Lori Calabrese, MD

Blog

IV Ketamine Treatment for the Saddest Day of the Year…? Maybe so, if it’s SAD – Seasonal Affective Disorder Treatment

So maybe you’ve heard of Blue Monday…? January 15, the saddest day of the year. This 13 year old hoax needs a little straightening out. See if you agree. Blue Monday? What does that have to do with psychiatry?

Pretty much nothing … but let me explain.

In 2005, a guy named Dr. Cliff Arnall in Wales devised a formula for determining the single saddest, most depressing day of the year.

Was he a neurologist? No. A psychiatrist? Not even close.

He was actually working to help a travel agency determine the most likely day that people would book a tropical holiday. The “psychology” behind it measured up to this: When you feel the worst, you want to escape. Get away. So what’s the next best thing…? A vacation on the beach! Once you’ve set up the get-away, you have something to look forward to, and you feel excited about it, and life gets easier. At least that’s the theory.

The “Gloominess” Calculation

And what did he base his calculations on to determine when you’ll feel the worst?

Of course, it had to land on a Monday…who likes Mondays..? Plus, it had to be after the long stretch of holiday excitement from Thanksgiving, Christmas, and New Years was past.

And it needed to be far enough past Christmas shopping that you’d have received the bills and wish you’d spent less. And far enough past January 1st to have broken your New Year’s resolutions.

Then…add to that the gloomy winter weather, the overcast skies… remember he didn’t live in Southern California, but in Wales…the cold and snow and rain, and the short days and long nights at that time of year.

So in Arnall’s equation to the right, W=weather, D=debt, d=monthly salary, T=time since Christmas, Q=time since failing new year’s resolutions, M=low motivational levels and N_a=the feeling for a need to take action.

Now, rather than taking the time to disprove his equation, let’s just be real. Arnall was quite pleased that he was paid for his clever equation, which earned him 1650 British Pounds, or about $2265.93 in US dollars. A drop in the bucket compared to the revenue gained by the travel agency who hired him. For them, it was a great ROI.

Internet Advertising … Is It Always True?

But the fact is, there is no truth to the idea that January 15 is the saddest day of the year. Just as there is no truth to Audi’s “Truth in Engineering” slogan, since we all know they cheated on the emissions tests with about half a million cars. Not as truthful as they claim, are they?

Audi’s slogan is part of a PR marketing campaign intended to sell cars, and Arnall’s formula was part of a PR campaign intended to drive business to a travel agency. Neither one was a scam, but rather a marketing gimmick.

And the fact remains, he just made it up!

There is NO saddest day of the year. And if this time of the year is hard for you, that may be a seasonal problem. And we can help with treatment, if you need it.

So, my suggestion is that social media participants stop aiding and abetting this 2005 advertising gimmick, so that we can talk about things like sadness, moodiness, and depression in real and helpful ways.

Sound good?

SAD – Seasonal Affective Disorder Treatment

This time of year can be difficult for those who are sensitive to light, or the lack of it. While some are unaffected by these short, overcast days, you may be one who is deeply affected by the cloud cover, the cold, the gloominess…

And if that happens, it’s great to do something to brighten your mood. Go to a movie, or get your hair done, maybe shop for a new shirt. If that helps you feel a lighter mood, then you’ve accomplished a worthwhile goal.

Some people know that this mood slide begins early in the fall, every year. And you might find that light therapy helps. The idea is to use a 10,000 LUX light box or lamp for about 30 minutes very early in the morning to replace the light you’re missing in your environment. There are some variables to this depending on you, related to how far the light is placed from your eyes, and how much you can tolerate the brightness.

One of the ways around this to to use a visor with a 10K lux light on the inner brim. They are so versatile and easy to wear that you can walk around, make a cup of coffee, make the bed, get ready for your day, all while wearing the visor. You’re not stuck sitting still in front of a light on a table.

For some people this can really help. For others with seasonal affective disorder (SAD), even light therapy might not be enough. SAD is also called winter depression and it can occur episodically, just when fall strikes, and last through spring. Sometimes, people who have depression chronically or who have frequent episodes always seem to have a seasonal exacerbation — a winter worsening. And an antidepressant along with light therapy may bring you relief.

However, some people suffer so severely from depression when it occurs as seasonal affective disorder, winter after winter, that they have periods when they can’t function at all. And just like any form of severe depression, seasonal affective disorder can be crippling, even devastating.

Where you’re too sluggish to function, and you feel hopeless, helpless, fatigued, and gloomy. And gloominess advances to despondency… Despondency may even progress to thoughts of ending your life.

If this sounds familiar…if you’re feeling this way and having thoughts you haven’t admitted to anyone yet, there is hope.

In fact, there’s more than HOPE. There’s a SOLUTION.

IV Ketamine Treatment Beats SAD – Seasonal Affective Disorder

Until the last several years, only a third of depressed patients were helped by antidepressants. Which has been wonderful for those patients, but what about those who didn’t improve?

Well for those, another 1/3 felt some improvement with a second try using another antidepressant, or a combination of medications.

And for those who did find help, life had hope again. They could return to work, resume their lives and relationships.

But what about the 1/3 who were left in the pits of depression and despair…? What about them?

There’s now another form of treatment for severe depression, and it is as effective for severe seasonal affective disorder, or severe winter depression, as it is for depression any time of the year. It’s called IV ketamine treatment, and it’s not just 33% effective. IV ketamine treatment is effective in treating 80% of treatment-resistant cases of depression at Innovative Psychiatry in South Windsor, CT.

That means that if you’ve tried medications and treatments that haven’t helped, you may be a good candidate for IV ketamine treatment.

IV Ketamine Treatment Operates Like a S.W.A.T. Team Against Depression

Ketamine acts on different aspects of the brain than traditional antidepressants. Rather than affecting serotonin or dopamine receptors, it works on rebuilding the synapse branches that connect nerve cells in the brain to each other.

Let’s pretend you’re in the old west. And you need to get a message to your family in Boston that you’ve arrived safely in San Francisco. You want to send a message by telegraph. So you go to the telegraph office, and they tell you that the lines have gone down between San Francisco and Boston due to tornadoes and fires. There’s no connection.

And you can’t reach anyone until all those lines are repaired.

IV Ketamine Treatment at Work

The synapse connections from signaling cells to more signaling cells in your brain have been broken down, weakened, or destroyed by the stress of depression. This is what depression does to your brain, and these connections have to be repaired and restored so you can get the information signals moving fast around your brain. When that happens, you’ll feel upbeat again.

