Lori Calabrese, MD

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  • Ketamine In A Pandemic: New Depression and Anxiety Can Strike Anyone

    Ketamine In A Pandemic: New Depression and Anxiety Can Strike Anyone

    The sky grew darker as clouds morphed from white to gray, and created a solid ceiling over the city.

    It had rained off and on for days, and thunderstorms had filled the night skies with a threatening latticework of lightening. In an aggressive assault on the grayness, Evie stepped back from the window and decided to turn all the lights on. The quiet in her bungalow, the gray skies, and the silence felt like a blanket that she couldn’t seem to shake off. She turned on music and tried to dance around the living room, but that didn’t last. There had to be a way to ward off this expanding gloom. She’d heard about ketamine in a pandemic, because these symptoms can strike anyone…even if they’d never had them before. Could that be what’s going on?

    Dread crept up inside her, and she couldn’t understand why. Where was this coming from? She didn’t object to this isolation. It had given her the excuse to read more, which she’d salivated to do for years. She enjoyed her own company.

    So where was the dread coming from?

    It was as if things she normally would do as part of her routine just seemed too hard to do lately.

    A heaviness grew darker and heavier in her chest..?  Her stomach…?  What was it?

    Evie had always prided herself in her ability to snap back from disappointment, to face fearful situations and push through them. She just lived with her sleeves rolled up, ready to take on whatever life tossed her way.

    Her younger brother had never been so resilient. And unfortunately, she hadn’t been very supportive.  She just had never understood why he wouldn’t just shake it off. Call a friend, pitch in and help someone in need, walk in the sunshine…and get over it! 

    Now…she was eating her words.

    Isolation and Even Social Distancing Take a Toll on Your Emotions

    She strained her brain to understand what was causing this. Internet articles pointed out that being cooped up this for weeks or months was affecting people in a negative way. 

    But Evie liked being alone. She loved the quiet. The uninterrupted freedom to do what she enjoyed.

    And these articles also talked about fear. People were afraid. Sales of guns had skyrocketed, and ammo was sold out and on back order, as people have bought up more and more.

    She had to admit to herself…that THAT was scary. All sorts of people armed against unknown dangers…

    But seriously. She wasn’t afraid of looters or invasions.

    It seemed clear to her that it was just a matter of waiting this out.

    Ketamine in a Pandemic Can Relieve Anxiety and Depression in Someone Who’s Never Had It Before

    So what was wrong with her?? Why was she lying in bed and reading all day every day? Things had piled up. Her garden needed weeding. But the idea of doing it was overwhelming.

    Motivation, initiative… it seemed to have drained out of some proverbial hole in her bucket.

    When a knock came on her door…Evie didn’t answer it. She just stayed quiet and waited for whoever it was to go away. The same with her phone. She didn’t want to talk…not to anyone. 

    She remembered a few months ago, when she saw a map of the world that depicted the incidence of this COVID-19 virus in countries around the world. She was stunned to see how every country seemed to be red. The entire world!

    So if she had thought she could just get out of town and wait for this to blow over, she was fooling herself. There was no escape on the planet.

    Maybe that shock started this…this feeling of dread…

    Large Scale Change Increases Stress

    Then they closed the schools and restaurants and businesses. Then required mask wearing.

    You know that feeling that “it will never happen to me”…?  But this thing has happened to everyone. Everywhere.

    So was the dread from feeling trapped?  Evie thought about that. It might be the case with some people, but how could she feel trapped all snugged up in our home she loved doing things she enjoyed?

    She didn’t know what was wrong with her or what specifically caused it. She did know that she wasn’t herself. There had to be some serious thinking about her brother and so many others who suffer from symptoms like this. Who really couldn’t shake it off, like she couldn’t now.

    And she acknowledged it was a difficult place to be. That her brother had been very brave all these years to keep fighting to function when medication and therapy didn’t work for him. 

    She’d read enough to know that many people were being affected by these circumstances. Some, like Evie, had never felt this way before. 

    She promised herself she’d call a doctor to see if she could get treatment — as soon as she could scrape up the initiative to do it.

    Evie’s not alone, is she? 

    And this is why telepsychiatry has been so vital through these months. A new flood of people who never needed psychiatric treatment before have emerged…and need treatment.

    Ketamine in a Pandemic: Depression and Anxiety Can Strike Anyone in These Circumstances

    Then, there are those who’ve been receiving treatment with prescriptions that now don’t seem to be working anymore. And in isolation, these people are at higher risk because they’re alone, and feeling all the things Evie feels, but often the symptoms of suicidal thoughts have been added to the mix.

    Ketamine in a Pandemic for Depression and Anxiety Can Be A Lifesaver

    A team of medical researchers set out to try to  evaluate the psychiatric effects this global pandemic — and the restrictions that have been part of it — to better understand its impact on mental health in individuals around the world.

    They published the results of their survey.  One of the most remarkable outcomes was that 41% of adults showed they were more concerned about their increasing anxiety, than they were about their financial problems. That’s 2 in 5 adults.

    Two out of 5 in line at the grocery store. Two out of 5 in line at the gas station.

    Think about it.

    Also, 2/3 said they feel like they’ve lost control of their lives. Sound familiar?  And 56% say they find it difficult to manage their responsibilities amid this pandemic.

    So, yes.  You’re not alone. If you’ve been struggling with these things too, just recognize you’re not alone. You’re part of the “new normal.”

    Except that it doesn’t feel normal.  

    And it doesn’t mean you should keep struggling with these feelings of uncertainty, anxiety, and depression.

    Do call your doctor and talk about what you’re going through.

    And…if you’ve been taking prescription medicines, and find they aren’t helping, don’t lose hope.

    Reach out for ketamine treatment, which can restore your resilience in the face of all this. It can restore your initiative and motivation. Aren’t you glad that there is something that can help in times like these? Ketamine in a pandemic can bring remarkable relief for depression and anxiety that’s triggered by these restrictions.

    At Innovative Psychiatry, we’re providing ketamine treatment here in our office every week. We’ve instigated safety protocols that allow us to provide you the essential treatment you need to help you get through this stressful time.

    While the process of recovery from a global pandemic is more complicated and time consuming than we wish, you don’t have to live in misery. Ketamine treatment can restore your hope, your resilience, your initiative, and your confidence.

    And if hopelessness has been rising up inside you, stripping away your belief that things will ever get better, that’s a symptom. It’s not reality. And ketamine treatment can relieve those thoughts, and help you get your momentum back.

    We specialize in treating suicidal thoughts. In fact, we’ve done research which shows ketamine’s remarkable effectiveness with this symptom.

    If you suffer from the symptoms we’re talking about, call us.

    We’re here to help you find your best self again. We want you to enjoy your life and live well.

    You aren’t alone. You really aren’t.

    Reach out for help. Your best days could be just around the corner.

    To the rejuvenation of your best self,

    signature of Lori Calabrese, M.D.

    Lori Calabrese, M.D.

  • For the Depressed Mom: Ketamine Can Restore Your Joy

    For the Depressed Mom: Ketamine Can Restore Your Joy

    “Motherhood is a choice you make everyday, to put someone else’s happiness and well-being ahead of your own, to teach the hard lessons, to do the right thing even when you’re not sure what the right thing is…and to forgive yourself, over and over again, for doing everything wrong.” – Donna Ball, author of At Home on Ladybug Farm

    Let’s talk about moms.

    Yesterday was Mother’s Day, and if you were a mom yesterday, chances are, you’re still a mom today. We could talk about all the idealistic and billowing praises that are bestowed upon moms in greeting cards, but let’s don’t. Let’s talk about what it’s really like to be one. And if you’re a depressed mom, ketamine can restore your hope, your joy, and your stamina to help your children grow. More about that in a bit.

    Motherhood Is a Handful.

    With the best of intentions, you gather your kids together and tell them you’re all going on a camping trip. Together! But….there is so much to be done before you can all load the car. So in the spirit of pitching in and working for the common good, you assign each one a task that will help shorten the prep time.

    Then you focus on your own tasks which include packing food for meals. While you’re busy in the kitchen, you hear an unusual noise.

    Closer inspection reveals that your 10 year-old son is in the bathroom (which he was supposed to be cleaning) after putting his sleeping bag  by the front door, and has filled the sink with water.

    He’s floating a little boat on the water with his pet hamster in the boat which immediately jumps out of the boat, over to the counter and jumps down under the cabinet and disappears.

    Oh dear.  

    Now there’s a loose rodent in the house. Aaaarrrgghhhhh!!

    Feel your resilience waning..? If you find out you’re a depressed mom, ketamine can restore. Keep reading…

    Your son, who got bored cleaning the bathroom, had gotten distracted with his hamster. Now how to find the hamster?

    Kids are just kids. Full of surprises. It takes a sense of humor…

    When It Rains It Pours

    Meanwhile, you stop in the boys’ room and find your 7 year-old, who was supposed to clean his room after delivering his sleeping bag to the front door,  sitting among a pile of Little Golden books. Reading. (What joy!) But apparently he had to go through the entire bookshelf of 43 Little Golden  books to find the one he wanted to read. His floor is covered with books he’s tossed.

