Ketamine’s effect bolsters a new theory of mental illness • Hacker News Board

Re: Ketamine’s effect bolsters a new theory of mental illness

#101

Post by spotman » Sat, Dec 19, 2015, 2:29 AM UTC

civilian wrote: post #11

spotman wrote: post #4

This makes me nervous. Ketamine has major issues with bladder damage when taken repetitively. Possibly with a low enough dosage this would be manageable, but speaking from experience from watching people that have been on the wrong end of the stick with this one. it can do some really serious long term damage in that department.

The depression-fixing threshold is smaller that most recreational use, and it would only be once every two weeks. That side effect trivial to rule it out. Educate yourself and stop being a pawn of the drug war. I watched two documentaries in short succession: Drugs Inc's episode on Ketamine, and a few episodes of Combat Medic. Drug Incs' played up the bladder damage, the persistant dissociative feeling with abusers,…

Just want to say, I hear you and in no way am I a fan of the drug war. I should have read more about toxicity levels before commenting.

The reason my initial gut felt this way is not due to any documentary or scare tactic it's purely personal experience.

I have two close friends that have taken the recreation too far. One now has permanent bladder issues and the other was lucky to get their habit in check in time. So my gut reaction was not very scientific, apologies.

I am a huge fan of legalization and science. Let people make their own mistakes and if there is a medical path that helps people I'm all for it!

Just hope that this is also part of the discussion ( harm prevention ) because there is some real risks with abuse, that personally I have witnessed first hand.

Having said that science over fear for sure, I am a fan of science over fear. I still feel more positive light than negative and am hopeful people use his for good!

Re: Ketamine’s effect bolsters a new theory of mental illness

#102

Post by drharvey » Sat, Dec 19, 2015, 2:33 AM UTC

rl3 wrote: post #95

_ywdj wrote: post #91

Earlier quoted context omitted.

While I agree that neither exist in complete isolation, it still doesn't preclude one from being the dominant cause. Well the argument I was responding to was that the two are completely unrelated , so if you accept that they're not, we're mostly on the same page. The question then is how common it is for one to be overwhelmingly dominant. From my experiences and research, I'd suggest that like most other biological…

> This may be where I lose you completely, but I would make the same argument for those conditions. While I'm not disputing that emotional techniques can be beneficial, my main point was that in certain cases, the cause of the condition is probably the result of overwhelmingly dominant biochemical or physiological factors.

I'm going to jump in here.

Meta-analysis has shown that approximately 80% of all cases of depression are initially caused by a major life stress (1). So "exogenous" factors seem to play a large role in triggering most depression. That said, not everyone develops depression following a major life stress - people have different levels of "endogenous" stress resilience/susceptibility. "Endogenous" stress resilience can be modulated, however, by "exogenous" interventions. For example, resilience can be increased by behavioral stress inoculation or even exercise, and it can be decreased by things like sleep deprivation or illness. It can also be partially inherited (i.e., if someone's parents were "exogenously" stressed, the offspring can inherit lower levels of stress resilience through "endogenous" epigenetic changes) (2).

And though 80% of initial depressive episodes may be triggered by stress, this tight correlation between stress and depression does not persist as strongly after the first depressive episode. Essentially, once someone has been depressed a first time, they are then "endogenously" more susceptible to subsequent episodes of depression.

So, is it exogenous or endogenous? Long story short, in most cases, it's both. Even if it doesn't start as both, it becomes both. And both "exogenous" and "endogenous" contributing factors interact in an on-going dynamic process.

1. http://hammenlab.psych.ucla.edu/pubs/05stressand.pdf 2. http://www.ncbi.nlm.nih.gov/pubmed/26410355

Re: Ketamine’s effect bolsters a new theory of mental illness

#103

Post by cpncrunch » Sat, Dec 19, 2015, 2:34 AM UTC

rl3 wrote: post #99

_ywdj wrote: post #94

Earlier quoted context omitted.

I would question the definition of a "fantastic" life. Appearance and reality are very different things.

I realize that. My point was that when the source of the depression is primarily biochemical/physiological in nature, that no matter how good the person's life is, or how well they apply emotional techniques, it can still cripple them.

How do you tell the difference?

Re: Ketamine’s effect bolsters a new theory of mental illness

#104

Post by chillwaves » Sat, Dec 19, 2015, 2:42 AM UTC

rconti wrote: post #67

kaybe wrote: post #58

Earlier quoted context omitted.

Are employer drugtests common in the US, even for non-critical work?

The crappier the job, the more likely that it drug tests. And, of course, safety-reliant jobs like truck drivers, warehouse staff, etc.

This. The only jobs I ever got tested for where the ones not worth having.

Re: Ketamine’s effect bolsters a new theory of mental illness

#105

Post by spangry » Sat, Dec 19, 2015, 3:17 AM UTC

slapshot wrote: post #71

astazangasta wrote: post #34

I have been depressed a significant fraction of my adult life. I am also a biologist who abhors the medical description of this problem. I don't even like the word 'mental illness'. This shit is not an illness, its a normal response to a fucked up life! Can I get at least some acknowledgment of this fact? The sine qua non for me was an issue of Nature a few years back that focused on depression, talked about how prev…

I am close to somebody who has been strongly affected by depression. She has, in any material respect, a perfect life. She has food, clothes, a supportive family, a great job, plenty of money, etc. There is nothing "wrong" with her life. But she suffers off-and-on depression. Not just "I feel bad" depression. Crippling, "can't get out of bed" depression. Periodic suicidal ideation. Occasional suicide attempts. She kn…

I'm very much in this category of depression. I have what is unfortunately termed 'melancholic depression'. I should note that I'm very sceptical of the DSM 'disease model' of mental illness, and am glad to see psychiatry and neuroscience beginning to converge. 'Discrete disease' is a poor abstraction for most mental illnesses. A better term for my kind of depression would be 'endogenous depression' (i.e. depression that comes from within). I have an objectively good life: I have a family that loves me, friends that care about me, and a job that I enjoy with colleagues I respect.

