Driftless Health: A first in Iowa, Lansing clinic offers ketamine therapy

By Kate Klimesh,

When Dr. Erica Burger, owner/psychiatrist at Driftless Integrative Psychiatry in Lansing, graduated from medical school and completed her psychiatry residency at a major hospital chain, she knew traditional medicine would not be her calling.  

When Dr. Erica Burger, owner/psychiatrist at Driftless Integrative Psychiatry in Lansing, graduated from medical school and completed her psychiatry residency at a major hospital chain, she knew traditional medicine would not be her calling.  “I wanted more for my clients, and I truly felt there was a better way to promote health and provide treatment than standard medical practice.”
Burger almost went into organic farming while studying at Northern Michigan University, but made a course correction, and pursued and earned her medical degree at Des Moines University and became a physician 7 years ago.  “That’s when I fell in love with the area, and knew I wanted to stay in the Midwest.” She then completed her four-year psychiatric residency at the Hennepin County Medical Center and Regions Hospital in the Twin Cities, while training in integrative psychiatry. “I realized I wanted to practice in a truly holistic way, and I would not be able to do that in traditional medicine.  That led me to open my own practice in downtown Lansing,” Dr. Burger added.  
Integrative psychiatry looks as much at medical causes of mental illness, and uses a multi-dimensional approach, with somatic therapy techniques, which focuses on experiencing a connection between body and mind to release stress, tension, and trauma in the body, including looking at a patient’s lifestyle and exercise habits while ruling out medical causes for mental health issues. In the field of integrative psychiatry, supplements, botanical support, teachable skills for emotional regulation, and the thoughtful use of medications can be utilized.
Somatic therapy incorporates body-oriented modalities such as dance, breathwork, and meditation to support mental healing, which are all supported and promoted by Dr Burger, as part of a holistic approach to healing. Burger also uses nutritional therapy –  food as medicine approach – as a way to affect positive change on the body and affect mental health.
With all these modalities to help treat patients, the most pioneering and unusual is Dr. Burger’s use of ketamine, a dissociative agent with psychedelic properties, in patients who are assessed as eligible candidates for the treatment.  This usually means clients who have found no progress or relief from other treatment options for chronic depression and is showing to be quite effective for PTSD, anxiety, OCD, eating disorders and substance use. 
Dr. Burger trained in ketamine at the Ketamine Training Center in upstate New York, as recommended by a fellow medical colleague.  She was able to experience the effects of ketamine in a monitored, safe setting with peers, and learn how to help others through the experience to glean a useful tool for her patients who may have not found benefit with the traditional therapy and medication route..   
Dr. Burger is the first licensed ketamine therapy provider in Iowa.  As a front-runner, she noted that has come with challenges as well as benefits for her patients.  “This is a pretty new realm of therapy.  I was able to experience ketamine personally so I can share my experiences with my patients.  That helps me understand patients’ experiences during their healing journey as well.”
I listen to people’s story and help them find meaning in their stories and insights.  Therapy in general is an empowering, it takes conventional medicine – pills and therapy – and puts it on its head. It’s not about me giving you recommendations or advice – telling them what’s best for them.  With Ketamine therapy, it’s a very intuitive, spiritual experience that allows you to listen to your inner healer, helping you to trust themselves and is a very empowering tool. I’m there to make a safe space and help them translate what they experience.”
Dr. Burger noted that for some clients who don’t respond to other treatments, ketamine, initially approved by the FDA as an anesthetic for adults and children in the 1970s and safely used as a sedative for decades, can be an option, and the only legal psychedelic option for therapeutic clinical settings in the U.S.
 Dr. Burger added that ketamine, legalized for use under clinical psychiatric and medical treatment, isn’t a true ‘psychedelic’ drug, but can can have psychedelic effects – especially at higher doses.  It is considered an off-label use of the drug, meaning not its primary prescribed use, but Dr. Burger noted many drugs used in psychiatry are off-label uses.
“Like many drugs used in psychiatry, we’ve observed potential mechanisms of action. We can’t tell you why they work, but we do keeping learning about proposed mechanisms, and studies continue to come out, but we do know they are effective.  It’s very dynamic.”
There are three different ways doctors think ketamine therapy works::
Ketamine increases neuroplasticity by increasing BDNF( brain derived neurotrophic factor), which acts as a growth signal for brain cells and neural connections.  Other options to stimulate BDNF are exercise and getting outside. Antidepressant medications can also increase BDNF – which is why they are helpful for chronic depression.  
Ketamine regulates the activity of the Default Mode Network, which can help reduce negative thinking and obsessive thinking.  It can help people get “unstuck” and feel more hopeful.
Ketamine also blocks glutamates, an excitatory neurotransmitter associated with inflammation and depression.  
Dr, Burger stated, “these are proposed mechanisms, studies continue to come out – it’s a very dynamic field.  We keep learning how they work, but we do know they are working.”
“I was a skeptic before I began reading the literature, and I care about effective tools, and I have felt this is a very effective tool.  The more I read and learned, the more benefits I can see for some patients. It is not a cure-all, it’s just a helpful tool – one that requires work and commitment to the treatment by the patient. They have to be open to the amount of self-reflection and introspection ketamine brings about.”