Category: Microbiome

Articles about the MicroBiome from Lori Calabrese, MD | The Ketamine Blog

What is the microbiome?

The microbiome is the genetic material of a vast community of microorganisms such as bacteria, protozoa, viruses, and fungi that live in the gastrointestinal tract of your body. The combined genetic factors in this environment make up more than 200 times the genetic material in your own DNA. As such, this collection of microbes provide a strong influence over your digestion, immunity, and overall health.

In fact, for you to be at optimum health and wellbeing, these organisms must be in balance. When they are, they assist your digestion and strengthen your immunity.

What is “Balance” in the Microbiome?

There are harmful bacteria and other microbes as well as beneficial ones. As long as the “good” bacteria keep the “bad” bacteria from taking over, you can enjoy health and wellbeing. But if the good guys and bad guys shift out of balance, it can cause you to become very ill from a variety of diseases.

And along with diseases, depression and anxiety can also become unmanageable.

How do you strengthen the gut -brain axis?

To strengthen your microbiome, you can

  • increase the fiber in your diet
  • Eat as much fruits and vegetables as you can, choosing a wide variety and including all the colors available.
  • Choose high fiber vegetables in abundance like leeks, artichokes, garlic, and onions for their prebiotic fiber content. Some vegetables are low in fiber and actually have minimal nutritional value.  Lettuce falls in this category.
  • Seek out polyphenols, as in nuts, seeds, berries, olive oil, brassicas (cruciferous vegetables, mustard plants, and cabbages) coffee, and tea (green tea is best of all!)  These are antioxidants and fuel microbes.
  • Avoid snacking to give your microbiome a rest.
  • Make fermented foods a strong component of your daily diet. Foods like yogurt, kefir, sauerkraut, kimchee
  • Play in the dirt. Spend time in the country, work in your garden, and enjoy the earth and the fresh air. Doing so will diversify your microbiome and multiply the types of organisms there to improve your health, your immunity and your wellbeing.

These articles about the microbiome are offered to improve your understanding of the beneficial properties it possesses.

  • Cerebral Folate Deficiency and Its Impact on Treatment-Resistance

    Cerebral Folate Deficiency and Its Impact on Treatment-Resistance

    Man thinks alone on cold silent shore may have cerebral folate deficiency.

    “If I see far, it’s that I stand on the shoulders of giants.”

    If you find yourself feeling alone and forgotten in your symptoms, feeling that there’s no one who really cares, please let me emphasize that there are hundreds, even thousands, of neuroscience researchers, medical doctors with PhDs, biochemists, psychopharmacologists, and psychiatrists who have been painstakingly searching for the answers you need for your suffering for generations, and millennia. You can feel alone, but there’s a host of people who have your back.

    After eons of exploration, and hundreds of generations have suffered without remedy, we are living in an amazing time when solutions are emerging. 

    Treating cerebral folate deficiency empowers you to enjoy the people you love.

    We’ve learned that the mild-mannered anesthesia medicine, ketamine hydrochloride, has been hiding in plain sight for nearly five decades, all along carrying within it the power to potentially transform your crippling depression, PTSD, and social anxiety into resilience, remission, fulfillment…and a rewarding life.

    It was right under our noses, but we were missing it…

    What else is lurking in plain sight that may hold the secret to relief for millions of people?

    More to Learn to Relieve Psychiatric Disorders

    While the vast majority of severely ill patients has been enjoying a life they’d not been capable of enjoying until they were treated with IV ketamine,  there were still those who seemed to be unaffected and un-helped by it. We haven’t known why.

    And even some of those who seemed unaffected and un-helped by ketamine treatment, began to improve in a slowly spreading glow until they too achieved remission months later.

    And we learned about genetic alleles for BDNF that may indicate an individual’s responsiveness to treatment, and clinical indicators associated with treatment response.

    Now we’ve been learning even more.  About deficiencies of nutrients that can cause depression and other disorders. One of these deficiencies has been exposed as a key factor in autism. And when the deficiency was treated with high doses, the symptoms of autism diminished!

    Who knew?

    Right under our noses.  Sometimes it takes generations of exploration passed down through generations of researchers to find the answers we’re looking for … which were lurking in plain sight.

    We’ve talked about how a deficiency in testosterone can be a culprit blocking remission from depression. 

    Another BIG player is cerebral folate. 

    Cerebral Folate Deficiency

    Cerebral folate deficiency is the cause of treatment-resistant depression in many people, and is easily treated.

    Folate is vitamin B-9, and provides important services throughout the body. In the brain, it plays an important role in neurotransmitter production. So when it’s deficient, the neurotransmitters tend to be produced more slowly.

    You can read the label on your breakfast cereal box and see that it contains folic acid.  But folic acid can’t cross the blood-brain barrier, which is there to protect the the brain from fluctuations that can interfere with its function.

    Only in the form of folinic acid or methylfolate can folate reach the brain. And to do that it has to have a transport, called the folate receptor alpha, to take it there.

    So to get B-9 into your brain to do its part in the neurotransmitter factory, it has to be in a certain form that can get through the security gate of the brain, known as the blood-brain barrier. Plus, it has to hitch a ride on a specific type of truck, and that truck has to be a specific model – the “low affinity folate transporter.”

    It’s not hard to picture that a brain can get low on this stuff. So many hoops to jump through! 

    How Cerebral Folate Deficiency Can Affect You

    And interestingly, most of the research  about this has involved infants and children. In fact, the story of folate in the brain has a gripping history. It involves autistic children and infants with severe neurological disorders..but as those discoveries made their way into adult psychiatry.

    Well, we’re talking about it now because it turns out that adults have deficiencies too…and this is a deficiency that may contribute to why your depression seems treatment-resistant — but the problem is not that hard to treat. Which is good news…really good news.

    Cerebral folate deficiency may cause this man treatment-resistant depression.

    In fact, if we find you’re treatment- resistant because of folate deficiency, we can prescribe folinic acid or l-methylfolate to treat the deficiency. Then, you may find you’re not treatment-resistant any more. Sound like a plan?

    This is BIG news.

    What this means is that some people who don’t get better with ketamine treatment, may just need their folate deficiency restored so their neurotransmitter factory can crank up again and turn out those much needed neurotransmitters.

    Then, ketamine has what it needs on hand to help you get dramatically better. 

    Isn’t that amazing??

    Researchers Paved the Way

    In 2005, Dr. VT Ramaeker defined cerebral folate deficiency as “any neuropsychiatric disorder involving problems getting enough folate into the brain.” He was referring to the infants he treated. They had severe neurological illness, and happily, many of them responded to high doses of folinic acid.

    Then, in 2013, Dr. Richard Frye studied 93 pediatric patients with autism and found that 75.3% had cerebral folate deficiency. He also found that those patients who had a cerebral folate deficiency also had antibodies to the folate receptor alpha — that specialized transport truck that takes the folate into the brain.

    Treating cerebral folate deficiency can transform depression to joy.

    The following year, we’re back to Dr. Ramaeker, who measured cerebral folate in 18 patients with treatment-resistant schizophrenia…and you guessed it! 15 of them had cerebral folate deficiency. He treated 8 of them with high doses of folinic acid and 7of them got better.

    Now, I should explain that finding the level of folic acid in the brain is a bit more involved than lab work. It requires a lumbar puncture so the folic acid in the cerebrospinal fluid can be measured. The measure of folic acid found in the cerebrospinal fluid is then multiplied by 1.5 to find the level in the brain.

    Then, in 2017, Dr. Lisa Pan measured folic acid in 33 patients with treatment-resistant unipolar depression. 12 of these had cerebral folate deficiency and 10 out of those 12 responded after high doses of folinic acid.

    Google’s Take on Folate and Cerebral Folate

    When you google “folate,” you get all sorts of links about how folate is needed in your body. It helps make red and white blood cells in the bone marrow, convert carbohydrates into energy, and manufacture RNA and DNA.

    (Hmmmm, makes you stop and think about BDNF. How it turns on mRNA to switch on DNA so the synapses proliferate and rebuild circuitry in the brain…  interesting…)

    But when you google “cerebral folate,” you find yourself reading about autism, and about treating it with folinic acid.

    Cerebral Folate Deficiency Causes Tragedies

    Cerebral folate is so important in the brain, that the lack of it causes all sorts of tragic results…. in infants, neural tube defects, spina bifida, cleft palate…

    To think that autism, schizophrenia, and depression show links to cerebral folate deficiency — in at least some people — pushes us and the psychiatric and neuroscience research community to learn more about the central role that l-methylfolate and folinic acid play in the the central nervous system and in the genesis of psychiatric disorders.

    These early important studies should prompt more extensive clinical studies. And they should prompt more interest in testing our patients with treatment-resistant disorders for this deficiency so that we can treat it sooner rather than later, don’t you think?

    Unfortunately, that’s not as easy as it sounds. But it’s a start for us to realize this B vitamin is essential to our health and wellbeing. And just might be the key to your treatment-resistant disorder.

    Treating Deficiencies in Vital Nutrients Helps You Thrive

    At Innovative Psychiatry we test for cerebral folate deficiency when we suspect it could be a cause of treatment-resistance. We prescribe treatment for it to help improve your response to your treatment, including ketamine, and in turn, potentially improve your resilience and remission.

    Remission gives the power to enjoy, which you can experience after treating cerebral folate deficiency.

