Things That Don’t Suck

The last two days have been washed in heavy winds. The leaves, just turned golden-yellow, are being stripped off of their branches to accumulate near the front door, where they’re much less pretty. It’s a small thing to be disappointed about, but it seems as though so many things in the world suck right now. For one thing, our Home Depot skeleton, David S. Pumpkins, is constantly buffeted by wind on the seat from which he offers a cheery wave. Every morning, I find him slumped over as if we force him to sleep outside on the park bench, when really, he just doesn’t have the muscle tone to stay upright. What must the neighbors think? He likes it out there, I promise.

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Up and at ’em, Dave!

You know what else sucks? Depression. I recently had my regular mental health bloodwork done to make sure my lithium level is within the appropriate range, as well as to measure my thyroid function. All is well. Lithium can cause hypothyroidism, which can cause fatigue. We thought it would be worth investigating as a potential cause of my excessive sleeping, but no – that’s just depression. Don’t get me wrong, I’m glad I don’t have to make adjustments or take new steps to deal with a whole new problem, but reducing my lithium dose or adding a thyroid med sounded like a simpler answer. Instead, the answer is just to carry on treading water in the sea of treatment-resistant depression. Just keep swimming, right?

So, let’s make some teeny tiny inflatable water wings to keep us afloat. Here’s what hasn’t sucked lately.

  • My houseplants are doing great. Man, they look healthy.
  • I learned how to use my new, short ChuckIt to throw a tennis ball like I’m skipping rocks rather than overhead. (My rodent-obsessed dog prefers to chase things that go along the ground.)
  • I unearthed two whole sets of flannel sheets that I forgot I had.
  • I swapped out the hummingbird feeder for the regular bird feeder, and it’s becoming quite popular.
  • The coyotes woke me up with their howling the other night. I always find it eerily mesmerizing. 7/10 spooky.
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Hi, little chickadee.

What hasn’t sucked for you, lately?

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Ink Blots and No Propofol : The Ketamine Chronicles (Part 24)

Yesterday, I had another IV ketamine treatment for my treatment-resistant depression. We tried getting rid of the propofol for this infusion, which sounded interesting because it had the potential to help me remember more about the experience as well as make the after effects easier. I can’t say that I remember everything, but the infusion feels more real in my memory than it has in recent weeks.

Is It Working Yet?

Despite having done this numerous times, it’s still hard for me to discern when the ketamine takes effect. I kept checking in with myself, thinking, “Is it working yet? Are those blob shapes my usual closed-eye blobs, or something different?” But eventually, it became suddenly obvious that it was working. I started to feel like my nose had melted, leaving just the bare nasal bones exposed. This somehow reminded me of a seal closing its nostrils before diving underwater. I wondered if what I was feeling was close to what it feels like to be a seal. In hindsight, this makes no sense. Just having no nose is nothing at all like being a seal, but it seemed logical in the moment.

Colors, Ink Blots, and Numbers

The beginning of the ketamine infusion is the part that I remember the most completely. At first, the darkness behind my eyelids felt very normal and familiar. But soon, pale colors moved gently against the black, like lava lamp goop merging and bubbling off.

The colors eventually faded and were replaced by intricate black and white designs that reminded me of kaleidoscopes. They were incredibly detailed, and I don’t think I could ever recreate it. As they morphed, their intricacy faded and I was reminded of Rorschach ink blot tests. Somewhere in my brain, it occurred to me that that association was especially funny, given the context. What does it mean if you see shapes within shapes that you created yourself?

Black and white ink blot swirl.
Photo by Hulki Okan Tabak on Unsplash

At some point, there were pages and pages of numbers that didn’t mean anything to me. They were mostly organized into columns and lists, and I tried to focus on interpreting them, but was unsuccessful. This is something that seems to happen repeatedly when I have an IV ketamine treatment for depression – I see overwhelming quantities of numbers or letters that I can never quite decipher.

That’s about the extent of what I remember. The rest of the ketamine infusion seemed to consist of fairly mundane experiences and scenes, although they escape my memory.

