Max M.
The appeal of the treatment for me was…
The appeal of the treatment for me was initially the chemistry of the drug itself. It seems to work without the reliance on continued treatment by promoting neurogenesis and glutamate triggered strengthening of synapses in the PFC and hippocampus, which for me, may allow distance from causes of anxiety. Additionally, the idea that it wasn’t an SSRI and could break through treatment resistant depression was also appealing for me. In short, I was intrigued by it, and felt that in a comfortable environment (the right set, setting, and preparation), the risk of a bad experience or other adverse effects would be minimal. The medication itself was taken in lozenge form at home with a clinician monitoring online and a peer treatment monitor in the room. I was given a good amount of preparation of what to expect and told to let go and be open. I was also coached through intention setting. After absorbing the drug through the mucous membranes, the excess was spit out. For the next hour, I had on headphones and a sleep mask for a more sensory-deprivation like experience. The medications effects peaked at about 20 minutes and subsided by around 50 minutes. The experience itself was a little hard to describe. It was similar to lucid dreaming in that sensory feelings in the body were lowered while the mind’s eye and sound were amplified. Visualizations came and went, and we’re both cosmic and personal. I had a good amount of control over whether to explore what I was experiencing further or find something else to experience. And as an experience, it did not initially seem that my intention was related to the effects of the drug. However, after journaling about the experience and debriefing, it was clear that I was able to get “distance from my demons.” I could see myself like I do others, and therefore didn’t have such high or unrealistic expectations for my behavior. Rather than worrying about being perfect and avoiding things that countered this ideal, I began to accept myself more fully and not only the parts I liked. I know a CBT technique of referring to oneself in the second or third person is helpful when facing negative emotions or experiences, and ketamine seemed to do the same thing. Since then, I’ve been less self conscious and more able to take risks. I’ve been more compassionate and forgiving and have found more direction in life. All of these have taken work, but ketamine seemed to be a catalyst for change. Almost like it coalesces fixed action patterns into a glass sphere that you can observe and interact with and compartmentalize. Maybe a better way of saying it is that the experience of ketamine makes it easier to recognize thoughts and behaviors that are protective, but may be limiting, and can help identify sources of those thoughts and behaviors. So rather than thinking my social anxiety is my fault, I can see why I am acting avoidant and remind myself that the situation I’m in now is different than the ones where I need the protection of isolation. To wit, it lowered the activation energy it took to take on novel projects or experience things I’d previously be too anxious to undertake. It’s also led me to pursue more therapy, as previously it had been hard to admit I needed it. In all, it’s not a miracle drug or a wonder cure, but can offer breathing room around trauma, anxiety, or depression.



