Lori Calabrese, MD

Tag: Ketamine Treatment for Treatment Resistant Depresson

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
Does Psychiatric Treatment Suffocate Creativity in the 21st Century?

Have you avoided treatment fearing it would subdue your talent?

This is a very real concern for some intelligent, talented people who suffer from certain disorders. The idea that suffering yields brilliant satire, beautiful music, heartbreaking poetry, and dazzling art that enrich mankind. It’s been a subject of controversy for eons. But is it true? If your treatment suffocates creativity, you can do something about that.

We speculate about the connection between artistic genius and depression or bipolar disorder. Theories emerged that Vincent Van Gogh’s severe depression. He suffered serious bouts of anxiety, and possibly suffered from bipolar disorder.

He self-medicated with alcohol… Of course, no medical treatment was available for his symptoms.

Ludwig von Beethoven stands as another historic creative genius we celebrate who suffered from bipolar disorder. Were his enthralling symphonies created by his illness?

Franz Haydn, his teacher and fellow composer, had remarkable words for him as he was getting to know him. “”You will accomplish more than has ever been accomplished,” he said. “You’ll have thoughts that no other has had. You will never sacrifice a beautiful idea to a tyrannical rule, and in that you will be right…”

He was brilliant…there’s no question. And some would argue that brilliance and bipolar disorder sometimes go together. And he grew deaf. A tragedy for a musical genius. His behaviors as reported by his peers may have been indicative of depression. Maybe bipolar disorder.

Still can you imagine his frustration at not hearing his own music?

We must remember that our belief in the presence of a diagnosis of these figures in history is conjecture. That we’re basing our views on what we read about them, what their contemporaries said about them. And we try to piece together the puzzle pieces.

So, if you’ve experienced severe bipolar I disorder, you may relate to some of these recollections of tormented icons. Their symptoms may seem pretty familiar to you.

Again, there was no effective treatment available to him at that time, so we can only wonder.

To learn whether treatment suffocates creativity, we have to fast-forward to the most recent 30 years of psychiatric treatment…and even better, the last five.

In the days when Prozac was such a breakthrough, and then Paxil, I remember someone describing the way she felt. She said it was like she was “coated in wax.”

The early SRIs, and later the SNRIs, provided so much help to depressed people that they were considered a breakthrough at the time. People would joke, “the city needs to add Prozac to the drinking water. It could quite possibly solve all of society’s problems!”

With time, we learned that these medications made a dramatic difference in quality of life for about 33% of those who suffered, and with some tweaking, titrating, and blending, over time that number increased to 50-65%.

But, eventually, it turned out that these medications weren’t always as remarkable as they seemed.

There were plenty of people who stopped taking the medications because of the side effects of weight gain, sexual dysfunction, and more. Plenty of others continued to take them and gained the weight and lived with the reduced sexual drive for the sake of functioning in their lives.

Of the creatives who took these medications, some claimed the medicine impeded their creativity, while others found that with a clear mind, they could create more effectively.

Those with bipolar disorder often take a mood stabilizer like lithium or depakote, and may experience more stability. But many others need a variety of medications to yield a more stable mood. And many others with bipolar disorder don’t experience any real or lasting relief from these medications.

Does Psychiatric Treatment Suffocate Creativity In All This?

While it wasn’t uncommon to hear patients complain of dampened creativity while taking SRIs and SNRIs, that’s not the case across the board.

Some who are treated for severe depression are relieved to discover they are able to be creative again. Others, not so much. It varies between people and can also depend on the symptoms.

And creativity and bipolar disorder share some genetic links, as well as some deviations from typical ways of thinking. Creativity includes new thoughts, original ideas, and freshness in composition of art, music, construction, etc.

Still, neuroscience research reveals that the most productive creativity in someone with bipolar disorder happens when that person is in a non-extreme state, or euthymic period, or a hypomanic period.

So, what about the last 5 years?

Ketamine Treatment Doesn’t Suffocate Creativity

Not only is ketamine treatment effective in treating depression and bipolar depression in far more people than SRIs or SNRIs, but it can actually enhance creativity. It’s in a category all its own.

Ketamine treatment’s extraordinarily rapid and robust effects can proliferate the brain cell connections and the communication between different parts of the brain. These benefits can expand so dramatically that you can, and likely will, find yourself in a remission that defies all logic.

A kind of remission that finds you catching up on all the chores you’ve avoided for the last several years, advancing your career in ways you’d never thought about before, building strong, healthy relationships, and having fun…I mean really having fun.

You can wake up singing songs that may have followed you while you dreamed, dancing spontaneously while you get your coffee. You may find yourself immersed in joy.

