As mental illness continues to be a significant challenge for many people, some are turning to more unconventional treatment options. One such treatment, ketamine-assisted psychotherapy, may offer the breakthrough that’s needed.

Ketamine-assisted psychotherapy, or KAP, is getting more attention as a viable option, particularly for depression that doesn’t respond well to other methods. It works quickly and can lead to lasting improvements.

The fast-acting therapy may be an appropriate solution for those at risk of suicide, and though not quite mainstream it is gaining popularity for its effectiveness and comparatively low risk.

What Is Ketamine-Assisted Psychotherapy?

Ketamine is historically an anesthetic with a reputation for safety. Synthesized in the 1960s, it’s today routinely used in hospitals for its sedative properties – it’s even safe enough in low doses for babies. But you may have heard about its other uses – as a recreational drug known as Special K. The drug offers pain relief along with an experience described as a trance, or dreamlike state.

Dissociation and hallucinations caused by ketamine are thought of as side effects when used for its other properties. These effects though are what many find make it especially useful in certain applications for mental illness. Rather than taking the medication alone or in an isolated setting, patients who undergo Ketamine-assisted psychotherapy can experience significant improvements with the help of an experienced therapist.

Significant improvements in depression and other conditions can come from having the Ketamine experience itself and someone to help interpret what comes up during it. This “dissociative anesthetic” is currently the only psychedelic drug that has FDA approval for such an application.

Ketamine, like many other medications used for treating mental illness, works with neurotransmitter receptors in the brain. These are how the brain – and the rest of the body – communicate important information. Most times we hear about serotonin and dopamine as the neurotransmitters affecting mental health, but Ketamine works on a different one – glutamate.

It works to make new connections possible within the neural network, an important process for learning. This neural growth is what works to facilitate change and lead to longer-term healing. It may be that in individuals with treatment-resistant depression the brain is no longer able to make neural connections as readily.

When this problem is alleviated, the insights gained in therapy are able to be integrated and contribute to more long-term positive outcomes. Ketamine’s interaction with glutamate receptors may also contribute to its dissociative effects.

Why Use Ketamine-Assisted Psychotherapy?

Ketamine has been used “off-label” to treat not just depression and anxiety, but PTSD, addictions, and bipolar disorder.

It has also been used to help with grief and major life transitions as well as chronic pain. With Ketamine-Assisted Psychotherapy, the ketamine experience is an opportunity to see things differently, with the help of an experienced therapist to help process what comes up. The psychoactive effect makes it easier to talk about difficult topics, enhances empathy and connection, and opens up greater meaning.

Essentially Ketamine’s effects appear to help a person uncover things we would normally shy away from and avoid thinking about. The things we push to the deep parts of our minds that contribute to depression and other ills. With a trusted professional, in a safe environment, these feelings brought up can be worked through and released. Another aspect of how the treatment works is the body’s response to those painful thoughts.

We don’t tend to think of dissociation as something that could help depression, but for treatment-resistant depression, this unique approach may help. It’s thought that being able to identify and process painful emotions – without the strong reaction in the body normally experienced when remembering trauma for instance – is key to the dissociation being helpful in the context of Ketamine-Assisted Psychotherapy. And because Ketamine makes neural connections happen more readily and faster, it can help to overcome the brain being unable to make new connections.

This medication can help to open up those spaces for breakthrough that would likely take a lot longer without the assistance of the medication. Essentially the medication “softens psychological defenses” to allow these breakthroughs to become possible. The treatment can add a spiritual component to work in therapy alongside the biological reactions.

Many describe Ketamine-Assisted Therapy as a bit of a shortcut in terms of getting to some deeper issues that would normally take longer to work through in therapy, but it definitely shouldn’t be considered a quick fix.

What Is A Ketamine-Assisted Psychotherapy Session Like?

Before the first session, you can expect an intake or screening process to determine eligibility. The treatment isn’t a good fit for everyone – it could be unsafe for people with certain conditions. There may be quite a long waitlist as well. Even as the treatment grows more popular, it still isn’t widely accepted or utilized by all mental health practitioners. If eligible to move forward, you’d likely have several sessions with the therapist first over the course of a few weeks, to further assess whether treatment is the best option. A Ketamine-Assisted Psychotherapy session might last anywhere from 90 minutes to 3 hours. The medication might be administered in a tab under the tongue or in a spray. Within a relatively short time, half an hour or so, the dissociative effects can be felt. Some have described vision changes like seeing space or the sky behind closed eyes.

After taking Ketamine a person may physically become nauseated, dizzy, or have an increase in blood pressure or blurry vision. The therapist or psychiatrist is there from when the first effects appear to after it subsides, to monitor throughout the entire experience. The immediate psychological effects can be profound – dramatic improvements to mood can take place right away. But as the effects of the medication wear off after a single treatment, a course of several sessions is recommended for the full benefits. Such a course of treatments may have lasting benefits for individuals with treatment-resistant depression. After a Ketamine-Assisted Psychotherapy session, there are usually follow-up sessions to integrate what came up during the experience with the medication.

The benefits of Ketamine-Assisted Psychotherapy of course must be weighed against the risks. Fortunately, there are an increasing number of mental health professionals experienced with this treatment that can help decide if it’s a good option.

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