Maybe She's Born With It, Maybe It's Ketamine
How I fixed my anxious and obsessive brain with KETAMINE.
I’ve been spending the last couple of months undergoing psychedelic therapy with ketamine. It’s been great, and I highly recommend it to anyone with existential anxiety, depression, or obsessive ruminations. This post is so that I can share my journey and demystify the use of psychedelics for therapeutic purposes.
I’ve always dealt with a fair amount of existential anxiety (if you’ve been reading my work for a while, you know this), but over the summer, circumstances with trying to adapt to small-town politics, falling in love, and interpersonal girl drama transformed that deeply personal kind of anxiety into full-blown social anxiety as well. I could barely function, I was terrified to leave the house, I holed up in my family room and just kinda shitposted some sense of community around me via the internet. Deeply unwell behavior. There was a point at which I was out of coffee, I was too afraid to go to the grocery store, so I DoorDashed Starbucks like a total bugman loser. A well-intentioned and very kind person who happens to work at the Starbucks sent me a note asking if the coffee had been for me—she didn’t mean to send me into an existential crisis but that’s when I realize that even from the safety of your living room with no one else around, in Southern West Virginia, you will somehow find a way to be perceived against your will.
It’s not a bad way to live, and I want to say that eventually, I will find the “social panopticon” of small-time life can be a good thing, but for now, it is very different than what I’m used to. (Often times it can be described as “jarring” at best and “unsettling” at worst.) I can recall the horrors of walking into a small private school my sophomore year and realizing that friendships, cliques, routines—they’re all perfectly settled-in by that point and to be “new meat” is a mortifying ordeal. I live this every day. I’m surrounded by lovely people, some very resistant to me, some dislike me for reasons I have yet to ascertain, some go out of their way to make life here difficult for me, some have no interest. It’s alright, but constantly feeling othered did not and does not assuage this newfound social anxiety.
“Until you make the unconscious conscious, it will direct your life and you will call it fate.” - C.G. Jung
One day, it all bubbled to the surface and I could not handle it anymore. Remembering a conversation I had with my best friend (a psychiatrist) a week or two earlier about ketamine therapy, I texted her before bed and figured out how to move forward. She gave a few additional options because she knows I like to feel like I’m making a decision myself: I do ketamine about it, or I could go with SSRIs which would ruin my libido (something that is very important to me)—and even the ones that wouldn’t would have to be a “long-term” commitment.
I don’t love the idea of taking meds every day for the rest of my life so I figured I would give the ketamine a try. I looked all over the internet to find an at-home (oral) ketamine provider who served West Virginia, of which it appears there is currently only one, Mindbloom. (More on that later.)
What is Ketamine Therapy?
For those who don’t know, ketamine is a dissociative anesthetic medication. Its on-label use is when it is taken in high doses as an operating room anesthetic. In lower doses, it can bring on psychedelic experiences and, in the correct setting, can be effective at managing treatment-resistant depression, anxiety disorders, and post-traumatic stress disorder (PTSD).
Though there are various kinds of ketamine therapy (intravenously in a medical office setting, intranasally at home, and I’m sure there are others as well), I opted to go the at-home treatment route using tablets that I let dissolve in my mouth (before spitting them out, an important detail). This dosing session was paired with medical oversight from a clinician (via Zoom) and a guide (also via Zoom). In addition to the time spent dosing, I also spent some time before session preparing and calming my brain, as well as time after to journal about my experience.
Before going any further, I would like to point out that there is a big difference between taking ketamine casually and for fun (nothing wrong with that, by the way, if you possess a certain kind of fortitude of the mind) and taking ketamine in a medically-supervised way to facilitate therapeutic insights. Yes, it’s definitely been the most enjoyable and effective therapy I’ve received so far, but I will say, it is, above all, a “ritual,” and should be treated as such.
