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Comment on The Ketamine Chronicles, April 2019parent

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It holds for a few months. During that time you can get your shit together. Try to figure out what is triggering the depression and try to change that thing. If you fail you can just do it again.

To be fair, I would much rather have a ket party once in a while than be on amohetamines (Adderall) for the rest of my life; which is an accepted treatment for certain disabilities.

Two remarks:

- It doesn't necessarily hold for a few months. For some people, it's not too much longer than an infusion session; for others, they might not even need the "booster" infusions some get.

- There's some patients for whom the "tolerance" for the antidepressant effect doesn't go away even after O(years) without taking it when it initially worked and then stopped, so you can't necessarily just do it again. (Source for this one is that it happened to me, and did not return while going as high a dose as the doctor was comfortable with.)

In many cases, depression is not triggered by some external influence.

The issue with saying this is we should probably have many words for different types of depression.

Probably not only split on this one variate (externally or internally triggered), but it means that certain types of depression are usually triggered externally and certain types not externally.

It's like saying that "in some cases, a broken leg is not triggered by some external influence". Sure, you could develop some bone density issue and break a leg when walking normally, so we tend to distinguish treatment of these cases--we may recommend a more permanent solution for someone who is prone to breaking their leg.

How can we even falsify your statement? To do so would require self-reports or some sort of real-time 24/7 measurement of the brain, the first doesn't really falsify anything, and the second is not very viable at the present.

Self-reports can easily lie. They also may simply not remember, or be in denial.

There is always an internal trigger.

The intersection between internal and external is not so clear.

What the ultimate cause is, who knows.

Is the idea of a ultimate cause is even a valid idea?

Personally I don't think so.

And the medical insurers and providers get to make hundreds of dollars for every $5 of ketamine dispensed, so it's win-win.

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