Lori Calabrese, MD

Tag: Ketamine Treatment for Bipolar Disorder

The Heartbreak of Suicide: You and Ketamine Can Help

The Heartbreak of Suicide – What Can We Do?

Each day last week,122 people in the United States took their lives by suicide. We want to talk about Kate Spade … and you. And how the heartbreak of suicide is stealing our loved ones. And what we can do to change that.

By now, most of us have read that Kate Spade died by suicide this past week. This is too important to ignore as if it’s just another news story. Yes, Kate Spade was an icon and many have cherished her distinctive purses, bags, and wallets.

But this isn’t about her products. This is about her.

And others who suffer like she did.

Quietly. In silence… and despair.

All sorts of reports have swept through the news without sensitivity to Kate Spade and her family. A note published publicly by her husband expressed his horror that a note allegedly by Kate to her daughter was published by sensationalistic news media without his consent.

Traditional Depression Treatment Fails Sometimes…Then What?

The bottom line is that when suffering from a psychiatric disorder ends in death by suicide, the public considers that death the business of mankind in general… regardless of the suffering of the family.

It turns out, Kate suffered from depression and anxiety for the last six years before her death. She was engaged in intense psychiatric care regularly. But she wasn’t getting better.

Her family and close friends wanted to help, tried to help, but she probably reached the point that just talking about her struggles wasn’t changing anything… maybe she laughed it off when her best friend expressed concern. Maybe she looked fine. Sounded fine.

Psychiatric Disorders Can Be Hard on Relationships

She and her husband lived in separate apartments the last 10 months, but near each other so their daughter could easily go back and forth between them. The three of them continued to share meals, and vacations.

Kate and her husband Andy had been together for 35 years and the love between them was strong… enduring. But Andy says now they just needed a break to work out their problems…divorce was never considered.

If you’ve known severe depression and anxiety, you know that the depression can be suffocating…the anxiety crippling. And for some, as the depression worsens, the anxiety becomes more intense.

The longer depression goes untreated, the more likely it seems that phobias, panic attacks, and other forms of anxiety can emerge that can leave you feeling unable to function in your life like you used to.

People like to speculate. They’ll tell you maybe it’s not depression. Maybe it’s bipolar disorder.

Kate’s husband has been adamant that she suffered from depression and anxiety for the last six years, and that she’d been in psychiatric treatment for the last five.

And that’s the tragedy.

When you know you’re suffering from a psychiatric disorder, and your doctor provides the best treatment he knows to offer, what if it doesn’t help?

What do you do?

The Heartbreak of Suicide

For decades, this has been the situation with up to 50% of patients suffering with depression. They take medications year in and year out. But they don’t work…or maybe they don’t work well enough. So they try to keep going through their routine until they just can’t anymore. At some point they occasionally mention death… or dying…or funerals…

And they try and try to buck up, keep enduring…until they just can’t anymore.

Their thoughts fill with the idea of relief that would follow the end of life. They resist as long as they can. Sometimes, they succumb.

And someone finds them, after it’s too late to help.

For all of our lifetime, when medications and therapy didn’t make a real difference for a suffering person, doctors have sometimes just said, “I’ve done all I know to do.” It sounds so horrible. Like that’s it. There’s nothing else.

Others suggest trying yet another and another new medication or therapy. When hope just keeps being deferred indefinitely…well, we get heartsick…and can give up.

There’s Hope That Rises Above Traditional Treatment

But here’s the tragedy for Kate Spade, and others like her.

We’ve never had ketamine treatment before the last several years. But we have it now. She suffered for 6 years without relief.

What about you? Untreated depression and anxiety can slowly erode your relationships, your confidence, and your hope.

Does your doctor know about the effectiveness of ketamine treatment, or how to provide it with the best, most effective methods…?

She had made a fortune with her Kate Spade brand in partnership with her husband over the years. So she didn’t miss her chance for effective treatment because of cost. She had the resources to pay for the best treatment.

We see people like her all the time here at Innovative Psychiatry. People at the top of their game who suffer from an array of psychiatric disorders … and need treatment so they can continue contributing to their world, engaging with their families, enjoying their lives.

We can wish Kate had known about ketamine treatment. We can wish her life had been restored, her relationships with family and friends strengthened because she had the energy to invest in and build them again. Because she no longer feared that openness would harm her brand.

But for Kate Spade, sadly it’s too late for that.

Still, stop and think.

So Many Suffer in Silence Until They Can’t Stand It Another Day

How many people across the US died by suicide last week…? 122 each day. One of them happened Friday, when beloved celebrity chef Anthony Bourdain also died this way. How many more…?