    If you suffer from treatment-resistant depression, and think you might be a candidate for ketamine treatment, call us. We’ll do an evaluation to learn more about you and your illness. We can also order testing to help ensure your best outcome with IV ketamine treatment.

    With so many who have gone before us, shining the light brighter so we can better see the obstacles to your joy, we’re here to help you find the life you ache to live.

    Ketamine KRIYA Conference 2018
  • Low T in Men Causing Your Treatment Resistant Depression..?

    Low T in Men Causing Your Treatment Resistant Depression..?

    Low T in men can be overlooked as the cause of depression.

    Since low testosterone in men has long been presumed to accompany aging, it can be overlooked as a cause of TRD in young men.

    John had gained 75 lbs (!) through the stressful and exhausting project at work. He’d come to hate the way he looked.

    Co-workers had turned on each other, undercutting rather than supporting each other as a team. John was a team player, and while his skill was beyond the skill of others on the team, he could feel himself slipping into depression…again. And his skills were slipping, too.

    Because he was losing his edge, it was getting harder and harder to think through to solutions, much less articulate them to the others. He knew he was doomed. As long as his mind worked he could maintain his position in the department, but as depression returned, he became sluggish, he felt dense, and hopelessness rose like water in a submerged car.

    To add insult to injury, his girlfriend was complaining that they never went out anymore, and that she felt he’d lost interest in her. He knew he hadn’t lost interest in her any more than anything else…he just didn’t have the energy to face restaurant crowds…or even show her what she meant to him. In fact, he hardly had the energy to get out of bed on lots of days.

    And to make matters worse, his sex drive was shot. He just didn’t care about anything, but also felt like a failure as a man.

    Before the project began, he had a few suicidal thoughts at night…  But through the tormented road at work this year, the suicidal thoughts were cramming into each hour of the day at about 40/hour. He winced to himself… almost sounds like the speed of a car rather than an obsession to die.

    This had been going on most of his adult life. Why couldn’t it be fixed? Why oh why did he keep trying…going to work…diving into the hopelessness again and again day after day? Why not just get off…?

    What was wrong with him? Where could he find a doctor who could help him..??

    Treatment Resistant Depression

    Major Depressive Disorder (MDD) is complicated by a discouraging rate of relapse, even with those who achieve remission at some point. Studies of long duration have shown that patients who have residual symptoms after treatment have a worse prognosis. Which is why we do all we can to help our patients achieve remission, if possible.

    Low T in men has similar symptoms as treatment resistant depression, so it may be the low T needs to be treated to improve depression.

    Treatment resistant depression (TRD) causes immeasurable suffering. Because the symptoms don’t improve with traditional medicines, the ongoing struggle to find relief only seems to worsen symptoms. And untreated depressive symptoms that go on in spite of treatments can be debilitating and costly.

    Treatment resistance occurs in 45% of depressed patients. These are patients whose symptoms have not improved after at least 2 medicine trials… or some combination…for 12-16 weeks each. This condition increases risks because of higher prevalence of suicidal thoughts, attempts, and tragically, death. Nearly a third of treatment resistant patients attempt suicide in their lifetime.

    For years, most people thought that there were far more depressed women than men. That women are more prone to depression because they are more expressive of their emotions. But it turns out that isn’t true.

    Depressed Men Don’t Act Like Depressed Women

    When men are depressed they may show it with anger, irritability or aggression.

    However, studies emerged revealing that many men display different depression symptoms than women, and as a result their depression can be overlooked. Rather than sadness, they sometimes exhibit anger, irritability, and aggression. As such, those around them may pull away, rather than recognizing their loved one is actually depressed.

    Another factor is that men are less likely to talk about how they’re feeling or seek help. So that creates the idea there aren’t as many depressed men as women, because their families can’t read their minds, right?

    So a man who’s irritable and autocratic may actually be depressed, rather than just a difficult guy. (Surprising, sometimes.) This is good news for those friends and family members who love them. Because, if he is, he needs treatment… but he may not ask for it. Even if he does, there is a strong chance the treatment won’t help, or at least, not much.

    If we’re to know what to do for him, we have to consider other things first.

    So what causes depression in men

    Low T in Men

    Honestly, the same things that cause depression in women, for the most part. Chronic stress, genetic factors, environmental factors, biological events like heart attack, stroke, chronic pain, or amputation, and other illnesses like diabetes, Parkinson’s, heart disease, or cancer.

    But, there’s another condition that’s often overlooked. Low testosterone, or low T, is seen with hypogonadism. 

    The testes produce most testosterone (90-95%). But a small portion is produced in the adrenal gland. And studies have established that testosterone treatment can help men feel better emotionally, so a deficiency of testosterone can erode their mood and outlook.

    Some men receive the diagnosis of hypogonadism. This is a condition that causes their bodies to produce too little testosterone.

    Low T in men is sometimes seen in young men who have treatment resistant depression symptoms.

    It’s been said that hypogonadism, or low T, is a malady of elderly men. But, that’s a generalization that doesn’t take into account the many men between ages 18-40 whose testosterone level is below 10.4 nmol/L and who have treatment resistant depression. 

    Low T in YOUNG Men

    Low testosterone is a leading cause of treatment resistant depression in older men, but many overlook that it’s a big cause of treatment resistant depression in younger (age 18-40) men, too.

    Stanley Korenman, M.D., and his team published their work about the link between low T in young men (ages 18-40) and depression in a paper published November 2018 in the Journal of the Endocrine Society.

    They studied 186 young men who made visits to a university medical center for any reason between the years 2013-2015. These men had symptoms of treatment resistant depression.

    The prevalence of hypogonadism was present in 22.6% of these men.

    The authors called for more research to determine if the hypogonadism causes the treatment resistant depression or if the treatment resistant depression causes the hypogonadism…maybe both?

    Because to neglect this connection may be to ignore a condition that’s reversible. One that turns treatment resistant depression into treatable depression. And treatable depression can be transformed to remission.

    We Strive to Treat YOU in YOUR Own Uniqueness

    Our approach at Innovative Psychiatry is to treat each underlying condition and its own symptoms, then watch to see how the /improvements in function combine toward resilience and remission.  It can be a tedious process but it’s all worth it when your symptoms finally dissipate.

    A key component of your recovery may include IV ketamine treatment, if you have a treatment resistant disorder. Ketamine does its best work in patients with the most complex treatment resistant illnesses. But for ketamine to do its best work in restoring your brain cell connections prolifically, you need to treat other conditions like low T that may get in the way.

    For this reason, we also may encourage you to see a specialist as we work on the process of treating your depression. We always love to work with your specialized health care team to help you get the most personalized care so you can feel really good again.

    Low T in men can be treated it can also help to relieve treatment resistant depression.
    There is no one-size-fits-all remedy for everyone and every complexity of illnesses. But we  must work together, exhaustively, and explore your disorders, your nutrient imbalances, your social and work life, your family life, your exercise, your diet…every aspect of your health…to tease apart those elements that may be contributing to the way you feel.

    And while it may require an investment of time, effort, treatments, and re-evaluations for awhile, it will all be worth it when you look in the mirror and love the person you see there.  Better days are ahead.

    You will never hear me say, “There’s nothing more we can do.”  Those days are over in psychiatry, I hope… but you will hear me ask, “What was the very best YOU you’ve ever been…? That’s the you we’re going to help you find again – together.”

    To the restoration of your best self, 

    Lori Calabrese, MD offers innovative psychiatric treatment like IV Ketamine
    Lori Calabrese, M.D.
  • Ketamine May Relieve Depression By Repairing Damaged Brain Circuits

    Ketamine May Relieve Depression By Repairing Damaged Brain Circuits

    NPR Logo

    Ketamine appears to restore faulty connections between brain cells, according to research performed in mice.

    The anesthetic ketamine can relieve depression in hours and keep it at bay for a week or more.

    Now scientists have found hints about how ketamine works in the brain.

    In mice, the drug appears to quickly improve the functioning of certain brain circuits involved in mood, an international team reported Thursday in the journal Science. Then, hours later, it begins to restore faulty connections between cells in these circuits.

    The finding comes after the Food and Drug Administration in March approved Spravato, a nasal spray that is the first antidepressant based on ketamine.

    The anesthetic version of ketamine has already been used to treat thousands of people with depression. But scientists have known relatively little about how ketamine and similar drugs affect brain circuits.

    The study offers “a substantial breakthrough” in scientists’ understanding, says Anna Beyeler, a neuroscientist at INSERM, the French equivalent of the National Institutes of Health, who wasn’t involved in the research. But there are still many remaining questions, she says.

    Previous research has found evidence that ketamine was creating new synapses, the connections between brain cells. But the new study appears to add important details about how and when these new synapses affect brain circuits, says Ronald Duman, a professor of psychiatry and neuroscience at Yale University.

    Studying ketamine’s antidepressant effects in mice presented a challenge. “There’s probably no such thing as a depressed mouse,” says Dr. Conor Liston, a neuroscientist and psychiatrist at Weill Cornell Medicine in New York and an author of the Sciencepaper.

    FDA Approves Esketamine Nasal Spray For Hard-To-Treat Depression

    So Liston and a team of scientists from the U.S. and Japan gave mice a stress hormone that caused them to act depressed. For example, the animals lost interest in favorite activities like eating sugar and exploring a maze.

    Then the team used a special laser microscope to study the animals’ brains. The researchers were looking for changes to synapses.

