May is Mental Health Awareness Month
Eating Disorders Are Psychiatric Disorders
Anorexia nervosa, bulimia nervosa, binge eating disorder… The National Eating Disorder Association lists 10 conditions as eating disorders. And, it so happens that ketamine treatment can work wonders and restore your life.
Too many people who don’t have a family member suffering with an eating disorder find it easy to judge someone by their appearance alone.
Either she weighs too much, or she’s “disgustingly” too thin.
Either way, it’s because she’s self-indulgent, lazy, or doesn’t know how to eat right. Or so they think.
Eating Disorders Cause Prolonged Torment
But for those who suffer from eating disorders, the problem is far more complicated. And the last thing they need is criticism… or to be judged because of their appearance. Individuals with eating disorders already criticize themselves more than anyone else ever thought about doing.
In a moment we’ll talk about ketamine for anorexia, but first, let’s try to understand how these conditions develop.
Here’s an example of of a problem that seemed to start out innocently …
Picture yourself 14 and enjoying all the snacks at a sleep-over party with all your friends. After you begin to feel full, you slip off to the bathroom, poke your finger in the back of your throat and up it all comes. You rinse your mouth, and rejoin your friends. Easy.
Two hours later, you’ve been to the bathroom twice more… an observant friend asks if you’re ok? You laugh a little and just say, “I can’t gain any weight right now but the food looks so good. I just go in the bathroom and throw up, then I can eat more. Pretty cool, eh..?”
Seven years pass … and you have to fit into that little black dress for the awards presentation ceremony at your university. Your dad always told you to “demonstrate your discipline in the way you look.” That “you don’t get a second chance to make a first impression.” There have been so many celebratory dinners lately … and you’ve learned you can always fall back on a quick trip to the bathroom to keep things under control.
Five years later, the stress from performing in your new law firm has taken its toll. You’re snacking now, and not ever really eating at all. The drive within you to throw up is overpowering… and you’ve dropped 3 dress sizes.
Anorexia and Bulimia Are Disorders, Not Self-Indulgence
You feel fat, and hate what you see in the mirror… You’re running 5 miles after work every night, swimming 30 laps before work in the morning. You’re not sleeping, hating life, and hating yourself…
Then, your boyfriend finds you unconscious in the bathroom… and calls 911.
And why did it happen to you…?
Eating disorders have been plaguing people since long before any of us knew they were a “thing.” The first physician to identify anorexia was Dr. Richard Morton in England, in 1689. Bulimic behaviors weren’t identified until much later by Pierre Janet, a French doctor, in 1903. In other words … this isn’t a new problem.
Eating disorders are chemical changes in the brain, but they’re so much more than that. They’re a way that you use food and/or exercise to manage unmanageable circumstances in your life. When life seems so out of control, there has to be a way to get some control back … you know?
A Race to Stay Ahead of Compulsions
Even though an observer may judge your behaviors associated with food, for you, it’s rather logical. Because the underlying shame, self-hatred, and critical voices cause unbearable anxiety. And for you, the eating behaviors sort of help you cope with that. At first.
In spite of the early identifying discoveries of these disorders, effective treatments remained hard to find until the late 20th century. And, even now, in spite of the best therapies available, anorexia is the most deadly of all the psychiatric disorders.
What…? It is the most deadly psychiatric disorder.
In terms of psychiatric diagnoses, anorexia holds twice the risk of death as schizophrenia, and 3 times that of bipolar disorder.
Add to that, the risk of suicide is dangerously high. 20% of those who die from anorexia, die by suicide.
The Battle For Effective Treatment of Eating Disorders
Cognitive Behavioral Therapy (CBT) has proven to be the most effective treatment for the compulsive aspect of eating disorders like anorexia and bulimia. And there have been some improvements for those who received this therapy.
Still, 1 in 5 people with anorexia nervosa dies. That’s too many. As a psychiatrist, I want to see people recover and get well…
And that brings us to ketamine treatment.
