The first time I remember feeling depressed was when I was six years old. Like many first-graders, I had a little potbelly, but I never paid much attention to it until I caught my side profile in the mirror one day. As I inspected my body from all angles, thinking about how much rounder I was than my friends, I began to feel something heavier than self-consciousness — I felt ashamed. Repugnant. Worthless.
A terrible thought crossed my mind: Who could ever love me like this? My eyes filled up with hot tears. It was the beginning of a lifelong feeling of inadequacy.
Depression has been an unwelcome guest in my life ever since, albeit to varying degrees of severity. Most of the time, it’s not much more than a small voice in the back of my head whispering, “You can’t do it” or “You’ll never be good enough.” But occasionally, the whisper turns into a scream so loud, it drowns out everything else.
That was the state I found myself in this past February after my then-psychiatrist instructed me to stop taking two antidepressants I had been on for 10 years—cold turkey. I’ve since learned that drastic medication changes are ill-advised at best and dangerous at worst, but I trusted him at the time. He was the one with the MD, not me. When I started to feel a bit down after stopping my meds, I was certain that my mood would even out soon enough. Over the course of the next six weeks, though, I went from sad to despondent.
I drove to the ER, admitted that I was actively suicidal, and received a mandatory three-day commitment to the inpatient psychiatric ward.
It’s impossible to convey what true mental anguish feels like in words. Suffice it to say, I now believe that hell is real, and it exists within the human mind. Imagine if every mistake you ever made and every negative thought you ever had about yourself played on a 24/7 loop in your brain. Add a sense of detachment, anhedonia, and a deep conviction that nothing will ever get better. Trying to fight it is a Sisyphean task, like swimming against a riptide that pulls you farther out to sea. If the torment lasts long enough, you become convinced that it would be better to feel nothing ever again than to continue suffering.
In sheer despair, I wrote a farewell note and prepared to go to the Golden Gate Bridge for the last time. But something — maybe fear, maybe the image of my devastated mother, maybe some dim hope that things would get better — held me back. I drove to the ER, admitted that I was actively suicidal, and received a mandatory three-day commitment to the inpatient psychiatric ward.
My stay in the hospital, combined with weeks of intensive group therapy, a return to my previous medication, and exercise all helped me improve — but not enough. While I was having more good days, the bad days were devastating. Beyond feeling depressed, I was exhausted. I had been in agony for about four months, and I was desperate for some relief.
I remembered a New York Times article I had read a few years back. It discussed the emergence of ketamine as a wonder drug for depression—some said it was the most revolutionary antidepressant since the development of selective serotonin reuptake inhibitors (SSRIs) nearly three decades prior. Although widely known as an anesthetic (and, due to its hallucinogenic properties, a street drug called Special K), ketamine, when administered through intravenous infusions, has been shown to induce feelings of serenity and well-being for even the most severely depressed patients within hours of administration.
Since the article was first published in 2014, a growing body of research further validated ketamine’s therapeutic properties. In March of this year, Johnson & Johnson received FDA approval to begin selling an antidepressant nasal spray derived from ketamine. Still, intravenous ketamine infusions are considered the gold standard.
I became fixated on the idea that ketamine might be my salvation. I started researching local ketamine clinics and reading testimonials from patients, many of whom described feeling as if they had a new lease on life. Some even said that their depression and anxiety disappeared entirely.
But the treatment isn’t without its drawbacks. Since intravenous ketamine hasn’t been officially cleared by the FDA to treat depression, it had to be administered off-label, typically at an expensive clinic, and with little chance of reimbursement from health-insurance companies. And because ketamine research is in its infancy, ketamine’s long-term effects are still unknown. At that point, though, I was just trying to survive the short-term.
In mid-June, I found myself in a drab medical building in Russian Hill that’s nestled among trendy restaurants and nightclubs, waiting for a consultation. After a few minutes in the waiting room, a shy but friendly nurse practitioner called me into her office to discuss my current depressive episode and previous medical history. On the basis of the severity and treatment-resistant nature of my depression, along with the fact that I had no disqualifying medical conditions, like hypertension or schizophrenia, the nurse practitioner confirmed me as a good candidate for therapeutic ketamine. I signed up for an initial treatment round of six infusions — each at $500 a pop, since the treatment wasn’t covered by my insurance.
