07. The Ketamine Diaries, Pt. 2: OCD, PTSD, Depression, & Chronic Pain

(upbeat music) - Hello and welcome to a chat with Uma, with me, your host, Uma R. Chatterjee. On this podcast, I bring together all of my roles as a neuroscientist, researcher, board certified mental health peer specialist, mental health advocate, community builder, and a survivor with lived experience to bring you honest and unfiltered conversations exploring our true human experiences in their fullest form. Every week, I'm bringing you conversations bridging the gap on all things neuroscience, psychology, mental health, lived experience, advocacy, psychedelics, and more. This is a space for raw unfiltered truth to truly explore ourselves for who we are and how we are. I cannot wait to connect with you, answer all of your questions and co-create this with you. Welcome to a chat with Uma. Hello, my friends. Welcome back to another week of a chat with Uma. And I am just so happy that you're here and that we get to share this space together this week. It's a really special episode for me because it is talking about all things my ketamine journey and this episode today is part two of the ketamine diaries, talking all of things, ketamine treatment for OCD, depression, PTSD, suicidality, chronic pain, and more. So last week was part one of the ketamine diaries and it talked about everything from the initial decision to why I decided to start ketamine treatments amongst a ton of factors in context and all of the considerations I navigated in terms of how I went through picking exactly how I'd be doing ketamine treatment to what went into my decisions financially and contextually and otherwise bringing in some of the research and the considerations from clinical standpoints into all of it and then talking you all the way to right when I was about to start ketamine treatments. And this week, part two is covering everything from the minute I stepped into that ketamine clinic for my first treatment and absolutely everything that transpired from that first treatment, all the way to all of the stabilization treatments, the maintenance treatments, and everything that's happened since all of the effects it's had on me, all of the side effects and everything that I gained and experienced during my trips and treatments themselves and the integration afterwards, the decisions I've made about moving forward with continued treatment and what I'm taking with me, what I'm leaving behind and just really sharing everything that I hope can give you insight into what to consider when making these decisions especially if you are considering going through ketamine treatments for any of these conditions or comorbid conditions or just from a more meta standpoint making informed decisions and kind of the thought processes around so many factors in a very unknown and experimental situation. And just a lot of things that I wish I knew, also putting a lot of pieces together from all of the research and the current state of the field and kind of forging my own path with how I navigate a treatment. So without further ado, we'll get into part two of the ketamine diaries and as always, I just encourage you to take what resonates and leave the rest because we are also individual and I share my journey not to shape anything with my intentions or my biases but to just provide more of a open and safe space for you to consider whatever comes up for you and make your own informed decisions even if they look nothing like mine because at the end of the day, we are all in this space together doing what we need to do for ourselves and I am just so grateful to have this space to facilitate that conversation for all of us however that looks like. So let's get into part two of the ketamine diaries. As always, just a disclaimer and reminder that everything I am sharing here is personal experiences and anecdotal information for educational purposes and none of this is medical advice or medical recommendations for you or anybody else. This is not representative of the views of any organization I'm affiliated with academically or professionally. These are all my own views, experiences and anything that I share is for educational purposes only. Anything that I share hopefully can inform questions for you with your medical providers to make the best decisions you can make for yourself. (upbeat music) So that leads me into the first week of stabilization treatments and what that looked like was going to the clinic every single day from 8 a.m. to around 2 p.m. and I would go in, fill out paperwork. I'll start with the first day. I went in, fill out paperwork, got acclimated to the clinic a little bit and then I made sure to go to the bathroom before because something that was stop of fine for me was how does one use the bathroom while on ketamine and I did find that out but to prepare myself I used the bathroom and I then had to go to the ketamine room and what it looked like was a reclining chair that I got to hang out on and there were all the medical things around me but at least there was that reclining chair and there was a smallish TV that was hanging from the ceiling which was supposed to keep me company and let me wash what I wanted during ketamine which was a whole other thing and then there was like the area where the nurse would sit and there was a small area for my husband to sit and so went to that room and basically got like a regular talking to about like you know this is what's gonna be happening and you're gonna be getting like a mediumish dose at the beginning to like prime your system for the first day and then it'll go up from there until like the highest dose towards the end of the week and it'll be you know around four to five hours and basically just giving me like the rules and the kind of like mitigating details of what was going on I also asked and had questions so maybe they gave me more they would give most people but effectively just telling me what would happen in like very reductionist detail like physical terms. Now when I asked questions about the conscious experience and again just trying to probe for like what kind of things they see in people and what support people get and whatnot they were just very, it almost like went over their head and it was just like this expectation of like well you just laid out and hang out and you watch TV or you sleep and I was very skeptical of that for good reason but I started once again like affirming within myself that I needed to take care of myself and go in with the education I have and I asked some questions to try to see if they really knew about like what was going on in the literature and like what it looked like in assisted therapy situations and kind of just like in the way it's being explored trial wise and it definitely seemed to me that nobody knew about that stuff so I just kind of had to let that go and trust that it would happen as it should. The things that I did once again to make my experience my own and prepare myself for what I thought would happen was again I knew that not the first day but a general after that my therapist would be popping in and of course my husband was there and the parts that really come into play in terms of the decisions I had to make during my treatments and before were that with the ketamine IVs and basically sitting with a IV in me for several hours there were a lot of side effects that come from that in terms of pain and nausea and a whole bunch of stuff so they preemptively prepare cocktails of medications for the side effects and then sometimes even for the side effects of the side effect medication and there were some decisions to be made about those medications beforehand and during and in those decisions I got to exert some agency so number one I was basically told that because I have anxiety I would be given benzos like in like IV benzos benzo diapenes for the purposes of my anxiety and immediately alarm bells rang for me because number one, you can hear my previous episodes about my experiences with Benzo's, but I did not want to take them. I knew what I experienced on them and did not intend to have that interact with my ketamine experiences, let alone experience it at all. So I was very vehemently against it. Yet the first day, I admittedly got nervous in terms of coming off as too pushy or too stubborn or all of the weird, like, judgmental limiting beliefs I have about myself and like a lot of the, like, medical trauma and experiences I've had. And I ended up just after kind of questioning the Benzo's and kind of being looked at like I was weird for asking questions, I ended up saying, okay. And I definitely regret that, but