    After sternly instructing him to pick up all his books PRONTO! you realize you better check on your 21 month-old daughter. Distractions can pile up when you’re focusing on packing 3 meals a day for 4 days and you have a houseful of active children…you didn’t notice she wandered off.

    Turns out she’s in your bedroom. At first sight, you panic. Is that blood?  Her face is covered! What happened?? 

    Upon closer inspection after snatching her up in your arms, you see that it’s not blood. It’s lipstick. Her face is so covered with the stain of it, you know she’ll be raw by the time you get it even partially off.

    Then you look at your feet.  Your favorite white leather summer bag, and your butter soft cream-colored pumps, have both been painted with lipstick to match.  

    How thoughtful. Sigh.

    The fact that that was a brand new tube of lipstick is now beside the point.

    Calamities, Crises, and Catastrophes

    Then…sniff, sniff… what is that smell…?

    You head for the kitchen, baby girl on your hip, and the kitchen and living area are in a cloud of smoke…then BEEEEEEEEEEEEEP!!!!!!    The smoke alarms.

    Run to the stove. OH NO!! The eggs you put on to boil for sandwiches have boiled dry and are burning!!! 

    Move the pan off the burner. Turn off the burner. Open windows. Gather kids and go outside for fresh air.

    You collapse into a lawn chair and watch the kids playing happily in the yard. The classic comic escapades of Calvin and Hobbes comes to mind…

    Maybe you’ll just get chicken at the drive-through…?

    Add to all of this the challenges of quarantine in a global pandemic!  There aren’t words. But you do what you have to do, don’t you?

    Motherhood is providing a listening ear, helping with Cub Scouts and Brownies, fighting fevers in the wee hours, encouraging the discouraged, instilling hope, tutoring when homework overwhelms, instructing, providing structure, instilling values, creating celebrations, stretching the budget, inspiring creativity, keeping idle hands occupied, teaching self-reliance, comforting broken hearts, and so much more.

    And this is when you’re healthy, resilient, and stable.

    But what about when you’re not?

    What about when anxiety makes it impossible for you to participate in sports with your child, or Cub Scouts, Brownies, or Blue Birds? 

    The sheer dread you feel about leaving the house to take your child to these activities and interact with the parents makes it so difficult that you may make it a time or two, but eventually the energy required to push through all that dread and fear leads to missing meetings and practices…if not abandoning it altogether.

    To the Depressed Mom: Ketamine Can Restore Your Hope

    Then there’s the guilt you feel for failing to give your child every advantage.

    What about when PTSD creates such traumatic responses in you that you just can’t leave the house, and find your reactions are terrorizing your children…but you can’t make it stop..?  

    If you’re a mom with PTSD…or a depressed mom… ketamine can restore your resilience and your hope.

    A simple pat on the back when you attend a gathering, or a loud noise in the kitchen…even the deep voice of a stranger… can send you into such terror, sweating, and reactions that, you know, you just feel safer at home.

    Or when you just can’t get out of bed… so you get the children to watch TV, because you know at least they’re safe, but it nags at you because you know this isn’t a healthy, carefree way to spend childhood.

    But it’s the best you can do. 

    If you struggle with symptoms like these, and they interfere with the mom you want to be…and if the medicines prescribed by your doctor haven’t helped…  there’s hope.

    When you’re a depressed mom, ketamine can restore your joy.

    Ketamine treatment consists of 6 infusions, give or take, over the course of 2-3 weeks. It’s, hands down, the most effective, innovative treatment for severe depression, social anxiety, PTSD, bipolar depression, and alcohol use disorder.

    If you’ve been seeing your doctor and the medicines she’s prescribed have worked to reduce your symptoms, then you’re all set. 

    But did you know that at least a third of people who have these symptoms are not helped at all by prescription medicines?

    That’s where ketamine treatment comes in. It works in the brain in ways these prescribed medications don’t. And its remarkable, even extraordinary, and robust relief is transformative for most of those who receive it.

    Ketamine works in multiple ways and in multiple areas in the brain. And it’s fast. So, instead of having to wait weeks or months for a prescription to help you feel better, with ketamine treatment you can feel better in hours or days.

    Ketamine turns on mRNA so it will turn on DNA to turboboost BDNF — brain derived neurotrophic factor — that works like a rich compost to trigger the rapid and prolific growth of dendrites and dendritic spines in the neurons in your brain.

    This multiplies the synapse connections fast to send signals across your brain, and wake up your emotions. Creativity blooms, quick thinking, solid decision making, initiative, motivation, hope…and joy all come to life and transform your outlook and your productivity.

    And you can love life again. 

    You Don’t Have to Endure Suicidal Thoughts…You Really Don’t

    In addition, if you’ve been plagued by suicidal thoughts, it can stop those thoughts in a few hours. Then you can be free to invest in restoring your life, rebuilding your thoughts and infrastructure, and restructuring and strengthening your relationships.

    It may sound too good to be true…but if you’re a depressed mom, ketamine can restore the real you, the person who has dreams for yourself and your children, and wants to have the resilience to help them fulfill their dreams.

    At Innovative Psychiatry, we enjoy the privilege of watching people walk out with fresh joy and hope every week.

    If you’ve struggled with the kinds of symptoms we’ve talked about here, and medicines haven’t helped, call us.

    We’re here to help you live well again, to find your joy in life again.

    Ketamine doesn’t do this for every single person who receives it –of course not!– because there isn’t any medicine or treatment that helps everyone. But it does amazing things for most. There’s no other treatment currently available that brings relief and restoration so quickly for so many who are so symptomatic — in the privacy of a beautiful office, beginning that afternoon . . .

    Discouraged, Depressed Mom? Ketamine Can Restore Your Resilience

    You can sing again, experience joy welling up inside you, laugh with your children, and all the things you have wished you could do.

    Give yourself the opportunity to feel truly better. Spend this year enjoying your life and your family. We can help you get there.

    To the blooming of your best self, 

    signature of Lori Calabrese, M.D.

    Lori Calabrese, M.D.

  • Explore: Method to Differentiate Bipolar Depression vs Unipolar Depression

    Explore: Method to Differentiate Bipolar Depression vs Unipolar Depression

    As you may know, May is mental health month.

    IV ketamine can restore her joy whether it's bipolar depression vs unipolar depression.

    And as such, it’s a good time to talk about symptoms of mental health disorders, don’t you think? We want to increase understanding and dispel stigma which will help people who suffer gain better access to the help they need. Stigma is steeped in ignorance about something someone doesn’t understand. In addition, the global circumstances of these last few months have impacted the mental health status of so many. So let’s use this month to broaden understanding and better equip us to respond to ourselves and those around us. So here’s something to talk about: A new way to differentiate bipolar depression vs. unipolar depression may be emerging.

    Leading Cause of Disability

    The leading cause of disability in the world today is not heart disease or cancer…it’s depression. Depression is that common. We talk about severe depression and we talk about bipolar depression. When you see someone with either of these conditions, they may look rather similar from your vantage point, but they’re actually two distinctly different conditions.

    When we diagnose someone in this depressed state, it can be difficult to determine whether they suffer from major depression or bipolar depression, unless they have a history of mania or hypomania to determine the difference.

    Unipolar depression and bipolar depression don’t feel the same…but they do sort of look the same.

    Which is why a doctor asks whether you’ve had times when your mood was elevated, you felt energetic, hyperactive, maybe irritable, angry… and overly confident…all at the same time?

    For this reason, so many with bipolar disorder are first diagnosed with major depression, especially those with bipolar II disorder, since their symptoms include far more depression than hypomania.

    When you first see a psychiatrist about your depression, it’s important to be patient. Because some of your symptoms may not have emerged yet…and you may appear to have unipolar depression. Then later, mania or hypomania emerges, and your doctor may change your diagnosis to bipolar disorder, along with your prescriptions.

    Because of the challenge of diagnosing someone accurately who has a low mood, researchers have been seeking a means of using some sort of biological markers to determine scientifically the proper diagnosis and character of the depressive symptoms.

    This man is in pain but doesn't know if it's bipolar depression vs unipolar depression.

    Something that would differ in patients with unipolar depression from those with bipolar depression. Possibly brain activity. Or maybe proteins in the blood? Possibly genetics?

    Exploring Bipolar Depression vs Unipolar Depression

    An interesting study conducted by Brain and Behavior Foundation researchers, led by Mary Phillips, Ph.D., performed with a relatively small group of subjects, suggests a way your doctor might differentiate the two disorders clinically to aid in accurate diagnosis.

    Using functional magnetic resonance imaging (fMRI), full brain scans were conducted on a group that included 18 bipolar patients who were in bipolar depression, 23 depressed patients who’d been diagnosed with major depressive disorder (MDD), and another 23 who were healthy without a diagnosed disorder.

    It’s unfortunate that their study involved so few, and also that 90% of those with bipolar disorder were diagnosed with bipolar II disorder, leaving only 10% who had bipolar I disorder. A more evenly distributed group might have told us more.

    Even so, they did make some significant observations.

    The working memory system is used by the brain to maintain, manipulate, and update information that is associated with tasks that are presently at hand. When the networks of nerves in this system are damaged, learning – reasoning – and decision- making ability can be disabled.

    This is particularly true in those with mood disorders, like depression.

