Lori Calabrese, MD

Tag: IV Ketamine for Depression

  • Ketamine and Other Breakthroughs in Psychiatry for 2019

    Ketamine and Other Breakthroughs in Psychiatry for 2019

    Man on a cell phone demonstrates one of the breakthroughs in Psychiatry of 2019.

    Tomorrow is the last day of 2019…and the day before a new year – and a new decade – begins.

    Let’s jump in and look back. Let’s celebrate our progress over the last year and consider the impact of new breakthroughs this year. Some of these breakthroughs in psychiatry for 2019 may surprise you.

    The World Health Organization says that depression is the leading cause of disability worldwide. (This is not a breakthrough–it’s one of the sad facts of our time.) And for at least 1/3 of those who suffer with it, traditional brand name and generic antidepressants on the market don’t work.

    In the early 2000’s, researchers discovered that IV ketamine caused a rapid and  robust response in people with major depression.

    Now, 10 years later, a ketamine derivative is one of our biggest breakthroughs this year. So let’s talk about that, and other breakthroughs in psychiatry for 2019, as well.

    Breakthroughs in Psychiatry for 2019

    1. Esketamine (Spravato)

    Spravato is one of the breakthroughs in psychiatry for 2019, because it won FDA approval this year.

    In March of this year, the FDA approved a derivative of ketamine, the left enantiomer of the molecule, in a specially designed nasal spray for treatment resistant depression under medical supervision in approved clinics. However, the FDA approved this to be used only in conjunction with another andtidepressant at the same tije.Use of esketamine requires the initiation of a new antidepressant at the same time. 

    After years of promising outcomes with IV and IM ketamine in treating depression and other disorders as an off-label treatment, FDA approval of esketamine presented a milestone — it’s a novel form of treatment as a nasal spray and it uses a derivative of a medication that we’ve been using successfully and safely for years. PTSD, cocaine use disorder, alcohol use disorder, bipolar depression, social anxiety, and suicidal thinking can all respond to IV ketamine.

    While esketamine hasn’t been studied for most of these conditions, it can create a robust add-on response to an antidepressant in some patients who benefit from low doses. And the beauty of it is that because of its FDA approval, esketamine as a medication is covered by many insurance programs.

    Although there are tons of hoops to jump through, red tape, paperwork, REMS monitoring (the risk mitigation program that the FDA requires that all doctors and patients participate in).

    So… FDA approval marked a new breakthrough in psychiatry for 2019, and a milestone in ketamine’s journey. The quest for wider acceptance as a remarkable treatment for people who’ve remained depressed in spite of traditional medicines.

    This 21st century novel and advanced treatment for psychiatric disorders is changing the face of disability.

    Growing numbers of people are experiencing not only improvement, but remission from their symptoms, and are recovering to build fulfilling and rewarding lives, relationships, and futures.

    Here at Innovative Psychiatry, we offer both IV ketamine treatment and esketamine nasal spray for those patients who are candidates for these treatments.

    2. Telemental Health Support

    Healthcare services provided by online video or telephone has been growing for a number of years. It has improved medical care for shut-ins  and the elderly who have difficulty accessing it in the office. Psychiatric patients in remote areas have received better psychiatric coverage through this means of communication.

    By combining technology with new policies, telemental health has advanced in its effectiveness again. Sometimes using a method of treatment reveals new opportunities for improvement as challenges reveal themselves.  

    So, The National Center for Performance Health in Florida recently established ecare4kids. This tele-counseling program serves public school children in Florida with online tele-counseling. All 50 states provide some amount of tele-health services through Medicaid.

    Then in February 2019, Congress introduced the Mental Health Telemedicine Expansion Act. The Ways and Means Committe approved it in June of this year to ensure more psychiatric health care in remote areas throughout the US.

    3. Gene-guided medicine

    The Human Genome Project completed mapping the genome in 2003.

    So what’s a genome? 

    Good question. It’s the complete set of DNA, or the genetic material, found in a microorganism or the cell of any living thing. In this case, we’re specifically talking about human DNA.

    To clarify, DNA is made of a pair of twisting or spiraling strands that consist of four chemical units which we call nucleotide bases. And the bases are made of adenine (A), thymine (T), guanine (G), and cytosine (C). These bases are paired in specific patterns, i.e., an A is paired with a T, and a G is paired with a C.

    This woman is bursting with excitement from the treatment she's gotten listed in psychiatry breakthrougs for 2019.
    Now imagine this: there are 3 billion of these base pairs in your DNA, which are held within 23 pairs of chromosomes…in the nucleus of every cell of your body.

    You can see how ambitious it was for this team to take on the project of mapping all this out.

    Well, now that we have that mapping, the obvious next step follows the reduction in price of mapping your own individual genome. The initial mapping project was estimated to cost 30 million dollars. 

    But the more they use this process, the more the process reduces in cost. The next steps can feasibly include things like getting your own map so your medical and health needs, and even the medicines you take, can be so specifically customized to your genetic profile as well as your environment and lifestyle, that the effectiveness of treatments you need can soar.

    Which brings us to the point that the disorders we talk about and treat are, in most cases, inherited to some degree. So you see multiple family members suffering from psychiatric illnesses at the same time…and all too often — severe illnesses.

    Imagine if we could better fit a medication or treatment specifically to your DNA profile. And the same for your family members. So much suffering from side effects could be eliminated.

    We have important information already available to us about the cytochrome P450 enzyme system (the enzyme system in the liver responsible for the oxidative metabolism of many of our medications) …and at Innovative Psychiatry we use evidence-based genetic information as we have available to help explain your responses and guide your treatment.

    4. Genetic Editing

    You feel like dancing like these friends from the psychiatry breakthroughs of 2019.

     …Say what?? It hasn’t been that long since we figured out what the genome looks like.  Now we’re talking about editing it? Like editing a paper?  

    Well, sort of.

    It turns out that this year genetic scientists broke through in a major way with a possible method for potentially removing genetic links to disorders and diseases like Alzheimer’s, ADHD, and autism, and replacing those links in the individual’s DNA with healthy links.

    So…scientists at Harvard and MIT took the wraps off a new approach to what they coined, “prime editing.” The chemist/biologist who led the unveiling described its usefulness as a metaphor of Word processing.

    A total WOW.

    He said these little prime editors search for certain DNA sequences and precisely remove them, then replace them with sequences that don’t produce disease. He says that 89% of disease-causing defects can be resolved by this method…eventually.

    Such astounding breakthroughs in psychiatry for 2019 – what can they imagine next?

    The potential here goes without saying. What would happen if we would eventually do a little primed editing and edit out suffering? Like the kind associated with severe depression? With bipolar disorder? With alcohol dependence? With anxiety? We get breathless just thinking about it!

    5. Psychiatric Healthcare with Cell Phones

    Man on a cell phone demonstrates one of the breakthroughs in Psychiatry of 2019.

    A technical/data science/healthcare company (Mindstrong) has secured a handful of patents to develop an innovative method of providing mental healthcare services over cellphones.

    By partnering with your health insurance company, services can be provided to you free of charge, including evaluations, psychotherapy, psychiatrist visits, medication evaluations, and support when things unexpectedly come up between doctor visits. Their psychiatrist will work with yours to provide smoother and continuing care. And because it’s designed to be free (for you), more people can receive care for their disorders.

