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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

#241

Earlier quoted context omitted.

But why call them spiritual experiences when hallucinations will do even better?

"Do people have ideas or do ideas have people?" might have something to do with the phenomenon of different humans preferring different labels for the same thing.

This is from Jung right? I've always been fascinated by his teachings, especially the collective unconscious. I'm just gonna leave a couple related quotes and ideas down here cause I want to.

Dostoevsky made observations like this, too.

"It was not you who ate the idea, but the idea that ate you"

"Men need to bow down to something; whether another man or an idea.”

I think Ernest Becker explored similar ideas in The Denial of Death, though through a different context.

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

#242

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…

Very well written statement.

> Importantly, this tracks with what we know about the protective effects of things like religiosity against depression. As such, the qualitative experience of the drug might not be something we can (or should) do away with. I would even go as far as suggesting that an absence of transcendence in one's life is precisely what causes a large segment of people to become depressed in the first place, and that perhaps drugs are helpful only insofar as they produce a transcendent experience.

Fantastic point and so well written. As someone who experimented in my late teens/early 20s, I wholeheartedly agree with this. The experience changed me in a positive way and has helped make me who I am today.

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

#243

Earlier quoted context omitted.

> 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. Ketamine dosed at levels used in a lot of the original depression studies won’t result in anything resembling a “trip”. Many of the more res…

I am happy to be sorted into the "responsible" category, since I prescribe IV ketamine with the mentioned 40 minute slow IV infusion at 0,5mg per kg of body weight. I would like to chime in a thought about the choice of words... I think that we might be doing us a disservice when reducing the whole discussion down to "trip" or "no trip". Some patients have mild sensory experiences from the treatment, some have unplea…

The definition of a "trip" varries wildly within the communities that take psychedelics and dissociatives. When someone who has never taken these substances talks about a trip, I don't know what they mean, and I'm not sure if they know what they mean.

I only say all of this to ask: Is there a scientific or medical definition for a trip? Is the medical community still trying to decide what constitutes a trip, or is that well defined?

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

#244
post #238

Earlier quoted context omitted.

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.

I take your point. I meant it in the context of an earlier poster - if not the title topic, itself - who drew a line between ketamine_as_medication and ketamine_for_fun, and implied that that recreational drugs as a form of depression therapy were merely a way to have 'a fun trip', and not of any real benefit.

However, insofar as fun is synonymous with happiness, which is antonymous with depression, every cure for depression involves the end goal of fun - one way or another. Pharmaceutically / chemically, emotionally, socially, intellectually, spiritually, you-name-it.

Therefore, regarding this topic, I was positing that, where usage of recreational drugs as a novel cure for depression is concerned, the fun is the curative. But I can see how my generalisation could be interpreted as minimalising, if viewed as a pithy solution precluding all nuance - which it was not intended as!

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

#245

Earlier quoted context omitted.

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".

Oh to me there's an easy one:

- conceptual layer failure => asylum

- neurobio layer failure => life support

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

#246

Earlier quoted context omitted.

> 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 exper…

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

I'm not quite sure about you because you are using words like transcendence. ;-) In my view the deep experience of the trip, what you call transcendence, is just another hallucination, just hallucination of meaning and understanding instead of simple images, sounds or sensations.

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

#247

Earlier quoted context omitted.

That sounds terrible. It really sounds like they were already pretty far gone. I was able to get help with my depression from magic mushrooms, but it was at most a moderate case.

LSD was negative for me. It basically made me realise that suicide was an option, and I struggled to stop thinking about it, even now

LSD was also bad for me. Just made me feel anxious and self-conscious. Sorry to hear it’s been so difficult for you.

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

#248

Earlier quoted context omitted.

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).

Prove it.

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

#249

Earlier quoted context omitted.

> 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?

Did you edit the comment? I don't recall seeing the footnote before. In any case it was a rhetorical question to understand your reasoning, as I personally don't take a stance on whether a soul exists or not.
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