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At the Bottom of a Well: The Ketamine Chronicles (Part 33)

April 14, 2021April 14, 2021 Genevieve8 Comments

I forgot to put on a scopolamine patch the evening before this ketamine infusion, but other than that, this one was packed with stuff intended on making the ketamine more effective. Cimetidine, magnesium, petocin, some anti-nausea drugs, to be honest, it’s all a blur. It was “the kitchen sink.” Getting infusions of IV ketamine for treatment-resistant depression is kind of a balancing act. It works best as an individualized recipe, and it seems that mine is always changing.

I don’t usually start out my ketamine infusions with chit chat, but this time, I spoke to Sarah for a couple of minutes before closing my eyes. What we talked about, I no longer remember, but it was casual and light. When I did close my eyes, I had the sense that this infusion might be a gentle experience at the surface between lucid and zonked. I was very wrong. I think that focusing on my conversation with Sarah diverted some of the weird sensations of ketamine from overcoming me, but they hit me later.

Sand and some lessons about depression

I remember a lot of sand. I was in a desert near some ancient stone ruins, and the sand was shifting like a river in the sunlight. I was on the ground, watching a snake struggle to squeeze between a crack in the stone building before the sand could drag it down. The snake succeeded, turning into a blooming flower as it rose up from the river of sand.

ground-level-photo-of-sand-dune-in-ketamine-dream-on-windy-day — *Photo by @wolfgang_hasselmann on Unsplash*

At some point, I was looking down a long tunnel into the ground – like a well – at some people on the other side. But as I strained to see who they were, I realized that I wasn’t looking down, I was looking up from the bottom. The people far above me leaned over the edge to gaze down, and the walls of the well crumbled into sand and buried me in darkness. It was quiet. It was something of a relief.

These experiences of being buried or of drowning are never frightening, but they do evoke a certain hopelessness. I used to have whole infusions dominated by water and the feeling of sinking, but lately, that theme has been absent. This theme of sand is different, but it feels much the same. I wonder if it has to do with the state of my depression at the time. In thinking back to the last few times I had a water-based internal experience, I do remember feeling similarly to how I feel now. I’m treading water, still moving a little in the direction of my goals, but I’m decidedly denser than my surroundings. Sinking would be so much easier than pulling myself upwards.

When I’m drowning or being buried in my ketamine infusions, it feels completely out of my control. The forces of water, sand, or perhaps depression, in this metaphor, are simply overwhelming. I think that my perception of depression is manifesting itself as unbeatable natural forces in my ketamine infusions. Most of the time, it doesn’t seem hopeless to that extreme in my real life, so it’s interesting that that’s how it comes out in my ketamine appointments. But, maybe that’s the only way my mind can conceptualize it in that setting.

In my visual experience of ketamine, depression feels like sinking alone in the dark, open ocean. It feels like being buried in sand at the bottom of a well, while people far away can only watch. But in reality, it’s neither of those things. It’s an illness that, like others, can be treated. Reality is clouded by depression, and it’s easy to forget how turned around I can become in my own mind.

Is the ketamine infusion over? Should I get up now?

At the very beginning of this ketamine infusion, my doctor pointed at the photo on the wall across from me and said, “We’ll just see if this starts moving.”

“I’m not supposed to have my eyes open,” I replied, referring to our frequent conflict in which I open my eyes and stare at various entrancing objects while he patiently reminds me over and over again that I’m supposed to have them closed.

“That was a test. You passed.” He laughed.

And then at some point in the infusion, I proceeded to leave my eyes open for what felt like a really long time.

In my defense, I was confused. I opened my eyes because I thought the infusion was over and that everyone was waiting for me to get it together. Let me tell you, trying to fight ketamine while it’s still infusing into your bloodstream is pretty impossible. I kept thinking that I needed to get up and walk to the car, and that seemed utterly beyond my capabilities.

abstract-blue-image-of-flowing-water — *Photo by Michael Dziedzic @lazycreekimages*

I vacillated between anxiously willing myself into wakefulness and resigning myself to living the rest of my life in that very chair. Words can’t describe how disoriented I was. Every time I blinked (which wasn’t often and was probably more like a short time with my eyes closed), the room seemed to change somehow. It was wider than I remembered, then it was taller, then the picture was farther away, and everything was tilting to the side. I couldn’t understand why it was taking me so much longer than usual to regain my faculties.

