Lori Calabrese, MD

Tag: Ketamine Treatment for Suicidal Thoughts

Men Who Seek Help for Their Mental Health are Leaders

Reaching Out for Help — and Treatment — Is the Bravest and Healthiest Way to Make Your Life Count

We’ve talked before about stigma, and the fear you can have of doing or saying anything that would attach a stigma to you.

Racism is in the news often in these times. It seems that being accused as a racist is one of the most dreaded accusations anyone can bear. And once that accusation is slung at someone, it’s hard to get out from under the the searing branding of it.

You don’t want to be a racist, and maybe even more, you don’t want to be SEEN as a racist.

In a similar way, there’s another label that gets slung around, and that’s “mentally ill” or “crazy” … right? Here’s worse: weak.

The stigma is painful. The label hurts. Those slinging those stones are not usually qualified to have any idea of its truth.

Just as the stigma of racism runs deep and its historical tendrils have insidiously reached all races, in all cities, and carried through generations, in a similar way the stigma of what people call “mental illness” has done the same.

Also, just as neuroscientists have discovered more and more about what actually happens in the cells in the brain that result in a disorder, there is more and more information to fight stigma.

Still, it exists. If you go to a psychiatrist to find out what can be done about the darkness, emptiness, despair you feel…will you lose your job? What about your family…Will they think you’re weak? How will your boss look at you…any differently? Will you have trouble getting insurance?

Which is why it’s so important that men seek help when they need it. It shows they know what’s important.

What are the risks?

But if you need an intervention to pull you back from the precipice of despair, from thoughts of suicide … does that mean you’re weak? Or simply that you need treatment to restore you to your full functioning self?

What about a celebrity athlete? Should a famous athlete be respectfully treated so he can move forward and perform, or should he be shamed and stigmatized as if he’s not worthy of his position?

But think about it. Truly independent, strong men seek help when they need it, whether to lift furniture, improve a skill, or check out something that doesn’t feel right. Like a pain in their heart. It’s as much about being a leader as it is about being well.

Dak Prescott has been in the news because of something besides his role as a Dallas Cowboys quarterback. After his mother’s death from colon cancer in 2013, during which his brother Jace was a present support and helplessly watched her suffering, Jace took his own life in April of this year.

Dak has begun opening up about these tragedies, and about his own struggles with depression and anxiety through the COVID-19 pandemic.

He spoke out in September about the importance of being vulnerable during difficult times, and reaching out for help, rather than trying to carry your pain silently inside.

He knows that doing that can be lifesaving.

Dak’s statements have opened up the dialogue again about men in masculine roles, and their difficulties in being honest and open to reach out for support and treatment.

This is an area of extra stigma not only for the athletes, but for their fans and their announcers.

The same can be said about other tough roles such as police and military.

And among the cultures in these careers, a true leader is too often believed to be one who doesn’t “allow” depression or panic. (As if we allow it, right?) And who certainly doesn’t need help … with anything. Or directions.

And yet, people of all walks of life can suffer with psychiatric disorders. Depression, anxiety, trauma, addiction. Hopelessness. They cut across all boundaries, all races, all cultures, all socioeconomic levels. They can creep in or hit you like a hurricane.

It has nothing to do with courage, energy, personal strength, or leadership ability.

It hits all of us. Ourselves, or someone we know.

Dak Prescott is joining with other male celebrities such as Dwayne Johnson, Michael Phelps, and Kevin Love, to encourage men to speak up, be honest and open about their struggles, talk about real things that matter, and embrace treatment when it’s needed.

They’re showing the world that strong men seek help when they need it, because that’s what leaders do.

And that’s a very productive effort toward reducing stigma, to letting all men be real, to feel what they feel — and to be honest and courageous to talk about it and reach out for support.

The beauty of it is that there is help to be found.

For depression, PTSD, suicidal thoughts, alcohol use disorder, and substance use disorder, IV ketamine treatment can make a robust and extraordinary transformation in your life over a few short weeks. Not for everyone, of course, but for many.

It can also dramatically relieve bipolar depression, postpartum depression, and adolescent depression and help you achieve a kind of resilience you didn’t know you had in you.

The era of taking antidepressants for months and years hoping they’ll eventually help even when they don’t… is outdated. Because we have more to offer. So if what you’re doing isn’t working to help, it may be time to reach out and see what else is out there.

At Innovative Psychiatry we see many men whose symptoms make them pretty miserable get back to their best selves after a few weeks of infusions…

And we’re set up to safely offer these infusions in the current COVID pandemic in our office in South Windsor, CT.

Dak Prescott is a brave man, who has owned up to his feelings, pain, and struggle…and has reached out for help.

He’s still a leader in his field. A leader who’s setting an example for health. A man seeks help. It’s a leadership thing…like a CEO, or an athlete, or a governor. Men seek help because they know they can’t do it all. So they choose their help wisely.

Do for yourself what Dak has done for himself. Connect with others who also struggle and seek support, and reach out for treatment here.

Stigma about taking hold of what you need to live well is so 20th century. This is a new dawn, a new world, with new solutions.

There is no weakness in reaching out to get what you need.

We’re here to help you with that.

To the restoration of your best self,

October 12, 2020
Recognize and Identify Depression and Seek Treatment

October is National Depression Awareness Month and October 8 is Depression Screening Day

40 million US adults struggle with depression and/or anxiety. But not everyone who struggles recognizes they even have an identifiable or treatable condition, or that they need treatment. That’s why there are tools that you can use to help identify the symptoms and figure out if you might want to consider seeking treatment. This week, participate with people you love so you can recognize and identify depression. It can be lifesaving. For so many, it’s both. And like pedals propel the chain on a bicycle, depression and anxiety can just keep aggravating and perpetuating each other until you feel like you’re losing your footing.

There was a time 20 years ago when society as a whole wasn’t aware of depression. There were all sorts of judgmental criticisms of those who suffered. So there is good reason to have a dedicated day — nationally — to draw attention to a condition that needs to be identified and treated.

Apparently, it’s working, right?

So let’s talk about screening.

It’s important to know if you’ve just had a tiring day…or if you’re actually bearing the weight of a condition. Depression can present itself as mild to severe and anywhere in between.

And while you may be able to get by with mild depression …in fact, you may be able to get through it with healthy activities, fresh air, good diet, and time to relax, severe depression probably is a sign you need treatment so you can function and recover.

To recognize and identify depression in yourself or those you love is so much better than ignoring symptoms and behaviors you don’t understand.

A screening tool measures – with your help – how you feel about your daily routine, about your energy, your sleep, your ability to concentrate, and your feelings about your life and future.

You can google “depression assessment tool” and take the little test to give you a somewhat objective impression. These tools are designed after a tool doctors use to help assess the severity of depressive symptoms called a PHQ-9.

Of course, tools like this aren’t intended to take the place of your psychiatrist, but using the tool informally may alert you to consider making an appointment.

To take it the next step.

Some people –you, maybe– have been moderately to severely depressed for so long, that your mood can lighten and you find your feel some relief but the screening tool still shows you’re moderately or moderately severely depressed. And it could be that you were actually severely depressed before you felt a lightening.

But with moderately or moderately severe depression, you should be under the care of a psychiatrist, to help you avoid a dangerous condition.

Remember, those tools can help you recognize your symptoms, get an idea of how severe they are and help you make a decision to see your doctor. Your psychiatrist will use a variety of screen tools, evolution, interview assessments, medical history, and more.

So you need to know what to look for in adults, teens, and children, don’t you?