I did learn from it. And after that first day, I did not take them anymore. But what that did do to me, what they intended for that to happen was, apparently, when one takes ketamine, it can cause anxiety, especially for people who have anxiety because they're not used to altered states of consciousness or even just like the feeling of the bad amount of ketamine in one's body. And of course, while I had not done ketamine, I have done several psychedelics at different dosages. I couldn't necessarily say that or maybe I could have, but I didn't say that. So I couldn't necessarily defend that idea. Like, I already know what it feels like or I'm used to that, so I don't need to take anxiety meds for it. I did have the, you know, kind of defense of, I have done very poorly on benzos in the past, but they kept trying to get me to do it. And so I did. The other reason that I didn't want to take benzos was because of the idea that benzos in the context of looking to reconsolidate memories and extinguish fear block that from happening because one is not exposing themselves to the full level of distress and anxiety and activation and panic that might come from an experience. And so in the context of ketamine, I first saw, perhaps, me reprocessing things or, you know, very strong feelings coming up that I oftentimes don't feel in my regular life to the degree that they should be felt because as I talked at length about in my psychedelics episode and the mental health episodes, I tend to not feel those, but on psychedelics I do. And I really didn't want to interfere with that because that's part of what me and my clinicians think is like a core part of my recovery process. So I figured benzos would be contraindicated for that yet, once again, the framework of ketamine treatments in this clinic and general clinics that are not, you know, neuroscience informed or looking at the psychological side and feeding back into the brain, like they're just not trained on that. Their thought process is like ketamine just does but it does and nothing really impacts what it does. So if you, whatever else you need with the ketamine. So they didn't really understand that that process. And again, I caved to that pressure the first day and definitely learned from it. I don't think it was a huge deal the first day because the first day, as I'll get into like the experience on it, it was just kind of weird. And I'm sure the benzo, they like some of that weird, really I didn't have much, I mean, I definitely did trip quote unquote, but it was very mild compared to what was possible. And it was kind of a primer for my system to just like experience ketamine at a certain dose and not totally freak out because it was going to go way higher in the next few days. So had I continued to take benzos, it probably would have made a much bigger difference in my future experiences, but that's what happened the first day. I say all of that and want to share that to be super transparent so that you can relate to whatever it is that might affect your own experiences and just hear my perspective and take that information into whatever decision you make between you and your providers. But I didn't really have that told to me. I kind of had to piece all of that together myself from all of the information out there. So I wish someone had said that that I had access to. So that's one of the many reasons I'm doing this. But what I can say about the first day is, again, they gave me that. They also gave me, oh, that's the other thing. Another part of the decision making process in terms of side effect medications was because that amount of ketamine oftentimes induces really bad nausea, they give in that cocktail of IV meds a anti-nauget medication. But there was a choice between a medication that didn't make you fall asleep or a medication that did make you fall asleep. And most people choose the one that makes you fall asleep so that you could just kind of get knocked out during the experience and whatever and come back out. Again, I was going in with the full intent of taking advantage of this state and whatever came up, not going to force it. But if anything came up, I would utilize that state to process it and move through it and experience whatever my brain was going to bring forth towards me in that state of consciousness. So sleeping didn't make sense in that situation. So I absolutely insisted on the not sleeping one, which I'm really glad I did. And we'll play a role in what comes next. And so those two decisions, the first day, it was on a benzo, but was not on the sleeping nausea med. And then I was given my first full day of ketamine. And all I can really say about that first day was it was just kind of weird and disorienting. And I tripped, but not intensely. And it was just kind of a blur. And it definitely had sedative effects during and after. But the recovery after getting off that ketamine and then coming home was not that bad. I think I was kind of woozy for like an hour or two and then I was relatively back to normal. I remember still because of my tendencies of never stopping working and doing stuff like I was still emailing people and still supporting and responding to the team. I direct my media team at the intercollegiate second dogs network. I was just still relatively doing stuff even though I had counted on not being that functional and figured like, oh, that's fine. Maybe things will just be kind of a little bit more intense from there, but maybe it's just I'm just going to chill. And maybe more things will come up. It's a little more intense, but nothing too wild. And boy was I wrong about that. So I went in on Tuesday. So that was a Monday. And then I went in the next day. And I was very clear this time that I did not want a benzo. I was very insistent. And I had to keep affirming that every single day because sometimes they would just assume I wanted it even though I waited clear. I didn't. And I'd have to confirm that it wasn't in my cocktail. They'd have to remove it and make a new one. It was a whole thing. But I was really insistent the second day that I did not want a benzo. I did not want to sleep. And they up the dose to like, I would say if dose one was like 50% of the max dose to was like 65% of the max. And that day, day two gave me a whole experience. It was actually a really decent experience. It wasn't like amazing. It wasn't like I was on cloud nine or I was like super joyful or happy. But it was not disorienting and weird like the day before. And it felt like I got insight. It felt like more calm and more insightful are the words that come to mind. And I wrote some things down from that day so I can take it back to like the analogies that came to mind. But what I saw that day was this kind of realization and vision of the difference of how my thought processes were working on the ketamine and the stark contrast to how my thought processes look like in my daily life. And that was particularly around OCD and then also like intersecting with trauma and fear. But a lot of it was OCD. So what I saw was I'm gonna try to describe this vision in a way that makes sense because it made a lot of sense in my head at the time, but I don't know if it makes sense outside of my head. So it looked like just imagine, this isn't even like a realistic situation, but imagine that there is a line of balloons and these balloons are like fully not inflated yet. They're just little balloons like the size of your hand that are just totally taught, okay? And these balloons are my desires or my interests of the things that like are egocentonic and lighten up and are my values and all of those things. So in my day to day life, what was shown to me was that these balloons, sometimes there's a slight amount of air that's that's pushed into these balloons and really quickly the balloon deflates and the air goes away. So it almost they all look the same even if they had been just a little bit inflated because they're all kind of like crinkly and whatnot and it's so small like there's such a small amount of air that goes into these balloons that it's like almost not inflated at all. And so the reason that that matters is because that that inflation is kind of like when my interests pop up or my values are engaged or when something is positive or interesting or just something that I want. But it deflates really quickly because I start into like my pathology really starts attacking the balloon and doesn't let it fully inflate and then my pathology questions if the balloon was ever inflated to begin with because it doesn't really look like it has been inflated because it's just a tiny bit of air or in you