Lori Calabrese, MD

Tag: IV Ketamine Treatment for PTSD

  • Living with Bipolar 2 When It’s You Who’s Got It

    Living with Bipolar 2 When It’s You Who’s Got It

    Is it Bipolar II, or Bipolar 2? Hard to get it straight? (Bipolar 2 is what’s all over the net but Bipolar II is what’s in the journals.)

    Actually, if you suffer from bipolar II disorder, it’s no laughing matter. It’s a lot like bipolar I, except the highs are much less intense. So we call them hypomanic. Even so, they’re not nothing. Not even close. Living with bipolar 2 is no fun, but with support, medical treatment, and patience with yourself, it can be possible to live an enjoyable life. To be well.

    But first, you need to recognize it, then you need the best psychiatrist you can get…right?

    How else can you find some leveling out of the horrific ups and downs?

    So Charming…almost Irresistible

    Sometimes you’re a charmer, and you feel like you’re beautiful to other people, which is awkward when it’s the opposite sex you’re charming. Neither your spouse nor the spouse of the one you’re charming appreciates your beauty…you know?? You feel like you have such gifts to share — and honestly you do — but when hypomania sets in what seems like gifts you give to others, from your perspective, may actually be symptoms. Yep, you heard that right… not really charm or beauty but symptoms of the disorder.

    Disappointing, I know.  Still you’re a creative, intelligent, giving person when you’re in that in-between place we call “your fun self.” And you really are a lovely person everyone around you cherishes as a friend… and your friends get that you’re living with bipolar 2. They know it’s no piece of cake.

    So, what’s it like when your charming and gifted self disappears?  Are you sorry to see him go? You can feel so bad about yourself when you’re depressed, and you feel like you’re more likable when you’re charming. Makes sense, doesn’t it?

    So think back. How were you feeling a month or two ago?  Did you feel charming and gifted?  If not, maybe that was a time you weren’t dealing with hypomania…

    So let’s say it was four months ago. If you have had 4 or more bouts of hypomania within the last year…then you know you’re a rapid cycler. That means you have these hypomanic episodes more often than some people do with bipolar II. (Still, you’re certainly not competing with anybody!) Mostly it just helps to have a feel for how often this happens so you can recognize it and respond to it, and so those who love you can, too.

    And it can help to be in touch with your cycles so you can avoid “mishaps…”

    You might even say to your sister or your mom…do I seem hypomanic to you? Or am I just in a good mood?

    It’s often easier for the people closest to you to tell the difference than for you. Because for you it might just feel GREAT. Fantastic. Beautiful. Normal. And whether you’re in a great mood or hypomanic, just feeding into a good mood can trigger an episode of hypomania. You stay up later, go out more, get super charged….and before you know it, yikes! Try to put a lid on it, if you’re able to.

    In the process of living with bipolar 2, maybe you feel edgy and impatient when you’re energized like this.  Instead of feeling charming and gifted and full of energy, maybe you feel more irritable and agitated? This is one form of mixed states, and it’s not much fun, either. (To say the least.) For some people that agitated state lasts longer, but then still for others it can be much shorter. And what are you supposed to do with yourself ….with those irritable, edgy feelings when you have them?

    I guess it’s hard not to punch someone, but it’s super good you hold back from doing that. It’s your condition getting you riled up…not really the other person as much. (Although we have to agree that some people are pretty annoying!) It’s a fact of life. Still, it’s important not to punch anyone, right?

    What’s it like when that charming feeling goes away? You may feel like your average self. Or…you may feel irritable and edgy. Or you may feel desperately low, sinking down, dark, sad, and angry.

    You feel so terribly tired, so defeated, like you want to die...  When you’re feeling that way, it’s not so clear to you that the way you feel is a symptom, and it will pass.

    And you feel like that for…weeks?? Months??  Do you know what can be done to help you feel better and not feel so terrible for so long?

    IV ketamine treatment can make a huge difference when you’re living with bipolar 2 depression.

    It works for bipolar depression just as it works for treatment resistant depression ….Imagine what it would be like to have bipolar 2 with no depression?

    Oh…It turns out it’s really called bipolar II! Not 2? Yes, not you bipolar 2, even though that’s a quick cute shorthand. It should be Bipolar II.

    With IV ketamine treatment, you would get six or eight infusions, roughly, over 2-3 weeks, and you should start to feel better if you do it when you’re depressed. LOTS better. Most people do. Just like with major depression, the dendrites at the synapses become pruned and broken and thinned out from the stress of the disorder. Ketamine restores them, builds them back up using brain-derived-neurotrophic-factor(BDNF). Ketamine sails through your lateral habenula and tamps down the bursting cells that prevent you from enjoying pleasure. Those G proteins slide off the lipid rafts in the cell membrane and get the neurotransmitters moving so signals shoot around your brain again, making you feel good. Happy. Creative.

    Living with Bipolar 2 means you're usually depressed unless you have ketamine treatment.

    You know, ketamine can stop those thoughts…the suicidal ones. Very quickly in our hands and in our office. Treatment doesn’t affect your memory …and suicidal thoughts can stop within a few short hours.

    Maybe you should think about IV ketamine treatment if you start feeling down again. And there are now more ways to get financing to pay for medical treatments like this.

    If you’ve actually had suicidal thoughts and images in the past, you know how serious that can be. 

    Just remember that there’s ketamine treatment if you get that down again. It can be like hope in a jar.

    You shouldn’t have to live with terrible depression.

    At Innovative Psychiatry, we see patients with bipolar II every day, and ketamine infusions help them feel so much better so much of the time. Not all, of course. But most. We treat their hypomania and mixed states separately from the depression. We watch them transform from burdened and depressed to walking with a spring in their step and chatting with ease. IV ketamine can do that.

    If you struggle and suffer from Bipolar II disorder, the symptoms that can be lifted off you by relieving your depression will make your life so much easier to manage. There are medications that help with hypomania, too. So many people with bipolar II / bipolar 2 have enjoyed the freedom that comes from ketamine treatment.

    When you come for treatment, you’ll enjoy a gorgeous, private treatment room where you can lay back and relax to make the most of your treatment. And we’ve gone the extra mile to install plasma cell technology to protect you from infection. This technology, developed by the Department of Defense and NASA, is high tech enough that it destroys 99.999% of viral and bacterial DNA from our indoor air, so we’re as infection-free as you can get. You can feel safe safe, without fear of the delta or mu variant, and become a happier, more relaxed person… free to live and enjoy your life.

    Whatever your shorthand is — II or 2 – living with bipolar 2 can be tough. And when it is, remember that IV ketamine’s extraordinary ability to defeat depression could be just the thing to pull you out and help you enjoy a rewarding life.

    If you’ve suffered from these symptoms, call us.

    Let us help you turn the corner and live 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,

  • Keep Your Eyes on AKT: It Might Explain How We Learn and Forget Fear

    Keep Your Eyes on AKT: It Might Explain How We Learn and Forget Fear

    You may hear people say, “Antidepressants and other psych meds just don’t do anything…”

    Some people say, “…placebos work better…” Oh please. But why do they say that?  Maybe their own experience with prescribed medicines was disappointing. So — of course — they’re disillusioned about these medicines. We get it. And we know that any given medicine that works for some people won’t help some others at all, or might even make them worse. Sooo… what’s up with that? Well, the answer isn’t simple. We do know that antidepressants,when first prescribed, only help about 30% of depressed people. We know that psych drugs help some people but not others and that men and women can experience depression and anxiety and fear differently. It’s a tangle to unravel it all. That’s why we’re so excited about new developments. We want to keep your eyes on AKT because it might explain how we learn and forget fear.

    Meet Jill and Greg to see how differences affect their well being and livelihood:

    Jill and Greg own a coffee shop together and are partners in life as well. They have a great balance of power, in the tasks they divide between them and the strengths they each bring. Greg is a people person, creative, funny, and efficient at both designing new drinks and training staff to make them just right. Jill is a numbers person, and sometimes comes off a little stiff and awkward, because she just doesn’t have Greg’s gift for setting people at ease. She also has some social anxiety going on.

    She does ordering from suppliers, closes out the books every night, and keeps a close eye on profit and loss. They’re a perfectly matched pair and love working together. That is, as long as they’re both at their best. With Greg building relationships with customers and vendors, and Jill keeping the financial end sound, they really do provide strength for the weakness of the other.
    Unfortunately, they both suffer from disorders that periodically causes some lost time at the shop. When that happens, the one who is doing OK ends up carrying a double load. And both of them struggle with anxiety… or basically fear on some level.

