Major depression is one of the most common mental health concerns in the country, with as many as 21 million American adults having suffered at least one major depressive episode in their lives. Treatment of depression has long focused on a variety of antidepressants, but today, more people are opting for ketamine therapy.

Ketamine therapy for depression is relatively new when compared to other treatments, but it’s an option that shows promise because of how the drug seems to reshape the brain. If you’ve been battling depression, this therapy could offer you some relief.

Take a closer look at how depression affects the brain and how ketamine therapy may help.

What Is Major Depression?

Major depressive disorder is a serious mental health condition that impacts how you feel, think, and act. Symptoms can vary in severity, but they generally include:

  • Losing interest in activities you enjoyed
  • Feeling hopeless, sad, irritable, or empty
  • Increased fatigue
  • Changes in appetite
  • Changes in sleeping patterns
  • Experiencing excessive guilt
  • Feeling worthless
  • Slowed movements or increased purposeless physical activity
  • Suicidal ideation
  • Concentration problems
  • Memory problems

To be diagnosed with depression, symptoms have to be present for most of the day every day for more than two weeks. There must also be a change in daily functioning.

Anyone can suffer from depression, but some people have risk factors that can make the condition more likely. A family history of mental health concerns, as well as being exposed to violence, abuse, or neglect, can affect your risk.

The Impact of Depression on the Brain

To understand how ketamine helps people with depression, it’s first vital to know the changes that this mental health condition makes to the brain.

Shrinking Brain Areas

People with depression can experience changes in the size of certain brain areas. One of these areas is the hippocampus, which supports learning, memory, and perception of space. The amygdala, which regulates emotions and memory, can also shrink, along with the thalamus, which sends information from the cerebral cortex to the brain stem.

The prefrontal cortex is impacted, as well. This is the area of the brain that controls cognitive function while also managing emotional reactions, impulse control, and attention.

For any of these areas, the length and severity of the depressive episodes seem to be connected to how much they shrink.

Brain Inflammation

People who suffer from depression can also have much higher levels of brain inflammation. That’s because they tend to experience unusual immune system activity. As with shrinking, the length of the depressive episode can also affect these inflammation levels.

Studies measuring inflammation in the brain by tracking the levels of translocator protein have found that people who experienced major depression for more than 10 years had up to 33% more of this protein than those who’d suffered depression for a shorter length of time.

But why is brain inflammation such a problem? Inflammation causes brain cells to die, leading to reduced neuroplasticity. Essentially, this means that inflammation makes it more difficult for the brain to change.

Abnormal Neurotransmitter Function

Alongside reduced neuroplasticity, depression can also result in abnormal neurotransmitter function. Neurotransmitters are chemicals that allow electricity to travel between the nervous system and cells in the brain.

Three crucial neurotransmitters called serotonin, dopamine, and norepinephrine behave abnormally in people with depression. These abnormalities can result in enhanced negative emotions.

What Is Ketamine?

Ketamine is a dissociative anesthetic that offers hallucinogenic effects. By acting on certain brain chemicals that distort hearing and sight, ketamine can create a feeling of mind-body separation while also giving you a sense of well-being.

Additionally, ketamine can induce a sense of sedation and provide relief from pain, which is why it’s been so widely used as a sedative during medical procedures.

Ketamine Therapy for Depression: What It Can Do

For those dealing with depression, this therapy option can offer significant benefits — especially if you suffer from treatment-resistant depression.

Target Glutamate

Glutamate is a brain chemical that acts like a neurotransmitter, sending messages to the glutamate receptors in brain cells. The glutamate then tells the cells what to do, which can vary from cell to cell. For example, if glutamate triggers a motor neuron, it can lead to a muscle contraction.

People who have depression tend to have lower levels of glutamate in certain areas of their brains and much higher levels than the norm in other areas. This imbalance can result in many depressive symptoms.

Unfortunately, increasing or decreasing the level of glutamate in your blood doesn’t impact the glutamate levels in your brain, as the blood-brain barrier prevents your blood from impacting your central nervous system and brain fluid. Another challenge is that people with depression may also have receptors that are less sensitive to glutamate — even if they receive more glutamate, their brains may still have trouble using it.

The good news is that studies show that ketamine causes a surge of glutamate neurotransmission activity in the brain, allowing it to function like an antidepressant. Ketamine may also block glutamate receptors in other areas of the brain, causing a “retuning” that can help the brain to find its natural balance again.

Fight Against Inflammation

Additionally, ketamine can provide relief to people suffering from depression because it helps fight inflammation. Ketamine exerts anti-inflammatory properties on your immune cells and inhibits the release of inflammatory cytokines.

Act Fast

One of the most important benefits that ketamine therapy for depression offers is fast-acting relief from symptoms. People who take antidepressants usually need weeks before they can begin feeling improvements. With ketamine, however, you may experience reduced depression symptoms in mere hours.

