The Crying is Back

I started crying again. I felt like things were better, less triggered, no recollection of panic attacks since starting ketamine treatments. Then the tears came back and I feared I was regressing. Yet neurologically and physiologically these are two different states. Prior to ketamine I was in a collapsed state, dorsal vagal shutdown, where the nervous system believes survival is threatened and escape or repair isn’t possible. In this state the crying was uncontrollable and got to be constant. The hopelessness felt absolute and permanent. I am told I'm in a nervous system that is still wounded, still grieving, but no longer trapped in the same physiological prison. Ketamine restores flexibility to neural networks. That means emotions that were previously frozen or buried can move.

"Doesn't that sound nice? Now you can cry and let it out and heal!" No one said these exact words to me, but I've heard many versions of it. I don't have any expectation of "healing", as I don't believe we can heal from everything. There feels like an expectation of those looking on from the outside, that "healing" is an actual achievable goal, and if you don't then it's your fault. Though the intentions are good, it's not helpful. 

Since things appeared to be going well, when the tears came back I was crushed and scared. My mother had sent a picture of a snowfall through a family text chain. My brother replied with a picture from the ocean saying he had a better view. This brother is also a therapist, who I reached out to when I was trying to get into intensive outpatient. He knew I was suicidal and going down hard. He doesn't know I'm now doing ketamine as he hasn't reached out at all to see how I am doing. He also got engaged over Christmas and is traveling the world with his fiancé. I am still unemployed, alone, and my one big goal when I got divorced was to travel and just an hour before this text I'd downgraded my Sky Miles Amex as I've lost flight status and can't afford to go anywhere. The comparison, looking at what I want yet just never happens for me, seeing a life I'd long for, it all just took me out. 

First thoughts were that I couldn't go through this again. I thought of the months in collapse where I'd be screaming and sobbing, and it nearly ended me. But the crying did stop this time. I saw that though painful, I got back to my level set depression state and kept going. 

I've wiped the tears once again. And I'll go on. But I'm so fucking tired of trying and living in this pain.

Tips & Tricks from the Psychedelic Trenches

Author's note: this post will speak directly to my personal experience. Yours might be different. Do what is right for you.

Going into my 5th ketamine session today. Might be at a higher dose, and doing this two days back-to-back, so I'm expecting to be decently out of it and that my experience will likely change from the previous ones. 

These are the steps I take that worked for me, some from advice from others, and some just knowing how my body reacts.

Comfort:
I need complete and absolute comfort in my sessions. Tried having my hair in a ponytail but that small pull on the hair was too intense. Changed underwear prior to a session as it was creeping up my butt a bit too much and I knew it would bother me. Soft clothes, nothing tight or binding, not even the slightest bit of irritation. 

Warmth & Weight:
I need to be extra warm. Not hot, but no amount of chill. I used a weighted blanket my last session and it comforted and grounded me in a way that I felt completely secure.

Food:
My first session I was nervous and didn't eat much. I had a 1/2 of an apple, small amount of almond butter, and a few hours later one slice of toast with a little almond butter. This was fine, but I have issues with low blood sugar so I don't think it was enough, especially as my session went over lunch so I wasn't able to eat again until midafternoon. The next session I had what is my go-to breakfast: I call it a protein pancake. Basically, a small amount of protein pancake mix, 1egg, cinnamon, stevia and a little almond milk to moisten. I eat it with berries. My blood sugar felt more even with this or maybe it's just what my body likes, so I've been sticking with it. Maybe it's because my sessions have been over lunchtime, but by the time I get home I'm shaky and struggling, so I need food that I can grab and go right to the couch. Tried to cook something after one session and it was too much effort.

Home prep:
I need to have everything in my home comfortable and ready to go, so when I get home from a session there is nothing for me to do but rest. Everything clean and orderly, food stocked, candles, lighting...I sort of make my own home spa setting.

Music:
I was advised to use ear buds and play music without lyrics. I played Ambient Deep Sleep (though there are many Ketamine playlists on Spotify). I can see how any music with lyrics, or even instrumental that brings up recall memory, might be triggering. 