    Greg was diagnosed with bipolar II disorder when he was a teenager. Jill was diagnosed with depression in college. She’s a worrier. He just explodes sometimes—and refuses to call it anxiety. Greg takes medication for mood stability that also has an antidepressant effect. Jill takes an antidepressant that only sort of works. They probably both need medicines that reduce anxiety.

    In a perfect world…

    Since their coffee shop venture requires all hands on deck to run smoothly, Jill and Greg are eager to find the right meds for both of them to help stay in the game. They need to be able to go in to work—they can’t afford not to. It seems to Greg that since his medication helps him as much as it does, Jill should ask her doctor to prescribe the same for her. She’s a nervous wreck! However, she knows enough about changing meds that she can’t just jump on another medication just because it works for Greg. She’s tried that before. It didn’t work.

    At this point, Jill has tried five different antidepressants over the past few years, and has researched enough about IV ketamine treatment that she wants to talk to her doctor about whether she’s a candidate for it.

    Considering something new takes a little bit of courage. She wasn’t sure what her psychiatrist would say. A visit with her psychiatrist surprised her–he was cautious but supported her trying something that might help. Jill decided to pay for it out of savings, because her bouts of severe depression were taking a toll on the shop and their income.

    She arranged for treatment and began infusions. When the treatment was complete, she had received 8 infusions over about 3 weeks, and she felt like she had a new lease on life. Her ketamine infusions seemed to wake up her brain. And that got better and better day by day — even after she completed treatment. She found she enjoyed singing and dancing, and painting became her new passion. When they had a problem in the shop, she had so many more ideas for solving it. Working on the book work was no longer a drudgery–she enjoyed it and got more accomplished in a shorter time.

    Jill and Greg’s life became so much better at work and at play. Greg still had slumps when his meds weren’t quite holding him, but their life was so much better overall. They had read that ketamine treatment could help bipolar depression, too. Maybe the next time he went through a bad bout of that, Greg would talk to his doctor about it. To see if it was right for him—not just to copy Jill.

    Finding the right medicine for you is sometimes a long search. And medicine that works for you may not work for your sister…or your son. But it’s well worth the work researchers do to better understand why.

    A research study at the University of Colorado Boulder offers one fascinating revelation about why those differences between people and genders might exist.

    It has to do with a key protein kinase in the brain called AKT…which functions differently between males and females.

    They found presence of a certain form of AKT (called an isoform) in male mice can help the male let go of fear from a past painful experience–and form a new adaptive response to get around the old fear. Wait, what? Doesn’t that remind you of the way synaptic plasticity helps you adapt?

    Ok, you’re right…mice aren’t people and it doesn’t work quite that way…. but AKT is remarkably similar across mice and humans and this kind of translational research can begin to give us specific information to make our medicines and medical care more specific. Potentially even gender specific.

    So you’ll do well to keep your eye on AKT because so much is being learned about how we learn and how we forget fear.

    By figuring out the very complicated cascades involved in creating synaptic plasticity, we may be on the verge of figuring out how to shape and foster the neuroplasticity–for the better.

    We may be able to personalize medication therapies so that they don’t just broadly address a disease state, but so that they can be specific for the man or woman who needs them. 

    Charles Hoeffer, the principal investigator of this study, said it like this: “We need to stop hitting every ‘disorder’ with the same hammer.”  Well said! (Wish I had said that!)

    We’re always talking about personalizing treatment. About how important it is to provide treatment that fits the individual. Just as that’s true with all of the fine details involved in ketamine treatment, it’s also true with all of the medicines we prescribe.

    So… about AKT. 

    It turns out AKT plays a lead role in synaptic plasticity. We’ve talked about that too…  The idea that the connections between cells in the brain can change and adapt. They can change and adapt as a result of an experience. (This is why trauma can change us.) But — so importantly — these connections can also grow, change, and adapt as a result of the deeply emotional experiences, like the incredibly deep and awe-filled experiences you can have during a ketamine infusion. So many of our patients do. We’ve talked about how taking advantage of that process by scheduling psychotherapy 24 hours after a ketamine infusion can enhance the effectiveness of the infusion. 

    Why? Because therapy helps you think differently about something…and synaptic plasticity empowers those changes in thought. Many of our patients also find that journalling, creative writing, meditation and other activities help to integrate those experiences into their lives, find meaning in the experience, and move forward. Keep your eyes on AKT… there’s so much more to learn.

    AKT helps you create memories. Like a child touching his hand to a hot stove. To encode that memory so that he will be cautious in the future around hot burners, his brain needs to activate protein kinases like AKT.

    In fact, AKT is one of the first proteins to present itself to form a memory like that.

    There are 3 main variants, or isoforms, of AKT and they do different things and affect people in different ways (More on that in a sec!)

    AKT1 is important in encoding new experiences and allowing you to forget the old.

    AKT2 is often found in the astroglia…which are star-shaped brain cells.

    AKT3 seems to be important in brain growth and development. This one plays a positive role in mental health and wellbeing. 

    And when AKT1 and AKT2 are working together in the prefrontal cortex, they’re vital for learning, for memory … for dynamic change.

    Maybe like the kind of dynamic change that you want for yourself. So yes. So many different forms, working singly and sometimes together, in ways we are only now just beginning to understand for people suffering with psychiatric disorders.

    Now. To add another twist to this picture. In this study, researchers found a dramatic difference between genders regarding AKT. 

    They found that male laboratory animals whose AKT1 was functioning well, had far more ability to replace unwanted memories with new ones…than those who were missing AKT1. 
    Draw that out for a moment now…. and imagine men who’ve experienced the trauma of illness, or assault, or combat… and imagine for a moment that they’re given the opportunity to experience something new — maybe hopeful, blissful, awe-filled, like they might during a ketamine infusion — and then the excitement of realizing that a tiny little protein kinase like AKT1 may play a part in helping to encode that new feeling. Turn it into a new memory. Make the old traumas fade. (That’s called extinction learning.) Teeny little AKT1 helps with this. In males. 

    Incredible.

    There are endless little nuances in your brain that translate your experiences, encode them, and shape your synapses…and your individual functioning. And maybe your future possibilities.

    AKT is one to keep your eyes on for sure.

    We keep learning, keep researching, and keep doing all we can to help you get better.

    (Let’s just say we read all this stuff for fun–at nights, on the weekends, and at 5 am with a double shot of espresso.)

    And at this point, serial titrated IV ketamine infusions still do the best job we’ve seen in bringing relief to more people with treatment-resistant depression and anxiety than just about anything else available today.

    But ketamine treatment doesn’t work for absolutely everyone. Is it because of AKT or something different? We don’t know. Not yet. Researchers like the ones at Boulder are still searching to understand the nuances of dendritic growth and synaptic plasticity in order to refine our treatments–and discover better ones.

    At Innovative Psychiatry, ketamine treatment is provided in a virus-free environment.

    At Innovative Psychiatry, we personalize treatment to fit you — all the complexity and all the wonderfulness of you! And we aim for remission. Not just response. That’s the reason we titrate your dose, duration of the infusion, and the number of infusions you need to help you discover — once again — your best self.

    When you struggle and suffer from the symptoms of disorders that can be tormenting and exhausting, getting treatment is paramount. And feeling safe is critical — so we have state-of-the-art technology that crushes 99.999% of all viruses and pathogens. During this pandemic we want to make things easy. We all need a little bit of easy.

    So now, reach out for IV ketamine treatment in a safe atmosphere where this treatment can help you live better, hope more, and enjoy the challenges and relationships in your life that give your life meaning.

    You can live a life of joy, fulfillment, accomplishment, and ongoing hope.

    If your meds have not been providing you relief from symptoms of depression, despair, PTSD, or suicidal thoughts…call us.

    Let’s talk about what you’ve tried that didn’t work. And if you’re a candidate for IV ketamine treatment, we can begin that.

    Even though ketamine treatment isn’t for everyone, it just might be a good fit for you.

    We’re here to help.

    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,

  • Repeated Ketamine Infusions Relieve PTSD Symptoms – New Study

    Repeated Ketamine Infusions Relieve PTSD Symptoms – New Study

    New study demonstrates that with repeated doses of IV ketamine, relief can last up to several weeks.

    A deep unfamiliar voice behind Sarah made her jump. In a flash, she turned and bolted down the stairs she’d been climbing, turned left, then left again, knocking into people in her path as she scrambled for a place to hide. A mad dash took her into the restroom, where she locked the door and turned off the lights to hide in the dark. Screams sounded as darkness enveloped the room. Her heart was pounding, sweat pouring from her scalp, down her face, her torso…her armpits. She willed her breathing to slow…so the man pursuing her would not hear her panting gasps. (Poor Sarah. She’s suffering… if only she knew what repeated ketamine infusions relieve…)

    Three women exploded out of their stalls complaining about the lights and searching for the switch. Sarah pushed past them to an empty stall and stood on the toilet seat with the door locked so her feet couldn’t be seen below the door.

