While I agree with parts of the sentiment of the article, and that better science is needed, I think the headline is almost clickbait in that it attempts to dismiss something that clearly has been life changing for a lot of people.
I am someone who has suffered bouts of depression, sometimes severe with consistent thoughts of suicide, since I was a child. I had been in therapy for over a decade (which was immensely helpful for me), and I had tried a couple different antidepressants. This spring, partially due to some particularly bad sleep issues, I had an unusually bad bout of depression where I was borderline non-functional. As a "last ditch" effort I went in for ketamine infusion therapy at a clinic. Before the therapy they have you take a "depression assessment" questionnaire, the PHQ-9. The scores range from 0 to 27, and I went in as a 25 (basically, ready to jump off a bridge).
Without exaggeration, my initial ketamine session, which lasted about 2 hours, was the most profound experience of my life, and I firmly believe it saved my life. Not only that, it completely changed my understanding of my mental illness. Mental illness is hard to separate from your vision of "you", because if you, say, break your arm, nobody considers you a different person, but your mind is really what people most consider to be "you" - when it's broken, it's hard to not feel like you are broken. With my depression, the best way I could explain it is not just that things that used to make me happy no longer did, not even that I could no longer feel joy, but that I couldn't remember what joy itself actually felt like. When you can't even remember what the emotion of happiness feels like, existence feels pretty bleak.
What ketamine did for me is essentially "broke the damn", and I felt an enormous rush of actually being able to feel emotions again. The analogy I like to use is that my depression was like "brain atherosclerosis", i.e. my emotional channels were "clogged", and the ketamine therapy was like "brain angioplasty" - it felt like it broke up all the "clot" in my brain so that my neurons could talk to each other again and I could feel. It was the first time I actually understood my mental illness as a physical disease. At the end of my session I was literally balling for like 30 mins just because the flood of emotions felt so intense.
The next morning I was singing in the shower, and a couple days later when I retook the PHQ-9 I was a 3. It's been about 9 months since my first session, and while I don't always feel as awesome as I did right after it, I do feel like my completely changed view of my depression has made me much more resilient, and also much more willing to ask for help. In my initial series I had 4 sessions spaced over about 3 weeks (the recommendation for an initial series is 6, but for me after the 4th one I was like "no, I'm totally good" - I didn't want to "get used to" the ketamine trip because it was such a powerful experience for me). I had one "booster" session of ketamine about 3 months ago when I was feeling not great, and it was very helpful.
Now, I know that I was extremely lucky - my shrink calls me a "ketamine responder". The problem with depression is that it's not a disease, it's a symptom, and since doctors don't often know the underlying cause, a lot of the treatment is just "throw things at it and see what works". I have a friend that got very little depression release from ketamine, but TMS (transcranial magnetic stimulation) was what was helpful for him. So I'm very, very wary of ketamine getting oversold as a "wonder cure" - it may work for some people, but not others, and I've already seen how CBD and marijuana shops have popped up all over basically planning to cure every symptom under the sun since marijuana was legalized.
At the same time, I'm also wary of psychedelics being dismissed in a similar way to how they were dismissed and demonized about 50-60 years ago. I fully understand that the plural of anecdotes is not data, but I'm also not trying to find the statistically significant treatment for your average person - I'm just trying to not die. For me, I have all the evidence I need, and I feel it would be a tragedy to take away that option for other people before we know more.
Thank you so much for sharing your story here. I've met people who have had similar experiences. So when I read this article in the Atlantic it's hard to not be upset, because miracles do happen with these substances. And sometimes that miracle is mysterious.
I am someone who has suffered bouts of depression, sometimes severe with consistent thoughts of suicide, since I was a child. I had been in therapy for over a decade (which was immensely helpful for me), and I had tried a couple different antidepressants. This spring, partially due to some particularly bad sleep issues, I had an unusually bad bout of depression where I was borderline non-functional. As a "last ditch" effort I went in for ketamine infusion therapy at a clinic. Before the therapy they have you take a "depression assessment" questionnaire, the PHQ-9. The scores range from 0 to 27, and I went in as a 25 (basically, ready to jump off a bridge).
Without exaggeration, my initial ketamine session, which lasted about 2 hours, was the most profound experience of my life, and I firmly believe it saved my life. Not only that, it completely changed my understanding of my mental illness. Mental illness is hard to separate from your vision of "you", because if you, say, break your arm, nobody considers you a different person, but your mind is really what people most consider to be "you" - when it's broken, it's hard to not feel like you are broken. With my depression, the best way I could explain it is not just that things that used to make me happy no longer did, not even that I could no longer feel joy, but that I couldn't remember what joy itself actually felt like. When you can't even remember what the emotion of happiness feels like, existence feels pretty bleak.
What ketamine did for me is essentially "broke the damn", and I felt an enormous rush of actually being able to feel emotions again. The analogy I like to use is that my depression was like "brain atherosclerosis", i.e. my emotional channels were "clogged", and the ketamine therapy was like "brain angioplasty" - it felt like it broke up all the "clot" in my brain so that my neurons could talk to each other again and I could feel. It was the first time I actually understood my mental illness as a physical disease. At the end of my session I was literally balling for like 30 mins just because the flood of emotions felt so intense.
The next morning I was singing in the shower, and a couple days later when I retook the PHQ-9 I was a 3. It's been about 9 months since my first session, and while I don't always feel as awesome as I did right after it, I do feel like my completely changed view of my depression has made me much more resilient, and also much more willing to ask for help. In my initial series I had 4 sessions spaced over about 3 weeks (the recommendation for an initial series is 6, but for me after the 4th one I was like "no, I'm totally good" - I didn't want to "get used to" the ketamine trip because it was such a powerful experience for me). I had one "booster" session of ketamine about 3 months ago when I was feeling not great, and it was very helpful.
Now, I know that I was extremely lucky - my shrink calls me a "ketamine responder". The problem with depression is that it's not a disease, it's a symptom, and since doctors don't often know the underlying cause, a lot of the treatment is just "throw things at it and see what works". I have a friend that got very little depression release from ketamine, but TMS (transcranial magnetic stimulation) was what was helpful for him. So I'm very, very wary of ketamine getting oversold as a "wonder cure" - it may work for some people, but not others, and I've already seen how CBD and marijuana shops have popped up all over basically planning to cure every symptom under the sun since marijuana was legalized.
At the same time, I'm also wary of psychedelics being dismissed in a similar way to how they were dismissed and demonized about 50-60 years ago. I fully understand that the plural of anecdotes is not data, but I'm also not trying to find the statistically significant treatment for your average person - I'm just trying to not die. For me, I have all the evidence I need, and I feel it would be a tragedy to take away that option for other people before we know more.