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Suicide Prevention: How to Talk About It

Prevention: Talking About Suicide With A Loved One

Prevention: Talking About Suicide With A Loved One

Life can be a whirlwind of responsibilities, and it can be easy to let days or even weeks to go by not checking in on the people we love. But it’s critical to pause and consider how the simplest outreach makes a difference.


National Suicide Prevention Week serves as a crucial reminder of the significance of direct and honest conversations with loved ones who may be facing mental health challenges. Talking an often taboo topic out of the dark, and into the light has the power to save a life. 


This week underscores the need for open and sincere communication within families and among friends. Mental health issues can affect anyone, regardless of age or background. When someone senses that a close friend or family member might be going through a difficult time, taking the initiative to initiate a conversation can be a lifeline.


Heading providers and medical staff discuss the topic of addressing suicide and offering their suggestions for starting the conversation, especially when the words are hard to say.


The Power of Using the Word


“It is important to actually ask the question using the word ‘suicide’,” shared Susan Hogan, a clinical therapist at Heading. 


“Sometimes people just want the pain to stop and are looking for a way out for a short time, but they are thinking of  making permanent decisions. Saying the word is important to address it directly.”


Detecting signs of emotional distress can be challenging, as individuals often conceal their pain. Therefore, taking the proactive step of reaching out is essential. Often people try to hide their distress to avoid being a burden on their loved ones. Susan suggests letting the person know that their pain is noticeable, and that you care. 


As a way to open up the conversation Susan offered a script that may encourage a loved one to open up about their thoughts and feelings, “Tell that person, You are important to me. It seems like you are feeling overwhelmed by your feelings. Your feelings are valid and sometimes our brains get stuck in negative thoughts/feelings I want to make sure that you are safe so I need to ask if you are contemplating suicide or self-harm in any way. Can we talk about this now?”


Asking is Always Better Than Not Asking


Communicating a desire to listen without judgment and acknowledging a loved ones feelings can provide invaluable support. Be brave, and be direct. By engaging in direct communication with loved ones, individuals become a source of comfort and hope for those feeling isolated and overwhelmed. 


“Ask your friend or family member if they have a plan of hurting or killing themselves,” shares Ryan McWhirter, psychiatric nurse at Heading.  “I don’t anyone regrets asking. But many people wish they would have spoken to a loved one if they never did.”


It’s important to remember that a simple conversation can save a life. 


Know About Resources


When someone is considering suicide they may not be considering resources available to help them in a crisis.  Knowing what those resources are, and being willing to share them with a person in need can help.


Go-To resources for support include:


#988 Crisis Hotline which is available by phone or text.


#911 If a mental health crisis becomes an emergency 911 can help.


988lifeline.org the Web version of the Suicide and Crisis Hotline


NAMI.org/help The National Alliance on Mental Illness help page. 


Apa.org/topics/crisis-hotlines The American Psychological Association publishes a page of crisis hotlines along with longer-term resources available by state. 


What About When You’re the One Feeling Hopeless?


If you’re the one experiencing thoughts of suicide, help is available.  Consider using one of the resources listed above.


“There will always be someone there to listen, even when you least expect it. Share your internal monologue with someone,” encourages Rae Reynolds, medical assistant at Heading. “People ready to help, and often when we reach out for help we find out that the person on the other end truly understands how we’re feeling and may have even been there themselves.”


The impact of compassion and concern should never be underestimated, not just during National Suicide Prevention Week, but throughout the year. Creating a world where no one suffers in silence, and where love and understanding prevail, is a collective endeavor.


Visit American Foundation for Suicide Prevention for more information: https://afsp.org/national-suicide-prevention-week/

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Methods to Receive Ketamine Therapy

Ketamine: Sprays, IVs, Injections, and Lozenges.

August 15, 2023

When it comes to finally feeling better Ketamine offers promise to those who have failed to find relief from SSRIs. More options for administering this medication now exist. Here's an overview of the most common.

Ketamine is a treatment that is offering many patients faster relief for mood  and chronic stress disorders particularly treatment-resistant depression, anxiety, and PTSD. For those that have not responded well, or at all, to other treatments like SSRIs, the medication offers hope for healing that many patients once felt was impossible.



Unlike a daily pill, Ketamine is offered in sessions over the course of a series. Ketamine sessions should be offered in controlled settings and supervised by medical professionals. 




Intravenous (IV) Infusion: This is one of most common and studied method of ketamine administration. An infusion of ketamine is delivered directly into a patient’s bloodstream through a vein. The dosage and duration of the infusion are controlled to achieve therapeutic effects. IV ketamine treatment often involves a series of sessions over several weeks, and requires medical supervision.



Intramuscular (IM) Injection: In this method, ketamine is injected into a muscle, and dosage is tailored to the patient. Intramuscular injections are considered an alternative to IV infusions, especially when IV access is challenging.  Like IV injection the dosage is carefully controlled based on body composition, past tolerance to the medication, and other factors your psychiatrist will discuss with you in your consultation and follow-ups. 



Nasal Spray (Spravato®): Esketamine, a derivative of ketamine, has been approved by the U.S. Food and Drug Administration (FDA) as a nasal spray for treatment-resistant depression. Patients self-administer the nasal spray under the supervision of a healthcare provider. Nasal spray offers a more convenient option especially for those who do not want IVs or injections.



