{"id":2640086,"date":"2023-07-26T06:00:26","date_gmt":"2023-07-26T12:00:26","guid":{"rendered":"https:\/\/www.outsideonline.com\/?p=2640086"},"modified":"2023-12-20T15:31:45","modified_gmt":"2023-12-20T22:31:45","slug":"ketamine-therapy","status":"publish","type":"post","link":"https:\/\/www.outsideonline.com\/adventure-travel\/essays\/ketamine-therapy\/","title":{"rendered":"I Was Traumatized After an Accident. Then I Tried Ketamine Therapy."},"content":{"rendered":"
\u201cI don\u2019t feel anything,\u201d I say.<\/p>\n
\u201cGive it a couple of minutes,\u201d says Catherine Boyd, a psychiatrist in Santa Fe, New Mexico, where I live.<\/p>\n
A few moments later, I begin one of the wildest adventures I\u2019ve ever taken, only this one is inside my head. I\u2019m sitting in a reclining chair in Boyd\u2019s office, wearing an eye mask and listening to a soothing playlist, having just been injected with my first round of ketamine, a dissociative drug that\u2019s used for the treatment of anxiety, depression, PTSD, and addiction, among other mental health conditions.<\/p>\n
Boyd checks in with me soon after and asks how I\u2019m doing. I tell her that it feels like a dentist is using a Waterpik to clean out my neural pathways. Then I feel like I\u2019m floating in a beautiful galaxy, and a stairway made of stars appears that leads up to infinity. Mostly, I see a nonsensical series of shapes and colors that look like the graphic designer Milton Glaser is doodling on the walls of my brain. It\u2019s mind-blowing.<\/p>\n
I\u2019d been thinking about trying ketamine for a few reasons, one being that I was in a scary accident a couple of years ago on the way down from the local ski mountain. A large snowplow came around a corner and collided with me, totaling my car. The plow\u2019s blade was up, and it came through the window behind me, unnervingly close to my head. I was physically shaken and bruised by the impact, and I shudder to think what might have happened if the plow had hit a second sooner.<\/p>\n
I was so happy driving down the mountain, thinking how lucky I was to be living this outdoor life. And then: boom!<\/p><\/blockquote><\/div>\n
Although the accident was traumatizing, I hadn\u2019t been able to shake off a lingering association it caused. That morning I\u2019d been skiing with a couple of friends; it was a powder day, and I finally got the hang of how to make the turns properly. It felt so good floating on top of the snow. I had to leave sooner than my cohorts to get to work, so I drove down the mountain alone. Along the way I was so happy, thinking how lucky I was to be living this outdoor life. And then: boom!<\/p>\n
Some might simply have been grateful that no one was seriously injured and moved on, but in my mind I connected feeling happy with getting surprised by something bad. This triggered a feeling of hypervigilance that I\u2019d experienced growing up with a family member who struggled with substance abuse, which had made me feel on guard, waiting for the other shoe to drop. If I was always prepared for the worst, my thinking went, then it wouldn\u2019t surprise me.<\/p>\n
This isn\u2019t a joyful or spontaneous way to live. I also stopped skiing in Santa Fe after the accident. I didn\u2019t want to be on that winding mountain road again, especially after a winter storm.<\/p>\n
\nTurner and a friend enjoying a powder day right before her accident<\/span> (Photo: Bettina Lancaster)<\/figcaption><\/figure>\n
\u201cKetamine turns off the activity of the brain\u2019s amygdala, a part of the brain\u2019s fear center, so traumas are more easily processed after a session,\u201d says Boyd, who\u2019s been administering the treatment for three years. \u201cMany of us have built up a vase around our brains, with defense mechanisms meant to protect us that we no longer need. Ketamine allows you to safely break down that vase and build a new one that works better.\u201d<\/p>\n<\/div>\n
The drug has been used in anesthesia for more than 50 years. But in a 2000 Yale University study, psychiatrists discovered that, given at lower doses, ketamine helped patients with depression. Several other studies were done over the years, including one that showed marked improvement for veterans suffering from symptoms of PTSD, and in 2019 the FDA approved use of the ketamine derivative esketamine as a nasal spray for treatment-resistant depression.<\/p>\n
\u201cKetamine doesn\u2019t work for everyone, but when it does, I\u2019ve seen it drastically improve mood and help people reach insights they haven\u2019t gained after many years of talk therapy,\u201d Boyd says.<\/p><\/blockquote><\/div>\n
The drug is also given off-label intravenously, intramuscularly, or via lozenges. I received intramuscular injections. Each session cost $651, and the treatment typically isn\u2019t covered by insurance.<\/p>\n
How ketamine works is complicated. The simplified version is that the brains of some people who have experienced depression or trauma can develop faulty wiring that perpetuates their symptoms. Ketamine can repair that wiring, establishing new, healthy neural pathways.<\/p>\n
\u201cKetamine affects glutamate signaling, which causes the brain to produce neural \u2018fertilizers\u2019 called BDNF\u2014brain-derived neurotrophic factor,\u201d Boyd says. \u201cThese fertilizers help neurons grow more connections.<\/p>\n
\u201cKetamine is an opportunity to gain great insight about yourself, your past, your life,\u201d she adds. \u201cIt doesn\u2019t work for everyone, but when it does, I\u2019ve seen it drastically improve mood and help people reach insights they haven\u2019t gained after many years of talk therapy.\u201d<\/p>\n
For the most severely depressed people, a common course of treatment is six doses over three weeks. I wasn\u2019t severely depressed, so Boyd and I decided to do one treatment per week, given on a Sunday, because afterward I felt woozy for an hour or so and needed to rest and be quiet.<\/p>\n
