Our brain constantly creates beliefs - about itself, about the world, about the future. They help us navigate reality. But in depression, this mechanism fails: negative thoughts are fixed, and it seems that it is impossible to change them.
And what if there was a way to restart this process?
Ketamine is a quick mood switch
Ordinary antidepressants act slowly - it takes a few weeks to notice the effect. And Ketamine, which was previously used as anesthetic, works quite differently. It affects NMDA receptors and within a few hours after administration can significantly change the mental state of a person.
Patients with severe depression that have not been treated with other treatments often described this effect as "changing the point of view". The negative beliefs that seemed unchanged for months or years suddenly lost their strength. Some even said that their thoughts no longer seem "their".
Depression as a trap of negative beliefs
WHO estimates that more than 280 million people in the world suffer from depression, and 700,000 lose their lives through suicide. One of the most dangerous symptoms is the belief that the situation will never change that you are worthless or doomed.
These thoughts work on the principle of feedback: if a person believes that they are not accepted in society, they begin to avoid others. This, in turn, enhances the sense of isolation. This is how a closed circle is formed, which is difficult to break.
What did the research show?
Scientists conducted an experiment: they asked patients with depression to assess the likelihood of negative events in their lives (such as an accident or a dog attack). They were then informed real statistical risks and made it possible to review their rating.
In healthy people, this is easy: they easily accept positive news and adjust their beliefs. But people with depression remained "deaf" for good news, continuing to believe in the worst.
But here's what happened after the introduction of ketamine: after four hours, patients began to respond to positive information as well as healthy people. Their brain became more flexible, and they learned to update their beliefs again.
What next?
Scientists still study how Ketamine changes the brain, but it is suggested that it helps to restore the balance between neural processes that are responsible for forecasting the future and emotional plasticity.
These discoveries can dramatically change the approach to the treatment of depression. Ketamine not only relieves symptoms, but "restarts" a way of thinking. This gives hope for new methods of therapy, where pharmacology is combined with psychotherapy.
Similar studies are already conducted with other psychodelics such as psylocybin. Is it possible that the future of psychiatry is the ability to change our beliefs just as we change our thoughts?
Perhaps the answer is closer than we think.
According to the material of the study "Assessment of the early Ketamine Effects for Bringing Patients with Patients with Depression Resistant", which was recently published in the journal JAMA Psychiatry.