Although I had experience with hallucinogens before, I couldn’t help but feel a little nervous when I showed up for my first session. Once I stepped into the treatment room, though, I felt at ease despite the vital-signs monitor and IV stand. The walls were powder blue and adorned with modern art. Natural light permeated the room. A gray leather reclining chair sat in the center, while a diffuser let out puffs of cucumber-melon-scented air.
It wasn’t long before the nurse came in and handed me an eye mask and a small MP3 player. With a small pinch, he inserted the IV, cautioning, “You might feel nauseous or anxious or even like you’re having an out-of-body experience. But try not to let it scare you — just relax and let everything unfold naturally.” I nodded, put on the eye mask and headphones, and waited for something other than soothing instrumental music to kick in.
“I went somewhere else,” I said, “and I saw things differently.”
Slowly, I slipped away to a higher place. I felt a gentle pressure all over my body, like I was being squeezed by an invisible force. My mind floated into the sky. The lilting new-age music began dripping like honey.
I was transported to a childhood memory of floating on my back in a northern Michigan lake during a light rainfall. My mind’s eye was so vivid, I felt as if I could reach out and touch the cold water if I wanted to.
“Isn’t this a beautiful feeling?” a singer crooned through my headphones.
A series of images flashed before me. I saw myself lifting a gray veil from over my face; my thoughts as falling leaves floating through the sky; a series of undulating, transforming 3D shapes (not entirely dissimilar from an old Windows 98 screen saver). As I allowed myself to be carried away by the visions and sensations, my inner dialogue became a stream of consciousness, revealing what seemed at the time to be profound universal truths.
I can’t live my life waiting around for a miracle. If I want change, I have to make it happen.
There is no one meaning of life. It’s up to me to define what gives me joy and what goals I work toward.
Just because you think something doesn’t make it true.
I recognize now that this sounds like the wannabe-profound ramblings of a college freshman who smokes weed for the first time, but through these frameworks, I was able to challenge the distorted, depressed thoughts that had been plaguing me. I wasn’t a failure, a disappointment to my family, a burden to my friends — these were just thoughts that stuck to me like tar in my depressed state.
Toward the end of my trip, a voice instructed, “You will now awaken.”
I took off my blindfold, and the nurse came in to remove the IV. I felt content but dizzy. I laid back, waiting for the vertigo to subside. After a few minutes, a doctor came in to talk to me. She asked me how it went.
I sat for a moment trying to think of how in my still-dreamlike state, I could describe what I had just experienced. “I went somewhere else,” I said, “and I saw things differently.”
She smiled.
The next four infusions were similar to the first. After the IV was inserted, I began tripping, a series of visions unfolding in front of me. Once I saw myself paddling a canoe down a creek, deftly navigating around eddies of toxic thoughts. Another time, I watched myself grow from fetus to child and all the way to adult. I had a series of epiphanies about how deeply I valued my relationships with friends and family, and how there is still an endless amount of things to look forward to. I realized that life is worth living precisely because it is fleeting.
Every time I came to the end of my trip, the sense of euphoria quickly faded, but the revelations that came to me had been internalized, at least on some level.
I’d be lying if I said I wasn’t a little disappointed, though. I didn’t undergo a magical transformation from depressed to not depressed. It was more like a series of incremental improvements that made living a bit more bearable. I didn’t feel like I had been reborn, but maybe that was too much to ask for. For now, maybe it’s enough to know that I’m through the worst of it and that I can face the future, whatever it might hold.
During the last infusion, my six-year-old self — the one who had first looked at herself in the mirror and felt so much shame — paid me a visit.
“What’s going to happen to me?” she asked, her voice quivering.
I knelt down to her, wrapping her in my arms. “Life is going to be scary at times,” I said, “but it’ll be worth it.”
Original article: https://thebolditalic.com/tripping-my-way-toward-wellness-one-ketamine-infusion-at-a-time-a6d54906ec35
