magnesium for depression, anxiety, and stress

 

How magnesium relieves anxiety, depression, and stress

Magnesium is fundamental to many processes in our bodies; it plays a role in over 300 biochemical reactions necessary for our physical homeostasis. It supports the cardiovascular system, endocrine system, and digestive system. It prevents the hyperexcitability of neurons that results in anxiety, stress, and cell death. For this reason it’s also being investigated as a preventative treatment for neurological diseases such as Alzheimer’s, Parkinson’s, and stroke. Magnesium also reduces the risk of heart disease, lowers blood pressure, and reduces the frequency of migraines.

Magnesium deficiency is extremely common

magnesium for depression, anxiety, and stress

Most people aren’t getting enough magnesium – it’s estimated that about 68% of all adults in the US are deficient in this essential mineral.

Why? Most processed foods are stripped of their natural magnesium. For instance, refined flour contains only 16% of the magnesium found in whole wheat. So much pasta, so little Mg! 

Water treatment facilities also tend to filter magnesium out of our drinking water. Poor diet is strongly linked to magnesium deficiency, and other factors like excessive alcohol intake and stress can also deprive our bodies of much needed magnesium.

Magnesium deficiency can cause anxiety, depression, weight gain, fatigue, insomnia, irritability, muscle cramps, diabetes… the list goes on.

Several studies have established magnesium’s efficacy in treating depression and anxiety. In one recent study, daily use of magnesium significantly reduced symptoms of depression  and anxiety within just two weeks.

Magnesium deficiency, stress, and neural atrophy

So how does magnesium work? Because magnesium is so vital to so many processes, its role in relieving depression is multi-faceted. However one way is by regulating the HPA (hypothalamic-pituitary adrenocortical) axis – our body’s main stress response system, which controls the secretion of our stress hormones. 

A second way magnesium may act to curb anxiety is by preventing glutamate from excessively binding to NMDA receptors. Glutamate is the main excitatory neuro-transmitter in our brains, and anxiety provokes an overactivation of NMDA receptors. Over time, these neural pathways become reinforced, and chronic overactivation of these receptors causes the death or atrophy of complementary neurons, resulting in neurological dysfunction. Long term, the cell death caused by NMDA overactivation causes a loss of neuroplasticity, and even  brain damage.

Don’t freak out – you can reverse this process and grow new brain cells. However, this neuronal death and atrophy causes key areas of the brain to shrink, a core physiological feature of depression. The hippocampus, which is responsible for learning and memory, is 10-20% smaller in patients with stress-related disorders like major depression and PTSD.

Have you ever heard it said that a depressed person has “stopped growing”? Well, this may be more than figurative – the hippocampus is also where all new neurons are born (perhaps thousands a day in healthy adults), so damage to neurons in the hippocampus may also limit our ability to form new neurons. If our ability to create new brain cells is stunted, it can affect our entire brain, literally limiting our ability to learn and grow. The prefrontal cortex, the area of the brain responsible for planning, cognition, creativity, self-expression, and social behavior, also tends to be smaller in people suffering from depression.

Magnesium may also support serotonin production, and increase the availability of GABA, the inhibitory neurotransmitter that relaxes us.

New neurons, neurogenesis and neuroplasticity

In short, magnesium deficiency can lead to excess anxiety and stress, which can in turn cause neurons and areas of the brain to atrophy, a central feature of depression. The good news is that you can reverse a lot of this damage by stimulating the growth of new neurons, which is called neurogenesis. Since all new neurons are born in the hippocampus, learning is a great way to stimulate neurogenesis. Exercise is also a classic way. Sex is said to help, too, by way of relieving stress.

Another experimental class of treatments, psychedelics, increases neuroplasticity and may even stimulate neurogenesis. Psychedelics reverse depression-related neuronal atrophy by stimulating the growth of dendritic spines and synapses in existing neurons. These are the very ends of neurons, where they communicate with other neurons. More and stronger synapses mean new connections and neural pathways, which translates to new ideas, thoughts, creativity, and growth.

Your brain will also need magnesium in order to create nucleic acids, which are essential parts of neurons and all living cells.

What type of magnesium should I take?

As with many supplements, absorption is a factor. Magnesium comes in many forms. Look for supplements with magnesium glycinate or magnesium chloride, which are thought to be among the most easily absorbed by the body.

Of course, mental health is complex; biological mechanisms interact with social,  environmental, and historical factors. However nourishing your mind and body by getting enough magnesium is an excellent place to start to feel better. 

 

community gardening therapy

 

30 individual and collective ways to heal trauma

 

By Tina Phillips, MSW

 

 

Overcoming trauma is a process. Trauma, or post-traumatic stress disorder (PTSD) can be caused by an event or an emotional experience in which a person felt a threat to their life and safety.

PTSD and in the event of chronic or repeated traumas, C-PTSD, can present itself as emotional distress, distrust of others, fear and anxiety, and emotional dysregulation. It can also cause depression, flashbacks, and avoidance.

There are both individual and collective ways to heal trauma. Some individual ways to heal from trauma are self-care, therapy, art, journaling, and using workbooks.

Collective ways to heal trauma may include group support, volunteer work, social support, and even activism. Activism and community advocacy can help us have hope for the future, and empower us to take action now that can improve our own lives and help our communities.

