Category: Optimal Wellbeing

Infrastructure for Optimal Wellbeing by Lori Calabrese, MD | The Ketamine Blog

Optimal Wellbeing. Something we all strive for, right? Something we wish for. But it’s so hard to achieve. Even so, we keep trying…and trying. But here’s what we’re talking about… We’re not trying to portray a utopia but rather ways to improve your thinking to help sustain the good sense of wellbeing you may have gained after your ketamine treatment. We want to help you build infrastructure for optimal wellbeing.

Look at it this way. Sometimes when you’re depressed for a prolonged period of time as in …maybe …years…? It colors the way you see everything. And it’s human nature to try to fit your philosophies of life to the way you feel. The result is a mindset that may pull you back into depression.

So it’s extremely important to your recovery and remission to learn to think about things differently in a way that supports a brighter outlook on life.

Because, while most psychiatric disorders have genetic links, the symptoms can be worsened by counterproductive, if not destructive, thinking patterns. To live well, with hope and continued initiative, just may require that you change your mind.

So the basis upon which you base your approach and reactions to life can undermine your progress …or spur it forward.

In these articles about optimal wellbeing you’ll read about facing the truth about your own motives and intents. You’ll also read about nurturing an attitude of gratitude to cultivate your own wellbeing.

There’s information for applying the science of happiness and the science of joy in your life, and for developing and using persistence. Things like this constitute your personal infrastructure that will support you with resilience in the face of challenges going forward.

And this infrastructure for optimal wellbeing can help your remission stand strong. Which makes life better all the way around.

See you inside.

Reduce Stress and Stay Safe This Holiday Season

Although some things are easier said than done…

Cecilia and Ben have been working remotely since March 2020, so they both work in their home. They’ve faced the challenge of setting up work spaces in their home so they both have privacy for their online meetings. It took some doing, moving furniture, opening up areas and storing what they could when they’d rather be relaxing on the weekend. It’s all been about reduced stress and staying safe and healthy.

So they’ve adapted. And have designed their lives around working remotely in their own spaces. For their own wellbeing and for everyone else.

They’re very careful about avoiding exposure to SARS-CoV-2, the virus that causes COVID-19. Twice a month trips to grocery store with gloves and masks. Very cautious.

Cecilia also has concerns about managing her bipolar disorder. With the help of medication, she manages fairly well. But she and Ben are careful about avoiding stressful situations to help with her stability.

They were invited to share Thanksgiving with Jake and Robin, Cecilia’s brother and sister-in-law…so they discussed–again, at length–how careful Jake and Robin were about isolation and precautions, and were assured they were extremely cautious. Both couples agreed to a COVID test the week before the holiday. All four tests came back negative.

Halfway through the day on Thanksgiving, they were enjoying a quiet time together chatting as they prepared the meal.

Suddenly, the doorbell rang. Jake and Robin looked at each other puzzled as if to say, Are you expecting anyone? No… are you?

When they answered the door, a jovial group of 8 more people roared Happy Thanksgiving!!! and charged through the door. The eight people included the Robin’s cousin, his wife, their 5 children, and Cecilia’s elderly mother.

Jake and Robin stepped out of the way, baffled, shocked, and horrified; Ben and Cecilia were equally horrified. Grandma came in with her walker. Four children ran through the house, and a baby in a carseat wailed from her position on the floor.

After quick greetings, and well-intended but strained smiles, Jake asked the parents of the wild offspring if they’d had recent COVID tests and they laughed and said, “No, of COURSE not!! Don’t you believe that whole COVID propaganda, Jake!! Relax! It’s Thanksgiving and it’s time for family!!!”

The new arrivals then commenced to talk about a party at another cousin’s house a few days before and what a great time they had.

“A party? How many were there?”

They held their breath.

“Aww, I don’t know… 30 or so. You should see Tom’s oldest. She is really grown up!”

So Robin said, “You know what? We love you guys and it’s great to see you…but we take this pandemic pretty seriously. We each got a COVID test last week to be sure we didn’t have the virus to expose to each other.

“We don’t want to hurt your feelings but until this COVID thing is resolved, we’re not letting anyone be here in the house who isn’t carefully isolating, using precautions, and can show a negative test result. We’re really concerned about Mom, too, because she’s high risk–she’s vulnerable to the virus and all kinds of complications. And she’s being exposed to you guys today. You’ve been with at least 30 people who may or may not have COVID, so now she has been exposed to those 30 people, too.

“To tell you the truth, you should all put on masks, and you should take her home. We can see that you don’t feel as cautious as we do, but we just have to protect our health and others the best we can.”

With bruised feelings, the cousins and Grandma all accepted masks to wear and loaded back into the car. They weren’t happy about being sent away without welcome. To say they took it personally would be an understatement.

The following week, Callie got a phone call from her mom. Her mom had not been feeling well for a couple days, so she went to the ER. With a history of heart trouble and asthma, she was worried. The hospital COVID test was positive, and Grandma was admitted to the ICU. Within 4 days, her breathing had deteriorated, and become very difficult, so her diagnosis was upgraded to COVID and pneumonia. Doctors said it was grave.

About the same time, Ben started feeling symptoms of severe fatigue, shortness of breath, and intestinal cramping. Cecilia drove him to a drive through testing center for another test. It came back in two days — positive.

Ben was the sickest he’d ever been. So weak he could barely walk to the bathroom. Cecilia tried to keep him quarantined in the bedroom. And she wore a mask and gloves and washed her hands often. After about 16 days, Ben began to improve. And Cecilia was weary and discouraged.

Cecilia’s daily calls to the hospital to check on her mom were frightening. Heartbreaking. Her mom was now on a ventilator. And her cousin’s wife was also sick with COVID.

After taking every precaution, Ben and Cecilia still found themselves exposed to COVID and were facing the possible loss of her mother. Their fear and grief were only surpassed by their profound frustration and powerlessness. They really thought they could reduce stress and stay safe for Thanksgiving.

You just never know, do you?

But all the more difficult, Cecilia’s bipolar depression symptoms were rearing up in the face of the deep frustration she felt. First frustration, then anger, then rage…at her cousin who ignored all the warnings and put her mom and everyone else at risk.

She could feel her mood moving from neutral to a dark melancholy… bipolar depression was looming… she could feel it coming on.

Oh no. How would she get through this and when her mom was in ICU? What if her mom died? It was all just too much. Her hope was dwindling. She felt both agitated and defeated… Even though she didn’t contract COVID, those around her who did played a role in her own condition worsening.

Reduce Stress and Stay Safe at the SAME Time

We’ve talked about how stress has become a traditional element of the holiday season, as we’ve allowed our traditions to become obligations. And how the stress that results from all those insurmountable obligations actually creates misery, sickness, and destructive conditions like depression and anxiety symptoms. So that to reduce that stress we need to make some hard decisions that put relationships and our own peace before the race to “get it all done.”

We’ve also talked about how this holiday season 2020 is unique because COVID cases are increasing so fast that we’ve been asked not to travel, and to limit the gathering in our homes to those who live there–and possibly one or two who’ve tested for COVID and received a negative result, and who are extremely careful about isolation and protection.

Of course, this appeal ricocheted around the internet and news media before Thanksgiving, and some heeded it. Many others ignored it.

Aside from the precautions for limiting spread of the virus that is causing the COVID pandemic, there is another issue that deserves attention. That’s the tension, anxiety, and depression symptoms that can be relegated to the ongoing news about the virus and the damage it can cause.

Add to that the conflict that arises when individuals hold opposing opinions about their decisions for celebrating the holiday… and the disagreements that erupt. Yikes.

This time of year is celebrated as a time of giving and receiving love and connection with friends and family. To worship true to your conscience, and hopefully be refreshed. Don’t you agree?

So what can you do when friends and family stir up conflict?

We all know someone who stirs up conflict wherever they go. The Button Pusher.

