Lori Calabrese, MD

Tag: Ketamine Treatment for Bipolar Depression

Every Body Deserves a Seat at the Table: Let’s Ensure They Have It

This is National Eating Disorder Awareness Week — NEDAwareness Week

People come in a wide variety, don’t they? No one more deserving than another. Whether there are differences in skin color, differences in gender, differences in sexual orientation, differences in religion…or differences in IDEAS. And no matter the differences, no matter the variety, every body deserves a seat at the table. We may speak of the table as a place to eat, or we may speak of the table as a place to exchange ideas. It happens that this week we’re talking about both. Because we want to think about how NEW ideas and NEW approaches can bring NEW FREEDOM to people with eating disorders.

An eating disorder causes you to see food and yourself in a distorted way. A way that affects you both physically and mentally. That distortion creates distorted eating patterns. And those eating patterns can cause damage to your body and your mind… as well as your life expectancy. And of all the eating disorders, anorexia nervosa is the most dangerous. With its poor response to treatment, such persistence, such rigidity. It takes over. It’s exhausting. We need more effective treatment for anorexia.

Eating disorders affect 32 million Americans. Twice as many women as men. Whether it’s bulimia, binge eating, anorexia nervosa, avoidant/restrictive eating disorder, or others, the need to raise awareness for support, education, and especially effective treatment, is paramount.

And although we hate bad news, there’s more bad news. The death rate in women with anorexia is 10 times greater than in other women. One major reason is that the metabolic and medical problems caused by self-starvation can be critical, even fatal. And also because the desperation triggered by anorexia can lead to suicide… and often does.

So let’s talk about what an eating disorder is…and what it isn’t.

In general, a variety of biological, psychological, and sociocultural factors tangle together and lead to a disorder of this type.

The idea that eating disorders are a “girl’s disease” a disorder where a girl seeks her parents’ approval is false. Archaic. Fiction. Can you say Old Wives’ Tale?? Similar to some other diseases, there is a biological basis for anorexia — and genetic studies identifying the first 8 genetic loci! — that is exacerbated by sociocultural and psychological/psychiatric components.

And, by the way, let’s square off against the idea that eating disorders aren’t serious. They can, and often do, wreak havoc on you and the people who love you. They can interfere with your relationships, your livelihood, and your own sense of peace and self-respect. And they can tear down your health.

We need to up our game if we want to erase this hold they have on us, and erase the shame and stigma they carry. We need to up our game if we want to make headway in treating the most deadly of these disorders — anorexia nervosa.

Anorexia has the highest mortality rate of any psychiatric illness. (Or it did, until the opioid crisis recently claimed the lives of so many.) That mortality is caused by the medical consequences of binge eating, purging, starvation, over-exercising. And these consequences include heart attack, kidney failure, osteoporosis, electrolyte imbalance… and suicide.

Because of the stigma attached to eating disorders, early diagnosis can be hard to achieve. And early diagnosis is important for effective treatment. Because these disorders can begin at any age. And last for years

…and let’s get One Thing Straight Now:

Eating disorders are NOT a matter of choice. They’re diseases governed by physiology and biology, with genetic, social, cultural, and psychological factors. Help remove the stigma associated with eating disorders, to make the world a safer place for everyone… because every body deserves a seat at the table.

Stigma comes from ignorance. It’s the inclination to pour shame on anything not understood. And that shame can be crippling. It can force someone who suffers into hiding…isolation… when it’s light, enlightenment, and help that is so deeply needed.

When you’ve been isolated in the throes of shame, (and you know you haven’t done anything to deserve it!) it’s hard…really hard...to come out. Sometimes it’s hard just coming outdoors, for Pete’s sake! But sometimes, it’s coming out with truth about yourself. About your sexual orientation, about your habits, or about the way you think…or eat. It makes you feel vulnerable… and like you’re making yourself a target for hatred, stigma, and judgment.

Sometimes eating disorders live silently inside— and sometimes they can’t help but show themselves, and then the anguish, the anger, the frustration, and the way they take over your life becomes…unbearable. And stigma or not, you realize you just have to find help.

And especially, if you suffer from Anorexia Nervosa.

There is plenty of stigma about anorexia… and you may hear people toss the term around disrespectfully, because they don’t grasp the critical nature of the disease. If they suffered from it themselves, they would not speak hateful words in ignorance, because they, too, would be informed. But that’s the nature of the beast of stigma, isn’t it?

The death rate in women with anorexia is 10 times the death rate in those who don’t suffer from it. But every body deserves a seat at the table, a chance to live well… and not die from the critical medical conditions caused by self-starvation.

And again, remember that this self-starvation is not by choice, but is associated with genetic factors, and fueled by changes in the brain that happen in some women and men when they start to lose weight, get energized, and begin to exercise compulsively. And we recognize that there are a host of other factors that can contribute to a slow spiral, a continuous weight lose, the emergence of anxiety, fear, and rigid rules.

But sadly, the most distinctive and cruel of the symptoms of anorexia is the “anorexia voice.” A voice talking to you, controlling you, commanding you, every minute of every day, telling you what to eat, what not to eat, when to exercise, when to feel guilty, and on and on and on it goes.

Treatment is effective only when “the voice” can be silenced, and you are free to make choices you want to make. About food, about love, about activity… about hope.

So what can be done?

Sometimes if you have a new idea, it takes courage to offer it up — like Conflict Zone: A Play on Eating Disorder Recovery, a live-streamed one woman show with a compelling storyline about the lived experience of recovering from an eating disorder kicking off NEDAwareness Week — but it could be brilliant. It could deeply resonate. It could breed a whole new movement fueled by hope.

And while it may draw stigma and resistance from those who don’t understand the idea, those who need what the idea could provide grab onto that thread of hope.

We’ve had the opportunity to work with a few other researchers to write up and publish a case report that incorporated a specially designed modified ketogenic diet combined with ketamine infusions that resulted in complete remission of severe and enduring anorexia in a 29-year old woman who had been ill for 15 years. Striking. Striking that her remission is complete and sustained and has persisted now for over a year. (See our blog about Caroline).

The case report has taken off, generated a lot of interest (and a lot of controversy — as you might guess when we put a ketogenic diet and ketamine on the table). It’s nice to see the metrics climb, the interest rise, to see the hope bud in people with anorexia who’ve lost hope of ever beating it… and to see the sparks fly in the imagination of the scientists, doctors, therapists and dietitians who try to help them. Our case report was recommended by Drs. Miletta and Horvath in Faculty Opinions as a New Finding, Interesting Hypothesis and Technical Advance, and written up in a lovely Faculty Opinions blog.

So… we’re now following up with a small clinical trial involving more subjects which is registered on ClinicalTrials.gov. Because we need an N greater than 1. We need to see if what worked will work for more people with chronic anorexia. This next step will give us more information about the effectiveness of our new sequenced approach in the treatment of anorexia.

As you can imagine, we’re cautiously excited to see what we can learn. And we’re hoping to see more and more studies to support novel treatments for anorexia.

At Innovative Psychiatry, we’re so pleased to see people with severe treatment resistant depression, bipolar depression, social anxiety, PTSD, and suicidal thoughts achieve remission with serial titrated ketamine infusions.

When you consider that the first paper published using ketamine for the treatment of a psychiatric disorder was using ketamine infusions for the treatment of anorexia — unbelievable but true!– more than 20 years ago, it’s WAY past time for people with anorexia to have truly effective treatment options to help them achieve remission. Every body deserves a seat at the table.

As our clinical trial launches, we remain right here, in the office, with boots on the ground, and continue to treat all of our patients for the symptoms that interfere with their lives.

If you suffer from depression symptoms, PTSD, social anxiety, or suicidal thinking, and medications haven’t helped, call us. You are welcome at our table.

