Lori Calabrese, MD

Tag: IV Ketamine for Suicidal Thoughts

  • COVID-19 Anxiety Has Gone Viral – How You Can Weather The Uncertainty

    COVID-19 Anxiety Has Gone Viral – How You Can Weather The Uncertainty

    Covid 19 anxiety has gone viral, and fear of catching the virus results in isolation.

    The President has declared a national emergency.

    Schools have been closed and gatherings cancelled. Your plans for Spring 2020 have been turned upside down. The news is filled with the increasing numbers of cases of this strange virus, and everywhere you turn, conversations focus on discussing the dangers and risks. What do you do with this information overload? COVID-19 anxiety has gone viral – How do you weather the uncertainty?

    Thousands Self-Quarantine

    Lilyanne, a mother of five, returned from a spring break trip to the northwest. It was a chance to see grandparents, aunts, uncles, and cousins. They were able to get outside and camp, and take in the beauty of the rugged Oregon coast. After she and her children arrived back in their small rural town in Oklahoma, she didn’t feel right. She checked her temperature and it was 102. No wonder!

    Before long she was coughing…hard. It was a dry cough but it hurt. Her preschooler was wheezing, and with her daughter’s asthma history she thought it best to take her to the doctor. The doctor prescribed Tamiflu for both Lilyanne and her little girl. 

    Her daughter Bessie started feeling better quickly but Lilyanne felt no improvement. She asked the doctor for a COVID-19 test, and the doctor said he wasn’t sure yet how to test for that.

    A couple days went by, and Lilyanne decided to go to an urgent care. She worried that she might get too sick to care for her children, and also wanted to know if she should isolate herself away from them. The urgent care had no idea how to do the testing either. 

    So Lilyanne went to the ER. She hated to expose others there but tried to be very careful. She needed to know if she’d been infected in Oregon or in the plane…or somewhere else.
    Covid 19 has gone viral with shortage of testing kits.

    The ER doctor tested her for other infections, but explained that she didn’t meet criteria for a COVID-19 test.

    “I don’t meet criteria?? Why not??” She felt overwhelmed.

    Covid 19 anxiety has gone viral, and she wished she knew what to do…

    The best thing she knew to do was to quarantine herself and her five children in the house. But to do that…she needed groceries so they could eat.

    Again, she tried to be really careful, using hand sanitizer every few minutes at the store. She quickly filled her cart with necessities since they’d been out of town 9 days. Then, she chose frozen meats, veggies, and snacks, along with milk, juice, pasta, and produce. 

    She paid without touching the cashier, wiped down the terminal where she inserted her card, and hurried out of the store.

    Once home, the kids helped with unloading groceries, and she took off her clothes, put on her nightgown, and crawled under the covers.  Before long, her oldest son, Colton, brought her a steaming mug of herbal tea.

    So far, none of her children showed symptoms, but how was this going to go? Her two oldest kids could handle meals, but how long could they manage the young ones? The laundry? Keeping the peace..?  How bad would this get?

    Could she trust all 5 of them to stay in the house, when she was in bed?

    Her temperature had risen higher. 102.9. The coughing was hard to control and painful. Her lungs hurt.  

    She called the CDC to ask them what to do…

    Anxiety is a natural response to a situation with an unknown outcome. 

    And just because the outcome is unknown, it doesn’t mean you’re facing doom. That’s the thing about anxiety. It feels foreboding. Scary. Threatening. 

    But if you can decide to think about it differently, you just might find a way to relax a little…and patiently see what happens next.

    For instance…

    Covid 19 anxiety has gone viral but you can take a walk in the fresh air like this puppy.
    If you’ve been watching the news or reading articles on the internet and you feel your heart rate increasing, turn off the TV for awhile, walk away from your computer, and take a short walk in the fresh air, do a little gardening, or go in the kitchen and cook something. 

    That heart rate rises to give you more energy to fight or run in a crisis, so put that energy to work for something productive and enjoyable.

    An unsolicited act of kindness, no matter how small, can help you redirect your energy and focus, and the smile you bring to the recipient will give you good feelings that help you feel a little better, too.

    Facetime or Skype a friend, and talk and laugh. Just because you’re isolated doesn’t mean you can’t continue to nurture your friendships, and show others you care. Keeping the connections in your life strong will gird up your own resilience to get through this challenge.

    There are also apps for your phone like Marco Polo, where you can talk back and forth and see each other’s faces. Just being able to talk face-to-face can help you relax, feel connected, and encouraged.

    Because COVID-19 anxiety has gone viral, and the people you care about are comforted hearing from you.

    And remember that by isolating yourself at home, you’re taking care of others. Odds are that you’re likely to recover fine if you’re infected with the COVID-19 but you quarantine yourself for the sake of those who might not recover as easily.

    When you isolate yourself, it’s an act of kindness toward all of those people whose paths you would cross.

    We’re all surrounded with people who have compromised immune systems, or underlying conditions, and we don’t even realize it. A colleague who suffers from Crohn’s Disease, Type 1 Diabetes, leukemia, or any other immunocompromised condition could be made critically ill by contact with you.

    And any of the people you see at the grocery store, on the train, in an airplane, or on an elevator are protected because you chose to isolate yourself until you’re no longer contagious.

    Now, even though we talk about productive things to do with the anxiety you might feel, sometimes you just can’t manage it. 

    Sometimes you need help.

    And just as we’ve used IV ketamine treatment for depression, it’s also shown significant efficacy for anxiety. We know that anxiety and depression often go hand in hand, don’t we?

    We know that that breakdown for treatment effectiveness goes something like this:

    About a third of patients with depression improve with their first trial of antidepressants, and another one third or so respond well to a second trial of a different antidepressant or combination. That leaves about 1/3 who aren’t helped by that method of treatment. The ones we might call treatment resistant.

    Still it’s not so much that those patients are treatment resistant, it’s that traditional antidepressants are the wrong treatment for those patients.

    But that group of patients shows wonderful response to IV ketamine treatment, with 80% responding remarkably well.

    At Innovative Psychiatry, we’re seeing patients every week who walk out with their heads high, a spring in their step, and full of anticipation and joy about what lies ahead.

    And the resilience these patients can enjoy that IV ketamine can supply, can give them the flexibility and resilience to bounce back in the atmosphere we’re challenged with right now in this country and the world.

    What’s more, IV ketamine infusions can stop suicidal thoughts in an afternoon.

    It’s so good to know you don’t need a hospital stay to receive this extraordinary treatment. You can come to the office, relax in a private area, and after your infusion, slip out quickly and head home with a ride.

    Covid 19 anxiety has gone viral but you can be happy and at peace through it all.

    Don’t let our current challenges tear down your confidence in your ability to manage your life. COVID-19 anxiety has gone viral, but it doesn’t have to affect you.

    If you’re part of that last 1/3 and need relief, call us.

    We’re here to help you safely receive treatment, so you can emerge with a new outlook on your life, new energy and resilience to face these challenges, and new hope and joy to build your future.

    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,

  • Ketamine Restoration in the Amygdala Repairs Social Connections

    Ketamine Restoration in the Amygdala Repairs Social Connections

    Nick walked in after school, slamming the door behind him.

    His mom looked up, startled by the noise. “What’s that dirty look about..?? You’re so judgmental!!” Nick was fuming, and with that he headed upstairs. His mom followed him upstairs and spoke softly, knowing her son was apparently volatile. She didn’t realize that what just happened could be repaired by ketamine restoration in the amygdala.

    “Nicholas, I’m sorry my face looked judgmental. I wasn’t feeling judgmental…I was startled by the noise the door made, and concerned that you seemed so upset. Did something happen..?”

    Nick crumbled. 

    He didn’t know why he misread his mom, or why he was so angry. Nick hated himself for being hateful. He just felt so angry so much of the time, and when he wasn’t angry, he just wanted to cry… what was wrong with him?

    “Sorry, mom.  I thought you were mad about me slamming the door. I have a lot of homework and I just don’t want to do it. It all seems pointless.”

    Nick’s mom knew he’d been under a cloud since the last school year. He was seeing a psychiatrist, which he always dreaded. The medications didn’t seem to be helping, in spite of the fact he was on his third different medicine.

    He’d all but refused to see the therapist any more. As his mom, she just wanted him to feel better and enjoy his adolescent life, but she was hitting a wall. All she knew to do was to encourage him to keep trying and to provide a little comfort where she could.

    “Why don’t you come downstairs, and I’ll make you a sandwich. Eating something might help your homework seem a little easier to face.”