I distinctly remember thinking, “I wish someone would just tell me what I’m supposed to be doing.” That thought gave me some satisfaction because after all, how could anyone get frustrated with me for being slow when they didn’t even tell me that I was supposed to be speeding up? “That’s *their* problem,” I thought. Having convinced myself that transportation to the parking garage was not my concern, I stared at the wall with the photo of the wolf and the goat and found that there actually were three frogs hidden in there, too. I occasionally thought things like, “What time is it?” or, “When did we start?” or, “Which way is up?” only to realize that the answer would mean nothing to me and there was no point in mustering up the energy to ask.

After some amount of time that may have been five minutes or five hours, I was told to close my eyes and that there were eight minutes left. Oh my God, what a relief. “How long did I just spend thinking I needed to get up? No matter, now.” Somewhere in my mind, I found some wry humor in my ability to carry my anxiety about inconveniencing people into Ketamine Land. I guess it follows me everywhere.

After that, I spent some time thinking about oobleck, which is a non-Newtonian fluid often made in middle school science class composed of corn starch and water. It moves like a fluid at rest, but solidifies when you exert sudden force upon it. I felt like I was surrounded by oobleck. Or maybe that I was made of oobleck. Things were flowing like a lazy river when I let go and rested, but when I tried to move, I found myself glued in place.

The eight minutes that were left when I closed my eyes instantly shrunk down to about twenty seconds, and then before I knew it, I was back to searching the inside of my brain for control of my limbs. I got my coat on, missed my face a couple of times trying to put my glasses on, wobbled out the door, and successfully made it to the car.

IV ketamine for depression is different every time

The rest of the day passed uneventfully. I was interested to see if the reintroduction of magnesium into my infusion would result in the wild limb jerking that happened the last time we used it, but thankfully, it didn’t. The bizarre afternoon I had that time has continued to be an isolated event. This time, I slept for most of the day, got up for dinner, then went back to bed. I think. To be honest, I don’t remember the details, but I know that it was fairly mundane.

Every infusion I’ve had has been different, which is why I find it so interesting to write about them. Even my experience once I get home tends to change, and I can’t always pinpoint why. Sometimes, I go about my day – working, writing, walking the dog – and sometimes, I just crash.

It doesn’t even seem like a wackier or more mundane experience correlates with any particular result. At least, as far as I can tell. Maybe there are just too many factors for a clear pattern to emerge.

For the time being, I’m planning some more changes to my medication regime, trying not to nap too much, and carrying on with tiny clams.

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Some Benefits of Ketamine for Treatment-Resistant Depression (for me)

March 24, 2021November 22, 2021 GenevieveLeave a comment

My last ketamine infusion was much less trippy than the previous one, so I’m relieved to say that I remember absolutely none of it. Much less fun to describe, but also less persistently, somewhat threateningly bizarre. We skipped the magnesium this time, and I did not have any sudden, limb-jerking spasms. It’s good to know that was likely the culprit. When I can’t remember an infusion, I feel pretty curious about the off-putting gap in my memory. I always think it’s interesting to know what I experienced during a ketamine infusion, and when I can’t, I feel like I’m missing out on something that I just can’t access. Thankfully, the benefits of ketamine for treatment-resistant depression remain even when I can’t remember them.

Eating Food

I’ve been having some problems with nausea and appetite since starting Wellbutrin. They mimic what I feel when I’m really depressed, just amplified. Food is not appealing, neither in my imagination nor my mouth. When it’s time to eat, my goal is to find something that’s least unappetizing. Eating it is a strangely empty experience, as if I can recognize the flavors but can’t assemble them into something I like. The closest analogy I can think of is that it’s like the difference between sound and music. For a few days following a ketamine infusion, that problem is gone. It’s easy to pick something to eat, and not only does it register as, say, a grilled cheese sandwich, but my brain is also willing to exchange it for dopamine. Things taste like how food should taste, and it’s great.

