Ketamine Assisted Psychotherapy (KAP) is gaining recognition for its effectiveness in addressing postpartum depression (PPD). The struggles faced by parents can significantly impact their well-being bonding with their newborns and overall quality of life. While conventional treatments such as therapy and medication are commonly used for PPD, not everyone responds positively to them which prompts the exploration of alternative treatment options.

What is Postpartum Depression

Postpartum depression (PPD) is a mental health issue affecting new birth parents following childbirth. Historically this was seen as only affecting new mothers, however this can affect all parents in the system as well as individuals that identify as gender neutral, non-binary, and trans men that birthed a child. The effects and symptoms of PPD surpass the usual "baby blues" experienced by many new parents by lasting longer and being more severe. While baby blues typically fade within two weeks after delivery, untreated PPD can linger for months or even years.

Symptoms of postpartum depression can show a range of signs, including:

1. Feeling persistently sad or having a low mood
2. Losing interest or joy in activities once enjoyed
3. Struggling to connect with the baby
4. Experiencing changes in appetite or fluctuations in weight
5. Having trouble sleeping
6. Feeling tired or lacking energy
7. Having feelings of worthlessness, guilt, or shame
8. Finding it hard to focus make decisions or think clearly
9. Experiencing intense anxiety or panic episodes
10. Having thoughts about harming oneself or the baby

Causes

Although the exact reasons behind postpartum depression (PPD) are not entirely clear, experts believe it stems from a mix of emotional and genetic factors. Hormonal shifts after giving birth such as decreases in estrogen and progesterone levels could play a role that leads to, or exacerbates, PPD. Other contributing factors may include the strain of childbirth, adjusting to the emotional demands of parenthood, lack of adequate support before and after bringing a baby home, past mental health struggles, and genetic predispositions.

The Role of Ketamine Assisted Therapy

Ketamine Assisted Therapy combines the anti-depressant effects of ketamine with therapeutic support to offer a comprehensive approach to treating PPD. Here are some key advantages of this therapy for postpartum depression:

• Quick Symptom Relief: One major benefit of Ketamine Assisted Therapy is its potential to rapidly alleviate symptoms. Unlike antidepressants that may take weeks to kick in ketamine can bring noticeable improvements within hours or days after treatment. This swift response can be crucial for mothers grappling with PPD as it helps them regain their sense of self and strengthen their connection with their baby.
• Improved Therapy Results: Ketamine has the potential to promote enhanced flexibility in patients making them more receptive, to psychotherapy sessions.
• Increased Insight: During KAP sessions patients have the opportunity to gain insights into their emotions and experiences which can contribute to a more meaningful healing journey. By combining ketamine’s effects with psychotherapy, it becomes possible to address the underlying factors of PPD and ultimately lead to long lasting improvements in mental health.
• Secure and Supportive Environment: KAP takes place in a therapeutic environment overseen by trained professionals. This setup contributes to the well-being of the patient and enables immediate assistance if necessary. The supervised use of ketamine along with the support offered during sessions establishes a comforting space for mothers to delve into their emotions and progress towards recovery.

Potential for Long-Term Benefits

By addressing both the symptoms and underlying factors contributing to PPD, KAP offers the potential for long-term benefits. The insights, neurochemical change, and coping strategies developed during therapy sessions can equip mothers with tools to manage future challenges which reduces the likelihood of relapse, as well as helping prevent future struggles with depression. KAP can also work towards helping positive self-belief, thoughts about self or the future, and beliefs about motherhood or the person as a mother.

Considerations and Care

It's essential for treatment with KAP to be part of a comprehensive care plan that includes follow-up support and integration sessions that help retain the benefits gained during the ketamine sessions. These integration and follow-up sessions can help deepen the change and provide space for processing the transition to new motherhood. Furthermore, as with any medical treatment, there are considerations and potential side effects associated with ketamine use which highlights the importance of continued care.

Breastfeeding

One of the advantages to using ketamine for treatment is its general safety in regards to breastfeeding. A study involving breastfeeding mothers who were administered IM (intramuscular) ketamine showed that the highest levels of ketamine and its effects in their system appeared within 3 to 4 hours after the dose was given (as reported by Wolfson and their team in 2022). Utilizing the Relative Infant Dose (RID), which measures the proportion of the medication the infant receives compared to the mother based on body weight, the findings showed a RID of 0.650% for a lower dose of ketamine and 0.766% for a higher dose. Generally, a RID below 10% is usually considered safe which puts this well within the 'safe' zone.

The initial data we do have offers a comforting picture and shows that ketamine and its metabolites are present in breast milk at low levels and decrease quickly within 12 hours after administration. Wolfson and their team believe it's unlikely for a breastfeeding infant to show any significant symptoms from ketamine present in breast milk. Moreover, when ketamine is taken orally (as it would be by the infant through breast milk), its absorption and effect are much less potent compared to when it's given via injection. With the information at hand, the general recommendation is to proceed, but with awareness and under medical supervision. If a breastfeeding mother enters treatment, a medical provider will create a plan to address any potential concerns. Although each person is unique and a doctor will be able to provide concrete information, an example would be temporarily pausing breastfeeding for around 12 hours after receiving a dose of ketamine.

Conclusion

Wrapping up, Ketamine Assisted Psychotherapy is a groundbreaking treatment choice for new mothers grappling with postpartum depression. By working towards symptom reduction, improving the effectiveness of psychotherapy, and aiding in the journey towards sustained mental well-being, KAP marks a significant progress in the care and assistance accessible to those impacted by PPD. As knowledge about and availability of this therapy expands it holds the potential to revolutionize the lives of parents and empowering them to be more present, active, and bonded with their newborns.

The brain remains plastic, even in adulthood, meaning you can reverse these changes. Your brain can heal. If you are interested in depression therapy, Elument is here to help. Book an info session today to set up see if you're a candidate for ketamine-assisted psychotherapy.