    Ketamine Restoration in the Amygdala

    While Nick ate, he decided to mention to his mom what his buddy in History had told him.

    “Mom, you know Zach? He’s been down for a long time…even longer than me. He told me today that he’s getting IV ketamine treatment. He said he took pills for a year and they didn’t help, no matter what brand the doctor ordered. Anyway, his dad read about this treatment, and Zach says it’s already helping.”

    “Really Nicholas? Does his doctor give him the treatment?”

    “No, he said his dad is taking him to a different psychiatrist who does it. He says his own doctor is all for it. He’ll go for two or three weeks and he’ll be done. So far, he’s finished the first week.  I can tell he’s doing better. He smiles and laughs. It’s weird. But I also envy him…”

    “I tell you what, Nicholas. You go work on homework, and I’ll see what I can find out about this treatment. IV ketamine you say? We’re going to find help, honey.”

    Three months later, Nick walked in the door, smiling ear to ear.  

    “Hi Mom. Since it’s Friday, is it ok for me to go to a movie tonight with Zach and Tim?  Oh and by the way, Chelsea said she’ll go to prom with me.”

    Nick beamed.

    “Oh that’s fantastic, Nicholas! I’m so glad she said yes. She’ll be on the arm of the nicest and best looking guy at school!  And sure, the movie’s fine. Zach and Tim are great guys.”

    IV ketamine restoration in the amygdala can make all the difference.

    Depression Can Impair the Amygdala’s Ability to Process Faces

    To the casual observer, this may all sound a little too easy. And for some people, it might be. Everyone’s different. But for most people like Zach and Nicholas, their misery is reversed by a series of 6 IV ketamine infusions, sometimes a few more.

    And in some cases supplements are needed to address low blood levels of certain hormones or nutrients first. But, when you consider the comparison of that to years of traditional antidepressants that aren’t working, it’s an easy choice.

    On top of that, the prospect of joy – and hope – in place of the damaged relationships caused by a short temper, a hopeless outlook, and absent motivation, is again…an easy choice.

    Humans like to feel good. When you don’t, you’re not very pleasant to be around, you know? Is there anything that makes you feel worse than severe, unrelenting depression complicated by anxiety and phobias?  It’s misery.

    And the thing is, it colors the way you see everything. You can be looking in someone’s face who’s just preoccupied, and interpret their expression as angry, critical, irritable… then you snap at them about it, and they feel attacked from out of nowhere.

    Guess what?  There’s a scientific reason you do that. It’s not just your imagination. And the good news is that IV ketamine treatment actually changes something deep in your brain to help you interpret their facial expression for what it’s intended to be.

    To understand this, we need to talk about the a wonderful structure in the brain called the amygdala.

    Ketamine Restoration in the Amygdala

    The amygdala consists of 2 almond shaped structures deep in the sides of the brain at the temporal lobe. It’s one part of the limbic system which processes emotion, records emotional memories, influences behavior, motivation, and the sense of smell, as well. 

    One key job the amygdala performs is helping you to look at facial expressions in others and determine their emotion. For instance, if you see someone frowning, with their face tense and lips tight, do you assume they’re happy? Of course not. It’s your amygdala that sees their expression and determines they may be angry.

    Well, when someone is suffering from a disorder like severe depression or bipolar depression, their amygdala may be malfunctioning.

    Study Explores Ketamine’s Effect on Amygdala Function

    So recently, a team of researchers led by Joana R.A. Loureiro in Los Angeles and Chicago set out to study what effect two rapid acting depression treatments have on the amygdala’s ability to accurately process facial expressions. Using functional MRIs (fMRI) they tested 44 adults who were all experiencing an episode of severe depression.

    They divided the group into two parts: 17 subjects were given an individualized number of treatments of ECT and 27 were given IV ketamine infusions 2 or 3 times a week until they had received 4 infusions. 

    This was an interesting approach because both forms of treatment affect brain function and emotional processing, so they wanted to see if it worked at the level of the brain cells. 

    Since interpreting the facial expressions of others is such an important part of social functioning, they focused on the subjects’ ability to accurately do that. The subjects were tested by the task of matching emotional faces on a screen. If the face at the top of the screen was smiling, they needed to match the face at the bottom of the screen that was also smiling.

    They found that both modes of treatment improved the accuracy of the subjects’ amygdala function.

    When Depression Impairs – Ketamine Repairs

    Now, about the type of scenario that Nicholas and his mom experienced. At the moment he walked in the door he believed he saw criticism and judgment in her facial expression, when her look was actually surprise and concern.

    When someone is severely depressed, it’s as though they have an affinity for negative feelings and beliefs. So, when they see a facial expression that appears negative to them, it goes to the bone. They feel it so deeply and lightening fast.

    It’s easy to see that this type of misinterpretation and reaction only further damages relationships that are already fragile when someone is severely depressed.

    And even though both ECT and ketamine improved the amygdala’s function, ECT is a treatment that carries some bias and even stigma for its side effects and history.

    We also know that ketamine not only blocks the NMDA receptors but it also activates AMPA receptors and an array of other actions that can make you feel remarkably better.

    And there’s another life-changing benefit ketamine can provide:

    IV ketamine can stop suicidal thoughts in a few hours.

    This in-depth study shows yet another way that depression impairs your function, and how ketamine treatment can restore it better than ever.

    Reach Out for Ketamine Restoration in the Amygdala – And Get Your Joy Back

    At Innovative Psychiatry, want to help you feel a lot better than just “less depressed.” We want you to experience joy, a song in your heart, hope for the future, and energized motivation to build the life you want, with healthy and strong relationships.

    It’s almost like using a car jack to crank up your life and replace the pain and loss with new ideas, new projects, new joy in relationships.

    If you can relate to Nick, and you want to feel joyful and able to care about others as you put your best foot forward, call us.

    We want to work with you and your healthcare team to help you experience extraordinary relief. 

    Reach out now for hope.

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

    To the restoration of your best self,

  • Does Hopelessness Accompany Suicidal Thoughts or Cause Them?

    Does Hopelessness Accompany Suicidal Thoughts or Cause Them?

    Tim dragged himself into the school cafeteria where the photographers had set up equipment to take school pictures.

    He felt angry, bitter, sullen, and hopeless. What purpose could there be in school pictures? What’s the point? he thought. Tim hated being at school. He felt like he would self-destruct if he didn’t get out of there. Then it was his turn for his portrait. He stared at the camera. The photographer said, “Smile!” (Does hopelessness accompany suicidal thoughts…or cause them?)

    He just stared straight ahead. Enduring. He knew if he smiled it would make him look like a horror-movie character. Click. Flash. And it was over.

    Tim got up, and dragged himself out of the cafeteria and out the back door of the school.  He shuffled home. He couldn’t stand being there any longer. 

    Right behind Tim in the line a pretty girl waited her turn. Emily smiled for the camera. She didn’t want to. But she tried to do the right thing. Her sad eyes gave away her despair. Emily lived in a neighborhood where everyone knew each other, got together, barbecued, and enjoyed the community.

    The problem with that is that one of her neighbors offered to spend time helping her with her music lessons. Her parents encouraged her to take advantage of the expertise of this “nice man.” Luis was 41, college educated, and very musical.

    Emily didn’t know how to tell her parents that every time she went to his house, he had other ideas in mind. She felt ashamed. Troubled. Scared. Dirty.

    She tried to be responsible and do everything expected of her. Her parents just knew she was a good student, kind, and obedient. Does hopelessness accompany suicidal thoughts…or cause them?

    Once when Emily tried to tell her mom about Luis, her mom corrected her before she could get it out. She told her to be sure to be respectful toward him when she was at his house.

    Emily clammed up.

    But she was reaching the breaking point. After two years, she didn’t think she could take this any longer. She didn’t know how to stop it. She was feeling more and more hopeless that there would ever be an end to it. And Luis threatened that if she told anyone he would hurt her family.

    So Does Hopelessness Accompany Suicidal Thoughts or Cause Them?

    Both Tim and Emily were losing their strength to hang on. Of the two, Tim was the most likely to be identified by teachers as one who might need to see a psychiatrist. His facial expressions, attitude, and disposition made him a likely candidate for that kind of help.

    Emily, on the other hand, seemed quiet, compliant, and responsible to the school staff. Her teachers guessed she must come from a very nice family.  Emily’s depression wasn’t easy to notice because she didn’t let it show. Her goal was to please those in authority in her life.

    Tim’s doctor, on the other hand, diagnosed him with bipolar II disorder. He prescribed medication, but Tim did not feel much better.