Yet I still have episodes where I sometimes can't get out of bed, or can't bring myself to leave the house. A couple of months ago I spent three days just sitting (and occasionally sleeping) in a chair, not even getting up to eat or shower. I just simply couldn't do it.

While it's true that people can experience temporary depressive episodes due to 'exogenous' factors (e.g. the death of a loved one), it is very different to 'endogenous' depression, and requires different types of treatment. While talk therapy and time can be very helpful for people to work through difficult and temporary 'adverse circumstances', it is of little help for endogenous/biological depression.

No amount of 'talk therapy' can convince my pre-frontal cortex to operate within 'normal' parameters or to get my brain to produce appropriate quantities of neurotransmitters like serotonin, dopamine and noradrenaline. I'm reasonably sure this is a chronic illness that I will never be rid of (as I've learned from 15 years of failed treatment attempts). On the upside, there's a good chance that there is some treatment out there, coupled with sustained lifestyle changes, that will allow me to stave off the symptoms so that I can live a relatively 'normal' life. In some ways it's similar to how type 1 diabetics can survive and live normal lives with regular injections of insulin.

Re: Ketamine’s effect bolsters a new theory of mental illness

#106

Post by drharvey » Sat, Dec 19, 2015, 3:23 AM UTC

I think some of these posts might be inadvertently debating dualism, "the philosophical position that mental phenomena are non-physical." You're arguing whether depression is caused by emotions and thoughts vs biology (mind vs brain), when Neuroscience doesn't make a distinction. Emotions and thoughts are biology - serotonin and glutamate and neurons are not considered to be separate from behavior, they are how behavior is encoded. In Neuroscience, the mind is usually considered an emergent property of the brain.

It's like arguing that a bug is a problem with the UI, not the code...

https://en.wikipedia.org/wiki/Dualism_(philosophy_of_mind)

Re: Ketamine’s effect bolsters a new theory of mental illness

#107

Post by rl3 » Sat, Dec 19, 2015, 4:03 AM UTC

cpncrunch wrote: post #103

rl3 wrote: post #99

Earlier quoted context omitted.

I realize that. My point was that when the source of the depression is primarily biochemical/physiological in nature, that no matter how good the person's life is, or how well they apply emotional techniques, it can still cripple them.

How do you tell the difference?

https://news.ycombinator.com/item?id=10762457

https://news.ycombinator.com/item?id=10761938

Perhaps they can provide some insight as to how.

Re: Ketamine’s effect bolsters a new theory of mental illness

#108

Post by pazimzadeh » Sat, Dec 19, 2015, 4:15 AM UTC

lilcarlyung wrote: post #25

What with the pro-drug posts here all the time. I'm guessing that most of the HN audience is American. Is it common among techies in the U.S. to experiment with psychoactive drugs, hence the interest and knowledge? Please, do not mention Steve Jobs acid experiences.

You could say that drugs are a way to "hack" the brain.

Re: Ketamine’s effect bolsters a new theory of mental illness

#109

Post by _ywdj » Sat, Dec 19, 2015, 4:20 AM UTC

rl3 wrote: post #99

_ywdj wrote: post #94

Earlier quoted context omitted.

I would question the definition of a "fantastic" life. Appearance and reality are very different things.

I realize that. My point was that when the source of the depression is primarily biochemical/physiological in nature, that no matter how good the person's life is, or how well they apply emotional techniques, it can still cripple them.

no matter how good the person's life is

I think the mistake here is to assume that a privileged life is a good life.

All the comments here that say things like "they had plenty of money, good looks, great career etc but were crippled by depression" make that mistake.

Re: Ketamine’s effect bolsters a new theory of mental illness

#110

Post by cpncrunch » Sat, Dec 19, 2015, 4:21 AM UTC

spangry wrote: post #105

slapshot wrote: post #71

Earlier quoted context omitted.

I am close to somebody who has been strongly affected by depression. She has, in any material respect, a perfect life. She has food, clothes, a supportive family, a great job, plenty of money, etc. There is nothing "wrong" with her life. But she suffers off-and-on depression. Not just "I feel bad" depression. Crippling, "can't get out of bed" depression. Periodic suicidal ideation. Occasional suicide attempts. She kn…

I'm very much in this category of depression. I have what is unfortunately termed 'melancholic depression'. I should note that I'm very sceptical of the DSM 'disease model' of mental illness, and am glad to see psychiatry and neuroscience beginning to converge. 'Discrete disease' is a poor abstraction for most mental illnesses. A better term for my kind of depression would be 'endogenous depression' (i.e. depression…

If you don't mind me asking, is there anything you can identify in the days/weeks before you become depressed, such as working long hours for a long period, boring work, excessive negative emotions, etc.

It's not that I don't believe your depression is endogenous, I'm just curious. I was in a similar position to you until I looked closely at my life and identified the factors that were causing my depression/CFS.