1. Do you feel empty? It may feel like sadness, or futility, too.

2. Do you feel irritable..? Do you find you’re just short tempered and easily agitated?

3. Do you find you’re getting too thin, or maybe you’re suddenly gaining weight like crazy?

4. Do you think about death, about dying, about yourself dying or someone else?

5. Is it hard to focus, concentrate, on your work, or a newspaper, or TV?

As we stop to think about awareness and education toward recognizing depression in others, and offering support, there are some points we can celebrate as being positives that seem to come from depression.

For example, you may not realize that people who have suffered from depression tend to have more capacity for treating others with compassion. They often find they are less judgmental and have more capacity for understanding in what other suffer in life, and this is interesting:

They tend to be more analytical.

So they can break down complex problems into smaller, more manageable parts than those who haven’t experienced depression, and they often actually perform better on certain tests.

Interesting, isn’t it?

Still, what’s far more interesting is to utilize ways to recognize and identify depression so you can do something about it. To find the treatment that will restore, refresh, and help you feel good again.

Antidepressants

While it’s true that 35-60% of the people who have been diagnosed with depression respond to the first or second trial of oral antidepressants, there are about 35% who don’t respond to anything.

These cases are often among the most severe, and many have considered their depression to be treatment resistant. (The depression is treatment-resistant — not the person!) You can imagine why many attempts to receive effective treatment over months, years, even decades can result in feelings of futility.

But in the last decade or so, IV ketamine treatment has become such a rapid and effective alternative treatment, that many have come to consider it their treatment of choice when nothing else has worked.

Let me be clear though, that no one treatment is the treatment of choice for all depressed patients.

Even so, even among that 35% who haven’t found help with other medicines or treatments, IV ketamine treatment can be effective.

“Effective” means that you could respond. Even better, “effective” means that you could REMIT.

Picture remission like this…energy to meet friends for lunch and really enjoy your time with them, resilience to perform well at work and excel in your job, to bounce back from disappointment, and to build strong healthy relationships.

And there’s more. Suicidal thinking is a life-threatening symptom of severe depression. IV Ketamine is also an extraordinary treatment to stop suicidal thoughts.

Our study on ketamine’s effectiveness to stop suicidal thinking in the office in our patients with depression demonstrates ketamine’s potential for this life threatening symptom in a real world population of real people with complicated histories and hard lives. It can prevent that trip to the ER. It can help avoid a hospitalization.

Our patients commonly go through ketamine treatment in our office over a couple weeks — and many emerge feeling wonderful. Ready to take on challenges, with the sparkle to be contribute, work with others, and be creative.

At Innovative Psychiatry, trying to do our best to help you and your family hasn’t stopped or slowed down because of the coronavirus pandemic. We continue to improve our protocols and technology for maintaining a safe environment for you.

If you struggle with depression and have not found effective treatment, call us.

Get with your loved ones and screen for depression this week. Reach out and take steps to recognize and identify depression in yourself or loved ones.

And if you’ve suffered from unimproved depression, or if you find you’re thoughts filled with death images or plans, call us.

The National Suicide Prevention Lifeline: 1-800-273-TALK (8255)

Sometimes the only person who can take care of you is you. Take care of yourself and reach out for help when you need it.

There really is hope available so you, your fulfillment, and your future.

We’re want to help you find relief from the emptiness, the despair, the futility, and instead experience the joy of living a rewarding life.

To the restoration of your best self,

We can all help prevent suicide. The National Suicide Prevention Lifeline provides 24/7, free and confidential support for people in distress, as well as prevention and crisis resources for you or your loved ones.

The National Suicide Prevention Lifeline 1-800-273-TALK (8255)

The Veterans Crisis Line and Military Crisis Line 1-800-273-8255 Press 1

Crisis Text Line: 741-741 Free text hotline 24/7

October 5, 2020
Bipolar Mixed States: The Doctor Who Diagnosed It in the 12th Century

If you suffer from mania, you’ve also experienced the transition that leads to it.

Someone identified that transition emotion over a thousand years ago. Surprising? Here we are in the 21st century, with all the technology and neuroscience we’ve discovered at our fingertips, and we still face that same emotion. And it often plays a strong role in bipolar mixed states.

What is it?

Anger.

So many in our current society speak of various psychiatric disorders as if they’re a product of modern contrivance. Sometimes in psychiatry, our role is not only to treat those suffering from a disorder, but to also defend them against the cruel cynicism of skeptics who discredit their struggle.

For someone who suffers from emotions that plunge so low, so dark, they don’t know how to hang on to a fiber of life… then without warning, those feelings change…shift…and become energized then agitated… with no reason….until they’re replaced by anger then rage….and more energy than can be managed….until they’ve reached a state of euphoria, unlimited possibility, and very high creative energy…. Someone like this knows the helplessness of erratic emotional states.

And if you’ve experienced these wide changes in emotions, you know it’s painful. When it’s happening inside you, it feels normal. It feels justified…because you don’t realize it’s happening because of malfunctioning signals in your brain.

If you feel anger…even rage… it just must be justified, right?

But many people with a disorder like this have to experience it for many years before they can identify those moments when their mood swings in a new direction. It’s hard. Really hard.

So let’s talk about this ancient philosopher and physician from the 12th century, Avicenna.

He saw this disorder, this syndrome… and described it. He talked about how it affected both the psyche and the body. Pretty profound for a guy who lived around the year 1100 AD. He called this condition “melancholia” and in present day mental health we might think of melancholia as depression.

But the syndrome he described included mania. And mania specifically identifies what we now know as bipolar disorder.

In his early descriptions, he divided this condition into two phases, the early phase and the chronic phase. Symptoms of the early phase were described as suspicions of evil, fear without cause, quick anger, involuntary muscle movements, dizziness, and ringing in the ears.

For the chronic phase of melancholia, he described moaning, suspicion, sadness, restlessness, and abnormal fear such as the “sky falling upon one’s head,” or “being swallowed by the earth.”

In our current environment, we would likely consider these last two as delusions, or psychotic features.

Not all people with bipolar disorder have delusions during manic or depressive episodes. But in some cases, it happens.

Avicenna also described some symptoms we might now see in “bipolar mixed states” such as increased libido, involuntary laughter, and acting as though one is king… which we’d now call “grandiosity.”

These can all be symptoms of the manic phase of bipolar disorder.

These are descriptions that are more than 1100 years old. But they describe a condition that we still see today, and work hard to identify and treat. What is so hard is identifying it first. An episode of anger does not mean you have bipolar disorder — not by a long shot. And even if you have bipolar disorder, getting angry could be just… getting angry. It may not mean you’re in a manic, hypomanic or even mixed state.

How to tell? Sometimes it’s difficult. It may take several episodes. Sometimes it can take years.

You don’t have to let it. The good news is that mixed mood states are treatable. If you’ve been ridiculed for the medicines you take, or the psychiatric treatment you participate in… if people around you don’t believe this is not only a valid and debilitating disorder, or think it’s something modern day doctors have dreamed up, here’s proof your struggle is valid.

People can be so… uninformed. You have to just shake your head in disbelief.

According to Avicenna, people have been suffering with this at least since the 1100’s. It’s still the real deal.

And he described bipolar mixed states without using the term itself: a combination of depressive and manic symptoms all tangled together at the same time. With a back drop of depression, and the addition of agitation, grandiosity, heightened sexual drive, anger, and emotions that are easily aroused, changed, that alter quickly.

There are doctors who attempt to diagnose bipolar disorder as specifically depression with at least one clear episode of mania or at least one clear episode of hypomania. But for a large population of patients, this is utterly frustrating. Because what they have–and what you may have–are mixed states, or mixed episodes.

