Lori Calabrese, MD

Tag: IV Ketamine Treatment for Substance Use DIsorders

Erase Alcohol Memory Triggers and Empower Your Control Over Drinking

Alcohol Use Disorder is the most common substance use disorder. It causes economic, psychosocial, medical, and personal burdens across the globe that nothing else compares to.

During the pandemic, people who’ve lost jobs and income, or been hospitalized with COVID, or who’ve lost loved ones to the vicious virus, have clear and easy-to-identify reasons for depression. But the vast majority of people who haven’t experienced things like this still struggled with depression and anxiety — and didn’t understand why. For many, that anxiety led to heavier drinking and substance use than was typical for them. And so for them–and maybe for you–taking a second look at ketamine’s effectiveness in erasing alcohol memory triggers is even more relevant if they’re trying to reduce the heavier drinking they’ve been doing. People need to get jobs again, and need to reduce their use of alcohol and other substances they’ve been turning to to cope. They need to take action.

If this is you, maybe you need to take action. Jump in.

We know that the rate of relapse for those attempting to achieve sobriety is very high. Unfortunately, with so many alternative and creative FDA approved treatments available, none has really demonstrated robust success. So, that leads to a closer look at ketamine treatment.

While there are good outcomes with ketamine treatment for alcohol use disorder, this treatment calls for in-depth exploration through further studies.

Two recent studies offered more information about these outcomes. (Still, more are needed. We know that and applaud our colleagues who continue to break ground in this field.)

One study published in the American Journal of Psychiatry December 2019 right before COVID-19 began to grow in the US revealed plenty. The stress of COVID-19 might show a thwarted effect. The monumental stress so many experienced. And to which so many succumbed. Thankfully, during this study, no one had heard of COVID.

Ketamine Plus Motivation Enhancement Therapy = Better Abstinence

Elias Dakwar, M.D., led this study, then followed it with one focused on cocaine use. He’s Assistant Professor of Clinical Psychiatry at Columbia University. And he’s become intrigued with whether ketamine can reduce craving in addictive disorders. …Interesting, right?

Motivational Enhancement Therapy targets a person’s motivation and determination to stop drinking alcohol. Ketamine can improve motivation and initiative… and motivational enhancement therapy can, too.

So the synergy between the two can be remarkably effective.

But wait…

There is another way that ketamine helps empower an individual to stop drinking. It impacts your memories tied to drinking in the past by erasing alcohol memory triggers.

In a study published in Nature, Ravi Das and his research team looked at whether ketamine could put the brakes on a phenomenon called maladaptive reward memories. They play a big role in substance abuse.

The idea is that when you see a cocktail, or a cold beer, it triggers memories associated with drinking it in the past.

(The same thing happens to sugar addicts. See a moist brownie, or a sundae dripping with hot fudge, and it triggers memories of the depth of enjoyment you experienced when you ate those before.)

And you want more.

Who can drink just one beer… or eat just one s’more?

We say these are maladaptive reward memories, because that decadent taste and texture, or the good feeling you had when you drank that cocktail or ice cold beer, is the reward you received from it. It’s maladaptive because those rewards are not necessarily good for you. More of the chocolatey treat leads to weight gain… and all the ills associated with too much sugar.

By the same token, the desire to have more of that feeling you get with more beer or cocktails, can lead to intoxication, impaired driving… and, we all know, to a PROBLEM.

So that’s where control comes in. To have one treat, or one alcoholic drink, then to stop and have no more. (We’re using the example of chocolate to make the problem more relatable for you if you don’t use alcohol. Hits a little closer to home, doesn’t it?)

Back to this new study. The researchers displayed a glass of cold beer, along with photos of people drinking, laughing, having a good time. It was all about studying the effect of memories associated with drinking alcohol. Ketamine treatment blocks the memory formation associated with alcohol consumption. They believed it could erase the triggers in the environment that seem to spur you to drink.

Their conclusion was that while ketamine can erase alcohol memory triggers, it is not a magic bullet all in itself—but rather it would be most effective when it’s combined with motivational enhancement therapy.

So if you understand that you need to incorporate the two together, to get the most out of treatment… then your power to stop drinking, or even greatly reduce drinking alcohol can be dramatically increased.

It’s like 1 + 1 = 3.6. (I love this kind of new math.)

It’s interesting that ketamine’s ability to erase or rework memories has been considered by some as a negative. So let’s be really clear here: ketamine doesn’t erase memory. But it can and it does dampen and strips the thrill away from memory rewards.

Innovative thinking and an innovative approach to alcohol—a problem that just about everyone thinks they have an answer for. We’re grateful to Drs. Dakwar and Das for giving us a whole new fresh idea for a substance use disorder that kills millions every year.

Sometimes it takes a village.

Sometimes it takes an innovator.

At Innovative Psychiatry, we see so many people whose drinking has changed dramatically following IV ketamine treatment. Reduced cravings, renewed motivation, abstinence. They get their lives back, they get their jobs back, and they get their relationships on track. Since alcohol use disorder can be right in there along with depression, anxiety, PTSD and other substance use disorders, IV ketamine can address multiple disorders at the same time. Ketamine’s ability to rewrite those memories, to change your experience when you’re exposed to scenarios that had previously provided triggers for you, can bring such freedom, hope, and a sense of control over your life… that you’ll be thrilled to get to know your best self.

We offer IV ketamine treatment in a soothing, relaxing, and private environment so you can settle in and get the most from your treatment.

We also have prepared our offices for you by installing technology that destroys viruses, bacteria, and molds in the air and on surfaces. See the little white box in the photo? It’s amazing that such a small container can be so powerful. NASA and The Department of Defense designed our disinfecting technology. (We’ve learned we can’t be too safe, haven’t we?) So you can rest reassured when you come for IV ketamine treatment. You can rest. You can set an intention… create a mindset… that will allow you to move forward while ketamine goes to work.

If you have found you don’t have the control you wish you did over alcohol, call us.

It delights us to talk with you, and with your healthcare team, to coordinate treatment to help you enjoy more success as you build your life and relationships.

Innovative Psychiatry is a full service psychiatric practice, and we offer IV ketamine treatment. If you find you drink more alcohol at a time than you wish, or more often than you intend, give yourself the benefit that ketamine can provide. Call us and let’s find out if you’re a candidate for this extraordinary treatment.

Ketamine isn’t for everyone. But we can absolutely evaluate whether you’re a good candidate or not for this treatment. Since the percentage of those who don’t respond is low, chances are IV ketamine will give you the advantage you need to move forward in your life without the burden of excessive and harmful drinking.

Cut yourself some slack.

To the restoration of your best self,

July 19, 2021
The Connection Between a Man’s Violence and His Anxiety: How to Help

Know any men who can flip from mild annoyance to a violent rage in a short minute? Know any women who are wounded and intimidated by a man’s anger? Now if that anger is violent then it’s likely lots of women and children as well are wounded and intimidated by it. Let’s talk about the connection between a man’s violence and his anxiety.

Anxiety/alarm.

A good book written by Russell Kennedy, M.D., titled RX Anxiety, is full of great advice for men whose anxiety is expressed in violence. Dr. Kennedy explains that anxiety is experienced both emotionally …in his mind…and physically, in his body. Anxiety is produced in the mind, and alarm is the result that is experienced in his body…physically.

So it should be no surprise that since a man feels this emotion in mind and body, that it would be expressed in both his mind and his body.

But in his body… how?

One of the human physiology’s way of calming this anxiety/alarm, is crying. When we cry it rewires the brain. But what if, as a boy, they taught you to not cry?

…

Tom was edgy, irritable. He woke up in an ambulance, which caught him off guard. They said he had a blackout. Once at the hospital, ER staff rushed to apply leads to all the right spots on his chest and legs for an EKGs. And then another one. After a variety of tests, they moved him to a cardiac unit in the hospital.

Tom felt fine. What was all the fuss? Then they handed him a pitcher that looked like it would hold a quart of milk with a wide open top. The nurse instructed him to “pee” into the pitcher !?!

He blushed, grumbled, let out a few curse words and said he couldn’t “go” in that sitting position.

From that point on, everything made him madder. Madder and madder. More and more irritated.

When a lunch tray was delivered to him, he cleared it from his bedside table with one angry sweep of his arm. Food, cutlery, his plate and glass, all flew to the side of the room, hitting the chair and wall in a big mess.

His nostrils flared. “Get all this away from me!”

In his most secret place of shame, Tom felt like crying. But that was unthinkable. So he had just lashed out…

A man’s violence and his anxiety are so closely connected. A cardiac event can cause unbearable anxiety in a man, and it’s not unusual for a violent expression to follow.

“Anxiety is an early warning system to help you survive… It’s not there to harm you, but in its constant warnings, it makes you feel unsafe.” -Anxiety RX

Tom may have felt angry and irritable, and may have behaved with a lack of control. But what was really going on?

Anxiety. There is very little in a man’s life to ignite anxiety like a cardiac event. Anxiety was eating Tom up inside.

