Nearly 20 million Americans suffer from a form of major depressive disorder (MDD) every year. An estimated two-thirds experience severe symptoms which deeply disrupts their personal lives, relationships, and job performance.
Ketamine is a NMDA (N-Methyl-D-Aspartate) receptor antagonist. The NMDA receptor allows for the transfer of electrical signals between neurons in the brain and spinal cord. For electrical signals to pass, the NMDA receptor must be open. Ketamine blocks the channel by binding within it.
This action leads to a temporary silencing of the Default Mode Network (DMN). The DMN is a network in the brain associated with rumination. “Rumination is the thief of all joy,” a wise person once said. When ruminating the mind spends time in the past or the future replaying events, analyzing, worrying, planning, perpetuating stories about self, other, and life that are generally untrue and lead to suffering. Unconscious negative or deleterious mental habit patterns—often a result of trauma—run the show until we become aware of them. You might think of them as filters through which reality is perceived. The color of the filter determines how life, self, and others are perceived. These destructive mental thought patterns cause one to feel depressed, anxious, isolated, and disconnected from life’s grandeur. One is not in intimate communion with the dynamic flow of life.
Ketamine quiets the DMN and therefore rumination for a period of time typically lasting from 30 minutes to an hour. Since rumination is quieted, other aspects of being are available that are usually not accessible due to the business of the mind. The experience is different for everyone, and different every time. Things buried within the unconscious mind are enlightened in order to be metabolized, digested, and integrated such that they no longer unconsciously run the show. Vaster aspects of oneself are typically experienced and their fan flamed through integration. It is possible that one’s capacity to be with more aspects of oneself increases. In addition to quieting rumination via its activation on the DMN, Ketamine enhances BDNF (Brain Derived Neurotrophic Factor) which is like fertilizer for dendritic sprouting (making new & healthier mental thought patterns: that which fires together wires together).
Research supports Ketamine’s efficacy in impacting Treatment Resistant Depression, PTSD, and other conditions. Typically, six sessions are given over 2-3 weeks in two-hour sessions. Ketamine is administered by the medical provider after vital signs are monitored. The first part of the 2-hour appointment is spent in a dissociative state. There is dissociation from the surrounding environment, and partially from the body. The remainder of the appointment is spent integrating the experience. The response rate with treatment resistant depression tends to be on the order of 60-70% over the short-term. Longer term studies are lacking at this time due to Ketamine’s novelty as a treatment for depression.
Ketamine is not a silver bullet. While it can aid in the alleviation of depressive symptoms, how one cares for oneself matters a great deal. It is important to take into account sleep habits, food choices, gut (microbiome) health (a significant portion of neurotransmitters utilized in the brain are synthesized in the gut, thus when the microbiome isn’t healthy, the brain isn’t functioning properly), exercise, mindfulness and meditation (what we place our awareness upon—consciously or unconsciously—impacts the entirety of our being), sleep habits, if one uses food, alcohol, or drugs in an addictive manner, community, and how much time is spent outdoors. These factors all matter a great deal to the health and well being of the human being ecosystem. These areas are addressed during the integration process to facilitate beneficial habits.
Please see the resources and links below regarding Ketamine as used for depression.