We have to ask how many of those deaths could have been prevented if everyone knew about ketamine’s effective treatment that takes the pain away?

How many people in our world still don’t know that treatment actually IS available that can give them their lives back…restore their joy, their motivation, their well-being? That can stop suicidal thinking. Quickly.

We can work together to share this reality with everyone we know so no one else has to die without hope.

We must work together to help people who suffer like Kate suffered find help. And hope. We must talk about psychiatric symptoms without shame. As freely as we talk about back pain, migraines, cancer.

If a friend talks about death…about dying…even off the cuff…even laughing about it…

What do you think?

Oh, weird… wonder why she’s talking about this right now…embarrassing…

I hope not.

But the stigma is right there. Along with shame.

What if I’m overreacting..?

Overreacting to a possible call for help is not life-threatening….but ignoring the situation just may be.

You can reach out. You can confide in your friend about something you’ve been through that was embarrassing. Lower the wall. You can ask if there’s anything you can do. You can share things you’ve read, like this blog for instance.

Brain and Behavior Institute published this statement by Dr. Jeffrey Borenstein on Friday:

“If you are concerned about a loved one, you should express your concern. Some people have the misconception that asking a person about suicide will increase the risk, but in reality asking does not increase the risk of suicide, but can save a life.”

And you can provide your friend with the Suicide Hotline and encourage her to call you or call this number if she ever feels serious about it:

If you or someone you know is in crisis, call the U.S. National Suicide Prevention Lifeline at 800-273-8255, text TALK to 741741 or visit SpeakingOfSuicide.com/resources for additional resources.

Ketamine treatment can stop suicidal thinking in 4 hours or less. Tell your friends and loved ones.

Ketamine Treatment Ends Suicidal Thinking in 4 Hours or Less!

The heartbreak of suicide can be prevented.

It’s true that ketamine treatment isn’t for everyone…but it’s effective for most, and even some of those who seem to not respond at first have a delayed response…and are living their lives with joy several months later. Ketamine is so remarkable, it deserves a chance to show you what it can do.

And you deserve the chance to experience the rapid and robust action of ketamine in your brain, relieving your symptoms.

If you suffer from a psychiatric disorder, or if you know someone who does, read the articles linked to this one and inform yourself. It’s no longer necessary to suffer under the burden of a seemingly untreatable disorder.

At Innovative Psychiatry, we offer a variety of novel, advanced options to reach the source of your disorder and help you get better. We’re not interested in treatment that just takes the edge off…

When you’re in pain, you’re in pain. A little reduction in symptoms really doesn’t help that much. You need to feel good. You need to feel well.

Please call us. Let us help you get better.

May the husband and daughter of Kate Spade, as well as her family and friends, be comforted and find peace. Our hearts weep for you.

And if you find your thoughts filled with images of death and dying…call us. We can help lift this terrible burden from you to help you rebuild a happier, more fulfilling life.

To the healing and restoration of your best self,

Lori Calabrese, MD

June 11, 2018
Dance of the Genes: Activity Patterns that Link Some Mental Health Disorders… and Not Others

May is Mental Health Awareness Month!

That means we have the privilege to talk about the realities of mental and emotional well-being, and the psychiatric disorders that threaten it.

Even 20 years ago, our society was still so steeped in the stigma that people with depression and other psychiatric disorders were often overwhelmed with burdens of shame and ostracized at school, work, and even within families. We haven’t completely defeated the stigma, but let’s take a moment to appreciate how far we’ve come.

Mental Health Awareness Through Media

It was an exciting moment when we first saw the public service announcement showing Glenn Close talking about her sister’s disorder and her love for her 8 years ago. Score ONE Against Stigma.

Glenn Close, the actress, whose sister has bipolar disorder and whose nephew has schizoaffective disorder, began speaking out with her family in 2010.

She and her sister founded BringChange2Mind that year, and have broadcast public service announcements and interviews about life with psychiatric disorders.

Her sister, Jessie Close, writes blogs for the BringChange2Mind website. Jessie responds to those who write or call about their own difficulties or of those who love them.

And Glenn Close’s family is not the only one who has spoken out. A host of celebrities have stepped up to expose their own personal struggles with depression, bipolar disorder, substance abuse disorder, and more. People like Mariah Carey, Catherine Zeta-Jones, Carrie Fisher, Ted Turner, and lots more have told their their stores and spoken openly about their struggles.

Thank goodness.

Neuroscience Breakthroughs Stamp Out Stigma

One of the most important ways we strike a blow to the stigma of psychiatric disorders is to talk openly about these illnesses, just as we do about illnesses of the heart, lungs, liver, and kidneys.

