Ketamine Healed My Brain

I am the least depressed I have ever been

Hey! Guess what?? I am not depressed.

Seriously! I’m not depressed at all. I took the PHQ 9 (a common depression assessment) and I got a TWO out of 27. (Higher scores mean more severe depression, a score of 4 or lower means minimal to no depression). A TWO!!!

This is wild for me. I was first diagnosed with major depression disorder (MDD) at age 15, though I remember symptoms showing up much earlier. For most of my life I hacked away at my symptoms with therapy, antidepressants, exercise, meditation, and the world’s biggest library of self-help books. And, for a while, this regimen actually sort of worked, and I got my depressive episodes down to about 3-4 weeks per year.

Then I had a baby. 

Like everything else about having a kid, absolutely nothing in my pre-baby life prepared me for the hell that is postpartum depression.

I felt like I had spent my adult life building a very nice, very functional house. And, in the moment that I gave birth, I set that house on fire. And now, my beautiful little house was gone, and I was left sobbing in the exposed, ash-covered basement wearing an adult diaper with an ice pack tucked inside.

With time, more antidepressants, lots and lots of therapy, exercise, meditation, sunlight exposure, nutrition, tarot, acupuncture, crystals, full moon rituals, journaling, bodywork, weighted blankets, affirmations, aromatherapy, yoga, a vision board, and every other self-care technique I could think of, I slowly, slowwwwwwwwwly clawed my way out of extreme postpartum depression into a moderate, everyday, permanently-tired-and-blah depression.

And I just hung out there. For over two years. 

There’s a stretch of the 405 in West Los Angeles where the “Adopt a Highway” signs read “adopted by Ketamine Clinics of Los Angeles.” In early 2023, while my husband was unable to drive for medical reasons, I was on the 405 for about 3 hours a day. Every single day, I looked at those signs and wondered.

Finally, I asked my therapist and my primary care doctor what they thought about ketamine therapy for depression. “You should try it!” they said. They noted research findings showing ketamine’s efficacy for depression like mine—"treatment-resistant depression,” or the kind of depression that sticks around even after therapy and medication. They told me that every patient they had who tried ketamine-assisted therapy had excellent results. And my therapist referred me to a local clinic.

Since starting ketamine therapy last fall, my depression has been in complete remission (in other words, I have basically no depression symptoms). My anxiety has also dramatically improved.

In the rest of this article, I share my experience with ketamine, and I talk a bit about how ketamine works and how to access it. The summary:

• During ketamine therapy, I experience “ego death,” or a complete loss of self, and some pretty cool hallucinations. The therapy feels like cleaning out the messy closet that is my depressed brain.

• Ketamine was originally developed as an anesthetic, but researchers have found it is very effective at treating a number of psychiatric conditions, including depression, anxiety, bipolar disorder and PTSD.

• Ketamine is not a treatment for ADHD.

• Ketamine therapy requires ongoing maintenance, and it can be difficult to access due to cost and transportation. More accessible, at-home treatments are available but we only have limited research on their effectiveness and safety.

This sort of, kind of, maybe looks a little bit like what I see during ketamine treatment.

What Ketamine Therapy Is Like

My ketamine-assisted psychotherapy sessions take place in private, comfortable rooms filled with plants, books, art, and soft lighting. I sit on a couch and chat with a medical doctor and a therapist about my mental health symptoms. They check my blood pressure and administer the ketamine. I lie down under a blanket, put on an eye mask and headphones, and listen to a carefully curated playlist. This lasts for about 45 minutes, and the therapist stays with me the entire session. Afterwards, the therapist checks my blood pressure again, and I spend about 30 minutes talking through what just happened.

The actual psychedelic experience itself is impossible to fully describe. Using language to describe a ketamine trip is like using a pencil to draw a picture of the Grand Canyon—you can’t fully capture the experience of actually being there. But I will try my best.

It begins with complete dissociation, or what psychedelic users sometimes refer to as “ego death"—I have no body, no name, no sense of self. There is no “I” at all, just an awareness of color and movement. Sometimes the awareness exists in a Georgia O’Keefe painting, sometimes it looks out the window of a train passing through a surreal clouded landscape, sometimes it sails on an ocean of green and purple stars. 

Then, slowly, pieces of identity will start to return to me. My name. The face of my daughter. The sensation of my tongue against my teeth. I’ll begin to remember, in a vague, confused way at first, that I am on a couch, in an office, in southern California, on the planet Earth. I’ll remember that I have hands and marvel at the ability to wiggle my fingers.

Sometimes I have visions related to specific things I am working through:

• I walked into an ice cave made out of painful, self-critical thoughts. It occurred to me that I could leave the cave if I wanted to. I calmly turned around, walked out, and floated away on a silvery river. 

• Angry red-orange tree branches hung over my head, embodying a feeling of shame. I looked up at the branches and watched as the tree grew higher, higher, and higher, the shame branches disappearing far far away in the stratosphere.

