iv ketamine with very high dissociation levels

[Ecdysis]

Third treatment today, first time with the full dose, which (as was expected) was far more intense than the previous 2 times.

It went well tho and I'm finding the treatment easy to participate in.

I've been observing and testing myself... Working out whether I know where I am while the Ketamine is at its strongest... what time it is, why I'm there, how I got there that morning, counting to 10, etc... Trying to see how much my conscious awareness is "impaired"... And I have to say that I don't find it more extreme than being drunk... I'm always fully aware of my location, my surroundings, why I'm feeling weird, the passing of time, who I am, etc etc... Which is a relief... I thought I might be far more spaced out - the way that anaesthics can cause you to be after an operation where you're totally disoriented and confused and sort of in and out of consciousness... For me, the Ketamine treatment is not like that at all. I'm fully aware and conscious of what's happening if I concentrate (tho if I relax, then like being drunk, I can focus on the sensations and kind of "forget" my surroundings) and don't feel scared that I'll get lost in the effect of it somehow. I was worried *before* - being unsure of what to expect and what effect it would have on me. But actually experiencing it has really put me at ease and it feels fine.

 

[Ecdysis]

Fifth treatment today (and third treatment on the full dose). Treatments are becoming easier the more I grow used to them.

Experienced a "first" today - at the height of the today's treatment, I experienced about 3 - 4 minutes of happiness/ bliss/ joy/ serenity.

It was very noticeable and memorable, because I remember thinking "Oh, this... yeah, I remember this... I used to feel this way sometimes before depression entered into my life...!"

The Dr was really pleased.

They've shifted me from initial 2x per week treatments to weekly now. Eventually it will go fortnightly and then monthly.

The Dr has indicated that he'd like to try me on double the normal dose in a few weeks time. So that will be interesting.

We discussed that the last 2 weeks it's been difficult to tell whether the treatment is helping, because I was coping with some massive stressors that basically nuked my brain. So trying to work out what was happening there and what might be possible effects of the Ketamine was just an exercise in futility.

Those issues, while not fully resolved, have significantly settled down, so both the Dr and I have our fingers crossed that improvement due to the Ketamine may become more pronounced in the coming weeks.

One thing I've been doing (and I've not discussed this with the treating Dr yet... mainly because I don't want to get involved in a discussion about this issue... or don't want him telling me to stop doing this...) is that I'm treating the Ketamine sessions a bit like a shamanic treatment... like a soul journey... like a vision quest type experience... So I'm going into each session with a certain question that's been unresolvable for me for ages and is really bugging me. So just walking into this space where my consciousness is altered, carrying this question and opening my mind to hearing answers from my subconscious or from the universe, or whatever.

I've been finding this deeply helpful and transformative. Today's experience with that was particularly intense and helpful. Very clear visions of answers to the questions I was holding. Very moving, very helpful.

So, I dunno... At some point I may tell the Dr that's what I've been doing... But I don't want him somehow messing up this process for me and since it's working well, I don't see a need to discuss it at this point. I'm stubborn with things like this and I trust my instinct, so I'm going to follow that. If any problems arise regarding this, then I guess I can ask for guidance from the treating Dr. But as it's currently going, I'm really pleased with it and finding it a relief to be getting some answers to questions I've felt so painfully stuck with for so long.

 

[Ecdysis]

Thought I'd report back on this... I'm about 8 or 9 treatments in now... I'm on the normal full dose and it seems to be helping in terms of allieviating my (treatment-resistant) depression.

The Dr's really pleased and has actually decided not to increase the dose any further at this point, as if it's helping then don't tamper with it, I guess?

I'm on weekly sessions until the end of August and then will go to fortnightly and then to monthly after that.

This week, there was another lady getting treatment with me together... I'd been a bit apprehensive about that at first, but it was totally fine.

We had a good chat before and after too and she's been getting treated for about a year. She'd gone monthly too but after about half a year of that, she took at turn for the worse again and now they've got her coming back in weekly atm.

I was really relieved to hear that that's an option... That if needed, they're willing to adjust and increase treatment as needed/ as appropriate.

