ketamine as a punchline
It's no joke: ketamine is a safe and effective treatment with potentially life-saving benefits. But if the media keeps using it as a punchline, I worry that people who could use the help will miss out.
Don’t come at me, but I just rewatched season one of Platonic on Apple TV and I have thoughts. This is a hilarious show, and I highly recommend watching it. But I was enjoying a scene sequence in which Sylvia gets accidentally dosed with ketamine at a divorce party she throws for Will. In a physical performance I’d pit against Leonardo DiCaprio in Wolf of Wall St. for comedic brilliance, Sylvia stops remembering how to walk and talk and takes down an entire aisle at the liquor store. Clearly the writers draw on ketamine’s street use as a party drug to inspire scenes like this, but I began to worry they delegitimize ketamine a bit. A Platonic viewer might be considering ketamine assisted psychotherapy for their treatment-resistant depression. They might be on the cusp of life-changing treatment, but after watching this episode, they might second guess their treatment options.
how does ketamine help?
Ketamine reduces activity in the Amygdala, which creates a soothing effect through binding with the Kappa opioid system, along with 5HT2A receptors sites. Ketamine works on glutamate and regenerates neuronal connections. It also enhances neuroplasticity, which means networks that don’t usually communicate with each other start to connect.
But most critically, ketamine turns down the volume on our default thought patterns. Our default mode network is our self-referential network; it’s what we’re thinking when we’re not aware we’re thinking. And in a depressed person, that default mode is pretty brutal. It focuses on failures, loneliness, rejections, losses, and abandonments.
Sometimes, after one dose of ketamine, the default mode network is disrupted. People begin to think differently about their lives. They’re disconnected from their inner voices and they’re able to find relief from emotional pain.
what does ketamine feel like?
Ketamine quiets sensory input and removes any sense of time. It reduces activity in the Amygdala, which is the part of the brain that alerts the patient to fear. So while under the effects of ketamine, most patients feel relaxed and experience a pleasant sensation. Many describe a dream-like, expansive state, floating and completely separate from one’s body. It’s common to see darkness, and feel as though moving along a track. Others witness their own consciousness, or feel a union with a divine love. The medicine’s effects are felt for 1-2 hours.
Lately, I’ve started to notice how often ketamine appears in many of my favorite TV comedies. I know the writer’s job is to find the joke, not educate the public. But I’m ready for Hollywood to move on to a different drug for a punchline – preferably one that doesn’t have potentially life-saving benefits.