Ketamine offers lifeline for people with severe depression, suicidal thoughts

– Read full CNN article here –

Mount Horeb, Wisconsin (CNN)A few months ago, Alan Ferguson decided he was ready to die — for the third time. In 2014, he attempted suicide twice, and the persistent thoughts of “I need to be dead” were echoing in his brain once again.

Now 54 years old, Ferguson was diagnosed with clinical depression when he was 18. Since then, he estimates, he’s been prescribed more than a dozen medications — SSRIs, SNRIs, tricyclic antidepressants — all to little or no avail.
“I never got to the point that I thought, ‘OK, I’m feeling good,’ ” he said. “It was always, ‘OK, this is tolerable.’ But yet those thoughts [of wanting to die] were still there.”

In early May, Ferguson abruptly stopped taking all of his medications, quit his job and gave away his dog, Zeke. That evening, he called his sister, Linda.
“It was a very good conversation,” he said. “Linda and I disagree on a lot of stuff, and that night I avoided the hot-button topics because I did not want her to have bad memories or bad thoughts of what I thought was going to end up being our last conversation.”
As luck or fate or professional intuition would have it, on a prescheduled call the very next day, Ferguson’s psychiatrist offered to refer him to a ketamine clinic in Milwaukee, about an hour and a half from his home.
Ketamine is a powerful medication used in hospitals primarily as an anesthetic, but recent scientific studies have shown significant promise with treatment-resistant depression and suicidal ideation.
Ketamine is also used recreationally, and illegally, as a club drug known as “Special K.” It generates an intense high and dissociative effects.
“I knew of the drug from having been a police officer, so I knew of its street use — illicit use — but I’m a pretty open-minded person too, and after all the traditional medications I’ve been on with no success, I thought, ‘Well, maybe they’re on to something here with this,’ ” Ferguson said. “I wasn’t worried about trying something I had never tried before. I was worried about trying something else that wasn’t going to work.”

A last hope

Ferguson put off his plans to end his life for another week and made his way to Ketamine Milwaukee. The clinic operates once a week, on Fridays, in a space subleased from a weight-loss clinic in a nondescript strip mall just outside the city.
Party drug ketamine closer to approval for depression
Party drug ketamine closer to approval for depression
Dr. Kevin Kane, a practicing anesthesiologist, is Ketamine Milwaukee’s medical director. Referring to the fact that there haven’t been any new classes of drugs developed to treat depression in decades, Kane said that using ketamine to successfully treat the disorder’s most stubborn cases might just be “the biggest breakthrough in mental health in the last 50 years.” He estimates that it is effective for 70% of patients with treatment-resistant depression.

“It’s indicated right now for … somebody who has tried and failed at least two medications, but that’s really not who we’re seeing,” Kane said. Instead, the patients who seek his care have tried more medications than they can count. Some of them have been depressed for as long as they can remember.
“The people we’re seeing aren’t walking off the street because [they’re] feeling a little down,” he said. “They’ve been struggling without relief for a long time.”

The ketamine is administered intravenously, and relief can come quickly — in just a matter of hours.
Ferguson said he woke up the next morning anxiously anticipating his pervasive “I need to be dead” thoughts. But there were none. Mid-morning: still none. Afternoon: none. Evening: none.

“No negative thoughts!” he recalled. “My problems still existed … but things were different. My most faithful, lifelong companion was gone!”
Ferguson doesn’t like to use what he calls the “m-word”: miracle. But he will refer to the way in which ketamine worked for him a medical marvel.
Whatever you call it, the treatment doesn’t come cheap. Infusions at Ketamine Milwaukee cost $495 each, and Kane typically recommends an initial series of five to six infusions, after which patients generally return every four to six weeks for booster infusions.

Because treating depression with ketamine is an “off-label” use of the drug, it is not covered by health insurance, even when it is recommended by a doctor. Ferguson was able to scrape together enough cash for his first infusion. A good friend gave him the money for his second. And his church rallied around him and paid for his third treatment. But the results, he will tell you, are priceless.

