Got no business feelin’ down – Music


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I got no business feeling down. Music can be fun. Turn on the best. Find your self. Have some fun here. Stop that freekin gloom.

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It will take some work. Words have power.

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Music

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Y’all know the Abyssinian Baptist Gospel Choir don’t you? What do you think they’re singing about? There’s better ways to be happy than to allow the mind to sink back down to the world. It’s the spirit!

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The Beatles, “I Wanna Hold Your Hand. And when I touch You, I feel happy inside. It’s such a feelin that my love I can’t hide. Yeah you, you’ve got that something, I think you’ll understand.”

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Whatever that Infinite is, that Bliss, the only way to know It is to BE It. You already are. You, I, we are infinite. So make happy. You can’t destroy the ones you hate, we gotta love em. They are us. They are god too. You cannot divide infinite by 2, it’s still 2. It’s all Infinite. Just run from the danger gods.

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How to understand this? “The seeds of love I sow, ” Led Zeppelin, Physical Graffiti,”Let music be your master. Will you heed the Master’s call?

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Ain’t no Judas. It’s all Love. Every last one. You don’t have to worry. It’s a movie. You are infinite, remember? It’s real and it’s a movie all at the same time. Step away for a bit and check out these lyrics I never heard til now.

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Love the Great Spirit, the Infinite, the Absolute, Truth, Consciousness. The world pulls us down. It succeeds! I got no business allowing that. I can do better. Just how to do that is this.

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Led Zeppelin, Physical Graffiti

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Houses Of The Holy  
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Let me take you to the movies. Can I take you to the show
Let me be yours ever truly. Can I make your garden grow
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From the houses of the holy, we can watch the white doves go
From the door comes Satan’s daughter, and it only goes to show. You know
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There’s an angel on my shoulder, In my hand a sword of gold
Let me wander in your garden. And the seeds of love I’ll sow. You know
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So the world is spinning faster. Are you dizzy when you’re stoned
Let the music be your master. Will you heed the master’s call
Oh… Satan and man
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Said there ain’t no use in cryin’ ‘Cause it’ll only drive you mad
Does it hurt to hear him lyin’? Was this the only world you had? oh-oh
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So let me take you, take you to the movie. Can I take you, baby, to the show
Why don’t you let me be yours ever truly.
Can I make your garden grow

you know.

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Kashmir
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Oh, let the sun beat down upon my face
And stars fill my dream
I’m a traveller of both time and space
To be where I have been
To sit with elders of the gentle race
This world has seldom seen
They talk of days for which they sit and wait
All will be revealed
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Talk in song from tongues of lilting grace
Sounds caress my ear
And not a word I heard could I relate
The story was quite clear.
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Ooh, baby, I been blind
Oh, yeah, mama, there ain’t no denyin’
Oh, ooh yes, I been blind
Mama, mama, ain’t no denyin’, no denyin’
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All I see turns to brown
As the sun burns the ground
And my eyes fill with sand
As I scan this razor line
Can I find, can I find where I’ve been
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Oh, pilot of the storm who leaves no trace
Like sorts inside a dream
Leave the path that led me to that place
Yellow desert stream
Like Shangri-la beneath the summer moon
I will return again
As the dust that floats finds you
Will move and search Kashmir
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Oh, father of the four winds fill my sails
Cross the sea of years
With no provision but an open face
Along the straits of fear
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Oh, when I want, when I’m on my way, yeah
And my feet wear my fickle way to stay
Ooh, yeah yeah, ooh, yeah yeah, but I’m down
Ooh, yeah yeah, ooh, yeah yeah, but I’m down, so down
Ooh, my baby, oh, my baby
Let me take you there
Come on, oh let me take you there
Let me take you there back to top
In The Light
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And if you feel that you can’t go on
And your will’s sinking low
Just believe and you can’t go wrong
In the light you will find the road
You’ll find the road
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Hey, ooh, did you ever believe
That I could leave you standin’ out in the cold
Hey, baby, I know how it feels
‘Cause I have slipped through
To the very depths of my soul
Oh, baby, I just want to show you what I’d give you
In case you ever been on the road
Now, listen, oh, as I was and would do for you, too
Honey, as you would do for me
I would share your load, let me share load
Ooh, let me share you load
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And if you feel that you can’t go on
In th light you will find the road
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Hey, oh the winds of change may blow around you
But that will always be so
Oh wo, when love is pain it can devour you
If you are ever alone
I’ll share your load, I will share your load
Baby, let me, oh let me, in the light
Everybody needs a light, oh yeah, oh baby
Everybody, everybody, everybody sure ’nuff they do
Light, light, light, in the light (Repeat)

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Be the witness. Watch the movie, don’t sink into it. It’s only the body. Step away for a few minutes. Be aware of love and consciousness of spirit. Expand consciousness as often as you can. Fill the heart with love. Practice this. Meditate from the heart. We get stuck but sometimes we need to break out some music. You are not the body or the mind. You don’t think God is fun? Infinite is more fun than imaginable, they say. You may have evolved in taste for music, Infinite Bliss has infinitely better, sages say.