    Sarah’s vision blurred as sweat poured into her eyes. With a quick swipe, she wiped the moisture from her eyes and forehead. And waited. Silently.

    By her watch, she saw time passing. She heard women come and go from the restroom…heard their quiet conversation…  but she waited, hands trembling.

    After 45 minutes crouched with feet on the toilet seat…Sarah began to feel calmer. It washed over her that she’d been hiding in a public restroom for close to an hour… and now she was late to work. 

    PTSD is Not Only Terrifying, It Seriously Interferes with Daily Living

    Again.

    Oh noooo.

    Reality settled in. After washing her hands without incident, she cautiously opened the door and saw nothing unusual outside the door. She began to realize that it had happened again. Like countless other times. The sound of that voice triggered her memory of the assault…and it was so real. Except it wasn’t. 

    She was surrounded in the trauma again. 

    And that was the problem. Yet again, she would clock in late and be reprimanded for it. There must be help to conquer the PTSD symptoms that had emerged after she was assaulted 2 years ago. She had to find peace. Sarah wanted her life back.
    Desperately.

    Repeated Ketamine Infusions Relieve PTSD Under Controlled Conditions

    PTSD can be so entrenched that it is very difficult to relieve — even with therapy, special trauma-based therapies, SRI’s, or a combination of approaches. Very early work with ketamine–and the brilliant neuroscientists behind those studies–showed ketamine could reduce PTSD symptoms.

    A recent study from the Icahn School of Medicine at Mt. Sinai published January 5, 2021 has made splashing news among ketamine researchers and clinicians as the first randomized, double blind, placebo-controlled trial of repeated ketamine infusions for chronic PTSD. Adriana Feder and her team deserve applause and admiration, and have just set the bar higher for ketamine clinical trials.

    It was brilliantly conceived, elegantly executed. Well done.

    Patients with chronic PTSD that had gone on for years, from a variety of traumas, were separated into two groups. One group received 6 ketamine infusions (3 times a week over 2 weeks); the other group received an infusion of midazolam, which was the “placebo” in the trial, but it is was an active placebo–it made them feel something but it wasn’t ketamine.

    Ok, now this is important: if you have PTSD, or if someone you love has PTSD, you want it to stop. That would be remission, and that would be ideal. But in the world of PTSD clinical research studies, researchers look for response, and response means a 30% decrease in your symptoms.

    That’s how response is defined, and that’s how it was defined for this study: 30% improvement. It doesn’t seem like a lot of improvement, does it? Unless your life is a nightmare. Then a 30% reduction is a lot of improvement.

    As it happened, 67% of those in the ketamine group responded after 6 infusions …  compared to only 20% of those getting the placebo study drug.

    A significant difference.

    And possibly even more exciting than that 67%, those who received ketamine infusions experienced significant improvements across 3 of the 4 PTSD symptom clusters: intrusions, avoidance, and negative alterations in cognitions and mood.

    So, Repeated Ketamine Infusions Relieve PTSD

    Dr. Feder and her team — and all of us, truly — are encouraged by this kind of outcome, and of course, call for more infusion studies using more infusions as well as trials using ketamine infusions combined with trauma-focused therapy. In fact, we can and are imagining all kinds of studies we’d like to see for PTSD — different infusion parameters, different infusion doses, titrated infusions, new medications, new therapies. The GREAT news is that relief for PTSD is under investigation and more effective treatment is on the horizon.

    Formal Studies Help to Establish Credibility

    Now, it’s important to note that for a study to be replicable, it’s required to use clear protocols and consistent dosing. In real world practice, we have the duty and the responsibility to treat each patient as an individual for the best possible outcome. Sometimes that means using a teeny, tiny dose, tinier that you would imagine; sometimes it means titrating the dose to get a better response.

    Medicine is a science and an art.

    Since we’ve learned that effective depression relief requires different treatment for different patients, and effective ketamine treatment often requires different ketamine doses for different patients (and different conditions), we might expect the same to be true for PTSD.

    The ketamine dose for each of the 6 infusions dose in this study was 0.5 mg/kg — the same dose used in the single-dose and early repeat-dose studies of treatment resistant depression.

    But we find clinically, and from our own published work, many patients with depression need higher doses to stop suicidal thoughts, to achieve remission, and to restore hope.

    By the way, notice that in the trial above, 67% of participants benefitted from ketamine infusions: they experienced a 30% drop in their symptoms. Ketamine is wonderful for those it helps — when it helps — but for reasons we don’t fully understand yet, it doesn’t help everyone. And it didn’t benefit everyone in the study. Ketamine is not a treatment that works for everyone. There isn’t anything that works for everyone.

    In real life practice, we can titrate. By that I mean that we use our expertise, in addition to evidence-based scientific results, to adjust the infusion dose during treatment (within certain parameters) to try to bring forth the most effective results for you.

    Because your treatment, of course, is about you. It’s all about you.

    New Studies, like this one with a Series of Ketamine Infusions for PTSD, build our Brain Trust about Ketamine so that We Can Provide More Relief to More People Who Need It

    One size may fit many, but not most, and one size never fits all.

    At Innovative Psychiatry, we treat PTSD with repeated titrated IV ketamine treatment. And we use our deep expertise with ketamine in psychiatry and in the treatment of trauma to give you the best possible results. We’re thrilled that randomized, controlled trials are now investigating this so carefully. Research underscores safety, efficacy, and credibility. The more researchers learn, the more we can help you.  

    If you’ve suffered with PTSD and other treatments and medications have not helped, repeated ketamine infusions may help remarkably. 

    And remember, until the COVID-19 pandemic has moved to another solar system (just kidding! — but wouldn’t that be great?),  we’re prepared to keep you safe when you’re here with us. We have the technology to keep the SARS-CoV-2 out of the air, and off of the surfaces in our office. We’re vaccinated, we’re tested regularly, we screen everyone. (And we keep the front door locked!) When you come for treatment, you can breathe easy. 

    We want you safe, and we want you relieved of PTSD and other symptoms.

    Because, like Sarah, you need a life that is free to develop. A life that’s not interrupted with unmanaged symptoms.

    And we want that life for you.

    So you can follow your own dreams, and build the life you want to build.

    If you suffer from PTSD and nothing has helped, call us.

    In fact, if you suffer from treatment resistant depression, bipolar depression, anxiety, suicidal thinking and nothing has helped, call us.

    Let us work with you to help you transform and enjoy your life.

    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,

  • Strong Support System Can Protect You From COVID-Related Depression

    Strong Support System Can Protect You From COVID-Related Depression

    HAPPY NEW YEAR! Here’s our hope for you that you’ll find ways to make 2021 a more fulfilling and rewarding year for you and your family.

    Let’s talk about the difference in between  isolation, solace, and quarantine. People need people, and the pandemic has created an atmosphere where it’s hard to tell if you’re just enjoying solace, or if your isolating yourself and pulling back from socializing in a way that builds the habit of avoiding social interaction. And there there is quarantine, where you isolate yourself to avoid spread of COVID-19 after being exposed to it. But a strong support system can protect you from depression symptoms caused by isolation.

    In the hustle bustle world of daily activity in a non-pandemic world, it can be difficult to find peace and quiet for an hour. That works fine for some people, who soak up quiet and refuel in a quiet atmosphere of solace.

    You know who you are. Lovely quiet periods help you refuel, and give you energy to get back out there.

    There are also people who draw their energy from being with people, listening to and absorbing their energy. If you’re one of those, it can be really difficult to be stuck at home in silence all the time. Without outside stimulation, your battery can run down dead and flat. Both in your personality and your emotions.

    This is true even when there is no pandemic to deal with.

    However, in a pandemic it can get more complicated and put more people at risk for depression.

    We want to get a handle on what can make life better while we see the pandemic through to its resolution. Right?  We do!!

    Quarantine can cause isolation if it goes on too long, can’t it?

    When a family of 5 is exposed to the COVID-19 virus, and all test positive, they need to quarantine until they’ve been symptom free, according to CDC guidelines. But what can be done to help prevent the isolation that can lead to depression…?  Interaction is a big and important step.

    Online friendships are lifesavers during this time of isolation and quarantine. Family and friends in your support system can help protect you when discouragement threatens to cause depression.

    Here are two stories…about two different friends and how their outcomes compared in isolation vs. quarantine with online support.

    First meet Tamara. She’s 19 and was attending community college for her first semester when the COVID-19 pandemic emerged. 

