Monday, March 27, 2023

Help Control Your Negative Thoughts With Ketamine Assisted Psychotherapy

Ketamine, a commonly used anesthetic, has been found to be useful as a treatment for  depression, anxiety, bipolar disorder, and other mental health issues. The drug was first  discovered in the 1960s and is sometimes known for its use as a recreational psychoactive substance. The first studies ever conducted on ketamine use in mental health treatment occurred in the early 70’s but it wasn't until the early 2000s that Ketamines's role as a treatment for resistant mood disorders was researched in larger and more robust studies. 

If you are like many people, you might feel as though your life is being run by negative thoughts.  You may feel that these thoughts control what you do and how you react to the world around you. You may not even realize how pervasive these negative thought processes are or have any insight as to their origins: childhood abuse, neglect, or trauma; addiction; anxiety and stress; depression; bipolar disorder, and more. 

Ultimately the goal of Ketamine Assisted Psychotherapy is to help one experience less of the negative thoughts, and emotional processes that plague so many people and are some difficult to make an impact on with most standard treatment modalities. 

What is ketamine, and why is it used as a treatment 

Ketamine is a medication that has many uses medically including for the treatment of pain, sedation, and induction of anesthesia but when administered in low doses can treat depression and other mental health disorders.

Ketamine works by acting on your brain's receptors, which are involved in perception and  consciousness. This alteration in normal consciousness is part of how it works to improve symptoms and an aspect of how it accelerates therapeutic progress. 

How a ketamine treatment works 

Ketamine is administered by intravenous infusion, and the effects of the medication last approximately 40-50 minutes. Ketamine works by blocking the NMDA receptor in your brain,  which controls how you perceive pain, stress, and emotion. Ketamine has been shown to be effective in treating depression because it modulates a neurotransmitter called glutamate that’s responsible for sending messages between neurons in your brain. In recent years more focus has been placed on glutamate's role in the treatment of anxiety, depression, PTSD, and chronic pain disorders and it is evident that modulating the glutamate system with medications like ketamine often produces improvements in symptoms that common antidepressants often do not improve with high response rates. The mechanism of action of ketamine is very complex, its actions on the NMDA receptor and on glutamate signaling are important aspects of how it works, but we are discovering new ways ketamine produces the responses to mood disorders it does all the time. Its effects on neuroplasticity and its use as an accelerant for psychotherapy are current areas of focus for researchers.

 Ketamine treatments and depression 

Ketamine is a powerful antidepressant that can be used in combination with other medications to  treat depression. It is often the case that the worse a patient's depression is, and the more they have done to try to treat it, the more likely it is that they will have success with ketamine treatment. 

Ketamine has been known to transiently reduce the symptoms of depression for many years, decades actually, but it was less commonly utilized in depression treatment because of the complexity of receiving the treatment and the stigmas associated with it. Most clinicians didn't see the utility in utilizing ketamine infusions to treat depression because most often the symptoms would return weeks or months after treatment. For ketamine treatments to produce reductions in depression symptoms that last beyond the chemical effects of ketamine, psychotherapy should be an integral part of the process. This fusion of ketamine administration and therapy is called Ketamine Assisted Psychotherapy, and it is what Transcend specializes in. 

Ketamine treatments for anxiety and PTSD 

Ketamine is a powerful anti-anxiety drug that has been shown to reduce the symptoms of PTSD. 

PTSD can cause anxiety, hypervigilance, nightmares, and visual or emotional flashbacks. 

When undergoing ketamine treatment for anxiety or PTSD, it is highly recommended to undergo this process with a Ketamine Assisted Psychotherapy trained therapist and to have ketamine administered by IV. It is important that the level of ketamine you are receiving is not worsening the anxiety or feelings that challenge hypervigilance during the process. Research on Ketamine Assisted Psychotherapy suggests that to influence symptoms that stem from traumatic events, it is important to process this trauma during the Ketamine infusion series. It is normal for the treatment of patients with significant trauma histories or with severe anxiety disorders to look different than those with other conditions. For ketamine treatment to be effective in anxiety and PTSD, it is critical that clients are therapeutically supported by clinicians whom they can trust and feel safe and comfortable discussing anything with. At transcend, you will find that our therapists can meet you where you are, no matter how anxious you are or how difficult the things you have faced are. 