The efficacy of Ferguson’s treatment is evident in a mood chart provided to CNN by Kane, with his patient’s permission. The black lines indicate Ferguson’s ketamine infusion dates, and the red dots are his scores on the PHQ-9 (a standardized depression questionnaire). On May 25, the day of his first infusion, Ferguson’s depression was rated “severe.” By his second infusion on June 1, it had improved to “moderate.” And by his third infusion on June 8, for the first time in his adult life, Ferguson’s depression rating measured “none.”

No more suicidal thoughts

Because of how quickly and how well ketamine works in some patients, some doctors have referred to it as a “save shot” for people who are suicidal.
“The ketamine may be a way to improve their mood and stop their suicidal thinking until the other antidepressants — the more standard antidepressants — have the six-week time window to work,” Kane said. “Ketamine may be just the thing that gets someone through that window until other medications get the chance to kick in.
“Sometimes, when you get so depressed that you can barely get out of bed, it’s hard to do the things that your therapist tells you to do to try and help yourself,” he said. “My hope is … that it gives people that lift in mood that allows them to start doing the other things that they know they can do to help themselves.”
A rat neuron before, top, and after ketamine treatment. The increased number of orange nodes are restored connections in the rat's brain.
A rat neuron before, top, and after ketamine treatment. The increased number of orange nodes are restored connections in the rat’s brain.
Kane explained that ketamine works in depressed patients by growing synapses in areas of the brain that have atrophied, namely the hippocampus and prefrontal cortex. “If you think of it like a tree that loses its leaves in wintertime, ketamine helps grow those leaves back,” he said. “It doesn’t necessarily have to grow an entire new branch or an entire new tree. It just has to sprout new leaves.”

Moreover, the same dissociative properties that made ketamine a popular party drug are what makes the medication so effective in treating severe depression.
“Sometimes, that can be a very powerful thing, that dissociation,” Kane said. “While you’re dissociating from your body, you may be dissociating [from] your mind as well. And, you may be able to see your problems and your issues that have really been consuming you as, ‘Yes, they’re still here, but now they’re over there. They’re in a little ball in the corner, and they don’t have the power over me anymore.’
“Sometimes, people can have very profound thoughts along those lines and realizations that they can take back to their therapy session, and [it] can be a really wonderful stepping stone for them to help maintain their relief.”

Dr. Gerard Sanacora, a psychiatry professor at the Yale School of Medicine, said little to no doubt remains about the rapid, robust anti-suicidal effect of ketamine. “I think the bigger question is: How do you maintain this? And how do you decide who is the best patient to receive this?”

Clinical studies have established that immediate side effects of ketamine can include increased heart rate and blood pressure. But Sanacora said further research is needed to determine the long-term cognitive impacts of ketamine treatment, as well as to develop standard dosing guidelines.
Sanacora, who is a co-author of “A Consensus Statement on the Use of Ketamine in the Treatment of Mood Disorders,” published in the medical journal JAMA Psychiatry, said that “for the majority of people — not everybody — symptoms do tend to return after some period of time.”

At least as of now, more than two months since beginning ketamine therapy, Ferguson said he hasn’t had a single thought of taking his own life.
“It really is remarkable for me to be able to wake up and not be sorry I woke up in the morning,” he said. Still, Ferguson is keenly aware that the drug is not a miracle cure, and he will require ongoing care for the rest of his life.
After receiving a ketamine infusion in June, Ferguson thanked Kane not just for saving his life but for giving him a life he never knew was possible.

Why ‘getting lost in a book’ is so good for you, according to science

– Read original article here –

“Transportation” — or the act of losing yourself in a book — makes you more empathetic, more creative and (hello!) it’s an escape.

Whether you’re the reader who rips through a new book each week or the one still slogging through that bestseller your friend recommended months ago, psychologists (and their research) say your time is being well spent.

