A month ago I was in a really dark place mentally and couldn’t get out. I considered TMS because it’s worked before (for about 9 months each time) but I didn’t have the energy to commit another 35 hours in the chair so instead I decided to try psychedelic ketamine therapy for treatment resistant depression. I wanted to write about it as I was doing it but I was…wait for it…too fucking depressed to make words work. That sounds ridiculous but it’s also ridiculous that our whole lives depend on brains that are basically just electric meat so maybe we should all stop being so judgey.
I finished my 6th ketamine session a week ago and today I finally feel like writing. And that is a very good sign. Want to know about how I got super crazy high to be moderately less sad? Of course you do.
I wish I could say that I was one of those people who went into full remission but it really just pulled me out of my super bad stupor and back into my normal, clinically-depressed-but-vaguely-functional self. It’s the difference between clinging to the couch and being too tired to breathe versus having enough energy to stand up in the shower. For those of you without depression who can’t relate, it’s like the difference between having a collapsed lung or having a really annoying head cold. But instead of it being obvious to everyone around you it shows up in your brain and hides so incredibly cunningly.
There are a ton of different types of ketamine therapies or practices and they each use different ways, methods and dosages. Some do it IV and some do injections. Some give you anti-anxiety meds that help keep you from disassociating and can also keep you from remembering some of the trip. Some couple the ketamine with talk therapy to help you recover from trauma and some put you in a dark room by yourself. Each clinic seems to think the other clinic is possibly doing it wrong and that’s probably because this is all still a bit experimental so if you’re thinking about doing it I suggest asking someone you love to help you find the right place for you because chances are if you are depressed enough that you’re considering paying hundreds of times the amount you would have paid for the same drug you could have gotten at a rave in 1992 that you maybe don’t have the energy to fully investigate all of the places near you to find the right one.
I chose a clinic my shrink recommended. They believe that the disassociation that can come with ketamine can actually be really helpful (rather than a bad side effect) because it can allow you to separate from yourself to view yourself more realistically so they don’t give you anti-anxiety meds unless the disassociation bothers you. Instead of IV ketamine they give injections into the muscle of your arm because they think that causes less nausea and the last thing you want when you’re super tripping on hallucinogens is to be projectile vomiting. They also gave me anti-nausea meds before each shot, which was nice.
So how does ketamine work? I’ve no fucking idea. Seriously. I just know that a lot of studies have shown it helps treatment-resistant depression, chronic pain and migraines. I have the first two so I thought I’d try it. The treatments weren’t covered by insurance but I could use my HRA and they cost about $300 each. (Prices vary A LOT by clinic.) Mine was on the cheaper side because I didn’t need talk therapy since my depression is chemical rather than trauma based. You typically get 6 sessions over two to three weeks and after that you can get touch-up sessions once every three months or so.
My first session. I’m put into a soft recliner in a small room. A tv shows videos of the aurora borealis and ocean creatures while pan flutes play. A laser-light thing straight from Spencer’s projects blue waves on the ceiling. The nurse gives me a shot of ketamine and leaves me alone but she assures me that she’ll be watching me on the camera and there’s a panic button I can hit if I need anything. I’m totally fine and I wonder how I’m supposed to spend a full hour being bored in a room. 5 minutes later my body has melted and I have entered another dimension. 10 minutes later the nurse comes back to give me another shot of ketamine and I try very hard to act like I’m not high at all and probably fail miserably.
I am off my face entirely and suddenly a (good) memory from 20 years ago that I thought was entirely gone came through as clear as if I was reliving it. The world separates. My mind explodes and I feel incredibly calm and flat, like my mind is sedimentary deposits under a river. Life and death seem removed and less scary. I suspect I’ve died and I’m concerned but too high to do anything about it. I hear a noise, like the sound of a jackhammer in slow-motion. There’s a growl under the world. I wonder if I’m hearing the mechanics of the earth turning. (I will hear this same noise every single session. Later I asked the nurse and she told me that about half of her patients say the same thing. That they hear a noise they’ve never heard before and that they can’t explain. Like explaining the color blue to someone who has never seen it. I ask her what it means and she shrugs, but in a very comforting way.)
I feel myself flatten out into one dimension and it’s so strange that I pull out my notes app to write this down but my fingers are now two feet long and spellcheck corrects what I try to write (“I am a flatness”) to “I am fat ass” which is not nearly as profound and slightly more insulting.
The hour passes and the nurse comes in as I am starting to become slightly more three dimensional. She asks if anything came to me when I was having the session. “I don’t know why silent letters exist?” I say. She nods. “And I felt like I went on a trip to the afterlife in my mind. OMG, IS THAT WHY THEY CALL IT A PSYCHEDELIC TRIP?” I am a dumbass but they’re probably used to this. She gives me a giant blue vomit bag in case I feel sick on the way home. I carry it out to the waiting room where Victor is waiting to drive me home and he says, “Um…where did you go and why would you need that big of a condom?” I go home and sleep like the dead, which is actually a really nice side effect.
The next day I feel about as terrible as before but I did clean up a dead bug that’s been on the floor of my office for a week and that feels like a positive sign. And also a sign of just how exhausting depression is when I’d rather just walk over a dead beetle for a week rather than sweep it outside.
This is where I would write about my second trip, where everything goes really, really bad and I fall in a k-hole of existential dread but this is getting long and I’m a little tired so how about if we make this part one and I’ll share all the rest next time?
Also, if you’re currently considering ketamine and that last paragraph scares you just know that if you (like me) have the type of anxiety that makes you have a bad trip they can give you anti-anxiety meds that makes it so much better. That’s what I did after the second session and it made a big difference for me. (Spoilers. Sorry.) Also, I was way too out of it and exhausted to record anything of my first sessions but by the last one I was able to do some actual videos so that I can walk you through step by step because if you’re anything like me, seeing how it all works beforehand makes it very much less stressful. Of course, before I got used to the ketamine (as used to it as you can get) I did make a series of weird videos where I am trying VERY HARD to appear totally in control because I wanted to be like, “Whatever. I totally got this.” Upon further reflection (and review of these videos) it is clear that I do not in fact got this.
Case in point…this video from my third session after my first 60 mg shot but before my second 60 mg shot.
Also, I have to say that I am VERY proud that I never went live on Instagram while high but I do have to apologize to my friend Maile who received a lot of video messages from me while I thought I was having psychedelic breakthroughs and profound thoughts while I was actually just ranting about octopuses.