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Ketamine's effect on depression may hinge on hope

med.stanford.edu

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

#231

Post by omginternets »

Natsu wrote: post #127
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 I've seen the results ketamine can give first hand, and the dangers of it, but I'm more convinced it may just be getting proper sleep given the connection between sleep apnea and depression. I would bet that if they engineer a version that does not cause psychosis it will work just as well for the population it does work on. And we should not be quick to dis…

To your point, I think that what you describe is also a common cause for depression. As Freud said (paraphrasing): most of my patient's aren't mentally ill, they just haven't learned how to live well. There is much to be said for the idea that psychological needs are (mostly) physiological needs like sleep, food, water and exercise. If we extend that to include social needs like love, security, a healthy sex life, stimulating conversation and adventure, we start to approach a notion of transcendence.

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

#232

Post by omginternets »

justatdotin wrote: post #75
omginternets wrote: post #58

Earlier quoted context omitted.

I just want to endorse this comment. Psychadelic drugs have a miraculous property: they elicit transcendent states reliably . Eat the mushroom and you will experience it. There are corresponding risks to this, of course, but that's the flip side of their utility as a (sharp) tool.

these tools allow exploration of not just introspection but also states that otherwise belong safely behind a closed door. Yes I might actually enjoy having countless shards of the universe's ideas slicing through my ego for a few hours at night over the weekend; no I never want that to experience that during a workday.

I mean, you don't have to do everything all the time. I certainly don't feel any transcendence right now.

I'm not sure what your point is, beyond perhaps "don't do drugs all the time?" If that's it, I don't think anyone here would object.

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

#233

Post by omginternets »

astrange wrote: post #108
acchow wrote: post #39

Earlier quoted context omitted.

Much of the benefit of psychedelics is the introspection , which you can do sober as well (although the depth of the reflection is magnified and qualitatively different while tripping). This is confirmed by the linked study (which shows that placebo-ketamine is also very effective).

There's also reliable studies that it isn't that, and I actually expect it isn't, since antidepressants in general don't work by making you introspect. Actually "rumination" is a symptom of depression, so they would make you do it less, and IME meditation is not about introspection either. Here's one showing a mechanism ketamine and antidepressants both act on: https://www.science.org/content/blog-post/how-antidepres…

Discussion of psychadelics often concern themselves with recurring or treatment-resistant depression, so the transcendental analysis is very relevant.

Depression seems to have more than once cause.

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

#234

Post by omginternets »

KptMarchewa wrote: post #79
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 am a materialist. I agree delusions are powerful mechanism against depression, but most of them, like religion, have awful side effects.

The words you're saying aren't materialist so much as they are logical positivist. As it turns out, there are things that are both true but not provable (be it empirically or analytically).

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

#235

Post by omginternets »

Xenolato wrote: post #202
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…

Counterpoint: Religion has mechanism which force you to life with depression. See the notion that suicide is illegal/bad. Also most old people I know are religios and still are depressed. Religion overall has very little effect on people. How many are religios and still break all rules. Alone hating on other people, being racists etc.

No objection. There are pathological cases of religiosity.

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

#236

Post by omginternets »

agumonkey wrote: post #83
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…

So you think the effects lie at the conceptual/existential plane of our brains rather than the neurobiological one?

I don't think there's a neat distinction separating the two.

Or, I could have just as well answered "both, but medicine is ignoring one".

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

#237

Post by omginternets »

bowsamic wrote: post #174
omginternets wrote: post #20

Earlier quoted context omitted.

Sorry, what can be harmful exactly? The experience of drugs? I completely agree. A corollary of my position is that you should be able to fix a fair bit of depression by providing non-pharmacological access to transcendent experience. The drug is then a (very potent and correspondingly sharp) tool among others.

The prejudice against it is huge to be honest. I am a Jodo Shinshu Buddhist and a majority of other Buddhists online mock me for using religion in the way you describe, that is, to connect with the Absolute and to understand my life. Not even just the secular ones, who call me pathetic for believing in Amida Buddha or Pure Lands, but even the very religious ones, who say that I am arrogant for thinking that I can giv…

>to connect with the Absolute and to understand my life

That's very unfortunate, seeing as it's the entire point of religion...

Your experience tracks very closely with my involvement with Roman Catholicism in my childhood and adolescence. It's frustrating beyond words, and has largely put me off from participating in religious institutions.

Thankfully, there are some incredible thinkers who have written books!

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

#238

Post by amp108 »

crtified wrote: post #150
suzzer99 wrote: post #87

Related to the psychological vs. physiological discussion: I can say with confidence that the first time I did ecstasy changed how I look at the world. We went for a walk barefoot on warm pavement and it was the most wonderful thing I ever felt. I realized on a visceral level that so much of our personal happiness is based on how we look at things, not what happens to us. I don't know if I got any chemical benefit fr…

Fun is arguably the best (some might say the only authentic) way to cure depression.

Dancing is arguably the best (some might say the only authentic) way to cure quadriplegia.

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

#239

Post by anon84873628 »

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…

Yeah. Seems likely that the subjective experience of the trip is simply what you feel when firing/rewiring the networks that cause the healing. There's no incompatibly between "it's the experience" and "it's the neurology" because they are one in the same.

But there are a lot of different ways to do the healing (e.g. consistent meditation as others mentioned) which will of course be coupled to different feelings/experiences. The "large psychedelic dose" method is just one end of the "works fast + feels strongly" spectrum. Of course as the science/technology develops we will find other points on the spectrum that balance the properties differently -- maybe even through placebo effect alone as suggested here.

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

#240

Post by p1esk »

nullindividual wrote: post #214
p1esk wrote: post #80

Earlier quoted context omitted.

Could you explain? What is the difference? I only had Ketamine once during surgery and I vividly remember the few hours after.

It of course depends on your IV dosage. You can see and hear things that aren't there. Even have a conversation with mythical, religious, or spiritual entities. You can experience 'past lives' (whether factual or not, which I don't believe so, experiencing something you THINK is a past life is interesting). And it can go south with disturbing or dark imagery.

Sorry my question was not clear - I’m curious about the difference between experiencing Ketamine administered during general anesthesia (like I did) vs administered when conscious (same dosage).
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