Sublingual or Buccal:  Ketamine can also be administered by placing a tablet or lozenge under the tongue or against the cheek. The medication is absorbed through the mucous membranes in the mouth. It’s important with this administration of Ketamine to follow the clinicians instructions for receiving the medication to ensure the best possible absorption and results.



Effectiveness of the different methods can vary based on the specific condition being treated, individual patient responses, and factors such as dosage and treatment protocol. The choice of method should be made in consultation with a qualified healthcare professional based on the patient’s individual circumstances and medical history.



At Heading clinics in Austin and in Dallas-Forth Worth the majority of patients receive ketamine through Spravato® nasal spray, or intramuscular injection.  Regardless of method all patients at Heading receive treatment with direct medical supervision.  Everyone responds to medications differently, and given the dissociative affects of Ketamine it can be safest to have clinicians who specialize in psychiatric care on hand to give guidance, answer questions, and offer support for patients going through their series.


If you feel you could be helped with interventional psychiatric treatments, like Ketamine Therapy, reach out.  Our clinicians in Austin and in Dallas-Fort Worth would love to support your journey to health and healing. 

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5 Ways to Improve Your Ketamine or Spravato® Experience

5 Ways to Improve Your Ketamine or Spravato® Experience

August 8, 2023

When it comes to feeling better it is understandable that people with treatment-resistant depression feel nothing will work. Spravato® - a version of Ketamine - has been giving people hope.

Ketamine and the FDA-approved version Spravato® are gaining attention for treating depression that hasn’t responded or has not responded well enough to other medications, therapies, or both.


Spravato® must be administered in person at an approved center or clinic under the supervision of an approved clinician. At Heading Ketamine is also administered in person.

Our team offered a few ways to improve the experience receiving Ketamine or Spravato® and get the most out of treatment.


5. Follow Preparation Instructions from Your Care Team

“We conduct a thorough psychiatric consultation with a patient to establish the best route of care. If Ketamine or Spravato® is determined as the best next step our our clinical staff  follow up directly with instructions to prepare. Prior planning for schedule, travel arrangements, and understanding the DOs and DONTs help a patient feel more relaxed and safe going into their series,” shared Dr. Arif Noorbaksh, based out of Heading’s Trophy Club, Texas center which is just outside of Dallas Forth Wort.  


4. Remember, Your Questions are Welcome!

Unlike traditionally prescribed SSRIs, which can take weeks for symptoms to subside, Ketamine or Spravato® prescribed for depression can create change very fast.  The immediate effects of the medication create an altered state, and this experience (sometimes referred to as a ‘trip’) can feel surprising and unexpected.


During your consultation, and on the day of your sessions feel free to ask all of the questions that are on your mind. Your care team will be more than happy to walk you through any aspects that you might be nervous about, and also help you better understand the medication itself and how it works with your body for healing. 


3. Explore Your Intention 

Establishing an intention for treatment can improve the experience. You may have heard of having a ‘bad trip’. While remembering or processing experiences during therapeutic sessions is part of the experience, the mindset going in can improve your perception of the experience. 


Feeling prepared can go a long way to influence feelings of safety and calm, which in turn allow you to be more open to the immediate experience, and continue to integrate and optimize once the acute effects of the medication have worn off (and while the neuroplastic window is still most optimal.)


2. Meet with a Therapist Prior to Treatment and Soon After Treatments

Intentions shouldn’t be agendas, but rather frameworks for experience.  Be gentle with yourself as you consider prompts and affirmations.  A therapist can help with this!


If possible it is recommended to meet with a therapist prior to your first session to prepare. Andrea Marquez, a therapist at Heading in Austin, had this to say about preparation before interventional treatments, “I like to team my patients exercises such as body scanning, breathing practices, and self-soothing techniques. This can help them get back to the present moment if they become overwhelmed or surprised during their first Ketamine or Spravavto® experience.”


Likely your therapist will also want to see you soon after your sessions, within a day or two, to help you process the experience and set intention for the next. Integration has long been an aspect of psychedelic therapies, and academic study of this aspect of treatment is ongoing. After you have your initial sessions under your belt you and your therapist can shift from preparation and coping skills for the immediate treatment itself into understanding and integrating the ways in which Ketamine treatment can positively influence your goals for change. 

Regarding post treatment therapy sessions, Andrea also shared, “Over time I help patients work on thought processes that they may notice when they are in an interventional treatment. Together we unpack what came up. I also ask the patient what they feel will best support them. Sometimes it is just to hold space for those thoughts, and other times they desire a move towards change.” 


1. Stay Consistent

Ketamine offers fast relief for many patients who are struggling. But, the long-term outcomes are most optimal with consistency throughout a whole course of treatment, along with staying involved with follow up psychiatry and psychotherapy appointments. 


Typically Ketamine and Spravato® series are set for a series of several sessions across 11-12 weeks with additional maintenance as needed.  Attending all of the sessions in the prescribed cadence is important to the long-term positive outcomes that can be experienced from this course of treatment.


