May is Mental Health Awareness Month. I want to spread the word about a new experimental treatment that shows great promise for those living with depression and PTSD that’s been difficult to treat with standard medications. In the last 15+ years, researchers and clinicians have found that ketamine — a dissociative anesthetic more widely known as a party drug — administered at low doses can achieve antidepressant affects in a manner completely different from how today’s standard antidepressant drugs work (see glutamatergic synaptic regeneration) with results that are dramatic, much faster than with the standard meds, and at far greater success rates (appx 70%).

That’s matched my experience over the last two months.

I was first diagnosed with depression 20 years ago and have struggled with managing it. Beyond counseling, meditation, exercise, etc, I’ve been on many different medications at varying doses and combinations. With each med change, there’s been a waiting period of many weeks to determine whether the meds are working. When they have worked, they’ve done so only for limited periods before the cycle starts over again and I’m back working with the doctor to try something different. It’s not only frustrating but defeating.

I could feel myself starting to fall back into another major depressive episode late last year, and despite various and desperate efforts to avoid it, I eventually sank fast and deep into that hole while in Cambodia from late December into early February. Getting through the several volunteer projects during that period was extremely difficult and I began to dread the upcoming ones I’d planned elsewhere in Asia in coming months. At the behest of a counselor I’d been talking with back in the U.S., I looked into recent research on ketamine therapy for depression. It didn’t take long before I decided that I needed to abandon my remaining travel plans to return home to seek that treatment.

I found two places in North Carolina offering ketamine therapy. The first place turned me down because the psychiatrist there wanted to tweak my meds one more time before resorting to ketamine. I appreciate the conservative approach, but felt like I’d been down the med changes path too many times. By that point I was in a very bad place in mentally, had blown the hell out of many weeks of long-planned (not to mention non-refundable) travel reservations and volunteer placements, and had dropped an additional boatload of money for a last-minute plane fare from Cambodia to the U.S. plus more for hotels & Airbnb’s, etc. back home. So my attitude quickly became, GIMME THE DAMN KETAMINE!!

That urgency I felt played a role in the second doctor’s determination that I was a good candidate for ketamine therapy, so I got the first infusion at that first visit. Just starting on this new therapy had me feeling better, and the ketamine experience itself was incredibly cool — ask me about minor dissociation plus closed-eye visualizations (a.k.a., minor hallucinations) !!! — but it wasn’t until the third infusion that I felt a lasting improvement. Once the change hit, it was dramatic and came only one week after starting the therapy. And that’s an important point to keep in mind for people considering this: some of the write-ups will talk about effects being felt within hours of the infusion, and while I’m sure that happens for some people with the very first infusion, for most patients it takes several infusions.

For me, the change went like this: The dark thoughts went away. My mood improved immensely. Anxiety lessened and soon disappeared entirely. I became less irritable and wasn’t so prone to quick/unreasonable outbursts of anger. I stopped waking up in bad moods every morning. The vague sense of impending doom disappeared. The antisocial tendencies receded. My sleep improved. I stopped having stress dreams. My motivation returned, allowing me to get back into an exercise routine, restart some meditation practices, and begin making new future travel & volunteer plans. My indecisiveness went away and my thought processes in general returned from the muddled state of recent months to more normal speed & reliability. All of this in the course of a week from infusions 3 to 5.

This past Monday was my 9th treatment. I completed the initial intensive portion of the protocol a month ago. That involves 6 infusions over a two-week period. I’m now in the regular maintenance phase in which we hope I can go anywhere from four to six weeks between infusions. So this isn’t a cure for depression but a potentially much better treatment option.

The biggest downside is cost. Because this is an off-label use of ketamine, insurance companies don’t cover the treatment, which can run from $300 to $700 per treatment. The FDA recently a approved a type of ketamine (esketamine) for use as an antidepressant that’s delivered via nasal spray; hopefully, insurance plans may start covering that version.

I’d be happy to talk to anybody who thinks this might be an option for themselves or someone they know. In the right circumstances and under the right treatment protocol, ketamine can save and vastly improve lives.