small-songbird-sitting-on-white-surface-with-white-background

Working on Depression

Sometimes I feel like a bird that can’t figure out how to fly. I periodically get launched out of a cannon (in this metaphor, that’s ketamine), then flap and flap to no effect. I’m trying to make progress, but gravity is always there. Eventually, I sink lower and lower, just exhausting myself with all that flapping.

That’s how it feels, but I don’t think that’s entirely accurate. Yeah, ketamine wears off eventually, and yeah, my brain has a biochemical problem that means I can’t fix depression just by flapping. But the flapping is doing something. All that work I put into therapy and maintaining a routine and getting exercise must be functioning in tandem with the ketamine to push my little bird wings just a smidge farther.

I know this because my mood still dips pretty low sometimes, but on the whole, I’m in a better place than I was a few months ago. Perhaps it’s that I bounce back faster, now. Or maybe it’s just knowing that it won’t last forever.

And now, being able to look back and see that I’m flippity flapping on my own a little makes it just a little bit easier to continue. Chipping away at something day by day is tedious and frustrating, but all of that work adds up. If you can look back at where you were a little while ago, it helps to notice that you have made progress, even if it’s just in the personal growth or a skill you’ve learned or the support you’ve gotten.

Keep flapping, everybody.

neon-sign-speech-bubble-shape

Therapy Code Words

Unfortunately for me and my therapist, my ability to write words does not always translate well to being able to speak them. I need time to think through an entire thought before I speak it, and I struggle sometimes to get the words out when the topic is something challenging. And not just for sensitive topics like self-harm or suicide, but even for topics like life goals.

In fact, the word “goals” makes my stomach twist. I feel so much internal pressure when it comes to my ambitions that any discussion of the topic overwhelms me. It’s as if I know that once I start really acting to reach my goals, I’ll have to go all out because I don’t know how to not do something 100%. And that’s overwhelming. And unrealistic. So I try to avoid talking about it or thinking about it beyond my daily sense of guilt for not “doing more”.

It goes without saying that I don’t like this. Goals are important, and they should be exciting, not something you dread. Yes, they often take hard work to reach, but I think the balance of work to reward should be worth it. I don’t want to put in work just to alleviate an unhealthy internal pressure; I’d rather work for something because I want the excitement and fun and pride of achieving the thing. Depression makes this hard. Excitement and fun and pride are not feelings that depression wants around. So, I find myself terrified of adding more to my plate and pursuing my goals, and terrified that I’ll do nothing and fall even more behind my self-imposed schedule. Trapped in between the two, “goals” is a scary word.

Here’s where the code word comes in. Instead of “goals”, my therapist and I talk about “clams”.

It’s groundbreaking, I know.

There’s no significance to clams, it was just the first word my therapist thought of, but it stuck. Much like the Potato Scale of Depression is useful in its humor, “clams” are somehow easier to talk about because of the silliness. It takes away the gravity of having a discussion about goals and replaces it with a lighthearted conversation about a bivalve often eaten with a lemon-butter sauce.

And this is how I want my goals to be. Not so scary. Not so enormous. Just little steps to bigger results, like shucking one clam at a time to make a chowder.

Photo: Andy Castille – @kikini

5 Ways I’m Reducing My Depression Naps

I sleep ok at night and WAY too much during the day. When I’m really depressed, I can get up early to take care of my dog and then go back to sleep until late afternoon. Sometimes, I can limit it when I have a lot keeping me busy, such as any work tasks I might have – which I do from home and largely on my own schedule within a day. But for the most part, I find myself frustratingly vulnerable to the sandman’s influence. Plus, now that Stella is no longer a puppy, she’s happy to spend hours on end with me, dreaming of whatever dogs dream of while we sleep on my bed. She used to wake me up every couple of hours to demand something from me, but now, it’s all snoozing.