    About 2 months into the semester, her school was closed and all classes were switched to remote online learning from home. Tamara was relieved at this because it’s natural for her to enjoy solitude, and looked forward to the peace and quiet and the chance to read voraciously without interruption.

    But there were some unexpected obstacles for Tamara. For one thing, as much as she loved to read, she struggled with algebra and chemistry. Quite honestly, in those subjects she’d always tried to get involved with study groups to help her grasp what she couldn’t seem to wrap her head around on her own.

    While study groups were available online, she didn’t benefit as much. However, she tried, and kept reaching out to various people in the group for help to understand the mysteries of those classes.

    So… she put in her time, worked on her assignments, and spent most of her free time reading books she enjoyed. 

    For the first 3 months, her freedom to enjoy the quiet and read one book after another was an indescribable luxury.

    However, because her mom had passed away a few years before this, she didn’t have her to talk to anymore. And talking to her dad didn’t go that smoothly. So she didn’t really have a true support group. Her only sibling was a brother who was in the Air Force, and his life was full.  She rarely heard from him.

    Long story short, Tamara was alone. Quite alone. 

    And the natural social interactions that had happened on campus before the pandemic weren’t available anymore.

    By the fourth month of the pandemic, she noticed she was losing her desire to have contact with anyone.  Online or in person.  She wore her mask and used hand sanitizer when she went to the pharmacy or grocery store…  But avoided eye contact.

    As Tamara moved into the summer months, she found she had far less energy she had before.  She didn’t want to leave her apartment. It became harder and harder to go to the mailbox. And she wasn’t really keeping up with friends anymore on facebook, text, or email.  

    Then someone stopped by and realized Tamara didn’t appear to be cleaning up her place — or even showering. She seemed shut down.

    Tamara was embarrassed, but honestly didn’t have the energy to do more than she was doing.  She was managing to keep her grades up in most of her classes, though Chemistry seemed a lost cause.

    Finally, her dad came by to see her.  He wore a mask and so did she, and they sat across the living room and tried to talk. Seeing her like this alarmed him. Dishes piled high in the sink, her own hygiene seemed to have lapsed…this wasn’t the Tamara he knew.  

    And he realized she was missing the support system that can protect against the threats of isolation and depression.

    So he asked her to let him help by getting her a telepsychiatry appointment.  That was actually a good solution, so she wouldn’t have to see anyone face to face…

    Now, meet Carolina. Carolina is 20, and knew Tamara in high school. They’d ended up at the same community college, but had not run into each other before classes closed for COVID-19. 

    Even though Carolina also enjoys solace, she has a nice group of friends to study with, and talk on her phone and text with. So even though she, too, has been home with remote online learning since a couple months after the semester started, she also has friends she talks to. 

    She doesn’t see them face to face, but they talk on FaceTime and Skype, as well as Marco Polo just so they can have live interaction. Carolina also lives at home with her family. Her parents are both working remotely from home, and her sister and three brothers are all learning remotely online.

    So, in spite of not seeing much of friends or relatives face to face, they meet up on Zoom, have a party, talk about their friends and their classes, music and the food they have delivered to their houses.  What’s tasty and what isn’t.

    If one of them is exposed to COVID-19 and then tests positive,  they all gather online to encourage and offer suggestions for managing it.

    The truth of it is that Carolina and her friends really haven’t struggled that much with feelings of depression. Maybe because they keep each other so engaged in daily living.  Somebody in the group always has a story to tell. All in all they offer each other a strong support system can protect against the damage that comes from too much isolation.

    Maybe it’s because their long term friendships have kept them all feeling more supported, resilient, and less vulnerable.

    It’s true that too much isolation can lead to depression symptoms in some people. And as we move into 2021, it’s a good idea to embrace the new year with a willingness to reach out to those who seem to lack support.  

    A really good idea.

    Everyone around you needs a support system right now. Some have it, others don’t really. But you can help with that online. 

    And there are also those who have been suffering under the weight of depression for a long time, and nothing has helped. Those who are sick and tired of feeling so hopeless, despondent, alienated, and drained.

    IV Ketamine Treatment Opens Doors of Hope

    For those, there is further hope in IV ketamine treatment. A series of 6 or maybe 8 infusions spread over a few short weeks, and expertly titrated to ensure you get the dose that’s right for you. Ketamine has blown the doors off depression treatment in the last ten years and especially the last 5. It’s reputation has grown from skeptical to celebrated in that time. Why?

    Because ketamine treatment does so much. In the brain-derived-neurotrophic-factor, the lateral habenula, the synapses, the G proteins heaped up on lipid rafts, the AMPA receptors and signals flying at high speed around your brain. For so many, ketamine can work so much better than the medications, therapy and treatments they have tried. It targets areas that were otherwise ignored before this.

    IV ketamine treatment can be extraordinary in its effectiveness to help you achieve remission.

    At Innovative Psychiatry, we’ve been so encouraged by the help ketamine offers that we’ve dedicated a section of our office for treating those who need to receive this breakthrough treatment. We’ve also responded to the concerns caused by COVID-19 by installing and using specialized technology that keeps the air and surfaces free of the virus that causes COVID-19, as well as the other viruses, bacteria, and molds that can threaten your health.

    While we’re not attempting to conquer the entire pandemic we are busily at work to help you get better, free of depression symptoms, in an environment where you feel — and are — safe.

    In spite of all the other challenges in the world, you can take them in hand best if you’re at your best. It helps so much if you’re strong, functioning, and creative to embrace today’s challenges. You need to be the best you, you can be. And a strong support system can protect you and help you build the resilience you need.

    We’re here to help with that, and to get you off to a much better start for the year.

    If you’ve been suffering, trudging, and feeling overwhelmed by daily living… if nothing much has helped, call us.

    We believe in what you can accomplish without depression symptoms holding you back.

    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,

  • Wake up and Dream Your Most Heartfelt Dreams This Holiday Season

    Wake up and Dream Your Most Heartfelt Dreams This Holiday Season

    A dream is a wish your heart makes, when you’re fast asleep…

    At least that’s what Cinderella sang, in Disney’s classic animated movie. But… the kind of dreams you have when you’re fast asleep are actually different than the dreams your heart makes. This is the week of Christmas, which has filled children’s dreams with sugar plum fairies and their favorite toys for centuries. It’s also the Christmas of the pandemic of 2020, which has had its own impact on dreaming. We’re living history right now; yet we’re also building our futures. So maybe we should all wake up and dream to make our lives better.

    But you’re not Cinderella or her Prince Charming. You’re you…and you live in the real world. And in a global pandemic, no less.

    You may know Jaxon. He’s been struggling to get his feet on the ground as long as he can remember. He’s tried one job after another, year after year. But during the COVID pandemic with its lack of job security, he’s realized he’s sick and tired of feeling he has no control in his life. So he’s decided to wake up and dream. He plans to take his uncle up on the offer to pay for his training as an airline mechanic. Jaxon is good with engines, and has been studying jet engines.  So as soon as the pandemic eases, he’s going to enroll in training. It will improve his life, and the life of his family. And he’s chomping at the bit to realize his dream.

    Then there’s Cheryl. She’s always dreamed of furthering her education so she can be a nurse practitioner or Advanced Practice nurse. She’s already a registered nurse with a Bachelor of Science degree. It will be a long road to earn the Advance Practice status, or Nurse Practitioner degree. But she wants more out of life. So she decided to not give up but wake up and dream. And the exhaustion of the COVID pandemic has shown her she wants to specialize and do her best work, as well as improve her income for her family’s sake. Her dream is to specialize in pediatrics. So she has begun taking online courses now to move toward that goal.

    After 10 months of COVID-19 this year, many have become discouraged and lost the pluck it takes to visualize life beyond this. Dreams of what we want to accomplish, or create…or overcome.  These are the dreams that are a wish your heart makes….

    “I want to own my own business…”

    “My wish is for a promotion..”

    “Wishing for a spouse and family…”

    “Someday, I’ll have my own daycare center.”

    “My dream is to be a doctor.”

    “I’m hoping to manage my symptoms so I can feel others respect me and I can build a life I’m proud of.”

    A dream is a wish your heart makes… it’s something you don’t have now, but wish you did. Something that you’re willing to wait for…and to work for… that you believe would improve your life.

    Your dream is the shape and color scheme of your hope. Hope says, “Life will get better.”

    Your dream determines HOW it will get better.

    A book published this year called Dream Big, written by the New York Times best selling author Bob Goff, is so timely for the pandemic and the stress you may feel. Actually, it’s called Dream Big: Know What You Want, Why You Want It, and What You’re Going To Do About It.

    Of course, it may not be that easy to know what you want. What you wish. What your big dream is. But it’s worth it to dig deep and figure it out.  You have to figure out what that dream is to figure out if it’s worth it to you to fight for it. 