We work to help you get the treatment that will help you with your symptoms and give you the freedom to live a rewarding life. In addition, we also work with our colleagues over the phone, email, and at conferences to learn all we can to better help you find remission. And, we pursue research opportunities to increase the medical knowledge available to all of us. For you.

Because every body deserves a seat at the table, including you!

We want to see you build a fulfilling life. That’s our heart in all we do.

So please call and let’s work together.

To the restoration of your best self,

February 22, 2021
You Can Call It Seasonal Affective Disorder or Any Other Name, It’s Still Depression

Across the country, extreme winter storms have descended upon us. Even in the Gulf states, short sleeve weather is suddenly shifting to snow. Temperatures are dropping from 70 degrees to 17 degrees.

And the gray skies that bring snow, also contribute to Seasonal Affective Disorder. Gray on the outside can turn some people gray on the inside. And typically, about 5% American adults suffer depression symptoms this time of year only. These sufferers feel fine the other seasons of the year. But something about gray skies, less light, and snow trigger sadness. Which is why they call it SAD. Call it seasonal affective disorder or SAD or any other name. It still feels like depression.

Symptoms include sadness, low energy, fatigue, weight gain or loss, and reduced interest in things they used to enjoy.

And specifically, symptoms begin in late fall…and subside in spring.

Sound familiar? If you’ve ever suffered from depression, you probably recognize these symptoms. Because this disorder that’s associated only with winter is a seasonal depression.

Some believe that the longer nights and shorter days interfere with your body’s internal clock. And that can result in changes in the brain. So using natural light and light boxes can help.

But this year… Katie Bar the Door!!

This year all bets are off. Due to the extra strain and anxiety caused by the COVID pandemic, plus the addition of flu season, the pandemic is causing anxiety and depression on its own. As the infection and death rate have grown, there is also SAD pulling people into darker places.

Social distancing reduces social interaction. Increased stress arises from financial difficulties, employment layoffs and remote learning. That cooped up feeling from being inside the house all day…as well as heightened alert about health… These stressors can cause brain cell changes that can lead to depression.

It goes without saying that so much time in the house because of COVID means less exposure to natural sunlight. You see where this is going.

SAD + COVID precautions + Flu season = Increased risk of depression and anxiety

We’re not making light of the bombarding risks facing you this winter that threaten your wellbeing. On the contrary, recognize that this season holds a unique storm of confusing symptoms. These symptoms can emerge in your health and your wellbeing.

The symptoms can be from depression you’ve had all year, or the result of COVID’s strain, or if it only happens this time of year it could be from SAD…. That’s why they call it seasonal affective disorder.

And being informed and familiar can help protect you from confusion and overwhelm if a tangle of symptoms should emerge in you or your family.

There are things you can do. For SAD, light therapy is helpful for lots of people.

Symptoms of SAD intersect with symptoms of major depressive disorder, and some of the symptoms can also be found in cases of flu and COVID, like fatigue.

So don’t be too unnerved if you find you have feelings of a deep dread, or increased agitation, or nervousness. If at all possible, this is not the time for controversial conversations about politics or religious differences. You may not realize the the underlying agitation or fear you feel may actually be stimulated by the pandemic and its restrictions, rather than the subject that seems so upsetting.

Families have been thrown into upheaval and even split apart by this dread and agitation that only began since the COVID crisis. Keep your relationships shielded and safe.

This is a great time for finding ways to reassure the people in your world, to find light-hearted discussions, and to maintain a sense of humor. This is a time for helping the people around you to maintain stability and get through this, rather than allowing controversy to up-end those already on shaky ground.

Find Healthy Ways to Bring Light Into Your Life

Seek out healthy and productive ways of occupying your thoughts, and avoid those counter to your wellbeing, such as alcohol and substance use. Do your best to find ways to brighten your family and friends with online games, painting projects, sewing and knitting (not just for the ladies now… you guys are missing creative fun if you don’t try it!), and all the ideas you can come up with that will get everyone talking and laughing in front of the computer screen!

If you’ve experienced SAD in prior years, this year may be more severe, so seek natural light as often as possible… You can call it seasonal affective disorder or just depression… either way, there’s hope.

And if you do have depression symptoms that don’t respond to medication, there’s hope. If the medication that has been effective for years has suddenly become ineffective over the past year, hang on. IV ketamine treatment just may make the difference you need.

Ketamine treatment is a series of individually titrated infusions within a couple weeks. Ketamine has a remarkable ability to tamp down feelings of hopeless and despair, while building up the connections between brain cells proliferate a dense communication network.

The result is a brightness of emotion, clearer thinking, restored energy for daily living, improved creativity, and the power to build healthy relationships. And…hope. It happens fast…and it can last.

Is it the same for everyone?

We have patients who may require a few more than the traditional six infusions, who recover so dramatically they haven’t needed more. That’s not to say those same patients might not eventually need another infusion eventually. They know to watch for the signs.

But sometimes people read articles and misunderstand about how ketamine treatment works. They think they have to keep getting infusions every couple months, or they read that ketamine treatment can’t really last.

Broad assumptions should be avoided when it comes to treatment in the brain. Results vary among different people, and as we often remind our readers, ketamine doesn’t work for everyone. But when it works, it can work dramatically well. And it can do a transformative work in most patients who are candidates for it.

Whether You Call It Seasonal Affective Disorder or Something Else, You Might Want to See what Ketamine Treatment Can Do for You

And when the clouds dump snow, make snow angels!

At Innovative Psychiatry, we’ve witnessed such extraordinary outcomes with repeated and titrated IV ketamine that we offer it to the community to help more people get better and live rewarding lives.

We also invite our ketamine patients to ask their healthcare team to collaborate with us as we deliver the infusions and they can follow up with any needed therapies.

Also, for the sake of safety, we have a protocol for patients who come to the office that involves special instructions, mask wearing, and special safety precautions.

To this end, we’ve installed technology that destroys viruses including the COVID and flu viruses, as well as bacteria and molds in the air and on surfaces. This means that when we open the door for your appointment, you can come inside for treatment with confidence, knowing you’re safe.

Don’t wait.

You may call it seasonal affective disorder…or SAD… or major depression or other affective disorders, but if they’re not helped by medication, call us.

This is a tough winter, and these intensive winter storms aren’t making it any easier. Reach out for resilience.

Your remission is what we live to help you achieve.

Life really can get better.

Reach out for hope.

To the restoration of your best self,

February 8, 2021
Resilience: Key to Your Wellbeing Through COVID 2021 and Beyond

Resilience is doing well when you shouldn’t be doing well.

— Dr. Sood, executive director of the Global Center for Resiliency and Well-being.

We’ve passed the 1-year mark of this pandemic, and it’s time to draw from our personal stores of personal strength to maintain our pace through the rest of the pandemic triumphantly. And the buzz word seems to be resilience. It’s the key to your wellbeing through COVID 2021 and beyond. Resilience means you bounce back from difficulty, recover, and more forward.

We don’t know yet if we’ll see this pandemic wind down in 4 months, 6 months, 9 months or a year. But for your own wellbeing and that of your family, your co-workers, our economy, and our community, we must develop the power to hold steady and see this challenge through.

The way we can do it is by developing and strengthening our resilience.

Since resilience is vital to our life and ability to survive emotionally, financially, in our healthy relationships, our mental and physical health, as well as our ability to handle trauma and loss… even our basic happiness… Well, we need to build it up, don’t we?

In fact, bolstering your resilience is probably the best thing you can do to prepare yourself for the challenges and changes you’ll face this year.

So How Can You Strengthen Resilience?