During treatment:
In the clinic I go to there are lounge chairs, a little table with barf bags (amazing I didn't need one), mints (for the chemical taste of ketamine going down your throat), kleenex, and a call button in case you need anything. I get situated by making sure my blanket is all the way up to my neck, laying way back, earbuds in and then stillness. The first session I don't think I moved at all but the ones after I did switch positions to my side later in the session. I did see one patient sitting up looking at his phone during his session. I can't imagine this, and struggle to even do this after the session at home, but again each experience appears to be individual.

Vitals:
Your vitals are checked before, during, and at the end of your session. It's typical for people's blood pressure to go up during a treatment. Mine goes down, but doing the opposite is typical for my body, which is all the more reason I'm relieved and amazed that I haven't had side effects from this.

Bottom line advice:
Tune into you. Listen to the advice of others, but your body is your best teacher (my yoga teacher voice coming out now). Your body knows what to do, don't fight it, just be there and let the drugs work for you.

He didn't love you

"He didn't love you." Said to me so matter of fact, as if I'd shrug my shoulders and say, "True!" then skip on down the lane. Always said to me in a way that assumes I didn't know this, and this knowledge would somehow change my feelings. Change my hurt. Change my heartbreak.

I loved his voice. His looks came and went. Sometimes looking so attractive and other times like a pudgy old man lying about his height. Though he'd always tell me how good looking he was. Soothing voice. A voice with conviction that you believed. Even when I knew he was wrong he would say things in such a way that my mind would question even with all proof before my eyes.

He didn't love you.

As I was crumbling, he said, "So have you cried yet today?" with a laugh and smirk in the undertone. He held me as we lay together on the beanbag that night. I was drunk, high, crying quietly as I plummeted further under. I never felt he cared, yet I clung to his arms with the distant hope that if he felt my pain he'd return to those early days of claiming he loved me. He saw and acknowledged I was breaking, even said he knew I was suicidal, yet offered nothing.

He didn't love you.

I drove drunk and high with him. Opening a bottle of wine and chugging it from the bottle while going down the road in broad daylight. Flying to Vegas to meet up with him and not telling anyone, where we agreed to play like we were in love and nothing in the past had happened for the time we were there. It was dangerous, and toxic, and I should really regret it but I don't.

He didn't love you.

I've lost two years of my life to this man. Longer. But even with the devaluation, the cruelty, the abuse...God we were so fucking great in some ways! He lied (yet said I did), said some of the most hurtful words ever spoken to me, broke me...but there was also a connection I have never had, and don't expect to again. 

He didn't love you.

The Magical Mystery Tour of my Brain

Author's note: I am documenting my ketamine experiences from my point of view. This is to share for anyone considering it, doing it, or supporting someone through this. I also believe, as with everything in life, our experiences are unique, so please take it from that view.

Two more ketamine sessions in and each one has had its own nuances. The day prior to my third session I had a brutal, but good, EMDR session with my therapist and was emotionally raw. I've also been told the third session can be rough as the novelty has worn off a bit, you know what you are in for, and likely wanting results. My mind raced during the third session, and I couldn't shut it off. Even after I got home, I was agitated though exhausted. Yet my fourth session was amazing! Back to being trippy (which I enjoy) and I was able to tell my mind when troubling images appeared "I'm thinking". No forced changed, no getting upset, just a reminder that my mind was thinking and didn't need my effort. On this session I also used a weighted blanket which gave me the containment and security, I think, to ease and calm into it.

Next week I am being moved to the higher dose (if it gets approved in time) and doing sessions 2 days in a row. I'm assuming I will be completely out of it for 2 whole days, and am making preparations to where I have food, house is clean, all boxes checked and nothing to worry about. 

How ketamine works in plain terms (And maybe it's just because I feel my brain changing or that I've struggled my whole life, that this fascinates me to no end. I underlined parts that really stuck out to me, adding some commentary in parenthesis that hit me.):

How ketamine works chemically in the brain

Ketamine works primarily by affecting the brain’s glutamate system, which is the main system responsible for learning, adaptation, and neural communication.