    And figuring out why it matters is a good step toward putting down roots for the future you dream of. 

    Then, you’ll start taking steps. Because that dream is your lifeblood and fuel.

    It’s timely that this book was published this year — 2020 — because so many have been so overwhelmed by the status quo of the pandemic, world economics, and politics, that they’ve given up the fight.  Their energy is drained, along with their determination and strength to move forward.

    But right now, in 2020, is the time to DREAM.  Not hide, not go to sleep. And certainly not give up. But since COVID has seeped into daily life, it may seem to you that it’s too late to fight.

    But you can stretch beyond the limitations you see around you in the pandemic. Reach far. Seek new possibilities. Dream big.

    It’s never too late to fight for YOU.

    Think of the time you have now to reevaluate and restructure your life plan. This is the time to decide if you want your life to continue, business-as-usual, or do you want to find ways to enjoy more, love more, help more.

    Right now is the time to make those decisions. The ones that pursue your dreams.  Because as the COVID vaccinations reach more people and the presence of this illness is reduced, and society becomes able to move around again… you’ll need to already be in your stride with your new plans, your new life style.

    But there’s another facet. And that’s the fact that symptoms prevent some hard working people from pursuing their dreams. In fact, severe symptoms of anxiety or depression can muddle a person’s ability to even form his own dream.

    When that happens, that person may need the treatment to get his symptoms under control so he can move forward toward his own fulfilling life.

    Depression and bipolar depression are two more disorders that can interfere with your power to pursue your dream.  Social anxiety can do that, too.

    PTSD is an example of a disorder that can severely block progress toward the fulfillment of a dream…or even forming one to pursue.

    IV ketamine treatment has well documented evidence for treating and relieving the symptoms of these disorders. It turns on mRNA which switches DNA to “ON” to turbo boost brain-derived-neurotrophic-factors which go to work proliferating the synapses (connections between brain cells) throughout your brain.

    Your brain wakes up, and signals light up your brain as they carry messages everywhere at high speed. You feel joy, you feel creative, you have a renewed ability to invest in your work and healthy relationships. You can wake up and dream because you have hope.

    At Innovative Psychiatry, we’re gratified to watch people come alive with hope and purpose after IV ketamine treatment. We offer this remarkable life-changing treatment in a safe atmosphere where we’ve invested in VB Enviro Care’s plasma cell technology that removes all COVID virus particles (in fact all viruses, bacteria, and mold) from the air and the surfaces in our offices.

    I know it sounds a little sci-fi and actually… it is. This technology was developed at MIT and NASA to fight biological warfare, and it’s extremely effective. You’re safe here and you can be treated without fear.

    We understand that the pandemic has taken a toll both emotionally and physically on so many and we want to help you restore, and achieve remission from your symptoms. So you can wake up and dream, and invest in the life you want to live.

    Ketamine doesn’t work for everyone. No treatment or medicine does. But it is so effective for the majority of patients who suffer from severe symptoms. It can be extraordinarily effective when everything else has failed.

    If you suffer from symptoms of severe depression, bipolar depression, PTSD, social anxiety, alcohol use disorder, substance use disorder, or suicidal thinking, call us.

    You can schedule appointments for IV ketamine treatment without a long wait…usually just a few days.

    Start 2021 hopeful, and empowered to live your life as your best self.

    We’re here to help so you can live a truly rewarding life.

    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,

  • Reduce Stress and Stay Safe This Holiday Season

    Reduce Stress and Stay Safe This Holiday Season

    Although some things are easier said than done…

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

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

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

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

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

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

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

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

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

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

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

    “A party?  How many were there?”

    They held their breath.

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

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

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

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

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

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

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

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

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

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

    You just never know, do you?

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

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

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

    Reduce Stress and Stay Safe at the SAME Time

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

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

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

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

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

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

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

    We all know someone who stirs up conflict wherever they go. The Button Pusher.  
    Then there are those who find their fuel by subtly inflicting guilt. We love them but we hate the guilt trips. 
    And every group has someone looking to push the crowd into doing something they don’t want to do…

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

    Aren’t you glad?

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

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

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

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

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

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

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

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

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

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

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

    We understand and can help.

    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,

  • Fight the Effects of Isolation Depression By Reaching Out to Help Someone

    Fight the Effects of Isolation Depression By Reaching Out to Help Someone

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

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

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

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

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

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

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

    The effrects of isolation depression are making this senior citizen want to give up hope.

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

    That caught his attention.

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

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

    Right..??

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

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

    Finally, he turned around in his chair and stretched.

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

    Thoughtfully, he laced his fingers behind his head.

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

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

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

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

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

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

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

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

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

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

    He pushed send, then his heart sank.

    What had he done???

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

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

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

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

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

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

    And he had discovered something he’d been missing.

    PURPOSE.

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

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

    Oh yikes.

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

    What if he got sick ?

    The responsibility for all these kids loomed over him.

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

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

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

    The Effects of Isolation Depression

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

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

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

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

    If that’s the case for you,…if you’ve tried prescriptions for many months that just never did help… and you would like to see what
    can do for you, we have good news. We’re offering this treatment at our office. Still.
    The effects of isolation depression are eased by family.
    Because it’s essential. Because it can be life-saving. 

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

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

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

    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,

  • What Does Loneliness Do To Your Health and Your Relationships?

    What Does Loneliness Do To Your Health and Your Relationships?

    What does loneliness do to you at Thanksgiving? Does the crowd of family help? Or hurt?

    Thursday is Thanksgiving, and most of us realize what a toll the holidays take on some people. But we may not understand why.

    Many of us have at least one loved one who is not comfortable in a family gathering at this time of year. They may be in pain, or mourning a loss, or just otherwise uncomfortable in a crowded room. Maybe you wonder what does loneliness do to someone who is isolated. Sometimes it could be age related: If they’re over the age of 65, they may feel like it’s hard to connect with the younger generation, and if they’re young they may feel like fish out of water.

    Or they may suffer from a psychiatric disorder that makes them miserable whether they’re alone or with family and friends. Bottom line, the holidays are a joyous time for many, but we need to stop and consider those who struggle at this time of year.

    Loneliness has been getting more attention lately, because it’s becoming more and more widespread.  It’s not just the elderly anymore, although the elderly who live alone or in certain settings still often ache so severely from loneliness that depression takes over and makes it worse. 

    What loneliness can do is to separate you from those you love and depend on, just as these lions depend on each other.

    You know that feeling when you’re lonely in a room full of people?  Loneliness doesn’t just attack when you’re by yourself.  If you’re mourning the loss of a companion because of death or divorce or breakup, the loneliness is so deep. Being surrounded with people, even people you know well and love, just may not soothe that deep corrosive ache you feel.

    But it’s not always about loss. 

    Tom is 69, has been single for decades, and has Narcissistic Personality Disorder. Tom has always been lonely. Because of his disorder, he doesn’t grasp that he does anything inappropriate, or that he offends others…especially his ex-wife or a girlfriend. His first marriage lasted over 20 years, but the older he got the more inflexible he got.

    What does loneliness do to you?

    And because of his disorder, he assumes that every conflict is because his mate doesn’t appreciate how good he is to her. He just can’t see that he causes the misery he does. All he knows is that he’s desperately lonely. So he is constantly on dating sights hoping to find the person who will fill that yawning void he feels. 

    Aging Sometimes Makes Isolation Worse

    Now at 69, he’s in a wheelchair and still looking for romance, but he’s run out of candidates…

    One day, he told his sister with incredulously…  “I figured out why my wives have all left me… they just didn’t appreciate how good I was to them.”  

    Tom just couldn’t see what was needed from him for a relationship to be fulfilling to both people.

    He couldn’t imagine he had room for improvement.  But that can go with Narcissistic Personality Disorder. And as much as he abused the people he loved, and drove them all away from himself, he couldn’t imagine there was anything he could do about their “lack of gratitude.”  And so he was desperately, heartbreakingly lonely.  And talked about it often.  

    But maybe that’s not so surprising really, for someone with that particular disorder.  

    Still, there are other scenarios.

    Some Think They’re Flawless, Others Believe Their Flaws Are Irreparable

    Either Way What Does Loneliness Do To Your Health, Your Relationships, and Your Self – Image?

    However, there are multitudes who struggle on the other end of the spectrum. Those who are unable to accurately assess their own worth to those who love them. They may be overwhelmed with shame and worthlessness. So many people who suffer from depression, bipolar disorder, PTSD, panic disorder….  

    What does loneliness do to someone covered in shame?

