A blurry woman holding a magnifying lens up to her eye so that her body is upside down and her eye is right side up.

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

August 22, 2020May 5, 2022 GenevieveLeave a comment

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.

An assortment of round analog clocks arranged on a wall — *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.

yellow-flowers-in-field-on-sunny-day-with-blue-sky

A Ghost Town: The Ketamine Chronicles (Part 22)

August 6, 2020May 5, 2022 Genevieve3 Comments

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.

Caribou-Colorado-silver-mining-town-in-1911-black-and-white

Caribou-Colorado-ghost-town-during-summer-of-early-21st-century

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.

Black, grey, and orange alphabet letters scattered around the word therapy

What is Ketamine-Assisted Psychotherapy for Depression?

July 30, 2020November 22, 2021 Genevieve1 Comment

Some people experience profound mental health breakthroughs with a treatment called ketamine-assisted psychotherapy (KAP). I’ve been treating my depression with IV ketamine infusions for a while, now, but never really considered ketamine-assisted psychotherapy an option for me. I’m comfortable with the arrangement of treatments I have now, and KAP has always intimidated me. I’m about to tackle that fear in my next IV ketamine treatment for depression. So what is ketamine-assisted psychotherapy? How does ketamine-assisted psychotherapy for depression work?

What is Ketamine-Assisted Psychotherapy for Depression?

KAP is a type of mental health treatment in which a person engages in talk therapy while having a ketamine infusion. Ketamine-assisted psychotherapy is effective partly because the dissociative state that ketamine puts you in can make you less inhibited. It lets you separate yourself from your emotions. A therapist can then help you through topics that might otherwise be too difficult to talk about.

My Treatment-Resistant Depression is Gaining Ground

I’m in a rut. Again. My previous ketamine infusion didn’t seem to have a large effect on my mood, so discussions began to circulate about how to adjust things. My doctor suggested a ketamine-assisted psychotherapy session and directed me to the release form that would allow him to talk to my therapist.

At this point, my alarm bells were going off, urging me to slow the KAP train down, but alas, here we are. My therapist had a conversation with my doctor, in which it sounds like they agreed that I am, indeed, in a rut. My therapist got some information about what ketamine-assisted psychotherapy for depression entails and then brought her thoughts to me at our regular session.

For context: One problem that I consistently run into during therapy is the brick wall between my mouth and certain emotional topics. Sometimes I can plow through it, but sometimes, I just shut down and the words don’t come out. There’s no fixing it until I go home and, often, write down what was happening on the other side of the brick wall.

A person wearing a mustard yellow sweater and bangles on one wrist is typing on a laptop while sitting at a wooden table — *Photo by Christin Hume on Unsplash*

The conclusion that everyone reached upon discussion of KAP was something like, “Well gee, KAP would probably improve that problem where Gen makes like a mollusk and clams up.” (It’s likely that that particular wording only happened in my own brain.)

Taking Charge of My Mental Health Treatment

Blue pen resting on an open notebook with lined paper on a wooden table — *Photo by Daniel Alvasd on Unsplash*

I’ve decided to give KAP a try. Despite constantly feeling like I don’t do enough, I do recognize that I work hard at improving my mental health. Beyond keeping up with the everyday tasks that seem to pile up to colossal proportions in my depressed mind, I also routinely push myself to leave my comfort zone. And yet, I continue to slog through quicksand. I sometimes feel like I “should” be able to heal myself with the tools I already have at my disposal, and if I can’t, it’s because I’m not working hard enough. This is garbage thinking. I’m allowed to add things to my treatment, and I’ll try something new if it seems like it could help me, even if it does sound scary.

Keeping an Open Mind

My therapist asked me, “What’s the worst that can happen,” when I expressed my reluctance to do KAP. We decided that the worst is probably that I could embarrass myself or cry a lot, both of which I have already done in front of my therapist. Still, I know how I feel during a ketamine infusion, and that knowledge makes the idea of having a therapy session at the same time feel uniquely invasive.

The sensation of talking while under the influence of IV ketamine treatment is something I’ve written about before because it is just so bizarre. I’m always struck by how quickly thoughts go from my mind to coming out of my mouth; there’s no time to deliberate on whether or not you’ll say it.

Again – thinking less is part of the goal for me in this ketamine-assisted psychotherapy experiment, but man, as a guarded person, the idea really provokes anxiety. Somehow, I’m also worried that I may not say anything. There is no way for me to enter into this with no worries other than to accept that there is no wrong way to do it.