    Using a mobile app, text therapy can be provided as Cognitive Behavioral Therapy (CBT), Coping and Emotion Regulation, Psycho-education, Crisis Management, Reflective Listening, and Empathy.  

    Since 75% of Americans own a cell phone, finding a way to reach a broader audience with mental healthcare is evolving to naturally involve mobile phones. Hmmmm…..

    Digital phenotyping collects data from the smartphone to provide measures of cognition and emotion. They say that the way you use your cell phone tells them a lot about your mood and state of mind. They can’t see you but they collect data. 

    They’re not covering every cellphone in the US yet, but they’re growing…and it won’t be long. 

    What do you think about this idea? I’d love to hear your comments below.

    With all these psychiatry breakthroughs in 2019, it’s easy to get caught up in the sci-fi talk and forget what we have NOW.

    We’re living in a new world, and IV ketamine treatment IS sci-fi. 

    We could not have imagined in the past century that a medicine originally designed for anesthesia would come out of the woodwork and actually provide a solution to major depression, alcohol overconsumption, opiate dependency, anxiety disorders, PTSD, OCD, bipolar depression, and suicidal inclinations. Ever.

    Let’s not miss what’s right in front of us. 

    IV ketamine treatment can resolve depression symptoms. 

    This is the jarring news we take with us into the new decade. 

    Depression, PTSD, OCD, social anxiety, bipolar depression, substance use disorders, and suicidal thoughts no longer have to be a final sentence. You can get better. Your life can transform to a new, meaningful, rewarding source of joy…and hope.

    If you wonder whether IV ketamine treatment could work for you, call us to schedule an appointment and come in. We invite contact from your health team, and we’d love to collaborate with them to help your life transform.

    We look forward to the opportunities to meet you and discuss options in the new year.

    Have a Happy and Healthy New Year in 2020 – full of  hope, purpose, and joy.

    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,

  • Your Generosity’s Impact on Depression

    Your Generosity’s Impact on Depression

    Your generosity's impact on depression is remarkable.

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

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

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

    Giving the Best of Yourself

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

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

    Generosity is so Good for Your Depression

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

    Good question!!

    Generosity's Impact on depression helps to release joy during the holidays.

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

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

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

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

    Stress is a Destroyer

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

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

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

    Generosity’s Impact on Depression and Mortality

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

    Generosity's impact on depression is increased by the mutual support and fresh air and exercise of these volunteers as they give of themselves.

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

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

    Volunteering is a Category All Its Own

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

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

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

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

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

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

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

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

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

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

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

    This man offers another a helping hand because generosity's impact on depression is unmistakeable when you help someone outside yourself.

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

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

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

    Have a Wonderful and Fulfilling Holiday Season!

    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,

  • IV Ketamine Can Create Resilience For You This Season

    IV Ketamine Can Create Resilience For You This Season

    Even during the holidays you can find yourself alone when everyone else is having a good time, but ketamine can help you enjoy being with people again.

    This time of year conjures up visions of sugarplums, elves, and Christmas trees guarding piles of gifts.

    There are carolers singing on the corner, and menorahs and dreidels and flickering candle light. Families come together, and friends are invited to share in the celebrations. A manger with a Baby surrounded by angels, shepherds, and wise men. Oh the wonders of this time of year. And oh the suffering for those who find it difficult to cope. But, IV ketamine can create resilience for you… Some suffer because of painful losses and deaths brought to mind again by both treasured or painful memories. Others suffer because of disorders that make it difficult for them to blend at family gatherings, whose symptoms impose so much pain and heartache, even chaos, they’re unable to enjoy any of it. 

    It’s for these loved ones we write today. The ones who’ve suffered for years – even decades – because their symptoms of depression, anxiety, phobias, addiction, eating disorders, PTSD, OCD, and the suicidal thoughts that eventually often show up and threaten have not been helped by the medicines prescribed for them.

    Dreading a gathering can disappear because ketamine can create resilience.

    Dreading the family gathering, or finding something else to do so they can justify missing it, they’re often ostrasized for “creating a scene and making the holiday about them.” Cruel judgments and short-sighted disapproval abound. But few realize how very much these dear ones wish they could seamlessly fit in.  

    Their “scenes” may very likely be due to untreated symptoms. 

    This is the time when IV ketamine treatment can make all the difference. And it’s not just for this holiday season. It’s for all the holiday seasons that will come in the future.  For all the school days, business days, birthdays, and everydays that lie ahead. Ketamine can create resilience for facing whatever life brings…

    And let’s be clear about something.

    IV Ketamine Treatment is NOT Esketamine Nasal Spray

    The ketamine molecule is racemic, which means it is made up of two sides, or enantiomers, which are mirror images of each other. This has caused some confusion. Because they’re NOT identical. Each one possesses its own traits, it’s own strengths and weaknesses. It’s own benefits. 

    Esketamine nasal spray is the left mirror image. We call each side an enantiomer. Esketamine is the left enantiomer. It has strengths and weaknesses, but it’s not the complete ketamine molecule. This is often misunderstood. It’s also a great deal more expensive than ketamine.

    However, esketamine nasal spray is “covered” by some insurances, at least partly. (It’s very expensive and eats up most of your high deductible very quickly.) But having the medication pad for may be a benefit that may make it worth trying for you. The office visits required for administration are another fee–and they are very poorly covered by insurance companies.

    Ketamine infusions on the other hand, are not usually covered.

    We’re joining with others in psychiatry promoting the idea that IV ketamine treatment should be covered by insurance. It should be. Ketamine is the complete compound with all the benefits. When it’s administered properly, it can be — and often IS — transformative.

    IV ketamine treatment can liberate you from the symptoms that make the holidays so painful. Those things that make it nearly impossible for you to enjoy family gatherings. 

    IV ketamine helps build something to make life so much easier, even holiday gatherings.

    Ketamine Can Create Resilience: And It Empowers You to Enjoy

    It’s resilience. Depression, alcohol use disorder, anxiety, PTSD, OCD, opioid use disorder, social anxiety, bipolar depression…all of these conditions have symptoms that are sometimes hard to treat. You might say “treatment resistant.” And when the symptoms go on and on, they wear down circuitry in your brain in certain regions. 

    Enjoy the giving season - ketamine can create resilience for you.

    When the circuits are worn down, the dendrites and synaptic connections between neurons are pruned back and the signals are hard pressed to make much progress getting from one area to another. So you feel vacant…numb…dull…and dark.

    But ketamine treatment restores those circuits. It stimulates mRNA to turn on DNA to turbo boost your brain-derived-neurotrophic-factor. When that happens it’s as if a rich compost infuses fast prolific growth into those dendrites, and dendritic spines…and your synapses multiply like gangbusters. Suddenly, your brain comes alive with a wealth of signals darting at the speed of light to help you think, create, plan, accomplish…and to bring you joy…and hope.

    Then, there are those G proteins floating along on their lipid rafts. Ketamine shoves them off those rafts and puts them back to work, which gets signals moving really fast, too.

