Mind & Medicine

Ketamine can produce experiences ranging from mild detachment to profound alterations in self, time, space and reality. At the deeper end of that spectrum, some people report experiences they describe as mystical or spiritual. Could the nature and depth of that altered state contribute to therapeutic outcomes—or is the experience simply accompanying a drug working through other mechanisms?

SSRIs and other psychiatric medications can alter the effects of some psychedelics, while stopping antidepressants carries its own risks. New research is challenging the assumption that patients must always discontinue conventional treatment before psychedelic therapy.

New treatments can expand what is possible in medicine. But innovation means little to patients who cannot afford it, reach it, trust it or find clinicians prepared to provide it. As ketamine, esketamine and psychedelic therapies develop, an old healthcare question is becoming newly urgent: who actually gets access?

IV ketamine is widely regarded as the gold-standard route for off-label racemic ketamine treatment in psychiatry. But ketamine can also be administered intramuscularly, intranasally, orally and sublingually—and esketamine is available as an FDA-approved nasal spray. These approaches are not interchangeable. Route changes the pharmacology, precision, monitoring and potentially the experience itself.

Joseph sought ketamine treatment while struggling with alcohol use and emotional distress. His experience eventually influenced Andrea to explore treatment herself. Their story is not evidence of what ketamine will do for someone else. It is a story about what can happen inside a relationship when two people begin confronting themselves differently.

Artem entered ketamine treatment shortly after a psychiatric hospitalization, carrying years of depression, anxiety and suicidal thoughts—and a deeply materialist view of consciousness. What happened during his treatments did more than change how he felt. It challenged what he believed about himself, meaning and the nature of consciousness itself.

Luna had lived with serious mental-health difficulties since childhood. After years of psychiatric care, therapy and multiple medications, she had begun to believe this might simply be how life would feel. Then she encountered ketamine. Her story isn't evidence of what the treatment will do for someone else. It is about what happens when a person who has nearly stopped expecting change begins to experience it.

Dan had learned how to achieve. Build the business. Solve the problem. Push harder. Control the outcome. But when severe depression entered his life, the strategies that had served him professionally were no longer enough. His experience with ketamine eventually confronted him with a very different idea: what if change sometimes requires letting go?

Chris entered ketamine treatment carrying the stress of entrepreneurship, disappointment and a growing sense that something in his life wasn't working. The problems waiting outside the treatment room didn't simply disappear. But his perspective on them began to change. That raises a deceptively difficult question: if the circumstances remain the same but our experience of them changes, what exactly has changed?

Maria had spent decades recovering, relapsing, returning to treatment and trying to understand the trauma beneath it all. She knew the language of recovery. She knew her patterns. She had done years of therapy. But knowing why she struggled had not necessarily changed how she felt. Her experience with ketamine became part of a larger question: once survival stops consuming everything, what do we do with the life that's left?

Alejandro's demanding career didn't become less demanding after ketamine treatment. The problems waiting for him at work didn't disappear. What changed, he says, was how long they followed him home. His experience raises a deceptively simple question: when circumstances remain the same, what does it mean to feel better?

Michela had spent years trying to understand herself—through therapy, yoga, somatic practices, retreats and other approaches. But understanding why she struggled wasn't always the same as experiencing life differently. Her experience with ketamine eventually brought her to an unexpected question: when does taking responsibility for ourselves become another attempt to control ourselves?

After years of physical illness, anxiety and business stress, James returned to ketamine treatment having tried it once before. This time, he says, something felt different. But the change he values most isn't found in the treatment room. It's in traffic, music, watering plants—and even unloading the dishwasher.

Research in people facing cancer and other life-threatening illnesses suggests psilocybin may reduce anxiety, depression and existential distress. But what exactly is changing—and how strong is the evidence?

Ketamine can rapidly affect mood and neuroplasticity. Researchers are asking whether the hours and days afterward create a temporary opportunity for new learning—and whether that opportunity can be deliberately used.

Children can be shaped by traumatic events they never personally experienced. Family dynamics, culture, stress biology and epigenetics may all play a role—but the popular idea that trauma is simply “passed through DNA” goes beyond what science has established.

Ketamine changed depression research by demonstrating that psychiatric symptoms could sometimes improve within hours. Now researchers are investigating its potential across PTSD, OCD, addiction, eating disorders, sleep—and even neurological disease. Some applications are supported by meaningful human evidence. Others remain almost entirely experimental. Where does the science actually stand?