Seen at LAX airport en route back to Australia – this cover of Time magazine:
The Anti Antidepressant. Depression affects 16 million Americans. One third don’t respond to treatment. A surprising new drug may change that.
It’s scary to think that ketamine and ketamine-like drugs are being considered the solution to “treatment resistant depression”. I’ve never liked this term and in my opinion, what it really means is that the root cause of the depression has not been found. To me it looks like the mainstream medical mental health community is desperate!
It really is time to get all the well-researched nutritional psychiatry approaches to the forefront! They do work! The timing of this article is even more interesting since I was returning from the first international meeting of the International Society for Nutritional Psychiatry Research in Bethesda, MD.
Lead food mood researcher Professor Felice Jacka presented her SMILES paper where dietary changes from a junk food diet to a real whole foods diet reduced depression in 30% of the participants.
Microbiome researcher Professor John Cryan discussed the gut brain connection. This paper: Recent developments in understanding the role of the gut microbiota in brain health and disease, was published just last week:
recent preclinical and clinical evidence suggest that targeting the microbiota through prebiotic, probiotic, or dietary interventions may be an effective “psychobiotic” strategy for treating symptoms in mood, neurodevelopmental disorders, and neurodegenerative diseases
And research on sulforaphane for psychosis, and depression and anxiety was presented: Sulforaphane produces antidepressant- and anxiolytic-like effects in adult mice
these findings demonstrated that SFN [sulforaphane] has antidepressant- and anxiolytic-like activities in stressed mice model of depression, which likely occurs by inhibiting the hypothalamic-pituitary-adrenal (HPA) axis and inflammatory response to stress. These data support further exploration for developing SFN [sulforaphane] as a novel agent to treat depression and anxiety disorders.
I presented on the benefits of a gluten-free/grain free/Paleo diet for certain individuals for depression and anxiety, and did a poster presentation on GABA for eliminating anxiety.
As you can see from the TIME Magazine article the only approaches that have been considered (and have failed) are medications in various different combinations:
Every week, when Ian Hanley sits down with his therapist, he goes through a list of depression treatments he’s been researching online. The best-known treatments at the top of the list–half a dozen antidepressants and known combinations of those drugs–are all crossed out….
Most diagnoses do not come with 20-plus medicines approved by the Food and Drug Administration to treat it–and yet with depression, more options don’t always mean better outcomes. Ever since the first antidepressants were introduced 60 years ago, doctors have had patients like Hanley–people who don’t seem to get better even after they’ve worked their way through the lengthy list of available drugs. About 30% of all people with depression don’t respond adequately to the available treatments. That’s a dismal failure rate for a class of drugs designed to improve a person’s basic ability to function.
According to this article in Time magazine:
The biggest development has been the rediscovery of a promising, yet fraught, drug called ketamine. It’s best known as a psychedelic club drug that makes people hallucinate, but it may also have the ability to ease depression–and fast. In a race to shape the next generation of antidepressants, Johnson & Johnson and Allergan are fast-tracking new medicines inspired by ketamine.
I encourage you to read the entire article and take note of the following: the side-effects seen with medications over the years and the fact that doctors “don’t know the consequences and potential side effects of taking tiny doses of ketamine over and over again”; “she tried nearly everything” (you’ll read this in all the articles advocating for ketamine but unfortunately they are only referring to medications); the ketamine effects are temporary and cost $15,000 per year (and are not covered by insurance); and ketamine “is thought to stimulate an opioid receptor in the brain” and is already known to be addictive.
When I shared this image and article on my Facebook page I discovered that is a pretty divided topic with a number of people feeling really strongly about the fact that this approach needs to be researched further and considered. I acknowledge their concern for the individuals who have not found a solution for their depression. BUT my question is this: have all the dietary and nutritional approaches been considered and looked into with these people who have not responded to antidepressants?
I strongly believe that ketamine is NOT the solution and that nutritional psychiatry is!
Have you used this ketamine approach personally or with patients?
Would you consider using ketamine personally if the antidepressants didn’t work for you? Or would you be more willing to work with a functional medicine or functional nutrition practitioner to find your true root causes and address them with diet, nutrients and a functional medicine approach?
I knew two guys who raved about how great ketamine made them feel. One ended up having domestic and housing problems. The other had a very hard time getting off of ketamine. I gather it wasn’t a pleasant experience for him after being on it awhile and getting off of it.
I’d rather deal with my issues nutritionally. I used SSRIs and they caused more problems and didn’t fix the ones I was taking them for.
Jessica
It sounds like they used ketamine recreationally. The approach I have written about is medically controlled IV therapy in lower doses than what is used recreationally. I have concerns about both.
