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The Subtleties of Water: The Ketamine Chronicles (Part 27)

I’m always looking up at the sky when the water closes over me. This time, it was cold, and an eggshell-thin layer of ice formed above me while I watched. Gentle waves followed one another, freezing over the previous layer and leaving a frosty texture on the surface. Darkness spread from the periphery of my vision until I strained to see through the last window of light, the only notable image being the shadow of a person standing above me on the ice.

I didn’t put a lot of effort into remembering this infusion. I know there were graceful, disembodied hands dancing amid blue and red lines, swirls, and dots. There was more water – ripples and waves, mostly. There was a pyramid with a circle above it, which turned into a blinding white light. I’m certain that there was a lot more, but it’s faded away from me by now.

My mental health is declining. I’m not sure why. Ketamine doesn’t seem to be working as well for me, now. Every day, I have to rate my mood on a ten-point scale. It’s hard to capture how I feel in numbers. Potatoes are easier, but still not quite enough. Honestly, sometimes words themselves seem too limited. How can I describe how I feel? This morning, I woke up at 4. I got dressed in the cold – same clothes as yesterday – and went to the kitchen for some food. I walked the dog when the sun came up, but we came home quickly because of the sharp, cold air. My eyes feel heavy. Not the lids – the actual eyeballs; they sit heavy in their sockets, like wet marbles or enormous caviar. I wonder, if I tip my head forward, will they fall out? When my depression is worsening, I often notice this feeling in my face. Everything is heavy and hard to move, and I’m sure my expression is grim. I think the clinical term is RDF – resting depression face. At least my pandemic mask covers most of it.

Maybe the person above me on the ice in my ketamine dream is me. I’m on thin ice. Skating across a just-frozen lake in my wool socks at 4am. Someone else is waiting beneath the surface, straining to see through the darkness. Is she also me?

__________

My recent ketamine infusions have all featured water, and I’m often drowning in it. It’s not scary – it’s peaceful. It’s soothing. I’ve never stayed up by the surface before; always finding myself sinking into the dark, quiet depths. But this time, I was floating – pressed against the underside of the ice, trying to see through it to the person on the other side. I was curious about this person, but the darkness closed in before I could begin to unravel what was happening, and then I found myself in a different scene, which I do not remember.

I’m fascinated by this recurring theme of water, especially because in my regular life, I’m not a big fan of it.

I have sensory processing disorder, and as a young child, I flat-out refused to swim. I was overwhelmed to the point of tears by the splashing, the echoes in the pool, the temperature change from air to water, and most of all, the fear of people touching me. I eventually came around to the idea, but never enough to take lessons. So, having never properly learned how to swim, I nearly drowned at a friend’s birthday party when I was 8. I remember being uncomfortable going into the deep end, but my friend was insistent. I lost my grip on the side of the pool and began to sink. When people say that drowning is not a dramatic event – there’s no splashing or screaming – they’re right. My head tilted back instinctively as I went under, and I could see my hand, extended above me, slip under as well while the rest of my limbs flailed uselessly underwater. A panicked hopelessness overtook me as I choked on chlorinated pool water. Then, my friend’s hand broke the surface, reached down, and grabbed my wrist.

I have never felt relaxed on or in water, and it’s not just the near-drowning that explains it. The same sensitivities that kept me from participating in swimming lessons have persisted into my adulthood. I dislike the unsteadiness of water, the unpredictability of how it will splash, the feeling of water on my face. And yet, when I’m reclined in my doctor’s office, ketamine moving into my bloodstream, visions of water are soothing. I can feel the cool, constant pressure of being underwater without the anxiety or the sensory overload. I can feel myself standing on the deck of a boat, watching the foamy water beneath me leap forward and recede, and I feel peaceful. I’ve seen whirlpools, rivers, melting glaciers, and the unbelievable enormity of oceans. It’s a strange experience to suddenly realize what water might be like for other people, as those feelings are foreign to me in my waking life.

