Why is Ketamine Effective for Anxiety?

If you’re suffering from anxiety, you’re not alone- according to the National Institute of Mental Health, nearly 1 in 3 Americans experience an anxiety disorder at some point in their life.

Despite this high prevalence, a large proportion of individuals suffering from anxiety disorders do not receive adequate care. Only about a fifth of individuals with anxiety seek professional help for their disorder. Even amongst those who do receive treatment for their anxiety, in the form of cognitive-behavioral therapy or pharmacological options like SSRIs, up to 40% do not respond to treatment, and even more continue to experience residual symptoms.

The significant treatment gap associated with anxiety disorders reflects a pressing need for increasing care access and expanding treatment options to include more effective modalities. One such novel treatment that’s garnering increasing attention in the field of psychiatry is ketamine, which has shown exciting promise in rapidly and effectively alleviating symptoms of an array of anxiety disorders.

Unlike first-line anxiety treatments such as SSRIs, which can take weeks before beginning to work, ketamine provides patients with immediate relief from their symptoms, producing improvements after only a single treatment session, with even greater beneficial effects manifesting with a course of repeated treatments.

Let’s dive into how ketamine works to alleviate symptoms of anxiety and produce sustained healing for transformational improvements in overall well-being and quality of life.

Ketamine Creates Distance from Automatic Negative Cognitive and Emotional Patterns

The default mode network (DMN) is a system of connected brain regions that are most active when the brain is not focused on completing a specific task or goal, and is instead engaged in introspective thought, including activities such as daydreaming, self-referential processing, thinking about the past, and contemplating the future.

Individuals with anxiety have been shown to exhibit dysfunctional alterations in their DMN activity and connectivity, with their passive, default cognitive processes automatically reverting to patterns of incessant worrying, catastrophizing, ruminating, and other negative thought schemas.

Over time, this harmful headspace can lead to worsened anxiety and depression, and can also give way to physical symptoms like tension in the body and insomnia.

Studies have shown ketamine reduces the functional activity of the DMN, effectively turning down the volume on the constant, jumbled stream of negative thoughts that the anxious brain reflexively falls into.

In this way, ketamine can help the brain break out of these negative cognitive patterns, creating distance between an individual and these repetitive mental loops and allowing them to view them with a renewed perspective.

Ketamine Restores and Promotes the Brain’s Ability to Change and Adapt

Chronic anxiety leaves the nervous system in a constant state of “fight-or-flight,” leading to an array of harmful effects in the body. One consequence linked to this overactivated stress response is that it can damage neurons in the brain, reducing their ability to function properly and adequately recover and repair, and leading to neuronal atrophy and reduced synaptic connectivity.

Research has shown that ketamine exerts neurobiological effects in the brain that support processes that can reverse this neuronal damage and enhance neuroplasticity.

Ketamine increases production of a key brain protein called brain-derived neurotrophic factor, or BDNF. Once referred to by John J. Ratey, MD, a professor of psychiatry at Harvard Medical School, as “Miracle-Gro for the brain,” BDNF is an important growth factor involved in neuron function that protects these cells against damage and plays a key role in regulating functional neuronal connections, synapse formation, and synaptic plasticity. By increasing levels of BDNF, ketamine facilitates the formation of new, healthy neural connections and supports overall neural health and synaptic connectivity.

In addition to repairing neuronal damage associated with anxiety disorders, ketamine’s ability to enrich neuroplasticity also leads to an increase in flexibility in the brain, making it easier to change negative patterns of thoughts and behaviors and replace them with more positive ones.

Individuals with anxiety commonly exhibit rigid patterns of thinking that keep them trapped in a cycle of persistent worry, dread, and hopelessness. These negative thought loops are often all-consuming and self-reinforcing - meaning the more time spent running these scripts of anxiety, the stronger and more automatic the neural pathways associated with these scripts become.

By enhancing neuroplasticity, ketamine effectively facilitates a rewiring of the brain, providing an opportunity for new, positive patterns of thinking to take root. Ketamine initiates a window of increased openness to change in the days and weeks following treatment, creating an optimal state for positive cognitive restructuring and behavioral change.

Ketamine Induces a State of Heightened Insightfulness and Reflection

In addition to these biological responses, the subjective effects experienced by a patient during a treatment session also play an important role in assisting the healing process.

At low-doses, ketamine induces a state of deep relaxation often described as “dreamlike.”  This altered state of consciousness allows patients an opportunity to slow down and look inward with increased clarity and awareness.

During a treatment session, ketamine creates a quiet space for patients to identify cognitive and emotional patterns that may be holding them back, and deeply-rooted emotions and important revelations are often brought to the surface of their conscious awareness.

Ketamine serves as a powerful catalyst for:

• Self-discovery
• Uncovering novel realizations
• Driving shifts in perspective that can result in profound positive transformation

In addition, studies have found that ketamine boosts mood and energy levels immediately following treatment. This period of elevated mood and mental rejuvenation can shift a patient’s outlook on life into one that is more optimistic and joyful, placing patients in an optimal state to take action in their healing journey. In this revitalized state, patients are empowered to manifest the insights gained during their session into tangible, beneficial changes in their daily lives.

Pairing a ketamine treatment program with integration and healing practices, such as meditation, breathwork, and journaling, can enhance positive therapeutic outcomes even further. These practices can help patients process session insights with increased awareness and give clarity to cognitive, emotional, and behavioral changes that can be made to create positive growth and transformation.

These non-medicinal modalities can serve as powerful tools in the healing process, helping embed the positive outcomes gained from ketamine treatment more readily into patients’ daily lives to create meaningful, long-lasting positive change.

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