• I was tangled up in the thick, black ropes of anxious thoughts. The ropes seethed and shuddered like snakes or angry scribbles. As time passed, the ropes gradually untangled, revealing that I was riding in a rainbow-colored hot air balloon. The balloon flew onward, free and unencumbered.

A lot of people describe ketamine therapy as a reboot for their brain, akin to restarting a computer. That metaphor rings true for me, though I’d also describe ketamine therapy as cleaning out a closet.

Before ketamine therapy, my brain was a horror show of a closet where I just kept putting more and more stuff, even though there’s no room for it. I can’t find anything, it stresses me out just to look in there. Sometimes, when I open the door, things fall on my head and hurt, like, a lot.

When I do ketamine therapy, it’s like taking every single thing out of that closet. Some things get donated, some things go in the trash, and the things that remain are put back neatly and carefully. The freshly organized closet is calm and peaceful, and nothing falls down and hits me in the head when I open the door.

So, yeah, ketamine is basically Marie Kondo for my brain.

What We Know About Ketamine

Ketamine was synthetically developed in the 1960s as an anesthetic by chemists who were trying to find an alternative to PCP. Starting in the 1970s, researchers observed ketamine’s antidepressant effects in animal trials, and recreational ketamine users also began to report improvements in their mental health. Within the last 50 years, an explosion of research has documented ketamine’s robust effectiveness as a treatment for various mental health conditions.

Research has found impressive results for ketamine as a treatment for depression, anxiety, bipolar disorder, post-traumatic stress disorder, substance abuse disorders, and eating disorders. Ketamine has also been found to dramatically reduce or eliminate suicidal ideation for the majority of patients.

One study of 537 patients with depression in a real-world clinical setting found:

• 54% saw dramatic improvement in depression symptoms that lasted at least 2 weeks

• 29% were completely depression-free for at least 2 weeks after treatment

• Of the 356 with suicidal ideation (SI), 73% experienced improvement in SI symptoms

Ketamine’s antidepressant effects are stunningly fast; many patients see improvement in just hours or days, compared to weeks with traditional antidepressant medications. (Personally, I didn’t see any results until my third session. From that point on, though, I started to see dramatic improvement in my mood immediately after treatment, and the effects of each treatment last for over a month.)

Ketamine interacts with the brain in multiple, complex ways, and researchers are still exploring how exactly this works. The leading theory is that ketamine encourages neuroplasticity in the brain, encouraging our neural networks to grow and reorganize. (This article has a concise scientific summary of ketamine’s proposed mechanisms, and Mindbloom has an accessible overview of the primary ways ketamine is believed to function in the brain.)

Ketamine, ADHD, and Co-Presenting Mood Disorders

Ketamine is not considered a treatment for ADHD (as far as I can tell, there is zero research on this). It’s also important to note that ADHDers—especially women with ADHD—often have their ADHD symptoms misdiagnosed as a mood disorder like depression or anxiety. 

Of course, it is also very common for ADHDers to have depression and anxiety co-presenting with their ADHD. For folks who actually have both ADHD and a mood disorder like depression or anxiety, ketamine could help with mood disorder symptoms. (In fact, one small study suggests that ketamine is just as effective at treating depression in ADHD vs. non-ADHD patients, though we still need more research on this.)

Accessing Ketamine Therapy

Despite compelling evidence for its effectiveness, it can be challenging to access ketamine treatment. 

1. Cost: Ketamine is considered an anesthetic, and its antidepressant uses are “off-label” and typically not covered by insurance. My PPO insurance covers the therapist sessions, but I have to pay for the medication out of pocket. 

2. Logistics: Ketamine is usually administered with an IV or with intramuscular injections, and these have to happen at a clinic under medical supervision. You also can’t drive after taking the medication. The time and transportation requirements here can be prohibitive for a lot of people, especially if you don’t live near a clinic. 

3. Maintenance: The effects of ketamine aren’t permanent. A common approach (and the one I did) is an intensive protocol of 6–8 sessions over 2-4 weeks, followed by maintenance sessions every 1-2 months.

For a more accessible option, telehealth providers offer oral ketamine that can be taken at home. There is less research on at-home ketamine use, but preliminary studies are promising. There are concerns that at-home ketamine could lead to abuse, though the evidence we have so far suggests that the risk of ketamine abuse among mood disorder patients is low.

Spravato, a variation of ketamine that is self-administered in a clinic by nasal spray, is FDA-approved and covered by some insurance companies. Spravato has more minimal psychoactive effects compared to regular ketamine.

Finally, there are some important contraindications for taking ketamine. In particular, ketamine can increase heart rate and blood pressure, so patients need to make sure any hypertension is treated before beginning ketamine therapy. A medical provider can assess whether or not you have any medical contraindications for ketamine therapy. 

Have you tried ketamine or other psychedelic mental health therapies? Do you want to? Do you have any questions about it? Let me know in the comments!

Stay curious,

Dr. Taylor Allbright

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