Each time you push past something that feels like a limit, you’re strengthening your resilience. Doing your sit-ups even though you’re not in the mood, getting up and dressing and leaving the house when you don’t feel like getting out of bed, choosing healthier foods like a salad when you’d rather have the smothered bacon fries…these are acts of resilience. They come from discipline and build resilience.

When you turn off the TV and get yourself out the door to volunteer to help others who need what you can give, your resilience grows.

It’s choosing self -control. It’s choosing to not give up. Things you do every day that build your inner reserves to call upon when the need arises.

While it’s true that some people are born with more resilience than others, it’s still good to invest in developing it. And even people who have a lot of natural resilience tend to keep cultivating it.

The challenge is to invest yourself to cultivate it when you never have before. Because by doing that, your ability to meet the challenges this year and next year will be far better than it was last year.

It’s worth the effort.

Motivation can power resilience. Getting up and doing those things you know you need to do can help you build the purpose so you can see the point of doing those things.

Practicing jazz on the saxophone for the hundredth time may feel like monotony, but it’s building skill on your instrument, as well as resilience.

How Do You Acquire Resilience?

We acquire resilience from the inside out and from the outside in. What does this mean?

Resilience comes from the rich stores inside you of self-love, self-worth, faith, hope, positivity, gratitude, courage, and conviction.

Resilience that comes from the outside in draws upon our support system, your community of people who care about you and for whom you care, your family, your friends, and your co-workers you feel connected to.

So it’s not hard to see how important it is that you choose that community carefully, guarding its impact on you, to help you build the inner strength and resilience you’ll need to draw from in difficult times. Because it’s the key to wellbeing through COVID 2021 and beyond.

Neuroplasticity Is a Wonder that Improves Resilience

As you know if you’ve been reading my posts awhile, neuroplasticity is the ability of brain cells to change or adapt. We’ve often talked about the neuroplasticity that ketamine treatment initiates.

That’s something a normal healthy brain does to help you adapt through life. But when you’re depressed, or affected by another disorder, that ability to change can become impaired.

On the other hand, when you build your resilience, neuroplasticity can function as it should.

The big obstacle is stress. We’ve talked about stress often, because it is so destructive to brain structures in the hippocampus, the prefrontal cortex, and the amygdala.

And one of the most important things you can do to bolster your resilience is to reduce the stress in your life. Because when you reduce stress, and let some time go by in a more “de-stressed” state, the brain cells in these structures can return to their normal working condition.

Then again, we also know that this stressed state can become severe enough that de-stressing isn’t enough to restore healthy function. Sometimes symptoms become so severe that suicidal thoughts begin to dominate your thoughts.

That’s when you need an intervention. Sometimes, lots of interventions. In some cases, medication can help. But since it only helps a small percentage of patients, you may need to seek out new help, other strategies, or other treatments.

When medications fail to bring you relief, and you’ve tried at least two different trials…you may want to find out if you’re a candidate for IV ketamine treatment.

That’s where we come in… because if you are a candidate, IV ketamine can be masterful at cranking up your neuroplasticity and your resilience.

And transformation can be soon to follow.

Resilience is the key to your wellbeing through COVID 2021 and beyond.

At Innovative Psychiatry, we meet people who are depressed, anxious, and sick of it all to determine if ketamine treatment might help. Many walk out at the end resilient, joyful, and full of hope.

Invest in resilience and build your inner joy to face what lies ahead. But if your efforts aren’t enough, and medications haven’t helped, call us.

If you’re a good candidate for serial titrated IV ketamine treatment, it will be our pleasure to help you through that process.

We also take your safety to heart in the midst of this pandemic and have invested in world class technology that removes COVID-19 causing virus from the air and surfaces in our offices. We use additional air sterilization processes that lay down microbarriers. And even with that presence, we still wear masks and ask that you wear them, too. We test ourselves and our staff with SARS-CoV2 PCR tests with a local DNA lab that gives us same day PCR results–incredible!–at least once a week. We also keep the door locked, to ensure that only those we’ve prescreened can enter. You can feel safe with us, and we know you need to feel safe so you can relax, receive treatment, and recover.

Don’t hesitate. Let’s find out if IV ketamine treatment can help you get your traction back. Your resilience. Your life.

We want to help.

To the restoration of your best self,

February 1, 2021
Discovery: A New Key to Ketamine’s Extraordinary Antidepressant Benefits

Ethan sat on his rock at the lake’s edge and stared across the water. He couldn’t help but wonder if it would ever be easier to get through a day. Not really easy, per se. But what about functional? To just have stuff to do and to get it done. Routine, like other people.

Ethan was so tired. Just didn’t feel the energy to do anything…and was deeply ashamed about it. He knew people thought he was just lazy. Maybe he was. He didn’t care about changing it, and felt so defeated. (There are so many people like this…who struggle, hopeless, and don’t know about ketamine’s extraordinary antidepressant benefits. Oh to get the word out!)

Would he ever be able to actually think? He’d felt like a goober for so long. Years. Really felt scrambled, it was so hard to read. But he could read fine when he was a kid. What the heck??

What was it like to feel loved? To love and feel loved? Why was he so empty…and why did love seem to be beyond his reach?

Why didn’t the antidepressants Ethan’s doctor had prescribed ever make a difference? Was medicine for this condition just worthless? Did it help anyone? Or was he just not doing his part somehow? It seemed hopeless. And he felt worthless. What was the point anyway?

Years of this empty futility had eroded Ethan’s endurance to keep trying. He could not for the life of him find a reason to live. Or a benefit to living.

Someone tell Ethan about ketamine’s extraordinary antidepressant benefits…. and hurry.

Is it Futile? Not With the Aid of Ketamine’s Extraordinary Antidepressant Benefits

Depression and bipolar depression. What can help you feel like living? It turns out that 30% or so of depressed patients just find no real help with traditional antidepressants like SRIs. These medicines just don’t help enough people.

When a second medicine is prescribed, if that doesn’t help either, well…we say that your case is treatment resistant. That doesn’t mean you’re treatment resistant, but that your depression medicine is failing to help you feel better and enjoy your life.

But the good news is that small doses of IV ketamine – that is, doses smaller than might be used in anesthesia – can be remarkably effective for lifting depression systems and restoring your joy, your creative energy, and your hope.

In fact, IV ketamine treatment can provide rapid and extraordinary relief of symptoms. And researchers have been trying to understand the WHY and the HOW of the underlying mechanism for years.

While there are some actions that have emerged to illuminate this process, more information is coming available. We’ve talked of the lateral habenula and the synapses in the brain many times.

New Research Unlocks a Ketamine Secret

Ketamine’s extraordinary antidepressant benefits are the talk of the decade. But ketamine’s secrets have only slowly been coming to light.

And just last month, research was published in Nature Research that shows that the ketamine and the ketamine metabolite hydroxynorketamine provide their antidepressant effects when mTORC1kinase is activated in the cell.

This research shows one of the things mTORC1 does is to turn on mRNA which initiates special binding proteins 4E-BP1 and 4E-BP2.

Actually, these binding proteins get lots of the credit for ketamine’s antidepressant benefits…as well as that hippocampal synaptic plasticity that promotes so much healing.

Remember that mRNA also turns on DNA to turbo boost brain-derived-neurotrophic-factor proliferating a dense growth of synapses.

It turns out that these same binding proteins are necessary for ketamine’s benefits in the lateral habenula as well. You may remember also how ketamine moves those G-proteins off the lipid rafts to get signals moving fast!

Ketamine is a powerful medicine. We don’t know why it isn’t effective for 100% of people who need it, or 100% of people who suffer from depression, bipolar depression, PTSD, and other conditions. We’re still researching and learning.

But we do know that IV ketamine treatment in the form of serial expertly titrated infusions is effective for more treatment resistant depressed people than any other medicine currently known.