What IV Ketamine Therapy for Depression Feels Like

I’m glad that we tried it without propofol. I was a little worried that it would be too intense, but it turned out just fine. As usual, I felt far removed from the room around me. My body was in the chair but my mind was somewhere else. It’s sort of like there’s a tiny me inside my own brain, viewing images that create a highly convincing sensation of having my eyes open. To then test it by opening my real eyes is a bizarre feeling.

The rest of my day was dramatically different compared to days when we’d used propofol in conjunction with ketamine. With propofol, I often sleep for the rest of the day, broken with occasional small tasks like walking the dog or doing some laundry. I must metabolize it slowly, because when I wake up the next day, I have a lot of trouble piecing together the order of events or even what I did at all. It becomes clear that I was lot less sharp than I thought I was.

Without propofol, the disorientation and grogginess wear off more quickly. I’ll sleep for several hours, but then can function fairly well, if a little physically unbalanced. I vastly prefer to be as alert as possible. The sensation of not actually having made decisions with my full wits about me is unsettling.

I’m hoping that my old pattern of improvement two days after a ketamine infusion is consistent. The short series of treatments we did recently helped combat my depression symptoms, but there’s definitely room for improvement.

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.

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It’s Been a Whole Month: Birthday, Anxiety, and Ketamine

I can’t believe it’s been a month since I last posted here. I have some in-progress posts that are languishing in my drafts folder, but none of them feel complete enough to be posted. So, to try to break through the stall in my writing, this is a rambling update that will have to be good enough for me.

Look at me, fighting perfectionism one disjointed blog post at a time.

Ketamine

I haven’t written about my most recent ketamine infusions because the propofol makes it harder to find anything about them to share. I think that going into it with the expectation that I won’t remember much makes it harder to grasp whatever snippets do remain. Having the intention to write about an infusion helps me pay attention to my experience; without it, the whole appointment just disappears from my memory in the hours following an infusion.

When I began my treatment with ketamine infusions, I was fascinated by the endless imagery that each infusion created. Every appointment held new associations and interesting scenes. But lately, they all feel the same. Of course, this is okay. The dose of ketamine that I receive would probably be too intense without the propofol, and I suppose I’d rather not remember much than have a terrifying trip. Still, there was something helpful about having something of the experience to hold onto.

I have the sense that I’m more able to remember things when I’m more present in the real world – like how you remember your dreams when you awaken in the middle of them. I wonder if the degree to which you’re aware of your surroundings during a ketamine infusion impacts its efficacy, if at all. Because if it’s not at all, I’d totally ask my doctor to poke me every 15 minutes and ask me what I’m thinking about so that he can write down whatever absurd, hilarious things I say. Although, my level of zonk is usually such that I probably wouldn’t answer.

Birthday

My birthday happened this month, and it caused a lot of anxiety about the future. It’s frustrating to be hindered by my own brain. I commonly hold myself to unrealistic expectations and judge myself harshly for not meeting them. I wanted a different path than the one I’m on now, and I’m having a hard time letting go of that vision. Not that I can’t eventually end up in the same place, but I didn’t see it progressing along such a challenging path. But that’s life, right? I’ve been trying to re-frame my birthday as just another marker of survival. If I can’t get myself to be pleased with my progress in the last year, I can at least be neutral.

Anxiety

Anxiety and depression often go together, and I’ve noticed a pattern in my mental health where I alternate between the two. As I start to come out of depression, the anxiety kicks in and I feel horrified by all of the time I “wasted”. I think about how far behind my expectations I am, and then I get a frantic sense of urgency to kick it into high gear. Unfortunately, I’m also easily overwhelmed and the prospect of “catching up” to my expectations triggers an avalanche of worries and insecurities. Ultimately, whether it’s depression or anxiety that is most immediately at hand, the result is still a barrier to my forward movement.

This flexible connection between depression and anxiety is not black and white. I wouldn’t say that I move completely out of depression and into anxiety – the Venn diagram has more overlap than that. My position within it just shifts into the middle so that I’m simultaneously slow, tired, and occasionally hopeless while also filling up with anxiety saturated with heavy judgement. Fun times.

