Ketamine is a synthetic anesthetic that was designed for surgical procedures in the 60s to allow smoother transition from a fully awake state into a state of general anesthesia and back out of general anesthesia to being fully awake. It became quickly apparent that Ketamine had other benefits than just being an anesthetic. Many people that were given Ketamine before and after surgery reported feeling less traumatized by the procedure, being more at peace and even happier for a period after exposure.
Today, Ketamine has been making the news as a new wonder drug for the treatment of depression and anxiety. Although it is not a miracle cure, it does offer great hope in helping folks with drug-resistant mood disorders. There is, however, another aspect of ketamine that is not widely talked about: its potential ability to facilitate repair of the damage caused to the brain by everyday stress and inflammation. This potential may carry implications far beyond our standard definition of treatments for mental illness and extend to improving brain function in general—even going so far as possibly preventing the progression of neurodegenerative illness and dementia. To understand how this medicine can have such far-reaching implications, we need first to understand how a modern brain becomes inflamed today and starts to lose its optimal function.
An Evolutionary Story
Our brains have developed over time to have distinct portions that are each responsible for different actions and functions. For the purpose of this discussion, our brain can be divided into its two major parts, the primitive brain and the developed, highly evolved brain.
The primitive brain, also frequently called the lizard brain, contains areas that store and process our most native instincts and behaviors. Fear, anger, sexual drive, and memories are stored in this region and influence our perception of the world and future behavior.
By contrast, the developed, highly evolved brain, housed in the prefrontal cortex, contains areas that contain and process our creativity, complex thoughts, and planning. The region that controls the back-and-forth transfer of information between these two parts of the brain is called the Default Mode Network, or DMN.
This DMN region tempers the function of our highly evolved brain, which wants to explore, create, contemplate, and analyze, with the basic needs and memories of the primitive brain by shunting the blood flow back and forth between the two parts. The DMN makes sure we accomplish basic survival activities, such as procreation, obtaining food, and seeking shelter, as well as avoiding dangerous situations by allowing us access to memories of past events that were dangerous and life-and-limb threatening in any way.
In a well-balanced individual, the lizard brain is given a limited time of activity that ensures our basic needs are met and then is suppressed to allow us to go on with more creative portions of our lives controlled by the developed, highly evolved part of our brain in the prefrontal cortex. Whenever there is a life-threatening or stressful situation—such as the death of a loved one or a traumatic event at work or home—the lizard brain is given the center stage because the blood flow is preferentially shunted there by the DMN and away from the prefrontal cortex until the stressful event is over.
If you are a Masai warrior herding cattle in the African bush, you have plenty of time to process the trauma of the loss of a family member, and, in time, the DMN ensures blood flow is shunted back to the prefrontal cortex, and life is resumed at the same high level of function. Unfortunately, in today’s hectic world, with us overwhelmed by social media and multitasking, we never really have the time to fully process trauma and stress, and the DMN is left shunting a bit more blood flow to the primitive brain than before. The trauma and stress, by the way, does not need to be a tragic loss of a loved one or from an accident. Constant exposure to the common stresses of a hectic job, a rocky marriage, eating processed foods, and being constantly exposed to toxins will cause the same damage.
As we are continuously exposed to one stressful event after another, the DMN becomes more and more dominant, shunting more and more blood flow to the primitive brain and away from the highly functioning prefrontal cortex.
This shunting of the blood flow shifts the balance of overall function to the primitive portion of the brain, and basic behaviors and emotions such as anger and fear are now allowed to control daily behaviors. The brain of those affected slowly enters a perpetually stressful state of fight or flight, where its behavior becomes reactive. In some cases, the mood is dominated by anxiety, depression, and antisocial tendencies. Frequently, these cases get recognized, are given a diagnosis, and treated, albeit not always effectively.
But what about the rest of us exposed to constant stress? Over time, more subtle changes occur to our brains. We become less patient, more reactive, and quicker to jump to anger. We experience difficulty in concentrating and staying on task, and we frequently feel mental fog and fatigue.
The Toll of Stress
Science has shown that chronic exposure to stress alone can lead to changes in the brain that in turn lead to its increased inflammation. This inflammation in turn leads to changes of the cell chemistry that can then lead to accelerated aging or senescence. Not only can these changes increase the risk of developing dementia, Alzheimer’s Disease, or even neurodegenerative conditions such as Parkinson’s Disease, but they can change the entire body’s cellular chemistry, leading to heart and gut problems and even cancer.
As the saying goes, “An ounce of prevention is worth a pound of cure.” In our current medical model, despite a multitude of slogans and proclamations by insurance companies to the contrary, there is little attention being paid to prevention. And improving brain health is all about prevention.
It is empowering to think that there are actually things we can do to maintain a sharp mind and avoid age-related brain illness. Certainly, lifestyle interventions to reduce stress, such as frequent meditation, avoidance of toxins, exercise, and a clean, anti-inflammatory diet, are all critical to brain health. However, ketamine allows us to take prevention up a few notches beyond just adapting our lifestyle.
Ketamine to the Rescue
When the brain is exposed to 40 minutes of intravenous ketamine therapy, many of the adverse effects of stress and inflammation start to become reversed; the blood flow is shunted away from the primitive brain by the DMN and to the prefrontal cortex.
This reduces the state of fight or flight and shuts off the DMN’s inhibition of the prefrontal cortex. As more blood is shunted to the prefrontal cortex, new nerve connections are being made and old ones are being repaired! This is called neurogenesis.
It has been shown that neurogenesis occurs within 24 hours of ketamine exposure. This process also allows for cells to go through a process of detoxification called autophagy and start generating more energy. The result is improvement of executive function, creativity, memory, concentration, and much more. We can start to see our problems in a clearer light and come up with more creative solutions to fix them. We can become more compassionate toward others and more tolerant of stress. I call it “having more bandwidth” to address whatever life throws at you.
Although Ketamine is at this point not officially recognized as a preventative measure for many diseases mentioned in this article, it is logical to conclude that it may work as I described. In its effects, it provides a detoxification of the brain.
It has become acceptable to go through a body detox or a cleanse on a regular basis to maintain health and prevent disease. What about a cleansing for the brain? Certainly, a regular detox of the brain makes as much sense!
The future research may show that getting ketamine therapy on a regular basis—say, three to four times per year—may be just as effective a preventive strategy against brain disease as exercise and diet, if not more.