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Ketamine-Assisted Psychotherapy

Updated: Aug 20, 2023

Learn about what ketamine is, how it's used in mental health treatment, and how you may benefit from this cutting-edge and legal form of psychedelic therapy.


What is Ketamine & How Does it Work?


Ketamine is classified as a dissociative anesthetic drug and was originally FDA approved for medical use in 1970. Ketamine is FDA approved to be used as a medication to provide anesthesia or pain relief during medical and surgical procedures. In 2019, the FDA approved a nasal spray called esketamine, which is derived from ketamine—to support patients with treatment-resistant depression. Ketamine is now widely used "off-label" to support people with an array of mental health difficulties.


Scientists are still trying to figure out exactly how ketamine works, but research so far shows that ketamine works by changing the way our brain cells communicate. Ketamine blocks a receptor in our brains called NDMA that is thought to play a role in depression. Unlike other antidepressants, which usually work on serotonin or norepinephrine pathways, Ketamine works via the glutamate pathway. Over-activation of glutamate receptors may contribute to depression, and Ketamine may work in part by blocking these glutamate receptors.


Ketamine is also a powerful anti-inflammatory medication. Since depression has been linked to chronic inflammation, this may also be part of it's antidepressant effect. Overall, ketamine is thought to create neuroplastic changes in the brain, which facilitates the growth of new neuropathways. Neuroplasticity, is the ability of neural networks in the brain to change through growth and reorganization. It is when the brain is "rewired" to function in some way that differs from how it previously functioned.


Research is growing to show potential benefits with use of Ketamine in treatment for many diagnoses including but not limited to: treatment-resistant depression, bipolar depression, suicidal ideation, OCD, PTSD, substance use disorders, anxiety, anorexia, chronic pain, and chronic relational problems.

What is Ketamine-Assisted Psychotherapy?

There is a difference between “Ketamine treatment" and “Ketamine-assisted psychotherapy”. Nowadays, there are many clinics where you can go in and receive administration of ketamine under the supervision a licensed medical professional. A potential problem with this is that treatment without psychotherapy puts the recipient in a passive position. They are not called upon to participate in their own treatment (except to show up for the appointment), and all of the “magic” is attributed to the chemical action of the medication. This could also lead to psychological dependence on ketamine to provide symptom reduction.


In Ketamine-Assisted Psychotherapy, ketamine and it’s benefits are used as a lubricant in the psychotherapy process. Meaning that you work with a therapist before, during and after your ketamine sessions. The goal is to use ketamine as a tool by capitalizing on the therapeutic benefits it provides, to support you with doing deep, inner work using your own internal psychological resources. Multiple studies show Ketamine + Psychotherapy works better than Ketamine treatment or psychotherapy alone. It is important to feel safe and supported by someone who knows how to hold space for this type of work in order to have a positive experience. And having proper guidance and support throughout the process is essential to creating lasting change over time.


Want to learn more?


I go deep into this topic and the nuances of working with ketamine on an episode of the Locally Well Podcast, which is linked below. Please give it a listen if you'd like to learn more about this treatment and if it may be right for you.





With Love & Gratitude,

Ann





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