know the context of me like a tiny bit of energy went towards something I that really resonated with me before all of my pathology of like attacking it and trying to understand it and questioning if it's actually me or if it's my OCD or if it's trauma or you know starting to compulse around it or overthink it or all of the pathological mechanisms within me start attacking my values. And so I and it's really hard for me to decipher between like if a balloon had even been engaged at all or not because so little air went into it that it like almost looks exactly like a normal balloon that hadn't been inflated. I hope this is making sense at all if not we'll get to the point of it but that's what was shown to me right and then what was shown to me was on ketamine and this state I was in and having more clarity and more space from my pathology in the state my balloons were able to inflate far more and even like sometimes fully and then start like moving and flying before sometimes they would deflate and come down and there was just a lot more space between them inflating and deflating than there was when I'm sober and so I had a lot more clarity and confidence because I wasn't engaging with that pathological doubt and attacking of my values or my balloons I was able to see what they actually were and so it was really nice because I saw what was possible when my state of being wasn't in such constant panic and attack and fear and it was just so beautiful to be able to see the things that do interest me and light me up and you know don't carry so much baggage until they're attacked and what I have written down here is space between what I want balloons and pathology OCD trauma etc. When sober balloon slightly inflate but they're quickly weighed down and deflate and they're so hard to find and on ketamine the balloons can inflate before eventually weighing down and I got to watch them and they made me so sad because of what it looks like in my real life and then there was some insight that I guess came to me and I wrote that down underneath it by the way I wrote all of this down after the ketamine sessions like when I was back at home and integrating that day I wrote of course I wasn't allowed to feel joy or be fun or have fun I just always need to be a good or right person so my pathology tries to protect me by bringing me back to homeostasis constantly and what that really means to me from reading that and tapping back into that feeling is that the ketamine helped me realize that so much of my pathology is so fixated on and focused on being right and being good and because I wasn't allowed to in my past and in the way I was you know raised informed and a lot of my values being attacked by the idea of needing to stay safe and for me what staying safe meant was staying as compliant and good and needless and thoughtless and valueless and joyless and just fitting myself into the really small box that meant survival for me so that I could move along in my life I and my pathology learned to protect me from or at least it thought it was protecting me from engaging with myself at all so that I could do what I needed to do to stay safe my circumstances not really carried along with me even though I had gotten out of those circumstances and I'm living a different life so that was really insightful for me and really beautiful and I took that day and thought that maybe I would just get like the rest of ketamine would just be like more insights like that and you know just giving me more awareness into myself and it would be beautiful and it kind of affirmed to me that I'm really glad that I went into it with so much knowledge about the actual experience itself and not just coming in and just numbing it out entirely and going to sleep or just ignoring it and suppressing it so that was beautiful and what I ignorantly thought would happen was that it would just continue to be that way and that definitely was not the case. I think that the flavors of day one and two were completely different from what came later and I'm just sharing that so that anyone going through this experience might know that it might change what the dosages and days and the evolution of the way the treatment goes. So yeah I came out of day two feeling like the theme of what I'd be exploring would be probably consistent and I really just wanted to feel more grounded in life rather than tethered and that's kind of like the intention I sort of came into day three with like hoping to explore that more because it felt very just profound and beautiful for me also though like totally open to whatever else would come up and you know hoping it would be just as positive and beautiful as day two. So day three I come in same thing no benzo the awake nausea med instead of the asleep one and this time I was told the dose would go up a good amount higher than it had really really ramping it up so I'd say this one was about 85% of the max I was gonna get maybe more like 87 to 90 but let's let's say around 85 to 90% so go into it and I basically the way I would describe this like six hour situation on day three was what was so intense it was so intense and I'm laughing because of the recollection of what I'm about to say but part of the context around this is that they would put some video on the TV that I talked about because generally people would just like put stuff on Netflix or YouTube which I cannot fathom how that would have made sense at all given like the levels to which I tripped but they put a sea turtle video on YouTube like a 11 hour long just a really long sea turtle video which is interesting because I didn't really know what to put I didn't foresee that decision and so I kind of just like let whatever nature video come forth go on and it had been on the last two days too and I really like the sea turtles from day one they just were nice which is interesting because I never had frankly given a shit about sea turtles before part of it might be like apparently I have triptophobia which is this thing where if you see a lot of circles or shapes that are of different sizes it like gives you the literal disgust response it's not controllable and like for me the circles on a sea turtle shell and the skin freak me out but for some reason it didn't those days so the sea turtle video just was on and it was just following sea turtles swimming around and it was beautiful and cool I didn't really focus on it the first two days but the third day I seemed to focus on it a lot and/or it colored by whole experience but I had this long journey initiation it felt like into this realization that I am a sea turtle that has been trying to live on earth and on land and flail around and function as a land turtle but I actually belong in the sea and I know how vague and abstract that sounds but let me tell you what I mean so I had this whole journey on day three of just seeing my life and seeing how it's unfolded and really seeing within myself how to differently, I have navigated life and how different I felt my whole life. And that's not new. I knew that I felt different, but I knew how different I felt. I've talked about this endlessly to anyone who hear me talk. I identified that when I was a child and I have known this as an adult, but I have had so much shame around being so different and feeling like just a complete other species of human almost. Like I just felt so weird and like something was wrong with me. And I just felt like I need to do everything I can to change myself and fix myself and apologize for myself. And that's really, that's not reflected just in how I engage with the world and the way I talk and the way I communicate and interactive people. Like I've always been told that I'm very different and I have that reflected very negatively growing up and being bullied and being isolated and not being able to make friends. And I was just so confused as to why something was so wrong with me. And you know, now as an adult, it's oftentimes treated less poorly and more just objectively. And sometimes people even share, I mean, now a day is it's seen as like a positive or reflected to me as a positive of how different I am and how much people I guess enjoy or appreciate the way I show up in the world. But I have a lot of baggage around it because I've just felt so much shame from how isolated and different I felt growing up. And there's so much more to that. And it's a lot of it's talked about in my previous episodes. But at that point related to day three, like that was really coming up for me. And I started just seeing so many pieces of my life kind of like come together, especially just not only like I said, have I just been