Lori Calabrese, MD

Tag: Ketamine Treatment for Social Anxiety

Bipolar Disorder Treatment for Depression and Suicidal Thinking

Treating bipolar disorder with all its comorbid symptoms can be a delicate process.

Some people suffer tragically when all’s right with the world. The COVID-19 changes have made the last 5 months especially difficult for them. Those who suffer severely lack the medications and treatments to help them function during this period of isolation and quarantine. For example, bipolar disorder treatment for depression, anxiety, and suicidal thoughts is all the harder in crises like these.

Many people suffer with these symptoms when the world is balanced and functioning. However, during this period of crisis their difficulties torment them mercilessly.

Bipolar disorder is one of the most severe psychiatric disorders, but unfortunately it has not received the most attention for studies, breakthroughs, and relief. Not even close.

This serious disorder plays a significant role in the lives of people who live in shelters, in jail, or who commit suicide.

To take it a step further, some doctors warn that no one should still be prescribing antidepressants for bipolar disorder.

I’m not one of them—but more on that in a bit.

It’s true that depression is a terrible symptom of bipolar disorder. In most cases, it dominates many more of your days compared to mania or hypomania. And it’s vital to find a way to treat the depression while also avoiding the mania (or hypomania).

Add to that the other conditions that often run hand in hand with mood disorders. Those that accompany the depression and mania — like severe anxiety, panic disorder, and OCD. Anxiety can appear as a cluster of conditions that vary in severity, with flares that occur willy-nilly. Boy, can they exacerbate each other! And boy, can a simple straightforward medication for an anxiety disorder suddenly make your mood disorder worse. And vice versa.

If you or someone you care about has bipolar disorder, you know what I mean. The meds that are supposed to help can be hellish.

Then, there’s another point to be aware of…

Bipolar Disorder Treatment for Depression, Anxiety, and Suicidal Thoughts …is Tricky

An article in Psychiatric Times recommended we use evidence-based medications like lithium, quetiapine, lamotrigine, lurasidone, and cariprazine, and avoid antidepressants in people with bipolar disorder. And they have reasons for that.

Those are excellent medicines. But what about when a patient doesn’t respond to any of them?

But people are individuals. And we design and personalize the treatment for each individual.

For instance, when we find that patients with bipolar disorder also have severe anxiety disorders (panic disorder, OCD), the anxiety can be hard to address with therapy alone or occasional medications. Sometimes it’s just so bad that it needs to STOP. We can sometimes control these it best with a concurrent SRI — the current updated term for SSRI — to suppress panic attacks or OCD.

Why do that? Because some people with frequent unpredictable panic attacks just can’t function very well. Some people with OCD are tortured by it.

Give them an SRI and it could go a long way towards suppressing all of that. But then … their mood can really go haywire. Rapid cycling can occur — and everything can spiral out of control.

There is no one-size-fits-all for psychiatric treatment. Especially if you have bipolar disorder. And its friends. Anxiety? Agitation? Hyped-up energy? Frustration? Each symptom must be teased apart and treated carefully, without upsetting the other symptoms. Without upsetting the rest of your life.

Because the fact is, bipolar depression can be severe, unrelenting, and life-threatening. To expect someone with severe bipolar disorder to muscle through bipolar depression along with panic attacks, anxiety, OCD, being untreated, too, is cruel. While you’re waiting for the proposed mood stabilizing medicines to relieve the plethora of symptoms you suffer…when it never happens, it can feel pretty desperate. You can feel pretty hopeless.

People who suffer from bipolar disorder live at risk for ending their own lives. Their frustration with unrelenting symptoms, their shame over behaviors when their mania –or hypomania– is not controlled, and their impulsiveness during mixed states make effective treatment so important.

The stakes are high.

Sometimes an SRI can ease the panic attacks…or the OCD… without actually relieving the depression.

And yet, what’s the alternative?

For some patients, these medicines can help prevent hypomania or mania, and in some they also stabilize depression, too. But when they don’t help the depressive symptoms, something more really does need to be done. Pretty quickly.

Ketamine Treatment Can Help with Bipolar Depression

And ketamine treatment can relieve bipolar depression pretty quickly. It helps many patients whose depressive symptoms aren’t relieved by these mood stabilizing medicines or SRIs. But we use it carefully. Because ketamine infusions occasionally induce hypomania.

At Innovative Psychiatry, we see people with bipolar disorder improve dramatically from ketamine treatment’s extraordinary antidepressant effects on their bipolar depression. By bringing relief with this treatment to the dangerous and overwhelming threat this condition causes, and by reversing the suicidal thoughts that can accompany it, mood stabilization can become easier.

Bipolar disorder is not a walk in the park, but effective treatments and personalized, innovative psychiatric care can bring you joy, peace, and a rewarding life.

It’s what we do. It’s what we live for.

We invite your healthcare team to work together with us to get you back to your best self. Please feel free to have them call.

If you suffer from bipolar depression, call us.

You actually can live very well with the right treatment for you.

We’re here to help.

To the restoration of your best self,

June 8, 2020
Ketamine Plus Motivation Enhancement Therapy = Better Abstinence

Study shows abstinence from alcohol improved when ketamine and talk therapy were combined.

We’ve talked before about the benefits of ketamine to reduce the craving for cocaine and for alcohol use, as well. A substance use disorder is can be a prison with no way out. We’re going to talk about the work of researcher who works for relief and freedom for those with disorders like this, Elias Dakwar, M.D., and his study using ketamine plus motivation enhancement therapy. But first, Jackson’s story can give an idea about how much suffering can happen for those with this type of disorder.

Jackson’s Story

Jackson wiped the sweat from his forehead, and told himself he could do this. He had an AA meeting in a few hours. Surely, he could make it till then.

He tried to focus on the TV, to get his mind off the yawning craving he felt for a drink. It had been three days since his last drink, and he knew if he started drinking again, he’d be right back at the crack house.

Nobody told him it was like this.

If he could stay away from crack, he might almost be able to get clean and stay clean. But he knew from experience that if he saw some on the table, there would be no avoiding it.

But what was really frustrating, was that drinking alcohol always led to his seeking out crack cocaine. He didn’t know why…but it just happened that way.

You know, when you’re partying with friends, or even just getting together for dinner… everyone’s always drinking. And you think Why not? Glass of wine or a beer… no big deal, right?

But one drink would lead to another… and another. And the next thing he knew he was waking up wasted. Hating himself.

Why oh why did he ever try cocaine the first time? It had wrecked his life. But he couldn’t blame it all on that. He knew that tendency to have one drink after another could be a problem, even if he hadn’t tried crack cocaine.

It definitely was not a well thought out, informed decision, by any stretch. It was sudden, impulsive, and fit right in with the fun he was having.

And it destroyed his life.

There was no way he realized at the time how it would put a ring in his nose and lead him around whether he liked it or not.

It was fun for awhile, but after some time he’d burned through his paychecks, his credit cards, and sold what he had just to get more. He’d stolen from his family, and betrayed everyone who mattered to him.

He wanted out.

But there was no getting out… it was like a vice clamped on his mind that wouldn’t let go.

Sheer Will is Often NOT Enough

So he’d stayed away from it for nearly a week, then went to dinner with friends. Of course, everyone had drinks, so he ordered one too. By dawn…he’d been using this stuff all night long. And had no idea what had happened to his car.

That happened over and over…and over.

He would have the best intentions, and ask his family to loan him money for his car payment, or help him buy a new car, so he could go to work and keep his job. And over and over again… he’d have a drink with friends and end up at the crack house.

So now. He had been going to Alcoholics Anonymous, and to Narcotics Anonymous. He was determined to win.

Then, his girlfriend just got fed up with it all and broke up with him. He NEEDED her. Why would she leave him now when he needed her the most??

He just needed something to help him relax…So he picked up a six pack of beer. Three days later he finally dragged himself out of that same awful flop house… and he was hating himself. Why couldn’t he find the willpower to stop drinking and stop using crack cocaine?

What Do You Do When You Can’t Stop?

If you suffer with substance use disorder or alcohol use disorder, the cravings can be so strong because of changes in your brain that cause them. But as far back as 2013, Elias Dakwar, M.D., published his research showing that IV ketamine can dramatically reduce these cravings.

Now, a research team led by Dr. Dakwar that includes shining stars like Sanjay Mathew, M.D., Frances Levin, M.D., and Carl Hart, M.D. has published another study that has taken this work a step further.

This new pair of studies shows that ketamine plus motivation enhancement increases abstinence for people with dependence.

In our story of Jackson above, we learned about his experience trying to abstain from both alcohol and cocaine. There are also those who struggle to abstain from either alcohol or cocaine individually.

People who fit in both of these categories can benefit from the work of Dr. Dakwar’s team.

They completed two studies in 2019 and 2020. One for alcohol use disorder and one for cocaine use disorder.

Cocaine Use Disorder

Dr. Dakwar’s team, including Sanjay Mathew, M.D., Frances Levin, M.D., and Carl Hart, M.D., has published another study that has taken this work a step further. These researchers were part of the team who conducted the 2013 study.