Most traditional antidepressants work on serotonin or dopamine and take weeks to gradually adjust levels. Ketamine works differently. It acts upstream, at the level of neural connectivity itself.

1. Ketamine temporarily blocks NMDA receptors

NMDA receptors normally regulate glutamate activity. Ketamine blocks these receptors briefly, which creates a controlled disruption in the brain’s usual signaling patterns.

This interruption prevents the brain from running its habitual loops in the same rigid way. (I'm a hard ruminator. Even when having a good time, in conversation, doing anything, the thoughts are incessant.)

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2. This causes a surge of glutamate release

Because NMDA receptors are blocked, the brain releases more glutamate through other pathways, particularly AMPA receptors.

Glutamate is not a “mood chemical.” It’s a plasticity chemical.

It tells the brain:

“Pay attention. Something new is happening. Adapt.”

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3. This activates repair and growth mechanisms

The glutamate surge triggers downstream processes, including the release of a protein called BDNF (brain-derived neurotrophic factor).

BDNF supports:

• growth of new synaptic connections

• strengthening of healthy neural pathways

• repair of stress-damaged circuits

Chronic depression and trauma tend to weaken and prune neural connections. Ketamine temporarily reverses that pattern. (Temporarily. I just had my gut clench in fear of what happens when this ends. I wonder if you do enough of these sessions that it actually allows for repair.)

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4. The brain becomes more flexible

For a period of hours to days after treatment, the brain enters a state of increased neuroplasticity.

This means neural pathways are less rigid and more capable of reorganizing.

Thought patterns that previously felt automatic and inescapable may loosen. Emotional responses may no longer trigger the same intensity of physiological alarm.

This flexibility allows the brain to update itself.

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Why effort is not required

This process is chemical and cellular. It does not depend on conscious effort. (This is a hard one for me. I've been told for so long that my mental state is from my lack of effort while I'm always trying.)

You cannot “force” neuroplasticity through concentration or willpower during a session.

The beneficial effects come from the biological cascade:

• NMDA receptor blockade

• glutamate release

• BDNF activation

• synaptic remodeling

These processes occur regardless of whether your mind is quiet, busy, creative, or distracted.

Trying to control your thoughts does not enhance the effect. In fact, excessive effort activates control networks that can interfere with the nervous system’s ability to settle.

The brain repairs itself best when it is not being micromanaged. (I straight up laughed out loud on this one! I absolutely micromanage my brain.)

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What you may notice subjectively

Because the brain becomes less locked into old patterns, people often experience:

• more space between thoughts and reactions

• reduced rumination

• emotional distance from previously overwhelming material

• increased ability to choose responses instead of being driven by reflex (Though mostly responsible, I'm a highly impulsive person. I've been judged harshly "Why would you do that?". I don't fucking know!)

These changes often emerge gradually, not all at once.

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The key point

Ketamine does not insert happiness into the brain.

It restores the brain’s ability to change.

Once flexibility is restored, the nervous system is no longer trapped in fixed survival patterns. New responses become possible.

And importantly, this process happens whether you try to make it happen or not.

Something Amazing

I found this quote I'd forgotten about that was my mantra and focus when I got divorced. "....Okay is not the reason you risk absolutely everything you've got for the smallest chance something absolutely amazing could happen!" I left without a dream or a clue as to what "amazing" would even mean for me. I simply couldn't live another moment trapped in mediocrity and lovelessness. I read it while trying to buy my condo (which my realtor and the closer said was the hardest closing they've ever experienced), I read while sleeping on the couch with a blanket too short to cover my feet because I was starting over with nothing, I read it when flying to Greece alone for the trip I'd always wanted with a partner. Hanging onto the smallest chance something amazing would happen.

