How Ketamine Infusions Affected My Treatment-Resistant, Rapid Cycling Bipolar
Any medical information included is based on a personal experience. For questions or concerns regarding health, please consult a doctor or medical professional.
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I’ve been rapid cycling with bipolar disorder for over a year. It’s the worst episode I’ve ever had. I’m 64 and I’ve been doing this since my early 20s. This period has been a seemingly endless cycle of being slammed down to the ground with debilitating depression and then jerked up to the ceiling in hypomania. Over and over again. A day up followed by weeks down, and with the typical accusatory tone of the disorder, constantly yelling at me that it was all my fault. If I’d only try harder. If I would only change the way I thought. If I’d only eat right. Avoid caffeine, avoid sugar. If I’d only exercise. Every day. If I’d only meditate several times a day. There was a litany of things I should do, but they’d only work if I did them perfectly. And of course, I could never do any of it perfectly. So it was my fault. I also have complex post-traumatic stress disorder (C-PTSD), obsessive-compulsive disorder (OCD), anxiety, attention-deficit/hyperactivity disorder (ADHD) and a couple of other minor players in what is my overall mental health adventure. I was having panic attacks almost daily. I was having emotional flashbacks left and right. There’s really no way to describe the hell that had become my life. I own a business and I couldn’t work. I just wasn’t functioning at all. I drifted through the days, wishing I could die and too afraid to make it happen. The OCD was certainly attempting to make it happen with vivid images of self-harm driving me to distraction.
My psychiatrist tried one medication after another. In an eight-month period, I was on then off six different medications. The last one almost killed me. Not physically, but the gruesome battlefield it turned my mind into. I would go from a melting puddle of tears to a rage in a five-minute span. Finally coming off of that last drug, my doctor declared my condition “treatment-resistant.” And that was met with amazing relief. No more drugs. That was quickly followed by the realization that I was now going to go into battle against this disorder bare-naked. Just me and it. That thought terrified me. I knew I couldn’t do it but what was the alternative?
Then I heard about ketamine. Ketamine is a drug that has been used safely for over 50 years as an anesthetic. They have recently started using it to treat treatment-resistant depression. It’s given intravenously (IV) in a clinic at a much lower dose than is used for anesthesia. After much research and many discussions, not all of them peaceful or friendly, my husband and I decided that it was worth a shot. I talked to my psychiatrist and he gave his blessing. I contacted the ketamine clinic and told them I’d like to begin treatment.
I was scheduled for six infusions in two weeks. You start with multiple infusions close together to get the ketamine into your system. The duration of the effect lengthens as you receive more of it over time. Because ketamine is a dissociative anesthetic, at the doses used for depression treatment it can cause a psychedelic experience with hallucinations and an “out-of-body” experience. They prepped me saying that my mindset was important. That seems like a funny thing to tell a suicidal person, but I took the advice to heart and prepared myself. I read all I could find about ketamine on the internet. I talked to my psychiatrist about it. My husband and I both went to the clinic where they patiently answered all our questions. We listened to happy music in the car on our way to my first appointment. I showed up for my first infusion with a little fear and a lot of hope. I tried not to let my hopes get too high, but when you’re barely hanging on to the bottom of the river, it’s hard for your hopes to go much of anywhere except up.
That first infusion literally changed my life. They sat me in an extremely comfortable reclining chair for the one-hour infusion. They showed me the camera that would be pointed at me, allowing them to monitor me the whole time but also leave me alone for the experience. They showed me the call button that was right by my elbow. They hooked the IV up to my arm along with a blood pressure cuff and a blood-oxygen monitor for my finger. They gave me a set of headphones to put on, through which electronic spa music was playing. They dimmed the lights. And I took off on a psychedelic journey that is literally beyond description, but I’ll try.
The effect of the drug started in about five minutes. It was a slow transference into a peaceful, safe-feeling place in my mind. Because of childhood trauma, I’ve lived all my life feeling like I was on the outside. Not allowed to be happy, not allowed to even acknowledge my own needs, I was used to being on the outside; it was just where I “belonged.” As I went deeper into the psychedelic part of the ketamine “trip,” I came upon a giant orb of energy. It was kind of pulsating and pink. Huge. And I instinctively knew it was humanity. And they were calling to me. They were inviting me to join them. They were telling me it was OK, I was welcome, yes, please come join us. And the safety of the cocoon I felt I was in let me smile and agree to go to them. I joined them.