Ketamine for Anorexia and Other Eating Disorders
In the 1990’s, many psychiatrists thought of eating disorders as a compulsive behavior disease, fueled by involuntary, frequent anorexic thoughts. Excitement of the hippocampus and glutamate-NMDA receptors can be blocked — to prevent recall of those anorexic thoughts — by ketamine, which blocks NMDA receptors.
Researchers developed a trial centered on ketamine’s potential effectiveness, combined with the use of nalmefeme, which is an opioid antagonist, or a compound that prevents the effects of opiate-like substances on the brain. This medicine doesn’t interfere with ketamine’s effects on the glutamate-NMDA receptors; it was added to keep patients awake.
An Early Trial: Ketamine for Anorexia and Other Eating Disorders – 1998
As early as 1998 — way before the early studies on using ketamine in depression — IV ketamine infusions were given to a group of 15 women with very severe, chronic anorexia. The patients chosen for the trial had been failed by other treatments they’d tried over the years.
It turns out that 9 of the 15 patients in the group achieved remission from anorexic thoughts and behaviors. They were given anywhere from 2-9 infusions of 20 mg/hr… which were long in duration – 10 hours – and repeated at intervals from 5 days to 3 weeks.
These participants reported a significant drop in their “compulsion” score, from 44 before they received the ketamine, to 27 after they received it.
The other 6 participants had no apparent response to the ketamine treatments. However, this took place before ketamine treatment was being used for depression and other psychiatric disorders. It’s been 20 years since that trial, and we’re now finding that some individuals seem to not respond to ketamine… initially.
Then, a few months down the road they experience extraordinary improvement … seemingly out of the blue.
We don’t yet understand what causes the delay. But it’s too bad those researchers didn’t follow up with the other six participants a couple months later. They might have been surprised by the results.
Help Spread Information and Awareness of Psychiatric Disorders
May is Mental Health Awareness Month. We’re all working together to openly talk with each other about our experiences with psychiatric disorders.
Many in our society have no idea that some people have a psychiatric disorder that causes the way they look and act. Anorexia, Bulimia, Binge Eating Disorder, Pica, Avoidant Restrictive Food Intake Disorder, Rumination Disorder, Orthorexia, Compulsive Exercise, Diabulimia, Night Eating Syndrome … are all eating disorders.
If you notice someone who seems to eat too much…or too little… resist the temptation to pass judgment. Chances are this is far more complicated than you realize.
Treat her or him with compassion, not criticism. Let this be a day where they can judge themselves less harshly.
And, if you struggle with behaviors you don’t understand, or with diagnoses that don’t respond to treatment, call us. Life is too short to be wasted criticizing yourself. Let us help you find the real you again.
Ketamine Treatment at Innovative Psychiatry
Ketamine treatment at Innovative Psychiatry is expertly provided in a beautiful and relaxing environment (complete with low lighting and a warm blanket to keep you comfortable). We continuously monitor your vital signs and your response during the infusion. With finely-tuned skill, we adapt and adjust your dose, rate, and the frequency of your ketamine treatment to cultivate the most outstanding results for you.
Ketamine treatment isn’t for everyone. There’s no psychiatric treatment that is. But even if you’ve tried other treatments without improvement, it’s very likely ketamine will help you in a dramatic way. It’s the most effective treatment available for many people whose symptoms seemed treatment-resistant.
Benefit from Extraordinary Outcomes from Ketamine for Anorexia and Other Mood Disorders
We see extraordinary outcomes from ketamine treatment for depression, anxiety, bipolar disorder, PTSD, OCD, suicidal thoughts, and other psychiatric illnesses that have not responded to prior treatments. Ketamine enhances neuroplasticity, and we desperately need fresh, updated studies of this treatment in anorexia and other eating disorders.
Schedule an appointment and see what can happen when ketamine goes to work to set your brain right by:
- Turbo-charging BDNF
- Abundantly proliferating synapses, dendrites, and dendritic spines among brain cells
- Blocking glutamate at the NMDA receptor
- Pushing the habenula to stop those depressing cell bursts
- Dragging those G proteins off their lipid rafts in the cell membrane so they can rev up signal transmission…
Ketamine is a force to be contended with in a depressed and disordered brain.
To the blooming of your best self,
Lori Calabrese, MD