IV ketamine treatment helps clear away the old broken branches, called dendrites and dendritic spines, to make way for new ones. Then it goes to work fast to rebuild new healthy, resilient connections that proliferate throughout your brain.

The result? Your sad, dark, depressed brain comes alive and lights up like Times Square on New Year’s Eve!

All that activity and signaling lightens your mood brighter and brighter, restores your motivation, your hope, your energy, and your creativity…and you feel better. So much better, it may be the best you ever remember feeling.

IV ketamine treatment also stimulates mRNA to switch on DNA to turbo boost brain-derived-neurotrophic-factors (BDNA). BDNA is like a rich compost in the brain that helps to stimulate prolific and rampant growth of dendrites and dendritic spines in the synapse connections.

Another of ketamine’s talents involves moving lazy G proteins off their lipid rafts and back to work to enhance the signaling communication.

Now let’s be clear…IV ketamine treatment isn’t for everyone. But more than likely, it’s just what you need to recover, to find your best self again, and to revel in your life.

So don’t let the gloominess of the skies at this time of year drain your hope. At Innovative Psychiatry, we’re innovative and we offer solutions — even more than we’ve talked about here.

If your winters are too hard to bear, call us. Let’s talk about options that just may be available for you. And you can dance on your way to work, and twinkle about the joy of building a warm fire to sit by when you get home at the end of the day.

Winter can be about popcorn, hot chocolate, fuzzy sweaters, and crackling fires. Discover how you can enjoy the beauty of winter through advanced treatment options like IV ketamine treatment.

There’s hope for your winters.

To the liberation of your best self,

Lori Calabrese, MD

January 15, 2018
IV Ketamine Treatment Can Prevent a Medical Leave of Absence from College

Are You a Depressed College Student?

Who sometimes just can’t go to class? … or do your work? Sometimes you can’t bring yourself to write the paper … or even do the reading. If last semester was awful, you hope this one will be better.

That you’ll get up. Get cleaned up. Eat some decent food.

It’s so hard to do when you don’t feel like doing anything. When you’re trying to pretend everything’s OK. When you don’t want anyone to know how bad it is, or how bad you feel.

College is supposed to be the best time of your life, right? And it feels like you’re screwing it all up. Maybe you’re wondering if you can even do it.

Should you withdraw? Take a medical leave …?

If you’re a parent, you may have agonized over what to do if you think your college student is depressed. Encourage them to stay? See a doctor on campus? Bring them home?

Too often … too late … the college or university decides what happens when you can’t function: they send you home on a medical leave of absence.

College Student Depression

Sometimes a young person graduates from high school and makes plans for college. Sometimes he’s excited about it. And that’s great!

But, sometimes he makes those plans because it’s expected. And he’s not up for the challenge. Depression or anxiety may have taken over his brain, and he’s just not functioning very well. Does that sound anything like you?

You may even pack up in Fall and move into the dorm. Your parents hope you’ll snap out of the subdued condition you’ve been in, and so do you. Your lack of energy, your sullenness, your tendency to stay by yourself all the time. And you just don’t feel like being around people, much less smiling. …How long has it been? I mean, since you smiled, or better yet, belly laughed?

Maybe you’ve been depressed for years…maybe you struggled in high school with anxiety or panic…It’s also possible you’ve seen a psychiatrist but the medication just hasn’t helped … like, at all.

Or … maybe you were fine until you got to the university and the heavy course load, the adjustment to roommates, dorm life and extracurricular activities, the overwhelming work… drove you into a corner that just got darker and darker…

If you’re depressed, or you’ve developed significant anxiety about school, social activities, grades, expectations, or maybe just trying to get caught up…you may have a tough time getting on your feet and moving forward without treatment.

Maybe, like some kids and teens, your symptoms started in childhood and you’ve had depression or bipolar disorder, or social anxiety, PTSD, OCD, and suicidal thinking from early in your childhood. Maybe you’ve tried not to wish you were dead, tried hard to push away suicidal thoughts without letting anyone really know. And maybe traditional treatments haven’t helped.

You may have been like this so long, your parents don’t understand and don’t know how to help. On the other hand, sometimes parents do all they can find to do but still… nothing helps or changes.

One thing is sure: depression and anxiety undermine your success in college. Without effective treatment, you’re set up to fail, to establish doomed academic habits, and even to cope in self-destructive ways.

William’s Story

A friend of mine, Bob Pollack, M.D. in Florida, recently published the story of a young college student who was the son of a Yale classmate back in his school days. This young man, named William, remembers loneliness and despair filling his childhood, rather than fun activities, friends, and sports.

He was reprimanded by teachers for being “out of control,” isolated from making friends, felt misunderstood by students, and generally alone.

He moved from school to school, because of a family move, or because the environment didn’t foster his best performance.

William was always alone when his depression was the worst. And lonely. He wasn’t one to speak to anyone.

Eventually, his dad contacted Dr. Pollack about IV ketamine treatment for William. Father and son flew to Florida for the series of infusions. The first day he felt woozy…until he ate some dinner, then felt better. Not a lot of change. But by the third infusion, he walked in, shook Dr. Pollack’s hand, and said, “Good morning.”

That’s when Dr. Pollack saw the treatment was taking hold.

Two weeks after the first treatment, William says he was “far less harsh” on himself and far less miserable. And it just got better from there.

William is back in college, and close to completing his degree. And so grateful for the treatment that gave him his life back. He now says with conviction that brighter days are ahead for those in darkness. He now knows there is hope for the future.

At Innovative Psychiatry, we have lots of Williams. Lots of Susans. Lots of Caseys. We hope you won’t hesitate to reach out to us. We really get what you’re going through.

What Do You Do When You’re a Depressed College Student?

You need to get better. Fast. You need something to work.

Before you lose more time, lose credit, miss out on an internship, or put off taking the LSAT or the GRE.

Because not doing well heaps guilt on you, intensifies hopelessness, and tears down your confidence on top of depression. If treatment hasn’t worked or if what you’re doing now isn’t working, reach out for help.

IV Ketamine Treatment treats depression, anxiety, bipolar depression, social anxiety PTSD, and OCD — and it’s extraordinarily effective even when nothing else has worked. It can stop your suicidal thinking in an afternoon. If you’re depressed, you’ve got an 80% chance that it will work — and there are genetic and clinical factors that can boost that chance even higher. Eighty percent.