different in the way I engage with people in life. But my trajectory in life has been so nontraditional and different and guided by choices that other people have oftentimes not had to make or have not seen life through the same vantage point is I have which everyone's different and everyone has their own journey. But I in particular have had a common thread of coming to different vantage points and different ways of decisions and existence. And it's been so isolating. But and also so shameful because it's not necessarily encouraged in our society and in our world and particularly from the cultures I come from. And just at the intersection of all of that, it's not encouraged to do things differently and until it totally pays off at the end by whatever arbitrary beacon of success like people hold. It is generally something that I'm judged for. And I just saw all of that and just was taken through this massive realization in concert with watching the sea turtle flourish in the water and just forge its own path and not follow the other turtles and other sea life and just exist and be and be free. I saw that I am that and it was time for me to accept that and to accept myself for who I am and allow myself to be who I am. I'm just different and weird and express myself differently and see things differently and that's beautiful. And I get to connect with other people and show up in the world as myself and still be myself and be the fully weird different person I am and still be loved and seen and cared for in this space of existence where other people uplift people for being who they are and I could see where so much of my shame and fear came from growing up and how much that had carried over to coloring how I saw people now without accounting for the different environments I'm in, the different levels of age and insight that people have and just the people have surrounded myself with now. So that there was that there was also just irrespective of how I am seen and treated in the world. This idea that choosing everybody else and choosing everything outside of myself is so painful and I deserve to choose myself and I am allowed to choose myself and it was just this liberating beautiful experience of shedding just those things I've been holding onto of the way I needed to protect myself and protect this. The little I had in terms of just trying to assimilate to what people wanted of me and what's quote unquote normal and just letting myself be and so I just basically realized that I'm different and it's okay and it was so beyond just what people perceive of me in general and like the way I show up but also who I had been trying to be, to be loved and cared for for so long and also on top of it all just what really really really was pivotal for me in that experience was realizing that also the world is not necessarily set up for people like me to be who I am and so it's so natural that I being a in this metaphor a sea turtle and trying so hard to live on land not knowing that there is the sea because the land is the illusion that we have all been shown that we have to live amongst first survival so you know this world of thinking a certain way and being productive in a certain manner and not being sensitive or inquisitive and and just putting our head down and being just just working endlessly and I was seeing myself in the way I've been born and I talk about this and I think my first episode of like my whole story of the idea of orchids versus dandy lions and how also I talked about in my mental health 3rd-eparth 3 in terms of all the psychological evaluation I went through the idea that I was shown by the people evaluating me that there is a actual epidemiological and medical concept of people who are orchids versus dandy lions and their different constitutions and the ways that an orchid is generally born from so many different parts of epigenetics and biology all the way to the way the environment shapes them and they tend to be much more sensitive they tend to be people with in the best circumstances are the most resilient and flourish and tend to be the most creative and have the best outcomes health wise and you know career wise just general output wise in those you know measurements of success I suppose they if it's a bell curve of people they tend to be either on the extreme right or the extreme left so the extreme right under the best circumstances where they're supported and being who they are they flourish the most and on the flip side if they aren't then they tend to have the most disease burden they tend to have the worst physical outcomes most things you know I think there is a statistic in this whole concept of orchids and dandy lions that I think two thirds of all of the disease burden of the world across all socioeconomic statuses and cultures and societies two thirds of it exists in about 15% of people and those 15% of people are considered oftentimes to be the orchids hello picture of me and like the eight million different illnesses I have and just the extreme nature of my life and the different things that have happened to me and that I have subsequently done you know I'm an orchid by all standards of the word I am very just highly sensitive and aware and I'm neurodivergent as fuck and I just wasn't in circumstances that let me flourish and encourage me to be who I am for a very long time and I so I bore the brunt of the opposite end of the spectrum sometimes it's the extreme of people who are orchids ended up being in the worst scenarios like the most incarcerated the most in the throws of addiction just statistically not necessarily causally in every single circumstance but just correlatively also homeless like there's just so many versions of that and I ended up in some versions of just the most extreme distress that people can experience and now I'm not and I'm coming out of that and part of that process of accepting myself for who I am and learning how to navigate life as I am even with the world being conducive of a typical person with a neurodivergent typical way of thinking and being and more of a resilient constitution physically having more capabilities like the strengths of dandelions are very encouraged and the quote-unquote weaknesses of orchids are very much punished. And so I had inadvertently lived my whole life without knowing about any of this, just in terms of pure survival, mechanistic ways of trying to survive. I had been trying to be a dandelion or in the analogy that really resonated with me. I had been trying to be a turtle that flails around in functions on land and I succeeded enough to be able to look like I could do it and I did do it, but it was so much harder because I wasn't supposed to be there in the first place. And when I accept that I'm a sea turtle and I go into the sea and I live like I'm supposed to in the sea, everything just makes more sense and I'm able to flourish. And I saw all of that that day and it's so beautiful. And it just gave me this language for liberation. And I was able to talk to my therapist, I had talked to my therapist that second day as well and explained the thing I talked to you about with day two, but like day three bringing that to my therapist was just so beautiful and so affirmed. And it was really hard for me because even on the ketamine, I felt so much shame around saying that out loud to someone outside of my mind and just the fear of being judged or being invalidated or just like being shown that maybe I'm wrong about all that and I'm delusional and that I am just tripping, but I was met with so much validation and just this relief from my therapist and my husband almost because it's something that they've known about me and seen for so long. Obviously not like I'm a literal sea turtle, but like that whole part of me and my self acceptance and the way I'm different. And it was just so beautiful to share in them seeing me and validating that and feeling the liberation and joy that I felt because they had seen that in me for so long and head hoped that I recognized that. So that was really beautiful and I wrote a lot from that and I don't need to bore you all with everything, but I specifically wrote in there that I don't have it in me to healthily put my square peg in a round hole. And I've known that I'm different, but I've hated myself and not believed in myself and rejected myself for so long that I didn't think I was worth pursuing life that actually fit me. I've been a sea turtle flailing on land trying to function my whole life and I've done it, but it's far harder and draining than finding myself back in the sea, swimming and being where I belong. My pathology keeps me so locked