It’s incredible that someone could work their way through half a dozen different anti-depressants and still be left without answers because that means they’ve been “looking” for years – but like you pointed out, looking in all the wrong places. I hope someday soon nutrition and lifestyle factors will be viewed as front line approaches and I can’t think of anyone better to lead the charge!
Erin
Exactly – it breaks my heart that they are looking in the wrong places and don’t even know the possibilities. And yes although my focus is anxiety, so many of my clients with anxiety also have depression, AND I could not ignore this article that I feel is doing a disservice to so many. Someone actually said this on my facebook post: “Shame on Time magazine for publishing this”
Here’s to nutrition and lifestyle factors being viewed as front line approaches for anxiety and depression (and in the important work you’re doing for migraine sufferers)
Spot on, Trudy! Ketamine is very dangerous…I long considered it but I have MTHFRc677t and all this junk almost killed me. Now I am an epigeneticist, using evidence based mind body interventions that work very well, especially meditation.
AND the gut! I just was given a copy of Mayer Mind-Gut Connection because it paralleled a blog post I had just done. He has a whole chapter on healing INTUITION and thus one’s own “gut instincts.”
Here is my gut-brain post: http://www.living-co-creatively.com/the-gut-brain-axis-let-your-hara-lead/
And here is a post on phenomenology. Really 15 minutes a day of positive meditation and a non-toxic diet are beyond miraculous. I know. I have the education as well of years of abuse, medical and personal as teachers. http://www.living-co-creatively.com/phenomenology-you-get-to-choose/
Thanks for the important wake up call to many. Time, spot on, too.
Nancy
Thanks for sharing and for the work you do – the gut brain connection is a powerful one!
I have thought about it. SSRI pooped out and now I’m left going through the list of drugs and bedridden. I’m even considering ECT. AND I have completely changed my nutrition and environment and seen functional drs , naturopaths , you name it I’ve tried it. Even the aminos. To be completely honest I feel so much worse since I changed my diet to only organic whole foods, and was already GF for years. Now DF , low fodmaps, low everything really. I have lost so much weight and my upset stomach cannot tolerate almost anything now. I’m spiralling down a black hole and it seems no one has any answers for me.
Hi Jodie
I am sorry to hear about your poor health and depression, and the fact that you have tried so much without results. Please make sure you have a good support system in place for when you feel you are “spiralling down a black hole” and keep searching for answers. I hope you can find a caring practitioner to help guide you in your healing journey. Let me know where you are located and I can make a referral for you.
When someone doesn’t respond to the dietary changes and nutrients we have to dig deeper and consider Lyme disease, heavy metals, medication side-effects, EMF sensitivities and more. Here is the list of 60+ causes I have identified https://www.everywomanover29.com/blog/60-nutritional-biochemical-causes-of-anxiety/
If we were working together I’d look at broths and nutrient dense shakes for the weight-loss – any good nutritionist should be able guide you in this area.
I don’t want to ignore the ketamine consideration and even through I’ve had some very vocal feedback on the facebook thread about the wonders of it in situations like this, I still don’t feel I can recommend it.
Jodie
A mental health colleague (psychologist/nutritionist) just shared this systematic review published last month and summarized in this blog from Mad in America – Researchers Find Inadequate Reporting of the Dangers of Ketamine Treatment for Depression https://www.madinamerica.com/2017/08/researchers-find-inadequate-reporting-dangers-ketamine-treatment-depression/
“Common side effects also resulted in a number of patients withdrawing from the study. Some of the many side effects that were reported included:
Worsening mood
Anxiety
Emotional blunting
Psychosis
Thought disorders
Dissociation
Depersonalization
Hallucinations
Increased blood pressure
Increased heart rate
Decreased blood pressure
Decreased heart rate
Heart palpitations/arrhythmia
Chest pain
Headaches
Dizziness
Unsteadiness
Confusion
Memory loss
Cognitive impairment
Blurred vision
Insomnia
Nausea
Fatigue
Crying/tearfulness
Suicidal thoughts were also commonly reported side effects of ketamine use, and one suicide attempt was reported.”
What is very concerning is this: “when ketamine is studied for depression, researchers tend to ignore the safety and side effect concerns—often not bothering to report such issues at all.”
