Talk Therapy vs. Ketamine for Anxiety

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Anxiety is a prevalent mental health disorder that impacts millions of adults and children daily. Anxiety symptoms can range from mild to crippling.

Some anxiety may be alleviated by making relatively simple lifestyle changes, such as reducing caffeine, exercising, and eating a balanced diet. However, many others who suffer from anxiety must seek professional treatment options.

There has been a rise in the use of ketamine to treat anxiety, treatment-resistant depression, and major depressive disorder. This alternative therapy can be highly effective in reducing symptoms of anxiety and depression.

What is Anxiety?

Anxiety is a term that often encompasses two types of anxiety — Generalized anxiety disorder (GAD) and Social anxiety disorder.

Generalized anxiety disorder is excessive worrying about real or imagined issues in life. It is often present with other psychiatric issues, such as major depressive disorder. This type of anxiety can be challenging to control and is often accompanied by the following symptoms:

  • Irritability
  • Restlessness
  • Difficulty concentrating
  • Fatigue
  • Aches and pains
  • Frequent headaches
  • Sleep issues

Social anxiety disorder is the fear of humiliation or embarrassment in social settings. Many individuals with this condition may avoid social settings due to the anxiety around their phobia.

Both GAD and SAD are generally treated with antidepressant drugs that boost brain chemicals, such as serotonin. However, these medications may not work for everyone, and they often come with side effects, including a possible increase in suicidal ideation. Because of the side effects of traditional antidepressant medications, many individuals have sought alternative treatments and have found success with ketamine.

What is Ketamine?

Ketamine works to address anxiety, major depressive disorder, and treatment-resistant depression by regulating glutamate in the brain, impacting AMPA receptors, kainate receptors, and delta-opioid receptors.

Glutamate is one of the brain’s chemical messengers, and it is vital in mood regulation, memory, learning, and neuroplasticity, which is the brain’s ability to adapt and change. Ketamine helps to re-wire your brain by disrupting problematic or harmful thought patterns, which allows you to form new, positive pathways.

It can effectively treat patients who have not responded to traditional pharmacologic interventions. Additionally, while many mainstream antidepressants take weeks to take effect, ketamine can alleviate symptoms of depression and anxiety in hours. This benefit can be particularly advantageous for treating patients with suicidal ideation who require immediate intervention or de-escalation.

Ketamine vs. Talk Therapy

Anxiety is also commonly treated by psychological interventions, including talk therapy, also called psychotherapy. And many patients benefit from improved mental health through therapy.

However, those with anxiety disorders who only have partial remission or efficacy with psychotherapy may benefit from ketamine therapy.

In these cases, ketamine offers an effective alternative or addition to the treatment plan. It can also be used to treat those experiencing suicidal thoughts immediately. In addition, most patients may benefit from continuing psychotherapy after they have started ketamine treatment for maximum mental health benefits.

Ketamine therapy is strongly augmented and supported by Ketamine Assisted Psychotherapy.

How is ketamine administered?

Ketamine is generally not approved or recommended for home use unless it is prescribed in sublingual tablets. In all other instances, it must be administered under the supervision of a healthcare provider. It can be administered in the following ways:

Intravenous (IV) ketamine infusions

This method allows for a slow, constant drip of ketamine to enter the bloodstream.

Intramuscular (IM) shots

This method entails shots being injected into a large muscle, such as your thigh or arm.

Sublingual tablets

This form of ketamine can be taken at home and may be used as a stand-alone treatment or for maintenance between IV or IM treatments. It takes longer for the body to absorb, so it may be less effective than other administration methods. It also isn’t FDA-approved, so it may not be covered by insurance.

Nasal spray

Esketamine is a form of ketamine that can be administered through a nasal spray.

Side Effects

Unlike antidepressants or anti-anxiety medications, there are few side effects or risks when using Ketamine to treat major depressive disorder or anxiety disorders. Side effects may include:

  • Dissociation
  • Lightheadedness
  • Potential for addiction
  • Increased heart rate
  • Increased blood pressure
  • Sleepiness
  • Nausea
  • Vomiting

Pregnant individuals should not use Ketamine. Also, those with heart conditions, arrhythmias, and conditions sensitive to blood pressure, such as aneurysms, should avoid ketamine. Ketamine should be avoided by those with psychosis, schizophrenia, mania, or paranoia.

Ketamine is both short-acting and long-lasting, meaning that patients can feel effects within minutes, but they may last up to a month.

Is ketamine right for me?

While ketamine may be highly beneficial for certain individuals, it’s not for everyone. Therefore, before pursuing this treatment option, it’s vital that you review information related to ketamine and anxiety and understand the risks and potential side effects.

If you have researched ketamine and still think it may benefit your condition, you should make an appointment with a qualified clinician. These healthcare professionals will conduct an initial assessment and risk evaluation before deciding whether to proceed with ketamine treatment.

Those who seek ketamine treatment may still benefit from psychotherapy. You will want to discuss this treatment option with your therapist and the healthcare professionals overseeing your ketamine administration.

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