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Integration - Broadening




This is the third post in our series of posts on ketamine integration. To read the first post, click here (link to #1); to read the second post, click here (link to #2).


Broadening is an important part of the integration process. Broadening refers to making changes in your life based on realizations from the treatment session or based on your specific goals. Imagine a small positive change in your thoughts or feelings radiating outwards to positively impact all other aspects of your life: your physical health, your spirituality, your relationships, your career and finances, your community, your environment… Soon, a small change will have transformed your life for the better. Kicking off this type of “upward spiral” is the goal of broadening.


Broadening can happen simultaneously with deepening or after you have found a sense of meaning from your experience (read more here). If you don’t have particularly intense experiences during your ketamine sessions, broadening will be the main focus of your integration process.


The changes you choose to make will be highly individual and should informed by the insights you have made during the deepening process or by your goals for ketamine treatment. As a starting point, these are some common and evidence-based changes that can improve your mental and physical health:


· Social Connection. Studies show that social connection is the strongest factor that protects against depression. Evaluate your relationships and prioritize those that feel supportive and energizing rather than hurtful and draining. You can reach out to friends and family just to talk or participate in an activity together. Even better, set up recurring plans like a weekly dinner or walk. If you are looking to build new relationships, consider volunteering, joining a support group (DBSA and NAMI have excellent mental health support groups), taking a group class in a topic that interests you, searching meetup.com for a group that sounds interesting, or playing in a recreational sports league.


· Physical Exercise. Exercise reduces inflammation, decreases the release of stress hormones, and improves chances of recovering from depression by over 20%. Studies show that yoga and Tai Chi can both reduce depression symptoms. Yoga with Adriene (https://www.youtube.com/user/yogawithadriene) is perfect for beginners, with short lessons that can be done at home with only a mat. If you are looking for something more intense, consider the “Couch 2 5k” running program—a gentle but effective introduction to running. It’s okay to start small. Any exercise is better than no exercise!


· Time in Nature. Spending time in nature lowers levels of stress, anxiety, and depression. As little as 10 minutes in nature can increase feelings of happiness and as little as 20 minutes significantly lowers the stress hormone cortisol. You don’t have to go far to get the benefits – even the greenspace in your local park will do you good. You can combine time in nature with social connection or physical exercise to reap the benefits of both at once.


· Meditation. Meditation has been shown to change the activity of brain regions involved in depression. Meditation is also a powerful tool for combating stress and anxiety. Much like the ketamine experience, meditation offers a sense of distance from negative thoughts or stressful feelings. Short (less than 10 minute) guided meditations are the best way to get started. Try the free trial of the Waking Up, Headspace, or Calm apps, or search for “guided meditation” on Spotify or YouTube.


· Sleep. Sleep profoundly affects your mood. Small changes that improve your sleep can lead to meaningful changes in your mood, energy, mental clarity, memory, and more. This is an excellent resource for good sleep habits: http://healthysleep.med.harvard.edu/need-sleep/what-can-you-do/good-sleep-habits Sleeping pills should be a last resort. While they can increase the amount of sleep you get, they negatively affect the quality of your sleep.


· Diet. More and more research suggests that food plays an important role in our mental health. Diet is especially important during ketamine treatment; your brain is building new connections between neurons and it needs the right building blocks to do so. Fruits, vegetables, whole grains, fish, olive oil, low-fat dairy, and antioxidants are associated with a decreased risk of depression, while red meat, processed meat, refined grains, sweets, high-fat dairy, butter and potatoes are associated with an increased risk of depression. While it can be overwhelming to think about changing your diet, small changes can be helpful: start with a piece of fruit as a snack or an extra side of vegetables at dinner.


· Habits. Ketamine treatment is an ideal time to re-evaluate habits that may not be serving you. This can include your use of substances (alcohol, tobacco, cannabis, caffeine, or others) or technology (screen time, social media, etc.). Because your brain is more flexible than usual, it may be easier than usual to replace unhealthy habits with healthy ones. Consider what the habit is doing for you (distraction, temporary mood improvement, improving energy, etc.) and try something different that might have the same effect.

When ketamine is working well for you and you finally feel better after months or years of suffering, it can be tempting to make multiple drastic changes all at once. This can quickly become overwhelming. Pick one or two areas to focus on and start with small changes. Once you start to notice how good these changes make you feel, it will be easier to build from there. Gradual change avoids burnout and is more sustainable in the long term. Gradual change also gives you the opportunity to make sure each new change truly aligns with your goals. If it doesn’t, that’s okay. Reflect on what you’ve learned and try something new.

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