One thing I've noticed is no desire to use/do ketamine in between therapy sessions. Mindbloom asks along the way if you have such yearnings, and at the beginning they surveyed me about my experience with alcohol and opioid dependency. I've had both, obviously. Alcohol in my younger years, but reliant on opioids for several sober years to deal with pain from car accidents.
For some people, ketamine may be seductive, I'm guessing, whether physically or psychologically. As for functionality, however, there's no way in hell you can take the dosage of ketamine that was prescribed to me and then walk around your life. It's a one-and-done thing⏤lying down, preferably. And really, the whole darn trip is over in about 15 to 30 minutes. The rest is just deep reflection and what-the-fuck-just-happened-ness.
Oh, and neuroplasticity⏤what happens to your brain in the ensuing moments, hours, days, weeks as neurons start firing in new directions.
I've read there are other ketamine clinicians or programs approaching it differently; for example, lower doses given more frequently. If I had to compare without having tried it that way, I think I prefer having deep experiences as I have done. These experiences have been sufficiently "disruptive"⏤to my experience of what is, to my belief in how things are or who I am or what I am like. Even disruptive, albeit temporarily, to my notion of pain. Experiencing my Self as pure vibratory hum indistinct from the bed and the world, even pain became⏤as I've heard it termed elsewhere⏤"irrelevant."
Let's talk about our feelings
Then there's all the stuff I've been feeling in between sessions. More emotion, whether from the profundity of the experience of/after ketamine or from no longer have three different types of antidepresssants in my body on a daily basis, all trying to keep my proverbial shit together while simultaneously wreaking unknown havoc.
I am moved to tears more easily (if this were possible, given I'm sometimes known to be a weepy mess anyway). Going through Christmas cards this past holiday season, I held each one in my hand and every photo and message provoked some thought or memory or happy feeling and I found myself crying tears of sheer joy at sharing in other people's lives. (That's the ketamine talking, people, no kidding, and without antidepressants to stifle or neutralize the effects of life coming at me.)
Oh God, and then when I was packing for Costa Rica, "Samba Pa Ti" (Santana) came on. That song just about sends me over the edge any old time, but this time it had me reflecting on leaving for CR, leaving my family behind for two weeks while also reuniting with old friends once I got there, then remembering another old friend who loved this song who’s now gone. My Big Big Bursting Heart!
A final nod to antidepressants
I believe strongly in the power of antidepressants. I don't doubt they saved my life and my sanity and alleviated my experience of pain during a very difficult time (Jesus, a very difficult five years, frankly.)
"What if to love and be loved's not enough?
What if I fall and can't bear to get up?" - "Stay Gold," First Aid Kit
So I'm not here to bash drugs prescribed by doctors and developed by pharma. Nothing is black and white. And what's for one is not always for all. Sometimes you need to get fixed, and fast. There may be a million and one holistic ways to sort yourself out but if you've gone batshit crazy and you're about to kill somebody or kill yourself or just disappear into a dark hole and not come out, you might wanna take whatever the hell pills they're gonna give you.
But if I hadn't decided to explore psychedelic medicine, I might not have had the gumption to venture off of antidepressants (although in my case, I kind of wandered aimlessly away from them, unintentionally). The promise of psychedelic medicine made me confident enough to let go of the daily pharmaceutical regimen and apparently, it's working.
The beach beckons. I will walk until I am satisfied in the walking.
Surprise ending (and new beginnings): What happened during my final ketamine session
My friend Cory who is something of an expert in psilocybin ("magic mushrooms") for depression, reminded me about the critical work of integration between sessions. I have to admit I've only attended one integration circle with a handful of other Mindbloom participants. I found it useful but difficult to schedule into my busy life although the circle guides have been persistently supportive, trying to accommodate me.
Meanwhile, I've been thinking about the things I've been doing intentionally to cultivate joy (one aspect of integration), like playing a daily happy song, dancing around by myself, and being with friends whenever I can.
