Ketamine…Again?

Before I sat down to write this today I was planning on doing another Vlog. (Note: I actually wrote this and intended to post it yesterday before I found out that Facebook and Instagram had both crashed!). I thought I needed to maybe hear my own voice again today but I’m just too vulnerable right now and so I wrote my words out instead. 

My Psychiatrist increased my new medication again late last week with the intent to get it to a therapeutic dose soon. It’s an anti-anxiety medication which I mentioned I would be starting a few weeks ago. As of yet I can’t say that it’s really been helping me. So for now I will just add it to the long list of failures.

Yesterday was a pretty bad day all around for me. My anxiety was very high which then turned to panic, crying, rumination and an increased amount of thoughts of death and dying.

As I also mentioned recently my Psychiatrist had put a plan together for me when we spoke a few weeks ago. It included this new anti-anxiety medication and it also included treatment for Ketamine…AGAIN which has been scheduled to start early next week. 

So for those of you who don’t know what Ketamine is I will give you a quick explanation here. For starters, it’s actually a very potent and sometimes deadly street drug known as “Special K”. It is also apparently used as a horse tranquilizer but most commonly it is found in anesthetic.

I’m not gonna bore you or put you through a science class today but people living with Depression are known to have “abnormal brain plasticity”. Continued studies and research have shown that using Ketamine can help to remove the “negative receptors” in our brain and then it like “plants a seed” in your brain which allows for new “neuropathways” and positive neuroactivity to grow and flourish.

Studies have shown that by using Ketamine to treat Depression there has been a 60% success rate so far and unlike anti-depressants it is supposed to work faster and more effectively.

Now let me go back for a second here and explain (for those who may not already know) what I meant before when I said I am scheduled to begin Ketamine treatment…AGAIN.

Several years ago during an inpatient stay at Sunnybrook Hospital I was asked to take part in a Clinical Trial for Ketamine. I had never heard of it before but I was the perfect candidate though because it is used mostly on patients who suffer with Treatment Resistant Depression like I do. I happily and very naively agreed to try it. I figured I had nothing else to do seeing as I was in the hospital anyways.

I filled out a ton of paperwork, spoke in depth and several times with the Psychiatrist in charge of the study. I filled out many questionnaires with his Associates. After I was given approval to begin the study I was scheduled to start the 1st of 6 treatments the very next day.

They told me during the initial consult that the Ketamine would be administered through an IV and that I would have to lay there in the OR attached to an IV drip for 45 minutes and then kept for observation for another 30 minutes following. Before we began the process I asked the Anesthesiologist if I would feel anything. He said you may feel a bit woozy. 

Well woozy was an understatement because for the next 45 minutes I lay on the cold table hallucinating, feeling disassociation and seeing psychedelic images flash before my eyes. It felt like a complete out of body experience with flashbacks as far back as my childhood. 

I hated every bloody second of it and couldn’t wait for it to be over. The next day I met with the Psychiatrist to discuss how it went and we both agreed it was probably best that I don’t continue with the study. Another epic fail.

Now let’s fast forward to March of 2020. My current Psychiatrist happens to be the Medical Director of 2 Ketamine clinics in the GTA and has studied it’s effectiveness on Treatment Resistant Depression for several years now.

Back in February or March of 2020 (everything is kinda a blur now) we began another discussion surrounding Ketamine and he asked me if I would be willing to try it again as with more scientific research and studies conducted it was now available in a nose spray form. And less invasive.

He told me he would administer the 1st dose in his downtown office at the hospital he works out of to ensure I tolerate it and that the following 5 doses could be picked up at a local compounding pharmacy and be administered under the supervision of my husband in the comfort of my own home.

I agreed to try it AGAIN cause well, I try almost everything at least once when it’s come to my treatment or in this case twice.

We were scheduled to begin the 1st treatment on March 15th 2020 at 6:00 p.m. It never happened. And if you have been following my journey very recently I kinda just let things slide from there once the pandemic hit.

As most of you know though I reconnected with my Psychiatrist a few weeks ago at which time he told me that patients were no longer allowed to administer the nose spray at home. The whole idea had been kiboshed over the past year as research had shown that it was a liability and quite dangerous to do so. But I guess it’s OK because since March of 2020 Ketamine is now available in an even less invasive form, a pill which is dissolvable under the tongue but still can only be administered under the watchful eye of a doctor/nurse. 

So I guess as they say, three times a charm as I have agreed to try it…AGAIN. The six sessions are to be completed at a clinic in Toronto (there is also a clinic in Mississauga too). Each session will take between 2 to 3 hours from start to finish to complete and I am not allowed to drive home afterwards. They actually recommend you don’t drive for 24 hours following. The sessions will take place twice a week for two weeks and once a week after that.

