Many are calling ketamine the biggest advance in depression treatment in years.
I'm going to die soon. For months, this is what the voice inside my head told me, repeating over and over. I was plagued by a deep depression, an eating disorder, and drug addiction. I had tried everything from therapy to shock treatments to alleviate my pain, and nothing seemed to work. I told myself I would try one last thing before calling it quits and taking that leap off the proper rooftop: ketamine infusions.
How did ketamine "save" the life of a 20-year-old drug-addicted walking skeleton? Wouldn't injecting a so-called club drug only serve to fuel addiction? I solemnly swear I am not under the influence of any mind-altering substances as I write this.
A few months prior to really pursuing the idea myself, I had read an article about ketamine infusions to treat depression, touting buzzwords like "cure" and "miracle drug." I was in desperate need of a miracle to cure my mental ailments, and remembered how much I loved cooking and snorting ketamine with those German boys on that lovely beach in Cambodia.
I started hunting for vetted information on these treatments. Since the 70s, ketamine has been approved in the US for use as a short-term anesthetic in humans and animals. Due to the dissociative (and therefore abusable) nature of the drug, it was classed as a Schedule III Controlled Substance in 1999. But ketamine has been prescribed off-label to fight depression for nearly a decade.
Ketamine works completely differently than common antidepressants like SSRIs (selective serotonin reuptake inhibitors) and SNRIs (serotonin-norepinephrine reuptake inhibitors). These compounds work by blocking the absorption of the neurotransmitters serotonin and norepinephrine, adjusting the levels of those chemicals to help regulate mood.
Instead of focusing on chemical imbalance, ketamine may change the structure of the brain. Scientists are still learning how ketamine works in the brain, but research has found that an injection of the drug triggers the release of a different type of neurotransmitter, glutamate, which stimulates regrowth of neural pathways that show loss of function associated with stress or depression.
The theory is that by targeting glutamate, the most abundant neurotransmitter in the brain, ketamine may be going straight to the root of the problem. Which may be why it works so fast—patients can show results within hours, versus waiting weeks or months for reuptake-inhibitors to be effective (not to mention bypassing their unpleasant side effects).
A National Institute of Mental Health study found that even one intravenous infusion of ketamine could produce "robust and rapid antidepressant effects." For the unfortunate souls who have tried everything else to no avail, this is huge. Some experts believe it could be a breakthrough that leads to a new type of glutamate-based antidepressants. Many are calling ketamine the biggest advance in depression treatment in years and even the future of psychiatry.
But why did I need a treatment so experimental it's currently reserved for treatment-resistant depression?
I've had some type of discomfort with living since I was little, enough so that my parents began taking me to therapy when I was in the first grade. I was never satisfied. Not with how I felt, looked, or who I was. Growing up, I'd always seen medication as a quick fix. Headache? Take two Advil. Strep throat? Down go the antibiotics. Soon enough, I would be good as new. One morning before school, I decided to take one of my older sister's Adderall. I was 12 years old. I wasn't quite sure what this pill would "fix," but I knew I wanted to try it.
Almost instantly, I fell in love. I didn't have to eat, but I could stay up for days composing brilliant messes. I continued experimenting with different drugs. The next eight years were a blur of constant intoxication and self-hatred. I was confused why I couldn't find any relief despite the chemicals I was forcing into my body, both prescribed and not.
After high school, I took a year off before college to "find myself." I traveled through Southeast Asia, Europe, and Central America. I worked with elephants in Thailand, taught and lived with orphans in Cambodia, and studied Ashtanga yoga in India. Thanks to Xanax and alcohol, I can't remember the majority of it, and thanks to my eating disorder and assorted uppers, I didn't get to try most of the delicious food.
By the grace of cocaine, Vyvanse, and Adderall I continued shedding pounds until I weighed little more than 85 pounds at 5'7". Unbeknownst to me at the time, I did not look good. Shocker. During a brief stint in college, I stayed up for days, painting the walls of my one-bedroom apartment and writing incoherent pieces for the classes I neglected to attend. Opiates and benzos offered a break from amphetamine-fueled insomnia. I often didn't have enough energy to so much as walk to the bathroom without needing to sit down (falling, on a bad day), and I was so depressed and anxious I rarely wanted to leave the house to see anyone or anything.
For years, I had considered death, seeking a way to bring it upon myself. It seemed like such a dream, so ideal. The world was a miserable place. I hurt myself in many ways and forms. I begged the world to let me die, to let me find peace.
My parents begged me to accept the help they were offering and go to rehab, but I refused. I believed I was far beyond help or hope. "This was the way I am, and I will always be this way! Leave me the fuck alone, it's not your problem, just let me die!" were some of the delightful things I yelled at them through the phone, though they have since informed me that most of the time I was so far gone the things I said made little to no sense.
Meds were out of the question. I had tried them in my teens, never seeing any worthwhile improvement. I wondered if shock treatment was the answer. I convinced my parents I would go to rehab if the ECT helped me feel like I could try to tackle the pain I felt. The doctors zapped me, and rather than seeing improvements, I simply lost about two months of memories. What the fuck happened in June and July 2015?
It was then I pulled the ketamine article out from the scary depths of my noggin. After finding a doctor on the ever-informative Ketamine Advocacy Network, I made appointments for the first two of a set of six infusions at $500 each. I clung to the small sliver of hope I had managed to muster, wondering if this could be it. I wasn't quite sure what results to expect, but I knew this was my last option.
At my appointment, the doctor described how ketamine worked and why it was promising for my treatment-resistant depression. He spoke of glutamate receptors versus serotonin, neurons and neurotransmitters. All I heard was "hope." The doctor said it might show results in as little as 24 hours after the first or second session. He said it wouldn't make me not want to die, but want to live. He said it had a success rate of over 95 percent, but not to get my hopes up too much, as there is no way to promise efficacy.
The infusions weren't as wild as people seem to think. I wasn't "trippin' balls" or tasting colors. No k-hole. Relative to the dose people take to get high off ketamine, the infusion is quite small, (0.5mg/kg versus the over 100 mg that is typically taken recreationally) and infused into the bloodstream quite slowly, over the course of about 30-40 minutes. I listened to Flying Lotus in the dark, dissociated a little, and proceeded to walk myself back to the subway.
Less than a day after my second infusion, I went out with friends. WHAT. Unheard of. I had forgotten I even had friends, or I'd scared most of them away. My housemates said things like, "woah, you're out of your room. What's going on?"
I went from a bedridden addict to a functioning addict, though I was already beginning to cut back on the drugs. I was up and out much more, and my mood had improved drastically; I felt less need to numb. For about six weeks after my set of infusions, these changes remained. I was feeling the positive effects of the ketamine, but it is not a miracle drug. You can change the way your brain works, but you need to change your life to find happiness. Much to the relief of my family, many friends, and parts of myself, I arrived at rehab in September of 2015.
Now it's December. I have been sober for over three months. I live in a transitional living house in Orange County, California. I am beginning amazing relationships with my parents and my sisters. I have a job I adore teaching yoga again and am making plans to return to school. I exercise and eat healthy. I think clearly. I have things I didn't even know I wanted. Not only can I face myself again, I love myself. I love my life. I want to live.
Ketamine is a promising treatment for depression, and a potential lifesaver for suicidal individuals that don't respond to traditional antidepressants. I don't know if it will prove to be the future of psychiatry, but I am certain that without it, I would have died. I'll always be amazed that it was a drug that saved my life.