We just added the FAQs page and it’s very much a work-in-progress.

If you have a question you don’t see here, ask!

Ok, but isn’t experiencing stress important?

One of the common misconceptions is that enhancing resilience means blocking the experience of stress. That’s resistance, not resilience.

Stress resilience is the active biological process that allows us to respond to and bounce back from stress. It’s similar to how the immune system fights off and allows us to recover from infection (which is what vaccines bolster). And like the immune response, despite its reputation, the stress response is actually neither good nor bad: it’s a homeostatic mechanism.

Homeostatic mechanisms allow the body to maintain its internal balance—or its “set point”—in a dynamic world, like a thermostat in your house. Set the thermostat to 72: if it gets too hot, the AC goes on; too cold, the heat turns on. Unlike resistance, which is unmoving, resilience is a system’s ability to be disturbed but ultimately return to its set point.

And when homeostatic mechanisms fail, it can result in disease. An immune system that’s too weak can result in infection - too active and it can result in autoimmune disease. When stress resilience fails, it can result in PTSD or depression. PTSD and most of cases of major depressive disorder are initially triggered by insufficient resilience to a major stressor. And just as optimizing the immune system doesn’t mean shutting it down, enhancing resilience doesn’t necessarily mean blocking the stress response; it means fine-tuning it to respond proportionally and dynamically to stress. Ideally even increasing the likelihood of post-traumatic growth.

Don’t we already have drugs that prevent mental illness?

No. We currently have no means of medically preventing psychiatric disease before they occur, or what’s known as “primary prevention.” Our current medications only suppress symptoms.

Vaccines, antibiotics, and painkillers offer a good analogy: Vaccines protect you from ever developing an infection (primary prevention), but are usually not useful once an infectious disease has already developed. Antibiotics can cure bacterial infections by killing bacteria, though we only occasionally use them as prophylaxis. Painkillers reduce the symptoms of infection (like fever and pain), but they neither prevent nor treat the disease. All of our current psychiatric medications are like painkillers: they only suppress symptoms. Antidepressants, lithium, and antipsychotics can prevent episodes and symptoms from occurring, but they do not prevent or cure the underlying disease.

What if I already have PTSD and/or depression?

We don’t yet know if resilience-enhancers will work if you already have a stress-induced disorder. It’s possible that, like vaccines, resilience-enhancers will only work when given prior to development of a mood disorder. Alternatively, the drugs may increase resilience against subsequent stressors, regardless of whether you already suffer from PTSD or depression.

As we continue to research these questions, there are treatments available now to help. Disclaimer: this is not medical advice. Finding the right therapist, therapy type, and/or medication regimen can take multiple tries and even months-to-years of mixing and matching. Since the healthcare system can be challenging to navigate (especially if you’re suffering from depression or PTSD), if there is a friend or family member you trust you might consider asking them to research options with you and to advocate for you. Alternatively, there are both in-person and online support groups that can help. Don’t give up: when you do find the right treatment combination, it can be life-changing.

If you are specifically interested in ketamine for treatment-resistant depression or as a rapid-acting antidepressant treatment (not as a preventative), it is currently available in some countries from ketamine clinics, as well as in the form of esketamine from J&J.

Is it just me?

Depression has now surpassed HIV/AIDS, malaria, diabetes, and war as the leading cause of disability worldwide. By some estimates, the majority of people will at some point in their life meet criteria for psychiatric disorder: which would mean mental illness is more common than it’s not.

It’s likely that one of your friends, family members, or coworkers is currently, has previously, or will at some point suffer from mental illness. Because depression, anxiety, PTSD, and related disorders are not always talked about, the overwhelming prevalence is often hidden in plain sight.

So no, it’s not just you. We’re all in this together.