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How Does Ketamine Work?

Ketamine's antidepressant effects are not fully understood, but it appears to impact the brain's glutamate system, leading to increased levels of Brain-Derived Neurotrophic Factor (BDNF), which promotes neural growth and adaptability. Additionally, ketamine affects serotonin and dopamine release, influencing mood regulation. Unlike traditional antidepressants, ketamine's positive effects often manifest rapidly within hours to days, making it valuable for severe depression or treatment-resistant cases. However, its use requires careful administration by healthcare professionals.

Intense stress experienced by patients with depression and mental illness can lead to alterations in brain cells, making them less adaptable and reducing their ability to communicate effectively. As a result, stressed individuals may struggle to cope with negative events due to disrupted connections between nerve cells. Ketamine is thought to facilitate the "rewiring" of these broken connections in the brain, enabling receptors to communicate more effectively and respond to neurotransmitters with greater efficiency.

“Think of the brain as a hill covered in snow, and thoughts as sleds gliding down the hill. As one sled after another goes down the hill, a small number of trails will appear in the snow. And every time a new sled goes down, it will be drawn into the pre-existing trail, almost like a magnet. Those main trails represent the most well-traveled neural connections in your brain. In time it becomes more and more difficult to glide down the hill on any other path or in a different direction. Think of psychedelics (ketamine) as temporary flattening of the snow. The deep woven trails disappear, and suddenly the sled can go into other directions, exploring new landscapes and, literally, creating new pathways” – Mendel Kaelen

When ketamine is in the system, patients may experience dissociative effects, commonly known as the "trip," which involves a feeling of mind-body separation. However, it's essential to note that the trip itself is not the treatment; it is merely a temporary state patients go through to receive the treatment. The actual treatment lies in how the brain reacts to ketamine and how it responds to the chemical.

Research indicates that within just one day of the first ketamine dose, the brain's lost connections begin to regrow. The more connections that regenerate, the more effective the antidepressant effects of ketamine are for patients. This process of regrowing and reactivating brain connections enhances the brain's ability to adapt and may facilitate a shift out of depression, anxious states, or cyclic negative patterns commonly associated with conditions like PTSD, addiction, and other mental disorders.

This phenomenon could also explain why individuals who previously did not respond well to antidepressants or therapy might now find relief or experience improved outcomes after ketamine treatment.

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