Then there are those who find their fuel by subtly inflicting guilt. We love them but we hate the guilt trips.

And every group has someone looking to push the crowd into doing something they don’t want to do…

Yours isn’t the only family with these delightful people.

Aren’t you glad?

The Good News. Disconnect your buttons before you have contact with the Button Pushers… Turn off your guilt switch and let the guilt purveyors buzz away while you walk away. And those Mr. Pushy types? Just say NO.

More good news: This is the pandemic year and it’s not recommended that you travel or join other households for the celebration. So contact could be limited to a ZOOM meeting. When it’s over, it’s over…!

This is a year to consider fewer gifts and more emails, cards, letters, especially those cards with pictures enclosed or attached. Share your news without exposing yourself, your family, or the vulnerable family members to potential illness.

Let the pandemic die down. Give the vaccinations some months to do their job. And let’s save Winter 2021 to hopefully move around the country and spend time with those we love.

Reduce Stress and Stay Safe — Enjoy the Holidays and Enter 2021 Healthy and Happy

And… if your efforts to reduce stress and stay safe are undermined like Cecilia’s and Ben’s were, you have options. They may be as simple as isolating and watching Christmas movies together, with popcorn and mugs of hot chocolate. But if you symptoms rise and intensify, if your medications aren’t effective in managing your symptoms of depression, bipolar depression, PTSD, alcohol use disorder, substance use disorder… IV ketamine treatment may be a very real and lasting help for you. It doesn’t work for everyone — because nothing works for everyone — but it can be extraordinarily effective even when everything else has failed.

With a series of titrated ketamine infusions personalized specifically for you and your response, you can feel like your best self again. Think back to the last time in your life when you were at your best self for a good stretch. Ketamine treatment can help you feel like that again.

It can be amazing, and has a remarkable effect on the structures in your brain. You can feel restored, with the energy to give your best on your job and in your relationships, with improved creativity. And hope.

At Innovative Psychiatry, people with these conditions and more come through every week. We have an atmosphere we keep safe from the spread of COVID due to 21st century plasma cell technology we’ve installed that destroys the COVID virus in the air and on surfaces. With the technology available anywhere to keep our air and surfaces COVID-free, and meticulous procedures in our office, you can come for treatment with confidence, and relax in a quiet private treatment room with reduced stress where you can stay safe.

Above all, take very good care of yourself, your health, your outlook, and the wellbeing of your family.

We care about you, and we’re here to help you experience relief of symptoms and the power to enjoy this time of year by enjoying what you love and those dear to you.

If you want to see what IV ketamine treatment can do for you, call us.

We understand and can help.

To the restoration of your best self,

December 14, 2020
Thanksgiving Day 2020 Holiday in the Pandemic – Learning New Ways to Share

We’ll never forget 2020. For the COVID-19 pandemic, for the social and political turmoil, for the economic struggles and adjustments that have accompanied all of it.

And we’ll never forget the Thanksgiving Day 2020 holiday when people stayed home, meals attended by only a few, while watching the graphs of COVID cases, hospitalizations, and deaths skyrocket.. When the SARS-CoV-2 virus surged and spread around the world, and faster in the US than anywhere else. And families were isolated at home or in the hospital, rather than gathering. But the truth is, we’ve lived an historical event since January. It will be in the history books. But for now, what do we do with it?

Well, maybe a good place to start is with Giving Thanks. You may have lost loved ones this year, maybe even from COVID-19, or you may just miss them during the holidays because they’re gone…

There are plenty of reasons to be sad, or angry, or frustrated. There are also reasons to be thankful.

Choose Gratitude No Matter What

A study at Berkeley found that people who practice gratitude on a regular basis have healthier emotional lives, are happier, and build resilience for tough times ahead.

In addition, the more often we practice and feel a given emotion, the more space that emotion occupies in our psyche and becomes the mood we live within.

Honestly, during terribly difficult and turbulent times like 2020, you get to choose your frame of mind. The way you see your life. If you tell yourself that life conspires against you…c’mon now…be honest…. If you tell yourself that you’re a victim of some villainous force, then you will believe yourself, and live within a life of self-pity, blame, despair, powerlessness or bitterness…that’s all you’ll have.

But. if on the other hand, you tell yourself that you’re blessed in numerous ways…list them!…that life is working in your favor no matter what the challenges….you’ll feel gratitude, inspiration, and the power to make your life what you want it to be.

For the Thanksgiving Day 2020 holiday, you can make the most memorable experience by applying gratitude.

Gratitude … expressing how grateful you are… is practice toward underpinning your brain’s circuitry, and strengthening your resilience. And doing that helps you see the good in challenging circumstances.

Because, truth be told, you want to be resilient and healthy, and we want that for you. During Thanksgiving, as you and your loved ones make decisions geared at the wellbeing of everyone involved, you need resilience, love, and the ability to adapt.

First, for the older members of your family, and those with underlying or chronic conditions, this is not the time to take chances.

The increases in SARS-CoV-2 burgeons on. It’s far better to love your vulnerable family members to stay home and celebrate with you over FaceTime or Zoom, rather than risk their being infected, hospitalized, and worse. Next Year. Thanksgiving 2021 should be a holiday — hopefully — when you can all safely be together again.

But for this one Thanksgiving, when you sacrifice face to face contact, you can yield a life shared for years to come. And don’t travel, or let anyone come to you who has to travel. The risks right now are only increased by transportation that involves contact with others.

Second to that, only those who you’ve been around and KNOW their attention to isolation, distancing, and precautions, are the ones to be allowed near you during the holidays. Maybe two or three trusted friends or family…? If anyone comes to visit, insist on a COVID test before hand within time to get the results. All the rest can visit you online, but confine their exposure to those who live within their own homes.

And third? Well, here’s a suggestion:

Share your love and gratitude with those important people who can’t be there. Write the gift of a letter to each one with a list of why you’re thankful for them, or to remind them of a memory you share together. Find a way to shower your family with love, without face to face contact.

Choose Warmth, Kindness, and Generosity for an Unforgettable Thanksgiving Day 2020 Holiday

By choosing the frame of mind you want during this holiday time, by putting to work all the best safety precautions, by carefully selecting anyone from outside your home who joins you, and by reaching out to loved ones with love through email and gratitude, you can have the happiest and most fulfilling holiday in memory.

In the face of the pandemic, and the changes it causes, ADAPT. That’s how you survive and overcome difficulty. By adapting and applying new approaches. And enjoying them.

At the same time, if you find yourself depressed, or caught in the throes of PTSD, or struggling with alcohol use or substance use, or social anxiety, IV ketamine infusions can really help.

At Innovative Psychiatry, we’re fully functional in spite of the pandemic, with newly installed technology that gives you and our staff the best possible protection from COVID-19 in our offices.

We continue to serve as an essential service and we’re here for you when you need ketamine treatment.

There are lots of things about holidays and gatherings that unsettle and trouble some people who already suffer …

If oral medication hasn’t worked for you, if you’ve suffered from your symptoms that nothing has relieved, call us.

We’re here to help you in a safe and supportive environment.

You’re not alone.

To the restoration of your best self,

November 23, 2020
YOUR Response to the Second Wave of COVID: Fear, Anger… or Acceptance?

“The second wave of the coronavirus has begun,” they tell us.

They say we’re in it now, and this will be worse than the first. How do you respond to announcements like this…with fear? Terror? Maybe anger? Some will… but you do have a choice. You don’t have to be the victim of your emotions. You can respond to the second wave of covid: fear, anger, or acceptance and common sense, rather than react instinctively.

Fear and anger trigger the fight or flight response…think about it. Have you noticed fear and anger in yourself or in the people around you during the first wave? It’s probably safe to say we all have.

But think about this. This is the second run. COVID-19 is no longer a surprise… You’re experienced at dealing with it. You know all about wearing masks and gloves. About staying inside and wiping down your home. Washing your hands. Maintaining distance from people when you have to go out.

