Mental Health

Low Dose Ketamine for Trauma and PTSD

Working with a psychotherapist while in the lucid yet detached state of mind ketamine promotes can help you process the traumatic event or events that underlay your PTSD symptoms and reframe your response.
Sharon Niv
5-8 Min.

Post-traumatic stress disorder (PTSD) can develop in the aftermath of a highly frightening event or series of events, often where a person fears for their life. Obsessive thoughts about the event, flashbacks or nightmares, avoidance of similar situations, and unexplained physical pain are just a few symptoms of PTSD.

Doctors have traditionally prescribed antidepressant medications like Zoloft, Paxil, Prozac, and Effexor, which are in the SSRI or SNRI drug classes, to treat trauma symptoms. While antidepressants are effective for some, they don't work for everyone, and it can take several weeks to determine their effectiveness. The side effects of antidepressants can be uncomfortable and may include gastrointestinal distress, headache, dizziness, sweating, and loss of libido.

Low-dose ketamine is an exciting option for treating trauma and PTSD and can be used concurrently with antidepressants if desired. Many scientific studies support the drug’s efficacy. One such study concluded that ketamine trial subjects “showed significant and rapid PTSD symptom reduction.”

What are Trauma and PTSD?

Trauma can be the physical result of a severe injury or an emotional, long-term reaction to a single distressing event or series of events. Combat, physical or sexual abuse or other violence, a serious accident, a natural disaster, or another severe psychological experience can trigger emotional trauma.

Most people experience one or more traumatic events in their lifetime, but most do not have debilitating symptoms that continue long after the frightening or upsetting event is past. Individuals struggling with severe symptoms linked to their trauma may be diagnosed with PTSD.

Those with PTSD are not alone, according to Veteran's Administration statistics, reporting about 13 million Americans had PTSD in 2020. Many people believe that only combat veterans struggle with PTSD. While veterans are at a higher risk than civilians, any person has the potential to develop PTSD in response to a traumatic situation.

According to the Veteran’s Administration (V.A.), you are at a greater risk of developing PTSD if you first-hand experience a “shocking and dangerous” event where you fear for your own or another person’s life. While witnessing the event can also result in PTSD, the risk is highest for those directly involved.

Sexual assault or other violence, combat, severe injury, or ongoing stress after the initial trauma are the most common triggers of PTSD in women. Combat, a severe accident, physical assault, or witnessing death are the most common causes of PTSD in men. The underlying cause of PTSD in children is often related to abuse or neglect.

Although trauma and PTSD can affect a person of any age, race, ethnicity, gender, or sexual orientation, LGBTQ+ people are at significant risk of developing PTSD. V.A. statistics find “up to 48 percent of LGB individuals and 42 percent of transgender and gender diverse individuals [meet] criteria for PTSD,” as opposed to a risk of only 4.7 percent in the general population.

Signs a Person May Suffer from Trauma and PTSD

Response to trauma may be acute, meaning short-lived, or chronic, which is a long-term condition. Most people have a heightened emotional response right after a traumatic event, often displaying shock, denial, or relief. Fear, anxiety, and anger may follow the initial response. Some people get over a traumatic event within days or weeks, while others experience related symptoms for years or even a lifetime.

PTSD is a chronic condition and can include mood swings, problems with interpersonal relationships, flashbacks, nightmares, and a pervasive sense of helplessness. Those with PTSD may live in a constant state of impending doom, certain that terrible things will happen. Although symptoms of PTSD often begin within a few weeks of the trauma, sometimes, they do not appear for several years.

How Does Trauma Affect the Brain?

Scientific research has shown that emotional trauma, chronic depression, or prolonged stress alters various brain functions and structures. No matter what the source of trauma is, it affects the brain. PTSD affects the areas of the brain that process fear, perception of and response to threats, and emotional regulation. The brain regions most closely linked to PTSD include the amygdala and the prefrontal cortex (PFC).

Amygdala - Houses fear circuitry, including “fight or flight” response to perceived danger, and stores emotional memories. Researchers believe intense trauma overstimulates the amygdala and other brain regions, triggering the hypervigilance and hyperarousal common in those with PTSD.

