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After almost four months of silence I'm finally writing up how my ketamine treatments are going. Yes, they're still ongoing: I have one tomorrow.
In short: It's been amazingly effective on my Generalized Anxiety Disorder (wikipedia), but only slightly effective on my PTSD and my debilitating dysthymia (wiki) . We are playing with the protocols to find a treatment plan that fits my very unusual constellation of symptoms.
Since I don't have a textbook diagnosis, the staff at the clinic has been good about working with me on designing new protocols that work best for me. Six weeks ago, I talked with the clinic's Medical Director to discuss trying a session at the length of the pain protocol (six times longer) but at the intensity of the mental health treatments (much lower dosage). I've now had a bunch of these extended mental health treatments and they're probably as close as optimal as we are going to find with Ketamine.
These extended treatments are definitely helping me find more interest in living: as far as hobbies, social life, and even in building a career.
Hopefully, in a future post I'll talk about what these Ketamine experiences are like for me, but they're far too profound for this post.
How often?
For the mental health protocol, they start at twice a week, with optional psychotherapy (solo or group) twice a week. I have now reduced that to once per week as we are reaching the limits of what ketamine can do for me and are now transitioning to maintenance on those benefits.
Why Ketamine?
There are basically three components to the effects of the Ketamine: sedation, neuron polyp growth, and psychedelic. As we increase the dosage, the psychedelic effect peaks first, then the neuro-regeneration, then the sedation. The primary goal of the depression protocol is to stimulate the rejuvenation of atrophied neurons by inhibiting the reuptake of the neurotransmitter Glutamate (wiki) — kind of like Prozac inhibits the reuptake of Serotonin. This [amazon] book seems an accessible book for in-depth knowledge of what we've western medicine has discovered so far on how ketamine works for treatment-resistant-pain and -depression.
So why has ketamine been so effective for my GAD?
For the first time since the earthquake (my dw posts 1 and 2) (wiki) I felt safe. For 33 years I've never felt safe — anywhere. That continuous fear was corrupting every part of my life. Those brief, 40-minute breaks from that fear allowed my brain to separate the corruption from that core fear and address and dismiss those other anxieties now that I could see them clearly.
Why this isn't an option for everyone:
Primarily it's the cost. It's very expensive and hard to access. While Ketamine has been safely used at higher doses as a sedative, its use for pain and mental health treatments is still under investigation. It's similar to a New Drug's phase III trial except ketamine is not a new drug. As such, the American FDA specifically prohibits clinics from charging insurers directly for these treatments. Some (not my) insurance allows patients to submit superbills to try to recover no more than 50% of the costs. I'm privileged that my mother has been very frugal throughout her life and can afford to buy me these treatments. They're saving my life.
Also, the detached, trance state isn't for everyone, especially those who heavily associate the almost out-of-body experience with their fear of death.
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