Both individual and collective methods are worthwhile endeavors. No solution is one size fits all, and it can take experimenting with different techniques and coping skills, and combining them to fit each individual. 

 

“Developing an inner refuge where we feel loved and safe enables us to reduce the intensity of traumatic fear when it arises.”  

Tara Brach

Individual methods

pet therapy

 

Individual methods of overcoming trauma can help us to feel our feelings and understand our experiences instead of numbing and avoiding them. These tools can help us embrace and process emotional pain and how it shows up for us in our bodies. Feelings can include shame, negative thinking, flooding and repeated thoughts, and low self-esteem. 

In addition, these methods can foster self-compassion and build a relationship with ourselves, allowing us to get to know ourselves better by opening up buried wounds of the past. Some individual ways to help heal trauma are to get moving and exercise. Don’t isolate, use stress reducing techniques, take care of basic health needs such as getting proper nutrition and sleep, and seek professional help if necessary. 

 

“There is no timestamp on trauma. There isn’t a formula that you can insert yourself into to get from horror to healed. Be patient. Take up space. Let your journey be the balm.”

Dawn Serra

Some stress reducing techniques that heal trauma

 

Deep breathing and progressive muscle relaxation

Deep breathing helps more oxygen get to your brain and triggers the parasympathetic nervous system, promoting relaxation. It also connects one to their own body and brings awareness to the rhythmic sound of your breath, bringing centered calmness. In addition, when we tighten a muscle and then release it, it causes deeper relaxation in that muscle. This can promote relaxation in the entire body if done one muscle group at a time. The body is connected to the mind, and thus this causes relaxation in the brain as well.

 

Using soothing scents, sights, sounds, or touch

five senses grounding trauma PTSD

 

Scent can help us relax, via our limbic system, which connects to emotion and memory. Relaxing smells can lower stress levels, promote soothing feelings, and help invoke positive memories.

Pleasing visuals can have a calming effect, helping us to destress and bringing us comfort. This can be as simple as looking at pictures of landscapes, ocean, animals, nature, or going outside and looking at nature.

Listening to music, the ringing of bells, the sound of ocean waves or rain, binaural beats, and guided meditation can all help reduce anxiety, decrease stress, tap into good memories, focus the mind, and promote enjoyment and positive feelings.

Touch can soothe us, make us feel connected, and increase well-being. Touch has been proven to lower heart rate and blood pressure, lower stress, and increase oxytocin. From a hug to a massage, touch comes in so many forms. Even a weighted blanket can help ease our anxiety and help us fall asleep. There are so many ways to bring touch into our lives and collect its benefits.

 

Grounding activities

People with PTSD can dissociate, or have the sense of not being themselves or in their body. In this case, grounding helps bring us back into our body and the present and feel our feelings. It can be as simple as lying on the floor, or anything that slows us down or engages us physically such as meditation, dancing, or going for a walk. When people are experiencing panic attacks or flashbacks, grounding is also used as a tool of distraction, drawing awareness away from anxiety by focusing on a cue which engages the five senses.

 

Mindfulness practice

Mindfulness practice is about bringing awareness into the present moment. It’s a way we can observe ourselves without judgement and getting overwhelmed. When practicing mindfulness people bring awareness into their bodies, feelings, and thoughts and try to bring them into balance.

Mindfulness is about paying attention. Not to the past or the future, but right here and right now. Mindfulness can promote stress reduction, help anxiety and depression, and quiet the mind so it becomes more focused and calm.

 

Meditation

 

Meditation promotes deep relaxation, focuses attention, reduces stress, increases awareness, reduces negative thoughts, can boost imagination and creativity, and increases tolerance and patience. There are so many different kinds of mediation and various methods – despite popular belief that it looks one way, and that way is hard. Learn more about it and you may find one that is right for you.

 

 

Workbooks

Workbooks are a great way to get the tools that therapy teaches you without the price tag. They range in price, but for around $15, you can get a workbook that will teach you about depression or anxiety and techniques on how to reduce them.

 

Art

Art, for example painting, beading, knitting/crocheting, adult coloring books, drawing, collaging, photography, origami, mosaics, etc., can all be healing.

Art helps us make more connections in the brain and connects our minds to our bodies. It helps us tap into our creativity and get in touch with our feelings, and it can help promote enjoyment, rhythm, and soothing feelings.

art to heal trauma

 

Journaling

journaling to heal trauma

Journaling is a cost effective way to put your traumatic experiences down on paper. Writing is a creative expression that can help our brains process information, reduce stress, and even boost our immune system. Writing can help us tap into the meaning of our experiences and see our own growth from them, as we re-read and reflect on our story. It’s also a great way to vent, without anyone else having to listen to it or react. It’s a way for you to get it all out with privacy.

 

 

Get in nature  

Nature can reduce negative feelings such as anger. Nature reduces stress, and promotes positive feelings such as joy. Nature tends to help both body and mind, and has been proven to reduce blood pressure, relax muscles, lower heart rate, and lower stress hormones. Nature can be soothing, help us feel connection, bring us balance and calm, and help us feel more resilient and focused. Nature can even distract us from our pain.

 

Video games 

It may surprise some, but studies show video games can be an effective way to treat trauma. Video games have a mindfulness-like effect, as well as a soothing effect through repetitive tapping and button pushing. They can also provide social connection, be used as a tool of distraction from painful symptoms, and help create meaning. Video games can be affordable and played in the privacy of one’s own home.