    That’s where the resilience comes from. Your active brain communication transforms your outlook and cognitive function. And if something comes along to knock you down, you finally have the resilience to think it through, get back up, and snap back. You have energy to face difficulty, energy to be around difficult people. Energy to contribute, and to rebuild strong, healthy relationships.

    Ketamine does that. Ketamine can create resilience by working in so many parts of the brain and it works fast.

    Think about it like you’ve rebuilt your car’s engine and you have the capacity now to take on difficult terrain, climb mountains, pull trailers, and get the job done. (I sound like a truck commercial but you see what I mean.)

    Restoration for the Holidays – Is There a Better Gift?

    If you enjoy this time of year, that’s wonderful. It’s supposed to be a wonderful time of year.  Enjoy it. Savor every moment.

    But if you don’t …if you can’t… call us. Let us help you find the resilience you wish you had. The resilience to rise above the struggles, and the ability to actually enjoy people you care about. 

    See how relaxed and joyful this woman is because ketamine creates resilience?

    IV Ketamine treatment may seem expensive at first blush, but when you consider how it can transform your life, and give you hope and resilience for the future, it’s worth finding a way. There are opportunities for financing your treatment through medical financing services. We also see families helping financially to get their loved one a chance to recover.

    Feeling better changes everything.  Everything.

    When you’ve felt like this so, so long, it’s hard to imagine what feeling good would be like. No worries. You’ll definitely know it when you see it. And your family may detect the changes in you before you even notice them yourself. 

    Reach for brighter days, healthier relationships, better performance in your career. Reach out for resilience.

    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,

  • Even One Dose of IV Ketamine Can Dramatically Reduce Heavy Drinking

    Even One Dose of IV Ketamine Can Dramatically Reduce Heavy Drinking

    Alcoholic drinks at a holiday party are abundant and a strong temptation if you're trying to stay sober.

    It’s the holiday season again and there are parties every weekend, with work, with friends, with family – they crop up everywhere.

    Festive gift bags provided at liquor stores make it easy to present a gift of alcohol in the busy bustle of the season. For some, holiday drinking is light and rare. For others, whose habit of drinking so excessively that it’s harmful to their health and to others, it’s almost continuous. In fact, it can be addictive. But it turns out, there is hope for those who would like to drink less, or stop drinking altogether. There’s a way, beyond sheer will, to dramatically reduce heavy drinking, and avoid the shame that goes with relapse.

    Take Jerry, for instance. His wife had suffered from breast cancer for 6 years, and every time they thought she had beat it, new tumors cropped up again. He watched her suffer in pain, with vomiting, severe weight loss, worsening weakness, until she just didn’t have anything to fight with anymore. 

    She had been in remission for a year, finally, and they were planning a trip to Europe, when suddenly she collapsed one day and tests showed an aggressive form of cancer had spread everywhere. In a matter of weeks, she was deteriorating fast. She died less than a month from the time of her collapse. 

    Just when they thought they had a future to enjoy together, she was gone. Jerry was devastated. He felt lost, without purpose, disillusioned. And so terribly alone.

    The Subtle Slide… 

    At first, he would drink a couple beers to relax after work in his empty, echoing house. The memories of her reverberated from every corner. After the first swallow of the ice cold beer, a relaxed feeling would wash over him. It felt like relief. Relief from the pain, the sorrow…the stress.  

    It wasn’t long before 2 beers turned into 3 or 4…then a 6 pack.  After that, he graduated to bourbon — or adding vodka to his soft drinks. By the time his wife had been gone a year, he was drunk all weekend every weekend…. and most nights after work.

    Friends invited him on outings, to dinner, camping and fishing… but he usually turned them down.  He just didn’t feel like socializing…

    This man drank whiskey till he passed out, but ketamine can dramatically reduce heavy drinking.

    Five years went by, and Although he managed to keep his job, his performance had dropped off. He hated his annoying itchy skin, and had some pain in his belly off and on… but not too bad. He just ignored it.

    One night after he had been to the cemetery to visit her, it started raining. Suddenly, an SUV made a sudden turn in front of him. As Jerry slammed on his brakes his car started spinning. When he realized he had finally stopped, he crawled out of his pickup. His head was bleeding onto his shirt… but the SUV was on its side. He could hear the cries of someone laying about 5 yards down the hill in the dark… then he saw flashing lights. Help was coming…

    It all began as grief, but spiraled until he committed a crime, and could have been responsible for someone’s death. Thankfully, no one died. But still…

    Jerry was in pain, grief-stricken, and depressed. His heavy drinking was his direct response to his terrible experience with his wife’s cancer and death. And the depression that had taken over left him with no reason he could find to take care of himself, or preserve his life.

    The other driver had caused the accident. Still, his blood alcohol was above the legal limit. So, he had to face charges for driving under the influence.

    Too Much Drinking Hurts You – and People Near You, Too

    While awaiting trial, he went to the doctor to find out about the pain he’d been having. The doctor told him he’d have to cut way back on his drinking. In fact, he urged him to quit altogether, if he wanted to live past the next few years.

    It was a wake-up call. 

    He really didn’t want to die. But could he stop drinking..? He’d tried before… and it always went by the wayside. He needed more help than just trying to use sheer will. He needed something that would help him dramatically reduce heavy drinking. And fast.

    So, he started with the internet. 

    He learned about a variety of 12 step programs. And about residential programs to help you not only stop and get the alcohol out of your system, but to also train you to respond to temptation so you could stay sober.

    And he read about promising studies with a medicine called ketamine — something he’d never heard of before.

    Jerry got the help he needed with IV ketamine treatment, and got stronger and healthier. He also started seeing a therapist. And he’s finding joy in living again…

    But now there are new findings that can help someone like Jerry even more. So you can dramatically reduce heavy drinking.

    A recent study — just published a couple weeks ago — has demonstrated that even a single dose of IV ketamine can dramatically reduce harmful drinking. As in, drinking so much that it harms your health and can cause harm to others around you, too.

    Ketamine Can Reduce Harmful Drinking By Rewriting Drinking Memories

    This is so cool.

    A group of researchers in London and Amsterdam conducted a study using ketamine applied to maladaptive reward memories, (MRMs) to see if ketamine can help rewrite those memories and thereby dramatically reduce heavy drinking. R. Das, G. Gale, and their team selected a group of 90 beer drinkers who had hazardous drinking patterns, but had not been diagnosed with alcohol use disorder. Also, no one in this group was seeking treatment for their alcohol consumption lifestyle. 

    A single dose of IV ketamine can dramatically reduce heavy drinking.

    The first day of the experiment, researchers showed all the participants photos of alcoholic drinks that included beer and stronger drinks. Then they asked the participants to rate how strong their desire to drink was.  Immediately after this, they gave each participant a cold beer to drink.

    On the second day, researchers divided the group into three sub-groups, but didn’t offer beer to anyone.

    Here’s where it gets interesting.

    With the first group, researchers showed them more photos of drinks to stimulate their memories about the pleasures of drinking. Then they gave them a dose of ketamine.

    In the second group. the research team showed them the photos of the drinks, then gave them a placebo drug.

    And finally, with the the third group, they showed them no pictures at all. They just gave them a dose of ketamine.

    Fast forward 10 days. 

