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Atra

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  1. Sad
    Atra reacted to JD4010 for a blog entry, Bottoming Out   
    I'm bottoming out today. That's a term we used to use when a car would hit the stops in the suspension after going over a big hump with a full load on board.
    The universe is definitely trying to punish me for something today. Probably just for existing.
    I'm in a coffee shop and they are playing old tunes from Simon and Garfunkel, as well as the Beatles. It's driving me nuts. Memories of 1969 are flooding back to me and they SUCK. I honestly hate this music. Jenifer Rigby can go to hell and burn.
    It doesn't help that I can feel my tonsils swelling up from some virus trying to invade. I can barely swallow and if I do, it really hurts. FML.
  2. Like
    Atra reacted to JD4010 for a blog entry, Oh yeah, a gratefulness journal!   
    A few months ago, I posted something about wanting to keep a gratefulness journal here. Well, I certainly failed at that.
    I just got through an extreme eye-opening experience. It reinforced my perception of myself as a failure. But! I learned something from it. Now if only I can follow through and correct what has been wrong with me.
  3. Sad
    Atra reacted to JD4010 for a blog entry, Here Comes the Night   
    Yeah, that old tune by "Them" keeps running through my head. The night never leaves for very long. And it comes rushing back with a vengeance. I spent last night reminiscing about what a piece of excrement I was in order to lose my girlfriend. I looked at some more old posts of hers here and my support is noticeably absent...that's because I was too goddamned stupid and/or full of myself to respond. As a result I got ditched. I obviously deserved it. I was so in love with her. Actually, I still am. I cannot get over her.
    This was definitely the hugest mistake of my life. I've made some massive mistakes but this one dwarfs them all. Frankly, I'm back to feeling suicidal. The most wonderful person to ever come into my life (besides my daughter) and I blew it with her. Absolutely wrecked everything from not being supportive enough.
    As if I needed another reason to despise myself.
  4. Like
    Atra reacted to JD4010 for a blog entry, On Street Adventure   
    Yesterday was really...something. I had to traipse all over town looking for prescription cat food for my two felines, both of whom have urinary tract issues. My daughter was along for the ride too. At one point, we were negotiating a traffic circle when I noticed movement out of the corner of my eye...it was some guy on a motorcycle doing 30+ MPH as he rounded the curve. I nailed the accelerator to get out of his way. Scared the hell out of me. Once on the straightaway, he caught up to me and started to pass on a 2 lane road. He got beside me on the driver's side and was yelling all kinds of obscenities at me. Then he would ride in front of me and lay on the brakes, forcing me to stop suddenly (with cars coming up on my rear bumper). I was trying to avoid him by taking alternate streets but he kept it up. He was screaming and motioning at me to pull over. Another car tried to get between him and I but he would roar right around them too.
    I kept right on going because A. my daughter was with me and B. I didn't know if he was packing heat or not. This went on for 15 minutes! He'd pull in front, grab his brakes, swing over as to hit my vehicle's door, and then pass me again.  I finally ditched him by pulling into a busy parking lot at an electronics store. He didn't follow me in there because of all the potential witnesses, I suppose. The guy was absolutely psychotic. He was younger and BIG. I'm older and was driving my rusty old minivan.  Why he saw me as a threat, I just don't know.
    I was able to avoid a collision in the traffic circle by getting the fook out of his way. And he goes off on me. Gah! Took an hour for my heart to stop racing. 😮
  5. Like
    Atra reacted to JD4010 for a blog entry, Not meant to be   
    Back when I was in second grade (shortly after the invention of the wheel), I developed a crush on this gorgeous girl. I wanted to sit by her at lunch, play with her at recess, and just generally hang out with her. I don't know if kids that age are supposed to have crushes but I certainly did.
    53 years later and I can still clearly remember her name and what she looked like. Unfortunately, "they" split us up in 3rd grade...she went off to a different school.
    This is but one more reason I fell so hard for my lost girlfriend. She reminded me of this beautiful girl I fell for over 50 years ago. Yes, maybe I "idealized" my lost girlfriend, but that doesn't change the fact the I was madly in love with her. Hell, I still am. I want to look at pictures I saved of her but I dare not. I'll fall down into that deep hole again and potentially never crawl back up and out of it.
    I'm pathetic. Maybe a meteorite will hurtle down from the heavens and obliterate me.
  6. Sad
    Atra reacted to JD4010 for a blog entry, Sad Story, part XXXVIII   
    Gah! I just accidentally deleted a long post here. Damn! So here goes again...
    Did you know I met my long lost girlfriend here on DF? It's true! She was a member for years.
    God help me, I can't get past her, even though it has been a year and a half since I last heard from her.
    The relationship started by one of us responding to a post the other had made. I think she talked me out of suicide...or I talked her down; I can't remember exactly. At some point we began corresponding via PMs. Our relationship grew slowly until we finally exchanged emails...and after a time, phone numbers. Probably a six month ramp up until I realized I was falling in love. And it seemed she was doing the same. We shared everything. We talked for hours on the phone. We supported each other through health and relationship issues.
    We eventually exchanged pictures and by golly, she liked the way I look. Amazing. I thought she was beautiful too. Stunning, in fact. Huge, deep dark brown eyes and lots of luxurious black hair. Good lord, I fell for her, HARD. We would message back and forth when I was in boring meetings.She would routinely crack me up and I'd have to stifle laughter. I thought about her constantly. I was in a state of bliss when we were chatting or talking over the phone. Just the thought of her warmed me inside.
    With her in my life, I felt alive again after years of near-death during my awful marriage and the divorce. I had a reason to get up in the morning. I was as giddy as a high school kid going out with his Big Crush. No, I was even happier than that. I was in heaven.