Writing this the day after Valentine's day which is a hugely sad and triggering day for me. I'd wanted a wonderful romantic Valentine's my entire life. No boyfriend in Jr High or High school. I watched as the other girls would get sent a rose on Valentine's day and hope, wish, and pray I'd get one but never did. My (ex) husband was the first to ever give me a Valentine's card. The first card, and every card for 24 years, said the same thing "I know I never say it but...". Every card. He'd buy me roses from the gas station that sold a dozen for $9.99. And I'm as happy as anyone for a great deal, but there was zero thought into who I was. He could have spent $5 on pink carnations and that would have shown actual care and thought about me. Even his Facebook posts were about him and not me, showing how he'd bought me roses but nothing about me, his wife. 

When I met my last boyfriend (I struggle to even call him that as it all progressed into such an abusive mess), I was desperate, hopeless, and prime for manipulation. By the time our first and only Valentine's rolled around, I knew who he was but I shoved it all down still clinging to just maybe getting one moment of something amazing. We had a wonderful dinner, beautiful loving card, flowers, presents and the public profession of love on a Facebook post that I'd been dying for saying I had brought him the happiest moments of his life and he loved me more each day. I wiped tears reading it and then I looked at the pictures he posted with it. Alongside adorable pictures of us as a couple he included one of my ass crawling up the stairs drunk and another of me before surgery (that only my closest friends knew about) where I have no makeup, hospital gown, hair net, IV in my arm. The tears changed from elation to hurt. I asked why he'd post those pictures, while being extra careful not to sound mad as I didn't want this moment I'd waited for my whole life to go wrong. He said, "Oh I just quickly grabbed a couple." In the short time we were together we had a massive amount of pictures of us, we dominated the Facebook feed, this was a purposeful cutdown. I smiled and stayed silent as I couldn't accept that this wasn't real.

My 5th ketamine session is tomorrow. One of the biggest things I've noticed is my thoughts are different. The sadness, hurt, and trauma aren't gone but they are distant. I can say, "That was awful and hurt me to my core." without spiraling down the rabbit hole. I saw all the happy couples posting yesterday, and though my mind said "you'll never get that", it didn't make me want to drive into a semi.

Though all signs show my existence will be to die alone, my life is amazing. I have an unbelievable amount of people in my life that love me and have given and shown up for me in ways I could never have fathomed possible. I have pushed through every fear, and self hatred, to do things my little self would never have dared to dream. (I didn't even allow the dream....I just kept going.) For some reason, and I do believe there is a reason, I'm still alive. This is a miracle as I was quite literally hanging from the edge and not telling myself to hold on, but to end it. But maybe, just maybe something amazing will happen.

Rewiring my Brain through Chemistry

After a lifetime of depression, anxiety and suicidal ideation (first memory of those thoughts at 6 years old), and trying everything I could find with no relief, it was suggested I try ketamine treatments. The first person to mention it to me was a friend who had said, "I get it. You're like me...your baseline is depression and when things get bad it goes catastrophic." It was the perfect description. It was sometime and nearly killing myself (no exaggeration...it was closer than I admitted to anyone), that it was brought up again with a psychiatrist. She was the first to make the connection between my inability to take nearly all antidepressants, and my body's inability to handle serotonin modulation (which is what SSRIs and SNRIs do). She said my case was a complex and severe condition which needed layered care. I was coming online out of dorsal vagal shutdown, unemployed, with nothing to lose so I agreed.

I am going to detail my personal experience: good, bad and otherwise, with ketamine, both for myself, for those that have done it, and for anyone considering it. Beyond these reasons, to also take the stigma off of mental illness. To shine a light where we've been told to hide. Yes, our brain broke, just like any other body part or system, and we're trying to heal it with science. 

Getting approved by insurance was the first hurdle, and along with approval my insurance said I had to be on an antidepressant. I was coming off of Cymbalta which instead of being stimulating was causing me to sleep 20 hours a day. But with the understanding of no SSRIs or SNRIs, we agreed to Wellbutrin. I recalled taking this before, and though I didn't feel it "worked", I didn't recall terrible side effects, and it's one of the few that doesn't mess with serotonin. 

My biggest fears weren't taking ketamine itself. Drugs don't scare me. I was fearful it would be a shit ton of effort for yet another thing that didn't work and feeling that if it didn't it would be the end of me. Some nausea concerns, as I have the world's weakest stomach, but after that curiosity.

