How Important Is It To Dissociate During A Ketamine Infusion?

A question we’ve been asked about ketamine treatments is, "How important is it to dissociate for the infusion?”

The simple answer is it is very important but there are a few considerations. Read on to explore this more.

The More Dissociation, The More Robust The Antidepressant Effect

There is a growing body of research showing the therapeutic effect of dissociative or psychedelic experiences. So, yes it’s important to dissociate. One recent study showed that when a person had a greater degree of dissociation, the more prolonged and robust the antidepressant effects were for those patients (1). But what's interesting is that in other studies it actually shows that maybe dissociation is not as important as we think it is. In general, what we’ve found in our patients is that the longer they can dissociate, the more effective ketamine can be. Although it's not absolutely mandatory or necessary.

What Is Dissociation? What Does It Feel like?

The other question that this brings up is, "What exactly is dissociation and what does that feel like?” During dissociation, a person experiences being disconnected from one’s mind, body, or past experiences or memories. Each person’s experience is different and each infusion experience is different for the same person. In other words, no two dissociative experiences are the same. Some people experience happy euphoric feelings, while others may experience a near-death like experience or relive past experiences.

Dissociation Isn’t For Everyone

Some people are not ready to have a dissociative psychedelic experience (Yes, ketamine infusions can be challenging and even scary), which is totally okay! Although we believe that a transpersonal experience can be therapeutic and healing, it’s only as good as the readiness and willingness a person brings to the experience. Sometimes there are situations when dissociation and even ketamine infusions are not recommended like in those with a history of schizophrenia.

RELATED QUESTIONS

Who else shouldn’t get ketamine infusions? People with uncontrolled high blood pressure, unstable heart disease, uncontrolled thyroid disease, active substance abuse, active manic phase of bipolar disorder, and or those with active delusions or hallucinations. Dive more into this topic at The Seven Types of People Who Should Not Get Ketamine blog post.

What is kinds of experiences can the ketamine infusion cause? During these experiences, a patient may relive memories, emotions, and stories which may contain unprocessed and/or repressed feelings. While this may not sound very appealing, this release allows for an opportunity to work through or process these past experiences and feelings. Learn more about this at What A Ketamine Infusion Experience Is Like and The Four Types Of Ketamine Experiences You Can Have blog posts. 

Dissociative psychedelic experiences sound scary. What should I do to prepare for or minimize them? A few things we recommend to our patients is to set an intention, remember to breathe during the experience, be curious about what’s going on, accept that this is the experience they are having, and have a plan on how to integrate the experience after the infusion.Explore this answer more at our How To Handle Challenging Experiences With Ketamine blog post.

Reference: 

(1) Luckenbaugh DA, Niciu MJ, Ionescu DF, et al. Do the dissociative side effects of ketamine mediate its antidepressant effects? Journal of affective disorders. 2014;159:56-61. doi:10.1016/j.jad.2014.02.017.

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