    Tim directed his anger at his dad. Because he felt his dad lacked understanding for his condition. He resented his dad expecting him to function when he felt so bad. He wished he could crawl into a hole and hide from the world.

    Emily felt completely alone in the world because she couldn’t talk to anyone about what she was going through. And though her parents were good people, they had no idea she continuously faced such a horror.

    We can look at Tim and Emily and draw our own conclusions. But you have to ask yourself does hopelessness accompany suicidal thoughts…or does it cause them?

    Tim’s problem wasn’t his dad so much as the symptoms of his illness that weren’t relieved by his medicine. And Tim didn’t know how to approach his dad in a way to help him see what he was going through. His dad just felt he needed to discipline his belligerent son.

    In Emily’s case, it seemed that her problems could be resolved by simply blowing the whistle on Luis. That message is plastered on the walls of the school… “Tell someone!”

    She’d heard that message all her life.  She could go to the school nurse, or a teacher she trusted, or even a police officer. But she didn’t.  When she would think about it, all she could think of was how hurt her parents would be that she talked to a stranger instead of keeping their business in the family. 

    She was also afraid her dad might do something crazy to Luis that would get him arrested, then  what would her mom and brothers do?

    Every time she thought about talking to someone she hit a wall of all the reasons why she couldn’t…

    Then, in a two week period, two students in the high school took their own lives.

    Everyone wondered why. 

    No one dreamed Emily was sad or had any reason to do such a thing. Except her heartbroken parents… because Emily left a note. And Luis was arrested.

    Tim’s dad was devastated. He’d been doing his best to help Tim get the treatment he needed, but each new medication required several weeks –sometimes months — to see if it helped him feel better. Talk therapy takes time, everyone said. And he hadn’t heard of a treatment like IV ketamine. He just assumed Tim’s doctor would do what was best for his son.

    It was so hard to know the difference between his son’s bipolar symptoms and just a bad rebellious attitude. He worried about it all the time. Just not knowing how to respond to Tim’s responses.  He wished he had a guide book. But now it was too late. He just didn’t realize how severe it was.

    These two deaths stunned and rocked the school they both attended. Two very different students who didn’t know each other, but who both could have been helped…if only…

    Does hopelessness accompany suicidal thoughts…or does it cause them?

    If you knew Tim or Emily, you’d likely have been grief stricken by their deaths. Probably baffled.  And for good reason. Because hopelessness and despair come in different forms. And you probably wish you could have helped them.

    Tim’s hopelessness was within him, as a symptom of a severe and difficult-to-treat illness.

    Tim probably spent most of his time in the throes of bipolar depression. When your mind and outlook are so dark so much of the time, you can desperately need a break from it. 

    But if you know of no medicine that will supply that break for you…  if your doctor knows of no medicine that will help without trying one after another… you get your hopes up over and over…only to experience a new type of grim despair. Hopelessness grows after years of this…and it may dawn on you there’s nothing that can help.

    And you don’t know where to look for hope.

    Emily’s hopelessness was internal, too. She felt trapped by an external force. If that external force could have been removed from her life, she probably could have recovered. Unless conditions like PTSD or severe depression complicated her condition. But even those conditions can be relieved with a novel and advanced treatment like IV ketamine.

    Children and teens should be able to live healthy, active, trusting lives in a perfect world. But it’s not a perfect world.

    When they’re assaulted, and wounded, they may need special care with a skilled therapist, support from friends and family, and treatment to help them heal. Sometimes that can be treatment with a novel, advanced treatment like IV ketamine.

    A group of researchers led by Ilya Baryshnikov, M.D., asked whether the hopelessness people with depressive disorders experience is a crucial predictor of suicidal thoughts and plans.

    They guessed that hopelessness was the sign that a person would be having suicidal thoughts, so they conducted an in-depth study which was just published this month in the Journal of Clinical Psychiatry.   

    They followed 406 people for 10 years, and used diagnostic tools to determine what role hopelessness played, as well as what role the severity of the depression played, in each person’s experience with suicidal thoughts.

    Standard tools like Scale for Suicidal Ideation, Beck Depression Inventory, Beck Hopelessness Scale, Beck Anxiety Inventory, Perceived Social Support Scale – Revised, and Eysenck Personality Inventory helped them evaluate the state of mind as well as personality traits of their subjects. 

    They found that hopelessness served to explain the suicidal thoughts, but wasn’t so much a crucial prerequisite… and that it’s actually the severity of the depression that leads to suicidal thoughts.

    In the cases of Tim and Emily, both needed intervention. For Tim, IV ketamine could have possibly changed his whole world. By helping him to achieve remission, and restoring his energy and hope, his world — and his relationship with his dad — could have been transformed. 

    It’s likely his dad, like so many, had no idea that IV ketamine was an option. Much less understanding about what it could do for his son.

    For Emily, it is possible the long term stress of abuse wore down her resilience, undermining her resolve to protect herself and report Luis. To trust her parents and make them listen, so they could help.

    In her case, too, IV ketamine could have helped restore her emotional strength to do what was needed to make herself and other girls in her neighborhood safe …to speak up.

    At Innovative Psychiatry, we see teens like Tim and Emily — and find the transformative effects of IV ketamine treatment can bring restoration not only to their outlook, but to many aspects of their lives. Relationships grow stronger, energy for school improves their performance, and their hope and joy billow. Not for everyone, certainly, but for most,

    If you, or your teen, have been depressed from major depressive disorder or from bipolar depression, and oral antidepressants aren’t working, call us. Let’s talk about whether you’re a candidate for IV ketamine treatment.

    If you’ve suffered from a major trauma that other treatments haven’t helped, call us. IV ketamine treatment can restore you if PTSD has impaired your function in life.

    IV ketamine can be dramatically effective also with severe social anxiety, alcohol abuse disorder, substance abuse disorder, and can stop suicidal thinking in an afternoon.

    We want you, and your teen, to be restored to the best you ever, and have a rewarding a fulfilling life with your own joy… and hope… abounding. 

    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,

  • Spravato: Esketamine Nasal Spray Controversy Storms Ahead

    Spravato: Esketamine Nasal Spray Controversy Storms Ahead

    This man is happy following treatment in spite of esketamine nasal spray controversy.

    Have you tried Spravato?

    Periodically, we’ve added our two cents to the discussion. Since its approval by the FDA in March of last year, we’ve seen a variety of protests from psychiatrists about its value for treating treatment resistant and severe depression. A recent article published in The Lancet provides an overview of the back and forth discussion. A group of physicians wrote a series of editorials published in The Lancet in October 2019, challenging Spravato’s value when weighed against its dangers and modest effectiveness. And the esketamine nasal spray controversy surges forward.

    A significant benefit for Spravato is supposed to be that because the FDA approved it, some insurances cover the cost of the medication and the cost of the doctor’s 2-hour office visit to administer it. (Stay with us–more on this later!) That’s a substantial benefit in the eyes of some patients.

    There have not yet been head-to-head controlled trials comparing racemic ketamine infusions to Spravato. But there are plenty of physicians around the country who have used both in their offices with patients. And when you compare Spravato with the effectiveness of IV ketamine treatment, Spravato’s benefit is less dramatic, and rather than occurring rapidly and robustly — it seems much milder and more gradual.

    Spravato esketamine nasal spray controversy is hot on The Lancet.

    In addition,  FDA approval requires the use of an antidepressant at the same time as Spravato.

    (It’s like Spravato is an adjunctive treatment to an antidepressant you’re starting at the same time, or an add-on to an antidepressant that’s on board but not completely effective.) Hmm. When you think about it, it may be harder and harder to know what the FDA trials really showed.

    So let’s look at the objections of these doctors, and the response from a team led by Ella Daly, M.D., associated with Janssen, the maker of Spravato.

    A Former FDA Recruiter Expresses Misgivings about Spravato’s Trials

    One of the critics of Spravato’s FDA approval was a former FDA reviewer himself. Erik Turner, MD, of Oregon Health and Science University in Portland, OR, made a point in his editorial.

    He said that some physicians who had heard that Spravato was a “game-changer” were likely to feel disappointed when they found out that  81% of the response to this medicine was experienced by those who were given the placebo!  

    Dr. Erik Turner challenges FDA approval of Spravato esketamine nasal spray.
    Erik Turner, M.D.

    As a former reviewer himself, he expressed his concern that esketamine nasal spray was basically approved on only two positive trials, in spite of the failed ones. 

    In a short-term trial to show effectiveness, the response of reduced symptoms was not maintained for even 24 hours. It’s not hard to see why that wasn’t satisfactory. 

