My Psychedelic Trip Out of Depression
Approximately 70 percent of people who try ketamine for depression say they respond to it. I’m one of them.
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Ketamine, a psychedelic sometimes used as a recreational drug, is being explored as a treatment for depression.
Visual: Mendowong Photography / Getty Images
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Before I started ketamine infusions this spring, I was milling around my house, unhinged, ducking into my bedroom to weep behind the closed door whenever my three young children were occupied. I felt like an actor playing a wife and mother. I had been having trouble concentrating on anything for several months, including my work as a journalist. Unable to read a book or watch a crime thriller — diversions I usually love and use to unwind — and in a torturous limbo with no plan, I felt hopeless, full of self-loathing, even suicidal. The only thing keeping me from hurting myself was the thought of what that would do to my family.
Globally, nearly 800,000 people die by suicide each year, according to the World Health Organization, which also reports that more than 300 million people worldwide suffer from depression. Approximately 10 to 30 percent of those with major depressive disorder have treatment-resistant depression, typically defined as a failure to respond to at least two different treatments.
I have treatment-resistant depression, as well as generalized anxiety disorder. Throughout my life, I have been on a quest to conquer these formidable demons. I am 48 and have been in therapy off and on — mostly on — since the fourth grade. I have tried approximately 14 different antidepressants, but they either haven’t worked, or they’ve caused insufferable side effects. I have done a full course of transcranial magnetic stimulation, during which magnetic fields were applied to my scalp at specific points that affect depression and anxiety. And I recently tried Nardil, a first-generation antidepressant that requires a special diet. I was dizzy at times with blurred vision and felt overwhelming fatigue to the point where I feared I might fall asleep while driving.
My psychiatrist and I agreed that there were three options left: inpatient care, electroconvulsive therapy, or ketamine. I didn’t want to leave my children, and I was worried about the cognitive side effects of electroconvulsive therapy. But I was intrigued by ketamine, having just written a story about it for The Philadelphia Inquirer. Instead of waiting for the newly FDA-approved esketamine nasal spray, which insurance would theoretically cover when it became available in an unknown matter of weeks or months, I opted to do the infusions, which were available off-label, meaning that the drug is being used in a way that has not been approved through the FDA process.
Approximately 70 percent of people who try ketamine say they respond to it.
But despite this success rate and the fact that ketamine has been safely used as an anesthetic for more than 50 years, I was concerned about receiving frequent infusions because the long-term effects are relatively unknown. Further, ketamine is sometimes used as a recreational drug and the psychedelic possibilities of this treatment frightened me. Some initial reports also indicate that repeated infusions may be addictive. But I was so desperate to feel better and escape my suicidal ideation that I was willing to risk soaring on a psychedelic high and other possible side effects in order to more fully live the rest of my life.
I went to Actify Neurotherapies, a company with a clinic near my home just outside of Philadelphia. My parents, who were gravely concerned about me and had the means, agreed to pay the $485 per infusion (the cost varies by clinic location). After an hour-long consultation with a psychiatrist who determined I was a viable ketamine candidate, a nurse led me to a room with a recliner and hooked me up with my first dose.
As the drug began to seep into my bloodstream, I felt immobilized in the chair, afraid to move my arm and disturb the IV. I put a Pandora “Chill” station on my iPhone to listen to through headphones, not realizing that the somewhat psychedelic music might actually make me more nervous while on a psychedelic drug. Some of the songs were instrumental, and as the ketamine began to flow, I realized that hearing music with words was better. The lyrics helped me remain more grounded.
As the minutes passed, I was able to let go of my anxiety and flow with the experience. I felt like I was swimming through the warm molasses of time in an eerie distortion of reality. I was simultaneously light and heavy, floating but also weighted down into my chair. My lips and body tingled. Some moments, I felt like I was merging into the music, sort of inhabiting it.
Then, in a rapid quickening of time, the 40-minute infusion was over, and I was onto the 30-minute saline flush given to make sure I received the full dose of ketamine and to help return me to the real world. I was not at all groggy afterward and felt that I could do pretty much anything I would normally engage in, including going for a run, which I did with the psychiatrist’s approval. I crashed later in the day and then awoke to put the children to bed and even catch up on a bit of work. I felt lighter and brighter and cautiously optimistic.
This lightening of mood continued through the next several infusions, my depression lifting to a great extent. I started listening to the music of my childhood during the treatments, finding the lyrics to be intensely meaningful while the ketamine was flowing into my body. Elton John’s “Tiny Dancer” seemed to stretch on forever during my second infusion. During my sixth infusion, I felt an ephemeral opening up, as if my brain and heart were more available to the world and to relationships and work. I felt a sense of joy, something I had a very hard time experiencing in my daily life.
