DEPRESSIONS NEGATIVE STIGMA
Depression, along with many other mental illnesses, is attached to a negative stigma – something many people don’t like to talk about. A big part of this stigma is due to a lack of understanding and awareness of what depression is. It’s hard to understand because many people who suffer from this debilitating illness seem to have a “good” life, which of course means different things to different people. The sad thing is that depression doesn’t discriminate. A person who has a great marriage, a couple of kids and a dog at home, along with a good career and financial stability seems like they have it all, but can be suffering from depression unbeknownst to the rest of the world. This person may not even understand why he/she is feeling this way, why they’re sad when they have everything they ever wanted. Depression isn’t about who or what we have in our lives, as much as it’s about our brain and the connections it forms that regulate mood. Until recently, the answer to depression symptoms was in the form of antidepressant medications, which unfortunately only work for a small percentage of people. However, there is hope for individuals suffering from depression, a new treatment that is showing promising results. Ketamine has been getting quite a bit of attention lately as a means to alleviate symptoms of depression, so much so that the FDA approved ketamine nasal spray for use in treatment-resistant depression.
Research has shown that a deficiency in certain brain connections between specific neurons in the brain contributes to significant depression. When treating depression, most medications focus on the monoamine system, specifically SSRIs and SNRIs. These medications typically take weeks before they begin to work, if they work at all. This can be due to the fact that depression is linked to a different area of the brain, the glutamatergic system. When focusing on treating deficiencies in connections in this part of the brain, we have seen significant improvements in formerly treatment-resistant depression.
THE KETAMINE DIFFERENCE
So what’s the difference between ketamine and what we have known for years as antidepressants? For starters, they work on different parts of the brain. The standard antidepressants target the neurotransmitters serotonin, norepinephrine, and dopamine. These neurotransmitters are crucial to normal brain function, so they have been a primary focus in depression research. Ketamine targets a different set of neurotransmitters and receptors, known as the glutamatergic system. Ketamine is thought to rebalance and grow connections between brain cells that are involved in mood regulation by blocking glutamate and stimulating the brain’s ability to adapt.
When administered properly, patients have experienced fast relief from their depressive symptoms. While research continues to be conducted, currently we have seen promising results from patients who receive a series of six infusions over the course of two weeks. Because the ketamine dose is low, the side effects are minimal. We do a series of six infusions at this low dose, so the neurotransmitters and receptors begin to form new lasting connections. Typically patients will receive booster infusions, with the hope that eventually the brain will maintain the new connections and no longer need ketamine to prompt the development of new receptors and synapses. While there is still much to be learned about the efficacy of long-term use of ketamine, it has shown promising results in a field that hasn’t seen much progress in years.
RESULTS FROM KETAMINE
After speaking with several individuals who have suffered from depression and had limited relief from previous treatments, ketamine infusion therapy has given them a new lease on life. People have mentioned that depression was what they thought life was, that they didn’t know what happiness felt like anymore, and that passive suicidality were normal thoughts. After going through ketamine infusion therapy, they told me those suicidal thoughts aren’t even there anymore, that they feel happy, and they’re hopeful. Upon hearing the stories from our patients, I am thrilled that they have found relief. There were a couple of patients that gave me goosebumps listening to their stories and how relieved they were that they found something that works for them. While this may not be the answer for everyone, at the very least, it is a step in the right direction for future research.