His early study included 8 volunteers and demonstrated how IV ketamine could reduce cravings for cocaine.

This new 2019 study included 55 cocaine dependent individuals who were admitted as inpatients for 5 days. During this study, they were randomly divided and one group received a single ketamine infusion and the other received a midazolam infusion. In addition, they began a 5 week course on mindfulness-based relapse prevention.

As it turned out, 48.2% of those who received ketamine with the mindfulness-based course maintained abstinence through the last 2 weeks of the treatment course, whereas only 10.7% of the midazolam group achieved the same.

So, this led to the study with alcohol use disorder.

Alcohol Use Disorder

It’s surprising to realize that death from alcohol use disorder accounts for a whopping 3.8% of all deaths globally.

And that’s just the deaths. It goes without saying that the impairment of life, the breakdown in families, the cost due to sick days related to alcohol use disorder is gargantuan and is an enormous social and economic problem in our society.

And while 12 step programs provide a valuable service, helping many to abstain and rebuild their lives, there are too many that fall through the cracks. Because of cravings.

Ketamine Plus Motivation Enhancement Therapy

So this team designed a study that involved more subjects than the earlier work, and that measured the impact of combining IV ketamine plus with motivation enhancement therapy in subjects with alcohol dependence.

These subjects were enrolled in motivation enhancement therapy, which had been determined to be only modestly effective by itself. They were given 6 sessions during a 5 week period, with a single ketamine infusion at week 2 then a motivational enhancement session 24 hours after that infusion.

Another group was given midazolam instead of ketamine infusions during week 2 with a motivation enhancement session 24 hours after the infusion.

As it turned out, the subjects who were given ketamine with the motivation enhancement therapy were able to abstain from alcohol longer than those given midazolam. 82% of them were still abstaining at the end of 3 weeks when the study completed. Of those given midazolam, only 65% were still abstaining.

And possibly one of the best outcomes of all, was that more of those given ketamine resumed abstinence if they relapsed than those given midazolam.

And this was with only one infusion.

Studies are conducted under strict controls, but imagine how much a full ketamine plus motivation enhancement therapy 24 hours after each infusion can do for you ability to stay sober and build the life you want to live.

Ketamine plus motivation enhancement therapy can be life-changing for you if you can relate to someone like Jackson.

At Innovative Psychiatry, we welcome the opportunity to collaborate with your therapist and the rest of your healthcare team to help you break the hold that cocaine or alcohol may have in your life.

There is evidence that talk therapy 24-48 hours after your ketamine infusions can be far more effective than talk therapy alone. One reason for this may be the neuroplasticity that ketamine stimulates. It makes it easier for your brain to change, think new and different thoughts…see things in a new way.

There is hope for Jackson, and there is hope for you. Don’t give up if substance use disorders have made you lose control of your life. Ketamine plus motivation enhancement or some form of relapse prevention therapy can give you back your life and your sense of control.

Of course, it will take work, but you don’t have to feel helpless. You can get your self respect, your dignity, and your joy back. You can rebuild those damaged relationships and build a rewarding life.

If you can relate to Jackson, and want out of the vicious cycle, call us. If you need freedom from alcohol or other substance abuse disorders, call us.

We want to see you whole and free.

To the restoration of your best self,

June 1, 2020
Chronic Stress Pathology: IV Ketamine Kicks It to the Curb

Is depression common ..?

Is it something suffered only by the rare individual…? The World Health Organization says it’s the leading cause of disability. Have you heard that? Not those rare people no one ever sees… but people all around you struggle to function, and paste on their “upbeat faces” … while feeling more alone than words can say. Likely as not, chronic stress pathology is at work wearing them down.

And it’s not just depression. It’s bipolar depression, and generalized anxiety disorder, and PTSD, and social anxiety… These conditions are all different, and the way their symptoms present in each person can be really different.

But all these disorders also have something in common. Something called chronic stress pathology or CSP. They may have been triggered by a traumatic event, or a terrible loss, and just a constant nagging of unrelenting heaps of difficulty that wear away at your ability to cope.

There’s something else they have in common. They tend to clump together …why? Because of what happens in your brain. We call it comorbidity.

We’ve often talked about how long and severe chronic stress prunes the dendrites and dendritic spines of the neurons in the prefrontal cortex and the hippocampus, breaking down synapses (or “synaptic connections”).

Well …it turns out that there is a cascade of changes during these chronic stress situations that also increases brain derived neurotrophic factor or BDNF to increase synaptic connections in the amygdala and nucleus accumbens in another area of your brain. The nucleus accumbens is part of the basal ganglia located near the hypothalamus.

Oh dear…this is getting a bit tongue-twisting.

But get this: in one part of the brain, the synaptic connections are SHRINKING from chronic stress while in another area, they’re EXPLODING where they shouldn’t be.

You heard right.

This creates a vicious cycle that continuously drags you back into this disordered condition over and over…making it terribly difficult for you to recover. In the amygdala, the hippocampus, the prefontal cortex, and the nucleus accumbens, nerve connections (called neuronal connections) are being changed and damaged because of long term chronic stress.

That condition may be major depression. It may be PTSD. It may be an anxiety disorder. But it goes on and on. And on.

These Disorders are NOT a Chemical Imbalance

You can see why the old idea — and people still talk about it like it’s a thing — that this is “a chemical imbalance”…is archaic, mistaken, and doesn’t even describe what’s going on at all.

We’re talking about dramatic changes in structures in your brain. Damage. Not just chemical changes.

Misinformation Feeds Stigma… But Knowledge is Power

This idea of chemical imbalances is leftover from 30 years ago, before neuroscience understood these structural changes and thought depression was the result of changes in serotonin alone….a neurotransmitter that turned out to be a only a component in the overall process.

Ketamine Research has Taught Us So Much More… About Chronic Stress Pathology And Its Effects on Your Brain

As we’ve talked about before, evidence has been accumulating for years showing that ketamine treatment can reverse the pruning of synaptic connections in the prefrontal cortex and hippocampus – caused by stress – by robustly increasing them — turning on your mRNA to switch on your DNA… and that releases BDNF.

And you know what BDNF does. It TURBO boosts those synaptic connections in those areas, which in effect turns the light on in the darkness. You feel better, function better. Your creativity flourishes. And you have the patience and capacity to build and repair your relationships. Hope surges and futility morphs into purpose.

But you know what? We don’t talk very often about ketamine’s effect on the synapses in the amygdala and nucleus accumbens. There, it turns off the production of BDNF and reduces those connections there which helps to reduce your symptoms.

It also tamps down the cell bursting in the lateral habenula to help you relax and enjoy yourself. So you can revel in the fragrance of honeysuckle, and the aroma of burgers on the grill.

The fact is that chronic stress pathology is at the root of much of your suffering. Your body is intricately balanced, your emotions are influenced by a complicated series of changes in your gut through your microbiome, in your brain cells, as well as your muscles and organs.

If you have a severely broken leg, the pain, repair, and convalescence of that injury can have a significant effect on your emotions. And symptoms of chronic stress, depression, and anxiety can make your muscles and joints ache.

Which is why I’m on a mission to eradicate the term “mental illness.” Because your whole body is affected when something is malfunctioning in just one part of it.

For example, diabetes can predispose you to depression. And so can open heart surgery. Your brain is part of your body…not a separate entity. And when one part of your body is affected, other parts are affected, too.

So, the more we learn about our brains and bodies, the more we understand about the intricacies of how we function on every level.

Now… what if you do have chronic stress pathology working against you? What if you’ve been traumatized… or what if you’ve weathered a long, repetitive, unrelenting assault of stressors?

Cheryl’s Story

Cheryl did. Cheryl’s husband began complaining about the family’s budget..insisting they needed to make changes or there would be nothing to retire on. He finally became harsh about the need to find a less expensive house. Cheryl worked 60 hours a week…and the kids had needs, and schedules, and practices, and uniforms…. When could she look at houses..? Or worse…when could she possibly pack?

But since her husband Ben was so adamant about it, she tried to cooperate. She looked at houses during her lunch break, and after she dropped her sons off at practice.

She stayed up late searching the internet for houses she could look at, but she and her husband couldn’t seem to find the time to look together. Finally, she found one that could work, and Ben took a look on his lunch hour and agreed it was just fine.

After frantically packing every free minute for weeks…they closed on the house and moved. Cheryl was exhausted and the rooms packed with unopened boxes in the new house just made her want to cry.

Then as soon as she moved, her mother asked her to go to the doctor with her. At the appointment, the doctor told her mother she had breast cancer. She explained the details, the treatment, and prognosis to both of them.

When they got back in the car they cried together.

Cheryl knew her mother would need her extensively through this process. And she was committed to be at her side as much as she could.

She rearranged her schedule, her children’s schedules, and approached her boss about shortening her work hours for the next several months.