I had to humble myself and ask for help, as you cannot drive and need to stay at the clinic for them to monitor you for two hours. A huge ask. But friends had offered and they were my only choice to make this happen. I created a Doodle and found times for anyone able. I'm still struggling to take this in, as I don't know how to repay it. For my first ride there my friend played Magical Mystery Tour by the Beatles. I howled laughing! It was perfect. 

The clinic was lovely. You could have put up a spa sign with their diffusers and flowers. They put you in a small room where there is a lounge chair that reclines, aromatherapy diffuser, mints (in my ketamine treatment it's taken nasally - feels like coke going down your throat with a nasty taste), barf bags in a cute basket, and a blanket. They take your vitals before, during and after. Once it was administered, I put in earbuds with an Ambient Deep Sleep playlist (I was advised by my friend to use earbuds and music without lyrics...just sounds), took off my shoes, pulled the blanket up and laid back. 

Initially I was just trying to relax and then I could feel the effects kick in. I started seeing red stalactites and stalagmites growing in darkness. There were distant colors but not psychedelic. Went into the galaxy for a brief moment but otherwise not seeing anything specific. While feeling trippy I was still completely aware of where I was and what was happening, though completely unsure of time. 

When I got up, I was extremely slow. I could talk but getting words out took effort. Some nausea on the drive home but that might have been due to hunger. Got home, ate a little, then laid on the couch watching "Sex and the City" for the thousandth time. Even texting was too much effort. I fell in and out of sleep the rest of the day and fell asleep early. The next day I was a little groggy but coherent. Felt OK but didn't want much head movement: this is due to inner ear sensitivity, nervous system settling, and the brain recalibrating.

I noticed after only one session that thoughts I ruminated on daily, sometimes all day, weren't gone but were distant and not as triggering. This is what ketamine does: lowers the volume on your threat signals and creates psychological distance, working with the brain's neural plasticity to make it less rigid. The trauma doesn't go away, instead it calms your reaction to it.

My second session was two days later and much different. I was much more alert the entire time. Nowhere near feeling like a tripping experience. After, though still slower, I was much more alert. Though I didn't want much activity the rest of the day I was awake and alert. The biggest physical sensation I've noticed after both treatments is the need to keep my head still. 

Not happy, but not spiraling. Looking on as the observer, and trying not to go down the rabbit hole of "what will happen to me if this doesn't work?". 

I tried

"Sometimes the greatest performances require the greatest sacrifice. And sometimes the people brave enough to make that sacrifice get punished for their courage." ~ From an essay on Anne Hathaway

I'm going to start making posts about my current ketamine sessions to work on treatment resistant depression and CPTSD. Doing this for myself to watch what happens and for anyone else who may decide this is something they should do. But before I talk in more detail as to why I've decided to chemically rewire my brain, I want to talk about my efforts and what has been said to me about my efforts along the way. 

What I have been told about my ongoing depression, anxiety, and suicidal ideation from people who said they cared about me: 

• You aren't trying hard enough.

• You like being a victim.

• You are always angry.

• You don't try hard enough.

• You don't have enough faith.

• This is because you haven't forgiven your abusers.

• Depression isn't real...you just have to do something.

• You just need to be more positive.

What I have done: 

• 30+ years of therapy 
• My bookshelf is nothing but self help books.

• I've journaled until my hand cramped, and I could no longer write.

• Every antidepressant they had (until it was recently found out my system can't handle serotonin modulation)  

• I cried until my throat was raw from screaming and wailing for hours.

• I've recited positive affirmations.

• I took drugs (legal and otherwise).
• Drank it away 

• I tried to fuck it away.

• I've prayed.

• I've meditated.

• I've written gratitude lists.

• I've had demons prayed out of me.

• I've written forgiveness lists.

• I've written apology lists.

• I've had energy work.

• I've had reiki.

• I've done intentions.

• I've done manifesting.

• I've done spells.

• I've done magic.

• I tried to die.

Nothing worked. I've tried. I promise you I tried so hard.