The more we make psychiatric disorders part of casual conversation, educating as we go, the further back we push the stigma associated with this suffering.

We also spread the word about everything neuroscience discovers related to the causes and treatments for mental health disorders.

And by the way, genetic links have been found for pretty much every major psychiatric disorder. Even 15-20 years ago there was enormous speculation among certain aspects of society about whether psychiatric disorders were even real…

But now, we have functional MRIs, genetic links and maps, and the pathophysiology of these disorders. Suffering patients are pushed into corners far less than they used to be, with demands to “prove” they’re ill.

But it’s not over.

Dance of the Genes

We need to keep learning, and keep shouting out the truths about psychiatric illness for the sake of those who suffer and need help. Always to drive away uninformed judgment, and stigma.

So let’s talk about some things that have been uncovered regarding the solid foundation of psychiatric illness. And the breakthroughs in treatment that are emerging. The treatments that can not just relieve, but conquer, these terrible illnesses. Let’s talk about the dance of the genes: activity patterns that link some mental health disorders and not others.

Researchers discovered certain arrangements of gene activity associated with specific psychiatric disorders in a recent study. Illnesses like depression, autism, alcohol use disorder, bipolar disorder, and schizophrenia show up as the result of these genes expressing themselves, according to the study published in Science in February 2018.

These researchers studied postmortem brain tissue from 700 identified patients with those disorders, and compared them with matched controls and with controls with a non-psychiatric inflammatory disorder. They were looking for patterns of genetic similarities and differences in the cerebral cortex — across large brain regions.

They found similar levels of certain molecules among people who suffered from autism, bipolar disorder, and schizophrenia.

As they studied further, they found out that there are links between bipolar disorder and depression, which doesn’t seem that surprising. BUT … also between depression and autism. And between bipolar disorder and schizophrenia — and autism and schizophrenia.

Researchers have known that since 2013. But most of the rest of us haven’t.

What’s really news is that certain psychiatric disorders are more similar biologically than we’d ever thought if we’re just looking at the diagnoses themselves–the names we use. If we just dig deeper…

Astrocytes Activate to Signal Specific Conditions

There are star-shaped cells in the brain and spinal cord called astrocytes that provide support for those cells that make up the blood-brain barrier, among lots of other things. They supply nutrients for nerve tissue, and help with repair in the brain and spinal cord after serious injury.

So the genetic patterns or systems these researchers found actually affect how the brain cells communicate with each other.

Because the astrocytes activate with certain conditions. And many of the same astrocytes activate in conditions we wouldn’t have expected to be linked to each other.

These researchers see potential for identifying those patterns that genes express in astrocyte activation for each condition, which can eventually help us identify the underlying biologic vulnerabilities for these conditions.

As complicated as this sounds, this is a stigma buster! It’s not only “proof” for these disorders, as if anyone has anything to prove. But, it paves the road to improving the diagnosis of psychiatric disorders in the future — faster and with better accuracy, so treatment can be the RIGHT treatment for better outcomes.

Reach Out to Those Around You

While these possibilities are brewing, reach out with compassion to those in your world, in your circle, who clearly suffer. You see it in their “inappropriate behavior,” their inability to perform, and their despair.

Take a breath. Give them a moment of kindness. Of patience. Recognize that they didn’t ask for these limitations. But they carry them every day without relief.

Give to mental health research. Support organizations that offer respite and treatment.

Psychiatric illness isn’t elusive or ethereal. It can be identified in genes, in functional brain scans, in genetic patterns that write their own recipes for health and wellbeing… or disabling illness.

Environmental, biological, psychological, and genetic factors come together and spark most, if not all, psychiatric conditions. There is pretty much always a combination of factors behind each illness.

The fact remains that countless people suffer without help. They reach out on Facebook, on Twitter, and especially on Quora. So many people who have taken the medicines and aren’t any better.

Thankfully, there are also those who are better. Those fortunate ones who get better with antidepressants, anxiolytics, and mood stabilizers. But far too many don’t improve…and feel more desperate every day.

For you, we want you to know you’re not alone in this struggle. As you can see, neuroscientists press forward, as well as psychiatrists and neurologists, working to help people like you get better.

Studying to find improved treatments. And hope.

Innovative Psychiatry Specializes in Tough to Treat Illnesses

At Innovative Psychiatry, we’ve been specializing in helping those who couldn’t find effective treatment before for many years. We love a challenge. And we offer a variety of novel and advanced treatment options to help you get truly better.