Each time, the ketamine momentarily carried me out of myself. I felt freer during the infusions and as if years of cobwebs were being swept from my mind. I had insights: I wanted to strengthen my marriage and try to be more loving toward my husband, for instance. There’s even research in mice that ketamine may spur the growth of new neural connections in the brain that have been diminished by chronic stress.
My positive experiences during ketamine infusions are not necessarily typical, however. Some people get nauseous or experience headaches. Though rare at the low doses used in depression treatment, others report descending into a “k-hole,” riding out a very bad trip.
Ketamine functions on NMDA receptors, components of the glutamate system in the brain, but scientists don’t know exactly how it works, why the effects vary between individuals, or why positive gains often fade with time. Research is ongoing; a recent study, for instance, showed that a new small-molecule drug administered to rats produced the rapid antidepressant effects of ketamine and esketamine with fewer known safety concerns.
In the meantime, ketamine infusions were available, and I chose them, despite feeling conflicted about being high during treatments. I worried that the experience was so pleasurable to me, that it meant I was developing a substance use disorder that would lead to drug-seeking behavior. My psychotherapist instead encouraged me to see it as relief-seeking behavior, since I had been miserable so much of my life. Plus, I was receiving the ketamine in a controlled environment. And I was getting better.
I had stopped crying. I was able to read a book that had been resting for months, unopened, on my bedside table. I watched “Delhi Crime” from end to end on Netflix. I was working harder than ever.
However, as the weeks passed, I was still not able to enjoy my family, my work, or my pastimes as much as I wanted to, and my anxiety remained high. I continue to battle that with visits to my psychiatrist and additional medications. I have even slipped back a bit, feeling more depression, under pressure from work and family issues. So far, the longest stretch I’ve gone between infusions is two weeks, and even that felt a bit uncomfortable.
Ketamine initially enabled me to recapture my life, but I am now reevaluating its benefits. I will try a few more infusions and then decide whether or not to continue.
If I have to give up ketamine, I will be crushed.
The psychiatrist at Actify Neurotherapies suggested that I might be a good candidate for esketamine, which calls for more frequent doses than the infusions. But esketamine is just now entering the market, and my clinic doesn’t anticipate having it until sometime in the fall.
Hopefully, with the help of my multiple doctors, I will find a way to make ketamine or esketamine work for me over the long run. In the meantime, I am waiting with millions of others who also suffer from treatment-resistant depression, wondering where to turn next.
Courtenay Harris Bond is a freelance reporter and writer whose work has appeared in The Philadelphia Inquirer, as well as on Philly.com, NewsWorks.org, and The Broad Street Review.
Tom Greene
Thanks for sharing your story. It will help thousands of people explore this important option.
Kay
Thanks for this piece. My history with depression and experience with failed drugs are so similar to yours as is the Ketamine experience almost down to your observations with music. Ketamine saved my life. My suicidality (think its a word) was ever present and growing after 2 year deep depression episode. It wasn’t a matter of if but when. Ketamine infusions wiped away a lifetime of a tangled emotions and impulses. The world was a new calm color and the relief experienced from an entire lifetime with depression being GONE brought me to tears of joy. Almost surreal. In fact if I didn’t have an awesome therapist I don’t know how I would have navigated the new me. The rx follow up for me was Ketamine nasal spray (altho the compounding pharmacy can make sublingual too) as needed. I am three months out of treatment and use Ketamine spray (note NOT esketamine) weekly. I went to an ER doc who does infusions as a side gig. The aftercare is 0. It has been up to me to figure out the spray. Right now I have leveled out- still amazed but can feel ‘the monster’ at my door but the it has no voice. Ketamine gave me the space to keep on a path the of behavioral changes i want to make and new ways of coping (which I never tried just relied on pills for years to mask the crisis) I could write so much more since the experience is so profound.
Just thank you for writing this.
Debra Campbell
I wish you well. Depression is such a hard battle, especially since it steals away so many of ones normal coping tools. I was especially interested in the finding that drugs such as ketamine may establish new neural pathways. I wonder if this could have treatment potential for Alzheimer’s? Do you know if this has been explored?
Thank you for your thoughtful, well-written article!
Pat Duran
I think anything that radically disrupts your normal perspective has the potential to relieve depression and even anxiety. Many hikers that spend time in the wilderness experience this, as do folks who go on long sailing trips. But unless you come back and make significant changes to your habits, of course the effect will wear off.