Making Decisions

Ketamine makes the days following an infusion feel remarkably lighter. The difficulty I have with making even small decisions is much improved. I just go about my days without getting stuck at every turn. Speaking of turns, I’ve really been enjoying my morning walks with Stella. When we come to an intersection, I let her choose, and we amble around a ridiculously inefficient route that’s different each day. I am typically a very routine-driven person, so this microscopic spontaneity is a teeny, tiny sign that says
_{“ketamine helped!”} If the ketamine wears off or some other factor occurs and my depression gets worse, I tend to become more rigid in the route we take. I’m sure Stella prefers our ketamine-lightened walks, and so do I.

Thinking about the Future

The bigger benefits of ketamine for treatment-resistant depression, for me, are centered around my attitudes about the future. Depression makes me feel hopeless, and ketamine lifts that – sometimes just a little, but sometimes a lot. I’m not sure what determines the degree of helpfulness, but it’s always a welcome effect. It makes it easier to imagine myself making changes and taking big steps.

Other benefits of ketamine for treatment-resistant depression that I notice include:

Sleeping less
Feeling more social
Experiencing something called “fun”
Feeling satisfied about completing a task
Noticing little things that I appreciate or find interesting
Reduced suicidal thoughts (hasn’t been much of a problem recently, but I’ve definitely noticed that in the past)

Lately, I’ve noticed that the most noticeable changes stick around for a few days or a week, then things level off to a pretty neutral place where I’m neither jazzed about life nor am I in the pits of despair. By three weeks, I’m in something like the salt marshes of despondency; not inescapable, but pretty unpleasant.

That is a completely individualized timeline. Everyone is different, and I get the feeling from the forum I’m on that there are a lot of people who go much longer between needing ketamine infusions. I kind of try not to think about it because of what they say about comparison, I guess. (They = various quotes)

Musings about Medication

hand-holding-stack-of-smarties-candy-in-palm — *This was tagged “medication” on Unsplash, and I thought, “that’s a weird swap of the typical ‘pills aren’t candy, kids!’ warning.” (Photo credit: Sharon McCutcheon)*

My medications may change again sometime soon, and although I just said that getting ketamine infusions for depression makes making decisions easier for me, I’m setting that choice aside for now. It’s harder to decide soon after an infusion because I feel like I don’t need to change anything. I feel better, therefore, I should keep things the same. But, ketamine wears off at some point, and even though I feel “better,” should I stop at that point? Maybe I only feel a fraction of my potential “better” but it seems like a lot because it’s better than abysmal. These choices are always hard. I don’t want to settle for just ok, but I worry that I’m expecting too much. Maybe this is exactly how happy people feel – they’re just more grateful for it.

But then a couple of weeks pass and I slowly start sliding backwards into napping and apathy and isolation, and I realize that there was no in-between. It was mildly happy and then increasingly depressed. There must be something more than that. I habitually blame myself for depression in the short term. A bad day or week makes me think that I let myself wallow and didn’t try to change things. I think that I’m lazy and burdensome and why can’t I just be cheerful? But when I look at the long-term – the years I’ve spent with depression – I feel kind of robbed. It’s easier to see the trends of it and the forks in the road where I didn’t pick the option the non-depressed me would have chosen. I may try to blame myself for all of that too, but the more reasonable answer is that depression has been in my way. Sometimes, that perspective makes me determined, and all of the other times, it makes me tired.

My last few months have been saturated with medication changes and mood fluctuations. I go up and down, up and down, and I’m thankful for the ups, but there’s something about the downs that feels so much more impactful. Despite the incremental progress I’m making after starting Wellbutrin, I feel completely insecure in that success, like it’s just visiting and will have to leave soon. A large part of me says that would be disastrous and I’ll just have to claw my way forward from here on out because losing ground would be unacceptable. I guess we’ll find out.

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Post-Infusion Confusion: The Ketamine Chronicles (Part 32)

March 2, 2021March 2, 2021 GenevieveLeave a comment

My experience of receiving IV ketamine for depression this time around is now almost completely lost in the recesses of my brain. I do remember having an odd, somewhat uncomfortable feeling early on that I recognized from one of my recent ketamine infusions. My best description of this feeling is that my thoughts were physically too large for my head and too fast to really grasp. But what was most interesting about this infusion was what happened afterward.

First of all, I was so incredibly disoriented that when I thought that my mom was driving in the wrong direction, I asked, “Wait. Where are we going?”