Of course, ketamine treatment doesn’t do all this for every single person treated with it, but these benefits are widespread and common. There are a handful of sufferers who don’t enjoy these outcomes, but the vast majority do.

In this day and age, on the brink of life changing treatments for severe psychiatric suffering, you have the opportunity to enjoy singing, dancing, and loving.

Watch the Clouds Part and the Sun Radiate Into Your Life

At Innovative Psychiatry, we celebrate with our patients as they taste of a brightness of life and a hope that had always alluded them before. We provide ketamine treatment in a pandemic-safe, cautious protocol that protects our patients and our staff.

With this exacerbated environment for increased depression related to the pandemic, it’s more important than ever to give yourself the additional support of a treatment that can renew your emotional energy and your patience to cope.

Does psychiatric treatment suffocate creativity? No…it doesn’t have to.

If you’ve feared treatment because you fear losing your creative edge, call us.

We’re here to help you open your doors and windows to let the light of your gifts shine through.

To the restoration of your best self,

August 3, 2020
Fallout From the Covid Pandemic May Not Be All Bad

As tough as these times have been, there have been some bright spots.

In fact, some people who have suffered terribly from symptoms of their disorders are actually stabilizing and improving. Feeling as though they’re less “disordered” and almost more normal than they’ve felt before. Can you imagine? In fact, as much as we’ve struggled with grief, loss, and frustration, as well as worsened conditions from disorders, fallout from the covid pandemic may not be all bad.

It’s something of a phenomenon.

On the other hand, it may just be common sense. For instance, for some who struggle with shame and increased anxiety because of social anxiety, to be allowed to remain at home, and visit with your doctor through telepsychiatry, the pressure to interact in a public setting among strangers is gone.

On top of that, that telepsychiatry visit gives you a sense of closeness with your psychiatrist you may not feel in the office. Some people feel less intimidated, and are even more likely to ask the doctor how she’s doing.

Some with agoraphobia may also feel more relaxed, since so many others they know are also safely locked up at home.

Even those under a dark cloud of depression, feel less like the “odd man out” because there are so many experiencing depression for the first time and are so alarmed, so baffled, and are looking for someone to talk to about it.

On the other hand, for most of the rest of us, there are all sorts of ways the pandemic has affected us. And it’s been a burden.

It might have been novel and interesting for the more optimistic the first month or two, but few still find it engaging now.

The Difference Between Depression and Grief

It’s important to understand that what you’re feeling may not be depression or anxiety at all. In fact, it may have nothing to do with any pathology, per se.

The process you would naturally go through when you grieve the loss of what used to be… could be affecting you. You may be also grieving the loss of a loved one. But grief is a natural part of life, and it includes feelings that are painful and troubling.

Think of it like you’re adapting: a completely healthy way to adjust to new challenges. Feeling deep loss, then over time adjusting to that missing person or those elements in your life, and finding ways to live with it.

Because the fallout from the Covid pandemic may not be all bad at all…in spite of the things you miss.

Do you miss eating at your favorite restaurant..? The wonderful food, yes…but you can pick that up and take it home…no it’s the entire experience, isn’t it? The way the wine tastes after they pour it, the wonderful service, the ambiance. Do you miss your children catching the bus each morning after breakfast, and the peace and quiet that settles over your home while you drink your coffee…?

It’s the little things. And you miss them, and that’s ok. While it’s not uncommon to get angry…(that’s the first stage of grieving, by the way)… it’s also not all that productive to get stuck there, is it?

So you look for ways to reduce the impact of it all by finding ways to help others, reaching out with kindness… and catching up on your reading.

We’re All In This Together and Fallout From the Covid Pandemic Can’t Keep Us from Getting Through To Brighter Days

And it stands to reason—doesn’t it?—that you are experiencing different effects from the pandemic and its side effects than your neighbor, your co-worker, and your family members.

If you’ve not been someone with a depressive disorder in the past, but you feel terrible right now, don’t panic. Because you’re walking your own path. You may be grieving the loss of life as you knew it up until December 2019… or…you may actually have been so devastated by these blows that you’ve developed a disorder and need treatment.

If you need it, you’ll get it. And if you need to try some experiences we’ve talked about before to nourish your resilience, strengthen your compassion, and improve your wellbeing… well how much better is it if there really is something you can do yourself?

On the other hand…

But if you can’t lift your head above the din of stressors, then there are treatments like ketamine treatment to restore your resilience, so you in turn can show kindness and support to others.

Which is why at Innovative Psychiatry we continue to be mask-wearing essential services for you, if you need us.

If you find yourself despondent, hopeless, unable to see any way to function, call us.

We provide ketamine treatment in a safe, protected environment so you can get a fresh breath of air, a sort of new lease on life, and the energy and initiative to make changes in your life you want to make.

