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A Gold Monocle: The Ketamine Chronicles (Part 31)

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)

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.

Photo by: Leni und Tom on Pixabay

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.

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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)

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.

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The Subtleties of Water: The Ketamine Chronicles (Part 27)

I’m always looking up at the sky when the water closes over me. This time, it was cold, and an eggshell-thin layer of ice formed above me while I watched. Gentle waves followed one another, freezing over the previous layer and leaving a frosty texture on the surface. Darkness spread from the periphery of my vision until I strained to see through the last window of light, the only notable image being the shadow of a person standing above me on the ice.

I didn’t put a lot of effort into remembering this IV ketamine infusion. I know there were graceful, disembodied hands dancing amid blue and red lines, swirls, and dots. There was more water – ripples and waves, mostly. There was a pyramid with a circle above it, which turned into a blinding white light. I’m certain that there was a lot more, but it’s faded away from me by now.

Treatment-Resistant Depression

My mental health is declining. I’m not sure why. IV ketamine treatment doesn’t seem to be working as well for me, now. Every day, I have to rate my mood on a ten-point scale. It’s hard to capture how I feel in numbers. Potatoes are easier, but still not quite enough. Honestly, sometimes words themselves seem too limited. How can I describe how I feel?

This morning, I woke up at 4. I got dressed in the cold – same clothes as yesterday – and went to the kitchen for some food. I walked the dog when the sun came up, but we came home quickly because of the sharp, cold air. My eyes feel heavy. Not the lids – the actual eyeballs; they sit heavy in their sockets, like wet marbles or enormous caviar. I wonder, if I tip my head forward, will they fall out? When my depression is worsening, I often notice this feeling in my face. Everything is heavy and hard to move, and I’m sure my expression is grim. I think the clinical term is RDF – resting depression face. At least my pandemic mask covers most of it.

Maybe the person above me on the ice in my ketamine dream is me. I’m on thin ice. Skating across a just-frozen lake in my wool socks at 4am. Someone else is waiting beneath the surface, straining to see through the darkness. Is she also me?

__________

Why Do I See Water in My Ketamine Treatments?

My recent IV ketamine infusions have all featured water, and I’m often drowning in it. It’s not scary – it’s peaceful. It’s soothing. I’ve never stayed up by the surface before; always finding myself sinking into the dark, quiet depths. But this time, I was floating – pressed against the underside of the ice, trying to see through it to the person on the other side. I was curious about this person, but the darkness closed in before I could begin to unravel what was happening, and then I found myself in a different scene, which I do not remember.

I’m fascinated by this recurring theme of water, especially because in my regular life, I’m not a big fan of it.

An Early Trauma

I have sensory processing disorder, and as a young child, I flat-out refused to swim. I was overwhelmed to the point of tears by the splashing, the echoes in the pool, the temperature change from air to water, and most of all, the fear of people touching me. I eventually came around to the idea, but never enough to take lessons. So, having never properly learned how to swim, I nearly drowned at a friend’s birthday party when I was 8.

I remember being uncomfortable going into the deep end, but my friend was insistent. I lost my grip on the side of the pool and began to sink. When people say that drowning is not a dramatic event – there’s no splashing or screaming – they’re right. My head tilted back instinctively as I went under, and I could see my hand, extended above me, slip under as well while the rest of my limbs flailed uselessly underwater. A panicked hopelessness overtook me as I choked on chlorinated pool water. Then, my friend’s hand broke the surface, reached down, and grabbed my wrist.

I have never felt relaxed on or in water, and it’s not just the near-drowning that explains it. The same sensitivities that kept me from participating in swimming lessons have persisted into my adulthood. I dislike the unsteadiness of water, the unpredictability of how it will splash, the feeling of water on my face.

And yet, when I’m reclined in my doctor’s office, ketamine moving into my bloodstream, visions of water are soothing. I can feel the cool, constant pressure of being underwater without the anxiety or the sensory overload. I can feel myself standing on the deck of a boat, watching the foamy water beneath me leap forward and recede, and I feel peaceful. I’ve seen whirlpools, rivers, melting glaciers, and the unbelievable enormity of oceans. It’s a strange experience to suddenly realize what water might be like for other people, as those feelings are foreign to me in my waking life.