    “Stress is associated with a loss of synapses in this region of the brain that we think is important in depression,” Liston says. And sure enough, the stressed-out mice lost a lot of synapses.

    Next, the scientists gave the animals a dose of ketamine. And Liston says that’s when they noticed something surprising. “Ketamine was actually restoring many of the exact same synapses in their exact same configuration that existed before the animal was exposed to chronic stress,” he says.

    In other words, the drug seemed to be repairing brain circuits that had been damaged by stress.

    That finding suggested one way that ketamine could be relieving depression in people. But it didn’t explain how ketamine could work so quickly.

    Was the drug really creating all these new synapses in just a couple of hours?

    To find out, the team used a technology that makes living brain cells glow under a microscope. “You can kind of imagine Van Gogh’s Starry Night,” Liston says. “The brain cells light up when they become active and become dimmer when they become inactive.”

    That allowed the team to identify brain circuits by looking for groups of brain cells that lit up together.

    And that’s when the scientists got another surprise.

    After the mice got ketamine, it took less than six hours for the brain circuits damaged by stress to begin working better. The mice also stopped acting depressed in this time period.

    But both of these changes took place long before the drug was able to restore many synapses.

    “It wasn’t until 12 hours after ketamine treatment that we really saw a big increase in the formation of new connections between neurons,” Liston says.

    The research suggests that ketamine triggers a two-step process that relieves depression.

    First, the drug somehow coaxes faulty brain circuits to function better temporarily. Then it provides a longer-term fix by restoring the synaptic connections between cells in a circuit.

    One possibility is that the synapses are restored spontaneously once the cells in a circuit begin firing in a synchronized fashion, says INSERM’S Beyeler, who wrote a commentary accompanying the study.

    The new study suggests not only how ketamine works but also why its effects typically wear off after a few days or weeks, she says. “What we can imagine is that ketamine always has this short-term antidepressant effect, but then if the synaptic changes are not maintained, you will have relapse,” Beyeler says.

    If that’s true, she says, scientists’ next challenge is to find a way to maintain the brain circuits that ketamine has restored.

    [Read the Original Post Here]

  • Weekly Ketamine Infusions Show Initial, Repeated Depression Benefits

    Weekly Ketamine Infusions Show Initial, Repeated Depression Benefits

    A new study shows that weekly ketamine infusions are associated with continued and maintained reductions in depressive symptoms among patients with treatment-resistant depression.

    The findings, which are considered novel among studies assessing ketamine administration for patients with treatment-resistant depression, evidence the promising role the controversial drug could play in psychiatric care.

    A team of investigators, led by Jennifer L. Phillips, PhD, an associate scientist in the Mood Disorders Research Unit at The Royal’s Institute of Mental Health Research, conducted a randomized, double-blind crossover comparison of single ketamine infusion versus active placebo control midazolam. The assessment, held with 41 participants with treatment-resistant depression at single treatment center, observed patients receive 6 open-label ketamine infusions 3 times per week over 2 once patients had a relapse of depressive symptoms.

    Patients who reported a decrease of at least 50% in the Montgomery-Åsberg Depression Rating Scale (MADRS) received another 4 additional infusions once weekly in a maintenance phase.

    Those administered a single ketamine infusion reported significantly reduced depressive symptoms at the primary efficacy endpoint of 24 hours post-care versus those treated with midazolam. The therapy showed cumulative antidepressant effects over repeated infusions, as well a doubling of antidepressant response rate in patients, according to linear mixed models.

    Investigators found that 59% of patients met the response criteria following repeated infusions, with 3 infusions serving as the median dosage required to reach achieved response. In patients receiving weekly maintenance infusions, no further improvement in MADRS scores were reported.

    The first-of-its-kind findings come just 1 month following the US Food and Drug Administration (FDA) approval of esketamine nasal spray (Spravato) for the treatment of patients with treatment-resistant depression. At the time, the therapy made history as the first novel treatment indicated for depression in 30 years—and headlines as one of the first hallucinogenic drugs to reach indication for a common condition.

    Dennis Charney, MD, Dean of Icahn School of Medicine at Mount Sinai and a member of the Yale University team that led pioneering antidepressant ketamine trials in the 1990s, told MD Magazine® that microdosing or implementing controversial therapies for psychiatric care require what any other trial requires: control, safety, and a carefully-assessed standard for efficacy.

    “No matter what treatment is being assessed, you have to follow those scientific approaches,” Charney said. “For conditions that don’t have effective treatments available, there should be an open mind.”

    Adversely, Dan Iosifescu, MD, associate professor of Psychiatry at NYU School of Medicine, director of Clinical Research at Nathan S. Kline Institute for Psychiatric Research, and prominent ketamine investigator, told MD Mag that—among other reasons—ketamine will never reach at-home therapy use due to its prominent abuse as street drug Special-K. He anticipated the marketed therapy will be costly, and prescribed as long-term therapy for only a small depression patient population.

    “For the majority of individuals that benefit from it, it will be essentially buying them time for other treatments—be them pharmacotherapies or device-based treatment, or psychotherapies, because those are beginning to work much more slower than ketamine does,” he said.

    Whatever its marketed use entails, Phillips and colleagues concluded positively that ketamine showed both initial and repeated benefits for antidepressant effects as a once-weekly infusion.

    “These findings provide novel data on efficacious administration strategies for ketamine in patients with treatment-resistant depression,” they wrote. “Future studies should further expand on optimizing administration to better translate the use of ketamine into clinical settings.”

    The study, “Single, Repeated, and Maintenance Ketamine Infusions for Treatment-Resistant Depression: A Randomized Controlled Trial,” was published online in The American Journal of Psychiatry.

    [Read the Original Article Here]

  • RESILIENCE! It’s the New Buzzword Among People with Mood and Anxiety Disorders

    RESILIENCE! It’s the New Buzzword Among People with Mood and Anxiety Disorders

    Reslience! it's the buzzword that people with psychiatric disorders are talking about.

    Too much screen time? Let yourself have 2 more minutes of it right now: because if you’ve been tooling around reading anything related to mood disorders or anxiety disorders, IV ketamine, and other advanced treatments, you’ve probably noticed that there’s buzz about resilience.

    Because of the world that has opened up since IV ketamine began treating depressed patients with its ability to create new branches and connections, the expectations of these patients have soared.

    No longer are patients satisfied to have a little relief from their depression. They’ve learned they can feel good. Feel “normal.” Enjoy participating in life the way others do.

    So now the question you hear on the internet isn’t this: “Will any medicine help me feel at least a little bit better…?”  No.. now it’s this: “Will this medicine help me feel resilient again?” Or “What can I do during this treatment to help it work… improve my chances of remission… develop more resilience?”

    Now before we go on, I want to clarify that no doctor can promise or guarantee remission of symptoms from disorders like depression, bipolar disorder, PTSD, addiction,social anxiety, or to promise or guarantee that suicidal thinking will go away. There just isn’t any medicine in psychiatry that helps 100% of people get well.

    Resilience! It's the Buzzword.
    But, even so, there are many people who’ve suffered for years, even decades, with these disorders who are now living lives they never dreamed possible. They’re painting, excelling at work, meeting the loves of their lives, enjoying their families, and contributing to their important relationships. They’re investing in hobbies, socializing with friends and family, and feeling good about themselves and their accomplishments.

    This doesn’t happen overnight, but resilience has freed them to invest in their lives, and provides the energy for things they could never do before.

    Resilience Protects You From Falling in the Ditch

    And when hard times come along, they have the resilience to grieve a bit, then brush themselves off and keep moving forward. This may be the most remarkable change of all.

    Resilience is the ability to adapt when a crisis comes along… to adapt to whatever the situation may be. To bounce back, recover, and move forward after an onslaught of difficulty.

    Since psychiatric mood and anxiety disorders often develop as a response to some degree, to something environmental or an upsetting/traumatic event, if you can adapt to that event or force in your environment, you can remove that response from your psyche.

    Adaptation is the way organisms throughout your world survive. When there’s a strong wind, if trees don’t bend under the wind they’ll be splintered and destroyed. But their ability to bend is their means of survival and the way they develop resilience.

    The same is true of you.

    If you have a continuous source of stress in your world, one that assaults your senses, emotions, or body, you can eventually be beaten down and weakened or destroyed by those assaults.

    But if you can find a way to bend like a tree does, to adjust yourself to accommodate those assaults, hurts, and winds of fury without being damaged, it will help you avoid being traumatized. And that’s how you’ll develop resilience.

    This brings up the story of a friend of mine. 

    Resilience! It's the new buzzword with patients who have been depressed.

    Jillian grew up in a small town in the midwest, and was a faithful member of a tiny congregation there. The pastor had served in her church for 40 years, and unwittingly preached a serious sermon every Sunday that reflected the smallness of his own tiny world in that tiny town.

    Jillian, like the rest of the church members, worked hard to live up to the expectations her pastor laid out in his sermons. Her town was small, her world was small, and those expectations left her view of life small, too.

    Culture Shock – From Small Town to Big City

    As she approached her thirtieth birthday, her husband broke the news to her. He’d been transferred to Chicago. 

    So they packed up their belongings, and moved into a pretty little apartment in that big, new city.  Her birthday was anything but a celebration. The traffic overwhelmed her … the variety of people she saw at the grocery store, the post office, and everywhere else were just so different than any she’d ever seen before.

