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Ketamine As A Form Of Consciousness Medicine

Ketamine As A Form Of Consciousness Medicine

Consciousness medicine is a therapeutic approach that utilizes altered states of consciousness and the power of thoughts to induce physical changes in the body and measurable improvements in health. This is not a fringe belief system, but a science-backed intervention with the proof of concept demonstrated in meditation, breath-work, hypnosis, mindfulness-based stress reduction, and psychedelics. Psychotherapy, in this lens, is also a form of consciousness medicine, as various therapies from cognitive-behavioral therapy (CBT), dialectical behavioral therapy (DBT), psychoanalysis, or positive psychology can cause structural and measurable changes in your brain and other organs.

It was not immediately obvious to me that ketamine therapy works through the action of consciousness medicine. My initial and later to be found false assumption was that ketamine worked like a traditional drug-based therapy. By administering this medication to patients, I presumed that there was an inherent healing power of this chemical directly making positive changes on brain chemistry. I considered ketamine as second- or third-line medication, working as a different drug class when first-line antidepressants, like SSRIs such as Prozac or Lexapro were not effective.

This perspective was created by my medical training.

As an anesthesiologist, I was trained to provide a cocktail of medications and inhaled gases to render my patients unconscious and allow surgeons to safely perform an operation. I had three simple goals. First, see that the patient survives the surgery by supporting all vital life functions. Second, prevent the patient from moving. Surgeons hate operating on a shifting target. Last, I needed to ensure that patients did not have any awareness during the operation.

I administered the assortment of medications at my disposal, and it was the constant delivery of gases or infusions that allowed me to achieve these goals in my short career as an anesthesiologist. When I turned off the drug switch, within minutes, the patients would wake up.

I continued my medical training into the subspecialty of pain medicine. When appropriate, I was trained to prescribe medications to help suppress hyperactive pain pathways. The prescribing standards aim to achieve a steady state of the drug to alter the body’s chemistry. Others were prescribed on an as-needed basis, and it was understood that the medications can lower pain when they are given, and then the symptoms return when they wear off. It is very straightforward. Once the drug leaves the body, the underlying physical function reverts to its prior functional state, that unfortunately, is in poor health.

This is how antidepressants work for mood disorders. The pill should have a twenty-four-hour effect to reduce unwanted symptoms such as depression, anxiety, automatic negative thoughts, and other symptoms. Patients must continuously dose themselves or run the risk of regressing and experiencing worse symptoms when the drugs are eliminated from the body.

Ketamine is a medication that is known to have significant antidepressant effects, but its mechanism of action is drastically different than a typical Prozac pill. When receiving a treatment in my practice, a certified specialist delivers a 45-minute ketamine infusion through an intravenous catheter. The medication does induce profound changes in the body, most notably an alteration of consciousness, that lasts during the duration of the infusion. After 20-40 minutes after the completion of the treatment, consciousness returns to normal because ketamine is rapidly metabolized. In fact, on average, after 10-12.5 hours, ketamine is basically undetectable in the body.

However, while the life span of medication is short, the benefits of treatment last for days and weeks. In fact, one of the most satisfying parts of my job is witnessing a deeply depressed and even suicidal patient return to the office one week after their first treatment appearing completely transformed with a large smile on their face. These patients act like the cloud of despair remains lifted, even though the ketamine does not have any lingering activity in the body this far out from the initial exposure.

I soon came to appreciate ketamine therapy not as a different medication class, but as an experience. This transformative experience holds the potential to stimulate new connections in the brain, leaving physical and cellular level structural changes to last much longer than the activity of the medication. Just as the human body gets stronger in the days after exercise because the muscle fibers grow in response to the workout, the brain responds to the state of ketamine-activated consciousness, to form new beneficial brain pathways after treatment. This is the underlying concept of hormesis, where short exposures to good stress, like exercise, induce increased robustness and improvements in the underlying function of the body.

It is my strongly held belief the benefits of ketamine therapy are caused by the mind’s enhanced state of activation, and that these same benefits can be achieved through methods such as deep meditation. One does not need psychedelics to achieve these profound brain states; however, they are very hard to reach.

Ketamine, in essence, is a form a medication-enhanced meditation. After treatment, one can experience the exciting potential that the mind inherently contains in boosting one’s mental health. The patients with the best outcomes become motivated to adopt a regular practice of meditation to constantly reinforce the gains from therapy. I provide every single one of my patients the strong recommendation to adopt a daily meditation practice, both before therapy, where your brain can be primed for the psychedelic experience and after, where you can more easily tap into that space. Furthermore, consciousness medicine practices such as mindfulness and meditation are free, it only takes minutes of your time, and there are virtually no side effects.

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