    She was the perfect woman, I thought. In spite of her health issues, which were significant. She was completely accepting of my craziness, and vice-versa.
    But then it came to a halt, after 3 wonderful years. In retrospect, I kinda sorta knew something might be wrong. Just hints. She called me less frequently and seemed to grow a bit distant. I chalked it up to her health issues, which were quite pronounced at the time. Finally, the calls and messages stopped coming. April 2017 was the end. No more messages or phone calls, in spite of my attempts to contact her again.
    To say I was devastated is a massive understatement. I felt like knife had been repeatedly plunged through my heart. I fell into a pit of despair that I still haven't crawled out of. I was crushed. I began drinking heavily because, "who cares?" I certainly didn't care. Life sucked grievously without her.
    I'd give anything to have her back. I've never been in love like that, even when my ex and I started dating. My GF was everything to me. Memories of her voice and beautiful face still haunt me, no matter if I'm awake or sleeping.
    I suppose I should resign it to just another failure and bitter disappointment in my life. I really should be used to this kind of thing after all these decades of the universe kicking me in the ass. But this one HURTS LIKE HELL. Hell's bells, I'm a guy and I'm crying as I type this.
    Whatever. That has become my response to everything since she left. Whatever. I'm doomed to the memories of her that constantly filter into my consciousness. Almost anything will remind me of her...a song, the sight of a woman with long black hair, mention of a place where she lived, whatever. Yes. Whatever.
  7. Like
    Atra reacted to JD4010 for a blog entry, "In My Garden"   
    I had a bit of a breakdown at work today. I flashed onto the name of a daycare center near here. It's called "In My Garden". That sent me down into a spiral of despair and regret. When my daughter was little, probably 18 years ago, we made her a reading nook in the back yard. It was nestled in between some tall shrubbery, more or less hidden from view. We created a fairy ring/garden in the middle of it. She loved to sit in there, enjoying the refuge from "the real world". I loved to see her in there of course...knowing that she was insulated from the ugliness of this F'd up world.
    There are billions of kids in this world. A majority of them are dying of disease, starvation, and neglect. Others are being blown to bits in wars over greed and power. All kids should have a place in a garden of their own. I wish my daughter didn't have to grow up in such a sick mess that we humans have created. I'm so damned sad just thinking about it, to the point of despair.
  8. Like
    Atra reacted to JD4010 for a blog entry, "Just be Happy"   
    Such utter simplicity--just be happy. Right? Ya, sure. The kicker is, I can almost imagine it for myself. ALMOST. Whenever I've put a lot of effort into "feeling happy", something has come along to make me spiral down and crash into the ground. Hard. OK, everybody has setbacks. I understand that. Maybe it's pure self-absorption that makes me think my own problems are worse than most people's. Could be. The question is, how do I change my outlook?
    Volunteer more. Of course. I do need to stop isolating. I was doing better for awhile but the past month has seen a return to my work-home-work routine where I sit like a bag of potatoes watching TV every night. My cats do provide a lot of comfort however so it "feels good" to be there. Yet I'm not interacting with other human beings. And you know what? I really don't want to. But I should, right?
  9. Like
    Atra reacted to JD4010 for a blog entry, A break from the mundane   
    I recently posted photos of the character Ruby from the TV series Supernatural. She's my idea of absolute beauty.
    Well, so is the character Ellie from the Supernatural episode "Trial and Error" that I watched last night. I paused the DVD for a long time to let my mind drink in her beauty. The actress is Danay Garcia, who is probably famous for all kinds of things...but I'd never seen nor heard of her before.
    I wish I was young, rich and handsome.


  10. Like
    Atra reacted to JD4010 for a blog entry, I'm ugly inside and out   
    I went to the home improvement store a little while ago to pick up some crap for projects I need to get done. It's 90F and humid AF out there. I was a sweaty mess walking around in the store, but all of the beautiful people were in perfect form.
    I'll come right out and admit that I resent the he11 out of them. My body is falling apart from a genetic disease I inherited from my mom's side. My mind is falling apart from severe depression. "Count your blessings", they say. Well, "they" can blow it out their @sses.
    I have a friend who keeps sending me these saccharine positive, inspirational, life-affirming messages. Stop it! That sh!t just makes me even more depressed.
     
  11. Sad
    Atra reacted to JD4010 for a blog entry, Goodbye, Littleton   
    Today I will be joining my ex and daughter to send an old friend over the rainbow bridge. We brought Littleton the kitty home in September of 2000, right as my daughter was starting kindergarten. They have been inseparable ever since. Until today. Poor old Littleton is no longer able to function. It will be a "blessing" to ease her through to the other side, but it's also going to be miserable to see her go. But we have to think of the kitty's quality of life first and foremost...right now, she's hating life. So the humane thing to do is end her misery. I get that rationally but the emotional side of me is have a very rough time.
    I'm feeling all kinds of regrets today.