    So, the researchers gave each participant an easy task and a difficult one, while the participant was undergoing an fMRI brain scan. The design of the tests was to highlight that people form expectations about a task before they fulfill it.

    Bipolar depression vs unipolar depression can both be treated effectively with IV ketamine treatment.

    A person might feel the task will be easy, so there’s little stress in performing it. But if he expects the task to be difficult, his stress increases before he begins.

    It turned out, that there were patterns of neural (brain cell) activation in the medial and lateral areas of the prefrontal cortex, that were related to how easy or difficult a task would be.

    Mechanism Defends the Person with Bipolar Depression From Emotional Pain

    The researchers reported that people with bipolar disorder may actually block anticipation of a negative experience to avoid experiencing negative emotion while performing a task. That basically people with bipolar disorder seem to have a built in defensive mechanism to help protect them from negative emotions.

    So enlightening. People with unipolar depression don’t do this. They feel what they feel. But those with bipolar experience such damage from their negative emotions.

    As I said earlier, unipolar depression and bipolar depression may look similar to someone observing people suffering from these. But they feel different.

    Let’s add to that, that both of these disorders can often end in suicide, unfortunately. Even so, it’s more common in bipolar disorder.

    There are traditional medicines for people with these disorders. And those medicines do help a lot of people.

    But not all.

    For that reason it’s important to seek help until you find treatment that helps you feel better, function better, and live a rewarding life.

    IV Ketamine Doesn’t Differentiate Between Bipolar Depression vs Unipolar Depression – It’s an Extraordinary and Robust Depression Treatment

    At Innovative Psychiatry, we offer IV ketamine treatment to help you experience relief from severe depression that prescriptions haven’t helped…. And for bipolar depression that is unrelenting in spite of prescription medications.

    Bipolar depression vs unipolar depression for this woman is still crushing.

    IV ketamine treatment isn’t effective with mania or hypomania. But the mania or hypomania is easier to manage and treat without bipolar depression. This treatment can be exceptionally effective for both unipolar and bipolar depression. In fact, it can be utterly life-changing.

    And… in regard to the risks of suicidal thoughts, IV ketamine treatment can erase those thoughts in an afternoon. A few hours. And if you’re not plagued by thoughts of death and dying, you’re a great deal freer to work toward healing, restoration, and joy.

    In this current global crisis, suicides have been increasing, among those with disorders, healthcare workers, physicians, and more.

    IV ketamine can save lives by removing thoughts that lead to suicide.

    IV ketamine has given her joy instead of depression.

    If you suffer from bipolar depression or unipolar depression, and medications haven’t helped, call us.

    Let us help you find your joy again, and your hope. The current global crisis is temporary, but it has affected the outlook of millions. The good news is that joy can be restored, and hope can return. You can feel resilient, and equipped for what life has in store.

    We’re here for you, and we’re working within a safety protocol so you can be treated without fear.

    Better days are ahead.

    To the restoration of your best self,

    signature of Lori Calabrese, M.D.

    Lori Calabrese, M.D.

  • Suicide Mortality and Coronavirus Disease 2019: A Perfect Storm?

    Suicide Mortality and Coronavirus Disease 2019: A Perfect Storm?

    Mark A. Reger, PhD1,2; 

    Ian H. Stanley, MS1,3; 

    Thomas E. Joiner, PhD3

    Author Affiliations: Article Information JAMA Psychiatry. Published online April 10, 2020. doi:10.1001/jamapsychiatry.2020.1060

    Suicide rates have been rising in the US over the last 2 decades. The latest data available (2018) show the highest age-adjusted suicide rate in the US since 1941.1 It is within this context that coronavirus disease 2019 (COVID-19) struck the US. Concerning disease models have led to historic and unprecedented public health actions to curb the spread of the virus. Remarkable social distancing interventions have been implemented to fundamentally reduce human contact. While these steps are expected to reduce the rate of new infections, the potential for adverse outcomes on suicide risk is high. Actions could be taken to mitigate potential unintended consequences on suicide prevention efforts, which also represent a national public health priority.

    COVID-19 Public Health Interventions and Suicide Risk

    Secondary consequences of social distancing may increase the risk of suicide. It is important to consider changes in a variety of economic, psychosocial, and health-associated risk factors.

    Economic Stress

    There are fears that the combination of canceled public events, closed businesses, and shelter-in-place strategies will lead to a recession. Economic downturns are usually associated with higher suicide rates compared with periods of relative prosperity.2 Since the COVID-19 crisis, businesses have faced adversity and laying off employees. Schools have been closed for indeterminable periods, forcing some parents and guardians to take time off work. The stock market has experienced historic drops, resulting in significant changes in retirement funds. Existing research suggests that sustained economic stress could be associated with higher US suicide rates in the future.

    Social Isolation

    Leading theories of suicide emphasize the key role that social connections play in suicide prevention. Individuals experiencing suicidal ideation may lack connections to other people and often disconnect from others as suicide risk rises.3 Suicidal thoughts and behaviors are associated with social isolation and loneliness.3 Therefore, from a suicide prevention perspective, it is concerning that the most critical public health strategy for the COVID-19 crisis is social distancing. Furthermore, family and friends remain isolated from individuals who are hospitalized, even when their deaths are imminent. To the extent that these strategies increase social isolation and loneliness, they may increase suicide risk.

    Decreased Access to Community and Religious Support

    Many Americans attend various community or religious activities. Weekly attendance at religious services has been associated with a 5-fold lower suicide rate compared with those who do not attend.4 The effects of closing churches and community centers may further contribute to social isolation and hence suicide.

    Barriers to Mental Health Treatment

    Health care facilities are adding COVID-19 screening questions at entry points. At some facilities, children and other family members (without an appointment) are not permitted entry. Such actions may create barriers to mental health treatment (eg, canceled appointments associated with child restrictions while school is canceled). Information in the media may also imply that mental health services are not prioritized at this time (eg, portrayals of overwhelmed health care settings, canceled elective surgeries). Moreover, overcrowded emergency departments may negatively affect services for survivors of suicide attempts. Reduced access to mental health care could negatively affect patients with suicidal ideation.

    Illness and Medical Problems

    Exacerbated physical health problems could increase risk for some patients, especially among older adults, in whom health problems are associated with suicide. One patient illustrated the psychological toll of COVID-19 symptoms when he told his clinician, “’I feel like (you) sent me home to die.”5

    Outcomes of National Anxiety

    It is possible that the 24/7 news coverage of these unprecedented events could serve as an additional stressor, especially for individuals with preexisting mental health problems. The outcomes of national anxiety on an individual’s depression, anxiety, and substance use deserve additional study.

    Health Care Professional Suicide Rates

    Many studies document elevated suicide rates among medical professionals.6 This at-risk group is now serving in the front lines of the battle against COVID-19. A national discussion is emerging about health care workers’ concerns about infection, exposure of family members, sick colleagues, shortages of necessary personal protective equipment, overwhelmed facilities, and work stress. This special population deserves support and prevention services.

    Firearm Sales

    Many news outlets have reported a surge in US gun sales as COVID-19 advances. Firearms are the most common method of suicide in the US, and firearm ownership or access and unsafe storage are associated with elevated suicide risk.7 In this context, issues of firearm safety for suicide prevention are increasingly relevant.

    Seasonal Variation in Rates

    In the northern hemisphere, suicide rates tend to peak in the late spring and early summer. The fact that this will probably coincide with peak COVID-19 prevention efforts is concerning and deserves additional study.

    Suicide Prevention Opportunities

    Despite challenges, there are opportunities to improve suicide prevention efforts in this unique time. Maintenance of some existing efforts is also possible.

    Physical Distance, Not Social Distance

    Despite its name, social distancing requires physical space between people, not social distance. Efforts can be made to stay connected and maintain meaningful relationships by telephone or video, especially among individuals with substantial risk factors for suicide. Social media solutions can be explored to facilitate these goals.

    Tele–Mental Health

    There is national momentum to increase the use of telehealth in response to COVID-19. Unfortunately, tele–mental health treatments for individuals with suicidal ideation have lagged far behind the telehealth field. Opportunities to increase the use of evidence-based treatments for individuals with suicidal thoughts have been noted for years, especially in rural settings, but fear of adverse events and lawsuits have paralyzed the field. Disparities in computer and high-speed internet access must also be addressed. Research, culture change, and potentially even legislative protections are needed to facilitate delivery of suicide prevention treatments to individuals who will otherwise receive nothing.

    Increase Access to Mental Health Care

    As COVID-19 precautions develop in health care settings, it is essential to consider the management of individuals with mental health crises. Screening and prevention procedures for COVID-19 that might reduce access to care (eg, canceled appointments, sending patients home) could include screening for mental health crises; clinical staff would be needed to some degree in settings that may currently relegate COVID-19 symptom screening to administrative staff. Also, rather than sending a patient with a child home, alternative treatment settings could be considered (eg, a private space outside).

    Distance-Based Suicide Prevention

    There are evidence-based suicide prevention interventions that were designed to be delivered remotely. For example, some brief contact interventions (telephone-based outreach)8 and the Caring Letters intervention (in which letters are sent through the mail)9 have reduced suicide rates in randomized clinical trials. Follow-up contact may be especially important for individuals who are positive for COVID-19 and have suicide risk factors.