Ketamine treatment is the most dramatically effective treatment we’ve seen in our lifetime. It doesn’t help everyone, but it does help most. Furthermore, its extraordinary antidepressant effects help our patients improve with such vigorous speed and depth that their lives begin anew.

Ketamine treatment relieves mental health disorders.

If you’ve been suffering from a psychiatric disorder that hasn’t improved from other treatments, call us. The right medicines given with the necessary expertise can change a life forever.

To the emerging of your very best self,

Lori Calabrese, M.D.

May 7, 2018
21st Century Psychiatry: Neuroscience Discoveries Fight Stigma

Stigma: A Mark of Disgrace Based On Belief in Certain Assumptions That Have No Factual Basis

“He’s not depressed…he just needs to get up and get busy.”

“PTSD is just a fancy name for weakness. Get over it!!”

“Bipolar disorder? What an excuse for bad behavior! Get some discipline in your life and you’ll be fine.”

Sound familiar?

Comments like these are insulting, stigmatizing, and prejudicial. They hurt. And they have no basis in fact.

In this day and age, there is no excuse for them.

These are just some examples of the stigma expressed in hurtful words that serve to fuel shame in people who have depression, bipolar disorder, a trauma history, or who struggle with substance abuse.

Why Are Psychiatric Diagnoses So Hard for Some People to Accept?

Do you ever hear someone say, “Diabetes… ridiculous. Work harder and you won’t have trouble with blood sugar. I work hard and I don’t have diabetes!”

Or…

“Cardiovascular my foot! You’re fine. Get back to work.”

Probably not. Why is that?

Because there is no real stigma attached to malfunctions in the heart or the terrible sudden dysfunction in the pancreas of a child who develops Type I diabetes.

The more science learns about the human body, and its ailments, the more credibility those ailments have.

Why The Brain is Such a Target of Stigma

Except for one part of the body…. And that’s the brain.

Since ancient times, the intricate and complex functions of the brain have been steeped in mystery and wrapped in tales of fear, sorcery, and voodoo. All of this has contributed to the stigma that has hovered over people with psychiatric illnesses like a dark cloud of shame.

As recently as decades ago, patients admitted to psychiatric hospitals for behaviors their families didn’t understand were heavily drugged and incapacitated.

There is a population of individuals today who still stand by the opinions that reigned at that time…and they’re still influencing younger family members and friends with those erroneous views.

Stigma-busting Research

If you’ve faced stigma about your psychiatric symptoms from family, friends, or your job, we have some encouraging news for you. We both know that the expression of stigma is simply a sign of ignorance. Lack of up-to-date information underscores old and outdated beliefs. The best defense against stigma we see about psychiatric disorders is information — scientific information.

A recent study shows we can use a blood test to distinguish biomarkers in bipolar disorder that are different from those in schizophrenia. Investigators have also developed a blood test that could help doctors more quickly diagnose schizophrenia and other disorders.

This one detects certain types of inflammation and oxidative stress. Another test can differentiate 20 metabolites found in urine that distinguish schizophrenia and bipolar disorder.

Tests like these are building a foundation of what we would call biological proof for various psychiatric disorders — proof that they’re real, that there are underlying genetics for many and pathophysiology — how things go wrong — that is being worked out and understood in labs and universities and clinics around the world.

These are exciting times!

Neuroscience discoveries fight stigma .. .And the more we talk openly about the data points, the sooner we can dispose of the stigma.

HOPEFULLY.

If you know me, you know I abhor the term “mental illness” — a term that subtly suggests that psychiatric disorders are somehow different — maybe even less valid — compared to so-called “physical illness.”

This is just another way of perpetuating the myth… and the stigma… that psychiatric illness has less credibility.

The fact is, psychiatric disorders are just as physical as pancreatic disorders, or pulmonary disorders, or gastrointestinal. They’re just a lot more complex to see.

The brain is the most intricate, “multi-media” operating system in the human body. It is absolutely the “last frontier” in medicine. And it has as much credibility as any other body system…and is as real as Saturn or Jupiter…two planets we can see but can not yet touch.

And if you’ve suffered from severe psychiatric symptoms, you KNOW how terribly real and concrete they really are. Because psychiatric disorders can encompass your whole body.

Neuroscience Discoveries Fight Stigma

So here’s another piece of scientific discovery that rips yet more of the stigma-fied rug out from under uninformed individuals who make hurtful and ignorant comments.

Millions of people are living today who remember when psychiatric disorders were blamed on poor parenting or even demon-possession. Thankfully, we’ve made light years of progress since then through the dedicated work of neuroscience.

