But first, a quick update..
I’m told I’m doing better. I guess I can feel it. Makes the inside harder to deal with sometimes when the outside looks okay. Doing DBT, EMDR, Ketamine and regular therapy. VNS still zapping along. Mostly used to it, sometimes annoyed by it. Very often sounding like Saw Gerrera when it’s firing.
Summer is summer. Not getting out enough. Wanting to, but it’s difficult. Working a little bit on recording audiobooks but haven’t done any of my own writing in a while. Created a book of short stories and it’s being published through Amazon Kindle Direct, but I’m having motivation issues getting across the very close finish line.
The depression is always there with open arms, ready to welcome me in at any time. The anxiety has two phases. The first is general all the time anxiety. Worrying, negative self talk, some suicidal ideation still, and anxiety based on interactions with other humans. It’s constant, exhausting, and defeating. It also feeds the hopelessness. The second phase, or type, is the one that feels like you’ve been shot in the chest by a sniper. The panic radiates from there and consumes everything. It can come from an actual anxious event, like when you get pulled over for speeding. But it can also come from worrying about something in the future or contemplating your place in the universe. It’s quite overwhelming and if the other kind feeds hopelessness, this one cut right to the core and removes most hope. I have DBT tools to deal with these, and tools to try and prevent or stop them when they happen. I guess I’m getting better at that.
I’m having a hell of a time dealing with getting better. Easing back into the uncertainty of life is hard for the reasons above. But I think there’s a bit of Stockholm syndrome with the depression. Being in the depression pit is deadening and flat but it’s a warm desperation and so familiar you don’t want to let go of it. Being peppier and brighter and doing things like smiling and laughing is great, I guess it adds to my quality of life. But it also makes me worry that everyone will forget what’s going on inside. I still want to smash pictures of me when I see them. I still know how awful I am and always will be. I’m still me. We’re working on all that as part of my PTSD in EMDR.
So there’s an update. As always, I’m going to try harder to post here. I have some inhibition issues about the blog, and my motivation is still in the sub basement so it’s hard to do much. But maybe this time I’ll try.
Ketamine Tears
(for real this time.)
A typical Ketamine sessions these days starts by getting dropped off at the clinic while wife goes shopping or working. I check in, do my PHQ and enhanced GAD inventories and wait for the technician. She comes out, takes the paperwork and we head back to the room. It used to have a great view and light, but they remodeled and now it’s a windowless room. Which isn’t bad, as it’s dim and mellow.
I pick a chair (hospital recliner) and sit down, get my headphones paired to my phone, and she puts the blood pressure cuff on me and readies the shots. Used to be one in the arm, but there’s a shortage and the stuff they get now is once in each thigh. I’ve learned to wear shorts rather than have to drop trou. I cue up my prepared music (very often it’s Beth Gibbons and the Polish National Radio Symphony Orchestra performing Górecki’s Symphony No. 3, the Symphony of Sorrowful song) and hit play. By the time the first shot is in, I’m already feeling it.
The music, by the way, is very important for me. That piece is excellent because it lasts exactly as long as the session. It’s a live recording and literally the applause at the end is my signal that it’s all over. It’s slow moving, builds to crescendos, no serious brass or sharp high note type of stuff. Bonus that it’s extra dark. I’ve tried near-ambient stuff and that was okay but not great. I once used a Radiohead song slowed down something like 800 times. It was good, and fit the parameters but didn’t mesh well with me and I ended up not enjoying things as much. I tried the Disintegration Loops by the American avant-garde composer and sonic artist William Basinski. It’s a tape looped repeatedly and it decays as it’s played, so the already downtempo tune breaks down and becomes more gray noise. It was ok, but not perfect. I keep coming back to Górecki because I’m used to the flow and it matches my most frequent visual elements. Anything with a beat is problematic. Tried Jimmy Van M’s bedrock stuff and it was mellow, but the beat just didn’t work at all.
Within minutes I completely dissociate and I’m off in my own little universe. I’ve described it before. Triangles, recursion, and the center of the universe at an atomic level. While I don’t need to, I usually close my eyes. Still need to write that piece about “Ketamine Tears” – my eyes water a bit during the hour.
Within the hour long treatment the blood pressure cuff takes my blood pressure every 15 minutes. Sometimes I feel it, most times I don’t until the last one, as the effect of the Ketamine is lessening. Apparently for a while there was a specific point where my BP went pretty high. I think it was at the most intense part of the hour, but I’ve never had fear or anger or anything in there.
By the 45 minute mark I’m either actively keeping my eyes closed and just watching what my brain puts in front of me while I listen to the music. It doesn’t feel the same as being “under” and there have been times where I’ve just opened my eyes at that point and picked up my phone.
Once, I came to and found a bunch of paper towel sheets on my chest. Apparently I had tried to drink water but was wearing a mask. Also, there was the time I came out and my legs didn’t work, but I think I’ve already covered that.
At the end of the hour and final BP reading, I’m set. I pack up my phone/earbuds/water and get ready to leave. And then I check to make sure I have everything. And then I check to make sure I have everything. Finally, then I check to make sure I have everything. Foggy doesn’t want to be forgetful. In the beginning, my wife would have me hold her shoulder as she walked me down the hall. Now I just stumble down the hall, head to the front door and my wife is waiting to pick me up.
I’m coherent but stumbling in every way for the rest of the day. Memory, speech, walking. They all feel harder but it gets better as time goes by. I’m not tired, just dopey. Because I feel like that for the rest of the day it’s hard to tell how or if it’s helped.
The next day I’m often brighter. I feel like my eyes are far more open, and things happen more easily. Not so much energized as bright or awake. I’ve had sessions that have broken a streak of horrible depression, just wiped it away. But I’ve also had sessions where it didn’t feel any different. As I write this, I’m on a “day after” and I feel all of that, but I’m also on a social hangover from much family and friends activity around the 4th of July holiday. (Social hangover is just that. It doesn’t mean I regret the social or it didn’t go well, usually, it just means I spent a crap ton of mental and physical energy and I’m dragging.)
Rinse and repeat every two weeks.