression Wears Down Brain Circuity

By her 6th birthday, she would arrive at home after she got off the bus, and enter the dark house frightened, alone, and shaken. The anxiety from those long afternoons alone in a dark house grew to a dread that followed her wherever she went.

Depression drained her energy, and her hope in life. Adolescence turned out to be a cruel time, and she felt she didn’t fit in anywhere. College was a chance to excel. Getting married was a no-brainer. And though she had transient reprieves from the trudging existence she endured, the dark hopelessness and choking despair always returned.

Pregnancy after pregnancy…she could conceive, but had no energy to care for the children, and would just go back to bed. The kids spent a lot of time at their friends’ houses while she slept on the couch. They learned how to make their own mac and cheese.

Hospitalizations didn’t make much difference. Medicines her doctors prescribed brought no relief. The kids raised themselves.

The Cost of Ketamine Treatment

But finally, when her first grandchild was on the way, and Lisa wanted the ability to build a relationship with this child, she heard about what ketamine treatment was doing. She learned that she would need at least 6 infusions, so she needed to be prepared to pay for them.

Those who knew her and loved her wanted to help. Eventually, a friend offered to help her pay for the treatment.

For Lisa, it got unreal right then. There was an unreal-ness about suddenly having a way to get real help…to maybe have an opportunity to feel good for the first time in her memory.

And as she’d hoped, within a week she was improving. Little beams of hope penetrated her cold damp tomb of anxious despondency …one little beam at a time. It was slow. She started taking walks, just because. Then she started reading books and meeting friends for lunch.

A friend’s help made the cost of ketamine treatment manageable.

Now, Lisa is a rosy-cheeked, very active grandmother. She takes her granddaughter on picnics and to the zoo, for ice cream, and to play in the park and feed the ducks. Her grown children watch in disbelief–where was she when they were little?–but they’re relieved that she is finally functioning, happy, productive, and interested.

She has the energy to share all kinds of experiences with her grandkids…both the physical as well as emotional energy. They play games and she teaches them about good sportsmanship and the competitiveness to win, too.

Lisa made little payments to her friend for three years to repay the loan that gave her back her life. She says that loan was the greatest gift she’s ever received. She has the power to love again. To dance and sing and play ball with her family.

Ketamine Treatment Must Be Available to Those Who Need It

Is there anything more important than the power to live your life well? Happily, generously, joyously?

When people ask me how they can afford to pay for this treatment, I wonder. A lot.

I wonder how we can afford to stand by while our sisters, our friends, our kids, and our husbands slowly shut down.

I wonder how we justify the days lost, the jobs lost, the unpaid FMLA’s, the lost opportunities. The kids’ games that we missed, the holidays we suffered through, the long agony of a weekend that was empty.

I wonder how our insurance companies so readily deny payment for an infusion that could stop suicidal thinking and save a life –but quickly fork over $1300 for an ambulance ride to the ER and another $1500 for the night spent on a gurney, waiting to see if the crisis worker will hospitalize you or send you home?

Insurance will pay for that, and refuse to cover ketamine infusions? The procedure exists, the billing code is there, the diagnosis is clear …the results speak for themselves.

I wonder, sometimes, not about affording ketamine, but about how we can afford this: to live like this, day after day. What’s it costing us? What’s it costing our kids?

In the light of the transformative effect of ketamine at its best, you owe it to yourself to find a way to give yourself an opportunity to live – and live well. To enjoy your life, to invest in it, to learn and grow, to stop the suicidal thoughts, to get rid of the depressive symptoms. To be happy.

It’s true that IV ketamine treatment can’t offer a 100% response rate, but no medicine can do that. The cost of ketamine is an investment… But there are few investments available to us with the return that comes from this extraordinary treatment.

James made this comment, “Instead of spending all my energy trying to figure out how to survive the week and how to ignore the suicidal thoughts that are always there, I’m excited about figuring out my next step, and I’m looking forward to good things happening. I’ve never experienced anything like that before.”

Everyone should have the opportunity to live free of symptoms, and to have the energy and hope to invest in the things you believe in.

At Innovative Psychiatry, we’re investing in you and your future. If you’ve suffered and treatments haven’t helped, call us. The cost of ketamine treatment? We think it’s worth it. It can make real living, fulfilling engagement, rewarding relationships, available to you.

To the unveiling of your best self,

Lori Calabrese, M.D.

September 30, 2019
Are There Biomarkers for PTSD and Suicidal Thinking?

Know someone who’s suicidal? Or…how about this? Do you know someone you think might be?

Is there someone in your life who’s always down, irritable, short-tempered… even jumpy, maybe? Maybe you wish they’d adjust their attitude, or take a chill pill. Sometimes, people can be like this and the problem is that they might be depressed. Or they may suffer from PTSD and even be suicidal. There are some researchers at Yale who are trying to identify biomarkers for PTSD and suicidal thinking. More about that in a moment, but first let’s talk about PTSD.

Some 8% of people will meet criteria for PTSD at some point in their lives. Those who have fought in active combat have roughly a 40% likelihood of receiving a PTSD diagnosis. But there are other life events that can also lead to PTSD such as sexual assault, domestic violence, cancer treatment, a child’s devastating illness, or a serious transportation accident, for example.