Mind you, this is not much different from what my regular therapist has advised me in the past. During the height of the pandemic when I was seriously making plans to order enough Xanax from China to go off myself somewhere (that was probably the second worst experience of mental anguish in the five years of depression I had endured at that point), my therapist caught me in time and prescribed weekly coffee dates, in-person with friends.
"You're a social person," she reminded me what makes me tick. "I want you to get out there and be with people, safety permitting."
I didn't talk about the Xanax or the rest stop on the Jersey Turnpike that might be a good location to hide out and have no one miss me for a day or so. Who asks for help when they're thinking about ending it? That's the last thing I'd wanna do is talk about it. If I was really gonna do it, I'd make plans and do it and not tell a soul. I wouldn't want help at that point. I'd be too far gone in my own reckless mind and too resigned to get help.
NOTE: I am not suicidal.
I am writing this in retrospect. I had suicidal ideation quite often, for a long time. COVID triggered it again and at one low point, I really did start fantasizing about a plan. That's as far as it ever got. I've never taken Xanax. I didn't like the idea of having to come up with $300 for a shipment either. Then I remembered, "Shit, life insurance." We're beaucoup protected as a family, unless of course somebody screws it up with suicide. So that was, frankly, one of the strongest deterrents.
Plus, my therapist swooped in along with my psych nurse, who changed up my Prozac and Wellbutrin cocktail and all was well once again. I'm glad I'm not dead (at least not like that). That's the best I can do for now as I still don't get a great thrill from living.
But I think my friend was referring more to the thoughts and insights that become available from having taken a psychedelic journey, with whatever it may be, and journaling is especially conducive to teasing it all out (which I vowed to do daily but have yet to succeed at).
This ketamine session: I was a tree (seriously)
However, I did write down the best things I've gotten from psychedelic medicine so far. Then I had the epiphany that I've been off of all antidepressants⏤Prozac and Wellbutrin for the crazies and gabapentin for neuropathy in my left leg⏤since last summer and ultimately ending my last dose in October.
Surely, that's nothing to scoff at! I'm no longer taking pill after pill every day. (Jesus, relief from all the constipation caused by the antidepressants is probably mentally healthy.)
And though the dip in energy is noticeable, I've had no long-sustained issues with mood. It fluctuates, perhaps like it would normally, whatever normal means for a menopausal woman.
Ketamine pills: Two out of three ain't bad
I prepped my ketamine supplies, made a fresh bed and took and shower, then found I was down one pill. I must've thrown one away with the packaging by accident during my last session.
Will it still work? I wondered.
The K train has been "express" lately and I wanna keep going FAST and HARD.
My next thought was, "You'll get what you get (and you don't get upset)," as my 17-year-old son's kindergarten teacher always said.
So I'll get what I get.
Today's the day. Tomorrow's the morrow.
Took the two ketamine tablets and held one in each cheek for 10 minutes this time (usually timer is for seven minutes but I wasn't taking chances of having a lesser experience). Swish, spit, and off I went on the K train express.
Intention for my sixth and final ketamine therapy session:
I AM SET FREE OF MYSELF
EVERYTHING COMES TOGETHER
The K train came right on time and took me away fast.
I was quickly at one with all there was. I remember very little but the darkness and the spaces other than I was All of them⏤not inside of them or experiencing them, but I myself was each space.
When light came in, I remember being high up in the trees looking out over a vast landscape of other trees and seeing below a few signs of urban life.
Then I realized I was the tree itself and it was so liberating to be able to see everything from above. I yearned to stay there but my Being morphed into some other state I cannot recall.
The music, clanging and chiming and rhythmic, was energetic, invigorating. I wandered. Aimlessly it seemed.
At one point, I swooped low, "flying" though not really distinct from all below me: lush forests, like you'd see flying low in a puddle-jumper plane, over remote wilderness. It felt so good and then I descended right into the black-green forestation, the hum and vibration perfecting the meld of me with it.