You’re an old pro at dealing with Covid-19. Just look at your muscle bound, highly skilled self.

There really isn’t anything to fear… is there? Not really?

Common sense says to take precautions. Wear a proper mask. Avoid contact with others. Maintain at least 6 feet from others in public. And to not push the envelope.

So…What’s pushing the envelope?

Gathering with others assuming the mask is enough. An infected sneeze or cough may actually not be enough. But if you confine your gatherings to Skype, Zoom, FaceTime… Sneezes and coughs from others can do you no harm.

Common sense.

On the other hand, if you succumb to your emotional gut reactions of anger or fear, the likelihood you’ll make risky decisions heightens the danger that you’ll inadvertently expose yourself to the coronavirus.

Is your response to COVID: fear, anger… or acceptance and common sense? Are you a supporter or a discourager? You have a choice.

And if you get sick, people around you will get sick, and the second wave of COVID-19 wreaks havoc on more lives.

In this second wave of COVID, you can not only choose how to spend your time in safe ways and safe places, but you can also set an example for others who haven’t really thought all this through.

You Can Be the Voice of Reason and Common Sense

So how will you respond in the second wave of COVID: fear, anger, or… acceptance and common sense?

Will you lead or follow? Either way, you can hopefully find the wisdom and sense of safety that goes with protecting yourself and your loved ones.

That’s what we’re doing here at Innovative Psychiatry. We’re using caution, a commitment to protect our staff and our patients, and we’re fueled by common sense , CDC guidelines, and state and local guidelines. We have the latest plasma technology air filtration system. (We’re all about innovation.) With social distancing, masks, faceshields, and gloves for ketamine treatment, and telepsychiatry for our psychopharmacology patients, we can help you safely.

But…what if you’re overwhelmed with fear… and it won’t calm down? What if rage keep growing, on the verge of exploding, no matter how much you try to be rational and calm?

When Fear Seems to Swallow You Up…

When that happens you may need additional support. You may need an antidepressant or talk therapy. But if you’ve tried other treatments and they haven’t helped at all, you may need ketamine treatment.

Ketamine treatment can restore the connections and structures in your brain that give you the ability to cope and to hope. When you can cope, your patience increases, your outlook brightens, and your inner strength grows.

Hope helps you see past the current pandemic, realizing that your life lies ahead…and that the pandemic will eventually pass and your life will still be there, ready for the new choices you make as you flourish.

Ketamine treatment also can enable you to feel joy, and to enjoy experiences even when you’re isolated. It can empower you to build a happy and rewarding life, and rebuild healthy relationships.

And when that happens, you can respond to COVID with kindness, caring, patience, and endurance…and help others around you achieve that peaceful frame of mind, too.

Because the COVID-19 pandemic is temporary. We’re all in it together. Let’s truly be with each other, our families, and our friends. Let’s look forward to our future.

To the restoration of your best self,

July 27, 2020
For Relief From Misery in These Difficult Times – Be Kind and… Compassionate

You see them everywhere… t-shirts proclaiming “In a world where you can be anything…be kind.”

Does that make you roll your eyes? Or does it affirm to you to focus on the way of living that can help us all get through these difficult times? Because in times like these, with upheaval, disruption from a pandemic, and hurting people everywhere, there is a shortage of generosity, support, understanding. So be kind and compassionate to everyone you meet, show gratitude for the little things, and you may find the struggles shrinking and becoming more manageable.

Kindness makes some people shy away. They don’t like the word. Makes them feel weak. But kindness is actually rooted in courage—the courage to do the right thing—and in strength to keep doing it even if your kindness is not acknowledged

Did you grow up in a kind household — or one where you felt undervalued and roughly handled…? It matters, you know. When you never see kindness, it’s not so easy to create it yourself, is it?

And yet, ask yourself: If you were surrounded by kindness, kind words, kind actions, and kind support, do you think you’d find that annoying…or would you possibly begin to bask in the safety and nourishing of it…? The fact is: we all need people in our lives to be kind and compassionate, and when they aren’t… we find ourselves lugging around a burden of isolation and neglect.

Healthcare Workers Give All They Have to Give

The world is in turmoil, and it doesn’t feel all that safe these days, but you do have the power to change it. One kind act at a time.

Isn’t it amazing how hard it is for humans to experience change? I heard someone complain that he liked to travel, and the forced quarantine was really causing him to chafe.

In his case, he wasn’t sick, wasn’t laid off, wasn’t struggling financially …but there was a mountain of inconvenient changes in his plans. A nice guy, a wonderful person…. but enforced changes were pressing on his comfort and stirring up…what? Impatience? Irritation? Annoyance?

So we have a world in turmoil, and it is forcing us to change our normal way of living. Some are suffering severely right now, and they need us to care, to listen, to show patience. You don’t know who they are — with a few exceptions, maybe, in your circle — but that’s why you need to be kind and compassionate with everyone because it’s the best response to those you don’t know.

Healthcare workers in hospitals, for instance, infected patients fighting for their lives, or the families of those who have lost the fight. These brave and heartbroken ones need your kindness and support most of all.

When you’re impatient because someone is standing at the checkout at the store too long…and you’re tempted to start throwing up your hands and saying, Move Along, Already!!

Stop.

Take a breath. She might have spent the last 14 hours with a mask on trying to save a patient’s life…only to watch him die. Be KIND.

Job Loss and Income Reduction Is a Part of Life Right Now…

Then there are those who suffer because of job loss, lack of sufficient income, and scads of difficulties caused by it. They need kindness and support, too.

The Guy At the ATM Who Keeps Sticking in His Card

…and you wait and wait.

Don’t HONK.

It could be that the last funds are gone from his account because of his reduced income…and he’s trying to find a credit card to borrow from.

Have compassion…he’s in a serious crisis. Because his family needs food, gas, and diapers.

Remember to Care.

But there are millions of us who are frustrated by the changes in our routine, changes in our access to stores and restaurants, changes in our lifestyles. Changes.

Be kind and compassionate because you need others to be kind and compassionate with you.

You can allow those changes to give you permission (or an EXCUSE) to treat others badly, or you can use those changes as fuel to empower you to lift the outlook of the people around you.

So what can you do to ensure you have more kindness to give to others?

Start, by nurturing yourself. Do things for yourself that improve your own sense of fulfillment, your own stores of patience. Soothe away the day’s tensions in a hot shower or go all out in a hot bath. Go fishing and listen to the quiet sounds of nature. Spend time with someone who is important to you…

It’s true that it’s terribly hard to offer patience, kindness, understanding when your own mind is raw with tensions, burdens, and mistreatment. So DO SOMETHING everyday that’s just for you.

Then, when you mess up, make mistakes, even bad ones, give yourself patience, kindness, and forgiveness. Because it’s in practicing kindness toward yourself that you learn to cultivate kindness and patience toward others.

Unhappy people often rail on themselves when they make mistakes, or fail in some way …. but truly, in order to be kind to others, you need to show yourself abundant kindness. (Abundant kindness, you’re thinking. What is that, even?)

In a World Where You Can Be Anything, Be Kind.

If you’re the first to respond to someone’s struggle, start with compassion. Show you care. Then, as you provide support, do it with kindness and patience.

And you know what??

To be kind and compassionate yourself brings more happiness to you…and to them.

Have you heard of a “WIIFM”? …. No..? So what’s a WIIFM? It’s finding out “What’s in it for me???”

When you are already happy, doing kindness for others, showing patience, doing something that adds to someone else’s happiness… these things make you happier too!

This very idea was confirmed in a study by a team social researchers led by Keiko Otake. Their results showed that when happy people actually count the number of times each day they show kindness, it makes them even happier. In addition, they found that showing kindness increases their own sense of gratitude in the simple things of life.