If you’re one of them, you know.

You KNOW you’re not either black or white emotionally. You KNOW you’re not specifically depressed or manic.

While you may be depressed at times, and you may experience mania at other times, you know that you also have all sorts of combinations of emotions in between the two.

It can feel like you are a vertical accordian with shifting degrees of manic and depressive symptoms at the same time and with the ratio shifting throughout the day, or from day to day … over sometimes every few days. So many variations make it hard to identify, difficult to explain, and frustrating to report. Symptoms like grandiosity and anger can signal other disorders, as well.

And you know it’s real, though you may be told something different.

When you suffer like this, you first need validation that there are things happening inside you that you don’t cause.

This is a very difficult condition, and what you experience may be different than what someone with the same diagnosis experiences. But it’s real.

And it’s treatable.

Bipolar disorder can be challenging to treat effectively — and may need patience and determination for you and your doctor to tame — but hang on to hope.

We’ve only talked about bipolar mixed states and mania but there is also depression in bipolar disorder. And bipolar depression is also extremely difficult to endure. It can be terrible.

Thankfully, bipolar depression can be treated effectively by IV ketamine.

Another aspect of the depression in bipolar disorder is the risk of suicidal thoughts. And IV ketamine can remove those thoughts and give you the freedom to live in joy.

At Innovative Psychiatry, we offer IV ketamine treatment for bipolar depression and see patients whose treatment has helped them emerge from the depressive symptoms that held them down. Not everyone, of course, but many.

And these patients often talk about how much easier their condition is to manage since the depression is gone.

While bipolar depression can be tough to break, ketamine treatment can break it. Give yourself the opportunity to see how good you can feel, how productive life can be, without bipolar depression undermining you.

If bipolar depression interferes with your life, call us.

We’re here to help you achieve remission, with resilience, hope, and the joy of a loving and productive life.

To the restoration of your best self,

September 28, 2020
Does Problematic Drinking Follow You Around Damaging Your Credibility?

New study reveals extensive genetic links not only to alcohol use disorder, but also problematic drinking without physical dependence

Brandon caught his breath and stopped. He looked around him. Where am I … and how did I get here? He was surrounded in pitch blackness. Couldn’t see a street light, not even moonlight. He realized he’d been walking at a fast pace, but where from? And where was he going? He remembered nothing, knew nothing, except this very moment. He felt terrible, and realized with horror he was about to be sick… After retching up his insides, the odor of undigested alcohol wafted from the ground. Then it all made sense. He’d had a lot of alcohol, apparently. Again. Problematic drinking follows you around just waiting to trip you up, he thought. He gingerly tried to move forward on ground that was shifting like a rough sea to find his way home. He wondered how long he’d been gone, and whether he’d hurt anyone… or broken any laws. It was torture no knowing.

Creeping forward, slowly, reaching in front of him to find something to steady himself, his hand touched something cold and solid like concrete or stone. As he followed what felt like a long wall, Brandon eventually emerged into the open where there were street lights, and the moon was shining brightly.

He looked behind him and realized he’d been in some sort of tunnel. A police car drove by and he instinctively hid. He had no idea what he’d done — and whether they were looking for him. But it was the not knowing that made him afraid.

Shame, Humiliation, Fear

This was all too familiar. Finding himself lost. No memory of where he’d been. Staggering to find his way home.

Brandon woke up in an alley. His shame and self-loathing sucked all courage out of him. Self respect always eluded him. The sun was up and he could find out where he was and get home. But, what then? His wife would be so furious. Why was he like this?

He just wanted to die.

Genetic Links When Problematic Drinking Follows You Around Like a Stray Cat

Neuroscientists have explored the genetic links to problematic alcohol use for many years. But more recently, a research team lead by Joel Gelemter, M.D., conducted a study published in Nature Neuroscience that included over 435,000 subjects (and of those, 200,000 came from MVP — the VA’s Million Veteran Program). Their paper found nearly 3 times the locations (they call them “loci”) in the human genome that seem to correlate to critically increased risk of problematic drinking.

As you know, we refer to the pathological use of alcohol as alcohol use disorder. These neuroscientists use the term “problematic alcohol use” in a similar context that includes those with alcohol use disorder, as well as those who are not physically depending on it or, as some say, addicted to it, but when they do use alcohol, it results in problems in their lives or those around them.

Both of these conditions interfere with your life, your work, and your relationships.

For generations, people like Brandon were judged “irresponsible” or “weak.” But the more we learn about your brain and your DNA, the more we come to understand how complex these conditions are.

Your genes determine the color of your eyes, your skin, your hair… they determine your height, your natural talents, whether you like chocolate or cilantro, the pitch and clarity of your voice.

They also lay a road map for the likelihood you’ll struggle with asthma, diabetes, depression, bipolar disorder…and yes, problematic alcohol use. Just as you would be cruel to criticize or judge a person by the color of a their skin or their eyes, it’s also cruel to judge their propensity for one of these disorders.

That’s why so much work is being done to better understand what people deal with regarding alcohol use. Problematic drinking can follow you and seem to never let go.

Research Reveals Links Between Problematic Drinking and Tobacco Use, Depression

Knowing the details of the links between DNA and problematic drinking doesn’t solve the problem, but it helps us know how to approach treatment.

For instance, this massive study revealed DNA connections with other related traits like tobacco-use disorder and substance abuse disorders. Since the human genome is 3 billions pairs of “letters”, they learned that even a single variation in one single “letter” impact these disorders.

Tough to wrap your head around it, isn’t it?

Long story short: problematic drinking can be related to tobacco use, schizophrenia, ADHD, and depression.

The study also revealed that about half your risk for problematic drinking is inherited, which can help us understand why willpower sometimes just isn’t enough to gain control of pathological drinking.

And while there is no panacea, no 100% perfect and effective treatment for all these disorders and conditions, there are things you can do, treatments you can reach out for, that can help restore your freedom.

Ketamine treatment, for instance, can slow down your drinking after just one infusion. And if depression or social anxiety is fueling your drinking, ketamine treatment can lift those symptoms so remarkably, you can achieve remission.

We’ve talked about alcohol use disorder, and today we’re including problematic alcohol use. But if you want life to be different, and to have the freedom to build a rewarding life, you may be a good candidate to see if ketamine treatment can help.

If problematic drinking follows you around, turning a social gathering into a nightmare for you, there’s hope. Maybe you don’t believe you have a disorder, maybe a 12 step program doesn’t seem like a good fit.

But several infusions of ketamine within a few weeks could be just the thing to give you back control in your life.

Reach Out for Change and Freedom

At Innovative Psychiatry, we see people who want balance in their lives, who want to restore their self respect and credibility. People who suffer from alcohol use disorder, and those who just have bouts of problematic drinking that strain the foundations they’ve worked hard to build.

And we see these people marvel at the benefits they’ve experienced from ketamine treatment. Some completely lose their desire to drink alcohol at all, others find their interest in a drink dissipates halfway through it. And if they also suffer from depression, PTSD, or even suicidal thoughts… they can leave our office after treatment feeling restored.

Do the struggles we’ve talked about sound familiar? Call us.

That problematic drinking with genetic links may be treatable. Reach out for help to get your life back in order.

We’re here to help, and offer ketamine treatment safely in our office.

Give yourself the opportunity to live really well.