The “Straw” of Caring for Others Before Yourself Can Break the Camel’s Back

This is such a common situation for men. Men who marry young, for instance, before they’re really equipped to be providers for themselves or a family. Maybe a young pregnant wife, or the perceived need to rescue a girlfriend from an abusive family. Crises like this can seem obvious and necessary, but can lead to a man’s overload.

Or maybe parents whose special needs require unexpected and exorbitant care and financial support.

There are endless possibilities of circumstances that could add the breaking straw to a man’s back resulting in constant worry — like where will I get the money to pay all these bills? and when will I find the time to care for everyone who needs me? And fear of the fallout if he fails…

You’d think true masculinity was just calm and collected happiness. So alpha male that it needs not or worries not. But typically masculine characters are always fighting, and most violence comes from some agitated level of fear and anxiety.”
–Liev Schreiber

Add to that, the belief that a man might unwittingly hold that being a caregiver gives his life power and purpose, a sense that he matters. However, he may not grasp at all that the burden that gives his life power and purpose may also break him under the load of anxiety and violence.

A Man’s Violent Release can Easily Follow the Anxiety that Accompanies His Responsibilities

As we mentioned earlier, all these things can happen to a woman, too. But we’re focusing on men today because they’ve so often been taught to avoid showing their feelings, and to not cry because it’s a sign of weakness. (You know men like this. Maybe you are one. Or maybe you’re a woman who has seen this, over and over) And that can have dangerous results

So when the pressure builds from a mountain of responsibilities they fear they cannot fulfill, instead of crying or panicking, that man can snap and become violent.

So our goal is to help him find ways to lower the pressure far in advance of the melting point.

To help him learn to take care of himself, give himself time to release pressure through enjoyable activities, and to spend time with the people who love him most.

Sons Need to Learn Self Care from Childhood to Equip Themselves to Respond to Stress Because there’s often a Connection Between a Man’s Violence and His Anxiety-Depression

And optimally, we need to train our sons to seek these releases as children and young men, before their responsibilities have so much power.

Each individual treatment room provides privacy and quiet, as well as an incredibly comfortable zero-gravity heated leather recliner — so you can be monitored during treatment, and relax deeply for the best possible infusion experience.

At Innovative Psychiatry, we’re here for you, and for the men in your life. And we love to work with and complement your your healthcare team to offer treatments that can help you or the people you love. When the anxiety is seated in PTSD or social anxiety, IV ketamine treatment can be a remarkable aid. And we can schedule your treatments so that you can to get the most benefit from the neuroplasticity ketamine offers to do the best possible work in therapy.

Above and Beyond

We have a devoted program for administering IV ketamine treatment, and have installed space-age equipment to remove viruses, bacteria, and molds from the air and surfaces. When you come for treatment, you can feel safe from risks–because we go above and beyond to keep you safe! So you can focus on getting better. The environment-purifying technology designed by NASA and the Department of Defense keeps the environmental air and surfaces free of pathogens. There is nothing else even close. We’ve taken the best steps available to ensure your wellbeing when you’re here.

Taking care of yourself, giving yourself what you need, can equip you to take care of all those responsibilities more effectively… and keep the anxiety and depression from overwhelming you.

Anxiety is not something to be ashamed of. It’s not weakness. But, like so many other things, it requires your attention to manage it, seek treatment, and be the best you can be for yourself and those around you.

Anxiety can take on a life of its own, and drive you to do things you would never normally do. If anxiety and/or depression has tried to drive you to violence before, you can kick it to the curb.

Please call us if we can help.

We look forward to working with you.

To the restoration of your best self,

July 12, 2021
Interesting Times: How They Help You Overcome and Help Others, Too
Ask yourself…”Do you prefer good times…or interesting times…?”

We’ve talked about how to recover after a crisis or trauma so you can get back up. Let’s take another step. Let’s talk about making use of your experiences so you can — and will — move forward. First and foremost, like letting go of the memories of falling short in the past. A failed grade, a missed touchdown, the end of a relationship, a project that didn’t impress your boss… or all those times you were late in picking up the kids… or forgot the cupcakes for the classroom on your child’s birthday. Or those painful devastating memories when you over-reacted to your child’s mistake and left her heartbroken. These are the interesting times: how they help you and others depends on how closely tuned in you are to the lessons to be gained and put into practice.

If you continue to revisit these moments of moral failure and apologize for them over and over, you’ll likely find yourself stuck in shame, remorse, and regret. These feelings can be so crippling. And you can find yourself immersed in interesting times… how to recover..?

Move forward and build a rewarding life. To do that, you just must find the way within yourself to LET GO of the past. Only then can you invest in the present and the future, as well.

Let go of the pain, too. A broken relationship, the memories of dysfunction, conflicts, betrayal, harsh, vicious words. All of these create scars, and scars can hold you back, tether you to those experiences and hold you in the past.

So, you have to let those memories go, release them, and embrace your experiences of today. Allow yourself to enjoy the new developments in your life.

Without these crippling memories and the pain…which tend to become the more interesting times that can help you eventually… without them you can’t learn how to exit them. To rise above them. To build your own good times with the insight that you have learned how to navigate another corner of life… because of the challenges, pain, and obstacles you worked to overcome.

Another thing to think about…and apply… is that when someone says something that annoys you, and you allow yourself to react, you’ll be the one who suffers. A big step toward letting go and moving forward is to let go of the need to have the last word, to punish the speaker with your anger, and to lash out.

It’s far more liberating to step back, put on your “logic filter” and run their comment through that. Leave your emotions locked in the closet until you have seen the situation logically, calmly, and with compassion toward yourself and the one who is speaking. Be the presence of peace in the conversation.

Build your sense of optimism on a pragmatic foundation. Rather than thinking of optimism as a DisneyWorld sort of reality, with streamers and balloons and fireworks and cartoon characters skipping around, think in terms of what has happened and the good outcomes that can emerge along with the bad ones.

Dig in to find treasures in your life. Ways you can make the world a better place for others, or just for one person. But watch for those opportunities. Watch for interesting times, how they can help you and others make better decisions on this go round.

Putting Trauma in Its Place

To move forward, there are certainly things that you can do to invite a more hopeful frame of mind. But there are also traumas and pain that have to heal and be put behind you so the “overcoming” efforts can bear fruit for you.

If you’re like most people, there were painful events, confusion, and even trauma and loss that emerged this last year. 2020 is a year we’ll not forget. Odds are, you acquired some trauma and sorrow in the process.

Avoid wallowing. Grief must be faced, then suffered, and put away soon so you have the room in your mind and heart to embrace the good that’s emerging…along with the bad.

The pandemic was …interesting. Not good times. And yet…good things happened. Babies were born, learned to walk and talk, some companies did well. Some employees excelled, and so did some students.

Look back at your resilient moments. What did you learn? Can you take it with you to next year and the year after?

Careers Have Been INTERESTING, TOO Lately… And oh yes…RELATIONSHIPS!

It’s not at all uncommon to enter a career path, and advice comes from everywhere telling you to stick it out, have tenacity and perseverance.

That’s just great advice for lots of things. But how do you know when it’s time to let go?

Well, no one can determine that but you. Whether it’s about a career path, or a relationship, or the city you live in… We know we can miss so much if we cut bait and leave before giving the current situation a chance. (At the same time, when you can see you’re going down with the ship, it may be time to swim for shore before it’s too late.)

Your heart may not want to let go, but your experience says that this is not going to recover and you need to save yourself…to try again another day. Interesting times and how they help you gather the tools you need to move forward, giving your room for more good times to enjoy your life.

Some principles apply to multiple types of situations… like relationships, jobs, projects…Here are some questions you can ask yourself as you work through your decision:
- Do you sense a lack of respect for you in your environment or relationship?
- And maybe most of the time you’re giving more than you take?
- Do you find that you think more about the past than the present? Are you in a good ol’ days mentality?
- Are you crying more than laughing far too often?
- And what about anger? Is it more commonly the way you feel…or is love, contentment, and peace the way you usually feel?
- Is the passion and joy gone?
Do you find you feel “less than others,” because of others’ attitudes toward you?

Do you feel physically and mentally exhausted…most of the time??

If you know what it is to be appreciated, supported to grow and excel, and you’ve been stuck in a situation for a prolonged period of time, it’s possible you are ready to let go. And move forward.

And as you embrace that purpose, you begin to gain from not only the experience, but what you did with it. Purpose, direction, and hope can build and grow in you as a result. And with hope, strength and resilience.

You don’t have all the answers, and neither do we. We’re all seeking to learn from our experiences so we can move forward in life. Because life isn’t perfect for anyone, is it? Fostering resilience is a great place to start.

At Innovative Psychiatry, we wish like you do for the good times…but keep learning that it’s the interesting times that give us more to help you.

It’s also true that sometimes choosing to face the obstacle of interesting times and push through it is overwhelming. Sometimes to face those interesting times you need depression, anxiety, and trauma treated effectively. That’s where IV ketamine treatment can come in.