During this disruptive time, finding joy in simple things, and expressing gratitude for them, can be a path to peace and increasing joy in spite of circumstances. And it can be contagious.

Delivering kindness to those in your circle can spread gratitude and joy to them, who in turn may offer more kindness to their own circle. At the same time, offering generosity and kindness stokes the fires of happiness within you, too. So crank up happiness …be kind and compassionate every day. All day.

It will transform you.

And What If You’re Just Tired of the Struggle? What if You Can’t Muster Joy, Patience, or Even the Power to Care?

Sometimes the prolonged stressors of times like this can wear down your resilience. Sometimes, no matter how deep you dig within yourself, you can find no joy, no hope, no energy to cope with anything.

And sometimes, if you live with depression, if you’ve been bruised by trauma, not even your antidepressants can help anymore. In spite of your medications, listlessness takes you over.

When that happens, you can reach out for ketamine treatment.

Stress prunes the dendrites and dendritic spines that build the synapses in your brain. Those connections between the brain cells that communicate and help signals travel with speed and abundance. They become broken down, sparse, weakened.

But since ketamine turns on mRNA and switches the DNA to “ON” to produce brain derived neurotrophic factor (BDNF), all that new BDNF turbo boosts the replenishment of these connections, and triggers a cascade of changes. The result — for many people, though not all — is a rapid and robust improvement in your outlook, your hope, your energy for challenges, your motivation and initiative… and you can feel tremendously better. Like renewed. Pretty much well.

It can be extraordinary. Life changing.

Then, keep building that wellbeing with kindness, warmth, generosity…giving your best to lift and support those in your path.

At Innovative Psychiatry, we continue to be an essential service, and are set up to provide you with ketamine treatment in a safe environment.

While none of us knows how long the precautions and ups and downs of the pandemic will last, you can reach out for the help to be who you want to be, for yourself and everyone around you.

You don’t have to be dragged down by the stressors of this pandemic. You can rise higher than the challenges, and sprinkle kindness in your wake.

We’re here to help if you need us.

To the restoration of your best self,

July 13, 2020
Fight the Effects of Isolation Depression By Reaching Out to Help Someone

Cameron pulled back the drape to look out into the empty street. No cars were moving, but an endless row of them lined each side of the street. A recent rain left the pavement dark and glistening. He let the curtain drop and walked into the kitchen for some herbal tea. The house was dark. Quiet. He had to admit to himself, it was lonely, too. Ok there. He said it. He felt lonely…as in alone. The effects of isolation depression were getting to him.

Cam woke up each day wondering what his purpose in life could possibly be. There was no point in this endless endurance. He didn’t have the energy or motivation to do much at all. He’d been to the doctor a few times, only to take medicine that didn’t change anything except make him gain weight.

The more he thought about it the more he wanted to die. His mind focused on how he could help that happen.

He’d been fighting off this wretched despair for weeks … trying as hard as he could to rise above the gloomy, empty feeling that had been trying to drown him. Even though he’d tried cooking, he got bored with that pretty quickly. He’d tried reading. But the constant silence stifled his outlook.

They’d been told on the news to stay home. Some sort of pandemic. But Cam didn’t care …he never went out much anyway.

He kept the blinds closed, the drapes pulled, and the door locked. The idea of seeing someone, or anyone, peering into his apartment made his heart race and the hair stand up on the back of his neck.

To pay his bills, he offered accounting work for people online. You might say a virtual assistant, of sorts. He could work on his own timetable…when he could function. Office hours never had worked for him.

Then, he saw a post on social media. Something about how to reduce your own anxiety and depression.

That caught his attention.

It said to find a way to help someone. Offer to do a favor for a friend or a stranger. That by doing that, it could help lift your own mood.

Cam thought about it a moment. Hmm. The idea seemed far-fetched, even ludicrous. (Like, really ludicrous.) People who feel crummy, who have no energy, and who are miserable around others…have got to be the worst possible candidates for acts of kindness and helpfulness. People with energy should do those things.

Right..??

After digging around in the fridge, he came up with some frozen potato fries and put a generous pile of them on a baking sheet in the oven. He checked for ketchup, confirmed there was half a bottle, and returned to his desk.

While he worked on a customer account, that message about generosity and kindness ran laps around his mind.

Finally, he turned around in his chair and stretched.

Could it be? Is it possible that a melancholy loner could actually do anything that would benefit someone else?

Thoughtfully, he laced his fingers behind his head.

Good grief, he thought. We’re not supposed to leave our homes. How on earth could someone like him do anyone any sort of favor?

Aaaacccckkk! Forget about it. It’s a crazy thought and it’s not happening.

He reluctantly turned back to his work, then the timer sounded.

After serving the hot, steamy potatoes up on a plate, he decided they smelled sort of good. He poured himself a glass of iced tea, and munched away. It was unusual for him to have an appetite at all.

He studied the fried potato in his hand…rolling it to examine it top and bottom distractedly.

Finally, he dipped it in ketchup, put it in his mouth, and then it hit him.

Numbers! That’s something I have to give, he thought. Something I understand. And all the kids are schooling at home. I wonder if they need math tutoring!

Maybe it was a little thing, but for someone who had found no purpose for his life, it was a world-changing revelation for Cam.

He realized he could fight the effects of isolation depression with his own skill with numbers.

Before self doubt had a chance to suffocate his idea, Cam got on the neighborhood social app, and announced that if there were any children or teens needing math tutoring, he would be happy to offer it online. For free.

He pushed send, then his heart sank.

What had he done???

He couldn’t face people he didn’t know. He didn’t feel like they’d like him, and his way of explaining math probably wouldn’t help at all. The effects of isolation depression had intensified his social anxiety… but could he push through ?

After all, he was weird… he knew he was.

Just thinking about someone contacting him for math help — then failing at it — made him die a thousand deaths. He just didn’t need any more failure.

An hour later, he heard the familiar :::BING::: It was a message. Someone in his building had a 12 year-old struggling with math. They were happy to pay him but just didn’t know how to help their son themselves.

Doing his best to sound like he was taking it in stride, he arranged a time the next day to talk with their son.

His heart was beating pretty fast …but it wasn’t as much anxiety, he thought, but maybe more excitement.

And he had discovered something he’d been missing.

PURPOSE.

Suddenly he had the purpose to help a preteen boy develop stronger math skills.

The next morning, he woke up, got his coffee, and sat down at his desk. There were five more messages. People whose kids needed tutoring…ranging in age from 11 to 17.

Oh yikes.

He didn’t know if he should try to work with all of them. What if he had a bad day and couldn’t function? That happened pretty often.

What if he got sick ?

The responsibility for all these kids loomed over him.

But finally, he made himself calm down. He decided he would try to do this a day at a time, and if it got to be too much he’d call his doctor. Or he could quit.

But for the first time in a very long time, he wanted to try.

Cameron isn’t alone, is he? You may be in a position a lot like his. Feeling cooped up, dragging from day to day, seeing no purpose in life, and wondering how long you can endure the days.

The Effects of Isolation Depression

If you live in a city that’s been “locked down” it can be hard to fight the isolated feeling of aloneness and despair.

It may be that finding a way to reach out and help someone in a small way could give you a lift, too.

IV Ketamine Serial Infusions Can Help You Fight The Effects Of Isolation Depression

Or, it may be too much to try without some help.

If that’s the case for you,…if you’ve tried prescriptions for many months that just never did help… and you would like to see what

can do for you, we have good news. We’re offering this treatment at our office. Still.

Because it’s essential. Because it can be life-saving.

We’re sympathetic to your situation, and in this climate of lockdowns, isolation, and uncertainty, we want to help you with the equipping to not only face the days, but to enjoy them. To have the initiative and hope to find ways to help others, and to enjoy the reward of it.

This public virus situation is temporary, but for now you need all the help you can get weathering the uncomfortable circumstances that arise, and to have the resilience to help others manage them, too.