Call it “the industrialized medical complex” or simply “the pressures of modernity,” but the average person in the West is, by and large, lacking the framework required to gain meaningful insights from psychedelic substances. There must be a liturgical, ritualistic aspect to taking these substances in order to get what we want out of them and not “lose our minds.”
Entheogen use is not the problem. The problem is using entheogens without a liturgical and cosmological framework which enables the integration of the ecstatic experiences they produce. Modern Western culture offers no stable method for integrating mystical experience into everyday life. An individual transcendental experience alone is either not enough or too much. Without a framework for incorporating it into the broader culture after it is acquired, it can leave the recipient more confused than before.
Theophanies requires a particular kind of preparation and the integration of those experiences demands an environment that accounts for it within an essentially traditional system of symbols and practices. SOURCE
In this sense, “ritual” means a thoughtful approach to integrating insights gained during a session with your waking life. Once your subconscious thoughts are bubbled up to the surface, the breakthroughs that come from that awareness need to be honored and cultivated. I’ll get into it more in a bit, but I did feel the need to add that caveat. Now that it’s out of the way, let’s continue.
Why Should You Consider Ketamine Therapy?
I’ll add another caveat here: I am not a doctor. I have never been a doctor, and I will certainly never be a doctor. I also tend to not trust doctors (I had some really awful experiences in my twenties with being misdiagnosed and being put on some medications that did lasting damage) so I did a lot of research myself. This article is coming from that perspective, as well as from my own experience. If you’re the kind to “trust the science,” I recommend checking with your general practitioner or whomever you speak with about mental health. However, I will say, your doctor may not be on board with psychedelic-assisted therapy. If it feels right to you and you want to pursue it, I’d say screw their opinion and go for it. (Especially since your ketamine clinician will check to make sure that you are medically able to complete the treatment and ensure that you’re safe throughout the process.)
Ketamine, like other psychedelic-assisted therapeutic methods, facilitates a “softening of the ego,” which is powerful in terms of helping you uncover profound breakthroughs you always had deep within yourself but needed a small shift in perspective to access. Additionally, ketamine benefits by building (or rebuilding) neural pathways in the brain.
Ketamine is a breakthrough medicine of the mind. It can rapidly —often within an hour or two— lift the symptoms of anxiety, depression, PTSD, OCD, and other conditions.
For most people, the action of a single small dose of ketamine lasts for a week and possibly longer; after a short series of repeated doses, this effect typically extends out for weeks to months. In addition, the subjective effects on consciousness and the psyche often lead to profound emotional and psychological insights. SOURCE
Pairing the ability to create new insights with the ability to heal the brain from stress (whether from depression, anxiety, OCD, or PTSD), ketamine is extremely helpful for those of us with existential causes of these mental afflictions.
Long-lasting stress takes a toll on the neurons of the cortex. Constant high levels of the stress hormone cortisol can make neurons atrophy—they shrivel and shrink. The dendrites go from large numbers of dense, spreading branches to smaller numbers of shorter, stubby branches that make fewer connections to other neurons. The axons shrink and get thinner. Intense stress can also change glutamate signaling and make the neurons less responsive and less able to connect with other neurons. Brain imaging shows that in depressed people, the prefrontal cortex is reduced in size. Shriveled connections in the cortex mean the neural pathways that control memory, decision-making, emotions, and attention don’t work as well.
In addition to its potency, ketamine is immediately effective. Traditional antidepressants, particularly if you must taper up to the proper dosage, can take weeks or months to become effective. Ketamine’s benefits can, and often do, appear 24-36 hours after.
Likely due to ketamine’s ability to increase neuroplasticity and reduce activity in the DMN, its therapeutic applications apply to a broad range of disorders that involve ruminating about the past (depression) or future (anxiety), fixating on self-destructive behavior (OCD and substance abuse), and other conditions in which the brain seems to get stuck in the same, repetitive negative groove.
What really sealed the deal for me was that, with the treatment plan I chose, I did not have to do a session every day, or even continue doing sessions after the initial six sessions. (Unless I wanted to—I may return in six months or so for maintenance, we’ll see.)
