I'm Starting Ketamine Therapy. Here's Why.

Next week, I'm going to take ketamine.

That sentence still feels a little strange to write.

Not because I don't know what ketamine is. I've been working at The Journey Within for about eight months, and I've spent a lot of time around the women who administer these treatments and help patients through them. I've listened to them explain the process. I've asked questions. I've watched people become advocates for something I wasn't sure I understood.

And now I'm going to be one of those patients.

I'm doing ketamine because I'm tired of living in a state of anxiousness, anger, frustration, imposter syndrome, and a bleak outlook on life.

I want to let go of things I need to let go of. I want to rewrite thought patterns that aren't serving me anymore. And, frankly, I'm willing to confront whatever I need to confront.

Why ketamine?

Ketamine is probably best known as a dissociative anesthetic. It has been used safely as an anesthetic and analgesic for decades. In mental health care, ketamine is also used at lower, sub-anesthetic doses for conditions including depression, anxiety and PTSD. That psychiatric use of ketamine is considered off-label, meaning the FDA has not specifically approved ketamine for those psychiatric diagnoses.

Spravato, which contains esketamine, is different. It is FDA-approved for treatment-resistant depression.

Ketamine also works differently from many of the psychiatric medications people are more familiar with. It affects the NMDA receptor and the glutamate system rather than primarily working through the mechanisms associated with traditional antidepressants.

But honestly, the pharmacology isn't what initially drew me in.

Neuroplasticity did.

I've got some thought patterns that have been deeply ingrained in me. Some of them were built through experience. Some were reinforced by my environment. Some came from being a survivor of conservative religious trauma. And some have been reinforced by the broader, increasingly misogynistic social environment I've lived in.

I don't want to pretend those things didn't happen.

I want to rewrite what happens next.

That's what interests me about ketamine: the possibility of creating a window in which the brain becomes more flexible and I can examine patterns that are difficult to see—or change—when I'm operating from my ordinary state of consciousness.

I'm also a little scared of it

Here's the funny part.

One of ketamine's defining characteristics is dissociation.

And dissociation scares the hell out of me.

I don't like feeling disconnected from my body. Even when I drink alcohol, I will stop before I reach that point because I don't enjoy the feeling of losing that connection and control. On the rare occasion I've gone too far, I find it frightening.

So voluntarily entering a dissociative state isn't exactly my idea of a relaxing Tuesday afternoon.

But the consent form I signed doesn't pretend that ketamine is going to feel like a massage.

Ketamine can create a non-ordinary state of consciousness—a period in which your experience of your body, your surroundings, your thoughts and even your sense of time can change. Depending on the dose and the individual, people may experience altered visual, auditory and tactile perception, time dilation, unusual thoughts or imagery, emotional shifts and a sense of separation from their ordinary reality.

Some experiences may be light.

Some may be dark.

Some may be both.

And I am going to have to let go enough to experience it.

That's the part I'm nervous about.

I know what I do when I feel like I'm losing control: I fight.

I fight to stay in and in control of my body.

So one of the biggest questions I'm carrying into this first treatment is whether I'll be able to stop fighting the experience long enough to actually experience it.

Fortunately, I trust the clinicians administering the treatment. I trust the amazing women I work with. And I've been through a lot of scary shit in my life.

I'll make it through this too.

This isn't a magic pill

This might actually be one of the things I like most about ketamine therapy.

I don't want a magic pill.

I know they're not magic.

I believe uncommon results follow uncommon effort. That's how I approach my physical health. I want to eat right. I want to exercise smart and hard. I want to sleep seven to eight hours a night. I want strong muscles, healthy bones and a body that can serve me well for a long time.

I believe in a holistic approach to health—mind and body.

So I'm not looking at ketamine as something that's going to swoop in and fix me.

I'm looking at it as a tool.

The consent form describes ketamine as a catalyst—something that may allow a person to access different ways of experiencing themselves and their thoughts. The clinicians aren't simply administering medication and sending patients on their way. The treatment includes preparation, monitoring and integration afterward.

That's important to me.

I've actually started looking for a talk or EMDR therapist to work with between my ketamine sessions.

Because if one is going to do the thing, one should do the thing all the way.

If ketamine opens a door, I want to be willing to walk through it.

What am I hoping to find?

I don't have a perfectly articulated answer.

Maybe that's part of why I'm doing this.

I'm hoping I'll learn something about the pain and anxiety I've been holding onto.

What is it?

Where did it come from?

What am I still carrying that I don't need anymore?

And where do I start fixing it?

I know I'm going into this willing to see things that may be uncomfortable. I don't expect every experience to be pleasant, and I don't think a difficult experience necessarily means the treatment isn't working.

The goal isn't to have a fun psychedelic experience.

The goal is change.

The consent form talks about the possibility of profound changes in mood, cognition and personality during treatment and in the days and weeks afterward. It also acknowledges that some experiences may be temporarily disturbing.

I'm okay with that.

I'd rather confront something uncomfortable than continue living inside a pattern simply because it's familiar.

What actually happens during ketamine therapy?

My treatment will be an intramuscular injection.

I'll be monitored by clinicians throughout the process, including monitoring of vital signs. I'll remain at the clinic until the clinicians determine that I'm ready to leave.

Because ketamine can affect balance and coordination, I won't be driving afterward. My partner is coming with me, and he'll drive me home and take care of me afterward.

Which brings me to another concern:

What the hell am I going to say?

Apparently, altered states of consciousness can come with fewer social filters.

My partner will be there.

So, babe, if I propose marriage or announce that we should have a baby, remember: it's just the drugs talking.

And if I start talking smack about my coworkers or bosses while I'm sitting in a room at my own workplace with one of the providers listening...

Well.

Yikes.

Jokes aside, that vulnerability is part of what makes this different from simply taking medication at home.

I'm intentionally entering an experience where I won't have complete control over what I think, feel or perceive. I'm doing it in a structured environment with people I trust, and I'm agreeing to remain there until they determine I'm safe to leave.

That feels very different from the mail-order ketamine I tried previously.

That was an expensive bust.

It didn't do a damn thing other than taste bad.

This time, I'm approaching ketamine as part of an actual therapeutic process.

So, will it work?

I have no idea.

And I think that's important to say.

Ketamine doesn't permanently relieve depression for everyone. People can relapse. Some people eventually need additional sessions, therapy, medication or other approaches. And some people may stop responding to ketamine over time.

I'm not going into this expecting six treatments to magically erase everything that's happened to me.

I'm going into it hoping for a different relationship with what has happened to me.

I want to rewrite some of the stories I've been carrying.

I want to find the thoughts that are helping me and strengthen them.

I want to recognize the ones that aren't helping me anymore and loosen their grip.

I want to confront what needs confronting.

And then I want to do the work.

This is the first article in what I'm planning to make a series about my ketamine journey. Right now, I'm writing from the other side of the consent form but before the first treatment.

I don't know what the experience will be like.

I don't know what I'll learn.

I don't know what will change.

Next week, I find out.

If you're wondering whether ketamine-assisted therapy might be appropriate for you, the first step isn't deciding whether ketamine is your answer. It's talking with a qualified clinician about your history, your goals and whether you're a candidate for treatment.

You can learn more or book an appointment with The Journey Within at journeywithin.net.