 

Get a pet 

It’s been proven that stroking the soft fur of a pet can increase our levels of oxytocin. In addition, having a pet can decrease stress levels, lower blood pressure, lower risk of a heart attack, and help ease depression, anxiety, and stress. A lot of these benefits come from playing with, walking, feeding, and petting a pet. Pets can help us get out of bed because they need us. (The secret is, we need them, too.)

 

ASMR (Autonomous Sensory Meridian Response)

ASMR can help people relieve bad moods, create soothing feelings, reduces chronic pain, and helps reduce stress, depression, and anxiety. ASMR can also help people to relax, fall asleep, and uplift their mood.

 

Join in person support groups, peer support groups, Facebook support groups, or other online support groups

The great thing about support groups is that you’re surrounded by other people who are going through the same thing you are. It instantly decreases your feeling of being alone or isolated. You are validated by others who confirm your experience and reflect back your own experience. This brings comfort and builds social bonds. Many groups are also easily accessible and affordable or free. Peer support is really a great way to help others as well, and feel like you’re giving back in return for advice and support you received from others.

 

Go to therapy

Therapy helps people process the trauma they have been through. Therapy also teaches a person about trauma and how it could be showing up for a person. Therapy helps a person talk about their traumatic experiences, and helps guide them to express their feelings in healing ways. Therapy can help you develop a narrative which is compassionate and accurate based on how trauma shows up for you and how it affects the brain.

Therapists provide psychoeducation, teach therapeutic techniques and tools, and use therapeutic techniques to treat trauma and reduce symptoms such as depression, anxiety, hyper-vigilance, or flashbacks. Therapy can help people regain a sense of power, increase self-esteem, help with daily functioning, teach people healthy coping and self-soothing skills, and help them develop resilience. Therapy can also help reduce stress, negative feelings, and self-harm. There are many types of therapy, and some may work better than others for you depending on your situation and needs.

 

Reading or listening to podcasts

reading therapy for PTSD
Ashwagandha for stress and anxiety

Herbs, supplements, & alternative medicine

 

Collective methods to heal from trauma

volunteering

 

Collective methods of healing trauma are also a creative way to channel our feelings and look outside ourselves for connection. Activism can help people share their feelings, empower themselves, receive validation, and create purpose and meaning for those who may feel they have lost their way.

These collective methods focus on helping others and giving back, building community ties, and fostering healthy relationships. These tools can help one process grief and loss, decrease loneliness and isolation, create safety trust, and build resilience. Furthermore these methods can help create positive change, can be transformative for the individual and society, and help a survivor take their power back.  

 
“The most beautiful people we have known are those who have known defeat, known suffering, known struggle, known loss, and have found their way out of the depths. These persons have an appreciation, a sensitivity, and an understanding of life that fills them with compassion, gentleness, and a deep loving concern. Beautiful people do not just happen.”
Elisabeth Kübler-Ross

 

Some systemic solutions that help heal trauma

 

Building social support networks

Traumatic experiences can isolate us, or cause us to self-isolate. However human relationships are extremely important for mental health and having a sense of belonging and support. Trauma survivors can help heal by finding social support through support groups, spending time with their friends and family, becoming part of spiritual communities, and building positive relationships  with coworkers.

 

Volunteering

Volunteering is a great way to make social connections, to build community, to help yourself feel positive feelings, and create purpose and meaning. Volunteering can also be fun, be good for building work experience, and helps increase leadership skills.

 

Writing for an audience 

Writing for an audience can help one express deeply held experiences in order to help others feel less alone and isolated. It can also help others to find techniques and ways to improve their own lives. This can be very fulfilling and also healing for the writer, whose lived experience can both be written about and expressed, and also read by many people, helping bring meaning and purpose, resilience, and courage to both the writer and the audience.

 

Advocacy

Advocacy work helps us raise awareness of our own cause. It helps us when we speak up for others who feel voiceless, helps us build resilience and courage and promote these in others, helps us use lived experience to fight for better policies and treatment for others, helps break down stigma, and be effective in promoting better wellbeing for people like us. Advocacy helps us feel less powerless, as we see the benefits of our work demonstrated in tangible outcomes and improved lives. 

 

Join a community garden

community gardening to heal traumaCommunity gardens make cities more beautiful and grean, and provide fresh and healthy food for the communities they’re in. If you already know how to garden, you can start to grow your own food, while meeting and teaching others. And if you don’t know how to garden, you can learn! The other gardeners will give you free tips, and many community gardens even offer classes. Learning, socializing, and eating healthy foods are all ways to nourish your brain and help heal trauma.

 

Restorative and Transformative Justice programs or circles 

Transformative Justice is a framework communities can use to address violence and abuse outside of the criminal justice system. It’s an approach that seeks to create accountability, safety, and healing within communities harmed by trauma, without perpetuating violent reactions or behaviors.

 

Movementand community building

Some people’s experiences of mental health treatment has itself been traumatic. This can be because of the stigmatization that comes with some mental health diagnoses, misdiagnosis, or experiences of forced institutionalization or dehumanization in psychiatric care. There are networks and communities of mental health survivors that critique the mental health system and advocate for it to be more patient-led. Joining one can give survivors a voice and be a source of social support, especially for those who have been traumatized by psychiatric institutions.

