Post-traumatic stress disorder (PTSD) is a mental health condition that may develop in response to experiencing or witnessing a traumatic event. It can lead to various symptoms, including flashbacks, nightmares, anxiety, and hypervigilance. These symptoms can interfere with an individual’s daily life, leading to maladaptations. Maladaptation refers to changes in behavior or thought patterns that are not beneficial or functional for the individual.
It can be helpful to focus on healing these behaviors common to PTSD patients during ketamine therapy sessions.
Maladaptations resulting from PTSD can include:
- Avoidance: People with PTSD may avoid situations, places, or people that remind them of the traumatic event. This avoidance can limit their ability to engage in social, work, or family activities, leading to isolation and reduced quality of life.
- Hypervigilance: Experiencing heightened levels of anxiety and fear, individuals with PTSD may become overly alert and sensitive to potential threats. This constant alertness can lead to exhaustion, irritability, and difficulty concentrating.
- Emotional numbing: PTSD can result in emotional numbing, where the individual becomes detached from their feelings to protect themselves from further emotional pain. This can make connecting with others difficult, leading to relationship problems and reduced emotional well-being.
- Negative thoughts and beliefs: PTSD can contribute to persistent negative thoughts and beliefs about oneself, others, and the world. These thoughts can lead to feelings of guilt, shame, and despair, which can harm one’s mental health.
Ketamine therapy has shown promise in helping individuals with PTSD by addressing some maladaptations. Ketamine is a dissociative anesthetic found to have rapid-acting antidepressant and anti-anxiety effects. It works through several mechanisms, including:
- NMDA receptor antagonism: Ketamine blocks the NMDA receptor, a key receptor in the brain involved in learning and memory. This disruption is thought to facilitate the formation of new neural connections, which can help individuals reprocess and integrate traumatic memories more adaptively.
- BDNF increase: Ketamine has been shown to increase brain-derived neurotrophic factor (BDNF), a protein that supports the survival, growth, and differentiation of neurons. Increased BDNF levels can help promote neuroplasticity, which may help the brain to reorganize and adapt to the trauma.
- Reduction of negative symptoms: Ketamine can help reduce anxiety, depression, and other negative emotional states associated with PTSD. By relieving these symptoms, individuals may be more equipped to engage in other therapies or activities that promote healing and recovery.
Ketamine therapy is typically administered in a controlled clinical setting, often as a series of intravenous infusions. The therapy has shown promise in providing rapid relief from PTSD symptoms and improving overall functioning. However, it is essential to note that ketamine therapy should be part of a comprehensive treatment plan, which may include psychotherapy, medication management, and support from mental health professionals.
American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
- This source provides diagnostic criteria and an overview of PTSD and its symptoms.
Feder, A., Parides, M. K., Murrough, J. W., et al. (2014). Efficacy of intravenous ketamine for treatment of chronic posttraumatic stress disorder: a randomized clinical trial. JAMA Psychiatry, 71(6), 681-688.
- This clinical trial discusses the efficacy of ketamine in treating chronic PTSD.
Krystal, J. H., Abdallah, C. G., Averill, L. A., et al. (2017). Synaptic loss and the pathophysiology of PTSD: implications for ketamine as a prototype novel therapeutic. Current Psychiatry Reports, 19(10), 74.
- This review article explores the pathophysiology of PTSD and the implications of ketamine as a novel therapeutic option.
Newport, D. J., Carpenter, L. L., McDonald, W. M., et al. (2015). Ketamine and other NMDA antagonists: early clinical trials and possible mechanisms in depression. The American Journal of Psychiatry, 172(10), 950-966.
- This article provides an overview of ketamine and other NMDA antagonists in the context of depression and related disorders, including PTSD.
Liriano, F., Hatten, C., & Schwartz, T. L. (2019). Ketamine as treatment for post-traumatic stress disorder: a review. Drugs in Context, 8, 212305.
- This review article provides an overview of ketamine as a treatment for PTSD, including its mechanisms of action and relevant clinical trials.