Give yourself the chance to rise above these difficulties. Give yourself the strength of resilience. We’re here to help.

To the restoration of your best self,

March 23, 2020
Your Generosity’s Impact on Depression

This is a time of year when we do lots of giving, don’t we?

And for the most part, we receive the giving of others, too. While it’s fun to receive and get stuff, receiving doesn’t have the impact on our brain, our outlook, our health and immunity, as well as our sense of well-being, that giving does. In fact, when we really give of ourselves, give a piece of ourselves, hoping it will truly help or benefit the person we give to, something wonderful begins to happen. I guess most of us feel a certain amount of obligation this time of year to make sure we have a gift for each person in our world… family, co-workers, neighbors, friends and those in all our other circles. But there’s an important distinction between obligated giving and true generosity from the heart. So let’s talk about one of the most important results: your generosity’s impact on depression.

It turns out that when you give out of obligation, it doesn’t really trigger any magical benefits in your brain. You still feel bad and you suffer a smaller balance in your checkbook. Plus you know…you still don’t know how to make things better.

Giving the Best of Yourself

But when you give of yourself – from your heart – something amazing happens. It can be a check you write from the money you’ve worked hard for. It can be giving your time and support to someone who needs something you specifically can provide.

No matter what you give, when you really want that person to deeply benefit from it, that’s when it helps you, too. Well, at that point things start clicking in your brain in a way that turns up the heat in your immunity protection. It also turns up the connections in the signals moving in your brain, and – no small thing – it turns your attention from yourself and how bad you feel to someone else and how you helped them feel great. You may have even given them hope.

Generosity is so Good for Your Depression

So why is giving so valuable, and your generosity’s impact on depression so life changing?

Good question!!

It starts in the mesolimbic pathway in the brain. Weird word, I know. But this strange phrase refers to a circuit in the brain that takes advantage of the neurotransmitter dopamine to link your behavior with a feeling of pleasure. You may have heard it called the “reward pathway.”

(It probably won’t surprise you to know that because of that, this area is studied by researchers seeking understanding and solutions for addiction.)

So, when you’re a giver, a series of events takes place triggered by a special set of chemicals like dopamine and its mesolimbic activity, endorphins that give you almost a sense of euphoria, and oxytocin.

Oxytocin is associated with tranquility and inner peace, as well as a sense of belonging, cuddliness, and connection. It’s the same hormone secreted when a mother nurses her baby….it causes the bonding between mother and child.

Stress is a Destroyer

Now when you’re spread too thin, or disasters are happening around you, both natural and figurative, that stress prunes and breaks down the synaptic connections in your brain.

Stress tells your body to prepare to fight or take flight. When your body keeps going into this state, believing you’re facing life or death, it wears it down. It depletes neurotransmitters, prunes the synapse structures and connections that allow for signals to be delivered, and increases cortisol. And when cortisol increases, these neurotransmitters stop producing.

But, it turns out, that even if you do experience a lot of stress, something as simple as giving of yourself, volunteering, and helping and supporting others can combat the destructive effects of stress… and prolong your life.

Generosity’s Impact on Depression and Mortality

A study led by Michael Poulin published in the American Journal of Public Health, 2013, found that a stressful life did not predict the mortality rate in those who provided help to others. However, in those who did not provide help to others, stress did predict their mortality.

A study published in the Journal of Health Psychology that focused on volunteering found that volunteering reduced mortality rates in a group of 2000 people more than exercising 4 times a week and regularly attending church.

Get this: it found that of the 2000, those who volunteered for 2 or more causes enjoyed a 63% reduction in mortality in contrast to those who didn’t volunteer at all.

Volunteering is a Category All Its Own

One thing about volunteering is that you have to really give of yourself. Your time, your energy, your comfort zone. And you probably believe in the cause and truly want to help the recipients. So with volunteering, you’re probably meeting the criteria for health benefits. And yet…that’s not why you do it, is it?

You do it because you really do want to help, to make a difference.

And it’s that heartfelt commitment to make a difference for someone and that deep desire to help, that triggers this cascade of neurotransmitter reward. Someone called it the “giver’s glow.”

It’s your generosity’s impact on depression in your life. It can help you go from shutdown…to glowing…!

What it does do is to reduce the effects of stress in your life and improve your immunity, while flooding you with a warm sense of connection, and belonging, and soul satisfaction.

These studies found that when someone is helpful regularly for a prolonged period of time, the benefits to their health and outlook compound, and carry on for a prolonged period of time.

Which is why it’s not only better for the organization to know they can rely on you every Tuesday for a year, but it’s much better for your wellbeing and longevity.

May Your Giving Season Be Your New Beginning of a Generosity Approach to Life

And, so here we are. It’s the Giving Season. We’ve had Giving Tuesday which helped to organize donations all around, and… which helps you with a tax write-off. But let that be only the start. Because if you donated for the tax write-off, that’s your benefit.

Still, if you make this the beginning of a new year of reading to the elderly, or teaching English as a second language, or literacy support, or anything that can help make another life or many lives better, healthier, and with more hope, then you may very well be on your way to a ripe and healthy old age.

Giving from the heart…giving unselfishly, giving of yourself in your own creative way, and giving your hard earned money to make life better for someone… can improve your outlook, your energy, and your sense of purpose. It can increase the neurotransmitters that move signals around in your brain, and improve your immunity.

What a truckload of benefits for you from giving of yourself.

And, if we at Innovative Psychiatry can help you with symptoms you can’t resolve yourself, please call us. IV ketamine treatment can give you the transformative restoration so you really can give your best self to others.

We want to help you find the power to live, and give, and bloom. To be satisfied and fulfilled with your life, your work, your relationships…all of it.

Have a Wonderful and Fulfilling Holiday Season!

To the restoration of your best self,

December 23, 2019
Each 4-Hours of Exercise Reduces Future Depression

Can you believe it’s already December?

We’re smack in the middle of the holidays! The last month of 2019 has begun. If this December is anything like the past, it will zoom by like a rocket. I hope your Thanksgiving was a joyful time for you. Going forward, it’s part of the tradition at this time of year to overindulge …then let diet and exercise obligations pelt us like hail at the start of the New Year. But I have another suggestion, and it’s related to exercise now. Beginning today, increasing your exercise can reduce your risk of depression going forward. In fact, exercise reduces future depression even in the holidays ahead. Wouldn’t that be nice?

As you know, depression can run in families, and when you’ve experienced recurring bouts of depression all your life, it can seem like an albatross. Something that’s part of your life that robs you of resilience and the energy to face the demands of a busy time of year like this.

If you have other family members who also struggle, you can start to think this is just how life is. And that there is just nothing you can do about it.

Trudging as if in mud, a dark cloud hanging over you…feeling listless and overwhelmed, and just wanting to go to bed.

But it doesn’t necessarily have to be that way.

Inherited Depression Isn’t a Life Sentence

There really are things you can do. Things like eating foods that support a brighter outlook by strengthening the microbiome, and by strengthening circuitry through omega-3 fatty acids.

Another way is to spend at least 30 minutes a day in the sunshine, and in good weather, more than that. Good for your spirit, good for your body as it makes Vitamin D. It’s essential for nearly every chemical reaction that occurs in your body, and especially those that impact your emotions and frame of mind.

And here’s another big one: the E word.

The E word?

That word we dread hearing from our doctorS, and when they ask about it, we look at the floor and mumble.

EXERCISE!!

Now don’t tune me out. Stay with me…

Many of us are on a guilt trip about working out, about not exercising enough on a regular basis. There are those inspiring icons who are at the gym every day, running, lifting weights, building muscle, stretching… the SLEEK ones. You can pick them out anywhere. The mall, the grocery store, your favorite restaurant.

But, my friend, believe it or not, those people are not the mainstream. And you are NOT shameful that your exercise schedule doesn’t match theirs.