 

Join a union

Economic disempowerment is a major contributor to mental health problems. Unions are a way to address disempowerment at the workplace and declining wages. Unions can build a community of solidarity at your work, uniting workers to fight for higher wages and better working conditions. A union will also support you if you’re being harassed on the job, and educate you as to your rights at the workplace.

unions for PTSD

 

Join or start a coop

Coops are a way to bring power back into our own hands and the hands of our communities. There are several different kinds of coops (and collectives). Worker coops are businesses that are owned and operated by the people who work there, so they tend to have better working conditions and serve the needs of their communities more than traditional hierarchical businesses. Consumer coops, like many local grocery stores, are owned by the people who shop there, and often have gathering spaces or offer events and services to the community. Having strong communities and socializing is good for our mental health, and can help us build support networks and overcome isolation and trauma.

 

We are working through trauma and towards healing both as individuals and as a collective. It takes many shapes and forms.  It’s up to us to design the toolkit that works best for us throughout our journey. Hopefully this has inspired you as a jumping off point to do some healing work of your own. 

Before Dawn by Bisbiswas

 

The ketamine craze: Ketamine infusion therapy for depression & PTSD

Ketamine clinics for depression and PTSD are popping up like wildflowers, but is it a poison or a cure?

 

ketamine for depression, PTSD, anxiety

 

Ketamine’s first recorded synthesis was back in 1956. It was approved for use in the US on humans and animals in 1970, and it became the most commonly administered battlefield anaesthetic during the Vietnam War. However during the 1980s it emerged on the street and became popular within the rave party and gay scene as a drug to get high on.

Though not widely used recreationally in the US, over the past decade ketamine has become UK teenagers’ “drug of choice”. Maybe they’re self-medicating… but the consequences of ketamine addiction can be serious. We’ll get to the recreational, or dark side, of ketamine later.

2020 saw ketamine hit the headlines once more as a successful treatment within clinics for patients suffering from treatment resistant depression. As with classic psychedelics like psilocybin, ketamine infusion therapy has shown promise as a treatment for depression, PTSD, OCD, anxiety, and even addiction.

 

Ketamine poison or remedyMoonlight Circus by BisBiswas

 

Despite its risk of abuse, because of its anaesthetic and pain-relieving applications, ketamine is a Schedule 3 substance in the US, as opposed to Schedule 1 like magic mushrooms, LSD, or MDMA. That makes it a lot easier to conduct research on ketamine and use it in clinical trials, and means that doctors can use it off label.

It’s because ketamine has approved medical applications that ketamine clinics are now able to proliferate across the US (and now also the UK), and news of it as a panacea is lighting up the marquees. The irony, of course, is that ketamine is much more dangerous than psilocybin, and probably less effective – or at least, its effects are shorter lived.

Ketamine clinics, like the company MindBloom, offer ketamine injections or infusion therapy, sometimes in conjunction with psychotherapy, Since the treatment is experimental and not approved by the FDA, it’s not covered by insurance – though some clinics are making ketamine infusion therapy as affordable as a visit to the psychiatrist.

 

How does ketamine work?

Ketamine is an NMDA receptor antagonist. NMDA receptors are activated by glutamate, the main excitatory neurotransmitter in the brain.

Overactivation or “excitability” of NMDA receptors is implicated in chronic stress and anxiety, and eventually leads to neural atrophy, a loss of neural plasticity, and depression.

As an NMDA antagonist, ketamine temporarily blocks glutamate from binding with NMDA receptors, preventing activation of downstream neurons (which we might experience as negative thoughts if we’re depressed). Glutamate is the most abundant neurotransmitter in the brain, and it’s especially involved in learning and memory and the formation of long-term neural pathways (known as long-term potentiation, or LTP).

The prevailing theory is that a series of chemical processes are then set off that increase levels of brain-derived neurotrophic factor (BDNF), a key protein for the growth of neurons, which is stunted when NMDA receptors are overactivated.

Blocking NMDA receptors also causes glutamate to activate more AMPA receptors, the other main glutamatergic receptor. In situations of chronic stress, AMPA receptors are underactive and there are fewer of them at synapses. However AMPA receptors are key to synaptic plasticity; they stimulate short-term and long-term potentiation, or the creation of new neural pathways.

ketamine and depression
A healthy synapse versus one under chronic stress, as in when NMDA receptors are overactivated

Neuroscientists believe ketamine’s antidepressant effect to be achieved by increasing the number of AMPA receptors and by stimulating BDNF in the brain, fostering the growth of new neurons and dendrites, and strengthening synapses. All of this increases neuroplasticity, or how healthy and flexible our brains are, which is thought to play a key role in the antidepressant effects of all psychedelics. 

This is a general overview; the exact mechanism by which ketamine relieves depression is still being investigated.

A recent study found that the antidepressant effects of ketamine may be through one of its metabolites, hydroxynorketamine.

Serotonin may also play a role. A 2020 study found that ketamine treatment increased binding with serotonin 1B receptors in the hippocampus of depressed patients.

 

What is ketamine like?

The ketamine high isn’t exactly like that of classic psychedelics such as LSD or psilocybin. It’s dissociative, so it can make you feel disconnected from your body as well as your regular thoughts and emotions. Users report feeling like they’re floating, with changes in perception and dreamlike states.