I hasten to say that ketamine treatment really doesn’t accomplish these things for absolutely everyone who receives it, simply because there isn’t any treatment that makes everyone well.

Even so, its beneficial effects on most of those with treatment resistant depression is nothing short of extraordinary. So much so, that NO ONE should suffer indefinitely without remedy.

There is hope.

And joy.

And the promise of a rewarding and fulfilling life.

Let us help you take the next step to wellbeing and peace.

To the restoration of your best self,

July 20, 2020
For Relief From Misery in These Difficult Times – Be Kind and… Compassionate

You see them everywhere… t-shirts proclaiming “In a world where you can be anything…be kind.”

Does that make you roll your eyes? Or does it affirm to you to focus on the way of living that can help us all get through these difficult times? Because in times like these, with upheaval, disruption from a pandemic, and hurting people everywhere, there is a shortage of generosity, support, understanding. So be kind and compassionate to everyone you meet, show gratitude for the little things, and you may find the struggles shrinking and becoming more manageable.

Kindness makes some people shy away. They don’t like the word. Makes them feel weak. But kindness is actually rooted in courage—the courage to do the right thing—and in strength to keep doing it even if your kindness is not acknowledged

Did you grow up in a kind household — or one where you felt undervalued and roughly handled…? It matters, you know. When you never see kindness, it’s not so easy to create it yourself, is it?

And yet, ask yourself: If you were surrounded by kindness, kind words, kind actions, and kind support, do you think you’d find that annoying…or would you possibly begin to bask in the safety and nourishing of it…? The fact is: we all need people in our lives to be kind and compassionate, and when they aren’t… we find ourselves lugging around a burden of isolation and neglect.

Healthcare Workers Give All They Have to Give

The world is in turmoil, and it doesn’t feel all that safe these days, but you do have the power to change it. One kind act at a time.

Isn’t it amazing how hard it is for humans to experience change? I heard someone complain that he liked to travel, and the forced quarantine was really causing him to chafe.

In his case, he wasn’t sick, wasn’t laid off, wasn’t struggling financially …but there was a mountain of inconvenient changes in his plans. A nice guy, a wonderful person…. but enforced changes were pressing on his comfort and stirring up…what? Impatience? Irritation? Annoyance?

So we have a world in turmoil, and it is forcing us to change our normal way of living. Some are suffering severely right now, and they need us to care, to listen, to show patience. You don’t know who they are — with a few exceptions, maybe, in your circle — but that’s why you need to be kind and compassionate with everyone because it’s the best response to those you don’t know.

Healthcare workers in hospitals, for instance, infected patients fighting for their lives, or the families of those who have lost the fight. These brave and heartbroken ones need your kindness and support most of all.

When you’re impatient because someone is standing at the checkout at the store too long…and you’re tempted to start throwing up your hands and saying, Move Along, Already!!

Stop.

Take a breath. She might have spent the last 14 hours with a mask on trying to save a patient’s life…only to watch him die. Be KIND.

Job Loss and Income Reduction Is a Part of Life Right Now…

Then there are those who suffer because of job loss, lack of sufficient income, and scads of difficulties caused by it. They need kindness and support, too.

The Guy At the ATM Who Keeps Sticking in His Card

…and you wait and wait.

Don’t HONK.

It could be that the last funds are gone from his account because of his reduced income…and he’s trying to find a credit card to borrow from.

Have compassion…he’s in a serious crisis. Because his family needs food, gas, and diapers.

Remember to Care.

But there are millions of us who are frustrated by the changes in our routine, changes in our access to stores and restaurants, changes in our lifestyles. Changes.

Be kind and compassionate because you need others to be kind and compassionate with you.

You can allow those changes to give you permission (or an EXCUSE) to treat others badly, or you can use those changes as fuel to empower you to lift the outlook of the people around you.

So what can you do to ensure you have more kindness to give to others?

Start, by nurturing yourself. Do things for yourself that improve your own sense of fulfillment, your own stores of patience. Soothe away the day’s tensions in a hot shower or go all out in a hot bath. Go fishing and listen to the quiet sounds of nature. Spend time with someone who is important to you…

It’s true that it’s terribly hard to offer patience, kindness, understanding when your own mind is raw with tensions, burdens, and mistreatment. So DO SOMETHING everyday that’s just for you.

Then, when you mess up, make mistakes, even bad ones, give yourself patience, kindness, and forgiveness. Because it’s in practicing kindness toward yourself that you learn to cultivate kindness and patience toward others.

Unhappy people often rail on themselves when they make mistakes, or fail in some way …. but truly, in order to be kind to others, you need to show yourself abundant kindness. (Abundant kindness, you’re thinking. What is that, even?)

In a World Where You Can Be Anything, Be Kind.