  12. Like
    Atra got a reaction from JD4010 for a blog entry, Second Ketamine Infusion – 6/12/2017, 50mg Part 1   
    Music Selections
    I had a general idea of what might characterize a good playlist and I solicited opinions from several sources to help me form a criteria:
    Should be music I like – OK that's pretty obvious Shouldn't be songs I'm already emotionally attached to – I'm not trying to relive good or bad times Songs must have no lyrics in a language I know – I want to avoid fixating on subject matter Favor shorter tracks over longer ones – at least until I know what works and I can always replay a track Minimalist with repetitive refrains – lesson learned from orchestral music and audio distortion. Repetitive because it is meant to enhance not distract Drop in a song that cues a relaxation response – a message from sober-me to Ketamine-intoxicated me that says, “Hey whatever is going on right now, know that you're going to be OK - oh and by the way, here's a funny little inside joke.” My playlist included a lot of ambient music drawn from TV, movie and video game soundtracks that I liked but hadn't yet worn out from excessive playback. Most of the music seemed uplifting to me. For the inside-joke song, I chose “Where Is My Mind” by the Pixies, a piano-only version with no lyrics. One of my favorite songs from one of my favorite bands, I figured I ought to recognize it no matter where my mind had flown to. Music Changes The Context
    The auditory distortions lent an amusing and playful quality to the music and I began to feel joyful, even ecstatic at times. I was aware that I was experiencing the euphoric quality connected with Ketamine and able to lose myself in it while also reflecting upon how long it'd been since I'd felt this good.
    When the music changed, the experience changed with it and I felt a small tug of regret that I hadn't included even more happy songs which might prolong this euphoric feeling. I was going to fumble with my iPod buttons to replay the previous selection (no easy task due to the numbness and visual distortion) but then it came to mind that although it was a really pleasant experience, a journey is defined by more than a single experience. The thought gave me tacit permission to let it go. The soft notes of “Where Is My Mind" drifted into my ears and a small smile spread upon my lips.
    Next up - dissociative experience and treatment after-effects
  13. Like
    Atra got a reaction from Bulgakov for a blog entry, Second Ketamine Infusion – 6/12/2017, 50mg Part 2   
    Dissociative Experience
    [If you listen to Maxence Cyrin's piano version of "Where Is My Mind", notice that the piano's pedal noise is picked up and amplified. It didn't occur to me this could have an effect on the context].
    My analytic mind dissolved into the song and the image of a grand piano in an empty room appeared in my head. The keys were being played without anyone sitting in front of them, no hands touched them. All sense of my physical form gradually dissolved until my body was actually inside the piano, below the lid, watching the felted hammers strike the metal strings directly above me. This mental construct lasted only for a brief time before the last remnants of my physical body were gone and I and the grand piano became as one. I remember feeling the bass notes in my chest, the treble in my extremities and the pedals were my lungs.
    The song was coming from me and being played in me. The entirety of this depersonalization experience lasted perhaps two minutes. Lacking possession of my executive brain functions, I remember feeling rather than thinking how it was okay to become one of the instruments in a song.
    Mindfulness Practice
    Throughout the infusion the blood pressure cuff constricted to measure my vitals and I understood what it was and why it was doing that. The sensation brought my mind back into my body. It also brought anxiety back into mind. As the pressure of the cuff intensified, an anxious thought bubbled up and whispered how this thing on my arm might keep constricting until it popped me like a crushed grape! But then the cuff would finish inflating and I could feel and hear my pulse, steady and vital. If ever I became anxious, this sensation was a reminder of where I was and regardless of where my mind went, professionals were caring for my body. This felt reassuring so I resolved that I would use the cuff constriction as a touchstone if I ever felt the dissociative effects got too intense. Feelings in my body like hunger also helped ground me.
    After-effects
    I noticed the uplifting feeling of joy hadn't completely disappeared, lingering for about 3 hours afterwards. I spoke with both the nurse and doctor about my mood change and while I felt lucid, my mind was oddly muted. The usual onslaught of thoughts, attached emotions and the “stories of the mind” that accompanied them - weren't there. Or perhaps they were there, they just didn't seem to matter so much. This “quieting of the mind” lasted for about 6 hours after infusion. 
    When I arrived home I did my laundry, cooked dinner and washed all the dishes. I noticed how I had more energy to do all this. Perhaps the earlier suggestion that Ketamine treatment improves functionality explains how I felt able to do more, or perhaps it actually was an effect of the treatment. Either way, it didn't matter.
    I ended my evening with 10 minutes of guided mindfulness meditation, hoping to cultivate some of these positive effects. I think the meditation helped. At bedtime, I wasn't churning through all that happened that day which is unusual for me. I was able to get to sleep just after 2am, not bad for an insomniac.
    The next entry will describe my third infusion, which took place the day after. More dissociation and a moment of realization of the value of human relationships that becomes a sort of therapeutic anchor.
  14. Like
    Atra got a reaction from Bulgakov for a blog entry, First Ketamine infusion – 6/11/2017, 50mg   
    I Wanna Feel Everything
    You know the feeling of not having had enough sleep. Reduced cognition, lack of alertness and awareness, all the soft-headed sensations. I suffer from chronic insomnia so that's my baseline most days but on this day adrenaline from the 2 mile walk and anticipation of getting the needle compensated. I met with the doctor and nurse and they explained the procedure and answered my many questions. They took vitals, then put me in a soft leather reclining chair and placed a blood pressure cuff on my arm and an O2 saturation/pulse monitor on a finger before undertaking the tortuous task of sticking me. Thankfully, the nurse was very competent and managed to get the catheter into a cooperative vein after only two tries. I have needle phobia so this process sucked more and took a lot longer than it should've.
    I didn't bring a companion with me so they asked if I'd like someone to stay by my side and I replied that it didn't really matter to me; do what you do. The nurse informed me that most patients cover their eyes with a sleep mask and their ears with noise-canceling headphones playing music during infusion, it makes for a more inward experience and it's generally more relaxing. Nope, I said. I wanted to be aware of my surroundings so that I could collect all the information I could about the experience. To my thinking, if Ketamine was an effective treatment for depression then it shouldn't matter and since this was my first of six infusions, why not make it a sort of controlled experiment.
    I'd come to regret that.