The DSM-5 sets the criteria for diagnosis of psychiatric disorders. It says there are several criteria required to diagnose someone with PTSD:

First, you must have been exposed to the threat of death or serious injury or sexual violence directly, or by witnessing it, or learning someone close to you experienced it. Or by indirect exposure as a first responder.

Second, you have to re-experience this traumatic event by reliving memories, or in nightmares, or maybe you suffer distress when you’re faced with a traumatic reminder of what happened.

Third, you likely make effort to avoid situations that would remind you of the traumatic event, or to think thoughts that pull you back into the painful memories of it.

Fourth, you have negative thoughts or feelings that resulted after the trauma. Like blaming yourself or others, shaming yourself, holding a negative attitude, and isolating yourself. You have lost interest in doing things you used to enjoy or getting out with friends. Does any of this sound familiar? Stay with me…because there’s hope coming…

Further, you find that you react to things that happen differently than you used to. Like you feel irritable and aggressive, or you may embrace high risk activities, or you may feel hyper-vigilant…always on edge for something to happen. Plus it’s hard to sleep or stay asleep, and it’s hard to concentrate. You’re likely to experience depression, anxiety, possibly substance abuse in an effort to avoid thinking about the traumatic experience.

Obstacles to Functioning

And all these things often result in problems with friends, with family, with your job, your education…and even with taking care of yourself and your own needs.

If you’re diagnosed with PTSD, these symptoms have lasted awhile and your doctor must know that you haven’t used other medications or illicit drugs that could have caused this.

PTSD isn’t just feeling bad about something that happened. It’s a reaction inside you to something terrifying that changes the way you think and feel and respond to life. It changes your body… and your environment. Because it changes the way your mind interprets what you see, smell, hear, taste, and feel.

How Fear is Connected to Suicidal Thinking

The Brain and Behavior Research Foundation recently offered a webinar about the work they’re funding with regard to PTSD, suicidality, and IV ketamine treatment. Lynnette A. Averill, Ph.D., Assistant Professor of Psychiatry at Yale University, explained the link between the fear and anxiety people with PTSD have and how it’s connected to suicidal thinking.

Three Regions of Your Brain are Key

So let’s talk about your brain, and how PTSD affects it. There are multiple parts of your brain that play a role in your experience as part of this disorder. And the trauma that caused this disorder triggered multiple changes in your brain. The prefrontal cortex, the amygdala, and the hippocampus are the primary areas involved, and what Dr. Averill’s team focused on.

The prefrontal cortex regulates our emotions and helps us make decisions related to them. The amygdala helps us with fear processing. And the hippocampus helps us interpret emotional context.

These three regions aren’t the only regions involved in PTSD, but they’re the most consistently significant.

The hippocampus loses volume when you’re traumatized. So as PTSD increases and its symptoms increase, too, the volume of the hippocampus decreases.

The prefrontal cortex thins in the presence of trauma. In fact, the more severely traumatized you are, the thinner the tissues in the prefrontal cortex. It makes the decision whether you’ll fight, run, or chill.

And the amygdala hyper-reacts. So it goes like this. Let’s say a T-Rex stomped down your street and through your yard. You look out the window and see his knees. Immediately, your amygdala sends out the alarm and calls upon adrenalin to scream, “FIGHT or FLIGHT!!”

PTSD Changes Brain Function

The job of the prefrontal cortex (PFC) is to call up the amygdala on speed dial…and tell him “Nothing’s wrong... It’s a hologram. Go back to your cable show… Everything’s ok.” And the amygdala settles back into his recliner.

Because PTSD doesn’t just change the way the brain areas look, it also changes the way they function…and so, in turn, the way YOU function.

Now here’s the thing. People who are suicidal have impaired executive function. This means that the organization, ability to focus and pay attention to others, as well as regulating emotion and disciplining yourself in a way that helps you meet goals…well, none of that is working well enough.

It means you’re likely scattered, and probably unpredictable. Maybe impulsive. The impairment of these abilities sets you at greater risk for making a tragic and impulsive final decision.

Is Suicide Rare?

Suicide is the 10th leading cause of death in the US across all age groups. To make that a little easier to grasp, think of it this way: 129 people take their own lives every single day in this country.

In 2016, suicide was the 2nd leading cause of death for people aged 10 to 24. More than leukemia, or fire, or overdose.

This is aside from the numbers for middle aged adults or the elderly. This includes children only 10 years old! And we need to better understand any biomarkers that can help us identify those who are at higher risk to even attempt suicide.

And it gets worse. Veterans are 1.5 to 2 times at higher risk for suicide. Sexual minorities are also at increased risk for suicidal thoughts and behaviors. The numbers include those individuals who suffer from bipolar disorder and have a 5 times greater risk for suicidal behaviors.

So this brings up this point. We need something to point to that’s common to all these conditions. Dr. Averill believes the link is synaptic growth.

Actually, it makes sense, doesn’t it? When synaptic growth stops, and synapses break down and thin out, you’re more likely to experience depression, anxiety, and PTSD along with other disorders that are stress-based. And when you treat this synaptic deficit, the symptoms of these disorders tend to dissipate.