    The people in Group #1, whose memory was stimulated by pictures, followed by ketamine, reported their consumption of alcohol had dramatically dropped. Then 9 months later, a follow-up revealed their alcohol consumption had dropped to half what it had been before the experiment.

    Group #3, who received ketamine without photos to trigger drinking memories, reported a smaller reduction in drinking, but still significantly less alcohol consumption. This was the case at both the 10 day mark and the 9 month follow-up.
    Group #2, the placebo group, reported a small decrease in drinking.

    So what happened here…?

    Ketamine Blocks Memory Restabilization

    Young man relaxing as he stares across the water, relieved.

    Das and his colleagues explained that maladaptive reward memories (MRMs) play an important role in “acquired overconsumption disorders” such as hazardous drug and alcohol use. Basically, the reward Jerry feels in terms of relaxation and relief from his grief when he drinks forms a memory, and when he thinks of it, he wants to drink again, even though that may not be good for his health or social, economic, and productive life.

    There’s a process that happens in a small time window each time Jerry thinks about having a drink to help him feel better. During that window, his recall of the memory of his relief when he drinks becomes rather fluid and changeable. If something can interfere with that association before he drinks, it can “rewrite” that memory so his desire to drink becomes a desire to do something different.

    Das and his colleagues explained that they believe ketamine can block specific receptors in the brain (such as the NMDA receptor) that help to RE-stabilize a memory. That blocking causes the memory to weaken. In this case, it’s the memory of the pleasure of drinking. In Jerry’s case, it might be the relief he feels from his grief when he drinks. 

    If someone wants to stop drinking, this change to that appealing memory of pleasure gives them the chance to rethink what they believe about alcohol, and what they believe about their health. 
    It gives them time to make a decision without that alluring maladaptive memory.

    Das encourages further study using ketamine to rewrite these MRMs. Because ketamine has demonstrated safety at high doses in anesthesia, they encourage studies using doses that can to saturate NMDA receptors to interfere with these MRMs.

    Addiction Relief with IV Ketamine 

    At Innovative Psychiatry, we’re thrilled every time a patient reports relief from addiction to alcohol or other substances. We get to see patients who’ve suffered from severe depression walk into our office smiling, happy, and full of hope. These people never take their new found wellbeing for granted. Their relief, surprise, and joy are palpable.

    IV ketamine treatment works in the brain in ways other medicines haven’t before, and it’s restoring and transforming lives like yours. 

    Don’t hesitate to call us if you’re plodding through a sorrowful, empty, hopeless existence because other medications and treatments you’ve tried haven’t helped. You still can find relief of depression symptoms and dramatically reduce heavy drinking.

    So much we’ve learned. So much more work to do.

    No matter how hard her life was, ketamine could dramatically reduce heavy drinking.

    Ketamine works on newer and better systems in your brain. It doesn’t help everyone, but it helps so many that we just keep studying to learn how many more it can help. Even so, chances are pretty good that it will reverse your depression, your PTSD, you substance use disorder, and transform your life to one of hope, courage, initiative, and joy.

    So think about it a bit. And then give yourself the chance to live a rewarding life. 

    To the recovery of your very best self, 

    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,

  • Each 4-Hours of Exercise Reduces Future Depression

    Each 4-Hours of Exercise Reduces Future Depression

    This lady is jogging and knows that exercise reduces future depression.

    Can you believe it’s already December? 

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

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

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

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

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

    Inherited Depression Isn’t a Life Sentence

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

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

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

    The E word?

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

    EXERCISE!!

    Now don’t tune me out.  Stay with me…

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

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

    Exercise reduces future depression, even if it's just stretching.

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

    But that’s not all.

    Exercise Reduces Future Depression

    Did you know that?  

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

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

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

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

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

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

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

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

    Jogging like this lady can lift your outlook with fresh air and beauty and exercise reduces future depression episodes.

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

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

    IV Ketamine Treatment Gives You a Head Start

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

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

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

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

    You Can Enjoy Energy, Initiative, and Hope

    As this man carries his exhausted dog, he enjoys the glow of sunset.

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

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

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

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

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

    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,

  • Gratitude, Suicide Research Scientists, and the AFSP

    Gratitude, Suicide Research Scientists, and the AFSP

    Welcome to November… this is the month each year we dedicate to thankfulness and gratitude. 

    I’m going to share with you some experiences I’ve had this week with gratitude, suicide research scientists, and the AFSP. No matter where you are in life, no matter your circumstances…if you think about it..look around you…there is most likely something you can be grateful for. 

    It may be something fundamental…like clean air or clean water…if your circumstances seem too dire to redeem. But start where you can. And acknowledge gratitude. Because when you do, something happens inside you.  Something happens in your brain. It’s almost as though a barely perceptible fragrance emerges.  Something that soothes your circuitry… and a partial drop of wellbeing falls into the pool of your spirit.

    We’ll be talking more about this as the weeks go by. But think about it. Try to think of something…anything… each day that you can be grateful for.

    I attended an inspiring conference last week. It was a gathering of over 400 scientific researchers from all over the world who gathered to exchange their findings and present their work on suicide research.

    These are the highest level super scientists, who perform the purist research with the tightest controls and the most elegant statistics to reliably measure their results. And it’s their work that feeds the world’s understanding of suicidality. What is it? And what causes it?  When does the risk spike? In whom? And what can we do to prevent it? Without these bright and dedicated men and women, we’d still be in the dark ages with our response as a society to suicidal thoughts and behaviors. Yes, I’m grateful.

    And we’d also be in the dark ages about how to respond or help.

    In terms of suicide research, these are the finest minds who’ve worked together and separately, tenaciously analyzing their data …and collaborating for decades.

    Gratitude, suicide research scientists, and the AFSP have filled up my week and it has me spinning in it all.

    An Invitation to Speak

    Much to my surprise, I was invited to speak to this stunning gathering. It humbled me, and I felt so privileged that I could contribute to this body body of hard-won knowledge. 

    I presented my findings from my own retrospective chart review taken from the population of my own practice. Mine wasn’t a prospective randomized placebo-controlled trial. It was a gathering of data about IV ketamine’s impact on suicidal thoughts. Its ability to stop them. To prevent injury or death… or hospitalization — or trips to the ER.  

    It’s not my intent to make a name for myself as a research scientist… that ship sailed a couple decades ago. I just want to share my experiences treating my own patients in truth…honestly...inviting peer review.

    This group received me well, as well as my presentation. I met some wonderful people. And it all got me thinking about what my place is in this universe of psychiatric treatment. Research. And ketamine administration for psychiatric disorders. 

    Where I Fit

    I’m not a researcher. I don’t carefully tease apart large data sets, or curate a cohort to remove mitigating factors or symptoms that could taint the results.  

    Quite the opposite, actually. I’m a practitioner, caring for my patients, and always seeking ways to help each one get better so they might have access to a fulfilling life. My heart is in helping patients enjoy improved lives…and in healing.
    Gratitude, suicide research scientists, and the AFSP work together to help a man like this one have joy again.

    From the earliest part of my training all those years ago, my heart was to find answers, methods, diets, nutrients, medicines… anything that could play a role in restoring these broken-hearted people, one patient at a time. 