    Hairstyles, clothing styles, and the way people just talked made her feel more like she was on another planet than just in a different city. She felt afraid to meet people or make friends. She was afraid she looked like a fool and she couldn’t imagine how you could trust anyone.

    This sad woman lacks resilience to bounce back after hardship.

    The more time she spent alone, the more isolated she felt. And the sadder she became. She was lonely. She missed the comfort of her home town.

    Her husband asked her often if she was making any friends. But she just told him that the people she ran into on the street weren’t “her kind of people” — and she felt safer alone.

    One day he arrived home from work and announced they’d been invited to dinner by one of his co-workers. She was excited to meet this co-worker and his wife. Surely they’d be a good match socially, too.

    The following Friday, Jillian and her husband drove to the address her husband pulled from his pocket. The front yard was alive with a variety of blooms that reminded her of English gardens she’d seen in books at the library. It was just beautiful.

    Jillian Adapts and Learns Resilience

    They knocked on the door — and it was opened by the strangest-lookingpeople she’d ever seen. She immediately wanted to go home, but her husband held her hand firmly as he warmly greeted the couple.

    Her husband’s co-worker had jet black hair that was shaved on the sides with a narrow path of hair from his forehead to his crown, pulled into a ponytail.  His wife had bright pink hair with spikes on top enhanced by a shag that softly fell on the left side of her head; the right side was shaved from her temple to her ear.

    Jillian’s alarm choked her. Then Cass, the pink-haired woman, spoke up and told her how glad she was to meet her. That most of her co-workers were middle- aged or nearing retirement, and she ached for friends her own age.

    When she spoke, Jillian began to relax. What a warm and genuine person, she thought. 

    “May I help you in the kitchen?”

    “Yes, I’d love the help!”

    So the two of them disappeared into the kitchen to finish up with dinner, and their husbands settled in to talk shop and about their hobbies outside of work.

    Jillian and Cass had so much more in common than she could have dreamed — and by the time they called the guys to sit down and eat, she had forgotten about the “strange” hairstyles.  She realized that her perspective of the world in her small town had apparently been pretty sheltered. And she was thankful she had found someone who could be a true friend.

    Resilience is Adapting to Your Situation, Which Helps You Bounce Back After Surprises, Disappointments, and Hardships

    The point is, that Jillian adapted. She was experiencing a stressful situation, and it was affecting her emotionally. Sadness was growing as well as isolation and loneliness. If she’d remained unwilling to bend, she might have eventually plunged into depression.

    Resilience gives this woman peace in the face of difficulty.
    But, after exposure to a stressor that felt threatening to her, she was instead willing to look beyond her distaste, and read the heart of a person who was ready and able to offer her real friendship. And many great adventures lay ahead as a result.

    Resilience! It’s the new buzzword for a reason. Beyond reduced depression symptoms, resilience protects your life from being interrupted by a trauma or disappointment.

    While this is an oversimplified example, it shows you how important it is to bend, rather than break. To change the way you think in a stressful situation so you can bounce back from disillusionment, disappointment, or betrayal.

    Resilience! It’s the New Buzzword for Adapting and Growing Stronger

    But, here’s the thing. Sometimes you face stressors that feel threatening to you when you don’t feel equipped to respond with resilience. In fact, sometimes you may not feel resilient at all.

    Sound familiar?

    Times when you’re drowning in depression or terrorized with PTSD. When you don’t have the energy to get out of bed, much less “bend with the wind.” What do you do then?

    Ketamine Treatment Enhances Resilience

    Well, that’s when you may need treatment. You need to get the help of your psychiatrist to get those symptoms under control. To empower resilience. And if the medications that have been prescribed for you haven’t helped, then you may need something more targeted, more potent.

    One medicine we use at Innovative Psychiatry for exactly this is IV ketamine treatment. We’re experts in ketamine treatment and we’ve offered it for years–way before most doctors–and most people–ever even heard about it.

    Resilience. It's the new buzzword among people who were depressed and now live in joy.

    You may need something like that to help you enjoy resilience and to make it stronger. Because from its vantage point, ketamine has a list of actions that can help you develop the resilience that will see you through stressors and losses that may come along in the future.

    Neuroplasticity Helps You Build Resilience

    Ketamine stimulates neuroplasticity, which is the ability of the cells in the brain to change and adapt. That neuroplasticity can enhance your psychotherapy, especially when your therapy is 24 hours after your infusion.

    It can also help you change your perspective of life and people. In doing that, it can help you learn how to “bend with the wind,” or whatever crosses your path. You can create and build up a level of resilience that empowers you to roll with the punches in life.

    Numerous studies have shown that the more often you adapt to small stressors in your life, the stronger you’ll be at adapting to big calamities. And the more you change your thinking to adapt to difficulty, the stronger your resilience can be.

    So, you can do things to strengthen your resilience…by choosing adaptive behaviors in smaller crises day by day.

    For example, you don’t have to succumb to the same old habits when something frustrates you, or makes you angry. With the help of ketamine stimulating your neuroplasticity, you can choose to think a different thought. Then practice it.

    I’m never going to get out of this job or this company. I’m doomed to a future of misery and mediocrity…

    You have the choice to accept that thought…or to grab the wheel and change its direction, like so:

    I’m not going to succumb to that thinking. I WILL excel at this job because I’m working hard to perform well. And I will be rewarded with promotions that will give me the resume that will promote me when I apply to new jobs. Bottom line, I’m not giving up..!

    You have choices when thoughts come to you, and when your choice is empowered by the neuroplasticity of IV ketamine treatment, you CAN overcome.

    Resilience helps you build a stronger remission of your symptoms... In fact, resilience is the reason so many people can undergo tremendous stressors, and bounce back.

    Resilience gives this woman peace in the face of difficulty.

    People like you, and those you love. Because resilience isn’t something you’re born with or NOT born with. Resilience is something you can develop with practice, determination, and persistence.

    That’s so important that I want to say it again: resilience is something that can be developed. You can develop it. And we can help you.

    We want you to live as the best YOU, you can be. And you can with the ability to adapt, and to apply resilience.

    Ketamine KRIYA Conference 2018
  • Can You Overdo Probiotics? What Will it Hurt? What Can Happen?

    Can You Overdo Probiotics? What Will it Hurt? What Can Happen?

    What’s too much? Too little? Or maybe it’s the wrong strain? How do you get it right..?

    You know the saying, “If a little does a little bit of good… then a lot must do a whole lot of good…”  But when it comes to probiotics, too much of a good thing can be a bad thing.

    We’ve talked before about the microbiome, the ginormous collection of microbes that live in your gut.

    Some of those bacteria, fungi, viruses, and other microbes maintain a thriving ecosystem of sorts that assists your body in many of its functions. And they also provide a powerful immune system to protect you from infections, cancer, and viruses from the common cold to HIV.

    There are — at any given moment – -10 microbes to every single cell in the human body. So we’re vastly outnumbered from the start.

    Side effects too much probiotics can be alarming, like racing thoughts,  pounding heart rate, numbness in left arm.

    But thankfully, the majority of those microbes help us function and protect us from invaders. The rest of them are always on the attack and being destroyed or eaten by the “good” bacteria.

    Until something happens that jars that system out of balance. For example:

    An infection treated by antibiotics, where the good bacteria are wiped out along with the bad.

    Stomach upset that results in vomiting or diarrhea, where massive evacuation of the intestine leaves behind a weakened balance of beneficial and destructive microbes.

    An injury that drives you to take a heavy load of ibuprofen, and your stomach lining becomes irritated, causing pain and bleeding.

    In each of these examples, ingesting probiotics can help to restore balance in your gut, and relieve symptoms.

    But, there are so many probiotic products! How do you know what to take and what to avoid? How do you know you won’t cause more harm than good?

    The fact is, it’s hard to know. And unless you conduct some deep research on the subject, but rather grab a bottle off the grocery store shelf, you may not know now or ever.

    Since you hear all around you how probiotics make you healthy, it’s natural that so many people want to overload their systems with “good bacteria” without respecting the balance within the microbiome that keeps everything working. But, can you overdo probiotics?

    Balance is The Secret to Nature’s Success

    For instance, when you think about the jungle, it may be tempting to remove everything you consider unpleasant so you can enjoy an exotic hike when you’re on vacation.

    So let’s say we had a way of removing all the mosquitos, spiders, and other pesky insects, as well as lions, and snakes, and gila monsters. That does make it sound like strolling through the jungle would be so much safer for us…  

    But.  

    We know, don’t we, that there is a balance in the eco system, and every creature is somewhere on the food chain? So if we removed insects… then birds and reptiles and anteaters might starve. And that would starve the larger predators and soon… well, the whole system would likely collapse.

    We know we can’t do that. Balance is the key all through nature, and it’s when our body systems are balanced that we experience well-being.

    Microbes in our body must be balanced too.

    The same is true with the microbes in your gut. We must respect and support the balance there. 

    So when you get sick you may need to build up the good microbes a bit. But if you try to flood your system with good microbes that overwhelm the balance with the destructive ones, other systems can be thrown out of balance, too.

    As we’ve stressed before, your microbiome is your gut-brain axis. So what goes on in your microbiome shows up in your emotions and vice versa.

    There are even specific bacteria that contribute to a happier outlook, reduce anxiety, and increase wellbeing. Some of the most helpful are Lactobacillus plantarum, Lactobacillus acidophilus, Lactobacillus brevis, Bifidobacterium lactis (B. animalis), and Bifidobacterium longum.