    In the FDA trials, Janssen used the Montgomery-Asberg Depression Rating Scale (MADRS) to rate change in mood in the subjects who were taking esketamine spray. Surprisingly, there was only a mean 4 point improvement on that scale which has a possible score of 60. 

    It’s only fair to note that 69% of subjects who were taking the active drug vs. placebo technically responded. However, when we consider that they deemed only 2 points on the MADRS as “clinically significant,” practicing psychiatrists might not see it the same way when evaluating their own patients.

    Still, 52% of the placebo group scored 50% or higher improvement on their MADRS rating. So research team labeled them “responders,” (meaning the nasal spray they were testing had made them feel 50% better). But…the nasal spray that the placebo group was using was a placebo….

    You can see why Dr. Turner had some misgivings about the accuracy of the conclusions.

    Maintenance Trial Findings Distorted..?

    Dr. Turner also challenged whether the maintenance trial’s findings were up to par because a single site in Poland was the basis for those results. Trouble was that 100% of participants in the placebo group there relapsed. Which most researchers consider a red flag.

    The Janssen team defended their findings, and pointed out that the FDA didn’t see the need to eliminate data from the Polish site. In this recent response published by Dr. Daly and her colleagues, they produced another analysis which eliminated the Polish data. They used updated estimates and concluded they maintained the statistical significance.

    Dr. Turner came up with his own calculation based on information openly accessible to the public. His conclusion was that there was a “non-significant difference.” So he made the appeal “in the spirit of open science” that Janssen would provide an unbiased researcher with the patient-level data to hopefully resolve this conflict and try to replicate Janssen’s findings.

    Then …there is the issue that 6 people died during FDA trials. Of the six, 3 were suicides. The suicides occurred on the 4th day, the 12th day, and the 20th day after the last dose of esketamine.

    Esketamine nasal spray controversy is about Spravato not helping people like the FDA implied it would.
    There were no deaths with the placebo.

    Again …troubling. And confusing for a lot of people.

    Right now, the FDA says that Spravato can only be administered in offices, clinics, or hospitals registered with the Spravato Risk Evaluation and Mitigation Strategy  (Spravato REMS). Patients must remain in the office for monitoring for 2 hours after each dose.

    Another Editorial by Two Experts Fuels the Esketamine Nasal Spray Controversy

    Ioana Cristea, Ph.D., of the University of Pavia in Italy, also published one of the editorials in October in The Lancet with Florian Naudet, M.D., Ph.D., of Universitaire de Rennes in France.

    Dr. Cristea pointed out that the mild benefits of Spravato should be weighed against its potential for harm.

    She also holds that since Spravato is so expensive, has high potential for abuse, and has a troublesome history for safety, the bar for FDA approval for antidepressants should be raised.

    And she has a point.

    In the real world, our patients suffer severe and complex disorders, and the need for robust and rapid solutions for them has been gaping for 30 years. 

    Mild benefits that build gradually are only effective in select patients. 

    At Innovative Psychiatry we do use Spravato for select patients — but we use IV ketamine much more often. 

    Why?

    Because IV ketamine treatment can yield such rapid and robust benefits. And many patients need a treatment that’s both rapid and robust. It’s often life-saving. And we’ve published our results using IV ketamine infusions to stop suicidal thinking in real-world patients and presented our ongoing data at several conferences.

    For some patients, the insurance coverage that makes Spravato more accessible to them is well worth the risk of a less robust outcome. And we’re pleased to help them access the treatment best suited to them.

    With that said, since Spravato is made with the left-side enantiomer of the racemic ketamine molecule, it’s lacking the attributes of the right-side enantiomer. This is a subject that’s been side-stepped. We need more data about the right-side enantiomer.

    Esketamine Nasal Spray Controversy – Was Spravato the Only Alternative to IV Ketamine?

    And another thought. Janssen’s stance in developing the esketamine nasal spray was that ketamine was only available in IV form. But was that a real concern? Long before Spravato was approved, compounding pharmacies were already creating nasal sprays for ketamine, so it’s clear that a nasal spray using the full racemic ketamine molecule was a viable consideration. Some doctors have been prescribing that, and oral lozenges (called troches).

    Spravato esketamine nasal spray provides only a mild and gradual benefit in some people.

    So was it really because ketamine was only available in IV form? Or was it because ketamine’s patent had expired? (Hint: The big money is in the patent.)

    Is it possible that safety and effectiveness were sacrificed in lieu of monster profits?

    There is no pharmaceutical company sponsoring controlled studies of racemic ketamine.

    But there are real-world physicians with complicated patients around the country willing to carefully and diligently report what they see in their day-to-day offices. These are retrospective studies of their protocols, their patients, and their patients’ responses. Submitted for peer-review. And published.

    We know because we’re one of them. (We’re actually the first one of them. With the largest numbers, and with extraordinary responses to treatment.)

    Why do we do this?

    Because we know that once insurance companies realize that IV ketamine treatment in the office can rapidly stop suicidal thoughts and plans in patients with treatment-resistant depression — even those who’ve made attempts before, been hospitalized, been failed by ECT, failed by TMS — those insurance companies are going to be pressured to stand up and listen.

    If we can turn these patients around (you? someone you love? someone you know?) so that they don’t have to go to the ER, and don’t have to be psychiatrically hospitalized…. WOW! What insurance company wouldn’t jump at paying for IV ketamine infusions instead of ambulances, ERs, and hospital days??

    That’s what I advocate for. Every day. Safe, effective, rapid treatment. Hope. Better lives for my patients.

    Imagine that.

    Imagine the goodwill gesture — such a small gesture, and such a small cost –for your insurance company to just simply approve payment for the codes we use everyday for office-based IV ketamine infusions for depression.

    What a concept. Radical. Life-saving.

    Read the paper. See for yourself.

    IV ketamine treatment stands as the most rapid, effective treatment against severe and treatment-resistant depression, as well as suicidal thinking, that we’ve ever seen. In the office, in an evening. In less than an hour.

    Which insurance company will step up and pay for IV ketamine to save a life?

    A girl can dream …and that goes for psychiatrists and their patients, too.

    If you believe Spravato can work for you, call us. We’re happy to provide this treatment for you. Don’t let the esketamine nasal spray controversy discourage you. In some people it works very well.

    Esketamine nasal spray controversy didn't stop this man from responding to treatment.

    If you’ve tried Spravato and you were disappointed with the results, call us and let’s talk about what IV ketamine might do that Spravato can’t.

    We’ll help you understand the differences in the fixed doses available with Spravato and compare them to what is available when ketamine is used IV.

    And if you suffer from severe depression or bipolar depression, PTSD, social anxiety, alcohol use disorder, or another substance use disorder, and have been failed by other treatments, call us, too.

    Because you can feel good again.

    You can rebuild your life with the motivation, initiative, and energy that’s been missing with restored hope … and joy. What’s more, creativity can return and grow as you invest in your career, your relationships, and your hobbies.

    We’re all about seeing you restored, fulfilled, rewarded.

    Give yourself the opportunity to live well again.

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

    To the restoration of your best self,

  • Student Need for Psychiatric Care on Campus Quadrupled

    Student Need for Psychiatric Care on Campus Quadrupled

    Mason walked to the student union and plopped down to drink his coffee.

    Man, he just wasn’t feeling it. He went to class, but the studying and note taking, and researching all year was getting to him. He just wanted to go to bed and stay there. Just another example of student need for psychiatric care on campus. I’m a statistic, he thought to himself. Great.

    It was that time in the semester for another round of exams, and he was worried he couldn’t pass them. He tried to study but it just didn’t stick. He’d go over it and over it…but couldn’t seem to retain much at all. 

    It’s not like he was partying or anything…he wasn’t doing much of anything social. He didn’t feel like seeing anybody. Just wanted to be alone.  So he’d try to study then just lay his book down and turn over and go back to sleep. 

    Spiring Break was 3 weeks away.  Maybe that would help.  But he had to pass all his exams before then. What was he going to do?  His self-confidence was fading, and he was feeling more and more like a real loser. What was wrong with him?

    “Hey Mase! What’s up? Are you going to the campus movie night tonight?”

    “No man.  I’ve gotta study…”  Mason felt like he was lying, because he knew studying wouldn’t help anything. His brain was a lump of cold oatmeal.  Useless.

    “Oh really? You know we’ve got a study group going for Chemistry, right?  You wanna join us?”

    “Maybe, man.  Where do you meet…? “  He knew he wouldn’t go.  He couldn’t handle being around people right now…

    “We meet in Greg’s dorm room. At Stratton Hall.  327 Tomorrow after lunch.”