Ketamine and Spravato® open a window for change. But you are the one who is making it happen. If you need help making your treatment and follow up therapy talk with your care team about scheduling. Advocating for your care is a positive and powerful step in the healing journey. Mental health professionals are happy to help patients find the best rhythm of care that empowers you to say committed to the process. 


Ketamine is an exciting area of research, and it has the potential to help many people who suffer from depression, anxiety, and PTSD. If you or someone you know is considering using Ketamine for mental health treatment, consider setting up a consult with Heading where you could receive ketamine or Spravato® treatment in our centers in Austin or Dallas-Forth Worth.

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Care Insights: Synergy of Ketamine and Therapy for Emotional Healing

The Synergy of Ketamine and Therapy for Emotional Healing: An Austin Therapist's Perspective

Maximal Benefits of Ketamine through Therapy with Andrea Marquez LCSW

In the heart of Austin, Texas and a few hours north in Dallas-Fort Worth patients arrive at Heading clinics to receive a groundbreaking approach to mental health and the treatment of depression, anxiety, and PTSD – Ketamine therapy. Ketamine Therapy, known for its association with psychedelic substances, has emerged as a beacon of hope for individuals battling mood disorders that have not been helped well enough, or at all, by traditionally prescribed first-line treatments. What sets this therapy apart is how its effects on the brain can directly integrate with the benefits of counseling, creating a dynamic duo that optimizes treatment for those seeking profound emotional healing.


Most often patients in Heading’s care receive treatments in the form of Intramuscular Ketamine or in a nasal-spray medication called Spravato®.  Patients will physically come in for Ketamine in Austin or Ketamine in Dallas to a Heading clinic. Ketamine treatment is a series of treatments over several weeks, and the safety, comfort, and expert support of in center treatments makes the choice to have in-person treatment well worth the visit. 


Conveniently, in between treatments patients are often paired with a therapist that sees the patient virtually. Combining virtual therapy appointments optimizes the benefits of the in-center treatment with the transformative change that can come from working with a licensed therapist who understands the healing potential of Ketamine, and the unique effects it has on the brain.  This article shares the perspective of one of Heading’s therapists who often treats patients who are also receiving Ketamine or Spravato® in the center. 


Meet Andrea Marquez, LCSW, a respected therapist and supervisor at Heading, who has been at the forefront of this innovative approach, combining the transformative power of Ketamine treatments with the healing potential of therapy. Andrea’s dedication to her patients’ well-being has led her to explore the untapped potential of neuroplasticity and the behavioral change that therapy can evoke in conjunction with Ketamine’s effects on the brain.

Groundbreaking Synergy: Therapy and Ketamine Unite

When asked to provide insight into the benefit of combination therapy and ketamine Andrea explained how the two healing modalities complement each other, creating a well-rounded experience for her patients. “Therapy combined with interventional treatment has been helpful in keeping patients engaged in treatment and gives them the ability to check in on their concerns and experiences,” she shared. 


Still, some patients are nervous about Ketamine, associating it with its illicit use and abuse as a street or party drug. Andrea understands their nerves and feels the combination of ketamine and therapy can calm these fears, and enhance safety and efficacy, “By providing a supportive environment, therapy helps destigmatize the use of Ketamine and empowers patients to make sense of their unique journey with the treatment and understand its usefulness.”

Neuroplasticity Unleashed: Ketamine Opens the Door

Andrea’s expertise in mental health and her understanding of neuroplasticity have led her to recognize the window of opportunity that Ketamine treatments offer. “Ketamine treatments place the brain in a unique state making it more receptive to change,” Andrea explained. 


It was an old belief that the physical structure of the brain became relatively unchangeable after a certain stage of development. Now scientists, psychiatrists, and therapists who are experts on the brain and thought processes know that this is not true. The brain is capable of change and healing. This capability for change, or neuroplasticity, is key in changing long held habits. Ketamine heightens the neuroplastic state and in this heightened state patients have the potential to break free from negative thought patterns and establish new neural connections, creating lasting positive changes in their mental landscape.

Reinforcement and Resilience: Grounding and Mindfulness Techniques

Ketamine therapy, though safe with relatively low risk of adverse side effects, can still be experienced as quite intense. While technically a dissociative anesthetic Ketamine produces a brain and body experience that is often described as psychedelic.



Prior to treatment Andrea teaches patients  grounding and mindfulness techniques they can use during sessions, providing patients with invaluable tools to navigate their emotional experiences. These techniques can be employed in Ketamine sessions and in every day life. “If I am able to meet with them before they get started, I teach them mindfulness exercises like a body scan, paced breathing, and self-soothing techniques,” Andrea explained. 


Feeling comfortable, safe, and well cared can make treatment a positive experience. Deep breathing, mindfulness techniques, and body scanning exercises help soothe the nervous system helping the patient’s breath rate, and heart rate remain calm, and bring awareness to areas of physical tightness or tension so that the patient can more fully relax. 



These techniques not only assist patients during their Ketamine treatments but also equip them to cope with intense emotions in their everyday lives, fostering resilience and emotional well-being.

Empowering Positive Change: Therapy and the Power of Thought Processes

As mentioned, Ketamine opens windows to review experiences and emotions in a new way, and establish new healthier connections. The benefits do not go away when the acute effects of the medication wear off. Instead, time in between Ketamine treatments offers a special period to address anything that’s come up. 