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The material on this site is for informational purposes only.
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It is not legal for me to provide medical advice without an examination.

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It is not a substitute for medical advice, diagnosis or treatment provided by a qualified health care provider.

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This site is not for email and not for appointments.

If you wish an appointment, please telephone the office to schedule.

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For My Home Page, click here:  Welcome to my Weblog on Pain Management!

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Please ignore the ads below. They are not from me.

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Ketamine Nasal Spray for Major Depression – The First Randomized Controlled Trial


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A Randomized Controlled Trial of Intranasal Ketamine in Major Depressive Disorder

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Psychiatrists from Mt. Sinai in New York this month have published the first randomized controlled trial of intranasal ketamine showing it is safe, well tolerated, and rapidly effective in treating symptoms of depression in persons with Major Depressive Disorder.

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This is a small study of 18 patients with treatment resistant depression showing a significant antidepressant effect occurred as early as 40 minutes in some. 44% responded after 24 hours compared to 6% placebo. Ketamine was significantly different from placebo at 40 minutes, 240 minutes, and 48 hours, but not separable from placebo at 72 hours or 7 days thought they were still better. And ketamine was significant at improving anxiety symptoms at 24 hours. There were no clinically significant changes in heart rate or blood pressure and all changes resolved in four hours. “No serious adverse events occurred.”

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“Intranasal ketamine was well tolerated with only very minimal increases in dissociation, psychosis-like symptoms or hemodynamic parameters.” They felt these very minimal behavioral side effects and insignificant changes in blood pressure and pulse were consistent with the lower blood levels of ketamine compared to the higher doses used in studies of IV ketamine. Bioavailability via intranasal route is reported to range from 25% to 50%.

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Their sample had an average of 4.1 ± 3.9 treatment failures, compared to 5.7 and 5.1 in previous studies – those required a minimum of 2 to 3 treatment failures to enroll. Other clinical characteristics did not differ including “duration of illness, length of current depressive episode, and history of ECT.” They allowed ongoing treatment of psychotropic medication.

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They chose a 50 mg dose based on a previous study and on the dose used in persons with a chronic pain disorder (Daniel Carr, et al 2004). It is a lower dose than the 0.5 mg/kg dosage commonly given intravenously. They point out one limitation of the study was the use of the single dose and a standardized protocol, which did not allow them to study optimal dosing. Future study is needed to address optimal dosing, relapse prevention and scheduling of treatment.

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The minimal side effects shown in their study correlates well with my experience. I find the effective dose of ketamine is idiosyncratic. That means it is unpredictable and specific only to that individual. Large males may need only the smallest dose, and tiny elderly females may require far higher doses. That may account for the higher response rate that I believe I am seeing, however, I have not tracked percentage of responders. I have not seen toxicity in years of prescribing either for intractable pain or treatment resistant depression. Importantly, in my opinion, relapse prevention must address not only different neurotransmitters but also neuroinflammation, pro-inflammatory cytokines.

 

 

 

 

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The material on this site is for informational purposes only.

It is not a substitute for medical advice, diagnosis or treatment provided by a qualified health care provider.

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For My Home Page, click here:  Welcome to my Weblog on Pain Management!

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Ketamine Rapidly Relieves Depression by Restoring Brain Connections


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This research is one of the most dramatic findings in the field of depression and mood disorders. It was published in Science by researchers from Yale and the National Institute of Mental Health, discussed by PBS here.

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The speed with which ketamine can relieve major depression is deeply moving to witness. In my experience prescribing nasal ketamine it works almost 100% of the time. I have discussed ketamine and previous publications on it for Major Depression and PTSD. It is also effective for suicidal and bipolar depression patients.

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Ronald S. Duman, PhD, the lead scientist, reviews his group’s research in this 2011 video:

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Stress and depression leads to structural changes in the brain and these structural changes are reversible.

