A Trip Down Memory Lane
Every news outlet has had at least one piece focusing on the growing usage of psychedelics for therapeutic purposes. Psychedelic mushrooms are being used for a multitude of reasons, one of which is medication resistant depression and anxiety, issues that many adult patients who have been diagnosed with Treatment-Resistant Depression (TRD), Major Depressive Disorder (MDD) with acute suicidal ideation or behavior, as well as Post-Traumatic Stress Disorder or PTSD, which may occur after a traumatic event, and/or Complex Post-Traumatic Stress Disorder or C-PTSD, which has deeper, developmental and neurological rootings.
Lucky for me, I check all the boxes.
For the past four months, I have been being treated with Spravato twice a week, a ketamine derived medication, made by Janssen Neurosciences, a Johnson & Johnson pharmaceutical company. My personal experiences with the medication have varied wildly from session to session. But this is apparently fairly normal with ketamine usage and because it is such a tightly controlled drug, the entire process is under watch.
Spravato is a nasal spray that tastes awful as it drips down your throat. The nasal cavity is incredibly plentiful with olfactory receptors to receive every bit of medication that sprays out. Each bottle contains two sprays, one for each nostril, which equates to 28mg or half of a dose. The Spravato administrator hands you the spray, you pump once in each nostril, and you chat for a few minutes before the remaining dosage is administered, for a total of 54mg, which is normally the beginning dosing prescribed, and can go up to 82mg, if a third dose has been prescribed.
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Each setting will vary by provider, but the one I see has a room dedicated to Spravato patients. It is a peaceful, dimly lit room that features two reclining chairs, a sound machine, few floor lamps, a dividing screen, and cozy af blankets that are never used by a patient twice before being washed. My provider only schedules up to two patients at a time, which during COVID days has been a blessing, especially since my appointments are early and I am usually the only one. It is relaxing, although I have been in the room with new, hesitant patients, and empathize.
Medications, especially new medications that for decades have been villainized as the cause of issues when they may in fact treat those issues, can be scary to begin a course. Putting pharmaceutical chemicals is not something many want to do, but do so because it helps them. I am pro what works.
Sessions are two-hour blocks, but 40 minutes is generally the amount of time most patients feel the effects. Because esketamine (generic name for Spravato) is a sedative, blood pressure must be monitored before, half way through, and then again at the end, and it is a requirement of the drug itself to have each patient fill out a Risk Evaluation and Mitigation Strategy or REMS form every time they have been treated, which asks the patient to self-evaluate their emotional and physical well-being over the past week. The questions are based on a score of 1-4 and are tallied at the bottom to monitor progress or recession.
My personal experiences have varied wildly from session to session. Each person’s response is and will be different, each time can be different. I have found that my trusty bluetooth eye mask is the perfect companion, along with some guided meditations on my phone. I generally feel my muscles relax in ways they simply don’t normally, even after a round of Yoga nidra (bedtime, soothing yoga.) But if I am not wearing an eye mask, I only feel a slight wobbliness and my muscles simply don’t respond the same.
The only way I can describe what happens is I somatically feel as if I am navigating through the gyri and sulci in my brain like corridors with stretches of doors opening to various memories -- not quite Monsters Inc. door-factory level, but similar concept I suppose. I have had such vivid visions of walking through past residences, people and experiences I swear I would not have remembered, that when I returned home I immediately started researching to verify the accuracy of these visions.
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The names and places that I had suddenly recalled during sessions were accurate, stretching back to toddlerdom, and despite my youthful appearance ala skincare obsession, I am no spring chicken. That alone fascinated me in my science-nerdy neurological functions obsession, enough to want to continue the treatment; the added bonus of actually healing and releasing such things, has been liberating to say the least.
But there are downsides of course. Sometimes I have a general pressure behind my nasal cavity or can develop headaches -- particularly without being properly hydrated. I felt queasy one time early on and was assured it was because I had not eaten beforehand. I haven’t had any issues since, other than occasionally walking out of the office looking like I have just done a few lines of coke, as Spravato does dry white and sometimes I don’t think to check.
Opening those doors has also been a Pandora’s jar of pain at times, but necessary to properly heal. And many such negative memories have been healed and/or accepted, finally allowed to apparate out of existence. Discussing how the treatment has been going with my physicians has them quite excited that it is working for me well (for now) and I am enthusiastic; but I am also a pragmatist and if/when it stops working, so will the treatments. As wild of a time as some of these sessions can be, my goal is to not need them any longer.
My experiences are solely my own and one should consult a medical professional if there are mental or physical health concerns.