This is my first follow up from my first post.
It's probably as strange to hear as it is for me to type - but as of today, 1-week after starting treatment, my depression has... gone. Or lifted.
Let me try to explain in ~100 sentences if you have the time.
It’s just a few days after I started a particular type of treatment for, what I am told is, treatment-resistant MDD, GAD, & PTSD. Those letters and whatever subsequent specifier you wanna use didn’t mean a whole lot to me a few months ago, and I'm surprised to say they don't say very much about me today.
I spent the last year of my life reconsidering my past and relinquishing my future. I've spent the previous few days reorganizing and reassuring my current status. For a guy that is almost infamously stoic, I’m sort of living George Costanza's opposite week.
I walked by a store-front and caught my reflection smiling without an explicit reason to be laughing at the moment. This isn’t like me. But no one is complaining either.
Instinctively, and I guess more genuinely than I'm used to doing, I smiled at someone at the bus stop, and I made her blush so thoroughly she had to hide her face behind her scarf. That same day, it felt nice to have to laugh with an immigrant on the street who beamed back at me like it was the first time a person had greeted at her in years. That definitely was a new experience.
I'm not cured. But everything seems better. Inside and out.
I feel a strange compulsion to take this experience that I am being offered and sharing it as far as I can go. I know there’s still more work to do, but I feel better equipped to do it. I'll remember the next time I feel myself in that hole that there a way to get out of it. Before I hadn't seen any evidence that felt applicable.
I don’t know how I’m going to feel in a month or year from now. I don’t know how much longer I’ll need to reapply treatment. What I can tell you is that my decision-making process has immediately started to find new ways of handling the same situations I was in just a week before. I have a certain resilience to those decisions that I never had before treatment.
And the funniest part is, it's not like someone was instructing and training me to think differently during this last week. The only thing this clinic did for me was put medicine in me while I thought about my life. And monitored my heart rate. And told me beautiful stories about visiting Italy and showed me cute pictures of their kids.
The only one influencing my decisions is me. You know, like antidepressants are supposed to work over the course of a year or two. But in this case, we did it for just 1-hour a day over 4 days. I'm already making new habits.
There's not only just the realization that I am an empowered as any other individual and the only one responsible for myself - but there is also a level of self-compassion and acceptance toward myself and the outside world that just was not there before.
Wait. That's not quite right.
All of the compassion, motivation, and tools were installed. I just couldn't access them.
All these years I spent examining these domains I felt it was necessary to improve my mind organically. And over and over again I attempted to execute and return these functions unsuccessfully. But, in the end, I just felt worthless for not being able to supply them the essential parameters. Where you get into thinking that there is something “wrong with me.”
The thing about whatever it is that is wrong with me is what is wrong with everyone. As a general rule, I think it’s pretty unproductive to spend any amount of time thinking about what the hell everyone else is thinking about - but I think in this case, it is helpful to look at the problem from a biological standpoint.
(This where all the neurology usually starts to come in, and people's eyes glaze over)
I’m not a medical expert. I’m not a counselor, psychologist, therapist, social worker, teacher. I’m not even a student. So I’m not going to pretend to be any of those things. I’m just a guy that listens well and reads his sources’ sources. I’ll try and keep this journal to be as helpful as possible to anyone who might be reading - so I will do my best not to mention any medical phrases that may or may not even be relevant by the time this is being interpreted. I’ll try to keep this within the context of my experience.
The first thing anyone wants to know when I tell them what I'm doing is what the experience of Ketamine is like - what do you see, hear, think, feel - etc.
What is kind of funny is the experience of Ketamine is the last thing I feel like talking about. At least in my case, I am much more interested in the after effects of Ketamine and how it appears to alter my higher thinking functions -- activating areas of my brain that were damaged or inaccessible before. Or that’s been the most remarkable effect that I’m still living. But I’ll do my best to indulge you.
The visual experience itself is, well, enjoyable. Especially so with the colors, lights, and shapes buzzing on around you. But most people agree it’s more interesting with the lights dim or your eyes closed.
You become acutely aware that your thoughts and your body are different elements. It might feel a bit odd to look down at your arm and feel a total disconnection for it, but for some reason, that part felt right at home for me. I almost imagine it’s like how a baby feels alone with themselves looking up out of their crib. Just a pacifier and the universe. Everything sort of seems to draw you inward. You almost don’t have a choice. Until you realize that you do.
This state introduces a new way of looking at things - removed of opinions and biases. A vivid pragmatism in the most utilitarian form.
I found this description from Erowid.org, that I thought was pretty helpful.
"Ketamine enables metaprogramming in individuals to a point where it seems like synaptic pathways are almost consciously being rerouted to achieve the desired reality shift. In the new state, one can literally “try on” new facets of personality, perception, and reality. For instance, you can invoke a new attitude for yourself, fit it into your old reality paradigm, judge possible outcomes and effects, then keep it or scrap it. You can project yourself into the future, into a new relationship, into a new career, or into a new life. Aforementioned is not an abstract projection; it is as if it is happening! When you find a new reality, resolution, or answer that suits you, you can live it out and measure it against the truth you just came disconnected from your traumatized state. If you want to keep it, it’s yours upon reentry into the physical. How long it lasts is up to you."
There are a lot of thoughts and theory behind depression, but one of the most prevalent ones that apply to my particular type of depression can be thought of more of a degenerative brain disorder than a mood/personality disorder. The short story is over time, either due to internal or external stressors, the brain will stop the formation of new cells as an essential cause of depression.
stress can cause neurons to shrink or retract their connections ... stress-related reductions in synapses in the hippocampus are directly related to the emergence of depression-like behavior
I’m not here to talk about brain cells
But given that we all have some predisposition to certain behaviors, it’s critical to understand how habits are formed, developed and executed in the brain. Many different triggers could get a person motivated (or demotivated) to go for a run. But for a person to physically perform those functions, there is an area of the brain that must be activated and must communicate with those areas that are motivating; otherwise, it will just never happen. If that particular area of your mind is depressed enough and unable to act, there is no motivational-meme-mountain.gif to trick you.
The sad part is that like any muscle, the solution should be simple, and working it out should be enough to fix the problem. But depending on the severity of your depression, you may never get a chance to prioritize that muscle, and you never get around to getting your ass off the couch.
What I was able to do just do was, in short, repair that function. To establish a robust try/catch block to help ensure that my motivation and reward system are firing together. Of course, that’s just one example. Mediation, journaling, routine cleaning, cooking, eating fruits/veggies. These are all things I’m able to execute more clearly today than I could two weeks ago.
Again, I'm not cured. But I'm better. And I'm happy to say that. Maybe now, in a year or two, I'll be able to go off my anti-depressants and regulate my life organically. You know, how it's supposed to work. I have a follow-up treatment this Thursday, and the training wheels go off. It’s kind of up to me, and we’ll see if/when I will need to be back.
Read Part I - The transfer I've been needing to take