Lori Calabrese, MD

Tag: IV Ketamine Treatment for PTSD

Marti’s Story: How Ketamine Smashes Treatment-Resistant Depression

Ketamine Can Eradicate Severe Depression

Do you know anyone who’s severely depressed?

I want you to meet Marti. If you’ve never experienced severe depression yourself, learning about Marti’s journey may give you a glimpse into what it’s like. And if you have…well…I hope Marti’s story helps you feel less alone…and helps you find hope for your future, too.

Marti was a sparkling preschooler, obviously intelligent, and full of charm and spunk. But the spark disappeared when she was about six years old. She was also diagnosed with Type 1 diabetes that same year…which only increased the stress in her young life.

In spite of the depression, she pushed through the best she could and performed well in school…receiving all sorts of academic awards. School was her refuge and solace. Even so, her immunity to infection was reduced by the diabetes and she seemed to get sick with every bug that floated through. That made things worse…and pushed her stress higher.

Family Crises Can Trigger Greater Severity in Symptoms

Then, when she was in 8th grade, her dad collapsed and had to go to the hospital by ambulance. Long QT syndrome they called it… basically a heart attack but he survived. However, he was in the hospital for 2 weeks…and because she was sick she couldn’t visit him. The helplessness of the diabetes, the constant double workload at school, her brothers’ illnesses, and her dad’s near death event, became the final straw.

A darkness began to build inside her beyond anything she’d known before. Her mind seemed to become numb…vacant… she seemed unable to think. Things like motivation, initiative…or even the energy to do anything… had disappeared. She felt lost, but that wasn’t all.

There were new fears. Fears of people, places, leaving the house, answering the telephone. School became an insurmountable mountain to climb. She began to hide under her bed for the school day so no one would know she didn’t go. She couldn’t go.

That was on the worst days. On the days she could muster the courage to get on the bus, she sat silently in class…looking at her desk. Holding onto her chair with all her might to keep herself from running out.

Classmates would watch her behavior and assume she was using drugs. They’d ask her…and she’d tell them no, horrified that she gave that impression.

Academics Suffer When Medications Fail

Her parents took her to regular visits with an acclaimed psychiatrist. After 18 months he was amazed she wasn’t doing any better. Concerned their intelligent and awarded student would not graduate from high school without close support, her parents took her out of school and homeschooled her during her senior year. She was able to make up the credits she’d lost and graduate, mostly due to the decreased stress of the public school atmosphere.

But…her condition worsened. She registered in a university hoping the new routine would help her improve. But it wasn’t that simple.

She had intermittent periods of working at school and making top grades, then falling back into the abyss of darkness that had become her constant prison. A good semester then a terrible semester. Finally, she was placed on academic suspension for a semester… and eventually dropped out.

Her doctor continued to increase her dosage, and change her medicines. But nothing really worked. She slogged along in the proverbial mud, losing her hope, her self respect, and adopting a new outlook that was angry, bitter, and critical… an outlook she called “realistic.”

These changes in her view of herself and others resulted in friendships with others who were also angry and despondent. The motivated and emotionally-healthy friends she’d had during her childhood and early teens all but disappeared.

Treatment-Resistant Depression Spreads DOOM

Marti wore “toughness” like an overcoat, and functioned well enough to be sullen and angry with her friends. Her social circle was a tough lot, but she tried her best to fit in with them.

Then she met “him.” He was handsome, weathered, and wore chains and black leather. Her epic bad boy.

Within 2 weeks, they’d had their first big fight.

Shattered by his dirty and cruel tactics, Marti realized she was in over her head. But she was determined to live up to the challenge. The verbal abuse and horrific scenes deteriorated to physical abuse, but just reminded her that she knew what it was to suffer. And he’d been alone without support, so she was determined to be that support and “help him heal.”

This pattern continued, with periodic breakups, apologies, and a patched-up relationship for two or three years. Marti’s depressed condition deprived her of the energy, the judgment, or the initiative to improve her situation. And she told herself magical stories about how her love and loyalty – no matter what he did – could heal his wounds…and they’d enjoy a happy life together forever.

So she trudged.

A Disordered Brain Obsesses on Death

And there were suicidal attempts. And interventions that saved her life. But if you know anything about depression, you know that suicidal thinking or attempting doesn’t stop because you want it to. Your disordered brain creates images of death and darkness…and compulsions… It’s the very opposite of a healthy, imaginative brain that creates beauty and joy.

Marti’s nightmares became a constant torment. Waking up in a cold sweat over and over in the same night, with visions of cruel and terrifying demons destroying her… and as soon as she fell asleep again they were back.

Insomnia kept her awake for 5 or 6 days at a time…she’d feel brittle, reactive, hysterical at the smallest provocation. Screaming and cursing when the dog barked or the doorbell rang. Her coordination was also brittle, so she’d accidentally break a glass or stub her toe and fly into a screaming, cursing rage.

The phobias increased. Marti loved photography and was given an all expense-paid trip to Thailand with a professional photography group who would help her learn more artistic techniques for her craft.

An Opportunity Becomes a Crisis

She’d acquired outstanding equipment for her photography business, but the depression made it nearly impossible for her to follow through on opportunities.

Meeting with clients, doing a shoot or a sitting, became too difficult to manage, as social anxiety, fear of failure, and agoraphobia stripped her of the confidence to follow through.

She boarded the plane to Thailand with her gear, and on a layover in Bangkok she suffered a gargantuan panic attack. She couldn’t think to find her luggage, her gear, or her phone. Finally, she called her family collect and asked them to help her get home. Knowing her fragile state, they readily complied.

Once home she slept for days as she recovered.

Her Own Worst Critic

Then the shame set in. How could she squander such a life-changing opportunity? How irresponsible could she be? She’d always hated herself, but now she LOATHED herself. How could she bear the disgust she felt for her inept failure?

You know, when you’re struggling, you need a best friend… and if no one else…you need to be your own best friend. But sadly, whenever life got hard, Marti would use that moment to beat herself down into a shriveled nub.

And that’s how it goes, isn’t it? When we feel awful, we tend to make it worse. And we usually need an intervention from outside ourselves to turn the disastrous tide.

A final year with “him” was packed with physical abuse and cruel unspeakable torment that resulted in injury for Marti in her spine, her pelvis, and her neck.

From Abuse of Herself to Assault by Someone Else

The stress of her life led to muscle cramping in her neck and shoulders that left her left shoulder 3 inches shorter than her right one. She was unable to move her upper body without extensive treatment.

But those wounds were just physical. It would be years before physical therapists and chiropractors could help her body recover from the damage.

Still, the worst was the emotional damage. The silent scars that held her in a vice of fear.

Chronic hospitalizations plagued her life as the multitude of terrible stressors triggered vomiting spells that lasted for days at a time. Every 5-10 minutes…around the clock.

And those vomiting spells threw her body’s pH out of whack…and triggered diabetic ketoacidosis…a potentially fatal condition that won’t correct itself without emergency medical intervention in an ICU.

Over. And over. And over.

Then, it got worse. The repeated diabetic ketoacidosis and the high blood sugars that accompanied it, caused damage to the nerves in her stomach.

Gastroparesis… a condition where the stomach’s ability to empty itself is paralyzed… led to deteriorating nutritional absorption. Basically, she was starving because her body couldn’t absorb nutrients.

Depression Can Kill and Must Be Stopped

It all began with depression. But depression is just the beginning… and when it’s severe, it can trigger a cascade of circumstances that can suffocate life.

One day late in the summer, on one of many days when “he” tried to kill her, she grabbed her shoes and keys and fled.

And she never went back.

In the aftermath of that day, she spent more and more time in the hospital intensive care unit. A year and a half later, she was transported to the ICU so often, she was in the hospital more than she was home. A lot more. And she knew she was dying…

She also knew she was losing her ability to see. What began as foggy-out-of-focus moments in the early fall, progressed to full blindness by Christmas.

