#2! This one goes into Michael Pollan, the ketamine “trip,” and dissociation. Content warning: suicide ideation.
What was your specific ketamine treatment?
I did the ketamine IV treatment. I did a total of 8: the traditional 6 of 0.5 mg/kg, and then 2 boosters of 0.7 mg/kg. Each infusion is spread out over an hour.
What was your ketamine treatment intended to treat?
It was intended to treat major depression.
How did you first hear about ketamine?
I’ve struggled with depression for a long time, probably from my early 20s. I’ve tried therapy on and off over the years, and have tried more than a fair share of antidepressants, most of which have had pretty horrific side effects. You also have to keep chasing the right dosage. I’d pretty much given up an all of that.
I developed a meditation practice and the skills to manage it, so the last time I saw a therapist was ten years ago. I learned my own coping skills.
At that time in my life, though, I would have suicide ideation, not to the point that I would do anything about it, but my mind did keep going back to the idea of wanting to get out of the situation. I don’t think I was a severe case—I never would’ve actually done it—but I did tell my therapist that if I didn’t have responsibilities or a family, I’d feel like there was no reason to stick around.
I was always looking for potential treatment, though after the antidepressants, I had accepted that this was the fate that I might have to live for the rest of my life.
One day, I read Michael Pollan’s book, How to Change Your Mind, and thought, this is interesting. The book really opened my eyes to the potential of psychedelic substances as a game changer. I tried to look for people who would do guided LSD or mushroom trips, but it was hard to find. So I thought, ketamine also has psychedelic properties, and is legal! That led me to looking around, and I eventually found a clinic in Cambridge.
How would you describe the history of your mental health?
Depression has always been around. Summers tend to be good, but winters are pretty brutal. I’ve had two really deep major depressive modes that lasted for months at a time, affecting my social life and my relationships with people. It was really difficult. During those times, I got plenty of therapy to help.
Ketamine has been a life changer for me. I didn’t realize how sick I was until my first ketamine treatment, which made me realize that there really is another way to see the world. Even just the fact that ketamine is there and available to me provides a great deal of comfort; it feels like a magic button to push whenever I need it. Frankly, it’s the reason I agreed to do this interview—I want to do anything to help make it more available.
What other treatments did you try before (or after)?
With antidepressants, you’re supposed to take it consistently, and then you might feel better three months later, if at all. For me, there was an improvement in my mental health when I was on antidepressants, but nothing earth shaking. I had to stay on the medications for years. I tried Wellbutrin and Paxil.
For ketamine, the positive effects become apparent immediately.
How would you describe the actual experience of the infusion itself?
The first time I went in, I met with a doctor who talked me through it and made sure I was a good candidate. For the actual infusions, I would sit on a very comfortable chair; they would lean it back, put in the IV, and press start on the machine. They would give me special eyeshades, and I would put on a special playlist.
After my first time, I kept thinking that everybody should go through the experience. I was telling the staff that they were unqualified to administer it if they haven’t experienced it themselves. How I experienced consciousness changed so much, and I had no idea about that going into it, and it didn’t seem like the staff did either.
The first time wasn’t scary, but there were some disturbing aspects to it. I remember thinking, I think I’m this guy named [redacted] sitting in this chair, and I have this life, but I’m not even completely sure about that. I completely lost touch of who I was. It was so jarring because I didn’t expect to feel that way going in, but now I always look forward to it.
It’s impossible to describe what the experience is like. But it’s not something people should be afraid of, and it’s definitely worth at least trying. I was skeptical of the treatment first, but after watching passionate interviews on YouTube of people who have been helped by this treatment, I thought, there’s no way those people are faking it. I can’t believe ketamine is not first line medicine.
Why has ketamine been so beneficial for you personally? What aspects of ketamine do you personally derive the most benefit? How has the mind-altering aspect of ketamine, a dissociative, has been significant to your experience, if at all?
When I first read about this and did a lot of research into how it all worked, the “trip” itself was always portrayed as the side effect rather than the component that was giving the benefits. But I’m pretty sure the “trip” is the main part of it.
For me, a trip is the notion of being able to see reality from a different POV. An hour on ketamine is like ten years in therapy. You’re going through waves of perception, flowing through them at 90 miles per hour. So much happens, and it feels like a very intense therapy session times a million.
I don’t want to scare people off with that description, because it’s a good thing. But from what other people have written about the treatment, I never expected to have the experience I had. I definitely “k-holed.”
I wish people had told me to expect an experience like that, because I was not expecting it at all. Afterwards, I even asked the nurse if anyone else goes through the same dissociation, and the nurse said that some people don’t really feel that aspect of it at all. Some people must just react differently from others.