In this episode of Sofia Unfiltered, Dr. Michelle speaks with Dr. Sara Herman, Cardiothoracic Anesthesiologist, Psychedelic Medicine and Integrative Health Practitioner
Dr. Sara Herman's Journey into Psychedelic Healing
Dr. Herman shares her transformative journey from the operating room to becoming a full-time ketamine therapist, influenced by her personal experience with breast cancer therapy. Her background includes undergraduate studies in human biology at Stanford, advanced training in cardiothoracic anesthesia at Harvard Medical School and Columbia University, and comprehensive training in psychedelic-assisted therapy and integrative healing. Dr. Herman emphasizes the ethical practice of psychedelic medicine with a holistic approach to patient wellness, detailing her unique path and insights into ketamine's therapeutic uses, from pain relief in the operating room to its potential for treating depression and other mental health conditions.
What are the Common Applications of Ketamine?
- Inducing General Anesthesia: Used for short-term sedation during procedures like reducing fractures and treating joint dislocations.
- Treating Pain: Administered in low doses to relieve severe pain from conditions such as trauma, fractures, and abdominal pain.
- Treating Status Epilepticus: Investigational use for refractory status epilepticus (RSE) when standard treatments are ineffective.
- Treating Depression: Potential for quickly relieving depression in non-responsive cases, but limited data and caution due to hallucinogenic properties.
- Treating Anxiety: There is limited research, but some trials suggest effectiveness in treating social anxiety disorder (SAD) and potential antianxiety effects.
It's important to note that while ketamine has therapeutic uses, its administration and use should be carefully managed by healthcare professionals due to its potential for abuse and hallucinogenic properties. Always consult with a qualified medical practitioner for personalized advice and treatment plans.
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Ketamine for Treatment-Resistant Depression
Treatment-resistant depression typically occurs when individuals have tried and failed multiple antidepressants over a specific duration, often more than two. Dr. Herman emphasizes the inexact nature of psychiatry and the trial-and-error process with SSRIs, acknowledging the challenges of side effects and the lengthy time required for therapeutic effects. She highlights ketamine as a potential alternative, with its minimal side effects and low risk, providing a viable option for those who may not respond to traditional antidepressants.
Dr. Herman also addresses the question of whether ketamine could be a first-line treatment for depression. Given its good safety profile, she suggests that the decision depends on the patient's and provider's conversation, considering the risk-benefit ratio. Contrary to the prolonged use of daily medications, ketamine therapy is viewed as a tool rather than a magical fix, often complemented by psychotherapy and integration practices. The neuroplastic effects of ketamine, contributing to increased connectivity between neurons and healing, offer a unique window of opportunity for individuals to engage in self-reflection and make positive lifestyle changes, potentially breaking the cycle of treatment-resistant depression.
Strategies for Optimal Ketamine Therapy
Dr. Sara Herman discusses the recommendations for patients during the neuroplastic window induced by ketamine therapy. She advises avoiding external noise such as social media, stressful conversations, and activities unsupportive of internal work. Instead, patients are encouraged to engage in supportive practices like journaling, meditation, walks in nature, and various forms of self-reflection. She also emphasizes the need for a supportive network, including integration specialists and understanding individuals, to navigate the transformative process effectively.
What is Ketamine Therapy Like?
In Dr. Sara Herman's ketamine therapy practice, preparation and integration play crucial roles. Before sessions, individuals undergo meetings covering logistical aspects, setting expectations, and creating a safe environment. The integration phase focuses on life coaching, making individualized connections, and guiding participants toward fulfilling lives. Trust, safety, and embracing personal growth are emphasized throughout the process, highlighting ketamine as a catalyst for transformative experiences rather than a quick fix.
Preparation involves detailed discussions about ketamine logistics, managing expectations, and cultivating a sense of safety, trust, and agency. The client's internal journey is emphasized, with various therapeutic activities like breathwork, journaling, and setting intentions. During the ketamine session, which lasts 40-55 minutes, clients are monitored for physiological parameters while being offered personalized experiences, such as music and other sensory stimuli. Dr. Herman serves as a guidepost, ensuring safety while respecting each individual's journey. The integration process begins immediately post-session, with a debriefing to capture the initial experiences. Subsequent integration sessions are scheduled, allowing clients to analyze, connect, and make lifestyle changes based on the insights gained, emphasizing the ongoing commitment required for lasting benefits.
What to Look for in a Provider?
As a ketamine therapy expert, Dr. Herman shares her journey with a poorly administered ketamine experience and highlights the crucial aspects of creating a safe therapeutic environment. Her initial negative encounter lacked preparation, a proper setting, and a supportive provider, emphasizing the importance of these elements.
In offering advice to individuals seeking ketamine therapy, Dr. Herman suggests looking for clinics that prioritize preparation and integration, possess inviting settings, and ensure the presence of a qualified support person during sessions. Additionally, she recommends considering providers who have experienced ketamine themselves and emphasizes communication with other mental health professionals involved in the client's care. Dr. Herman emphasizes the nuanced, individual nature of ketamine therapy, cautioning against unrealistic expectations and emphasizing the ongoing commitment required for meaningful results.
More from Sofia Health
Check out the full episode of the Sofia Unfiltered podcast, "The Pros and Cons of Ketamine Therapy for Depression", available on Apple Podcasts and Spotify.
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Disclaimer: The Sofia Unfiltered Podcast by Sofia Health is for general informational and entertainment purposes only and does not constitute the practice of medicine, nursing, or other professional healthcare services, including the giving of medical advice. No doctor/patient relationship is formed. The use of information on this podcast or materials linked from this podcast is at the user’s own risk. The content of this podcast is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard or delay in obtaining medical advice for any medical condition they may have. For any health concerns, users should seek the assistance of their healthcare professionals.