Mentally it’s not for the faint hearted; it’s a powerful tranquilizer and the trip is intense, introspective and psychedelic. As a street drug, ketamine can be quite moreish on a low dose so it’s very easy to go over on the second line… and then you may end up in a “K-hole”, coming around a few hours later with no memory of what happened.

The comedown is spacy and empty, leaving you feeling a bit down.

 

Ketamine infusion therapy for depression

We’ve known for at least 20 years that ketamine relieves depression. Since then, several studies have found ketamine infusion therapy to reduce depressive symptoms in patients with treatment resistant depression, meaning, those who have failed to respond to traditional antidepressants. 

Ketamine is fast acting, known to relieve depression almost instantaneously. It’s also promising for those at risk of suicide; ketamine has been found to significantly lower suicide ideation.

Most patients experience near total relief of their depressive symptoms within one to 24 hours of their treatment. On the down side, the antidepressant effects of ketamine typically wear off within one month, so it’s not a cure.

It seems that as a long-term treatment, patients need to receive injections weekly or monthly, though by combining ketamine infusions with psychotherapy their effects may last longer.

 

Ketamine infusion therapy for PTSD

People who have been through a traumatic event, or repeated or chronic events, can develop PTSD or chronic C-PTSD. Common symptoms include depression, flashbacks, anxiety or panic, and nightmares. However PTSD can also manifest in difficulty concentrating, cognitive impairments, loss of interest and detachment, emotional dysregulation, and reckless behavior. 

Since these symptoms are also common in those suffering from neural lesions or traumatic brain injury, a group of researchers theorized that PTSD may also be caused by a lack of synaptic connectivity.

They write:

“It is well established that chronic stress causes neural atrophy and decreases the number of synapses within cortical and limbic circuits implicated in the regulation of mood, cognition, and behavior. Glutamate synapses are the dominant form of synaptic connectivity in these circuits.”

So they hypothesized that ketamine could treat PTSD based on how it is thought to treat depression – building the strength of synapses by increasing BDNF, the number of AMPA receptors, and the number and strength of dendrites, the branches at the receiving ends of neurons.

Now that theory is being tested. A study just published in the American Journal of Psychiatry found that a two-week course of six ketamine infusions significantly improved symptoms of PTSD, and the effects lasted for nearly a month. Research on humans is still limited, but at least one other study has found similar results. More research has been done on rats, suggesting that ketamine can help us forget bad memories.

 

Ketamine and OCD

Since glutamate is thought to play a central role in the obsessive thought patterns which plague OCD, ketamine has been investigated as a possible treatment. A 2013 study found that treatment with ketamine had rapid and stable results, reducing symptoms of OCD in half of participants for at least one week.

 

Ketamine and addiction

Ketamine can itself be addictive, so it seems an unlikely candidate to cure addiction. However one study in 2019 found that one ketamine treatment plus five weeks of mindfulness-based therapy resolved cocaine addiction in 44% of participants for at least six months, while all of those who only received the therapy (the control group) continued using.

 

Ketamine & esketamine for anxiety

Though the effects aren’t as pronounced as they are for depression, a few studies have also found ketamine to be somewhat effective in treating anxiety. In one study, ketamine was found to reduce social anxiety but not generalized anxiety compared to placebo.

A couple of studies found that esketamine significantly reduces both depression and anxiety in chronically ill patients.

Generally ketamine is a sedative, however another study found that experiencing anxiety during ketamine infusions for depression was associated with poor outcomes. So the first word of advice to those seeking ketamine treatment for depression might be: just relax.

A second word of advice? If you’re having ketamine treatment, take magnesium supplements along with it. Ketamine and magnesium are thought to work in similar ways to treat depression, and a recent study found that supplementation with magnesium enhances ketamine’s antidepressant effects.

 

A look at recreational ketamine use across the pond (or, the case against ketamine)

 

ketamine craze: cure or poison?

 

In England, where ketamine is widely used as a party drug, people are seeing the dark side of ketamine, as young men in their 20s are starting to have bladder problems. This is because ketamine breaks down the wall of your bladder over time.

If you develop a habit and regularly take a lot of street ketamine, you will fairly soon start running into some serious problems, as tolerance grows rapidly. In the beginning it’s fairly cheap, selling at around 20 pound a gram in the UK — that’s enough to get you well and truly munted for up to five hours. And if you start using at the levels given to sedate animals like elephants and horses, your problems will deepen as your usage goes up and tolerance builds.

The obvious drawbacks are the onset of adverse physical effects after heavy or long-term use of ketamine. These are worse than most other street drugs; primarily the rapid destruction of your bladder and urinary function. It’s sad to see teenagers that have been caning k for a few years simply pissing their pants and having seriously painful stomach cramps.

People’s experiences are individual and specific, so whilst Jill who had a little dabble here and there for a few years managed to walk away unscathed and actually benefited from her experiences, Jack spent way too much money and is having a tough time trying to stay off it whilst suffering psychosis, kidney, and bladder problems. You can never know another person’s capacity to say no or have an understanding of how other drugs, medications, and personal traumas are affecting another person’s ability to make positive decisions.