into certainty and a charted path and my self hatred keeps me thinking that I only deserve to take the hard charted path because I'm undeserving of the freedom and peace that comes from the charted path I meant to create and that I'm not capable of creating that uncharted path. But today, I see that I am meant to make my own path and I am worth it. It doesn't mean that it doesn't scare me shitless and that a charted path is still so tempting to my fear. But rather, that I would be so much happier and fulfilled charting my own path. And perhaps I'm capable of it too. I'm worth it maybe. I'm worth pursuing the joy and self expression that I've always yearned for. And then I wrote a bunch of examples about that and come back to how I feel and I want to read that part too. Today, I feel accepting of myself. I accept myself for being different, divergent, with less hate, judgment, and small-mindedness than before for owning that truth. The issue isn't that I'm different. It's that I'm judging myself for daring to identify with or use that term on myself. Today, my truth coexist with my fears, rather than being fully drowned out and overshadowed by my fears. And there's just a lot more reflections and everything written there. But those parts felt really special to share because it just seemed to really capture the magic of day three. So I came out of that feeling kind of scared of owning all of that. Yet I also felt like it wasn't necessarily a choice. I couldn't run away from it anymore. It felt like I just was stepping into it. And I was feeling the natural transition of the fear and the just yeah, the fear of taking up space and being myself. And it's actually that day that I finally decided I am starting this podcast. I had had the podcast in me for like three years before that. I had the name I had everything I just did not do it. And had all the excuses in the world. And that day I said and realized that I I'm doing this and it just is an inevitability and it just is happening. So well, that's day three is why we're here today. So thank you for that. And that takes us into day four and five, which I wish I could tell you that day three carried through. And like I said, day one and two were like milder flavors. Day three was a beautiful and amazing and day four and five were quite different than that. So day four. And I feel like I'll lump day four and five in together. I'll go to detail about day four and then day five is just kind of like a table bring off from that. But day four, I come in same thing again, no Benzo, the awake medication, kind of feeling like more of a grasp on what would be happening, although that was not true because day four was going to go to about like, I would say 92 to 95% of a full dose, which is quite different than the past few days. I didn't know how much more could ramp up and keep in mind, there's like a cumulative effect of doing this every single day too at this point. It's day four. I tend to three days in a row of tripping for intensely for like six hours plus the calm downs and the integrations. And that was so much. And honestly, I was like really over it. And I didn't like continuing to come, but I was going to do it. And so that was the headspace I was in. I was also pretty, you know, calm and sort of hopeful from day three. So came to day four that way. And then got the dose and really quickly just descended into darkness and doom. It was horrific. And to sum it up and spare you all the gruesome details, it I was suicidal the entire time. It was horrific. And it just that entire six hours was me feeling every ounce of shame, every intrusive thought about myself rooted in logic or not. Feeling just so much hatred about myself, feeling just disgust and just it was horrible. It was just all, it was shame. It was so much shame and fear. And I never felt the extent of that. It was inescapable. And it constantly came back to this feeling, this almost like knowing that like, I need to end my life like I can't do this. And I use those words not to say it was objective. It's just like that's what I felt and that's what it felt like a knowing at the time. And of course, we're going to come back to what that all meant and how it's played out since then and how it perceived it. But that's just how I felt that it was horrible. And it felt like it would never end. And I was just, you know, like silent and just experiencing this all while like, you know, slumped over and like tripping. And I could it, I felt like I couldn't use words to express this to anyone outside of me because if I did, like they would try to put medication in me and like try to put me to sleep or just like, you know, freak out. And I told a little bit to my husband, but just I couldn't say exactly what I just said. It was really, really bad. And of course, you know, that sounded some alarm bells with the people administering it. But I also just. Whatever resolve I had inside me, I felt like I, there's something in me that knew that like I needed to experience this, whether it meant like, it was the capital T truth that I was feeling or like there was a purpose to feeling all this. And I stuck it out and it was horrible. And then I came out and I had therapy with my therapist that day in particular, it happened to be like right after because of scheduling right after I left the clinic and I was still like, really, really fucked up in the car, like I couldn't even open my eyes at the time, but like I was awake, but like it hurt to open my eyes. But yeah, I so I this time talked to my therapist after and then told her in the safety of my car with just my husband and her on the phone. Like what happened and as much as I could make coherent words at the time and luckily it didn't scare her as much as there was a lot of empathy. And she and my husband kept reminding me that this isn't forever and it will pass. And I genuinely didn't know how to believe them because it felt like this was just like I was just in it and it was just gonna never end and it was just horrible and I off of course I had no concept of logic and time because I'm in the depths of like like just a wild amount of ketamine in my body that had been going for hours but it was it was just it was so bad it was so hard and I really didn't know how I was gonna do a fifth day or even continue to live for that matter but like all I could do was come home and just I was super out of it and I also just felt so horrible and I just tried to just tolerate it and put my dog and hug my husband and try to sleep and that's really all it came out of that and that day five was like a less extreme version of that it felt like it couldn't feel the extreme nature of what I felt the day before it still sucked but it was maybe just wasn't as jarring because there was such a stark contrast between day three and four versus day four and five but it was more of the same and it really really really sucked and then I was done with that week and I was left to my own devices and recovery for about like a week and a half ish until like almost like a two week period passed and I was gonna do my first maintenance sessions which were gonna be the same dose as day four and five which by the way day five was probably like 95 to 98 percent I think almost at a hundred percent of what I could have gotten if they were probably reserving that last few of the percent for my upcoming maintenance treatments just in case that was needed because there's a certain cap for everybody based on their weight and what's acceptable and there's absolutely no going up from that cap because of safety purposes so there's always a little bit of buffer room to just like have some space to keep going if needed so yeah I was left to my own devices till those next sessions and integration and recovery from that week was really interesting so first of all apart that really really affected everything was the fact that all of those medications that I had mentioned to you that I'd been given every single day on top of the copious amounts of ketamine that had flowed through my body for about 30 hours that whole week on top of the nausea and pain and other medications and like the side effect medications and like just the cocktail that was put in my body every single day at such high doses it did a number on me and it just really messed me up physically in so many ways I was in so much pain and like different kinds of pain than I was in from the initial like you know point of chronic pain treatment which will get into how the pain was affected but in terms of like integration recovery my body was just so messed up my sleep was messed up my digestion was so so messed up