And the odds are excellent that it will help you achieve remission.

Imagine having a heart full of joy and courage, along with the determination to build a fulfilling life, and the initiative to develop healthy rewarding relationships.

Just imagine.

Imagine really caring. About anything…about everything that matters.

Imagine hope.

Ketamine’s Secret Unlocks Joy and Hope

At Innovative Psychiatry, we cultivate hope… and joy… through expertise in titration, dose, and frequency of life-changing ketamine infusions. We have world class expertise in helping people get better.

We also have a safe environment in the presence of COVID-19 pandemic.

Talk about world-class. We have transformed our offices into a coronavirus killing machine. Units in each room that destroy and remove the virus…in fact all viruses….from the air, and a spectacular spray/fog that destroys all viruses – including COVID-19 – from all surfaces. 99.9999% is ALL.

You’re safe here. To be treated, restored, and empowered to live the life you want to work for. Your life. Your dream.

If you have labored and struggled under the burden of treatment resistant depression, bipolar depression, PTSD, substance use disorders, and suicidal thinking, call us.

And if you feel unsure, read the posts linked through this one. There is so much information, and hope.

We’re here to listen, and to help.

You’re the reason we do what we do. So call us.

To the restoration of your best self,

January 11, 2021
Burgeoning Hope for 2021 & Saying Goodbye to 2020

It’s been a year unlike any you’ve ever known.

You might think 2020 has been the worst year you’ve ever seen. You may have lost loved ones from COVID-19, or you may have lost your business. And I’m so very sorry for all your losses…. Maybe you lost your job, and your family has struggled for food and safety. But… 2020 for you may have also been a year of change, re-evaluation, and new beginnings for you and your family. It depends on your circumstances and your response to them, doesn’t it? And as you say goodbye to 2020, don’t forget to embrace a burgeoning hope for new promise in 2021.

In the world of psychiatric treatment, which is our own focus, we’ve seen lots of change. IV ketamine treatment is not the experimental, questionable treatment for depression and PTSD many people considered it to be in 2014. It has gained such confidence in the eyes of practicing physicians. And now they’re bundling it with other treatments and therapies. These developments ease more and more people into restoration, recovery, and hope.

Just the story of ketamine treatment’s progress should give us burgeoning hope for 2021. And more hope for the discoveries of the new year.

In short, ketamine treatment has grown up.

This second decade of the 21st century has opened up hope for so many who’ve suffered with untreated symptoms for as long as they can remember. Besides the presence of the pandemic, what else has emerged during 2020?

It hasn’t been all bad, has it?

In the quest to treat alcohol use disorder, Elias Dakwar, MD conducted a study to test the effective outcome of adding motivational enhancement therapy to IV ketamine treatment. Dakwar’s research using IV ketamine for alcohol and cocaine use disorders goes back to 2013. His work published in 2020 shows his depth and dedication to study and breakthroughs for those who suffer these disorders.

His team did their work related to cocaine use in 2019, and the one regarding alcohol use in 2020.

Their results demonstrated that when ketamine treatment is combined with motivational enhancement therapy, abstinence is improved.

We can’t wait to see what Dakwar and other front leading researchers will uncover in their work in the new year. More burgeoning hope for 2021.

And as we reach toward 2021, let’s remember the naysayers ten years ago who scoffed about ketamine treatment, sensationalized it, laughed at the very idea of it. Let’s remember that new treatments are typically rejected by the mainstream and it requires innovative thinkers to help those treatments move forward. Real innovations are almost always surrounded by naysayers. For awhile.

Anorexia nervosa has been the subject of research and longstanding debates about causative factors and effective treatment approaches. It is the most lethal psychiatric disorder. And although new research is presented each year at national medical conferences, reliable treatment that leads to long-term recovery has remained elusive. Our own experience with a case study this year using a new approach to treatment was promising, and we’re eager to see more innovative research in anorexia to furthering this hope.

We’ve also learned that the stress of a pandemic can lead to an increase in severe depression, PTSD, substance use disorders, and suicidal thinking.

That quarantining for individuals who already suffer these symptoms can exacerbate and exaggerate them. That people who had felt that their medications managed their symptoms before the pandemic found that sometimes that was no longer true when isolation was added to the mix… Not to mention social distancing, closed restaurants and businesses and online learning away from schools.

Plus, a global pandemic can put everyone under stress, and we have a choice to decide how we treat those we meet. With kindness, patience, and understanding, or with agitation, criticism, and the belief that others should pay for our own frustration.

We learned that social distancing, hand washing, masks and gloves seemed to create their own stress. And even people who enjoyed being alone, who enjoyed solace, often found this level of isolation stressful.

A Vaccine is Emerging — More burgeoning hope for 2021

The big story in the news has been the development of a vaccine for COVID-19, which has possibly caused other forms of research to take a back seat temporarily. But this has been a global priority and thankfully vaccines are emerging.

Meanwhile, we’ve been digging deep to find safe “work arounds” for you. We want to make it possible for our patients to receive the treatment you need during this crisis. And that has involved changes we’ve made at Innovative Psychiatry.

Here’s another 21st century development. This one by NASA and MIT. And it destroys viruses like COVID-19, bacteria, and mold from the air and surfaces and removes them from the environment. We reached out to have this technology installed in our offices. Based on plasma cell technology that destroys the pathogen and leaves the air and surfaces in the office space pure, clean, and safe. Why? Because it’s pathogen free.

Developed as a prepared response for biological warfare, this technology is exactly what is needed in a pandemic.

And it can empower you to reach out to us for treatment no matter what is happening with the SARS-CoV-2 virus that causes COVID-19, so you can receive ketamine treatment in the safest possible place.

And remember, this solution doesn’t just remove the COVID virus from the room, it destroys all airborne viruses. The flu, too. And bacteria like staph, and pneumococci … and whatever else might make its way into microdroplets.

It’s been a tough year dominated by the pandemic, but we have the technology to fight that pandemic in a new fresh, effective way. Burgeoning hope for 2021 says the more ways we can destroy COVID-19, the better.

In a few days 2020 will end. And 2021 will begin.

Once again, we have a choice. We’ll have to continue to weather the growing numbers of cases, and the overflowing hospitals… for awhile.

For each of us, our mental and emotional wellbeing is best served by the kindness and generosity we show those around us.

At Innovative Psychiatry we’re in full swing. Eager to help you receive the treatment you need for anxiety, depression and bipolar depression, PTSD, alcohol use disorder, substance use disorder…and especially suicidal thinking.

We plan to beat this pandemic. To get to the other side of it. And to help you get to the other side of it.

So you can feel safe to come in with confidence and receive the ketamine treatment that will help you get better. Help you cope with life as it is now, and as it unfolds. To build your resilience, and to aim for remission.

We’re here for you to help you live 2021 with a new fresh outlook that makes it so much easier to face challenges with confidence, and the creativity to devise useful solutions.

We’re not saying that ketamine can do these wonderful things for everyone, since there is no medicine or treatment that works equally well 100% of the time in EVERY SINGLE PERSON. Let’s be clear.

But we continue to be stunned at how thorough and transformative ketamine treatment is for most.

We look forward to 2021 and to seeing you blossom with hope in the days and weeks ahead. May Your Days Be Bright…

If you suffer from symptoms that no other treatment has helped, call us.

We’re here and available to make appointments for you within a few days to help you enjoy a rewarding and fulfilling life of joy, creativity, and meaningful healthy relationships.

To the restoration of your best self,

December 28, 2020
Fantasize This: A Stress-Free Family Holiday Month… Crazy? Maybe Not.

