Ketamine Treatment D2

A Surprisingly Powerful Session

Today is the second day of my ketamine treatment.

Yesterday was pretty emotionally up and down. Nothing dramatic, but noticeable.

I also had a really good session with my somatic therapist, and afterward I found myself thinking about something I’ve become increasingly aware of during this process:

There is clearly a battle going on inside me.

Intellectually, I can see there is stuff I need to deal with: things beyond chemistry that I should have some control over. Emotionally…totally unregulated and raw.

And the way my intellectual self talks to my other selves…

The Bully Inside My Head

There is a bully inside me that would never even think of saying to others what it says it me.

 I would never tell anyone else they are stupid, or deserving of malice, or inept and ineffectual.

Yet that seems to be a running internal monologue.

For instance.

MeanMe: You idiot. Why did you drop the kumquat?!

Me: God! You’re so stupid for calling yourself an idiot for dropping the kumquat. Everybody drops kumquats, you idiot.

MeanMe: You freaking moron! How stupid can you be for calling yourself stupid because you called yourself an idiot?! What an imbecile!

Me: Whoa there, meat-biscuit! I have a Masters’ degree! I’m not an total imbecile. I’m a hypocritical gollywomp!...Well, that was a stupid internal conversation with myself.

Stupid! Stupid! Stupid.

I don’t even like kumquats.

And this can go on for minutes.

I chuckle at the irony. Not in a funny-ha-ha way. More in a “Yup, you should be institutionalized” way.

I wonder if the ketamine will help with that.

Okay, so…

Wow!

Today’s ketamine session was very different.

I got the full dosage today and it was great.

At first, it felt fairly similar to my first ketamine treatment session. But when the third dose hit, things changed.

I think my chosen music really helped me fly into this particularly good space.

I had this holistic sense of well-being, a full body hug, a sense that everything was going to work out okay.

I remember smiling broadly thinking that I’m a good person.

Not just skin deep, either. There was a depth, a weight to the feeling; a deep core-touching relief to this feeling.

I actually felt great.

What Does Ketamine Do to the Brain?

During the session, I started imagining what might be happening inside my brain.

I imagined synapses forming new connections.

I imagined neurons slowing down, stopping, and redirecting themselves toward something healthier.

I imagined my brain being given an opportunity to move away from some of the old patterns that have been keeping me stuck.

To be clear, that's my visualization, not a literal description of what I know was happening inside my brain.

But the underlying idea isn't completely disconnected from the science.

According to the National Institutes of Health (NIH), Ketamine's antidepressant effects appear to involve the brain's glutamate system and downstream changes in neural signaling and plasticity.

Glutamate System?

Yeah, I had to look that up, too.

Those of you who know me know what a research freak I am.

Okay, as simply as possible:

The Glutamate System works the chemicals that turn the brain’s neurons on and off. It builds and strengthens the parts of the brain that deal with memory and skills. It helps the speed of neurons involved in thinking and mood. I think.

Glutamate has been referred to as “brain fertilizer.”

At least that’s what they think right now. Researchers are still investigating exactly how ketamine works to rapidly change depression symptoms.

And that's one of the things that makes ketamine treatment so fascinating to me.

I have lost count of how many different anti-depressants I have tried before finding one that at least took the edge off. And traditional antidepressants often take weeks to produce noticeable effects. Ketamine has been studied specifically because its antidepressant effects can occur much more rapidly. Especially if taken intravenously. (See my previous post.)

In the journal Psychological Medicine, a systematic review and meta-analysis of randomized controlled trials found evidence of rapid antidepressant effects from ketamine, including improvements within the first day of treatment.

More recent research continues to support that possibility. A 2024 randomized clinical trial involving people with treatment-resistant major depressive disorder found significant improvements in depressive symptoms beginning within hours of ketamine treatment.

And this is coming from NIH, JAMA, The American Journal of Managed Care, Psychiatry Advisor, and tons of Universities.

So, yes, there is legitimate scientific interest in ketamine as a rapid-acting treatment for depression, particularly for people with treatment-resistant depression, like me.

But that doesn't mean ketamine is a magic reset button, though I wish it was.

Taking the nasal spray version, my nurses have continually reminded me that, while the intravenous deployment works pretty quickly, the nasal spray really needs a good eight to twelve doses to show any lingering improvement.

The research also shows why this treatment needs to be approached carefully.

Dissociation, dizziness, blood-pressure changes, and other short-term effects can occur. That’s why a nurse keeps coming into my room to check my blood pressure and blood oxygen levels.

Honestly, it was little embarrassing today because—for reasons as yet unknown to me—I was compelled to perform Tai Chi while laying in back in the Barcalounger. The nurse came in while I was “Repulsing the Monkey” and had to put on the BP Cuff while my right arm was trying to “Grasp the Bird’s Tail.”

Ketamine, eh?

Anyway, questions still remain about optimal dosing schedules and long-term safety. Current clinical recommendations are pretty clear on the need for monitoring and individualized decisions about repeated or maintenance treatments.

That’s why it’s so important to find a reputable ketamine clinic.

It is important to restate that I'm using ketamine as a treatment rather than simply chasing an interesting psychedelic experience.

I'm more interested in what happens after the session.

What changes?

What sticks?

What can I learn from the experience?

And can I use that experience to change some of those deeply ingrained patterns of thinking?

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After the Ketamine Treatment

Right now, I'm tired.

And, oddly enough, I'm a little down.

That's interesting because during the ketamine treatment itself, I felt an enormous sense of peace and well-being.

Now the grayness is back, that Eisengrauwolf lurking in the corner.

But it feels different.

Somewhere underneath the swirling gray, I can still feel something.

Hope.

It's faint.

It's certainly not overwhelming.

It isn't some magical certainty that everything is going to be perfect.

It's just there.

And honestly, that's enough for today.

Maybe that's what I'm supposed to be learning from this process.

Not that ketamine will suddenly fix everything.

Not that one treatment will erase years of negative thinking.

Maybe the goal is simply to create enough space for something different to become possible.

Four days until my next ketamine treatment session.

I'm very interested to see how those four days pass.