and I just had to take so many other things and just like let myself be useless and live next to the bathroom and just struggle I really struggled with being able to eat and having appetite which was really hard because like my body was so weak and it was just really really rough which interestingly like overlaid all of the horrible like horrific experiences I had in the last two days of that week and I was just left with the aftermath of all of that pain that I experienced internally and all of that shame and guilt and just this feeling of needing to exit life and it was really interesting because as the day has passed and as I was you know just kind of at a really horrible bottom like place physically and mentally I started getting clarity and indeed my therapist and husband were right and that it wasn't gonna last forever but it lifted in a way that I didn't really expect which I guess was what the ketamine did for me and me interacting with the ketamine which was so important I hope at this point it's kind of obvious that I was right in feeling and thinking that the actual experiences on the ketamine itself was gonna make a difference in my actual trips and then everything that came after but I'll try and just get ahead of myself in the days after what started coming forth for me was that everything I felt on that Thursday and Friday that fourth and fifth day were all of the feelings and thoughts that I had suppressed and that I had constantly felt within myself for a very long time like particularly shame and guilt and hatred and pain and anger and sadness and it all was internalized towards myself because I had not in my life been trained to or felt safe to healthily express any of that to any circumstance or people outside of me and as you've heard in my previous episodes a huge MO for me in terms of coping and the way my system just navigated reality was intellectualizing and rationalizing most things and not feeling emotions because they were unsafe and required being felt towards other things which would inherently mean that I was assigning some level of you know from a small perspective blame but from a greater perspective just like acknowledgement of things happening and processing them the way a human does I was not equipped to do so and so for the longest time I internalized and turned everything towards myself everything is my faults and everything is from me so that's what shame is right and that was the only thing I really experienced and I didn't experience other feelings and of course one cannot necessarily function and do well by feeling intense pathological amounts of shame all the time I mentioned in my mental health journey part three episode that my in the psychological evaluation I did the person the clinician who did my assessment said that they had never seen someone score or exhibit more shame than I had in their entire career and that was really really jarring and that honestly came forth for me in this whole integration period because I realized that it's it's hard for someone to function with that much shame so a lot of my pathology and especially with compulsions was to do what I could to avoid all of those feelings like I didn't know how to feel then and they just were stuff deep inside me and what it felt like the ketamine did quite similarly to the other psychedelics I've done which I talked at length about in my psychedelics episode it forced me to feel the things I did not let myself or could not let myself feel consciously in a sober state so that entire experience on day four and five was me experiencing the depths of despair that existed within me and that took the form of shame and guilt and self hatred and all the things that I just felt and believed inside and did not fully explore or look at and only if I could explore a look at it can I move through it and start living amongst it but it's so painful and scary to do so that of course I haven't had not in my sober state and so what it felt like was this ex-forced experiencing of it I say forced like by the by the ketamine in my system and what it decided to do and bring forth for me it was a facing of it so that I could start purging it and processing it and co-existing with it and so as the days passed by I started co-existing with it and I was able to grow outside of it and it existed and I was able to look at it and grow outside of it because I wasn't limited by it anymore it wasn't what was running me and what I was constantly avoiding it was just there and I was feeling it and I could survive through it which was so wild to me because in those days I genuinely felt like I couldn't survive and that I needed to end my life because it was so much and too much and I was unworthy of existing but in the days and weeks that came forth and passed like I started existing around it and acknowledging it and it not only showed me that I could do it but it also started lightening those feelings and I can't say that they've gone away entirely not even close they're definitely there but for the first time I'm able to be liberated by them just running my entire existence and me running away from it constantly because that was kind of like in a reduction of sense a large amount of the cycle I was experiencing in my life and so that was so profound for me it was so so fucking painful and it felt like it was in it was gonna take me out but with time and space and whatever the academy did within me and me interacting with it and sticking it out, it gave me so much liberation and this this sense of duality and coexistence and and peace and liberation and it's so beautiful and horrible and beautiful like it's all of it so I started to gain some level of insight and hope around what this was doing for me and it also showed me that everything I had experienced on psychedelics previously that I thought was too much for me I could survive because all of those experiences mind you right like generally they're you take them and you have it one day and then you don't do it for a very long time you know DMT might be an exception but that was different and I go into that in the last episode but not generally speaking like it's one big trip and then like you're done right but with this I did it every single day for five days and I could not escape it and I just was like in this bootcamp of needing to do it over and over and over and there's nothing quite like that that I've ever experienced and that I think most people to do psychedelics generally experience you know other than Iowaska perhaps that's a whole different story but having to do that and by having I be like I wasn't forced to by anyone like I forced myself to do it by having to do it for five days straight it showed me how much I could tolerate and handle which obviously I can tolerate and handle because I'm alive but like having to face all of that and the extreme nature of my experiences and how much I was under the influence of ketamine and the amount of consciousness altering experiences I had in one week just showed me how much I could handle and I realized I had this belief based on the past experiences of psychedelics and how painful they were and how much I perched in those that like that was just too much for me and I needed to run away from it but this showed me that I could handle it and maybe I should and that was really interesting for me so I came away with this new found you know I mean of course grief around the fact that that's what it needs to look like because I'm learning to feel multiple things at once and this new found like awe the resilience I had within me and the amount of healing that could happen by me just sticking with myself and allowing myself to face the most terrifying things that exist within me the things that I have suppressed for so long that my system has for survival reasons so basically like though next two weeks after that week was that coming to that sitting with that also dealing with all of the health side effects and really struggling but you know it forced me to take more rest than I generally do I generally feel every break I ever take with copious amounts of work and taking on all these other projects because I run away from rest and I really struggle with being still because of everything that I generally suppress and I can't say I did that perfectly that break but because I was so sick and so in the thick of it I did a lot less than I normally do which is beautiful and it gave me some newfound energy to be able to reach out to people and start talking to people more I'd been avoided to people for so long and I was just really really a shell of myself and was very isolated very obviously