Ketamine's effect on depression may hinge on hope • Hacker News Board

Re: Ketamine's effect on depression may hinge on hope

#221

Post by MadcapJake » Fri, Oct 20, 2023, 5:04 PM UTC

mnky9800n wrote: post #162

spicymapotofu wrote: post #161

Earlier quoted context omitted.

I believe this comment minimized the structure of spiritual experience in a hyperrational way, which is exactly as the GP comment warned against.

If your views in having a spiritual experience are exclusive to consuming psychedelic substances then you are minimizing what is available across the human experience in terms of spiritual explorations.

"If your views on crossing a river are exclusive to the usage of canoes then you are minimizing what is available across the human experience in terms of river crossings."

Somehow you turned someone's subjective spiritual exploration into them limiting themselves...

Re: Ketamine's effect on depression may hinge on hope

#222

Post by robocat » Fri, Oct 20, 2023, 5:48 PM UTC

teaearlgraycold wrote: post #44

PlunderBunny wrote: post #19

I don't want to downplay depression (which I have no experience of), or come across as being flippant, but could the placebo effect in many of these kinds of trials be as simple as "a caring person (professional and/or stranger) interacting with the depressed subject improves their condition?"

That seems really easy to control for

However giving randoms drug trials is rather evil.

Re: Ketamine's effect on depression may hinge on hope

#223

Post by kromem » Fri, Oct 20, 2023, 6:52 PM UTC

andrewedstrom wrote: post #78

Alternative explanation: ketamine isn’t better than placebo for treating depression when given to someone who’s under anesthesia. You have to be awake. Similarly, I bet that if you gave psilocybin to someone under anesthesia, they wouldn’t get the same benefits as someone who took it while awake.

Another alternative explanation: general anesthesia's disassociation alone combined with an expectation of transformative psychological change results in transformative psychological change similar to ketamine's disassociation combined with such an expectation.

Ruling out the general anesthesia as having an effect because general anesthesia without expectation of depression improvement doesn't improve depression seems like it toys with a false negative in ignoring the possibility of combined factors (specifically psychological disassociation plus expectations of change).

Re: Ketamine's effect on depression may hinge on hope

#224

Post by omginternets » Fri, Oct 20, 2023, 7:11 PM UTC

jiveturkey42 wrote: post #193

cnity wrote: post #139

Earlier quoted context omitted.

This system of scientific gatekeeping and law enforcement is a direct projection of the barriers put in place between individuals and god by the catholic church. For millennia authorities have attempted to prevent people from having meaningful spiritual experiences directly, of their own accord, via access to substances that grow e.g. in their nearest cow fields. In this way, your psychiatrist friend is simply the ne…

Because for every functional self-dosing career professional, there's 10 self-dosing tent dwellers living in squalor in every major US city

I certainly agree that the failure modes of addiction, homelessness and toxicity are worth avoiding.

Re: Ketamine's effect on depression may hinge on hope

#225

Post by omginternets » Fri, Oct 20, 2023, 7:14 PM UTC

Errancer wrote: post #178

omginternets wrote: post #7

Beyond the importance of controlling the placebo effect, I am worried that a lot of the drug-depression research is overlooking an important possibility: that the thing about ketamine/psilocybin/etc that is helping with depression is not some latent property of the molecule, but rather the actual transcendent experience of the trip. In other words, the trip is the point, not the mechanistic neuro-tinkering [0]. Impor…

I generally agree with you, but I would like to comment on the expression you used: "As a scientist, I can't really object to rationality on its own, but it may be worth considering non-rational, transcendent experience as a fundamental psychological need.". I think you would agree that if evaluations such as life-meaningfulness are secondary-properties or qualia like you said then arranging it as a debate between ra…

I completely agree with you. The opposition between rationality and life-meaningfulness was just a bit a useful rhetoric to get my my point across. I don't see any fundamental contradiction between the two, either.

Re: Ketamine's effect on depression may hinge on hope

#226

Post by omginternets » Fri, Oct 20, 2023, 7:16 PM UTC

nullindividual wrote: post #70

omginternets wrote: post #7

Beyond the importance of controlling the placebo effect, I am worried that a lot of the drug-depression research is overlooking an important possibility: that the thing about ketamine/psilocybin/etc that is helping with depression is not some latent property of the molecule, but rather the actual transcendent experience of the trip. In other words, the trip is the point, not the mechanistic neuro-tinkering [0]. Impor…

I find this... frustrating to read, at the least. This post assumes that all depression is a _lack_ of something external to the body. Or that depression is simply a chemical imbalance. It takes no accounting of physical deficiencies that can _never_ be cured and require a lifetime of maintenance, of which Ketamine can be (literally) lifesaving. The post is irresponsible. No one should be thinking that some sort of "…

Nothing I wrote is in opposition with psychiatric treatment.