“…Home…?” She replied. It then dawned on me that we were leaving my appointment rather than being on our way there. I was so impaired that I didn’t even remember going to the appointment at all.

The second very strange thing that happened post-infusion was that I began having brief, uncontrollable muscle spasms combined with sudden knee buckling that affected my entire body. I was wobbling along, trying not to fall in the parking garage, when it hit me. My arm shot out in front of me, flinging the apple juice I was holding onto the floor, and the rest of me doubled over for a second. It felt sort of like when you fall asleep sitting up and then violently jerk awake. Except, I was walking. For the rest of the afternoon/evening, this happened in varying degrees at least once per hour. At least, that’s my estimate. Then again, maybe we shouldn’t trust the person who couldn’t even remember going to a ketamine infusion.

The muscle spasms are mysterious but may have been due to the magnesium we’ve been adding, which helps some people see better results from ketamine. We plan to skip it next time, as it hasn’t made a dramatic difference for me, mood-wise. While magnesium may not be important for my depression, something was very different about this experience. The infusion itself seemed the same, but the bizarre visual, proprioceptive, and even auditory components extended far past the time when they usually disappear for me. I can only attribute this to the other measures we take in the effort to slow down my metabolism of ketamine, plus the somewhat recent increase in dose, but to be honest, I don’t know why this one was different.

Generally, by the time I’m capable of putting my shoes on to leave the clinic, things look pretty much normal. This time – not so much. Once home, I noticed that a piece of crumpled paper appeared to have cobwebs on it with tiny insects crawling around inside it. At first, I was completely fooled. Fascinated, unsettled, and fooled. I peered at it from a close-but-safe distance, trying to get my eyes to focus on its movement. I tried alternately holding my breath and blowing on it to see if the gentle movement was actually caused by my own proximity; I tried holding my hand above it to feel for a draft, and I tried touching it with another piece of paper. But, no matter what I did, the cobwebs continued to wave slowly back and forth at their own pace, and the small bugs never explored past the cobwebs. My little tests helped me realize that it wasn’t real, but I was so interested in it that I continued to stare.

Eventually, I dragged my eyes away from the paper to look behind me, and when I turned back, the bugs and cobwebs were gone. After the rather large amount of time I spent engrossed in a crumpled piece of brown paper, I suddenly understood via first-person experience why ketamine’s effects make for a useful clinical model of psychosis. The entire event was bizarre and deeply unsettling in a way I can’t quite describe.

My eyesight was frustratingly blurry, to the point that things actually looked clearer without my glasses. I’m not sure exactly how the physics of that works, but wearing my glasses seemed to make it much more difficult to focus my eyes than it was without them. Attempting to lock my gaze on something flat and relatively close to me, like texts on my phone, made the object recede and push forward into subtle 3-dimensionality on repeat.

Perhaps the most persistent phenomenon of this post-ketamine experience was the sound of voices next to me. I’ve been re-watching a show I like lately, and at some point in the afternoon, I realized that I had been “listening in” on the dialogue of several fictional characters off to my right for at least an hour — not sure about that timeline, though. Their voices sounded exactly like the actors’ voices; so much so that I felt I could identify the person speaking at any given time. There seemed to be a choppy plot- not one familiar to me from the actual show. My brain must have created a whole new plot, but I couldn’t tell you what it was. I again reminded myself that I was just not quite past the effects of ketamine, and that it would pass. It wasn’t that I ever thought those fictional people were actually next to me; the voices just wouldn’t stop. It was like listening to a podcast that I couldn’t turn off. I kept trying to distract myself with something else, but I would eventually drift away from it, back to the voices. Then, after what felt like a few minutes, I’d remember that it’s generally not good to be hearing voices and would try to distract myself again. I was moderately creeped out, but mostly exasperated by the fact that I couldn’t reliably corral my thoughts back to reality.

All of this – the experience of seeing and hearing things so long after an infusion is distinctly new to me. There have been times when I thought I heard things post-infusion, but I’m never quite positive that those sounds weren’t real, and they always happened much closer to the infusion. It seems possible that I might have just been thinking about that show and gotten pulled into an imaginary scene, which doesn’t necessarily count as hearing things. But the cobwebs – which I also saw once during an infusion when I left my eyes open for too long – definitely appeared to be taking up space in the real world, and long after I’m usually good to go.