    And that’s what motivates me still. To see sick people get well.  To see suffering people get better. For those who can’t function to function again. With all their complicated, intricately confusing pieces to their personal puzzles… to see those pieces relax…integrate…and thrive together in a restored and hopeful person.

    So this is all the more reason why I was so honored to be received by this exclusive group of scientists. I felt so privileged that my own work contributed to the body of knowledge on suicide prevention.

    My Gratitude, Suicide Research Scientists, and the AFSP

    I want to talk about the organization that fuels so much of this research with their funding. The American Foundation for Suicide Prevention (AFSP) was founded in 1987 by beloved actress Mariette Hartley because of her own personal and family struggle with suicide and suicidal thinking.

    Her intent was to bring hope and intervention to those who suffer in silence and die alone.

    Image result for Mariette Hartley

    Now, nearly 33 years later, AFSP has local chapters in all 50 states, and offices in NYC and Washington, DC.

    They’re busy at work to create a culture that’s informed and prepared to “be smart” about mental health, and the potential for suicide. They teach society in general, and the family and friends of those at risk in particular, constructive methods for finding those with suicidal thinking, and helping them get treatment. To keep them safe.

    Gratitude, Suicide Research Scientists, and the AFSP

    AFSP maintains a presence in Washington, DC to influence policies geared to save lives, and educate people in all walks of life about suicide intervention and  prevention.

    International Survivors of Suicide Loss Day is an annual event when people who’ve been impacted by suicide and loss can come together at events around the world to find support, healing, understanding…and to give back.

    Thanks to AFSP, when your loved one dies by suicide, you don’t have to bear the pain in withdrawn silence. And if you’re having suicidal thoughts, AFSP provides extensive resources to help you get better and live a healthier and happier life.

    As I attended this conference, I realized how far reaching the funding AFSP provides is.  How much research they fund.  The resources they offer to survivors to help bring healing and restoration. Like the online memory quilt, where survivors can create a “quilting square” to remember and celebrate their loved one’s life, through photos, videos, prose, and poetry.

    AFSB also created and supports the National Suicide Prevention Lifeline at 1(800)-800-273-TALK (8255) and the  Crisis Text Line reached by texting TALK to 741741.

    Carry It Forward this Holiday Season

    As the holidays lie ahead over the next two months, be aware that this time of year is not only a difficult time for so many, but also a dangerous one. Let’s be tuned in to identify those around us who may be in need of a listening ear, support, or intervention. Research has shown that you won’t put someone at higher risk if you ask them directly whether they’ve considered hurting themselves or of wanting to die. 

    Being direct, it turns out, actually saves lives. People who are suffering need hope. And they need to feel included. And that they matter. 

    Because you DO matter. Your pain matters.  You’re not invisible. 

    If you have thoughts of suicide, or the thought that you don’t want to live LIKE THIS anymore, reach out.

    And if you’d like to see if IV ketamine infusions can help, call us. 

    IV ketamine treatment can erase those thoughts in an afternoon, and leave hopeful thoughts in their place. It can help you want to build your life. It can increase your energy so that you can. 

    You can feel amazed. Astounded at the change and new hope.

    Does it do this for everyone?  Well, no.  Nothing does.  But it does this for most people who have not been helped by medicines before. The more severe your symptoms, the more effectively it seems to work. It does it for far more than any other medicine has.

    And there’s financing if you need it.

    Let us help you find your life again. 

    Lori Calabrese, MD offers innovative psychiatric treatment like IV Ketamine

    To the restoration of your best self,

    Lori Calabrese, M.D.

  • Who’s Affected by Severe Chronic Depression?

    Who’s Affected by Severe Chronic Depression?

    Severe chronic depression makes this man despondent.

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

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

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

    Gary is one. 

    Gary's angst is made worse by severe chronic depression.

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

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

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

    Gary sits on the railroad track with severe chronic depression.

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

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

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

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

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

    And Who ELSE?

    Dan is.

    A teen hand holds a beer and alcoholism is complicated by severe chronic depression.

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

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

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

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

    Alcohol Addiction and Depression… A Dangerous Combination

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

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

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

    There’s more to Dan’s story.

    Severe chronic depression combined with alcohol can make the depression worse.

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

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

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

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

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

    Cheryl is.

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

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

    Happy expectant couple walking together to keep a bright outlook.

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

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

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

    Happy Times Preparing for Baby

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

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

    Finally, she was in labor.

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

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

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

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

    Traumatic Birth Can Interfere with Bonding Between Mother and Child

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

    Severe chronic depression postpartum interferes with bonding between mother and child.
    She felt no connection to this tiny human, in spite of her husband’s reassurance… She felt sure she would have recognized her own baby, right?

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

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

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

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

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

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

    Postpartum depression. 

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

    Which brings up another point.

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

    The family is.

    Children worry when parent is lost in severe chronic depression.

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

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

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

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

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

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

    Maybe they need IV ketamine treatment. 

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

    Plus, it’s safe.  

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

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

    Remission Often Replaces Severe Chronic Depression at Innovative Psychiatry

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

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

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

    Remember Gary?
    IV ketamine treatment restored Gary from severe chronic depression.

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

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

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

    Then there was Dan.

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

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

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

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

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

    And Cheryl…?

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

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

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

    This mom kisses her baby after severe chronic depression is lifted by IV ketamine.

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

    Severe Stress Can Cause a Setback

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

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

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

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

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

    This Can Happen for You, Too

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

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

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

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

    Find Restoration from Severe Chronic Depression

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

    Severe chronic depression is gone from this mom since IV ketamine treatment.

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

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

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

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

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

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

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

    To the reinvigoration of your best self,

  • The Teen Suicide Epidemic – What You Can Do

    The Teen Suicide Epidemic – What You Can Do

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

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

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

    Silence.

    Tap tap tap…”Open up!”

    Nothing.  

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

    “Oh no….”

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

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

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

    One by one he checked their pulses. Nothing.

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

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

    What is Causing the Teen Suicide Epidemic? 

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

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

    Why??

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

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

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

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

    These high school girls are texting cruel comments to another girl...this is a major cause of the teen suicide epidemic.
    Because of this un-squelched form of communication, privacy has taken a hit, too. A middle schooler catches someone in an awkward situation and sends the photo or video to his contact list.  In seconds, a fragile, shy, insecure 13 year-old is publicly humiliated with nowhere to hide.

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

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

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

    Chronic Stress Causes Pruning of Signaling Structures = Depression

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

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

    And there’s another factor.

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

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

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

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

    Parents Seek Answers for the Teen Suicide Epidemic

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

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

    QPR

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

    Photo by Rachel Lynette French on Unsplash

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

    “Hi, would you like to sit with us?”  

    “How are you…?”

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

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

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

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

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

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

    Joining Forces to Save Lives

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

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

    Lots of Help is Available

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

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

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

    IV Ketamine Treatment works fast to Restore Brain Circuitry

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

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

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

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

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

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

    There are solutions. 

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

    Not always. But most of the time.

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

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

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

    Dr. Calabrese encourages her readers to get your PUFAs straight to improve or prevent depression.

    To the restoration of your best self, 

    Lori Calabrese, M.D.

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

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

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

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

  • ASKP Conference 2019: Celebrating the Response to Ketamine

    ASKP Conference 2019: Celebrating the Response to Ketamine

    A sullen, depressed teen girl is laughing and happy because she's fighting suicide with ketamine.