In a commentary on many studies, published February 2018 in Biological Psychiatry, the authors explained discoveries made by researchers about micro RNA (miRNA) and how it plays a role in either improving or exacerbating symptoms of psychiatric illness.

One finding showed that a certain type of miRNA could be found in tumors; another type was found throughout the body serving a variety of purposes.

miRNA-9 is found most abundantly in the brain, while miRNA-21 is abundant in a variety of tissues in the body. miRNAs can regulate a multitude of genes throughout the body.

And certain miRNAs regulate processes in the brain, like synapses and the replenishing of brain cells, or neurons. They estimate that 60% of all genes are regulated by at least one miRNA …and sometimes by many.

Tight and Multi-layered Gene Control

When multiple miRNAs regulate the same gene, it allows for regulation of many layers of processes and tight control of the protein “expression” of these genes. Genetic expression basically involves turning on the protein or RNA that the DNA creates to fulfill that gene’s blueprint.

This is how genes “express” themselves in the organism they are designed for. When something goes wrong in that process, it can lead to illness. In fact, improper expression of genes has been linked to pretty much every kind of illness or disorder across most of the body’s systems, such as cardiovascular, autoimmune, infectious, neurodegenerative, and psychiatric disorders.

So in the study of miRNA, researchers discovered that miR-137 regulates the maturing and differentiation of neurons, which has an impact on cognition and the physiology of the brain.

How about that?

miRNA and Neurogenesis

Another miRNA, miR-16 hinders the development and growth of neurons. Fluoxetine, an antidepressant, seems to decrease that hindering function, allowing more neurons to grow and thereby decrease depression.

Also, it seems to suggest that antidepressants that hinder or block the function of miR-16 increase growth of neurons in the hippocampus. Another plus!

And if fluoxetine can decrease those miRNA hindering functions, how much more so could IV ketamine treatment …right?

Neuroscience Discoveries Fight Stigma…

Well-meaning (but uninformed) adults in the ’60’s, ’70’s, and 80’s used to say “if mental illness is real, show me…where is it? Take a picture and show me!” These comments were even made by people in medicine. Shameful, really.

Stigma is such a terrible thing.

Well, the pictures are emerging. Concrete evidence is spreading.

And if you suffer with psychiatric symptoms…you don’t have to listen to those heartless comments anymore. There is a wealth of documented science that’s growing every day, every month, and every year.

Neuroscience Discoveries

I hear the things people say to my patients that cause deep hurt … that promote shame … that silence good hearts, and I’m struck by their courage to keep going. To fight stigma. To get well.

So, another point or two about miRNAs.

Various alterations, like the one accomplished by miRNAs to block the work of miR-16, have been linked to a number of psychiatric disorders. Researchers found this link in blood, postmortem brain tissue, and cerebral spinal fluid.

… And Another Discovery

Also, researchers have found that miR-132 is altered in the brain tissue of subjects in cases of schizophrenia and autism, and in the blood serum of subjects with major depressive disorder…as well as in animal models of depression and addiction.

Researchers think this may be due, in part at least, to the alteration of miR-132. Researchers suggest that this happens because of the role miRNA play in circadian rhythm or brain-derived-neurotrophic-factor (BDNF). We know (and love) BDNF. This protein has a clear role in mood regulation, cognition, and the growth of neurons.

Neuroscience Discoveries Fight Stigma

One last thought. This increasing knowledge about miRNA and how it can shape the causative factors of psychiatric disorders lays another row of bricks in the foundation of our understanding of the causes of different psychiatric conditions, and opens up new directions to improve treatment.

In addition, it’s further documentation that there are real cellular, biologic processes behind our diagnoses. And our treatments.

If stigma has intimidated you, take heart.

Neuroscience has your back.

Innovative Psychiatry Offers Advanced Treatment

And so do we. We see all forms of psychiatric illness here, and we work hard to find more effective ways to help you heal. At Innovative Psychiatry, we offer the most advanced and effective novel treatment options, like IV ketamine treatment and transcranial magnetic stimulation (TMS), along with medications, adjunctive help with nutrients like curcumin, and strategies to strengthen your microbiome.

To date, IV ketamine treatment rises above all other forms of treatment for many individuals who’ve been failed by traditional treatment.

If you suffer from depression, anxiety, cocaine or alcohol use disorders, PTSD, OCD, bipolar disorder, or suicidal thinking… and have not been helped by medications, call us. We’ll work together to determine the best treatment to help you live a productive, joy-filled life again. Build relationships again. Enjoy your favorite interests again.

To the restoration of your best self,

Lori Calabrese, M.D.

April 22, 2018

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