My Experience (Trips Included)
Upon ordering my Mindbloom treatment online (to the tune of $386 a month for three months—referral here to get $100 off your first month if you’re interested though—this isn’t sponsored btw, just trying to help!), I was given a calendar link to schedule a call with my clinician and get started. Our first call was about an hour long, and I took it by pulling over on the side of the highway on my way home from the airport after a work trip. She asked pretty basic questions about my health history, my mental health history, family mental health history, as well as general goals for my treatment and why I decided to try ketamine therapy in the first place. I explained my current situation, including how I was struggling to make a proper home for myself in West Virginia—as a fellow transplant, she agreed, which was very validating—and developed some pretty wild social anxiety as a result.
During the call, she approved my treatment and said she was going to start me at 400mg of ketamine for my first session and move up from there. She also provided some tips for getting the most out of the medicine, such as scraping your gums with a toothbrush to help the medicine get into your bloodstream a little easier. A couple days later, two packages showed up at my house: the meds, and some accouterments to go along with the dosing process.
Using the provided app, I was to then set a meeting with my guide, which would also serve as the first session. I was told to leave a two and a half hour-long period in which I could be undisturbed, and to clear my schedule for the rest of the day. I chose to start at 6:30PM on a Thursday evening.
I was a little nervous—no, very nervous before my first session. Part of this was because, aside from some small doses of mushrooms when already in a great mood and to help me focus at work when I was living in New York, I’ve very purposely stayed away from psychedelics. Why? I always said, “my mind is a scary place, I don’t need to be there alone.” I wanted to make sure that I had everything right, so I followed the rules fastidiously. These rules included:
No caffeine five or more hours before the session
No food three or more hours before the session
Take an Ondansetron tablet one hour before the session
A “peer treatment monitor” (in my case, Tyler) must be present before, during, and after the session
Your peer treatment monitor must take your blood pressure and pulse before and after the session
Prepare for the session by setting intentions (more on that later)
End the session by journaling about your experience (to aid in psychedelic integration)
Have a snack handy for after the session (this one is important, I was STARVING)
I started by day by reading about other people’s experiences with ketamine-assisted therapy so I could prepare myself for what was about to happen. Most of the stories online were positive, though some were a little frightening, and a couple were obviously made-up. (Sorry, but on low doses of ketamine in a controlled therapeutic setting, you’re not going to “trip balls” or have crazy visuals.) Still, I decided to make my first session a good one, and prepared myself in a couple of ways, ways in which I implore anyone who is getting ready to undergo any sort of psychedelic therapy to consider:
Setting Intentions
These intentions should be highly personal, if not somewhat vague. The purpose of them is to give your mind something to hold on to, but not upon which to ruminate or “covet.” What I mean by this is that when setting an intention for psychedelic purposes, it’s helpful to have an idea of how you would like the session to go, but in order to have a successful session, you must accept that your mind is going to do what it is going to do and trying to control that will not give you a better outcome. In fact, it can hamper the psychedelic process or create a “bad trip.”
There is a Taoist notion, the “unseen river,” and more often than not, we fight against it simply because we are unaware of its presence or how deep it goes. Psychedelics can help us break down the walls we build within ourselves to access that river and flow with it. There is also a Jung quote that I love in this context, which is, “until you make the unconscious conscious, it will direct your life and you will call it fate.”
I went into my first session with three main intentions (taken from my journal):
To Be Present "I'd like to let go of the things that cause me to worry and embrace the things that bind me to the current moment. I want to find this capacity within myself. Who Am I, Bereft Of An Outsider's Gaze? "I'd like to find that 'unseen river' and float on it. Feel The Love "I get so caught up in heartbreak and the 'bad,' I want to see the love that's been there all along."
Once you set these intentions, you let them go. It is not a requirement, or an expectation, but rather a north star.