    The Importance of Meeting Together

    Every once in a while — sometimes only once or twice in a physician’s career — a medicine or treatment comes along that’s a game changer. Something that sets its own records, raises its own bar, and helps people so profoundly that their lives are better because of it. A treatment so remarkable, it establishes a turning point for them. Where life is divided by the “before” and “after” of that treatment. IV ketamine is such a treatment. And we’re celebrating the response to ketamine every day.

    In the field of psychiatry, ketamine’s use off-label has established that line: the misery of “before” and the wellbeing of “after” for growing masses of patients who suffered all their lives, lived at risk of suicide, and found life difficult to bear. The same people who now are enjoying their families, their friendships, their work, and their hobbies.

    And because ketamine is FDA-approved for anesthesia, it presents us with a double- edged sword. On the one hand, it has shown us how safe it is with patients in every age group for 50 years at very high doses as an anesthesia and in pain. And on the other hand, its rapidly growing use in psychiatric disorders is off-label — outside of its FDA labelling for anesthesia.

    Collaboration in a New Field: Ketamine Off-Label

    Neuroscience researchers, psychiatrists, anesthesiologists, emergency department physicians and more have been scrambling to understand this medicine and its effects for years as we navigate this new territory.  

    And the best way to do that?  

    To put our heads together and exchange information, experiences, ideas, and data; and learn all we can together to bring the safest, most effective treatment to our patients.

    Do we see it all the same way?  Of course not. But by coming together regularly we grow and expand our grasp of what ketamine can do for our patients.

    And we have something deeply in common. We’re all celebrating the response to ketamine we see at every turn.

    ASKP for Ketamine Treatment

    The American Society of Ketamine Physicians (ASKP) is about this very thing. We gathered a few days ago to learn from each other, grapple with difficult issues we face, and to expand our knowledge and expertise to better serve our patients.

    This was the second annual meeting of ASKP, and we’re inspired by how we’re growing in numbers and experience.

    As physicians we vow to first do no harm. And then of course, beyond that, we want to help. For more than 50 years, and in more than 19,000 scientific papers, brilliant minds around the world have dug deep and broad in their research — from their universities, their labs, their clinics, and their practices to understand the science and the nuances of ketamine.  All so ketamine can help people who suffer.

    Dr. Jennifer Winegarden, who spoke on the use of ketamine in refractory cancer pain,  put it like this: 

    “We are really here because we want to relieve suffering, but coming up with a consensus for how exactly we’re going to do that is a lot of work; we are still in our infancy in discovering how we are going to do that.“

    The Speakers

    Steve Mandel, M.D.

    ASKP conference where we were celebrating the response to ketamine.
    Steve Mandel, M.D.

    President of ASKP and one of its founding members, introduced the meeting with a call for collaboration.

    He quoted Stephen Hyde, MD, a pioneer in ketamine treatment in Australia, stating “Given the unacceptably high rates of suffering, disability, and premature death experienced by people with treatment-resistant depression and the surprisingly low rates of problems arising from the use of ketamine to treat the disorder, this is a therapy that all patients and their doctors should be discussing.”

    And the speakers? Well, to read the list is to begin to stroll through ketamine’s hall of fame in clinical psychiatry. It was inspiring to listen to speakers who’ve been blazing the trail in the field of ketamine for treatment resistant depression.

    Sanjay Mathew, M.D.

    Professor of Psychiatry and Behavioral Sciences at Baylor University Medical School Houston and a key player in ketamine research in psychiatry, addressed us with a comprehensive review of ketamine for treatment-resistant depression even though the Houston airport was under water! Fantastic.

    Gerard Sanacora, Ph.D., M.D.

    Director of Yale Depression Research Program, another major thought leader and key researcher in ketamine and esketamine for TRD — in fact, a leader every which way! — the lead author on the APA Council of Research Task Force on Novel Biomarkers and Treatments for the Consensus Statement in 2017 on the use of ketamine off-label for depression . . . I could go on and on. He summarized the new data on esketamine, the left-facing ketamine enantiomer from Phase 2 and 3 clinical trials.

    Amit Anand, M.D.

    Professor of Medicine at the Cleveland Clinic and Vice Chair for Research for the Center for Behavioral Health there, and an expert on brain imaging, psychopharmacology of mood disorders, and ketamine. He spoke on a new study of the comparative efficacy of ECT vs ketamine for treatment resistant depression (TRD) where they plan to enroll 200 patients–so exciting because it will be so large.

    David Sheehan, M.D.

    David Sheehan MD celebrates the response to ketamine at the ASKP conference.

    Of course, one of the true greats in our field. He is the father of anxiety research, and an expert in depression, suicide assessment and harm reduction…. and the list goes on. His clinical work and research career spans 50 years and more than 800 publications on anxiety, depression, and suicide. He has developed multiple rating scales in the field that are widely used in clinical research and presented a gripping talk on the assessment, documentation and pharmacologic management of suicidality. He is Distinguished University Health Professor Emeritus at the University of South Florida College of Medicine, and has mentored and collaborated with scores of the major researches in the field over his career.

    Rachel Dalthorp, M.D.

    ASKP Board member, clinical psychiatrist and specialist in reproductive psychiatry at Balance Women’s Health in Oklahoma City, OK, spoke about hormonal challenges in ketamine treatment, and how to work with them to ensure optimum response.

    Omid Naim, M.D.

    of Santa Monica, CA and La Maida, spoke about the importance of creating and building community in transformation and healing.

    ASKP conference, Jeff Becker, MD celebrating the response to ketamine in his brilliant presentation.
    Jeff Becker, M.D.

    Jeff Becker, M.D.

    a clinician with deep expertise in neurospychiatry funtional medicine and noetics, first researched ketamine in 1998, and has been using ketamine in his clinical since 2004. He spoke about fMRI findings in ketamine treatment, and the important roles of chandelier cells, pyramidal neurons, and basket cells during ketamine treatment. Jeff, as always, was brilliant.

    Daniel Richman, M.D.

    Attending Physician at the Hospital for Special Surgery and a Clinical Instructor in the Pain Management Ceneter at New York Presbyterian and Memorial Sloan Kettering, and an expert on the treatment of Complex Regional Pain Syndrome (CRPS), presented a review of the challenges and the success in using ketamine infusions in anesthesia for CRPS — extraordinary help for the worst pain imaginable.

    Jessica Katzmann, Psy.D.

    focuses on ketamine-assisted psychotherapy in her practice, Healing Realms, and she spoke about how to help patients experience wellness and process their improvement and their experiences after ketamine treatment.

    Jennifer Winegarden, D.O.

    an expert on hospice medicine and the Chief Medical Officer of The Medical Team Hospice in Michigan, spoke on end of life care in hospice treating intractable pain with ketamine.

    There were lightening abstract presentations which wrapped up the conference: ketamine infusions with concurrent TMS, (Cindy McKinzie, PsyD. and Melanie Dillon, LCPC of Chicago), a case report of ketamine use for PMDD (Cassandra Gentry, PA, of Balance Women’s Health, OK), and a a review of Ketamine for Anxiety (Michael Banov, MD of PsychAtlanta in Georgia).

