It’s part 30 of the Ketamine Chronicles! Time flies, doesn’t it? My previous ketamine infusion (which I use as part of my treatment-resistant depression treatment), was surprisingly more effective than it has been in the last couple of months. I’ve been enjoying the general lightness and ease with which I can get out of bed. Last Thursday seemed to take a downturn, although it’s always hard to tell which factors explain which results. In any case, my regularly scheduled ketamine appointment was yesterday, so it was good timing, if so.
Whereas the last infusion was extremely trippy, this one seemed more mundane. That might only be because I don’t have much memory of what I experienced, though. At the start of my infusion, my ears began feeling incredibly hot, as if I’d just said something horrifyingly embarrassing. Once I closed my eyes, I remember feeling a tad uncomfortable, like my thoughts were becoming too big for the confines of my head. It seemed like I was seeing darkness for longer than usual, and I think that the lack of engaging visual noise is what made my thinking feel too big. Of course, I don’t remember what I was pondering, just that it was happening.
Once again, I fell asleep when I got home and then had several disorienting instances upon waking up and not knowing what day or time it was. It felt like I had been sleeping for many hours when my mom poked her head into my room. All that had registered in my brain a moment before was that my phone said 6:30. So, when my mom informed me of the shrimp and rice on the table, I momentarily thought, “why would she make shrimp and rice for breakfast?” It quickly dawned on me that it was, in fact, the same day. I woke up a few more times during the night, still briefly believing that it was the next morning. The pitch black scene outside my window hinted that no, it was not 11:30 AM. It took me a few seconds to reassess.
Start from the beginning of the Ketamine Chronicles! Or, visit the archives for a list of month-by-month posts. Other posts have far more absurdity and detail in my descriptions of what it feels like during an infusion.
Since this entry in the Ketamine Chronicles is pretty short, I thought I’d share the questions that I asked when I started ketamine therapy. I’m not sure that these are actually frequently asked, but it made the heading nice and concise, and I do love some organization. The answers to these questions are a blending of what my doctor told me, plus what I’ve learned through personal experience. Everyone is different, so the answers may not apply to everyone.
1. How do you know when you should get a maintenance infusion? Is it a sudden change, or more gradual?
For me, it’s usually a gradual change that I notice somewhere between two and three weeks after an infusion over the course of three or four days. I know that it’s time to get another infusion when I find myself doing a lot of nothing and feeling apathetic. My motivation disappears and I usually start thinking that acting to counter my symptoms is pointless.
However, it can be more of a sudden change for some people. They may wake up one morning knowing that, because their symptoms have returned quickly, the ketamine has worn off.
2. Do some people eventually manage their depression with just therapy, etc.? Or is the damage that depression causes a continuous process that you have to constantly work against?
Unfortunately, it’s the latter. After your initial series of infusions, you’ll need to periodically get maintenance, or “booster”, infusions. The effects of ketamine wear off at different rates for different people.
I suppose it’s possible that someone could really piggyback on the results of ketamine therapy and launch themselves into better long-term mental health, but as far as I know, the vast majority of people need booster infusions.
Exercise, therapy, social interaction, and other activities that support your mental health can help the effects of ketamine last longer. It’s possible for some people to extend the interval between their infusions. #goals
3. How do people decide whether or not to keep taking their medicine?
This is a uniquely personal decision that you make with your psychiatrist or other prescriber. I was hopeful that the benefits of ketamine would allow me to at least reduce some of my more side-effect prone medicines, but so far, trying it hasn’t worked out for me.
4. Is it possible that for some people, ketamine makes their meds work better because of the brain repair it facilitates?
Yes! As I discovered first-hand, going off some of my medications had pretty abysmal results. It’s clear that for me, the combination of my usual medications and periodic ketamine infusions is what works best. You can even try medications that you’ve taken and discontinued before, as sometimes they work better with ketamine.
5. Is my reaction to the first infusion a good indicator of whether or not it will work?
No. While ketamine works for some people nearly immediately, it takes longer for others to see any benefit. I didn’t feel better until roughly my fifth infusion.
Additionally, the way you do your first infusion is not set in stone. Sometimes, you need to change the dose or add other medications. It’s not a one-size-fits-all treatment.
6. Does ketamine ever “kinda work,” or is it all or nothing?
I apparently didn’t write down my doctor’s answer to this, so this is entirely my own experience.
I find that it can “kinda work” for me, depending on circumstances that I haven’t pinned down yet. Still, even when it’s not amazingly helpful, it’s still worth it for that small benefit. I tend to vacillate between “meh,” and “wow, I feel so much better.” So, much like question #3, it’s probably worth tweaking things if it’s less beneficial than you hoped.
However, for some people, it seems not to work at all. On the other hand, there are people for whom ketamine makes a dramatic difference almost immediately. It seems to be a continuum.
7. Will I do anything embarrassing during a ketamine infusion?
I don’t think I asked my doctor about this, but it was definitely part of my apprehension. I tend to be quiet during my infusions, in part because it feels nearly impossible to carry on a conversation. When asked if I’m doing ok, I usually just sort of nod my bobblehead a little.
I do know that other people are far more chatty than I am and can just talk the whole time. I doubt they divulge any deep, dark secrets without meaning to, though. Even though I can’t muster up the energy to speak, I have contemplated whether or not I should say something. Some of the things I see behind my eyelids are so absurd that I want other people to know about them. But even with that desire to share something funny, I’m still capable of deciding whether or not to say it. I probably would talk more if it weren’t so hard to work around my bubble gum tongue.
Feel free to leave questions in the comments. If I have an answer, I’d be happy to share it with you.