A retina specialist was called in and she went for surgery the day she got out of the hospital. Within two days she was back in ICU…but the surgery had succeeded in repairing the retina in her right eye. Her left eye was not reparable. But it was a start.

Then, her doctors recommended she undergo surgery for a feeding tube placement in her intestine, and formula was pumped into her body through that tube 24/7. After another week in the hospital, she was beginning to improve. The vomiting stopped. And she began to feel a little stronger.

A Mysterious Joy Begins to Bubble Up

But there was something else. She was feeling better. In barely perceptible ways at first. But little by little, joy was growing. In spite of her intestinal feeding tube. In spite of her blindness. She had hope. And she didn’t know why.

She would wake in the morning, remember she was blind…and cry. She grieved the loss of her eyesight. And facing that each day was so difficult.

But then she would launch into the day with a spring in her step. Initiative to move past this disability and build a new life. She had not had initiative since she was in 8th grade. She’d not felt joy since she was in kindergarten. What was causing this?

Ketamine Smashes Treatment-Resistant Depression

She heard about ketamine treatment… and someone suggested she check her surgery record to see what anesthesia she’d been given in surgery… so she did.

When the surgery record arrived in the mail 10 days later, she was astounded to find out she’d been given ketamine as an anesthesia in surgery. Could that be why she was feeling so much better??

Marti danced across the room just to consider that ketamine might be the reason she was coping so much better, and enjoying so much again. She set out to learn all she could.

That first IV ketamine infusion in surgery restored her wellbeing for 7 months. Then she began to feel the old depression returning, the critical thoughts, the anger, the hopelessness…but for the first time since she was a little girl…she didn’t want to die anymore.

6 IV Ketamine Infusions + A Couple Booster Infusions

So she set out to find a way to pay for a series of 6 infusions, as she’d learned that stacking infusions would produce more lasting results.

Within a couple weeks, her parents were able to help her with the money for a treatment of 6 infusions over 2 weeks. She’d heard that ketamine was available IV, IM, or intranasally...but she’d been convinced that IV was the best route for ketamine’s full benefits.

After the first infusion she felt no better…but that night her mother noticed she was folding clothes…for the first time in four years. Initiative.

Then, after the second infusion she thought she had a glimmer of hope. A lifting of pressure…of the weight that had been crushing her. Decreasing anxiety and diminishing sadness…she could tell she felt a bit lighter.

After the third infusion, she laughed a little, and talked a bit more freely… And from there her outlook grew better and brighter day by day through the last 3 infusions and over the next few weeks.

A few months later she’d been hospitalized more times (and with the intense stress of severe illness) she started “sinking” again…and called her doctor for a booster infusion of ketamine. She’d heard that sometimes that’s necessary. And she was glad she got it… it helped.

But four months later she needed yet another. Even so, that infusion of IV ketamine has held her remission steady for a long time.

She’s learning Braille, training to work, and excited about the life that’s ahead. She’s 32, in love with a wonderful guy who stood by her through the illnesses and surgeries, and life is working for her now on an exciting new level.

Marti believes in herself now and in her potential. And she’s eager to contribute to the lives of others. She’s joined the board of a non-profit blindness advocacy group. She has new friends who also have bright outlooks on life. Who are also productive and contribute to the community and to each other.

By the way, remember those terrifying nightmares that plagued her? They’re gone. Her dreams are bright and beautiful now…or at worst a little frustrating. The terrors that beat her up through all her nights for so many years are gone.

It All Began With Depression

And a co-existing illness. But treating the illness didn’t resolve the depression. Ketamine treatment did.

Marti feels transformed. Her family says she’s finally the person she was when she was 3 years old, before the assault of life hit. Her cleverness, wit, spunk, and joy for life has returned.

Marti is one of those people for whom the 6-infusion ketamine protocol wasn’t enough. She had researched extensively to understand how ketamine treatment ought to work and what to watch for. She also understood that to stay better required building a stronger infrastructure that would support her remission from depression.

And she actively worked to put that in place, through friendships, attitudes, and improved health. Active cooperation with her team of doctors, and doing the work in her outlook about her career and her relationships all helped strengthen that infrastructure.

And today, she’s in full remission. She sings every morning, dances a jig of her own design when she thinks no one is looking. Her life is full of promise.

She’s attracted to upbeat, healthy-minded people, and she loves herself. She enjoys life in a way she’s never been able to, and marvels at the frame of mind that held her captive 25 years.

Severe Depression Affects Every Aspect of Life

For those who have never experienced major depressive disorder in its severity, the fallout in Marti’s life may seem outlandish.

But Marti’s story demonstrates how all-encompassing and dangerous depression can be.

And why ketamine treatment is the golden child in psychiatric treatment these days. There’s no other treatment available that is as effective, potent, and all-encompassing for restoring life, hope, motivation, initiative, and a bright outlook to this degree.

At Innovative Psychiatry we’ve watched thousands of patients with treatment-resistant disorders follow the path Marti has in full remission.

Relief from social anxiety, depression, panic disorder, PTSD, OCD, bipolar disorder, addiction, substance use disorder, and suicidal thinking.

(Did I mention ketamine can stop suicidal thinking in 4 hours or less?)

If you suffer from severe depression that other treatments haven’t helped, call us. We can help you rediscover the life you’ve lost, just like Marti did. You, too, can enjoy remission from the crippling throes of mood disorders.

Give yourself the opportunity to live again, or even for the first time, and develop a fulfilling and productive life. Because you can.

To the restoration of your best self,

Lori Calabrese, MD

August 27, 2018
Rapid-Acting Antidepressants Help You Get Better FAST
Smash Treatment-Resistant Mood Disorders with Rapid-Acting Antidepressants: Like Ketamine Treatment

We’ve talked before about the line to the throne where ketamine treatment now reigns. Formulators in a lab were seeking to create a new anesthesia, and they thought they’d found one. They called it Sernyl—but the unpredictable side effects, hallucinations, and sometimes violent behavior, drove the pharmaceutical company to take it off the shelves.

It was not the kind of medicine doctors wanted to give their patients. Through a series of leaks and improprieties however, it began to drift onto the streets as an illegal substance. The drug was phencyclidine, or PCP. Remember during the ’70’s and ’80’s? If so, you know the havoc that PCP – or angel dust – wreaked on the street crowd.

Rapid-acting Antidepressants

But those researchers weren’t willing to give up. They kept working and developed another safer anesthesia that had some of the dissociative properties Sernyl had, but less in side effects when used at therapeutic doses.

They coined it a “dissociative anesthesia” and it became internationally popular in the surgical suite, in the emergency department, and in war zones around the world.

That medicine was ketamine hydrochloride. And testing for treating depression began forty years after ketamine was developed and widely used as an anesthetic.

And we’re now seeing outstanding results, as in remission of depression and other mood disorders, in both research studies and the clinical setting.

So it’s not surprising, is it? That ketamine treatment has become the role model for emerging new medicines that treat mood disorders.

Still, knowing what ketamine treatment can do for major depression, postpartum depression, social anxiety, bipolar disorder, PTSD, OCD, and suicidal thinking isn’t enough for neuroscience researchers.

They want more.

If ketamine does great work treating patients with treatment-resistant mood disorders, there must be more medicines that will also work as well.

Or so they hope..?

Antidepressants that Work as Well as Ketamine Treatment

So the search is on to find other rapid-acting antidepressants that eradicate major depression, PTSD, bipolar disorder, OCD, social anxiety… and stop suicidal thinking in four hours…or less, like ketamine treatment does.

It’s a tall order, but it’s the quest of the hour.