I feel as though, unhampered by the symptoms of my sensory processing disorder, I can connect to a larger, evolutionary interest in water that I am unable to find under normal circumstances. Humans have been fascinated with water for millennia. In fact, some evolutionary anthropologists believe that nearness to water supported the development of large brains – that we are, in part, the heritage of small, coastal communities of early humans whose lives revolved around the movement of water and the food within it. To this day, many island and coastal cultures retain great reverence for the ocean. When we gaze out upon a watery horizon, it is difficult to not be awed by the vastness before us. In my eye, to find our place in relation to bodies of water is akin to our struggle to find our place in the vastness of space. Questions of identity and survival are found in the depths, and I believe we carry the answers within ourselves.

My depression is a constant in my life. It is all-encompassing, lonely, and feels like drowning. I’m not one to find meaning in every dream, but the images of water that I experience during ketamine infusions have begun to feel profound. What does it mean? Certainly not that I should give in, wave a white flag and let the water crush me. Nor should I wait breathlessly under the ice, squinting as if to look through a frosted pane of glass, uncertain if I’m even above or below. Rather, I believe my visions of water are windows into the nature of the human experience. Perhaps they’re snapshots of how I feel – how depression feels to me. My mind is an ocean, and at times, it’s oppressive. I sink within myself, finding it easier to let the water cradle me as I descend than to keep swimming. At other times, I find comfort in accepting the changing nature of my illness. Like a river flowing downhill, impermanence is unstoppable, and the emotions of being a human move inexorably back and forth. When we crest the top of a wave and begin to fall down the other side, we wait for the next one, just as we take each arriving day. And when you are drowning, reach up. A helping hand may be just about to break the surface.

To start at the beginning of my journey with IV Ketamine for treatment-resistant depression, check out Part 1

4 thoughts on “The Subtleties of Water: The Ketamine Chronicles (Part 27)

  1. I’m glad I found your blog. Thank you for your vulnerability and sharing your experiences. My psychiatrist recommended ketamine treatments for me. My concern is that it ultimately doesn’t work. I’ve heard or read similar experiences to yours. In fact, outside of theoretical articles, I’ve only heard exactly your experience where sequential treatments become less effective and then stop working. I don’t know of anyone who’s life was dramatically changed forever by Ketamine. I think I’ve taken just about all the medications, varying doses, and combinations. I don’t want Ketamine to be another medication on the list of medications that doesn’t work. I’d rather not do it at all. Looking back on your Ketamine journey, would you do it again?

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    • Hi Tim, thank you for reading. I can certainly relate to your concern. It’s so frustrating to go through medicine after medicine with minimal benefit. I’ve thought about your question all morning, hoping to come to some tidy conclusion about myself, and I’ve decided that yes, I would do it again. Maybe the most important reason for that is that ketamine has given me periods of time with far fewer symptoms. I felt dramatically better for those weeks or months, and while it is disappointing to lose that feeling yet again, I do still value the time that ketamine gave me to really live again. Plus, it proves to me that I *can* heal, and I’ve found that even a small reprieve can bolster your strength. I’ve heard that some people can go months between infusions. Even if it stops working, would, say, a year of no symptoms be worth it? I suppose the answer is different for everyone, and I can understand your reluctance to put yourself through that. For me, though, I think it’s a yes.
      I’m coming to believe that I may always be searching for the magic solution to my depression, and that it may be better to view each treatment as simply one tool at my disposal. I might be changing my antidepressant once again, as sometimes ones that you’ve tried before can turn out to be more effective with ketamine “in the background”. I also find that doing another series of infusions in quick succession boosts me out of feeling suicidal. If at some point I decide to stop regular infusions, it may be useful as an emergency treatment. All that is to say, I haven’t given up on ketamine just yet.
      Sorry I was not more succinct – I could have just made this into a whole post! I wish you the best in whatever treatment you choose.

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      • Thank you, Genevieve. One more question. How do you manage to keep writing through the depression? I was a writer, too. I’ve written three books, contributed to an academic text book, and have dozens of published articles. I quit two years ago. I loved writing, but then it all just felt pointless.  Thanks again for what you do. I can very much related to your journey.Tim

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      • I have to manage it through bits and pieces. I have a running list of writing ideas that I add to if I ever have an inkling of inspiration, and if I ever sit down to write something and my motivation disappears, I keep the draft. I often find that things look better when I return to it later. I also wish I could write more, but often have periods of low or no productivity. I hope you can pick it back up! It sounds like it was something you found meaningful before depression hit.

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