Ketamine, originally developed as a surgical anesthetic, has emerged as the most effective treatment against depression. This has been demonstrated by the experience of hundreds of clinics across the country, as well as multiple research studies at prestigious institutions such as Yale, Mt. Sinai, UC San Diego, and Johns Hopkins. Ketamine is effective for all types of depression, including:
- Major Depressive Disorder (MDD)
- Treatment-Resistant-Depression (TRD)
- Unipolar and Bipolar Depression
- Post-Partum Depression
Depression, or Major Depressive Disorder
Depression, or Major Depressive Disorder (MDD) is defined as a persistent state of low mood and aversion to activity. To someone with depression, they describe it as a loss of that which makes life worth living. The core symptoms of depression can include:
- Suicidal thoughts
- Anhedonia, or a loss of interest in pleasurable activities
- Feelings of extreme sadness
- Hopelessness and despair
- Difficulty with thinking and concentration
- Low motivation
- Low self-esteem
Depression is believed to be caused by a combination of genetic, environmental, and psychological factors. It is often first brought on by stressful life events, such as the loss of one’s spouse or job. Specific risk factors include a family history, major life changes, childhood trauma, being a victim of abuse or bullying, certain medications, certain physical diseases, and substance abuse. About 40% of the risk of developing depression appears to be related to genetics. Some people have periods of depression separated by years in which they are normal, while others nearly always have symptoms present.
Depression frequently co-occurs with other mood disorders (which are also usually responsive to Ketamine therapy) such as
- Generalized Anxiety Disorder (GAD)
- Social Anxiety Disorder (SAD)
- Post-Traumatic Stress Disorder (PTSD)
- Obsessive Compulsive Disorder (OCD)
In addition, those suffering from Chronic Pain frequently also suffer from Depression and/or other mood disorders. As much as 85% of chronic pain patients have depression.
Treatment-Resistant Depression (TRD) is most commonly defined as major depression which has failed to respond to at least two classes of antidepressant medications, with a sufficient dose and duration. Failure to respond means either the depressive symptoms did not get better, and/or there were unacceptably severe side effects. As much as sixty percent of MDD patients do not respond to traditional antidepressants, i.e., have TRD.
Since traditional antidepressants often take two months to reduce depressive symptoms, many patients lose years of their life in a desperate sequence of trying one medication after another to find an effective medication. Meanwhile, their quality of life is horrible – they keep suffering with hopelessness, low mood, no motivation, despair, and recurring suicidal thoughts about how to end the suffering. At our Boulder Mind Care clinic we have treated TRD patients who have tried more than fifteen to twenty different medications to treat their depression.
We opened our Ketamine clinic to help the victims of TRD in northern Colorado, who were still suffering, losing relationships and jobs, often contemplating suicide. Ketamine has been well established in multiple scientific research studies at institutions such as Yale, Johns Hopkins, and the National Institute of Mental Health, to reduce depressive symptoms in 70% or greater of TRD patients. And Ketamine works rapidly, sometimes within hours, and has minimal to no side effects, in contrast with traditional antidepressants.
Bipolar disorder (BD) is very responsive to Ketamine infusion therapy. BD was previously known as “manic depression”, and is characterized by periods of depression alternating with abnormally elevated moods. If the elevated mood is either severe, or if it is associated with psychosis (delusions or hallucinations) it is called mania; if it is less severe, it is called hypomania. A person with mania, behaves or feels unusually energetic, happy, and/or irritable. As with unipolar depression, BD is caused by a combination of environmental and genetic factors; however, the genetic contribution is about twice that of unipolar depression, i.e. 70% – 90% vs 40%. Bipolar disorder is classified as bipolar I disorder if there has been at least one manic episode, with or without depressive episodes. Bipolar II, on the other hand, is defined as a history of at least one major depressive episode with at least one hypomanic episode (but no full manic episodes).
Post-Partum Depression (PPD) develops in 15% of women giving birth. The “Baby Blues” are often experienced in the first two weeks after childbirth due to lack of sleep, stress about the baby and being a ‘good-enough’ parent, in-laws, finances, etc. PPD is characterized by severe adverse changes in mood with depression and anxiety beyond the first two weeks. PPD symptoms do not resolve without treatment – and time is of the essence. This is the period when the all-critical bond develops between mom and baby; without bonding, the baby suffers emotionally and physically, which can have long-term adverse consequences into adulthood. In addition, without treatment, the mom is at risk for suicide. A recent study1https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5573543/# found that suicide accounted for 1 out of every 19 (5.3%) deaths in pregnant or postpartum women. Further, suicide most often occurred at 9 to 12 months after childbirth in the women in this study.
Ketamine infusion therapy is ideal to help women suffering with PPD, because of the rapid onset of improvement (within hours to days to reverse suicidal thoughts and other symptoms of depression, compared to the four to eight weeks typical of conventional antidepressants). Ketamine quickly lowers the risk of suicide, and allows the mother to bond with her baby.
Ketamine appears in small amounts in the breast milk; however the conventional antidepressants (SSRIs, SNRIs, atypicals, and antipsychotics) are rated as “Category D”, which means that they have all been shown to cause problems in the breastfeeding offspring of mothers given Ketamine. In contrast, Ketamine is rated as “Category C”, meaning it is unknown if it could cause problems in the baby. Due to both legal and ethical concerns, human studies have not been conducted specifically looking at whether Ketamine causes problems in the infant when passed through the breastmilk. However, it seems unlikely, as anecdotally, many pregnant and breastfeeding women have received Ketamine for various reasons, and to date there have not been any case reports of adverse effects.
Suicidal Thoughts or Ideation
Suicidal thoughts or ideation (SI) are a dangerous symptom of depression. At least 60% of people who die by suicide were known to have Major Depression, with a higher risk if there is also a dual diagnosis (ie alcohol and/or substance abuse). The suicide rate in the United States has risen every year since 1999. Furthermore, with the onset of the Coronavirus pandemic, this rate is trending even more sharply higher. There is hope, however, as suicidal ideation is especially responsive to Ketamine. Ketamine infusion therapy has been demonstrated to diminish or abolish suicidal thoughts in as many as 91% of patients suffering from SI.