Here is the actual abstract of the review http://www.sciencedirect.com/science/article/pii/S2215036617302729
Thankyou Trudy for your reply. Firstly I live in Qld Australia. I have seen a nutritionist but she was useless, nice girl, but had no idea. As money is a big issue , as a family we must have spent over 15,000 on medical test not covered by Medicare , and all the naturopathic and supps just in the last year, having to sell my car and other things to manage. Using all available Medicare resources available although that is allopathic in nature and those drs don’t know what to do. Have had my genes done and have started with MTHFR Aus , but first appointment pretty disappointed, but I rang and said what had happened and was changed to see the owner Carolyn Lediwsky yesterday. She seems very knowledgable so will wait and see what she comes up with. But agrees my gut is in very bad shape, hence increasingly less foods being tolerated. I have no idea how to eat more calories without feeling sicker. Sorry for the long vent.
I am MTHFRc677t…friend Sterling Hill who designed the app to interpret 23&me when they were shut down, on FB. She gives tremendous help on the web/FB; her site is https://mthfrsupport.com/ Sterling’s biz partner is a nutritionist. Once you take care of the basics, like amalgams and leaky gut and get on the righ diet you will do better.
Dr. Jess Armine is on FB too and answers questions is best buds with Ben Lynch and has taken Lynch’s training.
I imagine Trudy can do a lot but epigenetics is now moving fast. I specialize in education on it all. http://www.living-co-creatively.com
Much good luck.
Jodie
I’m sorry to hear about your struggles. Sadly for some people it can be a long and expensive journey. Glad to hear you’re working with Carolyn Ledowsky. Since I don’t know what happened I’m sharing this interview I did with Ben Lynch on one of the Anxiety Summits. Even having one of the MTHFR polymorphisms is not always straight-forward. https://www.everywomanover29.com/blog/anxiety-summit-methylfolate-anxiety/
I’d also look into the elemental diet that Dr. Siebecker suggests for SIBO.
When speaking about Ketamine and suicidal ideation, it can be a life saver. Even if just for a few days….was for me
Haley
Thanks for sharing. I’m so glad it helped you. I’d love to hear how it helped and how long you used it for? May I ask what other approaches you had tried before using ketamine and what do you do now to maintain a healthy mood?
As I mentioned my concern is using this approach when all the dietary and nutritional approaches been not been considered and addressed first.
After reading this article trying to find more data that Ketamine DOES work for treatment resistant depression and I wanted to share my story for my fiance’.
My fiance’ is type 1 bipolar and was on Lithium, Cymbalta, Viibryd, Lamictal, Seroquel and Geodon.
She suffered from severe PTSD while I went through my cancer treatment and also watching her mother die in front of her which exacerbated her bipolar depression. A 3rd year nurse she underwent ECT and it wiped some of her/our most precious memories. While most of the side effects had dissipated from the ECT her symptoms started to get worse. Her psychiatrist raised one of her medication doses which landed her in the hospital for three days because it was more than the therapeutic dosage and above 120mg. It was then we started looking at options such as TPS and Ketamine. She ate organic and healthy food, does not consume alcohol or smoke and despite some the drugs that are known to be weight gainers she kept it in check with a good diet. We wanted to see if nutrition could be the answer and we saw a different psy. that was a nutritionists as well. After 1 year there was no change and she still could not get off her meds. She kept her diet and we had found a board certified anesthesiologist that performs Ketamine treatments. We started 3 years ago with the Ketamine and since then she has stopped 85% of her medications one being lithium which was slowly causing kidney disease. She and I have never been happier! Her mood is always great, and she is able to reason, PTSD is GONE! She finished her RN and is employed by a large hospital.
So the question is how much and how long?? Well, the ketamine treatments were 6 treatments administered every other day. The cost was 3,000 which was 500 per treatment and in three years she received 3 single dose boosters which were 8 months apart. 15,000 per year sounds like someone who is undergoing ketamine for pain management as the dosage and duration are different as compared to treatment resistant depression.
We did not care that it wasn’t covered by insurance. People spends thousands per month on organic groceries to hope for better health and that isn’t covered by insurance but people do it anyway. I personally never believed in the whole “certified organic” label and no matter what you don’t have control of the air, water, soil, that you plan to put in your mouth. The reality is we live in very toxic environments and I have to disagree that nutrition will help depression however keeping a balanced diet does help keep weight and gut health under control because gaining weight can cause people to feel more depressed due to self esteem issues. Ketamine saved her life and has afforded her to be at peace in her mind along with a very rewarding career. Ketamine IS a possible solution for treatment resistant depression and the cost is not nearly as high as written in this article and nutrition was not the answer at least for her.
Joe
Thanks for sharing your fiance’s story – I’m sorry to hear what she has experienced and I’m so pleased she is doing so well.