Conventional antidepressants improve symptoms by increasing levels of neurotransmitters like serotonin and norepinephrine.

But it takes 9-12 weeks or more for someone to experience that improvement. So the loud and strong need for rapid-acting antidepressants shouts its demand for these solutions.

Why? Because when patients with severe disorders are inundated with thoughts of suicide, if those thoughts can’t be eradicated quickly, the risk of death is high.

In addition, lost work time as well as abandonment of the medication regimen, is more likely to happen. In short? Patient safety is compromised.

Seeking Ketamine Wannabes

So, there’s a strong focus on compounds that CAN bring fast relief. They include ketamine, scopolamine, and “mechanistically-related” compounds. We’ll get to those in another blog post.

But researchers added some newer ones to this list in the surge to find more rapid-acting medicines.

Compounds like:
- Antagonists of metabotropic (mGlu) 2/3 receptors
- Negative allosteric modulators of α5-containing GABA A receptors
- Psychedelic compounds like psilocybin
I know…I know… sounds like Greek.

How about this?

These compounds need to demonstrate their effectiveness in large groups of people. Most importantly, when medications fail to help people get better, these compounds need prove they can be effective.

And…as always…the biggest challenge is finding ways to make the positive effects last.

Rapid-Acting Antidepressants Help You Get Better Fast

Since the use of ketamine for depression began, the path of discovery started when ketamine first caused remarkable relief for depressed patients, but that relief didn’t last more than a few days or a week.

Researchers tested a variety of methods, and discovered an effective regimen was 6 ketamine infusions given every few days over 2 weeks.

By doing this, it seemed to bypass the short term beneficial effects and instead prolong them. As we’ve moved forward in clinical practice, we’ve found that increasing the number of infusions in some cases can ensure remission. That is, if the initial six fell short of that goal. And we’ve worked with different infusion protocols over 2-3 weeks.

Like all aspects of psychiatry, personalizing the treatment to fit the patient’s needs yields the most effective outcomes.

Review of Literature Clarifies the Search

A brand new review was published in Current Pharmaceutical Design July 29 focused on these specific compounds and their potential. The team, led by Jeffrey M. Witkin, reviewed the current literature on compounds that produce immediate symptom relief.

They determined that a foremost system for producing rapid effects is by amplifying excitatory neurotransmission (by glutamate) while activating AMPA receptors.

These drugs cause glutamate to flow out of the cells which provide what researchers hypothesize is a triggering mechanism to increase the amplitude of AMPA receptors.

They concluded that the focus in pharmaceuticals these days is rapid-acting antidepressant compounds like ketamine, scopolamine, and psilocybin. All of these need extensive study. And they pointed out that two medicines, rapastinel and esketamine are in the last stages of FDA trials.

So let’s look again at the up and coming compounds and medicines in the running to potentially supply the benefits that ketamine is now providing:
- Ketamine — still at the top
- Esketamine (developed by Jansen, a division of Johnson & Johnson)
- Rapastinel (developed by Allergan)
It’s probably fair to say that in the next few years we’ll be bombarded with many new medicines that operate quickly to treat mood disorders. But that’s the way of progress.

Even though esketamine is only half the ketamine molecule — with its own challenges and problems — it’s generating anticipation despite the problems that can come with an intranasal medication.

Keep in mind that FDA approval doesn’t guarantee a medicine is superior to others. But it’s a sign we’re in a new era of better, faster, and more effective medicines for psychiatric disorders.

Ketamine still reigns supreme. And physicians will likely need to combine esketamine with traditional antidepressants and mood stabilizers. Even so, mood disorder treatment is better than it used to be. Remember before ketamine treatment?

Back then, it was necessary to wait for weeks or months to enjoy the benefit of a medicine.

Times are changing and suffering is declining.

At Innovative Psychiatry, we’re celebrating the onward development of pharmaceutical progress, while also providing the outstanding benefits that ketamine can offer to our patients with treatment-resistant illnesses.

Our specialty is treating disorders that haven’t gotten better with other treatments. We’re here because we want to help you experience life like you were meant to live it.

To the restoration of your best self,

Lori Calabrese, MD
August 13, 2018
True Recovery From Trauma and How to Find Restoration

Trauma: Don’t Beat Yourself Up – Allow Your Loved Ones to Lift You UP

Have you been through something traumatic …? Maybe you’re a combat veteran, a first responder, or a victim of severe domestic abuse. It might have been a car wreck, or the unexpected sudden loss of someone you love. Fixed beliefs you form about that traumatic experience can insulate you from working through the scars you feel. If you tell yourself you “shouldn’t” be reacting to the incident, it keeps sitting deep inside you…haunting…but not healing.

Truth be told, you were traumatized. By rape. Infidelity. Fire. Hurricane.

What matters is that it traumatized you.

No one but you knows what has shaken you to your core. And continues to keep you shaken. But no one needs to. This was your experience. And YOU need to heal.

People are individuals and don’t react the same to the same stimulus. One combat veteran finishes his tour and goes back home, gets a job, and proceeds to build his “after-combat life.”

It’s not that he’s not shaken. But his reaction to all that happened may not have shattered him like the next guy. People go through divorce. One ex-wife gets thoroughly angry and surges forward like a steam engine to overcome the heartbreak she feels about her husband’s infidelity. But another one may be so shattered, so disillusioned she can’t work, can’t function, and trembles or vomits when she sees her errant ex-husband or drives by their favorite restaurant.

Sometimes It’s Appropriate to Let Yourself Feel Loss

But then, there’s another reaction. This is you if you’re the abandoned spouse who’s so empathic toward others and their pain that when you’re in pain you just try to ignore your sorrow when you see others who seem to be suffering more.

Sadly, you validate the pain and sorrow of others, and dismiss your own. The result is that you can’t validate your own grief like you would for someone else to help them heal. Sound familiar…?

Hey, Loss is Traumatic: It’s Not a Competition

If a woman loses her husband in a car wreck, and watched him die, she has reason to be heartbroken and deeply shaken. The fact that another woman lost her infant child in a sweeping illness does not trump the widow’s pain.

Both woman have lost a treasured loved one through horrifying circumstances. Both women felt helpless. There is no measuring stick to compare the loss of a husband with loss of a child. Both losses are terrible, and life-altering. In both cases, the women hurt terribly. Both were traumatic.

And both women need support, kindness, a listening ear, and patience. Both may certainly need counseling at some point to help them restore their desire to live and go forward. They’re not in any sort of contest with each other.

In fact, they’re each faced with shock and grief. And people do have to find their way through these very difficult times of life. Often they come through such times as a natural process. Other times it requires treatment.

But either way, the loss is devastating. And each person who suffers terrible loss is justified to feel traumatized…to grieve. To be supported. And to recover.

Let’s look at another perspective.

When a Traumatized Person Who’s Evaluated For PTSD, Is Not Given that Diagnosis…

Does it mean he or she wasn’t traumatized…? Or that the shock or pain of it wasn’t that serious?

NO.

There are certain criteria required for a PTSD diagnosis. Every person is different and responds to painful or traumatic experiences individually. Your pain, loss, grief, and trauma are real and valid.

Don’t let a label or diagnosis invalidate what you’re going through.

Some people, after a deeply traumatic experience, are actually diagnosed with PTSD. Most aren’t. What’s more, there can be other diagnoses after you endure something like this. If it’s not PTSD, it may be depression, or it might be panic disorder, or substance abuse, or an eating disorder.

Or…it might be that you’re sorting through all the complicated effects of grief, shock, and pain that can accompany a traumatic event or experience. To achieve true recovery from trauma requires that you be honest with yourself, as well as patient.

Let’s set labels aside.

If you’re suffering, that’s all anyone needs to know. And your suffering is valid. As time goes by, after a few years, if you’re still suffering the same symptoms you suffered immediately after the event…or even during the event …. then it might be time to see a psychiatrist to find out how to help you move forward.