I was only vaguely aware of my body at one point, as though my right ankle were lodged in something. I readjusted and back I went to being Nothing at all.
It was so blissful.
Was that my message: Being insignificant?
It must be like death, the comfort of not having the "weight" - physical and otherwise - of the human body, of human existence. I had nothing to carry around.
I also had a genuine "I am one with everything" moment⏤multiple moments actually⏤but at least one in which that message itself surfaced. I was inseparable from it All. I was it all.
Especially as a tree.
I wondered, is this how it all comes together? I am a tree. That's it?
Removing tongue from cheek, maybe...just maybe...that's what I had to see to be SET FREE FROM MYSELF.
And everything is still coming together.
Read Sober Psychonaut disclaimer for people in sobriety exploring psychedelic medicin
It all started last summer when I responded to an ad for ketamine for depression with clinical therapists, all guided and overseen but from the comfort of home.
Better yet, it was reasonably affordable. The cost of a six-session ketamine therapy program through Mindbloom is $386 x 3 - charged to my card over the course of several months. Like I said, reasonable.
Why was I interested in ketamine for depression? I've been curiously following the whole psychedelic medicine movement, noticing it gaining traction in more mainstream circles and hearing about its myriad applications for mental health issues from anxiety and depression to PTSD and other types of trauma, to addiction to alcohol and drugs.
I'm sober 30+ years, so my interest isn't so much in dealing with alcohol addiction. Fortunately, that craving was lifted from me in early sobriety. What has lingered heavily, however, over the last five years, is residual depression triggered by a car accident and exacerbated by perimenopause.
For some reason, I feel like I have to defend my decision to choose ketamine therapy and psychedelic medicine as a "last resort" when in fact⏤the more I read and understand about psychedelic medicine⏤if I could have chosen it first, I might well have done so.
Although I have eschewed the associated stigma of psychedelics, I'm still rationalizing it in my brain, like:
"You wouldn't be doing this if you didn't have issues with existential depression. You wouldn't have any 'excuse,' otherwise."
As if⏤my other viewpoint says (the one I actually believe)⏤one needs an excuse to have a mind-expansive experience that elevates mood, triggers new neuronal firings, and enhances the brain's neuroplasticity (ability to make new connections).
If you're wondering if I really tried hard enough to deal with depression in other ways, here's more about my journey to ketamine therapy as a sober psychonaut.
So what have I actually gotten from trying psychedelic medicine?
Ketamine, while not exactly psychedelic in the sense that LSD and mushrooms are psychedelic and produce elaborate visual and auditory experiences, is usually spoken of as a psychedelic drug.
It has been used as a legal anesthesia medication in hospitals since the early 1970s and only in recent years was discovered to be effective in lower doses as a treatment for anxiety and depression, among other maladies.
Unlike some LSD or psilocybin (mushroom) journeys, taking ketamine involves about 20 to 30 minutes of mental and physical preparation (think, nice shower, lighting candles, writing in your journal) and only about an hour-long period during which you're under the influence, if you will, of the medication.
I had my first ketamine for depression treatment in December and I have just completed my fifth out of six total treatments. I have also explored other types of psychedelic medicine, including psilocybin, in search of similar benefits.
Here are the best things I've gotten from trying psychedelic medicine:
Oh right⏤and I'm completely OFF of all antidepressants!
A multi-years' long cocktail of Prozac and Wellbutrin, and later Gabapentin for neuropathy/pain issues.
I won't denigrate the moments in between (it's true: I've still struggled with chronic pain, stress, a gloomy mindset) but prefer to allow for the fact that I have had some benefit from my experiences with psychedelic medicine these past few months.
And on it goes. The ride ain't over.
At the moment, I am:
I can accept that all of that is just “life” creeping in, as it does. But I’ve been feeling it for a few weeks and questioning whether ketamine for depression is really going to do it for me.
This is me without antidepressants.