IV ketamine can do things other medicines haven’t … and it can do so rapidly. That’s why we opened a separate arm of my practice that’s specifically equipped to provide IV ketamine treatment. Ketamine treatment has demonstrated repeatedly its unique ability to smash depression symptoms, sweep away anxiety, and stop suicidal thoughts in their tracks.

Because making this remarkable treatment available to whoever is a candidate for it is so important, we encourage communication from your healthcare team.

We want you to have hope.

And, because the pandemic is still making people sick, we have equipped our offices with technology designed by NASA and the Department of Defense, to clean viruses, bacteria, and molds from the air to help you stay well. We’ve taken every precaution to protect you from infection when you’re with us.

The result is peace of mind so you can focus on getting better.

We invite you to reach out for a treatment that works rapidly in most people, even in interesting times, to restore your motivation, initiative, hope…and creativity. You should have a rewarding and fulfilling life.

To the restoration and fulfillment of your best self,

Lori Calabrese, M.D.
July 5, 2021
Some Wounds ARE Invisible… But There’s HELP… IV Ketamine Treatment Can Crush PTSD. FAST.

June has been National PTSD Awareness Month. And June is nearly over. But PTSD awareness shouldn’t end with June. If you have PTSD, it can go on day after day…after day.

Something terrible happened. Over time, it seemed you slowly got past it. You hardly thought about it anymore. Then, in a split second, you’re there again. Something happens that triggers the memory, and you’re fighting all of the sickening feelings that just well up inside. You’re determined to break free and run. Turns out a friend is hugging you…. And you come back to yourself and feel embarrassed about your “over-reaction.” Some wounds appear invisible. But they run deep, and wide. And when they do, PTSD can be crippling, and it can take you captive in a moment.

National PTSD Awareness Month gives us an opportunity to realize that PTSD exists — more often than you imagine, and in people you’d never suspect… that it’s sometimes surprising in the way it’s triggered… and (so importantly!) that those who suffer from it have experienced severe trauma. While it’s true that two people can suffer the same kind of car crash or the same horrible domestic violence, and only one of the two develops PTSD, that doesn’t mean one is weaker than the other. The impact of PTSD has NOTHING to do with how tough someone is. There are a lot of factors that come together to predispose you to PTSD. Genetics can play a big role. And one huge new mind-blowingly transformative treatment — IV ketamine — can be exceedingly effective.

It’s important for you and for the people you know and love to learn the signs and symptoms of PTSD — for your own health and wellbeing, and to help others who suffer from it. Because since some wounds are invisible, so also the symptoms are sometimes only visible to those closest to the person suffering from them.

You may have symptoms of depression, anger, rage, irritability, suddenly becoming startled… or feeling numb and disconnected. There may be flashbacks or nightmares, or you may just find yourself reliving the terrible experience over and over. You also may have increasingly aroused emotions and mental thoughts, which can make it tough to sleep.

Ok, but there’s more to think about and watch for. Like the types of PTSD. Because all PTSD cases aren’t alike.

PTSD doesn’t accumulate traumas like depression can accumulate “reasons to be depressed.”

Comorbid PTSD – symptoms of trauma combined with symptoms of other disorders.

It’s not at all uncommon for people with comorbid PTSD to also have substance use issues. Because most people who suffer from PTSD typically suffer with more than one disorder, comorbid PTSD is probably the most common form of PTSD. Some disorders that often occur with PTSD are panic disorder and depression.

Normal Stress Response – This occurs during and following an experience that’s traumatic and stressful but before PTSD begins.

Not all people who experience a normal stress response advance to PTSD.

Acute Stress Response – Typically, someone experiences an acute stress response after a huge stress, like being frightened by a perceived predator, a near miss auto accident

…or even a frightening accident where all parties survived. But if acute stress symptoms keep coming back for a month or more, they may be transitioning to PTSD. Symptoms of acute stress response may include headache, sweating, chest pains, palpitations, nausea, and stomach pain. Acute Stress Disorder can be treated using support groups or therapy …and medication. IV ketamine treatment has shown great promise in treatment.

Complex PTSD – This describes a condition associated with more than one traumatic event.

A cluster of events, each driving its own response. And the responses can interfere with each other, drive each other, and complicate each other. Because some wounds are invisible… but still present and exhibiting deep trauma, which causes more of its own.

So… how can you know if you have PTSD? Maybe you feel anxious in the moment, or sudden sounds cause you to jump. Is that PTSD?

When most people go through a shocking or traumatic experience, they feel shaken, and off balance for awhile, but in time and with the kind of self care that helps them feeling their own pain and loss, they usually move on. Certainly they keep a memory that never leaves, but they don’t experience the torment and flashbacks of PTSD.

However, some people are deeply injured by a terrible experience, and may not improve without intensive treatment. As we’ve said before, while we don’t understand all the intricacies to explain why one person suffers so much more extensively than another, we do know there is a genetic link to this process.

If it happened to someone you love, or even to you, would you recognize the symptoms and know what to say in support? If you’re not informed and prepared in advance, you may be tempted to be irritable, dismissive, or annoyed.

First, of course, there has to have been a traumatic event. Something has happened that terrified you, you felt threatened to the point of death, and what you saw in the process was shattering.

Symptoms may emerge within a month…or they may not erupt for years. But once they emerge, they can cause severe problems socially, at work, and in relationships. Because PTSD symptoms show. Whether it’s a sudden panic attack in front of others, and you’re far too disrupted to explain, or in some other way, they make it close to impossible to go about your daily routine. Basic tasks can be impossible.

These symptoms fall into roughly 4 groups:

Intrusive memories, avoidance, negative changes in thinking …or mood, and changes in your physical and/or emotional reactions.

The symptoms you suffer may vary in intensity. With time, they may seem to disappear, then out of the blue you may be confronted with a moment that mimics that first trauma, and suddenly you’re in it. You’re terrified. You’re fighting for your life. Except that nothing dangerous or life threatening is happening. It just “feels” like it’s the same.

You can see how these moments could be upsetting to friends or co-workers. And eventually embarrassing for you.

You may wonder if you need to see a doctor. If these disturbing moments have been happening for more than a month since the original incident, then it is wise to see a psychiatrist. He or she can be very useful in directing your treatment, or referring you to additional treatment. Your psychiatrist is a specialist. Some wounds are invisible but he or she knows how to find them and treat them, to help you find your way back to a rewarding life.

If you should have suicidal thoughts, call a friend, family member, or a neighbor to spend time with you. Call your doctor to reveal the severity of your symptoms. In a crisis, call the National Suicide Prevention Lifeline (800) 237-TALK or text CONNECT to 741741, or call 911. Remember this has nothing to do with your mental strength or courage. The fact that you reach out for help is a great step of bravery for you to protect your well-being.

And if the thoughts are persistent, know that IV ketamine treatment can be dramatically fast working and can stop those thoughts in an afternoon. That reprieve will give you time to seek out more treatments.

At Innovative Psychiatry, we have seen IV ketamine treatment provide a wonderful lifting of symptoms and relief from PTSD to many patients. It’s nothing short of remarkable to see what this treatment can do for someone caught in the throes of trauma. Many patients find talk therapy and other forms distinctly more liberating after ketamine infusions. We like to work with your healthcare team to learn how we can help the process of restoration in your life.

IV ketamine treatment ferrets out the painful memories and thoughts and can dramatically relieve them. Just because some wounds are invisible doesn’t mean they can’t be healed.

Since we know that new strains of COVID are still emerging (and because frankly, we’re a health care office!) we wear masks, and have installed of the top plasma cell air disinfection at a level designed by NASA to remove viruses, bacteria, molds, and pollen from the air in our offices. So you can feel safe when you’re here, and you can focus on receiving treatment and getting better.

You’ll have a zero-gravity, soft leather recliner to make your experience feel well supported and secure, and heat at the touch of a button. We want you to get better, and want to help that happen any way we can.

To the restoration of your best self,

Lori Calabrese, M.D.

June 28, 2021
How to Stay Resilient When Life Changes Knock You Down – Bounce Back!!

Resilience – The power to bounce back emotionally after a major disappointment or event.

Here we are. COVID cases have dropped dramatically…right along with COVID deaths. We’re slowly transitioning from the pandemic to what we hope will be post-pandemic. Slowly over time. It won’t be a one day change, but an advancing progressive adjustment to a less restrictive environment. Some people have stopped wearing masks. However, many of us still do. The CDC says fully vaccinated people can go without wearing masks, especially around others who are fully vaccinated. But this doesn’t apply to those who are unvaccinated. This is one of a thousand frustrations all around you. So you’ll want to stay resilient when life changes–and we’ll give you some ideas how to do that.

A crowd of employers have begun calling employees back to work. Most employers of office workers have moved their employees home to avoid spread of illness, and all those employees are beginning to go back to work little by little. It’s not that they’ve not been working, but they haven’t had a commute as they work and meet on Zoom at home.

Many others, if not most, will wait yet awhile. It does still seem early.