Other associated problems may include scenarios such as where a person on ketamine walks into a busy road oblivious to their surroundings. Unfortunately it is also used by rapists, gay and heterosexual. Finally, it is illegal in most jurisdictions, so you could do hard time if caught dealing or importing–situations many addicts fall into whatever drug they are on to either fund usage or settle mounting drug debts.

An alcoholic who drinks hard liquor morning noon and night could develop cirrhosis of the liver, slurred speech, and a switchy personality, and whilst some may quietly destroy themselves others may be easily manipulated into violence and vicious cycles of low self-esteem, prison, and toxic relationships.

The recent studies have found that ketamine infusion therapy can immediately alleviate a person’s suffering who is suicidal, however the studies also show that after a period of two weeks the person is likely to be back in the same state of depression, so there is no long term gain.

Popular street drugs are popular because they give you a rush or cause an intoxicating effect, and a good experience will give you confidence to try it again. I suppose what I’m hinting at is that making a career out of ketamine will end up doing you serious harm physically and emotionally. While a short course may have benefits, it comes with no recommendations from my end.

 

Es/ketamine: don’t try this at home

There you have it, folks. While some psychedelic drugs may be safe to experiment with yourself for therapeutic purposes, ketamine is not one of them. Ketamine infusion therapy as an occasional treatment in a clinic may be safe, but it’s definitely one of those “Don’t try this at home” drugs.

And as for esketamine: since ketamine itself can’t be patented, pharmaceutical companies had to slightly change it in order to profit from ketamine therapy. Thus, esketamine is basically just a patented version of ketamine, though it’s said to be a bit weaker. And since most studies of ketamine have been by infusion, and since it’s slightly different chemically, it may be less effective in treating depression. And did we mention that ketamine’s addictive? Yeah, don’t get prescription ketamine.

 

city budget cuts and mental health services

  

Accessing treatment in a deteriorating system

 

By Angel V.

I was diagnosed with Borderline Personality Disorder about six months ago. Before that I’d had a diagnosis of bipolar one, a severe form of bipolar where rapid cycling and suicidal ideation are particularly common. Borderline personality disorder, or BPD, makes it difficult for someone to control and regulate their emotions, affecting interpersonal relationships, basic day to day functioning, and employment.

Finding treatment and therapy for both of these diagnoses is difficult. Even under the best of circumstances.

Before covid, my options were limited. Most people choose to go on a waitlist and wait for the type of therapy that is known to work best with borderline personality disorder, Dialectical Behavior Therapy, to become available. This type of therapy works best in a group setting and takes the form of a course wherein a person is taught better coping mechanisms, based on a practice of mindfulness.

I’ve been waitlisted for almost a year now.

Covid made treatments like this near impossible. People can meet in Zoom chat rooms, but scheduling can be difficult. And it requires a full group doing the full 6 to 12 week program in order to work.

 

mental health budget cuts

 

Cutting mental health budgets, militarizing the police

Part of the problem lies with state funding. Without people who are experienced in this type of treatment, who can facilitate the group, the number of groups that are available dwindles.

Funding for programs in Chicago and throughout Illinois was cut years ago.

Under Republican Governor Bruce Rauner, the state decided to allow mental health services to receive little or no funding during sweeping budget cuts. True to form, it was the most at need that received the least assistance under the new budget.

Psychiatric care for many programs were reduced drastically or eliminated completely as a result. In Chicago, a city of over eight million people, these budget cuts, and the reduction in services that they cause, have had deep and lasting effects.

Under Democratic Mayor Rahm Emanuel, many of the city’s major providers were shuttered because of lack of funding. Unsurprisingly, the first providers to go were the ones in predominantly Black and Latino neighborhoods.

The money that should be going to mental health services and clinics is going instead toward policing and prisons.

The 2021 budget allocates nearly $1.7 billion dollars toward police spending. This is nearly 40% of the corporate fund, the largest of funds of the city’s spending plan.

As seen during the Black Lives Matter Protests, the city’s police force is better equipped than some military forces. In addition to full riot gear, tear gas, batons, rubber bullets, police have availed themselves the use of the Long Range Acoustic Device, or LRAD, a sonic weapon intended to disperse protesters using an ear splitting deterrent tone, capable of causing permanent hearing damage. Use and operation of these weapons is not cheap. Spending suggests the city would rather deal with the problems that having an unhealthy population cause then preventing the problems by providing services.

 

A history of cuts to mental health services

Cutting health services is a hallmark of Republican budget strategies: As soon as he took office as governor of California, Reagan decided to slash funding for health services. The number of people suffering from mental health issues in the prison system effectively doubled as a direct result of this action.

Private board and care facility operators capitalized on former patients who needed assistance. There was money to be made providing spaces and services for the mentally ill. Those who didn’t end up in prison ended up in one of these facilities, or eventually on the street if their symptoms were severe enough and they were not receiving proper treatment and medication.

Later as president, Reagan decided to cut funding for health services again, reducing federal spending for mental health and pushing the responsibility for funding services onto the states.

This fiscal strategy of intentional neglect continues today. As recent as last year, 45’s proposed budget for 2021 included $2.9 billion in cuts to the National Institute of Health and another $708 million to the CDC, this during a pandemic.

In January, the senate overrode a veto to pass a $740 billion defense budget while denying us our $2,000 survival checks. The Democrats still haven’t delivered.