Ketamine Treatment Restores Synaptic Growth and Just May Be a Biomarker for PTSD and Suicidal Thinking

The most effective treatment for these disorders is likely something that restores synaptic growth. Furthermore, that something needs to act rapidly, because there is the risk these patients may make suicidal attempts.

It just stands to reason, doesn’t it?

Well, it so happens that IV ketamine treatment does just that, and fast.

It switches on mRNA which turns on DNA to turboboost brain-derived-neurotrophic-factor (BDNF) to rapidly proliferate new synapse connections with their dendrites and dendritic spines all through the brain. It also slides the G proteins off their lipid rafts in the brain cell membranes, so they can productively go to work enhancing signaling along these new synapse connections. And within 24 hours you can feel amazingly better. Or it might take you a few days depending on your brain and genetic makeup.

But traditional antidepressants take weeks or even months… in many cases it can be three or four. And far too many people struggling with intrusive suicidal thoughts have ended their lives by then. That’s why it’s so extraordinary that ketamine is a RAAD (rapid-acting-antidepressant) rather than a SAAD (slow-acting-antidepressant).

Ketamine treatment is life-saving for a LARGE percentage of treatment-resistant cases. Ketamine doesn’t work for everyone, but we’re learning every day how to help more people benefit from it’s restorative actions.

At Innovative Psychiatry, we work with people who suffer from PTSD and with people who suffer from suicidal thoughts. We’ve been so gratified to watch them walk out of the office with a smile, and energy, and a joy for living.

If you suffer from PTSD, depression, bipolar depression, social anxiety, addiction, or other disorders that make life seem hopeless, or if you have thoughts about ending your life, call us. Let’s work together to help you find your joy, your hope, your fulfillment, and your relationships again.

We want you to see how appealing life can be.

To the emerging of your best self,

Lori Calabrese, M.D.

*****If you or someone you know is contemplating suicide, call the National Suicide Prevention Lifeline at 800-273-8255. There’s someone available to listen 24 hours every day.*****

July 22, 2019
How the Biology of Suicide Illuminates Prevention

When someone commits suicide, you’ll sometimes hear people say, “It makes no sense! She had everything to live for…” Or, “What a selfish thing to do. What about all the people who loved him? What about his kids…his wife..?” But this sort of tragedy isn’t about selfishness. To grasp what happens with your suicidal loved one, we are beginning to understand that there is a biology of suicide, and it can play into whether or not someone takes her life. It also helps to know what can be done. Read one young woman’s story to see what I mean…

…Casey climbed the stairs and disappeared into the darkness of her room without flicking on the light. Somehow the darkness was more comfortable. More familiar. She dropped her keys on the hall tree and her purse and coat on the floor, then flopped onto the sofa.

Settling back, her neck resting on the back cushion, she stared blankly at the ceiling. Another day was behind her.

It was always a feat to survive another day of work. Miserable. Now that she had, her mind wandered to nothingness. The billowing relief that would come if she could just get off this ride…this miserable journey day in and day out… Casey lost herself in reverie thinking about what a relief that would be.

She couldn’t do it anymore. She just couldn’t. And…she wouldn’t.

No one in Casey’s life had any idea what she goes through. She seemed astute, responsible, reliable to those around her. Quiet. Sometimes a little short-tempered… But pretty self-sufficient.

The darkness wrapped itself around her, and she hung her head in exhaustion.

Random thoughts drifted through her mind. The summer she was 3. She had climbed a tree and went too high. As she looked down she felt a little lightheaded and swayed in the branch as the wind blew. She had thought that if she just jumped, she would go to heaven.

“Good grief,” she thought. “I was only 3 then. Was there ever a day in my life I didn’t think about dying? Wish I could die? Figure out how to die…??”

She closed her eyes. “Thirty one years. I guess it will go on as long as I live…” Then, she thought, but why? What’s the purpose of my life beyond dreading, thinking about dying, seeing only futility..?”

“Why put it off any longer..?”

And then, something happened.

She opened the drawer in her nightstand, reached to the back, and pulled out a tin of pills she’d been saving for years. The prescription said TWO pills. And she’d taken one and stashed one. There was another bottle she’d squirreled away in her closet, so she felt around till she found it and tossed it on the sofa.

After a bit she dragged herself into the kitchen, and pulled the Kentucky Honey Whiskey from the cupboard a friend had left at her house 6 months ago. As she reached up for it, she saw the Tylenol and grabbed it.

She knew that too much Tylenol would damage the liver, so slipped that into her pocket. The whiskey bottle was three-quarters full. That will help, she told herself. Then she grabbed a glass and took the bottle to the coffee table.

With all she would need in place…she lay down and drifted off to sleep…

Honking from the street below. HONK HONK HONK!! Wondering about the time, she looked at her watch. 11:49. Just a few minutes before midnight.

Methodically, she poured Kentucky Honey into her glass and chased the first few pills. Then poured another glass, and swallowed 4 or 5 more.

Pain pills and sleeping pills… hmmmmmm… It seems to me I should feel a little different by now. She was glad for the late hour. Unlikely anyone would find her too soon. No one ever knocks or stops by.