But do you know what we’ve seen?

People struggling with fear, worried whether it’s safe to re-enter company buildings. People who succumbed to depression, PTSD, and anxiety during the worst of COVID-19 and haven’t yet recovered.

So this is not as simple as it may seem.

Of course, our role is NOT to tell you when you should return to work in your company facility. Or when the kids should be back in school.

We just want to help you make the transitions ahead, embrace the adjustment within yourself that will allow you to make this change when the time is right. To help you navigate your concerns or anxiety if you face it.

You may have lost a loved one over the past year. Maybe you had to watch the funeral of a loved one over Zoom or Facetime. That must have been difficult for you. So many incidents and events were shocking. For so many people.

You may have had a baby over the last year. Did you have a COVID baby? We’ve learned that the birth of a baby during all the isolation, social distancing, and mask wearing has created such intense loneliness for some new mothers that postpartum depression has been more widespread and support has been hard to come by for many isolated moms.

One first time mom, who was weeping in frustration and overwhelmed, said, “I’ve always heard it takes a village to raise a child. So WHERE’S MY VILLAGE???” If you’re one of those parents, you will have to find your own transition and recovery. Make sure you’re fully vaccinated so you’re free to seek out friends and family to get their support, and improve your own resilience.

Then there are the children. Children who’ve been involved in distance/remote learning have displayed behavior outbursts and other forms of acting out. But on the other hand, some children thrived from the closer nurturing they felt while being home. And as they move into summer, and then repopulate schools in the fall (or whenever that will happen!) they may need guidance to help them adapt smoothly, re-socialize, and integrate in their school’s routine.

Maybe you’ve asked “Why me?” through the crises and losses the last year and a half. But when you think that way it nurtures self pity…which can be suffocating. Better to ask yourself in that instance…”Why NOT me?” Because if you’re alive in this world you’re going to have struggles, difficulties, and losses.

And you may be tempted to want to run. But resilience comes when you plant your feet, square your shoulders, and get through it. You can be resilient when life changes.

When my friend heard there was a pandemic wrapping around the world, her first thought was to get on a plane and escape it. Then she looked at the charts and maps on the internet and saw that this infection covered the globe, and there was nowhere to run. What a shock that felt like.

But by staying where we are, using personal protective equipment, and isolating ourselves, using social distancing when in public, we as a nation and as a planet have survived together.

Many say, “Failure is not an option”…but actually failure is a requirement for resilience. And in terms of the pandemic, as well as working at home, learning at home, there have been countless efforts that failed and required we try again and again to get whatever the need was to work. Stronger internet connections, getting food to people who needed it, keeping online services up and functioning well.

Here are some strategies for building resilience now:

Recognize that difficulties, losses, and inconveniences are part of life. Realize right off that all these things are not a sign of unfair punishment of you or me, but just part of life. And realize that you’ll find your way through it.

Make the serenity prayer a part of you…to accept things you cannot change. To change those things you can (or change the things you cannot accept.) And hold onto the wisdom to know the difference. So focus on where to put your attention… changing the things you CAN change. And choosing peace about the rest.

Choose Life. Choose what is good for you. Walk away from things that aren’t good for you. (Yep, we said walk away. Seriously walk away…) Then be patient and compassionate with yourself.

Here’s a challenge for you: Every day, list 3 things you’re grateful for. It will help you maintain peace and the strength to face new challenges…because you know that challenges are part of being alive too, right?

And… you know? every time there is a failure, or disappointment, or loss… once you’ve responded to it and moved forward, ask yourself, what you might learn from it… or whether someone was help from the natural fallout of it, etc. There is meaning all around you, and when you’re stressed with difficulty, it’s easy to miss it. So make a point to focus on the meaning you find in all those challenges… that will deepen those roots of resilience, too.

Stay Resilient When Life Changes — If you fall, you can snap right back up on your feet

Of course, not everyone can effectively build their own treasure chest of resilience. A disorder can make that very difficult. So we do offer IV ketamine treatment to help restore your resilience. To help your brain restore it’s own synapse connections, to take the G proteins off those rafts in the cell membrane and put them back to work. To slow down the bursting cells in the lateral habenula. And to generally help your hippocampus and amygdala function better, so YOU can function better.

Sometimes it takes more than well-intended exercises. Sometimes it takes an intervention. And even though IV ketamine treatment doesn’t work for everyone, it can be transformative for the vast majority who have treatment resistant depression, PTSD, bipolar depression, social anxiety, substance use and alcohol use disorders, and suicidal thoughts. It can replace those miseries with resilience, motivation, confidence, initiative, and especially hope.

So Reach Out for Resilience and the Life You Long to Build

At Innovative Psychiatry, we have the privilege of seeing people who have achieved remission from these disorders every week. Remission means you have energy to support others, to build your own life and healthy strong relationships, and to face difficulties with strength. Remission means you once again feel like the very best self you’ve ever experienced. It means you stay resilient when life changes and can snap back in the face of difficulties.

And while we’re transitioning from active pandemic to a post-COVID world, we’re not there yet. And we want you to have the confidence that in our office you’re completely safe from infection caused by any virus, bacteria, or mold. Our plasma cell technology that continually scrubs the air you breathe to keep you safe from viruses, bacteria, and molds while you’re receiving treatment with us.

Reach out for resilience. If you struggle with the disorders we talked about, reach out for the hope of remission.

We want that for you and we can help.

To the restoration of your best self,

June 21, 2021
How Do You Disrupt a Fearful Memory? Learn to Erase a Conditioned Fear Response

We’ve been talking lately about how neuroscience researchers explore for possibilities for better medicines.

Group therapy for combat veterans suffering from PTSD

Lately, there’s been more work exploring fear and memories of fearful experiences, and how to erase those memories…or at least make the memories weaker. Those memories play a big role in anxiety, PTSD, and bipolar disorder. We talked about AKT. Now, a team of researchers at Texas A&M University led by Stephen Maren, Ph.D. recently published their work in Nature Neuroscience, and used prolonged exposure therapy in an effort to extinguish to erase or weaken conditioned fear response memories.

These methods often work well for awhile…but in time about 50% of patients relapse and over the long-term the fear memories take hold with a vengeance.

Briefly, the way these therapies work is to repeatedly expose you to situations, sounds, or other associations with the trauma, over and over and over… with the hope that, in time, the trauma is no longer triggered.

But, unfortunately in many patients, remission from PTSD doesn’t last.

So, knowing that these efforts don’t prevent relapses in some patients, Dr. Maren and his team have designed innovative experiments (in rodents) so they can test the possibility of disrupting the original fear memory… this is the memory that we think starts all the suffering in a person who develops PTSD.

How do you disrupt a memory?

Because here’s the thing. The memory forms at the moment of the trauma…or in the 4-6 hour window that follows. This is a crucial time period.

Keep in mind that the 4-6 hour period from the moment of trauma or shock is the period of memory consolidation, or when the memory forms.

These skilled researchers sought to intervene during the period of time when memories are recalled due to a key stimulus …like a car backfiring… that might trigger a traumatic fear memory of assault, or combat…or a vehicle crash. This little window of time after a sound or other stimulus in the environment triggers the traumatic memory is called re-consolidation. The stimulus can result in reaction behavior… like hiding under a table… or striking someone nearby… or grabbing a weapon.

Think of triggering memories by this method, like noises, as indirect retrieval.

But keep in mind that retrieving memories this way – by indirect retrieval – can help retrieve the traumatic memory but without an attempt to manipulate or otherwise change the original memory. The researchers’ intention is to retrieve that person’s response to it. To weaken or erase a conditioned fear response.

…So back to the rodent experiment.

Backward conditioning was a key intervention the team used. It’s a unique and fresh method to get the rodents to retrieve their own trauma — a conditioned, context-dependent fear memory….without the subject being aware of the experience.

Ok, so this is where it got reeeeeally interesting.

With all this accomplished, they were facing 2 questions:

1) Could they use neural tracing technology to identify basic circuits that were activated in this process?

2) Could they intervene in such circuitry to see if they could alter the process of memory re-consolidation..to the extent they could alter or eliminate the fear memory and its potential to negatively impact behavior.

Then, the team switched on cells in the hippocampal fear memory circuit, which caused the rodents to “freeze” because of prior conditioning to react with fear.

And, in the final stage of this experiment, the team used rapamycin to disrupt this particular circuit associated with conditioned fear memory. (Rapamycin is used to coat heart stents and to prevent rejection of transplanted organ tissue. Weird, huh? )

Rapamycin interrupts the neuron’s ability to produce proteins that are necessary for the circuit to function. As a result, the inclination of the rodent to freeze in fear is weakened or erased altogether.

And it worked. And they did succeed in associating fear memory reconsolidating with circuitry in the hippocampus. They did it!

Basically, these researchers successfully interfered in a circuit to change an original fear memory… which is what begins and is key in trauma-related conditions like PTSD. By forcing the circuit to “forget” the fear, the “freezing” behavior can be weakened or erased completely.