National policy affects people who are suffering from mental illness personally.

Shortly after I was diagnosed with bipolar one, I was prescribed lithium to help with manic episodes and to regulate depressive cycles. I was on lithium for a year before switching to depakote after finding out lithium can damage the liver and kidneys.

Under the Affordable Care Act, also known as Obamacare, I qualify for Medicaid.

Without insurance, I would be paying hundreds of dollars for my medication. 

Even with medication, day to day functioning is a challenge. Trying to explain the necessity of taking medication to someone who doesn’t struggle with mental health issues is difficult and adds to the challenges that neurodivergent people face.

I am in constant fear of losing my insurance because of a change in the administration.

 

Change is possible: cities making progress

Forward-thinking cities have taken matters into their own hands. In 2018, Denver residents passed a measure that would allow for a .25% tax increase that earmarked funds for mental health treatment. Among a rash of suicides and overdoses, Denver wanted to see its citizens receive access to better mental health services. 

Other parts of the country have taken similar steps with positive results. In 2008, King County Washington saw a .1% increase in funding for behavioral health services. Within three years, they witnessed a drop in psychiatric hospital admissions of 29%, with a 35% drop in jail bookings.

The major problem with programs like this is how people access them. A lack of standards means that people might have trouble finding them, and without regulation there is a good chance that those most in need will slip through the cracks.

In Chicago, this has been a big part of the problem as well as limited services. People who are computer literate and who understand how to navigate bureaucratic systems are still left daunted by a confusing and complicated, time consuming, frustrating system.

For those who do not have the time, patience, and wherewithal, it’s easier to find other ways of coping with mental health issues.

 

 

how to talk to a depressed or suicidal friend

 

How to talk to a depressed (or even suicidal) friend

(Note: this article won’t prepare you to be a trained crisis counselor, so keep crisis hotline numbers, which are listed at the end of this article, handy. however, if a friend comes to you for help, one of the best things you can do is listen. below a crisis counselor tells us how.)

 

Suicide isn’t something most of us want to think about, let alone talk about. However we have to be real: the suicide rate has risen by 33% over the past 20 years, and it’s the 10th leading cause of death in the US. Before the pandemic, depression affected over 20% of the population.

The Covid crisis has made things worse for most people. A year later, the CDC now estimates that 40% of the population is struggling with anxiety or depression. Young people are being hit hardest, with a staggering 55-60% of people aged 18-29 experiencing symptoms. There’s been a corresponding rise in suicide attempts by children and teenagers.

These are conversations we may need to have at some point with friends and loved ones, uncomfortable as they may be.

So I asked my friend Sam how we should talk to friends that are depressed, or may even be suicidal. Sam’s been working at a suicide hotline for the last five years.

 

Why do people do it?

The first thing I ask Sam is, why do people do it? I try to get him to open up as to some of the common reasons that people make that decision, or make the call to the suicide hotline. After thousands of conversations with suicidal people, he must have some insight.

“Everything you can think of and then some,” is his response. He can’t comment on any leading causes, nor can he give me any stories. I figure tight-lipped is a trait you’d want in a suicide counselor.

What he can say is, “It’s never just one thing, it’s always a whole bunch of things.”

“It’s like a full grocery bag that you just keep piling stuff in, and eventually it breaks. It wasn’t that last thing that broke it, it was all of those things.” 

So there’s sometimes a straw that breaks the camel’s back, but it’s never just that. 

And of course, it’s subjective.

“People don’t kill themselves because of facts,” he says, “they kill themselves because of their thoughts and feelings.”

I pry a little further, curious if there’s a class dynamic, or if he’s noticed poverty as a factor.

“There’s an incredible diversity of people with access to a telephone,” he says. He resassures me that plenty of calls come from people from higher socioeconomic backgrounds. “Mental illness knows no class distinction,” he says

It would make sense that the most disadvantaged would have the least access to resources, like a therapist, or even a crisis hotline number, which likely skews his sample.

Anyways, Sam never claimed to be an expert in mental health statistics. So I did a little more research and found that, as usual, things are worse for the poor. Before Covid, both poverty and substance use disorders were found to be positive predictors of first-time suicide ideation. And poverty puts children and teenagers at greater risk of suicide.

So we may after all have to look out for the least among us, in wealth and stature. It also means that younger people may be having to look out an awful lot for each other.

Though according to Sam, many rich people are desperately unhappy, too. Which leaves me wondering, “Who does this world even work for?”

However this also means no one is immune, and depression and suicide can affect anyone’s family or social network. And we can all learn something about how to be there for others from crisis hotline workers.

 

So how should we talk to a depressed friend?

“Listen,” Sam says again and again.

“You’re not going to solve their problem,” he says. “What you can do is help them get through a moment.”

Our help shouldn’t be their be-all-end-all support system, and nor should we expect ourselves to single-handedly pull them out of their rut. However if we’re put in this delicate position, one of the best ways to help is by listening.

Unfortunately we get in our own way a lot. Sam says it’s normal for us – even those of us who think of ourselves as good communicators – to want to direct the conversation.

Since we naturally want a positive outcome, it’s easy to get distracted by that. However Sam emphasizes the need to keep the focus on the person. We might think that our advice can solve the other person’s problems, but it can’t, he says.