1. Running

Running is a two-birds-one-stone solution for me, because it offers both the physiological and biochemical benefits of exercise in addition to the incredible fact that you can’t sleep when you’re running. I’ve lost a lot of my endurance, but I’ve been maintaining at least some regular running, which is remarkably easier to do the more recently I’ve had a ketamine infusion. I recently noted that the day after an infusion, I ran three miles without stopping, which I hadn’t done in months. Then, a few days before my next one, I struggled just to run one mile. Why is it so different? I guess that as the ketamine wears off, I lose the mental energy to push myself very far, and I’m worn out as soon as I start. It’s frustrating, but I try to just be pleased that I got out there at all. Perhaps, if I manage to rebuild my endurance a little, it’ll be easier to keep it up even through the changes to my ketamine buffer.

2. Setting the Intention with No Nap Monday

No Nap Monday was created in response to the smashing success of Yes Day, both of which were proposed by my therapist. No Nap Monday has been far less successful, but I do try to at least sleep less on Mondays. Sometimes I set an alarm for something reasonable, which is definitely subjective and changes week to week. Sometimes, it’s an hour. Sometimes, it’s three. But no matter what, it’s good to at least have the intention.

3. Adding Activities

Ultimately, my goal is to not only sleep less, but also do more. It follows that I should attempt to add things to my routine. Volunteering is option that interests me. Over the years, I’ve volunteered or worked with animals in a few different capacities, and I always really enjoy it, so I tend to look for opportunities in that area. There’s an animal rescue near me that needs volunteers to feed the bunnies, and that sounds right up my alley. I just have to tackle my expert-level overthinking habit and then plow through my anxiety about new things and I’ll be right on track!

4. SAD Lamp Makes Me Happy (or at least less sleepy)

It’s now mid-October, so I pulled my seasonal depression lamp out of my closet the other day. The weather doesn’t affect me as much here in Colorado as it did in Michigan, but I can tell after a few cloudy days that I’m in need of some sun. Simulated sun will have to do.

5. Changing My Routine

Much as I hate doing it, deviating from my routine often keeps me from napping too much. I tend to get irresistibly tired as noon approaches, and my mood slopes downward in the afternoon anyway, so that’s my prime depression nap opening. By forcing myself to be busy doing other things during that time, I keep my brain on its toes. The downside to this is that I do well with routine for other reasons, so abandoning that makes me anxious and sometimes decidedly cranky. But at least I can prove to myself that I am capable of functioning without depression naps.

small-brown-and-white-owl-with-head-turned-to-side-and-large-yellow-eye

Owl Eye: The Ketamine Chronicles (Part 25)

I felt it quickly this time, the room beginning to sway and bend even before I fully settled in and closed my eyes. Still, I only saw darkness for what felt like a long time but was probably only a minute or two. Then, subtle lines took shape, and my mental lens zoomed in on an owl’s face. The eye was my focus – although the steely beak caught my attention as well. The image rotated slowly before fading away, the owl’s eye staring back at me.

IV ketamine infusions are one of multiple treatments I use for my treatment-resistant depression. We’re still adjusting it and trying new doses as things change, which makes for interesting little self-experiments. Last time, we went without propofol and discovered that it was fine for me; in fact, I preferred it. This time, I forgot to check for refills on my scopolamine prescription, so I didn’t use any prior to my appointment. With no propofol, no scopolamine, and a slightly higher dose, this ketamine infusion felt remarkably vivid. It was much like the first few infusions I had, which were dominated by immersive scenes and imagery that constantly changed.

After the rotating owl, the sounds of the room made an appearance in my mind. The gentle chug chugging of the infusion pump reminded me of a train, and I soon saw one on the horizon of my internal view. It belched smoke – an early, coal-powered one – and rumbled closer and closer. The black smoke filled the air, blocking my vision until all that remained was a small view of the front of the train as it trundled by. Black smoke, liquid, or goop filling my vision was something of a theme in this infusion. On other occasions, it expanded from small blobs until they met and pressed against one another, filling whatever volume my mental space contained while I tried to see through a narrowing hole.