    So many feel inadequate, and struggle with feelings of such abject worthlessness, they struggle to receive love and support. When they join their family for a holiday gathering, they feel like they stand out like a sore thumb as the “loser,” the one who has amounted to nothing, the black sheep…They rehearse these self-defeating opinions about themselves in their own minds until it’s all they can imagine. 

    And they know without question this is the view held by everyone who knows them. (whether it’s true or not) These people are their own worst enemies. So they arrive at a gathering of people they love on the defensive, unable to absorb the love around them because they’ve convinced themselves they don’t deserve it.  And they’re even lonelier with their family than they are at home.

    It happens that sometimes lonely people are forgotten people. Sometimes they’re displaced people. Sometimes they’re people who have driven others away.

    But they’re all hurting.

    An editorial by Nicholas Kristof in the New York Times recently focused on the rampant, widespread impact of loneliness as a health crisis. He compared loneliness and social isolation with the health risks of smoking 15 cigarettes a day, or of obesity. He made the point that since obesity is associated with 300,00 to 600,000 deaths a year, loneliness must be a serious killer.

    Loneliness does what to you? It increases inflammation which leads to a host of diseases.

    What we do know is that loneliness increases inflammation, heart disease, depression, and suicidal thoughts… among a multitude of miseries. Inflammation alone can lead to cancer, a plethora of chronic and debilitating illnesses, and death. We’re social creatures, and fundamentally, we each need to be loved by someone, and to love in return.

    We need to contribute, and we need someone to give back. 

    In a survey taken in the US and Britain, more than half of respondents said they are often, if not always, lonely. With the rising numbers of single adults who never marry, and those who find themselves single again and stay that way, social isolation has become a growing cloud… The connectedness of multiple generations in a household is a thing of the past. 

    In Great Britain, an effort to counteract this disconnectedness, this isolation, led to the formation of the Ministry of Loneliness, complete with the Baroness of Loneliness to lead it. Baroness Barron’s direction instigated initiatives to bring people together. Things like benches for conversations. Clubs to draw people together who have similar interests. Public invitations to connect, share hobbies and activities.

    The Baroness stresses that everyone experiences loneliness at some point in their lives…some more than others. But because of the shifts in our western society away from extended family units, more and more people live alone. They don’t have the built-in structures that keep them connected. And their health suffers.

    So she encourages building ways to connect around people’s strengths… like their talents and hobbies. And to avoid focusing on their weaknesses, such as their isolation and lack of friends.

    What does loneliness do to you when you're facing hardship by yourself?

    So what is it, actually, that happens in your brain when you’re lonely, and you feel isolated?

    Social Neuroscience

    A study led by Livia Tomova and her team published in the Journal of Social Neuroscience considered the work of John Cacioppo.  Cacioppo was a social neuroscientist who defined this field… what happens in the brain in relation to our connections with others.  What if those connections are missing?

    He was the first to study the effects of loneliness in the brain. He said that the brain is the organ that creates, monitors, nurtures, and maintains social connections, and that everyone needs them. However, if you have some and don’t feel you have enough, then you’re likely to feel lonely, anyway. Because it’s how you feel about your connections with others that determines whether you feel fulfilled, or lonely.

    Loneliness is like hunger and thirst in that it makes you want to take action to feel better.

    He compares loneliness to hunger and thirst because it signals you to do something to to help yourself feel better.

    We Crave Connection

    And it isn’t just knowing people. It’s having someone or a few someones whom you trust, and you can give to, and who gives back to you in a way you can receive. A single trusted friend or a few is far better than a crowd of acquaintances who don’t meet that need.

    So in the study, Tomova and her team focused on the dopamine reward system, trying to integrate their experiences with animal and human responses. Their results showed that in lab animals, social isolation typically increased social motivation, which was managed by the brain’s mesolimbic dopamine system. 

    However, in humans, social isolation or “alone-ness,” can lead to either increases or decreases in social motivation.  Put another way, humans may withdraw… or reach out feverishly… in response to a painful rejection. This takes place in a part of the brain called the insular cortex.

    But chronic loneliness leads to decreased social motivation., due to changes in the dopaminergic responses in the striatum.

    What Does Loneliness Do in YOUR Life?

    All of this is to say that loneliness, or that feeling that comes from having unmet social needs, can come from a variety of life circumstances, but it occurs in the brain. And in the brain, we respond. 

    You’re built to love and be loved.  To trust and to be trusted. To be interested in someone else’s life…and for someone to be interested in yours.

    When you love someone who loves you back, loneliness has no power over you.

    There is no medicine that will heal loneliness. But there is help for those things in your life that may contribute to it. 

    By the same token, as you join with family and friends this Thanksgiving, you can keep your ear to the ground for others in your company who may not be socially motivated…and help them to break through obstacles that prevent connections. 

    On the other hand, if you feel isolated and alone, and want to withdraw, consider a baby step or two and reach out to someone…anyone…in your world who seems to be withdrawn, too. 

    Your helping hand just may help both of you. 

    Happy Thanksgiving

    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,

  • Cost of Ketamine Treatment: Is it Worth It?

    Cost of Ketamine Treatment: Is it Worth It?

    The cost of ketamine treatment was worth it for James- his life is blooming.

    “IV Ketamine treatment…?  I can’t afford that.” 

    “Sure, I want to feel better.  I’ve tried so many medicines and treatments. I don’t even know what it’s like to enjoy something, anything…or to feel happy. I don’t have the energy to even get out of bed half the time, much less get anything done. But…the cost of ketamine treatment is way out of reach for me. I don’t even know if it’s worth it?” That’s Ann Marie, out loud.

    “When I go to work, my mind is plagued with images of people dying… or me dying. Dark, hopeless thoughts and pictures in my head. Sometimes gruesome…

    The cost of ketamine is a worthwhile investment.

    “But we all know IV ketamine treatment is for people who’ve got money….   right?”

    ……….

    This is what people say to themselves, and to their family…comments like this, or others similar…

    And since IV ketamine treatment can restore your hope, your motivation, and initiative, you’re likely to be far more able to make those payments after you’ve benefitted from the treatment.

    So, maybe they aren’t seeing the big picture…  in fact, maybe you aren’t seeing it either. It’s something to think about. 

    Because, you know, you don’t have to have the free cash to pull the payment out of your wallet on the spot. You know that, right? Countless companies offer medical financing to pay for medicines and procedures over time. Advance Care Credit, United Medical Credit, and M-Lend are a few.

    For example, have you thought about the benefits of investing in IV ketamine treatment ? Yes, there’s an initial investment, but have you thought about this..?

    Discontinue Medications and Save $$

    For one thing, you’ve likely been taking medications for your depression or other disorder for years…haven’t you? And even though they haven’t helped, you may still be taking them.

    But, the beauty of ketamine is that it works independently of SRIs, SNRIs, anxiolytics, etc. So by investing in as few as 6 ketamine infusions, or a few more as needed, you may find you’re well enough to think about eventually tapering some of the add-ons that didn’t add anything.

    IV ketamine treatment may make it possible for you to wean off expensive medications that don't help, so the cost of ketamine treatment may be reduced by savings.

    Some of your medicines may not be expensive, but some may be pretty pricey.  In some cases, people have found that IV ketamine treatment paid for itself in 3-6 months. Even when you have insurance, your treatment costs can be exorbitant. Now it seems like everyone has a huge deductible to pay before insurance even kicks in. How much money would you save if you were able to stop taking those …. add-ons that maybe aren’t adding anything? Well, that money could go toward paying for your IV ketamine infusions.

    Then, there are those calls for extra appointments with your doctor when your symptoms flares.

    Fewer Doctor Visits

    If you’re not having symptoms, you may find you don’t need to see your doctor as often as you were when your symptoms were so persistent and so severe. What a relief that would be–if you didn’t need to call to be fit in for extra appointments when you took a dive, didn’t have to reach out to an answering service on the weekend. You’d probably prefer to spend that time and money doing things you enjoy, right?

    Why pay for a parking garage and sit in a waiting room when you’d rather be hiking in the woods, or playing tennis, or shopping? When ketamine goes to work on your brain systems, and restores the circuitry there, you regain the power to enjoy. And if you’re enjoying yourself, it’s likely you may not feel the need to check in with your doctor nearly so often. 

    Add to that the expense and the hassle of lab work. Some medications require that regular lab work be done to monitor your liver, or your kidneys, or your blood sugar and your cholesterol.

    To spend more of your time enjoying your life, your work, your hobbies, and your relationships is a far more fulfilling way to spend your time than having blood drawn in a lab on a Saturday…don’t you think? 

    Cost of ketamine treatment can be offset by fewer meds and doctor visits so you can do things you enjoy, like picnics.