Silhouette of a person walking into a lake at sunset with ripples on the water and a view of the horizon

Just Float Away: The Ketamine Chronicles (Part 20)

July 9, 2020November 20, 2021 Genevieve3 Comments

Erin, the PA, tells me I have gorgeous veins. It’s just one of my many redeeming qualities. Prone to perfectionism and crippling indecision? Yes. But hey – at least I have great veins! Starting the IV for my ketamine infusions, which treat my depression, is always an easy process, which is nice. This time, we once again did a pretty robust dose of ketamine with some propofol to make it less intense. Erin got me set up while we chatted, and then Dr. G popped into the doorway, explained just how many anti-nausea drugs I got (technically four(?), if I remember correctly), and then stopped. “What are we NOT going to do a lot of this time?” He asked.

“[brief silence] Looking around!”

I got a figurative gold star for my answer. I promised Dr. G I’d keep my eyes closed, popped in my earbuds, and settled in.

What Ketamine Infusions for Depression Feel Like

The familiar floating sensation reminded me strongly of water, as usual. Behind my eyelids, the blackness rippled and flowed, hinting at some unseen current. Soon, minuscule red specks glittered against the dark, moving with the gentle waves and forming dynamic shapes. It seemed as if there were something beyond the darkness that I could nearly see, like I needed to travel through the black, quiet water to reach something.

I began to imagine that I was lying on a beach, submerged in shallow water, looking up at the sky through the water that lapped at the shore. The sand beneath me was gritty, but the water was clear and the sky was blue. It was peaceful. Soon, though, the movement of the water reminded me of my recent road trip vertigo and the anxiety it created, and the peacefulness was ruined.

I wondered if it would even be possible to have a panic attack while mildly sedated, but decided that I should put effort into preventing one, regardless. After all, it would be rather counter-productive. Bobbing and rolling in the imaginary water did make me anxious, although part of it was at the thought that freaking out would be pretty embarrassing. In trying to resist the anxiety, I realized that I was only making myself more aware of the movement. I needed to not fight it – to just accept that I was not going to feel completely still.

Dark blue water with gentle ripples on the surface — *Photo by Lothar Boris Piltz on Unsplash*

Once I let myself float away, the infusion seemed to speed up, and large chunks of time just disappeared. I don’t remember anything except standing in a room in a family member’s house, recalling the details of my surroundings with what seemed to be incredible accuracy. I actually worried momentarily that I might be flouting Dr. Grindle’s orders by having my eyes open. He might confiscate my gold star!

Except, wait- my eyes were closed. And yet, the windows let bright sunlight in through the blinds. The ones on the right were broken three slats up. The wicker chair with the yellow cushions was angled just right in the corner. The dresser with a sand dollar and a starfish on top sat just how I remember it. That rug that years ago was closer to shag but is worn and aging now, laid on the floor. I took in the scene quietly. There was nothing happening; I was just absorbing the room’s contents.

Recovering from an IV Ketamine Infusion

It seems like the more I think about it now, the less I remember how I got home. The infusion finished and Erin took the I.V. out. Then, Dr. G handed a bottle of apple juice to Erin, who offered it to me. I reached out and took it with my wacky inflatable car dealership arms and then decided to wait for my facial features to materialize before trying to drink it. Somehow, I got my shoes on and made it to the car with my mom, who politely stopped after every three or four steps down the parking garage stairs and turned slightly to make sure I was still on my feet.

I may have fed the dog twice that night. My memory of post-infusion actions is incomplete, and I don’t doubt for a second that Stella would take advantage of that. Maybe that’s why she begs for food in the evening after I’ve already fed her– because sometimes it works! This is why it’s important to not make any important decisions following a ketamine infusion treatment for depression. You might end up with a new boat or no house or, you know, a spoiled dog.

A padded grey sleep mask with an elastic band arranged on white linens

Trying a Sleep Mask During IV Ketamine Therapy: The Ketamine Chronicles (Part 19)

June 17, 2020November 22, 2021 Genevieve2 Comments

While walking through the grocery store the other day, a cheap sleep mask caught my eye. My previous post about ketamine for treatment-resistant depression, in which I was utterly entranced by a framed picture of what looked like a standoff between a wolf and a mountain goat but was really just a river and some rocks, piqued my interest in sleep-mask wearing. I grabbed the mask on a whim, intending to give it another try at my next IV ketamine therapy session.