Unpacking the new house was a mountain to climb…and Cheryl kept wondering why Ben wasn’t on hand to help…

And why was his job so demanding through all this, anyway??

Then she found out… Ben told her he wanted a divorce.

“A divorce?? NOW?? IS THIS WHY YOU WANTED TO MOVE…??”

Cheryl felt herself coming apart..

There was nothing to do but keep moving. Her children needed her to be reliable through this. To be a safe haven…a comfort.

Her mother needed her support as she looked a life threatening condition in the face.

Cheryl couldn’t think about how she felt…she had to keep going.

But 8 months later, after the divorce was final and her mother’s treatments were complete… Cheryl couldn’t get out of bed.

Over the weekend…Cheryl just felt like she was in a long dark tunnel. She called in to work on Monday. Her sister came over and got the kids on a bus…

Sometimes it’s just too much.

And what about you?

Have intense stressors piled up in your life and worn down your hope? Have you taken prescriptions that just didn’t help?

Do you feel like the crises just keep pelting you without mercy?

Sometimes we’re subjected to repeated stressful assaults in life that we can’t control. But there is something you can do about your ability to cope with it. Reach out for IV ketamine treatment.

At Innovative Psychiatry, we offer IV ketamine treatment expertly titrated and see resilience return to our patients every week. We also have published research that you can read about our results. We’re serious about what we do.

Things have changed since the days of “chemical imbalance” thinking. (That’s so 20th century!) Neuroscience is making 21st century discoveries that offer better treatments than we’ve ever known before.

And you get to take advantage of those advances.

If you can relate to Cheryl and prescriptions haven’t helped, call us. If you have symptoms of PTSD, call us.

IV ketamine treatment can reverse the damage caused by chronic stress pathology. Chronic stress doesn’t always result in this damage, but it does all too often.

And when you’re the one suffering, you need a solution. You need to cope. While ketamine doesn’t work like this for everyone, it does provide rapid, robust relief for most. And chances are, it will transform your life to allow joy, hope, and resilience.

Give yourself the opportunity to live well again. To enjoy a fulfilling and rewarding life.

To the restoration of your best self,

May 25, 2020
Ketamine In A Pandemic: New Depression and Anxiety Can Strike Anyone

The sky grew darker as clouds morphed from white to gray, and created a solid ceiling over the city.

It had rained off and on for days, and thunderstorms had filled the night skies with a threatening latticework of lightening. In an aggressive assault on the grayness, Evie stepped back from the window and decided to turn all the lights on. The quiet in her bungalow, the gray skies, and the silence felt like a blanket that she couldn’t seem to shake off. She turned on music and tried to dance around the living room, but that didn’t last. There had to be a way to ward off this expanding gloom. She’d heard about ketamine in a pandemic, because these symptoms can strike anyone…even if they’d never had them before. Could that be what’s going on?

Dread crept up inside her, and she couldn’t understand why. Where was this coming from? She didn’t object to this isolation. It had given her the excuse to read more, which she’d salivated to do for years. She enjoyed her own company.

So where was the dread coming from?

It was as if things she normally would do as part of her routine just seemed too hard to do lately.

A heaviness grew darker and heavier in her chest..? Her stomach…? What was it?

Evie had always prided herself in her ability to snap back from disappointment, to face fearful situations and push through them. She just lived with her sleeves rolled up, ready to take on whatever life tossed her way.

Her younger brother had never been so resilient. And unfortunately, she hadn’t been very supportive. She just had never understood why he wouldn’t just shake it off. Call a friend, pitch in and help someone in need, walk in the sunshine…and get over it!

Now…she was eating her words.

Isolation and Even Social Distancing Take a Toll on Your Emotions

She strained her brain to understand what was causing this. Internet articles pointed out that being cooped up this for weeks or months was affecting people in a negative way.

But Evie liked being alone. She loved the quiet. The uninterrupted freedom to do what she enjoyed.

And these articles also talked about fear. People were afraid. Sales of guns had skyrocketed, and ammo was sold out and on back order, as people have bought up more and more.

She had to admit to herself…that THAT was scary. All sorts of people armed against unknown dangers…

But seriously. She wasn’t afraid of looters or invasions.

It seemed clear to her that it was just a matter of waiting this out.

Ketamine in a Pandemic Can Relieve Anxiety and Depression in Someone Who’s Never Had It Before

So what was wrong with her?? Why was she lying in bed and reading all day every day? Things had piled up. Her garden needed weeding. But the idea of doing it was overwhelming.

Motivation, initiative… it seemed to have drained out of some proverbial hole in her bucket.

When a knock came on her door…Evie didn’t answer it. She just stayed quiet and waited for whoever it was to go away. The same with her phone. She didn’t want to talk…not to anyone.

She remembered a few months ago, when she saw a map of the world that depicted the incidence of this COVID-19 virus in countries around the world. She was stunned to see how every country seemed to be red. The entire world!

So if she had thought she could just get out of town and wait for this to blow over, she was fooling herself. There was no escape on the planet.

Maybe that shock started this…this feeling of dread…

Large Scale Change Increases Stress

Then they closed the schools and restaurants and businesses. Then required mask wearing.

You know that feeling that “it will never happen to me”…? But this thing has happened to everyone. Everywhere.

So was the dread from feeling trapped? Evie thought about that. It might be the case with some people, but how could she feel trapped all snugged up in our home she loved doing things she enjoyed?

She didn’t know what was wrong with her or what specifically caused it. She did know that she wasn’t herself. There had to be some serious thinking about her brother and so many others who suffer from symptoms like this. Who really couldn’t shake it off, like she couldn’t now.

And she acknowledged it was a difficult place to be. That her brother had been very brave all these years to keep fighting to function when medication and therapy didn’t work for him.

She’d read enough to know that many people were being affected by these circumstances. Some, like Evie, had never felt this way before.

She promised herself she’d call a doctor to see if she could get treatment — as soon as she could scrape up the initiative to do it.

Evie’s not alone, is she?

And this is why telepsychiatry has been so vital through these months. A new flood of people who never needed psychiatric treatment before have emerged…and need treatment.

Ketamine in a Pandemic: Depression and Anxiety Can Strike Anyone in These Circumstances

Then, there are those who’ve been receiving treatment with prescriptions that now don’t seem to be working anymore. And in isolation, these people are at higher risk because they’re alone, and feeling all the things Evie feels, but often the symptoms of suicidal thoughts have been added to the mix.

Ketamine in a Pandemic for Depression and Anxiety Can Be A Lifesaver

A team of medical researchers set out to try to evaluate the psychiatric effects this global pandemic — and the restrictions that have been part of it — to better understand its impact on mental health in individuals around the world.

They published the results of their survey. One of the most remarkable outcomes was that 41% of adults showed they were more concerned about their increasing anxiety, than they were about their financial problems. That’s 2 in 5 adults.

Two out of 5 in line at the grocery store. Two out of 5 in line at the gas station.

Think about it.

Also, 2/3 said they feel like they’ve lost control of their lives. Sound familiar? And 56% say they find it difficult to manage their responsibilities amid this pandemic.

So, yes. You’re not alone. If you’ve been struggling with these things too, just recognize you’re not alone. You’re part of the “new normal.”

Except that it doesn’t feel normal.

And it doesn’t mean you should keep struggling with these feelings of uncertainty, anxiety, and depression.

Do call your doctor and talk about what you’re going through.

And…if you’ve been taking prescription medicines, and find they aren’t helping, don’t lose hope.

Reach out for ketamine treatment, which can restore your resilience in the face of all this. It can restore your initiative and motivation. Aren’t you glad that there is something that can help in times like these? Ketamine in a pandemic can bring remarkable relief for depression and anxiety that’s triggered by these restrictions.

At Innovative Psychiatry, we’re providing ketamine treatment here in our office every week. We’ve instigated safety protocols that allow us to provide you the essential treatment you need to help you get through this stressful time.

While the process of recovery from a global pandemic is more complicated and time consuming than we wish, you don’t have to live in misery. Ketamine treatment can restore your hope, your resilience, your initiative, and your confidence.

And if hopelessness has been rising up inside you, stripping away your belief that things will ever get better, that’s a symptom. It’s not reality. And ketamine treatment can relieve those thoughts, and help you get your momentum back.

We specialize in treating suicidal thoughts. In fact, we’ve done research which shows ketamine’s remarkable effectiveness with this symptom.

If you suffer from the symptoms we’re talking about, call us.

We’re here to help you find your best self again. We want you to enjoy your life and live well.

You aren’t alone. You really aren’t.

Reach out for help. Your best days could be just around the corner.

To the rejuvenation of your best self,

Lori Calabrese, M.D.

May 18, 2020
For the Depressed Mom: Ketamine Can Restore Your Joy

“Motherhood is a choice you make everyday, to put someone else’s happiness and well-being ahead of your own, to teach the hard lessons, to do the right thing even when you’re not sure what the right thing is…and to forgive yourself, over and over again, for doing everything wrong.” – Donna Ball, author of At Home on Ladybug Farm

Let’s talk about moms.