    And money spent on co-pays and fuel, as well as wages lost from missed work and days you take under your FMLA for symptom flares and doctors’ visits…well, those funds have such better uses when you feel really well.  Baseball tickets, funnel cake, or…a picnic in the park!

    Cost of Ketamine Treatment Improves the Quality of Your Life

    But most of all, it’s the quality of your life. While the costs can be reclaimed in countless ways by a happier, healthier you as time goes on, can you put a price on your improved, deeply rewarding, utterly fulfilling new life?

    James comes to mind. A patient of mine who couldn’t remember ever feeling happy, or having fun, or enjoying those little moments in his life. Ketamine worked for him. And now, he enjoys a fragrance he notices in the air, the way the meat responds to the fire when he’s cooking, the clear blue of a mountain spring.

    Things he never noticed before because of the dark gray cloud that hung over him, suffocating him. He arranged financing for his treatment, and that monthly payment feels easy, because he lives every day the life he had wished for as long as he could remember.

    And his life has bloomed, because he has the energy to step out and live. He has a family that’s growing and his mind is on his family’s future…in fact, he realizes his whole life is ahead of him. He invested himself and the cost of ketamine treatment was part of that.

    Then, there’s Lisa. She grew up in a home where she never felt understood.  She was sensitive, intelligent, and meticulous. Her parents were hard working, confident, and not so tuned-in. Not really understanding their daughter’s sensitive nature, they made a plan for her from earliest childhood. She would be a doctor, and would make them proud. 

    But Lisa’s heart turned to music, and she sang like an angel. From the time she was losing her front teeth, she could feel her parents’ pressure to be who they wanted her to be. She wanted so much for them to appreciate her for who she really was.

    Lifelong Depression Wears Down Brain Circuity

    Innocent child waits in the darkness for her parents.

    By her 6th birthday, she would arrive at home after she got off the bus, and enter the dark house frightened, alone, and shaken. The anxiety from those long afternoons alone in a dark house grew to a dread that followed her wherever she went.

    Depression drained her energy, and her hope in life. Adolescence turned out to be a cruel time, and she felt she didn’t fit in anywhere. College was a chance to excel. Getting married was a no-brainer. And though she had transient reprieves from the trudging existence she endured, the dark hopelessness and choking despair always returned.

    Pregnancy after pregnancy…she could conceive, but had no energy to care for the children, and would just go back to bed. The kids spent a lot of time at their friends’ houses while she slept on the couch. They learned how to make their own mac and cheese.

    Hospitalizations didn’t make much difference. Medicines her doctors prescribed brought no relief. The kids raised themselves.

    The Cost of Ketamine Treatment

    But finally, when her first grandchild was on the way, and Lisa wanted the ability to build a relationship with this child, she heard about what ketamine treatment was doing.  She learned that she would need at least 6 infusions, so she needed to be prepared to pay for them. 

    Those who knew her and loved her wanted to help. Eventually, a friend offered to help her pay for the treatment.

    For Lisa, it got unreal right then. There was an unreal-ness about suddenly having a way to get real help…to maybe have an opportunity to feel good for the first time in her memory.

    And as she’d hoped, within a week she was improving. Little beams of hope penetrated her cold damp tomb of anxious despondency …one little beam at a time. It was slow. She started taking walks, just because. Then she started reading books and meeting friends for lunch. 

    A friend’s help made the cost of ketamine treatment manageable.

    A joyful grandma is grateful she had the cost of ketamine treatment so help her get well and happy.

    Now, Lisa is a rosy-cheeked, very active grandmother. She takes her granddaughter on picnics and to the zoo, for ice cream, and to play in the park and feed the ducks. Her grown children watch in disbelief–where was she when they were little?–but they’re relieved that she is finally functioning, happy, productive, and interested.

    She has the energy to share all kinds of experiences with her grandkids…both the physical as well as emotional energy. They play games and she teaches them about good sportsmanship and the competitiveness to win, too.

    Lisa made little payments to her friend for three years to repay the loan that gave her back her life. She says that loan was the greatest gift she’s ever received. She has the power to love again. To dance and sing and play ball with her family.

    Ketamine Treatment Must Be Available to Those Who Need It

    Is there anything more important than the power to live your life well? Happily, generously, joyously?

    When people ask me how they can afford to pay for this treatment, I wonder. A lot.

    I wonder how we can afford to stand by while our sisters, our friends, our kids, and our husbands slowly shut down.

    I wonder how we justify the days lost, the jobs lost, the unpaid FMLA’s, the lost opportunities. The kids’ games that we missed, the holidays we suffered through, the long agony of a weekend that was empty.

    I wonder how our insurance companies so readily deny payment for an infusion that could stop suicidal thinking and save a life –but quickly fork over $1300 for an ambulance ride to the ER and another $1500 for the night spent on a gurney, waiting to see if the crisis worker will hospitalize you or send you home?

    Insurance will pay for that, and refuse to cover ketamine infusions? The procedure exists, the billing code is there, the diagnosis is clear …the results speak for themselves.

    I wonder, sometimes, not about affording ketamine, but about how we can afford this: to live like this, day after day. What’s it costing us? What’s it costing our kids?

    In the light of the transformative effect of ketamine at its best, you owe it to yourself to find a way to give yourself an opportunity to live – and live well. To enjoy your life, to invest in it, to learn and grow, to stop the suicidal thoughts, to get rid of the depressive symptoms. To be happy.

    Cost of ketamine treatment brings great returns on investment through joyful living and loving.

    It’s true that IV ketamine treatment can’t offer a 100% response rate, but no medicine can do that. The cost of ketamine is an investment… But there are few investments available to us with the return that comes from this extraordinary treatment.

    James made this comment, “Instead of spending all my energy trying to figure out how to survive the week and how to ignore the suicidal thoughts that are always there, I’m excited about figuring out my next step, and I’m looking forward to good things happening. I’ve never experienced anything like that before.”

    Everyone should have the opportunity to live free of symptoms, and to have the energy and hope to invest in the things you believe in.

    At Innovative Psychiatry, we’re investing in you and your future. If you’ve suffered and treatments haven’t helped, call us. The cost of ketamine treatment? We think it’s worth it. It can make real living, fulfilling engagement, rewarding relationships, available to you.

    To the unveiling of your best self,

    Lori Calabrese, M.D.

  • Suicide Prevention: #Bethe1to Save a Life

    Suicide Prevention: #Bethe1to Save a Life

    Suicide prevention: #Bethe1to ask how they're doing, to connect with them and listen.

    Today marks the beginning of National Suicide Prevention Week 2019, and tomorrow, September 10, is World Suicide Prevention Day.

    More than just observing a day or week like this, let’s use the opportunity to learn what we can actually do to make a real difference in the life of someone who suffers from suicidal thoughts. The National Suicide Prevention Lifeline has created the hashtag #BeThe1To to pull together people interested in learning what you can do to help.

    Suicide Prevention: #Bethe1to Intervene

    Approximately 1 million people die by suicide each year, according to the World Health Organization. That’s about 3000 people per day, or one death by suicide every 40 seconds. In the US, over 47 thousand people died by suicide in 2017. As such, suicide is the 10th leading cause of death in the US alone. But those are the ones who died.  1.4 million attempted suicide. 

    When someone experiences suicidal thoughts, it doesn’t mean they’ll necessarily make an attempt to end their life. So if there were 1.4 million people who attempted to die, can you imagine how many suffer in silence from the torment of suicidal thoughts?

    And here’s the thing…

    You don’t really know whether a particular person who’s experiencing suicidal thoughts will try to stop living, even if you do know they’re having suicidal thoughts. 

    And that’s why it’s so important to know what you can do, and learn how to get comfortable doing it.

    Suicide Prevention: #Bethe1to Make the Effort

    Suicide prevention: #bethe1to reach out and ask how she's doing.

    So let’s talk today about how YOU can intervene and help protect people in your circle from making an irreversible decision. National organizations dedicated to suicide prevention, like Suicide Prevention Lifeline and the American Foundation for Suicide Research cannot ferret out everyone at risk. To reach all of those suffering requires your help, engagement, and willingness to reach out.

    Most people do care about the number of people dying by suicide, but the majority of those who care, don’t really know what they can do to make a difference. And that’s why these organizations exist. 

    #Bethe1to highlights what you CAN do. YOU CAN be the one to listen. To reach out. There’s an abundance of myths and misunderstandings surrounding suicide, and more importantly, suicidal thinking.  When someone is having suicidal thoughts, those thoughts often begin as an intrusion into their mind in most cases, rather than a decision. In most cases, the thoughts are a symptom of an underlying condition.

    Think there’s nothing you can do? That’s a myth.

    Just be genuine. Sincere. Caring.