    Can you overdo probiotics? Not by eating fermented foods rich in them.

    Fermented foods, like kombucha, kimchi, kefir, plain yogurt and sauerkraut introduce live bacterial cultures. They’re probiotic foods–they introduce varied bacterial strains that are so important to your health.

    But sometimes, if you can’t or don’t eat these, you might choose to buy a probiotic capsule. (Yep … we’ve all been guilty.) Sometimes it’s easier, faster, or you just need or want the extra assurance of varied bacterial cultures.

    If you choose a probiotic, it should include the specific bacterial strains above that help prop up and stabilize your outlook.

    And your dosing should be in moderation. Researchers state that a good probiotic should have up to 10 billion colony forming units (CFU) that you take daily, and that it should have at least 5 different strains per bottle. The more variety the better. 

    The reason you take a probiotic is to strengthen your beneficial bacteria so they’re not overwhelmed by the destructive ones, right?

    At the same time, you don’t want to overwhelm your system with those beneficial bacteria. There are so many questions we don’t yet have answers for… like can you overdo probiotics?

    Or… what happens if the yin-yang balance of tension between the two is removed? Do some of the beneficial bacteria switch sides? Do they become destructive… mimicking symptoms they have always before helped to eradicate?

    In which case… maybe too much of a good thing is a bad thing?

    Here is a better, more effective approach.

    Balance of Power in Your Microbiome is the Ticket

    But here’s where balance comes in. If your probiotic provides a great deal more than 10 billion CFU per day, you need to get your doctor’s advice. There are some products that provide 40 billion…and others even 400 billion CFUs.

    And while these may be helpful in someone who has been seriously ill and may need a strong probiotic for a few days, it’s not that hard to introduce too much probiotic into your system.

    Overdoing It By Over Dosing Probiotics

    Can You Overdo Probiotics?

    When this happens, side effects can emerge. It may be as simple as stomach upset and diarrhea, which can be terribly unpleasant. Or as complex as mimicking severe psychiatric symptoms like depression or anxiety or panic attacks.

    We need to learn from each other, and from research, and take caution when we hear of bad experiences others have had from accidentally mismanaging their probiotics.

    While research has not caught up with the widespread use of probiotics yet — we don’t have hard and fast guidelines about exactly what, how strong, how much, how often and for what, exactly — we’re learning more all the time. And there are cases of those who took a misstep and paid the price.

    Here’s one example…something that could happen to anyone:

    Carolyn is a 64-year-old woman in excellent health who’s always been robust and energetic.

    She’s cared for pets and farm animals all her life and loves working with and riding horses. There’s nothing she’s afraid of… nothing she won’t try.  In a word, she’s resilient.

    Years earlier, Carolyn had suffered a knee injury that occasionally flared up. She had been taking large doses of ibuprofen that eventually irritated her stomach and led to bloating, shortness of breath, cramping, and bloody diarrhea.

    She was frustrated with the misery and prolonged diarrhea, so she sought the advice of her nutritionist. He suggested a potent probiotic that provided 400 billion CFUs a day until the bottle was empty.  So she followed his advice and took the whole bottle. At that point she was feeling wonderful… physically and emotionally. 
    Can you overdo probiotics? Sometimes too much of a good thing is a bad thing.

    She was wrapped in a sense of burgeoning wellbeing and decided if a little did a little bit of good…  Her nutritionist suggested if she was to continue taking the probiotics, she should cut her dose in half.

    She went to the store to buy another bottle and continued to take the original dosage without reducing them. What could it hurt?

    Four days later, she awoke in the middle of the night feeling anxious. Her heart was racing, her left arm numb, and she was lightheaded. Eventually, she was able to go back to sleep, but the feelings of anxiety kept recurring.

    Three more days passed. She was laying in her bed at night when gripping fear overwhelmed her. Her thoughts were racing out of control, she was lightheaded…she thought of dying, of losing her mind, felt detached and terrified.

    Eventually, the terrible fear subsided, the racing thoughts slowed down, and she realized she was going to be ok. 

    But she was shaken.

    Carolyn had never experienced anything like this before in her life. She’d always been resilient and solid…both feet firmly planted… through even the most severe crises in her life.  What had happened to her?

    Even though the symptoms had passed again, they recurred often and unpredictably the next few days. She researched frantically to find answers for what was happening to her.

    The only thing that was different in her life was the probiotics, which had quickly healed her stomach problems. Could it have caused these new symptoms?

    Then she found an article in Mental Health Daily about the side effects and adverse reactions to probiotics that people have reported. And there she found her answer.

    That if you take more than 20 billion CFUs (she was taking 400 billion CFUs) per day, you can get side effects. And anxiety is listed as one of them. Who knew? She stopped the probiotics immediately. And hoped it would help.

    To the Emergency Department…A Heart Attack?

    Then, the next day, she woke from a sound sleep and believed she was having a heart attack. With her heart beating out of her chest, thoughts of dying in her bed overwhelmed her. She drove herself to the ED to get help. (Maybe not the best decision, but Carolyn was an independent sort.)

    She told the emergency department personnel that the only thing in her life that had changed was that she was taking probiotics. The nurse sloughed it off and said, “Probiotics never hurt anyone.”

    Her EKG was clear, so they gave her a medicine to calm her and sent her home.

    Happily, three days after she stopped taking the probiotic supplement, the anxiety dissipated, and she felt like herself again.

    She wanted to throw a party to celebrate!

    Professional Nutritionist Baffled

    The fact that the ED nurse had no idea probiotics could do this comforted Carolyn. She felt embarrassed to have unwittingly taken too much probiotics for too long…but apparently even some medical professionals weren’t aware there could be side effects with probiotics.

    Later, she told her nutritionist what happened, and he asked her why she didn’t stop when he told her to???  

    She sheepishly explained. 

    Then he said, “In my 25 years in nutrition, I’ve never heard of side effects with probiotics!”

    Carolyn told him, “Well, it sure happened to me!”

    She’s been doing great ever since the whole incident and is elated to be herself again. But she learned a hard lesson. “Harmless” probiotics deserve respect for their power and impact on the human system.

    Can you overdo probiotics? Maybe, but if you get them right you'll have health and wellbeing.

    From now on, she’ll ALWAYS follow directions when it comes to over-the-counter remedies. And especially probiotics!

    The good news is that if probiotics can cause this much change in someone who’s healthy, they can also make a significant difference in anyone who’s not.

    Along with improving health in your stomach and intestines, as well as reducing inflammation and infection throughout your body, they can also relieve symptoms of depression and anxiety.

    But be aware, they’re not to be taken lightly. Experts say that since each individual is unique, there is no one-size-fits-all for probiotic supplementation.

    Remember: In general terms, up to 10 billion CFUs daily. Start gently. Watch for out-of-the-ordinary symptoms. A specific strain may not be right for you, or a specific combination. Take several days or a couple weeks to test the effects of partial doses, raising the dose a little each day as long as you have no negative symptoms. Include your doctor in the process.

    This story isn’t to scare you away from using a preparation that can help you become stronger and more resilient. But rather to alert you to possible risks if you use probiotics without supervision or awareness of potential side effects.

    One more piece to the puzzle of health and wellbeing.

    And speaking of wellbeing, how is yours?

    When Nothing Else Helps, What Then?

    The use of things like probiotics to strengthen your microbiome, and bioavailable curcumin to improve your health, your mood, and your wellbeing, eating a healthy diet that includes fermented dishes like kimchee, sauerkraut, and yogurt, along with frequent exercise and a good night’s sleep, can all help you to achieve wellbeing in your life and reduce stress.

    But some of us are genetically predisposed to certain conditions, or find that life stressors spark symptoms or depression, anxiety, PTSD, OCD, addiction, and even suicide.

    Maybe you’ve taken the medicines your doctor prescribes but don’t feel they work because you’re still not better. Maybe the wait, or the weight gain, or other side effects are all not worth it any more.

    If that sounds like you, you may be a candidate for the kind of forward-thinking, innovative ketamine treatment that we offer.

    Since the beginning of this century it’s been intensively studied for treatment-resistant depression, bipolar depression, suicidal thoughts, and now for other psychiatric disorders. In the last few years its use has become more and more widespread, and studies have proliferated to learn more.

    For those of us in psychiatry who are treating our sickest patients with it, it’s the most extraordinary medicine we’ve seen in 50 years. In fact, in our lifetime.

    Can you overdo probiotics? Maybe, but you can get well with ketamine treatment.

    Interestingly, it seems to have the most robust effects on those whose disorder is the most severe. 

    If that sounds like you, we may be able to help you get better.

    As we say so often, ketamine isn’t for everyone…  But nothing else available works so rapidly and so well for so many struggling with hopelessness.

    So, if you’ve endured symptoms of a severe mood disorder way too long, call us.

    We want to help you start your new year on better footing, with the power to enjoy your life and relationships, and contribute to the lives of others.

    Here at Innovative Psychiatry, we see people who’ve been depressed for years walk out with joy, hope, and the energy to engage in the things that are important to them.

    Give yourself the chance to really live.

    To the emergence of your best self, 




    Lori Calabrese, M.D.
    Lori Calabrese, MD offers innovative psychiatric treatment like IV Ketamine

  • BDNF and Microbiome: Your Paved Path to a Fulfilling Life

    BDNF and Microbiome: Your Paved Path to a Fulfilling Life

    BDNF and microbiome pave your path to fulfillment in life.