December is National Stress-Free Family Holiday Month. Don’t Laugh. It really is…

OK, yes, I get it. It’s the holidays. In a pandemic. COVID-19 spread is skyrocketing. Finances are a struggle and it’s the holidays. Depression can peak this time of year. Everybody needs something and to go somewhere. And don’t forget Personal Protective Equipment. Did I mention it’s the holidays? Stress-free family holiday month? You gotta be kidding me.

We’ve talked about stress before, and the pathology that contributes to it. And how stress contributes to the wearing down of brain structures like synapses that can cause more serious disorders. Like depression, bipolar depression, PTSD, social anxiety, to name a few.

When do you need to be stress-free more than now??

Add to the holidays the risk of seasonal affective disorder, which for some people creates the symptoms of debilitating depression as the days become shorter, the skies are gray more often, and less light gets through.

When you feel bad, your stress increases. And when your stress increases, you feel crummy.

So how on earth do you make December a stress-free family holiday month? Especially now?

One approach might be to consider that even though the pandemic may create stress, the pandemic can also give us the freedom to reduce our own stress.

Case in point:

You can shop less. Agree with your family and friends that giving no gifts or else giving small token gifts is easier to manage this year. You can reduce your shopping and wrapping by say…80%? And use the time that’s left to do things you enjoy at home. And avoid exposure to others.

Perhaps spend more quiet and quality time with your spouse and family. Playing cards and board games, or just talking and laughing together.

You can bake together if you enjoy it.

But you can definitely reduce the stress that goes with hustle and bustle. You can make reasonable decisions to just pass up the hassles this year and give gifts next year.

Stressors Abound But Stress Doesn’t Have To

While it’s true that US COVID-19 cases in the month of November — 4 million — actually doubled the number of cases in October, your risk of infection is pretty low if you stay quarantined and isolated a while longer.

Daily deaths from COVID-19 in the US are back up to the numbers back in April. On April 15, 2752 people died in a single day, the largest number of the pandemic…until this past Wednesday, when 2300 people died.

COVID-19 is a serious risk, but that’s why you need to make good decisions that protect yourself.

The more you stay inside, washing your hands, wearing a mask if anyone comes in, and finding ways to ENJOY yourself, the less risk you face of the COVID-19 virus spreading to you.

And if you don’t feel afraid, the stress ratchets down.

If you don’t feel overwhelmed with more to do than you can every complete…well the stress ratchets down more.

If you don’t have to prepare to host a houseful of company for 10 days…you got it: the stress ratchets down even more.

Because one of the things that cause stress is fear. Another thing that causes it is exhaustion — mental and physical exhaustion.

And illness causes it, too.

Winter 2020 presents us with new options.

We can continue riding the treadmill in the midst of the storm…or we can just take a breath, and decide to make changes that help us — and our loved ones — enjoy improvements in life and relationships. And less risk of contracting the most contagious and potentially threatening virus we’ve seen in 100 years.

It won’t always be like this, will it? This is temporary. It may last a year or two. But it is NOT permanent.

So let’s take care of ourselves and each other.

In doing that, we can make this a stress-free family holiday month.

Another thought:

Think back over the last 5-10 years before we’d ever heard of COVID-19. During the hustle, bustle, and intense stress of December, can you remember thinking that somewhere along the way we’ve lost sight of what all this is about? That society — you and me — has gotten so caught up in the obligations at this time of year that we’ve forgotten how to enjoy ourselves and each other. To seize moments?

Holiday parties every weekend, office party, parties for the kids, shopping for a list of people a mile long, wrapping gifts, preparing meals and baking cookies for cookie exchanges, cleaning the house to prepare for company…and the list goes on.

That feeling of “stop the world…I wanna get off…” Sound at all familiar? Consider that this is your year for a reboot. Set new expectations, reduce expenses, invest less of yourself in “impressing” and more in “supporting” and “loving”…

Meanwhile, if you suffer from severe symptoms of depression, bipolar depression, alcohol use disorder, substance use disorder, PTSD, social anxiety…maybe even anorexia…. then the stressors of the Winter 2020 season can only aggravate the symptoms.

Some people whose symptoms were managed by oral antidepressants before COVID-19 and all the circumstances of this season, find the oral medications are no longer effective. In spite of medication adjustments and dosage changes.

And some of these people are finding they want to reach out for ketamine treatment because nothing else is working anymore.

If that sounds like you, just know you aren’t alone and that ketamine infusions may just make the difference. It has for so many others who have reached the point you have.

Yes, there is still some people who are not helped by ketamine and we don’t understand why. But research continues to clarify the dose, response, and safety of ketamine treatment.

At Innovative Psychiatry, we, too, are re-evaluating to find less stressful and safer means of helping you get better. We’re so gratified when we see patients who’ve suffered for years from treatment-resistant symptoms walk out of our offices with joy, relief, and hope following a series of ketamine infusions.

It’s enough that there are as many stressors as there are these days, but our hope for you is a stress-free family holiday month in December 2020. This is a unique holiday season like we’ve never seen before…and one we’re unlikely to see again in our lifetime.

And if you need ketamine treatment to achieve “stresslessness” at home… please do call us.

It’s possible to make some strategic executive decisions to reduce the stress as well as exposure to others for yourself and your family…while using this time to rediscover meaningful experiences within your household.

And by reducing stress in your home, life, and family…and receiving treatment for the misery of unmanaged symptoms, you and your family can enjoy a special and memorable December 2020 holiday month.

We’re here and ready when you are, and wishing a happy holiday month for you.

To the restoration of your best self,

November 30, 2020
Thanksgiving Day 2020 Holiday in the Pandemic – Learning New Ways to Share

We’ll never forget 2020. For the COVID-19 pandemic, for the social and political turmoil, for the economic struggles and adjustments that have accompanied all of it.

And we’ll never forget the Thanksgiving Day 2020 holiday when people stayed home, meals attended by only a few, while watching the graphs of COVID cases, hospitalizations, and deaths skyrocket.. When the SARS-CoV-2 virus surged and spread around the world, and faster in the US than anywhere else. And families were isolated at home or in the hospital, rather than gathering. But the truth is, we’ve lived an historical event since January. It will be in the history books. But for now, what do we do with it?

Well, maybe a good place to start is with Giving Thanks. You may have lost loved ones this year, maybe even from COVID-19, or you may just miss them during the holidays because they’re gone…

There are plenty of reasons to be sad, or angry, or frustrated. There are also reasons to be thankful.

Choose Gratitude No Matter What

A study at Berkeley found that people who practice gratitude on a regular basis have healthier emotional lives, are happier, and build resilience for tough times ahead.

In addition, the more often we practice and feel a given emotion, the more space that emotion occupies in our psyche and becomes the mood we live within.

Honestly, during terribly difficult and turbulent times like 2020, you get to choose your frame of mind. The way you see your life. If you tell yourself that life conspires against you…c’mon now…be honest…. If you tell yourself that you’re a victim of some villainous force, then you will believe yourself, and live within a life of self-pity, blame, despair, powerlessness or bitterness…that’s all you’ll have.

But. if on the other hand, you tell yourself that you’re blessed in numerous ways…list them!…that life is working in your favor no matter what the challenges….you’ll feel gratitude, inspiration, and the power to make your life what you want it to be.

For the Thanksgiving Day 2020 holiday, you can make the most memorable experience by applying gratitude.

Gratitude … expressing how grateful you are… is practice toward underpinning your brain’s circuitry, and strengthening your resilience. And doing that helps you see the good in challenging circumstances.

Because, truth be told, you want to be resilient and healthy, and we want that for you. During Thanksgiving, as you and your loved ones make decisions geared at the wellbeing of everyone involved, you need resilience, love, and the ability to adapt.

First, for the older members of your family, and those with underlying or chronic conditions, this is not the time to take chances.