Unlike self-employed techniques like journaling or reflection, both of which can be very helpful, taking the added step to meet with trained therapists during a ketamine treatment series offers deeper benefits. Licensed therapists, especially those who have worked with patients who are going through ketamine treatment, have skills, and experience to employ a variety of techniques that can be tailored to the patient’s case, and needs in the moment. 

One of the key aspects of therapy in conjunction with Ketamine treatments is the opportunity to work on thought processes. Andrea pointed out, “[After a treatment] We look at what comes up and what connections they make. Then I have the patient tell me what will best support them, whether it is just to hold space for those thoughts and emotions or if it is something they want to change.” Through this collaborative exploration, patients gain insights into their thoughts and emotions, empowering them to embrace their emotional healing journey.

In summary, Andrea emphasized the immense potential of integrating therapy with Ketamine treatments. This well-rounded approach creates a powerful synergy, optimizing the benefits of both Ketamine’s effect on the brain and the emotional healing, mindset shifts, and behavior change that therapy facilitates.

“Integrating therapy with Ketamine treatments allows patients to experience a more comprehensive and holistic approach to healing,” Andrea concluded.

Taking the Next Step

Through her expert guidance, Andrea illuminates the untapped potential of neuroplasticity, the power of thought processes, and the significance of grounding and mindfulness techniques in this integrated treatment. As the world of mental health continues to evolve, the synergy of therapy and Ketamine promises hope and healing for those seeking relief from depression, anxiety, and PTSD.


If you are interested in learning more about Ketamine or Spravato® treatments to address major depression, anxiety, or PTSD email info@headinghealth.com to request a psychiatric consultation. 

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Yes, Ketamine is Legal.

Ketamine Therapy for Depression: Known for Anesthesia, Now Saving Lives in Psychiatry

Ketamine Therapy for Depression: Known for Anesthesia, Now Saving Lives in Psychiatry

A Life-Changing Treatment Option

Ketamine is a medication that has been used in the medical community for anesthesia for years. In fact it’s effective use, and relatively low risk of adverse side effects, has placed it on the WHO’s essential list of drugs for quite some time. 



Ketamine, renowned for its longstanding use in anesthesia, has emerged as a powerful and rapid treatment for depression, particularly for those suffering from treatment-resistant depression. 



Those who are diagnosed with treatment-resistant depression are not void of help. Treatment-resistant is a term that has come under scrutiny, but its usage generally means that an individual with major depression is not responding or responding well enough to first-line treatments like SSRIs, therapy, or both.



With its unique mechanism of action and minimal side effects, ketamine offers newfound hope for those who have not responded to traditional SSRIs. This article explores the legal aspects of ketamine usage, its benefits in psychiatry, and the importance of expert supervision.



The Rise of Ketamine Therapy

In recent years, ketamine therapy has become more well known, especially with the challenges brought on by the Covid-19 pandemic, which strained mental health care systems. 



However a quick internet search for the term ‘Ketamine’ will show that many people, including Heading’s patient population in Texas, want to know if Ketamine is legal in their state, or legal at all. This isn’t all that surprising as many people only know about ketamine as a street or party drug. Like many other medications, it has been misused and mishandled.



The good news is that medically appropriate use of ketamine for mental health disorders such as major depression is not only legal, but game-changing for people who have struggled to find relief from other treatment modalities. 



Additionally, the release of Spravato®, the first FDA-approved ketamine variation for depression, has generated widespread interest in ketamine as a potent mental health treatment. Many individuals previously unaware of ketamine’s medicinal potential, associating it with illicit use, are now learning about its transformative effects in mental health support.



Ketamine centers across the country have begun to offer IV and IM ketamine, and Spravato®, and research is continuing to prove the efficacy of these therapies.



The Healing Potential of Ketamine

Beyond its anesthetic properties, ketamine can induce a dissociative state, offering patients an experience akin to a psychedelic journey. However, the therapeutic benefits extend far beyond the initial “trip.” Ketamine treatments, when administered under medical supervision, can lead to lasting improvements and neuroplasticity that inspire new ways of thinking, feeling, and processing experiences. 



While the trip gets a lot of buzz the therapeutic benefits of ketamine are reinforced through a full-series of treatment, and in coupling it with psychotherapy to maximize it’s benefits for behavioral and cognitive change.


The Legal Status of Ketamine

For medical purposes, ketamine is entirely legal and can be administered as a medication.


However, when used recreationally, it is illegal worldwide, given the risks of abuse and dependency associated with misuse.


Like any other medication, Ketamine is not a miracle drug. It is a tool in the psychiatric toolkit and needs to be used safely and effectively. It’s important for any patient to be fully evaluated to mitigate risks. To ensure safety, Heading conducts thorough evaluation and only provides ketamine therapy and Spravato® treatments in-center under professional supervision.



Psychiatric Use of Ketamine

Spravato® is FDA-approved for major depression resistant to other treatments, while other forms of ketamine therapy fall under off-label use. The medical community strongly supports the psychiatric usage of ketamine, thanks to consistent research and the approval of Spravato®. As access to ketamine expands, the practice of evidence-based medicine by qualified physicians remains pivotal.