    My Own Presentation

    I was honored to speak about my own work with ketamine. The talk was titled, “Real World Results: When Ketamine Stops Suicide” — pretty edgy, but thank goodness, I wasn’t the only one who spoke on suicidality. Suicide was discussed at so many different points throughout the conference, wherever we clustered, over coffee … and Dr. Sheehan’s superb talk on the assessment of suicidal ideation was a beautiful synthesis of clinical research, wisdom, and temperance. He drove home the important point that it is impossible to predict suicide for an individual.

    International Journal of Psychiatry Research celebrates the response to ketamine.

    My data on using IV ketamine in suicidal patients with treatment resistant depression was published recently in the International Journal of Psychiatry Research. As I said, we’re celebrating the response to ketamine at Innovative Psychiatry.

    I spoke about the real world results we’ve seen when we use ketamine for treatment resistant depression — and find that many of the people who come to us are suicidal, have made suicide attempts, have been hospitalized for suicidal thinking.

    Real Patients in the Real World

    Sometimes ketamine doesn't work, and the sadness continues.

    They feel terrible, and want those terrible thoughts to stop. One of the striking findings in my practice is how quickly — and completely — ketamine stopped suicidal thinking in real patients.

    I say real patients because I really mean real people–with complicated lives, multiple stressors, multiple other psychiatric stuff going on at the same time — most had 3 other psychiatric diagnoses in addition to treatment-resistant depression. Most were on 4 or more psychiatric medications, and had failed multiple antidepressants in the past. Many had been hospitalized, many had made suicide attempts… or multiple attempts. Many had failed ECT. Some had failed TMS.

    Or….I should say, our available treatments had failed them.

    They were just doing the best that they could to hold on until a better treatment became available that could help them.

    A Holding Environment

    For many of them, that better treatment was a short series of IV ketamine infusions — with the dose increased (or “titrated”) along the way.

    We work to create a holding environment–to hold on to hope, to offer it to our patients when their hope is strung out pretty thin, to offer it to their families, to give them a chance and to buy a little time so that treatment of their underlying depression, anxiety and trauma can begin. So that the suffering can stop.

    Celebrating the response to ketamine after Lori Calabrese's presentation.

    There is palpable excitement in the room when suicidal thinking falls away. In the IV ketamine treatment room, in the patient’s living room, in a crowded lecture hall when you describe this to other doctors. (…That’s me answering questions on the floor after my talk.)

    Celebrating the Response to Ketamine – The Game Changer

    We're fighting suicide with ketamine to erase suicidal ideation and people are getting well.

    Ketamine infusions don’t always work. I have to emphasize that, because we have to be clear: of course they don’t. We’re trying desperately to understand what are the factors involved when they don’t work for some people.

    But when they do –and they often do — when suicidal thoughts just stop, when the veil lifts, when the ability to enjoy things again slowly creeps back in for someone who has been stuck for so long in such a bad place …. well, then, it’s a celebration.

    So today we’re celebrating the response to ketamine.

    We’re talking, we’re writing, we’re buzzing with hope for the future and for the future of our patients.

    And we have hope to offer them. Real data from hundreds of people that we’ve treated. So that we can say, in our hands, this is what we find, this is what we see, this is what you can expect.

    We need more research–the elegant, beautiful, randomized, placebo-controlled trials with carefully curated patient populations, and primary and secondary endpoints, and exhaustive data analysis.

    And we need more real-world results with real, lived experience. Live suffering. And, yes, the messiness that comes with the complex and devastating psychiatric disorders that we treat every day.

    So indeed, let’s work together.

    Let’s celebrate the response to ketamine, and talk.

    Let’s talk about serial, titrated ketamine infusions, and how they can stop suicidal thinking. How they can maybe turn around that trip to the ER because you might not need it. How they might keep you out of the hospital.

    Joyful girl is celebrating the response to ketamine that changed her depression to joy.

    Most definitely, let’s talk. While we celebrate (and let’s keep celebrating the response to ketamine). And let’s talk so that we can save lives.

    Let’s talk so that we get insurance to listen and to reimburse you for a treatment that can potentially save your life.

    Because an infusion is cheaper than an ambulance ride. Less expensive than a night on a gurney in the ER. Much less awful than days spent hospitalized on a psych ward.

    Oh yes, let’s do talk. Doctor to doctor. Doctor to patient. Mother to daughter. Friend to friend. Share the news:

    Lori Calabrese. Titrated Serial Ketamine Infusions Stop Outpatient Suicidality and Avert ER Visits and Hospitalizations. Int J Psychiatr Res. 2019; 2(5): 1-12.

    We’re working hard every day to help you find the resilience you wish for, the fulfillment of a rewarding life, the enrichment of strong, mutual relationships.

    To the reinvigorating of your best self,

    Lori Calabrese, MD offers innovative psychiatric treatment like IV Ketamine

    Lori Calabrese, MD

  • Where Can You Find Real Help for a Suicidal Person?

    Where Can You Find Real Help for a Suicidal Person?

    To help a suicidal person, ask hard questions, then listen. Help them connect with people who care. You can save a life.

    What is a suicidal person like?  How do you find help for a suicidal person? Can you describe the profile of someone who wants to die? Are they melancholy?  Irritable or agitated?  Are they funny?  Always making people laugh when they’re dying inside? Do they present themselves one way in public and another way in private? Are they sad…do they fit in …or are they misfits?

    Yes. The answer is YES.  And NO.

    A suicidal person can be any of these people, or none of them.  Someone like you …or me.  Or different than both of us.

    Anyone is capable of suicide given the wrong set of circumstances.

    Someone who can’t remember a time when he wasn’t sad… or just vacant. A person who’s had a series of deep losses, major stressors, and profound disappointments: all in a row…or all at once.

    Someone who just finished medical school. A young mother; a 9 year-old child. An elderly field laborer. A mail carrier.

    The pastor of a mega church.  The owner of a multimillion dollar consulting firm. A thirty year-old single father. A world-famous performer. The head of a university medical department. A kindergarten teacher. A 14 year-old girl.

    Sister, father, son, daughter, grandmother.

    WHO is a Suicidal Person?

    For every person you find who ends his or her life, there are thousands with similar circumstances who don’t.  

    Why?  What makes the difference?

    You can help a despondent person like this man by talking to him, asking if he's thought about hurting himself, and talk to him about how IV ketamine can erase suicidal thoughts.

    What causes one person who seems to have “everything to live for” want to die, and another whose life is similar want to live and not even consider dying…? Why is it that two people can face shame, humiliation, failure; and one wants to die and the other bounces back and moves forward?

    One thing is for certain. It’s not about one person being weak and another being strong. 

    Or about one being flawed and another being “normal.”

    The complexities of suicidal thoughts as symptoms of a deeper, more complex underlying condition cannot be completely explained yet…certainly not here. But, somewhere in it all you’ll find genetic links, brain circuitry, complicated response mechanisms, and more. 

    Why does one person bear the burden of kidney malfunction or lung disease and another doesn’t?  Or Type 1 diabetes? Or liver disease?

    One person’s genetic makeup provides a tendency toward more resilience and another’s genes lean more toward less resilience. One woman’s genes map out a future with breast cancer while another’s don’t.

