"For six years now life has been really good for James. He has a great job as the creative director of an advertising firm in New York City. He enjoys spending time with his wife and kids. And it has all been possible he says because for the past six years he has been taking a drug called ketamine https Before ketamine James was unable to work or focus his thoughts. His mind was filled with violent images. And his mood could go from ebullient to dark in a matter of minutes. Ketamine helped me get my life back says James who asked that we not use his last name to protect his career. Ketamine was developed as a human and animal anesthetic in the s. And almost from the time it reached the market it has also been used as a mindbending party drug. But ketamines story took a surprising turn in  when researchers at the National Institutes of Health showed https that an intravenous dose could relieve severe depression in a matter of hours. Since then doctors have prescribed ketamine off label to thousands of depressed patients https who dont respond to other drugs. Article continues after this message from our sponsor And pharmaceutical companies are testing https several new ketaminerelated drugs to treat depression. Johnson  Johnson expects to seek approval for its nasal spray esketamine https later this year though the approval would be limited to use in a clinical setting. Meanwhile doctors have begun trying ketamine on patients with a wide range of psychiatric disorders other than depression. And there is now growing evidence it can help people with anxiety bipolar disorder posttraumatic stress disorder and perhaps even obsessivecompulsive disorder. I think its actually one of the biggest advances in psychiatry in a very long time says Dr. Martin Teicher https an associate professor of psychiatry at Harvard Medical School and director of the Developmental Biopsychiatry Research Program at McLean Hospital. Ketamine may also offer new hope for people like James who have symptoms of several different psychiatric disorders. James had a happy childhood he says. But his thoughts were out of control. I always felt like I was crossing a freeway and my thoughts were just racing past me he says. He spent much of his childhood terrified of an unknown an ambiguous force out there. The fear was overwhelming he says. I literally slept with the cover over my head with just room to breathe through my mouth until I went to college. And there was something else about James his body temperature. I overheated constantly he says. I would wear shorts all year long. In my s in my apartment I would sleep with the windows open in the middle of the winter. In his late s James saw a doctor who told him he had attention deficit hyperactivity disorder. So he started taking stimulants. At first the pills helped him focus. Then they didnt no matter how many he took. Hed done well as an idea guy in the advertising industry. But now James was trying to work at home and it wasnt going well. ADHD pills will make you interested in anything he says. So I was putting the desk together and taking the desk apart. I was putting a laptop stand together and taking it apart. I was going in a massive downward spiral. James had always suffered from mood swings. But now they were rapid and extreme. And he couldnt stop thinking about gruesome scenarios like a murderer coming for his family. My wife took a summer off to be with me because she was scared of what was going to happen to me he says. She would go to work for a few hours then rush home. There would be times Id call her just screaming Please come home. I cant get through another minute.  Eventually James found his way to Dr. Demitri Papolos httpbipolarchild.comaboutauthors an associate professor of clinical psychiatry at Albert Einstein College of Medicine. He was like a whirling dervish when he came into my office Papolos says. He was extremely fearful and scanning the environment all the time and he overheated at the drop of a hat. Papolos diagnosed James with a variant of bipolar disorder he calls the fear of harm phenotype. It typically appears in childhood and often doesnt respond to traditional psychiatric drugs. But Papolos has found that the condition does respond to ketamine. Its been transformational he says. In January Papolos published a study https of  children with the problem. They inhaled a nasal mist containing ketamine about twice a week. Nearly all got dramatically better. Scientists still arent sure why ketamine works but theres evidence https that it encourages the brain to rewire to alter the connections between cells. That process has been linked to recovery from depression. And it may also explain why ketamine helps people who have symptoms associated with several different psychiatric disorders. I think its having multiple effects and that means its probably useful for multiple different disorders Teicher says. One of those effects involves a part of the brain involved in temperature regulation. And that could explain why patients like James usually stop overheating once they are taking ketamine. James started taking a ketamine nasal spray every other day. He says his response was dramatic. One day I turn to my wife and Im like I feel calm today. I dont know if its the sun coming in I dont know if its just the way were sitting here but I feel like I could go and sit at the computer and work.  The next day James did sit down at his computer. A month later he was back at work."