Every Tuesday and Friday morning, I get high. It’s planned. I never stray from these two days, never take anything else. But on Tuesdays and Fridays, I get up at precisely 8:15AM. I get dressed, prepare myself. Then, around 9:30AM, the needle goes in. It takes around five minutes for the effect to really kick off.
I am no drug addict. I receive Ketamine injections twice a week as a treatment for depression. An anaesthetic drug, Ketamine is often used recreationally. But it’s now increasingly being used as a revolutionary—and sometimes life-saving—medication for people with depression, who haven’t responded to other treatments.
Before I began treatment on Ketamine, I'd been mentally unwell for several years. I had treatment-resistant depression, was chronically suicidal, experiencing psychotic episodes, and had made several attempts to take my own life.
Like many people who are trialled on Ketamine, I have been through the mill when it comes to medication and other treatments. Venlafaxine, Mirtazapine, Escitalopram, Nortriptyline, Lithium, Olanzapine, Risperidone, Aripiprazole, Paliperidone, Chlorpromazine, Quetiapine, Lorazepam, Clonazepam, Propranolol, Zopiclone, Melatonin, Promethazine… These are the medications I have been on, some of which I still take, for depression, psychosis, anxiety, and associated sleep problems. I’ve tried all the CBT and compassion–focused therapy skills, as well as breathing techniques, mindfulness, sleep hygiene, and probably more that I can’t remember.
On top of medication, I have had over 40 sessions of electroconvulsive therapy (ECT). The first course of seven was involuntary, when I was 18, and the further three courses were voluntary over the next few years. Until I discovered Ketamine, ECT was the only thing that properly helped. But it is a terrifying procedure to have. You have to go under a general anaesthetic for it, which is scary in and of itself. The memory loss is significant. I do not remember much of the time around when I was having ECT, and also suffered from poor short term memory. I am certainly glad that I had it, as I most likely wouldn’t still be alive if I hadn’t, but I am also certain I will never have it again.
Unlike other antidepressants, which can take weeks to have an effect, Ketamine works extremely quickly. We are talking hours, not weeks. For me, I start to feel better about an hour after the injection, and that effect lasts for several days. Many people only need to have the injection once a week, or once every couple of weeks. And for a number of people, it really is the only treatment they have found helpful.
I remember vividly my first Ketamine injection. I was so nervous—nervous that something would go wrong, that I’d have a bad reaction, but mostly that it wouldn’t work. My psychiatrist stayed with me for a little while after it was injected, and my sister was there too. Then, everyone started to feel distant, like they were speaking to me from somewhere far away, even though I was sitting right next to them. The main trip only lasts 20 minutes, but it feels like hours. And then, I come out of it. My mind becomes more organised and after an hour or two, I am back to normal.
Once I’m back with it, I quickly can feel the improvement. Things feel lighter inside my head. I have more energy, I can concentrate better. One of my sister’s friends told her that I looked like “a different person” once I started having it. She couldn’t believe the change. Ketamine has completely changed my life. I am so much more stable than I was a year ago. Stable to the point that I am able to make decisions about my wellness that I would not have been able to make in the past, throughout my numerous hospitalisations and time spent under inpatient Compulsory Treatment Orders. I am also recovering from the side effects of ECT, with my memory and concentration improving.
This is why I was extremely concerned to hear the news that the Ketamine Clinic would no longer be accepting new patients, and that current patients may be taken off it once new treatment plans are agreed upon.
My reaction to this news was one of sadness and of fear. Sadness for the people on the waiting list who will not get the opportunity to benefit from ketamine in the same way that I have, and fear for myself and for other current patients and what the future holds for us.
“For many of us, ketamine was our last chance, our only chance for living a life out of hospital, or even for living full stop,”
For many of us with treatment resistant depression, the only other option is ECT. I remember being 18 and being vehemently opposed, but being compelled to have it against my will. It was the most terrifying thing I have ever experienced. The fear lessened as time went on, but it never went away completely. Don’t get me wrong, ECT is a great treatment which has helped a lot of people, myself included. But is not without fear, nor without serious side effects. I will not be willingly having ECT again, even if the Ketamine Clinic closes for current patients at some point in the future, as new treatment plans are made. Unfortunately, that doesn’t leave me with a lot of options. I get very suicidal and paranoid when my mood drops, and if I no longer have an effective treatment for this, I don’t know what will happen next time.
To the people who have made the decision to close the Ketamine Clinic: If you take ketamine away from us, you are taking away a lifesaving treatment. While I’ve had my ups and downs on it, and my mood still varies, ultimately I am a lot more stable than I was a year ago. For many of us, ketamine was our last chance, our only chance for living a life out of hospital, or even for living full stop.
The DHB says only 20 percent of its patients benefited from ketamine. But 20 percent isn’t terrible considering people like myself are on it after having tried literally everything else.
If this is related to cost, I am concerned and confused. The other main treatment for treatment–resistant depression, ECT, requires the time of an anaesthetist, a psychiatrist, an ECT nurse, and an anaesthetic technician. It is around four times the cost of ketamine.
Please, please consider the people whose lives you may be altering by cutting this programme. It is all very well to talk figures and ‘efficacy’, to talk costs, to make decisions above our heads without consulting us.
While you're doing this, we are waiting very anxiously to hear if we will have to go back to suffering. To not being able to get out of bed. To waking up in the morning and wishing we hadn’t. Because these are the lives we used to live—the life I used to live—and if you get rid of the programme, that is what some of us face returning to.
I am hoping that the Ketamine clinic for depression is not closed and is in fact extended throughout the country, so more people can benefit from it. Hope is pretty hard to come by in the barren land of depression, but ketamine gave me some hope back: the glimmer that I might actually be able to live life without the constant worry of relapse, hospitalisation, then having to pick myself up and put all the pieces back together again and again and again. And that hope is definitely worth it.
This article originally appeared on VICE NZ.