Better odds than anything else we’ve got.

We’ve never had anything like this in your lifetime.

Ketamine Treatment Can Prevent Medical Leave of Absence from College

Ketamine was developed in the late ’60’s as an anesthesia medicine used in surgery, emergency rooms, and war zones. It’s been used safely for more than 50 years among all ages, from the very young to the very old. But is it a safe treatment to offer to college students? Because of course, people know it — and have abused it in massive doses — as “Special K” on the street.

When we use IV ketamine treatment for depression, a much tinier dose is used than is ever required for anesthesia. We administer it with a state-of-the-art infusion pump to ensure precision delivery to the delicate brain systems involved in mood regulation.

Very quickly, the synapses and dendrites in the connections of your brain cells begin to grow, flourish, branch, and become healthy and abundant. When that happens, signals begin traveling through your brain in higher numbers and at faster rates.

And that brings your brain to life. You can concentrate. (Which means you can go to class, read, study for exams.) You feel optimistic, motivated, hopeful, with new initiative and resilience. Creativity blooms again. Your ability to enjoy your relationships, your studies, and your life grows like a blue ribbon garden.

Ketamine treatment can prevent you from having to take a medical leave of absence from college — or help you come back from a medical leave — if you suffer from treatment-resistant depression, anxiety, bipolar disorder, PTSD, OCD, and suicidal thinking. It can help you restore and have the resilience to continue toward your goals. Because it works fast. A special task force of the American Psychiatry Association called it rapid and robust.

If you’re a college student who’s suffering from suicidal thoughts, or worse … if you’re making a deadly plan no one knows about … IV ketamine treatment can stop those thoughts in minutes or hours. And you’ll feel relieved. Hopeful.

Traditional antidepressants take weeks or months. Time is precious when you’re desperate.

We’re dedicated to treating the sickest of the sick, those suffering the most from psychiatric mood disorders like severe depression, crippling anxiety, the worst cases of bipolar disorder, disabling PTSD, shackle-laden OCD, and critical life-threatening suicidal thinking. We provide IV ketamine treatment, TMS, nutritional guidance using curcumin and microbiome support, among others.

Please understand that IV ketamine treatment isn’t for everyone. We will evaluate you carefully to determine if you’re a candidate for ketamine treatment or another advanced treatment option — and if you are, we won’t waste time.

We have a special place in our hearts for college students.

And we’ll work with your doctor and therapist so that when you’re done with treatment, you can launch your life.

You can experience relief, restoration, remission.

When getting well matters, and you don’t have time… or a semester… to lose … if you’re struggling with depression, anxiety, bipolar disorder, PTSD, OCD, or suicidal thinking, and you haven’t been helped by traditional antidepressant treatments, call us.

At Innovative Psychiatry, we’re here to help you with expertly administered, advanced treatment options by a seasoned psychiatrist with deep expertise from Wellesley, Hopkins, Harvard, and Yale. We get college. We know how important it is.

And we’re here to help you flourish there.

To the restoration of your best self,

Lori Calabrese, MD

January 8, 2018
Forbes Magazine: Ketamine May Reduce Depression, Suicidal Thoughts Within Hours

Ketamine, known mostly as a party drug, has assumed a new identity in recent years—as a promising antidepressant. And, though research is still under way, it seems to reduce symptoms of depression very quickly, and in people who haven’t been helped by traditional antidepressants. Now, a study published in the American Journal of Psychiatry finds that for depressed people who have suicidal thoughts, it may also help alleviate these thoughts much faster than anything that exists currently—within hours.

The study, carried out at the Columbia University Medical Center and the New York State Psychiatric Institute, looked at 80 patients with clinical depression. They all had suicidal thoughts that were intrusive enough to fall into the category of clinical suicidal ideation. The participants were randomized to receive a low-dose infusion of either ketamine or midazolam, a sedative; they were followed for six weeks, during which time the participants all received usual psychiatric care. To measure their depressive symptoms and suicidal ideation (thoughts or urges), the participants filled out questionnaires, like the Scale for Suicidal Ideation and the Beck Depression Inventory.

Within 24 hours, the participants who’d received ketamine reported significant changes in symptoms compared to those receiving midazolam. They had a reduction in suicidal thoughts, depressive symptoms, and fatigue. In fact, the participants who didn’t respond to midazolam were later given ketamine, and they showed the same improvements.

And these changes seemed to last for up to six weeks. The side-effects, which were mainly dissociation—a sense of detachment—and increased blood pressure, resolved within minutes or hours after the ketamine injection.

When the researchers teased apart the variables, they found that the reduction in depressive symptoms accounted for only a third of the reduction in suicidal thoughts, which suggests that ketamine’s effects on suicidality comes from more than just a reduction in depression. What that might be still needs to be explored.

“Adjunctive ketamine demonstrated a greater reduction in clinically significant suicidal ideation in depressed patients within 24 hours compared with midazolam, partially independently of antidepressant effect,” the authors write.

Suicide rates in the U.S. have risen a lot in recent years—according to the CDC, they’ve increased by almost 27% percent between 1999 and 2015. It’s particularly concerning since young adults and teens—especially girls—represent an especially large part of the rise.

The study builds on a growing body of literature suggesting that ketamine may be a real player in depression treatment, which hasn’t changed much over the years. As most people know, the usual antidepressants can be ineffective for some people; and for those for whom they work, it can take many months to find the right one, since they can take several weeks to kick in. For people who are suicidal, it’s especially critical to find faster and more effective treatments.

“There is a critical window in which depressed patients who are suicidal need rapid relief to prevent self-harm,” said study author Michael Grunebaum in a statement. “Currently available antidepressants can be effective in reducing suicidal thoughts in patients with depression, but they can take weeks to have an effect. Suicidal, depressed patients need treatments that are rapidly effective in reducing suicidal thoughts when they are at highest risk.”

More work will need to be done to understand ketamine dosing, especially over the long-term, as well as long-term side-effects that may develop. Some doctors are already offering ketamine infusions for people with treatment-resistant depression, although it’s not approved by the FDA for this purpose. (And people should not be self-administering ketamine, since at the wrong dose it can be harmful, addictive, or fatal.)

So far the results are encouraging, and it will be exciting to watch the developments as they come in. “Additional research to evaluate ketamine’s antidepressant and anti-suicidal effects,” said Grunebaum, “may pave the way for the development of new antidepressant medications that are faster acting and have the potential to help individuals who do not respond to currently available treatments.”