The truth is, exercise is for YOU. It’s for your enjoyment (no I’m not kidding), for your own release of tension, it’s for your health to keep your arteries clean and clear and your heart strong…and to ward off diabetes and other diseases.

But that’s not all.

Exercise Reduces Future Depression

Did you know that?

You’ve probably heard it will help you combat depression now…but who feels like getting out and moving anyway? When you feel crummy, exercising is the last thing you feel like doing.

Except that getting outside, breathing in fresh air, and moving your body, your joints, your muscles… can be a lifeline of hope if you let it.

In fact, a biobank cohort study published in Depression & Anxiety, showed that when you’re active it can help prevent depression in the future regardless of your genetic predisposition.

Using a data base of 8000 people of European ancestry, Karmel Choi, Ph.D. and her colleagues determined that an increase in physical activity was associated with decreased likelihood of depression episodes in the future. And this wasn’t just in cases of people with a background of heavy daily workouts or participations in sports.

Whether the activity was intense, like aerobic exercise or the use of exercise machines, or lower-intensity movement like yoga and stretching, each time they added a 4-hour block of activity in per week it was linked to a 17% reduction in the likelihood of a new episode of depression going forward. According to these findings, exercise reduces future depression. It’s worth pushing through.

Exercise – At Least As Important in Fighting Depression As What You Eat

Recognizing this can help your psychiatrist prescribe more movement and activity to reduce depression for you going forward.

When you’re depressed, it goes without saying that you just don’t feel like getting out, being active, pushing through the fog and inertia to initiate exercise, but doing so anyway can open the door to better days ahead.

And even if your doctor tells you to be active 4 hours each week, it doesn’t mean that you will. It can really seem futile, when your outlook is dark. But it’s worth the commitment and the effort.

And if you find you can hardly get out of bed…if at all… and you really do need some sort of a leg up just to start the exercise, you may be a candidate for IV ketamine treatment.

IV Ketamine Treatment Gives You a Head Start

At Innovative Psychiatry, our patients often find they’re so much more able to participate in their own recovery after IV ketamine treatment. By restoring synaptic connections and signaling pathways in key brain regions, returning the lateral habenula to optimal function, your energy can improve dramatically — for getting exercise, building relationships, enjoying your family, doing things with friends, pursuing hobbies, and performing at work.

The G proteins can slide off their lipid rafts to enhance neurotransmitters to do their jobs, and you can enjoy motivation and initiative you’ve lacked for so long…to do things like exercise for the sake of your future health.

It’s true that IV ketamine treatment isn’t for everyone… Some people just don’t benefit like we want them to. But those are the exception rather than the rule. Sometimes when a patient doesn’t respond at first, several weeks later they’ll experience restoration as a sort of delayed response. It can seem to bubble up on its own.

In fact, there has never before been a medicine for depression that has been so quickly and so widely effective. Never.

You Can Enjoy Energy, Initiative, and Hope

If you’ve tried antidepressants without improvement, you owe it to yourself to let IV ketamine treatment show you what it can do. We have financing options to help you access this extraordinary treatment, and we can schedule you within a few days in most cases.

Whether you suffer from depression, bipolar depression, PTSD, opioid use disorder, alcohol use disorder, and/or suicidal thinking, IV ketamine treatment can transform your life. You really don’t have to just endure. You really can have the life you’ve wished for as long as you can remember.

If you want to be proactive toward your recovery with better diet and more exercise… and to invest yourself in the lives of people you love… but you just can’t find the initiative or energy to do it, call us.

IV ketamine treatment offers the most robust, remarkable antidepressant benefits to more people with treatment resistant mood disorders than any treatment we’ve seen in psychiatry to date.

This is YOUR time. 2020 can be your best year yet.

To the restoration of your best self,

December 2, 2019
Omegas: The Very Real Effect of Fatty Acids on Your Brain

Eat a diet that supports your positive mood and mental health.

We’ve talked about the microbiome, or “second brain,” and how we can weaken or strengthen it with what we eat. We’ve talked about eating fresh vegetables of all colors. And how fermented foods like sauerkraut, pickles, kimchee, and kombucha introduce healthful organisms into our intestinal DNA system. We’ve talked about curcumin, and its benefits against depression. Now let’s talk about the very real effect of fatty acids on your brain.

Did you know that some of the most important, even vital, foods you can ingest are fatty acids? Maybe that sounds a little creepy… But it’s true.

The World Health Organization estimates that major depression is the greatest single cause of disability worldwide.

A study by JR Hibbeln showed that around the world, countries that consume the least amount of fatty fish show the highest levels of major depression (MDD) in their population. And countries where fatty fish is the main diet show the lowest incidence of MDD.

You Have a FAT Brain

You think I’m kidding..??

I’m telling you, your brain is 60% fat. 60% !! Shocking fact when you step on the scale. But don’t try to lose that excess weight from your head, because THAT fat is pretty important.

Fats reside in the neuronal membranes–the brain cell membranes–and in the myelin sheaths that surround them. And they’re important for delicate synapses. Remember that synapses are the connections between neurons.

The saturated fatty acids are combined in what’s called a lipid bilayer and that lipid bilayer forms the membrane that surrounds each brain cell. It’s made up of straight chain carbon atoms so the membrane is more firm like butter is firm at room temperature.

Now–this is where it gets interesting– unsaturated fatty acids are made of bent chain double bond curvy molecule structures. Because of this, there’s more space between molecules so when unsaturated fats are incorporated into the cell membrane, the membrane is more fluid. So, if you compared oil to the firmness of butter, these are more fluid like olive oil, for example.

The omega 3 fatty acids are fluid ones.

Another remarkable characteristic of omega-3 fatty acids is that they’re precursors to eicosanoids like prostaglandin which can reduce inflammation. Super important for psychiatric disorders, which are associated with increased inflammation.

Eicosanoids go by the nickname ‘local hormones’ because they act on cells close to their site of production. So fatty acids in your brain cause the release of prostaglandin, which reduces inflammation that contributes to depression.

That’s a mouthful! But it tells a promising story.

Get the effect of fatty acids by eating more fatty fish.

Fatty acids like omega-3s are considered essential fatty acids, and you can only obtain them from your diet.

So to maintain a healthier, more positive outlook, decrease inflammation that can lead to depression, and actually fight depression symptoms, increase the amount of mackerel, salmon, oysters, sardines, and trout in your diet. Make sense? I hope so, because doing that can make a real, tangible difference for you.

In addition, seaweed is a nutrient dense food that’s rich in omega-3 fatty acids. Nori seaweed typically presents itself in sushi, and is a tasty snack on its own. Also spirulina and chlorella are also in the algae family and are a good source of omega-3s that you can add to shakes and smoothies.

Fatty Acids Are Essential for Your Brain Health

In a presentation at the annual meeting for the Society of Biological Psychiatry in NYC last year, Dr. Roel Mocking spoke about the critical requirement of fatty acids in psychiatric wellness.

He demonstrated that Omega 3 fatty acids reduce inflammation, reduce the release of cortisol from the hypothalamus-pituitary-adrenal-cortex-axis, and activate the amygdala.

The amygdala is one part of the brain that contributes significantly in processing emotion and decision-making. When someone’s amygdala is damaged, or destroyed, they tend to be fearless, and don’t use the necessary caution to make safe decisions since the caution the amygdala would create is absent.

So, by multiplying your fatty fish consumption, you provide your amygdala the fuel to be activated to process fear and enhance circumspect decisions. You can also reduce the release of cortisol, the stress hormone that has a negative impact on your health. And you equip your brain to reduce inflammation…all of which improve your mental and emotional functioning.

The Effect of Fatty Acids on Your Brain

Dr. Drew Ramsey, a nutritional psychiatrist, and author of 3 books on foods that feed the brain, is an assistant clinical professor at Columbia University. Dr. Ramsey promotes better nutrition for the brain with his patients. He laments that most Americans overfeed themselves in calories but starve themselves of the critical micronutrients the brain needs to thrive.