To the restoration of your best self,

September 21, 2020
Prepare Your Family to Respond to the Risk of Adolescent Suicide

September is National Suicide Prevention Month And Adolescents Have the Highest Risk

So let’s look at adolescent suicidal behavior. If you have an adolescent in your family, you may not be able to even imagine your child contemplating suicide. Or, if your child visits a psychiatrist regularly for a disorder, you may worry that he considers death or dying, and you may privately feel terrified about it. But, it’s ok to ask. Have you? This is not a taboo subject, and since risk of adolescent suicide is so much greater than it is for adults, it’s a subject to be discussed openly in every family.

Did you know that about half of all teens who attempt suicide for the first time die? 50%! It’s so alarming. How can you prepare yourself, and more importantly, prepare your child, if you had no idea she was thinking about it?

Brain and Behavior Research Foundation funds dedicated suicide researchers across the globe who seek to learn as much as possible about suicidal behavior in youths. And that gives you an edge over parents a generation ago. By studying teens who consider death, dying, and ending their own lives, these researchers have been learning ways to help you make your child at least somewhat safer.

And of course we want to do those things that can interrupt a self-destructive plan…to make time for treatment, relief, and hope.

Because one thing about adolescents is that they can be unpredictable, impulsive, impetuous, and lack emotional regulation — even when they’re healthy and having a normal day!

But, when a teen is struggling with a disorder, when his or her emotions are all over the map and something has happened that seems irreparable to him, or when he finds himself in crisis and can see no way through it, he can make an irreversible decision that silences his options.

Of course there are some teenagers who never consider self destruction. Some whose sense of survival is strong and immovable. And if you were that kind of youth yourself, you may not be able to grasp that your own teen could be different…might think there is no way out, might think that he has no other option.

Did you know that the risk for suicidal behavior in an adolescent is about 100 times higher than it is for an adult?

It’s true.

And because of this, as a parent you can’t presume this risk doesn’t apply to your family. So it can be so helpful to have some ideas about what to look for.

You need to be informed and alert enough to watch for signs that your youth could be at risk for suicidal thoughts or behaviors.

There are screening programs for uncovering risks in your youth, more sophisticated programs than charts you fill out on paper. Machine learning has been developed that collect more detailed information.

These researchers have learned that 10.7% of those who die by suicide visited the Emergency Department within the last 2 weeks.

And this will surprise you…

Their reason for the ED visit is not about suicidal thoughts…but other complaints, like chronic medical illness like diabetes or asthma, aches and pains in their body, assault, head injury, alcohol or drug intoxication, or because they are using the ED as a primary care clinic.

This is so important

It’s important because it’s during these visits for physical maladies that patients can be screened for suicidal behavior risk.

Just think about it… when someone you love attempts suicide or dies by suicide, and you realize they visited the ED 10 days earlier, how could you not want to throw your hands up?

As parents, keep this aspect of your adolescent front of mind for all medical treatment, and if you have concern that your child may be considering dying, ask for help.

Parents do the best we know, but do reach out for medical help, psychiatric evaluation, and diagnosis.

More thoughts that may surprise you:

These conditions may predispose your youth for suicidal behavior:

If they’ve attempted suicide before

(And remember, 50% of teens who attempt suicide die on the first try)

If they have problems sleeping

Or, if there is marital conflict in the home

If they have a tattoo

(Remember, not everyone who has a tattoo is at risk for suicide, but a large percentage of those who consider or attempt suicide DO have tattoos. So consider that if your child wants a tattoo that it’s not unreasonable to explore whether he may have pain he hasn’t talked about.)

Also, if they have been imprisoned (again, a source of pain)

Of course, if they have a mood disorder

And pay attention if they use negative words commonly that are associated with death, dying, evil, darkness, self-hatred, etc. Because this is also a risk factor.

Use of positive words like happy, joy, sunny, sunshine are not typically part of the vocabulary of a teen at high risk for suicidal behaviors.

Create a Safety Plan

Finally, when you do have risk of adolescent suicide in your family, participate with your youth’s healthcare team, therapist, and psychiatrist to create with your child a Safety Plan together. Identify those triggers that can increase distress and work together to find those things that can decrease it.

The effectiveness of the plan you form relies on the involvement of all involved, and your child’s willingness to help and respond.

And then, in the case of an unexpected suicidal young person, for whom you have no prepared plan, you can start by helping him or her call:

The National Suicide Prevention Lifeline: 1-800-273-TALK (8255)

With all that said, remember there is an option available as a part of your safety plan that can intervene without hospitalization or a trip to the Emergency Department.

Ketamine treatment can has been so remarkable in its ability to stop suicidal thoughts in a few hours or less. It can stop them. Erase them.

And when that happens, it gives you the freedom to work on getting better. Because the crisis can pass.

This is so extraordinary that I conducted and published a retrospective chart review on a patients I’ve treated — with complicated stories, real life issues, lots of different symptoms, and the suffering that happens when treatment doesn’t work, with such promising results that I’ve had the opportunity to share what I learned with colleagues across the US and in the UK.

Ketamine treatment can rapidly replace thoughts of death and dying with hope to give you the opportunity to work toward getting better, and even remission.

At Innovative Psychiatry, we offer ketamine treatment to people as young as 14, in a safe environment during this pandemic. We see teens and adults improve dramatically every week. Not all—some teens and adults don’t respond—but many experience complete remission from their symptoms.

Risk of adolescent suicide is high. It’s the second leading cause of death in persons age 15-24.

If you or your teen suffers from symptoms of depression or suicidal thoughts or behaviors, reach out or text one of the support hotlines, or call us if you would like to consider ketamine treatment to stop those thoughts.

We understand all too well how these symptoms can not only disrupt — but endanger — your life, and we want to help. Seeing you experience relief from your pain, torment, and suffering is why we get up in the morning.

Your desire to pursue a fulfilling and rewarding life is your fundamental human need, and we want to help that happen for you.

Reach out for remission.

To the restoration of your best self,

We can all help prevent suicide. The National Suicide Prevention Lifeline provides 24/7, free and confidential support for people in distress, as well as prevention and crisis resources for you or your loved ones.

The National Suicide Prevention Lifeline 1-800-273-TALK (8255)

The Veterans Crisis Line and Military Crisis Line 1-800-273-8255 Press 1

Crisis Text Line: 741-741 Free text hotline 24/7

September 14, 2020
Don’t Be Shy – Talk to Someone Suicidal Because You Might Save a Life

This is National Suicide Prevention Awareness Week — Be aware and reach out.

And while you may never have talked with someone who’s considering suicide, it’s likely you will at some point. Just as we need to refresh our CPR skills periodically, it’s important to refresh skills to talk to someone suicidal. It’s easy to brush off the risk as something dramatic like someone preparing to jump off a bridge. But the truth is, the guy in the next cubicle or the doctor you work with or a lady you see crying in the restroom — any of them could be struggling with suicidal thoughts.

How often have you heard people say, “he had everything to live for,” or “he seemed like such a happy guy” or “she was so much fun.” Everyone’s baffled. And yet, obviously, it wasn’t all what it seemed. But maybe nobody asked.

Most of the time, when someone reaches the point of considering suicide, it happens somewhat quietly. Thoughts of death and dying begin to creep into and then crowd their thoughts, but if you don’t ask, they may carry through on their thoughts without giving away their plans.

You have to ask.

Because, truth be told, we want to prevent suicide, don’t we? I know there are those who say that a person has the right to decide when he wants his life to end. But it’s a fallacy to assume that. Because those who have the clarity to make such a decision rationally, are the exception — not the rule.

In most cases, suicide attempts and completed suicides are the result of a desperate desire to “not live like this anymore.” It’s the result of desolate misery and finding no other option.