    What followed was alot of self-monitoring which certainly didn't make the experience enjoyable. Without distractions, my ever-chatty anxiety was with me in each moment, narrating every perceived drug effect – light nausea, anesthetic numbness and the heavy tongue feeling that gives you. If you've been given Novocaine for a dental procedure you know what I mean. Ketamine is an analgesic so that part is actually nice, any soreness or pain in my body was totally masked. However, this was very different from my recreational drug experiences, I wasn't prepared for the strength of the anesthetic sensation and this and my constant body-monitoring was making me uncomfortable. Five or ten minutes into the infusion, I wondered with some apprehension how strong these effects were going to get. My eyes kept drifting to the IV stuck in my hand.
    I began to smell and taste rubber although none was in or around my face, kinda strange(1). I got the doctor's attention and asked him some random question about Transmagnetic Stimulation, or TMS. I wasn't really interested in it, just wanted to try speaking and I think I was also a little scared. I desired an intellectual moment for some semblance of normalcy, The doctor kindly declined my invitation to discuss it and gently suggested that I relax into the experience.
    The blood pressure cuff attached arm to my arm constricted every 5 minutes. I used it as a reminder to shift my attention to my breathing so that I wouldn't allow anxiety control the entirety of my awareness.
    About 15 minutes into the infusion, things started to get kinda weird.
    Sound Distortion
    I'd brought some music with me, Brandenburg Concerto by JS Bach so I decided to listen. This is orchestral music so, lots of instruments playing harmoniously in a precisely composed piece but under the influence of Ketamine, it sounded as if the orchestra was playing in an underground parking structure. Ketamine distorts sounds by giving them a flanging(2) and/or a stuttering effect – which you might be familiar with if you've ever taken Nitrous Oxide. That didn't work well with classical music and after a few tracks I pulled out the earbuds.
    I heard the fussing of a young child that seemed to be coming from the hallway outside the door to the treatment room but I wasn't sure if it was real or hallucinatory (turns out it was real). The sound was distorted, stretching into a wail, then stuttering. The noise wasn't bothersome, it was like an anchor to reality and it also called to mind pleasant memories of playfulness as a child.
    At about the midpoint of the infusion, things started to get really weird. 
    Time Perception Distortion/Dilation
    I observed the doctor and nurse standing at the foot of my chair looking over some papers attached to a clipboard. I perceived their perfectly still bodies in a kind of frozen, timeless moment that I'll try to describe: they're standing there (at this present moment), they were there - but it was some time ago (like an afterimage) and they will be standing there (the moment is yet to happen). My brain is perceiving and processing all three temporal states as happening in the moment they're observed.
    Now, that is some kinda freaky so I'm going to attempt an awkward and inadequate analogy.
    Imagine you're observing a pendulum in motion with a strobe light behind it flashing at quick intervals. As you watch it swing, you can't determine at any given moment if it's at it's equilibrium point in the center or in one of many points along it's trajectory. Vision reports to your brain from moment to moment that the pendulum is simultaneously at rest and oscillating.

    This perceptual distortion brought with it no feeling of dissonance or anxiety for me, I'm familiar with this effect from my recreational experiences with psychedelic drugs. I regard the event as an “a-ha” moment: were we not creatures forever trapped in linear time, I imagine this is how we might perceive our world. 
    Some time later though impossible to know how long, I noticed the doctor sitting on a stool by my chair. I probed my feelings, did I feel scrutinized or uncomfortably exposed/vulnerable? No. I self-soothed anyways by acknowledging that it's comforting to know I was being cared for and should anything at all go wrong, there is no safer place I could be than here. I don't see him leave but the doctor vanishes. I probed my feelings again – did I feel lonely? No.
    Visual Distortion
    When looking directly at the faces of the doctor and nurse, they appeared elongated or misshapen. This is not the same as a visual hallucination because the external stimulus is actually there. The effect is similar to passing a lens over a photograph, but in three dimensions. I decided it's unpleasant so I looked away.
    Completed Infusion And After-effects
    For the remainder of the infusion I felt fairly calm despite near-constant monitoring of my body and the drug's effects. I didn't experience any emotional distress, no symptoms of my MDD manifested. My anxiety, whenever it felt present, as felt far away which is strange for me. Anxiety returned at the end if the infusion when the IV machine began to beep and a red light atop the unit began flashing. While the still semi-aware observer in me understood this indicated that the infusion was complete my anxiety, always up to the task of distorting my thoughts, informed me that a red flashing light never, EVER indicates anything good. I was mindful of how silly that sounded and regarded it with mild amusement.
    I'd read about Ketamine being a dissociative anesthetic with out of body experiences, commonly referred to in the literature as depersonalization, being a side-effect. One study even suggests the dissociative features of Ketamine might predict a greater antidepressant response(3). Well, there was no dissociative episode in my first infusion which wasn't a let-down, I think. I didn't want the first one to be too overwhelming and I went into it with a view towards collecting information rather than seeking a specific experience.
    The nurse informed me she was hanging a saline bag and that I had completed my first transfusion. I felt a sense of pleasure and relief knowing that I had completed the therapy without serious incident. When she spoke she used a lot of hand gestures, which really seemed helpful in that it facilitated communication, I was still very intoxicated. It also conveyed a sort of gentleness and openness - as if careful word choice and sweet intonation could not be trusted to do so alone. Her hand movements left vague trails which I recognized as mild hallucinations. The executive function of my brain seemed to be “waking up” and I was surprised by just how quickly the drug effects seemed to leave my system once the saline flush began.
    15 minutes later, the doctor met with me to ask about how I felt and if I felt any change in my mood. I was slightly disappointed to report that I didn't feel an elevation in mood or could report some definitive, significant change in my condition. He explained that only a small number of patients do after their first infusion and referred me to the Ketamine Advocacy Network web page to read more about the therapy and what to expect in the infusions to come.