Yesterday was Mother’s Day, and if you were a mom yesterday, chances are, you’re still a mom today. We could talk about all the idealistic and billowing praises that are bestowed upon moms in greeting cards, but let’s don’t. Let’s talk about what it’s really like to be one. And if you’re a depressed mom, ketamine can restore your hope, your joy, and your stamina to help your children grow. More about that in a bit.

Motherhood Is a Handful.

With the best of intentions, you gather your kids together and tell them you’re all going on a camping trip. Together! But….there is so much to be done before you can all load the car. So in the spirit of pitching in and working for the common good, you assign each one a task that will help shorten the prep time.

Then you focus on your own tasks which include packing food for meals. While you’re busy in the kitchen, you hear an unusual noise.

Closer inspection reveals that your 10 year-old son is in the bathroom (which he was supposed to be cleaning) after putting his sleeping bag by the front door, and has filled the sink with water.

He’s floating a little boat on the water with his pet hamster in the boat which immediately jumps out of the boat, over to the counter and jumps down under the cabinet and disappears.

Oh dear.

Now there’s a loose rodent in the house. Aaaarrrgghhhhh!!

Feel your resilience waning..? If you find out you’re a depressed mom, ketamine can restore. Keep reading…

Your son, who got bored cleaning the bathroom, had gotten distracted with his hamster. Now how to find the hamster?

Kids are just kids. Full of surprises. It takes a sense of humor…

When It Rains It Pours

Meanwhile, you stop in the boys’ room and find your 7 year-old, who was supposed to clean his room after delivering his sleeping bag to the front door, sitting among a pile of Little Golden books. Reading. (What joy!) But apparently he had to go through the entire bookshelf of 43 Little Golden books to find the one he wanted to read. His floor is covered with books he’s tossed.

After sternly instructing him to pick up all his books PRONTO! you realize you better check on your 21 month-old daughter. Distractions can pile up when you’re focusing on packing 3 meals a day for 4 days and you have a houseful of active children…you didn’t notice she wandered off.

Turns out she’s in your bedroom. At first sight, you panic. Is that blood? Her face is covered! What happened??

Upon closer inspection after snatching her up in your arms, you see that it’s not blood. It’s lipstick. Her face is so covered with the stain of it, you know she’ll be raw by the time you get it even partially off.

Then you look at your feet. Your favorite white leather summer bag, and your butter soft cream-colored pumps, have both been painted with lipstick to match.

How thoughtful. Sigh.

The fact that that was a brand new tube of lipstick is now beside the point.

Calamities, Crises, and Catastrophes

Then…sniff, sniff… what is that smell…?

You head for the kitchen, baby girl on your hip, and the kitchen and living area are in a cloud of smoke…then BEEEEEEEEEEEEEP!!!!!! The smoke alarms.

Run to the stove. OH NO!! The eggs you put on to boil for sandwiches have boiled dry and are burning!!!

Move the pan off the burner. Turn off the burner. Open windows. Gather kids and go outside for fresh air.

You collapse into a lawn chair and watch the kids playing happily in the yard. The classic comic escapades of Calvin and Hobbes comes to mind…

Maybe you’ll just get chicken at the drive-through…?

Add to all of this the challenges of quarantine in a global pandemic! There aren’t words. But you do what you have to do, don’t you?

Motherhood is providing a listening ear, helping with Cub Scouts and Brownies, fighting fevers in the wee hours, encouraging the discouraged, instilling hope, tutoring when homework overwhelms, instructing, providing structure, instilling values, creating celebrations, stretching the budget, inspiring creativity, keeping idle hands occupied, teaching self-reliance, comforting broken hearts, and so much more.

And this is when you’re healthy, resilient, and stable.

But what about when you’re not?

What about when anxiety makes it impossible for you to participate in sports with your child, or Cub Scouts, Brownies, or Blue Birds?

The sheer dread you feel about leaving the house to take your child to these activities and interact with the parents makes it so difficult that you may make it a time or two, but eventually the energy required to push through all that dread and fear leads to missing meetings and practices…if not abandoning it altogether.

To the Depressed Mom: Ketamine Can Restore Your Hope

Then there’s the guilt you feel for failing to give your child every advantage.

What about when PTSD creates such traumatic responses in you that you just can’t leave the house, and find your reactions are terrorizing your children…but you can’t make it stop..?

If you’re a mom with PTSD…or a depressed mom… ketamine can restore your resilience and your hope.

A simple pat on the back when you attend a gathering, or a loud noise in the kitchen…even the deep voice of a stranger… can send you into such terror, sweating, and reactions that, you know, you just feel safer at home.

Or when you just can’t get out of bed… so you get the children to watch TV, because you know at least they’re safe, but it nags at you because you know this isn’t a healthy, carefree way to spend childhood.

But it’s the best you can do.

If you struggle with symptoms like these, and they interfere with the mom you want to be…and if the medicines prescribed by your doctor haven’t helped… there’s hope.

When you’re a depressed mom, ketamine can restore your joy.

Ketamine treatment consists of 6 infusions, give or take, over the course of 2-3 weeks. It’s, hands down, the most effective, innovative treatment for severe depression, social anxiety, PTSD, bipolar depression, and alcohol use disorder.

If you’ve been seeing your doctor and the medicines she’s prescribed have worked to reduce your symptoms, then you’re all set.

But did you know that at least a third of people who have these symptoms are not helped at all by prescription medicines?

That’s where ketamine treatment comes in. It works in the brain in ways these prescribed medications don’t. And its remarkable, even extraordinary, and robust relief is transformative for most of those who receive it.

Ketamine works in multiple ways and in multiple areas in the brain. And it’s fast. So, instead of having to wait weeks or months for a prescription to help you feel better, with ketamine treatment you can feel better in hours or days.

Ketamine turns on mRNA so it will turn on DNA to turboboost BDNF — brain derived neurotrophic factor — that works like a rich compost to trigger the rapid and prolific growth of dendrites and dendritic spines in the neurons in your brain.

This multiplies the synapse connections fast to send signals across your brain, and wake up your emotions. Creativity blooms, quick thinking, solid decision making, initiative, motivation, hope…and joy all come to life and transform your outlook and your productivity.

And you can love life again.

You Don’t Have to Endure Suicidal Thoughts…You Really Don’t

In addition, if you’ve been plagued by suicidal thoughts, it can stop those thoughts in a few hours. Then you can be free to invest in restoring your life, rebuilding your thoughts and infrastructure, and restructuring and strengthening your relationships.

It may sound too good to be true…but if you’re a depressed mom, ketamine can restore the real you, the person who has dreams for yourself and your children, and wants to have the resilience to help them fulfill their dreams.

At Innovative Psychiatry, we enjoy the privilege of watching people walk out with fresh joy and hope every week.

If you’ve struggled with the kinds of symptoms we’ve talked about here, and medicines haven’t helped, call us.

We’re here to help you live well again, to find your joy in life again.

Ketamine doesn’t do this for every single person who receives it –of course not!– because there isn’t any medicine or treatment that helps everyone. But it does amazing things for most. There’s no other treatment currently available that brings relief and restoration so quickly for so many who are so symptomatic — in the privacy of a beautiful office, beginning that afternoon . . .

Discouraged, Depressed Mom? Ketamine Can Restore Your Resilience

You can sing again, experience joy welling up inside you, laugh with your children, and all the things you have wished you could do.

Give yourself the opportunity to feel truly better. Spend this year enjoying your life and your family. We can help you get there.

To the blooming of your best self,

Lori Calabrese, M.D.

May 11, 2020
Suicidal Risk Triggered by Stressors in the Covid-19 Crisis

Russell paced back and forth by the window.

The gray, rainy morning had finally broken and sunshine peeked through the clouds as they parted. Patches of clear blue were spreading across the sky. It seemed to Russell this change in the weather should brighten his thoughts, but they didn’t. He guessed it would take something much more powerful than a weather change to alter his outlook. He thought about how dark he felt…and wondered if there was suicidal risk triggered by stressors that affected people right now.

Russell was losing his belief in living. This wasn’t the first time he’d felt such futility in the daily endurance exercise that characterized his life. He’d felt hopeless before — but with time, a new job, and better pay, he’d lightened up and everything began to make sense again.

Then, he met someone and felt like he was basically sitting on top of the world. He hoped he could keep his life working so well. The idea that joy would become commonplace for him… that would be so great.

The job was such a good fit. And he seemed to learn it quickly. His skills improved every week and every month… then he was promoted. His boss would pat him on the back…tell him to keep up the good work and all that.

He believed he had a real future in this job…and a career in the making.

Jenna came along, and maybe it’s because he was feeling so much better, or maybe it was because she was so amazing…but it was easy to talk to her, and so rewarding to listen. It wasn’t long until they were spending lots of time together.

Then, the coronavirus crisis took over the world. There was no place to escape to…it had covered the entire globe! Nowhere was safe.

