It’s now Winter Solstice in the Pacific Northwest which means some days can feel like night for 24 hours straight, with icy drizzle and a melancholy dark sky hangs its head low. But the colorful holiday lights come on earlier each afternoon and give us hope to get through this season of darkness that can feel like a long depression Coupled with pressure to look happy, spend money on gifts and travel to see relatives you might not want to spend time with, “The most wonderful time of the year” can be the darkest. The darkness a great time to journey inward.
I met with my nurse practitioner yesterday over a Zoom call to do my initial intake, she’s part of the team in my Ketamine therapy treatment plan I’ll be doing over the next few weeks. Except for taking the medication, all the talk therapy and guidance is administered online. I was a little nervous just to talk to her as it was an assessment interview, I feared I would be rejected for treatment as I was rejected by a few months ago by a local “medicine journey” practitioner I connected with from the MAPS directory for psilocybin and MDMA treatment.
The nurse practitioner asked about my health and medical history and I said no to most of the questions (heart problems, breathing issues, stroke, diabetes, etc) except for the headaches and problems sleeping. I wake up with headaches almost every morning. Typically they wake me up about five hours after falling asleep and I wake up burning hot even though I sleep in a room that’s 65 degrees or cooler with breathable cotton sheets and blankets. I’m in menopause so I take Estrodiol (conjugated estrogen) to help with “hot flashes” associated with hormone fluctuations at night, but I think the main issue is stress and depression. I try every day to be proactive regarding my health and sleep cycle: I don’t eat anything three hours before bedtime, I try get some exercise each day but it’s hard when you’re exhausted all the time from not sleeping well so it becomes a vicious cycle. Since it’s dark so early this time of year I use a Lightbox for a few hours the morning to help with Seasonal Affective Disorder and my doctor recommended I take a higher dose of vitamin D in the winter (vitamin D is synthesized from being exposed to sunlight.) My dentist said he suspects I’m grinding my teeth in my sleep which may be contributing to the headaches- my father was prescribed a mouth guard for sleep to prevent his teeth grinding (he also struggles to sleep a full eight hours and has mild chronic depression.)
I have extremely intense dreams every night, not necessarily terrifying nightmares that wake me but there’s a few familiar dark themes that have played in my head for years now: Nearly crashing the car I’m driving as the brakes don’t work. Seeing people or animals nearly get run over or crushed by cars or falling objects. Missing my flight, losing my purse, losing my phone and I can’t get contact anyone. Struggling to lift and carry all my baggage as I walk around New York then getting my bags stolen. Walking around partly naked in public frantically searching to find my clothes. Creepy men trying to grab me but I have no strength to hit them hard enough to defend myself. Climbing up crumbling a building that’s slowing breaking apart and getting stuck there. I’ve moved in next door to my mom and Helen’s apartment in Manhattan and I’m talking to them in the hallway to see if they’ll invite me in (this is the one dream where I wake up disappointed realizing it was all a dream.)
I hesitate to go to sleep every night as I know the movie in my head I’m about to watch won’t be joyful or make me feel rested and relaxed the next day. It feels like my trauma and shame are trying to shake me awake me up every night and I beg my brain to stop.
The nurse asked if I’ve seen a therapist, then asked about my depression diagnosis and meds.
I’ve been on and off with talk therapy since I was 14. In my twenties I saw a therapist weekly for years and she introduced EMDR into our sessions, which at the time was a new and promising form of treatment for PTSD, but I didn’t feel much different after many sessions.
I’ve been on Lamictal for the last 10 years years at different doses and that was a big turning point in stabilizing the mood swings. I was diagnosed by therapists as possibly having Bipolar Two from my rapid mood swings but I refused to stay on any meds for more than a few weeks. I was hospitalized briefly in 2009 when I fell into a deep mental spiral after being on a mania high. After years of trying different antidepressants, finding Lamictal was like finding the right key on the ring to stabilize the rudder so the boat doesn’t sink when the seas get choppy- I think that’s the best way to describe how the meds work on my mental state. Many people in my family are on medication for chronic depression and bipolar two, which in a weird way gives me comfort knowing that I what I have is medically “real”, possibly genetic and not all made up in my head.
Then I told her why I sought out Ketamine therapy.
I was rejected by a psychedelic medicine healer after filling out a very long application and being very open and honest about why I wanted to heal. After they read I had Bipolar Two and taking a mood stabilizer, they said they didn’t want to chance something happening as they had no experience with people like me and suggested ketamine therapy. I was really pissed off as I trusted them and I felt vulnerable revealing much personal information. It took me a few more months to get the energy to search for help again. The NP was surprised the first thing they didn’t ask in their initial intake was about my medication and depression diagnosis before applying. She works with many people who take meds for mood stabilization who also do therapy treatments with psychedelics and ketamine.