All of this, of course, only occurred in my mind. But, wow, it stayed with me after I came back to reality. There was an openness in me that I had never experienced in my life. This only lasted about 12 hours after that first infusion, but the duration of it increased with each infusion I got. I wasn’t as cynical about other people. I was able to experiment with letting people into my mind and my world. It was OK to let the “secret” of me out. I think anyone who lives with C-PTSD from childhood trauma will understand what I’m talking about when I talk about the “secret.”
Four days later, I had my second infusion. I arrived at the clinic in a state of extremely high anxiety. I let them know what was going on so they were aware. Ketamine is used in the treatment of anxiety too, so we went ahead. This time, there was no giant orb of humanity opening in welcome to me. Instead, I entered into a green-gray world of jarring sharp edges and harsh climbs and deep dives. It was scary. At one point I became aware that Colleen, a nurse specialist at the clinic, was sitting beside me holding my hand. They had observed my agitation through the monitor and she came to “sit” with me. She kept telling me “you are safe” and just holding on to my hand. I don’t remember many details of it now, mostly I remember it was incredibly frightening and uncomfortable. I am very grateful that Colleen was there to hold my hand. I never asked her, but her hand had to have hurt afterward, I held onto her so tightly. I do remember telling her I wanted to get back to the “pink.” My first trip had been so good and peaceful … and pink. This one was green and ugly and I didn’t want to go back there ever again.
Coming out of that trip, they assured me that it happens sometimes. Brent, the anesthetist administering my treatment, told me “you aren’t here to get high, you’re here to get healthy.” I’ve hung onto that because he’s right. While the trips are usually good and enjoyable, they can get bad too. But it doesn’t matter. Either way, the drug gets into you. And it does what it needs to do.
The night before my third infusion, two days later, I didn’t sleep at all. I was in hypomania. Since I was awake, I watched “Moonstruck,” one of my favorite movies that always makes me smile. I watched a few videos about ketamine treatment. And I cruised into the daylight hours watching YouTube videos about random acts of kindness. I arrived at the clinic in a super frame of mind. I was ready for it. My mindset was in a rosy place and it was a good experience, as have almost all of the infusions been since then.
I don’t really know if my experience with ketamine is typical or not, which is part of the reason I’m sharing it. My experience has not matched the things I read about on the internet or watched on YouTube. Ketamine is without a doubt a lifesaver. It can absolutely take you from the edge of suicide and yank you up to remember what it is like to want to live in a matter of hours, not a matter of weeks like antidepressants take. But my recovery hasn’t been linear. It’s been three months since my first infusion. I still plunge down into pretty deep depressions, but they don’t last. And for the most part, I’m better than I’ve ever been. My husband, whose main objection was the cost, doesn’t care anymore what it costs. He’s that happy with the results. The neuroplasticity that ketamine provides is a very real, very amazing thing. It has opened up parts of my mind that I didn’t know were there. It’s allowed me to experience what acceptance feels like. And now that I’ve experienced what it feels like, I can reach it in everyday life. I don’t have to be on a ketamine trip to feel accepted. My mind knows now what it feels like and I’m strong enough, and maybe brave enough, to get myself there by remembering it. Mindfulness is easier now too. I enjoy staying in the moment and being with the people I’m with. I’ve only dissociated once since I started treatment.
Don’t misunderstand me; it’s still a lot of work to maintain my mental health. I have an infusion once a month. As of last month, I have ketamine lozenges that I use at home three days a week in-between infusions. I see my therapist once a week. I meditate (almost) daily. I try to eat well and keep a healthy sleep regimen. My husband of 35 years and I talk a lot. He’s been much more open to hearing what it is like inside my mind and I’ve been so much better able to share that with him. I never could talk about it before because of the deep shame and certainty that it was all my fault. We’ve started making it a habit to take short day trips away from home on weekends. We’re reconnecting with each other and I’m practicing being open to life and to other people. I’m feeling closer to both of my sons and I’m able to share this experience with them too.
At the risk of sounding really corny, I feel like it’s a whole new world for me. And at my age, I feel like that’s saying something. I am so grateful that this drug is available. I’m grateful to the clinic where I go. They take such good care of me and they make me feel so wonderfully safe when I go there. I’m grateful to my doctor who encouraged me to go ahead and try this treatment. He has since gotten more involved in knowing more about ketamine himself and has started referring other patients there. This is a good thing.
I’m not completely out of the woods. I don’t know what the long-term effect of ketamine will be on me and on my mental health. But for right now, ketamine has given me back hope and increased my quality of life many times over. And having been hopeless, without hope, I know how important hope is. I think I can do almost anything as long as I have that.
For more experiences with ketamine treatments, check out these stories from our community.
Getty Images illustration via Anney_Lier