The Importance of Professional Guidance

For psychiatric medical facilities like Heading, offering ketamine as an interventional service requires guidance from trained and qualified psychiatrists. Full psychiatric evaluations are conducted before commencing therapies, and patients are closely monitored by medical professionals throughout their treatment journey.



This level of support and supervision provides patients with a sense of safety and confidence in their treatment.



Embracing Best Practices

Centers that offer Spravato®, like Heading, go through a strict approval process and must adhere to rigorous protocols to ensure optimal treatment outcomes. These standards for Spravato® offer a clear benchmark for best practices that may be adopted for all ketamine therapies to ensure the best possible treatment for patients.



Professional organizations and researchers also play a crucial role in promoting experience sharing, evidence-based research, and education among clinicians working with ketamine.



Get in Touch with Heading

If you have questions about the safety and effectiveness of Ketamine treatments for depression or wish to schedule a consultation, reach out to the Heading staff.


Our team is eager to connect with you and learn more about your needs, helping you embark on a transformative journey towards improved mental health.

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What is Depression?

Depression & Treatment

Depression & Treatment

You are not alone.

At Heading we specialize in the treatment of depression.

Depression is often described as a cloud that comes over one’s life, blocking the sun. Sometimes depression can be sourced back to the onset of a particularly difficult time in life, but sometimes people experiencing depression cannot attribute their feelings to a particular circumstance or continue to struggle with their mood even after circumstances in their life have changed, or experience symptoms somewhat inexplicably. No matter the cause, known or unknown, depression makes life difficult, can be debilitating and sometimes life threatening, and is a mental health issue that should be taken seriously.


Depression experience is often characterized by feelings of sadness, an inability to experience pleasure, low mood, and a lack of motivation or energy. While everyone may feel down or “blue” at times, depression is much more persistent and should not be seen as a sign of weakness or something that can simply be overcome. In fact Depression is a leading cause of disability, and for those suffering from long-standing depression it can cause significant lapses in work and employment, further impacting their ability to engage in adequate care. 


Depression is a widespread issue in the United States, affecting over 16 million adults in 2016, according to the National Institute of Mental Health. There are different forms of depression, including Major Depressive Disorder, Seasonal Affective Disorder, which is related to seasonal changes, Bipolar Depression, and Treatment-Resistant depression. Given its prevalence, it is important to emphasize that no one should suffer alone, and that is why Heading is here to help.




Depression can manifest in various forms, and one of the most commonly diagnosed types is Major Depressive Disorder (MDD). Major depression differs from regular depression in terms of severity and duration. While regular depression may have milder symptoms and last for a shorter period of time, Major Depressive Disorder involves more intense and persistent symptoms that significantly impair daily functioning. It is crucial to recognize the distinction between the two, as proper diagnosis and treatment can be tailored accordingly.




When it comes to treating depression, a combination of medication and psychotherapy, known as combination therapy, is often recommended. Medication is utilized to alleviate certain symptoms of depression, such as low mood, loss of appetite, or disrupted sleep patterns. Antidepressant medications, such as selective serotonin reuptake inhibitors (SSRIs) or serotonin-norepinephrine reuptake inhibitors (SNRIs), are commonly prescribed in these cases.


Psychotherapy, particularly Cognitive Behavioral Therapy (CBT), plays a vital role in combination therapy. CBT aims to identify and modify negative thought patterns and behaviors that contribute to depression. By working with a therapist, individuals can develop healthier coping strategies, challenge distorted thinking, and learn effective problem-solving techniques. Psychotherapy helps individuals gain insights into their emotions and provides them with the tools to manage depressive symptoms.


For many people whose depression becomes major or severe, combination therapy is more effective than a single line of treatment alone.  However many people find that coordination of care between a therapist and psychiatrist can be time-consuming and difficult.  This is one reason why Psychiatrists and Therapists at Heading work together through the phases of care for those seeking more than one line of treatment. 




In some cases, individuals with Major Depressive Disorder may not experience significant improvement even after receiving appropriate treatment. This is known as treatment-resistant depression. Treatment-resistant depression is diagnosed when symptoms persist despite adequate trials of different antidepressant medications and psychotherapy approaches.


When faced with treatment-resistant depression, it is crucial to consult with a mental health professional who can reassess the treatment plan. The therapist may recommend alternative medication options, such as different classes of antidepressants or augmentation strategies, which involve combining multiple medications to enhance their effectiveness. Additionally, other therapeutic modalities like Spravato®, IM Ketamine, or  or transcranial magnetic stimulation (TMS) may be considered for individuals who do not respond to conventional treatments.


Remember, depression is a treatable condition, and there is hope for recovery, even in cases of treatment-resistant depression. Seeking professional help and exploring different treatment options can lead to significant improvements in symptoms and overall well-being.


We are here to provide support and renewed hope that healing is possible. Together, we can work towards breaking free from the grip of depression and rediscovering the brightness in your life.



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Preparing : A Guide to Your First Ketamine Treatment and Spravato® Treatment

Preparing for a Transformative Ketamine Therapy Experience

Preparing for a Transformative Ketamine Therapy Experience

A Guide to Your First Ketamine Treatment and Spravato® Treatment

Why Ketamine?