At least the anxiety pushes me to do more than I otherwise would. I would rather be motivated by the reward of doing the thing rather than the fear of not doing the thing, but I also prefer being motivated at all over not at all (if that makes sense). I’ve been trying to run again, and have been somewhat successful in the last couple of weeks. The wildfire smoke in Colorado has intermittently lifted and returned, so I don’t always get clear air, but I figure the benefit to my mental health probably outweighs the damage.

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This is kind of a rambling post, but again, I can’t seem to write anything in this context that seems worthy of posting. So, this will have to do. In other news, this is not my kitten, but look at how cute she is.

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Ketamine-Assisted Psychotherapy 2: The Ketamine Chronicles (Part 23)

Compared to my first ketamine-assisted psychotherapy session, the second one was wildly more entertaining for me, but much less productive in terms of the number of words coming out of my mouth. KAP stands for ketamine-assisted psychotherapy. The idea is to utilize ketamine’s ability to lower your mental barriers in order to more comfortably talk about difficult topics with your therapist. I know that I was very nervous for my first session and likely fought the ketamine in an effort to stay in control, but I didn’t expect my slightly more relaxed approach this time to produce such a dramatic difference.

A Delicate Balance Between IV Ketamine and Therapy

I think I remember that there was a slight dose change from last time to this time, but I don’t think it was enough to really impact my experience. But, in a bewildering turn of events, being more relaxed actually led to me saying less. Rather than unleashing a flood of thoughts and feelings, I found myself being washed away by images and colors. My ability to imagine images certainly made my conversation with my therapist more bizarre, and most of the time, quite disjointed.

We started out by talking about bridges. I had tried to create a metaphorical bridge that crossed into my protected mental fortress during a previous ketamine treatment infusion, but I got stuck with a drawbridge that lifted every time somebody tried to cross.

This time, I saw a fraying rope bridge with missing wooden slats. It stretched across a dark chasm with no visible bottom. It was a long bridge with not enough tension, making it sag in the middle. Despite its frayed appearance, the connections to the edge of the cliff on either side were sturdy. It would be a harrowing journey to the other side, but you could do it.

Thinking about this as a lucid person, it strikes me that the metaphor breaks down at some point. Clearly, I have a well-protected area of mental privacy. I don’t open up easily, and I don’t tend to rely on many people. But to picture a dry, brittle rope bridge stretching across a dark chasm implies that it would be frightening to attempt to cross it. It’s scary for me to allow people to cross the bridge, but I certainly hope the crossing isn’t scary for them. Perhaps the drawbridge was a better metaphor for me. In any case, I only come up with bridges that are difficult to cross.

Distractions During Ketamine-Assisted Psychotherapy

I found it extremely hard to stay focused on the topic at hand during this infusion, sometimes pausing and saying things like, “The blood pressure cuff makes me think of fish being squished.” (The cuff periodically tightened, which distracted me and produced a feeling of what I imagined felt like raw fish being rolled and squelched under pressure.) If an answer to a question didn’t immediately pop into my mind, I found myself floating away from it – the room and the people within receding into the distance.

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Photo by Jon Tyson on Unsplash

At times, I remembered that I was supposed to be answering something, but wasn’t at all sure of how much time had gone by since my therapist asked the question. Is she still waiting for me to answer? Are we still on that topic or did we move on already? I don’t think I remember the question. It was chronologically confusing – seconds slipped by without my notice like water flowing over stones, and yet the small movements of my therapist and doctor in the room were auditory markers of real time. How much time passed between my last thought and this one? It’s too hard to think in words. Better to just float. I don’t usually try to hold onto the real world during ketamine infusions, and it proved to take a lot of effort.

Articulating Thoughts and Images

I also don’t usually talk during my regular ketamine treatments for depression, so it was interesting to discover just how hard it is to describe the images I see. I can write about them in detail after the fact, but in the moment, they just escape description. Take, for instance, when I said I was seeing “a bunch of…cleaning things.”

