a-oK: the ketamine diaries #2 - what it is... and isn't

I gave in and tried Ketamine treatments for my bipolar depression at the end of 2022. These are my stories. Dun dun.

sound waves blurring in and out
Photo by Pawel Czerwinski / Unsplash

Note: There's absolutely no chance I will not make light of being an I.V. drug user in this post. There's also nothing funny about addiction. I get that. I'm going to do it anyway.

"If Heaven has a vibe, that's it," was the first thing I uttered about my initial ketamine treatment, which I decided to try for bipolar depression. That was before I fully understood what I'd just experienced, and also not experienced.

gif of Ron Swanson shaking his head and saying "what the hell just happened?"

For real though, what did just happen?

You can find questions all over the interwebs from people wanting to know how ketamine treats mood disorders, depression, anxiety, etc. The short answer: it doesn't.

Let's get the boring facts out of the way.

Ketamine is a dissociative anesthetic commonly used in surgeries for both humans and animals. Created in 1962, it was approved by the US government for human use in 1970. And it's still widely used today, approved even for use on toddlers that need to be anesthetized.

It's also considered (in clinical settings, of course) extremely safe, more so than other I.V. anesthetics, because ketamine can induce unconsciousness without negatively affecting breathing or heart rate in patients.

Did  you know it actually bumped PCP as the safer alternative in medical practice? I sure didn't, because I thought PCP was strictly a street drug, which makes little sense because most illicit drugs are simply preexisting ones that have made their way into the general public through one shady avenue or another.

Wow, sometimes we are woefully uninformed, especially when it comes to things that evolved before we were born.

a gif of a man saying "some are better than others"

What happens when you're on ketamine?

Ketamine is primarily dissociative, which means you'll feel outside of yourself. For many, there's a sensation of floating. You feel disconnected from your body.

From there, you can take a couple different routes, ranging from the sensation of perfect peace to the terrifying perception of a near-death experience (though that usually only occurs at dosages well above those considered therapeutic).

People often report time slippage. In your mind, there is nothing but the present, so the 40 minute infusion can feel like anywhere from 3 minutes to 47 hours. You can't really say with much certainty.

The truth is, not only is every person different, every treatment is different. Out of my first 6: four were so incredible that I never wanted them to end, one was meh, and one so agitating, I couldn't wait for it to be over.

It seems to depend a lot on what's been on your mind and what kind of state your body is in from an anxiety standpoint. Don't take that as canon. It's merely a stab in the dark based on my own experience.

gif of a Shiba Inu that says "feeling gooood"

Now to the (potentially) real good stuff: after.

Every chance I got after my first treatment, I led with telling people I'd finally gotten to achieve my longtime "dream" of being an I.V. drug user! This is something I developed when I lost my job at the end of 2018 and had such a hard time finding a new one. I was perfectly capable of working and supporting myself, but then I got sick for months (turned out to be my gallbladder), and even once I was better, it was near impossible to find gainful employment.

I often felt like a lazy degenerate and it was like "gosh, maybe I should just give in and become a drug addict because somehow my life is mimicking one anyway." That's not logical. Brains often aren't.

But honestly, I was so depressed (well beyond what I understood), I've always thought I was lazy and that's always been my excuse for NOT being a drug addict. I have a super addictive personality. I would absolutely be hooked on anything. But for better or worse, I'd never go to the trouble of getting the actual substances, so I remain safe.

Now? These days, I might get off my ass for K. Alright, not really. The beauty of the process is that it's heavily monitored in-office and though I'm no longer "lazy," the pill version is lame and I'm not going to logistically figure out how I'd get and alter the substance to give myself an I.V. at home.

Which is to say, I was psychologically addicted to ketamine the first time I had it. Like, give me a catheter and a feeding tube and just let this be my new life addicted. But not physically. My body doesn't need it at all. There's a difference. Note to self: maybe we should talk about addictive personalities one day.

a gif of a man saying "this is it, this is, this is for real"

That time abnormal was a good thing.

I was abnormal (perhaps for the first time ever in a good way). The first treatment rocked my world. I woke up the next day and my head was quiet. My head has NEVER been quiet. Not once when I was conscious can I ever remember there only being one thing going on in there.

But it was, and I was baffled. I still heard all the same stupid things about how terrible I am. Worst person ever. Burden on everyone. All that, plus the suicidal stuff. But for the first time ever, I had a modicum of control. I could be like, yeah whatever, I have other things to think about. And then I just... actually thought about other things.

The contrast has been night and day. Literally a before and after moment in my life. A flag firmly planted in the timeline of who I was and who I am now.

You may have noticed I said "I woke up the next day." That was purposeful and important. You see, the way ketamine "treats" depression is a bit of an accident. The drug is completely out of your system within hours. But what doctors are finding is that when it's been kept at a certain level in your bloodstream for a certain amount of time (aka a 40 minute infusion), it sends a signal to your brain to release more of a protein referred to as BDNF, which is the protein your brain uses to repair, rebuild, and even create neural pathways.

You see, if your depression isn't actually caused by the age old "chemical imbalance," which apparently a TON of cases aren't, we still have this thing called a brain. And brains are actually brilliantly adept at healing themselves during sleep. It would appear, however, some people's brains need a bit of an alarm to go off because they've either not acknowledged or at least not attempted to fix any damage caused by trauma or depression or just generally being alive as a human being because life is hard!

So all ketamine really does (super emphasis on "when administered properly") is send that alarm. Sure, you get a (hopefully) nice high beforehand, but that's just kind of a spa vacation. It's actually your real life human BRAIN that does the work, which is beyond fascinating to me. And every day becomes new because that brain (hopefully) continues to do the work of healing, and actual physical damage is reversed. That's pretty damn cool.

a gif of a man saying "yes, I read articles. thank you."

You all are the best.

If you read this, if you read any of my writing, thank you. Truly. Sometimes things have a specific purpose in my mind. This series, well it's more about attempting to spread the word and normalize something based on my experience, and I fear it's not always relevant to people who agreed to join me on my newsletter journey.

But apparently it's a thing on tiktok for people to take ketamine and do weird shit or to talk about the highs themselves, so I want to document this journey, this "after." Not the usually fun, sometimes not so great highs. That's not helpful to anyone. That's just glamorizing nonsense behavior.

I've been helped to a degree I never thought possible, BUT I've also inherited a new set of problems I didn't expect, and I'll convey more about that in the next post of this series.

Until next time, purple pig satellite.