If I’m correctly piecing this together from my garbled and typo-riddled notes, which I took in the car on my way home, the sensation of being smothered by the black smoke brought my awareness to my mask. This, in turn, created an image of cloth above my face, an illegible tag sewn into the seam (a common theme in my infusions is not being able to decipher letters or numbers). My mind then conjured up a lovely memory of building a couch fort with my brother as kids. The memory itself was jumbled and consisted of snapshots – balancing the cushions just right, sliding head-first over the arm of the couch and down into the fort, and sitting with my knees pulled up in the dark confines of our shared space. The most convincing parts of the memory were the sensations. I could feel the texture of the couch upholstery and the give of the stuffing in the cushions. I noted the darkness with cracks of light where the cushions didn’t meet, and the feeling of the seat cushion grazing the top of my head. I don’t think I’ve ever re-experienced a memory during a ketamine infusion before. It was a comforting feeling to be returned to the experience of being a kid, entranced in the moment by the fantasy of a simple couch fort.

As usual, water made an appearance in my ketamine dreams. This time, it began with a slowly spinning whirlpool of green/yellow water, lit from within to make the water glow. Soon, I was in the whirlpool and it turned into the ocean. The water swelled around me and wave after wave overtook me until I was underwater. It was not frightening, although in describing it, I realize it sounds a lot like I was drowning. Once underwater, I saw an apparently incredible scene which I do not remember but my notes describe as, “Turtle? Fish on lines like balloons. Underwater city of fantastical things.”

If only I could remember. What treasures have been lost in the depths of my brain? (Water puns fully intended.)

I returned to the room several times during this infusion, convinced that it must be over soon, only to find that the people had swapped or left or reappeared. My mother had gone to run an errand and had dropped me off, but returned partway through my infusion. I saw her sitting in the corner maybe four feet from me, yet it seemed that she was very, very far away. It was a little like looking through the wrong end of binoculars. I tried to read her expression – was she even looking at me? The more I tried to settle my gaze on her, the more my eyes refused to cooperate. They jumped around and made double images, and eventually, I admitted defeat and closed them once again.

The scenes and images I was seeing were so numerous that they seemed to be packed into time in an unbelievable manner. It’s strange to think that I could experience so much in such a short amount of time, but even after all of that, there was more. I remember walking over a mountain range with an enormously tall man – I was also enormous – while he proudly described in great detail how he made the mountains. In another scene, a golden dog (I think it was a statue?) was hidden in a room packed with items. My notes reference my teeth feeling soft, something about lizard scales, and robotic cats. “What if they found my head underneath San Francisco?” must have been in response to an extremely bizarre episode of Star Trek that I recently watched in which Data’s head is found during an archaeological dig underneath – you guessed it – San Francisco.

I’m so glad that I took notes on my phone immediately after the infusion, because I find that the memory of it fades over time unless I can remind myself of what I saw. I was functioning pretty well after my appointment, and was able to get myself to take notes rather than close my eyes on the way home. The rest of the day was fairly pleasant. I greatly prefer infusions without propofol both because of its effects during the infusion as well as because of how it alters the rest of the day. Of course, I wasn’t entirely myself until several hours afterward. I took my shoes off somewhere in the house upon getting home and promptly lost them. I could not figure out where I put them until I found them the next day in a closet. Why would I put them away?! In a closet?? Absurd.

Things That Don’t Suck

The last two days have been washed in heavy winds. The leaves, just turned golden-yellow, are being stripped off of their branches to accumulate near the front door, where they’re much less pretty. It’s a small thing to be disappointed about, but it seems as though so many things in the world suck right now. For one thing, our Home Depot skeleton, David S. Pumpkins, is constantly buffeted by wind on the seat from which he offers a cheery wave. Every morning, I find him slumped over as if we force him to sleep outside on the park bench, when really, he just doesn’t have the muscle tone to stay upright. What must the neighbors think? He likes it out there, I promise.

plastic-skeleton-wearing-scarf-and-cloth-mask-lying-on-red-park-bench
Up and at ’em, Dave!