She asked what kind of outcomes I hoped for in treatment.
I want to stop the bad dreams, the morning headaches and the depression from running my life. I’m scared to try Ketamine therapy but it’s my last hope- I’ve done talk therapy since I was a teen, I’ve been on and off a bunch of anti-depressants over the years, I’ve tried meditation to get the thoughts to calm down. The last time I did psychedelics was in high school - before I had the mental baggage I have now it scared me. I’ve done low THC cannabis edibles that either do nothing or I feel like I’m in one of my dreams where I’m having them same bizarre conversation with someone that loops for eight hours.
I tried my first “float” session last week at a sensory deprivation tank center- 90 minutes floating naked in a shallow pool of salty water in a pitch black room. It’s supposed to help you go into a meditative state and let go of all your thoughts and emotions. I went into the small windowless room, crawled into the warm water and turned off the light. As I floated on my back and my ears went under the water, within 10 seconds I was panicked and I struggled to get up and find the light switch in the dark. I stayed in the water with my eyes closed, pushed myself up and down from each side of the pool and pretended I was a mermaid at sea, humming a low-pitched “OM” vibration sound that reminds me of a foghorn in the distance. I got out of the tub and dressed after 30 minutes. I felt a little embarrassed when the front desk receptionist asked why I left so early, as if I was the first person they met who didn’t want to stay for the whole $75 session. I felt defeated, like my brain and all its heavy thoughts couldn’t even stay buoyant in the salt water and it won this round again.
After my intake interview the NP said I would be a good candid for Ketamine treatment and the company would be shipping my first dose next week along with anti-nausea medicine (I told her I’m very sensitive to dizziness and Ketamine can trigger it.) I will be meeting with my “guide” for the first time in a few weeks over Zoom before I do my first dose. She will also be meeting my partner who will be my PTM (Peer Treatment Monitor, AKA a “trip sitter”) who will give instructions on how to check in and give aftercare. Along with the medication, the company provides a blood pressure meter, an eye mask and a journal that I’ll be using to “set and intention” before and after the session.
“The neropathways of out brain are like a path in the snow we take each day to get the mail at the mailbox in front of our house. We take the path of least resistance because it’s what the brain knows and those footprints grow deeper over time. It becomes harder to carve a new path. In your session, Ketamine will erase that path and show you new directions. Your brain will be in a neural plasticity state for two to three days after your session so it’s very important to first set intentions before and after writing down all your thoughts and insights at that time,” the NP explained. She also addressed my fears about having a bad “trip” like I did on the psychedelics I took for fun in high school. “Ketamine is used as an anesthetic, it doesn’t usually make people hallucinate unless directly ingested.” I then understood why they direct clients to put the Ketamine tablet between their cheek and gums for seven minutes but must spit out all your saliva and rinse your mouth with water. It works best subcutaneously with less side affects like nausea and hallucinations. It’s very different than how my friends use “Special K” as a party drug, which I have no interest in partaking in.
I’m excited to write down everything and share it online with the world. But I realize that I polish and censor myself on an unconscious level when I write publicly, so I’m giving myself permission to have a boundary and keep my thoughts and feelings private, at least for now. I don’t want to suppress anything. My other fear about healing my trauma is the same fear Steven Tyler from Aerosmith had when the band got sober in 1989 after years of heavy drug use and partying: if they stopped being under there influence they would lose their creativity and ability to make great music. Many of their biggest hit were recorded at the hight of their drug use in the ’70's. But to Steven’s surprise, he didn’t lose his creativity after getting sober, he said it was reignited the band year after being creatively blocked for years. He said in an interview, “All the magic that you thought worked when you were high comes out when you get sober. You realize it was always there, and your fear goes away.”
My intention for my ketamine treatments: to heal my core mother wound, to mourn her loss and leave the PTSD in the past. To let go of the deep shame and let go of the fear of others seeing (and judging) different facets of me- my sex work, my sexual self and history of trauma and depression.
My other intention is to let go of the fear of the therapy actually succeeding: the fear of losing my “magic” as an slightly crazy artist and becoming this gray middle-aged average woman blending in and sleepwalking through life like most people do, getting her taxes done in a timely manner year after year and dying a sleepy death. I want to live my life fearlessly, I want to be a sexy badass revolutionary who’s written about in history books; a humor-driven creative spirit who inspired the world to live openly and shame-free. I want to die a happy care-free old woman living her life more freely than she did in her youth because there’s nothing more to fear. I want to embrace the darkness so I can live in the light.