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As hundreds sat silently, attentively at Rutherford’s Staglin Family Vineyard two weekends ago for a presentation on mental health developments, Dr. John Krystal of Yale University School of Medicine clicked on a video presentation to share a patient’s story.

A young adult, Ashley Clayton, appeared on the large screen and described feeling daily “aloneness and despair” before slipping into severe depression.

Depression, Krystal explained to the attendees from a temporary stage set up on the Staglin property, is the leading cause of disability in U.S. adults. Confounding the problem, he added, is the fact that the general anti-depressant treatments we use today are variations of those established 60 years ago.

According to Krystal, a leading expert in depression as well as schizophrenia, alcoholism, and post-traumatic stress, these treatments are not always effective, leading to such results as 30% remissions and 30% non-response after the first year.

Krystal was the keynote speaker at the 25th annual Music Festival for Brain Health Scientific Symposium, held Sept. 14.

Why have we been so slow to develop new treatments? Research, Krystal said, continued to concentrate on drugs that were targeting neurotransmitters such as serotonin and norepinephrine. These transmitters, however, account for less than 20% of the existing neurotransmitters in the brain. Neurotransmitters in general are thought to regulate the majority of our brain activity, including moods.

Newer work led by Krystal, however, began to look at the problem anew — to think differently about the brain and look at what he calls “the biology of depression” and their chemical messengers. A group of neurotransmitters, GABA and glutamate, were found to account for 80% of our brains’ neurotransmitter activity. This discovery led Krystal’s team to try ketamine (and a version called esketamine) which targets glutamates instead. The use of the sole term “ketamine” throughout this article is done for ease. Esketamine is also known by the name of Spravato. For more information on esketamine, visit yalemedicine.org/stories/ketamine-depression.

After just 24 hours with ketamine, Ashley Clayton shared that she felt like herself again.

Approved by the FDA in March, it is believed that ketamine helps the brain regrow connections between nerve cells lost due to the impact of depression as well as stress. Early studies show that ketamine may be helpful for PTSD patients. The new connections that are created appear to enable mood regulating circuits to function more effectively.

Krystal’s research is made possible partly through funding from One Mind, the organization created by the Staglin Family to make change happen in mental health treatments. Krystal’s developments, and those of many other research teams working on breakthrough discoveries, are becoming a reality due to the fierce dedication of the Staglin Family. For 25 years, the Staglins have put their power behind fundraising efforts toward improvements in mental health. Close to $400 million has been raised to date.

The Music Festival for Brain Health is an annual event held at the Staglin Family Vineyard where guests learn of exciting developments happening today in brain health; can share their stories or ask questions of the scientists; enjoy a wine tasting extravaganza in the Staglin caves where close to 100 top Napa Valley wines, including rarities such as Screaming Eagle, are poured by their winemakers and staff; and attend a grand concert on the property. This year, Sheryl Crow was the headlining event, and actor Glenn Close was in attendance to lend her support for the cause.

Due to funding raised by One Mind, there is amazing work being advanced to help with depression, psychosis, schizophrenia and many other mental health disorders. Better understanding and treatments are on the way. We just need to pay attention and get involved in any way we can. If that is by purchasing a ticket to next year’s 26th annual Music Festival for Brain Health at the Staglin Family Vineyard, then we are all that much closer to breakthrough discoveries in mental health.

Catherine Bugue is the St. Helena Star’s tasting panel writer and is the co-founder of the Napa Valley Wine Academy in Napa.

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