But there ARE options. For most people, if you can give them a way to live that’s joyful, productive, and rewarding without the incessant pain they endure, they would opt-out of death and choose a life that’s enjoyable and full of hope.

And it’s for that reason we want to prevent suicide.

To give this suffering person a chance to live well. In a moment we’ll talk more about that. But for now, let’s focus on how to prevent a useless tragedy.

So what can you do?

Be AWARE that there are hurting people around you. We all have busy lives and plenty of pressures, and it’s easy to be absorbed in our own pressures and worries and completely miss the guy we talk to every day who has actually reached the end of his endurance.

So develop the habit of asking.

Ask the people in your world how they’re doing, and listen to their response. Pay attention and show them that it really matters to you. This is paramount and is the primary way to find out if someone who crosses your path needs your help. Convey that you mean it.

“How you doing, Jack? No…I mean really. How are you doing?”

When you show that you’re not impatiently trying to give the expected greeting so they’ll disappear, but that you do truly care deeply how they are, you’re more likely to get real answers.

And little by little, you’ll become known as someone who really cares, and someone a person could actually talk to. Which is why you want to talk to someone suicidal, because your caring could possibly be life saving for them.

Understand that a person who is this depressed, or this desperate, has probably become isolated. And that’s a very lonely place.

To break that isolation, reach into it and show you care. One of the most powerful things you can do to prevent suicide is to be a friend to someone who’s isolated. Listen to them, spend time with them. BREAK the isolation.

Feeling utterly alone in the world is part and parcel to the anatomy of suicidal thoughts. And remember, you can be utterly alone in a crowded room.

Make Them Safe

So what do you do if you talk to someone suicidal..? Start by removing weapons from their environment, if you can. Remove knives from the kitchen, guns from their house, maybe even the car keys. And don’t leave them alone. Find a friend or relative they trust to stay with them. Help to make their living environment a safe place.

Also, do all you can to remove medications and alcohol from their household. Your purpose is not to control their life, but to provide safety while you find a way to give them hope.

Then tell someone. One of their friends or family. Someone you can trust who will be with them, help them feel understood and supported.

And talk with them about treatment. About someone who can help them weather this storm and find new hope and new options to help them live.

This is why you talk to someone suicidal.

Help them find it. Give them some good ideas for professional therapists. Because their life is more important than their crisis. It really can get better.

The National Suicide Prevention Lifeline: 1-800-273-TALK (8255)

Especially with the help of ketamine. Know that ketamine treatment can erase suicidal thoughts in a few hours…or even less. That those horrific thoughts and images can be eradicated with the astounding effects of ketamine treatment.

And that amazing benefit can give them the chance at life they wish they had had before…and give them the opportunity to find relief, restoration, and remission from depression and suicidal thinking.

So there may very well be a solution. But how will they know unless you talk to someone suicidal and tell them? Suicidal thoughts are not limited by age, income, or any demographic. Children are susceptible, doctors and nurses are, investors and teachers are, your co-workers are.

There is an alarming increase in suicide among doctors. No one is immune. So reach out and talk. And listen.

At Innovative Psychiatry, we take suicidal thoughts very seriously. We offer ketamine treatment for suicidal thoughts and are thrilled to see the freedom from torment ketamine can provide. Someone whose life is at risk — high risk — because their thoughts are bombarded with death, dying, and ending their own lives, can walk out of our office relieved, hopeful, and grateful that those thoughts are gone.

Ketamine treatment can be transformative, not just for suicidal thinking but also for the symptoms of depression, despair, substance use disorders including alcohol, PTSD, and anxiety. We share the joy of our patients as they walk out with hope and in remission.

Not always, of course, and not everyone. Ketamine treatment is not a cure-all for everyone. No treatment is.

But is may be what helps you when nothing else has. It may be what finally puts your symptoms into remission. If you yearn for the benefits ketamine can provide, call us.

We want to see you enjoying your life with hope and freedom from torment. Life can be rewarding and productive for you. Relationships can be strong and fulfilling.

Reach out for hope. We’re here to help.

To the restoration of your best self,

We can all help prevent suicide. The National Suicide Prevention Lifeline provides 24/7, free and confidential support for people in distress, as well as prevention and crisis resources for you or your loved ones.

The National Suicide Prevention Lifeline 1-800-273-TALK (8255)

The Veterans Crisis Line and Military Crisis Line 1-800-273-8255 Press 1

Crisis Text Line: 741-741 Free text hotline 24/7

September 7, 2020
COVID Hassles Annoying? Ketamine Can Help You Embrace Living Again

COVID-19 – Growing number of people suffer from anxiety, depression, and suicidal thoughts who’ve never faced mental health issues before.

We’ve talked about it before, but the numbers are growing. Quarantine, masks and gloves, working from home, kids schooling at home, social distancing, Zoom meetings. It’s not just the change in routine, it’s the feeling of isolation, of needing a break. Sometimes you just want to go out to eat on Friday night…right? But with businesses closed, you can’t. Cabin fever with tired parents, kids bouncing off the walls… where do you go to get refreshed? With COVID hassles annoying, ketamine can help you break through and enjoy your life again.

You wanna hang out with the girls, paint a picture, drink wine, and chat till the cows come home. But you can’t.

Or go to the gym every morning and work out your frustrations, break a sweat… and go home loose and ready for the day. But the gyms aren’t open.

2020 has been a tough year. A year you won’t likely forget.

Of course, if you’ve gotten sick with this coronavirus, that’s its own battle. But for those who have dutifully worn their masks, stayed home and attended Zoom meetings all day without being infected, there is still a risk caused by the stress of confinement and isolation.

And it’s serious enough that far too many people have succumbed and faced psychiatric disorders for the first time in their lives.

A poll by the Kaiser Family Foundation found that 45% of those who responded to the poll in April 2020 stated their mental health had suffered during COVID. That was 10% more than the previous month.

Social isolation in adolescents increases fear and worry, which create their own type of stress, wearing down coping skills. Too often, those worry cycles plunge to suicidal thoughts, and the desire to escape the misery.

Seniors are also at increased risk. Those who are shut-ins rely on loved ones for the stimulation, interaction, and camaraderie to keep their outlook bright. Without those regular visits, hopelessness can quickly wear down their purpose and resilience.

Common Sense Says Isolation Takes a Toll

This is not to BLAME the pandemic, but to recognize that people all around us need a lift these days. Every bit of interaction is restorative for the speaker and for the listener… or both.

It’s one thing to show compassion to those who have suffered from mental health disorders all their lives, because it’s certainly true that each of you need extra support through these times.

But, isn’t it alarming to realize so many people have been so negatively impacted by the pandemic, with all its inconveniences and isolation, that they’ve used up their coping ability and have also succumbed to depression, anxiety, and suicidal thoughts?

So let’s look at this more closely.

True, this pandemic has caused annoying inconveniences, some more difficult to bear than others. But we can’t go back in time, can we? We can’t undo the release of this virus, its spread around the world, the cost to families, the economy, and our general well-being.

COVID Hassles Annoying – Ketamine Can Restore Resilience

At the same time, we don’t have to break under its influence, right?

In times like these, mastering the art of bending, adapting to circumstances, can keep you feeling like you actually ARE in control.

That means if you’re accustomed to traveling on a whim, and you’re not so free to do that right now, you can shudder and fume at the frustration; or you can set travel aside for a better time and choose something new and accessible for your stimulation and reward now.

An IT guy built his own igloo shaped pizza oven in his backyard. Never laid a brick in his life. But he invented a new interest and poured himself into it. And in so doing, kept anxiety and depression at bay.

