The days following my first IV ketamine treatment for depression were filled with anxious self-awareness (Am I feeling better yet? Is the ketamine working?) I’m pretty sure the answer to the first question was “no,” but it’s hard to say. Suffice it to say, nothing dramatic happened for me as a result of my first ketamine infusion.

In an attempt to not get my hopes up nor be overly pessimistic, I’ve decided that my approach will be one of detached curiosity. I’m going to see the entire thing- the feelings leading up to an IV ketamine treatment, the experience of the ketamine therapy itself, and the potential changes that result- as if I weren’t invested in the outcome. It’s just a fascinating experiment on my own brain. At least, that’s what I’m aiming for.

Adjusting My Ketamine Treatment for Depression

The first ketamine infusion was so bizarre that I was trying to prepare myself for anything. In fact, I was already faced with an opportunity to maintain detached curiosity. I had some adjustments planned for the second infusion, and I wondered what effect they would have on the overall experience. Instead of over-ear headphones, I brought regular earbuds in the hope that they would eliminate the overwhelming sound of my heartbeat that noise-canceling headphones created. I also decided that I would put my head back against the headrest at the beginning of the infusion so that future me wouldn’t have to consider whether giving my neck a rest was worth ripping the fabric of space-time.

As it turns out, the first ketamine treatment session is often the most strange. Subsequent infusions give people something of a tolerance to the trippy effects of the medicine. My doctor suggested that we reduce the dose a little and add a second nausea medication. So, the reduced dose, increased sleepiness from the nausea med, and improved tolerance to ketamine made my second ketamine treatment positively… relaxing. I might have even fallen asleep.

When I got there, things were a little busier than at my first appointment. I was introduced to the nurse, who is only in on certain days, and invited into the second room (across the hall from the one I was in last time, mysteriously labeled “Staff Pool and Spa”). The nurse got my IV in, set up the EKG leads, and took an initial blood pressure reading. I then had time to talk to my doctor about the plan of action. I had a tenacious migraine after the first infusion, which he said is rare, but happens sometimes. He suggested we try an anti-inflammatory medicine to prevent another headache, but I wanted to go without. I sometimes get tension headaches that morph into migraines when I’m extremely stressed and anxious, and that’s exactly what this one felt like. I felt much more comfortable with the process the second time around, so I was pretty confident that if stress is what caused my headache, I wouldn’t get one this time.

Getting More Comfortable with Ketamine Treatment for Depression

The nurse came back in and got things started, and I did my best to relax. I put my head back against the headrest, started some soft instrumental music in one earbud, and closed my eyes. The ketamine felt much more subtle this time, which I imagine is a result of both my body becoming accustomed to it as well as the reduced dose. It didn’t hit me as suddenly, but I found myself realizing that I had stopped paying attention to the room around me. I had a thought, and before I forgot, I turned to the nurse and said, “What is this room labeled?” She looked at me blankly, perhaps thinking that I was already too high to articulate logical thoughts. I quickly clarified, “Y’know, the other room is ‘Staff Pool and Spa.’ So what’s this room?” Understanding washed over her face, and she laughed and said she didn’t know. She got up to peek around the outside of the door and came back with the disappointing answer of “nothing.” We mused that this room should have a funny name, too. Someone floated an idea, but by that point, I was really sinking into a ketamine haze and don’t remember what it was.

The nurse sat next to me, taking notes, and the machine beeped softly just behind me. My mother sat in the corner, typing on her laptop. I gently floated in half-perceived consciousness. I waited for the images to begin, but all I saw were the backs of my eyelids. Black and pale yellow shapes inflated and pushed against one another; they were more distinct than what I normally see when I close my eyes, but it definitely felt like the same process of retinal neurons misfiring. I was a little on edge, waiting for weird images to creep in, but once I realized that wasn’t going to happen, I tried to just let go and float. I put the other earbud in (groping for my ear with numb fingers) and settled back.

Attempting Mindfulness During IV Ketamine Therapy

Large chunks of time were punctuated by movement in the room. I heard my mom close her laptop and take out her knitting. The metallic needles clinked together softly. The nurse put her hand on mine and told me to take a deep breath, in through my nose and out through my mouth. Apparently, I had forgotten to breathe and my blood oxygen level dropped. At some point, the doctor cracked the door open and I heard him whisper to the nurse that I should keep my eyes closed so as to minimize nausea. Later, the nurse and the doctor switched. I noticed the differences in how they walked, sat down, and how much noise they made while taking notes and shifting around. I kept my eyes closed the entire time. My usual discomfort in having my eyes closed around other people and activity was suppressed by the ketamine; I was paying attention when something happened, but I was content to only listen.

Having Patience with Ketamine for Depression

When the ketamine infusion was done, it seemed like it took less time for me to return to normal. The additional nausea medicine worked wonders, although I did feel more sedated. I’m happy to report that I did not get a headache following the infusion. However, I’m not happy to report that I’m not happy. Definitely still depressed. I’m trying really hard to not get discouraged, as I’m only 1/3 of the way through the initial series. I won’t lie, though, it’s tough to not be disappointed.

Reminder to myself: detached curiosity.