[Read the Original Article on Forbes.com]

January 2, 2018
2018: Neuroscience Breakthroughs like IV Ketamine Treatment Mean Breakthroughs for YOU

Neuroscience breakthroughs like…IV ketamine treatment..?

Exactly.

2018 lies before us, like a valley that spreads to the horizon. And while it’s impossible to access the future, you can move forward knowing that each “today” you live has promise that was unheard of until recently.

Especially if you suffer from untreated or treatment-resistant depression, anxiety, bipolar disorder, PTSD, or anxiety — social anxiety, OCD or phobias.

Neuroscience researchers have been discovering more and more about treating psychiatric mood disorders that has transformed our approach to treatment — and the outcomes, as well.

The 21st century breakthrough of IV ketamine treatment for depression is transforming psychiatric medicine. Studying the effects of this treatment has revealed that depression and other mood disorders wear away at the signaling structures in the brain, leaving synapses, dendrites and dendritic spines broken, weakened, and sparse.

Neuroscience breakthroughs like IV ketamine treatment can bring breakthroughs to you … to your life.

The clearing away of those broken down structures, and the rebuilding of new ones in a denser, more prolific, forestation turns out to be key to treating depression. The old theory that depression was caused by levels of serotonin or dopamine that were too low … well they’re ancient history now.

Neuroscience Breakthroughs like IV Ketamine Treatment means Breakthroughs for You

Actually, so far we know of four ways ketamine clears away depression and erases suicidal thinking so quickly. And we’re watching with anticipation to see if research this year will reveal even more.

So another intervention ketamine performs is related to the G proteins that are piled on lipid rafts in the cell membranes of the neuron cells in the brain. Depressed people have these G proteins piled up on lipid rafts, where they can’t do their job to enhance signaling from synapse to synapse.

For those who are helped by traditional antidepressants, it takes several hours for those G proteins to slide off the rafts and become productive.

This is one reason it takes so long for traditional antidepressants to work for those they help. But when ketamine is given, they slide off the rafts within minutes. Remarkable.

Yet another healing action of ketamine is its effect on DNA. Turns out it also switches on mRNA which in turn flips the DNA switch to “ON” and that fire hoses BDNF across the synapse network.

BDNF is a growth factor like the richest of composts, and it empowers the dendrites and dendritic spines to burst into blooming branches like a giant oak tree. When the BDNF is fueled by ketamine, it turbo boosts that prolific branching of synapse structures, and your brain lights up like New York City. Unprecedented.

A well-lit brain is a happy brain.

Quoting from our earlier post entitled, “Breaking News: Another Way IV Ketamine Smashes Depression,”

As new synaptic connections are built, and greater communication between brain cells develops, the brain gains the ability to see things in a different perspective, and your outlook becomes brighter and healthier.

IV ketamine can jump start that process. Wait. No. It can turbo-charge it.

Extraordinary.

And the fourth action IV ketamine treatment performs is increasing glutamate levels to equip synapses to send more and faster signals across the brain, which traditional antidepressants don’t touch. Brilliant.

APA Task Force Issued a Consensus Statement in May 2017

What a year it’s been!

Four actions of ketamine we know about so far. The outcome is so extraordinary, so successful in such a large number of treatment-resistant cases, the American Psychiatry Association assigned a task force to issue a statement about the use of ketamine, this anesthesia medicine, off-label for treating depression.

Their statement was one of the most momentous and widely read articles of the year. In fact, it’s listed as #3 on JAMA Psychiatry’s “Most Talked About Articles of 2017.” Suffice it to say that those who were on the task force are true experts in our field. They’d seen ketamine’s power to lift depression right out of the water.

So they offered guidelines and cautions, and expressed their elation when interviewed that such a thing has happened in their lifetime.

They also specify that ketamine should be administered under a psychiatrist’s supervision.

TheHealthSite.com featured a list of the 6 best medical achievements of 2017 that everyone should know about…. Ketamine for depression stood strong on that list.

Of course, we know ketamine’s discovery didn’t happen this year. Many years of studies and clinical trials laid the groundwork for ketamine’s popularity now.

Thousands of patients have experienced the relief, the return of joy, initiative, creativity, and energy without side effects that ketamine provides.

Never before has there been such a medicine that treats so many disorders in such a huge percentage of the population as ketamine.

Ketamine has delivered HOPE.

At Innovative Psychiatry, we see 80% of patients who’ve suffered for years with treatment-resistant depression, crippling panic attacks, suicidal thoughts that won’t stop, severe bipolar disorder, PTSD, social anxiety, and OCD experience relief, restoration, and relaxation after treatment.

Another neuroscience breakthrough that means breakthroughs for you is Transcranial Magnetic Stimulation or TMS. It uses a coil to create a focused magnetic field over the front left side of your head. Specifically the left dorsolateral prefrontal cortex region.

Then it sends tiny repetitive pulses deep into the brain to the emotion-regulation region. This stimulates the nerve cells and wakes them up. When they wake up, they begin to function again and give you better emotional regulation and function.

With TMS treatment, you sit quietly for anywhere from 16 to 37 minutes, five days a week for 6-8 weeks. About halfway through the series of treatments, depression begins to lift, and you begin to feel better and better. Again, faster than traditional antidepressants, and without any of the weight gain, sexual dysfunction, fatigue, or GI side effects they can cause.

The sophisticated technology of TMS continues to develop. Even 5 years ago TMS seemed experimental and wasn’t widely available. But, like ketamine,TMS built a strong reputation for effectiveness.

In general terms, clinicians and hospitals report 60-75% success with TMS around the US. We see 75% of our patients consistently respond — and often remit — at Innovative Psychiatry.

Again, HOPE.

Curcumin has gained an ever stronger reputation for its use as an adjunct in treating depression. Plus the connection between the brain, mood, and the strengthening of the microbiome is growing and gives us more and more opportunities to work with your diet and lifestyle to improve your mood.

No known treatment lifts depression, anxiety, bipolar disorder, PTSD, or OCD in 100% of cases at this point. But these innovative treatment options prove successful for 75 – 80% of people who suffer in spite of traditional treatments. Obviously, hope soars for you if suffer with depression.

If you suffer from suicidal thoughts, depression, bipolar disorder, PTSD, social anxiety, OCD, you can feel better. The age of despair for sufferers is quickly dissipating. This has never been the case before. You really can feel better….lots better….as in really good.