Ketamine therapy and its derivative, Spravato®, have emerged as promising treatments for individuals struggling with major depression and other mental health conditions. These innovative therapies offer new hope for those who have not found relief with traditional antidepressants. If you’re considering ketamine treatment, it’s essential to prepare yourself adequately for this potentially life-changing experience. 

In this blog, we will explore the key aspects of preparing for a ketamine therapy session, while incorporating insights from Dr. Arif Noorbaksh, a psychiatrist at Heading Health in Dallas, Texas, and Austin, Texas.


Understanding Ketamine Therapy

Ketamine therapy involves the controlled administration of ketamine, a dissociative anesthetic, to induce an altered state of consciousness, which many compare to a psychedelic experience, and interacts with the brain through the glutamate system which is different than many antidepressants which address serotonin reuptake. Spravato®, a nasal spray formulation of esketamine, a variant of ketamine, has been approved by the FDA for treatment-resistant depression specifically. 


Ketamine introduces windows of neuroplasticity, even after the immediate dissociative effects have worn off, empowering patients to reexamine thoughts, behaviors, and patterns that are proving detrimental to their mental health. This aspect of Ketamine therapy is one reason why very often those who are seeking Ketamine treatment are also seeing a therapist who understand their treatment and can help them integrate it into their therapy sessions, optimizing results. 


Dr. Noorbaksh also explains, “Ketamine and Spravato® appointments typically last a couple hours. Feeling safe, comfortable, and prepared is important for the process.” 


The purpose is to promote psychological exploration, facilitate emotional healing, and alleviate symptoms of depression and thus feeling safe, informed, and well cared for during your treatment not only makes the experience more pleasant but it actually aides in the effectiveness of treatment itself.  


Creating a Safe and Comfortable Environment

Dr. Noorbaksh emphasizes the significance of ensuring a safe, comfortable environment during ketamine therapy sessions. 


He advises, “Some people feel a little queasy from treatment. It’s helpful for a patient to eat earlier in the day to avoid hunger, but also not within two hours before treatment to reduce nausea.” 


To enhance your comfort, he suggests bringing along comfort items such as comfortable clothes, an eye mask, a favorite playlist with headphones, and even a pillow and blanket. These items can help you relax and feel at ease as you allow the medication to take effect.


Addressing Coffee, Alcohol, Medications and Other Substances:

Dr. Noorbaksh also highlights the importance of discussing medications and substances with your healthcare provider prior to undergoing ketamine therapy. He shares, “At Heading we have a full consultation to determine appropriate treatment. Also prior to Ketamine and Spravato® treatments we advise patients regarding alcohol and caffeine use, and other medications – including over the counter medications – to ensure safety before, during, and after treatment.” 


Open communication with your healthcare provider about your current medications, including over-the-counter drugs, alcohol, and caffeine, is crucial to ensure the safety and effectiveness of the treatment. It is helpful to have your medical history, medication list, known allergies, and a willingness to discuss substance use on hand when connecting with a doctor about Ketamine therapy.


Proper Planning for Transportation

Dr. Noorbaksh stresses the importance of arranging safe transportation to and from your ketamine therapy sessions. He advises patients to make suitable arrangements, as they will not be able to drive after treatment. 


“Patients should leave their own car at home, make safe travel arrangements as they cannot drive after treatment, and must get a good night’s rest before resuming normal activities, including driving, the next day,” he explains. 


By planning ahead, you prioritize your well-being and the safety of yourself and others.


Ketamine Therapy in Austin, Texas, and Dallas, Texas

If you’re considering ketamine therapy in the Austin, Texas, or Dallas, Texas areas, Heading Health offers comprehensive treatment options including Ketamine therapy, psychiatry and medication management, and psychotherapy. 


With the guidance of experienced professionals like you can embark on a transformative journey toward mental wellness with a care plan personalized to meet your needs.


Schedule Your consultation

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5 Ways Spravato® is Different Than SSRIs

5 Ways Spravato® is Different Than Most Depression Medications

5 Ways Spravato® is Different Than SSRIs

Spravato® is a version of ketamine administered as a nasal spray. It is used to treat a type of depression called treatment-resistant depression. Treatment-resistant depression is a type of depression that is not improved by other medications. Spravato® is different from SSRIs, which are commonly prescribed for depression, in a few ways:


1. How it works:

Spravato® affects a different part of the brain called the glutamate system, and blocks certain receptors to help improve depression symptoms. Whereas SSRIs work by inhibiting the reuptake of serotonin changing the levels of this chemical in the brain.


The glutamate system and the SSRI system are different in terms of their role in the brain and how they affect depression. In simpler terms the glutamate system and the SSRI system are like two different teams in the brain that work in separate ways to help with depression. 


Glutamate plays a role in regulating mood. Glutamate is the most abundant neurotransmitter in the brain and is involved in various brain functions, including mood regulation, cognition, and learning. It acts as an excitatory neurotransmitter, meaning it helps facilitate the communication between nerve cells.On the other hand, the SSRI system focuses on a different brain chemical called serotonin. Serotonin is a neurotransmitter that also plays a role in regulating mood. SSRIs, which stands for selective serotonin reuptake inhibitors, work by increasing the levels of serotonin in the brain. By preventing the reuptake of serotonin, SSRIs help to keep more of it available in the brain, which can improve mood and relieve depression symptoms.