And if it’s been a while since your last date with a good book, the experts have a few reasons that might convince you to give it another go.

“One of the benefits to reading fiction is simply that it provides enjoyment and pleasure,” Melanie Green, PhD, associate professor in the department of communication at University at Buffalo, tells NBC News BETTER. “It can provide an escape from boredom or stress.”

Plus, reading has been shown to help us better understand and interact with other people, keep our brains sharp, expand our world views and grow as individuals, Green says. “Stories allow us to feel connected with others and part of something bigger than ourselves.”

Green researches the idea of “transportation” — or what makes it possible to get “lost in a book.” She says it’s more likely to happen if you’re reading a high-quality text, but “quality” in this case is subjective and something that gets determined by you. For some it’s a quick-moving plot that’s critical, while for others engaging characters or a poetic writing style is most important if you want to get lost in the storyline. And some people are just more interested in one type of story (romance, for instance) versus another (thriller), she adds.

Regardless of the specific volumes that suck you in the most, here are just some of the things that can happen when you get lost in a novel.

Stories about other people teach us to be the types of people we want to be

Reading makes us think and feel in new and different ways, explains Keith Oatley, PhD, professor emeritus in the department of applied psychology and human development at University of Toronto. “You give up some of your own habits and thoughts, and you take on your own idea of being a different person in circumstances that you might otherwise never had been in.”

Back in 2009, Oatley and his colleagues found that after reading one of two different versions of the same story — one an original piece of fiction and the other a retelling of the same story written in a non-fiction style — participants who read fiction changed in their personality traits more than those who read the non-fiction version of the story, and reported feeling higher levels of emotions.

Objectively, Oatley and his colleagues haven’t measured whether these changes might be labeled as “good” or “positive,” but he says to think about it in terms of personal growth akin to how we want kids to grow and develop in their own ways (not because society is telling them to be one person or another).

“It is very important in the social world to understand others, to understand ourselves, and not just get stuck,” he says.

Reading helps provide that sense of belonging that all humans need

Reading can give us a sense of belongingness that we all instinctively want as human beings, according to Green.

Researchers at the University at Buffalo showed in an experiment that reading actually satisfies that need for human connection because it can mimic what we feel during real social interactions. A group of 140 undergraduate students were asked to read either “Twilight” or “Harry Potter and the Sorcerer’s Stone” for a half-hour. Afterward the students reported (psychologically-speaking) becoming part of the characters’ worlds during that time and having some of the same feelings of satisfaction and happiness that we get from real-world social interactions.

“Social connection is a strong, human need,” the study’s author Shira Gabriel, PhD, associate professor of psychology at UB, said in a press release shortly after the research was published. “Anytime we feel connected to others, we feel good in general and feel good about our lives.”

It bolsters all sorts of social skills

Reading fiction also helps us better understand, connect with and interact with others in the real world (after we put that book down).

“We get to enter the minds of these other people. And in doing that we understand other people better,” Oatley says. Research from he and his colleagues showed that people who reported reading the most fiction scored higher on both empathy tests and social ability tests.

Research shows that people who reported reading the most fiction scored higher on both empathy tests and social ability tests.

If you can identify with a character in some way, you actually get to lead a different life (temporarily and, of course, in a limited way), says Oatley. Multiple studies have replicated these findings, Oatley says. And data suggests the same area of the brain actually gets fired up when people read and comprehend fictional stories, as gets activated when we’re in the process of understanding other people.

Think of learning how to fly an airplane by using a flight simulator in addition to flying an actual plane. You get to encounter a lot of different scenarios where you’re completely safe, but you can learn a lot about what to do in an emergency, unusual weather conditions, and more. “Fiction is the mind’s flight simulator,” Oatley says.

And importantly, the research shows it’s reading fiction that improves empathy and not the other way around, Oatley adds. (It isn’t that people who are empathetic happen to prefer to read more.)