If you’re the first to respond to someone’s struggle, start with compassion. Show you care. Then, as you provide support, do it with kindness and patience.

And you know what??

To be kind and compassionate yourself brings more happiness to you…and to them.

Have you heard of a “WIIFM”? …. No..? So what’s a WIIFM? It’s finding out “What’s in it for me???”

When you are already happy, doing kindness for others, showing patience, doing something that adds to someone else’s happiness… these things make you happier too!

This very idea was confirmed in a study by a team social researchers led by Keiko Otake. Their results showed that when happy people actually count the number of times each day they show kindness, it makes them even happier. In addition, they found that showing kindness increases their own sense of gratitude in the simple things of life.

During this disruptive time, finding joy in simple things, and expressing gratitude for them, can be a path to peace and increasing joy in spite of circumstances. And it can be contagious.

Delivering kindness to those in your circle can spread gratitude and joy to them, who in turn may offer more kindness to their own circle. At the same time, offering generosity and kindness stokes the fires of happiness within you, too. So crank up happiness …be kind and compassionate every day. All day.

It will transform you.

And What If You’re Just Tired of the Struggle? What if You Can’t Muster Joy, Patience, or Even the Power to Care?

Sometimes the prolonged stressors of times like this can wear down your resilience. Sometimes, no matter how deep you dig within yourself, you can find no joy, no hope, no energy to cope with anything.

And sometimes, if you live with depression, if you’ve been bruised by trauma, not even your antidepressants can help anymore. In spite of your medications, listlessness takes you over.

When that happens, you can reach out for ketamine treatment.

Stress prunes the dendrites and dendritic spines that build the synapses in your brain. Those connections between the brain cells that communicate and help signals travel with speed and abundance. They become broken down, sparse, weakened.

But since ketamine turns on mRNA and switches the DNA to “ON” to produce brain derived neurotrophic factor (BDNF), all that new BDNF turbo boosts the replenishment of these connections, and triggers a cascade of changes. The result — for many people, though not all — is a rapid and robust improvement in your outlook, your hope, your energy for challenges, your motivation and initiative… and you can feel tremendously better. Like renewed. Pretty much well.

It can be extraordinary. Life changing.

Then, keep building that wellbeing with kindness, warmth, generosity…giving your best to lift and support those in your path.

At Innovative Psychiatry, we continue to be an essential service, and are set up to provide you with ketamine treatment in a safe environment.

While none of us knows how long the precautions and ups and downs of the pandemic will last, you can reach out for the help to be who you want to be, for yourself and everyone around you.

You don’t have to be dragged down by the stressors of this pandemic. You can rise higher than the challenges, and sprinkle kindness in your wake.

We’re here to help if you need us.

To the restoration of your best self,

July 13, 2020
Gender-Related Psychiatric Conditions Caused by Forced Abstinence from Alcohol

There’s more to getting sober than to just stop drinking…

Ever heard someone say, “Oh, she’ll never stop drinking…she’s just weak…” I’m here to tell you there is more to it than just not drinking anymore. And certainly it’s not about being weak or strong. There’s a condition that causes more conditions, and altogether they sabotage a person’s hard efforts to get sober. Abstinence from alcohol, after prolonged heavy use of it, can lead to changes in the brain that trigger other disorders. Gender-related psychiatric conditions like depression, PTSD, anhedonia can be triggered by abstinence. Disorders like these emerge as a result of sudden abstinence, and to maintain abstinence you may need treatment to relieve the other disorders, too.

Meet Leann…

Leann tripped as she skittered down the steps of the theatre. It was a beautiful July night, with a soft breeze on her shoulders. Collie and Jack were soon right beside her by the time she regained her footing.

“You ok Leann? Watch that first step…it’s a doozie!” Everyone snickered at the bad joke.

“Ok,” Jack took over. “Fun play, but let’s focus on our next course of entertainment…”

Collie jumped in. “Let’s do a bar hop!”

Jack joined in. “Ok yes…there’s a great little place at the next corner. We can stop there and decide where to go next!”

All three filed into the pub and found a table. They’d each enjoyed a couple drinks at intermission, but that was an hour ago. Time to recharge. After ordering mojitos all around when the waiter came by, the friends split up to go to the restrooms, and found themselves back at the table just after their drinks were served.

Time was passing fast as they talked and laughed, and after a second round, it was time to move on.

Bar-hopping? Might Lead to Excessive Alcohol Consumption…

The next stop was 4 blocks to the east, so they enjoyed the aromas of downtown restaurants and strolled those blocks in no time.

Then, after a variety of chef-created drinks that seemed to crank up the atmosphere all the more… they staggered out….laughed at their unsteady gait…and crossed the street to a well-known hotel bar.