If you’d like to start 2018 on a brighter, fuller, more functional, and happy path, call us. We live one day at a time, because “now” is all we really have. But live well. Live as the best you you can be.

To your very best self in 2018,

Lori Calabrese, MD

January 1, 2018
JAMA: A Consensus Statement on the Use of Ketamine in the Treatment of Mood Disorders

Importance  Several studies now provide evidence of ketamine hydrochloride’s ability to produce rapid and robust antidepressant effects in patients with mood and anxiety disorders that were previously resistant to treatment. Despite the relatively small sample sizes, lack of longer-term data on efficacy, and limited data on safety provided by these studies, they have led to increased use of ketamine as an off-label treatment for mood and other psychiatric disorders.

Observations  This review and consensus statement provides a general overview of the data on the use of ketamine for the treatment of mood disorders and highlights the limitations of the existing knowledge. While ketamine may be beneficial to some patients with mood disorders, it is important to consider the limitations of the available data and the potential risk associated with the drug when considering the treatment option.

Conclusions and Relevance  The suggestions provided are intended to facilitate clinical decision making and encourage an evidence-based approach to using ketamine in the treatment of psychiatric disorders considering the limited information that is currently available. This article provides information on potentially important issues related to the off-label treatment approach that should be considered to help ensure patient safety.

[Read the Full Research Article Here]

December 28, 2017
How to Start Today to Build Christmas Cheer and Hanukkah Happiness… in Time for December 2018
Christmas Holidays…Hanukkah

…. a season of Joy?

The song says this is the most wonderful time of the year, and for so many children, it is…but for others, not so much. It’s also a treasured time for many adults…but not all. And while there’s no magic way to go through some step-by-step plan to snap from sorrow to happiness, there are some purposeful things you really can do to get your brain in a happier mode over time.

Because although it feels like happiness and sadness come from your heart, they’re actually manufactured in your brain. And neuroscientists have done some remarkable work to get to the bottom of what makes or breaks our feelings of contentment, happiness, emotional warmth, and feeling loved.

There really are things you can do!

We have a tendency in our society to just let the way we feel “happen” to us. Some of us are naturally upbeat…others of us lean toward the grumpier side. Still others are downright melancholy.

But if being happy doesn’t come naturally, you can regularly take some simple steps to train your brain into a happier, more upbeat outlook. And it’s like going to the gym. If you go once a year…the results aren’t so impressive, right? On the other hand, if you go every day all year long … you’ll have a toned, well-developed body that responds instantly to any demand.

Emotions are like that, too. If you’re a 97-pound weakling in the emotional part of yourself, every wind that comes along can knock you down. But, build your emotional strength and resilience, and you can stand and command in the face of all kinds of adversity with grace, patience, and confidence.

Weight-lifting for emotional resilience

A book by Alex Korb, neuroscience researcher at UCLA, entitled The Upward Spiral, reveals all sorts of eye-opening activity that happens in the brain in response to sadness, guilt, and rejection…and shows how you can turn those negative feelings on their ear by simple emotional strength-building actions.

You know what it’s like to feel guilty or ashamed…these are terrible feelings and make it seem impossible to be happy again. Pride is an emotion you may use to try to overwhelm the feelings of guilt and shame, but interestingly, they all stimulate activity in specific parts of the brain: the dorsomedial prefrontal cortex, the amygdala, insula and the nucleus accumbens.

There’s a lot of scientific jargon there, but these structures are as important to your emotional life as your heart, kidneys, and lungs are for your physical life.

Turns out that worrying, which is a natural reaction to guilt and shame, actually decreases activity in the amygdala, and is calming. (You’re tricking your brain into thinking you’re at least doing something about the problem.) Sounds crazy, because worrying does other things like stir up ulcers, so it’s not really a good solution.

Play the Glad Game

However, there is something that is:

When you feel down, ashamed, guilty, or fearful, when you’re worrying a hole in it…Stop.

Play Pollyanna’s Glad Game. Remember the old Walt Disney movie Pollyanna? A child whose missionary parents had died was sent to her aunt’s to live. She had a way of turning frowns to smiles by following the principles her parents had taught her. Like counting her blessings when she was down.

Ask yourself what you’re grateful for. Think hard. Just because you’re down, or maybe even devastated by one of life’s worst losses, there is always something to be grateful for. What’s important is that you search for it. It could be that you have a warm place to live…or if you don’t, it might be a friend you have, or that you’re healthy.

Or if you’re sick … it might be that you have good care, or that you simply have a beating heart.

But think about it, and search for it. Because gratitude increases neurotransmitters in your brain like serotonin and dopamine. And those neurotransmitters help signals move through your brain, to lighten your mood and to help you feel more sociable.

And here’s another thing… expressing gratitude to others in your life, helps them feel grateful to you, too. And that stimulates more mutual gratitude … and those relationships slowly become stronger.

So, bottom line, the search for things you can be grateful for actually helps your brain spiral upwards, as the title of Korb’s book describes. Do it, everyday and often, to train your brain to be happier and stronger.

But I’m just too angry…

Now, let’s be realistic. Sometimes you feel so beaten down, so hopeless, so angry, or so scared, that you can’t – just can’t – think of something you’re grateful for. The best thing to do when that happens? Just name names.

If you feel angry…? Say, “I’m angry.” If you’re scared or worried…? Say so. Best to not go into a diatribe about it, as that can backfire. But if you just call it what it is, simply expressing the emotion you’re feeling reduces the activity in your amygdala and actually helps you feel some relief.

So call it what it is. Then move on.

Another stab at the gratitude exercise might also be more effective right about now. And remember…this is an exercise regimen to build a brain that’s better at happiness so keep up the good work!

Get off the fence and MAKE that decision

Now, let’s talk about those times when something is eating at you in the back of your mind. You know that gnawing… and it’s so subtle but unsettling…. You have to consciously stop and ask yourself, “what’s bugging me??”

It just could be a decision you NEED to face and MAKE. Staying on the fence about it is building anxiety, and anxiety creates all sorts of havoc in your emotions. It can make you irritable, withdrawn, distracted.

But making the decision does good things in your prefrontal cortex. And that calms down worry and anxiety, helping you to feel more relaxed wellbeing.

So you need to get that decision settled.

Here’s a clue that might help you get there. Decisions are sometimes choices that aren’t easy. Maybe there’s no perfect choice. At those times, neuroscientists say that a “good enough” decision is better than no decision. Far better.