    Strengthen your microbiome, build up your BDNF: Live Better and Enrich Your Relationships

    Feel sluggish…like your brain is falling down on the job? “Why did I come into the kitchen?” “Where are my keys?” “I’m so overwhelmed…!” Wishing you had more physical and mental energy… and feel kind of foggy..?

    It’s not surprising if you do. It can happen to anyone, but there are things you can do about it.

    BDNF Grows Brain Cell Connections 

    We’ve talked before about BDNF (brain-derived-neurotrophic-factor) and how it works like a rich compost causing brain cells to branch prolifically creating a dense network of connections to move signals around and through the brain. 

    We talked about how the abundance of signals help you think more clearly and understand with more depth.  In turn, you have more neuroplasticity to change your perspective and your outlook to improve your enjoyment of life and the meaning you draw from it.

    BDNF and microbiome work together to help your life and relationships.

    Did you know there are things you can actually do to increase your BDNF, and in so doing, improve your sleep, your memory, cognition, and outlook?

    We’ve talked about the impact stress can have. How it prunes away signaling structures in the brain, wearing down and destroying synapses, and leaves you with a sparse number of connections between brain cells that slows down thinking, creativity, problem-solving, and hope.

    Brain Cell Connections Empower Life Connections

    Dr. Hannah Critchlow is a Cambridge neuroscientist whose work shows us how we form our own subjective views of the world. She weighed in on the effect of stress on your function as a leader in the workplace which also applies to your role in important relationships in your life, and basically your own well-being, as well.

    In a NYT article by David Donaldson April 4, 2018, she made the point that stress “seeps into the brain, and basically starts to damage the dendritic spines — the connections in the brain — so you get a much less connected brain and it becomes much more difficult to think flexibly and creatively.”

    She points out that research has shown that working out at the gym or going for a jog can help reduce the effects of stress on the body, and mental and physical activity can reduce the effects of stress on the brain’s functioning.

    And…since BDNF is such a huge boost for building synapses — those connections between brain cells — and improves resistance against stress – doing things that increase BDNF is the ticket. 

    BDNF and microbiome pave your path to fulfillment and leadership.

    Dr Critchlow says that some people have high levels of BDNF naturally. This certainly helps them with productivity when they’re under stress.  But for those who don’t, regular exercise can actually boost their own BDNF levels.  

    But there’s more.

    BDNF and Microbiome: There’s More To It than Exercise

    She emphasizes that beyond exercise, engaging in meaningful socialization and getting a full night’s sleep also boost BDNF.  Things like going to new places, exploring new environments, exchanging new ideas — both listening and expressing — also give more synapses a jump start.

    But here’s the rub. It’s tough to discipline yourself to regular exercise, go to new places, stretch your boundaries, and have stimulating conversations when you’re depressed and lack the energy to do anything. Even if you’re just feeling a bit blue.

    So Dr. Critchlow recommends developing an attitude of positivity, to keep those synapses growing.

    Her own hack is to maintain a gratitude journal…and she writes down 3 things at the end of every day she’s grateful for. Doing that helps her keep her mind focused to help herself think with more positivity as well as think about how she might pay it forward and help others have more positive days ahead.

    It’s also helpful to listen to your own emotions, and use them to try to pick up on key alerts within you… and try to make sense of them. It’s not always easy, but it helps to learn to let them inform our decisions, rather than pulling us down into a dark pit. 

    Sometimes the alert is about something or someone in our environment, and other times it’s about our own “slightly flawed view of reality.” Either way, it gives us something to work on or make new decisions about how to live better and help others, too.

    What Makes BDNF Increase?

    BDNF and microbiome can give you a path to fulfillment.

    So…since you and I want to live better lives, and enjoy richer relationships by deeply engaging in stimulating conversations… and reaching out to show interest in others, how can we increase our BDNF to help us have the energy to want to?  

    Harvard neuropsychiatrist John Ratey is the author of, Spark, The Revolutionary New Science of Exercise and the Brain. He stresses the importance of exercise for release of BDNF. From his point of view, exercise is more for the brain than the body. (Think about this and how important this might to you!) He says that it turns the power switch in the brain to ON. 

    But, if exercise isn’t the only way to cultivate the release of BDNF, what else can you do? 

    Well, one suggestion is to reduce your intake of sugar. Because it so happens that high glucose decreases BDNF release, the neuroplasticity fuel in your brain that helps you learn and change, and stimulates the very ability to learn itself. 

    Most of us are either trying to lose weight or avoid gaining it. (So we already have a guilt trip in place about our waist size.)

    Try this instead of self-reproach:

    Reach for a clearer mind, success in your work, and fulfillment in your relationships….  Make your diet decisions in light of your desire to enjoy your friends, your spouse, and your children. And to find work meaningful, to work more effectively with your coworkers, and to enjoy the success that goes with better team building.

    No guilt here. Just rewards.

    Give Your Pancreas a Break!

    Another method is to use short periods of fasting now and again. You can work it into your schedule daily like some do, or just plan it for once a week. For example, if you stop eating at 8pm, then go to bed and sleep from 10pm-6am and put off breakfast til 8am, you’ve given yourself a 12-hour fast and hardly notice it.

    BDNF and microbiome can help you bask in contentment like this woman.

    A 12-16 hour reprieve like this gives your pancreas some off-duty time and boosts BDNF. 

    This can increase the resistance to dysfunction and degeneration of those brain cells we talk about so often. The healthier and more resilient your brain cells are, the more resilient you are.

    There have been a number of studies focused on what happens to BDNF following intense exercise. One example involved a 3 minute sprint, followed by 2 minutes of rest, then another 3 minute sprint.

    Participants enjoyed a 20% increase in their learning ability immediately afterwards.

    You can, too. 

    Rich Socialization = Higher BDNF

    Did you know that children who grow up in a highly stimulating and engaging social environment display less anxiety and higher levels of BDNF? In addition, they develop better social behavior in adulthood as a result.  

    You can probably think of someone this describes. 

    Children involved in team sports with social activities that occur around their team are an example that comes to mind. The exercise, the sense of accomplishment, and the great times with their friends increases their BDNF — and their synapses — and their sense of well-being.
    BDNF and microbiome improve when you spend time with friends.

    But, this need for rich social interactions — and their benefits! — applies to all of us, even the introverts.  Rich socialization is about the quality, more than the quantity, of your relationships. And as long as there is quality engagement with people you enjoy stimulating your emotions and your mental performance, BDNF increases.

    The Benefit of Supplements

    Supplements can boost BDNF, too, and including them in your diet or supplement regimen can play an important role in your sense of well-being, emotional balance, and bright outlook.

    Krill oil, for instance, increases the omega-3 levels in your body, and one of the omega-3 fatty acids can help increase BDNF.

    Resveratrol is found in dark grapes and red wine. It can also help increase  BDNF, as can components found in green tea.

    And, curcumin can increase BDNF, so it’s not surprising that it’s being studied for its antidepressant as well as anti-inflammatory benefits. We’re learning that it may help prevent cognitive decline as you age. 

    BDNF and the Microbiome

    Add to those nutrients a regular dose of broad-spectrum multi-strain probiotics to strengthen your microbiome and your gut-brain axis, and you have the set-up to greatly improve your brain’s ability to produce and release BDNF, your sense of wellbeing, and your fulfillment in important relationships. 

    When diet is not enough…

    But what if you do all these things — really do them –and still don’t feel well?  In that case, you may need treatment to gain enough function so you can improve your outlook. 

    And if you’ve suffered with depressive symptoms for months or years and no doctor has been able to help you feel better, you may need a different type of treatment than pills.

    Some people need something novel…more advanced than pills.

    Consider ketamine.

    BDNF and microbiome may not be enough, so ketamine treatments can  can bring you to joy like this man.

    Ketamine treatment is a series of IV infusions that can turbo boost your BDNF to stimulate dense branching and new connections between the neurons in your brain. Its actions are so rapid, so robust, that you can begin to feel improvement within a couple of hours. 

    At Innovative Psychiatry, we’re witness to the transformation people experience with this extraordinary and effective medicine. Daily.  

    If you suffer with little to no improvement and need a real solution that can help you enjoy a rewarding life and fulfilling relationships, call us.

    We can help you find the you that seems lost and forgotten. The you that has ached for a chance to live … and love. 

    Reach out and give yourself the chance to enjoy. To love. And to be productive. 

    We’re in your corner. And we want to help you live the life you long for.                                            

    Lori Calabrese, MD offers innovative psychiatric treatment like IV Ketamine

    To the igniting of your very best self,

    Lori Calabrese, M.D.

  • Microbiome Gut-Brain Axis Influences Your Mood for Better or for Worse

    Microbiome Gut-Brain Axis Influences Your Mood for Better or for Worse

    New Research on How the Gut – Brain Axis Helps Improve Your Symptoms

    Microbiome gut-brain axis makes woman joyful and happy.

    You’ve heard the saying, “You are what you eat,” and you may or may not have bought into it. I know, I know… When someone starts saying things like that, you brace yourself for sermons on eating kale, removing the sugar addiction from your life, avoiding gluten, eating chia seeds.  And you may have thought to yourself, I can make my own choices, thank you very much! But the microbiome gut-brain axis can turn all sorts of things in your mental health around.