I still stand by my nutrition and biochemical recommendations first and ketamine as an absolute last resort, if at all. Many of the 60+ root causes of anxiety may also apply to someone with bipolar disorder too so please keep these in mind in the future if she has mental health challenges again – more here https://www.everywomanover29.com/blog/60-nutritional-biochemical-causes-of-anxiety/
And these resources specifically for bipolar
– midday bright light therapy https://www.everywomanover29.com/blog/midday-bright-light-therapy-bipolar-depression/
– toxoplasma gondii https://www.everywomanover29.com/blog/toxoplasma-gondii-schizophrenia-bipolar-disorder-ocd-unresolved-anxiety/
– gluten and real food https://www.everywomanover29.com/blog/bipolar-disruptive-mood-or-gluten-and-junk-food/
I also always recommend organic and especially if someone has any mental or physical issues – some studies here https://www.everywomanover29.com/blog/organic-foods-stanford-study-pesticides-and-the-brain/
At Lone Star Infusion in Texas we recognize the importance of lifestyle changes. We advocate strongly for exercise and healthy eating of a Whole Foods diet. However, many of our patients are so depressed they are suicidal or on the brink of even more extreme treatments like ECT or hospitalization. After Ketamine treatments they are able to begin the lifestyle changes that will keep them from becoming depressed again. But the ketamine is a life saver for them. Ketamine makes the changes possible.
Allison
Thanks for contributing to the discussion. It’s wonderful that Lone Star Infusion advocates for exercise and a whole foods diet. As I write in the blog post I really feel we can do more than offer ketamine – and find the roots cause of the depression and address them.
And as I shared with Jodie, this systematic review summarized in this blog from Mad in America really concerns me – Researchers Find Inadequate Reporting of the Dangers of Ketamine Treatment for Depression https://www.madinamerica.com/2017/08/researchers-find-inadequate-reporting-dangers-ketamine-treatment-depression/
“Common side effects also resulted in a number of patients withdrawing from the study. Some of the many side effects that were reported included:
Worsening mood
Anxiety
Emotional blunting
Psychosis
Thought disorders
Dissociation
Depersonalization
Hallucinations
Increased blood pressure
Increased heart rate
Decreased blood pressure
Decreased heart rate
Heart palpitations/arrhythmia
Chest pain
Headaches
Dizziness
Unsteadiness
Confusion
Memory loss
Cognitive impairment
Blurred vision
Insomnia
Nausea
Fatigue
Crying/tearfulness
Suicidal thoughts were also commonly reported side effects of ketamine use, and one suicide attempt was reported.”
What is very concerning is this: “when ketamine is studied for depression, researchers tend to ignore the safety and side effect concerns—often not bothering to report such issues at all.”
Here is the actual abstract of the review http://www.sciencedirect.com/science/article/pii/S2215036617302729
Trudy
All medications have side effects. In fact, all interventions have side effects. All psychiatric medications have been known to cause worsening of symptoms in some patients. The amazing the about ketamine compared to other psychiatric medications is how fast and effective ketamine can be while most of the side effects are contained during to the brief infusion while the benefits last for the whole month.
Allison
I agree all meds have side-effects but not all medications have the side-effects we see with ketamine and I’m going to have to disagree with on the fact that all interventions have side-effects. There are a multitude of nutritional interventions that have zero side-effects: eating to balance blood sugar, a gluten free diet, a grain free diet, addressing low omega-3s and so on. With interventions like addressing infections/parasites/candida there may be die-off symptoms for some people.
I’d love you and your team to look into the ketogenic diet for your patients with severe depression. Both patients in this case report suffered from sever depression, had been on multiple medications in the past and one had even had ECT – Ketogenic diet: reductions in auditory hallucinations and delusions, better mood and energy, and weight loss https://www.everywomanover29.com/blog/ketogenic-diet-reductions-in-auditory-hallucinations-and-delusions-better-mood-and-energy-and-weight-loss/
I am kind of speechless. Psych drugs nearly killed me. That is how I got diagnosed MTHFR after 3 sessions w a good psych. I am allergic to a great many drugs and as we say in MTHFR and in natural health, no one size fits all.
Sterling Hill and I are working on a book about how people have really messed themselves up even on benign treatments. Sterling was inspired to do this after she tried things herself and got herself hospitalized.
And if any of these drugs work for you great. I will tell you the trend is away from these things into as non-toxic a lifestyle as possible and that does not just mean organic food; it means a great deal more. And I realize that only the really determined will make the effort. Drugs have succeeded because they offer quick answers. Living holistically requires dedication, not just money. I have a book by a Ph.D. right here explaining how historically doctors were taught to prescribe pills to save time with interpersonal issues.