just I was I told everyone I was holding on by half a thread and that thread started to grow and I started to talk to people more and just send more people love and voice messages yeah though who you are if you got them from me at the time and I decided to start really entertaining the idea that I needed to start this podcast and start sharing myself more and taking up the space that I had avoided taking up for so long and being myself and so that was beautiful and I felt hopeful and I felt like I should probably you know continue doing this ketamine thing the way I plan to for us you know as long as needed because it had had such a profound effect on me so I get to now the first maintenance sessions which was like it was I'd done that week right and then another week passed and then the week after that that first day so a week and a half almost two weeks after that whole week I came back for my first of two maintenance sessions and long story short it was pretty much at a hundred percent it was super super high and for some reason those days they just got me to a point where like I couldn't really think anymore like I was just super super just in something and I'm sure a lot was processed and done but like I couldn't really interact with thoughts very much and so that was kind of a it was a non event like I don't have much to say from the actual trip other than like it just was a whole bunch of things and there's not like a commonly held theme through it all but it definitely helped me and same thing that Friday what was really notable about that though was the side effects the physical effects of all of that was like five times worse than it was the two weeks before which that was already really bad and took me a while to recover from but these dosages and whatever they put in my cocktails was it just my body did not have it it was so bad and I basically just spent the next week and a half before I had to go back to school like trying to get myself to be functional again and I lived next to the bathroom I was in so much pain digestively like cognitively I really really struggled it was a hotness and the biggest takeaway of all of that was I couldn't keep doing that like it was a really hard breaking realization but I figured that everything I suffered through that first week like maybe it's because it was a whole week and there was a lot and you know it would just doing it maybe like once a month or once every whatever two days in a row would not wreak that much havoc in my body but it did and it was so much worse and I can't I couldn't physically deal with that it could I I can't discount like how much it was worth to me psychologically like to go through all of that ketamine but I could not justify like it basically rendering me ineffectual in between all those sessions for however long it would take to go into remission or like stop taking those treatments and here's the other thing this is probably the biggest part which full circle I guess I didn't really talk about through this experience because it didn't come up too much for me at the time but it was probably the biggest decision-maker in the fact that I'm not continuing with ketamine which spoiler alert that's the decision I came to my chronic pain didn't get better and that really was a hard pill to swallow. There were periods during the actual trip where like I felt like I didn't I wasn't feeling the pain because I was busy immersed in the trip and I was also just like on the ketamine itself and it edged in a float I kept telling myself that it was getting a little bit better like in my integration periods and maybe they did but then they'd come back full swing at night or in the middle of the day and I was telling myself and the clinic was telling me that it might just take longer it might take more treatments it might have been flow but at a certain point especially when I came back for my maintenance treatments and it was right back where it used to be and almost as often as it was before like basically what the clinic said was well you know you might just need it for life and you might need to just do it every two weeks and I'm like what like that doesn't even at all corroborate with how ketamine works and it really irked me because it just clearly showed me that this the clinic was out for just you know take to be frank I'm just taking as much as they could from someone and they weren't willing to admit that I just didn't work and it was supposed to have worked a long time ago that's just how it does work if it's gonna work it's gonna work pretty early on and and it's going to last and it did not for me and I would have rather them just have been honest and offered me to continue going for the mental health aspects of it but that was a part of my decision but mostly if I could have handled the side effects of everything I would have probably been like happy to continue just for the mental health benefits because I got so much from it and I could really really would like to continue whatever it helped with me in terms of just my overall like ability to feel more emotions and my depression being decently better like maybe 25% better which is huge for me compared to normal but because of the side effects and because the chronic pain was not helped mostly because of the side effects I decided I can't continue with these treatments like I literally just I have a life to live I am in grad school one could argue that I should just take all my time off to continue but like at what expense I mean what if I am just like in between treatments completely physically fucked it, it's not gonna change. Like what am I doing with like what what what is my life? Like it would be so much more miserable than it would be helping my say to being. So I decided I need to stop and it really broke my heart. But there's a lot of good that has come since. So for one, like I told you earlier and going back to my psychedelics episode, this entire experience with ketamine really showed me that I could handle the distress and the intensity of the emotions that would come up and all of the purging that might happen during psychedelic trips at that level. And it's also largely therapeutic and beneficial for me from multiple perspectives. So I now feel this newfound sense of confidence and resilience to be able to continue some form of what I look at as like continued dosage of rattling up my brain and inducing the mechanistic changes that ketamine and other psychedelics in different ways induce for my own benefit. I can use other psychedelics for that. And I can use them far less often because ketamine is such a short acting and not as powerful substance in that way. So instead of doing it every two weeks to every month that such a high dose for such a long time, I in theory. And of course, this is just like me experimenting and looking at what's possible. I can use another psychedelic that's far more powerful and far less harsh. And I can use that philosophy and that framework to continually as I feel called to and as I feel the effects waning on my being continue inducing that healing within myself. So that's amazing because I had written off doing psychedelics in that way or general for like in the past because of my experiences. And now I know I can do them and I will. So that's exciting. In terms of the actual things I came in for again, like the audit of chronic pain, OCD, PTSD, and depression, this is my assessment now with integration and time passing and like kind of the overall trajectory of my experiences. It definitely helped my depression like overall from like a just how I feel on a day to day standpoint, like 25 to 25 percent, maybe even 40 percent, certain days. So on average, I would say like 30 ish percent, which is beautiful. And like the biggest amount of reduction I've ever experienced outside of just my past of my medical issues helping resolve some of the overall dysfunction in my body. So that's beautiful in terms of OCD has not helped in the ways I can quantify at least. It does not reduce the number or the frequency of my obsessions or the compulsions that I engage in. I can't say that I'm necessarily even more aware of them, but I can't say that the interplay they have with my depression has been less into which is beautiful. Same thing with PTSD, it has not helped itself, but any interplay it has with my depression and kind of coalescing and the overlap I can see a reduction in too, but not the PTSD itself. And it didn't help my chronic pain. So that's not as beautiful of a story as I'd like to tell you, but that's the honest truth with the protocol I went through and what I've experienced within myself