Because a life-altering event isn’t something you just get over. It’s a part of who you become…every major life event is. But if the way you feel about it is preventing you from living your life and productively contributing to your job or hobbies you enjoy, it may be that an intervention can help you get your life back.

True Recovery From Trauma

Mental and emotional health isn’t defined by a lack of difficulty or upheaval, but by the skills you learn as you live to cope and recover from those challenges and difficulties that happen.

Resilience … takes time to develop.

And…even if your ability to cope needs a little nudge or a leg-up, you’re still learning and building your life skills. And you’ll continue.

The Secret of the Phoenix

There will be fires and wars in life. Betrayals and shocks. But if your goal is to learn to rise from the ashes, you’ll likely gain strength and resilience through the processes you endure, and the storms you weather.

Even so, if you find that the results of trauma in your life have interfered dramatically in your ability to move forward — whether you have PTSD, general anxiety disorder, panic disorder, severe depression, bipolar disorder, substance use disorder, and especially if you have suicidal thoughts — call us.

At Innovative Psychiatry we specialize in helping people who haven’t gotten better with other treatments.

And the most powerful tool we’ve found among the novel, advanced treatments we offer is ketamine treatment. Sometimes in the process of grief, or in processing trauma, you can get sort of stuck, unable to progress forward into a healthier place. Ketamine treatment has proven over 50 years its safety with adults and children.

The extraordinary actions of ketamine treatment can rebuild the structures in your brain that stress and trauma break down. It’s like it restores your tool box so you can rebuild your life. And it can be a huge help in your true recovery from trauma.

Learn about how to choose the best ketamine clinic, or best psychiatrist who offers ketamine treatment, and be your own best advocate. You deserve to live well and enjoy a restored life.

To the restoration of your best self,

Lori Calabrese, MD

July 30, 2018
Ketamine Boost Infusions: When You Feel Better-ish, But Not Better Enough

Ketamine Boost Infusions Combined with Infrastructure Changes May Help You Sustain Remission

What do you do when the symptoms return?

You spent years in that condition. The sadness, the hopelessness…the numbness. That terrible shame. Unable to participate. Shut down. Withdrawn.

Or, maybe the symptoms were reactions to sudden noises…smells…darkness… or touch.

They may even have been obsessive thoughts…and compulsive actions that follow.

Or the old dreaded cravings…and relapse close behind.

You even wondered if you could go on much longer.

Then, you heard about ketamine treatment, and you found a way to pay for the treatment series of 6+ infusions. Afterwards, you came alive and felt so much better.

For once, you had hope, motivation, initiative. There was energy to live, invest your effort, build healthy relationships. You enjoyed your job and began to really excel. You actually felt happy. It was exhilarating to not just barely hang on.

Then it happened. …out of nowhere…those old symptoms began to return.

Maybe your job performance led to more responsibility. And the higher level of stress began wearing down your synapses…those connections between the cells in your brain. It’s possible that after awhile those cells in your lateral habenula began bursting too much and too often.

Plus all those G proteins that had slid off the lipid rafts in your cell membranes may have started piling back up on those rafts. The numbness that had gone away, came back.

Why?

Could it be because your wife’s cousin is living with you, taking advantage of your hospitality, rather than trying to find a job or her own place. And you keep stuffing your feelings…you don’t want to upset your wife.

Or maybe your boss takes credit for every innovation your create. But you? You keep working long hours and your husband is fed up that you’re never home.

Stress.

You’re so mad at yourself for not accomplishing more, so you carry your feelings on your sleeve, and jump down the throat of anyone who crosses you. You KNOW they don’t deserve this treatment…but you’re too ashamed to apologize.

Or, perhaps you got a little cocky with your sobriety, and began hanging out with friends who still use the substances you’ve broken away from… ? Any type of hard and stressful situation can make you think back to the old days…

It also might even be that this disorder is in your genes…that your whole family fights depression and it’s like a heavy gray blanket covering everyone around you. It could be to get better you might have to purposefully surround yourself with more positive, uplifting people …?

Or separate yourself from obligatory situations…

Sometimes we can’t see the nose on our proverbial face. We need someone to point it out and help us see specifics like these in our own complicated lives.

And we need to take action.

Tell your spouse what you really feel. Stand up to your boss even at the risk of getting fired. Because your self respect is too important to just silently bow to his abuse and dismissal of your value. That might reduce your stress.

Sometimes it doesn’t take much…just a step… to stand for what’s right. But when you do, the chains fall off.

And your own personal infrastructure – the things that make your life yours – is freed up to support your well-being.

So back to the causes. All of the mechanisms associated with stress can go into play, and undo some of the work the ketamine treatment had accomplished.

This is why it’s important to find ways to improve the “infrastructure” in your life, to reduce stressors that wear down your resilience.

Without making healthy changes in the areas most critical to your wellbeing, the same stressors that caused you to need ketamine treatment in the first place may cause you to need it again.

But…let’s be clear: there are no published studies about “booster” infusions

Can you believe that?

None.

But in all fairness, it can take years to gather data on recurrence of symptoms and how to best treat them.

Still. We need research!

Meanwhile, what do we do? The best we know to do is to use our clinical judgment if symptoms try to creep back in. We collaborate with you, and your treatment team, about the best way to proceed.

Lifestyle changes? Any improvement in the stressors in your life that you can make…well, that can be a big help.

A medication change perhaps? Some people continue their medications while receiving ketamine infusions. A change in medication might help…

Or is an additional ketamine boost infusion what’s called for? Perhaps so. If nothing has ever worked for you before to control your symptoms, you may know that ketamine infusions are your “go-to” solution.

Those of us in clinical practice have learned that additional infusions down the road can help refresh the work ketamine began.

Many patients…and their doctors…take a shortcut straight to ketamine because of their experience that it worked so beautifully after all those failed rounds of antidepressants and other treatments.

But we still don’t have research to show us in those cases how often we should prescribe a booster infusion or whether maintenance is inevitable for the foreseeable future.

My experience says that ongoing maintenance doses really aren’t required in many, if not most, cases. There is no research to guide us at this point. I do wonder why? …and hope that changes soon.

For now, I think it’s premature to make a blanket recommendation for ongoing maintenance “booster” infusions every few months indefinitely.

There are too many cases of patients who only need one or two or three after the initial series… then no more for a year or more. Psychiatrists need to work with their patients and the health care team to guide the best recourse for each individual patient.

But remission is the goal. Helping you feel truly good and able to live productively.

One or two ketamine boost infusions at a time can support and sustain remission. Especially if the patient’s infrastructure is in place and strong.

So…maybe you still feel better than you did before you knew about ketamine…but you don’t feel as good as you did a few weeks ago.

What do you do?

When you feel better, but not better enough, you may need a ketamine boost infusion to get your brain working well again and get you back on track.

Kick It Up a Notch!

Every brain is different, just as every person is different. Dosage and frequency can vary.

Another point… for the purpose of rebuilding and strengthening your personal “infrastructure,” you might benefit from therapy with a skilled therapist after each of your ketamine infusions.

This is when the neuroplasticity in your brain is very high, and it’s easiest to consider new ways of thinking, of reacting, of decisions…that make your life more functional, less stressful, and more rewarding.

Some people don’t need additional infusions at all. When you feel better, really so much better you’re empowered to build the life you want, there’s no need for boosters. And there’s no need to schedule them in advance.

But when you feel better but not better enough, you need to take action and find ways to get completely better. Start with another ketamine infusion. And take an inventory of your daily life. What do you need to change to make it better?

It might be taking action to change something. Or it might be taking action to change your attitude about something. But use those extra ketamine infusions to explore your life, your heart, your attitudes. And with the help of your therapist, make some solid decisions that renew hope in your life.