After one of my ketamine treatments, nature\u2019s colors popped more\u2014the vibrant green of a tulip\u2019s spring growth, the pink flowers of a cactus on a hike.<\/p><\/blockquote><\/div>\n
Even though the experience can feel like a trip, ketamine works differently than more familiar psychedelic drugs like psilocybin and LSD. While ketamine has long been abused as a street drug\u2014often called Special K\u2014when administered legally by a doctor, strict protocols are in place.<\/p>\n
I went through a detailed intake process, filling out comprehensive forms on my physical and psychological health to make sure the treatment was right for me. Boyd says that people with a history of psychosis, mania, high blood pressure, and heart or liver disease should not try ketamine. Nor should pregnant women.<\/p>\n
Boyd takes my blood pressure and oxygen saturation levels before and after each treatment\u2014ketamine can raise blood pressure and heart rate and cause nausea\u2014then injects a small dose to make sure I can tolerate the effects, checks in to see if I want a second dose after that, and sits with me the entire time the drug is in my system, around 40 to 60 minutes.<\/p>\n
We also talk over how I\u2019m doing before each treatment, and we discuss what came up for me during the session afterward. The whole process takes around two hours.<\/p>\n
There are hundreds of ketamine clinics all over the country right now, and there\u2019s even a way to receive the treatment online, through a company called Mind Bloom that sells and ships tablets. When I mentioned to Boyd, an avid kayaker and snowboarder, that I\u2019d also heard of spas and nature retreats offering ketamine, she was cautious.<\/p>\n
\u201cKetamine is a dissociative medication, and most people are very inward during the session,\u201d she says. \u201cFor this reason, I would not recommend doing it in nature. Ketamine turns off the cortex and disconnects the body from the brain. It is an introspective tool for inner exploration and should be done safely in a medical setting after a person has been appropriately screened.\u201d<\/p>\n
There\u2019s no way I could have been walking around outside during a treatment. I saved outdoor activities for the days after, when it felt peaceful and healing to be in natural settings and I craved quiet time to contemplate what had come up for me during a session.<\/p>\n
As for the risks, Boyd says we\u2019re still in \u201cthe wild west\u201d phase, as the drug\u2019s use for this treatment is so new. But she assured me that, at the small doses she gave me, it\u2019s generally very safe.<\/p>\n
It was important to me to work with a trained psychiatrist who understands neurochemistry and the brain. Boyd also strongly recommends seeing a therapist to help process any revelations. While a ketamine journey can be spectacular and beautiful, it can also bring to the surface challenging issues from your past or current life, which happened for me.<\/p>\n
\n
Boyd says that everyone experiences ketamine in a different way, but most people find that they connect to a sense of something greater than themselves.<\/p><\/blockquote><\/div>\n
A positive side effect I didn\u2019t anticipate was that the interior awe I experienced when taking ketamine made the exterior world more vibrant, too. After one treatment, I left Boyd\u2019s office and looked up at the mountains above Santa Fe, which had a fresh layer of snow and appeared exceptionally majestic. Nature\u2019s colors popped more\u2014the vibrant green of a tulip\u2019s spring growth, the pink flowers of a cactus on a hike.<\/p>\n
Which brings me to one of the many ketamine insights I had: there is wonder and beauty all around us, if only we\u2019d slow down enough to see it.<\/p>\n<\/div>\n
Boyd says that everyone experiences ketamine in a different way, but most people find that they connect to a sense of something greater than themselves. After each treatment, I felt moments of tranquility that I hadn\u2019t felt in years.<\/p>\n
My ketamine journeys often brought up images of nature. One time I felt like I was sitting at the bottom of the ocean, hanging out with strands of pulsing seaweed. I also took a trip into what felt like the inside of my heart, and I was trying to open it up. Another time I struggled to identify a bizarre image that looked like a floating piece of lettuce, and my mind clearly said: Stop trying so hard to make sense of everything.<\/p>\n
That insight helped me to begin unraveling the accident trauma. I could see that my brain wanted to assign a reason to bad things that happen, and that it was easier for me to think the universe didn\u2019t want me to be happy than to concede that I had no control over a snowplow coming out of the blue and nearly killing me.<\/p>\n
Challenging things are going to happen to all of us on occasion. It\u2019s part of being a human crashing around in a busy, modern world. What we can change is our resiliency when traumatizing incidents occur. That\u2019s where ketamine really helped. It allowed me to see trauma from a kinder, more distant perspective, and it gave me a better platform from which to process it and move forward more peacefully.<\/p>\n
I wish I could tie this up in a neat bow and tell you that I\u2019ve since driven up the ski mountain and felt no fear and that everything is fine again. I haven\u2019t. The unraveling of trauma takes time.<\/p>\n
But I can feel my hypervigilant tendencies loosening, and I\u2019ve been seeking out more fun. I\u2019m also more open to heading up that road than I have been in a long time. I\u2019m tired of missing out on those powder turns.<\/p>\n
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