Mental & Emotional Health
I Tried Ketamine for Depression
I’ve been treated for major depressive disorder for my entire adult life.
I’ve been lucky enough to respond well to medication and, while the disease never went away entirely, I coped pretty well for nearly 20 years. But then researchers discovered that the drug I’d been taking had long term effects on the heart; my doctor did an EKG and I was looking at an increased risk of heart attack.
I tried other things, different medications, yoga, running, therapy—and sank deeper into not just depression, but a suicidal place I’d not crossed over into before.
My psychiatrist suggested looking into electro-convulsive therapy (ECT), which is far more precise and effective than the movie version, but still something I’ve always considered a last resort. I met with doctors about transcranial stimulation, a technique involving magnets—that isn’t covered by my insurance and costs $12,000 for the first month.
But these last few years, I’ve kept an eye on news of psychiatric research involving drugs like LSD, MDMA and ketamine for use in treating depression. Ketamine is medically used as an anesthesia, illegally as a hallucinogen (often known as Special K when used recreationally)—and there’s been a lot of buzz about its value in treating depression, though no one really knows how it works.
One of the few approved ketamine clinics is just three hours from my home, which feels like a sign.
Before anything can happen, I fill out an extensive medical evaluation—more questions than I’ve been asked anywhere before in my life. About my mental health, obviously, but physical health and family history as well. The clinic’s medical director calls me and we go through it all. I have a video session with a therapist as well.
I’m worried I won’t be sick enough to qualify for treatment. I’m desperate at this point; a week of treatment, four ketamine infusions, is $2,000. That should get me to a baseline where I would need to come in just once a month. This seems doable to me and honestly, I’m out of options.
The team explains how this works: the ketamine dosage is obviously much lower than what is used to put someone asleep for surgery. The drug is administered by an EMT, in a comfortable clinical setting—great recliners, good lighting. You have an IV. You are under the influence for about an hour, and the dosage can be slightly increased or decreased during that time.
I arrive for my first treatment in an office park; the clinic seems like a day spa when you walk inside. Everything is beyond tranquil. No sudden movements, everyone speaks in a whisper. There are even soothing water features.
I was worried I would be afraid. I have always been, quite literally, terrified of losing my mind. Of not knowing what was real and not. It was my primary anxiety about doing this and one I worried I was going to make happen by thinking about so much.
I brought my iPod and put on my favorite band. At some point, I asked the EMT to take it out of my ear. He’d said it would ground me, during the experience. I stopped wanting that. I wanted to let go. That’s the whole point of the ketamine: getting you out of your head seems to help.
I hear a man’s voice through the walls while I’m under-the-influence. I wonder if this is a hallucination, the voice of God, a result of my religion or my father Issues. I ask about it afterward. No, my EMT says. The guy next door was talking the whole time. Everyone reacts differently. This annoys me. With all the other features, it seems like the rooms ought to be soundproof. I should have asked if it was real while I was in, but forming words was virtually impossible.
There was kaleidescoping when I opened my eyes a few times. The perspective was very odd. I don’t know how else to describe it.
I was more at peace than perhaps I have ever been.
I do not believe it was less than an hour, and I can verify by my watch later that this is, in fact, true. It seemed cruel to bring me back.
The next 24 hours, to give your body a chance to adjust, you are not allowed another treatment. I was warned that the afterglow I felt was not a cure and would wear off. And I was prepared for that, I thought.
But the next night, shortly after the clinic called to check on me and schedule my next appointment (and one for each of the following three days), I crashed.
This was two years ago, but it is still hard to recount. I can only describe it as a breakdown. In retrospect, being alone in a hotel room was probably not a good idea. Whether it was a reaction to the ketamine, to my own anxiety about the treatment, my inherent depression, or any of a million other things—who knows. I remember very little of the next 24 hours except that it was all I could do to not kill myself.
I never made it to a second ketamine treatment.
I’d like to try again, as I suspect the drug wasn’t the real problem. For now, I’ve found a combination of medications that are keeping a handle on my demons. And I read every study or essay about new treatments for depression because we know so little about brains. Every step forward is important in finding a way to help at least one more person.
Editor’s note: Check with your physician before deciding to explore this method of treating depression.
Research continues into the drug ketamine as a treatment for depression. Recently, investigators from the University of Illinois at Chicago College of Medicine discovered more about the molecular mechanisms behind ketamine’s ability to squash depression. Their findings were reported in the journal Molecular Psychiatry. According to a news release from UIC, two thirds of patients who didn’t respond to traditional antidepressants had fast and lasting relief after being given ketamine intravenously. As this first-person account shows, though, the response to ketamine can vary.