Renew your wellbeing.

Slash that powerless feeling and remove it…put yourself back in control.

It may require additional infusions every few months for awhile to get your life on track, your infrastructure in line with your purpose, and to create a life you enjoy. But it’s worth the effort.

And by the way, there’s no shame in additional ketamine boost infusions. No one but you knows what’s working for you. This is not a competition.

The goal is for you to live life as your best self, rather than a shadow of that. That you can enjoy your work, your hobbies, your relationships, and your purpose.

At Innovative Psychiatry we work closely with you and your health care team to help you find the most productive and fulfilled you. Call us.

To the emerging of your very best self,

Lori Calabrese, M.D.

June 25, 2018
Remission by Ketamine Treatment: How You Can Hold On to the Benefits

IV Ketamine is a Most Extraordinary Medicine

Here Are Some Ways to Hold On to Its Benefits

This ONE medicine can relieve a wide array of psychiatric disorders. Remission by ketamine treatment is at center stage of the mental health world.

The same medicine that lifts depression and restores creativity, initiative, and hope, also stops suicidal thinking in 4 hours or less and relieves social anxiety.. and, oh yes, OCD. It restores balance in bipolar disorder, and dramatically reduces cravings in substance use disorders…it helps PTSD heal and may also prevent PTSD in first responders.

Ketamine isn’t just an anesthesia medicine any more.

It’s changing lives and taking the world by storm.

It can restore your power to enjoy the beauty of a yellow warbler as it sings among the cherry blossoms. Remember when you felt nothing…? A void. Empty. Isolated. But remission with ketamine treatment changes everything.

You’ve never seen a medicine like this. While pharmaceutical companies are testing other forms of the ketamine molecule, or other molecules similar to ketamine, there is so much more to be learned about ketamine itself!

These other molecules don’t rival ketamine in effectiveness — well, actually, nobody’s doing head to head comparisons.

Because ketamine itself has become the gold standard. Its broad reach and widespread actions relieve suffering in so many different disorders that for so many it has become hope in a jar.

Who could have ever dreamed the day would come when a few infusions could lift a new mother right out of postpartum depression and empower her to bond and enjoy her newborn…? Those heartbreaking stories you hear in the news … can be averted.

Think what ketamine could have done for Vincent Van Gogh if ketamine treatment had been available in his world. Of course, it was unheard of, but it could have saved not only his ear…but his life.

Because it’s saving lives.

Remission by Ketamine Treatment: Antidote for Psychiatric Misery

The terrible anguish that depressed persons suffer has an antidote now. Six treatments (or a couple more) and you can live again, create again, enjoy people again, come out of the terror of darkness again.

You can feel love, hope, initiative, motivation, and creativity. In the morning, you can spring out of bed, and sustain energy and productivity all through the day. Enjoy the taste of a flavorful tomato right off the vine. Tackle long forgotten projects again, complete them, and look at your work with deep satisfaction.

You no longer have to be trapped in a vacuum, unable to connect, lost in the shadows of your mind. You don’t have to fear your own reactions to unexpected noises, or insensitive comments someone drops in your presence.

Feel whole again, find out you can have self-control, and build a life you’re proud of. For many who suffer with depression anxiety that just won’t cut them a break, such a concept is an elusive dream.

But it’s time for us to take a step further, and learn more.

For instance, what factors influence how effective ketamine treatment is for you?

Infrastructure for Optimal Wellbeing

Without question, one factor is simply all those unknowns. Because we’re learning daily about what ketamine can do, as well as the unique genetic, environmental, and other factors that may prevent one brain from responding to ketamine when the next one responds so dramatically. There are factors we just don’t know or understand yet.

We have so much to investigate and learn.

But there are some factors we do recognize.

For instance, it appears that there are environmental factors and personal ones, too, that may determine how long a series of ketamine infusions will benefit you.

Remission is Most Enduring when Your Personal Infrastructure Is in Place

When we speak of infrastructure, we’re referring to all the things in your life that play a part in your outlook and productivity. Things like your attitude, your response to stress or conflict, your nutrition.

To get the most out of ketamine treatment, it helps to do the work to learn and practice healthier reactions and responses, so you don’t pull the same old problems in after you.

It helps if you’ve learned to practice self-love along with respect for others. To manage your anger, and avoid the pitfalls of co-dependency. It helps to feed your microbiome to help maintain your emotional balance.

Because even if ketamine’s wonderful repair work brings you to peace, if you haven’t done repair work in your thinking, your attitude, your outlook, your view of yourself…as well as your view of others… the destructive habits that may have crept in with the misery of your disorder in the first place will slowly tear down the work your ketamine treatment accomplished in your brain.

Not what you want.

You could, then, get a booster infusion to refresh the good repair.

On the other hand, if you’re actively participating in therapy to help you change your attitude and outlook, as well as your responses to the things that happen in your life, you may find your outlook stabilizes after you reach remission… and lasts.

This, of course, is not to say that if remission doesn’t last, it’s your fault. It’s not. There are far too many factors involved in what you’ve experienced to blame your symptoms on any one thing, especially something within your control.

But consider this.

Choices You Make Can Strengthen Remission

If a stressful life has found you reacting and angry in response to small frustrations, or if you’ve been in a toxic relationship where you know you’re being abused and exploited, and stressors like these aren’t changed, you can see why you’d become more and more worn down and stressed…even despondent…all over again.

But let’s say you found the courage to leave that destructive relationship…or you figured out how to change the way you perceive small frustrations so you’re able to be unruffled by them (and ketamine can help you accomplish these things)…you can see how the peace and emotional health in your life would benefit. Don’t you think..?

That’s the thing about ketamine. It can do its part to restore those brain structures that have been worn down and broken by stress, but it can’t force you to get some distance from those factors.

That’s a step you must take … and ketamine treatment can help you get there.

Hard Decisions Lead to Better Living

Here at Innovative Psychiatry we’ve seen this happen in our patients time and again. Sometimes, a patient reaches remission and has a new lease on life. But in a month or two she’s so disappointed because she thinks the ketamine treatment has “worn off.”

However, rather than the treatment wearing off, it’s far more likely that new damage is happening because of her unchanged thinking or environment. When our patient understood the impact of those things, and she entered counseling, her need for booster or refresher infusions seemed to disappear. We have seen this process in many patients.

Many patients have been able to enjoy remission for over 2 years once they learned to make healthy changes in their lives.

There really are things you can do – with ketamine’s help – to maintain the joy of remission by ketamine treatment.

Medical Skill with Ketamine Treatment Can Turn B- Results to A+ Results

Another important factor in achieving and maintaining remission seems to unmistakably be tied to the methods used in administering this medicine. The outstanding and life-saving benefits of ketamine treatment have changed the way the world views depression, social anxiety, bipolar disorder, PTSD, OCD, substance abuse disorders, eating disorders…and suicidal thinking.

But, to get the most out of your ketamine infusion, in addition to building your infrastructure, you need to choose a psychiatrist who is most skilled in administering ketamine to your best advantage.

We use precision infusion pumps, state-of-the-art monitoring equipment, and we’re adept at titrating dose, rate, and frequency to achieve optimal outcomes.

Our goal for you is remission of your symptoms with ketamine treatment.

There’s no question that ketamine treatment can renew your hope if you or your loved one suffers with stubborn symptoms.

Know that you can feel better, live better, and restore what your symptoms have taken from you. You can find your real and best self, and enjoy the world you’re in.

If you suffer from symptoms that medicines and treatments haven’t helped, call us. We can help you turn your emotional and mental chaos into order through ketamine treatment. You can enjoy new hope and purpose for your life.