    Media Reporting

    Because of suicide contagion, media reports on this topic should follow reporting guidelines and include the National Suicide Prevention Lifeline (1-800-273-TALK). The hotline remains open.

    Optimistic Considerations

    There may be a silver lining to the current situation. Suicide rates have declined in the period after past national disasters (eg, the September 11, 2001, terrorist attacks). One hypothesis is the so-called pulling-together effect, whereby individuals undergoing a shared experience might support one another, thus strengthening social connectedness. Recent advancements in technology (eg, video conferencing) might facilitate pulling together. Epidemics and pandemics may also alter one’s views on health and mortality, making life more precious, death more fearsome, and suicide less likely.

    Conclusions

    Concerns about negative secondary outcomes of COVID-19 prevention efforts should not be taken to imply that these public health actions should not be taken. However, implementation should include a comprehensive approach that considers multiple US public health priorities, including suicide prevention. There are opportunities to enhance suicide prevention services during this crisis.

    [Read the Original Article Here]

  • Suicidal Risk Triggered by Stressors in the Covid-19 Crisis

    Suicidal Risk Triggered by Stressors in the Covid-19 Crisis

    Russell paced back and forth by the window. 

    The gray, rainy morning had finally broken and sunshine peeked through the clouds as they parted. Patches of clear blue were spreading across the sky. It seemed to Russell this change in the weather should brighten his thoughts, but they didn’t. He guessed it would take something much more powerful than a weather change to alter his outlook. He thought about how dark he felt…and wondered if there was suicidal risk triggered by stressors that affected people right now.

    Russell was losing his belief in living. This wasn’t the first time he’d felt such futility in the daily endurance exercise that characterized his life. He’d felt hopeless before — but with time, a new job, and better pay, he’d lightened up and everything began to make sense again. 

    Then, he met someone and felt like he was basically sitting on top of the world. He hoped he could keep his life working so well. The idea that joy would become commonplace for him… that would be so great.

    The job was such a good fit. And he seemed to learn it quickly. His skills improved every week and every month… then he was promoted. His boss would pat him on the back…tell him to keep up the good work and all that.

    He believed he had a real future in this job…and a career in the making.

    Jenna came along, and maybe it’s because he was feeling so much better, or maybe it was because she was so amazing…but it was easy to talk to her, and so rewarding to listen. It wasn’t long until they were spending lots of time together.

    Then, the coronavirus crisis took over the world. There was no place to escape to…it had covered the entire globe!  Nowhere was safe.

    Settling Into a New Normal in a Global Crisis

    He was assigned to work from home. That was ok. Not great. It wasn’t easy to do as well, or be as creative, under these circumstances. But he was grateful for the paycheck. Surely this was a temporary setback.

    Next thing he knew, however, the governor ordered a lockdown. HIs company laid off thousands of people. And he was included in the second round of cutbacks. 

    So, now he’s home, he has no job, and no way to get one.  Russell made a point to watch the statistics around the world to see if the tide was turning yet. He was lonely, and he missed Jenna. Even though it helped to talk on the phone or online. There were plenty of apps to connect with her. But it wasn’t the same.

    The Crisis Hits Close to Home: Fighting Panic

    One day, she sent him a text. “Russell, my sister Beth tested positive for the coronavirus today. She’s self-quarantined in her apartment. I’m so worried. And my mom is beside herself.”

    Russell tried to be understanding…this was terrifying. He wondered when Jenna last saw her sister.  When her mother had last seen Beth. He wondered if either of them had been exposed.

    This made it all seem so much more real. More threatening, to himself and everyone he cared about.

    He felt horrifically helpless. So he paced. He washed his hands for good measure. Then paced more.

    Darn!  It’s so hard to feel useless like this!! He checked on Jenna often, and always remembered to ask about Beth’s condition.

    Finally, it turned out that Beth was being transported to the hospital. She was struggling to breathe at all. 

    Russell felt his throat closing. He fought panic.

    Jenna was devastated about her sister’s decline. She said their mom was in a heap. Neither Jenna nor her mom could be at the hospital with Beth.  

    Weeks were going by. 

    How could you stand with someone if you couldn’t be near them?  How do you do it all verbally?  He feared his relationship with Jenna was disintegrating like his job had. But he knew her primary concern was her sister, and he was sure worried about her, too.  

    Russell had never been the best communicator. In times of difficulty it was hard to find the words. He’d always made up for it with effort. Showing his support with hugs, helping out with food, etc.

    He had no idea how to do that from miles away.

    He feared his relationship with Jenna was disintegrating like his job had. But he knew her primary concern was her sister, and he was sure worried about her too.  

    And felt so helpless.

    When he wasn’t talking or texting with Jenna, he was applying for jobs online. It seemed he had surely applied for hundreds of them by now. But nothing. No responses to his applications. He could only imagine the number of applicants competing for each job. He was sure it was more than ever before in his life.

    Still he kept applying. 

    It was good to stay busy, and at the same time, it felt so futile. 

    Weeks turned into months, and he finally applied for unemployment. Sickening.

    How could everything be so good, then take a 90-degree turn straight into the toilet??

    As if it all wasn’t enough, he heard from Jenna about her sister. Beth, who’d been in the ICU on a ventilator, finally died. They had thought she was improving…thought she would come off the ventilator soon… then suddenly, she deteriorated. And died.

    Russell was stunned. Speechless.

    Jenna was heartbroken. Blind with grief. He tried so hard to comfort her.  To listen. But there was nothing he could say to relieve her pain.

    He couldn’t go to her, hold her, take her out to dinner so she could vent. And her mom was grief stricken and seemed to expect Jenna to comfort her. 

    He couldn’t think. It was as if the entire world was self-destructing around him. His head was spinning.

    Profound Grief Causes Its Own Isolation

    Jenna seemed to just be gutted…depleted…with no more to give to anyone.

    She withdrew after that. She and her mom could not have a funeral for Beth. As the days went on, they both seemed more and more traumatized by the circumstances surrounding Beth’s death.

    Russell became less and less vital to their grief, it seemed. If they needed his support, he didn’t know how to give it. He felt so useless. So powerless. Utterly flabbergasted that life had collapsed as it had in a couple short months.

    The grief he felt for Jenna’s loss eroded his foundations. His resilience. The energy seemed to drain out of him. His hope disappeared.

    He’d been in his house for 2 months, and the strain, disappointment, disillusionment, loss, confusion, and anxiety of his circumstances became worse and worse until they were unbearable.

    He saw no reason to go on. He looked at the future through his dark perspective, and it looked hopeless.

    Even after the lockdown was lifted, he still wouldn’t have a job, right along with millions of other people. He would be evicted from his apartment, and lose his car. 

    The melancholy of the past swelled until he was drowning in it. Russell just didn’t have the energy to go on.  He didn’t believe he was strong enough to face any more…

    He wanted to die. Every hope… every purpose… for living was gone. He couldn’t see how he could go on…

    Russell’s Not Alone: So Many Fight Despair in Times Like This

    The crisis created by this COVID-19 coronavirus is creating stressors and fears that go far beyond the risk of the viral illness. And as our friend Russell identified, there is no where to escape to. 

    Hundreds of thousands of people feel the same feelings and are thinking the same thoughts. But in each case, the situation is not necessarily as it seems.

    Unfortunately, it is what seems to be true that people all too often act upon. And suicidal risk triggered by stressors in this crisis rises higher and higher.

    However — and this is important — thinking about suicide is not logical thinking, even though it may seem to be at the time. Suicidal thoughts are symptoms of a disordered mind.

    Suicidal Risk Triggered by Stressors in This COVID-19 Crisis

    The stress of isolation, financial difficulties and strain, the uncertainties about income in the future, the emotional pressure of being separated from those you care about and who care about you, combined with a host of feelings that come out of nowhere in a time like this… can push you to the point of desperation.

    And…if you’ve struggled with psychiatric symptoms in the past, these elements can put you at higher risk.

    But There Are Ways to Find Relief

    However, as overwhelming as circumstances appear, they’re still temporary. They will change. Life will be restored. But that can be hard to grasp if the thoughts are swirling and swirling around inside your head.

    Meanwhile, you can seek support from friends and family online, see their faces and vent, laugh, and cry together.

    You can reach out for counseling through telemedicine. And then consider treatment.

    Again, suicidal thinking is a symptom of a disordered mind.

    If you find yourself thinking those thoughts, reach out for help. The circumstances of your life are not normal right now. And people everywhere are feeling similar feelings, as well as desperation, cooped up in their homes.

    Suicidal Risk Triggered by Stressors Like Grief, Financial Uncertainty, and Fears of All Kinds… Can Be Lowered With Treatment

    At Innovative Psychiatry, we’re treating people every week with ketamine treatment provided with carefully planned safety protocols.

    Ketamine treatment is one of the most effective treatments for severe depression, bipolar depression, PTSD, social anxiety, and suicidal thoughts we know of. It also can relieve substance abuse and alcohol abuse.

    As it goes to work restoring the synapses in your brain, proliferating connections between nerve cells to explode communication through your brain, it also can restore your motivation, your creativity, and your joy.