And 2 margaritas each with limes stuck onto the glasses that were cut to look like little suns surrounded with rays. The girls ordered theirs frozen and Jack requested his on-the-rocks.

It was getting late so they decided to have one more. Leann went for a Bailey’s Irish Cream martini, Collie requested a Godiva smoothie, and Jack ordered 2 fingers of Kentucky Honey neat.

Then they called for a cab and helped each other stagger to the cab at the curb, laughing and snorting every step of the way.

The next morning, Leann and Collie had spent the night in Leann’s apartment, and someone’s cell rang. They both startled awake…then groaned and grabbed their heads.

“Turn off that noise!!“

They were miserable.

Utterly. Heads splitting, stomachs rolling and threatening to erupt.

They looked at each other, and one of them whispered…”it was fun last night…wasn’t it?”

“Oh my gosh, Collie, what were we thinking??? I feel so so sick….” And with that Leann ran to the toilet heaving… and barely got there in time.

After Collie left to go home and nurse her hangover, Leann poured herself a drink, to hopefully make the symptoms milder….

And so it went. That pattern….going out under the guise of “fun”…drinking too much… then waking up sick and drinking more and more every day to feel better.

By Friday, she was ready to start the cycle over again…

(Watch how gender-related psychiatric conditions emerge and threaten her ability to get control in her life…)

But on one of these Friday nights, Leann was with a group she didn’t know that well. When she reached that stumbling down part of the night…someone she barely recognized insisted on driving her home, so she’d be “safe.” Except, he wasn’t about her safety, but about isolating her and taking what he wanted. She landed in a parking lot, her underwear torn off, her clothes filthy from the asphalt…her makeup smeared all over her face.

And deeply humiliated…traumatized…and feeling like a fool.

She got a cab home…then took a shower… and cried.

The next day, after drinking lots of water and tomato juice, she realized she needed to talk to someone she could trust, so she called Jack. She’d known him since high school, and he’d always made her feel safe. And he had a good head on his shoulders.

Sometimes You Need a Reliable Friend

She felt so foolish…but she told Jack through sobs what had happened. He was angry some creep had assaulted her. But they talked about her lifestyle, and that if it didn’t change, she could be hurt again, or worse.

They made a pact that day. They agreed to start spending Friday nights together, without alcohol, and play cards or something, but break this cycle. After spending every Friday and sometimes Saturday this way for the last 3 years… popcorn and vita water was a BIG change.

Well, they played cards and board games all weekend, just as they planned. By Monday, Leann was feeling a bit down. It was neat to do something companionable for a change, and she and Jack had talked and laughed. But still…she felt sort of bummed out.

By the end of the week, Leann was wanting to drink. But she remembered that horrible assault in an asphalt parking lot, and determined to play games with Jack. No matter what.

And that’s what they did. But she was having a hard time caring about the games by now. They decided to watch TV together all weekend, just to stay occupied.

Jack hadn’t imbibed in as much alcohol during the weeks as Leann had, and he was suffering less than she was.

Gender-related Psychiatric Conditions

This “fast” from alcohol was affecting her more intensely than she ever dreamed it would. It was as if her body had become accustomed to it. Like she was in a sort of withdrawal like someone with a drug addiction. She had had no idea this could happen…and the realization shocked her.

Leann’s abstinence, she realized, was not just physically hard, but emotionally hard, too. Was that a thing? She’d never heard of this before. But she was feeling depressed, nervous…and listless. She was jumpy, easily startled.

As her emotions sank, her hope evaporated, and she had little interest in food or sweets. A huge change for her. Eventually, Leann began to think about dying a lot to escape this misery. She just didn’t think she was strong enough to endure much more of the body shakes and aching or the depression and anxiety that had become her constant companions. Either she was going to start drinking again, or she would die.

What else could she do??

…

Treatment for Gender-Related Psychiatric Conditions Can Help Prevent Relapse

Well, interestingly enough, there were options she didn’t know about. Leann’s story is a common one, as teens and young adults learn their limitations with alcohol, and find out they’ve developed disorders through overuse.

Alcohol Use Disorder is a common and costly neuropsychiatric disorder, that robs sufferers of their health and stability. Once this disorder is established, withdrawal from alcohol can result in a wide variety of destructive conditions, such as depression and anxiety. These, in turn, increase the risk of relapse and make it extremely difficult for the sufferer to abstain from alcohol in the long term.

Studies have shown that there are changes in the brain cells that vary by gender. For instance, women are more likely to relapse due to the emotional impairments they experience as a result of abstinence, like depression and anxiety. Men, on the other hand, are more likely to relapse when enjoying the social presence of others who are drinking alcohol.

