TO YOUR HEALTH
Ketamine Assisted Psychotherapy: The “Journey” to Healing the Mind, Body and Spirit
er; but its usage for the treatment of depression and anxiety has only recently grown in popularity. The World Health Organization (WHO) has classified ketamine as an essential medicine due to its evidence of efficacy, safety, and cost effectiveness with respect to disease preva - lence and the relevance to public health. Despite its popularity in the anesthetic and pain management field, it has been used off-label for about 20 years to treat depression and anxiety. It has taken several years for the general public to consider this medication as a safe and useful option for mental health due to some bad publicity it attracted in the 1990s for its abuse and misuse as a party drug. So, how does ketamine work and what does it do to your brain? Ketamine works by blocking glutamate receptors in the brain. By doing so, it disrupts some of the communication to the nervous system which blocks the reception of pain. When ketamine is used
BY ELENI BOOSALIS, PSYD
The human experience has been wrought with anxiety and depres- sion since the beginning of time. The treatment of such mental health issues has evolved greatly for the past several centuries and has varied from bloodletting and purging to lobotomies and ECT. Fortunately, we have come a long way, but a large portion of the population contin- ues to struggle with mental illness. According to the National Alliance on Mental Illness, it is estimat - ed that 1 in 5 adults in the US will experience a diagnosable mental health condition every year. That equates to approximately 46 million people. Thankfully, the stigma of mental health treatment has im- proved in the past several decades, and it is now acknowledged there are many factors involved in cultivating a healthy body and mind.
in psychotherapy, it is used at a lower sub- anesthetic dose, which actually increases the production of glutamate. This process has been proven to increase neuroplasticity and neurogenerativity in the brain, thus allowing the client to make rapid psychological, emo- tional, and behavioral changes. The purpose of psychotherapy is to change maladaptive thinking and behavioral pat- terns, which is very challenging for most people. Therefore, combining ketamine with psychotherapy makes it more likely that the client can make changes with less resistance. You can liken it to working with wet clay and being given an opportunity to mold yourself with more ease and less discomfort. The majority of research on Ketamine Assisted Psychotherapy (KAP) indicates it is more effective than psychotherapy alone, and more effective than ketamine alone. Some benefits of ketamine are that it offers a high likelihood of rapid mood improvement in a matter of hours or days, has fewer side effects
The treatment of mental health issues such as depression has historically been man- aged with medication, therapy, or a combina- tion of the two. Traditional antidepressants have targeted Serotonin and Norepinephrine, with research showing that only about 40- 60% of individuals show some reduction in symptoms. The most commonly researched and prescribed psychotherapeutic approach has mostly included Cognitive Behavioral Therapy (CBT), which has shown to have an estimated success rate of 50-70%. While re - search supports that a combination of medi- cation and therapy is most effective, the suc - cess rate of this approach is also estimated to be between 50-70%. Unfortunately, the poor success rate of antidepressants is also accompanied with a delayed onset of 4-6 weeks for these medi - cations to reach their therapeutic potential. Furthermore, it often takes several attempts with different medicines or a combination of medicines to find the optimal treatment ef -
than traditional antidepressants, and is considered a very safe med- icine. In the long term, many clients experience a remission of MDD and anxiety symptoms as well as improved introspection, resilience, and overall mood. The goal of KAP is not only to process emotional material that has felt “stuck” or too painful to process with therapy alone, but also to access the client’s “inner healing intelligence.” By decreasing defens - es and resistance, clients can often access the part of themselves that holds the power to heal themselves. As therapists, we believe each person carries the knowledge and power to heal themself if we can just get our defenses and unprocessed trauma out of the way. Ketamine’s Holistic Journey There are three main ways to administer ketamine. For chronic, severe, and treatment resistant depression, the first line of treat - ment involves 6-9 infusions over the course of 2-3 weeks. This is of - ten recommended for highly depressed and suicidal clients for it’s fast-acting relief. It is not normally accompanied with therapy and is mostly administered in an infusion clinic. The other two modes of
fects. The likelihood of side effects also contributes to the challenge of determining the best medication and dosage for each individual. Another challenge to achieving positive outcomes is the possibili- ty of “treatment resistance”, particularly with respect to medications. The definition of “treatment resistance” is described by the US Food and Drug Administration (FDA) as “inadequate response to a mini - mum of 2 antidepressants despite adherence to treatment.” According to the Journal of Clinical Psychiatry (2021) It is estimated that 30% of adults diagnosed with Major Depressive Disorder (MDD) are clas - sified as treatment resistant. Treatment resistance also affects 30-50% of those diagnosed with Anxiety Disorders. With continued increase in the prevalence of depression, anxiety, and suicide in the US, and with such a large percentage of those individuals being treatment re- sistant, the mental health community is constantly seeking to improve the treatment outcomes of individuals suffering from anxiety and de - pression. Ketamine Assisted Treatment Ketamine is not new to the medical world. In particular, ketamine has been widely used since the 1970s as an anesthetic and pain block -
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PATHWAYS—Fall 24—11
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