I learned a lot about what to expect from my first IV ketamine treatment for depression when my doctor asked if I had ever tried any hallucinogenic drugs. My response was “no,” and my experience was about as trippy as I could expect from that lead up.

My First Ketamine Treatment for Depression was Bizarre

I’m writing this from my bed at 8:20 pm, the evening after my first ketamine infusion. I do have work to be doing, and I tried that for a while, but I figured, “Hey, I spent 45 minutes today coming to terms with the fact that I was just a floating head who no longer had a body, then blessedly reunited with my limbs over the course of 20 nauseating minutes, only to come home and do work? I don’t think so.” So, in an effort to empty my brain, here are my first impressions, unexpected experiences, and mundane realizations of today.

The door to the room I was in was labeled “Staff Pool and Spa,” and I’m not at all sure what to make of that. My doctor seems to have a good sense of humor. I did wonder what the other room was labeled, but was too focused on not letting my baby giraffe legs buckle on the way out. I’ll report back.

If you missed Part 1 of The Ketamine Chronicles, I’m getting a series of six infusions of ketamine for treatment-resistant depression. I was afraid of this for a couple of reasons, one being the uncertainty of what the ketamine treatment itself would be like. I wish that I could give some kind of concrete answer to that question for anyone with the same anxiety. There are commonalities, I’m sure, but there’s no way anyone else could see the exact same quilted rocket launching into outer space that I did. Or, if for some reason you do, we should hang out sometime.

What Ketamine Treatment for Depression Feels Like

For me, the general feeling of an IV ketamine infusion is one of warmth, dissociation, and internal images. The first sensation I noticed was warmth, particularly in my arms and chest. It was quickly joined by the feeling that my limbs were all floating away from me. Looking around the room became extremely disorienting. It was like my brain could interpret whatever my eyes started on and where they stopped, but nothing in between.

Thinking and Speaking

For a while, I was pretty with it. My doctor asked me some questions to gauge how far gone I was, and I had no trouble answering them. I had to remember three words and repeat them back a few minutes later, and I had to count backwards from 100 by 7s (not very far). The comprehension and answering of these questions was no problem. What was weird was the sensation of talking itself. It was like there was no space between thinking and talking, so as soon as I had a thought that I had some intention to speak out loud, I heard it coming out of my mouth as if someone else had said it.

Losing Touch

After a while, I started to retreat from the room and into my mind. When I closed my eyes, I was unnerved by the sensation that my body and my head were very slowly spinning in opposite directions. So, I tried to keep my eyes open. Everything in the periphery of my vision faded out until I could only see what my eyes were focused on. But even then, my brain would pull me in, and although my eyes were open, I wasn’t seeing anything.

Perception of Sounds

I was listening to calm, instrumental music through over-ear headphones, but the music was dramatically overshadowed by the sound of my own heartbeat. This was somewhat distressing, so I took the headphones off. Without the headphones, the buzzing fluorescent lights held my attention. It began to sound like cicadas were all around us, and I was reminded of warm, spring evenings in Michigan. I closed my eyes.

Leaving My Body Behind

What I saw in my mind during the ketamine infusion is fading and jumbled, and I remember it in much the same way that I remember my dreams- just out of reach. I do know that the beginning was defined by knit and quilted geometric shapes moving and growing slowly. Dark purple colors against dark backgrounds, shapes like wheel cogs and tower spires. For some of it, I felt like my mind was falling (at this point I didn’t have a body), but not in a frightening way. Just a slow, gentle descent. Later on, I felt impossibly tall and constantly growing. I stretched through the atmosphere, into outer space. I soared past the moon and out beyond our solar system. I thought about telling someone but decided it might sound a little grandiose to describe my incredible, galactic height.

Time is Impossible to Follow

My sense of time was warping; when my doctor said it had been about 30 minutes, I felt like it had only been 10. After that, though, time seemed to move agonizingly slowly. When I heard “just a few more minutes” I was a little relieved, but soon began to wonder why my definition of “a few” and his definition seemed to be so wildly different. My mother was sitting across the room; why would they leave me here for another hour? Eventually, some beeping next to me indicated that things were ramping down. I slowly returned to my rapidly overheating body. I managed to say “very hot,” and the blanket was removed, along with my scarf. The room wobbled, my stomach turned, and I closed my eyes again.

The time it took to fully come out of the effects of the ketamine infusion was probably about 20 minutes, but again, I wasn’t the best timekeeper. Moving my head and eyes provoked the nausea, so I tried to stay completely stationary. We chatted about what it felt like, what kinds of things I saw, and what I thought about during the ketamine treatment. When I felt sturdy enough to bring my legs up to my chest, I put my head down on my knees and cried. I can’t say why – the anxiety beforehand, the nausea, the fear that it won’t work, maybe all of the above. It was an overwhelming experience, but I’m told that it gets easier.

Trusting the Process of IV Ketamine Therapy

I was hoping that I would sit down to write this and be able to say that I feel miraculously less depressed, but that isn’t the case. For some people, ketamine therapy for depression makes them feel better within hours of their first treatment. For others, it takes a few more infusions. And for still others, it doesn’t work at all. So, for now, all I can do is wait.

Until next time.