The increases in SARS-CoV-2 burgeons on. It’s far better to love your vulnerable family members to stay home and celebrate with you over FaceTime or Zoom, rather than risk their being infected, hospitalized, and worse. Next Year. Thanksgiving 2021 should be a holiday — hopefully — when you can all safely be together again.

But for this one Thanksgiving, when you sacrifice face to face contact, you can yield a life shared for years to come. And don’t travel, or let anyone come to you who has to travel. The risks right now are only increased by transportation that involves contact with others.

Second to that, only those who you’ve been around and KNOW their attention to isolation, distancing, and precautions, are the ones to be allowed near you during the holidays. Maybe two or three trusted friends or family…? If anyone comes to visit, insist on a COVID test before hand within time to get the results. All the rest can visit you online, but confine their exposure to those who live within their own homes.

And third? Well, here’s a suggestion:

Share your love and gratitude with those important people who can’t be there. Write the gift of a letter to each one with a list of why you’re thankful for them, or to remind them of a memory you share together. Find a way to shower your family with love, without face to face contact.

Choose Warmth, Kindness, and Generosity for an Unforgettable Thanksgiving Day 2020 Holiday

By choosing the frame of mind you want during this holiday time, by putting to work all the best safety precautions, by carefully selecting anyone from outside your home who joins you, and by reaching out to loved ones with love through email and gratitude, you can have the happiest and most fulfilling holiday in memory.

In the face of the pandemic, and the changes it causes, ADAPT. That’s how you survive and overcome difficulty. By adapting and applying new approaches. And enjoying them.

At the same time, if you find yourself depressed, or caught in the throes of PTSD, or struggling with alcohol use or substance use, or social anxiety, IV ketamine infusions can really help.

At Innovative Psychiatry, we’re fully functional in spite of the pandemic, with newly installed technology that gives you and our staff the best possible protection from COVID-19 in our offices.

We continue to serve as an essential service and we’re here for you when you need ketamine treatment.

There are lots of things about holidays and gatherings that unsettle and trouble some people who already suffer …

If oral medication hasn’t worked for you, if you’ve suffered from your symptoms that nothing has relieved, call us.

We’re here to help you in a safe and supportive environment.

You’re not alone.

To the restoration of your best self,

November 23, 2020
The Vicious Cycle Of Psychiatric Disorders and COVID

Sam wasn’t sleeping enough. As in, not much at all. She just couldn’t drop off. But even if she did she’d wake right back up.

Day after day, week after week. She’s done everything she knows to do. And she has to work, so she just has to get by. Still, it scares her because her mind just isn’t clear. On top of that, she felt nervous all the time… shaky. What’s so hard about walking to the mailbox? What was the matter with her… Was there any connection to psychiatric disorders and COVID? The very idea made her shudder.

But it was real. And there were some things that had become harder and harder for her…since a couple months before she stopped sleeping. She didn’t know if being overly tired was making her feel uncertain about things like answering the phone or walking down the street, or if the nervousness was keeping her from sleeping?

Still, she was careful with COVID precautions. Always had her mask with her, and her hand sanitizer. She did have to work in the office, but everyone wore masks, and the cleaning service wiped everything down each night.

In spite of all that, she started feeling bad. Odd symptoms. On top of the shakiness. A tightness in her chest, strange feeling in her throat, and she felt sort of washed out. Then she ran a fever so she called in. Since her symptoms continued, she went for a drive-through COVID test… and it was positive.

Arrrgghhhh. So she had to stay home. But she felt so weak and crummy. After calling in to work, she went to bed. Fever and chills continued over night. And she realized she was getting weaker and weaker. Overall…her symptoms reminded her of the time she had mononucleosis in high school.

It was hard to be alone and try to figure out what to do.

Time to Take Action

The next day, she was afraid to wait any longer, so she called her doctor to get his advice. He told her she should go to the hospital.

The harder it was to breathe, the more discouraged she felt. Thankfully, they put a commode by her bed, because even walking to the bathroom in her room was just too much exertion.

This was far worse than mono. It was becoming scary. And because of the pandemic, her family couldn’t visit her. That night, she woke up panicking for air. She heard an alarm…her room filled with people in protective garb… then everything went black…

Sometimes A Disorder Seems to Make You Vulnerable To Contract COVID-19, and Sometimes COVID-19 Seems to Make you Vulnerable to Developing a Disorder…

Phil was 73, recently retired as COO of a successful marketing firm, and was beginning to enjoy his freedom. Of course, the pandemic wasn’t helping matters or helping him with his retirement plans. He wore a mask when he went out, kept sanitizer in his car and used it often.

Occasionally, he’d go fishing or play a round of golf. And when he did, he was outside and didn’t wear a mask.

One day, he noticed one of his golf buddies seemed to have a cough. Phil asked him about it, and he said he had something stuck in his throat from breakfast. Three days later Phil didn’t feel right. Something was off. By lunch time, he was feeling bad. Achy, draggy, his throat hurt, his stomach hurt. He called his golf buddy who told him he had been admitted to the hospital.

What???

Social Distancing and Masks Matter to Avoid the Vicious Cycle of Psychiatric Disorders and COVID

Phil was healthy, spry, in good shape. He truly didn’t feel vulnerable to catching anything. He called his doctor, who told him to get a drive-through COVID test and to call back after taking his temperature. Oh no. It was 101 degrees. He went for the drive through COVID test, and by the time he got home he felt like he was in trouble. He had no idea …if this was COVID…. that it could get so bad so fast.

By supper, he didn’t want to eat, and his breathing was shallow and rapid. His wife called 911, and by midnight he was on a ventilator.

His wife was terrified.

Phil was so sick. His family was so afraid he wouldn’t survive. But after 11 days in the hospital he began to improve, and they removed the respirator a couple days later.

Once he was home again, resting and rebuilding his strength, his wife noticed he was missing words. He called common objects by the names of something else. At first it embarrassed him, and then he lost track that it was happening.

In less than 6 months, he forgot the names of his grandchildren, and a few months after that, they had to put special locks on the doors to keep him from walking out and getting lost.

He didn’t really have dementia in his family, medical history… and his behavior was baffling for the people who loved him.

Phil’s Battle with COVID May Have Set Him Up for Dementia, as It Has Others

It’s a Vicious Cycle of Psychiatric Disorders and COVID

As if we didn’t already have enough to think about, new research has emerged that reveals a vicious cycle between psychiatric disorders and COVID.

Yeah…I know.

Specifically, between depression/anxiety as well as insomnia and COVID. And for the older patients, between COVID and dementia.

The study, led by Paul Harrison at Oxford, examined the electronic health records of 69.8 million people from 54 healthcare organizations in the US between January 2020 and August 2020.

They found that in the 14-90 day period after their COVID-19 diagnosis, 5.8% received their first-ever diagnosis of psychiatric illness. This compares to the 2.5 -3.4% who are diagnosed with psychiatric illness after another illness without COVID.

Another study, led by Nora Volkow at the National Institutes of Health, conducted a study of over 61 million adults found that people who have been diagnosed with a psychiatric disorder in the last year have a heightened risk for COVID…and they tend to have worse outcomes that those who fight COVID without a psychiatric diagnosis.

Gee.

And the diagnosis that seemed to cause the greatest risk was depression. So to provide perspective, for those who had been diagnosed within the last 12 months with a psychiatric disorder and also contracted COVID-19, the death rate was 8.5%, compared to 4.7% for those who had no psychiatric diagnosis.

The study couldn’t reveal WHY this is the case, but researchers have some hypotheses.

For one thing, if you’re depressed, it’s hard to care, so therefore more likelihood of abandoning precautions. In addition, if you struggle with psychiatric symptoms, you may have a higher sensitivity to stress, and you may have less resilience to cope with the uncertainty, isolation, and financial challenges associated with the pandemic.