Reading is good for our brains and may even help us live longer

We’ve all heard from countless grade-school teachers that reading improves our vocabulary. But neuroscience research shows it’s good for other cognitive skills, too, by stimulating the neural networks in the brain that improve our social cognition and conceptual processing of abstract content. And evidence suggests that may have measurable benefits in terms of health.

“Reading, by engaging the brain, may keep the brain active enough to prevent cognitive decline that is associated with a variety of diseases associated with earlier mortality,” explains Avni Bavishi, an MD candidate at the Feinberg School of Medicine at Northwestern University.

A 2013 study found that people who reported reading and doing other similarly cognitively stimulating activities throughout their lives had less cognitive decline compared with people who didn’t read or engage in other such stimulating activities as much. And a subsequent study by Bavishi and colleagues showed that people who report reading more actually live longer on average compared with individuals who didn’t report reading.

Getting lost in a good book provides the good kind of escape

And finally, if you need a break from the daily grind or everyday stressors, reading can take your mind away from what’s worrying you — in a good way — by letting you temporarily escape, Green says. “People who are absorbed in a story world aren’t ruminating on their own personal concerns.”

Studies show that several types of media, from books to TV shows to music, can definitely help with mood management.

Of course, ignoring a problem in the real world isn’t the answer, but spending too much time thinking about things that are out of your control (like current events, a pending job offer or family squabbles) isn’t good either, Green says. So the next time you’re feeling anxious or stressed, use it as an excuse to dust off the novel on your bedside table.

Out of the Darkness Ann Arbor Walk

“When you walk in the Out of the Darkness Walks, you join the effort with hundreds of thousands of people to raise awareness and funds that allow the American Foundation for Suicide Prevention (AFSP) to invest in new research, create educational programs, advocate for public policy, and support survivors of suicide loss.”

Event Details…

Family and friends of Ben Price may join team Blackbird Ann Arbor to walk in Ben’s memory.

Thank you!

50 Of The Most Beautiful Sentences In Literature

1. “At any rate, that is happiness; to be dissolved into something complete and great”
—Willa Cather, My Antonia

2. “In our village, folks say God crumbles up the old moon into stars.”
—Alexander Solzhenitsyn, One Day in the Life of Ivan Denisovich

3. “She wasn’t doing a thing that I could see, except standing there leaning on the balcony railing, holding the universe together.” —J. D. Salinger, “A Girl I Knew”

4. “I took a deep breath and listened to the old brag of my heart; I am, I am, I am.”
—Sylvia Plath, The Bell Jar

6. “Beauty is an enormous, unmerited gift given randomly, stupidly.”
—Khaled Hosseini, And the Mountains Echoed

7. “Sometimes I can feel my bones straining under the weight of all the lives I’m not living.”
—Jonathan Safran Foer, Extremely Loud and Incredibly Close

8. “What are men to rocks and mountains?”
—Jane Austen, Pride and Prejudice

10. “‘Dear God,’ she prayed, ‘let me be something every minute of every hour of my life.’”
—Betty Smith, A Tree Grows in Brooklyn

11. “The curves of your lips rewrite history.”
—Oscar Wilde, The Picture of Dorian Gray

12. “A dream, all a dream, that ends in nothing, and leaves the sleeper where he lay down, but I wish you to know that you inspired it.”
—Charles Dickens, A Tale of Two Cities

14. “As Estha stirred the thick jam he thought Two Thoughts and the Two Thoughts he thought were these: a) Anything can happen to anyone. and b) It is best to be prepared.”
—Arundhati Roy, The God of Small Things

15. “If equal affection cannot be, let the more loving one be me.” —W. H. Auden, “The More Loving One”

16. “And now that you don’t have to be perfect, you can be good.”
—John Steinbeck, East of Eden

18. “There are more things in Heaven and Earth, Horatio, than are dreamt of in your philosophy.”
—William Shakespeare, Hamlet

