Some people find relief from depression with ketamine, which is approved by the Food and Drug Administration as a surgical anesthetic.
Jason G, who asked GPB News not to use his full name, is the 46-year-old Atlantan who described his first experience with ketamine as eye-opening.
“Once I realized I was in this dark box,” he said. “And as the light was reaching my eyes, I could see all these tiny little threads, almost like spider webs attached to my body from somewhere in space. They are all attached to me.”
He felt like a doll pulled by strings.
Spider webs represent all the different pressures, responsibilities, negative thoughts and pressures that pushed him in different directions.
Jason said, “I remember a voice in my head asking, ‘Are you ready to give up? “
He said, “Yes.”
That’s when the web released it.
“I cut all of those strings at the exact same moment, and it just felt like releasing this tremendous sense of relief, this overwhelming positive feeling,” Jason said.
The ketamine trip was something Jason said he would never forget. His experience taught him to reframe the way he perceives stress.
Ketamine, while in the hallucinogenic category, does not always produce hallucinations. The mind-altering drug has been used for years off-label with patients with treatment-resistant depression and PTSD.
Reactions include severe changes in mood, perception, thinking, body perception, and self-control that some patients find frightening, while others do not.
Dr. Michael Muench leads the Atlanta Field Clinic for the wellness trip where Jason and his wife find relief.
The Toronto-based drug therapy company opened here in 2021, following other clinics opening in Toronto, New York, Los Angeles and Chicago in 2020.
As a psychiatrist, Muench takes on the medical part of the ketamine journey. It monitors the session and checks vital signs such as heart rate, breathing, and pulse.
A therapist is there to help facilitate patients’ entry into the trial, but Muench said that within about three to five minutes, patients aren’t communicating as well as in a typical speech therapy session.
Not all people talk, and that’s ostensibly unremarkable,” Muench said. “Someone will be lying there quietly, not talking, with an eye cover and noise-canceling headphones.”
But the benefit of ketamine continues even after the drug is gone.
“The course of psychedelic therapy is not mediated through pharmacology, but through vision, understanding, and experience,” Munch said. “A good way to describe it is that if you saw something, you wouldn’t ignore it.”
After traditional cognitive behavioral therapy and psychotropic medications like Prozac and Zoloft failed, Jason said ketamine helped him focus on the root causes of his anxiety and depression.
“I remember my therapist showing me exercises like, ‘After you have a negative thought, I want you to flash a red stop sign in your mind and then stop and explain to yourself why that thought is unreal. “Well, if I had to do it for every negative thought I had, I wouldn’t have time to get anything else done in my day,” Jason said.
Nidia Goeti, a therapist with the Atlanta Field Trip, said it reminds people that feelings of discomfort are not inherently bad.
When patients come off their ketamine journey, Guity lets them sit back and process their experience for a while.
“You get depressed for a reason; you get anxious for a reason,” Guity said. “So, when we actively respect those feelings, we work with them and not necessarily against them or resist them or act like they don’t exist.”
Over time, she said, these feelings will not be severe or frequent.
“This is progress,” Getty said. “There is no hiding there is no.”
Munch said depression is a very individual condition and does not necessarily stem from a single cause.
“Due to the development of selective serotonin reuptake inhibitors (SSRIs) in the 1980s, we also found [depression] Highly with serotonin levels,” he said. “The reality is that depression is actually different things for different people, and so an example might find, for example, that their treatment-resistant depression is actually very intertwined and closely related to a particular trauma.”
A Schedule III non-narcotic has been available to prescribe licensed drugs since the 1970s. Since then, multiple studies have shown that ketamine helps some depressed patients who feel like they’ve tried everything else.
But patients can only receive ketamine injections under the supervision of a psychiatrist. This is because its therapeutic benefits may decline with overuse, and the drug has the potential for abuse such as in dance clubs and rave parties.
Ketamine works differently from drugs that target the neurotransmitter serotonin, said Dr. Bawadi Dunlop, director of the Mood and Anxiety Disorders Program at Emory University.
Ketamine acts on the glutamate systems in the brain, which appear to be disrupted in many people with depression.
“There was a concordance between understanding how ketamine works, and understanding what — or a partial understanding — of what goes wrong in the brain when people become depressed,” Dunlop said.
Dunlop said much remains unknown about the underlying disease process that causes depression, but he compared it to any other physical injury, such as a broken arm.
Like a splint in a broken arm, he said, antidepressants protect it while it heals.
But sometimes the bone is so fragile that it needs surgery.
This is where Dunlop said ketamine comes in, like a surgical pin that holds these fragments together.
And ketamine works much faster than pills, which need time to build up in the body.
“Ketamine can lift them from depression to a state of remission in a relatively short period of time of two to four weeks,” Dunlop said. “And that’s a large percentage of patients who improve in this way.”
Studies show that about half of people who seek ketamine treatment for depression find some relief.
Last October, the National Institutes of Health awarded the first grant in 50 years to research the therapeutic effects of the classic drug, psilocybin, known as the “magic mushroom” on depression.
Dunlop said a new trial will begin recruiting this fall at Emory University, to study the effects of psilocybin on frustrated cancer survivors.
He said these are people who have lost their motivation and purpose in life, and have really felt like they have lost their way and how to move forward after receiving their cancer diagnosis and treatment.