To the realization of your best self,

Lori Calabrese, MD

June 18, 2018
Post-Traumatic Stress Disorder (PTSD) Can Strike Anyone – A College Kid’s Story

Twenty One Years Old. Enjoying campus life with her friends. Working toward her degree …and her dreams…

Then, a soreness in her mouth… and a trip to the doctor.

CANCER.

“Squamous cell carcinoma of the tongue,” the doctor said.

What??!!?

She’d never heard of such a thing. What could have caused this? How did it happen? Where did it come from…??

When you’re young, with all your hopes and dreams ahead of you, you don’t have the life experience to cope with such a devastating blow. So it’s not really about coping…it’s about taking action.

Fight now.

…process later.

The oncologist promised Nicole, a beautiful, intelligent college student, a full recovery but she would have to endure a horrifically aggressive treatment. There was nothing to do but just close her eyes and dive in.

For starters, she did some quick research. First step was a shocking surgery…removal of 75% of her tongue. Traumatic experience for anyone… But for a college kid? How could she ever feel normal again…?

She also learned that to truly eradicate this invader, she needed to add chemo to the radiation treatment. She wasn’t taking any chances.

Only two weeks to recover from a disfiguring surgery, then radiation and chemotherapy had to begin. A move with her mom into the Ronald McDonald House to be close to treatments, and another surgery to insert a feeding tube into her stomach. Terrible pain like she’d never known.

But it had to be done. The radiation treatments would destroy her ability to swallow, so they had to prepare for nutritional formula to feed her through the treatment process ahead. The pain was excruciating. But then chemo began.

Within 3 weeks, Nicole had lost her ability to swallow, and was hospitalized. She’d lost 35 lbs. of her 130 lb. frame. From the beginning, she had researched to understand the most thorough way to fight this rare cancer, in hopes that she could endure treatments and eventually be completely DONE with it all.

She kept her eye focused on the goal: to SURVIVE…and to get back to normal…and to her life.

After Traumatic Cancer Treatment You Can’t Go Back – Only Forward

When the treatment was finally completed, she was discharged and she moved home again. A 6-hour drive to get home, then a party with her friends that night to celebrate her return to her life.

Finally…it was OVER!!!

…or was it..??

Sometimes, you can be so strong and face the most terrible experiences, the worst life-threatening trauma, and pat yourself on the back for all you’ve endured. But then, out of nowhere, about the time you think you can relax and get back to your life, the other shoe drops.

Not with a thud…but with a crashing, devastating explosion…and ripples that affect every aspect of your life.

Severe Insomnia Sets the Stage for Worse Things to Come

First, came the insomnia. We’ve all heard about insomnia…when someone has trouble sleeping. But, have you ever gone for 5 or 6 days without sleep…? I mean NO SLEEP for day after day and night after night? Unless you’ve experienced this yourself, you can’t imagine what happens in your brain under this type of duress.

It’s used for torture in some third world prisons.

Then, let’s say you finally fall into a sleep but only sleep a couple hours…then it starts again. Day after day after day. You feel like you’ll go off the deep end.

The relentless stress builds and builds.

Tears Give Way to an Eating Disorder

One day, Nicole and her mom went to the mall to buy some clothes for Spring. They were excited about doing something fun and sort of “normal” again. But, when Nicole stepped out of the car, she broke into tears…and tears gave way to sobs. Hard sobbing without relief… She couldn’t breathe. She couldn’t move.

All she could do was sob and sob, wondering even at the time what was happening to her. Eventually, her mom called her dad to come get them and take them home.

That day marked the beginning of 11 years of flashbacks, extreme reactions, embarrassing meltdowns, and crippled emotions. She thought the nightmare was over when she finished her treatments, but a new nightmare was just beginning…

Nicole started back to school in the fall, and everywhere she went people told her how great she looked. (She knew she didn’t look great. She was “scary” skinny…) But more and more she heard it all the time.

Were they just glad to see her back in school…? Or did they really think she looked better than she used to…? She decided to stay ultra thin, to make sure she kept looking “great.”

Before long, she was sneaking out of the house early in the morning to go to the gym, counting calories, and weighing four times a day. After feeling so profoundly out of control with the cancer, she’d found something she could control. And…she liked it.

Working out daily, walking when driving would be more convenient, cutting calories… and hardly sleeping. All of which continued until she graduated with her degree.

Happily, her boyfriend proposed the day of her graduation, and they moved from Pennsylvania to Virginia. She’d been given a clean bill of health by her doctor… she was cancer-free. It seemed everything was going to be ok.

Post-Traumatic Stress Disorder (PTSD) Persists

But it turned out that the cancer was the easier foe to conquer. The fallout afterwards, which in time she was told was PTSD, was a much harder beast to vanquish.

A victim in a hospital scene on TV, the smell of an alcohol swab, or the mention of x-rays or medical procedures would make her freeze. Unable to breathe, choking in terrible panic, screaming for help, time and again… she felt like she was dying.

Her husband urged and even begged her to get help, but she refused. Going to the doctor — any doctor — might start the attacks. If she needed a chest x-ray, she just knew they’d find cancer. If her child needed to see the doctor, it was terrifying for her. Any buzzing noise took her back to that radiation machine years before. A routine scab on her husband’s ear, a swollen lymph node in her daughter’s throat, a sore finger…anything…. would trigger the panic attacks and the fear that she or her loved ones would have cancer and die.

Over the years, she and her husband brought 4 beautiful little girls into the world, two of which were twins. But the routine joys of pediatrician visits as children grow became the war zone for her flashbacks and terrors…

Until she sought treatment… and her life finally began to change.

But let’s get back to that in a bit. First, what is PTSD, and what can you do about it..?

What is Post-Traumatic Stress Disorder (PTSD)?

PTSD sometimes follows a traumatic or life-threatening event, with symptoms typically appearing in the first 3 months after it happened. However, in some cases symptoms may not show up for much longer…even years.

Your symptoms may be repeated, involuntary memories, flashbacks of the event that seem as real as the original incident did, efforts to avoid being reminded of the trauma, feeling detached or estranged from others, in addition to angry outbursts, irritability, and ongoing fear, terror, and shame. You can also become emotionally numb.

In Nicole’s case, she was able to finish her Bachelor’s degree, work at her job, and parent her little girls. But, functioning was really tough for her. In your case, you might be unable to function much at all.

For some people, the symptoms can subside over time, but in others, they can go on for years, or even a lifetime without treatment. The severe distress that’s caused by the horrific trauma may need psychiatric treatment.

Sometimes medicine and therapy help. But for some, it just doesn’t.

Nicole is doing better and better now. In hindsight, she wishes she had sought help sooner. She wishes anyone with these symptoms would go for help as quickly as they can.

But, since the treatment she needed required that she see a psychiatrist, and the thought of seeing a doctor triggered more panic attacks, it was really tough to cross that threshold.

At Innovative Psychiatry, Ketamine Treatment Gives Hope

At Innovative Psychiatry, we specialize in treatment-resistant psychiatric disorders. That means we specialize in helping people get better who didn’t get better with other medicines and treatments before.

We’ve had extraordinary results treating these special patients with ketamine treatment. Ketamine treatment has a way of rebuilding signaling systems in the brain that have been broken down by stress, anxiety, and depression.

When administered expertly, ketamine is even more effective than many people realize in treating depression, anxiety, PTSD, OCD, social anxiety, panic disorder, eating disorders, and suicidal thinking.

By rebuilding broken down synapse connections between the brain cells, enhancing signal transmission from the prefrontal cortex to deep in the brain, and proliferating the structures that provide those pathways, ketamine produces rapid and widespread improvement to the point that many patients declare themselves “well.”

June is National PTSD Month, and this month we want to show some of the types of PTSD, and help get the word out that there is effective and lasting treatment. And that you can have your life back again.

You can enjoy your job again, build your relationships with spouse, family, and friends again. Catch up on neglected projects and enjoy them. Get out and about and relish your days.