Or is this how everybody feels on Life? (Go figure⏤everybody’s on antidepressants.)
Throw in a wild card:
What started with a car accident has accelerated to severe osteoarthritis and now knee pain. Pain is what started this whole fucking depression thing with me in the first place.
Hellerhoff, CC BY-SA 4.0, via Wikimedia Commons
Can ketamine help the vicious circle of pain and mindfuckery?
So then the mindfuckery starts:
And on and on it goes.
Nonetheless, here are my intentions for this fifth ketamine therapy for depression session:
VITALITY (aka aliveness)
But I'm feeling set back, frankly, because pain wasn’t the predominant issue when I set out on this ketamine journey. I didn't try psychedelic medicine to deal with pain (still just white-knuckling it through pain and taking the occasional painkiller). But now pain is interfering with my life and making me cry.
Alright, that’s all I got.
I’m going IN.
Mama’s upstairs trippin’ her ass off on Special K
Swirl, swish went the medicine (nowadays I hold this shit in my cheeks and practically gargle before I spit it out).
All I remember of my fifth ketamine session was the vibration. I was the vibration. It was me. I was inseparable from it and could feel no pain, no legs, no body, nothing—no sense of Self, only that I was vibration, sound and darkness. The Mindbloom music track took me there.
It was, as I’ve noted in past entries, blessed relief to feel Nothing-ness.
I had very few visuals because it was so dark but when I could see it was just the most exquisite, satisfying sense of Self; Self as Everything, moving as one through all of it—a black, pillowy sky with dim stars and no physical heaviness to contend with. I experienced the greatest comfort being cradled by All-ness. By Being All-ness.
I was tripped out, man!
It was all vibratory and humming—the audio—and when I finally noticed my body again, it was like being buried up to your neck in sand at the beach. Maybe a toe could be sensed somewhere. Perhaps more like being a melted chunk of chocolate, stuck and half-absorbed into the earth for good.
Things became more landscape-y, the music more harmonious, ethereal, and then it seemed to go on forever, making me wonder if that intense part happens for barely 15 to 30 minutes and the rest of the hour I’m just cruising, wandering, waiting for the clock. Time gets lost in down in a K-hole—and I was there for sure.
(Mindbloom and psychedelic therapists who practice ketamine therapy for depression probably prefer not to use the term K-hole as that’s more associated with dance party drug trips on ketamine and with ketamine abuse.
I’m just sayin’, the K train came and it was the express. I got on and went all the way.
Tip: Open the ketamine pill packages so the tablets are easy to extract and you’re not fumbling once the music starts.
What about my intentions for my ketamine session?
Here's how it shook out on each intention I created:
Trust – I trusted the medicine and the journey
Hope – I experienced painlessness, thus a glimmer of hope
Vitality – I was sparked because of the adventure I had just returned from.
The real work, however, still happens in real life; that is, in between sessions. My friend Cory reminded of the importance of doing the integration work so I'll be writing more about that soon.
Ketamine: Is it just a drug experience or does the drug provide the experience needed?
I was curious about this question, posed in Michael Pollan's How to Change Your Mind: What the New Science of Psychedelics Teaches Us About Consciousness, Dying, Addiction, Depression, and Transcendence.
When you take ketamine or psilocybin or ecstasy or LSD or whatever it is in a therapeutic setting or under clinical guidance, and then you emerge with some new form of consciousness or a message from the Universe, is it just a drug experience or does the drug provide the experience you needed to move into a new frame of mind? To alter your consciousness as it were.
Photo by Polina Kovaleva from Pexels
Someone on the outside looking in might well say, "Well of course that happened, you were on drugs!"
But one of the practitioners that was mentioned in the book reminded Pollan such a point is irrelevant. You're getting what the Universe is delivering no matter what and the drug is facilitating that particular possibility.
In which case, there is really no case to be made for, "Yeah, but you could get a message from the Universe without the drug."