    A family member picked me up and drove me to her house for lunch. I was super hungry and devoured the meal. In the middle of a casual conversation with her, I realized that I felt more “like me” than I had in a year - it's hard to explain the feeling. Afterwards, I felt I had enough energy to walk the 2 miles home. As soon as I arrived I got to work on a musical playlist for my next infusion and realized I was feeling excitement at actively working on shaping the Ketamine therapy. I paused just long enough to acknowledge that I hadn't been excited about about a damn thing in over a year. 
    I was able to fall asleep with some ease around 1am.
     
    The next post will be about my second infusion which happened the following afternoon and did include a dissociative event. I'll write about how I believe I changed the context of the Ketamine trip using music as a guide and to cue a particular response.
    ___________________________________________________________
    (1) I asked an Anesthesiologist if he could explain the rubbery taste and smell. He said strange tastes and odors can be rare after-effects of general anesthesia but he'd never heard of this in connection with Ketamine. I'd been put under with inhalation anesthetic for surgery before and it occurred to me that my first experience was when I was only 6 or 7 years old. Back then, anesthesia gas was delivered through rubber tubes. Did Ketamine's anesthetic sensations in my body trigger a sort of recollection of that taste?
    (2) See Flanging in Wikipedia to listen to a sample of this sound effect.
    (3) "Ketamine-Induced Dissociative Symptoms Predict Antidepressant Response", Psychiatry Advisor, May 17, 2018.
     
  15. Like
    Atra got a reaction from JD4010 for a blog entry, How'd I get here?   
    Background
    Male, 48 years old at the time of this writing diagnosed with Major Depressive Disorder (MDD) treatment refractory and Generalized Anxiety Disorder (GAD). Mental Illness runs in both sides of my family, my mother was diagnosed but her mom wasn't and while she died before I was born, by all accounts she was 32 flavors of effed up. For treatment, I've gone through the most popular categories in the antidepressant alphabet soup– SSRIs, NDRI, SNRI, Tetracyclic and Trycyclic experiencing zero relief even at maximum therapeutic doses and in various combinations. I experience periodic panic attacks for which I was prescribed Benzodiazepines. I have chronic insomnia and was given medications in the hypnotic class – which did not help - so until recently I self-medicating with Cannabis.
    In addition to mental illness I have an autoimmune-related skin condition called Lichen Planus for which there is no understood cause or cure. It's characterized by an itchy rash that appears and spreads and then completely goes away whenever it wants. I'm also diagnosed with a rare inner ear disorder in my left ear known as Ménière's disease for which there is no cure or treatment and is characterized by hearing loss and sudden, random episodes of debilitating vertigo lasting 20 minutes to 8 hours.
    Major Depression Strikes
    I experienced bouts of depression throughout childhood and adolescence and two major depressive episodes in my adult life. The first major episode came in 2006 and followed a job loss and the end of 12 year relationship. For 4 years I felt like a ghost, isolating myself from family and friends unable to job hunt, unable to socialize apart from the online gaming community I'd thrown myself into.
    One random day, I woke up angry at myself and my hopelessness and decided I needed help. Rather than seek it from a mental health professional, I bought some books on meditation and began practicing. I also started walking 2-5 miles everyday. Together, this seemed to work, I began to feel empowered and my symptoms went into partial remission. By then, I'd been out of the job market about 6 years so I chose volunteer work in my field of expertise which I did for a year before seeking and landing a new job. I started dating again and showed up to absolutely anything anyone invited me to, no matter how weird or uninteresting. I still experienced anxiety and insomnia but I managed. At that time I well feeling self-assured and so very proud of having beat depression, touting my “Meditation, not medication!” slogan to just about everyone I knew.
    Yeah. Pride no longer follows the statement.
    Major Depression Strikes back
    My second major depressive episode happened in 2014. I don't even recollect if how exactly began, depression is such an insidious disease. I know my mental health deteriorated when I was fired from my job and undertook end-of-life care for my father, who was slowly dying of heart failure. At the urging of my partner who was taking antidepressants, I finally sought help from a psychiatrist. I was prescribed antidepressants, went to biweekly therapy and joined therapy group classes to address the depression and anxiety. I didn't respond to the drugs but the classes were kind of helpful. I had trouble digesting the information, difficulty concentrating and remembering what we covered. My psychiatrist followed a drug protocol, increasing dosage to therapeutic maximum or limits of my tolerance, then augmenting with another medication followed by tapering off before introducing a new class of antidepressants.
    Despite the treatments and therapy, my mental health continued to slide. I became frequently irritable, frustrated and hopeless. I had emotional meltdowns and lashed out at family, friends and my partner. For more than a year, I sunk into severe depression with loss of even basic functionality. I couldn't leave my house and felt unable to respond to invitations, phone calls or texts. I went to couples counseling in addition to the other therapy work but it wasn't helping. I didn't feel that anything in my life had value, so I left the relationship. After that, I felt emotionally numb, experienced anhedonia which was followed by suicidal ideation.
    You Want To Shoot Me Up With What?
    I first learned of Ketamine treatment for depression from my therapist. Let me tell you that I consider myself a skeptic, which in terms of healthcare means, I need there to be peer-reviewed, science-based evidence if I'm to believe a treatment has any merit. There's so much utter nonsense out there – especially in California, where I live. I read whatever I could find about Ketamine but was underwhelmed by the body of evidence supporting it's efficacy in treating depression, unimpressed by testimonials (the plural of “anecdote” is not “evidence”)* and dismissive of articles in popular magazines which I deemed sensationalized.
