Depression, ketamine, and what happens next

First published in ABC News | December, 2022

Live in the moment. It’s advice so prevalent you could drown in it.

But if you’re in the middle of a depressive episode, you don’t have a choice.

All sense of history vanishes: you can’t believe you’ve ever felt differently than you do right now. Any sense of future disappears, too. Hopelessness stops all clocks.

I’d been suffering with treatment-resistant depression for almost 10 years when I first heard about ketamine therapy. I’d tried a half-dozen antidepressants with careful guidance from my psychiatrist.

Some worked for a short time, a few months each, before their effects faded away. Some had side effects too harsh to bear: sleep interrupted by what felt like electric shocks, or a brain fog so severe it made any creative work impossible.

But ketamine, typically used as an anaesthetic or recreationally as a party drug, is thought to work differently to traditional antidepressants. It increases the activity of glutamate, a neurotransmitter in the brain’s frontal cortex.

Research shows ketamine works faster than medication that targets serotonin — for some people, almost immediately. Depression can cause you to lose some synaptic connections, too, and ketamine helps those lost connections to regrow.

I found a small clinic in the outer suburbs of Melbourne conducting a clinical trial into ketamine and depression. After a battery of tests — blood, urine, heart rate and more — I was given the opportunity to try it.

It ran for two months, and I was in the control group for month one, which meant I received a placebo. (How did I know? Believe me, it’s not hard to tell.)

In month two, though, I was in the intervention group and would go to the clinic twice a week for someone to pinch my stomach and inject me with ketamine.

The feeling of being on ketamine is hard to explain. As my psychiatrist says, “it’s a very strange drug.”

Read the full essay at ABC News.