How Esketamine Transformed My Fight Against Depression

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Oct 9, 2024

#MentalHealth, #SchizoaffectiveDisorder, #MajorDepressiveDisorder, #MentalHealthRecovery, #PsychiatricHospitalization, #MentalHealthAwareness, #ManicEpisode, #Paranoia, #Therapy, #MedicationManagement, Lived exprience, mental health

#Therapy, antidepressants, anxiety, depression, drug-resistant depression, esketamine therapy, healing, health, hope, ketamine treatment, mental health, mental health awareness, mental health support, mental illness, mental-health, neuroplasticity, personal journey, psychiatric treatment, remission, therapy

Title: Riding the Waves: My Experience with Esketamine Therapy for Depression

Personal Note to My Readers:

This post can be read as a stand-alone piece. It is also part of a broader narrative I’m weaving together on my blog. If you’ve been following along, you know that I’m working on a series. The series intertwines personal experiences, theoretical concepts, and current events. In the next part, I’ll delve into an esketamine treatment I received just two days ago. This session was different because it was administered by my psychiatrist for the first time instead of my usual nurse. It also happened on the anniversary of the October 7th massacre.

During our session, my psychiatrist said that all of us Israelis are dealing with a form of collective psychosis. This post took a lot of effort to write. I was using three AI tools at the same time: WordPress, Grammarly, and ChatGPT. Each tool provided suggestions that didn’t always work well together. It made me reflect on how writing about personal experiences shouldn’t have to be “optimized” by algorithms. I’m not perfect, and neither is my writing. That’s okay. Trying to implement every piece of feedback in the quest for a “perfect” post is an impossible task.

Riding the Waves: My Experience with Esketamine Therapy for Depression

Introduction:

Esketamine therapy is a relatively new treatment option for drug-resistant major depression. It’s often considered a last line of defense for those who have exhausted traditional methods. This treatment isn’t meant for reactive depression that arises solely from difficult life circumstances. Instead, it’s for people like me. It’s for those with chronic, treatment-resistant depression. These individuals haven’t responded to at least three different classes of antidepressants. When other treatments fail, esketamine can sometimes offer a lifeline. But the path is not straightforward. The treatment itself is complex.

Understanding Esketamine Therapy:

Esketamine is a derivative of ketamine, which was originally developed as an anesthetic. In recent years, it’s found a new role in mental health treatment. Esketamine works by targeting NMDA receptors in the brain. Unlike traditional antidepressants that affect serotonin or dopamine levels, esketamine helps repair and regrow synaptic connections. Essentially, it rebuilds pathways that depression erodes. This regeneration is believed to account for its rapid effects and potential to improve neuroplasticity.

The Personal Experience:

Each esketamine treatment feels like venturing into unknown territory. I receive it as a nasal spray, though intravenous infusions are more common for other patients. During each session, I’m placed in a specially designed room—dimly lit, quiet, and meant to be a safe space. There, my mind can wander without distractions. The session always starts the same way. I enter a quiet room and settle into a comfortable chair. The nasal spray soon alters my reality.

But the journey isn’t always pleasant. For the first hour after inhalation, I often feel trapped. I’m unable to move as my mind drifts into unsettling thoughts. I can’t just get up and distract myself like I would in other situations. Instead, esketamine leaves me suspended—both physically and mentally. It forces me to confront whatever thoughts surface. There’s no escape until the drug begins to wear off.

At other times, the experience is entirely different. A wave of euphoria washes over me. My body and soul feel elevated. The world around me lights up in vivid, surreal colors. I feel an overwhelming sense of compassion, empathy, and love for everything. It’s as if the drug temporarily reveals a version of life that my depression has hidden away. I float in a state of transcendence, seeing beauty in everything.

But esketamine treatment is not about getting high. Its purpose is to rebuild synaptic connections that chronic depression has eroded. It aims to plant the seeds of hope. It allows my mind to shift from the endless winter of depression to a long-overdue spring.

Managing the Rollercoaster of Remission:

With time, I began noticing small changes. I realized that I was no longer completely anhedonic. There were brief moments when I could enjoy the simplest things. I cherished a conversation with a friend. I delighted in watching trees sway. I found peace in just sitting quietly and meditating. For the first time in a long while, intrusive thoughts weren’t blocking my mind.

During the first month, my mind seemed to clear. I started thinking about the future again, rather than just waiting to disappear. But this reprieve was temporary. The debilitating thoughts crept back in, and I relapsed into that familiar state of emptiness. I found myself sleeping for long hours, staring at the ceiling, barely stepping outside.

But just as the darkness seemed overwhelming, something shifted again. The fog lifted, even if just a little. The remissions are temporary, like fleeting bursts of sunshine on an otherwise stormy day. During these moments, I seize every opportunity to write, read, and connect. I don’t know when the next wave will come, pulling me back into that void.

Lessons Learned: Managing Esketamine Treatment:

Over time, I’ve developed some strategies to help manage the ups and downs of esketamine therapy:

Stay Sober Before the Treatment:
Avoid any substances, including marijuana or other drugs, before and during the treatment period. They can interfere with esketamine’s effectiveness.
Avoid Benzodiazepines and Sleep Medications the Night Before:
I should not take these medications. They make the treatment less effective the next day. I need to follow this rule carefully to get the full benefit.
Create a Safe Environment for Aftercare:
After each session, I ensure there is someone I trust to talk to. I reach out to my mental health coach. It helps me process the experience and transition back into a normal headspace.
Take It Easy on Treatment Days:
Esketamine days are not for making big plans. I rest, avoid strong stimuli, and let the treatment settle in. I take the entire day off to let my mind recalibrate.

Final Thoughts: A Message to Fellow Patients:

If you’re a fellow patient receiving esketamine treatment, I’d love to hear about your experience. Feel free to comment and share your journey. Remember, if you can’t see or feel any hope right now, know that hope always exists. Only death can end it. Stay alive. Survive. Breathe in and out—just that—if you can’t do anything else. Consider using peer support, online chats, or any services available in your location. You’re not alone.