Esketamine: Breaking Depression’s Grip

Esketamine

An FDA-approved treatment for treatment-resistant depression and depression with suicidal thoughts offers new hope to individuals who haven’t responded to traditional therapies. Administered as a nasal spray under medical supervision, it often works rapidly to alleviate symptoms of depression by targeting NMDA receptors in the brain. This novel mechanism often produces quick improvements in mood, providing relief for those who have struggled with chronic, debilitating depression. However, one of the unique aspects of esketamine therapy is its dissociative effect, which sets it apart from other treatments.

During the session, many patients describe a range of dissociative experiences—feeling detached from their body, as if they’re floating or watching themselves from a distance. Others report changes in their perception of time, space, or reality, describing the sensation as dream-like or surreal. While these dissociative effects may seem unusual, they are temporary and typically fade shortly after the treatment. For some, this experience can even provide a mental reset, creating space to view their thoughts and emotions from a new perspective, which can be therapeutic in itself. Though different for each person, this dissociation is a key part of the esketamine experience and likely contributes to its rapid antidepressant effects.