and yet everything I said before is true. And everything feeds into all of it and I have a lot more insight into the inner workings of how things feed into each other. And I have a lot more zeal for life. I'm clearly a lot more expressive and taking up space and acting on those values and acting in the face of fear in a way that I have not before, clearly, and all the insights I've leaned from everything I shared from you on those different days, the good days, the bad days are so valid. And of course, like the novelty of it all can wane, but it stays with me and granted again just for time and the timeline sake of it all. The trip happened at the, I think it was December 19th to 23rd and then like two weeks after that. And now it's February 26th. So I should have already had like another session or two of the, or like two sessions or four sessions, like the set of two sessions of ketamine by now based on the schedule that they'd give me and I haven't and I can definitely feel like a slight decline, but I still feel really good and I know that whenever the decline is substantive enough, I will be doing something to induce that state again. And I have taken the wins that I have gotten the insights and the lift and depression and the overall improvement of my affect and it has made a difference in my life. And what it has given me is the zeal and hope and the light to continue to have hope for the other issues that I talked about that weren't necessarily directly improved by the ketamine. I had for a lot of reasons kind of started losing a lot of hope in more recovery from my OCD and my PTSD and their comorbidity and I have more acceptance of where I am now. That's another, that's a huge part of this too. Like I feel like I'm able to accept more. It's not complete. It's not perfect. Absolutely not. But it's much more than it had before. And I'm able to accept now and I'm able to look forth to what's possible and have patience and some level of trust within myself and serantivity and circumstance that I will get what I need. And I have also just been able to expand into just more coexistence of things. I wouldn't, like I do see my binary thinking coming out in an instinctual sense still like around OCD and things like that. But then in like the more meta picture and really taking time to be more present and sit, I am able to see an except more coexistence of like in a very basic sense things are really, really hard right now. And I am objectively where I am and I'm improving and things can get better and all of it could be true. Which is something I really struggled with and it sounds super simple, but I really struggled with until this shift. So that's beautiful too. And another huge part of what's changed for me is that I can feel somewhat more emotions now. Which it's kind of weird because it's I feel like I'm learning how to human and they come out and it feels uncontrollable and awkward sometimes. I'm probably judging myself for it more than other people that are experiencing me, but I'm sure it is kind of jarring and strange. And I it's a lot and I really appreciate it. It's hard, but I appreciate it and I'm really grateful for it. I'm starting to feel like little bursts of anger now, which sounds like you know, anger has been pathologized whatnot. Like maybe it's just my baggage coming out right now, but it's so liberating and I feel like I don't really know how to handle it and I'm scared of it, but it's starting to come out little by little in situations where I feel safe to feel that like with my husband and with my therapist, like when I'm just reflecting on experiences and situations and I'm able to start feeling some anger and it's just very foreign feeling. And it's so interesting to learn how to human as a 26 year old. And I know that there's so much that will come from this and there's so much more to report, especially as I continue on with engaging this level of treatment and you know self-ministration supported by clinicians, all of the things like just going down this line of support, also being able to engage with like proper evidence-based psychotherapy and treatment for the conditions I have as I get more access and space to be able to do so. And there's I guess I'm just hopeful and I am so grateful that I have this space to continue processing and sharing and I just really wanted to put this out there as imperfect as this is and as much as I wish there could have been like a more finite end or there could have been a whole you know a more comprehensive story. I had to expose myself to the idea that I needed to finally put this out as is where I am now because this isn't ever a well thing journey and it's not like I'm going from like struggling to cured or like struggling to super super amazing. It's evolving and flowing and you know what that's life. So I'm just so grateful to be received and this way on my own terms and being able to share more of the reality of a version of this experience and I just hope that everything I talked about in terms of the factors of choosing and what I experienced and went through and the decisions I made and didn't make and the options I had in front of me just give you any insight into empowering yourself to make those decisions however best fits for you even if they're completely different than mine and I just as always want to bring more awareness to exploring these treatments in the contexts of illnesses and disorders that are not talked about as much as they should be partly because they're pathologized partly because they're not amplified or represented and here in this space that we co-create together in the safe beautiful space I am fighting the pathology around talking about this openly in the stigma because I don't believe in it and there's so much harm that's caused from suppressing the actual experiences people have and we relate and learn from each other so this is me radically sharing my truth and creating the space of other people and all of you can own yours too and we can actually learn from each other and grow and access the support and autonomy that we have within ourselves amongst this evolving an open system of healing that exists in all facets of our lives so I've just grateful to do this on my own terms and to be received by all but so much love and care and I hope I acknowledged and answered all of the questions that came up for you if you have more please let me know please message me email me submit it in the question box of this podcast that's linked below reach out on social media just let me know what more you want to know about this I can promise you that far more is coming on the podcast about talking about everything you're probably wondering about ketamine from the scientific perspective the clinical pharmacology the mechanisms of action why it is we're looking at ketamine what the differences between ketamine and other psychedelics what even constitutes a psychedelic how psychedelics work in the brain what we do know all of those things I promise you so many conversations are coming and I cannot wait I just had to get this part first part out because you all have been asking and I had to just I just had to address it all so I can't wait to bring more of the information around these to you too and to just keep talking about real life and just creating the space of openness and love and safety with you so thank you so much for being here for this episode and as always it would mean the world if you could leave a rating and review for the podcast that is what helps us grow and I truly mean it when I say that every single rating and review makes a difference in being able to create this space and support me in doing this work so if you could just take the second on whatever platform you're on to just hit that five star and let me know your thoughts that would mean the absolute world to me and if you could share the podcast share clips from social media to whoever you think is interested whoever you think would benefit from these conversations and if you could share the link to the show and the name of the show to anyone who you love who you feel like would resonate with this show please take the second to do so it would mean so much to me and just keep letting me know what you want to hear this podcast is being co-created and built with y'all with everything that you ask me because like I said I have so many things that I could talk about and I really appreciate hearing reviews that I can shape it with what you want to know because this podcast is in service of you and of me and all of us so thank you for being here I can't wait to see you next week and have a beautiful week y'all