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Depression affects 17% of the population, almost one in five of the population. Only one third of patients are effectively treated by existing antidepressants, even after many weeks. Nerve growth factors, in particular BDNF, are decreased by stress, with a very significant loss in depressed patients. BDNF produces antidepressant behavior in rodent models of depression.

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BDNF is important for influencing the survival and function of neurons.

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There are certain neurogenic zones in the brain that produce new neurons. Stress decreases the number of new neurons. Chronic antidepressant use increases the numbers and proliferation of these new neurons. Antidepressant treatment increases neurogenesis and this is dependent upon BDNF, this neurotrophic factor.

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[His slide shows] Exercise, Prozac, ECT, antipsychotics, antidepressants increase neurogenesis.

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Not only are there more synapses made by ketamine, but they are a larger size which is indicative of ones that are more functionally connected. Antidepressants take many weeks. A single dose of ketamine rapidly reverses depressive behaviors and loss of connections and completely reverses the decrements that had occurred over several weeks.

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In suicidal patients given ketamine at Yale in the Emergency Room, within a matter of hours, the suicidality is completely reversed. These people are better for weeks after a single dose of ketamine treatment. [emphasis mine]

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Therapeutically ketamine is even more rapidly acting than ECT.

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Ketamine increases BDNF. But research shows its effects are blocked in mice that are deficient in BDNF. Riluzole also influences BDNF, but the side effect profile is so serious that I would not consider prescribing it without more data on safety.

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Safety concerns are often raised in publications regarding chronic ketamine use. Most of my patients have no side effects at all. It is one of the safest medications we have and only a small percentage experience transient side effects. The favorable side effect profile, simplicity and low cost is key. The results for nasal ketamine are not 100%, neither is IV ketamine, but I have patients who respond to nasal spray when they failed IV ketamine. More importantly, they can carry it in their pocket and use as needed.

 

My experience prescribing ketamine goes back almost to the year 2000 for persons with chronic pain who have used ketamine several times daily, and since Spring 2012 for Major Depression. Its effect for depression lasts longer than for chronic intractable pain where it is short lasting. In the past, I prescribed it orally, by mouth, but since late 2011 I have prescribed it in a nasal spray and that form works for depression.

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The neuroprotective action of ketamine has been published since at least 1988.

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Patients can use nasal ketamine as needed. Schedules vary, everyone is different. It is short acting, but it does not stop working.

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However, the use of other adjuvants, such as glial modulators, in treatment of depression is essential to understand, and is now work in progress. The role of inflammation and glia in the pathogenesis of depression has been well established since 2000, and discussed here.

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Does ketamine also restore brain connections in patients with chronic pain? Chronic pain and major depression both lead to brain atrophy and memory loss. Both cause the same imbalance in glial cytokines. Both may respond to glial modulators, e.g. low dose naltrexone among others that have worked in some patients.

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“The original link between ketamine and relief of depression was made at the Connecticut Mental Health Center in New Haven by John Krystal, chair of the department of psychiatry at Yale, and Dennis Charney, now dean of Mt. Sinai School of Medicine, who helped launch clinical trials of ketamine while at the National Institute of Mental Health,” reported by Yale  here.

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I hope to add new approaches to treatment of anxiety that has failed to respond to other interventions.

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The material on this site is for informational purposes only, and is not a substitute

 for medical advice, diagnosis or treatment provided by a qualified health care provider.

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Please understand that it is not legal for me to give medical advice without a consultation.

If you wish an appointment, please telephone my office or contact your local psychiatrist.

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For My Home Page, click here:  Welcome to my Weblog on Pain Management!

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Carry On —> Inspiration


keep-calm-and-carry-on

This is a Cinderella story that will melt the most cynical heart.

Susan Boyle, the British singer, is an instant sensation!

Over 85.2 million viewers have seen her on YouTube in just one week – a record –

to watch her sing “I Dreamed A Dream from Les Miserables.

Born with brain damage, she was taunted all her life because she is slow.

Asked how she had the confidence to sing in front of a large audience, she says:

” I just had the ability to keep going.  You have to keep going.”

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…..a beautiful, inspiring video

of Nick Vujicic, born with no limbs, speaks to students

whose tears run down their cheeks, whose love pours out to him.

Nick has found the purpose of his life and has become strong

through the agony of learning how to overcome what had defeated him from birth.

The miracle we are looking for is inside each of us.·



For My Home Page, click here:  Welcome to my Weblog on Pain Management!

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