Become Resolute To “Ride The Waves”
Have you ever been “down the shore?” (As my people would say.) When you’re caught in a rip current, you’re told to turn towards the shore and wade or swim until you’re out of it. If you fight against the current, you’re going to get tired and you’re going to drown. The same goes for psychedelic experiences. If they take a turn for the “scary,” you need to ground yourself (breathing helps) and recognize that the only way out is through.
Pretty much immediately after the medicine kicked in for me, I headed towards something very dark. It was existential, it dealt with perhaps my biggest fear of all time, and the darkness had fully enveloped me. I breathed, a went through it, and I felt a peace on the other side. I cried, and I cried hard, but once it was over, I felt a weight was lifted and I was finally “okay.” It happened a few more times, I went through a dark period and then a period of joy. This allowed me to experience a shift in perspective that I don’t know I would have been capable of without some psychedelic aid, and certainly not if I had fought against it.
Prioritize Integration
While your neural pathways are rebuilding themselves and your ego is softened, this is a perfect time to integrate what you learned during your experience with your real life. For everyone, this is different. For me, it looks like journaling, sharing with Tyler, and setting mini goals for myself between sessions. Sometimes these goals can be to focus on my breathing, sometimes they can be more cerebral, such as taking petty thoughts captive (I can be a very internally petty person, particularly to those who have hurt me) and turning them into positive notions. The girl who’s been starting weird stupid rumors about me? Every time I’m tempted to think or say something mean about her, say three nice things about her. All the women who hate me for absolutely no reason? I need to pray that God blesses them and hope that we can someday be friends. It’s not easy, but the shift in perspective afforded me with the insight that it’s rarely about “me,” but rooted in their own personal struggle.
I will emphasize the fact that it is not always easy. If Tyler is reading this, he’s probably laughing or rolling his eyes, but I can say with full confidence that these practices have limited my snark by at least 50% and that’s a healthy start. There is always more work to be done, and there always will be.
My “Trips”
Now that we have the “beforehand” pretty well-covered, I’m sure you are dying to hear about my experiences. Because I’m most interested in demystifying the process, I’m going to get a little vulnerable with you and share about my first trip directly from my journal. Abridged, of course:
My body feels heavy, but I am floating, surrounded by soft pink. It is my mother’s womb. I am safe, I am protected. She protects me, she fights for me. I recall how she allowed her body to be cut open to give me life. A darkness creeps towards me and I wonder if it is the inevitable death of everyone I love—I instinctively clutch my stomach—it is grief for the child I’d lost so long ago. The children I never got to take home. I let the darkness envelop me. I am paralyzed. I am terrified as this darkness washes over me. Am I grieving the loss of these children, or the motherhood that I will never experience?
The black turns to violet. I am sad, but I am alright. I feel peace. I wonder how it would feel to fly on the wing of a seagull, tiny and weightless on the very tip. I stay with this, and ponder nothing specifically.
I hear the voices of the men who have hurt me. Not their actual voices, but I sense the timbre in vibratory patterns. I am no longer filled with hurt, I forgive them. In a soft orange haze, I realize they did not set out to hurt me, but to try to build themselves up. I am filled with compassion and let them go.
Yellow. The names of women here who so dislike me. I recognize that this similar sense of loathing is borne of fear, of hurt. I can no longer despise them. God loves them, maybe they don’t know that. I wish for them to be filled with bliss, the way I was with my Chrismation.
Clouds of light blue and I think to myself, “what if words are all I have to offer?” Words are what I want to share, but so many decide to not see past my looks. Beauty is a curse in this way. I consider my sweetheart and the words we share with each other. If this is all, this is okay, I feel safe.
It all comes over me in waves. I weep because it is beautiful and profound. I want to listen to the hymn of Kassiani.
I wake up.
Tyler hears me stir and brings me snacks and a hug.
I am thankful.
I am present.