    As a result, resilience replaces listlessness, energy replaces lethargy, and hope replaces despair.

    In spite of how it all seems to you right now, that reality you’re experiencing is based on temporary circumstances… In the challenges ahead, how much better to have the energy and hope you need to conquer and create a reality that fulfills you?

    Suicidal risk triggered by stressors of the covid crisis can be reduced by ketamine treatment.

    There is a future. And you’re in it.

    You can reduce the suicidal risk triggered by stressors in your life by reaching out for ketamine treatment. If you’re experiencing some of the things Russell is, call us.

    Give yourself, and those who love you, the benefit of treatment that can give you a new lease on life. You can be amazed at how the direction of your thinking transforms.

    There is life beyond this COVID-19 crisis. And you’re in it …with a bright future.

    To the resilience of your best self,

  • Coping with Anticipatory Grief in the Covid-19 Crisis

    Coping with Anticipatory Grief in the Covid-19 Crisis

    Jocelyn and her friends missed their interaction on Friday nights after a week of work.

    They’d meet somewhere and have dinner and talk about work, their plans for the weekend, the people they knew, and their hopes for the future. But since the COVID-19 crisis, they worked from home and Friday was just another day.  So they decided to have a meet-up online. Jack set up a zoom meeting so they could all see each other, and it commenced Friday night at 7pm like they’d always done before. They ate their dinner in front of their laptops and chatted about this and that, vented about isolation, about technical problems when all work had to take place online, and family frustrations. And they talked about the horrid emotions they felt. The idea that millions were expected to get sick and die. Scott, a therapist, mentioned ways of coping with anticipatory grief. Someone else said, “Wha..??” Jack said, “What the heck is anticipatory grief??”

    Scott went on to explain that horrid feeling they all described, the dread they felt about all the sickness and death, the fear that their friends or family members would likely be among the dead…that this all falls under the category of anticipatory grief: Grieving about losses that haven’t happened yet, but might. 

    He also said that when you read all the articles that come out every day about the potential damage the COVID-19 virus can do, that dread increases day by day. Then you hear about someone’s co-worker or family member who tested positive for the virus, it gets a bit closer to home, and your dread and fear of loss increases.

    When Fear and Grief Hit Home

    Next, you get word that your own relative or co-worker dies… or the relative or coworker of someone close to you dies, then you feel the loss up close.  It becomes your own loss.  And it hangs on you, weighing you down, long after…because it goes so deep. 

    Celia hesitated, then spoke up. “My aunt died. It’s been so sad I haven’t wanted to talk about it. But she lives in New York City, and tested positive. She tried to recover at home…then her breathing got really bad one night and they had to take her to the ER. She was in the ICU with a ventilator for 17 days. Just about the time she seemed to be getting better, she suddenly got bad again…and died that day.”

    Everyone told Celia how sorry they were. How terrible it was to lose someone you love over a virus.

    Nick spoke up. He had a sadness about him most of them had noticed.  He said, “ A friend of our family…someone I grew up with…started feeling bad, and called the doctor. The doctor told her to go for a test at a drive through testing center. She tested positive and her cough was so intense, her breathing so bad, they admitted her to the hospital, too. Within 3 days she was gone.  She was my age! It’s so hard to make sense of it.

    “I hear about people protesting the lock down…or throwing COVID parties…and I want to scream. So many people don’t get it. I wondered myself in the beginning. But as I saw the numbers increase around the world, I realized this is real. I wish each one of those people who went to one of those parties could see how it feels to lose someone you care about. And who knows who’s next?? It could be one of us!”

    Celia jumped in and said, “Yes…or to see what’s it like to be sick with this. Sure there are people who aren’t having symptoms, but talk to the ones who are! My friend got sick and had to let someone take care of her child while she convalesced.  She said it was the worst thing she ever experienced.”

    Scott then pointed out how THIS is anticipatory grief. Realizing that someone you care about could get sick. Could die. And worrying about it. 

    “And,” he said, “there are things you and I can do to help us get through this.”

    Study: 40% Say Anticipatory Grief Is The Worst

    “A Swedish study,” he went on,” found that no matter how much you grieve before you experience the loss, it doesn’t reduce your grief after the loss really happens. And that 40% of the people studied felt the grief you experience when you anticipate loss is far more stressful than the grief you experience afterward.”

    Jocelyn asked, “If that’s the case, then it sounds as though I’d be much better off waiting until someone dies to grieve, than grieving about everyone in advance. But I do feel fearful…I have anxiety all day and especially at night…On top of that, I’m drinking more than I ever have. Just to try to relax and not think about what could happen.”  

    Scott agreed. “But how do you wait until you have someone’s death to actually grieve??? Coping with anticipatory grief is so much harder than we could have expected!”

    Celia finally blurted out, “My husband is beside himself. He’s so angry, filled with doom and gloom. Constantly rehearsing the latest statistic in illnesses and deaths in every country around the world. His rage is so hard to be around, even though I know it’s just how he’s coping. But it all makes me all the more lonely…

    Symptoms of Anticipatory Grief

    “Ok let’s all look at this, guys…” Scott was talking in a softer voice now. “We have Nick, who’s been so sad, and has lost a lifelong friend, and Celia’s husband who is irritable and furious about what’s happening…and likely struggling with feeling out of control…which he is… and Jocelyn who feels fear, anxiety, and uncertainty… and Celia who’s sad about her aunt, stressed about her husband, and lonely.  
    “You know what?  All of these things are symptoms of anticipatory grief. So what can you do, what can WE do, to cope right now…and get through this?

    Coping With Anticipatory Grief – We Need Each Other

    Nick, Celia, and Jack all said at the same time: “Keep getting together like this!”

    Scott and Jocelyn laughed…and heartily agreed.

    Nick admitted that meeting and talking, opening up and feeling understood were all amazing for him. He could see that spending time together was great medicine.

    So they agreed that the lockdown would no longer interfere with their mutual support. And they would continue their Friday night @ 7 gathering online, until they could meet in person again.

    Grief is a looming and saturating condition for many, if not most, of us during this COVID-19 crisis. Grieving over the death of someone we care about is a form of grief that’s inescapable when we lose someone, no matter the circumstances. 

    But anticipatory grief is another form that can cause anxiety, depression, and overwhelm. In trying to prepare for loss, it magnifies the suffering of loss itself, and can continue to cause more pain months or more after that loss occurs. Right now, news from government and medical experts can ignite enough fear to trigger anticipatory grief. 

    How long will I be out of work?  Will we lose the house?  How will we feed the family?  What if one of us dies?  Who will take care of the children?…And that suffering intensifies the actual suffering from this global crisis. Coping with anticipatory grief includes finding ways to stop the cycle of fear in our thinking.

    Like these friends, fear of what might happen, fear of losing loved ones or other things in life you hold dear, can overwhelm your outlook, and drown your perspective.

    But if you have friends like these, people who care about you and with whom you can discuss your feelings and listen to theirs, you may be able to restore balance to the way you look at life.

    But What if You’re NOT Coping with Anticipatory Grief? And Friends Don’t Help?

    Unfortunately, sometimes talking, listening, and caring isn’t enough. Sometimes you realize you don’t have many friends. Sometimes you need help. If the stressors of life, and of this period of isolation, have worn you down, stripped your resilience, and damaged your hope, then you may need the help of a treatment that can make a real difference in everything for you.

    At Innovative Psychiatry, we know that the COVID-19 crisis, and the enforced isolation that has been necessary because of it, can drain your hope, your energy, and your motivation.

    You may find you’re drinking more than you mean to, or that you’re using other substances and it’s getting out of hand.

    It can make it almost impossible to just keep being brave, and willing, and steadfast. It can make you feel like you’re afloat at sea, all alone, without hope or remedy.

    But as we’ve talked about so many times before, this is caused by the pruning and wearing down of synapses in your brain. That’s what stress does. But ketamine treatment gets your brain-derived-neurotrophic-factor (BDNF) going…burgeoning…which works like a rich compost to produce…no — more than that…to PROLIFERATE… the dendrites and dendritic spines that create those synaptic connection between the neurons in your brain.

    And when that happens, your outlook brightens like the sunrise, your thoughts begin to flash through your mind, your creativity starts blooming, and your joy and hope are restored.

    That same dose of ketamine can also help reduce your drinking, and your use of substances.

    With all that going on, believe it or not, you can be resilient whether you’re isolated or not.

    Ketamine Treatment Can Erase Suicidal Thoughts, Too

    That’s the beauty of ketamine treatment. And what’s more? It’s so effective.

    And remember. The kind of discouragement, depression, and fear we’ve been talking about can make some people want to stop living. If you have struggled with those thoughts, if you’re not coping well with anticipatory grief, we want to help. Because ketamine treatment can stop suicidal thoughts in an afternoon.

    This is why we’re open when everything else is closed. Because taking care of you is essential. And that’s what we’re here to do.

    If you’ve struggled with some of the feelings Jocelyn, Nick, Jack, Celia, and Scott were talking about, call us.

    We’re here and still providing ketamine treatment right now with safety protocols to protect you and to protect our staff. Just call us, and we’ll talk you through the process.

    You don’t have to suffer alone. We’re here to help you get through this confusing time, and to help you experience the joy and hope that will see you through.