Open ocean near the surface with light filtering down from above.
Photo by Cristian Palmer on Unsplash

I feel as though, unhampered by the symptoms of my sensory processing disorder, I can connect to a larger, evolutionary interest in water that I am unable to find under normal circumstances. Humans have been fascinated with water for millennia. In fact, some evolutionary anthropologists believe that nearness to water supported the development of large brains – that we are, in part, the heritage of small, coastal communities of early humans whose lives revolved around the movement of water and the food within it. To this day, many island and coastal cultures retain great reverence for the ocean. When we gaze out upon a watery horizon, it is difficult to not be awed by the vastness before us. In my eye, to find our place in relation to bodies of water is akin to our struggle to find our place in the vastness of space. Questions of identity and survival are found in the depths, and I believe we carry the answers within ourselves.

Lessons from IV Ketamine Treatment for Depression

My depression is a constant in my life. It is all-encompassing, lonely, and feels like drowning. I’m not one to find meaning in every dream, but the images of water that I experience during IV ketamine treatments have begun to feel profound. What does it mean? Certainly not that I should give in, wave a white flag and let the water crush me. Nor should I wait breathlessly under the ice, squinting as if to look through a frosted pane of glass, uncertain if I’m even above or below. Rather, I believe my visions of water are windows into the nature of the human experience. Perhaps they’re snapshots of how I feel – how depression feels to me. My mind is an ocean, and at times, it’s oppressive. I sink within myself, finding it easier to let the water cradle me as I descend than to keep swimming. At other times, I find comfort in accepting the changing nature of my illness. Like a river flowing downhill, impermanence is unstoppable, and the emotions of being a human move inexorably back and forth. When we crest the top of a wave and begin to fall down the other side, we wait for the next one, just as we take each arriving day. And when you are drowning, reach up. A helping hand may be just about to break the surface.

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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The Taste of Music: The Ketamine Chronicles (Part 26)

The last couple of weeks have been hard for me when it comes to depression. I recently wrote about how IV ketamine can make me feel like I’ve been launched out of a metaphorical cannon. The last time, it was like a little pbthpbpthh – an underwhelming puff that was more like being propelled by air coming out of an untied balloon than like being launched out of a cannon. I don’t remember much at all of the previous ketamine infusion, so I didn’t push myself to write about it. I thought it would likely be boring, anyway.

The Ups and Downs of Ketamine and Depression

I can’t say for sure why that IV ketamine treatment was less effective than others. It could be hormones. It could be the changing seasons. It could be that I haven’t been exercising much. Maybe it’s all three. Whatever the reason(s), I’ve been front seat on the struggle bus – sleeping in my clothes multiple nights in a row and then wearing them the next day, getting my work done late or barely on time, napping by mid-morning. I find myself paring down my daily activities. Prioritizing one thing means getting rid of another thing, as the energy needed to do both is more than I have. In some ways, I’ve been getting along ok – my mood has been dipping here and there. But overall, that hasn’t been terrible. The hardest part is honestly the lack of energy.

Dissociation with IV Ketamine for Depression

So, I’m hoping that this week’s ketamine infusion can knock me back into better functioning. One change this time around is that I decided to stop using scopolamine for my infusions. I used it the last time and it resulted in a very…buried experience. I’m not sure how else to describe it. It was sort of smothering – as though I had sunk far, far below the surface of the Earth, and there was nothing I could do to get back to the room.

Every once in a while, from leagues above me, I’d hear someone tell me to take a deep breath – the pulse oximeter on my finger had alerted them to the fact that I had stopped breathing. And I found that often, I just did not care. I felt like my body was just a suit I was wearing, and maintaining it was proving to be a lot of work. I could feel that my heart rate was slowing and my lungs were waiting for me to inhale, but it didn’t feel like it was innately me, and so I was content to just watch it happen. In fact, when I was told to breathe in, my recollection is that I felt a little annoyed at having to exert the effort. A couple of times, I tried to ignore it, but the voice was persistent, so I relented.

My experience with scopolamine is not entirely strange, I don’t think. Apparently, it can add to the dissociation that ketamine produces, which explains my sense that my body was not really a part of me. My description of that infusion is a little unsettling in hindsight, but in the moment, I don’t remember being afraid or anxious at all. Actually, the whole infusion was very relaxing, minus the slight annoyance of having to breathe. You know, those fragile humans, needing oxygen. Geez.

