This easily explained:
Ketamine seems to repair some kind of cell damage, thereby increasing neural plasticity.
That is a huge asset, but long endured depressions leave many unhealthy neural circuits over the years. These have be unlearned one by one, which takes time.
Ketamine increases freedom of thought and emotion, but you still need a goal and long-term plan to precisely target and unwork all the patterns that circle back to depression.
Luckily the entrypoint away from happiness is discernable and it is bittersweet: giving up, thereby reducing stress. Which is sweet at first, but turns into hell fast.
There is a nice scene in the documentary "Le route de l'opium", where they interview, I believe the guy responsible for europol drugwar coordination. They ask why the laws and system are like this if they are so incredibly stupid and not working.
His answer: Because this is the way many individuals earn the most money with it. Change anything and manufacturers, dealers, corrupt politicians etc. would lose money.
An exam-question a german lawyer told me to illustrate how layman's understanding of law and expectation of logic therein often doesn't apply:
"Your employer tells you to break into an opponent's office and steal something. You do that, jump out of the window and break a leg. Is your workplace insurance legally obliged to cover the medical cost?"
There is a theory about epilepsy that systems that compare actual perceived state with projected state break down. Psychedelic experience might be similar.
So my interpretation: Instead of perceiving something happening to you (in time), you perceive everything to "be you". Instead of critically thinking about if and why something makes you laugh the thing itself because the laugh.
I work together with a psychology professor (was head of department) now and then. She said there's a large problem with students, even graduates, just not understanding statistics and math properly (or at all)
I was very sick as a child: I had neurodermitis (Lichen simplex chronicus) so I was constantly scratched bloody. I also had asthma and countless plant, animal and food-allergies, so I couldn't eat most things (dairy-products, sugar in every form except honey, salt, chocolate, white flour, eggs, nuts, citrus-fruits, the list goes on and on). Spent a lot of time in hospital.
When I was about 9 or 10 years old I got to a point where I was completely fed-up by all the rules I had to follow: Eat this. Don't eat this. Be careful during sports because of your asthma. There's ozone in the forest.
So I decided to ignore every single symptom until it got so strong that I'd have to go to hospital again. I also started showering cold every day and trained myself to sleep without a blanket, so I wouldn't sweat, which would irritate my skin.
I don't know when it happened, but all my problems completely disappeared over time. I'm 30 now, tests I do now and then, say my allergies and asthma are still there, but i'm more or less symptom-free.
Whenever I feel bad I consciously use the placebo-effect, for example by drinking a large glass of water and telling myself that THIS glass of water is EXACTLY what my body needed right now and will make everything better.
Note that I'm not advocating to reduce medicine: When I have a headache, I'm the first to take an aspirin. All I'm saying is that there's definitely a large cognitive component in health and feeling well, which can be trained.
The main emotion involved in procrastination is disgust. A basic emotion that is as strong as fear, but is completely learned and can be attached to every kind of situation, activity or just the thought of starting them.
Procrastination is protecting yourself from feeling the upcoming revolting disgust these activities can bring. You avoid feeling it, like you avoid touching a hot plate, that's why the disgust never shows. Only when somebody forces you to do it anyway.
The (scientifically tested) theory for this is called Anstrengungsvermeidung (german for "effort/stress avoidance") and isn't widely adopted.
That is not too surprising. On the one hand serotonine not only acts as a neurotransmitter, but has a mechanical function controlling blood-pressure and a multitude of other things as well.
(See this comment: https://news.ycombinator.com/item?id=9476594)
Easier triggered bodily alertness in unpleasant situations probably creates a feedback-loop which shuts off rational thinking (frontal cortex) further -> anxiety.
On the other hand, I think a good metaphor for it's complex role as a neurotransmitter is "bandwidth". If your serotonine-levels are too low, some regions in your brain have trouble communicating with each other. Hence when your amygdala starts sending out signals of imminence, your rational prefrontal cortex might be able to think "No need to be afraid.", but it's not able to properly communicate that back. The other way around works too: the signals of imminence might not arrive clearly ("I didn't even realize I was afraid"), so you can't act properly.
If serotonine-levels are too high, this communication and loops might work TOO well. Imagine a "weak non-specific signal" from a confused (lack of a better word) amygdala that starts off a thought, which in turn throws the amygdala into a feedback-loop that you can't get out off. In that situation it would have been easier if the weak signal would have been dismissed in the first place.
For my ADHD a combination of ritalin, a LOT of sport (martial arts) and playing the piano did wonders. About a year of the sport and I've managed to lower my dose by about 50%.