If you’re suffering, and nothing has helped, call us. Helping relieve stubborn psychiatric disorders is where we find our deepest fulfillment. We want to see you well. You’re not alone.

To the revitalizing of your best self,

Lori Calabrese, MD

June 4, 2018
Mental Health Issues in College Students — Prepare Early

Does Your College Student Know Where to Find Mental Health Support?

Jonathan stood at the curb, watching his parents drive till they were out of sight. He felt lost. Vulnerable. Tired. He didn’t know much about mental health issues in college students … or even first graders, for that matter.

Jonathan had been depressed most of his life. His parents noticed the pain in his eyes from the time he was a preschooler, and tried to help in every way they could. He was their first child, and they didn’t recognize he needed professional help.

His sadness and social anxiety held him back in countless situations. He was very bright and did well in school, but socially he was isolated much of the time. He searched early, and visited colleges with his parents. But contributed very little to the decision.

They chose a small private college, where student/faculty ratio was intimate and friendly. And when it was time to go, they packed him up and drove the 4 hours to the campus. He followed as they carried his belongings to his dorm room. Afterwards, they all went to dinner, then back to the dorm. Hugs all around with words of encouragement. And they left.

Jonathan had no idea what he would do. As time moved on, he tried very hard to do well in his classes. But his energy for it eventually faded. And after a year he told his parents he wanted to leave school. He withdrew, packed up his belongings, and drove away.

Treating Mental Health Issues in College Students – A BIG Problem

A rising problem in the US education system is the minimal attention given to the mental health of students — especially college students.

Since 80% of incoming freshmen are 18, some 17 or younger, and others 19 or older, most of these students are still very much adolescent. Add to that the fact that 75% of psychiatric disorders are diagnosed before the age of 24, and you can see that the college years are predisposed to turmoil for many kids.

And if you don’t really believe your student is susceptible to mental health issues, think about this: 45% of parents say their child has been diagnosed or treated for a psychiatric disorder. Add to that: those who need help but haven’t sought it. Those who are afraid … of stigma, cost, and the rumors they’ve heard about psychotropic medications. Or children of parents who are misinformed.

Do the math, and you’ll see that your daughter or son has more than a 50/50 chance of needing psychiatric treatment in the years ahead.

Yikes.

How Common are Psychiatric Symptoms in Teens?

A survey was conducted with 712 parents of children in grades 9-12 and first year of college this past fall. The question asked if their child had been diagnosed or treated for anxiety disorders, stress, mood disorders, learning disabilities, self injury or suicide attempts, and more.

A full 20% reported anxiety disorders, 18% reported stress, 17% reported mood disorders, and 17% reported learning disabilities. These are parents whose children have been diagnosed or treated.

Of the same group of parents, 54% said their children had not been diagnosed or treated for a psychiatric illness.

Not because they hadn’t seen symptoms. But because they had not sought treatment. Some percentage of that 54% includes families with psychiatric suffering that they’re not recognizing or acknowledging.

Some People Don’t Believe in Psychiatric Illness…Still

There are still factions of society in this 21st century world who still don’t believe in the validity of psychiatric illness.

So, if they’re faced with it in a child, they consider these disordered behaviors as a lack of discipline, or misbehavior, or rebellion. So they apply more discipline to the situation. Consequences maybe. But nothing that treats the very real symptoms in the brain.

When teens from that kind of home environment enter the university environment, we see symptoms emerge that often require attention. The stress, the social pressure, and exhaustion from disordered sleep patterns sometimes lead to a crisis … sometimes even a need for hospitalization.

And again, by the way, the years a student spends in college coincide with the years the largest number of people in the 15-24 age group are diagnosed with a psychiatric disorder. Is there any wonder why…?

The Need for Diagnosis and Treatment in College is Steadily Rising

The Center for Collegiate Mental Health reported in 2017 that the demand for mental health services on college campuses has increased continuously over the last seven years. Hands down, the most often repeated request is for counseling for anxiety and depression.

Parents who were surveyed listed their top criteria in choosing a university with their child. Those criteria included things like affordability, distance from home, academic reputation … but mental health services weren’t included on that list.

While it may not be all that unreasonable that parents don’t automatically explore availability of mental health services in the colleges they consider, you probably should place these services high on your list. It’s just smart.

Get Your Student in Touch with Mental Health Services Near His Campus

If your son or daughter is already seeing a counselor or psychiatrist, continuing treatment or finding mental health professionals they can trust on campus or nearby could make the difference in their academic success or failure. Cradling the idea that he or she can just “wing it” is not a recipe for satisfactory outcomes.

On the other hand, if your child has shown no signs of psychiatric stress or disorder, just be aware, and stay informed. The student with the highest performance in high school can still develop depression, anxiety, or bipolar disorder in college. That’s not to say your child will fail. Not by a long shot.

But in far too many cases, parents are caught by surprise when a child with excellent performance falls into severe depression … and just withdraws and shuts down.

High Performance Students May Suffer Burnout

Sarafina was voted Most Likely to Succeed in high school, along with Class President, Homecoming Queen, and president of the honor society. She was hard working and disciplined, and maintained a 4.0 GPA even with a part-time job. When she started college, she got a work-study job on campus from the very beginning, and secured loans for her tuition.

She worked tirelessly toward her goal of acceptance into medical school.

But during her third year, something began to go wrong. Stressors that included unstable family members, a volatile political environment on campus, and the pressures of school and work finally capsized her ability to function. She had to withdraw from classes to seek psychiatric treatment for bipolar disorder, complicated by way too much drinking.

She just couldn’t do it any longer.

This is not an uncommon scenario with high achieving students. In some cases, the years of strain to get ahead, the sacrifices… and the pressure, culminate in an overwhelmingly bad place.

There Is Effective Treatment Available Now

If your child struggles with psychiatric mood disorders like depression, anxiety, bipolar disorder, social anxiety, PTSD or OCD, there is treatment that can help – therapy, and medications like SRIs.

And…even if they don’t, there is IV ketamine treatment.

Ketamine Treatment..?

Ketamine treatment for psychiatric mood disorders uses a tiny dose compared to the small amount used for anesthesia. We give these doses 3 times a week for a 2-3 weeks, depending on your individual needs.

Ketamine turns on mRNA to switch on DNA that turbo boosts the Brain Derived Neurotrophic Factor (BDNF). BDNF is like a rich compost…that infuses dendrites and stokes neuronal (brain cell) connections, called synapses.

These dendrites branch out in fast motion to create dense dendritic spines, causing the signaling system in your brain to bloom like tomatoes at the county fair. When that happens, the signals start flying around in your brain connecting your thoughts, emotions, and well-being and bringing healthy, alert stimulation and balance.

At the same time, ketamine can erase suicidal thinking. Why is that important? Because there is no medication besides ketamine that has been shown to stop suicidal thinking in 4 hours or less. This is life-saving for someone in crisis, intent on suicide.

Your son? Your daughter? …You?

The second highest cause of death in college-age students? Suicide.

This is serious, and can mean life or death for the child you love. The best protection for your child is prevention. And after that, treatment. Ketamine treatment can prevent suicide now.

Innovative Psychiatry Treats Your High School or College Student

And, if you do have a teen who exhibits signs or symptoms of anxiety, depression, social anxiety, panic disorder, bipolar disorder, PTSD, OCD, or thoughts of suicide, call us. The earlier they receive effective treatment, the higher their prospects of recovery.

At Innovative Psychiatry, we see 80% of treatment-resistant psychiatric mood disorder cases achieve remission with IV ketamine treatment. Eighty Percent!

There’s never been such an amazing medication for depression and anxiety before.

Let us help you and your family restore, rejuvenate, and rebuild on solid, healthy ground.