Although I’ve agreed to try it again given I feel like I’m running out of both viable options and steam, but I have been told by my doctor that I am very likely to still feel those same hallucinations and disassociative feelings that I don’t like. I’ve done many other treatments and have tried many hallucinogens over the last several years. I don’t like feeling as though I’m tripping out on LSD.

I’ve been consumed with very negative thoughts for several days now (surprise, surprise) since booking my treatment. I’m experiencing extreme anxiety and feelings of overwhelming guilt and lets not forget those feelings of being a burden that weigh me down too. I’m questioning my decision to do this again for many, like OH MY GOSH, too many reasons.

For one, it’s still very new and likely not to be a forever cure from what the current research shows. I will very likely need to continue on some type of maintenance program after the six sessions are done. But like how long term? And does anyone even know what the long term effects of it could be, especially cognitively. As it is, I did ECT (Electroconvulsive Treatment) several years back. Probably the most invasive and scariest treatment I’ve done. The eight treatments I did fucked me up royally. It fried my short term memory, my ability to recall many things and I find myself often forgetting what I was talking about mid…sentence.

But at the same time Psychedelics seem to be the wave of the future for treating mental illnesses and especially for people like myself who are treatment resistant. I’ve even tried “shrooms” in a pill form, but couldn’t tolerate the hallucinations it caused, although my Psychiatrist is also currently working on many new studies and its amazing effects on Treatment Resistant Depression as we speak.

I’ve tried so many different treatments over the past seven years and how I see it, I have failed them all, many of which have cost a shitload of money because they were not covered by either Ohip or insurance, Ketamine now included. I wish I could understand why if there is such a need for these treatments and Ketamine for one has one of the highest success rates among all treatments including anti-depressants then why has it not yet become part of the mainstream health care system so that more people can have access to it? I know, dumb question.

It’s an expensive treatment, especially if it becomes ongoing. It’s an expense we really can’t afford at the moment and just adds to the extraordinary guilt I already live with on a daily basis. The “what if” I’m not part of that 60% success rate, the “what if” yet another attempt fails and we throw away even more money that we don’t have. How can I live with that on my conscience?

The answer is, I can’t.

I’ve carried on and on AND on the last few days with all the other reasons as to why I also shouldn’t do it as well and feel like a burden yet again to my family by having to take me and sit with me for 2 to 3 hours (plus the 30 plus minute drive there and back) while I have my treatments.  

These are very real struggles for me which of course my Psychiatrist tried to remind me the other day as I rambled on about all my reservations that I’m having that it’s my Depression talking and that my Anxiety is happily cheering him on. I can’t let them win.

But it’s so fucking hard though and the noises in my head are loud as hell. It’s literally killing me.

They keep telling me I don’t deserve to live a life free of chronic Depression, debilitating Anxiety and daily thoughts of Suicide. They keep telling me I’m just gonna fail at this attempt too. They keep telling me to give it up already and that I’ve already used up my many chances at recovery over and over AGAIN. Like why would this time be any different?

Thanks for listening to me today. I so appreciate the extra set of ears. Somedays the best medicine is just knowing that someone is there listening to my very real and terrifying emotions with only the purest of intent.

#ketamine #empathy #education #treatmentresiatantdepression #mentalillness #mentalhealth #depression #anxiety #itsoktonotbeok #youareenough #maskoff #psychiatrist #psychiatry #acceptinghelp #threetimesacharm #selfcare #youmatter #youareenough #yourmentalhealthmatters #mentalillnessawarenessweek

Update

* Content below could be very triggering for some people. Please do not read if you feel it could be of harm to you’re own mental well-being * 
 

The other day I expressed myself as best I could in a post/blog about what it feels like to struggle with thoughts of suicide. (See blog: https://youareenough712.wordpress.com/2021/08/23/what-does-it-feel-like-to-be-suicidal/)

My head has been completely cluttered by loud and intrusive noises that won’t fucking leave me alone no matter how much I fight back. I’m in such a fog that I easily lose my train of thought mid sentence (and I even forgot my own address last night). I feel as though I am holding on by a thread right now. I am vulnerable and scared and I’m not sure how much fight I have left in me anymore. 

My heart knows how loved and needed I am but I just wish my brain could get on the same page. Words can not express my endless gratitude for the overwhelming amount of support I’ve received since my post the other day. 

Every message has been exploding with overwhelming kindness and empathy (the 2 greatest traits any human can have) and it warms my heart knowing how many people care about my well-being, feel inspired by my courage and enlightened by my honesty and truth. I’ve received private messages from people I haven’t spoken to in 30 years who understand what I am feeling and others whom I met just weeks ago.

I am especially grateful to one friend inparticular who literally dropped everything she was doing yesterday to sit with me for over 3 hours after I experienced a breakdown earlier in the day.