When you accept that a good enough decision is acceptable, you release yourself from the stress of striving for perfection, and avoid activating the ventromedial segment of your brain which heightens your stress.

Instead, accepting good enough switches on the dorsolateral prefrontal cortex regions, and you feel more in control…which is far more comfortable.

And…you know what? Good enough is almost always good enough. Things have a way of just working out, especially if you’re at peace and not tormented.

Neuroscience says that actively choosing…or making the decision…increases the feelings of reward from dopamine activity.

Just do it.

You deserve the break.

Now, you’ve established some great habits:
- like making a list of all the things you’re grateful for, building an attitude of gratitude
- Naming names, calling out those emotions that feel awful, and taking the wraps off ‘em
- Make that decision, and get out of limbo
And you know what…? People who are naturally upbeat and happy tend to do all these things instinctively. Ever noticed that?

Hugs for Christmas cheer and Hanukkah happiness

And now the best of all, and my personal favorite, is to give and receive love with touch. Hand holding, shaking hands, hugs and squeezes, and pats on the back.

In fact, research shows that 5 hugs/day for 4 weeks builds happiness in a measurable way.

Physical touch releases oxytocin, which is a neurotransmitter that gives a sense of wellbeing. This is the same neurotransmitter that’s released in the mother when she’s nursing her baby. It gives the mother a sense of wellbeing along with a stronger bond to her infant.

Holding hands and hugging are some of the most therapeutic methods of touch, because that oxytocin reduces reactivity in the amygdala.

So get out there and hug, dear friend. Do it for science. And do it for your own happiness. And do it all year round for next year’s Christmas cheer and Hanukkah happiness. The more the better and for as long as possible!

Take the findings of neuroscience researchers…and use them to YOUR advantage

“[Optimism] is not about providing a recipe for self-deception. The world can be a horrible, cruel place, and at the same time it can be wonderful and abundant. These are both truths. There is not a halfway point; there is only choosing which truth to put in your personal foreground.”
― Sonja Lyubomirsky, The How of Happiness: A Scientific Approach to Getting the Life You Want

And if you’ve been suffering from symptoms of severe major depression, panic attacks, bipolar disorder, OCD, or PTSD, and you’ve tried at least two forms of medication or other therapy, call us. Innovative Psychiatry specializes in advanced treatment options that can be provided in cooperation with your current psychiatrist.

Help us help you by calling us for an appointment. We can determine if you’re a candidate for IV ketamine treatment or Transcranial Magnetic Stimulation (TMS). Here at Innovative Psychiatry we’ve consistently seen 80% positive results in our most treatment-resistant patients. We’ve also seen 75% positive response in our treatment-resistant patients to TMS.

2018 can be your best year to date. There are outstanding alternatives available now to help you if nothing has helped before.

To the year of your best self yet,

Lori Calabrese, M.D.
December 26, 2017
Ketamine Treats Social Anxiety Disorder…Seriously…?

Yes. Let’s be really clear.

Because nothing seems really clear if you’re someone who just doesn’t want to go …

Go?

Yes, who doesn’t want to … or can’t just easily … go. To work. To class. A meeting. That job interview. Even out for coffee. Or Shopping.

There are a thousand reasons you might not be able to go. You might be too tired, too busy, not interested … or too stressed, or depressed.

You may be too introverted or shy or … just too worried about what others will think of you, about how you seem to them, about whether or not you’ll do or say something embarrassing, or worse, yet, humiliating.

Humiliating is the worst

It’s a dread and a fear that you can’t shake if you have social anxiety disorder. Reassurance doesn’t help. Self-talk falls flat.

And it’s different than being introverted or shy. Social phobias and anxiety are often mislabeled “introversion”… but they’re not the same. We’re pretty complex — sensitive to the number of people around us, whether we know them, how they perceive us.

If you’re an introvert, you draw your energy from quiet time with your own company.

If you don’t know the people around you and feel uncomfortable, you may be shy — but once you get acquainted, you may be someone who comes out of your shell and chats them right up.

But if you have social anxiety, it means a sense of vague, but intense, fear rises inside you in social settings where you feel you will be observed, or noticed, or scrutinized. It could be by people you know or … by people you don’t know. You may believe that everyone is talking about you, criticizing you, even ridiculing you.

It can be so difficult that you find it hard to speak at all. Your palms may grow sweaty, your voice may crack …you may blush deeply over and over…where they can see it.

You wish you could control it, because the reaction you experience and the fear that you’ll make a fool out of yourself … and that others will notice and not want to interact with you is far worse than just getting acquainted with someone
. It’s crippling. You’re frozen. Wishing for an escape.

You feel like such a jerk.

How to Escape from Social Anxiety??

If you talk to a friend or counselor about it, they may ask, “so… what is it exactly that you’re afraid of?”

Well…how do you answer that..? Is the anxiety you feel something that just happens that you can’t prevent?

I’ve met lots of people who don’t even realize they have social anxiety. They never had a name for it. They believe it’s just the way they are, and they try to live with all the “can’ts.”

But I know others who dread entering an elevator with someone of the opposite sex, or who die a thousand deaths before walking into a classroom of students they haven’t met before, or who will cancel plans rather than experience the misery they feel when attending a gathering.

Social anxiety just makes life so difficult.

It holds you back in so many ways — from your own family, from making friends, from raising your hand in school to being able to sign up for classes, or talk to a professor. From entering an elevator with people in it.

Fast forward and you see it holding you back from using your native intelligence –to express your ideas, talk to a coworker, or to your boss … or the mortgage loan people or your server at a restaurant. If you can get to the restaurant.

It can ruin your life.

And put you at risk for developing other things that can ruin your life … like depression, alcoholism, and cardiovascular disease. Geez!

Most people who labor under the pain of social anxiety would get rid of it in a New York minute…if they could.

Treatment for social anxiety has been along the same lines as treatment for any anxiety-producing condition. Antidepressants and anxiolytics – medications that reduce anxiety — along with therapy have been the treatments used for the last 50 years or so. But, unfortunately, these have been only partially helpful.

Why isn’t treatment more helpful…?

About 1/3 to 1/2 of all people with social anxiety disorder don’t respond to the treatments that are out there for it –SSRI’s, venlafaxine and cognitive behavioral therapy. Even when you wait for 8 to 12 weeks to get the full benefits. All evidence-based treatments, for sure, but with inadequate relief for most.