Today, I feel much more like myself, although I’m strangely exhausted despite doing basically nothing all day yesterday. My vision is still a tad blurry, which I think might have been the scopolamine patch I was wearing, which can dilate your pupils. I’m going to make a checklist before the next time of things that I need to do when I come home from a ketamine infusion. It’s difficult to keep things straight when you can’t remember whether you even made it to the infusion in the first place! I’m going to take this weird continuation of my ketamine infusion experience to mean that it might be more effective against my depression this time. Or, maybe it’s a really bad sign and nobody else ever experiences this. When I find out, I’ll let you know.

If you liked this post, consider starting at the beginning of the Ketamine Chronicles, or visit the archives to find month-by-month posts.

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A Gold Monocle: The Ketamine Chronicles (Part 31)

February 16, 2021February 17, 2021 Genevieve3 Comments

The warm, vaguely citrusy feeling of ketamine spilled down my back while I tried to get my earbuds in and my music started. I fumbled around for a moment, not sure which earbud was which, but finally settled with the knowledge that I had a 50/50 chance of getting it right. I jammed those puppies in there while the world outside my eyeballs spun around. After some time, I realized that I had left my index finger suspended in the air with the pulse oximeter on it. One of those deep-seated memories, the ones that you wish you could get rid of because they always seem to displace more critical information, rose to the surface. Yes. I remembered that SpongeBob episode in which Patrick teaches SpongeBob that holding your pinky up is fancy, so, “the higher you hold it, the fancier you are.” I kind of wanted to laugh, but was afraid that if I started, I wouldn’t able to stop and I’d just spend the whole infusion cackling over fancy pinkies.

I’ve learned that if I don’t put my head back and try to relax my neck before the ketamine gets started, it takes a herculean effort to do so later on. I find this strange. Like I did when I left my finger pointed up, I can go long stretches of time without even noticing that I’m doing it. One would think that sitting in a reclined position with their neck bent to keep their head aloft would be really uncomfortable. But somehow, it’s just easier to forget about it than to try to move. It reminds me of that locking mechanism that birds do with their feet so that they don’t fall off of telephone wires while they sleep. I just get stuck in whatever position I’m in when the ketamine hits me.

I don’t remember much from this ketamine infusion, although I know that it was one of the most choppy, disconnected visual experiences I’ve had during a ketamine infusion. There was a man dressed in 19th century clothing – ruffled white collar peeking out from a buttoned up, navy tailcoat jacket, with a gold monocle arranged over his left eye. He was leaning over me, large grey beard waggling while he spoke, telling me something about achievement and perfection and getting started before it’s too late.

I don’t think that I’ve ever heard my ketamine dreams make any noise at all, except for one time when I heard some garbled gibberish in the center of my head after an infusion, when I was on my way home. Who knows what that was, though – the radio, people on a crosswalk, etc. But in any case, it was startling to realize that someone imaginary was speaking to me during an active ketamine infusion. I don’t remember exactly what he said, but the advice the man was giving me wasn’t encouraging. It was more like a stern lecture, siphoned from my own inner dialogue about failure, perfectionism, and growth. Quite strange.

Side note: I started writing this when I got home from my infusion. This morning, I opened up my laptop to see that I had written “before it’s two late.” I must have been more impaired than I thought. It’s not as bad as, say, waking up to find that I’d spent all my money on vintage beanie babies or clown figurines, but whoo, boy. What an egregious mistake for an editor to make.

The image of monocle man is what I remember with the most clarity, but I also remember a taxidermized rat with an oblong hole in its neck. A live white rat emerged from the hole, pulling itself free like some kind of disturbing mammalian version of a snake shedding its skin. Seriously creepy. Other than a lot of colorful TV static and a white sand beach, that’s all I remember.

I wish I had a better way to end this post, but that’s all I’ve got. Go look at something heartwarming to get that rat image out of your brain. Bye, for now!

Not Much to Report & Ketamine FAQs: The Ketamine Chronicles (Part 30)

January 26, 2021 Genevieve2 Comments

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.

Ketamine FAQs

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.

woman-with-raised-eyebrows-holding-palms-up-by-shoulders-with-bent-elbows-with-question-marks-in-each-hand — *I love strange stock images. Photo by: Tumisu on Pixabay*

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.

