Ketamine, once used frequently as a battlefield anesthetic during wartime and more recently as a club drug, has found new acclaim in its use to treat depression. Scientists and medical professionals have documented Ketamine’s ability to alleviate depressive symptoms in just hours, but didn’t really understand how it worked. Now new research hints at revealing the secret mechanism of action. In the most recent study, mice were injected with a stress hormone and then recorded exhibiting depressive symptoms such as refusing to eat in addition to recording the loss of synaptic connections in their brain. The mice were then given a dose of ketamine as investigators recorded surprising brain changes. The synaptic connections previously recorded, started to repair themselves after only twelve hours. In addition to repaired neuronal connections, the depressive symptoms that the mice had shown disappeared almost instantly. Ketamine therapy holds great promise in being able to quickly treat suicidal thoughts and depression, and this research helps uncover its secrets.
Medscape just published an article titled “For Noncompliant Patients, a Fix That Works”. I often read posts on this website, to stay informed of the latest medical breakthroughs, treatments, and health issues and feel they are one of the most credible and informative sources out there on the web today. I have several chronic health challenges, not the least of which is being an ashamed educated smoker…..which surely complicates all the other health problems I have as well as being a problem on its own. Addiction is a tricky thing. I have tried without success yet several times to quit smoking, so in this respect I suppose I am a noncompliant patient……which made the article piqué my curiosity.
Many doctors over the years have approached the topic of quitting smoking with me. The talk usually goes like this: “Well,are you still smoking?”. Yes I say. “You are slowing your body’s healing process and constricting your blood vessels by continuing this. You need to quit.” I know I say to myself silently, as my eyes lower their gaze towards the floor. “Here, take this pamphlet. There is a quitline phone number on the back of it to give you options on how to quit. So, how is your pain today?” And the discussion ends just like that. Now don’t get me wrong…..it is certainly not the doctors fault that I haven’t been successful at quitting yet, only mine. It is noteworthy though that this is typical of most doctor patient conversations of this type.
This article recognizes that many patient noncompliance discussions are just not done in the ideal way. Whether it is an issue like mine, or taking lifesaving medicine as directed, or changing other lifestyle habits that directly impact health and mortality there is an overall sense of frustration. Enter a new approach that doctors can take with their patients…..it’s called motivational interviewing. I quote from the article: “A growing number of doctors have been using a special technique that gets superior compliance from patients….. It’s a way of talking with patients that’s designed to elicit their barriers to compliance and assist them in overcoming those barriers. Studies show that doctors using this method of interaction can often work wonders. ” So what is motivational interviewing, you ask?
At first glance, I thought perhaps this was some new conversational technique that had just been discovered and unleashed upon the medical community with astonishing results. Then I read the entire article. Well, it turns out that motivational interviewing is exactly what the specialty doctors I trust the most, and feel are truly integral in my support, have done all along. In a nutshell, its demonstrating genuine empathy for the patient. The “technique” as described involves partnering with the patient, asking positive open-ended questions to stimulate a dialog, using scales to encourage patient interaction, and planting the seeds of change. Funny that I would assume most of these would be commonplace, yet my experience has shown the opposite. I have a handful of phenomenal doctors that I consider key members of my “team”, and I went through dozens more before I landed in the office of these gems. Looking back now I see the one thing that makes these doctors different…..keepers if you will….from the others that I chose not to continue treating with. They all have empathy. Each one of them makes me feel like they take a genuine interest in ME. With these docs, I don’t feel a number or a chart or worse yet…..a paycheck. Yep, what sets them apart and makes them stellar in my eyes is their authenticity when they say they really care about me…..it shows. And the proof that this technique actually works? I am after all still struggling with smoking…..a fact that these specialists don’t typically address with me. Well to me the proof is that after a decade of despair, uncontrolled pain, and a general tumbling down into the rabbit hole I found this team and have made remarkable progress in recovery and general everyday functioning in the world. Although I still have scary issues that arise, I am doing so much better in the last couple years than anyone could have imagined. That is my definition of success. As the article states, doctors can get the ball rolling in less than five minutes during a visit because most change happens incrementally over time. And that is the key in my mind…..a general chipping away of old patterns to be replaced with new through caring conversations and gentle reminders, always reinforcing the goal. So it’s not really the message that doctors are delivering that makes the difference. It is, in fact, HOW the message is delivered that works these wonders. Imagine that.
I have battled the beast otherwise known as major depressive disorder for a decade or so now. During my battles I did extensive research on treatments for this debilitating condition and consulted with many professionals. I met with dietitians and nutritionists. I met with spiritual counselors, I joined a support group…..which turned out to be a triggering and numbing experience for me personally. I had, and still have, many sessions with psychologists. I was treated by psychiatrists. I considered whether I should have ECT therapy….. otherwise known as electric shock…… after several courses of several different anti-depressive medications seemed not to work. At one point, one of my treating doctors had me on a regimen of medications that included an SSRI, a tricyclic antidepressant, an antipsychotic, an anti-anxiolytic, and gabapentin. Within six or seven weeks of this regimen, I developed a pretty severe reaction called serotonin syndrome that put me in the ER.
Finding a treating psychologist that is a good fit for you is a tricky thing in my experience. It has a lot in common with finding a mate. It takes a bit of time to figure out if you are a good fit. Just like dating, some things look pretty and shiny and wonderful on the surface, but as the layers peel back over time, you find some behaviors or thought processes that are deal breakers……you just aren’t the right fit. For some people they find the right fit on the first or second try. With me, it took five. It seemed like it took forever and I was ready to give up hope on the whole thing. But number five was THE ONE. And his advice and guidance has been more precious to me than any diamond ring. While helping me address and process the trauma and issues that are my life in a way that will lead to my maximum return to health, he has passed on to me some real gems. So many of these things in hindsight seem so obvious……the kind of “duh, why didn’t I think of that” obvious. And I am about to share one of them with you.
As a firm advocate of holistic healing, he understood my strong dislike of taking psychotropic medication. But he also knew that I was struggling with strong suicidal ideation and very scared of my own mind. During the course of one of our sessions, he told me that a wise old guru once shared with him that when a person feels down, what they need to do most is go give back. The worse one feels, the more depressed one is, the more urgently they need to go volunteer. They need to help someone else who is struggling. His prescription to me that day…..immediately go do something nice for someone who was suffering and expect nothing else in return. And you know what?…..This RX is one that really works.
During the eight years before getting this prescription, I had not heard or read of this idea once before. But it seems so natural. What a concept! If you are feeling down…..force yourself to get out from under your covers and go give back. Not only will you receive the blessed feeling of doing something good, it will naturally lead you to contemplating gratitude. Practicing gratitude flips a metaphorical switch in your brains thought processes for the positive. You will be amazed the power that a smile to a random person holds. I know I was, and continue to feel this way . I find that something Tony Robbins says quite a bit holds true in my life…..if you look at the ceiling and smile and laugh…..even if you are forcing it…..it is practically impossible to feel bad in that moment. While it is virtually impossible to look up and smile every minute of every day…..doing something to help someone else on a daily basis is much more attainable and gives you the same results.
So please go share this “secret”treatment…..dare I even say for some a cure……for depression. Give it a try and tell everyone you know. Let’s make this the worst kept secret ever. Keep on going!