Ketamine is a legal, safe and effective treatment option for treatment-resistant depression (TRD), major depressive disorder, PTSD, and anxiety.  It has the potential to accelerate the healing process in individuals suffering from an array of distressing mental health symptoms.

 

Ketamine therapy combines the therapeutic effects of the drug with the support of a trained guide.

Since it came on the market as an anesthesia drug in the 1960’s many physicians have observed and reported its antidepressant effects. But we've just seen in the last 20 years a resurgance of its use for depression as ketamine clinics have popped up across the nation. It  is the first truly new antidepressant in over 30 years, as it works on an entirely different neurotransmitter system, the glutamate system.  Every other antidepressant on the market works on the monoamine system – to enhance serotonin, dopamine, and norepinephrine.

In the early 2000’s that formal studies began looking at the effects of low-dose (subanesthetic) ketamine  on depression.  Since then there have been hundreds of papers repeating the overall positive effects, demonstrating we in fact do have a new, fast-acting, low side-effect medication for depression, and especially hopeful for treatment-resistant depression. 

Ketamine is a dissociative analgesic.  In higher doses it puts one to sleep, but in lower doses the individual remains conscious of the dissociative nature.  Many clinicians believe this dissociative state is an unwelcomed side effect.  Others believe it is part of the transformation process and can be used to benefit the patient in the correct therapeutic setting. 

In simple terms, it’s as if this dissociative state turns off the normal thinking “ego” mind, and people are able to think about situations and feels emotions without their usual charge – one may be thinking of a triggering event, but it does not produce discomfort.  In this state we are able to observe ourselves in a detached way that proves very helpful when it comes to modifying behavior. 

What I see most in my practice is a return to joy. Patients often say “I didn’t know I could feel that way again,” and “I’ve been depressed so long I didn’t remember what it felt like to not be depressed.” This brief (ketamine session last one-two hours) encounter with a joyful (or at least neutral) state is enough for the brain to begin to rewire itself around the experience, and start to produce new pathways. 

Having an experienced guide depends the experience and allows for the integration of insights, helping to establish long-term relief and true change.  As my mentor, psychiatrist Phil Wolfson, MD teaches, ketamine is "a time out from ordinary mind," allowing a much needed respite from the psychological exhaustion brought about by depression. 

 

"Ketamine’s potential lies in its ability to catalyze individual transformation. The primary effect of ketamine seems to be its ability in recipients to shift their awareness from one fixated mind-state or perspective to a new one. Hopefully and usually, this kind of paradigm shift leads to a more enlightened view of their human condition. With adequate attention given to set and setting in its application, this can lead to better personal behavior." - Michael Ziegler

"What I love most about Dr. Kalstein is how she shows up. She is one of the very few that is with me totally. When I am with her the environment is like an inner home that is safe. It allows the ability to express what ever arises in the moment. In my time with Dr. Kalstein I have had extraordinary breakthroughs in many areas that were not fully seen and accepted, I now have gone more deeply into truly accepting the variety of experiences of my life.”

- Sasha H, ketamine patient