    I was honestly confused as to why any doctor would prescribe Ketamine treatment when it seemed they understood so little about the mechanism by which it treats depression.
    And yet, Ketamine treatment is covered by my insurance and they actually have their own program going for treating their patients. Nevertheless, it still took me 6 months of agonizing, soul-crushing MDD symptoms from when I was initially recommended for the program until I finally agreed to participate.
     
    The blog entries that follow are my experiences in the Ketamine treatment program starting with the first of 6 intravenous infusions, which began in June 2017.
     
  16. Like
    Atra got a reaction from JD4010 for a blog entry, First Ketamine infusion – 6/11/2017, 50mg   
    I Wanna Feel Everything
    You know the feeling of not having had enough sleep. Reduced cognition, lack of alertness and awareness, all the soft-headed sensations. I suffer from chronic insomnia so that's my baseline most days but on this day adrenaline from the 2 mile walk and anticipation of getting the needle compensated. I met with the doctor and nurse and they explained the procedure and answered my many questions. They took vitals, then put me in a soft leather reclining chair and placed a blood pressure cuff on my arm and an O2 saturation/pulse monitor on a finger before undertaking the tortuous task of sticking me. Thankfully, the nurse was very competent and managed to get the catheter into a cooperative vein after only two tries. I have needle phobia so this process sucked more and took a lot longer than it should've.
    I didn't bring a companion with me so they asked if I'd like someone to stay by my side and I replied that it didn't really matter to me; do what you do. The nurse informed me that most patients cover their eyes with a sleep mask and their ears with noise-canceling headphones playing music during infusion, it makes for a more inward experience and it's generally more relaxing. Nope, I said. I wanted to be aware of my surroundings so that I could collect all the information I could about the experience. To my thinking, if Ketamine was an effective treatment for depression then it shouldn't matter and since this was my first of six infusions, why not make it a sort of controlled experiment.
    I'd come to regret that.
    What followed was alot of self-monitoring which certainly didn't make the experience enjoyable. Without distractions, my ever-chatty anxiety was with me in each moment, narrating every perceived drug effect – light nausea, anesthetic numbness and the heavy tongue feeling that gives you. If you've been given Novocaine for a dental procedure you know what I mean. Ketamine is an analgesic so that part is actually nice, any soreness or pain in my body was totally masked. However, this was very different from my recreational drug experiences, I wasn't prepared for the strength of the anesthetic sensation and this and my constant body-monitoring was making me uncomfortable. Five or ten minutes into the infusion, I wondered with some apprehension how strong these effects were going to get. My eyes kept drifting to the IV stuck in my hand.
    I began to smell and taste rubber although none was in or around my face, kinda strange(1). I got the doctor's attention and asked him some random question about Transmagnetic Stimulation, or TMS. I wasn't really interested in it, just wanted to try speaking and I think I was also a little scared. I desired an intellectual moment for some semblance of normalcy, The doctor kindly declined my invitation to discuss it and gently suggested that I relax into the experience.
    The blood pressure cuff attached arm to my arm constricted every 5 minutes. I used it as a reminder to shift my attention to my breathing so that I wouldn't allow anxiety control the entirety of my awareness.
    About 15 minutes into the infusion, things started to get kinda weird.
    Sound Distortion
    I'd brought some music with me, Brandenburg Concerto by JS Bach so I decided to listen. This is orchestral music so, lots of instruments playing harmoniously in a precisely composed piece but under the influence of Ketamine, it sounded as if the orchestra was playing in an underground parking structure. Ketamine distorts sounds by giving them a flanging(2) and/or a stuttering effect – which you might be familiar with if you've ever taken Nitrous Oxide. That didn't work well with classical music and after a few tracks I pulled out the earbuds.
    I heard the fussing of a young child that seemed to be coming from the hallway outside the door to the treatment room but I wasn't sure if it was real or hallucinatory (turns out it was real). The sound was distorted, stretching into a wail, then stuttering. The noise wasn't bothersome, it was like an anchor to reality and it also called to mind pleasant memories of playfulness as a child.
    At about the midpoint of the infusion, things started to get really weird. 
    Time Perception Distortion/Dilation
    I observed the doctor and nurse standing at the foot of my chair looking over some papers attached to a clipboard. I perceived their perfectly still bodies in a kind of frozen, timeless moment that I'll try to describe: they're standing there (at this present moment), they were there - but it was some time ago (like an afterimage) and they will be standing there (the moment is yet to happen). My brain is perceiving and processing all three temporal states as happening in the moment they're observed.
    Now, that is some kinda freaky so I'm going to attempt an awkward and inadequate analogy.
    Imagine you're observing a pendulum in motion with a strobe light behind it flashing at quick intervals. As you watch it swing, you can't determine at any given moment if it's at it's equilibrium point in the center or in one of many points along it's trajectory. Vision reports to your brain from moment to moment that the pendulum is simultaneously at rest and oscillating.

    This perceptual distortion brought with it no feeling of dissonance or anxiety for me, I'm familiar with this effect from my recreational experiences with psychedelic drugs. I regard the event as an “a-ha” moment: were we not creatures forever trapped in linear time, I imagine this is how we might perceive our world. 
    Some time later though impossible to know how long, I noticed the doctor sitting on a stool by my chair. I probed my feelings, did I feel scrutinized or uncomfortably exposed/vulnerable? No. I self-soothed anyways by acknowledging that it's comforting to know I was being cared for and should anything at all go wrong, there is no safer place I could be than here. I don't see him leave but the doctor vanishes. I probed my feelings again – did I feel lonely? No.