 

[brokenpony]

Thought I'd report back on this... I'm about 8 or 9 treatments in now... I'm on the normal full dose and it seems to be helping in terms of allieviating my (treatment-resistant) depression.

The Dr's really pleased and has actually decided not to increase the dose any further at this point, as if it's helping then don't tamper with it, I guess?

I'm on weekly sessions until the end of August and then will go to fortnightly and then to monthly after that.

This week, there was another lady getting treatment with me together... I'd been a bit apprehensive about that at first, but it was totally fine.

We had a good chat before and after too and she's been getting treated for about a year. She'd gone monthly too but after about half a year of that, she took at turn for the worse again and now they've got her coming back in weekly atm.

I was really relieved to hear that that's an option... That if needed, they're willing to adjust and increase treatment as needed/ as appropriate.

can you talk about how you know it is helping your depression? i know that is a weird question kind of because maybe it should be obvious but i am curious how you evaluate/quantify if something is helping.

 

[Ecdysis]

Hi @brokenpony - it's not a weird question at all - it's something I've been curious about too and been paying attention to, to try and figure it out.

Given that everyone's depression is different to start with and then their reaction to Ketamine treatment is different, my experience is obviously just a single outcome amongst countless possible outcomes... But having said that, I'll give my best shot at describing something that is not actually all that easy to describe.

So, I was watching myself for any signs of improvement and they were very subtle at first, so initially I wasn't sure if it was the Ketamine helping, or just random fluctuations in mood. The first time I noticed it was when I was driving to an appointment 2 hours away and I'd driven 1.5 hours and then they called to cancel the appointment at the last minute... I obviously uttered a few expletives, once they'd hung up... but other than that, I didn't crash/ go into a meltdown/ feel miserable... which is what had been happening with any minor hurdle when my depression was really, really bad. Like, literally anything could set me off into a dark spiral. But on this day, I just cursed for a few minutes and then made alternative plans and ended up having a pretty good and productive day... And afterwards I remember thinking "Oooh... well, that hasn't happened in a really, really long time (like several years)... I wonder if that's the Ketamine helping...?"

So those kind of subtle things kept happening... Which were kind of signs that something might be improving... But too vague to really tell...

Then, a few weeks later, it started becoming a bit more pronounced and me and the Dr were like "Yeah.... we think it is actually having a positive effect..."

It didn't magically "fix" my depression... I would say that what started happening first is that the "worst" of the depression started getting a bit less worse... if that makes sense...

So, for example, I was thinking about suicide about 30 times a day before I started the Ketamine treatment... And then that went down to like 15 times a day... And now I'm at about 5 times a day.

So it hasn't magically made the depression "go away" and hasn't even made the suicidality "go away" but a reduction from 30 to 5 times a day does feel like a hugely significant shift. It's the difference between "relentless" and "occasionally".

And that's how I'd describe it overall with my depression symptoms... that the "worst" of it is slowly getting less bad.... Think of a radio that's on full volume (at setting 10) and someone turning it down to 9 and then to 8... That doesn't feel "amazing" but there's a sense of relief that while the radio is still blaring too loudly, it's not *quite* as loud and you're not getting *quite* as bad a headache from it...

That's the best I can explain it, really... I hope that makes some sense/ is vaguely helpful.

Edit to add: since I'm only about half way through the initial treatment, I'm very definitely hoping for some further improvement along the way...!!!

 

[Friday]

Edit to add: since I'm only about half way through the initial treatment, I'm very definitely hoping for some further improvement along the way...!!!

Even if the treatment itself “only” brings you to this point? Having the crushing weight lifted even just a little bit makes doing the things that help more, and more, and more… actually possible. Like the last minute cancellation didn’t trigger a dark spiral, so you were able to change your plans and have a good day. That’s huge. Subtle shifts? Are often the most important.

THRILLED it’s working for you.

And if it works even better/more? Awesome.

 

[brokenpony]

That's the best I can explain it, really... I hope that makes some sense/ is vaguely helpful.

Edit to add: since I'm only about half way through the initial treatment, I'm very definitely hoping for some further improvement along the way...!!!

thank you for sharing, i hope your condition continues to improve!