You're getting what the Universe is delivering no matter what and the drug is facilitating that particular possibility.
Some may argue that we get messages, inclinations, intuition, judgment all the time without taking psychedelic medicine. Shouldn't that be sufficient?
I say it's sufficient if you find it so.
For me, all the dis-ease and mal-aise that guided me to this path has indicated to me there must be something more or that I must find something more. I am not an easily satisfied human being. I always seek improvement, greater clarity and connection with self and others and beyond. When that went missing, I went looking. So I consider whatever comes up from psychedelic journeying as crucial to my all-around self-exploration and well-being.
Have you tried psychedelic medicine?
What are your thoughts on having a "drug experience" vs. the drug facilitating an experience that allows for something else to open up?
The mindset video for session 3 of my Mindbloom ketamine therapy reminded me of the importance of set and setting. Here are a few tips for set and setting for ketamine sessions:
Intention: Loving myself and being present
I’m also committing to being present and engaged on this journey as I haven’t remembered much of what transpired in my mind during the first two sessions. I am creating the intention of:
…and continuing to go wherever the medicine takes me.
I am a bit tired of mind this morning so I am aware that I could get lazy about staying present (or is it focused?). I’ll check Mindbloom for pointers.
I take the pill that prevents nausea.
It's called Ondansetron (also called Zofran or ODT), a 4mg tablet.
Dissolve 1 tablet under the tongue 60 minutes prior to each ketamine treatment.
Here's what happened during my third ketamine session.
Read Sober Psychonaut disclaimer for people in sobriety exploring psychedelic medicin
I felt a surprising burst of energy and joy after ketamine session number four.
Saturday afternoon after my morning ketamine session, I spent hours in bed writing and working on my website and wasn't tired or lethargic but relaxed and at ease.
At 5 pm we came together from all corners of the house to go for a family car ride and maybe a hot chocolate. There was still snow everywhere, including my car top so when I went to adjust the sun/moonroof to see the nearly half-moon for our ride, snow came crashing in on us, which I found hilarious and chalked it up to the best part of the outing.
We rode in the dark on Lancaster Avenue and listened to music, grabbed drive-thru hot chocolates at Starbucks and kept meandering. When we got home, I proposed watching the new Get Back Beatles documentary, which was thankfully met with zero resistance so I did a quick subscribe to Apple TV and we all settled in to watch together.
On Sunday, I awoke with a surprising amount of energy which lasted all through the day (an unusual thing since I'm often longing for a nap in the afternoon). I hustled with writing and then proceeded to take down the Christmas tree. This was after driving to Conshohocken in the morning to meet up with my sister and niece, visiting from out of town. We had breakfast together and gabbed a couple of hours, then I strolled around IKEA (lots of steps). I was still going strong by 5:30 pm when I gradually tapered off and made some dinner.
HEALTH. One of my intentions from fourth ketamine therapy session! Being in motion is good for hip pain.
FREEDOM. Of mind, being present, enjoying even the mundane. I cranked the stereo loud for several hours as I did the undecorating. Thin Lizzy, Pink Floyd, The Beatles Revolver album. I went through all of them, album by album. Music reminded me of how much music matters in my life.
JOYOUSNESS. Obviously, joy showed up, too.
The night before after everyone cleared the room from the Beatles documentary, I sang Beatles karaoke by myself.
Note to self: MORE SINGING
My energy continued when I retired last night, putting away all my clean clothes, unpacking my suitcase from Christmas in Maryland, tidying up. I was physically tired and ready to be done but I did it and I was motivated to do it.
That's how I would sum up the last two days of activity. I had a natural compulsion to get things done rather than the feeling of dread and "I have to..." that often comes up for the simplest of things in my life whether it's Christmas decorating, putting clothes away, or organizing a drawer.
I just realized how nice that feels⏤to have a natural compulsion to get things done. A relief.