    “Thanks man. Maybe I will…”

    Depressed or Anxious Students Seek Solitude to Avoid Embarrassment

    Mason trudged off toward his dorm before someone else came along to strike up more conversation.  He felt like he was dumb as a rock. What had happened to him?  It used to be easy to learn. Mason’s self doubts were common for students suffering from disorders. Student need for psychiatric care was weighing down the healthcare system on campus.

    Once in his dorm, he sat at his desk and opened his economics book…determined to get something out of it. He opened to the page he was supposed to be reading and started reading.

    Then his mind wandered off to an online game he had played last year…  the action was really good in it. And it was challenging.  He had to really work at making points. There were some cool guys who played… Wonder why they…

    Aaackkk!!! Mason realized his mind was wondering again.  He put his eyes back on the beginning of that page and started reading again.  He read the first half of that page 4 times…and couldn’t recall what it said.  

    He slammed his book shut and dove into his bed and covered his head with his pillow. And that’s when his roommate walked in talking out loud. Mason pulled another pillow over his head.

    If only he could sleep. I mean really sleep. When was the last time he’d actually slept all night?  Laying there in the dark, his mind wandering…his worry about school choking him… listening to his roommate snore.  How does he do that??  He’s over there sleeping like he doesn’t have a care in the world. 
    Student need for psychiatric care is tripled what it used to be on campus and this young man needs treatment.

    He knew his parents would disown him if he didn’t make the grades. He was so tired…

    Student Need for Psychiatric Care on Campus Soars

    It’s true. Mason isn’t alone. The Center for Collegiate Mental Health (CCMH) at Pennsylvania State University released an annual report in 2018 that showed that student demand for mental health care on 550 university campuses increased by 30-40% between 2009-2015. The increase in enrollment was only 5%. 

    The primary complaints have been much the same as they’ve always been as students seek counseling for depression, anxiety, and relationship struggles. 

    And there’s a difference between relationship counseling and student need for psychiatric care due to depression, bipolar disorder, anxiety disorders, and PTSD.

    But, a recent article in Psychiatric News, a publication of the American Psychiatric Association, indicated that students carry more distress than they used to, and it’s more upsetting and worrisome to them.

    So they tend to take things harder, and if they never struggled before, they still are more likely to struggle in college.

    Social Media is Again at Fault

    Students now are also tormented by the belief that everyone else around them has a perfect life, and that they’re the only one struggling.

    This is largely related to the facade they see on social media. As they internalize these false beliefs, some students succumb to self-doubt and self-hatred, because of these comparisons.

    Suicide May Be a Consideration..?

    On top of that, suicide has become less implausible…more common place—at least from some students’ perspectives.  Obviously, this is a grave concern for campus counseling services. Through surveys, the CCMH has found that suicidal thoughts have increased among students every year for the 8th year in a row.

    Student need for psychiatric care on campus is overwhelming, and some students slip through the cracks.

    The reality of it has burdened these organizations to not only train their own staff for suicidal thoughts in students.

    They also must train everyone on campus to recognize signs and symptoms and take action… including campus police, professors, residential advisors, librarians, and anyone else whose job includes student contact.

    Some campuses focus on meeting the need in more minorities and male students, who tend to avoid mental health services. Other campus are including a counseling office in the campus clinic to make counseling more accessible with less stigma. 

    At any rate, while all these campuses scramble to provide services their students’ needs, the demand has risen so fast that they remain limited in resources for what they can do.

    Meanwhile, more intervention is needed. The demand overwhelms the system.

    Many of These Suffering Students Can Achieve Remission Off Campus

    Many of these students are diagnosed for the first time with depressive or anxiety disorders in college. But many more were diagnosed years earlier, and have been undergoing treatment before college. The increased pressure and demands of college often push them into more severe symptoms.

    For these who’re being treated before they enter college, or for whom treatment has become inadequate, a very real option can be IV ketamine treatment. When medicines are no longer helping, or never did, IV ketamine infusions can relieve symptoms dramatically. 

    The lack of energy, the struggle to learn, the despair, can be replaced by motivation, initiative, and the creativity to study and perform once again. 

    The restoration of brain circuitry, and proliferation of structures in the brain can rapidly build the resilience to embrace school again.

    On top of that, suicidal thoughts or behaviors can be eradicated in an afternoon with IV ketamine treatment. It’s a remarkable way to reverse suicidal thoughts, so a student can focus on getting better.

    IV Ketamine Can Transform Students and Reduce Student Need for Psychiatric Care on Campus

    At Innovative Psychiatry, we see students like this regain their joy and hope after IV ketamine treatment and walk out with confidence. IV ketamine treatment can lift your student’s outlook and energy. Despair can become hope, and listlessness can turn into purpose-driven initiative.

    These students are resilient and happily studying together because of IV ketamine treatment.

    That sullen student can wake up with new ideas, energy to socialize, and a song he’s singing. 

    This treatment can be transformative. And the more ill your child is, the more powerfully it seems to work.

    If your child sounds like Mason, or if his symptoms are even worse, call us. 

    And if you can relate to Mason’s story, and don’t know where to turn for help, call us… we want to help you rediscover your creativity, energy for work, relationships, and fun. We want to see your hope restored.

    Don’t let something like your education or your future fall by the wayside. You don’t have to because you do have options. 

    Let us help you live again with 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,

  • Relieve the Heartbreak of Elderly Depression with IV Ketamine

    Relieve the Heartbreak of Elderly Depression with IV Ketamine

    Ruby’s daughter let herself in with her key at the back door.

    When she walked in, the house was dark. Strange…she thought. Her mom was usually home on Saturdays.  She quietly stepped through the house looking for some sign of her mom.  A grave sense of dread came over her as the house continued to be silent…what was she going to find…? She stepped into her mom’s bedroom, and saw her form lying in bed. Joan stopped and caught her breath. Joan had been worried about her mom lately, and the heartbreak of elderly depression, since her husband died 11 months ago.

    Then a weak voice said, “Hi honey…”

    Joan exhaled. What a relief.

    “Hi Mom! The house was dark and quiet…  I was concerned.  You rarely leave the house on Saturday…”

    Joan stopped short of voicing what she’d feared.

    “Are you feeling ok? Why are you in bed..? It’s really dark in here…”

    “What day is it?” Ruby quietly asked.

    “It’s Saturday, Mom. How long have you been in bed..?”

    “Well, I remember watching the weather on Tuesday…I was wondering if I needed to wrap the pipes.”

    “Ok.  That was Tuesday…  Do you remember what happened Wednesday?”

    “I guess I’ve just been sleeping…”

    “Mom?  Since Tuesday?”

    “I don’t know…maybe? I got up and went to the bathroom at times then just felt tired and went back to bed…”

    “Do you remember if you ate anything..?”

    “No…not really.”

    Joan was alarmed.  Her mom hadn’t eaten since Tuesday.  No wonder she was weak. And she’d gone four days without her medicines. 

    Four Days without Her Medication

    Joan headed to the kitchen to make her mom some soup.  She wanted to go easy and see how she digested soup before solid food.  After opening the can of soup and dumping it in the pan, she looked at her mom’s medicines.

    Well, that confirmed it. The pills were still in the Wednesday, Thursday, and Friday compartments.

    Joan was shaken to think if she hadn’t dropped by, and another week had gone by, what could have happened.

    Joan brought her mom the bowl of soup with some crackers and a glass of milk on a tray.  She helped her 84 year-old mom sit up and propped her with pillows, then set the tray in front of her.  Slowly, her mom nibbled on a cracker, sipped the milk and finally scooped a spoonful of hot chicken noodle soup.  She closed her eyes as she swallowed.

    “Ok mom?”

    “ Yes, it tastes good.”

    Joan talked about trivial things to try to lighten the mood. Ruby had looked after everyone all her life, but since Joan’s dad, her mom had seemed less and less engaged in her own life.

    Maybe listless was the word. 

    She’d withdrawn from her bridge friends. She’d said it didn’t seem as fun anymore. Her grandkids were all grown with families of their own. Cleaning house and cooking was a chore without Charles to do it for.

    She just got tired of the struggle. What was the point?

    She felt tired all the time, and found herself taking more and more naps.  

    How do you find purpose in life after the companion who’s been there for 62 years is suddenly gone?

    The Heartbreak of Elderly Depression

    The more questions Joan asked, the clearer it became that her mom wasn’t fighting the flu, she was depressed. At least she seemed to be.