He prescribes antidepressants and other medications for his patients, and engages in psychotherapy with them, too. And he teaches that fresh and nutrition-packed foods help make other treatments more effective.

It’s a shame, according to Dr. Ramsey, that it’s so rare for Americans to eat foods that meet the needs of the “most complex and energy consuming organ in the body” which is the human brain.

Eat the Rainbow

He recommends “eating the rainbow,” as in eating all the colors of fruits and vegetables. Fresh foods like oranges, apples, bananas, pineapple, bell peppers, tomatoes, avocados, kale, sweet potatoes, and blueberries.

Combine these with fish like mackerel, salmon, trout, sardines. And walnuts, pecans, and almonds.

These can help prevent harmful inflammation, and feed your brain, your heart, and your digestive system.

They can reduce symptoms of depression and anxiety, and promote mental clarity.

Ketamine Treatment Can Help Give You a Fresh Start

So, if your diet changes and medications aren’t bringing the relief you hope for, then let’s talk about ketamine treatment. Because this remarkable treatment of at least 6 infusions within 2-3 weeks has been changing lives across the country. It just may change yours, too.

At Innovative Psychiatry, we encourage brain supporting foods that improve your outlook and emotional wellbeing.

While we don’t center an entire treatment program around food, we do work with patients and guide them in supporting their brain function by avoiding food dyes and preservatives.

In addition, we show them that by adding healthy foods, micronutrients, and lifestyle changes, they give their brains and emotions an optimal environment for restoration.

If you suffer from depression, symptoms of anxiety, or other mood disorders, and other treatments have brought no relief, call us.

We’ll talk with you and determine whether you’re a candidate for ketamine treatment. We’ll guide you to eat foods that improve your well being. And please do follow the links in this article to read more information about your microbiome and your restoration.

It’s all about getting better. Enjoying your life. Watching symptoms fade and your strengths rise.

Call us, and let’s create a plan to help you restore joy and fulfillment in your life.

July 1, 2019
Study Finds Ketamine Nasal Spray Effective For Treating Depression: What You Should Know

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

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

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

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

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

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

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

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

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

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

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

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

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

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

[Read the Original Article Here]

May 29, 2019
Opinion: The New Ketamine-Based Antidepressant Is a Rip-Off

Johnson & Johnson patented a form of the psychedelic with less research and a ridiculous price tag.

In a popular and public move, the United States’ Federal Drug Administration recently approved intranasal esketamine, one of the components of the psychedelic ketamine, for treatment-resistant depression. The nasal spray costs nearly $900 per dose—or roughly $7,000 for the first month of treatment, and each treatment takes at least two hours in a clinic. (It has yet to be decided how much of the cost insurance plans will cover.)

Esketamine can be unwieldy to use and carries a number of significant potential side effects. Shockingly, it was no better than placebo in two of the three short-term Phase-III studies submitted to the FDA for approval.

But the biggest problem at hand is not the drug itself. It’s the fact that instead of representing a revolution in mental health treatment, as it has been touted to do, esketamine is not a breakthrough at all. It’s just a way for pharmaceutical company Johnson & Johnson to make a significant profit off gullible insurance companies and vulnerable patients.

Generic Ketamine Works

Generic ketamine is available for a fraction of the price of esketamine, has been shown to work—and work safely—in small-scale single-dose and multidose trials for treatment-resistant depression, can be administered in a variety of ways, and has already been used off-label for decades to treat thousands of patients with depression and suicidality.

It’s currently difficult, if not impossible, to provide generic ketamine treatment in public clinics, even to patients who need it, because there haven’t been any large-scale, randomized trials, both with and without psychotherapy. Without these trials, and resources, physicians can’t be reimbursed by insurance companies for ketamine treatment like they will be able to do with esketamine.

Ordinary ketamine is a racemic medication, meaning it is made up of two molecules that are mirror images of each other. Because ordinary ketamine is generic, Johnson & Johnson simply isolated one of the two molecules in regular ketamine so that it qualified as “new.” The reality is that we don’t know whether esketamine is more or less effective than regular ketamine because there have been no head-to-head trials between the two. Johnson & Johnson only tested esketamine against a placebo, likely because they feared esketamine might actually perform worse than the generic version.

As many critics have pointed out, this strategy has become the bread and butter of drug development in the United States today. Largely because of the influence of pharma on the FDA itself, our drug approval process rewards copycat variation of already-available drugs instead of truly innovative pharmaceutical design.

When Psychotherapy Is Missing

The trials for esketamine also reveal a larger issue in the field: they de-emphasized the importance of psychotherapy while focusing solely on its chemical effects. The most effective treatment strategy for treatment-resistant depression is intensive psychotherapy along with the use of medication, but the FDA esketamine trials didn’t include therapy at all.

Getting insurance companies to pay for psychotherapy is already difficult, and without it as part of the protocol, they will likely offer no reimbursement for patients interested in receiving a psychotherapy session after their esketamine dose in order to process the experience.

Our colleagues who offer ketamine-assisted psychotherapy say that this is a vital part of the process. One such session can require upwards of three hours of one-on-one treatment in order to prepare patients for the experience, take care of patients while they are under the influence of ketamine, and then integrate the effects afterwards. Ironically, insurance companies would save more money paying for generic ketamine-assisted psychotherapy rather than esketamine treatment alone, as the former is both cheaper than the latter and can lead to long-term remission of symptoms.

Alternatives

Private ketamine clinics currently do exist, but they have to fight the stigma of the drug, and sporadic cases of malpractice. Some private clinics do not properly screen patients prior to initiating treatment and often charge outrageous sums of money—one reason that both patients and medical systems have been hesitant to implement it more widely. Those clinics that are providing ketamine responsibly, however, offer a potentially lifesaving treatment for patients living with depression who have exhausted all other available options.

Although there are no quick fixes for the broken drug-development and approval process that led us to esketamine, it is possible to take concrete steps to address the most glaring problems. Insurance companies and the FDA ought to require head-to-head study designs of clinical trials to investigate generic and patented medications. Additionally, current research on medication-assisted psychotherapy with other psychedelic substances such as MDMA and psilocybincan serve as a model for future research that explores ketamine-assisted psychotherapy, instead of the drug alone.

While Johnson & Johnson rakes in the profits from esketamine, patients dealing with depression and trying to navigate our struggling mental health system will bear the cost. Fostering the development of mental health treatments that are novel, effective, and affordable will require a critical examination of the undue corporate interests that drive drug approval in American psychiatry today.

Dr. Michael D. Alpert is a psychiatrist and clinical faculty at Harvard Medical School. He is also a therapist with the MAPS Clinical Study of MDMA-Assisted Psychotherapy for PTSD.

Dr. J. Wesley Boyd, MD is a psychiatrist and associate professor at the Center for Bioethics at Harvard Medical School.

Dr. Marco A. Ramos is a psychiatry resident at Yale University.

[Read the Original Post]

May 27, 2019

Category: Optimal Wellbeing

Infrastructure for Optimal Wellbeing by Lori Calabrese, MD | The Ketamine Blog

Although some things are easier said than done…

They’re very careful about avoiding exposure to SARS-CoV-2, the virus that causes COVID-19. Twice a month trips to grocery store with gloves and masks. Very cautious.

Cecilia also has concerns about managing her bipolar disorder. With the help of medication, she manages fairly well. But she and Ben are careful about avoiding stressful situations to help with her stability.

Halfway through the day on Thanksgiving, they were enjoying a quiet time together chatting as they prepared the meal.

When they answered the door, a jovial group of 8 more people roared Happy Thanksgiving!!! and charged through the door. The eight people included the Robin’s cousin, his wife, their 5 children, and Cecilia’s elderly mother.

