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." 

Downright Spock-like.

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!

"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. ​

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). ​

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.

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:

• Feeling hopeful⏤Whether this is psychosomatic or it's genuine, the fact that I'm focused on the possibility of lifting up out of a lifetime ahead spent living with depression, is different.
  
  
• Connectedness⏤I wouldn't say it's there every moment of the day, but feeling disconnected from Self and Source was a big part of my malaise when I decided to try psychedelic medicine for depression. I've had moments during ketamine treatment of total integration, way beyond one-ness with All That Is (just yesterday morning, for my fifth ketamine therapy session, I was pure vibration, inseparable from vibration itself, with no sense of Self or my physical body at all) as well as in between sessions, when with people, noticing the sheer joy and appreciation of being with people I love to be with.
  
  
• Big love⏤It's bound to come up in the psychedelic experience at some point: Everything comes back to Love. Everything is Love. All you need is Love. I am Love. I am Loved. We are Love. Love, love, love. Maybe some people don't need to be reminded, but apparently I did.
  
  
• Creative expansion⏤This means multiple things to me. As a writer, my urge to express, inform and persuade, to put something out in the world, is scratching at the door constantly. My interests in a variety of new things, including psychedelic medicine, are expanding exponentially, and I'm hungry for learning and growing while also writing in order to help others catch a similar wave.
  
  
• Moments of not wanting to miss out on life⏤I'd say this is the closest I've come to joie d'vivre⏤the ultimate measuring stick for my happiness. I chose joie d'vivre because I used to have it so I know what it feels like and if it were ever to return I would know I have triumphed over existential depression. To have savored a few magical moments these last few months, especially in the company of old friends and family, and felt my heart swell with love for people and the moments of life I was getting to live, that was indeed something akin to "loving living.

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:

• Tired 
• Weary
• Resigned
• In pain
• Anxious 
• Resistant

 
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:
 
The pain
 
The pain
 
The pain
 
The pain
 
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

 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.

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.

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.

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."

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.

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:

LOVING MYSELF
BEING PRESENT

…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.
​

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. 

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.
Fucking age.
Fucking fuck.

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.

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. 

Darkness.

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. 

BRAIN SCRAPE
BRAIN DETOX

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.