The drugs you are speaking of here (altho I am not sure about ketamine) are extremely complex, beyond those people who are on multiples, they all contain not just the drug but “excipients” and adjuvants, the fillers that make them long lasting and easier to digest. Every one of those elements could make you ill or like me, suicidal. On top of all this, we now are finding glyphosate (round up) in most pharmaceuticals probably due to any plant adjuvant used. So, on top of all those other excipients, your body is trying to handle pesticides.
We are moving beyond genetics now. I believe you really need to start learning about epigenetics, the study of the environment, inside and out, on health. I teach this all. Trudy is spot on. Diet and lifestyle changes are what is needed and safe relationships learning to process episodes.
You/we MUST meditate every day and whenever feeling upset. I have people put the insight meditation app on their phone (nsighttimer.com), its free and take a nap earbuds in, whenever upset. I have several favorites for anxiety. At night in spite of the wifi risk, I listen to the great Aussie hypnotist, Michael Sealey, all night. Here is MY personal playlist; he has many more. https://www.youtube.com/playlist?list=FLMOEouaIcdF0EnM7hmxEHhg
As for diet, I use ketogenic primarily because it is anti-inflammatory and I am pre-diabetic. Before the MTHFR diagnosis and my own work to get all genes analyzed, I was legally disabled by bipolar and PTSD. Now using my own studies including doctoral work in Transformative Learning and Change, I teach others how to deal w emotional issues and wellness from now largely accepted non-invasive body-centered practices especially meditation. With on famous epigeneticist/neurologist, now spiritualist, people have been known to heal serious diseases in one 4 day retreat. Brain cells have been shown to change rapidly w regular meditation.
I sense I have gone on too much here and this may not be received. I am a big fan of mad in America AND I believe you need to start learning epigenetics. Drugs are only a way far last option as far as I am concerned. I support psilocybin, a mushroom, at death for a spiritual experience and there is lots of good research. MDMA is now being used for soldiers w PTSD. As their issues are way beyond my realm, I will not speak. And you may say these patients are, too. I say they first need to clean up their bodies and minds.
BTW I tried a long while before I had my genetics done to get into ketamine trials and I am now glad I missed out. We are biochemical wonders of divine design. I suggest you read Super Genes and begin to explore alt mental treatments; frequencies are used a lot now and are validated many places.
I know there is now a house for those really needing a place to just be crazy near San Francisco; look up Michael Cornwall Ph.D. on FB, he is a founder and allied with MIA. Sorry to be blunt. I would do everything else before drugs. And I graduated from a school that celebrates another drug claimed to change lives: ayahuasca. It is natural and greatly damages the liver. Good look with all this chemistry. I choose as much as I can to keep life simple, low stress and healthy. I hang with healthy minded people and avoid negativity even in the US politics.
I am also a phenomenologist and was a long time Buddhist. We say, hocus pocus focus (world famous Tony Robbins uses something like this as does Oprah). YOU get to choose which end of the stick of any issue you will focus on. You can choose drugs and identify as mad and depressed or you can choose hope, joy, courage, and compassion for yourself and your life. I wish you the best. And am very happy for anyone who tried and the drugs helped. I personally would follow Trudy’s advice and some of the things I mention.
Thanks for reading. And the best to all of us.
Nancy
Thanks for sharing your concerns about ketamine and ayahuasca – I have similar concerns. I actually have concerns about psilocybin and MDMA and believe dietary approaches (like the ketogenic diet you have found to be therapeutic) and targeted nutrients and a functional medicine/nutrition approach to be effective and safe. As you know I’m also all for a “non-toxic lifestyle” and nutrient-dense food plus supplementation as necessary and tools like meditation – so thanks for the work you do. And yes, environment always needs to be considered.
Just to clarify for other readers of the blog, I don’t consider MTHFR a diagnosis but rather a clue that this polymorphism may be causing issues. It may also not cause any issues.
Thanks, Trudy for your refinement of the MTHFR diagnosis….in me it is homozygous and with all my genetic defects together, which the doc did not test, there have been issues that lifestyle have changed immensely. Not sure how a clue differs from a dx but always like re-frames. Thanks. This is why the trend is to take a history BEFORE testing and that is how my doc worked way back in 2014.
Nancy
Wonderful to hear that lifestyle changes have helped so much. Instead of clue maybe I should have said predisposition which may or may not be expressing at any one time 🙂
Even better and much more in keeping with epigenetics….we are more than our DNA.
Appreciate your refinement. Yes, if I eat folic acid, in processed food, I am predisposed to be very ill for probably a week. Did that with some Trader Joe’s Mac and Cheese, which I used to love and could eat but the environment changed and so did my body. Won’t eat that again soon.
Cheers,
np