    Lori Calabrese, M.D. is on the front end of the race to stop PTSD in its tracks using IV ketamine treatment.

    To the restoration of your best self,

  • Resilience During Social Distancing in the Pandemic

    Resilience During Social Distancing in the Pandemic

    “May you have interesting times always…” the asian proverb says.

    Annie's resilience during social distancing helps her to enjoy the moments wherever she is.

    Well, these are interesting times. Some of us might think a little too interesting…!  And I guess most of us are eagerly looking toward the time when we’ll have times that are less interesting and more peaceful and predictable. Who could blame us?  Still, for now, these interesting times require most to be shut-in in the name of social distancing, to “flatten the curve.” And prolonged periods of missing our routines, our friends, our gatherings, and enjoyable habits can really take a toll. Many otherwise healthy people are experiencing anger..even rage…, depression, feelings of anxiety, and grieving over the loss of friends or family members, as well as the loss of what makes life feel “normal.” But it’s actually possible to experience resilience during social distancing, believe it or not.

    Even the basic loss of freedom to do what you want when you want to is devastating for some. And even though we know in our heads that this is temporary, that doesn’t necessarily help as much as you think it should. 

    And while there’s no right or wrong way to feel through this challenging time, there are some things you can do to improve your own resilience.

    For Some, Resilience is Second Nature

    Take Annie, for instance. 

    Annie is a single, middle-aged woman who lives alone with her orange tabby cat. She has always been upbeat, generous, and helpful, while taking care of her responsibilities. The one who bakes cookies as a gift when a new neighbor moves in, pitches in after the garbage collectors come by returning her neighbors’ receptacles to their garage doors, and offers a bright smile to whomever she meets.

    When the COVID-19 pandemic emerged, she was dutiful in washing her hands often, and being careful during trips to the grocery store. Then the social distancing order meant she stayed in her house or garden at all times. She was fine for the first few weeks, enjoying contact with her friends and family online.

    Resilience During Social Distancing May Not Be as Easy as Expected

    But, after awhile, she noticed a dark wave of melancholy creeping over her. She was surprised by it, and discouraged. What was the matter with her…? She didn’t object to staying home awhile, to help stop the spread of the virus, and prevent more people getting sick.  

    Why did she feel this way?

    Day after day, the gloom grew darker, and more overwhelming. Then she even found it was hard to get out of bed.  

    Why??

    Where was this coming from???

    She tried to fight it, to drag herself out of bed, clean and disinfect the house, and sweep the porch and sidewalk. She tried to pull weeds from her flowerbeds…but after 2 or 3 weeds, she just lost interest. And went back to bed with a book.

    For a week, she forced herself to be productive, hoping this weight that was getting heavier would dissolve. 

    Resilience during social distancing helps Annie to maintain hope.
    Eventually, she stopped sleeping. Laying in bed in the dark all night long, watching the sun come up then dozing a little while.  Night after night. She grew more and more tired, and anxiety wound her up till her thoughts raced all night long.

    She had a prescription the doctor had given her for sleep in case she needed it about 6 months ago. So she took the prescribed dosage, and it made no difference. All night long — wide awake.

    Who would have thought that the lack of resilience during social distancing could interfere with sleep?

    Finally, she decided to stop fighting it. She could do nothing about the social distancing, or about the weight of gloom. But she could just take the time to take care of herself and see what happened.

    So Annie gave some thought to her dietary habits. For one thing, she decided to be careful to eat what was good for her, as she had avocados, walnuts, salmon, and chicken from her last trip to the store. She stayed away from the  chips and cookies in the cabinet and tried to eat foods that actually benefitted her brain and body.

    And she gave herself the next week off. No cleaning or gardening unless she wanted to. Why not?? She was home every day anyway.

    It was an experiment, and the world wouldn’t end if she didn’t clean for a week. She hoped that by taking pressure off, and taking care of herself, resilience during social distancing would become strong again.

    Since news of the pandemic began, Annie had searched the internet throughout the days looking for information about hospital capacities, testing availability, and masks and gloves up till now. So she decided to stay off the internet for the coming week, too.

    “They’ll have to figure it out without me I guess…” and she laughed to herself at the absurdity.

    And she chose books to read that had hope in their message. Fiction with happy endings, non-fiction with a message of hope. About that time, a trusted friend sent her an email to see how she was doing. 

    It seemed like a good idea to get some of this off her chest. So she told her friend how she’d been feeling, and how baffling it was.

    A Friend Can Divide the Burden

    Her friend, Carrie, was so understanding. Carrie said, “Annie!  You’re not alone! I’ve been having some bad days, too. I think lots of people have. When you look on facebook, it’s everywhere!”

    Resilience during social distancing is important for Carrie.

    Carrie went on, “Some people are angry, others are whining and complaining, others are criticizing the government or other countries or whoever they can find to blame. I think that these changes, along with worry about whether we will get it, or someone we love will die, along with the uncomfortable reality that we’re out of control, just takes a greater toll than we realize. I think we all need to be patient with ourselves. This pandemic is going to end. It’s not permanent.”

    Nothing Carrie said was a surprise, but somehow talking about all this, and hearing her support, seemed to help a little.

    When Resilience is Natural for You, It’s Easier to Restore

    So Annie embarked on her “week off” and just did what she felt like doing and what she enjoyed. She read books, relaxed, drank coffee in the mornings, and San Pellegrino at night with her healthy foods. 

    After 3 days of this, Annie woke up and realized she had slept all night. That was a breakthrough. The next day she went for a walk on her street. 

    Then, the next day, she worked in her flowerbed, and pulled out weeds and turned the soil. Her heart was getting lighter, she could tell. A few days later, she was ready to clean her house, a little at a time. Most importantly, she sensed hope emerging inside her again. A little exercise, reduced pressure, good food, and sunshine…as well as avoiding depressing news sources …and Annie was almost as good as new.

    Resilience during social distancing helps Annie find productive ways to enjoy each day.

    You may find that Annie’s remedy can help you, too. It’s helped lots of people going through these “interesting” times.

    When You Aren’t Naturally Resilient, There’s Still Hope…

    But, if you’ve been depressed, anxious, overwhelmed since long before the pandemic began, Annie’s remedy may not be strong enough to make the difference you need. And if that’s the case, don’t worry. 

    There’s no shame in a condition that saps your energy and darkens your outlook. It just might mean that you need treatment to help you find the hope Annie did.

    Because hope is something every human needs to live well.  And resilience is a product of hope. You need both.

    Ketamine Treatment Restores Resilience

    We have a treatment that can restore hope, joy, and resilience for you if you’ve lost them.  It’s not a temporary or artificial “fix” like some people seek in shadowy places. Ketamine treatment goes into your brain cells and stimulates the growth of essential elements that are missing.

    Things like brain derived neurotrophic factor (BDNF) that proliferates the production of synaptic connections that brighten the communication of thoughts and creative signals in your brain.

    It’s more like ketamine sets your brain cells in optimum working condition, like they should be. 

    And when that happens, your mind can function to provide you with a sense of wellbeing, so you feel hopeful, joyful, and resilient.

    At Innovative Psychiatry, we’re an essential service in this crisis, present and ready with a full safety protocol for treating patients who need to be treated during this difficult and challenging time of social distancing. 

    The coronavirus hasn’t reduced the need for treatment of depression, PTSD, anxiety, suicidal thinking, and other conditions, but has actually increased it. And we’re here to help you get through this uncertain time with treatment that can reduces, or even eradicate your symptoms.

    Resilience during social distancing due to the pandemic is important, and can be restored in you.

    Resilience during social distancing helps you find joy in the midst of the pandemic.

    We understand the difficulty of social distancing, of feeling isolated, and of coping with symptoms that traditional medicines aren’t helping. 

    If you believe ketamine treatment can help you, call us.

    We’ll talk about whether ketamine treatment might be a good fit for you and talk you through the process of treatment.

    There really is a way to function and feel up for the challenges of life during this time. You really can have joy again, and hope.
    Lori Calabrese, M.D. is on the front end of the race to stop PTSD in its tracks using IV ketamine treatment.

    To the restoration of your best self,

  • When You’re Tormented by Fear, PTSD, and Panic in Isolation

    When You’re Tormented by Fear, PTSD, and Panic in Isolation

    Shannon awoke, looked around the room hoping the new day would reveal it had all been a nightmare, and that life was back to normal.

    But when she saw the the shattered mirror – cracks spreading out from a broken center – she remembered hitting it with her fist last night and realized nothing had changed. She looked at her hand…to  see if it was cut. It was no surprise to see the cuts on the heel of her hand, the dried blood. It looked like the damage was minor and it would heal on its own. Why do fear, PTSD, and panic strike so hard at night?

    The nights were hard.

    Stay Safe, Stay Home the governor had said…

    But for someone like Shannon, these instructions were costly. She understood it was important. But the silence, the darkness, the feeling that the walls were closing in turned her apartment into a house of horrors at times. Those sounds she couldn’t identify that made the hair stand up on the back of her neck and her heart race. 

    She’d grab the 18” long flashlight she kept in bed with her, to defend herself if an intruder broke in. The baseball bat was just under her bed if she needed it.