Like, gone.

If you or someone you love suffers from PTSD… a painful fearful memory, that’s triggered by little noises, a sight or smell or other cues, this can be life-changing.

Such an important step toward developing a new way to treat PTSD, or perhaps even substance or alcohol use disorders. Cues that trigger relapse might feasibly be interrupted in the circuit, to prevent it.

Heady, exciting stuff!

Thankfully, as we watch this development unfold, we have IV ketamine treatment NOW. IV ketamine treatment that’s effective in treating PTSD, substance use disorder, alcohol use disorder, social anxiety… all cue-related conditions. And of course, it is robustly effective for treatment-resistant depression and bipolar depression, and there is new exciting evidence of how ketamine is effective in teenagers.

It’s encouraging to see how research is exploding as we continue to seek treatments that can resolve devastating relapse and suffering.

At Innovative Psychiatry, we are meticulous about our outcomes, present our data at scientific meetings, publish our own findings in peer-reviewed journals, and stay up nights and weekends reading. We are on the cutting edge for breakthroughs in psychiatry and neuroscience. You deserve to be treated by experts dedicated to excellence.

If you suffer from any of these conditions, you would probably like some support, some help, and probably some treatment. We’ll schedule an appointment for you to come in and talk about your history, your current difficulties, and the possibility that you might be a candidate for IV ketamine treatment. We won’t be able to make a judgment about that until we talk.

If you’re a candidate, you can come to our practice with confidence that you’re sa fe even in this ongoing pandemic. Our plasma cell technology for removes 99.99% all viruses, bacteria, and molds from our air and surfaces means you can relax and focus on your treatment… and getting better.

Better days are ahead for you to live, dream, build, and hope.

We really want that for you. And we’re ready to help.

To the restoration of your best self,

May 17, 2021
What Makes Ketamine Work? This Research Team Seeks Answers

We’ve talked about ketamine’s rapid antidepressant effects. Last month we talked about the role of dissociation in ketamine’s antidepressant benefits. Neuroscientists are studying ketamine to find out WHY it provides such rapid antidepressant results. They’re hoping they can determine what exactly ketamine does in the brain, and whether they can isolate that action from the side effects without losing its extraordinary effectiveness. It’s a long road (rife with trials!), but they soldier on… hoping to make new medications that could become more available to more people. So let’s follow this team of neuroscientists through their quest over nearly 2 decades so far, to see what makes ketamine work.

Lisa Monteggia, Ph.D.

A team of researchers, led by Lisa Monteggia, Ph.D., have studied this question for 18 years. Beginning in 2003, she and her team were interested in what makes antidepressants work. At the time, they knew that neurons released the neurotransmitter serotonin to keep the mood stable. Therefore, if the serotonin level was “low,” that was the cause of depression. (Or so they thought.)

A lot of antidepressant medicines at that time were designed to increase serotonin availability. (They worked to prevent serotonin from being taken back up by the releasing neuron, and to keep it around in the synapse.)

However, Dr. Monteggia’s team saw a problem with that whole explanation because those antidepressants (SSRIs and SNRIs–serotonin reuptake inhibitors and serotonin norepinephrine reuptake inhibitors) took weeks to relieve depressive symptoms — when the meds worked. So they realized other things must be going on at the same time, since serotonin alone wasn’t the key element.

Next, her team identified an important aspect of neuronal signaling, as well as something vital for antidepressant effects… and that was brain-derived neurotrophic factor (BDNF).

A variation of the gene that “tells” cells to make BDNF contains an error or oddity that can change what the gene and the BDNF do. And that’s significant. Because further studies showed that people who have this “odd” gene, can have a reduced, dampened effect from antidepressants.

Hmmm..!!

Now don’t miss this next part of her story: As her team was studying this weird anomaly, another team (remember research was going on globally!) published their work about the ketamine, an anesthesia agent that can produce rapid antidepressant effects when given at a low dose — too low for it to produce anesthesia.

Ketamine already had a reputation for abuse when taken in moderate to higher doses.

But this finding was so important! That at a low dose, ketamine can effectively sweep away symptoms in someone who has severely treatment resistant depression. Basically, someone who has not been helped by anything else they’ve tried for their depression.

So this really charged up Dr. Monteggia and her research team. They committed to learning all they could about ketamine. And they say they want to use it as a Rosetta Stone, so to speak. In other words, they want to use low dose ketamine as the key to understanding rapid acting antidepressant action. Why? Because maybe understanding the mechanisms of action of ketamine could fuel the development of new antidepressants without side effects… Ah!

For one thing, it may hopefully show us how effective antidepressants work. (Actually work, not how we assume or think they work.) To learn the actual mechanism behind effectiveness; as in, something we haven’t yet seen or identified.

The other is that ketamine is known to impact a specific protein in the brain…the NMDA receptor. This receptor is found embedded on certain neurons — a lot of neurons!!

The team confirmed that ketamine blocks the NMDA receptor. In addition, ketamine has specific effects on a certain signaling pathway, and when they blocked that pathway, ketamine didn’t work.

Ok…the process of elimination.

But let’s see what else they learned.

Here’s one exciting thing … and we count on it with ketamine treatment. They were able to show that when ketamine blocks the NMDA receptor which affects signaling…it produces a series of downstream effects which trigger a special form of neuroplasticity in the brain cells.

Neuroplasticity is the ability of the connections (or synapses) between the brain cells to change their strength. So ketamine helps those synapses change their strength in new and unexpected ways.

The team has tested other medications to see if they act like ketamine. (For instance, memantine is similar to ketamine in some ways, and it does block the NMDA receptor, but it goes about it in a different way. So interesting, though: despite all that, it does not have the same effect on signaling as ketamine, nor does it trigger this novel type of plasticity that ketamine does.)

They only see this specific type of plasticity with rapid antidepressant action. Eureka!!

(OK, so we’re a little excited here. I know.)

So it occurred to them that perhaps this special form of plasticity may actually be an integral part of rapid antidepressant action.…? And they wonder whether this type of neuroplasticity plays a role in “healing” depression, and demonstrates what makes antidepressants work … Not sure yet.

But here’s something to keep in mind: some experts in the field of neuroscience call ketamine a “dirty” drug.

Don’t panic!

When they say that, they don’t mean it’s grimy. They mean that it works in many ways to affect many parts of the brain — it doesn’t do just one thing that explains definitively how it relieves depression. If they could develop a drug that targeted the absolute biologic mechanisms that are specifically involved in depression, bipolar depression, PTSD, suicidal thoughts, and the rest, that would be a breakthrough!

So ketamine emerged as a treatment for psychiatric disorders — quite by surprise.

This team of researchers believe that ketamine’s actions are especially important in the hippocampus. They believe that after ketamine affects brain cells in the hippocampus, changes flow back to the prefrontal cortex (this part of the brain is behind your forehead) and other areas.

So they’re hoping they can follow the path of those changes backward…from hippocampus to prefrontal cortex to other area. The more they learn, the closer they may come to understand rapid acting antidepressants better.

They believe that blocking NMDA receptors results in that novel neuroplasticity and call it “homeostatic” neuroplasticity. This is a different form of plasticity than the one involved in learning.

And as they continue forward with these experiments, studying homeostatic plasticity, which they believe is at the core of what makes ketamine work as an antidepressant, then they can work with other, perhaps newer, medications that do the same thing…to find more and better options.

Meanwhile, we do have IV ketamine treatment. And people often experience remission with it. So we’ll keep using it, and celebrating your joy, freedom…and hope.

At Innovative Psychiatry, we happily work with you in hopes you’ll achieve remission with IV ketamine treatment. We’ll joyfully welcome you for your treatment, and you’ll receive that treatment in a safe environment with clean, pure air. Sanitized to 99.99%. We take every precaution, like our intense plasma cell technology, to keep our environment here safe for you.

Innovative. Super modern. Seeking the best.

For you.

IV ketamine treatment is just like that in our hands: innovative, supermodern, seeking your best self. Is it for everyone? Does it make everyone better? Sadly no. Which is why we’re so grateful that there are teams of researchers…around the world…who won’t give up, who seek more options and even better ones, for all of us.

If you struggle with the kinds of disorders we’ve talked about, and treatments haven’t helped, call us.

We’ll set an appointment to help you know whether you might be a likely candidate for this extraordinary treatment. Your rewarding and fulfilling life lies ahead.

We look forward to meeting you.

To the restoration of your best self,

May 10, 2021
Suffer from Postpartum PTSD? Ketamine Can Bring Back Your Joy

We say that childbirth is utterly natural. But the experience of giving birth doesn’t always go as planned. Sometimes there are surprises, disappointments, unexpected changes, fears, and excessive pain.

A terribly painful labor or delivery can become a traumatic memory for a postpartum mom. Loss of the baby during the process can also create an unbearable trauma for the mom. Especially in situations where the infant doesn’t survive, the mom can be so deeply affected that the smell of baby powder or lotion can trigger a cascade of PTSD symptoms. Or the cry of a newborn baby. Mothers who suffer from postpartum PTSD can have severe reactions to triggers for months after delivery.