Lon Ball
In my student days in Boulder, CO un the 60’s LSD was available as the 1st recreational drug and widely experimented with even before it was stigmatized by Timothy Leary, Paul Lee and Richard Alpert of Harvard. Sandoz chemical engineer discovered it and was roundly embarrassed by its use for recreation. I was part of a unknowably large groups of students who tried it. One friend dosed for 2 months nearly everyday with no lasting side effects and no habit. My experience was very limited because I found that there was little to be learned by subsequent “trips”. I took my experiences as religious sacraments with no desire to repeat. But I do not have depression, at least not then, and have tried many different substances that are natural, not synthesized. As an organic farmer, I harbour a prejudice against synthetics and did at that time as I became an inveterate label reader at supermarkets. We are all simply anecdotes as individuals talking or writing about our experiences. We all have different reactions to the varous drugs as you can see by reading drug product side-effect labelling. At 73 years, I can tell you that I have no regrets and value my psychedelic experiences of 50 years ago.
Here are the conclusions of the 60s sub-culture; what was taken as axiomatic to get the most out of psychedelics.
1. Avoid synthetics and go for the naturals that have long history of ethnobotanical use.
2.Have a good relaxed and experienced, comfortable companion; “trip guide” to help you keep on track. Is your husband a candidate, or a sister to share your fascinations and sense of discovery?
3. Be a day tripper, daylight hours in a enjoyable natural envirnoment, Lake, mountains, good weather.
4. Be prepared to experience visual patterns and emotions of your earliest childhood. I never had, nor did my acquaitances ever ‘see’something that was not there, not what I would consider a halicintion in that sense, just intensified concentrations of emotions & vision. LSD can trigger some negative emotions that never happen with the naturals.
Naturals: Amanita muscaria mushroom called Soma by some cultures. (side effect vomit at beginning)
Psilocybin spp. avalable in Oregon Willamette Valley at beginning or Fall rainy season. Buy from a mycologist.
Mescaline
Peyote, cactus family, bad tasting and begins also with vomiting as sied effect. Like Ayuhuasca, peyote requires cultural guide, Native American Church
Qat from western Asia, Tajikistan, Kazakstan region. Very mild.
You are worried about experimentation? Anxieties can be set aside, perhaps once you realize that you have been doing dangerous experimentation with the many synthetics you have already tried. Think about how childbirth environments have changed since the 1050’s, for example. Did you recognize you broke some of the rules that I listed? I cannot imagine tripping in such a sterlie place as the one to which you have been subjected. My condolences are no comfort but when you expereince the naturals, you will be most gratified. Enjoy yourself, you deserve it.
5. Anticipate the best
Michael Bear
Psilocybin,, the active ingredient in psychedelic mushrooms is showing promise as a possible treatment for PTSD among returning veterans.
One unfortunate side-effect of the so-called ‘war on drugs’ is that it has made much harder for researchers to obtain these substances to do research with them. We need to at least make them available to scientists, if not the general public, to further evaluate possible benefits for treating mental health disorders.
Glen McFerren, M.D.
Thanks for sharing. I’ve been following the reports about ketamine for a while now (I’m a psychiatrist). I’m not optimistic about esketamine, and the costs are much more than your infusions with a much less robust response, as well as mandating use WITH an antidepressant. However…
Some really positive studies out of the UK on psilocybin (the ingredient in “magic mushrooms”) treatment for treatment resistant depression. Good response rate that seems to last months. With recent votes in Denver and Oakland, this may soon be fast-tracked for further study.
All the best to you.
Jesse M.
LSD has done the same for me as Ketamine has done for you. I teared up a lil reading how your mind started changing, Things made more sense, you felt happier, etc… LSD is the pretty much the main ingredient to Natural Mushrooms that grow in the ground & can make you high. This is another way to treat your depression, I have mine. It made me think differently forever, better. Now I’m concerned about others & not just myself first. Humbled. A reason to keep on living.
I have never tried real Ketamine, just internet copy-cats when I was younger. But those did change me also. But even though LSD has permanently changed my thinking for the better, I do feel it’s anti-depressant properties do wear off after not taking it for a while. So maybe all these fast acting anti-depressant drugs need to be taken more routinely. I don’t, but I wish there was a legal way that we could. For now I just rely on my THC/CBD. It’s not the best for my type of stress/depression, but it does get me through (It’s not part of the family of psychedelics). I have a medical cannabis card for multiple herniated/bulging discs in my neck, while taking those meds for pain/muscle spasms, I noticed the anti-depression plus that it gave me also. That is another way.
Also have you ever heard of Ayahuasca? I have never tried it, but supposedly it’s the ultimate psychedelic life changing drug out there! Only problem is it’s only legal in a certain country or something, & you have to do a ritualistic spiritistic ceremony. Too weird for me. I have experimented w/ other psychedelics, & I would say that there’s something in each that can cure anxiety/depression in ways we would never imagine!
If you can’t continue in the ketamine treatment, I heard they are also testing LSD as another future anti-depressant drug & are looking for people, only problem for me is I live in Hawaii. We’re always the last of the US States to get things. I hope the best for you in you look for the cure!
Pierre Ordinaire
LSD is a synthetic substance, the active components of magic mushrooms are psilocybin and psilocin.