    Visual Distortion
    When looking directly at the faces of the doctor and nurse, they appeared elongated or misshapen. This is not the same as a visual hallucination because the external stimulus is actually there. The effect is similar to passing a lens over a photograph, but in three dimensions. I decided it's unpleasant so I looked away.
    Completed Infusion And After-effects
    For the remainder of the infusion I felt fairly calm despite near-constant monitoring of my body and the drug's effects. I didn't experience any emotional distress, no symptoms of my MDD manifested. My anxiety, whenever it felt present, as felt far away which is strange for me. Anxiety returned at the end if the infusion when the IV machine began to beep and a red light atop the unit began flashing. While the still semi-aware observer in me understood this indicated that the infusion was complete my anxiety, always up to the task of distorting my thoughts, informed me that a red flashing light never, EVER indicates anything good. I was mindful of how silly that sounded and regarded it with mild amusement.
    I'd read about Ketamine being a dissociative anesthetic with out of body experiences, commonly referred to in the literature as depersonalization, being a side-effect. One study even suggests the dissociative features of Ketamine might predict a greater antidepressant response(3). Well, there was no dissociative episode in my first infusion which wasn't a let-down, I think. I didn't want the first one to be too overwhelming and I went into it with a view towards collecting information rather than seeking a specific experience.
    The nurse informed me she was hanging a saline bag and that I had completed my first transfusion. I felt a sense of pleasure and relief knowing that I had completed the therapy without serious incident. When she spoke she used a lot of hand gestures, which really seemed helpful in that it facilitated communication, I was still very intoxicated. It also conveyed a sort of gentleness and openness - as if careful word choice and sweet intonation could not be trusted to do so alone. Her hand movements left vague trails which I recognized as mild hallucinations. The executive function of my brain seemed to be “waking up” and I was surprised by just how quickly the drug effects seemed to leave my system once the saline flush began.
    15 minutes later, the doctor met with me to ask about how I felt and if I felt any change in my mood. I was slightly disappointed to report that I didn't feel an elevation in mood or could report some definitive, significant change in my condition. He explained that only a small number of patients do after their first infusion and referred me to the Ketamine Advocacy Network web page to read more about the therapy and what to expect in the infusions to come.
    A family member picked me up and drove me to her house for lunch. I was super hungry and devoured the meal. In the middle of a casual conversation with her, I realized that I felt more “like me” than I had in a year - it's hard to explain the feeling. Afterwards, I felt I had enough energy to walk the 2 miles home. As soon as I arrived I got to work on a musical playlist for my next infusion and realized I was feeling excitement at actively working on shaping the Ketamine therapy. I paused just long enough to acknowledge that I hadn't been excited about about a damn thing in over a year. 
    I was able to fall asleep with some ease around 1am.
     
    The next post will be about my second infusion which happened the following afternoon and did include a dissociative event. I'll write about how I believe I changed the context of the Ketamine trip using music as a guide and to cue a particular response.
    ___________________________________________________________
    (1) I asked an Anesthesiologist if he could explain the rubbery taste and smell. He said strange tastes and odors can be rare after-effects of general anesthesia but he'd never heard of this in connection with Ketamine. I'd been put under with inhalation anesthetic for surgery before and it occurred to me that my first experience was when I was only 6 or 7 years old. Back then, anesthesia gas was delivered through rubber tubes. Did Ketamine's anesthetic sensations in my body trigger a sort of recollection of that taste?
    (2) See Flanging in Wikipedia to listen to a sample of this sound effect.
    (3) "Ketamine-Induced Dissociative Symptoms Predict Antidepressant Response", Psychiatry Advisor, May 17, 2018.
     
  17. Like
    Atra got a reaction from Bulgakov for a blog entry, How'd I get here?   
    Background
    Male, 48 years old at the time of this writing diagnosed with Major Depressive Disorder (MDD) treatment refractory and Generalized Anxiety Disorder (GAD). Mental Illness runs in both sides of my family, my mother was diagnosed but her mom wasn't and while she died before I was born, by all accounts she was 32 flavors of effed up. For treatment, I've gone through the most popular categories in the antidepressant alphabet soup– SSRIs, NDRI, SNRI, Tetracyclic and Trycyclic experiencing zero relief even at maximum therapeutic doses and in various combinations. I experience periodic panic attacks for which I was prescribed Benzodiazepines. I have chronic insomnia and was given medications in the hypnotic class – which did not help - so until recently I self-medicating with Cannabis.
    In addition to mental illness I have an autoimmune-related skin condition called Lichen Planus for which there is no understood cause or cure. It's characterized by an itchy rash that appears and spreads and then completely goes away whenever it wants. I'm also diagnosed with a rare inner ear disorder in my left ear known as Ménière's disease for which there is no cure or treatment and is characterized by hearing loss and sudden, random episodes of debilitating vertigo lasting 20 minutes to 8 hours.
    Major Depression Strikes
    I experienced bouts of depression throughout childhood and adolescence and two major depressive episodes in my adult life. The first major episode came in 2006 and followed a job loss and the end of 12 year relationship. For 4 years I felt like a ghost, isolating myself from family and friends unable to job hunt, unable to socialize apart from the online gaming community I'd thrown myself into.
    One random day, I woke up angry at myself and my hopelessness and decided I needed help. Rather than seek it from a mental health professional, I bought some books on meditation and began practicing. I also started walking 2-5 miles everyday. Together, this seemed to work, I began to feel empowered and my symptoms went into partial remission. By then, I'd been out of the job market about 6 years so I chose volunteer work in my field of expertise which I did for a year before seeking and landing a new job. I started dating again and showed up to absolutely anything anyone invited me to, no matter how weird or uninteresting. I still experienced anxiety and insomnia but I managed. At that time I well feeling self-assured and so very proud of having beat depression, touting my “Meditation, not medication!” slogan to just about everyone I knew.