In the story above, there is no mention of Jack’s history before that night, but if he’d been abstaining, the barhopping with friends was an easy setup for relapse for him. On the other hand, Leann’s depression and anxiety after a couple weeks of abstinence was intensifying her craving to drink, and might have led to relapse for her.

Because gender-related psychiatric conditions determine different changes in brain cells, and therefore different vulnerabilities to relapse.

Her listlessness, her reduced interest in food or sweets… the sudden forced abstinence had triggered anhedonia.

She needed treatment to help her maintain her abstinence. A treatment that would relieve the neuropsychiatric changes that abstinence had triggered. Depression, anhedonia, PTSD, anxiety symptoms….these comorbid conditions threatened to push her to relapse.

So what could she do?

She could reach out for ketamine treatment, that’s effective with each of those comorbid conditions and with alcohol use disorder.

We’ve talked before about how studies have shown that even one ketamine infusion can dramatically reduce alcohol consumption. Also, if you’re female, the comorbid conditions increase the risk of relapse for you.

Since ketamine treatment can be so remarkably effective with these conditions, it’s almost like a firehose extinguishing the fires of these additional symptoms, too. And gender-related psychiatric conditions affect your ability to maintain abstinence but ketamine can prevent relapse.

What can you do if you’re struggling with alcohol use disorder?

Combine abstinence with ketamine treatment. Feel better, engage in life and the things that matter most. Build your career, your relationships, your self respect, and your hope.

There really is a way out of alcohol over use. And a way up to better, more fulfilling living.

If you can identify with Leann’s story, call us.

If you want to control your drinking, and have failed when you tried before, call us.

Independence Day is ahead, and you can be in control of your sobriety before the celebration. You can enjoy the joys of life…and love…without the impairment of excessive drinking. You’re understood and accepted here… we understand how social drinking can sometimes cause changes in your brain structures that lead to a risky lifestyle.

We want to help you achieve the life you want. To enjoy celebrations safely and without impairment. We want you to revel in your wellbeing.

To the restoration of your best self,

June 29, 2020
Ketamine Slashes Anhedonia in Treatment Resistant Bipolar Depression

Depression shows its face in a lot of different ways:

If you live in the misery of bipolar depression, anhedonia is right there, up close and personal. So what is it? Anhedonia is the loss of interest or pleasure in things you used to enjoy. So you stop enjoying. But if you can’t enjoy... life can taste like… sawdust. Bipolar depression is never fun. It’s interesting that those who suffer the type of depression that’s dominated by anxiety often have trouble sleeping…and tend to lose weight. While those who suffer from the type of depression dominated by lethargy tend to gain weight and sleep long hours…. like 19 hours straight. And anhedonia is right there, in your face, when you’re depressed. It can permeate your life and creep into conditions that sometimes tag along with depression and bipolar depression, like PTSD or substance abuse. And ketamine slashes anhedonia in these conditions.

Now, here’s the problem. In bipolar depression, there is plenty of evidence that shows that the usual treatments for bipolar depression don’t relieve the anhedonia. In fact, they sometimes actually blunt the rewarding experience. We’ve talked about this in other articles, referring to the activity of cell bursting in the lateral habenula.

Let’s be frank. When you’re depressed, you want to feel better. NOT feeling isn’t good enough. You need to be able to enjoy.

We talked about how important that is. To live a fulfilling and rewarding life includes enjoying. Because without any enjoyment, life is more of a drudgery…and you trudge through proverbial mud day in and day out.

Who Says So??

Peer reviewed studies have demonstrated that depressed patients with anhedonia have a poorer prognosis for recovery than depressed patients with no anhedonia. And anhedonia can also cause emotional blunting and even physical blunting, like inability to experience sexual pleasure or orgasm.

A study published in the American Journal of Psychiatry demonstrated that when anhedonia is present in a major depressive episode, it can predict that suicide is likely to end that life.

In 2014, there was no FDA approved treatment for anhedonia…and the suicide rate was climbing, and continued to climb and is still climbing. Currently, suicide is the 10th leading cause of death in the US.

All that illustrates that “not enjoying anything’ isn’t as tepid as it may sound. It can actually be life-threatening.

And in the meantime, in order to understand depression and bipolar depression, you do need to wrap your head around anhedonia.

Ketamine Treatment Slashes Anhedonia in Bipolar Depression

A neuroscience research team led by N. Lally that included Carlos Zarate and D.A. Luckenbaugh, looked at the effects of ketamine on anhedonia in Oct 2014. The study showed that ketamine causes rapid-acting anti-anhedonic effects in treatment-resistant bipolar depression. To go a step further, they found it it improves and relieves anhedonia independently of its antidepressive benefits.