To the restoration of your best, happy self,

Lori Calabrese, MD

February 24, 2018
IV Ketamine Treatment Can Prevent a Medical Leave of Absence from College

Are You a Depressed College Student?

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

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

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

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

Should you withdraw? Take a medical leave …?

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

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

College Student Depression

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

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

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

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

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

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

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

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

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

William’s Story

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Better odds than anything else we’ve got.

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

Ketamine Treatment Can Prevent Medical Leave of Absence from College

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

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

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

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

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

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

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

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

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

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

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

You can experience relief, restoration, remission.

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

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

And we’re here to help you flourish there.

To the restoration of your best self,

Lori Calabrese, MD

January 8, 2018
2018: Neuroscience Breakthroughs like IV Ketamine Treatment Mean Breakthroughs for YOU

Neuroscience breakthroughs like…IV ketamine treatment..?

Exactly.

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

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

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

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

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

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

Neuroscience Breakthroughs like IV Ketamine Treatment means Breakthroughs for You

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

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

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

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

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

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

A well-lit brain is a happy brain.

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

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

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

Extraordinary.

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

APA Task Force Issued a Consensus Statement in May 2017

What a year it’s been!

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

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

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

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

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

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

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

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

Ketamine has delivered HOPE.

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

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

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

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

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

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

Again, HOPE.

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

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

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

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

To your very best self in 2018,

Lori Calabrese, MD

January 1, 2018
Ketamine: PTSD and Depression Treatment For Veterans …and For You, Too
There’s No PTSD and Depression Treatment Like This Treatment: IV Ketamine

Do sudden noises make you jump and feel like your heart just stopped? If someone pats you on the back while saying hello, does it take everything inside you to keep from beating them to the ground? Do you find yourself on edge, feeling more and more tense and vigilant as the sun goes down…?

If this sounds familiar, you may be suffering from Post Traumatic Stress Disorder, or PTSD.

PTSD is cruel, and happens as a result of severe traumatic experiences that live on in your head even after the event is over.

Military men and women who’ve seen active combat sometimes suffer from PTSD. As time passes, the symptoms are more likely to become worse than better.

PTSD Caused By More Than Combat

But, it’s not only the combat zone that causes it. It can be caused by a dangerous event, like a car crash, or domestic violence, or a major natural event.

Whatever the original cause, PTSD has a way of creating a life of its own. You tend to reach a point where you separate the past from the present based on date of that event. Life before the trauma, and life after the trauma.

That particular battle where you were ambushed, and your friends were maimed or killed.

That specific day when the beating was so vicious, his rage so terrifying, that you dream about it every night and wake up in a cold sweat.

That storm of storms that ripped your house apart while you trembled in the bathtub with your children…

As painful and terrifying as these memories are, many people just don’t know what to do but try to white-knuckle the nights of terror, then pull themselves together and muscle through the days.

The trouble is, “just muscle-ing through” doesn’t improve the symptoms. At least most of the time.

Instinctive Responses to PTSD Symptoms Don’t Help You Get Better

People tend to respond to the horrific symptoms of PTSD in either of two ways. Either they avoid thinking about the event, the traumatic memories, and anything associated with it, or they become extremely alert and on edge.

If you’re trying to avoid thinking about the painful and terrifying memory, it might look something like this:
- You’d probably avoid going places, or seeing people that reminded you of what happened.
- You’d also likely avoid discussing it with anyone, or talking about anything that might stir up the memory
- As a result, you’d likely not want to be around other people, since you can’t know when someone might talk about something that conjures that pain
- And you’d probably feel safer just not going out, and not making plans to do much of anything in the future, because you just feel safer at home.
On the other hand, if you’re one to respond to this trauma with extreme alertness, you might have these reactions:
- You can’t go to sleep or even if you can, it doesn’t last. Sleep becomes almost impossible to maintain.
- Emotional outbursts are frequent, out of proportion to the circumstances, and leave others shaken and you embarrassed.
- Concentration is tough. Focus almost impossible.
- Irrational reactions to common everyday things like a barking dog, a ringing doorbell or honking car, or even someone patting you on the back…
These are part of your daily life.

PTSD and Depression Treatment

As widespread as PTSD is, you’d think treatment would have been figured out long ago. But that’s not the case. Until now, PTSD and depression treatment have been limited to certain SRI’s that have been prescribed like Zoloft and Paxil, with limited results. These are the only two medications approved by the FDA for PTSD. But they aren’t always effective.

PTSD has a long-standing reputation for being really hard to treat. And that’s been especially true among those who are serving and have served in active duty military settings. In real English: Combat.

Combat PTSD Conference

On October 18 of this year, Dr. John Krystal, Chair of the Psychiatry Department at Yale University, spoke to a group of researchers at the San Antonio Combat PTSD Conference.

Dr. Krystal studies ketamine, and how it affects the brain. As he spoke, he expressed that ketamine works rapidly relieving symptoms of depression in trials, and some patients showed a reversal of symptoms after just one intravenous dose.

With excitement in his voice, he spoke about the astonishment of working with people who suffer from treatment-resistant depression, and seeing their response to a single dose of ketamine. He said, “it’s the most remarkable thing I’ve seen in my career…!”

When he spoke about ketamine’s impact on men and women with PTSD, he noted that while not all achieve complete remission from symptoms, the average achieve 50-75% reduction in symptoms. Since traditional antidepressants only provide about 10% reduction in symptoms, this is clearly a remarkable relief for these patients.

And, he added, ketamine’s dramatic improvement over symptoms isn’t the only reason for its promise for PTSD patients.

Its rapid onset makes it the one medication that can reverse the suicidal thinking fast in these people.

Ketamine Does More Than Anesthetize Symptoms – It Restores Brain Structures

As we’ve talked about here before, PTSD and depression can cause the synaptic structures in the brain to break down. Dr. Krystal refers to this as “loss of synaptic connectivity.” When these breakdown, certain mental functions are impaired. Things like memory, planning ability, and emotional control are greatly affected – as seen in patients with PTSD.

The beauty of ketamine is its action in restoring those structures, replenishing them, and doing it very fast.

A 4 week study is underway on ketamine and its use in PTSD. The study takes place in San Antonio, TX and West Haven, CT, involving nearly 200 military personnel. The aim of the study is to test various ways of dosing ketamine, and its effectiveness.

We welcome studies conducted to learn more about ketamine. My professional reaction to the impact of this remarkable drug on those who suffer from PTSD, depression, and other psychiatric mood disorders is similar to Dr. Krystal’s: “It’s one of the most remarkable things I’ve seen in my career.”

Ketamine: Most Remarkable PTSD and Depression Treatment Out There

At Innovative Psychiatry, we’ve consistently seen 80% of cases of PTSD, depression, anxiety, and other mood disorders achieve a strong response to ketamine treatment. We offer a variety of innovative treatments, but ketamine is hands-down the most extraordinary PTSD and depression treatment we offer.

If you suffer from PTSD, you know that this condition can wreck your life and relationships. You know the helplessness and shame you feel after flashbacks, irritable over-reactions, and night terrors.

I’ve heard PTSD patients who endured traumatic combat experiences say they refuse to see anyone who hasn’t been in the military. And I understand why.

But, this medication is not like the others. Patients with PTSD emerge from ketamine treatment feeling as if a weight has been lifted off, feeling more at ease, less vigilant, and more able to process their trauma. They feel more resilient, more able to contribute to healthy relationships. They feel safer in their own skin.

After treatment, we encourage you to work with your own psychiatrist or therapist to continue to rebuild your life. You’ll most likely find your ketamine treatment has dramatically transformed your ability to process the trauma you’ve experienced, your outlook, and your desire to move forward in your life.

To the restoration of your best self,

Lori Calabrese, M.D.
November 5, 2017

error: Content is protected !!