You know what else sucks? Depression. I recently had my regular mental health bloodwork done to make sure my lithium level is within the appropriate range, as well as to measure my thyroid function. All is well. Lithium can cause hypothyroidism, which can cause fatigue. We thought it would be worth investigating as a potential cause of my excessive sleeping, but no – that’s just depression. Don’t get me wrong, I’m glad I don’t have to make adjustments or take new steps to deal with a whole new problem, but reducing my lithium dose or adding a thyroid med sounded like a simpler answer. Instead, the answer is just to carry on treading water in the sea of treatment-resistant depression. Just keep swimming, right?

So, let’s make some teeny tiny inflatable water wings to keep us afloat. Here’s what hasn’t sucked lately.

  • My houseplants are doing great. Man, they look healthy.
  • I learned how to use my new, short ChuckIt to throw a tennis ball like I’m skipping rocks rather than overhead. (My rodent-obsessed dog prefers to chase things that go along the ground.)
  • I unearthed two whole sets of flannel sheets that I forgot I had.
  • I swapped out the hummingbird feeder for the regular bird feeder, and it’s becoming quite popular.
  • The coyotes woke me up with their howling the other night. I always find it eerily mesmerizing. 7/10 spooky.
chickadee-landing-on-house-shaped-bird-feeder
Hi, little chickadee.

What hasn’t sucked for you, lately?

blue-ink-dropped-in-water-with-black-background

Ink Blots and No Propofol : The Ketamine Chronicles (Part 24)

Yesterday, I had another ketamine infusion for my treatment-resistant depression. We tried getting rid of the propofol for this infusion, which sounded interesting because it had the potential to help me remember more about the experience as well as make the after effects easier. I can’t say that I remember everything, but the infusion feels more real in my memory than it has in recent weeks.

Is It Working Yet?

Despite having done this numerous times, it’s still hard for me to discern when the ketamine takes effect. I kept checking in with myself, thinking, “Is it working yet? Are those blob shapes my usual closed-eye blobs, or something different?” But eventually, it became suddenly obvious that it was working. I started to feel like my nose had melted, leaving just the bare nasal bones exposed. This somehow reminded me of a seal closing its nostrils before diving underwater. I wondered if what I was feeling was close to what it feels like to be a seal. In hindsight, this makes no sense. Just having no nose is nothing at all like being a seal, but it seemed logical in the moment.

Colors, Ink Blots, and Numbers

The beginning of the infusion is the part that I remember the most completely. At first, the darkness behind my eyelids felt very normal and familiar. But soon, pale colors moved gently against the black, like lava lamp goop merging and bubbling off.

The colors eventually faded and were replaced by intricate black and white designs that reminded me of kaleidoscopes. They were incredibly detailed, and I don’t think I could ever recreate it. As they morphed, their intricacy faded and I was reminded of Rorschach ink blot tests. Somewhere in my brain, it occurred to me that that association was especially funny, given the context. What does it mean if you see shapes within shapes that you created yourself?

At some point, there were pages and pages of numbers that didn’t mean anything to me. They were mostly organized into columns and lists, and I tried to focus on interpreting them, but was unsuccessful. This is something that seems to happen repeatedly in my ketamine infusions – I see overwhelming quantities of numbers or letters that I can never quite decipher.

That’s about the extent of what I remember. The rest of the infusion seemed to consist of fairly mundane experiences and scenes, although they escape my memory.

Ketamine as a Dissociative Anesthetic

I’m glad that we tried it without propofol. I was a little worried that it would be too intense, but it turned out just fine. As usual, I felt far removed from the room around me. My body was in the chair but my mind was somewhere else. It’s sort of like there’s a tiny me inside my own brain, viewing images that create a highly convincing sensation of having my eyes open. To then test it by opening my real eyes is a bizarre feeling.

The rest of my day was dramatically different compared to days when we’d used propofol in conjunction with ketamine. With propofol, I often sleep for the rest of the day, broken with occasional small tasks like walking the dog or doing some laundry. I must metabolize it slowly, because when I wake up the next day, I have a lot of trouble piecing together the order of events or even what I did at all. It becomes clear that I was lot less sharp than I thought I was.