Settling Into a New Normal in a Global Crisis

He was assigned to work from home. That was ok. Not great. It wasn’t easy to do as well, or be as creative, under these circumstances. But he was grateful for the paycheck. Surely this was a temporary setback.

Next thing he knew, however, the governor ordered a lockdown. HIs company laid off thousands of people. And he was included in the second round of cutbacks.

So, now he’s home, he has no job, and no way to get one. Russell made a point to watch the statistics around the world to see if the tide was turning yet. He was lonely, and he missed Jenna. Even though it helped to talk on the phone or online. There were plenty of apps to connect with her. But it wasn’t the same.

The Crisis Hits Close to Home: Fighting Panic

One day, she sent him a text. “Russell, my sister Beth tested positive for the coronavirus today. She’s self-quarantined in her apartment. I’m so worried. And my mom is beside herself.”

Russell tried to be understanding…this was terrifying. He wondered when Jenna last saw her sister. When her mother had last seen Beth. He wondered if either of them had been exposed.

This made it all seem so much more real. More threatening, to himself and everyone he cared about.

He felt horrifically helpless. So he paced. He washed his hands for good measure. Then paced more.

Darn! It’s so hard to feel useless like this!! He checked on Jenna often, and always remembered to ask about Beth’s condition.

Finally, it turned out that Beth was being transported to the hospital. She was struggling to breathe at all.

Russell felt his throat closing. He fought panic.

Jenna was devastated about her sister’s decline. She said their mom was in a heap. Neither Jenna nor her mom could be at the hospital with Beth.

Weeks were going by.

How could you stand with someone if you couldn’t be near them? How do you do it all verbally? He feared his relationship with Jenna was disintegrating like his job had. But he knew her primary concern was her sister, and he was sure worried about her, too.

Russell had never been the best communicator. In times of difficulty it was hard to find the words. He’d always made up for it with effort. Showing his support with hugs, helping out with food, etc.

He had no idea how to do that from miles away.

He feared his relationship with Jenna was disintegrating like his job had. But he knew her primary concern was her sister, and he was sure worried about her too.

And felt so helpless.

When he wasn’t talking or texting with Jenna, he was applying for jobs online. It seemed he had surely applied for hundreds of them by now. But nothing. No responses to his applications. He could only imagine the number of applicants competing for each job. He was sure it was more than ever before in his life.

Still he kept applying.

It was good to stay busy, and at the same time, it felt so futile.

Weeks turned into months, and he finally applied for unemployment. Sickening.

How could everything be so good, then take a 90-degree turn straight into the toilet??

As if it all wasn’t enough, he heard from Jenna about her sister. Beth, who’d been in the ICU on a ventilator, finally died. They had thought she was improving…thought she would come off the ventilator soon… then suddenly, she deteriorated. And died.

Russell was stunned. Speechless.

Jenna was heartbroken. Blind with grief. He tried so hard to comfort her. To listen. But there was nothing he could say to relieve her pain.

He couldn’t go to her, hold her, take her out to dinner so she could vent. And her mom was grief stricken and seemed to expect Jenna to comfort her.

He couldn’t think. It was as if the entire world was self-destructing around him. His head was spinning.

Profound Grief Causes Its Own Isolation

Jenna seemed to just be gutted…depleted…with no more to give to anyone.

She withdrew after that. She and her mom could not have a funeral for Beth. As the days went on, they both seemed more and more traumatized by the circumstances surrounding Beth’s death.

Russell became less and less vital to their grief, it seemed. If they needed his support, he didn’t know how to give it. He felt so useless. So powerless. Utterly flabbergasted that life had collapsed as it had in a couple short months.

The grief he felt for Jenna’s loss eroded his foundations. His resilience. The energy seemed to drain out of him. His hope disappeared.

He’d been in his house for 2 months, and the strain, disappointment, disillusionment, loss, confusion, and anxiety of his circumstances became worse and worse until they were unbearable.

He saw no reason to go on. He looked at the future through his dark perspective, and it looked hopeless.

Even after the lockdown was lifted, he still wouldn’t have a job, right along with millions of other people. He would be evicted from his apartment, and lose his car.

The melancholy of the past swelled until he was drowning in it. Russell just didn’t have the energy to go on. He didn’t believe he was strong enough to face any more…

He wanted to die. Every hope… every purpose… for living was gone. He couldn’t see how he could go on…

Russell’s Not Alone: So Many Fight Despair in Times Like This

The crisis created by this COVID-19 coronavirus is creating stressors and fears that go far beyond the risk of the viral illness. And as our friend Russell identified, there is no where to escape to.

Hundreds of thousands of people feel the same feelings and are thinking the same thoughts. But in each case, the situation is not necessarily as it seems.

Unfortunately, it is what seems to be true that people all too often act upon. And suicidal risk triggered by stressors in this crisis rises higher and higher.

However — and this is important — thinking about suicide is not logical thinking, even though it may seem to be at the time. Suicidal thoughts are symptoms of a disordered mind.

Suicidal Risk Triggered by Stressors in This COVID-19 Crisis

The stress of isolation, financial difficulties and strain, the uncertainties about income in the future, the emotional pressure of being separated from those you care about and who care about you, combined with a host of feelings that come out of nowhere in a time like this… can push you to the point of desperation.

And…if you’ve struggled with psychiatric symptoms in the past, these elements can put you at higher risk.

But There Are Ways to Find Relief

However, as overwhelming as circumstances appear, they’re still temporary. They will change. Life will be restored. But that can be hard to grasp if the thoughts are swirling and swirling around inside your head.

Meanwhile, you can seek support from friends and family online, see their faces and vent, laugh, and cry together.

You can reach out for counseling through telemedicine. And then consider treatment.

Again, suicidal thinking is a symptom of a disordered mind.

If you find yourself thinking those thoughts, reach out for help. The circumstances of your life are not normal right now. And people everywhere are feeling similar feelings, as well as desperation, cooped up in their homes.

Suicidal Risk Triggered by Stressors Like Grief, Financial Uncertainty, and Fears of All Kinds… Can Be Lowered With Treatment

At Innovative Psychiatry, we’re treating people every week with ketamine treatment provided with carefully planned safety protocols.

Ketamine treatment is one of the most effective treatments for severe depression, bipolar depression, PTSD, social anxiety, and suicidal thoughts we know of. It also can relieve substance abuse and alcohol abuse.

As it goes to work restoring the synapses in your brain, proliferating connections between nerve cells to explode communication through your brain, it also can restore your motivation, your creativity, and your joy.

As a result, resilience replaces listlessness, energy replaces lethargy, and hope replaces despair.

In spite of how it all seems to you right now, that reality you’re experiencing is based on temporary circumstances… In the challenges ahead, how much better to have the energy and hope you need to conquer and create a reality that fulfills you?

There is a future. And you’re in it.

You can reduce the suicidal risk triggered by stressors in your life by reaching out for ketamine treatment. If you’re experiencing some of the things Russell is, call us.

Give yourself, and those who love you, the benefit of treatment that can give you a new lease on life. You can be amazed at how the direction of your thinking transforms.

There is life beyond this COVID-19 crisis. And you’re in it …with a bright future.

To the resilience of your best self,

April 27, 2020
Coping with Anticipatory Grief in the Covid-19 Crisis

Jocelyn and her friends missed their interaction on Friday nights after a week of work.

They’d meet somewhere and have dinner and talk about work, their plans for the weekend, the people they knew, and their hopes for the future. But since the COVID-19 crisis, they worked from home and Friday was just another day. So they decided to have a meet-up online. Jack set up a zoom meeting so they could all see each other, and it commenced Friday night at 7pm like they’d always done before. They ate their dinner in front of their laptops and chatted about this and that, vented about isolation, about technical problems when all work had to take place online, and family frustrations. And they talked about the horrid emotions they felt. The idea that millions were expected to get sick and die. Scott, a therapist, mentioned ways of coping with anticipatory grief. Someone else said, “Wha..??” Jack said, “What the heck is anticipatory grief??”

Scott went on to explain that horrid feeling they all described, the dread they felt about all the sickness and death, the fear that their friends or family members would likely be among the dead…that this all falls under the category of anticipatory grief: Grieving about losses that haven’t happened yet, but might.

He also said that when you read all the articles that come out every day about the potential damage the COVID-19 virus can do, that dread increases day by day. Then you hear about someone’s co-worker or family member who tested positive for the virus, it gets a bit closer to home, and your dread and fear of loss increases.

When Fear and Grief Hit Home

Next, you get word that your own relative or co-worker dies… or the relative or coworker of someone close to you dies, then you feel the loss up close. It becomes your own loss. And it hangs on you, weighing you down, long after…because it goes so deep.

Celia hesitated, then spoke up. “My aunt died. It’s been so sad I haven’t wanted to talk about it. But she lives in New York City, and tested positive. She tried to recover at home…then her breathing got really bad one night and they had to take her to the ER. She was in the ICU with a ventilator for 17 days. Just about the time she seemed to be getting better, she suddenly got bad again…and died that day.”