Last night though my pain got to be too much to bare and Rich drove me to emerg. I was in such a panicked state that I was certain I was having a heart attack. I have panic attacks often but this one felt different. Once ruling out that it wasn’t in fact a heart attack my hope was that they would give me a script for some Ativan which is used primarily to treat anxiety disorders, trouble sleeping and severe agitation. All of which have been causing my downward spiral. 

It is also extremely addictive. I know this first hand because a few years ago I had an extreme addiction to the drug. I’d started hoarding bottles of them from doctors and other inpatient treatment facilities. I had 100’s of them in my possession and nobody knew, not even Rich. 

I was no longer taking antidepressants at the time after more than 20 concoctions and lots of horrible and dangerous side effects led me to a further diagnosis of Treatment Resistant Depression. But Ativan wasn’t giving me those side effects. Instead it was numbing my pain and helping me sleep more. So I took more. I just loved the clouded feeling I was getting from it without all the added and dangerous side effects from the antidepressants. 

I finally fessed up and came clean to my Psychiatrist at the time when my kids began voicing their concern to Rich that they were nervous being in a car with me. By now I had been taking 8 to 10 pills at one time every day. I truly don’t know how I was even functioning or still alive.

Now back to last night. Rich took me to the emerg at the brand new hospital nearby our home. It officially opened to the public only 2 months ago. It is affiliated with our other local hospital and I sadly recognized several familiar staff from the amount of visits to their emergency room over the years.

It was very clean. The floors and walls still looked fresh. I wanted so bad to come on here today and give this new hospital a glowing review but aside from the clean floors and fresh coat of paint I can’t really say anything positive from my own personal experience, especially given the amount of emergency rooms I’ve been to before to compare to this one during a crisis (and potential heart attack!). Even when I’ve been stripped of my belongings and my dignity left on the dirty floor or had security guards practically sitting on top of me I’d still put this experience below them all.

I was there for close to 7 hours and I observed a lot. I heard a lot too as they would call patients to the nurse’s station to give them their results before releasing them and I was in a room right across from it all (wouldn’t it be smarter to go talk to the individuals in their rooms, we are still in a Pandemic I thought and really do I need to hear everyone else’s diagnosis?). One of my most concerning observations though was when they called a lady to the desk (who’s mask was not on properly and they kept asking her to fix) to give her a script for an antibiotic and puffer to treat her pneumonia and then proceeded to tell the woman “but I’m pretty sure you probably have Covid”. Did they not test her for it? Did they not tell her maybe she should self isolate?  Rich and I looked at one another in complete disbelief. SMH

Anyways back to my night which I returned home from just before 3am. I had an ekg and blood work done to rule out any issues with my heart. The doctor spoke to me about what else was going on at the moment as well including if I had an intended plan of carrying out a suicide. I was visibly shaken and he decided to give me an Ativan to calm me down and then he put in a request for their crisis team to come talk to me further.

We discussed my prior issues with Ativan which is clearly stated in my file as well as any other one of my doctor’s files who had once prescribed it to me. We also discussed how dangerous and addictive it is and that he would give me the one for now but was not comfortable giving me anymore to go home with. 

The crisis worker eventually came to talk with me by which time the Ativan had kicked in and I was physically and emotionally exhausted and my mind was shutting down while trying to talk to her. By this time, Rich had left to try and get some sleep for a couple of hours. 

The Crisis Worker asked me a whole bunch of questions, all standard to someone who is in crisis. Do you have a plan and what is your plan was her main concern and focus. The one positive of the night was that she had actually taken the time to go through my (lengthy) file before coming to talk to me so it saved me a lot of catching up on my history over the past 7 years. 

My hope was still for her to let me have a few Ativans to take home with me so I can try and get some sleep and numb the severe and debilitating anxiety and desperate plans of suicide I’ve been experiencing. And to hopefully lift some of the fog. She spoke with the doctor and came back with a prescription for 5 Ativan for me but then she quickly regretted her decision.

She made me promise I wouldn’t go home and take them all at once or go to another hospital to get more. She also made me promise that I would call and speak with my Psychiatrist today and her last promise she had me make to her was that and I quote “don’t do anything stupid”. I know she meant it very lovingly!

I slept for a solid 3 hours last night within minutes of getting into bed thanks to the Ativan. That is huge for me, like Super Bowl huge. I have not gone to the pharmacy yet today (or gotten out of bed for that matter) to fill the script which I promise I will hand over to Rich who has been the keeper of all my meds for years as I am not sure I can be trusted right now to be perfectly honest. But a promise is a promise.

If you or someone you know is in crisis please seek help immediately. 

#promisespromises #ativan #incrisis #suicidal #depression #anxiety #reachoutforhelp #itsoktonotbeok #youarenotalone #newhospital #emotionallydefeated #yourmentalhealthmatters #mentalhealth #mentalillness #youmatter #youareenough