    An important part of your body is home to a ginormous community that actually affects your mood for better or worse… and your psychiatric symptoms, too.

    We’ve talked before about the microbiome and how it impacts your mood. Well, neuroscientists have been digging deeper to learn more. And knowledge is power. So let’s talk about how the organisms in your intestines impact your mental health.

    Did you know that you have over 100 trillion bacteria thriving in your body? This bacteria is not an invader to be removed. It is part of the balance you find all through nature and helps your body function — and your emotions, too.

    But what happens when something causes all these bacteria to shift out of balance? Like for instance, when you take an antibiotic? 

    It’s not hard to guess that when you take an antibiotic, it may destroy your good bacteria right along with the bad.

    Research Reveals Changes in Microbiome Gut-Brain Axis Trigger Mood Changes

    Well, when you lose the bacteria that are supposed to be living in balance in your intestines, you pay a price…every time.

    A team of researchers in China has published a review of some things research has revealed about your micro biome and what attacks on it can do to your mental health.

    Their work demonstrated a wide array of consequences you experience when you take antibiotics, when you take probiotics or prebiotics, or when you’re stressed.

    First of all let’s get a picture of where to find this community of microbes. 

    Microbiome gut-brain axis needs probiotics so this man will feel better.

    From your mouth all the way through your digestive tract…esophagus, stomach, intestines, and colon, there are trillions of bacteria helping you to stay healthy, and helping your body function properly.

    Along with similar pathways in your immune and endocrine (or hormonal) systems, these massive numbers of bacteria, fungi, and viruses create the microbiome brain-gut axis.

    And that connection includes the nerve cells that run from the brain throughout your body along the same pathway. As a result, the gargantuan community of microbes in your gut affect your emotions in dramatic ways.

    A team of researchers led by Lu Liu at China Medical University conducted a review of 41 international studies on the gut-brain axis which they published in May 2018.

    Stress Impairs the Balance of Your Microbiome

    One group of studies they reviewed showed how chronic stress changed the balance of the microbes, and that change resulted in depression.

    In contrast, they found that when they had a reduced amount of these microbes in the intestines, they had depression and anxiety.

    And that stress produces cortisol. But by introducing a certain organism, Lactobacillus rhamnosus, the cortisol production dropped, and with it so did anxiety and depression.

    Mood and Cognition Effects of Your Microbiome

    It turns out that organisms in the microbiome secrete neurotransmitters that improve your cognition, memory, and mood, as well as your sleep and appetite.

    In another study, bacteria from a person with depression were transplanted to a person without depression, and that person became depressed, too. (Pretty wild, right?) The reason is because specific strains of organisms cause depression, and when the balance of the microbes in a healthy person are thrown out of balance, depression-causing bacteria can swell and dominate the microbiome. 

    One research team found that when depressed people drank yogurt, a bacteria that fights depression, Bifidobacterium, increased in their system.

    Another team studied the microbiome in people with bipolar disorder compared to others without psychiatric disorders.

    People with bipolar disorder showed lower amounts of Faecalibacterium.

    Prebiotics Improve Mental Health

    It turns out that when you take prebiotics it can increase mRNA and brain-derived-neurotrophic-factor (BDNF).

    We’ve talked about how ketamine treatment turns on mRNA to increase BDNF which works like a compost to turbo-charge branching of synapse connections between neurons in the brain. 

    Prebiotics can help with that too. The more synapses that are developing, the more neuroplasticity is happening in your brain, and the more you can make the kind of changes in your thinking that will improve your overall mental health and wellbeing.

    In addition, we know that elevated cortisol is associated with anxiety and depression. When prebiotics are introduced, cortisol levels drop and with that, anxiety, vigilance, and focusing on negative thoughts drops, too.

    So what is the result? Happiness, confidence, energy to tackle challenges!

    What About Probiotics?

    Probiotics regulate the balance of the microbes in the microbiome. When probiotics in food were given to someone with anxiety and poor sleep regulation, that person’s sleep improved which reduced chronic stress and anxiety.

    Probiotics also changed the microbiome in the lining of the intestines, called the mucosa. This change resulted in healthier mucosa by reducing the bacteria that cause inflammation there.

    In terms of anxiety and self-criticism, probiotics demonstrated they could reduce self-criticism in those facing stressful circumstances, and improve their ability to evaluate and re-evaluate circumstances to foster better problem-solving.

    Antibiotics Change the Microbiome Gut-Brain Axis for Better or for Worse

    Depressed woman needs stronger microbiome gut-brain axis to feel better.

    One study showcased how reduced anxiety could follow the use of neomycin, bacitracin, and anti fungal medicines, which disrupted the balance of microbes.

    However, the BDNF also changed, resulting in slower developing of synapses…and depression.  But when the antibiotics and anti- fungal medicines were stopped, the microbes returned to a better balance, and mood was restored.

    In another study, introduction of infection-producing microbes resulted in poor cognition, reduced BDNF and dendritic branching, and increased anxiety.

    While more study is needed, there is a strong suggestion from all these studies that disruption in your microbiome gut-brain axis, including anything that throws it out of balance, causes not only the commonly known symptoms of infection but also various psychiatric symptoms as well.

    The effects of the state of your microbiome go both ways.

    Disrupt the balance and you’ll likely experience negative psychiatric and emotional symptoms.

    Build up the microbes that keep your microbiome in balance, and you’ll experience the rewards in countless ways … not the least of which is your emotional balance.

    Ok, we get it…

    Research Reviews Can Tell Us What We Know…

    They make it so beautifully clear. Elegant. Like it all makes sense. Until you realize that after you’ve read the review, you don’t quite know what to do. Next.

    Like how exactly to improve your gut microbiome. What to eat? What to buy?

    Food or powders or capsules or apple cider vinegar?

    How do we KNOW that our microbiome is improving? How long does it take — and how quickly can we wreck everything if we slip?
    If this doesn’t give you anxiety…..

    You Can Get Better… You Can Retool Your Microbiome and You Can Reboot Your Mood

    But how?

    Wonder how you can you retool your microbiome?  We’ve got lots of recommendations.

    Microbiome gut-brain axis can become depressed by antibiotics.


    So how can you reboot your mood? We’ve got the most innovative treatments available — if you need them, including ketamine infusions.

    Maybe you’ve found too little help from treatments you’ve tried that haven’t worked for you.

    You may need a more novel, advanced treatment like ketamine treatment to restore you to the best place possible for you.

    At Innovative Psychiatry, we see people dramatically improve and even achieve remission of severe treatment-resistant depression, and bipolar depression every week. We see marked improvements in PTSD, OCD, social anxiety. And we see people who struggle with addictions lose the drive to drink or use.

    In addition, and possibly even more important, we see patients with intense suicidal thinking just relieved of those thoughts. Usually within a few hours. They say that relief is not even the word.  

    Ketamine treatment can be transformative. From restoring the signaling structures in your brain along with restoration of other brain systems, to improving initiative while reducing – or obliterating – anxiety and depression symptoms.

    We love working with your psychiatrist and therapist and healthcare team to help bring about the rapid and robust benefits of carefully targeted ketamine infusion treatment.

    If you’re weary of treatments that don’t help, call us. We have the expertise and experience to get the very most from your ketamine treatment for you. 

    You can live a fuller, more rewarding, life.

    And if you’re using probiotics and prebiotics already, respond in the comments below and tell us what you use — and if they’ve improved your mood or helped relieve depression or anxiety. Sound good? Let’s share information about what works.

    Lori Calabrese, MD offers innovative psychiatric treatment like IV Ketamine

    To the restoration of your best self, 

    Lori Calabrese, M.D.

  • Gut-Brain Axis – How Your Gut Microbiome Communicates with Your Brain

    Gut-Brain Axis – How Your Gut Microbiome Communicates with Your Brain

    This young woman is enjoying her healthy lunch of fresh raw vegetables for feeding her gut bacteria to affect her brain through gut-brain axisYour gut-brain axis is one of of the most effective systems you can use to transform your mood. Really? Really. We’ve been talking about that microbiome eco-system community that lives in your gut, and how it affects your mood, your wellness, and your mental health. The gut-brain axis is the pathway of communication between your gut microbiome and your brain — and it’s the system that makes all this possible.

    The Gut-Brain Axis is Complex and Powerful

    By definition, the gut-brain axis is the two-way communication that takes place between the GI tract and the central nervous system, using biochemical components. They include:

      • neuroendocrine and neuroimmune systems
      • hypothalamic–pituitary–adrenal axis (HPA axis)
      • sympathetic and parasympathetic arms of the autonomic nervous system
      • enteric nervous system (the nerves the run through the gut)
      • vagus nerve
    • gut microbiota

    The Vagus Nerve Highway is the Gut-Brain Axis

    How does all this stuff work? Your gut microbiome combines forces with the nervous system in your intestines, your hormone or endocrine system, your neuro-immune system, and your autonomic nervous system. Then it sends signals along the “highway” of the vagus nerve from gut to brain and back to carry communication signals between the two. 

    About that nervous system in your intestines… The GI tract has been called the “second brain” because of its intricate network of mesh-like neurons that determine its function. In addition, it fits the “second brain” picture because of the massive trillions of cells that live there in the form of synergistic bacteria – which provide 75% more DNA than the human body does. And, because of the signals that are delivered back and forth to create equilibrium in the body and mind.

    The two-way communication between gut and brain occurs via hormonal and chemical signals like norepinephrine, serotonin, and tryptophan, as examples.