    Last night she couldn’t see anyone, but the sounds started reverberating around her, and she finally exploded through the house ready to fight. She screamed, she cried, and she finally sank to the floor sobbing.

    She’d wanted to die. She wondered how she could escape her life and her terrifying thoughts.

    The mirror happened at some point during that experience and she wished she had never woken up again. But she did.

    Right now she was calm. Why did she get so wound up by the dark?  

    Fear, PTSD, and Panic Attacks Seem to Get Worse at Night

    All day she tried to manage herself. Her doctor had reminded her to try to avoid news broadcasts and news websites. Just reading about all the evolving changes in the city and country every day was overwhelming and depressing. Her doctor had pointed out that the sheer volume of information was too much for anyone to digest.

    Instead she encouraged Shannon to find people online she could encourage. Or to offer to pick up groceries for people in the apartment  complex who were at greater risk for the COVID-19 virus. 

    She’d said that doing things to help others can give her more peace and good feelings. And can help her stay balanced.

    But it was hard.

    Even though Shannon had followed her doctor’s advice, even interacting with friends on social media was becoming more challenging as more and more people were spewing anger, rage, and blame.

    Sometimes it seemed as though fear attracted fear. And she wondered how to attract optimism, instead.

    Listening to the rants of her friends stirred up her anger, too.  But more than anger was the fear that their fears ignited.

    And when you have a disorder, fear can present its own danger.

    Counting her pills helped her verify she had been taking her meds on schedule. Of all times, this weird time shut in her apartment was not the time to miss her meds.  She needed all the help she could get and she knew it.

    Shannon decided she better request an online meeting with her doctor on the secure server. She thought she better tell her what happened last night.  She didn’t want to.

    It was embarrassing, but she was learning that facing her symptoms in all their “glory” gave the doctor the information needed to make sure her meds were at the best dosage. 

    She’d only been coming clean with her doctor for a couple years. Before that, she’d always tried to protect herself with a clean and respectable image and then everything would fall apart. She guessed she’d learned that her condition wasn’t something she should be ashamed of, but rather a condition with symptoms she and her doctor worked together to manage. 

    It had lifted a load off her to finally accept the condition rather than hide it. She wondered…if she did die here, how long would it be before they found her body…?

    Shannon forced herself to stop thinking that way. She just had to not think like that…but how could she make the thoughts go away?

    The Relief Ketamine Treatment Can Bring

    Next door, Sam woke up after the night of bumping, pounding, broken glass, screaming, and crying that kept him awake last night, wondering how he could face the day. He thought he might have dozed for an hour or two in all.

    One of the hard things about working at home was the desire to crawl back into bed or doze on the couch when he was tired.  

    Nevertheless, he showered, got his coffee, and sat at his computer at 8:30am right on schedule.

    Fear, PTSD, and Panic Attacks Can Affect People Near You, Too

    As his day began, he was distracted thinking about all the noise from next door. It wasn’t the first time. He wondered if the person who lived there was being mistreated by someone or if she was there alone.

    If she was there alone, he sure could understand this social distancing getting to her. It seemed to him that social distancing is great for happy introverts who want to quietly read books or something but it had to be hard for people who draw their energy from spending time with other people.

    As for himself, he was just so relieved that he had as much self control in these circumstances as he did. 

    For years, PTSD had kept him so torn up, so terrified at times, that his wife and children were afraid of him. Being shut in like this would have been really really hard.

    But he was lucky.

    He’d learned about a treatment that helped him find a calm, a feeling of well-being, and  a peace he didn’t know was possible.

    His buddies from Afghanistan had talked about all kinds of special treatments. There were camps people went to that were so expensive, he didn’t have the means to try them.  

    One of his friends came back doing somewhat better, but still had the awful flashbacks at times. A couple others didn’t get much out of it…after all that money.

    There were counseling programs, outpatient medicines, and more.

    But one guy told him about ketamine treatment. And this guy seemed almost well. Hard to believe but he did.  They became good friends and talked more and more often. He said that fear, PTSD, and panic were much more rare now.

    Turned out the guy went for 6 treatments at his psychiatrist’s office… and he just kept feeling more and more normal.

    So Sam looked into it. He found out he could get special financing from a medical loan service, so he went for it.

    That was a year and a half ago, and he was just so glad for his calmer frame of mind during this lockdown. He could only imagine what this period of time would be like otherwise. Fear, PTSD, and panic would have been the fabric of his existence. But…

    By eating healthy, working out in his living room over lunch hour, and looking for ways to help people around him, he felt a bit more like a hero to some of the older people in his complex, and less like someone who came home from the war broken. 

    He did attend an online meeting for people with PTSD once a week,  and tried to apply everything the therapist suggested. But he also felt like he had things he could contribute, too. This treatment almost seemed to increase his insight into the trauma he experienced, so the more meetings he attended, the less victimized he felt.

    Sam wished he could help the girl next door.  He wished he had something to offer. He needed to think about that more. Maybe he could come up with something to cheer her up without having actual contact with her.

    He felt so privileged to be living this well. It was as if he’d been to hell and back…and he just wanted to give something somehow to those who hadn’t found the freedom he had.

    Weathering The Coronavirus Crisis

    As you get through the days in your home, you look around you, and there are people in all the other homes and apartments you see. Some are coping fine, though they may be getting cabin fever. Others are working hard, with some tension building as they work because of the conditions in the world.

    But some are suffering. Fear, PTSD, and panic attacks along with severe depression threaten the health and wellbeing and sometimes the lives of some. From ailments that make life alone at home a lot harder. And those whose symptoms are intensified by the isolation they feel may be suffering more than you can imagine.

    Here at Innovative Psychiatry, we’re seeing patients every day.  Our psychopharmacology patients we see by telemedicine. It’s important for all of us to avoid face to face contact, but it’s also important to take care of our patients.

    And those patients who need ketamine treatment? We’re carefully treating you here at the office. Using a safety protocol that protects you, and protects us, too.

    We’ll screen you for exposure to COVID-19 to protect your safety and ours, as well.

    Ketamine treatment can help ease your symptoms, improving the neuroplasticity in your brain cells, so you can change the way you see things, and respond to them.

    And …often even separately from your symptom improvement, it can erase suicidal thoughts in a few hours. If you’re isolated, and the suicidal thoughts have become overwhelming, call us.

    And if you suffer with PTSD, severe depression, severe bipolar depression, with symptoms that medication doesn’t relieve, schedule a consult to see if ketamine treatment could be right for you.

    For suicidal thoughts, you’ll be amazed at what ketamine treatment can do to give you peace from those.

    Stay Safe, Stay Home. But if you find it too hard to get through the days and nights right now, and if the terror and despair overwhelm you, call us.

    We’re here to help you achieve a healthier, more balanced frame of mind to see you through the current crisis and beyond.

    You can get through this, with help. We’re all in it together.

    Lori Calabrese, M.D. is on the front end of the race to stop PTSD in its tracks using IV ketamine treatment.

    To the restoration of your best self,

  • When Coronavirus Illness and Grief Hit Home

    When Coronavirus Illness and Grief Hit Home

    Leia dragged herself off the couch.

    Good grief. She felt soooo tired. She didn’t sleep that well last night…couldn’t get comfortable… maybe that’s why, she guessed. After walking into the kitchen to brew some tea, she decided to just take it easy and read a book on the coffee table. After awhile…she dozed off. Then, her phone beeped and woke her with a start. Shoot. Her tea was cold. She dragged herself up to go make more… uggghhh… what was this burning…?  Sort of a weird sensation from her windpipe to her lungs…  strange. Surely not, she thought.  She hadn’t heard anyone mention this sensation when she read about symptoms of the dreaded coronavirus. Covid-19, they called it. Coronavirus illness and grief was all over the news. But she and her friends never expected it to affect them.

    Leia realized she was too tired to wait for hot water for her tea. She slunk back to the couch and collapsed. She needed to go to the bathroom but didn’t know if she could get there without rest first.

    What’s the matter with me??

    Then, Leia remembered a little test people talked about online to help you see if this was “the virus.”  They said to fill your lungs with air, hold it for ten seconds, then let it out. 

    They said if it hurt to hold it, it might be a sign you’ve contracted the covid-19 virus.

    Ok, she thought to herself. I’ll do that.

    She filled her lungs and counted…1… 2…3…owww!

    She quickly exhaled.

    That really hurt. Leia wished she had tried the test when she was well so she could see what it’s supposed to feel like. But it had never been painful to hold her breath.  She knew that much.

    The Coronavirus Illness and Grief Is Worse Than Imagined

    The next morning, Leia woke up feeling desperately worse. The aching all over her body felt like her body was breaking. To call it an ache was far too mild a description. Especially in her back and all her joints.

    She had to get to the bathroom. She steadied herself on the side of her bed… then gingerly crept slowly to the bathroom. This is overwhelming…! What was she going to do ?  The severity of whatever this was surprised her.

    After she awoke from a nap, she let out a little cry from the body pain. It occurred to her to take her temperature. Where was the thermometer…? She pulled herself up from the couch, holding onto the lamp table until she was upright. Her chest hurt… exerting herself a little made her gasp for air.

    The coronavirus illness and grief requires checking for fevers.