That’s why it’s so exciting to see innovative treatment available for social anxiety disorder with impressive results from the absolute gold standard of clinical trials: a double-blind, randomized, placebo-controlled crossover trial — recently published in the journal Neuropsychopharmacology. IV ketamine treatment has novel actions in the brain that reduce anxiety and fear fast.

Ketamine Treats Social Anxiety Disorder

Ketamine switches on mRNA to switch on DNA to turbo boost BDNF, as you can read here. And it works rapidly to slide the G proteins off their lipid rafts in the cell membranes, as described here. Those G proteins have to be off the lipid rafts to do their job improving signaling between the synapses and neurons.

And…ketamine also blocks NMDA receptors AND improves glutamate levels, which you can learn more about here.

So far, we know about these four actions of ketamine in the brain. And ketamine is kicking bootie and taking names across the anxiety spectrum: PTSD, OCD, phobias, and now social anxiety disorder,

Jerome Taylor and his colleagues set up an elegant proof of concept study with just enough patients to give it power. Eighteen adults with social anxiety disorder, as described in the DSM-5, were given either a ketamine infusion or placebo infusion…and their responses were measured 3 hours after the infusion, and multiple times over the next 14 days. A great sample of real-world, complex people, some on and some off meds — just like in real life.

Then, 28 days after their first infusion, they came back in and got the other infusion; if they had a ketamine infusion first, they got a saline placebo the second time, and vice versa. Turns out that 17/18 patients knew when they got ketamine instead of saline, so the blinding wasn’t perfect. But there are always limitations to studies, and opportunities for refining the questions we ask and the methods we use the next time around.

Still.

Ketamine treats social anxiety. Ketamine was safe, generally well-tolerated, and worked. People responded to ketamine, and they had significantly greater reduction in anxiety that lasted up to 28 days, compared to when they were treated with placebo. Fear, avoidance, social anxiety, and social avoidance all fell significantly.

Of course, study results are often reported in the most conservative terms. We always need and want to know more. But this trial provided fine evidence that ketamine is effective in reducing social anxiety. Hopefully, this kind of anxiety reduction can lead to more social activities and opportunities for people who so suffer so terribly. Hopefully, this study will open the doors to more inquiry.

Isn’t that outstanding??

We always love to see clinical trials and studies that put ketamine through its paces. We love to hear of others who find ketamine to be effective in treating mood disorders.

Because here at Innovative Psychiatry, we see it every day. In fact, within our practice we see a strong 80% positive response to ketamine even in people who’ve failed everything.

We like to say that they didn’t fail — everything failed them. If you feel like what you’re doing isn’t working, you’re not alone. You may have one thing — depression, maybe, or bipolar disorder — or you may have a lot of things — PTSD, anxiety, and OCD.

But we have one of the 6 Best Medical Achievements of 2017 to offer you: IV Ketamine Treatment. We’ve used it for years … before anyone knew it was going to become one of the 6 Best.

…We’ve always been on the cutting edge.

We’re not a pop-up clinic. We’re not a johnny-come-lately.

We’ve developed our approach over the past 20 years to help those who suffer the most…and are desperate to find relief. We stay up at night to find solutions that are novel and innovative, that will allow you to function again and find joy in your life with the advanced treatment options that we offer.

We’re the only psychiatry practice in Connecticut that’s daring enough and forward-thinking enough to bring you a menu of advanced treatments in a beautiful outpatient office with its own library of research articles that supports everything we do: IV ketamine treatment, TMS, reducing inflammatory factors, improving nutrition and enhancing the gut microbiome.

We have advanced treatment options for you

If you’ve been suffering with a treatment-resistant mood disorder like depression, social anxiety, phobias, panic attacks, PTSD, bipolar disorder, and OCD, please call us. Let’s set up an appointment to figure out if IV ketamine or another innovative approach is right for you.

We don’t take over your medication management or therapy — we offer advanced solutions to enhance what you’re already doing — with the doctors you’re already working with. So you can finally leave social anxiety, depression, bipolar disorder, PTSD, and OCD behind.

We want you to feel better… and we believe we can help.

We’re closed for the holiday but we’ll be back to schedule appointments right after the New Year. Put us on your calendar.

To the new emergence of your best self,

Lori Calabrese, M.D.

December 19, 2017
6 Best Medical Achievements of 2017 that Everyone Should Know About!

2017 Has Changed the Way We Could Treat Depression, Alzheimer’s, Cancer and AIDS

Sandhya Raghavan | Updated: December 15, 2017 5:51 am

Like its predecessor, 2017 has also been blamed for being the worst year ever, collectively by the internet. But when you look at some of the medical milestones of the year 2017, you’d be forced to reconsider. Researchers in 2017 have worked tirelessly to make our lives a little better and a lot healthier in the years to come. These include breakthroughs in Alzheimer’s, Parkinson’s, cancer and HIV treatment.

Here are some of the greatest medical achievements of 2017 that will make each of us proud.

1. Oxygen therapy for Alzheimer’s disease

Among the latest breakthroughs is the use of hyperbaric oxygen for the treatment of Alzheimer’s disease. A progressive disease, Alzheimer’s is known for its resistance to treatment. But discovery is hailed as a milestone in Alzheimer’s treatment because it is said to improve the pathology of the disease and correct some of the behavioural problems in patients. Here how oxygen therapy can reduce symptoms of Alzheimer’s.

2. PaxVax’s vaccine that can stop outbreaks quickly

Cholera is a gastrointestinal disease that affects the small intestines. One of the hallmarks of the disease is that it can assume epidemic proportions. And as of 2010, cholera has been classified as a pandemic. To counter this problem, the vaccine company PaxVax has developed a cholera vaccine, a single dose of which can stop the epidemic in its tracks, controlling big outbreaks more quickly. PaxVax vaccine can stop cholera epidemic from spreading.

3. Using one’s immune system to fight cancer in children

CAT T-cell Therapy is one of the latest and the most effective breakthrough in cancer treatment. According to a study conducted by Memorial Sloan Kettering Cancer Center in New York City, researchers have found a way to treat acute lymphoblastic leukaemia in children by using the immune system to attack and kill cancer cells. This helps children afflicted by the dreaded disease to achieve remission quicker and live a normal childhood.