    Chart shows how gut bacteria affect the brain and body through the gut-brain axis.

    Gut Bacteria Can Undermine or Equip Your Mind and Emotions

    And let’s be clear: the operations between these trillions of bacteria work to help your body accomplish much of what it does. They also have a significant impact on your frame of mind,  your mental acuity, your inclination towards emotional distress – or toward recovery – and countless other feats.

    The purpose of this article is simply to show you there’s a highway between your gut and brain. And if you want your brain to fare well, treat the microbiome in your gut well. On the other hand, neglect it, and there’ll be dear prices to pay.

    Feed your gut with beneficial bacteria like lactobacillus acidophilus, and freight trucks will barrel up that highway to your brain bearing peace of mind, pain regulation, and stress management.

    But neglect it – feed it fats and sugars and keep your life idle and sterile – and a freight train will charge for your brain bringing infection, depression, anxiety, and insecurity.

    Studies Pull Back the Curtain

    Myriad studies have been conducted to see what the results are from this communication, from gut peristalsis, to immunity from disease, and emotional and mental well-being.

    In one study, mice born and raised in a germ-free environment had a very weak microbiome and showed a panicked reaction to difficulty. On the other hand, when certain beneficial bacteria from a broad and healthy microbiome were given to these mice, they reacted with a calm confidence in managing the high-risk situation.

    Then in another, mice were injected with the fecal matter from people with depression. (Remember, the microbiome lives in the intestines so the fecal matter contains a sample of that microbiota). The normally carefree mice showed signs of depression and anxiety. When they were offered sweet water as a treat, they turned it down, and through a variety of tests displayed anxiety with more and more intensity. So in their case, their behavior dramatically changed when microbiota from a depressed person entered their body.

    And in still another study, 22 healthy men were given a capsule that contained bifidobacterium longum for a month.  Remember this one? – it reduces cortisol, the stress hormone. You won’t be that surprised to learn that…you guessed it…they reported feeling less stressed.

    You Can Change Your Personal Outcomes

    The point is, even though you have neurons throughout your body, nearly three-fourths of those outside your brain live in your intestines, and are connected to your brain by way of the vagus nerve “highway.”

    It’s not that easy to just trade in your current microbiome for another. But, you can definitely influence the balance between beneficial probiotic organisms and those that cause dis-ease. In other words, those that make you sick or miserable on some level. They foster stress, depression, agitation, anxiety, and mental distress. To gain beneficial balance over the dis-ease, feed your microbiome probiotics and prebiotic foods.

    Those prebiotic foods include non-digestible fiber that you find in raw foods like garlic, jicama, onions, leeks, and artichokes. They feed the Raw veggies that feed the microbiome and gut-brain axisprobiotics and improve your digestive processes. Remember, as silly as it may sound, probiotics eat prebiotics, so feed them well!

    You can take that information and change what you do. Trade computer and TV time for gardening and working out. Eat healthy foods to reduce inflammation, improve immunity, improve mood, reduce your response to stress, and create an inner peace and tranquility you may not have imagined.

    You Really Can Change Your Destiny Through Your Gut-Brain Axis

    Meanwhile, as you work to improve your microbiome, we can improve your well-being from treatment-resistant depression and anxiety. If you need help gaining a brighter outlook, let’s talk. Because with the use of advanced psychiatric treatments like IV ketamine therapyTMS treatment and medications, you can experience a real improvement, and still keep getting better through your improved microbiome. Contact me and let’s work through this together, step-by-step.

    To your ever-developing best self,

    Lori Calabrese, MD

    Lori Calabrese, MD offers innovative psychiatric treatment

  • Your Microbiome: How It Affects Your Mood

    Your Microbiome: How It Affects Your Mood

    Young woman buying fresh vegetables to support her microbiome and moodWhat Is Your Microbiome and Why Does It Matter?

    In the last five years, researchers have learned more and more about the the organisms in our own intestinal tract, our microbiome. Let’s talk about the connection between those organisms and their affect on our physical and mental health, for better or for worse.

    The types of specific organisms that flourish there have a strong influence on the function of the brain and nerve pathways — and, therefore, on your mood and peace of mind.

    What does Depression have to do with your belly?

    Anyone who suffers from depression may know there’s an inherited tendency for that to occur. If either of your parents also struggled with depression, the chances are stronger that you might, too. But beyond your own personal DNA, there’s another huge area of DNA that may influence the moods you experience far more.

    Deep within your intestines is a community of microscopic bacteria which are both helpful and harmful. This community of trillions of mutually beneficial microbial cells make up the bacteria of your gut. We call it your personal microbiota. Each of these cells contains genes, and the combination of the genes in all of them is your own personal microbiome.

    If the genes in your microbiome influence low stress and a positive outlook, the effect on your mood is likely to be positive. But if the genes in your microbe-flourishing gut are  favorable to high stress and melancholy, the impact on your outlook is likely to push you into a rut of stressed living.

    For the most part, this microbiome is friendly and beneficial to your digestion. It makes use of far more nutrients from your food than would be possible without it. However, in recent times, scientists discovered that this same community of bacterial organisms are to blame for inflammatory and autoimmune diseases like atherosclerosis, asthma, and autism.

    You can change your life

    Learning to understand the microbiome and even influence its effect is potentially a superbly rewarding endeavor.

    So we have to ask: if this teeming ecosystem of bacteria in our intestines can accomplish good productive health-promoting feats, or trigger destructive diseases that can cripple us for life, is there a way to affect this microbiome so it does good and not evil?

    To better understand the answers to this and other questions, we need to understand how the natural flora in the gut exchanges information and products with the brain.

    The vagus nerve can bring the strongest guy to the ground

    And it turns out there’s a nerve that connects the two, called the vagus nerve.

    Have you ever seen someone faint at the sight of blood? This fainting reaction happens when the vagus nerve tells that person’s brain to suddenly dilate blood vessels in the body, which results in fainting… and they go out like a light.

    It’s the reason that you might see a picture of something gory, and feel a sick feeling in your stomach right before your brain declares “lights out” and you fall to the floor. It’s the vagus nerve that sends those signals.

    So with that in mind, what does the vagus nerve communicate to the brain, and what determines that choice?

    Think of it this way:

    When friendly, health-promoting bacteria ( probiotics) dominate the environment in your gut, those bacteria tell the brain that the environment is favorable for an upbeat mood. Then the sullen melancholy feelings mysteriously melt away. Nutrients and protein are sent to the brain to nourish that upbeat mood, and your glum outlook subsides.This lady is relaxed and upbeat because of favorable microbiome in gut.

    But the opposite is true if the dominating bacteria promote depression, stress, and anxiety.

    The gut is the largest organ in the immune system? Really??

    The gastrointestinal system is the largest organ in the immune system. This flourishing ecosystem of bacteria can have a positive or negative effect on other aspects of your well-being. So it’s important to your daily welfare to understand how this happens. Then you can take action to promote the best possible environment in your gut for your best well-being and mental function.

    Certain bacterial families weaken your immune system, decrease your confidence and emotional stamina, and promote a chronic long-term condition of high stress.

    Others reduce stress and promote wellbeing and resilience.

    Studies have shown that the more extreme stress is in your life, the community of symbiotic organisms in your gut will create a favorable environment for chronic stress, and unfavorable for mental relaxation.

    Stress or Relaxation

    Just as “birds of a feather flock together” so it is with these organisms. If you allow stress to go unchecked, the bacterial environment in your gut will shift. And it will come to match that ecosystem of stress and illness. Over time, you’ll find you feel locked-in and stuck in that stressful lifestyle and the outlook that goes with it.

    But, it’s also possible to actually change the environment in your gut. It can be made to support low stress, an upbeat outlook, and energy to enjoy life. And you can do it through the foods you eat, the things you do for pleasure, the amount of sleep you get, and more.

    For instance, studies have discovered that when lab animals were given probiotics, their high anxiety behaviors were calmed and their immune response was normalized, as well as their apparent relaxation.

    Psycho-biotics

    If probiotics do that much for lab animals, how much more will they do for you?

    Certain bacteria in specific families are considered “psycho-biotic” organisms because, like the probiotics just mentioned, they have an antidepressant effect on the brain.

    Further, through systems involving these gut microbes, nutrients are processed and passed through the blood-brain barrier. That improves the relaxation of processes that take place in the neurons. (The nerves that carry information signals to and from the brain.)

    The point here is that these probiotic systems are even equipped with a transport to make sure the right nutrients reach the brain and produce the hoped-for results.

    This is all great news for those of us who feel we drew the short straw concerning mood disorders in our family tree. It turns out that by investing in the mountain of genetics in our gut microbiome, we have the power to turn our genetic destiny on its proverbial ear.

    Watch for my blog next week.  Learn more about good microbiota to nurture. See a list of actions you can take, foods you can eat, and factors you can include in your daily life. All of this will ensure your probiotic heroes are flourishing in your gut promoting your best, most productive, and well-adjusted self.

    To the flourishing of your best self,

    Lori Calabrese, MD

    Icalabrese-0195_g_crop-webf you’ve suffered from depression, anxiety, or other mental health obstacles and have not had relief, Dr. Lori Calabrese, MD offers innovative psychiatric solutions. Contact us here for an in-depth evaluation. We’ll learn which solutions could work for you best and transform your life as you know it. We’re here to help you find your very best self.

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