Acceptance and Flow in Depression Treatment with Ketamine

The most notable aspect of this infusion in my memory is that at some point, my music stopped. I’ve never had an infusion in which there was no music, so when I noticed its absence, I was mildly worried about what it would be like without it. Not worried enough to move or to say something, of course. That would be too much work. So I just waited, accepting that it wasn’t what I had planned for, but that was okay.

Noise in the IV Ketamine Clinic

The sounds of the room, which are often prominent at the beginning of my infusions but fade away as time goes on, were extremely loud. I was most aware of the infusion pump next to me, which emitted constant mechanical noise. My mother was typing in the corner, and every once in a while, I noticed the sounds of papers shuffling or a door closing. I remember thinking that I felt like a pillar in a sandstorm, tiny particles being whipped into motion around me. The sand was the noise, and as it bounced off me and flew around the room, it started to sound a little like music. Rhythmic whirring from the machine combined with staccato typing somehow resulted in organic, landscape-based images in my mind. There were lots of shades of brown, but that’s pretty much all I can remember.

Brief Synesthesia?

Another first for me this time was that I seem to have experienced synesthesia. To some degree, I think I always come close to it during ketamine infusions – the way I associate music with colors and images is not something I’m able to do when lucid. This time, though, I could taste sound. I can’t quite conjure it up enough in my memory to understand what it was like, but I do remember it dawning on me that tasting sounds is not something people usually do.

When the noise in the room morphed into strange music, I became distinctly aware of the inside of my mouth. My tongue felt oddly small in the cavernous space behind my teeth, and the general feeling was of something… earthy. There is absolutely no way I can accurately compare the experience to anything, especially because I don’t remember it clearly enough. As I wrote in my hasty, post-infusion notes, “I can taste music. Indescribable.”

Images from My Subconscious

The rest of the ketamine infusion is jumbled in my memory, but I’m pretty sure the other images I can remember were from the beginning, when the music was still playing. I remember watching dogs eating something, and then their faces stretched and stretched until they turned into alligators. Eventually, an alligator head kept on stretching until it turned into the tendons of a human hand, which stretched until they were the layers of a landscape. Somehow, my brain went from dogs to alligators to tendons to landscape. I could explain the associations from my recent thoughts and experiences, but it would be convoluted. Suffice it to say, all of the elements of that bizarre sequence somehow make sense to me. Brains are fascinating.

Seeing Improvement in Depression Symptoms

Given my general lack of response to the previous IV ketamine treatment, we tried adding magnesium to this most recent one. It’s been two days now since my infusion, and I am definitely feeling a bit better. I woke up this morning, put on clean clothes, washed my face, and did three laps at the dog park instead of one. Improvement is improvement, no matter how small!

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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Working on Depression

Sometimes I feel like a bird that can’t figure out how to fly. I periodically get launched out of a cannon (in this metaphor, that’s due to IV ketamine treatment for depression), then flap and flap to no effect. I’m trying to make progress, but gravity is always there. Eventually, I sink lower and lower, just exhausting myself with all that flapping.

That’s how it feels, but I don’t think that’s entirely accurate. Yeah, ketamine wears off eventually, and yeah, my brain has a biochemical problem that means I can’t fix depression just by flapping. But the flapping is doing something. All that work I put into therapy and maintaining a routine and getting exercise must be functioning in tandem with the IV ketamine to push my little bird wings just a smidge farther.

I know this because my mood still dips pretty low sometimes, but on the whole, I’m in a better place than I was a few months ago. Perhaps it’s that I bounce back faster, now. Or maybe it’s just knowing that it won’t last forever.

And now, being able to look back and see that I’m flippity flapping on my own a little makes it just a little bit easier to continue. Chipping away at something day by day is tedious and frustrating, but all of that work adds up. If you can look back at where you were a little while ago, it helps to notice that in working on depression, you have made progress, even if it’s just in the personal growth or a skill you’ve learned or the support you’ve gotten.

Keep flapping, everybody.

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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.

landscape-photo-of-tall-grasses-near-road-going-towards-mountains-shrouded-in-wildfire-smoke

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.