19. “America, I’ve given you all and now I’m nothing.” —Allen Ginsburg, “America”

20. “It might be that to surrender to happiness was to accept defeat, but it was a defeat better than many victories.”
—W. Somerset Maugham, Of Human Bondage

22. “At the still point, there the dance is.” —T. S. Eliot, “Four Quartets”

23. “Once upon a time there was a boy who loved a girl, and her laughter was a question he wanted to spend his whole life answering.”
—Nicole Krauss, The History of Love

24. “In spite of everything, I still believe people are really good at heart.”
—Anne Frank, The Diary of Anne Frank

26. “The pieces I am, she gather them and gave them back to me in all the right order.”
—Toni Morrison, Beloved

27. “How wild it was, to let it be.”
—Cheryl Strayed, Wild

28. “Do I dare / Disturb the universe?” —T. S. Eliot, “The Love Song of J. Alfred Prufrock”

30. “She was lost in her longing to understand.”
—Gabriel Garcia Marquez, Love in the Time of Cholera

31. “She was becoming herself and daily casting aside that fictitious self which we assume like a garment with which to appear before the world.” —Kate Chopin, “The Awakening”

32. “We cross our bridges as we come to them and burn them behind us, with nothing to show for our progress except a memory of the smell of smoke, and the presumption that once our eyes watered.”
—Tom Stoppard, Rosencratz and Guildenstern Are Dead

34. “The half life of love is forever.”
—Junot Diaz, This Is How You Lose Her

35. “I sing myself and celebrate myself.”
—Walt Whitman, Leaves of Grass

36. “There are darknesses in life and there are lights, and you are one of the lights, the light of all lights.”
—Bram Stroker, Dracula

37. “Tomorrow is always fresh, with no mistakes in it yet.”
—L. M. Montgomery, Anne of Green Gables

38. “I could hear the human noise we sat there making, not one of us moving, not even when the room went dark.” —Raymond Carver, “What We Talk About When We Talk About Love”

39. “I would always rather be happy than dignified.”
—Charlotte Brontë , Jane Eyre

41. “I have spread my dreams under your feet; / Tread softly because you tread on my dreams” —W. B. Yeats, “Aedh Wishes for the Cloths of Heaven”

42. “It frightened him to think what must have gone to the making of her eyes.”
—Edith Wharton, The Age of Innocence

43. “For poems are like rainbows; they escape you quickly.”
—Langston Hughes, The Big Sea

45. “I wondered if that was how forgiveness budded; not with the fanfare of epiphany, but with pain gathering its things, packing up, and slipping away unannounced in the middle of the night.”
—Khaled Hosseini, The Kite Runner

46. “So we beat on, boats against the current, borne back ceaselessly into the past.”
–F. Scott Fitzgerald, The Great Gatsby

47. “Journeys end in lovers meeting.”
—William Shakespeare, Twelfth Night

49. “It does not do well to dwell on dreams and forget to live, remember that.”
—J.K. Rowling, Harry Potter and the Sorcerer’s Stone

50. “One must be careful of books, and what is inside them, for words have the power to change us.”
—Cassandra Clare, The Infernal Devices

List courtesy theunboundedspirit.com

Speak of me

Ah yes, all lies, God and man, nature and the light of day, the heart’s outpourings and the means of understanding, all invented, basely, by me alone, with the help of no one, since there is no one, to put off the hour when I must speak of me.

— Samuel Beckett, The Unnamable

My lesson

Under the skies, on the roads, in the towns, in the woods, in the hills, in the plains, by the shores, on the seas, behind my mannikins, I was not always sad, I wasted time, abjured my rights, suffered for nothing, forgot my lesson. Then a little hell after my own heart, not too cruel, with a few nice damned to foist my groans on, something sighing off and on and the distant gleams of pity’s fires biding their hour to promote us to ashes.

— Samuel Beckett, The Unnamable