At this point, I’ve lost track of how many IV ketamine treatments for depression I’ve had (they don’t line up exactly with the number of blog posts). My treatment-resistant depression has dug its heels in once again, and I’m wrestling for the millionth time with whether or not there is any chance of improvement for me (despite having experienced significant improvement that fell apart when the pandemic began. Clearly, it is possible).

In a conversation with my therapist in which I explained my growing sense of hopelessness and how it makes me reluctant to keep going with ketamine infusions, she pointed out that I have said that ketamine makes a difference in my mental health. It’s true. It’s tough to remember that the hopelessness is the depression talking. I can’t trust my assessment of the world when I’m getting all my info through the warped view of depression. At least, I think. Sometimes it’s all so confusing.

The Wolf and the Mountain Goat

The wolf had its mouth open, partway through devouring some kind of amorphous, green animal. Perhaps a giant frog? An algae-covered sloth? Try as I might, I couldn’t interpret the image correctly. But there, below the wolf’s fearsome jaws, was a pure white mountain goat kid. It stood perfectly still, watching the wolf eat its catch.

That mountain goat should move, I thought. Directly below a hungry wolf definitely seemed like a risky place for a baby mountain goat. But nothing moved at all. The image was static. And then I remembered that I was not supposed to have my eyes open during my ketamine infusion, and I definitely was not supposed to be staring at the photo on the wall across from me. There is no wolf in that photo- nor is there a mountain goat. It’s a picture of a river flowing through rock formations with greenery on the shore. It was quite a trip.

I can’t unsee it.

Ketamine Depression Treatment and Visions of Water

From the beginning, I could feel the warm air inside my mask. At some point, it started to feel like liquid, like I suddenly possessed the ability to breathe underwater. I’m fairly neutral when it comes to swimming in real life, and I don’t have any particular fascination with water. But ketamine always brings out these intense associations with bodies of liquid water and, occasionally, ice.

Ripples and waves of all sorts, whales, jellyfish, cold rivers flowing downhill, being on a boat, icebergs; these are all images from previous ketamine treatments that stand out enough for me to remember them. Perhaps the physical sensations of unsteadiness trigger my brain’s water-related pathways. Except that I’m always decidedly stationary during ketamine treatments. In any case, I’d be interested to know if other people also see lots of water during their ketamine infusions.

Drowning in Deep Water

This time, it was the ocean, or perhaps a very, very deep lake. My perspective was from beneath the surface, and I could see someone sinking slowly from the glowing blue into the inky blackness below. I was watching the person, but I also was the person. We were sinking through vast expanses of empty ocean, only water and light around us. It was striking but lonely – only the silhouette of a human form, gently falling through deep water.

Slowly, the light receded above and I began to think that I didn’t want to be in darkness. It occurred to me that the person was drowning, and although I felt comfortable enough, that meant that I was also drowning. We were, after all, the same person. I didn’t know what was beneath us, and the unknown was somewhat unsettling. But everything was heavy, and the constant pull of the water was hard to resist.

It was confusing; how was it possible that I was breathing the water that filled my mask? I must be drowning, but I felt fine, only incredibly heavy. Then I heard my own voice in my mind say forcefully, “open your eyes,” and suddenly, I was back in the room, looking at the wolf and the mountain goat once again.

Space and My Mental Map on Ketamine

Have you ever looked at a familiar room and felt like you’ve never seen it before? Like you just never really looked at the angles of the walls or the color of the furniture? I’ve noticed that my ketamine infusions often give me the sensation that a room has changed and space is distorted.

When my eyes are closed, I feel as though everything is moving closer to me, but also over me. It’s like the weight of my body is folding space so that my surroundings move up and over me. Things feel much smaller, and I’m always momentarily surprised when I open my eyes, the space instantly expands, and I find myself in a bigger room than I expected. And every time, it’s as though I’m looking at a room that I’ve never really looked at before. By the time I’m semi-lucid and ready to set my legs in motion towards the hallway, the feeling has passed and the room is familiar again.

Some Thoughts on Masks and Privacy During Treatment with Ketamine

I don’t often relax in places that aren’t my own home. Even friends’ and family’s places give me that tense feeling of being a guest; I’m less familiar with my surroundings and therefore need to be alert and polite. It’s uncomfortable to imagine that someone might walk by and catch me making myself at home by taking a nap or, I don’t know, putting my feet up.

I’ve obviously been forced to let that go to a very large degree while treating my depression with ketamine infusions. But it’s gotten me thinking — this might be why I tend to open my eyes so much. My vulnerability alarm goes off when my eyes are closed anywhere that’s not my home. I guess it periodically yanks me out of whatever trip I’m on so that I can look around for a second. Maybe that also explains some of why I remember such vivid scenes. It’s like when you wake up in the middle of a dream and can recall it with perfect clarity, versus sleeping all the way through it, and then all you know in the morning is that Shrek was there.

That said, lots of people wear a sleep mask during their ketamine infusions and find that the darkness helps them immerse themselves in the experience. I have found that wearing a mask that covers my nose and mouth does make me feel oddly secure – like it’s hiding me from any eyes that may look in my direction. I wonder if a sleep mask would have the same effect, or, as I expect it might, just make me feel more vulnerable by preventing me from looking around occasionally. Who knows – I may try it someday.

(Imagining my entire face covered in masks makes me feel like the spider in that viral voice-over video: I cannot see you, you cannot see me…I am hidden.) 

If you’d like to read more about my experience with ketamine for depression, start from the beginning of The Ketamine Chronicles or visit the archives. Click here for mobile-optimized archives of The Ketamine Chronicles.