Ketamine is a psychoactive molecule also known as arylcyclohexylamine.
It is FDA approved as a dissociative anesthetic and procedural sedative. In the last two decades, ketamine has been increasingly clinically applied at sub-anesthetic doses as an off-label treatment for various chronic and treatment-resistant mental health conditions, such as depression, substance use disorder, post-traumatic stress disorder, and anxiety disorders. There is also research suggesting beneficial effects for OCD, eating disorders and end-of-life care.
It is a rapidly acting antidepressant and mood enhancer which can be felt within a couple of hours of treatment. In addition ketamine can be a tool for psychospiritual exploration.
HOW DOES KETAMINE WORK?
SCIENCE:
Scientifically speaking, ketamine is a mixture of two compounds that are mirror images of each other but not exactly alike. It’s like your hands, mirror images, but not the same. One such compound is called esketamine or S-ketamine and the other is arketamine (also called R-Ketamine or Ketamine) They have the same atomic structure with slightly different orientations in 3-dimensional space which gives them slightly different properties.
Ketamine’s effects on the brain are complex and multifaceted. It works primarily by blocking the N-methyl-D-asparate (NMDA) receptors. This prevents glutamate from attaching to the NMDA receptor and it can now attach to different receptors.
Glutamate is the most plentiful excitatory receptor in our brains. At low (sub-anesthetic) doses, ketamine increases glutamate which leads to an increase in Brain-Derived Neurotrophic Factor (BDNF). More BDNF increases neuroplasticity, the ability of brain cells to form new connections with one another.
Glutamate is also released in the prefrontal cortex of the brain which can lead to the more psychedelic effects on altered perception. Additionally, ketamine affects other neurotransmitter systems such as opioid, serotonin and cholinergic receptors which contribute to its diverse pharmacological effects.
When it binds to NMDA receptors, ketamine blocks the neurotransmitter glutamate at the receptor site. This blockade disrupts the normal functioning on glutamatergic neurotransmission which leads to the characteristic effects of ketamine.
While ketamine blocks some NMDA receptors, it also increases glutamate release in the prefrontal cortex of the brain. This is instrumental in the more psychedelic effects of altered perception.
Although scientists don’t know exactly how ketamine leads to an anti-depressant response, for example, it’s hypothesized that part of it is from the increase in brain neuroplasticity. Neuroplasticity refers to the brain’s ability to reorganize itself by forming new neural connections throughout life. This process is crucial for learning, memory, new ways of approaching self and others, and adapting to new experiences.
If neural networks are primed for change or new learning from ketamine, then it makes sense that it’s possible to guide neuronal adaptations into a direction that supports positive change.
Ketamine also affects connectivity between different parts of the brain - some parts connect and other parts disconnect. Unlike traditional anti-depressants, ketamine turns down activity in the brain’s default mode network (DMN)
DEFAULT MODE NETWORK:
Robin Carhart-Harris first hypothesized the brain’s default mode network in 2001.The main idea is that the DMN is a network of interconnected brain regions that are active when a person isn’t engaged in tasks or focused on the outer world. Instead the DMN is active during times of rest, self-reflection, day-dreaming and introspection. It’s thought to be involved in processes like autobiographical memory, imagining the future and understanding the thought and feelings of oneself and others.
Therefore, turning down the activity in the default mode network can help by reducing rumination, excessive self-referential thinking, pessimism and negative thought patterns associated with conditions like anxiety and depression. By quieting this network, you may experience greater emotional regulation, improved mood and enhanced resilience to stressors. It can also facilitate mindfulness, present-moment awareness and promote overall psychological well-being. All of this helps with ketamine’s therapeutic benefits.
SPIRITUAL, MYSTICAL, TRANSPERSONAL EFFECTS:
At certain doses, ketamine can open the door to what some call, mystical, transpersonal or spiritual experiences. These can carry you into something that is numinous, a felt sense of transcendence. They have a profound impact on healing because they can give you a sense of oneness, of connection to something greater than yourself, however you might name it.
These experiences can help you shift your perspective, see your problems in a new light and feel a sense of peace and acceptance. They can also bring about feelings of awe, gratitude and love which have been shown to have powerful effects on physical mental and emotional well-being.
Additionally, transcendent or numinous experiences can help you tap into your inner resources, your inner healer, for coping and resilience which lead to greater emotional strength and clarity.
By helping you realign with your own values and meaning-making, these types of experiences can play a significant role in your own personal healing process. I believe this will benefit you, others and the world.
In 1973 Carl Jung wrote about the healing power of numinous and transcendent experiences in his ‘Letters’:
The main interest of my work is not concerned with the treatment of neuroses but rather with the approach to the numinous. But the fact that the approach to the numinous is the real therapy, and insasmuch as you attain to the numinous experience, you are released from the curse of pathology’.
There are many ways to cultivate your connection with the numinous. Regardless of how you do so, one consistent aspect was highlighted by Jack Kornfield in his book, ‘After the Ecstasy the Laundry’. His title says it all. After a profound experience, we are faced with the task of translating it into our daily lives. In other words, we still have to do our laundry.
The same can be said about your life after a spiritual, numinous, transcendent experience on ketamine.
How does it change you? What will you create? How now shall you live?
To Learn More About Ketamine:
Go to History of Ketamine and Ketamine Resources to learn more about ketamine medicine.
Go to What is Ketamine-Assisted Therapy and How Does KAP Work? for more information on ketamine sessions.
My “Why Ketamine” page talks about the benefits I’ve seen in people and why I’m enthusiastic about offering you the opportunity to work with ketamine.