By Isabella Starcher
I sat in an elongated chair, looking around the bare medical office room, listening to the "Brain Mush" playlist queued by the nurse.
A warm blanket draped across my legs, I stared at the IV in my arm wondering what the treatment was going to feel like.
As I watched the TV screen in front of me, I drifted into a kaleidoscope of colors. All I could think about was Van Gogh's famous quote, “I don't know anything with certainty, but seeing the stars makes me dream.”
A few hours later, I was a Ketamine convert.
It makes sense why this protocol is quickly becoming a favorite among those looking to ease their chronic pain, depression, anxiety, PTSD… or a myriad of other problems.
And it could be a serious solution to a growing mental health epidemic in this country.
Mental health a growing problem in the U.S.
One in five adults, or 51.5 million Americans, account for having a mental illness. This number has risen significantly within the past three decades, and the need for a solution is more urgent than ever.
Mental health treatment has been making headway in recent years for finding unconventional ways to deal with depression and anxiety.
One drug in particular has revolutionized the potential for mental health improvement, and it’s Ketamine.
Ketamine was first created in 1963 by Dr. Parke Davis, who was trying to find an alternative to the leading drug for anesthesia at the time – PCP.
PCP had been effective, but it left patients with horrendous side effects. It was potent, created hallucinations, and left patients with lasting psychological problems. Ketamine, on the other hand, had no side effects.
Even though Ketamine was originally designed for anesthetic purposes, it has created significant potential in mental health recovery.
Ketamine has proved highly beneficial for treating diagnosed mental illnesses such as depression, anxiety and even PTSD. The side effects are minimal and it does not come with the same danger of addiction as many prescribed antidepressants and pain pills have in the past.
Ketamine’s journey from operating rooms to psychiatric clinics is creating a shift in understanding of mental health and what can be done about the growing crisis.
Savannah's story: From prescription reliance to freedom
Savannah Adams has been receiving Ketamine treatments for about a year after attending Clemson University, when her mental health took a turn for the worst.
But Adams' mental health didn't start declining inside the classroom. It started at home in a tumultuous environment. At 15 years old, Adams was put in front of a psychiatrist, her mind struggling to make sense of what was happening.
In a brief consultation, the teenager was prescribed antidepressants.
"I was put on antidepressants and an antipsychotic at 15 years old,” she said. ”After a 30-minute conversation"
Adams became reliant on her medication, the weight of her mental health took over and she didn’t know who she was anymore without her medication.
"I felt alone,” she said. “I didn’t find joy in the world. I was angry", says Adams.
Adams explained that it takes a few months for that kind of medication to work. But when it did, she didn’t like how she felt.
“It was weird because one day…I just didn’t feel like me anymore,” she said. “I didn’t find joy in the world.”
It wasn’t until Adam’s grandmother suggested she see a new psychiatrist that introduced an alternative treatment option, Ketamine therapy.
“We learned about it in PE in school, but I didn’t know it was an option let alone legal,” Adams said.
But she decided to give ketamine therapy a chance, and the results were life-changing.
Adams receives treatments twice a year, at the minimum, and has stopped taking her past antidepressants almost entirely.
"It was almost like the world around me and everything that was wrong, I didn’t feel the weight of it anymore." -Savannah Adams
How ketamine works on the brain
Ketamine’s ability to regulate glutamate is what makes the treatment different from other typical antidepressants.
“It works because of NMDA and glutamate receptors, it creates pathways, some people think of it as laying railroad tracks, like reconnecting things” says Dr.Bevier, PA at Charleston Ketamine Center.
The picture to the right represents the brain, the purple lines are the pathways of glutamate.
Glutamate is the messenger in our brain that communicates signals between nerve cells; glutamate controls mood regulation.
Glutamate’s function and ability to deliver messages to other cells is determined by something called NMDA receptors. Together, glutamate and NMDA receptors regulate mood.
Interruptions between glutamate and NMDA receptors lead to depression because there is an interruption in the mood regulation process.
Ketamine infusions work by restoring the imbalance of transmitter activity, this is what alleviates depressive symptoms. Ketamine recreates a blocked pathway, which allows glutamate and NMDA receptors to communicate again.
After receiving treatments since February 2022, Adams describes her feeling of peace.
“I just feel clear,” she says. “My mind was stuffed for a long time, and the treatments made it clear again, like life wasn’t so bad."
First ketamine study finds success
In 2000 at Yale University, Dr. John H. Krystal conducted the first study that proved Ketamine is useful in treating depression.