    Joan wondered how long she’d been depressed. And whether she’d thought about ending her life… It had really shaken her to walk through that dark silent house.

    She asked her mom more questions. Ruby was matter-of-fact. “Yes, the doctor told me I was depressed a couple years before your dad died. He prescribed some pills for me, and I took them, but they didn’t do anything. I think they must have been those sugar pills you hear people talk about. I finally stopped taking them.  There was no point.”

    “Joan,” Ruby said, “I miss your dad. Charles and I talked about everything. Without him, life is flat. It’s just so empty. I have you and your sister, and I love you both, and all the grandkids and their families. But I feel so empty.”

    “Mom, I can only try to imagine how much loss you feel with Dad gone. We all miss him, but he was your constant companion and love for 62 years. I ache for you… and I can’t help but feel that even though grief has made you feel empty, that does’t mean your time on earth is finished. Maybe something can be done to help you feel better, you know? Would you be ok with me making an appointment to see Dr. McShane? We can go together.. Ok?”

    The Heartbreak of Elderly Depression – How Can We Help?

    Here’s the thing. Our parents (and grandparents) do look after everyone else all their lives. Then, they slow down, and the the rest of the family can easily forget to touch base. Why? Because life is busy. We all live with packed schedules, and a week can go by without our even noticing it.

    Our elderly loved ones can find themselves withdrawing, slowing down, and feeling somewhat useless. It’s not that unusual for depression to follow. 

    In many cases, prescribed antidepressants help. But in some, they don’t help in spite of trying more than one. When the disorder doesn’t respond to multiple treatments, something more advanced is needed.

    IV Ketamine Treatment Can Reverse Elderly Depression

    IV ketamine for treatment resistant depression may just be the treatment of choice, to restore your parent’s brain circuity. By turning on mRNA which switches DNA to “ON” your brain-derived-neurotrophic-factor (BDNF) turbo boosts the prolific and rapid production of dendrites and dendritic spines to sweep through the important parts of the brain with connections to send signals at the speed of light.

    Depression lifts, joy surges, creative thought grows, and Grandma gets that sparkle back in her eye,  and has the energy to play bridge with the girls again… and make cookies for children in the neighborhood.

    At Innovative Psychiatry we love treating grandparents and watching them get a new lease on life. Of course, if they’re grieving losses, they can grieve while still enjoying life. 

    Ketamine treatment doesn’t prevent grief, which is a part of life.  But ketamine can help them think through the grief in a healthy, healing way. And meanwhile, they can also enjoy their friends, family, and grandchildren.

    Your Loved One Can Recover from the Heartbreak of Elderly Depression, and So Can You

    Do you have a parent or grandparent who seems to have lost their joy for living? Maybe they’ve tried antidepressants but still seem serious, irritable, edgy… or bland, shut down, and without energy. Maybe you notice they don’t bathe very often anymore, and have lost interest in their appearance, or in things they normally love to do. 

    If this sounds familiar, and you have loved ones you hope can be helped by IV ketamine treatment, call us. 

    In fact, if this describes you, please call us and let us help you find your joy again.

    IV ketamine treatment rapidly proliferates your brain circuits with an abundance of new synapse connections that make the way for restored creativity, emotion like joy, happiness, love…and hope. You want to do things you enjoy again.

    Amazingly, this proliferation also increases emotional energy that can translate to more physical energy, too. Initiative and motivation increase, and joie de vivre abounds. Few phrases express what ketamine can do like this French phrase, which means “a cheerful enjoyment of life and exultation of spirit.” 

    If you have lost the song in your heart, you can have that restored. Some of our patients report waking up in the mornings singing. 

    How about you?  Have you lost your song? IV ketamine treatment can restore it, and give you that, “Oh what a beautiful morning!” feeling. 

    It’s amazing to realize that people with joy and a song in their heart are that way because they have a LOT more synapses than others, isn’t it? 

    Let us help you and your mom find your songs again.

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

    To the restoration of your best self,

  • Why is Depression in Teen Girls Increasing So Fast??

    Why is Depression in Teen Girls Increasing So Fast??

    Depression in teen girls might be reduced by less social media and more involvement pets.

    Juliette stopped in her tracks.

    She could see from halfway down the hall that her locker had been trashed. Covered with photos, markings, and fake blood, it looked like a crime scene. As she got closer, she could see printed photos someone had taken of her while she was dressing in P.E. She ran to the locker and yanked off and crumpled the photos as fast as she could. (With friends like this, it’s no wonder there’s a rise in depression in teen girls.)

    As she stood staring at her locker frozen, her face burning with humiliation, she couldn’t think… Then, in one sweeping motion, she pulled all the trash off her locker door and wadded it up. 

    Only then did she look up and see the bystanders, the sidelong glances, and hear the snickering muffled giggles of her “friends” gathered around watching.

    She grabbed her books, slammed her locker door and shot off to class.

    Juliette sank into her seat, head down, heart-broken, and wondered why??  Who did this and why?  

    She felt betrayed, angry, heartsick. And abandoned.

    She didn’t say a word for the rest of the day, just kept her head down and shot out the front door when the bell rang to go home.

    Her mom was waiting outside, and Juliette jumped in the car, put her face on her lap and said, “Drive!”

    “What’s the matter, Jules?”  Her mom was alarmed.  She’d never seen her 13 year-old like this. 

    “Just drive.”  

    So her mom put the car in gear and did.

    Teen Trauma Triggered by Ridicule and Humiliation

    Once home, Juliette flew upstairs, slammed her door, and locked it. She dug her phone out of her purse for the first time since she saw the locker. Two hundred and thirteen messages. She wondered if there might be apologies… so she opened one …then another.

    NO apologies. Total strangers making jokes, rows of laughing faces, some even calling her crude names. The photos she saw on her locker had gone viral. All over Instagram, Pinterest, facebook…

    Her friends were silent.

    She thought she would die. How could she ever show her face in that school again? She could never leave her room again. She covered her head and sobbed.

    “Jules..?  Honey, are you OK?  Did something happen?”

    “Mom, I just want to be alone.”

    This isn’t something my parents can help with. I’m alone with this nightmare, she thought.

    So a traumatic experience begins to fester…

    Scenes like this aren’t uncommon if you have kids. You got her into ballet at 3, then gymnastics at 5, then soccer at 7. Always hoping to help her gain confidence in herself, to help make the transitions of childhood to adolescence, and adolescence to adulthood advance more smoothly. To help her develop an anchor within herself that would see her though the storms, and the things that others did.

    And your happy, socially-balanced child does great with her activities, her friends, slumber parties, and sports events.

    Until the day she’s publicly humiliated.

    The humiliation can happen on Snapchat, Facebook, Instagram, and other social media sites. It can happen in text messaging. Or it can happen at school and at slumber parties.

    And, while the cruel embarrassments and humiliations children and teens impose on each other are terrible — and seem almost insurmountable for some students– it’s what follows if they can’t get past it that can be life-threatening. 

    Believe it.

    Depression in Teen Girls Can Be Deadly

    Sometimes, what we parents see is a child, preteen, or adolescent, who is acting differently.  Who won’t talk to us. Since we don’t know what they’ve faced at school, we may be clueless about the trauma they’re experiencing. We may think they’re just being moody teenagers.

    Sadly, the trauma may cause such a deep pain that they can’t find words to “get it off their chest…” So they may isolate, huddle, and try to figure out how to cope on their own.

    An experience like Juliette endured isn’t usually a single event. There’s the aftermath. Someone in her shoes may skip school for a few days until she can muster the courage to step out and go again. But even when they do go, there are whispers, snickers, more text messages. 

    And sometimes even more incidents that go from bad to worse. 

    The stress continues, long after we parents think it should be over.

    Or we may never know it happened in the first place.

    And as we often talk about, prolonged severe stress can result in that pruning of the dendrites and dendritic spines that destroys synaptic connections between brain cells. And depending on how severe the pruning is, and how long it continues… the outcome is often depression.

    “But she’s a kid…” you may think. “She doesn’t have severe stress. How could she?”

    It’s an unfortunate miscalculation to think that a child can’t experience severe stress. Her world is her reality. And she’s been building that world since she can remember. If everything that makes her world a warm and inviting place of support, caring, and acceptance is disassembled and left in shambles, then her world is shattered. 

    And as her parents, you can’t fix it. 

    That’s not to say you can’t be a comfort and a support. But no one can fix her world for her but herself.  A pretty daunting task for a devastated 13 year-old.

    It turns out that teen depression rates have been increasing for years, but the rate of depression in girls is rising faster than it is in boys.

