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Author Archives: Robert Pollack

Robert Pollack

About Robert Pollack

Board Certified Psychiatrist in practice over 42 years. Currently focused on Genomic Assessments as part of our treatment assessments and Transcranial Magnetic Stimulation (TMS) therapy along with general adult psychiatry. Currently serve on adjunct faculties of UCF, FSU, USF and Uof F. We currently accept most Insurances.

Could treating depression worsen symptoms in the long run?

Published Thursday 26 October 2017 By Tim Newman
Fact checked by Jasmin Collier

According to a recent study, although treating major depressive disorder has benefits in the short-term, over a longer period of time, it may make the condition worse.
Major depressive disorder is a serious, debilitating mental illness. In the United States, it affects more than 16.1 million people over the age of 18. Although its prevalence is high, it is still a difficult condition to treat.

Treatments include medications such as selective serotonin re-uptake inhibitors and talking therapies, such as cognitive therapy. No case of depression is the same, and often, individuals receive a range of treatments across their lifetime.

How well the treatment of depression works has come under scrutiny over recent years, and the debate is by no means over. The latest study, published in the journal Psychotherapy and Psychosomatics, adds another dimension to this ongoing conversation.

Clinical Treatment Compared with Community

Individuals with major depressive disorder who receive medication or cognitive therapy often see a reduction in their depressive symptoms and experience significantly longer times before relapse.

But over the longer-term, the picture is less clear. This is primarily because studies generally only run for 1–2 years. This gap in our knowledge could be important.

Around 85 percent of patients within specialized mental healthcare settings experience another major depressive episode within 15 years, but only 35 percent of people with major depressive disorder in the community have a relapse in the same time frame.

These figures come from a 2010 study that looked at predictors of depressive episodes. They concluded that “[c]linical factors seem the most important predictors of recurrence.”

Why might there be such a difference in relapse risk? The new study set out to investigate whether or not this disparity might be due to the treatments they received.

The research was conducted by Jeffrey R. Vittengl, from the Department of Psychology at Truman State University in Kirksville, MO.

[Read the Full Article on Medical News Daily Here]

November 1, 2017
Robert Pollack

About Robert Pollack

Board Certified Psychiatrist in practice over 42 years. Currently focused on Genomic Assessments as part of our treatment assessments and Transcranial Magnetic Stimulation (TMS) therapy along with general adult psychiatry. Currently serve on adjunct faculties of UCF, FSU, USF and Uof F. We currently accept most Insurances.

Texas Standard on Ketamine as a Treatment for PTSD

A short but interesting podcast from Texas Standard discussing Ketamine: The Future of PTSD Treatment?

Ketamine: The Future of PTSD Treatment?

#ketamine #ptsd #depression #florida #psychiatry

October 20, 2017
Robert Pollack

About Robert Pollack

Board Certified Psychiatrist in practice over 42 years. Currently focused on Genomic Assessments as part of our treatment assessments and Transcranial Magnetic Stimulation (TMS) therapy along with general adult psychiatry. Currently serve on adjunct faculties of UCF, FSU, USF and Uof F. We currently accept most Insurances.

College Student Finds Relief Through Ketamine Infusions

William Storey remembers a childhood filled with hopelessness and loneliness instead of birthday parties and bike rides.

 

“I was abnormal at an age in which abnormality is very unhealthy,” states William, now 23.
The abrupt and dramatic cultural change caused by his family’s move from Maine to Georgia when he was eight complicated the challenges William already faced. Over the years, he’s been diagnosed with attention deficit hyperactivity disorder, bipolar disorder, severe depression and Asperger’s syndrome, a higher – functioning form of autism.

 
Generally, Asperger’s patients struggle to communicate with and relate to others. They may lack empathy and have difficulty reading other people’s moods and making friends.

 


During his early years in private school, William felt isolated and misunderstood, especially by classmates, and by teachers who disciplined him for “being out of control.”

 

He explains the mindset of those teachers this way: “I like to think of it as, This nail doesn’t seem to be fitting into this particular piece of wood quite the same way the rest of them do, so we should probably hit it more.”
By the time he reached fourth grade, William wanted to die. “I hated my life,” he recalls. “I hated everything.” In seventh grade, William switched to a public school, where he thrived for two years. “I was a straight-A student,” he notes. “I was well-liked by my teachers. I had no social problems.” Halfway through his freshman year of high school, however, he “hit a breaking point.”

