Ketamine was originally developed in the 1960s as an anesthetic alternative to PCP (aka "angel dust"). Ketamine was favorable not only because the effects of PCP are wildly unpredictable and its use was resulting in people launching themselves off rooftops believing they could fly, but also because it’s fast-acting, reduces pain, and keeps heart and breathing steady. Because ketamine can produce a euphoric, "outside of oneself" effect, it wasn’t long before people began taking ketamine recreationally. In the 1980s, due to its dissociative effects, and because it can enhance sensory experiences, ketamine (or "Special K" as it was coined) was adopted by club kids and ravers. Because it was easier to obtain ketamine from veterinary offices than hospitals, it gained the misleading reputation as a horse tranquilizer. In the 1990s, researchers began noticing something intriguing: patients who received ketamine in medical settings reported significant improvements in their mood, sometimes within hours of administration. This unexpected finding sparked interest in exploring ketamine's potential beyond anesthesia. Studies since then have shown that ketamine therapy can rapidly alleviate symptoms of depression, even in individuals who haven't responded well to other treatments. So, how does ketamine actually work for depression? Unlike traditional antidepressants that can take weeks to kick in, ketamine acts quickly by targeting certain receptors in the brain involved in mood regulation. It's like giving those neural circuits a reset, helping to restore balance and improve mood. In conclusion, ketamine's journey from anesthetic to antidepressant is remarkable. Research has consistently shown that ketamine can be highly effective in treating various mental health conditions. When paired with psychotherapy, ketamine enhances the effectiveness of mental health treatment by addressing both biological and psychological aspects of the condition simultaneously.

Provider Insights

Ketamine, a Brief History

A few years ago, when organizations started offering ketamine through online prescriptions, several of my veteran clients asked for my opinion. Citing benefits from research is one thing, but providing experiential data is a different animal. So, I decided to try a six-week at-home, self-guided protocol, with my husband as my chaperone. To say that I gained nothing from the treatment would be untrue. As we navigate life, our constant internal chatter can be overwhelming. Having an hour twice a week to experience a non-ordinary state, free from my inner critic and taskmaster, reminded me that a profound peace within me is always accessible. It reaffirmed my deep sense that there is a different way to live—one marked by ease and grace. That said, as I educated myself about the function of ketamine and the processes that make the medicine so impactful, I realized that I had left much of the benefit on the table. Dr. Carlos Zarate, a leading psychiatrist and researcher in ketamine’s use for depression, famously described it as "Miracle-Gro for your brain." Ketamine not only promotes neuroplasticity (the brain's ability to reorganize and adapt by forming new neural connections), but also restores brain connectivity. Over time, particularly when dealing with mental health conditions like depression and anxiety, our focus tends to narrow. Many of us have experienced times in our lives when we’ve lacked robust motivation to engage, and our thoughts were colored by a negative hue. This phenomenon can be likened to a snowy mountain covered in ski tracks, where our emotions get stuck in ruts and our thoughts and behaviors follow suit. Ketamine acts like a fresh layer of snow, allowing new tracks to form and making those new possibilities more enduring. The new paths we create are more likely to become habits, which underscores the importance of both the preparation and integration phases of ketamine treatment. Preparation not only educates you about what to expect, significantly reducing anxiety, but also helps you identify what you want to change. With your therapist, you can set intentions for your journey and develop a roadmap for achieving them. During integration, after your dosing session, you can process the experiences and insights that emerged. Exploration and interpretation encourage new ways of thinking about your problems. You will develop an actionable plan and identify key areas for change. Your therapist will equip you with tools to maximize the impact and significance of your treatment. The insights you gain and the steps you take will lead to lasting, positive transformation in your life. Once I realized how much more impactful the treatment could be, I decided I wanted to change the way ketamine is offered so clients can fully benefit from their treatments. I was dismayed to see that many clinics—actually, all of them—simply insert an IV, leave the room, and then send you on your way. While you will undoubtedly gain some value, as I did on my first journey, the benefits are likely to be short-lived. When ketamine is used as a tool to support psychotherapy, clients can experience truly life-changing shifts.

Why Ketamine-Assisted Therapy?

When someone goes through a traumatic experience, their brain reacts in complex ways. Events that are extremely distressing can trigger physical responses that continue even when we're not consciously aware of them. For example, surviving a bear attack might make someone scared to go back into the woods, even if they logically know another attack is unlikely. The anxiety felt while walking in the forest can be so intense that they might avoid hiking altogether. In simpler terms, trauma sets off a chain reaction in the brain. When reminded of the trauma, a part of the brain called the amygdala activates and causes fear. The body also gets ready to fight, run away, freeze, or sometimes act overly friendly. At the same time, important brain areas like the hippocampus (which helps with memory) and the frontal cortex (which handles thinking and speaking) can shut down. During a crisis, survival instincts take over, pushing aside more complicated thinking tasks. After the trauma, these responses can pop up unexpectedly and mess with daily life. For instance, during a work presentation, a sudden interruption might trigger a defensive bodily response, making it hard to think clearly and communicate well. This shows how trauma can sneak into everyday activities. While these bodily reactions are amazing ways our body tries to protect us, they can be extremely difficult for people dealing with long-term effects of trauma. Regular talk therapy can be ineffective at touching trauma because talking about the event/s can bring back these physical reactions, making it hard to communicate clearly and learn new ways to cope. That’s where ketamine comes in as a game-changer for treating trauma. By calming down hyperactive parts of the brain like the amygdala and limbic system, ketamine helps people process and talk about their trauma more easily. This temporary change gives a crucial opportunity during ketamine treatment to rethink and reshape how traumatic memories are understood. Furthermore, ketamine also boosts connections between brain cells, which helps solidify new learning and behaviors. This combination of therapy and brain changes shows how ketamine treatment could greatly improve healing for those struggling with trauma, offering new paths forward and hope for recovery.

Amy Buesing

Ketamine, a Brief History

Why Ketamine-Assisted Therapy?

Trauma, and the Brain