Ketamine treatments for bipolar disorder 

Bipolar depression is different from major depression, but they both respond to ketamine treatment. When treating bipolar disorder with Ketamine infusions, it is important that the timing is right. It is not best to do infusions on days in which a person is experiencing any manic symptoms. Research so far has not determined that Ketamine administration will cause manic symptoms or worsen them, but for a variety of reasons, it remains the recommendation not to do infusions in these states. It is critical that patients with bipolar disorder undergo ketamine treatment in the care of a KAP therapist to help screen for mania on infusion day and to ensure the appropriate timing of sessions. Both bipolar 1 and 2 can be treated with ketamine and mood-stabilizing medications are generally compatible with ketamine. 

Ketamine treatments for OCD 

What is OCD? 

Obsessive Compulsive Disorder (OCD) is a mental disorder that causes you to have persistent,  unwanted thoughts (obsessions) and the urge to perform repetitive behaviors or rituals  (compulsions). Obsessions can include: 

Fear of germs or contamination

Excessive concern about order, symmetry, and exactness 

Unfounded fear of losing control of your mind or body 

Intrusive sexual thoughts or images

OCD can be treated with ketamine infusions. We find that OCD clients often require a special kind of support and careful ketamine administration to have success with treatment. It is not useful to provide ketamine experiences that may challenge one's sense of having control at a pace at which one is not ready. Often times the treatment of OCD involves a progressive immersion to states that feel less controlled and processing fears and other psychic processes that can stem from experiencing this. OCD is a frustrating and debilitating condition for many, and there are very few treatment options for it. Transcend has significant experience treating clients who have OCD with KAP. 

Ketamine treatments for suicidal thoughts and ideation 

Many research studies have looked at Ketamines's role in treating suicidal thoughts. Ketamine can improve many mental health symptoms, but one of its most powerful effects is reducing suicidal ideation. At Transcend, most of the clients we see elect at least some degree of suicidal thought processes at intake, generally more chronic or passive in nature. Clients that have suicidal thoughts so severe that they are no longer safe to be treated in the outpatient setting are best supported in an inpatient setting, but the majority of patients experiencing suicidal thoughts, they don't want to kill themselves, they want the pain of their condition to improve, and they have become hopeless that there will be a relief. Suicide starts to feel like it would be the only way to stop this emotional pain or these intense thoughts. 

Just know that if you are experiencing these times of thoughts, you are not alone, it is actually extremely common to have these thoughts when struggling with depression and other mental health conditions. We may never know the real incidence of suicidal thoughts because many, would never feel that they could trust the clinicians that are treating them enough to process these thoughts. It is not uncommon for our therapists to help patients process these thoughts in a safe and non-judgmental environment. Sometimes just the act of saying, “I have been thinking about killing myself if things don't get better,” is therapeutic. Having that thought doesn't always mean somebody actually is planning on attempting suicide, and keeping those thoughts and feelings inside just makes them grow and feel even scarier. 

Just know that there isn't anything you can't share with our team, if during your treatment, you and your therapist decide it isn't safe for you to be treated outside of an inpatient setting while sorting out these thoughts, we will help get the level of care you need to ensure your safety, but if these thoughts are just thoughts, they need attention and a caring and supportive environment to process them until they can stop. Many patients have come to Transcend with suicidal ideation, often present for years, and after treatment, found themselves no longer having these intrusive thoughts be a part of their inner experience. 

Getting started with Ketamine treatment  

As you can tell from this article, Ketamine can be used to treat a variety of conditions, and we are discovering new conditions that respond to ketamine treatment all the time. Most people considering Ketamine treatment find themselves with so many questions and concerns and also just generally cautious about trying a new treatment that is not “mainstream” yet. You will find that if you reach out to our clinic and complete a consultation, Transcend has this process down. Every place that offers ketamine treatments does things differently. At Transcend, we focus on providing a safe and heavily supported environment that is most likely to produce lasting results with minimal or no maintenance sessions. If you are considering this treatment for yourself or a loved one, schedule a free consultation with one of our care coordinators. We highly encourage you to do your research on this treatment but know that having a talk with someone who has watched hundreds of people go through this process is just a call away. 

Help Control Your Negative Thoughts With Ketamine Assisted Psychotherapy
March 27, 2023