It was a whole new adventure for him… that began with a new and surprising thought.

A school bus driver had no students to drive on her bus since students were learning online from home. So she dove into art development tutorials, and mastered skills in drawing beautiful, life-like animals.

Pandemic? What pandemic?? She was having too much fun to notice.

Adapting means changing course to accommodate changing circumstances.

That’s not to say these responses are always successful. But they are, more often that not.

On the other hand, warding off symptoms of anxiety and depression by inventing new stimulating interests, honing new skills, or finding new forms of entertainment, are sometimes not enough.

There are those who know these principles, but in this atmosphere found symptoms of anxiety, depression, and despair creeped over them in spite of their efforts to escape.

Sometimes that happens.

Sometimes listlessness takes over, with severely reduced energy, a bleak outlook, hopelessness, and a lost sense of your own worth.

Which can make way for thoughts of dying. Thoughts that there’s nowhere to go from here. Thoughts that you’ve spent all you have to give, you’re depleted, and your life is finished.

And those thoughts can become dangerous for you.

If you find that the thoughts of death, dying, and despair are prevalent for you, there is help.

COVID hassles annoying – ketamine treatment can erase suicidal thoughts

As much as we talk about ketamine treatment demonstrating extraordinary responses in those who are depressed, or suffer from PTSD, or substance abuse, or even anorexia nervosa, it’s also remarkable in its prowess for erasing suicidal thoughts.

The National Suicide Prevention Lifeline 1-800-273-TALK (8255)

Suicidal thoughts can be plaguing you to desperation, then an infusion of ketamine can make those thoughts disappear in a few hours.

Life saving.

Astounding.

It’s so dramatic that I published a retrospective chart review of my own patients in my large practice.

This treatment can erase those thoughts without hospitalization or emergency department visits, and give you the freedom to safely get better and enjoy life again.

At Innovative Psychiatry, we treat patients with ketamine treatment for depression, social anxiety, PTSD, alcohol use disorder, and substance use disorder. And we also treat suicidal thoughts for their own sake.

If keeping yourself diverted, seeking new stimulation and developing new interests to get through these times with healthy hope stops working… if you feel yourself sinking into a sense of loss, confusion, despair, call us.

We can help you find joy again. Invigoration instead of despondency.

And if you feel like you don’t want to live, please call us.

With ketamine treatment, you can be free of those thoughts and feelings, and find them replaced with hope and rewards in life.

To the restoration of your best self,

We can all help prevent suicide. The National Suicide Prevention Lifeline provides 24/7, free and confidential support for people in distress, as well as prevention and crisis resources for you or your loved ones.

The National Suicide Prevention Lifeline 1-800-273-TALK (8255)

The Veterans Crisis Line and Military Crisis Line 1-800-273-8255 Press 1

Crisis Text Line: 741-741 Free text hotline 24/7

August 31, 2020
The New Molecular Masterclass Ketamine Conference – Online!

Ketamine continues to move forward.

This NMDA receptor antagonist, ketamine, was studied in treatment of major psychiatric disorders during the first decade of 2020. Certainly, as these studies galvanized physicians to offer ketamine treatment in their offices, its use has become more and more widespread, the studies continue, and ketamine as a breakthrough treatment for psychiatric disorders and pain is gaining maturity. This online gathering is the first of its kind… a new Molecular Masterclass Ketamine Conference that explored the ketamine molecule inside and out.

In 2018, we enjoyed the first meeting of the American Society of Ketamine Physicians. Plus, the year before, we enjoyed the burgeoning interest and excitement of KRIYA. Patients who suffer treatment resistant psychiatric disorders need what ketamine can do. So, physicians and researchers energetically work to learn all they can to meet that need.

This year, August 21 and 22, marked the first Ketamine Molecular Masterclass (what a cool title!). Organized by our friend and colleague in psychiatry, Jeffrey Becker, MD, CEO of Bexson Biomedical.

The presence of this event on the calendar speaks to the advancements of ketamine treatment and its growing sophistication. The conference was sponsored by Bexson Biomedical and other cosponsors to show the potential benefits of ketamine in patient care, research, and investments.

If you remember, we first talked about Dr. Becker at the International Conference on Ketamine for Psychiatric Disorders that took place in Oxford, England in 2018. He’s presented at KRIYA Conference several times and at ASKP 2018 and 2019 conferenc. He’s a player. A leader. And an innovator. He hit the trifecta!

Leaders In Ketamine Science

Experts in the field — clinicians, researchers, digital tech wizards, marketers and investors shared their perspective and experience for all to digest. Clearly, this conference made it clear ketamine treatment is no longer an experimental and untrusted anomaly.

Happily, with two decades of studies and experience, innovators are moving it forward. This new molecular masterclass ketamine conference educated, enlightened, and inspired us. It piqued the curiosity of participants, and excited interested in furthering research and development in this new space.

Ya shoulda been there!

But if you weren’t able to zoom in on us, the MasterClass was recorded and you can access it through Microdose, the host.

So let’s stay real. Ketamine treatment isn’t a panacea and it isn’t perfect, as we know. We haven’t found a treatment or medicine that is, actually. So, one of the goals of this conference was to present information about possibilities, pitfalls, medical concerns, delivery gaps, and medical/legal issues.

From psychiatrists, anesthesiologists, and other practitioners, to neuroscientists, business men seeking new streams of revenue, and investors jumping in on new leads, the vibe on this online gathering was charged with excitement.

For instance, speakers grouped into vibrant panels to explain one aspect or another of this budding industry.

They talked about treating depression. Then compared the clinical dissociative and psychedelic effects of ketamine during treatment compared to the classical psychedelics associated with 5HT2a receptor responses. They elaborated on how music can shape and affect treatment…

With each new panel, we saw a sort of fruit basket turnover. We were always hearing from a new group of experts, with the opportunity for chat on the side.

Truly, with the social distancing of 2020 and all that has gone with it, an online molecular masterclass ketamine conference pumped us with a breath of fresh air. We were packed full of information, inspiration, and hope.

A grand parade of highly respected and beloved leaders like David Feifel, M.D., PhD, Wes Ryan, M.D., and Will Van Derveer, M.D. were added to talk about the differences in bolus doses of IM ketamine and IV ketamine given over time. Furthermore, they also talked about whether the benefits of ketamine treatment are as rapid as people say…

The Technical Side of Ketamine Innovations

We heard from the founders of Osmind and Maya in a panel moderated by Steve Best, M.D., in combining ketamine with TMS and talked about what we need to do and discussed how data can drive change, and drive payors to pay for this treatment

I had the opportunity to touch on my own data using ketamine to stop suicidal thoughts in the office and avoid ER visits and hospitalization. (Aetna, are you listening?)

And I snuck in a reference to our most recent case report of a new sequenced treatment using a metabolic diet and IV ketamine. This produced rapid (and startling!) remission and recovery in a young woman with severe chronic anorexia.

Next came Gregg Petersen, MOD, Daniel Richman, M.D., Nadiv Samimi, M.D., and Jennifer Winegarden, D.O. They talked about pain management with ketamine, and explained answers to a myriad of questions regarding pain management.

A fine panel elaborated on the use of ketamine for PTSD. Brent Turnipseed, M.D., Tatiana Santini, Jesse Gould, Jon Wolfe, and Abid Nazeer, M.D.

If you can imagine, there were more than 40 impressive speakers and thought leaders. They spoke on pharmacology issues, business related issues, the risks involved with ketamine, training programs, new developments using ketamine for post-operative pain and more.

