Author: Joana Petiz
Sapo, January 6, 2025
It's not a miracle solution, but in cases of resistant anxiety and depression and some addictions it can really make a difference, guarantees Bárbara, who tells SAPO about the horror trip that took her to the bottom and how she once again saw a light that she hadn't seen for decades. Vítor Rodrigues, a psychiatrist and professor at ISPA, explains how it works and what a difference it makes to deal with the after-effects of psychedelics, allowing for levels of awareness that help treat the causes rather than the effects.
Intelligent, independent, committed and determined, Bárbara was still a teenager when she decided to go to Norway to attend high school. She didn't speak a word of Norwegian and didn't know anyone, not even the host family she moved in with, but she dreamed of international experience and, being an excellent student, she gave her all to be selected for the program (a kind of very restricted Erasmus, aimed at high school students). College would lead her to yet another self-imposed challenge, which she overcame with flying colors, completing a degree in Computer Engineering in the United States, which would open doors to a luxurious career.
This could be a story with a happy ending and no hiccups, but Bárbara's life was, in fact, quite different from what those who dealt with her would have guessed. "Few people understand, because I was actually privileged in life, but today I understand that I was already dealing with depression as a teenager," she tells SAPO. Now 31, she recounts how she had to hit rock bottom to gain the courage to look for a way out of her resistant anxiety and depression, in a country where 23% of people suffer from mental health problems and only 10% of them receive adequate treatment. Bárbara found that door in ketamine-assisted therapy.
"My parents divorced when I was 12. My father was an alcoholic and I was always a very fearful child; I remember panicking, always thinking that something would have happened if my mother simply didn't answer the phone..." She immediately went into a downward spiral, imagining terrible scenarios for herself and her younger sister, and even though she didn't yet have the vocabulary to express it, she felt her world crumbling and she was hopelessly buried. For years, more than a decade, the solution to the deep terror and powerlessness that pulled her deeper and deeper into depression was to ignore it, bury it, move on regardless. "I felt I had no other option, given the excellent conditions I had in life," she now tells SAPO, revealing how everything was made worse by the conviction that she had no right to feel miserable. [...]
"People often see depression as a weakness," Vítor Rodrigues, clinical director of The Clinic of Change, which opened its doors in Lisbon in 2023 and where Bárbara finally found a path to real improvement, explained to SAPO. "People think they have to overcome the situation on their own and put off seeking help. And the abusive coaching currents that sell this exaggerated optimism - those theories that everything is good, there are no bad things except in my mind and I'm capable of fighting them - don't help, because sometimes we're not well and we have to seek help." [...]
"For a significant percentage of people suffering from depression and anxiety, medication improves, but doesn't overcome the problem; antidepressants and therapies are tested and the person drags on in this situation, without ever really feeling well again, with the risk of double depression and increasingly frequent relapses," explains Vítor Rodrigues, pointing out that these are the people who are suitable for the ketamine-assisted psychotherapy treatment that The Clinic of Change offers, among a range of other treatments and support. This treatment was the subject of several panel discussions at the National Psychiatry Congress last year, with studies presented by Francisco Santos (Approach to resistant depression: the experience of using ketamine in an NHS hospital), Pedro Castro Rodrigues (Ketamine combined with psychotherapy for resistant depression: real-world evidence and the role of subjective experience) and Pedro Zuzarte (Ketamine in a public service: new frontiers in the treatment of resistant depression, addictions and other comorbidities).
The bottom and finally the light
On returning to Porto to work, Bárbara's mental health began to deteriorate to the point where "the depression was so resistant to treatment that even the drugs stopped working, whatever the cocktail was". She went on sick leave several times, despaired, tried all the solutions they offered her, to the point where she was even admitted to Aveiro Hospital for electroconvulsive therapy. "I felt so bad that every day when I went to the Metro I would stare at the tracks. I never did anything because I didn't have the courage."
And then she hit "the absolute bottom". "I was tired of trying everything and I couldn't do it any more. At lunchtime, I went home, lay down and decided to have one last moment of comfort and never suffer again," she says. "I was taking a medication that I knew had a risk of overdose and I took the whole box - I think also because I was aware of the possibility of it being a reversible decision, if they arrived in time to help me." Facing her mother's look of deep sadness when she woke up in hospital was the springboard for deciding that not only would she never try anything similar again, but that she needed to react, to look for a real solution.
"I was interested in and studied everything related to treatments for resistant depression and I found studies on ketamine that excited me, because they suggested that it was one of the few substances that can reduce suicidal intent by 40% in just 24 hours. It was a miracle," says Bárbara, who eventually heard the news about the opening of The Clinic of Change, went to investigate the work of David Nutt and Awakn, the British partner pioneering this innovative treatment, read everything available about ketamine-assisted therapy. And finally she contacted Vítor Rodrigues. "I was informed about the treatment and the risks, and I was desperate for a solution. I had taken time out for myself, to become a person again, instead of just being in stand by mode."
[Continued]
Read the full article and watch the video of the conversation.
A The Clinic of Change é um prestador de cuidados de saúde com o n.º E166508, sediado na Rua das Picoas, 12 R/C, 1050-173 Lisboa, com licença de funcionamento n.º 22863/2023, inscrito na ERS com o n.º 39467.
Diretor clínico: Professor Doutor Victor Amorim Rodrigues, Médico Psiquiatra com a cédula profissional n.º 31127, emitida pela Ordem dos Médicos.
