Ketamine for depression: Tough talk and a warning

Ketamine infusions aren’t anything like going to a spa or meditative retreat for rejuvenation, deep insights, or personal growth. They are a medical procedure for a serious illness, with many similarities to going for ECT.  I feel the need to say this because as someone who really believes in the future of this treatment I think a lot of the public hype about it is becoming dangerous.

People seem to be expecting ketamine treatment to be the definitive answer for their suffering when nothing in life really works that way.  They are waiting to experience some kind of sign during or right after their infusions, rather than understanding that all recoveries require time, effort, adjustments, and so on. But more frightening is the related tendency for people to downplay the need for psychiatric supervision while receiving this treatment. Depressed people are being tempted to seek help from anyone who can administer ketamine without seeming to realize how risky this is. Too many are relying on internet forums for crucial information and support because they lack sufficient professional care. And some of the patients doing improvisational ketamine treatments with inappropriate providers don’t seem to have exhausted other proven options, such as psychotherapy (or TMS, ECT, and so on). Taken together, these trends are very alarming.

Doctors need specific expertise to be able to provide ketamine treatment effectively and safely. They also need to be closely monitoring your mental health, overseeing all your various medications, and addressing your questions/concerns (or communicating with a mental health professional who has responsibility for these aspects of the treatment).

If your depression is severe and treatment-resistant enough to require an experimental treatment like ketamine, it is definitely serious enough that you need psychotherapy and/or another form of careful monitoring by a mental health professional. Please, the possibility of hospitalization ought to be kept in mind, at least as a back-up plan, if you are thinking you need to start this treatment. That people’s first impulse is instead to find some doctor willing to play around with giving them ketamine as part of an uncharted and incredibly expensive do-it-yourself project suggests that the hype about ketamine being a quick and easy miracle cure has gone way too far.

I understand all too well that people suffering from depression feel very desperate. And I know that some of the doctors hanging up their shingles as ketamine providers genuinely believe they are going to help these people (and not just cash in on their desperation). I am just afraid that people are going to end up getting really hurt.

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