Both systems have different ways of addressing depression, and medications like Spravato and SSRIs target these systems to help people with depression feel better.


2. How you take it:

Spravato® comes as a nasal spray that you use in your nose making the absorption very quick. SSRIs usually come as pills that you swallow.


The nasal spray does of Spravato® are administered after you’re seen by clinic or center staff, and a psychiatrist. From there the effect of the medication will start to set in, and the psychiatrist and medical staff will monitory and support the patient during the appointment which typically lasts 2 hours. Those taking Spravato® should have a ride home after their appointment, and have a restful sleep before driving.


3. When it’s used:

Spravato is used when other medicines, like SSRIs, haven’t worked for depression. SSRIs are often the first choice for treating depression.


Diagnosing treatment-resistant depression involves a full evaluation. Initially, depression is diagnosed based on symptoms and criteria, and some people find successful reduction of symptoms with medication, therapy, or both.  However for some, these first-line treatments don’t work. For those individuals, a psychiatrist will assess treatment history, including the types of medications, other interventions, and side effect. From there they may recommend a different type of treatment, like ketamine or Spravato®. 


4. How quickly it works:

Spravato® has rapid benefit with some patients experiencing improvement within hours or days. SSRIs usually require several weeks of continuous use for symptom relief.


The method of taking Spravato®, as a nasal spray, is one reason why patients’ feel effects rapidly. However, quicker symptom relief is also related to the way in which Spravato® connects with the brain. Researchers are also studying the ways in which Spravato® improves neuroplasticity, or the brain’s ability to change, which can accelerate the relief the symptoms of depression especially when offered in combination with therapy. 


5. Where it’s taken:

Spravato® is given in a clinic or center with mental health care experts on hand for you. In contrast, SSRIs can be taken at home  as a daily pill. 


Many patients find the presence of their mental health professionals very comforting. Since Spravato® is a version of ketamine some people may be hesitant to participate in treatment out concern about the psychedelic-like effects of the medication. However, the dosage and care of each patient is closely monitored by psychiatrists, nurses, and medical assistants who are familiar with Spravato® treatment enhancing both safety and efficacy. 


It’s important to know that Spravato has risks and side effects, so it should only be used with a doctor’s guidance. If you have questions about depression treatments, it’s best to talk to a doctor who can give you personalized advice based on your situation.

Connect with care, today!


Welcome Dr. Aneel Ursani, MD

Heading Welcomes Dr. Aneel Ursani, MD

Heading Welcomes Dr. Aneel Ursani, MD

Dr. Aneel Ursani has joined Heading as Chief Medical Officer. With his years of leadership and entrepreneurial experience Dr. Ursani brings drive for innovative medicine and a belief that nimble, mission-driven businesses will lead the way for better patient outcomes and a healthier mental outlook. 



In connecting with Dr. Ursani about this new position he shared his insights and excitement about the new role and what he hopes to accomplish both for Heading and how his plans for Heading align with his vision for improved psychiatric medicine.


Why did you choose Psychiatry?

I chose Psychiatry for many reasons, but I was drawn to it in medical school because of how different it was from the rest. Rarely in other specialties do you have the privilege of personally getting to know your patients at such a deep level. Patients share things they wouldn’t share with anyone else. You often see them in their hardest moments and can play a pivotal role in their recovery.


How does Psychiatric Medicine continue to inspire you?

The approach to treatment is comprehensive and every case is personalized. Solutions are not solely pharmacological but often involve troubleshooting deep rooted issues which have strong psychological and social components. That’s certainly challenging, but it’s rewarding when it leads to long lasting positive change in a person’s overall health and wellbeing.

What’s your vision for the future of mental health care?


We have a lot to address to improve mental health care in our country. We have gaps in access to care, long wait times, a provider shortage, concerns about affordability, as well as accountability. At Heading we are directly working to address all of these.  


How is a team approach, with psychiatrists and therapists working together, particularly beneficial?

Patients who have been struggling for a long time often need a combination approach, and they need providers who take their insurance. 

Offering more than one service line, with in-network providers, makes the care process easier for patients. Our goal at Heading is to treat patients with the same care and compassion we’d offer our family – with the right treatment combinations to ultimately achieve full remission. As a company who believes in value based care, having a combination of providers in one practice is a win for everyone involved – providers, payers, and most importantly, patients.


Ketamine therapy is growing in interest, as is interest in other psychedelic treatments. How do you think psychedelic treatments will be part of the mainstream psychiatric landscape in the future?

Ketamine therapy has a special place in the psychiatry treatment algorithm. 


There is a large subset of patients who are treatment resistant to traditional oral medications and talk therapy. Ketamine certainly has a huge impact on these patients and the fact that we are able to offer this and other interventional treatments to our patients is exciting. Having access to these treatments, and potentially the treatments that may be available in the future, makes me excited about how the field of psychiatry can continue to address gaps.


Interventional treatments like Spravato® and ketamine, and other psychedelic therapies which may become more available soon, are still considered fringe by many. How can Heading continue to pave the way for broader acceptance and access for those who need these services?


The opportunity lies particularly in the subjects of accountability and outcomes. 


