Sunday, October 31, 2021
Alex Papp, MD
It is immensely gratifying for us to see the robust response to ketamine in some patients, especially since many of them had struggled with depression for years, trying one medication after another, with only partial success at best, while having to endure unpleasant side effects. Clearly, this is the benefit one hopes for in the treatment, but for many there is an additional, positive side effect: the psychedelic experiences.
These experiences are often difficult to be translated into words, but, apparently, not for everyone.
Every patient completes a Ketamine Experience Questionnaire at the end of each treatment. Part of this questionnaire is an option to write about the experience in their own words. This box is often left empty, but a lucky few are able to record what they heard/saw/felt during the encounter. Many patients find these experiences to be personally uplifting or meaningful, and for the observing clinician they provide insight into the fascinating images human minds can conjure up.
Angie was one of our most prolific commenters. Perhaps not surprisingly, she was a writer and singer, who was able to remember her psychedelic experiences in great detail and jot them down on the questionnaire. She sought treatment for feeling sad and anxious and “stuck” as an artist. Here are some of her experiences in her own words, starting with one from the beginning of her treatment series (all specific details, such as songs, persons or locations, have been altered, as well as her name, of course.):
I had an auditory experience. Heard Jacques Brel doing “Vesoul”, but I’d also been thinking about that song over the weekend. It was a mesmerizing rhythm to me. The song seemed to loop around me like the most fragile of wings. I was also aware of the shift between light and dark from the computer monitor.
More focus on music ensued:
At first I experienced more visually. Felt as if I were looking through … late summer / early fall afternoon window with a beige lace curtain, but I didn’t see anything beyond. Then the auditory started about halfway through and I heard a different song of mine. I was able to rewrite a whole section of the song (and I’m hoping I can remember it later). I was also very aware of the coolness of the room on my skin. It was refreshing and comfortable.
Later architectural and geographic features started to emerge, together with intensely personal details:
This experience was my favorite. I had a sense of the profound. Very fast images revealing themselves, as if I were riding on a train and was observing. The sound changed in the beginning as if I were experiencing the pleasant the version of what my sister called “swounds”, sort of the sound one might here before fainting. I could open my eyes, but when closed began to see repetitions of color opposites, e.g. orange and blue, as if I were looking at a building at night. I heard a song from the 80s then thought I felt like I was on the train in England. My skin felt as if there were a pleasant, light breeze sort off caressing me. It felt as if there were a definite ending, even though I continue to feel a little floaty.
And then this, from a period when she was seen less frequently due to a stable and enduring response to treatment:
This experience was certainly the most physical. I felt undulations, from beneath as well as over me, not unpleasant. I just noticed and rode them through. I had my spatial sense organized into various areas as if I were in a Turkish bazaar. Did not get to the feeling of freedom as I had before, but not so much as to feel closed in … just a lot of movement, swells and the waves of motion. Heard the music of a song nearly 35 years old, Come Undone. The flow over the song matched my physicality … just moving forward as if I were on the train or subway. Not so much visual stuff at this time … any colors were sweeping with the undulations … bright to read, wavelike. In the beginning I saw calendars and clocks in confusion, I suppose the march of time forward, me trying to follow along.
This was the entry made after the treatment which turned out to be the last:
What first came to me was an image of my very favorite uncle. From an old photo, I’m guessing he was in Jackson Hole. Then the blinding white light/reflection from the snow became a sort of upward cascade of architectural features, and then the white tiles falling away as if I were blasting through some sort of blockage. When the tiles had fallen away I got the impression that I was in Portugal basking in the sun. It felt like I was among the turrets at the Belem Tower in Lisbon, but bright white. I started hearing a song called from a band called “Happy Mondays” which kept looping around, weaving its way in and out. I thought of my time in Santa Fe with my ex/re-boyfriend and I was in a very happy space. My uncle was a Vietnam vet, ravaged by the memories of the war, but his spirit always shone as bright as the reflection off the snow.
She scheduled her next treatment as “TBA”. When a few months later I contacted her, she was in Southern Europe, visiting the beautiful sights she dreamed about during her ketamine experiences. She was working on her writing, felt at ease and contented.