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Kaleidoscope: The Ketamine Chronicles (Part 29)

January 5, 2021May 5, 2022 Genevieve2 Comments

Right away, I could hear my heartbeat in my ears and head, and my face seemed to be pulsating with the rhythm. My ears became surprisingly hot, but all of that faded away after a few minutes. Usually, when I close my eyes, I see bizarre images, but they’re mostly distinct and recognizable. This time, there were points in this IV ketamine infusion when I felt like I was traveling through a three-dimensional kaleidoscope – just shapes and colors that morphed together as they moved.

A Small Hallucination?

The real world was also especially distorted this time, and once, when I opened my eyes, the wall across from me appeared to be covered in pale yellow cobwebs. There were two tiny silhouetted figures standing among the cobwebs, engaged in what looked like a silent argument. After a minute or so, one of the figures sprouted wings and fluttered away like a moth. I don’t think I’ve ever had my ketamine dreams intrude upon the real world when my eyes are open before. It was really trippy.

I don’t remember much of the internal experience of this ketamine infusion, but I know that there were a ton of lines – straight lines, wavy lines, crosshatched lines, diagonal lines, lines moving away from me, and lines coming closer. Sometimes, I was looking for something among the lines, but it was always hidden out of sight.

If you’ve ever seen those “deep dream” images created by Google’s neural net API, you know roughly what my experience was like this time. Here’s one I just made out of a picture of a sloth.

I had always assumed that trippy pictures like that were just weird approximations of what it would be like to be high. But no, it really looked a lot like that. Just take that image and imagine it moving, and that’s pretty much it.

There were rarely any distinguishable objects in my inner view this time, though. It was mostly just a sea of odd, moving blobs and spirals. When the lines and colors and moving kaleidoscope patterns got to be too much, I’d open my eyes briefly. I’m technically not supposed to do that, but it did serve as an effective break from my brain’s wild mishmash of subconscious vomit.

Physical Sensations of Ketamine Infusions

At some point, I switched my crossed ankles and was immediately struck by the sensation that my legs were melting. My bones seemed rather rubbery, and the weight of my feet extending past the footrest made me feel as though my shins were bending in the middle. I remember thinking that I felt just like a Salvador Dali clock, melting over the edge of the footrest. My whole body threatened to melt, at which point I’d slip off the chair into a puddle on the floor. It occurred to me that it would be difficult to get back to the car that way.

Visual Signals on IV Ketamine

During my moments of open-eyed room viewing, I noticed that the door looked unusually soft. It appeared to be made entirely of clay or putty. The color was the same, but it looked temptingly squishy, like if I went over there and pressed my hand on the edge, it would just mush in on itself. Perception is so interesting. Just 20 minutes earlier, I had interpreted the same visual signals in a completely different way.

Is Interpretation Important for Healing with Ketamine?

Ever since I wrote that post about water in my ketamine dreams, I haven’t had any further peaceful drowning experiences. Maybe it’s a coincidence, but I do think it’s interesting that after contemplating potential meanings of that recurring image, I no longer find myself experiencing it. What does still happen is the spreading darkness. This time, I was trying to look through a bright skylight while inky blackness approached from all around. It closed in until all that was left was a pinprick of light. Whenever that happens, my mind just switches gears and I begin a new dream-like vision.

My next ketamine treatment appointment is three weeks from now. I think I already feel lighter, although still a little spacey. My memory of yesterday is kind of foggy, and conversations I had feel choppy and surreal. I got home mid-afternoon and promptly fell asleep. At 11pm, I awoke suddenly, wondering where I was. I had fallen asleep on top of my blankets, oriented the wrong way with my feet on my pillow. I sometimes nap this way in order to differentiate naptime sleeping from nighttime sleeping, but it was still incredibly disorienting. I managed to do all the usual things I do before bed and then crawled under the covers the right way.

I hope this ketamine infusion works; I’m feeling discouraged about my depression again. I’m tired of being tired and unmotivated. The pandemic set me back a good deal, and I find myself forgetting that I had made some good progress last winter. It just feels like I’ve felt this way forever.

If you liked this post, consider starting from the beginning of The Ketamine Chronicles, or visit the archives for month-by-month posts.