Leanne has five children. The first four of her deliveries were increasingly traumatic. In one case, the baby’s head was lodged at the side of the pelvis and after hours of pushing with no progress, she was moved to surgery for a C- section. This was the fourth delivery. More about that one in a bit.

With the first, she labored for 38 hours and when the baby was finally born, she tore through her rectum. Bonding with her baby didn’t go well, because she was in so much pain. Plus, she felt beat up, traumatized, exhausted, and unable to find any warm feelings for her newborn. (And too ashamed of this to say it out loud.) Eventually, over months, she began to improve.

But within 7 months of that birth, she found out she was expecting again. She sat down and cried. She didn’t feel ready. The pain in her rectum had only recently subsided.

Then, the circumstances of her second baby’s birth were also excessively painful. (We’ll leave out the details.) She began to feel like she just had terrible luck… or just wasn’t supposed to be a mother.

From that time, she cried anytime her husband tried to touch her. She couldn’t separate the suffering of the two births from amorous times with her husband. Leanne couldn’t face the risk of another childbirth. One day she was so angry, she slammed the dishwasher door hard over and over, then sat down and cried.

Leanne’s husband quietly slipped out of the house and bought a new set of dishes.

Leanne talked with her doctor, and he said that she suffered from Postpartum PTSD.

Then, one day Leanne and her husband went to visit friends for a backyard cookout. They took the babies with them and really had a wonderful day. That night, they were both relaxed, and enjoyed cuddling. One thing led to another…

And soon enough, Leanne was pregnant with her third child. She’d been in therapy for 2 years at that point, so she was guardedly optimistic…but on shaky ground.

This time, unfortunately, the crisis was placenta previa… specifically the placenta was overlapping the opening of the womb to the birth canal. Once she began to dilate, portions of the placenta broke free, causing a rush of blood loss. She started to hemorrhage. She panicked, called her husband, called her doctor, called her mom. ( If only she had called 911…but she was too shaken to think clearly.) Of course, her husband was on his way, and told her to call 911 NOW. She called 911 then called a neighbor to come stay with her little toddlers. She was rushed to the hospital, unconscious when she arrived. Doctors went to work hoping beyond hope they could save both mother and child.

Thankfully both mother and child survived, but again, Leanne was exhausted, shaken, and shut down. She just couldn’t relate to the baby. She was overwhelmed with guilt that her mistakes had come so close to causing the baby’s death.

Even though Leanne and her husband were committed to living a natural lifestyle, and had never used birth control, she just felt she couldn’t go through this again. But he stood strong about not using birth control. So she used the best form of preventing pregnancy she could think of. Anytime her husband touched her or was affectionate, she pushed him away…or sometimes she just fell to the floor in a heap, weeping her heart out.

She had times when she just began to tremble and couldn’t stop. One day she dropped a jug of milk that spilled and splattered all over the kitchen. Then she had to pull herself together to clean it up. Who else would?

By this point, she tried to be a good mom to her innocent babies, but so much of the time she felt vacant. Other times she felt angry. Then, there were times when she had such anxiety that she didn’t dare drive, even to the grocery store.

She managed to avoid pregnancy for two years. Her marriage had become volatile. She just couldn’t be calm to communicate with her husband. Everything was falling apart.

Her husband suggested they let the 3 kids stay with Grandma and Grandpa, so they could take vacation to somewhere peaceful. They took a week in Jamaica. It was wonderful with swimming, great food, walks on the beach, and local music. (And those drinks with umbrellas! She loved them!) So many sites, smells, and friendly people. They both believed this was just what the doctor ordered.

On their 5th night, they danced to local music, and drank more umbrella drinks than they realized… They found their way to their room and collapsed in bed. The next day neither of them remembered how they got there. In their inebriated state, their celebration led to baby-producing activity. So rare for them, at this point.

You guessed it…baby #4 was on the way.

Leanne home-schooled her children, so by now she was doing lessons with babies #1 and #2.

At least on the days she was functioning. But her anxiety was pretty high. How could she take care of these children when she was so shaky? A few times during the pregnancy she experienced a panic attack. Her therapist was working with her to help her work through the anxiety.

Bless her heart. This was the delivery we mentioned earlier. The baby’s head seemed to be stuck to the side in her pelvis and they couldn’t get the baby to move into the birth canal. It was the last straw for Leanne. She had a full out panic attack during the latter portion of her labor. She was standing up in her bed and screaming and crying. No one could calm her. She just wasn’t rational. She was terrified. So they did an emergency C-section after putting her sleep.

When she emerged from the anesthetic, she was disoriented, surprised to learn her 4th baby was born and doing well in the nursery. Her doctor encouraged her to rest before they brought the baby to see her. But she just withdrew.

Leanne had had dreams of being such a natural “earth mom” …she’d started out wanting to give birth to her children at home. But each childbirth had been too risky to continue at home. She felt cheated. Angry. Beaten. Each labor and delivery was a nightmare.

All her plans for meaningful home births had been vanquished. She knew she suffered not just from postpartum depression but from postpartum PTSD … and she just didn’t know what to do about it.

Her doctor had advised Leanne and her husband to consider a tubal ligation during this C-section but she had been far too distraught for a decision like that. So he encouraged them to consider it later, to give her a chance to recover.

While they were “thinking” about it, she got pregnant once again. She told her doctor she definitely wanted the tubal ligation done during her final C-section. As it happened, this 5th birth went smoothly as a C-section, and the tubal ligation was completed in the same procedure.

She was able to bond with her new baby peacefully, and she enjoyed him so much.

A wonderful, simple, easy, planned C-section — with no crash carts, hemorrhages, horrible images, horrible fears, horrible pain. Why couldn’t it replace all those awful memories? Why did they shake her up during the day, and infiltrate her dreams at night? And why did every little thing seem to be a trigger? The kids were healthy, right? They were OK, right? She was OK, right? Well on that one, no…she was really not ok. She still suffered from postpartum PTSD symptoms — and all the treatment she had had over the years hadn’t made a dent in it.

So when a friend encouraged her to consider IV ketamine treatment, Leanne grabbed her phone, and started trying to learn what ketamine can do for postpartum depression and postpartum PTSD. She made the call.

Scheduled her appointment. And left the children with a babysitter.

After the first infusion, she felt no different. Same after the second. After the third she decided to cook a new recipe for supper. Such a little thing, right? But it was such a big deal—she hadn’t done that for months. (Ketamine can restore initiativ e and motivation.) After the fourth, she could feel rays of hope inside her. Almost like rays of sunshine, she said. By the time she went for the 5th infusion, she was calmer. No longer shaking. And although there was still anxiety, she was becoming hopeful. She had good days and bad days. But there was improvement. She could feel it. She just wasn’t there yet.

So she went for a 7th infusion…and then an 8th. By this time she went for her 8th infusion, she had joy. She felt free of the fear and anxiety. And as the days passed, she felt more resilient all the time.

She became her old self over the next several weeks — felt happy, calm, fun-loving. (Oh wow, when was the last she she’d felt that?) She had patience with her children, she had creativity in home schooling them, she enjoyed socializing. She also had the initiative and motivation to clean up the house and invite another couple with kids over for dinner — outside, on the patio.

Leanne hadn’t felt this good since her first baby was born.

She also found the patience, wisdom, and determination to work with her children in family therapy in hopes of improving their security with her and building the bonds that suffered with these pregnancies and deliveries.

And she was thankful that her husband was still at home so they could work together with a marriage counselor to strengthen their relationship.

IV ketamine treatment has developed a track record for helping women who suffer from postpartum PTSD to achieve remission. Choosing to seek out this treatment was a wise move for Leanne to make. At the same time, it’s important that you understand that ketamine is not for everyone. (There isn’t anything that works for 100% of people 100% of the time.) But ketamine can be transformative for most people who are suffering from severe postpartum PTSD, depression, social anxiety, bipolar depression, postpartum depression, and more.

At Innovative Psychiatry, we’re experts in psychiatry, in postpartum disorders, and in all the treatments available for them—including IV ketamine—and we work with you to map out the best course of treatment for you. We have the protocols and — incredibly important — the technology to protect you from viruses including COVID-19, bacteria, and molds, so you can come for your treatment with peace of mind. You can breathe easy…even if you haven’t for months.

If you suffer from postpartum PTSD, don’t keep toughing it out. Call us.

We’ll set up an appointment to talk about your history and current symptoms and all the things we need to know to determine if you’re a candidate for IV ketamine treatment. You deserve the care of a specialist.

Don’t hesitate to call. Get your hope back. And the power to enjoy your family.

We want to help.