The rest of the sessions were similar, albeit much less profound. They often dealt with femininity, causing me to consciously think about what femininity is, and how I can be embodied. Part of this has been found in making amends with my body to forgive and heal my wombspace. So much of my experiences were also heavy on forgiveness and perspective and finding the happiness I experiences in relationships (romantic and platonic) past, rather to self-medicate with bitterness as a coping mechanism. Aside from the darkness at the beginning of the first session, the rest have been entirely positive and healing. I can say with full confidence that the first session alone was more helpful than several years of traditional therapy had been.
What’s really great about these sessions is that they’re so finely-tuned that the medication kicks in after about seven minutes (when it’s time to spit out the medication) and its effects last for 25-35 minutes exactly.
My Outcomes
Like many others, I saw an immediate, marked improvement in my focus and my ability to be present. I can best describe it as this, summarized from a series of texts I sent to a friend shortly after:
It’s like for pretty much my entire life, my brain was a prism that would absorb the most irrational of sentiments and refract then into obsessive notions. Now, it’s really insane how peaceful it is. I didn’t realize how cacophonous my thoughts were, or how constant they all were, until now, and it was like flipping a switch. Everything just stopped and I could appreciate things as they were happening instead of stressing about the past or the future. Like probably tmi but I don’t think I ever really enjoyed “intimacy” at all because I just couldn’t focus, I couldn’t be present, I could only feign the vulnerability necessary for it to be good. That’s much different now. It’s nice haha.
After my first session, I felt “peace” pretty much immediately. Within the first couple of hours, I was able to keep my cool in a situation that would have previously stressed me out. Then, I woke up the next morning and it was like someone gave me an entirely new brain. I don’t even know how to describe what it was like before, I think the closest I can get is to say it’s like if you’ve been listening to white noise for so long that you just get used to it, and then once it turns off, it’s so stark that it’s almost eerie.
I had a pretty intense trip but it was instantaneous, the renewed perspective was jarring. I don’t think I’d ever felt so lucid in my life. I don’t think I was ever an “unhappy” person but I was perhaps a little too existentially involved for my own good.
I’m still not perfect, but the difference is shocking. I’m still figuring out ways to integrate my experiences, and healing is a process that is never completely over. Having said that though, it’s been really, really wonderful, and I’m looking forward to continue growing.
Q&A
I asked you all for your questions on Instagram a couple weeks ago—I think I’ve done an alright job of answering the more general ones in this post, but for some of the more specific ones, here’s what I have:
“How expensive is it? Am I safe to assume it’s not covered by insurance?”
I will say that it was not cheap—all-in, the program I used was close to $1,200 for six sessions. I had a great experience with Mindbloom, I would recommend it 100%. I have a friend who is using Joyous right now, and while it is much cheaper (about $100 a month), she is not getting the same results that I did. (They take a microdose approach, and there is less guidance.)
I cannot speak from experience so I am not sure if you will get similar results, but I have heard that esketamine, the nasal-spray version, is FDA-approved for that use so it can be covered by insurance.
“Is it scary?”
Like all psychedelics, it can be—but it doesn’t have to be. Rolling with the punches (“riding the wave,” which I spoke about earlier), keeping grounded (breathwork can help this), setting intentions, and not trying to control an outcome are all ways to avoid a “bad trip.” Aside from the one dark moment I shared from my first session, I had only good experiences.
I know that on psychedelics, there is a weird concept of time that you may be experiencing, but it also help to keep in mind that the sessions are medically-dosed and for this reason, very exact. Mine have lasted almost exactly 30-35 minutes each.
“Can I get addicted to it?”
I don’t believe you can, but this is definitely a question for a doctor. (Which, once again, I am not.)
Thank you for reading all of this, I’m honored to have shared my journey thus far with you all and thrilled to see where it goes next.
I've been taking antidepressants for decades and they allow me to function, but I've also had glimpses of how much better my life would be if my brain was less noisy. How does ketamine use fit with antidepressants - do I need to stop my medication to try it? Will I be able to lessen my meds if ketamine helps me?
SOOO beautiful and informative top to bottom- grateful to read this and especially to learn of your positive experience 😍