She popped more pills into her mouth.

The Kentucky Honey was becoming harder and harder to swallow. Her head was spinning from the glasses of it she’d had so far.

All she could think about was the relief she would feel when this was over…

No one had any idea…she had always held her feelings and frame of mind close to the vest. Impossible to get her to talk, really…

We do so much research about what drives someone to suicide. But what actually happens– biologically?

Why Now? Why Tonight ?

Some people think about suicide every day of their lives and never act on it. What’s behind the moment someone actually takes the step to end his life? And what role does biology — the biology of suicide — play?

Two prominent researchers are known for their insightful hypothesis about this way back in the 1990’s. Their contemporaries swore by the prevailing belief that depression was caused by low levels of the neurotransmitter serotonin. (You remember those days?) These two were burning the midnight oil trying to figure out HOW that was true.

Their names were Charney and Krystal. Dennis Charney is now the Dean of Icahn School of Medicine at Mount Sinai in New York. He was focused on depression. John Krystal was exploring schizophrenia to better understand and treat it.

In both cases, their work at Yale at the time led them to glutamate, the most prolific neurotransmitter in the human body. As an excitatory neurotransmitter, glutamate helps brain cells communicate, so it’s critical in learning, memory development, mood and …. the list goes on.

So they went to work together to learn what they could.

Now, you need to understand that at that time, even though ketamine was a solid and relied-upon anesthesia medicine, its dark reputation as an abused substance in the club scene — and on the street — kept it from getting much attention in research.

Glutamate Paves the Way to Ketamine

Ketamine causes specific behaviors in people who use it on the street, usually within 2 hours after taking it. But the amount they ingest is around 100 times greater than the doses used in anesthesia, or the even smaller dose these researchers gave their subjects.

This is where some people get the wrong idea about ketamine. If they’ve heard about it or seen it on the street, they tend to be terrified of its use therapeutically because of severe side effects they’ve seen.

But when ketamine is used in tiny doses therapeutically, it’s a completely different “animal.”

Even so, Charney and Krystal didn’t want to miss anything that might show up later so, in an abundance of caution, they decided to monitor their research subjects for a full 72 hours after their ketamine infusion. They chose 9 subjects to try the ketamine infusion, but 2 of them dropped out. So they followed 7 depressed subjects for 72 hours. This was a turning point. Keep reading…

Four hours after the ketamine was administered, they checked on the patients. These patients declared they felt better. In fact, they felt a great deal better! Our researchers were shocked beyond belief. Everyone knew that antidepressants take weeks or months to produce an antidepressant effect, and this medicine produced dramatic results within 4 hours.

They didn’t expect anyone to believe them, and kept these results under the radar for years. When they finally did publish their results in 2000, they got …. not much attention.

Low Serotonin Severely Alters the Brain – Which Plays into the Biology of Suicide

But during the same time another research team, John Mann and Victoria Arango, set out to study the brains of suicide victims. Over time, they discovered that certain areas of the brain showed alterations in serotonin. A significant kind of alteration.

In fact, this situation reminded them of the well-known story of Phineas Gage, back in 1848. Gage was a railroad worker, and had been impaled by a 43-inch cylindrical iron tamping bar right through his skull.

Amazingly, he survived the accident, but his personality completely changed. His doctor later wrote that Gage’s “character” was altered by the damage and his “animal propensities” emerged, as he put it. He wrote that Gage was fitful and irreverent. He called him capricious and vacillating, and complained that he used the “grossest profanity.” Now Gage had been a foreman: a responsible, circumspect, hardworking man before the accident. So you see, the change was dramatic.

It wasn’t until more modern times that research revealed the area of the brain destroyed by the iron tamping bar is the area that controls inhibitions, and in Gage’s case, his social inhibitions.

And that’s one of the same areas affected by “low levels of serotonin transporter binding.”

So, with low levels of serotonin, the inhibition disappears. In the cases of these suicidal victims, the researchers think the inhibition that kept them from committing suicide was lifted, and they surged forward and ended their lives.

But again, this may have happened as a number of other social, economic, and interpersonal factors were unravelling. There are so many contributing factors to suicide. And even when we can study and pinpoint biological correlates, we know that low levels of serotonin in the cerebrospinal fluid, and probably low levels of serotonin transporter binding don’t always result in suicide.

Of course they don’t.

Moreover, even if the doctors of these patients had known the exact biological areas and brain processes involved in suicide, and had a way to modulate the activity there, it still might have taken weeks or months to reach a therapeutic effect — and it might not even have worked …as it may have been too late.

Ketamine Takes Its Cue From the Biology of Suicide in YOUR Brain

So this is a HUGE key to why ketamine treatment can be so vital to erasing suicidal thinking. Because it can erase those thoughts in an afternoon, in the psychiatrist’s office. No need to wait weeks or months and risk suicide while you wait for it to take effect.

Compassion for Suicidal Loved Ones

People who succeed in, or even attempt, suicide, aren’t thinking about the feelings of others. (There’s some truth to that…but not necessarily what the criticizers think.) Quite honestly, in that condition they can’t. They may have been induced by their disordered brain to think about suicide for a very long time, or maybe just so intensely, whether they wanted to or not. Then, if the biology of suicide kicks in and they have little or nothing to help them hold back, they may act impulsively and without recourse or consideration of consequences.