To the restoration of your best self,

May 3, 2021
Postpartum Stress Is Vicious: Reach Out for Support…It Takes a Village
Do you have a COVID baby? If so, you’ve had compounded stress.
Most moms are familiar with the exhaustion (and the overwhelm!) that often takes over when your newborn comes home from the hospital. It isn’t as though you were sleeping great before you went into labor. Then contractions started and progressed to active serious labor. Then the hard pushing. Bottom line, giving birth is hard, hard work. You think you just can’t wait till the baby is OUT of your body so you can finally sleep. WAKE UP CALL!!! Actually, once baby is outside your body, she’s adjusting too. So she cries. And cries. What can you do but nurse her till she drops off to sleep… until 30 mins later she wakes up in your arms crying again. So you put her back on the breast. And then it starts. And a challenging pattern emerges. Baby feels warm, secure, and happy when she’s nursing. Then, bereaved when the nursing stops. And you? Stressed to the max. Postpartum stress can be persistent if you’ve had a COVID baby…and even if your baby was born before COVID.

The trouble with that is that anxiety can shoot up when baby nurses, wakes, and nurses some more. Because you want some sleep… you NEED sleep.

And when anxiety rises, it’s hard to go to sleep. Your mind just keeps racing.

So what do you do? You call your mom, your sister, or your best friend to come and walk baby while you get some rest. And that’s not all it’s cracked up to be either, because you lay on the bed, wide awake….staring at the ceiling…worrying about the baby.

This is especially true for first time moms who so want to be perfect moms in every way but hadn’t counted on exhaustion and stress making you miserable. In fact, postpartum stress can be especially brutal for moms who try to be perfect.

Try to relax and let go. Perfect moms don’t exist. Cut yourself lots of slack and call in help when you feel like you’re at the end of your rope. Don’t keep pushing. Because you just have to break the stress cycle periodically.

And kick guilt to the curb!

This is also true for moms with a baby/toddler and other children…. it can be so hard to cover all the bases of everyone’s needs. Plus laundry, cooking, baths, keeping the house picked up after you’ve been up all night with the baby.

And You Wonder…Where Can You Find Postpartum Stress SOLUTIONS?

Parenting books are full of advice about how to manage your baby AND your other children when there’s no one to help. (Ha! is what I said when I read them, on baby #4.) But, when you try to put their advice to work…well it’s not as easy as it sounds.

Postpartum stress is that midlevel and escalating stress that occurs after the baby blues but before postpartum depression takes over.

If relief isn’t found, postpartum depression can settle in.

FAST FOWARD 10 months…

You finally got the baby into a schedule where she sleeps several hours each night and you depend on that chance to rest. Then you go on vacation. (Ha! they say it’s a vacation….) The changed vacation schedule disrupts baby’s schedule and she starts wanting to find comfort in constant nursing again.

By the time you get home from your trip, you’re exhausted again. And not sleeping. And you’re crying more than baby. Sound familiar?

Stress plus exhaustion is a devastating combination.

First, understand that babies are individuals with temperaments unique to them. Some are easy going, relatively relaxed, and honestly, some seem almost self contained. Moms with babies like this have no idea why you’re so stressed. So ignore what those moms say. Right??

Some babies are “high need” and may require lots of patience. This type of baby may also be colicky, and as the saying goes, it takes a village. To walk her, to soothe her, and to give you a break to rest and breathe.

You always hear that childbirth is a natural part of life…and it is. But it’s still a huge strain on your body and emotions. If you don’t have support, it can be difficult to recover.

And women who don’t receive support during childbirth have a harder time recovering from it. They can continue to struggle for weeks or longer. In fact, a study by researchers led by CT Beck found 18% of American moms reported symptoms of PTSD. We call that postpartum post-traumatic-stress-disorder –really!–and we’ll be talking about that, soon.

What is postpartum stress anyway?

It’s like this…when something goes on that sets you on edge, but it doesn’t happen just once…or twice. It happens all the time, all the time. Like a baby crying incessantly…or children screaming because they’re mad, The longer this cacophony goes on the more it strips your patience…your ability to cope…to endure. And it goes on and on, day and night, week after week after month. It goes from acute stress to chronic stress… postpartum stress.

When this happens, think of it as wearing down the synapses — those connection between neurons in the brain that help messages go from one part of the brain to the other. Those synapses can break down. The dendrites and dendritic spines also break away. You can think of it as pruning, like you do to a tree. But in terms of synapses, this is not a good thing. As those synapses break down, the connections between neurons are lost. And what’s left is a depressed mood. Anxiety. Misery.

Postpartum Stress Needs to be Relieved

Whether by natural means of relief and support, or by a remarkable treatment. Because left untreated it can easily advance to postpartum depression, a more dangerous condition.

What it comes down to is that you need all the synapses you can get in the right parts of your brain so you can be resilient and not defeated. So you can embrace challenges as they arise.

This is why it takes a village. Because you must have support from grandparents, friends, family, and as your baby grows older and is easier to manage, you can help another young mom.

But what if postpartum stress has resulted in damage too extensive for you to find the relief and resilience you need just by taking a nap, or walking and relaxing while someone else cares for baby?

Well maybe that’s where IV ketamine treatment comes in.

Nothing restores resilience like IV ketamine treatment. Nothing restores those synapses as thoroughly or as fast as IV ketamine treatment. For so many. Because ketamine restores resilience by restoring those synapses, by causing mRNA to flip on DNA to turbo boost brain-derived-neurotrophic-factors. By moving those G proteins off the lipid rafts to get those neurotransmitters revved up to do their job. By stopping the cell bursting in the lateral habenula… all these things working together to help you feel up to the tasks before you… Full of initiative, the motivation to do what needs to be done, and the hope for making your life rewarding again.

At Innovative Psychiatry we’re in place to meet you here when you arrive for ketamine treatment. Because if you want to rise above the hopeless and dark listlessness that is overshadowing your time with your baby, we’re here to help. And for the safety of you and your baby, and the confidence it brings, we’ve outfitted our offices with a space station technology developed by NASA to remove 99.99% of the viruses, bacteria, mold, and pollen from the air and surfaces in our office.

We keep the door locked so that only those who have been scheduled to be there will be there. You can feel safe here.

We’re here to help you get better, feel better, and have the power to enjoy your baby, and your family. To have the power to face the challenges with resilience.

Take affirmative steps to find out if you’re a candidate for IV ketamine treatment. Call us.

We’re here to help.

To the restoration of your best self,
April 26, 2021
Is Dissociation Important for Ketamine to Work?

The Big Question

Is dissociation needed? Is it necessary? Can you get better without it, or with “just a little bit” of dissociation? Does the kind of dissociative experience you have during a ketamine infusion predict whether ketamine is going to work? Or how much it will help? …. or If it will help faster? If it will work better….? Will it be scary? Will it be negative? Can it set you back….or make you worse? Can you do anything to shape it (yep, the dissociative experience) to get the most out of it? Boy, what IS dissociation anyway? And is dissociation important for ketamine to work?

I’m tellin’ ya, that is the question of the hour. Every hour. (Or every 90 minutes, I should say. Because that’s the time we set aside for you, when you receive a ketamine infusion. )

When you come in for ketamine, we dive deep. We look for what you used to be like at your best self—really like. Or… if it feels like you never had a best self, we go back further still. And then we look at all of the factors that have contributed to where you are today: what happened, how it happened, what the interplay is genetics, experiences, people in your life, work and the things you love, symptoms and how they’ve spiraled out of control, treaters and treatments that didn’t work out for you.

We want to understand your narrative. Because if you are a candidate for treatment with IV ketamine, we want to offer you the hope and the possibility to change that narrative….and write a new one moving forward.

So the question is what does that? What moves you forward? Ketamine itself? the racemic molecules, the NMDAR antagonism and disinhibition? glutamate activation? the multiple downstream effects involving AMPA activation, and g-protein fast action sliding off lipid rafts? The production of BDNF (brain-derived neurotrophic factor), and the growth of new branches on neuronal trees that leads to synaptic plasticity and flexibility of thought?

There is a lot of action that ketamine creates (and a lot that we are still exploring because we don’t have all the answers yet about exactly how it works). And it is all very wonderful and scientific. We love the molecular, we love the granular….we love translational neuroscience. But more than that, we love the transformation that we see when science blooms deep in the mind.

And that’s what happens in dissociation.

Science blooms in the mind.

Let me tell you what that means.

Dissociation has been described with all kinds of terms, including feeling dreamy, floaty, spaced out …. Detached from yourself or not a part of yourself, feeling detached from your surroundings. Having changes in your sense of self and where you are–feeling like you’re not yourself but a collection of thoughts or a mind/heart somewhere in the universe.

You’ll hear people describe it as feeling weird, loopy, or really trippy, with visual experiences, or feeling that time expands or contracts. Feeling an ineffable sense of awe. Or sometimes feeling like something dark is trying to intrude.

Early reports with IV ketamine for depression suggested that dissociation was associated with a good response to ketamine. Not that it was to be avoided, but that it was actually OK. More than OK, it was part of the treatment and part of what might be helping lift depression.

More recent clinical research, and the experience of countless ketamine clinicians and thousands of patients suggests not only that is it welcomed, but that the dissociative experience during your treatment could be necessary, maybe even IMPORTANT for you to experience, to remember, to analyze and to integrate into your life’s experience as your move forward…and AWAY from your depression, your anxiety, your trauma.