It shows you're not a doctor, but you're right: it's complicated condition (maybe even "configuration") and on top of that it's hard to diagnose in adults, because they tend to have formed habits around this condition.
There's a crude test though: Take (a small dose) of Ritalin, Adderall or other stimulant that increases activity in the striatum and see:
* Do you mainly feel sweaty, agitated and super-alert: probably no ADHD.
* Do you feel like you're able to think properly for the first time in your life or get sleepy even -> hints to ADHD.
I'm never sure what to make of people praising the therapeutic value and giving statements like "it's like a series of breakthroughs you'd get after years of therapy wrapped up into a couple hours.".
LSD, like other psychedelic drugs (Psilocybin, MDMA, DMT, ...), floods the brain with (mimics of) neurotransmitters, enabling it to make (almost arbitrary) connections. Hence the synesthesia. It's "therapeutic" effect stems from the fact that the brain/mind/consciousness is leaving the treaded paths it usually takes "automatically" and forms (forces) new trains of thoughts.
Hence the fascination: People are used to their brains working in a particular way, sorting your experiences into "proper" categories, and are stunned when they realize that they can actually process information in completely different ways as well.
This is what people mean talking about "filters" being "removed". Aldous Huxley popularized this idea in "The doors of Perception".
Different medications like SSRIs have this effect as well, but by magnitudes less strong.
It's a torrent of thought(fragments) that your brain switches through on this drug. There might be some in there that actually help you cope with a problem you had in your life, but there are lot of "useless" bits as well.
So what taking LSD does is giving you a perspective you haven't had before. This might be of therapeutic value, but so can be other experiences you haven't had before. Like living in a monastery in Tibet. Getting a baby. Seeing a fellow soldier getting killed in the field. Not sleeping for 70 hours.
I'm sceptical of the praises because:
* LSD doesn't make your prior brain-structure go away. It softens it and forms new paths, but chances are high that you go back feeling the same and thinking the same as before. True therapeutic progress is always slow and iterative, because that way it is stable and lasting. Slamming the psychedelic hammer onto your mind knocks you out of your path, but the experience can't be integrated that well because it usually is too random. Also the iterative approach (meditating, behavioural therapy) makes your brain actually start to produce the neurotransmitters needed to form the desired thoughts.
* People usually feel really well for some time after taking this. This is logical, because they realized that their mind isn't as immutable and frozen as they were afraid it is. Also on strong serotonergic agents like LSD you also experience bodily effects like low to moderate fever (which you don't feel cause you're somewhere else). This can culminate in a serotonin-syndrome [1] [2].
When coming down from this condition it's naturally that you feel well, like you would "coming down" from food-poisoning.
What I find really interesting are two common emotions/feelings that people on psychedelic drugs experience:
* Spontaneous insight: that all the things they are experiencing are "true", "right", "eternal". Also "sacred" or "holy".
* All the things around are alive, vibrant, conscious.
I would like to know what in the mind actually produces the feeling of "truth" and what in the mind discerns between "conscious" and "unconscious" things.
I was very sick as a child: asthma, neurodermitis, a lot of allergies etc.
At one point when I was 8 or so I thought that it really sucks that I have to be careful about how, when and where to play, run etc. so I decided to ignore all my symptoms until they get too bad to ignore.
I also started to shower cold (or rather: end every shower cold). And i "taught myself" to sleep without a blanket. It really just feels weird, and after two or 3 times you are used to it.
I'm almost 30 now, i'm rather temperature-insensitive, which means than I have no problem going out in a t-shirt in winter, but also can do sports in the hot summer-sun. I also, on lab-tests still have all my allergies, but don't feel any of it.
It's very useful, and awesome what you can do with your mind :).
Drugs are a fascinating topic in my opinion, because they have affected humankind and it's decisions since ever and more than anyone wants to admit. It's a topic that is everywhere, and that simultaneously nobody has a clue about (a bit like climate change or high finance). People don't know which drugs there are, how they work, how dangerous they are, how much they are used etc.
I talked to many people who are affected by the topic: teachers, psychologists, doctors, concerned relatives. I keep telling them: Even in this rich city Vienna, drugs aren't something that pops up in dark alleys behind trainstations, drugs are everywhere and used by functioning people you had no idea about. And they use massive amounts.
There are doctors who say that they tell their clients, that it's ok to smoke one or two cannabis-joints a week. What they don't realize is that a regular smoker (which might be a 13-year-old) doesn't smoke one per week, but more like 5 joints a day.