All of that adds up to weakened resistance and greater risk for relapse.

It all comes down to comorbidity…and psychiatric disorders fall into the category of “underlying conditions” that increase your risk, just as diabetes and heart disease do.

And so, just like the grandmother who has chronic asthma, or the business man with heart disease, you need to take special precautions to protect yourself from becoming infected with COVID-19.

These revelations about how COVID-19 illness can seem to make you more vulnerable for psychiatric disorders, including dementia, and how recent psychiatric diagnoses can also make you more vulnerable to being infected by COVID-19, tell you how important it is to protect yourself through the rest of the pandemic. This vicious cycle can result in long term problems that make the precautions worthwhile.

Be extra careful to protect yourself from the vicious cycle of psychiatric disorders and COVID.

At Innovative Psychiatry, we’ve taken more extra steps to protect you and our staff by using VB Enviro Care’s plasma cell technology tools to remove dangerous pathogens from the air and surfaces. And we still wear masks. And so will you.

Because our focus is for you to get better. To reach a point where you feel like the best you’ve ever been. So we want to treat your symptoms, and we also want you to stay well, free of COVID-19 and the flu.

IV ketamine treatment has demonstrated dramatically that at this point it may be the most rapid and best treatment available for depression, bipolar depression and PTSD, and so much of the anxiety that goes along with them.

If you believe ketamine treatment can help you, call us.

Let’s work together to help you experience the rewarding life you long for.

It’s the only life you have, right? Do this for yourself. Call us.

To the restoration of your best self,

November 16, 2020
IV Ketamine Maintenance Infusions: How Many? How Frequently?

Charlene could not remember a time when she wasn’t depressed. A series of tragedies in her family along with psychiatric disorders in her relatives, all seemed to lead to her own depression. Antidepressants she’d taken for years seemed to do very little. Regardless of dosage or ration, she’d long ago lost hope that she’d every be better. Some people just had to live a life of wasted dreams. Dull. Flat. Empty.

That’s how she felt.

She’d tried to go to college, but found she was too unstable. She wanted to excel. But lack of motivation and dread seemed to have far more power over her than good intentions. She knew someone who went for IV ketamine maintenance infusions… but who knows? A lifetime of depression had tainted her, dulled her. She guessed the person she was must have become molded around the depression that had ruled her for so long. She hated herself, soaked herself in shame. Worth NOTHING. No education, no accomplishments, nada.

She wondered how she could ever be any different.

Now she had passed her 31st birthday, and she’d heard about ketamine treatment…she was thinking she might invest in it for a birthday present to herself. So she scoured the internet to learn what this treatment could do, and whether she should put hope in it.

The more she read, the more she learned, and her confidence and hope grew. So she called for an appointment. She wondered if ketamine infusions would work. And if she would need IV ketamine maintenance infusions.

She wanted an expert who really knew what they were doing. She wanted someone who would know what to do with severe symptoms. Symptoms that resisted everything. And everyone’s effort. She really wanted to find someone who was an expert in treating what she’d been told she had: treatment-resistant depression.

To find a psychiatrist who emphasized treating each patient individually, with remission as the hopeful goal.

She felt blamed. Like SHE was resistant. But she wasn’t. She did everything, took everything, tried to meditate in the morning, walked outside everyday, posted stickies on her mirror. Which she thought was stupid. And pointless.

Because none of it worked.

So was she just going to end up going to someone who would say, yeah, year, oh sure. ketamine? yes, you should do that …

She wasn’t born yesterday. Nor was she an idiot. She didn’t need a yes-man or a yes-woman, or a yes-doctor, for Pete’s sake. Who would just plop her down and promise her the world.

Here’s what she found: a place where she met a doctor who really wanted a ton of background information. Who took the time to collect it and read it and spent an hour with her before even getting to ketamine. (Not someone who did a phone screen. Nor someone who accepted someone else’s word for what she had. And not someone who interviewed her in a treatment chair.) Someone who wanted to know her story and her backstory. Who asked her questions that weren’t checklists. And someone who told her she was looking for all the factors that might indicate that ketamine could be helpful to her AND…all the things that she had working against her, that might make ketamine NOT work so well for her.

She was bowled over.

What if this actually worked? And if it did, was she going to need IV Ketamine Maintenance Infusions?

A Plan for Charlene

Lots of talk. Lots of tears.

And then the treatment started. Charlene received a series of infusions over a couple of weeks. Six to be exact. And she could feel some change — but not enough. Then, she was hospitalized and in the ICU for 9 days… The severity of her condition, the stress of it on her body and mind, resulted in her losing the improvement she thought she felt after the sixth infusion.

She called the psychiatrist. Why would it fade so fast? Did that mean it wasn’t working? That it was never going to work? That it would be like every other thing she had tried?

She was encouraged to have two more infusions. Here is where she got a migraine. She wasn’t sure it was worth it …the money! She wasn’t sure SHE was worth it.

But she got 2 more infusions. She didn’t know if 2 more were considered IV Ketamine Maintenance Infusions or not. Still, she began to improve dramatically, but was under pressure to move to a new place. The extreme stress of moving under pressure with the earliest hints of remission blooming was too much.

Once again, the benefits of the ketamine treatment seemed to lapse. So she went in about 2 months later, and had another infusion. In all of them, her dose and rate were titrated to support dissociation.

The goal was to get well — sustainedly well — and stay well.

That’s what she wanted. That’s what her doctor wanted.

(Isn’t that what everyone wants?)

The next morning, Charlene reported learning a new song in her dream. She sang it for her family. Someone told a little dad joke, and she exploded into laughter…with her eyes shining.

This never happened with her.

Her family told her she used to sing for them when she was a preschooler.

Early Signs of Remission

That was just the beginning. Over the next couple of months she became more and more lighthearted, hopeful and joyful. She began building the friendships that had lapsed during her depressed years.

It was as if the real person she was…the one that emerged from infancy… had replaced that person she thought was irrevocably tainted by depression.

About four months later, she was sick and in the ICU again. But once she recovered, her remission remained solid. A year ago she had to go through a massive move involving her mother’s abandoned belongings, and years of her own belongings that had stacked up during her depression.

And her resilience stood strong.

Feeling well was her goal. STAYING well was her goal. It’s called REMISSION.

And she got there with an approach that was not cookie cutter. It’s a wellness model, not a business model.

Her remission remained intact, and she maintained a light heart throughout the process of packing, throwing away old mementos of dear family members who’d died, and hauling off items she wanted to donate to charity. It was a gripping experience in addition to exhausting. But she felt resilient.

Her remission remained solid.

Two years later she married a warm, loyal, and kind man her family loved. The stress of planning a wedding will bring many brides to their knees, but she remained strong and flexible through the process.

She was so glad to be alive. And to be in love. She never took a single day for granted.

Somehow her physical health has also improved dramatically along with her emotional health. She had given up on antidepressants when she originally went in for ketamine treatment, and hasn’t looked back. It has been three years and she’s never had another booster or IV ketamine maintenance infusion.

Maintenance Infusions: Yes or No?

Each Person is Unique with Unique Needs for Treatment

Charlene is not like anyone else. Of course not. Every person is different. But the questions that came up for her after her series of infusions come up for lots of people. Do I need more? How do I know if it will be worth it? How frequently should I have them?

What’s the data really, about that?

Turns out there’s not a lot of data about maintenance treatment out there.

A recent retrospective chart review from Massachusetts General Hospital (my old stompin’ grounds!) looked at a group of 85 outpatients who received 2 ketamine infusions a week for 3 weeks starting at 0.5 mg/kg.

The study followed these patients naturalistically — that means their outpatient psychiatrists could change their medications and they could change their therapists or the therapy they were getting while they were going through their infusions.