What I actually was seeing was more like a set of rectangular brushes that fit together into a grid. They were a very light pastel range of purples and blues. Why was I thinking about puzzle-piece bristle brushes during my IV ketamine treatment? I have absolutely no clue. Part of what made it hard to describe was that the image was so enthralling that pulling myself out of it to come up with words was difficult. But part of it was that I knew that what I was saying came across as completely bizarre. Trying to describe why such a mundane-sounding image was so pretty just kind of stumped me.

The random and nonsensical images that I was trying to describe reminded me of “Drinking Out Of Cups,” a video from the mid ’00s of Youtube (contains profanity). I tried my hardest to explain it, but seeing as it’s a video about nonsensical things, I had a hard time putting it into words while lost in my own nonsensical world. I think I slipped into fits of giggles halfway through and had to finish up with, “I dunno, I’m not doing it justice, but it’s really funny.” Also, “outta” is a really hard word to say when you’re on a mixture of ketamine and propofol. Just in case you wondered.

A Featherless Parrot

At some point, vials of colorful sand spilled into a desert, creating clouds of blowing particles with swirls of color. I was seeing it from above, and the drifts and valleys the wind created were captivating. It was a beautiful but rather lonely landscape. A parrot with no feathers appeared in the foreground, and when I mentioned this, my therapist questioned me for clarification. “Yeah, like a…a plucked chicken,” I answered.

“Aw, poor guy,” she said.

To which I then said, “No, h-he seems ok, though.” Well. That’s a relief.

blue and yellow parrot
Photo by @davidclode on Unsplash

Staying on Topic in Ketamine-Assisted Psychotherapy

I wonder if, despite being more relaxed this time, I had a harder time engaging with therapy because I don’t know how to filter my mental experience. Last time, I may have been so nervous that I just locked everything down indiscriminately and tried to function as “normally” as possible. I was more open to KAP this time, which left me free to be distracted by anything and everything that entered my thoughts. It seemed to take enormous effort to hold on to the real world while holding the door open for therapy. I’m imagining a large wooden door to Ketamine Land, and within the door to Ketamine Land, a smaller door labeled “therapy.” I think I accidentally opened the big door to Ketamine Land and was bowled over by the peculiar sights within. I should have only opened the door-within-the-door and accessed the loosey-goosey-ness of Ketamine Land in a smaller, more manageable way. I’m not sure how to do that, but perhaps it takes practice.

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.

Moose Revelations & the Magic of Yes Day

In an effort to help me become more easy and breezy, Fridays have been dubbed “Yes Day” by my therapist. I’m supposed to not hesitate when I’m faced with a decision on Fridays – just say yes. I mentioned this in a recent post, in which a therapy session combined with ketamine saw the creation of No Nap Day, which was slipped past my steel sieve mind on Friday under the guise of a Yes Day opportunity. Just kidding- I knew exactly what I was agreeing to.

I had good reason to say “yes” to No Nap Day. My Yes Day adventures have already resulted in positive experiences, so it only follows that I should keep it up. I’m not generally a spontaneous person. I rarely do anything on a whim, and sudden changes to my plans make me anxious. Sensory processing disorder makes me strongly prefer routine over spontaneity. I know that I like all of the sensory aspects of my familiar routine; anything new is overwhelming and could be very unpleasant.

Then again – it could be wonderful, and by saying “no” to new things, I run the risk of missing out on some great stuff. Take last month, for example. I go hiking with my mom every week. We usually pack lunch, make frequent stops to look at wildflowers, and generally have a wholesome nature experience. I usually enjoy these outings a great deal, but on this particular day, I was tired. The fresh air and pre-hike coffee did not perk me up, and I trudged up the mountain with heavy boots.

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We reached the first of two lakes about 2 miles up the trail, and as we rested on a flat boulder, we discussed our options for the rest of the day. My mom wanted to continue on to the second lake and the glacier, but I was reluctant. Heading back to the car and going home sounded pretty good to me, but it was Yes Day, after all. So, I said “yes” to continuing on. Stella led the way up the trail, and although I was still tired, we got into our usual pace before long.