 

“I think a lot of it had to do with age, hormonal imbalances, feeling more ostracized from my peers,” William shares. “I had a handful of people that I was at least acquaintances with up until that point. But they stopped interacting with me as much when high school started, for their own reasons.”

 

He stayed behind when his classmates moved on to tenth grade. As William repeated his freshman year, his conflicts with teachers led school administrators to threaten expulsion if he caused further problems. He managed to finish ninth grade, then transferred to a “less academically rigorous” school.

 

“It was honestly kind of a joke,” he relates. “I barely did anything, and I still made straight A’s.”
Disappointed and frustrated, he entered an early enrollment program at the University of West Georgia. William lived in a dorm and worked on his high school studies and college classes at the same time.

 

“I did well the first year,” he points out. “The second year, I had similar problems to when I was in the ninth grade again. It resulted in my father pulling me out of the program and bringing me home.” More than 18 months later, he was ready to return, but by that time, he was too old for high school. He obtained his GED, but West Georgia didn’t consider that sufficient to re-admit him until William and his family successfully appealed to the state’s board of regents.

 

Though back in college, he wasn’t back on track. William was desperate for consistent relief from the depression that had plagued him for much of his life, despite taking “nearly every antidepressant on the market.”
Then, last spring, William’s father called Robert Pollack, MD, a friend since their days together at Yale University, to inquire about IV ketamine infusions, a relatively new therapy for treatment-resistant depression.
Dr. Pollack’s Fort Myers-based practice, Psychiatric Associates of Southwest Florida, embraces newly emerging therapies based on pioneering discoveries about the brain. Those include genomic testing to determine which antidepressant might be most effective according to the patient’s genetic profile, as well as transcranial magnetic stimulation (TMS) and theta-burst stimulation (TBS). Both use magnetic pulses to rouse areas of the brain and relieve depression.

 

Since 2015, Dr. Pollack has also used ketamine, an anesthesia drug introduced in the 1960s that can alleviate suicidal thoughts and act more quickly than many antidepressants. He estimates that 72 to 75 percent of his patients treated with ketamine have had a positive response.
William traveled to Fort Myers for a series of six infusions over two weeks. Following each 30- to 45-minute procedure, it took him a short while to get his bearings.

 

“I was very woozy, then I went to the hotel where we were staying, got food and I was fine the rest of the day,” he asserts. “Within two weeks of the initial treatment, there was a definite change. I was far less harsh on myself. I was far less miserable.”

 

When his depression was at its most devastating, William wouldn’t leave home or interact with anyone.
“By the third treatment, he shook my hand and said, Good morning,” Dr. Pollack reports. “I’ve known him a long time, and that’s a first. People with Asperger’s don’t usually gain a lot of social skills. But William now sits here and laughs. He tells jokes.”

Preventing a “Ruined Life”
William calls Dr. Pollack “a godsend” whose scientific approach is “radically different” from the many other mental health professionals William has seen over the years. He recommends keeping “an open mind about some of the more experimental treatments, because everything has to start experimentally.” William’s new regimen has him taking fewer medications, which has allowed him to lose weight. He returns once a month for booster infusions. While still “a bit anti-social,” William says he’s getting better and eventually may overcome it.

 

A student of philosophy, he’s also well on his way to completing his four-year degree at West Georgia in Carrollton, where he has his own apartment and is looking ahead to a career. Teaching is a possibility; so is the legal profession. “There are so many paths, and I’m not really sure which one I’m supposed to go on yet,” William states. “But I’m also not too bothered by that because at least I’m aware that there is a way forward.”
He’s eager to share his story because he wants people to know how much he and others like him have suffered, he says.
 

“The way kids with autism tend to be treated, at least in the area I grew up in, is damning,” William declares. “It results in lost lives. Even if they may not end up as suicidal as I was, it really warps a person. It makes it very hard to move on, to be productive, to be happy. And it seems as though people just don’t care, and that really saddens me.

 

“Misunderstanding may be the cause, but at the same time, I have trouble differentiating between misunderstanding and willful ignorance, because the end result is still a ruined life.”
Brighter days are ahead for those living in darkness, William affirms, and life is worth living.
“There is hope for the future,” he concludes, “that I certainly did not feel a year ago.”

 

[Read the Original Publication Below]

October 16, 2017
Robert Pollack

About Robert Pollack

Board Certified Psychiatrist in practice over 42 years. Currently focused on Genomic Assessments as part of our treatment assessments and Transcranial Magnetic Stimulation (TMS) therapy along with general adult psychiatry. Currently serve on adjunct faculties of UCF, FSU, USF and Uof F. We currently accept most Insurances.