DEPRESSION AND THE DEFAULT MODE NETWORK

We’re born free of associations. Little by little, we learn that the stove burns, the red light means danger, the bee means a sting. This framework of rules and associations is known as the Default Mode Network (DMN) and is necessary to keep us safe and alive. But a life full of injuries and traumas and disappointments (the raised hand means a beating, promises are actually lies, laughter means scorn, the workplace means discrimination) can make the DMN so strong that it cuts us off even from the love and support and good of the world. Humans are intensely social animals and MUST have connection; isolation equals depression, depression equals hopelessness, and hopelessness leads to destruction (of the self or others). Ketamine temporarily dampens the DMN (for about 72 hours, this is known as the window of neuroplasticity), allowing the individual in treatment to calmly analyze the associations they’ve built up over a lifetime and determine which serve them and are logical, and which are born of fear and avoidance and must be cut loose. After a course of ketamine-assisted psychotherapy (6-8 ketamine administrations + 3-4 therapy sessions), we see a remarkable ability of patients to place logic above emotion, deciding calmly which people, places, and relationships are healthy for them without history and trauma making those decisions for them and keeping them locked in their pasts. The DMN is like a ski slope with ruts and tracks worn from hundreds of skiers: ketamine is the heavy blanket of snow that wipes the tracks clean, allowing patients to create new paths unencumbered from what once was.