For those of us who love them, unless we’re tormented by the same suicidal thoughts, we can’t imagine what it’s like to want to die, or to feel compelled to die.

This isn’t selfishness…it’s sickness. It’s also not selfish when a Type 1 diabetic’s blood sugar drops so low he convulses. It’s a consequence of his serious illness.

And it’s for this reason that it’s important to never dismiss or ignore talk of suicide.

Thankfully, IV ketamine treatment can provide the safety stop to put on the brakes and end the suicidal thoughts.

It can give your loved one time to heal and move forward with their lives.

Biology of Suicide at Innovative Psychiatry

At Innovative Psychiatry, we’ve seen so many who fought the torment of suicidal thoughts and inclinations, walk out free of those thoughts after IV ketamine treatment.

Many times they’ve reached the point of emergency late in the day and needed immediate treatment. Then, after ketamine treatment, found immediate relief. The biology of suicide – in those cases — is side-stepped and overcome by the most rapid and effective treatment for suicidal thinking of our time.

We’re also flooded with relief for them as the suicidal thoughts subside, the light comes to their eyes, and they leave relaxed and eager to continue restorative treatment for their depression symptoms.

***If you have suicidal thoughts a few times a week, or 20 times a day: please know that there is hope. Those thoughts can stop. Reach out immediately for support by calling the National Suicide Prevention Lifeline at 800-273-8255. OR text HOME 741741. Someone is available to listen 24 hours every day. ***

And consider IV ketamine treatment. It can help you experience freedom from those tormenting thoughts and find hope and purpose in your life again through relief from depressive and anxious symptoms. Fast.

The first step happens when your life is no longer at risk.

Your life really can be fulfilling, rewarding, and productive as you experience what ketamine treatment can do for you. While it’s not a one-size-fits-all treatment, IV ketamine treatment can restore your motivation and initiative, your creativity and energy, so you can invest in your relationships, your career, and your hobbies with enthusiasm and joy.

July 15, 2019
Antepartum and Postpartum Anxiety: Moms Who Suffer Without Feeling Sad

Treatment can help anxious moms relax and enjoy their babies.

Jill was so excited to be pregnant. She’d waited for 4 years after she and Joe were married to start trying. She was just elated three months later when a home pregnancy test showed those two little lines. She was pregnant! Even the slightest thought of antepartum and postpartum anxiety never crossed her mind.

In spite of waves of nausea off and on the first couple months, by the time she got through her first trimester, she was feeling better. Her excitement to see and hold her precious baby was bubbling up like crazy. How could she wait six more months??

But as she moved through the 4th month, she began to feel… uneasy.

Just this vague sense that something bad could really happen… maybe something about her pregnancy wasn’t going as it should? She worried that something was going wrong with the baby. What if there was something wrong that they couldn’t see? Or a problem with his development? What if he was in that 3%? What if something went really wrong during delivery?How would she take care of him?

Day by day the dread grew worse. She asked her doctor about her concern, and she assured her that everything looked good. Told her that she should enjoy her pregnancy.

That was the problem. She couldn’t. She was worried sick.

Then, when she reached her third trimester, the dreams started with a vengeance. Night after night she’d dream she gave birth … to an alien. Or a forest creature. Or a monstrous murderous demon. She was so ashamed that these were her nightmares that she couldn’t tell anyone. No one.

When something is so terrible, who can you tell? Who can you trust?

The nightmares were so cruel, so vivid, that she’d wake up in the wee hours sweating, heart pounding, and screaming. Her husband would try to comfort her, then she’d go back to sleep. And the nightmare would continue. It was as if she couldn’t escape.

By the time the baby was born, her joy was gone, and in its place loomed a terrible dread. She feared for the baby, and what he would grow to be. Not who…but what. She tried to nurse him in the hospital but would break down and cry and ask the nurses to take him for awhile to give her a break.

Going Home From the Hospital Didn’t Help

It wasn’t supposed to be like this! What was happening to her? Why couldn’t she enjoy her newborn son?

The first 6 weeks or so she tried. She really tried. She was exhausted, and wondered if she’d ever get enough sleep to feel better. Waking every hour or two around the clock took a toll she didn’t anticipate. Her thoughts about her baby seemed irrational, even to her. She couldn’t imagine why she ever thought she wanted a baby. Now here she was, stuck in a permanent nightmare. She felt cheated.

Then her worries about what she might do to him if she let her guard down overwhelmed her. She mentioned her concerns to her pediatrician during a routine visit, and he explained that this could be postpartum anxiety and gave her a card to see someone he trusted.

Within a few months after her treatment began, she was beginning to see life, her son, and herself in a new light. She could sort of imagine now that it was possible she could have a good and loving relationship with him.

It helped enormously to know all this was a condition her hormonal imbalances and stress created. To fully realize that neither she nor her infant son were to blame. She read all she could find on antepartum and postpartum anxiety.

There wasn’t much.

But where, oh where, did it come from?

