Ketamine—a New Hope for Depression

The voice belongs to a psychologist. I am lying on a couch, trying out the latest craze—PSH, or Private Subconscious-mind Healing. I am habituated to bouts of internal, directed-at-self, anger.

Using a mild state of self-hypnosis, PSH has released people suffering from worry, migraines, and anxiety, according to Dr Lindsay Duncan, psychologist, and author of Gremlins of the Mind.

Neuroplasticity is the Holy Grail of the psychologists who recommend using our mind to change our brain so that problems like anger, smoking, and overeating can be overcome. So what about serious depression?

Plasticity defines the brain. Play the piano thousands of times, and new neural pathways form that make certain plays go on autopilot. But latest research in neuroplasticity indicates a pliability never before imagined. Psychologist Dr Joel Wade, who uses directed consciousness, as against Dr Duncan’s subconscious-mind healing, calls neuroplasticity “tremendously exciting.”

Author and private-practice neurologist, Dr David Perlmutter, contends that the ability of the brain to reorganize itself by function, i.e. neuroplasticity, is an exceptional gift. He recounts a case he encountered in the Eighties, whereby a 58-year old had regained his speech function, yet the area of the brain that normally controlled speech showed the same extensive damage in an MRI seen previously. His brain had reorganized functionally, an astonishing plasticity. Today Science knows how this happens.

Does that mean that at any age, we should be able to practice proper techniques that make us happy, and get better at it the way you would if you were learning to play the piano? Yes, says Dr Wade— “Happiness fundamentally on many levels is an earned treasure,” whereas “depression is often a symptom of helplessness.”
 

Like Colin, James and Richard were also fans of 20^th Century thinker Ayn Rand, who posited that happiness resulted from achieving your values. Says James, who at one point was unable to shake off suicidal thoughts on his own:
 

Richard, however, is free from depression for 35 years now, after suffering in high school. He blames his Christian upbringing for creating a virtue versus happiness dichotomy in him.
 

Yet the view that happiness is a state that results from achieving your goals cannot explain why someone like Robin Williams would give his life away, having arrived at the pinnacle of an achievement tower. By all accounts, Robin was also a caring, generous person, the sort, if happy, would have been held as an exemplar by the positive psychology school. If Robin can be suicidally depressed, is this an illness, which can hit anyone, at any time?

This is exactly what the Black Dog Institute implies. The nanny-state funded institutions will quote statistics and anecdotes that drive home that inference—absolutely anyone, anywhere, can get the uncontrollable, unforeseeable, bolt-of-lightning strike.

Perhaps hundreds of millions in the world are suffering. Can we use neuroplasticity to rewire these poor people?

Unfortunately, Christopher Pittenger and Ronald Duman of the Yale University School of Medicine infer in the Neuropsychopharmacology Review that “chronic stress, which can precipitate or exacerbate depression, disrupts neuroplasticity.”

That would explain why Janet’s symptoms arrived with a sudden episode of inexplicable anhedonia (joylessness) after a prolonged period of stress—living with a boyfriend who suffered depression, having to deal with clients who never got better and the breakup of an engagement. A health worker, Janet is young, slim, and tall. Her eyes sparkle; her gait is lively. Yet she says she is not back to hundred percent.
 

Science is, however, no closer to telling us what comes first. Does major depression cause a reduction in neuroplasticity? Or does a spontaneous reduction in neuroplasticity caused perhaps by chronic stress, lead to major depression?

Dr Emma Seppala of Stanford University’s Center for Compassion and Altruism Research, looks instead toward introspection. She contends that we are less aware of this internal world, with its varied landscape of emotions, feelings, and sensations. “Yet it is often the internal world that determines whether we are having a good day or not, whether we are happy or unhappy. That is why we can feel angry despite beautiful surroundings or feel perfectly happy despite being stuck in traffic,” says Dr Seppala.

Mental voyages cost nothing. No airplanes, visas, taxis, or traffic. And yet, we see a lot.
 

Afterward, he tells me that the second session is often the one with the most potent release of pent-up, unresolved conflict. I feel spent, but free.

Will this change last? I am the one who has to make it last—catch myself having the wrong thoughts, then drive my emotional car into leafier woods, creating a new path. Keep driving on it until it looks like a well-worn pathway and the old one gets the undergrowth.

However, for the sake of a friend in Springwood who suffers grave melancholic episodes, I keep digging around. There are those like Colin and James, who have neural pathways like rail tracks—any attempt to detour the railcar, risks derailment.

Finally, I find it. In November 2013, in The Frontiers in Cellular Neuroscience, Shawn Hayley and Darcy Litteljohn of Carleton University, Ottawa, wrote about ketamine, which promotes an “unusually rapid and sustained antidepressant response after a single administration,” an effect, which been linked to rapid neuroplastic events. Ketamine targets downstream neurotransmitters that existing drugs don’t. This matters because many patients do not respond to anti-depressants currently available (SSRIs), or regress after stopping therapy. Now the medicate-the-brain school has married the use-the-mind-to-rewire-the brain college. Medication as a catalyst to starting anew, then purposeful living as a preventive strategy is similar to occasionally needing antibiotics to overcome an illness, and then taking care.

Excited, I rush to Springwood to tell my friend all about ketamine.
 

As dusk falls, we toast to ketamine, a party drug and an anaesthetic now heralded as an elixir, but still in its early days as an anti-depressant. Nevertheless, I have given him hope, itself a very powerful anti-depressant.

The subconscious cannot be a benign healer unless it is strongly directed. As a fiction writer, I have often instructed my subconscious to go to work on a plot point at night. So, on the way home, I visit an unattended office, from which I have seen mountains with my eyes closed. I scribble a verse on a note and stick it under the door. I won’t be coming back here.
 

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About the Author: Vinay Kolhatkar

Vinay Kolhatkar is a freelance journalist, novelist, screenwriter, and finance professional. He is the Chief Editor of The Savvy Street. Vinay has authored a TV pilot screenplay Undercover: The Story of Jamila, and two literary thrillers A Sharia London and The Frankenstein Candidate.. He is also the co-author of Media Wars: The Battle to Shape Our Minds. More about Vinay is at the Founder page.