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Stella was awed by snow in July, we humans were awed by the views and the beautiful waterfall, and I managed to be distracted from my fatigue enough to enjoy myself. We almost made it to the glacier, but our second wind was fading in earnest, so we took in the view and then headed back down the trail.

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Going downhill is easier than uphill in some ways and much harder in others. Upon reaching the parking lot, we hurried to the car and got the AC going. Stella had her head out the window as we turned onto the road, and we all enjoyed the bliss of sitting down.

Almost immediately, we came upon a car stopped in the middle of the lane. We waited for a few seconds, and then my mom said “Maybe there’s a moose!” I admit – I scoffed.

“They’re probably looking at Google Maps, trying to figure out if they’re going the right way.” I said. We chuckled a bit as we crawled forward, until the driver of the stopped car waved us around them. As we passed, I looked to the right and blurted “There IS a moose!”

“What?! Really? Should I…”

“Yes, back up!” I urged her. We rolled backwards until we could see it. An enormous moose (all moose are enormous, I suppose) was standing calmly by the road. He was munching on the thick vegetation around him, ears flicking lazily at the gnats.

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His antlers were velvety and magnificent. They’re such strange-looking adornments – one might even say goofy – and yet they’re so sturdy and solid. They make an effective reminder that moose are very, very, very strong animals. This one was content to carry on chewing, paying no mind to the gawking humans. I think that’s part of what makes them so interesting to watch; they’re completely unbothered by activity around them. They’re not as skittish as white-tailed deer, not as pugnacious as, say, a brown bear. They just sort of…stand around. Not to say that they won’t charge and cause you serious bodily harm, but this one’s general demeanor was one of complete and utter boredom. He was so unimpressed with us that it was almost like he was thinking “Yeah, yeah, snap some pictures. Now go home, kids. I have important vegetarian work to do, here.”

My mom and I rode that excitement all the way down the canyon. Along the way, it occurred to me that I had Yes Day to thank for it. After all, we would not have seen the moose if we had turned around when I first wanted to. Instead, I said “yes” to the rest of the hike, putting us in exactly the right place and time to witness that moose’s dangly neck thing (I now know it’s called a dewlap) waggle above the leaves. Moose are so silly, and yet so distinguished. Truly a creature of contradictions.

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A Ghost Town: The Ketamine Chronicles (Part 22)

I woke up a couple of hours after going to bed following my most recent IV ketamine treatment for depression. It was around 1 o’clock when I began my slumber, so when Stella woke me up, looking like she needed something, I automatically fed her dinner because it felt like I had been asleep for a long time. Then I wandered into the living room, where it dawned on me that bright sunlight was streaming in through the windows.

What day is it? Is it still daytime?

Temporary Disorientation After IV Ketamine Treatment for Depression

Perhaps I entered a different dimension where time passes more slowly. Or maybe I’m taller than the moon and my head is therefore circling the sun at a different rate. I went back to sleep, but apparently woke up periodically to accomplish my nightly routine. Wednesday’s cubby in my pill organizer is empty, and I vaguely remember flossing my teeth. Half of what I wrote here was already done, which surprised me when I opened my laptop this morning to write. My phone informs me that today is Thursday, although it feels like several days have passed since yesterday’s ketamine infusion treatment.

An IV Ketamine Therapy Reset

I usually go about three weeks between appointments, but my depression has made a comeback. Similar to how I first began getting ketamine infusions, we decided to do a short series of infusions in quick succession to try to reset things and boost my mood. In addition to the short series, we’re also trying another medicine that can enhance the effects of ketamine therapy.

Scopolamine is an anti-nausea drug that comes in the form of a patch that you place behind your ear. I can tell that it did something; the infusion itself felt more enveloping than usual, and for hours afterward, I had this weird sense that I could feel my blood traveling through my blood vessels. It almost felt like being squeezed – like the boundaries of my body were working harder to keep everything contained within my skin.