Jake and Robin stepped out of the way, baffled, shocked, and horrified; Ben and Cecilia were equally horrified. Grandma came in with her walker. Four children ran through the house, and a baby in a carseat wailed from her position on the floor.

“A party? How many were there?”

“Aww, I don’t know… 30 or so. You should see Tom’s oldest. She is really grown up!”

So Robin said, “You know what? We love you guys and it’s great to see you…but we take this pandemic pretty seriously. We each got a COVID test last week to be sure we didn’t have the virus to expose to each other.

About the same time, Ben started feeling symptoms of severe fatigue, shortness of breath, and intestinal cramping. Cecilia drove him to a drive through testing center for another test. It came back in two days — positive.

Cecilia’s daily calls to the hospital to check on her mom were frightening. Heartbreaking. Her mom was now on a ventilator. And her cousin’s wife was also sick with COVID.

But all the more difficult, Cecilia’s bipolar depression symptoms were rearing up in the face of the deep frustration she felt. First frustration, then anger, then rage…at her cousin who ignored all the warnings and put her mom and everyone else at risk.

She could feel her mood moving from neutral to a dark melancholy… bipolar depression was looming… she could feel it coming on.

Reduce Stress and Stay Safe at the SAME Time

Aside from the precautions for limiting spread of the virus that is causing the COVID pandemic, there is another issue that deserves attention. That’s the tension, anxiety, and depression symptoms that can be relegated to the ongoing news about the virus and the damage it can cause.

This time of year is celebrated as a time of giving and receiving love and connection with friends and family. To worship true to your conscience, and hopefully be refreshed. Don’t you agree?

We all know someone who stirs up conflict wherever they go. The Button Pusher.

Then there are those who find their fuel by subtly inflicting guilt. We love them but we hate the guilt trips.

And every group has someone looking to push the crowd into doing something they don’t want to do…

Yours isn’t the only family with these delightful people.

The Good News. Disconnect your buttons before you have contact with the Button Pushers… Turn off your guilt switch and let the guilt purveyors buzz away while you walk away. And those Mr. Pushy types? Just say NO.

More good news: This is the pandemic year and it’s not recommended that you travel or join other households for the celebration. So contact could be limited to a ZOOM meeting. When it’s over, it’s over…!

This is a year to consider fewer gifts and more emails, cards, letters, especially those cards with pictures enclosed or attached. Share your news without exposing yourself, your family, or the vulnerable family members to potential illness.

Reduce Stress and Stay Safe — Enjoy the Holidays and Enter 2021 Healthy and Happy

With a series of titrated ketamine infusions personalized specifically for you and your response, you can feel like your best self again. Think back to the last time in your life when you were at your best self for a good stretch. Ketamine treatment can help you feel like that again.

Above all, take very good care of yourself, your health, your outlook, and the wellbeing of your family.

We’ll never forget 2020. For the COVID-19 pandemic, for the social and political turmoil, for the economic struggles and adjustments that have accompanied all of it.

Well, maybe a good place to start is with Giving Thanks. You may have lost loved ones this year, maybe even from COVID-19, or you may just miss them during the holidays because they’re gone…

Choose Gratitude No Matter What

For the Thanksgiving Day 2020 holiday, you can make the most memorable experience by applying gratitude.

Gratitude … expressing how grateful you are… is practice toward underpinning your brain’s circuitry, and strengthening your resilience. And doing that helps you see the good in challenging circumstances.

But for this one Thanksgiving, when you sacrifice face to face contact, you can yield a life shared for years to come. And don’t travel, or let anyone come to you who has to travel. The risks right now are only increased by transportation that involves contact with others.

Share your love and gratitude with those important people who can’t be there. Write the gift of a letter to each one with a list of why you’re thankful for them, or to remind them of a memory you share together. Find a way to shower your family with love, without face to face contact.

Choose Warmth, Kindness, and Generosity for an Unforgettable Thanksgiving Day 2020 Holiday

In the face of the pandemic, and the changes it causes, ADAPT. That’s how you survive and overcome difficulty. By adapting and applying new approaches. And enjoying them.

“The second wave of the coronavirus has begun,” they tell us.

Fear and anger trigger the fight or flight response…think about it. Have you noticed fear and anger in yourself or in the people around you during the first wave? It’s probably safe to say we all have.

You’re an old pro at dealing with Covid-19. Just look at your muscle bound, highly skilled self.

So…What’s pushing the envelope?

Gathering with others assuming the mask is enough. An infected sneeze or cough may actually not be enough. But if you confine your gatherings to Skype, Zoom, FaceTime… Sneezes and coughs from others can do you no harm.

Common sense.

On the other hand, if you succumb to your emotional gut reactions of anger or fear, the likelihood you’ll make risky decisions heightens the danger that you’ll inadvertently expose yourself to the coronavirus.

In this second wave of COVID, you can not only choose how to spend your time in safe ways and safe places, but you can also set an example for others who haven’t really thought all this through.

You Can Be the Voice of Reason and Common Sense

Will you lead or follow? Either way, you can hopefully find the wisdom and sense of safety that goes with protecting yourself and your loved ones.

But…what if you’re overwhelmed with fear… and it won’t calm down? What if rage keep growing, on the verge of exploding, no matter how much you try to be rational and calm?

When Fear Seems to Swallow You Up…

Ketamine treatment can restore the connections and structures in your brain that give you the ability to cope and to hope. When you can cope, your patience increases, your outlook brightens, and your inner strength grows.

Ketamine treatment also can enable you to feel joy, and to enjoy experiences even when you’re isolated. It can empower you to build a happy and rewarding life, and rebuild healthy relationships.

You see them everywhere… t-shirts proclaiming “In a world where you can be anything…be kind.”

Did you grow up in a kind household — or one where you felt undervalued and roughly handled…? It matters, you know. When you never see kindness, it’s not so easy to create it yourself, is it?

Healthcare Workers Give All They Have to Give

The world is in turmoil, and it doesn’t feel all that safe these days, but you do have the power to change it. One kind act at a time.

Stop.

Job Loss and Income Reduction Is a Part of Life Right Now…

The Guy At the ATM Who Keeps Sticking in His Card

Don’t HONK.

Remember to Care.

So what can you do to ensure you have more kindness to give to others?

Then, when you mess up, make mistakes, even bad ones, give yourself patience, kindness, and forgiveness. Because it’s in practicing kindness toward yourself that you learn to cultivate kindness and patience toward others.

In a World Where You Can Be Anything, Be Kind.

If you’re the first to respond to someone’s struggle, start with compassion. Show you care. Then, as you provide support, do it with kindness and patience.

And What If You’re Just Tired of the Struggle? What if You Can’t Muster Joy, Patience, or Even the Power to Care?

When that happens, you can reach out for ketamine treatment.

It said to find a way to help someone. Offer to do a favor for a friend or a stranger. That by doing that, it could help lift your own mood.

Right..??

Aaaacccckkk! Forget about it. It’s a crazy thought and it’s not happening.

Numbers! That’s something I have to give, he thought. Something I understand. And all the kids are schooling at home. I wonder if they need math tutoring!

He realized he could fight the effects of isolation depression with his own skill with numbers.

He pushed send, then his heart sank.

PURPOSE.

But finally, he made himself calm down. He decided he would try to do this a day at a time, and if it got to be too much he’d call his doctor. Or he could quit.

The Effects of Isolation Depression

IV Ketamine Serial Infusions Can Help You Fight The Effects Of Isolation Depression

If that’s the case for you,…if you’ve tried prescriptions for many months that just never did help… and you would like to see what

can do for you, we have good news. We’re offering this treatment at our office. Still.

Because it’s essential. Because it can be life-saving.

This public virus situation is temporary, but for now you need all the help you can get weathering the uncomfortable circumstances that arise, and to have the resilience to help others manage them, too.

**Exercise Reduces Future Depression**