I learned a lot about what to expect from my first ketamine infusion when my doctor asked if I had ever tried any hallucinogenic drugs. My response was “no,” and my experience was about as trippy as I could expect from that lead-up.
I’m writing this from my bed at 8:20 pm, the evening after my first infusion. I do have work to be doing, and I tried that for a while, but I figured “Hey, I spent 45 minutes today coming to terms with the fact that I was just a floating head who no longer had a body, then blessedly reunited with my limbs over the course of 20 nauseating minutes, only to come home and do work? I don’t think so.” So, in an effort to empty my brain, here are my first impressions, unexpected experiences, and mundane realizations of today.
First of all, because I’m a woman of child-bearing age, I’m required to take a pregnancy test. I had better improve at peeing in a dixie cup because it’s not just one test, it’s before every infusion. Why am I so bad at that?
Second of all, the door to the room I was in was labeled “Staff Pool and Spa”, and I’m not at all sure what to make of that. My doctor seems to have a good sense of humor. I did wonder what the other room was labeled, but was too focused on not letting my baby giraffe legs buckle on the way out. I’ll report back.
If you missed part 1, I’m getting a series of six ketamine infusions to combat my treatment-resistant depression. I was very scared about this for a couple of reasons, one being the uncertainty of what the treatment itself would be like. I wish that I could give some kind of concrete answer to that question for anyone with the same anxiety. There are commonalities, I’m sure, but there’s no way anyone else could see the exact same quilted rocket launching into outer space that I did. Or, if for some reason you do, we should hang out sometime.
For me, the general feeling of a ketamine infusion is one of warmth, dissociation, and internal images. The first sensation I noticed was warmth, particularly in my arms and chest. It was quickly joined by the feeling that my limbs were all floating away from me. Looking around the room became extremely disorienting. It was like my brain could interpret whatever my eyes started on and where they stopped, but nothing in between. For a while, I was pretty with it. My doctor asked me some questions to gauge how far gone I was, and I had no trouble answering them. I had to remember three words and repeat them back a few minutes later, and I had to count backwards from 100 by 7s (not very far). The comprehension and answering of these questions was no problem. What was weird was the sensation of talking itself. It was like there was no space between thinking and talking, so as soon as I had a thought that I had some intention to speak out loud, I heard it coming out of my mouth as if someone else had said it.
After a while, I started to retreat from the room and into my mind. When I closed my eyes, I was unnerved by the sensation that my body and my head were very slowly spinning in opposite directions. So, I tried to keep my eyes open. Everything in the periphery of my vision faded out until I could only see what my eyes were focused on. But even then, my brain would pull me in, and although my eyes were open, I wasn’t seeing anything. I was listening to calm, instrumental music through over-ear headphones, but the music was dramatically overshadowed by the sound of my own heartbeat. This was somewhat distressing, so I took the headphones off. Without the headphones, the buzzing fluorescent lights held my attention. It began to sound like cicadas were all around us, and I was reminded of warm, spring evenings in Michigan. I closed my eyes.
What I saw in my mind during the ketamine infusion is fading and jumbled, and I remember it in much the same way that I remember my dreams- just out of reach. I do know that the beginning was defined by knit and quilted geometric shapes moving and growing slowly. Dark purple colors against dark backgrounds, shapes like wheel cogs and tower spires. For some of it, I felt like my mind was falling (at this point I didn’t have a body), but not in a frightening way. Just a slow, gentle descent. Later on, I felt impossibly tall and constantly growing. I stretched through the atmosphere, into outer space. I soared past the moon and out beyond our solar system. I thought about telling someone, but decided it might sound a little grandiose to describe my incredible, galactic height.
My sense of time was warping; when my doctor said it had been about 30 minutes, I felt like it had only been 10. After that, though, time seemed to move agonizingly slowly. When I heard “just a few more minutes” I was a little relieved, but soon began to wonder why my definition of “a few” and his definition seemed to be so wildly different. My mother was sitting across the room; why would they leave me here for another hour? Eventually, some beeping next to me indicated that things were ramping down. I slowly returned to my rapidly overheating body. I managed to say “very hot”, and the blanket was removed, along with my scarf. The room wobbled, my stomach turned, and I closed my eyes again.
The time it took to fully come out of it was probably about 20 minutes, but again, I wasn’t the best timekeeper. Moving my head and eyes provoked the nausea, so I had to settle with the awkward feeling that I wasn’t making enough eye contact while people were talking. We chatted about what it felt like, what kinds of things I saw, and what I thought about during the infusion. When I felt sturdy enough to bring my legs up to my chest, I put my head down on my knees and cried. I can’t say why- the anxiety beforehand, the nausea, the fear that it won’t work, maybe all of the above. It was an overwhelming experience, but I’m told that it gets easier.
I was hoping that I would sit down to write this and be able to say that I feel miraculously less depressed, but that isn’t the case. For some people, ketamine makes them feel better within hours of their first treatment. For others, it takes a few more infusions. And for still others, it doesn’t work at all. So, for now, all I can do is wait.
Until next time.