Balloon Head: The Ketamine Chronicles (Part 28)

January 1, 2021November 18, 2021 Genevieve2 Comments

Before yesterday, it had been about three weeks since my last IV ketamine infusion for depression. Lately, I notice an improvement in my depression in the days following a ketamine treatment infusion, but it doesn’t last for as long as I’d like. Changing or adding a medication seems like a good option at this point. For a couple of weeks now, I’ve been battling my pharmacy and insurance for access to Wellbutrin. It’s been quite a hassle, but I hope it will be worth it.

For this infusion, I used a scopolamine patch and took cimetidine, both of which may help the effects of ketamine last longer. When we’ve done this combination in the past, I’m pretty well zonked for the rest of the day, and the experience of the infusion mostly disappears from my memory. Scopolamine makes me feel slightly off balance, and it gives me wicked dry mouth. Not just dry mouth, though – it’s also inside my nose and throat. Yuck.

What Does IV Ketamine Feel Like?

Often, the first sensation I notice during an IV ketamine treatment is warmth in my head and neck. This is quickly followed by a sense that my head is either expanding or shrinking. This time, it was shrinking. It felt a bit like the skin around my head stayed in place, but everything underneath it was crumpling into a little tin foil ball. At some point, the feeling reversed. The warmth radiating upward evoked a strange floaty sensation, and I remember thinking that my head felt like a hot air balloon, stretching out and lifting off.

The Visuals

Perhaps the dryness in my mouth and throat is what led to the first image I can remember: a drab, grey fish drying out on a sandbar. Somebody came by and tossed it back into the ocean, only for it to find itself surrounded by sharks.

The fish dream did not last long, and I soon moved on to other things. Once again, numbers dominated parts of my ketamine therapy experience. Spreadsheets, tickets, and measurements scattered throughout my brain. My mind seemed to be going a mile a minute, and interspersed with the numbers were seemingly random objects and animals that flashed into focus and then disappeared. It started to become overwhelming, so I opened my eyes a few times. After the speed and intensity of my split-second ketamine dreams, the room was suddenly, jarringly quiet and still.

Dissociation and Blurred Vision

Something I’ve noticed about IV ketamine is that when I open my eyes, everything is so blurry and unstructured that I can’t tell where the people around me are looking. It’s interesting to note how much it bothers me to not be able to read people’s expressions or body language. I don’t notice that being so crucial in my daily life because it just happens naturally for me. But when I suddenly can’t do it anymore, it’s almost like the people around me are aliens whose emotions and thoughts are completely inscrutable.

Sound and Distortion

At times, quiet conversations and activity in the hallway and other room seemed incredibly loud and close. I wondered if there were people standing right over me, but when I opened my eyes, the noise stopped and the same calm, serene room greeted me. When I looked up, the ceiling tiles resembled oil paintings of pastel landscapes. I closed my eyes and was met with more odd images, many of which I don’t remember. There were translucent shrimps on the sea floor, skeletons, and a curtain made of long, interwoven strips of orange, red, and pink fabric.

Absurdity in IV Ketamine Experiences

At one point, a sequence of images told a bizarre story. I had found two birds and put them in a cage until I could figure out what to do with them. But as I turned away, the larger of the two birds veeery slowly swallowed the smaller bird whole. WTF. I’m relieved that I managed to interpret my post-infusion notes, because what I wrote down in reference to that particular ketamine dream was “mbira dram” (bird dream). Even autocorrect couldn’t help me with that one.

Some Mildly Unpleasant Side Effects

I went to bed early last night but woke up around 11pm extremely confused about what day/time it was. I had completed my whole nighttime routine before going to bed, so I just decided to not worry about it and went back to sleep. I was awoken a couple more times in the night because of how dry my throat was. It felt so desiccated that just breathing irritated it. Definitely unpleasant, but bearable if it means the ketamine works better against my depression. I was developing a headache when I went to bed, and it’s still hanging on around my right eye and forehead, but in a mild way. I had a headache after the previous infusion as well, which I had assumed was PMS. Perhaps not, though.

To try to boost my mood, we’re going to do another ketamine infusion in a few days. In the meantime, I’m going to enjoy the fact that 2020 is officially over.

Happy New Year!