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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

#201

Post by Octabrain »

ravishi wrote: post #180
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…

Same thing happened to me the first time I tried using molly. I am convinced it was actually a fake of some amphetamines and caffeine or something. But it still had an effect on me: for the first time in my life I was able to have fun while being surrounded by a crowd of people (it was a music festival). It didn't make me feel dumbed down like alcohol used to. I just felt happy, just wanted to have fun and enjoy the…

Similar experience here. It triggered the thought in my mind of "this feeling exists". It's weird to explain. It's like MDMA created a reference in my mind and, instead of making me to fall into the process of "I need the drug to be happy", it made me to search for things in life that bring me that feeling of happiness and comfort I got as a reference from the experience. I remember vividly the walk to home after the party, with a beautiful girl holding my arm, the hot shower afterwards...it was the first time in my whole existence that I honestly thought "life is beautiful".

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

#202

Post by Xenolato »

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.

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

#203

Post by theGnuMe »

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…

The simplest metaphysical thing to be amazed at is that we are all conscious and ascribe theory of mind. Be amazed. Also we are all connected evolutionarily as well and we evolved with other organisms so the whole planet is basically connected. That we have paleolific components of our brain and we can use meditation to calm them. All great stuff that doesn’t require the psychedelic. Also recognize that We are social animals so human connection is vitally important. I can regulate your behavior via mirror neurons.

Religion is community at its heart.. but maybe we need an abstract idea of god to foster that community.

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

#204

Post by theGnuMe »

alisson_dover wrote: post #49
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).

Many psychedelic-era personas expressed this sentiment as well: you don't need psychedelic drugs to reach that state, you could also spend 10 years practicing meditation daily. This view ignores the major application of these substances. Ketamine-induced self-therapy is accessible instantly and acts as a major reset. When you are experiencing long-term depression and/or anxiety, the advice to "just meditate" or do de…

Meditation is really about changing your life. It’s a daily practice like exercising. It’s taking action and doing the work. So it probably offers longer relief from depression since it is a life change.

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

#205

Post by CodeCounselor »

tudorw wrote: post #165
CodeCounselor wrote: post #158

Earlier quoted context omitted.

I apologize if I misunderstand you, which is very possible. I interpret you as saying that unless there is a "trip" there is only a placebo effect left on the table so to speak. I think this is somewhat refuted by the fact that the standard ketamine infusion protocol (that does not normaly induce "trips") has an effect size that dwarfs the effect size of placebo (say 0.2 - 0.4). Some studies have shown ketamine appro…

Thanks for all the detail, I'm interested to know if you have explored CYP gene expression (polymorphism) and it's impact on metabolising ketamine as factor in treatment?

Hello. Sadly no. This is something that is probably overlooked and/or neglected on a regular basis. Often when the question comes up the most pragmatic next step is to switch drug or modality to something that doesn't rely on the suspected metabolic pathway in question...

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

#206

Post by mistermann »

nottorp wrote: post #169
cnity wrote: post #149

Earlier quoted context omitted.

I believe you have misread my post. Powers that be continue to want me to not have mind altering experiences. I continue to have them anyway. So it goes.

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.

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

#207

Post by hattmall »

raducu wrote: post #145
stavros wrote: post #134

Earlier quoted context omitted.

Yes, but if that were the case, we'd see it being universal around the world until a few decades ago, which, as far as I know, isn't the case.

Transcending death and a longing for deeper meanings for life are quite universal, but yeah, tripping, I don't think so. But some people might be more comfortable saying there's a fundamental need for tripping than saying there's a fundamental need for religion (which usually encompasses transcending death and deep meanings for life).

There's a fundamental need for observing the world through different lenses / perspectives. Humans, some more than others, are geared toward identifying threat / negative environmental attributes mainly through pattern recognition.

This is hugely beneficial, until it isn't. Having the ability to utilize multiple lenses to see things in a different perspective allows us to unrecognize the threats from our most used perspective.

The over recognition of threats, particularly those you can't control, plays a major role in depression (rage) and anxiety.

Everyone has a default perspective but getting deeply involved in anything can allow us to gain additional perspectives.

Religion provides an alternate perspective. E.g it is the will of Allah, Jesus died to save me, ending any suffering ends all suffering, etc.

With that when you look at things you can apply those perspective filters and see things differently.

Deep interests are filters as well. An example that is a personal anecdote is when I became involved in woodworking and construction I look at houses and "see" how they were built, I see the components, the connections etc, I see trees as board feet and just intrinsically visualize their milling.

It happens with other things as well and it can bring anxieties too, I'm far more concerned that some buildings are going to collapse at random after I have been involved in construction.

Religion can of course add anxieties.

Any new perspective can. Having a new perspective / different way of thinking, on a physical level is a rewiring of connections in the brain. The perspective can become reflexive, mental muscle memory.

The activity of drugs is to induce this rewiring effect. Changing the actual way the brain works by binding to receptors and forcing new connections or reroutes.

Historically people would play many roles, typically changing with the seasons, each which offered a different focal perspective.

As well they would have a deep guided religious experience, use perspective changing drugs and have a strong notion of either self or community which offered further perspectives.

Today many people follow the same path and pattern far too frequently. Affording very limited development of alternative perspective. This leads to a much more developed recognition of negatives due to lack of diversified perspectives.

What else could happen though, it's often, daycare for 3 years, school for 12/16+ then work for 30-40 years. Perhaps there's a year or even just a couple summers of exploratory travel, then we're relegated to a few weeks of vacation and commercialized cultural holidays.

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

#208

Post by suzzer99 »

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.

Yeah but that serotonin crash afterwards was bleak. At this point in my life I can do E about once a year. Any more than that and I get really depressed afterwards.

Although I do know people who are clinically depressed, and the hangover/crash doesn't bother them as much, because it's their normal state anyway.

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

#209

Post by jpadkins »

NickM wrote: post #43
supportengineer wrote: post #28

Earlier quoted context omitted.

In a late-stage capitalism world, where the climate is collapsing, and homes are unaffordable, where does hope come from?

Not to downplay the current world problems, but you could make similar arguments at any point in history about any number of big problems humanity has faced. Yet, people still find hope and keep solving problems.

in the past we had religion, which gives some people hope. we have yet to find the replacement for religion.

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

#210

Post by mistermann »

sitkack wrote: post #183
Errancer wrote: post #178

Earlier quoted context omitted.

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…

Can one be a rationalist and still believe that, “the universe if fucking lit” and marvel at how wonderful it is? I believe being rational allows one to really experience the depth and breadth of the place we are in. Bleak utilitarianism is why so many reject applying themselves to a deeper understanding of the world, willfully ignorant in a way to manufacture wonder via a lack of comprehension. It starts early, with…

> Can one be a rationalist and still believe that, “the universe if fucking lit” and marvel at how wonderful it is? I believe being rational allows one to really experience the depth and breadth of the place we are in.

Based on observations of the Rationalist community over the years, I would say that it is possible as a rationalist, but not as a Rationalist, in that they tend to believe our knowledge of reality is limited to that which is endorsed by science.

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