An Unsuccessful First Attempt

My first attempt to cover my eyes during a ketamine infusion for my depression was at my very first appointment. Not knowing what to expect and finding that I had never experienced anything like it, I was overwhelmed by the bizarre, dissociative sensations of ketamine. I remember the darkness behind the mask inducing a feeling of slow spinning, like turning a heavy stone on the end of a long, long string and then letting go. Soon, my head began to spin in one direction while my body spun in the other, and I took the mask off, preferring to keep my eyes open.

Adapting to Change is Tough with Sensory Processing Disorder

A light blue satin sleep mask with a black border and black strap lying flat on a light grey surface

I hadn’t worn a sleep mask during a ketamine infusion again until yesterday. I brought my newly purchased satin mask, seemingly made for someone with no nose, and slipped it on just as the ketamine infusion started. My immediate reaction was, “I don’t like this.” But, comorbid sensory processing disorder makes it hard for me to discern what exactly something feels like and if it’s to my liking or not. Therefore, my default is no new things ever. I decided to give the mask a few minutes, which I attempted to measure by the progression of songs on my playlist. By the time two or three songs had gone by, I had mostly forgotten about it.

Physical Distortions and IV Ketamine Therapy for Depression

At first, I was frustrated because nothing seemed to be coming to me. It was just dark. Gradually, subtle circles of purple and yellow faded in and out. I couldn’t tell if the ketamine was working yet or not, so I shifted my attention to my body and found that I was all stretched out. My feet were incredibly far away from my head, and the more I thought about it, the more I stretched. I got thinner and thinner, and I eventually was reminded of taking Flat Stanley home in elementary school. (Flat Stanley is a children’s book about a character who travels the world. As part of a literacy project, kids make paper Stanleys and keep a journal about his adventures, swap Stanleys with a partner via snail mail, then mail them back, often with photos of Stanley out and about.)

I felt like Flat Stanley – like I had been rolled out with a rolling pin and then peeled back up. Briefly, I considered the strange photos that would result if somebody took me on their family vacation, this flattened-out woman waving in a gust of air, Little Timmy reaching up to hold my paper-thin hand while everyone says “cheese.”

IV Ketamine Therapy Creates Indescribably Sharp Images

Sometimes, the things I see in my IV ketamine therapy infusions are bizarre or fantastic, and sometimes, they’re closer to real memories. After the Flat Stanley adventure, I enjoyed a slow-motion movie of my dog, Stella, running by me. We locked eyes as she rushed by, a moment captured in the dusty roll of fur on her shoulder and her tongue lolling out of the side of her open mouth. In slow motion, the prairie grasses waved lazily and Stella’s paws hung in midair, a snapshot of a great freedom gallop. I’ve seen such an image hundreds of times, yet my lucid memories never produce such a striking, detailed image as what I saw during my ketamine infusion.

A black dog with pointy ears sitting and panting outside

Memories and My Subconscious

My thoughts of Stella led me to a less pleasant memory. She killed a young rabbit the other day; I tried to stop her but was too slow. The weight of its still-warm body in my hands came back to me in my ketamine infusion. I looked at the delicate veins in its ears and a bit of fur stuck to one dark eye as I gently wrapped it in an old cotton t-shirt. Seeing it again during my ketamine infusion wasn’t disturbing, but it evoked some sadness and a sense of wastefulness.

I only vaguely remember other images from this ketamine infusion – mostly measurement things like ticking numbers on a digital counter and tape measures stretching out.

The Verdict on the Mask

Overall, wearing the sleep mask during depression treatment with ketamine made me much less concerned with time. I never have any idea how much time has passed, even when I try to keep track of how many songs have gone by. Usually, returning to the real world periodically reminds me that time exists, and I then wonder where I am in its course. But with the mask, I was just floating in darkness.

I still don’t love the feeling of having my eyes covered, but it wasn’t as bad as I thought it might be. Occasionally, I considered taking it off but decided that lifting my arms would be too much effort. I did eventually sense that a good deal of time had passed, and I lifted a corner of the mask to peek out. Erin told me I had ten minutes left, so I leaned my head back and forgot all about time, once again.