Over half of people diagnosed with treatment resistant bipolar depression suffer from serious anhedonia. And the researchers in this study demonstrated… and concluded….that ketamine treatment is vital for the treatment of anhedonia in patients with bipolar depression.

We’ve talked before about how bipolar depression is characterized by an intensity that distinguishes it from major depressive disorder. And these researchers found that even when a patient with bipolar depression can laugh at a joke, or likes eating something sweet, he lacks the motivation to to go to the effort to get it for himself.

So lack of motivation is embedded in anhedonia, and to restore motivation requires alleviating the anhedonia.

But standard antidepressants aren’t always effective for anhedonia, at least there’s no proven evidence of it. So something had to give.

And ketamine treatment seems to target regions in the brain that cause anhedonia. Not as part of its antidepressant benefits, but independently.

We also know that IV ketamine also stops suicidal thoughts…and again it seems that it can do this independently from its antidepressant benefits.

Is it any wonder so many are so excited about the restoration they’ve experienced after ketamine treatment?

And what about you?

Do you know what anhedonia is like from your own experience? Do you recognize the description of not enjoying things you used to enjoy…of having no motivation to drag yourself out of bed or to do anything?

Ketamine treatment can be an ideal treatment for your symptoms, even when nothing else has worked — and sometimes, especially when nothing else has worked! — and can relieve depression by targeting a variety of areas in your brain, It’s almost as if it’s custom made just for you to dissolve your bipolar depression symptoms.

I’m not saying ketamine treatment is a cure-all. Far from it. Depression and bipolar depression are complex disorders that require multifaceted treatment approaches. When anhedonia persists no matter what you do or try, you may want to consider ketamine treatment.

Ketamine Slashes Anhedonia For You, Too

At Innovative Psychiatry, we offer ketamine treatment for treatment resistant depression and bipolar depression. And our patients often tell us they’re amazed at the relief they experience and at how much easier it becomes to manage their lives after treatment.

If you haven’t experienced relief, or even just partial relief, from the prescriptions you’ve taken…and you still don’t enjoy… call us.

If you find yourself thinking about dying, or wish you didn’t have to wake up in the morning… reach out for help. Don’t go it alone. Call the National Suicide Prevention Lifeline at 1-800-273- TALK (1-800-273-8255) or in the US, text HOME to 741741 to connect with a crisis counselor at the Crisis Text Line.

And learn about how we’re using IV ketamine infusions to help stop suicidal thinking in depression.

You really can enjoy again…the fragrance of a flower, the energy to have fun, the motivation to accomplish your goals and build healthy relationships.

Give yourself the chance to find out how good you can feel.

To the restoration of your best self,

June 22, 2020
Ketamine Can Stun PTSD Through This Pandemic

As businesses and services begin to slowly, cautiously open back up, we have questions.

Is it safe to be around others? Experts say social distancing is still the ticket, as well as masks and gloves and hand washing. Yes, yes, and yes. And what if you’ve got something gripping you in the midst of this pandemic that just makes everything so much more difficult to control? We’re going to talk about how ketamine can stun PTSD through this pandemic — and make it let go of its grip.

Tom could use a little of that. For sure. He found managing his outlook, frame of mind, and overall health…. challenging.

Tom had been isolated for months. The COVID-19 lockdown was doing a number on him. It had really cramped his style, and being cooped up for so long made him feel like exploding. He’d undergone treatment for PTSD, but even though he’d seen improvement, he had to be careful about his frame of mind and exercise and nurture peace in his life.

After two tours in Afghanistan, he had some trauma and scars. Headaches, nightmares, chronic pain, a little hearing loss. He’d lost some good buddies. And then later, he lost his emotional and mental balance.

For years, the scenes from those six years crashed into his awareness with a blast that was so real, he reacted to it as though he was there all over again. And while the scene was exploding around him, triggered when he least expected by the littlest things, his body reacted, again and again, just like it did the first time. When it was real.

He’d hit the floor, smelling fear, seeing enemy fire around him. And sometimes he’d crawl to his gun safe and scrabble for the gun, on high alert. Ready. Waiting.

His wife eventually was so frightened by his reactions when he was terrified and reacting to his terrors that she finally just moved out with the kids. And he was left alone.

Have you ever been terrified … and then abandoned by the one person you trusted would always have your back?

Imagine how that could magnify the terror!

If only he’d known that ketamine can stun PTSD…and transform his nightmare into joy.

Tom felt like he’d tried everything. A variety of treatments and programs. Doctors, therapists, meds, you name it. In some cases, he’d see a little improvement, but even that turned out to be temporary. The discouragement choked him. Despondency flooded him. He didn’t know how he could go on.

He had said he wouldn’t go through any more treatment unless the person offering it had seen combat. It didn’t seem to him that anyone could imagine what this was like. And he didn’t want to keep wasting his time.