Although the response to the first 6 infusions using was only modest, and the drop-out rates were high, about 47% of the patients went on to receive maintenance infusions and 33% continued maintenance.

The investigators attributed this to the patients perceiving benefit from continued treatment. They received an average of an additional 2.3 +/- 1.5 infusions during maintenance.

We applaud these efforts. Research is long, hard, and time-consuming.

I think one of the things this study points out is that a one-size-fits-all approach to treatment doesn’t yield the most beneficial outcomes. Because one size doesn’t fit all. And just like with antidepressants, one strength doesn’t fit all. We need more research on dosing, titration, and schedules.

Each Doctor Chooses What He or She Believes is the Best Course

Medicine is both an art and a science. We’re deeply steeped in the science (from Wellesley, Hopkins, and Harvard …how could you not be?) — and we’re deeply committed to the art.

We bring the best of what we’ve learned, the best of what we know, and the best of who we are to you.

At Innovative Psychiatry, we just don’t use a one-size-fits-all approach to depression treatment. Or to ketamine treatment. We don’t now and we never have since the beginning. With each patient we tease apart symptoms and medical history, along with the patient’s experiences and descriptions to find what’s needed for that particular patient. We custom fit the infusion protocol and recommendations between visits to each individual patient.

See how that’s worked in a young woman with anorexia. Her anorexia has been in remission now for 10 months and counting.

It’s a wellness approach to treatment because we want to see our patients achieve remission in every case possible.

It means doing our homework, staying up late and scouring the reading, to find out what other experts have experienced, learned, and tried. Going to conferences. (Well, staying at home and logging in to conferences now!) Then applying what we learn to each patient according to his or her specific needs.

Because it’s all a vital part of helping each patient achieve remission. Some patients may need maintenance infusions, and when they do, we make it part of our wellness approach to their ketamine treatment.

Overall, remission is the goal. We can’t promise it, but we do everything we can to make it possible.

We want you well.

Or as close to well as possible.

We want to see you enjoying your life, investing in your future, and in healthy, strong relationships… and the things you most like to do.

Give yourself the chance to live the best life you can live.

To the restoration of your best self,

November 9, 2020
Two Big Causes for Dread Today: The Vote and Second Surge of Coronavirus

Disasters can come in many forms… barring natural disasters like earthquakes or floods… political disaster and a rising pandemic sound pretty daunting.

There’s the anxiety that accompanies voting tomorrow, and hopefully you’ve had the opportunity to vote early and avoid the big final voting day… Then add to that the OUTCOME of the vote the next day. The fact that it will go one of two ways… and it’s easy to cling to the idea that the world as you know it will end if the vote doesn’t go YOUR way. Eeesh…. Right along side that is the rising tide of COVID-19 in the news as the daily infection rate rises higher and higher. The CDC reports 99,750 new cases this past Friday in the US, the highest single day count of new cases ever in the US. That’s up from 63,000 October 16. We are neck deep in the Second Surge of coronavirus.

Yikes…

Both of these issues have been looming. At the end of the summer, COVID seemed to have been receding. Then there was talk of the Second Surge of coronavirus. Now, the news is full of the threat of the worst flu season in memory because of the combination of influenza and COVID-19.

Like the growing gloom of black thunderclouds on the horizon, when the low barometric pressure is a hint of the impending storm… there is the sense in the nation that disaster looms.

And you feel helpless.

And fearful that life will become somehow unmanageable, so difficult that it may overwhelm you and those you love.

Stop and take a breath.

Breathe in…

Breathe out…

Repeat.

Because of particularly strong clashes of ideals and passions, they’re calling this vote an Election on Steroids.

There was a time when elections were so apathetic that big chunks of the population didn’t bother themselves to vote.

Not now.

Where the presidential election is concerned….only one candidate will win. You know that.

But here’s the rub. No matter who you voted for, life will move forward. Your life, your family, your job…your routine…will move forward.

Those who didn’t vote for that candidate will adjust. And those who did are sure to suffer their own disappointments at some point too…but that’s how life goes.

You. Your loved ones. That’s who deserves your energy and support. So get up. Keep living, and being grateful for everything that’s good in your life.

Remember that your vote is one vote in a nation of millions of people. We live in a great nation with all its faults and all its strengths. And you’re a part of these millions of people who comprise this nation.

We’re all connected, no matter who we voted for, or who wins. We’re connected by virtue of being Americans, and by virtue of being human. We all share the same DNA and we need each other.

Tensions Foster Divides But You Can Bridge Them

During the tensions of an election it’s easy to fall into grievous criticisms of other beliefs and ideals than your own. But honestly, it’s beneath all of us to do that.

During the terrible fires that have swept across the northwest, California, and Arizona, Americans go and help. Right..? They don’t ask if the people evacuating are of one ideology or another. They just help because they’re people.

And doing so increases peace in the helper.

After this election is completed tomorrow, think about what YOU can do to maintain your peace of mind, your stability, your support of other humans. It’s likely there will be others who react because their candidate didn’t win, and those who celebrate because their candidate did win.

But think about your life, your loved ones, and your wellbeing as a family. Make an effort to understand those you don’t agree with. Make a decision to limit the time you spend watching the news, or reading news or political rhetoric on the internet.

And focus on the good in your life, the people you love, and your care for them.

Second Surge of Coronavirus: The Double Whammy Flu Season.

People everywhere are seeking ways to protect others from the ravages of the spread of these viruses. We already have cities in our country where hospitals are full…businesses have been shuttered.

The numbers of cases per day are swiftly rising. In the US overall, on October 16, the number of cases/day was 68,000 but is now 99,750.

Just Think.

There IS a need to take every precaution. To choose safety, rather than take chances.

In NYC this weekend, a Halloween party was held where 400 people attended. Many wore no masks. Why? You have to wonder. Of course, police handed out citations to all they could, but what causes people to knowingly contribute to the second surge of coronavirus …?

Ok. Yes. We’re all fed up with masks and gloves, sanitizers, and handwashing, as well as social distancing. But that’s no reason to stop doing what’s safe, is it?

Still, you cannot change what other people do. But you can make your safety decisions based on what is currently happening. And you should.

So if you know the people in the post office or grocery store line aren’t wearing masks, don’t go there! You can always send gifts from websites and have them delivered directly to your recipient.

When you go to the grocery or hardware store, use one where you can park in a special space and they’ll bring your purchase to you. So that you avoid going inside. You do have choices to keep yourself and loved ones safe.

See how easy this can be? No muss, no fuss, no frustration.

You can stay safe from this second surge of coronavirus by making thoughtful choices that take care of you.

Plus, it’s a lot easier to make choices that are right for you than to let yourself get fearful, resentful, and angry at those you see not following the safety protocols.

What Else Can YOU Do to Navigate and Weather the Sense of Dread You Feel At This Weird Time?

Walks in the fresh air can help. Eating a diet that’s chosen from all the food groups, especially all the colors of vegetables and fruits. Greens, reds, blues, purples, yellows…

And if you need the kind of treatment ketamine infusions can provide, call us.

At Innovative Psychiatry we’ve taken extra steps to make sure we’re constantly destroying COVID-19 and flu viruses in our offices. We’ve gone the extra mile, so you can feel safe here, and our staff is safe, too.

And…if the root cause of your feelings of dread are related to something else — bipolar depression, major depression, social anxiety, or trauma leading to PTSD — ketamine treatment may help.

If you struggle with these and treatment hasn’t helped, call us.

Ketamine treatment may be able to help you rise above the dread and feel hope and clarity again.

This is an unusual autumn. We won’t see another one like it anytime soon. And we’re going to get through this safely, together.

Please call us and let us help.

To the restoration of your best self,

November 2, 2020

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