I talked to Dr. Grindle (whose name frequently autocorrects to Dr. Griddle, which I think is hilarious) about our plan of action at the beginning of the appointment. My previous infusion was my first experience with ketamine-assisted psychotherapy (KAP). The goal of it was to help me bypass the frustrating barriers to talking that I run into in therapy by having a ketamine infusion and a therapy session at the same time. It was a fascinating experience, but also a little overwhelming, so I decided to just do a normal ketamine infusion yesterday. I’ll revisit KAP another time.

Building a Metaphorical Mental Health Bridge

I don’t remember much from this infusion. The addition of all these other anti-nausea and sedating medications makes it hard to remember what I thought about and saw during the infusion. They also make me crash when I get home, which lets whatever memories I do have fade away before I have a chance to write them down. One part that I can vaguely recall came from a suggestion made by my therapist. After our KAP session last week, we marveled at how much I resisted talking about particular topics, even while zonked out on ketamine. This week, she suggested that I imagine building a bridge across the moat that protects my mental fortress. I have yet to figure out why some parts of my everyday life show up in my IV ketamine treatments and some don’t. The image of a bridge over a moat certainly stuck, although probably not in the way that my therapist hoped it would.

Mixing Memory and Imagination

Thinking about castles and fortresses created an odd merging of memories and imagination in my mind. At first, I found myself thinking about the ruins of castles on the Danube River in Germany and in the rolling hills in Wales. I imagined the people who lived in those castles milling about and going about their daily lives. Then, I seemed to combine that train of thought with memories I have of going to Caribou, an old silver-mining ghost town from the 1870s. It’s situated not far from where I grew up.

We used to go up there and explore the crumbling stone structures and look for currants and wild raspberry bushes. In my distorted ketamine haze, I saw people working in the half-built structures. All of the trappings of normal life were there; a large pot in the fireplace, a sturdy wooden table on the dirt floor, women in long, pioneer dresses and aprons bustling around in the four walls under the open sky.

Mental Barriers

At some point, the ruins were surrounded by a moat, and a figure stood on the opposite side. Remembering that I was trying to let the person cross the moat, I conjured up a drawbridge. Interestingly, simply creating the bridge was not enough. I couldn’t seem to keep the drawbridge down; it kept raising over the water, leaving the moat impassable again. It was somewhat frustrating – like those dreams where everything keeps going wrong, no matter how much you try to find a way around it. I suppose next time, I should build any bridge but a drawbridge.

A Middle Ground with Major Depression

I feel a little bit better. When I’m awake, I feel more motivated to get things done, and my immediate reaction to being faced with an opportunity or an obligation is not automatically, “Ugh. No.” This is one of the more frustrating phases of depression for me. I feel capable of doing things, I sometimes even want to do things, but I’m so unbelievably tired that I waste hour after hour asleep. I’m starting to wonder if that’s a normal depression symptom plus side effects of the medicines I take, or something else entirely. All I know is that it makes me feel enormously lazy when I wake up at 5:30am and am struggling to keep my eyes open only three hours later. It hasn’t always been that way; when I was first diagnosed with major depressive disorder, I didn’t feel the need to take a nap until mid-afternoon, and I could limit it to something more reasonable. I’m not sure what happened besides a worsening of my illness and the meds I take, or if those factors explain it all. Something to ponder.

An unidentifiable woman wearing a jean jacket sitting with her hands clasped in her lap and her legs crossed while talking to a therapist in the foreground.

My First Ketamine-Assisted Psychotherapy Session: The Ketamine Chronicles (Part 21)

Ketamine-Assisted Psychotherapy was completely new to me. I’ve had numerous IV ketamine treatments for depression and I’ve been in therapy for years, but I’ve never merged the two in the same setting. The first goal was to find a dose of ketamine that caused me to dissociate enough to let my defenses down, but not so much that I was incapable of answering coherently. I was nervous beforehand; the unknowns of it were stressful. Once we got started, though, that anxiety faded.

What it’s Like to Do Ketamine-Assisted Psychotherapy for Depression

My doctor asked me to tell him when I started to feel the effects of the ketamine, and when I didn’t, he asked me again a few minutes later. “It’s hard to tell with my eyes closed,” I said, “but yes, I think so.”