    Teen Depression is Threatening Our Children

    Girls and boys. But is there difference in how much and how often it strikes? Why are teen girls becoming depressed more often than boys?

    For one thing, by the age of 15, girls are actually twice as likely to become depressed as boys. It’s surprising, isn’t it?  …but there are reasons. 

    The smart phone, for instance. By the mid 90’s, both boys and girls were using them. And those babies born by then were the first generation to live out their entire lives in the age of smart phones. Those babies are 25 this year. 

    Let’s hear from those young women, shall we?

    A team of researchers analyzed 3 surveys that included 200,000 females in the US and the UK.  And…they learned some things.

    For example:

    Fill a classroom with 25 teens, and give them the freedom to use their smart phones. Then, walk up and down the aisles and glance at their screens. You know what you’ll see, first thing?

    They’re not doing the same things.

    The boys are playing games… on their smart phones, or talking about sports, and texting each other about the games.

    The girls?  They’re texting, and on social media.  What are they texting about ?  Their appearance, their clothes, their hair…and someone else’s appearance, clothes, and hair. 

    And when one sends off a text, she’s reassured that she’s accepted when she receives a response right back. No pauses.

    If there’s a pause before she receives a response…because maybe the other girl is in the restroom, or is carrying too much in her arms to text easily,  the first girl begins to feel dismissed.

    Anxiety rises.

    And that knee-jerk reaction happens over and over and over, day and night, month after month…year after year.

    Hurt Feelings, Misunderstandings, Feeling Left Out

    Now, add to that the pecking order on social media platforms. The girl with 8 likes is shamed when compared to the girls with 500 likes and shares. And don’t kid yourself. Those comparisons are made. Ruthlessly. 

    Images that create a fantasy of one girl’s life lead to others feeling ashamed of their “plain” homes, clothes, and activities. None of this is grounded in the real world. But then smart phones and social media have little to do with the real world.

    The pressure is intense enough that one study found that girls who compare themselves to other girls on social media were more likely to be depressed.  

    And get this: in 2017, a full one-fifth of teen girls said they’re suffering from major depression. One Fifth!

    Then, there are the cruel “jokes” some girls play on others, where messages, videos taken without permission, and compromising  photos are sent out and go viral.  And young girls become convinced there is no remedy to restore their lives after such exposure, and at the tender age of 10, or 12, or 14… they end their lives.

    So is it all social media?  No.

    Don’t boys use social media? Yes, they do.

    But these researchers also found that social media and the interactions there have a stronger effect on girls than boys. 

    They found that 15% of girls who were on social media only 30 minutes a day, due to other activities, family rules, etc, were unhappy. But 26% of girls who were on social media 6 hours a day were unhappy.

    Now let’s look at the boys. Only 11% of the boys who were on social media 30 minutes a day were unhappy.  And those boys who were on social media 6 hours a day? Only 18% of them were unhappy.  

    So what is it about girls that more of them seem to succumb to depression from social media? 

    Researchers found it was that being popular, and having positive interactions with others is tied to their sense of satisfaction, happiness, and confidence.

    Social media can either build up the social ties a teen girl enjoys, or it can destroy them through bullying, shame, and conflict.

    And we can’t forget that pressures about image and appearance continue to increase at this age…

    Now… what can parents do?

    One obvious step might be to postpone your child’s access to social media. That message is being disseminated by experts on adolescent mental health far and wide.  

    While it’s illegal for a child to have a social media profile before the age of 13, parents might consider extending a moratorium on social media use longer than that. 

    The social pressure among teens to excel on social media is not aimed at their growth, self-confidence, or character, but is actually designed to pull them into an addictive activity.

    We all know Mark Zuckerberg as co-founder of facebook. But do you know Sean Parker? He joined Zuckerberg 5 months after Facebook was launched as a student directory, and Zuckerberg credits him with the phenomenal growth it enjoyed. Which made him a billionaire.

    Referring to facebook, Parker said,“It’s a social-validation feedback loop … exactly the kind of thing that a hacker like myself would come up with, because you’re exploiting a vulnerability in human psychology.”

    He went on to say that social media like Facebook “…literally changes your relationship with society, with each other. It probably interferes with productivity in weird ways. God only knows what it’s doing to our children’s brains,” he said.

    Children aren’t equipped with the life experience or brain development to see these sites for what they are. Rather, they’re swept up in the tidal wave that is adolescence and the need for social acceptance at probably the most vulnerable time of their lives.

    As parents, they need us to be proactive, to give them time to develop the life skills to keep such activities in their place. 

    They need time to just grow, physically, mentally, emotionally, and socially. To develop healthy relationships with their peers, and to survive their preteens, teens, and early adulthood so they can go on to become the best they can be. 

    Depression in Teen Girls Needs to Slow Down. Let’s Do Something.

    Would this approach prevent depression in girls?

    No, no, of course not. But it just might protect your daughter from depression. And maybe her friends. And maybe some of their friends.

    By finding opportunities to get your daughters talking with their friends about the dangers and risks of social media, and using text messaging less… and in more responsible ways… perhaps we can open their eyes. And a lot of others.

    Maybe that could go viral.

    Maybe a new culture could emerge where our daughters lived well, and survived their own adolescence… and could go on to have daughters of their own.

    After all, that’s what we want for them, right?

    Ketamine For Treatment Resistant Disorders

    If your daughter — or son — has developed depression, and medicines aren’t helping, call us. Let’s talk about IV ketamine treatment — which shows a much higher response rate than antidepressants.

    The sooner your teen’s disorder is treated and relieved, the sooner her resilience is restored, the better equipped she (or he) will be to tackle the life issues she faces as she grows to adulthood.

    Depression in teen girls is increasing, but we’re not powerless to fight it. Let’s work together to turn the tide on disorders that result from things like the intense stress of social media.

    And if your teen is struggling without relief, learn about IV ketamine treatment. It’s saving lives.

    To the restoration of your best self…and your teen’s,

    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,

  • Can Use of Opioids Lead to PTSD? And If So, What Can You Do?

    Can Use of Opioids Lead to PTSD? And If So, What Can You Do?

    You know how a disorder – like bipolar disorder or PTSD – can make you so miserable…even make you want to self-medicate?  

    Doing so is rarely a good idea, though it may seem at the time that it helps.  But that’s for another post. Anyway, you know how self-medicating often accompanies these disorders, and we’ve assumed that the self-medicating is driven by the symptoms of the disorder: the ups, the downs, the agitation and rage, the misery… If the symptoms were to go away, there would be no need for self-medicating. Right? Doesn’t that seem logical? Well, a recent study says no…in fact, self-medicating with opioids… or even using prescribed opioids may lead to PTSD!

    Mood Swings in Bipolar Disorder Make You Want to Self-Medicate

    Take bipolar disorder, for example. You feel yourself swinging up, up, up until you’re confident, then agitated, shooting words like a machine gun, and feeling more energy than you can manage… you just want to feel normal, you know?  So you start drinking beers as fast as you can to slow down… and…well, it’s not an exact science.

    You end up drinking way too many until you’re frankly drunk…but there’s still energy you have to manage, somehow. You may want to jump in a car and head down the freeway… but thankfully, you can’t find your keys.

    OR… your mood starts plunging and plunging.  Way too fast… and before too long you want to scream and cry. You feel so hopeless, and disgust and self hatred take over your mind… and it feels like you have fire ants on your brain. 

    You need something to help you feel better. So you reach for something that helps you feel like you’re at a party. Then, after awhile, you’re a mixed up ball of horrific and frustrating feelings…and you decide to go for something different that will help you chill.

    This is a dangerous and destructive path, but it’s tragically common. This is self-medicating.

    And, unfortunately, you may not even realize that use of opioids may lead to PTSD.

    =============

    Meet Zach. He served two tours in Afghanistan. He wanted to go back for a third, but his family needed him at home. (At least that’s what he told himself.)

    Zach never talked about it, but he’d gotten high with friends off and on in high school. He had joined the Marines for the hard work and discipline, to get himself back on track.

    Now this.

    Anyway, he had rehab. Who was he kidding? There was no way he could go back. He figured he was nervous about going home after all that happened…

    The truth is, Zach got through the first tour fine. Then, on the second tour, he and some fellow marines were helping some children carry water to their homes.

    He and Rex were heading in the same direction when a little girl approached them with eyes as big as saucers. Rex naturally reached for the child and at that moment she detonated. The child had been wrapped in home-made explosives under her clothing.