Then he started drinking again. Tom had been sober for years…but his desperation, his loneliness, and the humiliation he felt by his behavior was sometimes just too much to bear. He had to find some relief.

He wondered…maybe if he got just a little drunk, for just a little while, it would give him some relief. It would quell these horrid episodes.

Tom was alone.

Locked up in his house.

And living through terrors.

He felt helpless.

And angry.

He signed up for an online alcohol recovery group, hoping it might help him get a grip. They met 3 times a week, and he felt like maybe it would help… but the jury was still out.

Then one afternoon, the conversation turned and seemed to suck him right in. Some of the members were talking about PTSD.

Finally, something relevant!!!

And a young woman spoke about her pain, and her quest for freedom, as well as her determination to stop hiding her pain behind alcohol.

She’d been sexually assaulted in a parking garage at night. A stranger who came out of nowhere.

She described her own night terrors.

And he could see that she had lived in her own type of combat. And he ached for her.

A New Solution Emerged

Later, as some of the more involved members continued their online discussion, a middle-aged guy, who said he’d also served in Afghanistan, mentioned a treatment he’d had that transformed him. Wiped out his PTSD symptoms. That the PTSD that had all but destroyed him seemed to be gone…he wasn’t sure….but he had not had PTSD symptoms for 17 months. He had tried ketamine treatment.

Blew his hair back.

He said he and his wife were back together, and the kids were learning they could relax around him again. His own self respect was getting stronger as he worked his way through the daily challenges of life.

He also said that the treatment had seriously helped him stay sober. It was like the cherry on top of the sundae.

Tom and the young woman both wanted to know about the treatment that had made such a dramatic difference for him.

“IV ketamine treatment,” he said. “I read about it, checked some studies I found online, talked to some people I found who’d gone for it, and realized I needed to give myself a chance. I wanted to see if I could get better.”

He was quick to add, “They tell you that not everyone benefits from this treatment, so be prepared. It might not work. But the percentage of people who felt it worked was extremely high, from my point of view. Ketamine can stun PTSD and it did for me.”

Tom realized this was his chance.

Ok, so it doesn’t work for everyone. But if this treatment worked so well for this guy, it might do just as well for me, he thought. He’d lost his family, and his job was shaky. He had to try.

So he made the call.

Sometimes Solutions Emerge Unexpectedly – For Example: Ketamine Can Stun PTSD

That’s Tom. He lived his life responsibly and with a heart of service when he signed up for the Marines. And he served bravely and well. But it cost him his family and a rewarding life because of PTSD. It cost his peace of mind and his self respect. He felt helpless and weak because of his episodes of terror. Man, did he hate feeling weak.

Tom desperately needed a solution… especially after months in lockdown during the pandemic. All that had just intensified the pressure and intensity of those earth-shattering attacks.

After so much loss, and so many failures from treatments he sought, Tom was desperate, and beginning to consider ending his life.

Even though he didn’t believe in 12 step groups, he tried one anyway to reach out for support in his isolation. And there online, he found good people who cared. But the biggest surprise was the treatment he learned about that had nothing to do with the 12 steps.

His new friends told him about IV ketamine treatment.

More and more evidence shows that glutamate, the excitatory neurotransmitter, goes to work to respond to stress, impacting the formation of traumatic memories and all the pathophysiology of PTSD.

Ketamine treatment works on the mechanisms that create traumatic memories, and can help reform the memory in a way that releases the traumatic aspect of it. By stimulating neuroplasticity, these mechanisms can adapt and help that memory to become more circumstantial rather than traumatic.

And rather than requiring several weeks or months to deliver these trauma reducing benefits, ketamine can work fast — within hours, days, or a week or two.

Ketamine Can Stun PTSD

And loosen its grip.

At Innovative Psychiatry, we provide IV ketamine treatment for people who suffer from PTSD caused by combat, sexual assault, a devastating illness, and more. And we see people with terrible trauma make their way out from underneath their PTSD symptoms, all the time.

It doesn’t take away the fact that the trauma happened. But it can take away the hold that the trauma has on you.

Can you relate to Tom? Has the pandemic imposed isolation that has intensified your symptoms? Do you wish for relief from your episodes that nothing else helped? If so, call us.

We don’t want to imply that ketamine is a cure-all for whatever ails you. That wouldn’t even sound real. And it isn’t effective for everyone. But no other treatment has been so effective for so many who suffer from psychiatric symptoms that nothing else helps.

We’re here constantly working to make sure you get the relief you desperately need.

We want you to achieve full remission. And to enjoy a fulfilling and rewarding life.

Give yourself the opportunity like Tom did.

To the restoration of your best self,

June 15, 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
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

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