    Inching slowly, she made her way into the bathroom and searched for it. When she thought she couldn’t stay on her feet much longer, she spotted the thermometer, grabbed the alcohol and made her way back to the couch. Her labored breathing alarmed her…

    Once near the couch she started coughing…long and hard. She leaned in to get the alcohol bottle and thermometer to the coffee table. Then, holding onto the table she braced herself till she reached the couch and collapsed.

    This is terrible! What’s going to happen to me here..? Her thoughts scared her, so she tried to calm herself.

    Honestly, she needed someone there with her. Even getting her own fluids was so hard. The simple act of going to the bathroom was terribly difficult. 

    Leia wondered if she should carry her pillow and blanket with her on her next trip to the bathroom so she could lay down there and not have to walk back to the couch.

    Coronavirus illness and grief is hard to bear when you're alone.
    She thought about the night she had dinner at a friend’s house with a few other friends. Everyone there was sure they hadn’t been exposed to that virus. These were 20-somethings who’d lived their lives without incident and had come to call this pandemic an “old person’s disease.”

    They had even laughed at the thought that they needed to be that careful, locked in their houses, washing hands all the time. Sillyness.

    That was six days ago.

    Oh dear… how could we all have been so naive..? So wrong??

    She needed help, but knew she mustn’t ask anyone to come over. This was an awful illness, and even though she felt scared, she wouldn’t wish it on anyone.

    She’d heard about someone in their circle of friends who was staying with his girlfriend’s family while he fought it. She wondered how he could expose them that way. It seemed wrong to her.

    She coughed hard again. A dry cough with nothing that came up. But it hurt. Her lungs hurt. She thought to herself that it would be hard to describe to someone what it felt like.

    She managed to reach her thermometer from the coffee table, and checked her temperature. 

    102.4F

    Oh no.

    The cough, the aching and weakness, the fever… she’d bet the farm she had “it.” If she had the energy she’d text others who were there that night at the dinner… see who else was sick. But it was too much.  Coronavirus illness and grief was a Goliath… She drifted off to sleep again.

    Leia woke up drenched in sweat. But she was too weak to move to get dry clothes… This must be COVID-19. She’d never felt anything this severe. Coronavirus illness and grief filled her with sorrow and regret. How she wished she’d stayed home and avoided that dinner.

    Her chest felt tight. She tried to take a deep breath but couldn’t.  And it hurt so much.

    The next time she woke up, she could barely breathe. She could barely move. She could tell her fever was up again but it was too hard to reach the thermometer.

    Leia drifted off to sleep, fighting for air…

    Avoiding Coronavirus Illness and Grief Justifies Isolation

    Is COVID-19 just like the flu? Really?? Is that what you’ve heard? One report after another emerges where you read that someone believed all this caution was part of an elaborate hoax. And then they suffer from this infection themselves… and try to spread the word that this sickness is terrible, so take it seriously.

    Worse than anything they’ve experienced before. Unfortunately, some even die.

    You know, it’s probably safe to say that our whole country’s population is grieving on some level.  Elizabeth Kübler Ross wrote a book decades ago about the stages of grief. It starts with denial, then advances to anger, then  bargaining, then depression/resignation …and finally acceptance.

    Do you find yourself in any of these stages?

    Actually, you may experience more than one stage at the same time…and you may repeat stages, too.

    Coronavirus illness and grief can be so suffocating when you're alone at home feeling scared and sick.

    If you’ve heard about “corona parties” where people thumb their noses at quarantine and lockdowns by gathering for a party… Not only are they likely to be cited or arrested, but these people are in the first stage of grief…Denial.  It’s really not a river in Egypt, right?  

    Denial’s about telling yourself something isn’t really happening, and as a result you can sometimes put yourself and others at risk..  and even in grave danger.

    So, when you see that going on, don’t adopt that outlook. Leia, in our story above, made that mistake along with her friends. And she paid a dear price.

    Even so, you need connections, interactions, exchanges that say you care, and that others care about you, too.

    If you have complied with self-quarantine, you may still be grieving. Most are. And that’s ok.

    It’s hard to see the changes taking place in the world, and to not know what to expect.

    Will life ever return to the way it used to be?

    It’s ok to ask the questions, and to ponder the answers. There’s uncertainty for everyone. 

    Coronavirus Illness and Grief Can Seem Overwhelming

    Still, try to reassure yourself that you’re not alone. Most people are grappling with the same questions, and will find answers together.

    Even so, just knowing that may not be enough. If you find the questions and uncertainties go around and around in your mind, if you find that you’re weary and losing hope… if it seems insurmountable, call us.

    We’re here to help you through times like these. It’s possible you may need treatment beyond what’s been in place up till now for your depression and anxiety or PTSD. Being cooped up and losing your routine can be so unsettling. Possibly frightening.

    Ketamine treatment can bring you resilience to cope with the coronavirus illness and grief.

    Our patients find that ketamine treatment can help them balance, restore, and become resilient again in the face of times like these.

    If you wonder, call us. We’ll speak with you on the phone to determine if you’re a good candidate for ketamine treatment and to screen you for possible exposure to COVID-19.

    You will get through this, and we’re here to help. While non-essential workers are locked in their homes, our medical services are essential for helping you cope with your life now, and to help you get better for your future.

    We’re here to help you breathe in life again.

    Lori Calabrese, M.D. is on the front end of the race to stop PTSD in its tracks using IV ketamine treatment.

    To the restoration of your best self,

  • Houston based depression psychiatrist, Dr. Sandhya Prashad, M.D., tells how this new drug might save lives and cost less than expected

    Houston based depression psychiatrist, Dr. Sandhya Prashad, M.D., tells how this new drug might save lives and cost less than expected

    As seen on a Sussex Directories Inc site

    FDA approves Spravato, a version of ketamine backed by Johnson & Johnson that sees rapid results in patients battling treatment resistant depression and suicide.

    HOUSTON, March 5, 2019 /PRNewswire/ — “New FDA approved depression treatment, esketamine, is the biggest advancement in depression treatment in thirty years” – says Houston based Psychiatrist, Dr. Sandhya Prashad. This approval allows ketamine treatments to be more widely available and will likely be covered by various insurance providers for patients who have failed previous treatments.

    Depression is the leading cause of disability worldwide, and an estimated 16.2 million adults in the United States have had at least one major depressive episode. According to a survey conducted from 2011 to 2014 by the U.S. Centers for Disease Control and Prevention, one (1) in eight (8) Americans age 12 and older are reported to have used antidepressants within the past month.

    Ketamine has been hailed as the most important advancement in the treatment of depression in the past 50 years. Ketamine works on the NMDA receptor and modulates glutamate instead of serotonin, norepinephrine, and dopamine like traditional antidepressants. It is thought to help restore nerve synaptic connections in brain cells in people with major depressive disorder. It also works faster than other antidepressants. Patients often report symptom improvement in days instead of weeks. Suicidality also often improves rapidly.

    Other psychiatrists in Dr. Prashad’s network have been sighted to confirm the drugs’ effectiveness and long-term results as per this weeks interview from the TODAY show: esketamine nasal spray discussed on the Today show.

    Today, Johnson & Johnson’s nasal form of Ketamine, esketamine, which will be marketed under the name Spravato, was FDA approved. The long-term safety study showed that esketamine was generally tolerable, with no new safety signals with dosing up to 52 weeks. Discontinuation rates due to esketamine-related adverse events were low.

    Traditional, conventional antidepressant drug treatments have a therapeutic lag of 3–4 weeks, and about a third of patients do not respond. At this time, ketamine has been available as an off-label treatment for depression and is not covered by insurance. Given the fact that ongoing treatment is required, it can become rather costly, and this has greatly affected its accessibility for patients. Johnson and Johnson has been developing a nasal version of ketamine called esketamine (Spravato) for treatment resistant depression. With FDA approval, insurance companies will begin to cover costs of the medication and make the treatment more widely accessible. The drug would be the first novel therapeutic for depression in 35 years.

    “We’ve always prided ourselves in offering the most advanced treatments to our patients,” Dr. Prashad said. “Insurance coverage of esketamine will allow this life-saving treatment to be accessible to patients that need it. With one-third of those suffering from depression unable to respond to antidepressant medications, being able to provide relief to patients that are otherwise treatment resistant is a great opportunity.”

    Dr. Sandhya Prashad, board certified Psychiatrist based in Houston, has specialized in treatment resistant depression and has been using ketamine in her practice since 2016. A graduate of Baylor College of Medicine for both Medical School and Psychiatry Residency, she has presented on the national level at conferences regarding the use of ketamine. She is a founding member and the secretary of the American Society of Ketamine Physicians (www.ASKP.org) which is a non-profit organization created to advocate for the safe use of ketamine for mental illness and pain disorders and to expand access to ketamine therapy. Dr. Prashad was also named one of Houston’s Top Doctors by H Texas Magazine for 2017, 2018 and 2019.

    Patients may learn more about the treatment and the practice by calling 832-436-4055 or visiting www.houstonketaminetherapy.com

    For Press Inquiries, contact:
    Bianca Bucaram
    The Bucaram PR Group
    713-898-6552
    bianca@bucaramprg.com

    SOURCE: Dr. Sandhya Prashad

    [Read the Original Post Here]

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