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The Altered-State-of-Consciousness Aspect of a Feeling of Lightness Is Reported to Be Associated with Antidepressant Benefits by Depressed Individuals Receiving Ketamine Infusions: A Systematic Analysis of Internet Video Testimonials

Kurt Stocker, G. Hasler, Matthias Hartmann

Psychotherapy and Psychosomatics March 18, 2019 DOI: 10.1159/000497441 (opens in new tab)

Study at a glance

AI-extracted from the abstract
Characteristics Qualitative study Peer reviewed
Sample size 62
Population Depressed individuals reporting on YouTube videos about their experiences during and after ketamine infusions
Intervention Ketamine
Topics Altered states of consciousness Esketamine Ketamine
Key findings More than a quarter (17 of 62, 27.4%) of depressed individuals in YouTube testimonials spontaneously described a sense of lightness, or reduced heaviness, that they associated with antidepressant benefit after ketamine infusions, despite not being asked about it. The authors report finding no prior article on this possible association, and note that such lightness was rarely reported in an analogue analysis of testimonials from depressed individuals receiving electroconvulsive therapy (4.0% vs. 27.4%).

Abstract

5 “I kind of enjoyed the next few hours till dinner. I was still kind of floating on air” (5: 06) (T29). 6 “I had this awkward weight that I carried around me wherever I went (0: 47) ... Literally I had the sensation of this steal armor that I wore my entire life [that] – chunks of it – were falling off (3: 03)” (T16). 7 “I did immediately following the first session – and in the second and in the subsequent – feel a little bit of a lift to the weight on my chest. And if you suffer from depression I think you know what I’m talking about. You physically feel this turning in your stomach. It makes you physically nauseous (3: 30) ... I didn’t experience what I call my breakthrough session until it was my ninth ketamine session and it was so profound and I felt like I broke through so many emotional barriers that I was able to see things differently (4: 35) ... and during that time I was still progressively feeling lighter and lighter as each session went on (6: 10)” (T26). None of the testifiers were asked about experienced heaviness/ lightness/floating in these videos. Our finding that more than a quarter (17 out of 62, 27.4%) of the depressed testifiers spontaneously report upon experiencing a sense of lightness – or less heaviness – that they associate with a reduction in depressive symptoms is in stark contrast with an extensive literature search that we conducted (see online supplement). We could not find a single article that addressed the question if a ketamine-induced sense of lightness might be associated with antidepressant benefits for depressed individuals. Three testifiers (T4/11/26) mentioned body parts in relation to positively associated lightness (“head,” “throat,” “chest,” “neck”). Others might still have implicitly referred to bodily sensations (e.g., T16, “I had this awkward weight that I carried around me wherever I went”). These testimonials suggest that the association between ketamine-induced lightness and other forms of lightness induction might substantially differ; e.g., eliciting lightness through certain movements might evoke a pleasant “summer day” memory in healthy participants [9], while ketamine-induced lightness seems associated with more profound psychological experiences such as breaking through emotional barriers (T26). Furthermore, compared to depressed individuals receiving electroconvulsive therapy (comparison group), an analogue systematic analysis of internet video testimonials showed that antidepressant-associated lightness is rarely reported (4.0 vs. 27.4%, χ2 = 10.78, p = 0.001 [see online suppl. material]). The aim of this letter is to highlight the need for future studies investigating the intriguing link between a subjective sense of lightness and antidepressant benefits, as well as the need for therapeutic studies that investigate a potential antidepressant benefit from stabilization of the subjective feeling of lightness after ketamine infuDear Editor, There are two frequent effects of ketamine whose potential interrelationship has hardly been investigated: a feeling of lightness/ floating in healthy participants and recreational users [1–3], and temporary antidepressant benefits in individuals with treatmentrefractory depression [4, 5]. Feelings of lightness/floating are a typical occurrence in psychoactive-substanceor psychologically induced altered states of consciousness [6, 7]. As subjective lightness/ floating has been reported to be associated with elation [8], we hypothesized that depressed individuals receiving ketamine infusions associate it with an antidepressant state. In a systematic YouTube search (online supplement; for all online suppl. material, see www.karger.com/doi/10.1159/000497441), we found 62 videos of depressed individuals reporting on experiences during and after ketamine infusions. Seventeen out of 62 testifiers spontaneously reported experiencing a sense of lightness – or less heaviness – that they associated with antidepressant benefits. Some examples are the following (for more, see online supplement): 1 “After my first treatment I woke up the next morning and I had less heaviness in my throat and my chest. The heaviness that you feel on an ongoing basis saps your energy (0: 10)” (T4). 2 “The weight was gone. The heaviness, the darkness, the weird, awful thoughts, the sadness – I had completely forgotten what it felt like (2: 22)” (T21). 3 “I felt happy and light (2: 31)” (T19). 4 “Bubbles are rising from the back of my neck (3: 24) ... all the pressure in my head just starts to feel light and normal again (4: 47)” (T11). Received: September 11, 2018 Accepted after revision: February 3, 2019 Published online: March 18, 2019

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Ketamine for Depression, 4: In What Dose, at What Rate, by What Route, for How Long, and at What Frequency? 2017 Qualitative review
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