We’re all familiar with postpartum depression, but you rarely hear people talk about postpartum anxiety. While the two often join forces, they’re actually individual disorders. Since postpartum depression is often associated with sadness and anxiety, postpartum anxiety is sometimes overlooked.

It’s actually possible to feel overwhelmed, severely stressed, and have thoughts of harming your baby or… of ending your own life… without feeling sad.

When a woman gives birth, several changes go into high gear in her body. Pregnancy hormones drop, lactating hormones kick in, and the sudden changes in her brain give way to mood swings.

Add to that the painful engorgement in her breasts as milk comes in, lack of sleep from her baby’s waking every hour or two to eat, the soreness in her perineum from stitches, (or in her abdomen from a C-section) and cramping of her uterus as it recovers from pregnancy and childbirth, and this new mother is enduring substantial stress.

Stress + Fear = Anxiety

Even though many people are more familiar with postpartum depression, roughly 6% of all pregnant women and about 10% of those who are postpartum develop anxiety that’s severe enough to need treatment.

It’s natural for a new mother to have mild worries or nervousness about whether her baby is eating enough, whether the baby’s stool is like it’s supposed to be…and wonder if she’ll ever feel rested again.

But when mild worries become more intense, concern becomes a constant dread that something bad is going to happen, or intrusive thoughts begin of harming the baby or yourself, it’s time to seek help.

So why do some mothers seem to adapt to the new addition to the family, along with hormone changes, the lack of sleep, and the new routine, while others feel and think things they don’t want to feel or think, struggle to bond with the baby or enjoy her, and wish for a way to escape … either temporarily or permanently…?

There are a number of factors. And none of them are the anxious mother’s fault.

Risk Factors for Antepartum and Postpartum Anxiety

First, mothers who have relatives with anxiety disorders –or have had anxiety disorders themselves in the past — are at higher risk for postpartum anxiety than woman with no family history of anxiety at all. In addition, women with thyroid imbalance are at higher risk, also.

Most of the time when we refer to postpartum anxiety, we’re talking about a generalized anxiety disorder that develops during or after pregnancy. Symptoms like nervousness, constant worry, difficulty sleeping, racing thoughts, tension…

But there are a couple more types of postpartum anxiety that are important to highlight.

Postpartum Panic Disorder

Panic disorder doesn’t mean being panicky, or having anxiety that escalates easily until you feel wound up. It means having frank, out of the blue, and unprovoked panic attacks. You’re not just worried all the time about whether the baby is eating enough, whether you’re capable of being a good mother, or whether the baby will get sick, you begin to get random episodes of sheer panic.

Sometimes multiple times a day.

Shortness of breath, fast heart rate, chest pain, dizziness, and tingling along with feeling confined or like you’re suffocating can make it extremely difficult for you to take care of your baby, yourself, or the rest of the family. These sensations can come and go, but you may need professional help to cope with them and reduce their impact on you and your new family.

Postpartum Obsessive Compulsive Disorder (POCD)

Symptoms of OCD can emerge during or after pregnancy, too. They’re similar to general symptoms of OCD but tend to be focused on the baby. Intrusive thoughts about harm coming to your baby can crowd your mind, and even shock you.

The next thing you know, you find yourself checking things over and over and repeating things over and over to try to avoid a circumstance that would allow your thought to come true.

And…you’re probably horrified at the thoughts that pop into your mind. But this is why we call them “intrusive” thoughts. They intrude into your thoughts without you inviting them.

They’re a result of disordered circuitry, and misfiring signals, in your brain as the result of relentless and overwhelming stress, shock, and genetics.

Of all of the antepartum and postpartum anxiety disorders, this may be the most difficult and the most upsetting of all. Even though you probably know in your head you would never follow through on the thoughts, and you also know that the repetitions and cycles of checking don’t really help, you probably feel powerless to stop. But treatment can do what you can’t by yourself.

Because this condition is treatable, and you need to not endure these symptoms alone. Seek help and treatment so you can get your life and your relationship with your child back on track and in a healthier, brighter place.

Postpartum anxiety disorders are not your fault.

You’re not to blame for the intrusive thoughts, the fears, the compulsive reactions. These are a result of your genetics, your circumstances, your stress, and your family history. But treatment is not only available to you, it also can return your world back to its right and rewarding function.

Antepartum and postpartum anxiety disorders come in various forms with a variety of faces. But it’s vital that you not confront this alone. Rather, seek treatment. And please know that this is not your fault. Even so, you may not get better without help outside yourself.

If you’re pregnant and feeling feelings and thinking thoughts that aren’t what you wish you they were, there is help available. If your baby has been born, and those feelings are just starting or are getting worse, call us. We can help you feel better, or refer you to someone who can.

Don’t face postpartum anxiety disorders alone.

You and your baby deserve a loving and happy relationship together.

July 8, 2019
Study Finds Ketamine Nasal Spray Effective For Treating Depression: What You Should Know

A new study finds that a nasal spray formulated from the anesthetic ketamine is a safe, fast-acting and effective treatment for treatment-resistant depression. Researchers presented the findings this week at the annual meeting of the American Psychiatric Association.

Esketamine, the intranasal formulation of ketamine, recently received FDA approval as a depression treatment when used with an oral antidepressant, based in part on findings from this study. The results open the door to a potential new alternative for the estimated 30% of depression patients suffering from treatment-resistant depression.