4. Kicking and killing HIV virus

HIV has the ability to resist medication and treatment by lying dormant in CD4- T cells. So when the patient stops the medication, this dormant virus awakens again and starts attacking the body again. So the scientists from UCLA, Stanford and National Institute of Health have been trying to find a way to smoke the virus out of its hiding places and attack them when it activates. The team of scientists have aptly named the technique “kick and kill.”

5. Animal tests for head transplantation

Till recently, head transplantation as a possibility existed only in science fiction. But a recent experiment conducted by a group of Chinese doctors brought this fantasy a step closer to reality. The doctors severed the spinal cord of 15 rats and tried to reattach them in 9 of them. Except for one, all the rats survived for close to a month after the experiment. A Russian man suffering from muscular spinal atrophy has volunteered for the spinal transection surgery.

6. Ketamine as a treatment for depression

In a revolutionary discovery, ketamine, an infamous date-rape drug, found redemption in 2017 as a possible treatment option for depression, PTSD and suicidal ideation. Research has revealed that ketamine, an anaesthetic drug, could be able to tackle depression like no other drug has done so in the past. If studies are to be believed, ketamine will be able to reduce depression within hours after injecting it intravenously.

[Read the Original Article Here]

December 18, 2017
Medscape: Ketamine Rapidly Reduces Suicidal Ideation

Megan Brooks

December 13, 2017

A subanesthetic intravenous infusion of ketamine can rapidly reduce suicidal ideation in patients with major depression, and the clinical improvement is maintained 6 weeks later, results of a randomized controlled study suggest.

This study is “the most definitive demonstration so far of a clinically meaningful reduction in suicidal ideation within 24 hours after ketamine treatment,” first author Michael Grunebaum, MD, from New York State Psychiatric Institute, Columbia University Medical Center, New York City, told Medscape Medical News.

The study was published online December 5 in the American Journal of Psychiatry.

Largest Study to Date

The study included 80 patients who were admitted voluntarily to an inpatient research unit at New York State Psychiatric Institute with major depressive disorder and clinically significant suicidal ideation (Scale for Suicidal Ideation [SSI] score ≥4).

Forty patients were randomly allocated to receive intravenous racemic ketamine hydrochloride 0.5 mg/kg, and 40 patients were allocated to receive midazolam 0.02 mg/kg in 100-mL normal saline infused over 40 minutes. Midazolam was chosen as the comparator because it is a psychoactive anesthetic with a similar half-life to ketamine and has no established antidepressant or antisuicidal effects.

Baseline characteristics were similar in the two groups, including the SSI score. The mean SSI score was 14.3 in the ketamine group and 15.7 in the midazolam group.

The average SSI score 24 hours after infusion (primary outcome) was 4.96 points lower in the ketamine group than in the midazolam group (95% confidence interval [CI], 2.33 – 7.59; P < .001). Cohen’s d for the difference in mean group change was 0.75, which is a medium effect size.

Treatment response was defined as a reduction of ≥50% in SSI score. The proportion of patients who experienced a treatment response at day 1 was greater in the ketamine arm than in the midazolam arm (55% vs 30%; odds ratio, 2.85; 95% CI, 1.14 – 7.15; P = .024). The number needed to treat was 4.

Notably, the investigators report, the improvement in suicidal ideation largely persisted during the 6-week period of uncontrolled observation. This may be partly explained by the fact that patients continued prior psychotropic medication, which was optimized after ketamine infusion.

There were greater reductions in overall mood disturbance, depression, and fatigue, as assessed with the Profile of Mood States, on day 1 after ketamine vs midazolam infusion. Results of a mediation model suggest that ketamine’s effects on depression and suicidal thoughts are at least partially independent, the researchers note.

Adverse effects (mainly an increase in blood pressure and dissociative symptoms) were similar to those reported in other ketamine studies. The adverse effects were mostly mild to moderate and transient, typically resolving within minutes to hours after infusion, they note.

“This is the largest study to date in suicidal, depressed patients, using a randomized, midazolam-controlled design, and also addressed various prior research limitations, which have included measurement of suicidal ideation with a single questionnaire item and patient samples with low levels of suicidal ideation or mixed diagnoses,” Dr Grunebaum told Medscape Medical News.

“We think the most noteworthy results of this study are that it shows, using a rigorous clinical trial design, that ketamine treatment was associated with a clinically meaningful reduction of suicidal thoughts in suicidal, depressed patients within 24 hours and that with optimized, clinical pharmacotherapy in an uncontrolled follow-up observation, this reduction appeared to last for at least 6 weeks,” said Dr Grunebaum.

Potential Lifesaver

Reached for comment, Seth A. Mandel, MD, chairman of psychiatry at Northwell Health’s Huntington Hospital, New York, said, “There has been a cottage industry of nonpsychiatrists performing ketamine infusions for treatment-refractory depressed patients. My concern in these cases has been, what happens if it fails for someone who has put their last hope in this treatment?

“This study points to a more positive and practical use for ketamine infusions,” said Dr Mandel, who was not involved in the study.

“It could be a very useful and even lifesaving temporary maneuver performed in ERs or outpatient ambulatory settings, buying valuable time until treatment can be optimized over the ensuing weeks. It may not only be useful in preventing suicides but also in avoiding costly hospitalizations for acutely suicidal patients,” he noted.

Dr Mandel cautioned that it’s “unclear from the study what happens with these patients beyond 6 weeks. Does suicidal ideation return, and if so, should the treatments be repeated, and for how long? What are the long-term effects of repeated infusions? Further studies are needed to answer these questions.”

The study was supported by the National Institute of Mental Health. Several authors have disclosed financial relationships with various companies, as listed with the original article.

Am J Psychiatry. Published online December 5, 2017. Abstract

For more Medscape Psychiatry news, join us on Facebook and Twitter.

Medscape Medical News © 2017

This is a re-post from: Ketamine Rapidly Reduces Suicidal Ideation – Medscape – Dec 13, 2017.

December 14, 2017
What Your Friend With OCD Needs from You

Wonder how to help someone with OCD?

Think about what your friend with OCD needs from you…

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

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

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

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

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

Well, it all becomes a vicious cycle.

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

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

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

What Does Your Friend with OCD Need From You?

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

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

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

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

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

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

What Symptoms Look Like

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

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

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

Easy Tasks are Tougher for Her

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

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

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

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

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

Give Her Credit for Improvement

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

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

You’re Friends First

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

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

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

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

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

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

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

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

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

We look forward to working with you for the better.

To the release of your best self,

Lori Calabrese, M.D.

December 11, 2017

error: Content is protected !!