Everyone told Celia how sorry they were. How terrible it was to lose someone you love over a virus.

Nick spoke up. He had a sadness about him most of them had noticed. He said, “ A friend of our family…someone I grew up with…started feeling bad, and called the doctor. The doctor told her to go for a test at a drive through testing center. She tested positive and her cough was so intense, her breathing so bad, they admitted her to the hospital, too. Within 3 days she was gone. She was my age! It’s so hard to make sense of it.

“I hear about people protesting the lock down…or throwing COVID parties…and I want to scream. So many people don’t get it. I wondered myself in the beginning. But as I saw the numbers increase around the world, I realized this is real. I wish each one of those people who went to one of those parties could see how it feels to lose someone you care about. And who knows who’s next?? It could be one of us!”

Celia jumped in and said, “Yes…or to see what’s it like to be sick with this. Sure there are people who aren’t having symptoms, but talk to the ones who are! My friend got sick and had to let someone take care of her child while she convalesced. She said it was the worst thing she ever experienced.”

Scott then pointed out how THIS is anticipatory grief. Realizing that someone you care about could get sick. Could die. And worrying about it.

“And,” he said, “there are things you and I can do to help us get through this.”

Study: 40% Say Anticipatory Grief Is The Worst

“A Swedish study,” he went on,” found that no matter how much you grieve before you experience the loss, it doesn’t reduce your grief after the loss really happens. And that 40% of the people studied felt the grief you experience when you anticipate loss is far more stressful than the grief you experience afterward.”

Jocelyn asked, “If that’s the case, then it sounds as though I’d be much better off waiting until someone dies to grieve, than grieving about everyone in advance. But I do feel fearful…I have anxiety all day and especially at night…On top of that, I’m drinking more than I ever have. Just to try to relax and not think about what could happen.”

Scott agreed. “But how do you wait until you have someone’s death to actually grieve??? Coping with anticipatory grief is so much harder than we could have expected!”

Celia finally blurted out, “My husband is beside himself. He’s so angry, filled with doom and gloom. Constantly rehearsing the latest statistic in illnesses and deaths in every country around the world. His rage is so hard to be around, even though I know it’s just how he’s coping. But it all makes me all the more lonely…

Symptoms of Anticipatory Grief

“Ok let’s all look at this, guys…” Scott was talking in a softer voice now. “We have Nick, who’s been so sad, and has lost a lifelong friend, and Celia’s husband who is irritable and furious about what’s happening…and likely struggling with feeling out of control…which he is… and Jocelyn who feels fear, anxiety, and uncertainty… and Celia who’s sad about her aunt, stressed about her husband, and lonely.

“You know what? All of these things are symptoms of anticipatory grief. So what can you do, what can WE do, to cope right now…and get through this?

Coping With Anticipatory Grief – We Need Each Other

Nick, Celia, and Jack all said at the same time: “Keep getting together like this!”

Scott and Jocelyn laughed…and heartily agreed.

Nick admitted that meeting and talking, opening up and feeling understood were all amazing for him. He could see that spending time together was great medicine.

So they agreed that the lockdown would no longer interfere with their mutual support. And they would continue their Friday night @ 7 gathering online, until they could meet in person again.

Grief is a looming and saturating condition for many, if not most, of us during this COVID-19 crisis. Grieving over the death of someone we care about is a form of grief that’s inescapable when we lose someone, no matter the circumstances.

But anticipatory grief is another form that can cause anxiety, depression, and overwhelm. In trying to prepare for loss, it magnifies the suffering of loss itself, and can continue to cause more pain months or more after that loss occurs. Right now, news from government and medical experts can ignite enough fear to trigger anticipatory grief.

How long will I be out of work? Will we lose the house? How will we feed the family? What if one of us dies? Who will take care of the children?…And that suffering intensifies the actual suffering from this global crisis. Coping with anticipatory grief includes finding ways to stop the cycle of fear in our thinking.

Like these friends, fear of what might happen, fear of losing loved ones or other things in life you hold dear, can overwhelm your outlook, and drown your perspective.

But if you have friends like these, people who care about you and with whom you can discuss your feelings and listen to theirs, you may be able to restore balance to the way you look at life.

But What if You’re NOT Coping with Anticipatory Grief? And Friends Don’t Help?

Unfortunately, sometimes talking, listening, and caring isn’t enough. Sometimes you realize you don’t have many friends. Sometimes you need help. If the stressors of life, and of this period of isolation, have worn you down, stripped your resilience, and damaged your hope, then you may need the help of a treatment that can make a real difference in everything for you.

At Innovative Psychiatry, we know that the COVID-19 crisis, and the enforced isolation that has been necessary because of it, can drain your hope, your energy, and your motivation.

You may find you’re drinking more than you mean to, or that you’re using other substances and it’s getting out of hand.

It can make it almost impossible to just keep being brave, and willing, and steadfast. It can make you feel like you’re afloat at sea, all alone, without hope or remedy.

But as we’ve talked about so many times before, this is caused by the pruning and wearing down of synapses in your brain. That’s what stress does. But ketamine treatment gets your brain-derived-neurotrophic-factor (BDNF) going…burgeoning…which works like a rich compost to produce…no — more than that…to PROLIFERATE… the dendrites and dendritic spines that create those synaptic connection between the neurons in your brain.

And when that happens, your outlook brightens like the sunrise, your thoughts begin to flash through your mind, your creativity starts blooming, and your joy and hope are restored.

That same dose of ketamine can also help reduce your drinking, and your use of substances.

With all that going on, believe it or not, you can be resilient whether you’re isolated or not.

Ketamine Treatment Can Erase Suicidal Thoughts, Too

That’s the beauty of ketamine treatment. And what’s more? It’s so effective.

And remember. The kind of discouragement, depression, and fear we’ve been talking about can make some people want to stop living. If you have struggled with those thoughts, if you’re not coping well with anticipatory grief, we want to help. Because ketamine treatment can stop suicidal thoughts in an afternoon.

This is why we’re open when everything else is closed. Because taking care of you is essential. And that’s what we’re here to do.

If you’ve struggled with some of the feelings Jocelyn, Nick, Jack, Celia, and Scott were talking about, call us.

We’re here and still providing ketamine treatment right now with safety protocols to protect you and to protect our staff. Just call us, and we’ll talk you through the process.

You don’t have to suffer alone. We’re here to help you get through this confusing time, and to help you experience the joy and hope that will see you through.

To the restoration of your best self,

April 20, 2020
Resilience During Social Distancing in the Pandemic

“May you have interesting times always…” the asian proverb says.

Well, these are interesting times. Some of us might think a little too interesting…! And I guess most of us are eagerly looking toward the time when we’ll have times that are less interesting and more peaceful and predictable. Who could blame us? Still, for now, these interesting times require most to be shut-in in the name of social distancing, to “flatten the curve.” And prolonged periods of missing our routines, our friends, our gatherings, and enjoyable habits can really take a toll. Many otherwise healthy people are experiencing anger..even rage…, depression, feelings of anxiety, and grieving over the loss of friends or family members, as well as the loss of what makes life feel “normal.” But it’s actually possible to experience resilience during social distancing, believe it or not.

Even the basic loss of freedom to do what you want when you want to is devastating for some. And even though we know in our heads that this is temporary, that doesn’t necessarily help as much as you think it should.

And while there’s no right or wrong way to feel through this challenging time, there are some things you can do to improve your own resilience.

For Some, Resilience is Second Nature

Take Annie, for instance.

Annie is a single, middle-aged woman who lives alone with her orange tabby cat. She has always been upbeat, generous, and helpful, while taking care of her responsibilities. The one who bakes cookies as a gift when a new neighbor moves in, pitches in after the garbage collectors come by returning her neighbors’ receptacles to their garage doors, and offers a bright smile to whomever she meets.

When the COVID-19 pandemic emerged, she was dutiful in washing her hands often, and being careful during trips to the grocery store. Then the social distancing order meant she stayed in her house or garden at all times. She was fine for the first few weeks, enjoying contact with her friends and family online.

Resilience During Social Distancing May Not Be as Easy as Expected

But, after awhile, she noticed a dark wave of melancholy creeping over her. She was surprised by it, and discouraged. What was the matter with her…? She didn’t object to staying home awhile, to help stop the spread of the virus, and prevent more people getting sick.

Why did she feel this way?

Day after day, the gloom grew darker, and more overwhelming. Then she even found it was hard to get out of bed.

Why??

Where was this coming from???

She tried to fight it, to drag herself out of bed, clean and disinfect the house, and sweep the porch and sidewalk. She tried to pull weeds from her flowerbeds…but after 2 or 3 weeds, she just lost interest. And went back to bed with a book.

For a week, she forced herself to be productive, hoping this weight that was getting heavier would dissolve.

Eventually, she stopped sleeping. Laying in bed in the dark all night long, watching the sun come up then dozing a little while. Night after night. She grew more and more tired, and anxiety wound her up till her thoughts raced all night long.