The study included 197 adults from 39 outpatient centers over a two-year period. All of the participants had either moderate or severe depression and hadn’t responded well to at least two antidepressants in the past. Participants were randomly assigned to one of two groups: The first switched from their current antidepressant treatment to esketamine nasal spray and a new oral antidepressant; the other switched from their current treatment to a placebo nasal spray and a new antidepressant.

The results showed significant improvements in depression symptoms among those in the esketamine group compared to the placebo group four weeks into the study, with signs of improvement starting much earlier.

“The study supports the efficacy and safety of esketamine nasal spray as a rapidly acting antidepressant for patients with treatment-resistant depression,” the study concluded.

“Not only was adjunctive esketamine therapy effective, the improvement was evident within the first 24 hours,” said Michael Thase, M.D., one of the study authors. “The novel mechanism of action of esketamine, coupled with the rapidity of benefit, underpins just how important this development is for patients with difficult-to-treat depression.”

The researchers reported that most of the negative side-effects in the esketamine group, including dissociation, nausea, vertigo, dysgeusia (impaired sense of taste) and dizziness, disappeared within a couple of hours. A small percentage of patients dropped out of the study due to side effects.

Ketamine has been in headlines for more than a decade as the party drug (aka “Special K”) with promise of becoming a next-generation depression treatment. Early studies showed patients with a history of treatment-resistant depression responded well to ketamine almost immediately. Those studies generally used intravenous ketamine at a low enough dose to not deliver anesthetic effects (what ketamine was originally designed to do in humans and animals), but intravenous ketamine for the treatment of depression hasn’t been approved by the FDA. The intranasal formulation (brand name Spravato) received FDA approval in March of this year but is only available through a restricted distribution system with a certified clinic or doctor’s office.

The news isn’t entirely upbeat, however, with some researchers urging caution as the drug moves closer to pharmacy shelves. In commentary accompanying the study in the American Journal of Psychiatry, Alan Schatzberg, M.D., from Stanford University School of Medicine, cautioned that while this study shows potential benefits of using the drug, “there are more questions than answers…and care should be exercised in its application in clinical practice.”

Schatzberg pointed out that clinicians don’t have adequate information about how often the medication should be prescribed, how long patients should use it, or what the correct course of action should be if patients eventually stop responding to it.

He also highlighted the potential for abuse, echoing concerns raised by many health professionals all along the drug’s road to approval. Using the history of opioids as an example, he added, “We have witnessed four decades of supposedly new and safer opioids that have turned out often to be, if anything, even more abusable and lethal.”

“Still, the agent [esketamine] could be helpful to many patients with refractory depression,” Schatzberg said, ending on the positive, “and efforts to develop rapidly acting agents for severely depressed patients need to be applauded.”

The study was published online in the American Journal of Psychiatry.

You can find David DiSalvo on Twitter, Facebook, Google Plus, and at his website, daviddisalvo.org.

[Read the Original Article Here]

May 29, 2019

Category: PTSD

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

Our purpose in offering these articles about PTSD is to reduce stigma. It’s also to help the reader better understand the causes and symptoms of PTSD. Better understanding helps each of us to offer support to those in our lives who need understanding for episodes they’re unable to prevent.

Symptoms of PTSD

Articles About PTSD Treatment

Talk therapy

Medications

IV Ketamine infusions

Reach Out for Ketamine… to Get Better… and Make 2020 Your Best Year Yet

This is the first Monday of the New Year…so how do you start a new year?

IV Ketamine Treatment – The Game Changer for Psychiatric Disorders

Like most exceptional medicines that are designed for sedation and/or pain relief, it’s been abused by people on the street and in the club scene for its dissociative side effects. As a result, it’s sometimes been misunderstood as a result.

Why wait any longer? Why not reach out for ketamine now and start this new decade on far better footing..? Stick your neck out and make the call for treatment now because you deserve the chance to live a fulfilling life, free of symptoms that keep your life shackled.

Ketamine Treatment Relieves a Broad Variety of Disorder Symptoms

IV ketamine treatment can be a bit tepid in relieving symptoms for those with milder cases. But, let me quickly say that when you feel bad, it doesn’t feel mild. And that’s why we have criteria to help us measure the severity of each case.

Freedom from the Doldrums

One reason may be the resilience ketamine builds. You’re able to adapt and quickly recover from the offenses that happen and you have the power to just snap back and be ok. It’s amazing…in fact, it’s priceless.

Neuroplasticity + Psychotherapy = Peace & Joy in life

Then, to point out yet another talent of this treatment, researchers and therapists have learned that because of the neuroplasticity ketamine creates in your brain circuitry, psychotherapy can be much more effective about 24 hours after an infusion.

You’re probably thinking, How Can I Do THAT? I Can’t Seem to Get Out of Bed??!!

There is more help available for your tormentous symptoms than has ever been seen by your parents or grandparents or great grandparents…

PUSH through.

The drowning man has to take hold of the rope. If he’s passive and tries nothing, he’ll drown.

The mountain climber who loses his footing and careens over the cliff has to reach out and GRAB – something. A rock…a rope…a bush…?

