Depression Cure: Your brain on ketamine

(Excerpted from “Ketamine Is Revealing a New Understanding of Depression and the Brain”; emphasis added)

“Nearly all antidepressants work in line with what’s called the monoamine hypothesis of depression, which emerged in the 1950s. The hypothesis asserts that depression is caused by low levels of chemical messengers in the brain called monoamine neurotransmitters, which include serotonin, dopamine, and noradrenaline. The idea is simple: Increase levels of these neurotransmitters in the brain and reverse depression.”
“Exactly what ketamine does to the brain is still under investigation. But most scientists agree that it has to do with glutamate, the most abundant neurotransmitter in the brain, and the strengthening of connections between neurons in areas implicated in depression.”
“Drugs like ketamine can rapidly trigger neuroplasticity, the recreation and strengthening of connections between neurons, and the way the brain rewires itself. And they suppress the brain’s default mode network (DMN), areas thought to be associated with introspection and mind-wandering.”
“[Carlene MacMillan, MD, psychiatrist and CEO and co-founder of Brooklyn Minds] likes to think of ketamine as fertilizing a garden. ‘Ketamine very quickly increases the activity of the neurotransmitter glutamate in the frontal part of the brain that is underactive in depression. This leads to new connections forming between neurons in that area and causing old ones to regrow.’”

The neurotransmitter theory Tanabe lays out is one compelling perspective as to how ketamine might work. But the psychological, almost psychedelic qualities of ketamine that Moskowitz highlights can’t be overlooked.
Your mind on ketamine

(Excerpted from “A Good Drug for a Bad World”; emphasis added)

“[Maybe] we’ll never fully understand why drugs like ketamine help our brains solely through science. Because science cannot describe the out-of-body experience, the spiritual revelations, the mindfuck of a drug like ketamine. And that — the mindfuck — just as much as its chemistry, is key to ketamine’s power.”
“Sad, then, that drug companies are now trying to remove the pleasurable parts of drugs. Researchers are hard at work trying to separate the components of recreational drugs and see if they can be used to treat depression without also causing you to have fun. […] It’s a shame that our puritanical culture views fun and medicine as incompatible. Because I’m pretty sure the reason ketamine worked on me had less to do with the chemical changes to my brain and more to do with it allowing me to see my life completely differently.”
“That sense of a different reality — one where fewer things matter and everything feels lighter — was a description I’d heard from other people, too. It’s not that ketamine just chemically lifts all this weight, it’s that it shifts your perspective so radically for the half-hour or so that you’re on it that the experience becomes a tool, a reference point, for a new life.”
“‘If you think that all we need to do is tweak the serotonin receptors of a person who’s undergone some major psychological trauma, that just doesn’t make sense,’ said [Carl Bonnett, MD, who founded several ketamine clinics].”
“Patients who have gone through trauma aren’t just chemically broken, Bonnett said; they are trying to answer some basic fundamental questions about life: Why did this happen to me? How can the world be so cruel? […] ‘When I put you into a psychedelic space, when I show you the string above the puppets, when I give you a backstage pass to your life, when I let you see things differently — that’s what can potentially answer that question.’”
“We’re all being traumatized right now, to varying degrees, thanks to a yearlong pandemic. And we’re all asking these humongous questions: Why are so many people dying around us? How did life get this stressful? Is humanity always going to be this cursed? It makes perfect sense to me that the drug of the moment wouldn’t be something that just takes you out of reality, but one that gives you a different world to look forward to.”
Medium