We’ve come a long way in our quest to develop the many therapies ketamine can provide. To see businessmen and investors stepping up to the plate along side physicians and therapists.

Wow.

Connecting the people who need the hope ketamine can provide with the treatment itself is just gratifying and thrilling. Just Wow.

These are people who make things happen.

And that comes back to helping you. Do you suffer from symptoms or a psychiatric disorder that medicines and treatments haven’t helped?

At Innovative Psychiatry, we get up every morning to help people like you with this extraordinary treatment.

And we assure you, we continue to use the safest protocols during this pandemic to protect you and our staff so you can receive the treatment you need. Just call us.

Conferences only have value if we bring the knowledge home … if people can get better as a result, one person at a time.

So, let this week be your week. You can feel better, function better, overflow with hope, joy, and fulfillment, living with gusto the rewarding life you have ached for.

Let us help you get better.

To the restoration of your best self,

August 24, 2020
School’s Starting: How’s Your Teen Now? Watch for Anger, Depression, Anxiety

School is starting for the 2020-21 school year, whether remotely or on campus.

Never before have these students started a new school year during a pandemic. It’s been over 100 years since the last one, and few of those students are still alive. But these students, yours and mine, are pioneers now. School’s starting, how’s your teen coping with what lies ahead? They’re facing a new school year with social distancing, mask wearing, frequent hand washing… and they’re also facing new subjects, anxiety about whether the pressure will be too much, whether they’re up for the task… and they’re concerned about socializing.

Some have already started. The desks are six feet apart, they’re wearing masks. And they feel uncertain. Shy… afraid they’ll do something wrong. Others are afraid of the long hours at their desks… Because those need movement and stimulation. They’re afraid of consequences.

Some of our students will take whatever changes they face in stride. Those are the adaptable ones. But others won’t.. because change causes them to suffer anxiety.

While, as a parent, you may be eagerly awaiting school to start so you can get those kids back into school, since you may have had them home since March.

But, make sure you’re in tune with them. Listen to their fears and don’t dismiss them. No matter how you feel about what’s happening in the world, your teen may not be equipped to handle the early adjustments of this new experience.

Because here’s the thing… stress, especially long term continuous stress, can lead to circuitry damage in their brain cells…and that damage can result in depression.

Stress Damages. In Fact, It Can Kill.

In a teen, depression doesn’t usually come with a label written across their forehead.

It may look like anger or rebellion. It may look like laziness. It may look like stubbornness.

And symptoms like these are actually depression, PTSD, bipolar depression, substance abuse, social anxiety, suicidal thoughts… and if it is, it may need treatment.

Because these conditions create their own fallout, like poor grades, inappropriate behavior, non-compliance…

Then, without proper and EFFECTIVE treatment, the condition can deteriorate to criminal behavior…or even suicide.

Suicide is the 3rd cause of death among teens.

Did you know?

If your teen talks about wanting to die, listen.

Adolescents are emotional, their hormones rage, and they sometimes seem to be all over the map.

But listen to them with respect.

Because you need to watch… since school’s starting: How’s your teen doing?

Parents of teens who have ended their own lives will be the first to say that dismissing these claims was a mistake. But in retrospect they realized their child had been crying for help for a long time.

Is a “cry for help” really just manipulation?

No…a cry for help is a plea for HELP. And what seems to you to be a solvable, transient struggle – or growing pains – to your teen may seem like the end of the world.

Don’t let it be.

Now, it can get tricky.

If your adolescent has never been diagnosed with a disorder, you may not realize his disorder is escalating. A fellow psychiatrist tells the story of seeing a 14 year-old he’d known since he was born as a family friend.

During the intake evaluation, he finds out the boy has been deeply subdued, without joy, extremely shy, and having difficulty making himself participate in school work. He looks at the parents and asks, Why am I just now hearing about this??

Truth be told, if the boy’s parents had perceived psychiatric care in the same category as dental care, he would have. But, they’d never dealt with a disorder in the family before and didn’t know how to identify it. They tried more structure, more emotional support, more consequences… until one evening they found him in the fetal position in the shadows…and realized they needed help.

Your heart goes out to that fellow.

And it goes out to his parents, too.

Because they loved him and wanted him to be happy. They just didn’t recognize the signs.

What about you?

And what about your teen?

Would you know the signs if your teen displayed the need for help?

Are you sure? His life may depend on it.

So think about this:

Has your son or daughter suffered a severe loss like a crippling humiliation, a lost relationship, or death of someone close…?

What about substances like drugs or alcohol…?

Has he or she been depressed for a long time? Has treatment helped? Because if it hasn’t, it’s the same as no treatment at all.

Has he or she ever been abused physically, emotionally, or verbally? Are you sure?

Does he or she suffer from a dual diagnosis, like bipolar depression and substance use disorder, or depression and anxiety, or PTSD and alcohol use disorder..?

Has there ever been a suicide attempt before?

Has there been an arrest before?

These are all risk factors for potential suicide attempt or completion. Any of these indicate the need for special care.

Further, if your teen talks about death, or feeling rotten inside, or hopeless, or worthless… is withdrawn, sullen, and talks about violence, or wanting to die, reach out for help.

The National Suicide Prevention Lifeline 1-800-273-TALK (8255)

At Innovative Psychiatry, we offer ketamine treatment every week. Specifically, if you’ve tried other antidepressant medication trials for at least a few months each, and have experienced no relief, ketamine treatment can help you achieve remission when other medicines didn’t come close.

And if you endure suicidal thoughts and visuals, ketamine can erase those thoughts in a few short hours…maybe less.

In this era of psychiatric treatment, you just don’t have to endure without treatment… or with treatment that doesn’t work.

So… like I said, school’s starting: How’s your teen doing now?

We treat adolescents and adults, age 14 and up with ketamine treatment when it’s appropriate, and celebrate with our patients as they complete treatment and walk out with the joy of a life of freedom of symptoms.

While ketamine treatment doesn’t affect everyone this way, it does do this for most. And there are other ground breaking treatments you can try if you’re one of those rare people not transformed by ketamine.

Thankfully, we no longer live in the Dark Ages even our grandparents did when it comes to psychiatric care. There is hope now. Wholeness. Remission.

If you struggle with symptoms like we’ve talked about here, call us.

We want to help you glide through the challenges ahead with resilience.

To the restoration of your best self,

We can all help prevent suicide. The National Suicide Prevention Lifeline provides 24/7, free and confidential support for people in distress, as well as prevention and crisis resources for you or your loved ones.

The National Suicide Prevention Lifeline 1-800-273-TALK (8255)

The Veterans Crisis Line and Military Crisis Line 1-800-273-8255 Press 1

Crisis Text Line: 741-741 Free text hotline 24/7

August 17, 2020
Keto Plus Ketamine: A New Approach for Anorexia?

If you know someone with anorexia nervosa, you know how chronic… dangerous… and life-threatening it can be. I bet you didn’t know it could go into full remission.

This is the story of a novel idea, a brand new course of treatment, an innovative treatment procedure, and a protocol that was born out of love.

It’s a heartbreaking disease. And as surprising as it may be, there has been no effective treatment for it, whether it be medicine or psychotherapy. Self-starvation, hyperactivity, anxiety, body dissatisfaction, and difficulty managing one’s emotions all accompany this horrific disorder. A new approach for anorexia is desperately needed… a new procedure, a new sequenced treatment…something.

There are 32 million people–of all ages, races, and genders–in the US with an eating disorder. And someone dies every 62 minutes here because of their eating disorder. Anorexia is the scariest. The death rate in women with anorexia is 10 times higher than for other women, and that’s because the self-starvation causes medical problems that can be critical…. and because desperation can lead to suicide. A new approach for anorexia is vital.