We think dissociation is incredibly important, and that the way that you recall your experiences during dissociation, interpret them, and look for meaning will help you grow, develop flexibility of thought, open you up to new possibilities and reawaken old loves (like the love of music, or sports, or the outdoors) or invite you to seek out new ones. The biological changes that lay the structure, and the ineffable and sometimes spiritual or mystical experiences that can occur during dissociation can be absolutely transformative. Stunningly effective. In a way nothing else we have is.

Is it important?

You betcha.

Can we prove it?

Ah. That’s another story.

Prominent Ketamine Researchers Seek Answers

Recently, two veteran neuroscience researchers in this exciting “ketamine for depression” saga, Elizabeth D. Ballard, Ph.D. and Carlos A. Zarate, M.D., published a groundbreaking paper in Nature Communications. They addressed the question about whether dissociation is important for ketamine’s antidepressant effects.

To do that, they scoured over 76 papers — peer-reviewed published reports and clinical trials of IV ketamine used in the treatment of depression, reviews, psychedelic research.

There are physicians who offer 6 ketamine infusions at a “standard dose” of 0.5 mg/kg over 40 minutes. This was the early protocol used in early research trials. And there are certainly many who haven’t veered from it.

There are others who have taken a more flexible path to help more people achieve remission. We’ve hinted about how we titrate the dose, the rate, and the number of infusions, in an effort to evoke a better response. Getting better is what matters. Living better is what sings.

Still, there has been some controversy about the role dissociation plays in ketamine achieving that response, especially remission from severe depression. So, we applaud Elizabeth Ballard, PhD and Carlos Zarate, MD for their diligence in trying to find answers to the questions.

Let’s talk about their paper, and address the current position ketamine holds among treatments for depression and other disorders, and how far it’s come.

This beautifully written manuscript highlights the immediate antidepressant effects ketamine treatment produces, along with the short-term dissociative effects that often occur during the infusion itself.

So… is dissociation important for ketamine’s antidepressant benefits? Let’s see…

They say the primary purpose for their publication is to scrutinize other studies and to learn — through a close examination of other research — and figure out the answer to this question. Is the side effect of dissociation necessarily a requirement of the antidepressant impact that is so restorative to so many… you could even say most…patients?

Oral antidepressants have a slow onset of relief, taking at least weeks, and often months, to bring relief. In fact, after all that waiting, sometimes those medicines don’t improve symptoms much at all. (If you’re reading, you probably know this firsthand.)

Ketamine, in contrast, can create rapid improvements in many symptoms within hours or a day. Ketamine treatment is not for everyone (for a variety of reasons). But for those who are good candidates, ketamine usually provides more relief and more remission than any other medicine we use.

Extraordinary Restoration in Treatment Resistant Conditions

Ketamine shows its greatest effectiveness and rapid responses in treatment resistant depression, bipolar depression, PTSD, OCD, social anxiety disorder, substance dependence, and suicidal thoughts.

As we’ve also talked about before, in a separate action, ketamine has become known for rapid eradication of suicidal thoughts. We’ve reported our own real world results about how ketamine can stop suicidal thoughts in an afternoon in the office, preventing visits to the emergency department and hospitalizations.

Chemists originally developed ketamine as an anesthetic to replace phenylcyclidine (known as PCP) in the ’60’s because PCP caused delirium, agitation, hallucinations…and violence. So it was taken off the market. Those chemists set out to develop ketamine in the same laboratory to initiate anesthesia. Ketamine didn’t illicit violent behaviors, thankfully. But dissociation and out-of-body experiences accompanied it and it was labeled a dissociative anesthesia.

Then, in the early part of the 21st century, studies began to explore what ketamine might do for people with treatment resistant depressive disorders using small doses…and the results were eye opening.

As far as the connection between dissociation and an effective antidepressant response to ketamine:

A study in 2014 found that the other side effects of ketamine, such as systolic blood pressure changes, diastolic blood pressure changes, pulse changes, or manic symptoms, weren’t associated with improvement in depressive symptoms…not at 230 minutes, or at 7 days after the infusion.

On the other hand, dissociative symptoms were associated with antidepressant improvement at 230 minutes, and at 7 days after the infusion.

Another finding of note was that some subjects with treatment resistant depression respond enthusiastically to their rapid improvement. But, when healthy subjects received the infusions, some of them experienced a transient period of dysphoria, feeling uncomfortable and ill at ease, after a ketamine infusion.

Beyond various side effects — including dissociation — that others have experienced, there’s more to consider. Let’s talk about the importance of a patient having the ability to access a “non-ordinary state” of mind to fully benefit from the work that ketamine does.

This “non-ordinary state of consciousness” can usher in neuroplasticity in the brain. Where the synaptic connections are growing, proliferating, changing… and this state of change can open your mind to think new thoughts, and to think differently about things that happen.

Like how you feel about a trauma, or a stressor, and to change your response to that experience.

The experiences, the meaning, the imagery often open up new and deeper ways of thinking about the experiences in your life in new ways, and give you an opportunity to perhaps forge a new path.

How exhilarating that can be!

So now, ketamine treatment…a series of infusions over a few weeks….is building a reputation for effectiveness with treatment resistant depression, bipolar depression, social anxiety, PTSD, OCD, and substance dependence. And by a separate action, ketamine has shown it can eradicate suicidal thoughts rapidly.

Because ketamine’s effects have been so remarkably effective in those it helps, it’s inspiring the development of new medicines in hopes of discovering more wonderful treatments for people who suffer.

So what is dissociation, really?

According to one expert, dissociation is defined as a discontinuity in the normal integration of consciousness, memory, identity, emotion, perception, body representation, motor control, and behavior. These veteran researchers acknowledge that it would be beneficial if ketamine could be as effective without the side effects of such things as dissociation. But it is not yet clear whether the dissociation is a core feature of the antidepressant response. Or, it could be just a side effect. Ballard and Zarate point out that the evidence is just not conclusive or clear.

Yes…but what’s important about dissociation??

Well, that depends on who you are…and where you’re coming from. The early researchers showed it was important because it was associated with a better response to ketamine treatment. Ballard and Zarate, in the paper we talked about above, question that because their analysis of the literature to date suggests the findings are inconsistent. They conclude that “the relationship between dissociation and ketamine remains an open question.” Part of the question may be that the rating scale used in most of the the studies to “measure dissociation,” the CADSS, might not be the right one. It was designed to measure dissociation just before and after the recall of traumatic memories in patients with PTSD. But it might not really be the best scale to capture the rapid dissociative experience that happens during a ketamine infusion and the range of experiences —like perceptual changes, peacefulness, bliss. (There are other scales out there that might capture these better.)

So…if you’re a researcher, “important” means predictive of, or statistically associated with, or prognostic for. Then “is dissociation important?” means “is it necessary for response or remission?”

Stick with us here.

However, if you’re a pharmaceutical company, you might see dissociation as just a weird and hard to quantify experience. Troublesome. You list it as an adverse effect. (Because it’s not the primary goal of treatment–remission is.) It could get in the way of your FDA approval, and of allowing your newly developed drug to be approved for at-home use. It can affect your sales. It might get in the way, it might push you to test and produce low doses and leave it at that.

BUT…if you’re the one sitting in the chair, what you want to know is this: Is what I experience during an infusion important for ME? How can I make sense of it? For me? How can I use the experience… to help me? Can dissociation—and the whole experience—actually help me?

What ketamine infusions can do for you is what is important to you. The whole experience — from start to finish, from the beautiful serene setting to your mindset and your intentions (and your hopes and your fears) as the infusion begins — can and should be integrated so that you can move forward and into a better, richer, life.

Infusion. Infused with hope.

There really is hope.

At Innovative Psychiatry, ketamine treatment continues to be the best treatment we offer for rapid relief and remission of depression and suicidal thoughts, and for rapid relief in so many of the conditions we’ve discussed. We look forward to following the research — and working with our own patients, who are often our finest teachers — and to learning from all of it as the field moves forward.

We’re also set and ready to provide ketamine treatment for you in our safe offices. We’ve installed a system that destroys bacteria and viruses, including coronavirus, from the air and lifts them from hard and soft surfaces so you can get treatment, even in the midst of a pandemic, without hesitation or fear.

We titrate your dose and adjust your infusion rate to make your treatment comfortable, productive, and effective. We want you to get better. We want you to find your joy again…to embrace bliss.

If you’ve found that your medicine for your disorder isn’t helping, call us.

We’ll talk about your history, your symptoms, your needs… and determine if ketamine treatment is a good fit for you.

Although we can’t guarantee your outcome (no one can), we’ll offer you our best judgment, and all of our clinical expertise. This treatment is very effective for the majority of our patients, and it could be transformative for you.

Call us and let’s work together to see what ketamine treatment can do for you.

To the restoration of your best self,

April 19, 2021

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