We must be a data driven healthcare system anchored in measurement based care – we have to demonstrate that we can help patients heal. 

Our patients deserve the highest quality care, and that means access to the treatment that is right for them. Ketamine may not be the answer for everyone. SSRIs may not be the answer for everyone. Staying close to the science, and offering highly tailored care means better outcomes.  


At Heading we strive to provide them the right treatment through our variety of treatment offerings. This includes evaluating the appropriateness for traditional as well as cutting edge interventional treatments. 


Heading is a mental health practice offering virtual medication management, virtual therapy, and virtual nutritional therapy statewide in Texas, and in-person IM Ketamine and Spravato® therapies at their centers in Austin and Dallas-Fort Worth.  Heading treats adults dealing with a wide variety of mental health disorders and has a particular speciality supporting patients with long-standing and hard to treat disorders like treatment-resistant depression, major anxiety disorders, and PTSD. As he comes on board Dr. Ursani will lead the way in continuing to advance a team-approach for more holistic in-network care that keeps patients at the center of every treatment plan. 

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How to Prepare for Your First Psychiatry Appointment with Jen Smith, MSN, RN-BC

Getting Ready for Your First Psychiatry Appointment with Jen Smith, MSN, RN-BC

Getting Ready for Your First Psychiatry Appointment with Jen Smith, MSN, RN-BC

May is Mental Health Awareness Month. When it comes to mental health awareness an understanding of how to navigate psychiatry and therapy appointments can help with the anxiety that might come with starting a new treatment. With that in mind, we asked our provider team what they want people to know about getting mental health care.

In this article, we’ll be sharing tips from Jennifer Smith, a registered nurse and nurse educator at Heading Health with centers in Austin, and Dallas-Fort Worth, on how to prepare for your first psychiatry appointment.

Here are Jen’s tips before your first session:

Tip 1: “Feel free to write down a list of questions you want to ask your provider.”

It’s helpful to remember that your providers are on your team, and there to support you exactly as you are. While it can be nerve-wracking, there is nothing to fear.  Remember that you are doing something positive for yourself, and the agenda and goals you have for your health are important. Your Psychiatrist will be eager to learn more about you and your needs. 

Before your appointment, take some time to think about any questions you may have for your provider. Writing them down can help you remember them and ensure you get the answers you need. You might want to ask about your diagnosis, treatment options, medication side effects, treatment duration, follow-up appointments, and self-management strategies.

Tip 2: “You can take notes too! Write down notes from your provider.”

You might have a vision of a doctor with a clipboard, or a screen where they are writing down information in your chart.  Sure, that’s an important part of keeping track of your needs and information from your session.  But the provider isn’t the only one who is allowed to write down information. You can keep notes too.

During your appointment, your provider will likely discuss your symptoms, medical history, and treatment options with you. To help you remember important details and discussions, take notes. You can use a notebook or note-taking app on your phone. 

Some practices, like Heading Health, have digital communication systems that allow patients to ask questions of their provider through a secure patient portal. This can be helpful when you have questions between appointments. 

Tip 3: “There will be tasks including paperwork. Complete paperwork prior to the appointment, bring a list of medications and a summary of your health history.”

Before any medical appointment, even those that take place via telehealth, there is necessary intake paperwork that has to be filled out. This includes insurance information, consent, medical history, and sometimes it also includes information about appointment and care preferences.  Completing this paperwork prior to the appointment is best.

When it is time for the actual appointment bring a list of medications you’re currently taking and a summary of your health history. This information helps your provider understand your medical background and any medications you’re currently taking. 

Make sure to include the medication name, dosage, and frequency. Additionally, include any medical conditions you have, surgeries you’ve had, and allergies you have.

Tip 4: “Remember, it’s totally ok to be nervous.”

It’s natural to feel nervous before your appointment. After all, you’re discussing something personal and may not know what to expect. However, your provider is there to help you and provide the best possible care. If you’re feeling nervous, try taking deep breaths and remind yourself that you’re taking an important step towards improving your mental health. 

It might be helpful to tell a supportive friend or family member about how you’re feeling before and after your appointment. Or, keep a journal about your experience. It can be helpful to express feelings or anxieties about the process and may even be helpful to reflect on it later.

Tip 5: “Keep in mind that you know yourself better than anyone else. Be your own advocate.”

Remember that you know yourself better than anyone else. Speak up about your symptoms, ask questions, and share your concerns. If you’re not comfortable with a particular treatment option, let your provider know. If you feel like you’re not being heard, don’t be afraid to seek a second opinion. By advocating for yourself, you’ll ensure that you’re receiving the best possible care.

It’s also ok to speak up if something feels out of sync. Often times bringing up concerns about communication or fit during care can feel daunting. But, it’s important to speak up. Your care team wants to know if you feel like the work you are doing together is gelling, and also won’t be offended if it’s time to match you with a provider that might be a better fit either within the same practice or by referring out.

In summary, preparing for your first psychiatry appointment involves writing down your questions, taking notes, bringing a list of medications and health history, acknowledging that it’s normal to feel nervous, and being your own advocate. By following these tips, you can have a successful first appointment and start your journey towards better mental health. Remember, seeking mental health care is an important step towards taking care of yourself, and you deserve the best care possible.