To understand the persistence of anorexia, you need to recognize it’s not just about not eating…or losing weight. Those are actually the results of the most crucial symptom, which we call the “anorexia voice.”

Some medication solutions and some psychotherapy approaches may claim up to 60% response… meaning 60% got better. But for how long? A couple weeks…? A month? These patients require something different, a new approach to anorexia treatment.

What’s more, 40% of adolescents never gain their weight back, and of the 60% who do, only half of them restore emotionally. On top of that, treatment is expensive. Multiple hospitalizations, out-patient treatments… the average cost of treatment is $110,000. This is what you might call the “white knuckle” approach. Hard work… mediocre outcomes.

And there are so many who never get better.

This is because they try to treat the actions of abstaining from food or over-exercising, rather than the symptom that’s most stubborn to relieve… that voice in your head we call the anorexic voice.

That voice that tells you you’re fat when you weigh 96 lbs and look in the mirror. The voice that tells you to not eat because you’re getting fat. The voice that says you’re ugly… that you’re too tall, or too short; too fat or too skinny.

Like I said, we need to see something new and different, some new approach for anorexia.

This singular aspect of anorexia is the most difficult to manage.

And this symptom must be erased if you’re to get well and stay that way.

Anorexia Nervosa often emerges in adolescence, but it can go on and on….

In fact, if it continues for 3 years, it’s considered chronic and enduring… even treatment resistant, as we often say referring to other disorders.

To find an innovative sequence of treatment, a new approach, a different protocol….that would dissolve the symptoms of anorexia nervosa…where the symptoms subside and the lack of symptoms lasts, and that voice goes SILENT…well, it could be life saving for many, and life restoring for the rest.

And that’s where a new approach for anorexia can bring hope.

You may remember that we talked about the use of ketamine treatment to treat eating disorders back in May of 2018. And we pointed out way back then that eating disorders were actually the first psychiatric disorder studied with ketamine treatment. I.H Mills and his team conducted this study in 1998. 22 years ago!

Well, I’m delighted to talk about my most recent work with a team of experts and an extraordinary 29-year old woman, Caroline, who’s suffered from anorexia nervosa since she was 14.

I was privileged to work with a medical doctor specializing in internal medicine and addiction medicine with a brilliant and compelling idea about a new course of treatment (Barbara Scolnick, MD), a reknowned dietitian and keto specialist (Beth Zupec-Kania, RD), a brilliant neuroscientist (Chiye Aoki, MD), an expert in eating disorders (Tom Hildebrandt, MD) and an extraordinary young woman, Caroline.

And we’ve published a case report on the effectiveness of it for her.

Effective isn’t the word. Exhilarating is more like it. Remission. Unexpected, fully sustained, and shocking. It comes from a brilliant idea, and from just being willing to look at anorexia with a different lens, with an innovative treatment that was upending and surprising in its rapidity and its effectiveness.

Get ready. It’s time to open your mind.

To understand the novel course of treatment we used, you need to understand a little neurology and pathophysiology. So, here’s a quick crash course.

Lipids, and Lions and Bears, Oh Me!!

Getting back to neuroscience, metabolism, and hibernation, some studies have examined how the root cause of anorexia may be related to lipid signaling and how chronic starvation may be connected to hibernation.

As you know, hibernation is what bears do in the winter, and lots of other animals, too. To survive the winter, their body metabolism slows way down, along with their temperature, so they can survive for several months without food.

In patients with anorexia nervosa, their long term starvation signals their body through their fats (lipids are fats), to slow down to help them survive. For the patient to recover, those lipid signals must be returned to normal both in their metabolism and in their central nervous system. This is vital information in the search for a new approach for anorexia nervosa treatment.

To get those signals back to normal requires fats be introduced, even if they are processed at a much higher rate. So, a medical keto diet was developed by the team for Caroline, to ensure she had enough healthy, wonderful fats to improve her brain health and restore her metabolism. And her mood.

And her anorexia improved. But it didn’t completely stop. The voice was still there.

Then she began treatment with IV ketamine. We planned 6 treatments, but she didn’t need them. She got only 4. Because her anorexia symptoms — the obsessive thoughts, obsessive behaviors, and the anorexia voice in her head — completely stopped. And they’ve been gone for more than 6 months.

Long enough to call it remission. And to know for sure that it’s real. Long enough to write it up as a case report, submit it for publication, and get it published.

It is real. It’s so real that it’s a little unreal. If you’re in the anorexia world, you know how wild this sounds. Keto? No way. Anorexia experts and dietitians alike hate the idea, don’t trust it, see it as dangerous….and might think it’s just plain wrong. Ridiculous. Risky.

Ketamine infusions? In a patient whose metabolically compromised? Unknown. Untested. Too risky. Until we carefully weighed the risks and benefits — for her– created the right set and setting, and gave it our best shot. Medicine is a science. And an art.

So this is the new treatment protocol, the new combined treatment, the new procedure, if you will, that we designed: it’s a duo. And it worked.

Let’s talk about Caroline for a moment. She’s real, riveting, and absolutely raw.

Caroline is 29, and had suffered from anorexia nervosa since she was 14. Over the years she had intermittently struggled with alcohol dependence from the age of 18. She had seen numerous specialists, had been in and out of treatment programs, and she received supportive therapy periodically. She also attended Alcoholic Anonymous meetings at least once a month.

Obviously, she needed someone to come up with a new idea. The usual treatments just weren’t working. She desperately needed a new approach for anorexia.

And before beginning this new procedural treatment course, she had abstained from alcohol for 15 months, which was a major accomplishment. It’s also an example of how psychiatric disorders are often found in clusters. This girl wanted to be better…she worked so hard. But that voice…

She experienced the kinds of restrictions not uncommon for someone with anorexia.

Caroline preferred to eat alone, and used a napkin rather than a plate. She ate only ice cream or peanut m&ms for days at a time. And used low calorie sweeteners excessively. She had “safe” foods which consisted of Splenda, frozen yogurt, zucchini, eggplant, and coffee.

In addition, she exercised compulsively every day, usually for 2 hours. She had managed to keep her weight around 125 lbs. Hospitalization had been required two separate times in her life to help her metabolism stabilize. The first time was following a grand mal seizure 12 months after she was diagnosed with anorexia nervosa. She weighed 96 lbs at admission, that time.

Personalized and Medically Designed Ketogenic Diet Specifically for Caroline

Not something you can google or YouTube… personally designed for her body and metabolism by a registered dietitian renowned for her expertise in developing ketogenic diets for neurologic disorders.

And when you watch this remarkable story you’ll hear us talk about how the keto diet seemed to help her head clear. Her body began to respond. Her true personality emerged. She felt better.

But that pesky, ruthless voice just kept cracking the whip. Constantly …constantly… trying to force her to stop eating and keep exercising.

…Combined with Ketamine Infusions – An Innovative New Approach for Anorexia Treatment

Then, came the ketamine treatment… as it turned out in her case: 4 infusions. And the voice died. It just disappeared.

And she was free. For the first time in 15 years, she was free to be herself, make her own decisions…and pursue her own happiness.

A case report, of course, is just that. It’s a report of one person.

It’s exciting preliminary work, though. The novel treatment procedure and the dramatic outcome that Caroline experienced–sustained remission and recovery–with a medically designed ketogenic diet followed by IV ketamine infusions deserves further study and more research.

We may be on a new horizon.

To the restoration of your best self,

August 10, 2020

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