    Rex blew apart, as did both children. Zach lost his right arm and his ear. Such an inhuman thing to do. The scene was tattooed in Zach’s memory and he couldn’t escape from it. Children’s body parts, his friend and marine brother’s hands, leg, organs, everywhere.

    Rage Begins… and Panic

    Rage burned within him that anyone would stoop to the evil of murdering children that way just to get rid of a marine or two.

    When he got home, he wasn’t the help to his family he wanted to be. He had trouble holding a job… any sudden startle stirred up the fight in him and sent him into a cold sweat at the same time. Like the wait staff dropping a dish. The clatter sounded like that explosion inside his head. His only thought in moments like that was to tear apart the reprobate who did this to these little kids. And stole his friend.

    Zach was seething all the time. Going through surgeries for his arm stump and ear reconstruction. Jumpy, easily provoked, irritable…and at times terrified. His marriage was deteriorating. His children afraid of him.

    He talked to a buddy about getting his hands on something to calm him down… he hated being like this.

    Something had to give…then his wife learned about a “new” treatment for PTSD…

    ============

    Researchers Asked, Can Use of Opioids Lead to PTSD?

    So…  it turns out this self-medicating road goes both ways. A new study released in December 2019 demonstrated that heavy opioid use over time before a traumatic event influences us to be traumatized by the event… basically it alerts us to be so fearful of that experience that we can develop PTSD as a result.

    We’re talking about Post Traumatic Stress Disorder, or PTSD. And like bipolar disorder, PTSD has an established reputation as a disorder that is quite often co-morbid (meaning you have more than one illness at the same time) with substance use disorder.

    In fact, 40% of people diagnosed with PTSD also struggle with substance use disorder (SUD) …meaning they may have addictions, or they may regularly use a substance that masks or combats the way they feel…until it doesn’t. 

    Now get this: almost 35% of people who struggle with an opioid use disorder also suffer from PTSD. Sound familiar?  

    PTSD <=> SUD

      40% <=> 35%

    A bit of a coincidence you think..? Maybe, but more likely this two way street of comorbidity with PTSD and substance use disorder does cause us to stop and think….can opioid use play a role in the development of PTSD?

    Laboratory Animals Develop PTSD after Opioid Use

    This study I mentioned was just published in Neuropsychopharmacology last month, by a team at UCLA led by Zachary T. Pennington. Their carefully planned study involved laboratory animals and demonstrated how the use of opioids during a time that preceded a trauma increased fear learning.  Or, to be more clear… use of opioids may lead to PTSD.  

    Interestingly, in cases where the opioid use occurred after the traumatic experience, there was no lasting fear or PTSD reaction.

    The team used an upsetting/frightening stimulus to create a traumatic experience for the animals and noted their reaction to it. Then after creating the condition of “withdrawal” from opioids using morphine and naltrexone (a medicine used to block the effects of opioids) they placed the animals in an environment where only a mild stimulus was used, and saw that the animals reacted strongly in fear — basically they froze in place — as though it was the original severe experience.

    Sounds a lot like PTSD, doesn’t it?

    Remember Zach? The guy who is a combat veteran with PTSD freezes when someone pats him cheerfully on the back to greet him. It’s all he can do to avoid turning and fighting that person to the ground. Why? Because it feels like he’s being assaulted, and all those horrific memories flood him as if they’re happening right now.

    Researchers also gave control animals (the ones who don’t receive opioids so they can be compared to the ones who do) saline injections instead of morphine, and then followed with the traumatic experience. Those animals experienced far less fear and anxiety reactions compared to the ones who had been given morphine prior to the traumatic experience.

    Stress Enhanced Fear Learning (SEFL)

    They call this approach “stress-enhanced-fear-learning” (SEFL) and it’s a model for us of PTSD and how it ca develop. 

    And this demonstration shows us that people who’ve used opioids, whether they were prescribed — or obtained illegally — could be vulnerable to PTSD from traumatic experiences in the future. The resilience necessary to quickly recover from trauma seems to be drastically reduced in those who are exposed to opioids.

    The media is full of the dangers of the opioid crisis, but this is one we didn’t see coming. Use of opioids at a particularly vulnerable time can lead to PTSD …or at least that’s what this study seems to tell us.

    Still, the researchers emphasize that there’s a difference between fear learning and fear expression. Fear learning is the process we go through where we’re frightened by something unpleasant that we don’t want to experience again…and by it we learn to be cautious and recognize danger.  (This is a good thing.) The amygdala is the primary place in the brain where fear is processed and stored. Some types of fears are then sent to the hippocampus for further storing.  But that’s not the point.

    Fear expression is what we do and how we look when we feel fear. Fighting or running are expressions of fear. Freezing can be an expression of fear, too.

    Fear expression is our response to the fear we feel.

    The way we express fear has nothing to do with the learning process we go through to establish a fearful memory. But the process we go through to learn the fear has a lot to do with whether we quickly recover from it, or whether it turns into a fearful memory that becomes traumatic every time we think of it…and that’s the story of PTSD.

    What we didn’t know before this study, is that using opioids may make you really vulnerable to PTSD, so avoiding them if you can is better for your overall wellbeing going forward. 

    Because use of opioids may lead to PTSD…

    Of course, since this is the first study that has identified the role opioids may play in the development of PTSD, there are lots more studies needed. We’d like to see studies that test the development of PTSD if the opioids were used 6 months ago, a year ago, 2 years ago…?  

    In this laboratory setting, with lab animals — not human beings — it had only been a week.

    And because this study focused on the reactions of lab animals, we don’t yet know how the results would look in human subjects. In addition, we can’t know without more research, what this means for people who already take opiates for pain.

    It’s certainly true that none of us knows when we might experience something traumatic. It can happen to anyone… at any time. An assault, a vehicle collision, a catastrophic illness, a vicious divorce.

    The study demonstrated this phenomenon only in cases where the animal had previously had the opioid before experiencing the trauma. When the opioid was administered after the trauma there was no PTSD reaction.

    So… of course we’d like to avoid opioids as much as possible for unexpected surgeries, accidents, and injuries just in case of trauma in the future…? At the same time, we don’t know enough yet to be alarmed.

    This is how it works with new discoveries. Tiny pieces of information eek out…one bit at a time. And so we look forward to what else can be learned about this PTSD – Opioid connection.

    Still, we’re excited about an effective treatment for PTSD if it does develop, and for certain substance use disorders, as well.

    IV ketamine treatment has demonstrated what it can do for both of those, both in studies and in real world practice.

    At Innovative Psychiatry, we use novel and advanced treatments for disorders that haven’t responded to traditional medicines and treatments. IV ketamine treatment reigns proudly at the top of that list. 

    And we’re always thrilled and amazed to see how effective ketamine can be in reversing a cluster of disorders all at once. By treating PTSD and depression with IV ketamine, we often see phobias disappear, too. By treating suicidal thoughts with ketamine, which can be utterly life-saving…we often see depression lift, and PTSD with it.

    There’s nothing magical about ketamine. It’s just a man-made molecule that happens to work in a surprising number of ways. But when you’ve been tormented by the traumatic flashbacks of PTSD, disrupting your life and your family, and then those terrifying visuals and experiences subside with ketamine infusions, it sure can seem like it’s magic. And it thrills your family just as much as it does you…when they see your new-found peace and resilience.
    If use of opioids leads to PTSD for you, IV ketamine treatment can help you achieve remission like this relaxed guy on the beach.

    If you suffer from fear and the fearful memories that disrupt you life, your career, and your relationships — or if you’ve been diagnosed with PTSD but treatments haven’t helped, you owe it to yourself and the people you love to reach out for the freedom you can enjoy after IV ketamine treatment.

    Your life can change through the extraordinary effects of IV ketamine treatment. 

    Expect around 6 -8 infusions or so… and be patient if you don’t immediately feel better after the first one. Give it a little time and a few more infusions…

    On average, it’s common for people to experience ketamine’s benefits after the 3rd infusion. But that’s an average and individual experiences vary.

    You do your part, we’ll do our part…and we’ll also eagerly embrace collaboration with the healthcare team who knows you well.

    You can have a better life. You really can. Find out how you can enjoy the resilience to snap back after something goes wrong. Reach out for help to get better with IV ketamine treatment. We’re here to walk you through it, and to help it go smoothly. You’ll be in a quiet, comfortable room, with lights turned low for your infusions. And you can bring soft music to play, if you like. A blanket to keep you warm and secure.

    This is your chance to emerge better, balanced, and joyful. This is your opportunity to restore hope.

    We look forward to talking with you. Call us.

    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,

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