    The longer the thoughts go on, the more they can torment. And possibly influence the person experiencing them. So you can #Bethe1to interrupt the cycle, distract this friend or loved one from the influence of the thoughts, and counteract the thought’s impact.

    So WHAT CAN YOU DO?

    #Bethe1to  ASK

    Suicide prevention: #bethe1to be there for him.

    Start with developing a new habit, a new aspect to your interactions. Check on the people around you at work, at school, and at home. Ask questions. Inquire about their wellbeing. Show them that they matter to you. 

    “Are you Okay?”  

    Simply asking the people who are in your world if they’re okay can give you a more accurate idea about their wellbeing. Your question doesn’t need to be intrusive, but rather just a simple way of showing that you care about how they’re feeling, rather than just focusing on what they can do for you, your business, or your family. 

    “How are you feeling these days..?”

    The more you ask, the more comfortable you’ll get with asking the questions, and with the conversations that ensue. At the same time, it can set your friend at ease if you talk about your own mental health and experiences so he knows you can relate to his struggles. But avoid dominating the conversation by focusing on yourself. The goal is to get him talking.

    “You know, you have seemed kind of quiet lately, and I don’t notice you hanging out with the people you usually do. I just wondered how everything’s going for you..?”

    It’s true that much of the time, that person will say something like, “Sure, I’m great! How are you?” To which you can respond that you’re great, too, and smile and move on. But when someone is suicidal, they tend to isolate themselves… or may have been isolated from others. That aloneness leaves them without connections to others … and without feedback or support.

    The more isolated a suicidal person is, and continues to be, the more likely they may be at risk of imminent death. 

    So let them know you’re here… to listen. Resist the temptation to tell them why they shouldn’t hurt themselves…or how hurt people who love them would be.

    That isn’t productive. Ask them reasons why they want to die, and accept what they say without judgment. Then ask them reasons they might want to live. Focus on their reasons for living or dying…not your own.

    Studies show that by replacing their isolation with interaction, caring, support, and connections, you can help them move away from the risk of suicide and see value and purpose in their life again.

    Once they tell you they’ve thought about how much easier it would be if they died, you know they’re having suicidal thoughts. And you can say that the fact that they’re having these thoughts is likely an indication that something’s going on with them…

    #Bethe1to  Keep Them Safe

    Suicide prevention: #Bethe1to ask questions and listen, and show them you take them seriously to keep them safe.

    The next step is to keep them safe. If someone tells you they’ve been thinking about dying, or that their loved ones would be better off without them, they’ve admitted to you that they’re having suicidal thoughts.

    Begin your response with reassurance that they’ve taken a good step by talking about it. People can be overwhelmed by feeling vulnerable after revealing something so intensely personal. They may withdraw from fear of judgment.

    Your reassurance is invaluable at this point.

    To keep them safe, ask more questions and stay connected. Ask them if they’ve ever tried to hurt themselves, to see how concrete these thoughts are to them.  Ask them if they’ve thought about how they might do it…?  If they have a plan and if they’ve taken any steps toward that plan. It’s also important to find out if they’ve considered the timing yet… when do they plan to do this?

    While it may sound uncomfortable to talk about these details, this is where life-saving begins. Further, many people are reluctant to discuss these details because of the fear that they’re planting the idea of suicide in this person’s mind. And maybe they fear they’d feel responsible if the suffering person took action. But this is not the case. 

    Suicide Prevention: #Bethe1to Reach Out and Reverse Their Isolation

    Studies have shown that engaging this person in conversation and connecting with her about her plans, helps her air these thoughts…consider the realities and consequences. Most importantly, discussions like this promote connection, and dispel isolation. The very conversation itself establishes human connection and communicates the value of her life. Or of his life.

    In addition, the information you gather through this discussion helps you evaluate whether you need to take action. The more details they have thought through, the greater the risk and more imminent the danger they’ll complete their plan.

    Plus, if the method they plan to use is a method that’s likely to cause a final irreversible result, such as a firearm, and if they have access to that method readily available, then you may realize you need to do something to protect them.

    Perhaps drive them to the hospital, or call for help, if necessary, to protect them.

    Research has revealed that if you can put time and space between this person and his suicidal plan, he is likely to rethink the plan.

    How often have you heard, “If they’re determined to die, you can take the weapon away from them and they’ll just find something else…”  

    This is not actually true. In most cases, removing the method and keeping them safe for awhile gives them time to rethink their plan.  With support, they’re more likely to see value in their life and relationships and they tend to move away from the imminent threat.

    #Bethe1to  Be There for Them

    Suicide prevention: #Bethe1to listen, and care.

    Do the best you can to be there physically, if at all possible. At the very least, be on the phone with them. Talk with them about others in their life they trust and would like to have nearby. It’s important that you not commit to be there with them if you know you won’t follow through. Remember, protecting them from isolation is life-saving. Keep them connected to you and to others who will help them remember the good in their lives. 

    Someone with suicidal thoughts is likely isolated, and feels they don’t belong. Ask them about the people in their lives they like or trust and would like to have nearby.

    #Bethe1to  Help Them Connect

    Suicide prevention: #bethe1to listen, really listen, and show someone who feels isolated that you care.

    At this point, help them reconnect with those they’d like to have nearby. Help them connect to other resources where they can build more connections with people who understand and will listen. Online organizations or local organizations in the community will give them more to plug into. And a place to reach out.

    Ask them if they’ve considered a therapist, if they have insurance to help with that…what their feelings might be about it.

    This can give them the safety net of a place and people to turn to if there is a future crisis like this one.

    An excellent resource is to contact the Suicide Prevention Lifeline: 800-273-8255 for talking, more resources, and advice.

    There is also a MY3 app they can put on their phone for safety, crisis, and other resources. Through the app they can make connections for support, too.

    A study conducted by Gould et al. on the impact of Applied Suicide Intervention Skills Training (A.S.I.S.T.) used on the Suicide Prevention Lifeline showed that calling the Lifeline reduces the likelihood of death, and individuals were found to be less depressed, less overwhelmed, less suicidal, after talking with the trained counselors trained by Applied Suicide Intervention Skills Training.

    In other words, persons who call this crisis hotline actually feel better after the call because of the degree of insightful and targeted training the volunteers have had.

    #Bethe1to  Follow Up

    Suicide prevention; #bethe1to make them feel they belong.

    Once they’ve been released from the hospital or crisis center, give them a call, send text messages, drop them a post card – or all of the above – over time.

    This helps to remind them they’re valuable, that their life is valuable, and that they do belong. Combined with psychiatric care and community mental health support, your effort to maintain connectedness can help protect them from falling back into the “suicidal thinking” frame of mind.

    Supportive ongoing contact can help them move forward on a path toward restoration.

    When you talk with them, listen. What they say is far more important than all the things you may want to say. You’ll learn about where they are in terms of life-threatening decisions. And, since they’ve been so isolated, being heard and feeling cared about are vital tools for restoring their desire to live.

    And… don’t tell them “everything is going to be alright.” It can sound to them like you haven’t listened at all. Listen to how they’d like their life to be. Support their own view of the future. Their own reason to live. Not your own. 

    And one more thing: talking over a meal can also raise their blood sugar, and improve their mood. Deeply depressed individuals sometimes don’t eat well. The simple experience of eating nutritious food can boost their outlook in small increments, while combining the food with friendship can have a significant effect on their hope… at least temporarily.

    At Innovative Psychiatry we use innovative treatments to arrest suicidal thoughts:

    IV Ketamine Treatment Can Stop Suicidal Thinking in an Afternoon

    Suicide prevention: #bethe1to help them belong.

    Once you’ve helped your friend or loved one put some time and distance between them and their method and plan, they can consider IV ketamine treatment for suicidal thoughts. IV ketamine has proven to be remarkably effective for removing suicidal thoughts in most cases.

    That’s in addition to severe depression, bipolar depression, social anxiety, PTSD, addiction, panic disorder, and OCD. With a different mechanism used to relieve other symptoms, ketamine can erase those thoughts and images of death and suicide within just a few hours.

    By doing this, it can erase the tormenting images and thoughts, so you can feel better, sooner. And at the same time, you can turn your focus to building a better outlook to maintain remission through all of the things that help keep you well.

    IV ketamine treatment can lift the burden of suicidal thoughts and images, and can also transform your life with new initiative, motivation, fresh perspective…and hope. It can give you the energy to rebuild your relationships and your career.

    You can be free of suicidal thoughts, despair, and that awful feeling that you don’t belong or fit in.

    You can live a full and rewarding life, and IV ketamine treatment can help.

    Lori Calabrese, MD offers innovative psychiatric treatment like IV Ketamine

    To the restoration of your best self,

    Lori Calabrese, M.D.

error: Content is protected !!