 

[Ecdysis]

On my way home from this week's treatment session.

I forgot to write about one thing I've been doing:

I like to view each session like a shamanic vision quest journey... as opposed to just some chemical process... So I take a deep question that's part of my depression/trauma mix into the session with me and see what happens.

I've been doing this with every session and for me personally, it's deeply helpful and healing.

 

[Ecdysis]

Ketamine treatment again today... I've lost count... Maybe 10th or 12th session?

So, for example, I was thinking about suicide about 30 times a day before I started the Ketamine treatment... And then that went down to like 15 times a day... And now I'm at about 5 times a day.

So it hasn't magically made the depression "go away" and hasn't even made the suicidality "go away" but a reduction from 30 to 5 times a day does feel like a hugely significant shift. It's the difference between "relentless" and "occasionally".

Spoke to the treating Dr about this today... Said that I am extremely grateful for the effect it's had so far... But that if in any way possible, I'd like to aim for further improvement, cos while 5 x per day is a huge improvement coming from 30 x a day... objectively, 5 x day is still more than I'd really be aiming for... So the Dr's said they'll increase the dose further for the next 4 appointments and then we'll re-evaluate and see how I'm doing then. It seems they're willing to try "what it takes" to get a good improvement, which I'm very grateful/ relieved about. I had been slightly worried that it might just be a "standardised" treatment and either you improved, or you didn't, or just improved a bit, or whatever... But he said that cos they can see it is helping in my case, they're willing to keep doing the treatment to try and achieve the desired result. So yeah, feeling very grateful and a bit hopeful that there may still be further (significant?) improvement.

 

[Ecdysis]

Started the higher dose today and wow, it's a lot more effective. Currently the plan is to do three more sessions at this dose and then to see if I'm ready to move into the "maintenance" phase. Previously, I was seeing some improvement but felt sceptical about going into a maintenance phase any time soon. After today's session it feels much more viable and workable. So very grateful to have access to this and that I'm seeing an effect from it.

It's so interesting to see how quick the effect at this higher dose is. They'd told me that they sometimes use an even higher dose as an "immediate emergency treatment" for people who are severely, acutely suicidal. Like, patients where they literally worry this person is going to walk out of the building and kill themselves that very day. In those cases, they can give an emergency level dose of Ketamine and apparently it can stop a person who is that intensely suicidal from being suicidal right there and then. After today's session, that seems pretty plausible to me.

I'm going to be interested to see how long the effects last... I'm hoping it'll last all week until the next treatment.

And I really hope this treatment becomes mainstream soon. I know so many people who this would be so helpful for. It's painful knowing that I'm lucky to have access to something that so many people need desperately. All I can do is play my role in being a well complying patient and reporting back to the Dr's in a helpful way and let others know about it and hope that that's a contribution towards it becoming more accessible.

 

[Ecdysis]

Did my 2nd session at the higher dose yesterday and... holy crap...!

It certainly works along the lines "more is more". The anti-depressant effect is really pronounced.

@brokenpony if the cost per session is a problem, I wonder whether your Dr would consider doing double the dose for half as many appointments? Don't know if that would be feasible/ cheaper.

On a related note... been seeing the Matthew Perry stuff in the news today and am super annoyed by it, as shit behaviour like that is going to bring a treatment like Ketamine into disrepute and prevent patients who really need it getting access to it. Am really pissed off at everyone involved, including Matthew Perry. Can't believe he had the cheek to sell his big anti-addiction book and do interview tours about being clean... while he was obviously still abusing... Grrr....

 

[Ecdysis]

I've been doing a lot better since they increased my Ketamine dose. I was very, very suicidal for a long time before I started the treatment mid June and experienced a reduction in that over the first 8 weeks of treatment. Now, for the past 3 weeks, on the higher dose, I've been completely free of suicidal thought or feelings for the entire 3 weeks.

I've still got a whole lot of other depression symptoms that are still lingering (lack of motivation, lack of concentration, anhedonia, isolating, etc) but am hopeful that the continued Ketamine treatment will help with those too.