In my last blog, I shared about my journey this past year and one of the treatments that have helped me heal – ozone therapy. Another treatment, Ketamine Assisted Psychotherapy (KAP), has made a tremendous difference in my mental health and journey to overcome chronic pain. The purpose of sharing my healing journey is to raise awareness about Ketamine Assisted Psychotherapy and overcome the stigma associated with this clinically-proven method of treating mental health and chronic pain.
Although ketamine has been used for decades by anesthesiologists in surgery, its use for the treatment of depression, PTSD, and chronic pain is fairly new. Much is still unknown about how exactly it works, but in the last two decades, researchers have determined that ketamine – when used medically – rewires the brain by reforming synapses that were lost due to chronic stress or trauma. This effect can be felt within hours, as opposed to traditional SSRIs which can take weeks to begin working. Not only this but while SSRIs only work when actively in your system (thus causing rebounds if you try to go off of medication), ketamine’s effects may persist longer term. The brain does not rely on daily medication but rather is stimulated to repair and continue functioning after a brief period of ketamine treatment. Ketamine has even effectively alleviated previously treatment-resistant depression.
Another fascinating aspect of Ketamine Assisted Psychotherapy is that the new synapses formed make the brain more adaptable. This is called neuroplasticity. If you’ve ever tried to change an unhealthy pattern or thought process, you may have found yourself stuck, wondering how to retrain a brain that is set in its ways. Ketamine treatments stimulate the brain to form new neural pathways, so working on positive thinking and self-love during the time of treatments may encourage those specific parts of the brain to grow, making it easier to create lasting change. It is for this reason that doing some form of therapy during ketamine treatment can greatly increase the long-term benefits.
My journey with KAP
Like many others in the Mighty Well community, I was prescribed antidepressants at the start my treatment for chronic illness. In January of 2020, I sought out an alternative antidepressant therapy as a way to get off of traditional SSRIs. The medications I had been taking since I was 17 didn’t seem to be working as well as they did when I was younger. My experience with SSRIs suggested that they were masking, rather than treating, my underlying challenges.
I was ready to get to the root of my struggles with depression, medical PTSD, and chronic pain. Despite my concern about staying on antidepressants long-term, I still needed an improved mental health approach. I had researched using ketamine for treatment-resistant depression and managing chronic pain. As a result of this research, I decided to incorporate it into my own treatment regimen under medical supervision.
There are four different ways to administer ketamine:
- Sublingual lozenges
- Esketamine, an FDA-approved nasal spray
- Intramuscular (IM) injection
- IV infusion through a Peripheral Intravenous Line (PIV)
Sublingual lozenges were recommended as the gentlest method of treatment. Some insurance may cover ketamine treatments for chronic pain, and there is currently a push to make it more widely covered for mental health. I underwent eight rounds of Ketamine Assisted Psychotherapy and was able to get off of my SSRI with the supervision of a medical professional and integration coaching.
According to Leia Friedwoman M.S., a psychedelic integration facilitator, “Psychedelic integration is the process of distilling down our insights and experiences from a journey into something that we can incorporate in our day-to-day lives. Ketamine Assisted Psychotherapy can be healing all on its own, but many folks find that it is helpful to have support outside of the session for processing and exploring the images, emotions, and sensations that came up during the trip.” Although there are some holistic ketamine centers that offer preparation, ketamine sessions, and integration support, there are a number of clinics approaching ketamine therapy from a purely medical standpoint. These clinics do not provide integration support, and some do not even offer to have a therapist or support person present with the patient during their ketamine treatment. It’s important that any person considering ketamine treatment spend time to figure out the sort of support and container that is most supportive and appropriate to them.
I chose to complete a program called mindbloom, an at-home ketamine therapy program with telehealth. I don’t recommend this for everyone, but it was the right fit for me because of the accessibility, price point, and convenience of completing treatment in my own home. If you are looking for a different approach, there is now an abundance of clinics and approaches available.
Some are more traditional medical settings that can be very hospital-like, while others are more meditative or spa-like. Many people accessing these clinics are seeking a way to get off of SSRIs as well, to treat long-term or treatment-resistant depression, and/or PTSD. I have also heard from folks in the chronic illness community who are using ketamine at a much lower dose to treat chronic pain, such as starting with 25mg and working up to 100mg. Friedwoman notes, “This dose is low enough that it will likely not cause any mind-altering experience, although this all depends on a person’s weight and the way it is administered.”
The ketamine experience
Though not all consider ketamine to be a psychedelic, it is included in the emerging field of legal psychedelic therapy. Technically, it is considered a dissociative medicine. For me, undergoing a guided ketamine therapy session was like watching a movie while in a meditative state. I felt very calm and was able to revisit very difficult experiences in my life from a loving perspective. It was not scary at all and, in fact, was very enjoyable. I only felt the mind-altering effects of the medicine for about 45-60 minutes.
While ketamine poses an exciting and interesting opportunity for many, it does not come without risks and important considerations to make. Although this hasn’t been seen as widely in clinical use, there is a very real risk of ketamine addiction, so people need to be mindful and work with a medical team or experienced professional. The Mighty Well team recognizes the elitism and privilege required to access medical treatment; at the same time, this treatment is not something one should attempt alone. The current hype about psychedelic medicines such as ketamine can also lead to expectations, which may result in disappointment when people have their own unique first experience. “Ketamine healing is not necessarily a linear path; for some people, the medicine may take them in a different direction than they expected or wanted to go. Part of the journey is bringing curiosity and compassion in when you process the places the medicine has been taking you,” says Friedwoman.
For me, eight rounds were enough to achieve breakthrough mental health results and taper off of my SSRIs and nerve pain medication. It gives me great pleasure to share that my mental health is in amazing shape today, and I am proud to say that ketamine therapy helped to change my life for the better!
Finally, there is a stigma around ketamine being a “club drug” but it is FDA approved and has been used for over 50 years with surgeries. Many patients wonder about the legality of ketamine. While abuse of this controlled substance is illegal, medical use (when prescribed and monitored by a doctor) is legal. Because it is safe (albeit with a potential for psychological addiction, due to the dissociative quality of the experience) and becoming more mainstream, ketamine is not difficult to access as a medical treatment. If you are curious about it, ask your doctor if it might be a good fit for you.
Would you like Mighty Well to cover more about emerging psychedelic therapy for mental health and chronic pain? Let us know in the comments, or email us at [email protected]!