She had a prescription the doctor had given her for sleep in case she needed it about 6 months ago. So she took the prescribed dosage, and it made no difference. All night long — wide awake.

Who would have thought that the lack of resilience during social distancing could interfere with sleep?

Finally, she decided to stop fighting it. She could do nothing about the social distancing, or about the weight of gloom. But she could just take the time to take care of herself and see what happened.

So Annie gave some thought to her dietary habits. For one thing, she decided to be careful to eat what was good for her, as she had avocados, walnuts, salmon, and chicken from her last trip to the store. She stayed away from the chips and cookies in the cabinet and tried to eat foods that actually benefitted her brain and body.

And she gave herself the next week off. No cleaning or gardening unless she wanted to. Why not?? She was home every day anyway.

It was an experiment, and the world wouldn’t end if she didn’t clean for a week. She hoped that by taking pressure off, and taking care of herself, resilience during social distancing would become strong again.

Since news of the pandemic began, Annie had searched the internet throughout the days looking for information about hospital capacities, testing availability, and masks and gloves up till now. So she decided to stay off the internet for the coming week, too.

“They’ll have to figure it out without me I guess…” and she laughed to herself at the absurdity.

And she chose books to read that had hope in their message. Fiction with happy endings, non-fiction with a message of hope. About that time, a trusted friend sent her an email to see how she was doing.

It seemed like a good idea to get some of this off her chest. So she told her friend how she’d been feeling, and how baffling it was.

A Friend Can Divide the Burden

Her friend, Carrie, was so understanding. Carrie said, “Annie! You’re not alone! I’ve been having some bad days, too. I think lots of people have. When you look on facebook, it’s everywhere!”

Carrie went on, “Some people are angry, others are whining and complaining, others are criticizing the government or other countries or whoever they can find to blame. I think that these changes, along with worry about whether we will get it, or someone we love will die, along with the uncomfortable reality that we’re out of control, just takes a greater toll than we realize. I think we all need to be patient with ourselves. This pandemic is going to end. It’s not permanent.”

Nothing Carrie said was a surprise, but somehow talking about all this, and hearing her support, seemed to help a little.

When Resilience is Natural for You, It’s Easier to Restore

So Annie embarked on her “week off” and just did what she felt like doing and what she enjoyed. She read books, relaxed, drank coffee in the mornings, and San Pellegrino at night with her healthy foods.

After 3 days of this, Annie woke up and realized she had slept all night. That was a breakthrough. The next day she went for a walk on her street.

Then, the next day, she worked in her flowerbed, and pulled out weeds and turned the soil. Her heart was getting lighter, she could tell. A few days later, she was ready to clean her house, a little at a time. Most importantly, she sensed hope emerging inside her again. A little exercise, reduced pressure, good food, and sunshine…as well as avoiding depressing news sources …and Annie was almost as good as new.

You may find that Annie’s remedy can help you, too. It’s helped lots of people going through these “interesting” times.

When You Aren’t Naturally Resilient, There’s Still Hope…

But, if you’ve been depressed, anxious, overwhelmed since long before the pandemic began, Annie’s remedy may not be strong enough to make the difference you need. And if that’s the case, don’t worry.

There’s no shame in a condition that saps your energy and darkens your outlook. It just might mean that you need treatment to help you find the hope Annie did.

Because hope is something every human needs to live well. And resilience is a product of hope. You need both.

Ketamine Treatment Restores Resilience

We have a treatment that can restore hope, joy, and resilience for you if you’ve lost them. It’s not a temporary or artificial “fix” like some people seek in shadowy places. Ketamine treatment goes into your brain cells and stimulates the growth of essential elements that are missing.

Things like brain derived neurotrophic factor (BDNF) that proliferates the production of synaptic connections that brighten the communication of thoughts and creative signals in your brain.

It’s more like ketamine sets your brain cells in optimum working condition, like they should be.

And when that happens, your mind can function to provide you with a sense of wellbeing, so you feel hopeful, joyful, and resilient.

At Innovative Psychiatry, we’re an essential service in this crisis, present and ready with a full safety protocol for treating patients who need to be treated during this difficult and challenging time of social distancing.

The coronavirus hasn’t reduced the need for treatment of depression, PTSD, anxiety, suicidal thinking, and other conditions, but has actually increased it. And we’re here to help you get through this uncertain time with treatment that can reduces, or even eradicate your symptoms.

Resilience during social distancing due to the pandemic is important, and can be restored in you.

We understand the difficulty of social distancing, of feeling isolated, and of coping with symptoms that traditional medicines aren’t helping.

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

We’ll talk about whether ketamine treatment might be a good fit for you and talk you through the process of treatment.

There really is a way to function and feel up for the challenges of life during this time. You really can have joy again, and hope.

To the restoration of your best self,

April 13, 2020
When You’re Tormented by Fear, PTSD, and Panic in Isolation

Shannon awoke, looked around the room hoping the new day would reveal it had all been a nightmare, and that life was back to normal.

But when she saw the the shattered mirror – cracks spreading out from a broken center – she remembered hitting it with her fist last night and realized nothing had changed. She looked at her hand…to see if it was cut. It was no surprise to see the cuts on the heel of her hand, the dried blood. It looked like the damage was minor and it would heal on its own. Why do fear, PTSD, and panic strike so hard at night?

The nights were hard.

Stay Safe, Stay Home the governor had said…

But for someone like Shannon, these instructions were costly. She understood it was important. But the silence, the darkness, the feeling that the walls were closing in turned her apartment into a house of horrors at times. Those sounds she couldn’t identify that made the hair stand up on the back of her neck and her heart race.

She’d grab the 18” long flashlight she kept in bed with her, to defend herself if an intruder broke in. The baseball bat was just under her bed if she needed it.

Last night she couldn’t see anyone, but the sounds started reverberating around her, and she finally exploded through the house ready to fight. She screamed, she cried, and she finally sank to the floor sobbing.

She’d wanted to die. She wondered how she could escape her life and her terrifying thoughts.

The mirror happened at some point during that experience and she wished she had never woken up again. But she did.

Right now she was calm. Why did she get so wound up by the dark?

Fear, PTSD, and Panic Attacks Seem to Get Worse at Night

All day she tried to manage herself. Her doctor had reminded her to try to avoid news broadcasts and news websites. Just reading about all the evolving changes in the city and country every day was overwhelming and depressing. Her doctor had pointed out that the sheer volume of information was too much for anyone to digest.

Instead she encouraged Shannon to find people online she could encourage. Or to offer to pick up groceries for people in the apartment complex who were at greater risk for the COVID-19 virus.

She’d said that doing things to help others can give her more peace and good feelings. And can help her stay balanced.

But it was hard.

Even though Shannon had followed her doctor’s advice, even interacting with friends on social media was becoming more challenging as more and more people were spewing anger, rage, and blame.

Sometimes it seemed as though fear attracted fear. And she wondered how to attract optimism, instead.

Listening to the rants of her friends stirred up her anger, too. But more than anger was the fear that their fears ignited.

And when you have a disorder, fear can present its own danger.

Counting her pills helped her verify she had been taking her meds on schedule. Of all times, this weird time shut in her apartment was not the time to miss her meds. She needed all the help she could get and she knew it.

Shannon decided she better request an online meeting with her doctor on the secure server. She thought she better tell her what happened last night. She didn’t want to.

It was embarrassing, but she was learning that facing her symptoms in all their “glory” gave the doctor the information needed to make sure her meds were at the best dosage.

She’d only been coming clean with her doctor for a couple years. Before that, she’d always tried to protect herself with a clean and respectable image and then everything would fall apart. She guessed she’d learned that her condition wasn’t something she should be ashamed of, but rather a condition with symptoms she and her doctor worked together to manage.

It had lifted a load off her to finally accept the condition rather than hide it. She wondered…if she did die here, how long would it be before they found her body…?

Shannon forced herself to stop thinking that way. She just had to not think like that…but how could she make the thoughts go away?

The Relief Ketamine Treatment Can Bring

Next door, Sam woke up after the night of bumping, pounding, broken glass, screaming, and crying that kept him awake last night, wondering how he could face the day. He thought he might have dozed for an hour or two in all.

One of the hard things about working at home was the desire to crawl back into bed or doze on the couch when he was tired.

Nevertheless, he showered, got his coffee, and sat at his computer at 8:30am right on schedule.

Fear, PTSD, and Panic Attacks Can Affect People Near You, Too

As his day began, he was distracted thinking about all the noise from next door. It wasn’t the first time. He wondered if the person who lived there was being mistreated by someone or if she was there alone.

If she was there alone, he sure could understand this social distancing getting to her. It seemed to him that social distancing is great for happy introverts who want to quietly read books or something but it had to be hard for people who draw their energy from spending time with other people.

As for himself, he was just so relieved that he had as much self control in these circumstances as he did.

For years, PTSD had kept him so torn up, so terrified at times, that his wife and children were afraid of him. Being shut in like this would have been really really hard.

But he was lucky.