Who Is Eligible for Ketamine Therapy?

If you struggle with major depressive disorder, you may be eligible to receive ketamine therapy for depression. It’s often an appropriate option for those who have a treatment-resistant condition, but there may be some people who are not well-suited because of pre-existing medical conditions. These conditions include:

  • Liver disease
  • Psychiatric disorders, such as schizophrenia
  • Heart disease
  • Pregnancy
  • Hyperthyroidism
  • Mobility issues
  • Drug or alcohol use disorders

The best candidates are people who are in good general physical health and who have tried other treatment options without success.

What to Expect From Ketamine Therapy for Depression

Currently, the type of ketamine therapy that has FDA approval for treatment-resistant depression is esketamine, which goes by the brand name Spravato. Spravato is meant to be used with an antidepressant and only in healthcare clinics. This ensures that patients are monitored for at least two hours after their sessions.

Spravato is a nasal spray that you receive twice a week for anywhere from one to four weeks, and then once a week for five to nine weeks. After that, you can receive it once a week or every other week.

Although they don’t yet have FDA approval, other treatment options can also include IV ketamine infusions or injections. An IV infusion can last 40 minutes or so. You can expect to start feeling the dissociative effects quickly and continue experiencing them for as long as a half hour after the drip ends. Most people who receive treatment appear to be asleep, though you will be conscious.

The effects of one infusion or nasal spray can wear off in hours or days, depending on your own chemical makeup. Getting more sessions can help you achieve longer-lasting results.

At Plus by APN, we pair each ketamine session with therapy from a qualified therapist who’s trained in psychedelic-assisted therapy so that you can achieve the best possible results.

Does Insurance Cover Ketamine Therapy for Depression?

Some insurance companies cover Spravato, which is the nasal spray version of the therapy. IV ketamine isn’t covered by insurance, but there are payment plans and other options available to ensure that you can receive the care you need.

Possible Side Effects of Ketamine Therapy

As with any chemical treatment, you may experience some side effects when you choose ketamine therapy for depression. Some people feel dizzy, confused, or nauseated. You may also experience some visual disturbances and a faster heart rate. However, all of these effects are temporary, and they don’t build up over time.

Combining Talk Therapy With Ketamine Therapy

One of the most effective options for people with treatment-resistant depression is to combine ketamine with talk therapy. This combination allows you to experience relief from symptoms that can hinder the effectiveness of psychotherapy.

Importantly, the changes that depression makes to the brain can make it more difficult for talk therapy to make a difference. Your brain has decreased neuroplasticity if you have depression, so trying to make changes to the way you think might be very difficult.

This can lead you to stop attending your therapy sessions altogether. But ketamine can help increase certain brain activity so that you can get more out of other therapies, like cognitive-behavioral therapy (CBT).

One of the factors that can make CBT less effective is inflammation in the brain. Inflammation affects memory and learning while also increasing the sense of social disconnection and rejection sensitivity. Since ketamine has anti-inflammatory effects on the brain, it can make a significant difference in CBT sessions.

At the same time, ketamine aids in reducing inhibitions, making it easier to talk about specific subjects during your sessions. Exposure-based therapy can benefit from ketamine as well because the drug can disrupt fear memory consolidation.

Finding Your Path Toward Healing at Plus by APN

Depression can impact all aspects of your life, making each day a challenge and putting you at risk of choosing harmful coping mechanisms to ease the symptoms. If you’ve battled this mental health condition through traditional therapies without success, it may be time to consider another option.

Ketamine therapy for depression offers the chance to make structural changes to your brain to effectively counteract depression. By combining talk therapy with ketamine therapy, you can have the opportunity to start healing and feeling better.

At Plus by APN, we offer ketamine therapy for depression. Our top-of-the-line facilities allow you to receive the care you need in a comfortable, safe environment — without feeling like you’re in a hospital setting.

We can create a personalized treatment plan designed to address your specific needs. Contact us by phone at 424.644.6486 or by filling out our confidential contact form to find out how we can help you overcome depression.

References

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  • Nikkheslat, Naghmeh. “Targeting inflammation in depression: Ketamine as an anti-inflammatory antidepressant in psychiatric emergency.” Brain, behavior, & immunity – health vol. 18 100383. 10 Nov. 2021, doi:10.1016/j.bbih.2021.100383
  • Srivastava, Ipsit, and Maria Lindskog. “The Effect of Ketamine on Synaptic Mistuning Induced by Impaired Glutamate Reuptake.” Neuropsychopharmacology, vol. 48, no. 13, 2023, pp. 1859-1868, https://doi.org/10.1038/s41386-023-01617-0. Accessed 15 Nov. 2024.
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