Healing is not a destination... but a journey of self-discovery, self-acceptance and self-love.

Featuring Del Ray Psych & Wellness

Over the last decades, occurrences of depression, anxiety and suicide have spiked in adults, children and adolescents. It’s a disturbing fact, and one that a growing number of pharmaceuticals are often employed to treat. Like so many other pharmaceutical drugs, ketamine has proven itself useful for more applications than the pain relief and anesthetic purposes it was originally approved for and has, in the last 20 years, been used off-label to treat psychological issues.

But what is it? For those of us who don’t speak “doctor,” ketamine is a drug that has been used since the 1970s as an anesthetic and pain blocker. “Ketamine affects the brain by blocking glutamate receptors,” explains Dr. Eleni Boosalis, Clinical Psychologist and the co-owner of Del Ray Psych & Wellness, LLC, a local provider of Ketamine-Assisted Psychotherapy (KAP).

In other words, it helps disrupt some of the communications to the nervous å—blocking the sensory reception of pain. All very helpful in the physical realm.

It also carries effects of the psychological kind. “At lower subanesthetic doses, glutamate production increases, which can promote neuroplasticity and neurogenerativity, which is very beneficial for producing a rapid and sustained antidepressant effect,” Boosalis goes on. “It helps build new connections between neurons. As a result, change and growth is more accessible.”

The change and growth to which the good doctor is referring is that of the mental, emotional and psychological kind. In fact, ketamine’s off-label use for these purposes began in the early 2000s, when it was first noticed that the drug had a rapid effect on depression and suicidal thoughts. This led to many studies over the next few years, which, in turn, led to an increased number of doctors and psychiatrists prescribing ketamine “off-label”—or, for purposes other than those for which it was originally developed—to treat depression and other mental disorders. Two decades later, an abundance of research has been conducted, supporting the efficacy of the use of ketamine to treat chronic, treatment-resistant depression, anxiety, OCD and PTSD.

Treatment of these issues, however, still needs to be in conjunction with therapy to be truly effective—for several reasons. “The combination of ketamine with therapy has shown remarkable results in helping facilitate therapy by decreasing one’s defenses, increasing introspection and getting clients ‘unstuck’ in therapy,” Boosalis says. “In our experience, it has felt like it takes therapy and healing to the next level in a way that we haven’t seen with just therapy alone or with just medicine alone.”

"Through the insights gained during ketamine journeys and the therapeutic support provided, individuals may develop enhanced resilience, self-compassion and new coping mechanisms. These skills can help individuals better navigate life's challenges and maintain their mental well-being in the long term.”

- Dr. Lauren Fisher

Adds Dr. Lauren Fisher, Clinical Psychologist and Dr. Boosalis’s partner at Del Ray Psych & Wellness, LLC, “Ketamine journeys, particularly when used in a therapeutic context, have been associated with several short-term and long-term benefits. It's important to note that the research in this area is still ongoing and the effects can vary between individuals. Short-term benefits include rapid mood improvement, enhanced emotional insight, increased relaxation and stress reduction. Long-term improved treatment-resistant conditions include depression and post-traumatic stress disorder and enhanced resilience and coping skills. Through the insights gained during ketamine journeys and the therapeutic support provided, individuals may develop enhanced resilience, self-compassion and new coping mechanisms. These skills can help individuals better navigate life's challenges and maintain their mental well-being in the long term.”

In other words, the effects ketamine has on the brain may break down barriers that make therapy alone ineffective. If you’ve ever sat through a therapy session feeling as though none of it is changing anything because there’s just something in your way, this can be an extremely helpful addition to your treatment options. “Ketamine may offer an alternative treatment option for those who have not responded to traditional therapies,” Fisher says. “It's important to note, however, that ketamine journeys should always be conducted under the supervision of trained professionals in a controlled and therapeutic setting. Furthermore, individual responses and outcomes can vary and ketamine should not be seen as a universal or standalone solution for mental health conditions.”

While it may not be a one-size-fits-all solution to mental and psychological issues, KAPs are offering an alternative that many patients may need to see relief from whatever they struggle with.

Those issues include a range of treatment-resistant depression, anxiety, OCD, PTSD and substance use disorders. According to Drs. Fisher and Boosalis, even those who have not yet been given a clinical diagnosis can also benefit from KAP, simply because there are psychedelic and biochemical effects within the brain that help facilitate personal healing and growth and help relieve issues of stress, extreme burnout, identity challenges, life transitions or feelings of stagnation.

While ketamine isn’t free of side effects, it is considered a relatively safe medicine and is used widely as a general anesthetic for both children and adults. Says Fisher, “Brief and intended side effects include an altered sense of perception and time, heightened sensory awareness, visual and auditory hallucinations, disconnection from one’s body and surroundings, drowsiness, difficulty speaking and blurred vision. Some can feel disorientation, nausea and numbness.”

These immediate side effects often decrease after an hour and are completely gone within the span of four hours. As for what happens during these hours of “altered states of consciousness,” Fisher explains that clients are “better able to access internal healing resources, are more open to insights and can release trauma imprints more easily through direct material, imagery or somatic movement.”

Think of it as removing the inhibitions that keep you bottled up and unable to release your emotions, keep your mind closed off or keep you from letting go of things that are toxic to your mental health.

Danielle Reynolds, LCSW, CCTP, PMH-C

Rare but serious side effects of ketamine may include elevated blood pressure, altered breathing, hallucinations, dependence and momentary loss of consciousness. However, the team at Del Ray Psych works closely with medical providers in screening patients to determine the safety of treatment and minimize the risk of adverse reactions.

If you’re wondering how KAP sessions happen and what they entail, it’s unlike any other office-based therapy session. Each session is held in a cozy, comfortable and quiet office setting with a trained and licensed trauma therapist. The clinic’s medical providers prescribe sublingual lozenges that can be self-administered by the patient during each office session. The entire session takes place over the course of two to three hours and includes “preparation and intention setting, the medicine journey and recovery.”

Preparation requires 30 to 45 minutes, during which time the therapist leads the patient with breathwork, relaxation and intention setting, along with any other elements of preference such as lighting candles, movement, mantras or journaling. “The purpose of this preparation [is] to help shift your nervous system into a relaxed state to maximize the effects of the medicine and the neuroplasticity,” says Fisher.

The lozenge is self-administered during the medicine journey (45-60 minutes). Patients wear eyeshades with calming music playing in the background. The therapist is present throughout the session to help guide the patient through the journey to record insights and experiences and to help the patient feel safe and secure as they process whatever begins to arise in their mind.

“The final hour includes immediate integration of material that arose and time for you to recover with snacks and a drink, along with time to journal or relax prior to leaving,” says Fisher. “We also provide information on how to best optimize your experience once you leave. A follow-up integration session occurs 24 to 48 hours later to help you make sense of your insights and to translate that into everyday changes in your life.”

Six to eight KAP sessions are the recommended length of treatment and can be performed as a standalone treatment or as a supplemental therapy to your regular talk therapy. Parts of the treatment process are also reimbursable by insurance. “While it is an investment, many of our clients have reported making significant and rapid changes in several months that they were not able to make in several years of talk therapy,” says Fisher.

For more information, visit delraypsych.com.