He’d learned about a treatment that helped him find a calm, a feeling of well-being, and a peace he didn’t know was possible.

His buddies from Afghanistan had talked about all kinds of special treatments. There were camps people went to that were so expensive, he didn’t have the means to try them.

One of his friends came back doing somewhat better, but still had the awful flashbacks at times. A couple others didn’t get much out of it…after all that money.

There were counseling programs, outpatient medicines, and more.

But one guy told him about ketamine treatment. And this guy seemed almost well. Hard to believe but he did. They became good friends and talked more and more often. He said that fear, PTSD, and panic were much more rare now.

Turned out the guy went for 6 treatments at his psychiatrist’s office… and he just kept feeling more and more normal.

So Sam looked into it. He found out he could get special financing from a medical loan service, so he went for it.

That was a year and a half ago, and he was just so glad for his calmer frame of mind during this lockdown. He could only imagine what this period of time would be like otherwise. Fear, PTSD, and panic would have been the fabric of his existence. But…

By eating healthy, working out in his living room over lunch hour, and looking for ways to help people around him, he felt a bit more like a hero to some of the older people in his complex, and less like someone who came home from the war broken.

He did attend an online meeting for people with PTSD once a week, and tried to apply everything the therapist suggested. But he also felt like he had things he could contribute, too. This treatment almost seemed to increase his insight into the trauma he experienced, so the more meetings he attended, the less victimized he felt.

Sam wished he could help the girl next door. He wished he had something to offer. He needed to think about that more. Maybe he could come up with something to cheer her up without having actual contact with her.

He felt so privileged to be living this well. It was as if he’d been to hell and back…and he just wanted to give something somehow to those who hadn’t found the freedom he had.

Weathering The Coronavirus Crisis

As you get through the days in your home, you look around you, and there are people in all the other homes and apartments you see. Some are coping fine, though they may be getting cabin fever. Others are working hard, with some tension building as they work because of the conditions in the world.

But some are suffering. Fear, PTSD, and panic attacks along with severe depression threaten the health and wellbeing and sometimes the lives of some. From ailments that make life alone at home a lot harder. And those whose symptoms are intensified by the isolation they feel may be suffering more than you can imagine.

Here at Innovative Psychiatry, we’re seeing patients every day. Our psychopharmacology patients we see by telemedicine. It’s important for all of us to avoid face to face contact, but it’s also important to take care of our patients.

And those patients who need ketamine treatment? We’re carefully treating you here at the office. Using a safety protocol that protects you, and protects us, too.

We’ll screen you for exposure to COVID-19 to protect your safety and ours, as well.

Ketamine treatment can help ease your symptoms, improving the neuroplasticity in your brain cells, so you can change the way you see things, and respond to them.

And …often even separately from your symptom improvement, it can erase suicidal thoughts in a few hours. If you’re isolated, and the suicidal thoughts have become overwhelming, call us.

And if you suffer with PTSD, severe depression, severe bipolar depression, with symptoms that medication doesn’t relieve, schedule a consult to see if ketamine treatment could be right for you.

For suicidal thoughts, you’ll be amazed at what ketamine treatment can do to give you peace from those.

Stay Safe, Stay Home. But if you find it too hard to get through the days and nights right now, and if the terror and despair overwhelm you, call us.

We’re here to help you achieve a healthier, more balanced frame of mind to see you through the current crisis and beyond.

You can get through this, with help. We’re all in it together.

To the restoration of your best self,

April 6, 2020
Insomnia and Suicide: Will Treating One Prevent the Other?

A cause and affect relationship that’s a recipe for profound misery…is there hope?

Jarrod turned over. The room was dark except for the light of the clock. 3:45AM glowed brightly in the darkness. Jarrod sighed heavily. It had been 5 hours since he turned off the light. Exhaustion weighed him down like lead.

He hadn’t slept more than an hour all week. Why does it have to be so hard to just get some rest?? Rage was growing in a slow boil in his chest… He was afraid of what he might do if something didn’t break this maddening cycle. Sometimes he wanted to explode from the frustration. Sometimes he wanted to give up and die.

Much of the time, just after he dropped off, an alarm of sorts sounded inside his head and woke him wide awake again…

What is life if it has to be spent like this?

Months. Years. A lifetime.

None of his medicines worked. None. He felt defeated just thinking about it.

He tried to count sheep. His mind wandered fretfully slamming him with accusations, fears, uncertainty…hopelessness. Despair.

Buuuuzzzzzzz !!!

5:30AM. His alarm. He only slept maybe an hour and a half.

There was no choice but to drag himself out of bed and force himself to face another day… he knew he just couldn’t go on like this much longer… in fact, he wouldn’t.

Life-Threatening Misery

It’s not hard to connect the dots between insomnia and suicide. If you’ve suffered from chronic insomnia, you know the wretchedness of staring at the ceiling and watching the hours tick by.

And the longer it goes on, the more you worry about how you’ll get through the next day on 4 hours of sleep…or three hours… then 2 hours. Well, an hour and a half.

Have you ever experienced unrelenting insomnia for several nights in a row? If you have, you know that just as you’re getting sleepy, hoping you’ll drop off, suddenly you wake with a start and realize you had fallen asleep and woke up only 3 minutes later! It makes you want to chew nails.

In fact, it’s so terrible that prisoners of war are forcibly prevented from sleep as a torture to break down their resolve.

It’s not hard to see that prolonged insomnia can lead someone to want to die. Nor is it far-fetched to consider that having a desire to stop living could keep you from sleeping.

So which comes first? Well, it’s hard to know.

Sleep Disturbance is Treatable

Researchers have found that insomnia is an independent risk factor for suicidal thoughts, but a factor that’s not etched in stone. Because this is something that can be changed. And when it is, it relieves its influence on suicidal behaviors.

Genetics can’t be changed. Environment is hard to change. But insomnia..? It can usually be treated.

In addition, research has shown that insomnia is a risk factor and predictor for depression.

Over 65% of adults with major depressive disorder report sleep problems. More than 90% of adolescents with depression seek treatment for disturbed sleep.

And among both adolescents and adults, those who seek treatment for problems with sleep experience more severe forms of depression than those who are depressed without sleep disturbance.

Insomnia Is An Independent Culprit

Traditionally, there has been an assumption that insomnia was a symptom of depression, but further research shows that sleep disturbance symptoms are experienced most often before the onset of depression, and continue longer after depression symptoms are relieved.

So is it the first symptom of depression that shows up long before other symptoms..? And the last to go after depression is resolved? Or is it a separate disorder that commonly accompanies other disorders?

You and I both know that when you go without sleep, or without enough sleep, 2-3 days in a row, it’s natural to find you’re more irritable and less able to control your mood.

When someone goes without sleep 5 days…or 8 days… their mental state becomes impaired, as well as coordination, cognition, and judgment. Often, at some point, they’ll finally sleep. Maybe for a few hours, maybe longer. And once they’re able to fall asleep once and remain asleep a few hours, they may have more success for the next few nights with more restful sleep.

Then the cycle begins again.

The Link Between Insomnia and Suicide Can Lead to Death

One recent study found that dysfunctional neuroplasticity may be to blame for insomnia. And that dysfunction can drive not only insomnia but other severe symptoms that are truly unbearable for you.

The theory is that neuroplasticity is a major mechanism in the cause of depression.

Neuroplasticity is the way the brain adapts to changes in the environment and to various stimuli.

Since sleep promotes synaptic neuroplasticity and a healthy ability to adapt and change, the lack of sleep reduces your ability to do that. Synaptic plasticity is also reduced in major depressive disorder.

Now think about this:

As many as 50% of people diagnosed with psychiatric disorders are never helped by medicines or therapies. Because of this, there’s been a need for a novel and advanced treatment to bring relief to their symptoms, as well as to their suicidal thoughts.

Ketamine, a glutamate modulator, restores neuroplasticity, and the adaptive ability that goes with it.

So it stands to reason that ketamine treatment can relieve both depression and insomnia. In fact, in a separate action, it can also erase suicidal thoughts in an hour or so.

Insomnia and Suicide

Stubborn long-term insomnia that doesn’t respond to medicines or therapy is not uncommon at all. But it contributes to your illness in ways that are so dangerous, it’s important to find effective treatment.

Suicidal thoughts are also life-threatening, and the longer they continue, the greater the risk to your survival.

If medicines and therapies haven’t relieved these symptoms, you may be a candidate for ketamine treatment. Ketamine treatment can restore your neuroplasticity and erase suicidal thoughts within 4 hours or less. Then, after that, you may find you can finally sleep.

At Innovative Psychiatry, patients walk out restored every week. They find they can do things they couldn’t do before, work through inner turmoil that they were unable to before, build relationships they lacked the energy and resilience to build before.

They can build rewarding lives and relationships.

And you can enjoy these breakthroughs, too.

Call us. You owe it to yourself to give your life and yourself the best advantage.

To the emerging of your very best self,

Lori Calabrese, M.D.

March 4, 2019

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