    How Many In a Week..?

    Last week was Suicide Prevention Week. On last Monday, September 9, 2019, a beloved associate paster of a prominent church in Riverside, California, officiated over the funeral of a lady who had ended her life. Before the day was over, he had ended his own, too.

    Don’t ask why. Ask, “How can I help?”

    We Need to Supply Real Help for a Suicidal Person

    Then, two days later, the director of psychological services at a prominent state university jumped from his 17th- story balcony.

    The gentle and caring pastor was a devoted, loving husband and father of two. He founded Anthem of Hope in 2016, for those who suffer from depression and suicidal thoughts. He had always been open about his own struggles with the same.

    Jarrid Wilson, pastor at Harvest Christian Fellowship, died by suicide last week.

    Jarrid Wilson was a kind-hearted, vibrant, encouraging person, with two beautiful children, and an amazing wife. He’d suffered from depression since childhood. His depression and suicidal thoughts became too much to bear for him that day. 

    His wife is grief-stricken, suffocating with the loss of her best friend, and his church is stunned.

    Our hearts go out to his family, his church, and all who knew and loved him. 

    Jarrid’s life didn’t end because of something that was wrong in his life, but because of something that was malfunctioning in his brain. This is why we promote treatment for suicidal thoughts. 

    When you hear someone say, “She had so much to live for,” remind them that this is an illness. It’s not about hating her life.

    We must find help for a suicidal person like Dr. Eells.

    Gregory Eells, Ph.D., was accomplished and a strong, capable leader. Was there a reason, or was his death also the symptom of an underlying disease..?

    That’s the thing about suicide. Since we don’t know what his thoughts were, we can only guess. But it’s important to understand that stress…too much of it for too long…can lead to depression.

    Prolonged Severe Stressors Can Result in Depression and Lead to Suicidal Thoughts

    Stress breaks down those signaling structures and interferes in other areas of the brain. When that happens, the connections between brain cells become pruned and sparse… and signals are reduced in strength and number. The more severe the depression, the more profusely suicidal thoughts may grow.

    Crisis on top of crisis; death and loss; financial difficulty; illness; divorce; foreclosure; …all of these things together can prune away those connections and lead to deep and overwhelming depression.

    Then come the thoughts. Maybe a desire to escape the torture? Possibly. But more likely they’re somehow related to the poor communication of signals within the brain. The darkness. The silence. The void. The vacancy of any reward.

    These thoughts tend to intrude in your mind when your depression and anxiety are most severe. Some people experience these intrusive thoughts of death and dying no matter what they’re doing. The more their condition worsens, the more these thoughts bombard their minds.

    Suicide is Reaching Epidemic Proportions

    In 2017, 1.4 million people attempted suicide, succumbing to those intrusive thoughts. Of those, 47 thousand people died. We talked last week about how this means that suicide is the 10th leading cause of death in this country alone.

    Let's help a suicidal person like this by reaching out and talking to her, and telling her about IV ketamine for suicidal thoughts.

    And we haven’t even scratched the surface of all the people who have suicidal thoughts, plans, or intentions. Most of us are unaware of the numerous people around us who struggle with suicidal thoughts, because they maintain a brave mask.

    This is why IV ketamine treatment is so vitally important now more than ever. As suicide threatens to take more lives, we need more and better ways to prevent it. And to do that, we need treatment that stops those thoughts.

    IV Ketamine Can Provide Extraordinary Help for a Suicidal Person

    By a mechanism that’s separate from what ketamine infusions do to relieve depression, they also can stop those intrusive suicidal thoughts in an hour or two…or an afternoon. So even those patients who might not feel relieved of depression symptoms after ketamine infusions, may still be relieved of those thoughts of death…and dying. 

    IV ketamine infusions are a life-saving treatment, and nothing else comes close. Other medicines that have been used for this purpose required weeks or months to be effective. And, well…with someone severely suicidal, that may be too late.

    Ketamine acts in a multiple areas in the brain, and in a variety of ways. We do know some of the ways it works, but we suspect neuroscience researchers will continue to uncover more and more of ketamine’s handiwork going forward.

    Ways IV Ketamine Goes to Work in Your Brain to Lift Depression

    We know that as a NMDA receptor antagonist, ketamine increases levels of the excitatory neurotransmitter glutamate, the most prolific neurotransmitter in the body. 

    We know that ketamine turns the mRNA switch to “ON” which turns on DNA, that turbo boosts BDNF (brain-derived-neurotrophic-factor). Then the BDNF acts like a rich compost, stimulating growth of the connections between neurons, or brain cells, called synapses…and their branches of dendrites and dendritic spines.

    IV ketamine helps suicidal thinking by erasing those thoughts and replacing them with hope.

    These synapses, and dendritic branches proliferate abundantly throughout the brain, building superhighways for signaling to be high speed and abundant, lighting up the brain like a Christmas tree. 

    The slow, dark, sluggish signals that crept along during depression, explode with speed and efficiency as the brain comes alive.

    When this happens, your thoughts become creative, extensive, and bright. Your outlook soars, and so does your initiative and sense of purpose. Resilience replaces despair, and hope sets down roots. THIS is real help for a suicidal person.

    While all this is going on, there’s a change in the lateral habenula, that tamps down that bursting of cells that prevents you from enjoying reward. Your ability to enjoy moments, scenery, beauty, appreciation, and love is restored.

    Then, there are those G cells stacked up on lipid rafts in the cell membrane. They lazily while away the afternoon. Then IV ketamine comes along and slides those G’s off the lipid rafts and puts them back to work moving signals down the highway.

    These are the things we KNOW about.  We’re sure there are more actions we don’t know yet. But we will.

    The result is joy. And hope. And the energy and motivation to take initiative and build relationships, strengthen bonds, improve productivity at work, creatively advance in all you do, for a rewarding and fulfilling life.

    Spread the Word and Stop the Torment to Provide Real Help for a Suicidal Person

    At Innovative Psychiatry we see people like Jarrid and Gregory often. And we see so many others. People who don’t want to die…but who don’t want to keep living like this, tormented by pain and suicidal thoughts, images, and ideas. People who want to enjoy life, enjoy their families, and invest their energy in their careers, hobbies, and interests.

    IV ketamine treatment can erase suicidal thoughts and restore your best self.

    We’re thrilled and relieved to see the majority of them walk out without suicidal thoughts at all, confident they can get better with therapy and medication. Or they walk out in remission.  

    That’s the beauty of IV ketamine treatment at work. We’re trying to get the word out that there is now a treatment that can rapidly stop suicidal thinking. Help us spread the word.

    We’d like to help you.

    Are you tired of living like this? Do you ache for the freedom to build your relationships, your career, and your hope?

    Protect yourself from those thoughts of death that try to lure you to an action you don’t want to take. Call us. Let us help you tap into the life you hunger for.

    You’re not alone, and we’re here to help.

    Please, if you have suicidal thoughts, call us. Or call the Suicide Prevention Lifeline: +1(800) 273-8255. Those intrusive thoughts are symptoms of an underlying condition and treatment can help.

    IV ketamine treatment can erase those thoughts in an afternoon. We want you to live and to discover what life can be for you. We want to help you heal.

    To the healing of your best self,







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