PFC - Regulates and interprets emotions and initiates behaviors and decision-making. Intense events and emotions also create a state of hyper-activation in some regions of the PFC, which then passes on the aroused states of hypervigilance and hyperarousal to the amygdala. Trauma also causes hypoactivity (sluggish or underactive) in other areas of the PFC, leading to dysfunction or atrophy of the affected connections.

The good news is that changes in brain circuitry and functions caused by intense trauma may not be permanent. Many research studies show the phenomenon known as brain neuroplasticity, which describes the brain's ability to repair damaged connections and form new ones. Neuroplasticity, coupled with how ketamine interacts with various brain regions, enables the drug to facilitate emotional healing significantly.

How Can Low Dose Ketamine Help with Symptoms of Trauma and PTSD?

Experts have long believed it is ketamine’s interaction with glutamate receptors that provide such rapid relief of PTSD symptoms. Scientists have identified the beneficial impact of ketamine on glutamate receptors and theorize that it triggers the repair of atrophied brain regions and new neural connections.

Glutamate is a critical chemical messenger in the brain that regulates such functions as mood and memory. The chemical is essential in producing gamma-aminobutyric acid (GABA), which blocks specific brain signals to slow activity in the central nervous system, effectively reducing emotions like fear and anxiety.

Ketamine also blocks GABA and glutamate receptors to increase activity in atrophied areas of the PFC, which helps improve impulse control, emotional regulation, and cognitive function.

And while ketamine’s impact on glutamate receptors is an essential piece of the puzzle, scientists have recently discovered another critical piece — ketamine also interacts with opioid receptors.

Opioid receptors interact with regions of the brain that regulate pleasure, reward, motivation, and pain perception. While doctors have prescribed opioids for decades to treat severe pain, depression, anxiety, and other mood disorders, the drugs carry a high risk for abuse, addiction, and overdose.

A study released by the Stanford School of Medicine concluded that ketamine also activates opioid receptors in the brain, providing significant relief from depression and pain without the risks associated with opioid drugs.

Ketamine acts rapidly to calm activity in hyper-aroused areas of the brain and increase activity in atrophied regions. Many researchers now believe it is the dual action ketamine provides — activating opioid receptors and interacting with glutamate receptors — that makes ketamine so effective in treating trauma, PTSD, depression, and anxiety. Studies have even found ketamine effectively and rapidly improves treatment-resistant depression (TRD), which doctors have historically found highly challenging to treat.

As mentioned, lasting effects of trauma, including PTSD, can happen to anyone who experiences a frightening, intense event. However, combat veterans are among those with the most significant risk of developing PTSD. Because of the high rate of veterans with PTSD, depression, and suicidal ideation, the U.S. Department of Veterans Affairs approved a derivative of ketamine known as Spravato (brand name esketamine), acknowledging it as a safe and effective treatment. Spravato is a nasal spray administered by medical professionals at an approved medical clinic.

How Can You or a Loved One Access Ketamine to Treat PTSD or Other Mental Disorders?

You can legally use ketamine in the U.S. to treat PTSD, depression, anxiety, or other mental disorders if you work with a qualified medical professional. Ketamine protocols, doses, and delivery methods vary, so it's wise to question your provider about what to expect. Some protocols recommend higher doses than others, and it's essential to understand that higher doses of ketamine can trigger a psychedelic response, which can be frightening and, sometimes, make certain mental disorders worse.

Very low dose ketamine is an excellent alternative to a nasal spray or infusion — it is safe to take at home, has few, if any, side effects, and allows you to experiment until you find the dose that is most effective for you. Although low dose ketamine does not produce a hallucinogenic response, it does trigger a gently altered state, creating an ideal environment for reflection and change.

Working with a psychotherapist while in the lucid yet detached state of mind ketamine promotes can help you process the traumatic event or events that underlay your PTSD symptoms and reframe your response. Low dose ketamine in combination with talk therapy is proven to produce rapid healing with excellent long-term results.

Contact the Joyous team today to learn how low dose ketamine can change how you think, react, and view the world around you. Our expert, compassionate team will help you find the dose that enables you to find the calm, beautiful center of yourself and your life as you finally put your trauma where it belongs — behind you.

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