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How Does Ketamine Treat Depression?

How Does Ketamine Treat Depression?

It’s normal to have times when you’re unhappy, anxious, or just want to be left alone. But if these emotions become all-consuming and result in self-isolation from family, friends, or others, thoughts of harming yourself, and your quality of life takes a nosedive, you may be experiencing depression. Fortunately, many treatment options are available, including ketamine.

What is Depression?

Depression (major depressive disorder) is a widespread and serious medical ailment that negatively affects your feelings, your thoughts, and how you act. Luckily, it’s also a treatable condition. Depression triggers feelings of sadness, and you may lose interest in things you used to enjoy doing. For many, it can result in many emotional and physical problems, seriously hampering what you do at work, home, and elsewhere. It affects nearly 40 million U.S. adults, and even more globally.

What is Ketamine?

Ketamine is a medicine that started out as a human anesthetic in the early 1960s. Since that time, it’s been used in pre- and post-operative settings, as a sedative for injured or unruly people and, for more than 50 years, to treat symptoms of mental illness, chronic pain, and other conditions which aren’t responsive to standard therapy. Ketamine is undoubtedly successful when applied in a controlled manner, and was approved to fight treatment-resistant depression in 2019.

Know the Symptoms

Everyone reacts to depression differently, and, as such, its symptoms are unique for each person. But generally, the symptoms can be mild to severe and may include:

  • Being sad or having a low mood
  • Lack of interest in hobbies or favorite pastimes
  • Changes in eating habits, leading to weight loss or gain
  • Problems sleeping or sleeping too much
  • Low energy or amplified fatigue
  • Doing more purposeless physical activities (you can’t sit still, pace, flail about) or slowed speech or movements (these activities must be clear enough to be observed by others)
  • Feeling worthless or guilty
  • Problems thinking, concentrating, or decision making
  • Thinking of death or suicide

Symptoms must last at least two weeks and must represent a change in your previous level of functioning for a diagnosis of depression.

Ketamine for Depression

It’s not entirely obvious how ketamine works. It applies an antidepressant effect through a new process, but ketamine might be able to help you successfully manage depression symptoms when others haven’t worked.

Ketamine targets NMDA receptors in the brain, binding to them and appearing to boost the quantity of a neurotransmitter called glutamate in the places between neurons. Glutamate then triggers connections in the AMPA receptor. Combined, the early blockade of NMDA receptors and activating AMPA receptors leads to the release of different molecules to help neurons communicate amongst themselves along new pathways. This process is known as synaptogenesis, and likely affects mood, thinking, and reasoning.

GABA and glutamate are known playmakers in seizure disorders and schizophrenia. Combined, the two create a multifaceted push-and-pull reply, sparking and discontinuing electrical activity in the brain. It’s possible the two may oversee regulating most brain activity, including mood. Further, severe stress can change glutamate signaling in the brain and impact the neurons “that make them less adaptable and less able to communicate with other neurons.”

The short translation? Depression and stress make it tough to deal with negative events, which is compounded for someone already challenged with challenging things in their lives. 

How else does ketamine potentially influence depression? It could, for instance, reduce signals intertwined with inflammation, which is linked to mood disorders, or enable communication within some regions of the brain. It may also strengthen or repair damaged neurotransmitters like glutamate. Ketamine likely works in many ways concurrently, but more research is needed to understand them.

Diagnosis & Treatment

Diagnosing depression depends on:

  • A physical exam, usually performed by a healthcare provider who’ll ask about your health. It’s possible your depression is linked to an unknown physical health problem.
  • Lab tests, like a complete blood count or a thyroid test to ensure it’s working as it should.
  • A psychiatric assessment. A mental healthcare provider will ask about your behavior, feelings, symptoms, and thoughts. You may be asked to complete a questionnaire to provide answers to these questions.
  • Comparing your symptoms to criteria for depression in the Diagnostic and Statistical Manual of Mental Disorders, published by the American Psychiatric Association.

Treatment may involve certain kinds of psychotherapy or medicine or a combination of both. Another option is counseling paired with ketamine therapy, but ask your doctor which is right for you based on symptoms and overall health.

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