This is a point which get's more important now that states around the world are legalizing cannabis. It really isn't very hazarous, in the sense that it kills you or makes you unable to function, so people can get used to smoking excessive amounts. But: every psychoactive substance you take constantly will, by definition, change you. When usage-patterns get to the "all the time"-category most points doctors and legalization advocates make become invalid, because now it's not about side-effects of a drug you take now and then, but about the effects of a permanently altered state-of-mind you "cultivate".
I regulary ask sellers at highway petrol stations which cigarettes and smoking-utilities they sell the most. There was not only one time where their answer was: long rolling-papers and the lightest tobacco = ingredients for a joint.
LSD isn't just something out of a Beatles song, some people told be they had tried it with 15, because they could get it at their (noble high-society)-school. There were hooligans at a big local football/"soccer"-stadion charged with possession of it.
The issue/problem of cocaine is interesting, because (like cannabis) it is one of the few drugs that permeates all of society from blue-collar-workers to high-society.
I once helped a completely confused guy in a smoking to get a taxi home, who stuttered that he lost his purse while getting high on cocaine on some actor's party. He is a painter and a director at one of the famous theatres here, and gifted me a painting he had with him for the taxi-fare I paid.
I once saw two truck-drivers delivering goods to the local supermarket around the corner, snorting something of a magazine at 6.30 a.m.
It's a bit hard to get data about mass of cocaine consumption in the US, but estimations are about 200 tons (400k pounds, please adopt the metric system!) per year. They regularly find unmanned submarines who can transport tons of cocaine. Some of them are sophisticated enough that they might be able to cross the atlantic. Think of the R&D involved there, that cartels have the money to buy.
One of the problems in the vietnam-war was that Vietnam was and is a big platform in international drug-trafficking and many US-soldiers got addicted to heroin while trying to "get away" from the war. Estimations are that more than 40.000 soldiers were addicted. Many of them probably still are, no matter what some people say, it's close to impossible to get away from heroin/opiates. The only easy way to deal with the poor addicts is provide them with their stuff until the end of their lives.
Afghanistan was (still is?) the largest Opium and Cannabis-exporter in the world. Since they don't have many other goods than that, in the 90ies the US more or less allowed or tolerated the drug-business there, so the warlords ("afghan resistance") could buy weapons to hold back Soviet Russia.
So, in the war since 2001 US-money flows to both sides of the conflict. US-soldiers are paid to fight against warlords who get their money from selling their heroin in the US (and in the rest of the world). Isn't that ridiculous?
[..insert many more anecdotes and hair-raising numbers..]
To sum it up:
* Drug use is way more excessive than society is comfortable with.
* Drugs aren't mostly used while sitting on the sofa, they are used while working, while riding vehicles, while doing anything really.
* Almost everything people know about drugs (from names to numbers) is incorrect (if they know anything at all).
Disclaimer:
* Numbers above might be inaccurate, because I don't have time for proper references, but the magnitudes should be correct.
* This is not an opinion about how to work with the situation (i wouldn't call it problem, since drug-use has been always there, it's a property/corner-stone of human existence), I have opinions about that, but it's a very complicated matter. There's also a difference in advising addicted individuals and their relatives, which is (depending on the drug) relatively easy, and finding rules/laws for society at large.
You probably need something targeting dopamine, the heavy limbs/fatigue, excessive sleeping etc. are typical symptoms of dopaminergic systems not working properly.
Try an NRI like reboxetine. Exercise to make it work better. Go outside for 15 minutes in the morning, if you don't do that already. A study showed that light exposure of 30 minutes per day make a 1/3 reduction in medication possible. And stop smoking cannabis, if you do, it has catastrophic effects on dopaminergic systems.
I have exotropia on one eye and completely lack binocular vision.
My right eye is my "main" eye (95%) and my left eye just submits the missing parts from the left that my right can't see because of the nose being in-between.
I always have the right side of my nose in my field of view, except that at the same time it's somehow not there. Like 50% opacity. The left side of my nose isn't visible.
When I "hide" a finger behind my nose for the right eye and look in it's direction it's gone. When I stare straight forward, it appears again.
That is a huge asset, but long endured depressions leave many unhealthy neural circuits over the years. These have be unlearned one by one, which takes time.
Ketamine increases freedom of thought and emotion, but you still need a goal and long-term plan to precisely target and unwork all the patterns that circle back to depression.
Luckily the entrypoint away from happiness is discernable and it is bittersweet: giving up, thereby reducing stress. Which is sweet at first, but turns into hell fast.