During the guided meditation for intention-setting, the girl narrating said to hold your intention for how you want to be and experience life these next few months. To create an intention in the positive: "I allow myself to feel joy and happiness" vs. "I don't want to be sad."
Truth is, I almost didn't do this today.
But here's what happened during my fourth ketamine for depression therapy session.
I woke up, felt every aching bone in my body from slipping on black ice yesterday, let alone these last weeks to going on several months really, the hip pain has gotten so bad I can barely cross the room sometimes. The hips, it seems, affects the knees and even ankles.
Fucking car accident.
My mood has been a bit low and who knows whether the horse came before the cart on that one. Not feeling good physically is always a recipe for low mood and the pain cycle continues: pain - depression - pain - depression
So I'm a little weepy and feeling sorry for my sorryass self this morning.
But I did get up and take a shower which had a purifying effect. I asked for help, got my husband to make the bed, kids fed the cats.
And I've committed to hanging in bed today.
Am I just a spoiled rotten human? Demanding to be more happy about living?
Work, too, has been gnarly.
I always love what I do⏤health and medical content writer⏤but I don't do well when I'm buried with work.
It ceases to be fun and fulfilling.
And so there's that.
So my intention for this fourthe ketamine therapy session is:
...is encompassing of all of that. Freedom of mind, especially freedom to do, say, be, go⏤all of it. Health, all-encompassing but especially this pain thing. And joyousness, levity, in the moment. Levity for my life, levity about my life.
I was reading somewhere about the sensitive sort (can ya tell that I am?) left too long to wander aimlessly about the mind will always find something to brood about.
Am I just a spoiled rotten human? Demanding to be more happy about living?
Blood pressure 117/74
In I go...
And she was gone (hopped the K-train)
I swished the sour ketamine around in my mouth (three tablets to the cheek, I prefer to sublingual; not sure it matters but man-oh-man sessions 3 and 4 have been intense). The leading soundtrack fed to me in my Mindbloom program talked about if you had lost it all⏤death, that is, no return, what sweetness there'd be in the ordinary of this moment, if you could just come back here and savor it all again. Using the example of a disgruntled family around the dinner table, everyone bickering, what we wouldn't give to have those moments if they were taken away.
I swished and swished and could feel the intensity of the medicine coming over me as the sound segued into an ominous rhythm. All was dark, dark, dark. My timer indicated seven minutes so I spit in the cup, rinsed with juice, spit again and fell back into my pillows with eye mask and new over-ear headphones.
And I was TRANS-PORTED.
I was one with the bed.
No separation between me and it. The sound was all there was. Rolling and thundering through darkness. I held on and rode with it the entire time, looking in all the corners and crevices of my mind.
One room filled with dark, I could see a ceiling high above there were white squares neatly arranged. Then just inhaling and becoming darkness again.
Thoughts were minimal. Blessed relief!
But I did pause as a few popped up.
I missed my father. And then real tears flooded over the rims of my lower eyelids.
But I finally fixed on my intention: FREEDOM, HEALTH and JOYOUSNESS.
They couldn't have been further from where I was⏤but I stuck with it.
Eventually the soundscape shifted⏤akin to Pink Floyd's "Welcome to the Machine"⏤leaving the heavy industrial drumming, demanding drone. A synthesized chime came in, piercing the auditory experience, poking and plucking at my brain.
These things came up for me.
Soon I was noticing my surroundings again. I bent one leg to the side. I wiped the tears under my eye mask. I suddenly doubted my husband had actually set the time for one hour and would he remember to check on me?
I peeked at my laptop and it indicated 10:59 a.m., still 10 minutes to go. I got restless but resumed headphones and eye mask, synthetic ambient music easing me into the coming down (or out?).
I was momentarily bored, ready for it to be over, but remembered everything that comes after is as key to what happens during a ketamine therapy session.
It was BOOM. Wow. I went that time. Really gone. There was no me.
I was the darkness.
Navigating the psychedelic medicine universe as a sober person