The study found evidence that ketamine can, “produce rapid antidepressant effects" in people with treatment-resistant depression.
"The rapid onset of antidepressant effects seen with ketamine is unprecedented in the field", says Krystal, chair of the Department of Psychiatry at Yale.
Studies have shown that a single dose of ketamine can alleviate symptoms of depression within hours.
Treatment-resistant depression is depression that has not been treatable with the most common antidepressants.
The most commonly prescribed antidepressants are Zoloft, Prozac, Celexa, and Lexapro.
“They’re very difficult to come off of,” says Dr. Becki Bevier, physician assistant at Charleston Ketamine Center.
Adams was prescribed antidepressants for half a decade - and they were useless.
“The medication never worked," Adams said. "It was just another cycle of side effects."
Medications can become addictive quickly, because of the way they affect the brain's neurotransmitter.
Long-term use of antidepressants creates a tolerance to a certain dosage, meaning eventually you will need a higher dosage for the same “effect."
“People can become addicted or dependent on the mediation very easily, unintentionally just by the nature of the medication,” said Dr. Bevier.
Getting a dose of ketamine
Ketamine treatments are administered intravenously (IV), this is an infusion. An infusion means the medication goes directly into your bloodstream.
Laird Bowen, office manager of the Charleston Ketamine Center, says it’s ”tough to put into words” what a treatment is like.
”It is just a weird feeling, weird is the only word that comes to mind,” he said. “Reality doesn’t feel the same during the treatment.”
Note that patients can receive treatment at a specialized Ketamine clinic without a prescription.
During the treatment, the medication is slowly administered into the body for about an hour.
The amount of Ketamine that is injected depends on variables such as pre-diagnosed conditions, or an individual's response to the treatment.
“Some patients add ketamine to their regimen, others decrease usage almost immediately and stop taking their prescriptions because they feel better,” says Dr. Bevier.
Downside
The treatment itself allows for the brain to be completely blank, meaning a patient must have to let go of all surroundings externally and internally.
Some patients struggle doing that because of a lack of control.
“During the treatment some people get frightened, it's an impulse control thing,” Dr. Bevier pointed out..
Ketamine’s initial studies show promise in treating mental illnesses, but it does have limitations.
"It doesn’t work for everybody," Dr. Bevier added. "For some patients, it’s frustrating because most have failed several medication trials before coming here."
Mental illness is a complex issue with different contributing factors, and it can be influenced by factors such as pre-existing medical conditions, environment, and genetics.
Some people are immune to antidepressants and some are immune to Ketamine treatments. Why that happens is still unknown.
“We don’t have an exact answer/reason as to why it doesn’t work for some people and it works for others,” says Bevier.
The cost of infusions can cost up to $800 and ketamine is not FDA-approved yet so insurance doesn't cover the hefty cost.
The initial study conducted at Yale was just 20 years ago. Ketamine is still being researched, but early studies are promising.
But there are uncertainties such as long-term effects, affordability, and the lack of understanding why it doesn't work for everyone.
Ketamine is a fast-acting treatment, working quicker than other commonly used antidepressants such as Zoloft, Prozac, or Lexapro.
And unlike Zoloft, Prozac, or Lexapro, ketamine doesn’t require an increased dosage over time to get the same effect – the kind of side effect that can create a dependence and a slippery slope into addiction.
Ketamine does not have addictive properties, says Bevier.
“There is no type of dependence at all,” she said.
Ketamine is a new treatment, and its success is giving hope to practitioners and patients.
“We had a patient that was terrified to drive and absolutely refused one treatment and they drove themselves again,” says Bevier.
One infusion of ketamine is showing more success than other typical antidepressants.
“Seventy percent of patients who haven't responded to antidepressants respond to ketamine." - Dr. Gall Serruya, Psychology Today
One patient traveled to South Carolina from California for a Ketamine treatment after having been to Mayo Clinic for chronic pain and severe depression. There seemed to be no end in sight and nothing was working.
Until a therapist recommended ketamine.
“I was a little skeptical about it all at first, but after one treatment, I had hope again," the patient wrote in an online review.
Is ketamine treatment the future?
As I came out of the ketamine-infused daze, I observed my surroundings and the world around me, almost as if I was coming out of surgery.
I couldn’t help but wonder, is ketamine the future of mental health? Will we, as a society, finally be one step closer to fighting the growing number of mental illnesses?
Mental health is a journey, and unfortunately, there isn’t a “one-size-fits-all” solution, or overnight fix.
There are only steps that can be taken to move forward in trying to solve the growing problem.