    Yeah. Pride no longer follows the statement.
    Major Depression Strikes back
    My second major depressive episode happened in 2014. I don't even recollect if how exactly began, depression is such an insidious disease. I know my mental health deteriorated when I was fired from my job and undertook end-of-life care for my father, who was slowly dying of heart failure. At the urging of my partner who was taking antidepressants, I finally sought help from a psychiatrist. I was prescribed antidepressants, went to biweekly therapy and joined therapy group classes to address the depression and anxiety. I didn't respond to the drugs but the classes were kind of helpful. I had trouble digesting the information, difficulty concentrating and remembering what we covered. My psychiatrist followed a drug protocol, increasing dosage to therapeutic maximum or limits of my tolerance, then augmenting with another medication followed by tapering off before introducing a new class of antidepressants.
    Despite the treatments and therapy, my mental health continued to slide. I became frequently irritable, frustrated and hopeless. I had emotional meltdowns and lashed out at family, friends and my partner. For more than a year, I sunk into severe depression with loss of even basic functionality. I couldn't leave my house and felt unable to respond to invitations, phone calls or texts. I went to couples counseling in addition to the other therapy work but it wasn't helping. I didn't feel that anything in my life had value, so I left the relationship. After that, I felt emotionally numb, experienced anhedonia which was followed by suicidal ideation.
    You Want To Shoot Me Up With What?
    I first learned of Ketamine treatment for depression from my therapist. Let me tell you that I consider myself a skeptic, which in terms of healthcare means, I need there to be peer-reviewed, science-based evidence if I'm to believe a treatment has any merit. There's so much utter nonsense out there – especially in California, where I live. I read whatever I could find about Ketamine but was underwhelmed by the body of evidence supporting it's efficacy in treating depression, unimpressed by testimonials (the plural of “anecdote” is not “evidence”)* and dismissive of articles in popular magazines which I deemed sensationalized.
    I was honestly confused as to why any doctor would prescribe Ketamine treatment when it seemed they understood so little about the mechanism by which it treats depression.
    And yet, Ketamine treatment is covered by my insurance and they actually have their own program going for treating their patients. Nevertheless, it still took me 6 months of agonizing, soul-crushing MDD symptoms from when I was initially recommended for the program until I finally agreed to participate.
     
    The blog entries that follow are my experiences in the Ketamine treatment program starting with the first of 6 intravenous infusions, which began in June 2017.
     
  18. Like
    Atra got a reaction from Bulgakov for a blog entry, The Night before First Ketamine Infusion   
    Make Me A Believer
    I really hate indoctrination. But hey, any port in a storm, right? There are lots of reasons to be skeptical about Ketamine treatment but nevertheless, I decided to set aside my doubts and buy into the notion that it could help me rewire my brain. This  began with accepting that depression had a physical impact on my brain, developing neural networks strengthened by frequent use which were rather unhealthy and I wanted to alter them. But how? I read up on neural plasticity and dendrite excitement, synaptic regeneration, even watched a boring video of a scan of a rat’s brain on Ketamine. 
    In doing this I was able to convince myself that the therapeutic value of the drug is not limited by how long it remains in the body. Rather, the lasting effects must have something to do with how patient and therapist can leverage the impact on neural networks in some manner that results in psychological transformation.
    Just writing that makes me think of out-there “woo-woo” stuff and I admit, it sounds like a big reach. I probably misused some words because I lack the vocabulary to describe it in scientific terms so, just bear with me. 
    At bedtime, I was very anxious. I knocked back 100mg of Trazodone and crawled into bed hoping to get some rest. Moments later, the dynamic duo of Anxiety and Depression, like a pair of unwelcome pals at the local bar, pulled over a couple of chairs to count off the reasons I should dread tomorrow.
    If you want a cheap laugh at my inner dialog with my two pals Anxiety and Depression, enjoy.
    I got about 2 hours of sleep.
    Protocols
    The list things you aren't allowed to do before infusion is long and crappy. You must fast for at least 10 hours. No liquids except water or plain tea. No Benzodiazepines, no Gabapentin. No alcohol. No drugs at all except for your antidepressant and necessities like allergy meds and stuff they think is OK. 
    I decided I would walk 2 miles to the clinic because I read that exercise does good stuff for the brain, blah, blah, blah would you just get on with the infusion story, pal? Ok...
  19. Like
    Atra reacted to Floor2017 for a blog entry, SECRETS   
    If you only knew that you are not alone. There are so many suffers that are
    going through the same kind of things that you are, but the world will never
    know because so many people are afraid of what somebody might say about
    them or what someone might think about them.  But if the truth be told we are
    all suffers and we are all making adjustments on how to live from day to day,
    So, that we can learn how to live the best life that we can live under the
    circumstances that we are faced with on a daily bases.  
  20. Like
    Atra reacted to GSpolar for a blog entry, Does it matter?   
    What we do matters.  
    They are real souls, the 10 people who are watching DF, who are so scared of the stigma, imprisoned at 'home' to such a degree, or hurting so deeply.....
    10 are watching at any given moment for every 1 who dared to even sign up anonymously.
    If you read this, you probably have encouraged at least one person anonymously, with nothing to gain, just out of love.  
    And for every 1, there were really 10, check out 'Activity/All Users' to see for yourself.  
    How terrible is a disease that 10 are afraid to admit it for every 1 who does.....
    How valuable is even one note of encouragement, 1 genuine hug.  Multiply your hugs by 10........You're changing outcomes of life, you really are
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