Mitigating the Madness

Backstory and Information

More than 8% of adults (18+) and 15% of youths (12-17) suffer from depression each year in the United States, making it one of the most common mental health disorders, and yet as of 2021 only an estimated 61% of adults seek treatment. Of the millions of people with depression, it is estimated that approximately 30% of those people meet the criteria of treatment-resistant depression. Treatment resistant depression is characterized by a failure to respond to at least two antidepressant treatments, most often oral medications.

Ketamine was first approved by the FDA in the 1970s for use as a general anesthetic, but it wasn’t until 2000 when it’s qualities as an antidepressant were really taken into consideration by a team at Yale’s School of Medicine. By the year 2010, the evidence for ketamine helping with treatment-resistant depression was such that many doctors were already adopting it as a treatment for their patients through IV infusions.

It wasn’t until 2019, that the FDA approved the first ketamine-based drug specifically for treatment-resistant depression. For many people, myself included, this drug, Spravato is a game changer in treating depression, and helping people take back their life. This week was my first week on the Spravato treatment, and after the second treatment I feel something akin to normal for the first time since the onset of my depression as a teenager some twenty plus years ago.

This experience has inspired me to start blogging once more, but this time about mental health with the hope of sharing information with people like me. No one should have to live with depression hanging over their every move, making life anything but enjoyable.

The Treatment

Spravato is a nasal spray, which was a huge concern for me to start with. As an individual with autism, sometimes smells and tastes can cause sensory problems which, if extreme enough, can cause meltdowns. Luckily, the smell is minimal and the taste while disgusting is not a deal breaker. For the first month of treatment, doses are administered twice a week and after each dosage I have to stay in the clinic for two hours so that the staff can monitor me for any serious side effects. All of this is pretty normal and as far as I can tell, protocol when using Spravato.

My first treatment was different. I wasn’t sure what to expect, but I had read all the information I could find about the treatment. In addition to educating myself on Spravato, I also talked to, and read experiences of people that had used ketamine recreationally. I was nervous going into the treatment, but when individual in charge of the Spravato treatments at my mental health clinic told me about the huge difference this treatment had made in the lives of the people that she had cared for, I was set on taming my anxiety enough to at least try one treatment.

The day of my first treatment, I was in a lot of pain (I have chronic lower back pain) and my anxiety level was nearing critical mass. I was afraid to take my Xanax which I have for break-through anxiety because I wasn’t sure if it would interact with the treatment, so I summoned all my spoons and forced myself to go. The experience itself was really calming, the staff at my mental health clinic are amazing and I love them all dearly. I’ve only been into the office a few times since starting medical therapy there, but everyone I’ve met seems to know who I am and call me by my preferred name. There were other individuals that were at the clinic for treatment as well, and while I was painfully shy and trying to keep my world as tiny as possible, the other patients seemed nice as well.

The Spravato Squad (I just came up with that nickname for those of us undergoing the treatment.) were taken into the treatment room. We were seated in comfortable reclining chairs, given something to drink if we wanted, and candy to help with the “flavor” of the Spravato. The treatment coordinator went over the administration, dosage schedule and general plan for the week with me and another person who was starting their first treatment as well. As I put the spray nozzle into my nose I was expecting the worse, while the spray wasn’t exactly pleasant, it wasn’t bad. The smell was something like rubbing alcohol, and while the taste was bitter and rather gross the candy I had helped.

So there I sat in my recliner, playing Slay the Spire on my Nintendo Switch waiting for something to happen, and in a matter of minutes it did. I started feeling a little light headed like the world around me, including me, was just floating in time and space like one would do in a tranquil pool of water. After a little more time focusing on my game wasn’t going to happen. It took all the cognitive function I could manage to retrieve my AirPod Pros from my bag and get them in before fumbling with my iPhone to get my Spotify to play music. No sooner than I had gotten my music up and playing than I started to feel sleepy. The last thing I remember of my first treatment was watching the lights on the ceiling (there is a star projection device in the room) feeling the calmest I’ve been in probably a decade before falling asleep.

The next thing I know my care coordinator is waking me up and asking me how I felt. I was a little sleepy, but I didn’t feel as heavy and weighed down as I did when I walked into the clinic earlier that afternoon. It wasn’t just my mood that felt better, for the first time since 2006 I was out of pain. That alone was enough to motivate me to my second treatment. It is worth mentioning, that Spravato or esketamine is not labeled as a treatment for pain, it just happened to be a great “side-effect” for me.

A couple of days later it was time for my second treatment, and I had a little better idea of what to expect. I had created a music playlist, settled myself into my recliner with a strawberry blow pop and my copious amounts of water and was ready for round two. The treatment in the clinic went pretty much the same way as my first time, but the difference for me was waking up the following morning.

First, I slept through the night without waking up every hour or so which was fantastic, but what really surprised me and inspired me to start writing again was how I felt. I didn’t wake up, lay in bed and detest the fact that another day had come and I had to some how muddle through it. I wasn’t overly tired, nor was I in that nearly manic state when I haven’t been able to sleep more than four hours in four days. I was fine, well as close to fine as I can be considering my other issues.

I got up, and while I wasn’t completely out of pain, my pain was manageable. I was in a good mood, and had a decent amount of energy. I was able to cook breakfast and actually enjoy doing so. I was also able to take my ESAs (two little ratties that I purchased around the 20th of March) to the vet for their first visit and wellness check without feelings so anxious that I needed to take medication. The difference has been like night and day so far and I couldn’t be happier.

For years I thought that my life was going to be one plagued with depression and medication that only made life bearable at best. After trying antidepressant after antidepressant, I’ve finally found something that really seems to be working for me, and after only two doses. I look forward to taking my life back from this crippling mental disability, and sharing that journey with you, the reader.

*If you are struggling with depression, you’re not alone and there is help. Please reach out to your doctor or mental health professional.*