Put yourself in their shoes. More than anything, that person often needs someone to listen, to feel heard and understood.

Only ask open ended questions. A question that can be answered with a yes or no doesn’t encourage people to open up – and it means you’re directing the conversation (without even realizing it).

Here are some examples (but you can come up with your own list):

  • How have you been doing lately?
  • Why do you think you’ve been feeling that way?
  • What happened that makes you think that?
  • What do you think might help you?
  • How can I support you?
  • What do you want to do?

Above all, shut up and listen. We should, “Be cognizant of our own needs becoming impediments, and focus on creating a safe space for people to vent.”

 

What not to do

“Whether or not we have a good intention doesn’t matter in how effective we are at communicating,” Sam tells me.

If someone tells you they’re having suicidal thoughts, try not to freak out on them. This can make things worse. By staying calm, you make it safe for them to open up to you. But even then, we all struggle to communicate and listen.

“A person is not a problem to be solved,” Sam says. “It’s a process, it’s not about solving things.”

“We’re all bad communicators,” he says, “and we all have the same problems when it comes to communication.”

Careful! Even when we think we’re helping, we unconsciously find ways to try to control the conversation, whether because we feel uncomfortable and we’re nervous, because we think we know better, maybe we’re too eager to help, or even just eager to get out of the conversation.

“Have great respect for that which you do not know,” he says. “Just because you don’t understand someone, it doesn’t make them confused.”

Here are a few communication traps to avoid:

  • Patronizing, or treating the person as if they’re a sociological category. 
  • Trapping. Or asking leading questions like, “Have you tried… therapy?” “Have you tried… exercise?”
  • Minimizing the persons concerns. We might think it would help to reframe what seems like a difficult problem as “not that bad” or that it “could be worse”, but this can also make a person feel dismissed and unheard.
  • Anticipating – or finishing another’s sentences or thoughts for them.
  • And there’s scoreboarding, which is focusing on making your points instead of listening out of some need to be right.

 

How do you know if someone is depressed or suicidal?

“It’s often intuitive,” he says. “Look for clues, like has their behavior changed, are they taking care of themselves?”

Because so many people are isolated these days, it can be difficult to know who’s in trouble. It’s good to check in with friends you think might be vulnerable or having a hard time. And if you think someone you know is seriously depressed and might harm themselves, don’t ignore it. 

Don’t avoid the person, or act like everything is okay. “Depressed people are very observant,” Sam says, and they’ll usually notice if people are acting differently around them. So if it’s the elephant in the room, don’t be afraid to say that you notice it.

“They know it makes people uncomfortable, because it forces them to consider something that most people would prefer not to think about,” he says. So a lot of people who are suffering with suicidal thoughts may not bring them up because they think it will make people uneasy.

On the other hand, there’s a certain finesse involved. If your friend is depressed and you want to create a safe space where they can open up to you, maybe don’t just come out and say, “Hey buddy you seem really depressed lately wanna talk about it?”

Try to avoid judgmental language. Obviously if they’re hinting at it, or otherwise confided in you, they’ve opened up a door that makes it easier to communicate with them about serious issues.

If they’re more secretive, or not a close friend, you’ll have to use your best judgment to determine if and how to bring these issues up with them.

Sam suggests “tip-toeing your way into the conversation,” as you would into a pool, for instance by bringing up changes in their behavior.

For example, you might “tip-toe” your way in by asking something like, “I noticed you haven’t been leaving your room much, is everything okay?” or “You’ve been quiet lately, is something on your mind?”

Even if they say they’re okay, if they’re clearly not, you can leave your proverbial door open for them to chat with you. Make sure they know that they can text or call you if they need anything or just want to talk. Or invite them out for a coffee just to talk about life.

On the other hand, if someone is practically begging for help, pay attention.

“Take people seriously if they express or hint that they’d like to kill themselves,” Sam says. “Whether or not you think they’ll go through with it, it’s a call for help and a sign of something being seriously wrong.”

However, before diving (or tip-toeing) into a conversation, first ask yourself “Do I really want to get into this?” Because if you’re not willing to sit down and really listen, maybe you shouldn’t be the one having that conversation. If not, hotline numbers are below.

Remember, the golden rule: listen.  And empathy helps. That whole “do unto others” bit.

However if it becomes too much for you, or you don’t feel like you’re helping, get them to talk to a mental health worker or crisis counselor. Even calling a suicide hotline with them might help them overcome anxiety about making a call that could be the first step in getting help.

 

Just being there

There are other ways of supporting your depressed friends. Remember, they’re likely feeling alone, so just spending time with them or watching a movie (or chatting with them online or on Zoom) can make a big difference.

“Just being there has value,” says Sam. “We’re social creatures.”

listening to your friends

 

Sam adds that it may be tempting to want to hear a “thank you” at the end of the conversation. But people in distress are often so preoccupied by their problems they can’t think beyond them. 

“So sometimes you won’t get a thank you and that’s fine. Just being there listening – especially if they feel like they were heard,” can save someone else’s life, or at least get them through a moment.

 

If you or someone you know may be considering suicide, contact the National Suicide Prevention Lifeline at 1-800-273-8255 (en español: 1-888-628-9454; deaf and hard of hearing: dial 711, then 1-800-273-8255) or the Crisis Text Line by texting HOME to 741741. You can also find resources at the Samaritans website.