Re: Ketamine's effect on depression may hinge on hope

#227

Post by omginternets » Fri, Oct 20, 2023, 7:19 PM UTC

Fluorescence wrote: post #140

omginternets wrote: post #30

Earlier quoted context omitted.

I couldn't be happier! Do me a favor: help me preach the good word that philosophy is an important and practical subject! :) If you want me to really tickle your noodle, consider that a lot of modern-day issues stem from a quest for transcendence in a society that has largely dismantled the institutions capable of delivering it. In particular, I am of the (somewhat provocative) opinion that things like radical Islami…

> at their core, performative quests for such transcendence That sounds like a middlebrow dismissal of what these groups are. I think you can describe them with more tangible psychological/philosophical motivations which I don't find useful to describe as "transcendence" e.g. - belonging : the appeal of the gang, the cult is to find acceptance, your tribe, your family. If life has thrown you to the curb and vulnerabl…

What you are describing is exactly transcendence.

People are giving themselves to higher-order causes beyond material comfort. They are organizing around rituals of belonging, gurus, directly seeking meaning, applying rational thinking towards advancing their values, experiencing deep personal emotion around systemic or cosmic injustices, and deriving a sense of elevation among "the dreary day to day".

Re: Ketamine's effect on depression may hinge on hope

#228

Post by omginternets » Fri, Oct 20, 2023, 7:21 PM UTC

caturopath wrote: post #99

omginternets wrote: post #7

Beyond the importance of controlling the placebo effect, I am worried that a lot of the drug-depression research is overlooking an important possibility: that the thing about ketamine/psilocybin/etc that is helping with depression is not some latent property of the molecule, but rather the actual transcendent experience of the trip. In other words, the trip is the point, not the mechanistic neuro-tinkering [0]. Impor…

> Importantly, this tracks with what we know about the protective effects of things like religiosity against depression I always took the mechanism to be community, that sort of thing. I guess if you're right we'd expect Pentacostals to be protected more than Lutherans, etc.? Do we have any idea what data is out there that might be able to disentangle this sort of question?

I'm not sure I'd agree, at least not directly. Community is transcendence of self, and both Pentacostals and Lutherans concern themselves with questions of divine order. I'm not sure I see a significant difference between the two (for our purposes, at least).

Re: Ketamine's effect on depression may hinge on hope

#229

Post by omginternets » Fri, Oct 20, 2023, 7:24 PM UTC

scotty79 wrote: post #143

omginternets wrote: post #7

Beyond the importance of controlling the placebo effect, I am worried that a lot of the drug-depression research is overlooking an important possibility: that the thing about ketamine/psilocybin/etc that is helping with depression is not some latent property of the molecule, but rather the actual transcendent experience of the trip. In other words, the trip is the point, not the mechanistic neuro-tinkering [0]. Impor…

> but rather the actual transcendent experience of the trip As a materialist I think it's absurd. But I think that trip is sure sign that the substance actually does something to neurons. And in case of some substances like drugs if you reduce dosage or adjust protocol so that trip doesn't happen means that you also got rid of any significant effect it might have on the brain. In my opinion saying that experience of…

>And in case of some substances like drugs if you reduce dosage or adjust protocol so that trip doesn't happen means that you also got rid of any significant effect it might have on the brain.

We agree. My point is that the evidence seems to be going in the direction of:

1. removing transcendence removes part of the benefit; and,

2. to complicate matters, many protocols fail to properly control for transcendent experience because a lot of control groups are placed in a quiet room, free of distraction, and invited to ponder life.

We're both materialists. Mine is a materialist position.

Re: Ketamine's effect on depression may hinge on hope

#230

Post by omginternets » Fri, Oct 20, 2023, 7:24 PM UTC

colordrops wrote: post #126

omginternets wrote: post #7

Beyond the importance of controlling the placebo effect, I am worried that a lot of the drug-depression research is overlooking an important possibility: that the thing about ketamine/psilocybin/etc that is helping with depression is not some latent property of the molecule, but rather the actual transcendent experience of the trip. In other words, the trip is the point, not the mechanistic neuro-tinkering [0]. Impor…

> In other words, the trip is the point, not the mechanistic neuro-tinkering Are you claiming that there is a soul? Becauae many posit that the brain and thus our experiences are made of matter and energy and as mechanistic as anything else.

I believe I addressed the question of materialism vs dualism in my original comment?