Having Hope with IV Ketamine Therapy for Depression

I have not been doing well, lately. I tried to go off of one of my medications (with the OK from my prescriber), and it backfired tremendously. I’m back on it and hoping that things will return to how they were before I decided to go messing with my meds. Hopefully, this ketamine infusion will help me get back on track.

silhouette of wolf standing on ridge with tall grass at sunset

The Wolf and the Goat: The Ketamine Chronicles (Part 18)

May 21, 2020November 17, 2021 GenevieveLeave a comment

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

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

The Wolf and the Mountain Goat

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

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

I can’t unsee it.

Ketamine Depression Treatment and Visions of Water

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

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

Drowning in Deep Water

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

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

The silhouette of a person falling through open ocean with light filtering down from above. — *Photo by Daoud Abismail on Unsplash*

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

Space and My Mental Map on Ketamine

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

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

Some Thoughts on Masks and Privacy During Treatment with Ketamine

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

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

A hand holding a stack of neatly folded, colorful face masks. — *Photo by Vera Davidova on Unsplash*

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

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

A stretch of straight open road with a body of water to the left and blue sky above

The Day 2 Mystery of Depression Treatment: The Ketamine Chronicles (Part 17)

May 10, 2020November 20, 2021 GenevieveLeave a comment

It’s been two days since my most recent ketamine infusion, which I have administered by my doctor to treat my depression. Usually, I write these posts in The Ketamine Chronicles as soon as I’m able so as to not forget too much of the bizarre experience. This time, I found that I didn’t have much to say immediately following my ketamine infusion.

Ketamine for Depression Has Not Been a Straight Line

For transparency’s sake in my attempt to document my experience with ketamine treatment for depression, I’ll just say it. My mental health has been in decline over the last few weeks, to the point of struggling once again with self-harm, something I thought I had kicked over a year ago. The previous ketamine infusion seemed not to do much for me in terms of mood, but gave me more energy and motivation, a mismatch that left me restless and confused. I felt the drive to do something but had no desire to follow through. Perhaps this is what led me back to self-harm. Multiple stressors, not exercising as frequently, and a strange mix of motivation and hopelessness led me back to an old, unhealthy coping mechanism.

A dense forest with thick fog and a path extending down the middle. — *Photo by Andrew Neel on Unsplash*

No Memory of Higher Ketamine Doses

I had my most recent ketamine infusion on Friday. Like last time, it was relatively empty of bizarre images, at least that I can remember. At this point, my dose is pretty much at the upper limit of ketamine for my body, so Dr. G has been giving me propofol to make the experience less trippy. In my last ketamine infusion, I stubbornly kept my eyes open for a lot of the infusion and seemed not to care about breathing. This time, I don’t think I could have opened my eyes if I’d tried. I remember chatting with Erin, the PA, while she got the I.V. set up. I know we talked about haircuts, but I’m not sure what else. The propofol hit me way before the ketamine did, and the last thing I remember is Dr. G taking an exaggerated deep breath and wagging his finger at me sternly before leaving me in Erin’s capable hands.

Breaking the Speed Limit

When I closed my eyes, the world disappeared above me as I sank down into peaceful nothingness. At some point, I remember feeling as though I were a passenger in a car on a highway, open road stretching ahead of me. We began to go a little too fast for my liking, but I was stuck– carried along by the seat beneath me. This is the only image I remember with clarity from this infusion. I also remember that, because I couldn’t feel my face, I was occasionally concerned that I may have taken my mask off. Laughable in hindsight that I thought I could have moved with enough coordination to do that.

Ketamine on the Second Day

Yesterday, the day after my ketamine infusion, I felt no different than I have for the past few weeks. Actually, I think I may have felt worse. But today, I awoke with a wonderful sense of relief from my symptoms. Whether this lasts remains to be seen, but it follows an interesting pattern. The day immediately following an infusion is often disappointing for me. I’ve learned to not put too much stock into whether or not a ketamine infusion has helped based on the day after. The second day, however, is usually when I notice the changes that ketamine creates. I don’t know how common this is, but I think it’s interesting.

I have already put on my exercise clothes, anticipating a long run later in the day. I’m looking forward to today’s project of re-painting the grape arbors. I have mental plans to clean the kitchen and change my sheets, and maybe even vacuum. It’s great to feel better, but the previous few weeks have me apprehensive about this infusion; will it last? Will I need to adjust my medication or have more ketamine infusions to stabilize my depression?

We shall see. But for now, it’s nice to feel a bit better.