“Why is it harder to tell with your eyes closed?” My therapist asked. I paused to think.

“I guess because I don’t have any reference points. When my eyes are open, I can see that things are getting fuzzy or moving slightly, but with my eyes closed, all of that is gone.”

This is where my memory of the infusion gets a little foggy. I remember talking about particular topics, and I remember it being easier to answer quickly. In my normal therapy sessions, I take time to think about my answers, which leaves lots of space between our talking points. During ketamine-assisted psychotherapy, I found myself answering with less deliberation.

The majority of what we talked about flowed fairly well, but then we’d hit a tricky topic and my defenses went up. I’d stop talking, trying to decide if I should speak or not, and if my therapist pushed a little, I’d open my eyes. Opening my eyes seemed to be an indicator of my resistance to an especially uncomfortable topic. I must have been trying to exert some control over the situation, although I wasn’t fully aware of what made me open my eyes.

Anxiety about Ketamine-Assisted Psychotherapy

I had been worried that ketamine would make me incapable of holding back or deciding what I would or wouldn’t speak on. It turns out that the brick wall of lucidity also exists under the influence of ketamine. The presence of that brick wall usually makes me anxious; I worry about it. Why can’t I just talk about this stuff? There’s nothing behind it that’s secret or an enormous revelation. I feel like I’m wasting everyone’s time by being so silent, but I just can’t seem to break through it. Ketamine made me too relaxed to care much about what my therapist and my doctor thought of my silences.

Setting Goals with KAP for Depression

For a few weeks now, Friday has been “Yes Day.” On Yes Day, I make a deliberate effort to say “yes” to opportunities that come my way. It’s a step towards becoming more spontaneous and a way for me to push myself to get out of the house. This ketamine appointment was, of course, on Friday. At some point during the infusion, my therapist mused that we could have No Nap Day in an attempt to combat my excessive sleeping. When asked if I was on board with Mondays being No Nap Day, I jokingly accused my therapist of exploiting Yes Day in order to create No Nap Day. In the end, I said “ok,” which I think counts as “yes.”

How IV Ketamine Treatment Feels During KAP

Unlike my usual trippy IV ketamine treatment experience, I didn’t “see” anything this time. I think focusing on the conversation kept me from getting sucked into any kind of creative extensions of whatever random thoughts usually pass through my mind. All I saw was the darkness behind my eyelids, although it did seem somehow more dark than what I see when I simply close my eyes. It was deeper than that, as if I were farther away from access to my eyelids. I felt as if I had to swim upwards to reach them.

With my eyes closed, I sort of forgot that there was a person attached to the voice I was hearing. Not entirely – I knew somewhere that I was talking to my therapist, but it was easier to just focus on the disembodied voice without any of my usual curiosities. In our normal sessions, I often wonder what she’s thinking about my answers, but during KAP, all I could think about was responding to the question immediately at hand. It was an interesting change.

Doing Ketamine-Assisted Psychotherapy with a Trusted Therapist

Being able to remember only parts of the infusion is odd. The gaps in my memory that I notice after an infusion usually feel like how dreams disappear when you wake up. I’m often left with the impression that I’m forgetting something rather inconsequential. This time, however, the knowledge that we were talking about real things has left me feeling slightly raw. I feel sort of scrubbed at in a nonspecific way, and it’s mildly uncomfortable. I imagine this would be more intense if I didn’t already know my therapist well.

I also feel like this ketamine infusion consisted of a lot of work. Usually, they’re relaxing and somewhat meditative; I just float along and let whatever comes into my mind pass by. This time, the effort of speaking and of thinking in sentences made it feel a lot less restful, but a lot more purposeful.

If you’re thinking about ketamine-assisted psychotherapy, remember that this post is only my experience, and only of my very first one. Apparently, I’m tenacious in my resistance to open up; it may be easier for you to let your defenses down. While parts of it were uncomfortable, it was never scary.

I now have to think about how I want to proceed. Choices, choices!