It doesn’t happen all at once the very first minute…

Maybe it just trickles at first, but then the trickles become waves, and the joy and initiative surges, and you find you’re CAPABLE of doing things you want to do, that you’d all but forgotten about.

Your family may notice the changes in you before you do. You may show unexpected initiative before you FEEL all that much better. (Miranda, are you actually folding clothes? Unbelievable!)

Reach Out for Ketamine!

If so, maybe it’s time you do your own homework? The National Institute of Health funds extensive research about ketamine treatment because it’s so extraordinary.

IV ketamine treatment is the most effective medicine for psychiatric disorders we’ve ever seen. It’s not FDA approved because no one wants to pay for FDA trials if they can’t make a profit off a patent. And..ketamine is too old…there’s no patent to be had.

Reach Out for Ketamine and Get Better for 2020

Tell yourself that it’s your turn to get better. And that you’re not going to give in to excuses. That you want to live better, healthier, and more balanced. That you want your life to BE better. Give Hope the benefit of the doubt.

This step can turn your entire life around for the better. But you’re the one who has to take it.

So…you may say, What if it doesn’t work for me?

Well…we say, What if it does??

Do you really want another decade to crawl by while you’re trapped in the misery and despair of this disorder?

Reach out for Hope and for a better life in 2020 and beyond.

Reach out for ketamine and grab onto HOPE.

Who’s Affected by Severe Chronic Depression?

Just think about it. How far reaching is this one condition?

Let’s take a closer look at the people affected by severe chronic depression. Who are they?

Gary is one.

Even though he’d always been optimistic, and bounced back after disappointments, this time he utterly lost his footing. Shock and devastation swarmed around and within him. He lost his bearings…and withdrew into the quiet safety of his house.

Something needed to give. To help free him from the box he’d built around himself.

And Who ELSE?

Dan is.

At 42, he drank whenever he was free. He had managed to get through college with a degree and land a job that was steady, but nights and weekends were his time to reward himself — whether anyone was with him or not. He worked hard to earn the right to get smashed on Saturday night.

Alcohol Addiction and Depression… A Dangerous Combination

Now in his 40s, Dan began to understand why. And he realized he was likely to spend his life alone and drunk, if something didn’t change. He’d actually tried to stop drinking but something always happened and he was back at it. He felt pretty defeated. It seemed to be bigger than he was.

There’s more to Dan’s story.

Some people suffer with a complex combination of disorders, and diagnosis and treatment can be complicated, too. We talked about Gary and his traumatic experience, the depression and phobias that followed and led to his eventual confusing behaviors, and a Bipolar 2 diagnosis.

So who else is devastated – and disrupted – by severe depression symptoms?

Cheryl is.

Happy Times Preparing for Baby

Finally, she was in labor.

As the fog cleared her head, her memory of the labor returned. Her new baby slept in her bundled blanket. And Cheryl put the pieces together. She had had a baby. She was sleepy because of emergency surgery. The baby couldn’t get out… But where was that baby?

Traumatic Birth Can Interfere with Bonding Between Mother and Child

She felt no connection to this tiny human, in spite of her husband’s reassurance… She felt sure she would have recognized her own baby, right?

Her behavior worried (and angered) her husband. He just didn’t understand his wife’s coldness. Was this damaging Phoebe? What damaged Cheryl to cause this?

Postpartum depression.

Who Else is Affected… or should I say, Overwhelmed ?

The family is.

But IF, and only IF, you can safely and effectively reduce or even eliminate, the symptoms of depression, you may be able to see your life restored and functioning again.

Maybe they need IV ketamine treatment.

Plus, it’s safe.

The World Health Organization includes ketamine on its List of Essential Medicines. Respected around the world in ORs, ERs, disaster areas, and war zones, ketamine isn’t new.

Remission Often Replaces Severe Chronic Depression at Innovative Psychiatry

IV Ketamine Treatment Does Its Best Work When Symptoms of Severe Chronic Depression Seem Untreatable

Remember Gary?

After 7 infusions, Gary bloomed. The warm, outgoing, generous man who had served people in need all his life re-emerged. Gary’s confidence returned along with his energy to participate in the lives of people who needed his help.

Then there was Dan.

After the second infusion, he definitely felt less depressed. Improved. NOT great…but better. By the time he arrived for the 4th infusion he was feeling pretty good. Hopeful…motivated.

And Cheryl…?

When Phoebe was six months old, Cheryl received her first infusion. On the way home with her husband she could tell no difference. He encouraged her to keep an open mind. That he’d heard it could take awhile.

She was expressing joy more and more and laughing with Phoebe. By the end of the 6th infusion she didn’t feel perfect but she did feel happy. The doctor said it would get better and better.

Severe Stress Can Cause a Setback

She felt much better again after the infusion, and Phoebe stayed well all summer. They had daily walks in the sunshine, and Cheryl and Phoebe both had rosy cheeks and and a tan.

This Can Happen for You, Too

Unfortunately, many providers of ketamine don’t understand this, and give the same dose at the same rate to every patient, then schedule them to come in for regular maintenance infusions, indefinitely.

Find Restoration from Severe Chronic Depression