Without propofol, the disorientation and grogginess wear off more quickly. I’ll sleep for several hours, but then can function fairly well, if a little physically unbalanced. I vastly prefer to be as alert as possible. The sensation of not actually having made decisions with my full wits about me is unsettling.

I’m hoping that my old pattern of improvement two days after an infusion is consistent. The short series of infusions we did recently helped combat my symptoms, but there’s definitely room for improvement.

If you’d like to start at the beginning of the Ketamine Chronicles, click here.

blurry-road-with-green-trees-showing-movement

It’s Been a Whole Month: Birthday, Anxiety, and Ketamine

I can’t believe it’s been a month since I last posted here. I have some in-progress posts that are languishing in my drafts folder, but none of them feel complete enough to be posted. So, to try to break through the stall in my writing, this is a rambling update that will have to be good enough for me.

Look at me, fighting perfectionism one disjointed blog post at a time.

Ketamine

I haven’t written about my most recent ketamine infusions because the propofol makes it harder to find anything about them to share. I think that going into it with the expectation that I won’t remember much makes it harder to grasp whatever snippets do remain. Having the intention to write about an infusion helps me pay attention to my experience; without it, the whole appointment just disappears from my memory in the hours following an infusion.

When I began my treatment with ketamine infusions, I was fascinated by the endless imagery that each infusion created. Every appointment held new associations and interesting scenes. But lately, they all feel the same. Of course, this is okay. The dose of ketamine that I receive would probably be too intense without the propofol, and I suppose I’d rather not remember much than have a terrifying trip. Still, there was something helpful about having something of the experience to hold onto.

I have the sense that I’m more able to remember things when I’m more present in the real world – like how you remember your dreams when you awaken in the middle of them. I wonder if the degree to which you’re aware of your surroundings during a ketamine infusion impacts its efficacy, if at all. Because if it’s not at all, I’d totally ask my doctor to poke me every 15 minutes and ask me what I’m thinking about so that he can write down whatever absurd, hilarious things I say. Although, my level of zonk is usually such that I probably wouldn’t answer.

Birthday

My birthday happened this month, and it caused a lot of anxiety about the future. It’s frustrating to be hindered by my own brain. I commonly hold myself to unrealistic expectations and judge myself harshly for not meeting them. I wanted a different path than the one I’m on now, and I’m having a hard time letting go of that vision. Not that I can’t eventually end up in the same place, but I didn’t see it progressing along such a challenging path. But that’s life, right? I’ve been trying to re-frame my birthday as just another marker of survival. If I can’t get myself to be pleased with my progress in the last year, I can at least be neutral.

Anxiety

Anxiety and depression often go together, and I’ve noticed a pattern in my mental health where I alternate between the two. As I start to come out of depression, the anxiety kicks in and I feel horrified by all of the time I “wasted”. I think about how far behind my expectations I am, and then I get a frantic sense of urgency to kick it into high gear. Unfortunately, I’m also easily overwhelmed and the prospect of “catching up” to my expectations triggers an avalanche of worries and insecurities. Ultimately, whether it’s depression or anxiety that is most immediately at hand, the result is still a barrier to my forward movement.

This flexible connection between depression and anxiety is not black and white. I wouldn’t say that I move completely out of depression and into anxiety – the Venn diagram has more overlap than that. My position within it just shifts into the middle so that I’m simultaneously slow, tired, and occasionally hopeless while also filling up with anxiety saturated with heavy judgement. Fun times.

At least the anxiety pushes me to do more than I otherwise would. I would rather be motivated by the reward of doing the thing rather than the fear of not doing the thing, but I also prefer being motivated at all over not at all (if that makes sense). I’ve been trying to run again, and have been somewhat successful in the last couple of weeks. The wildfire smoke in Colorado has intermittently lifted and returned, so I don’t always get clear air, but I figure the benefit to my mental health probably outweighs the damage.

landscape-photo-of-tall-grasses-near-road-going-towards-mountains-shrouded-in-wildfire-smoke

This is kind of a rambling post, but again, I can’t seem to write anything in this context that seems worthy of posting. So, this will have to do. In other news, this is not my kitten, but look at how cute she is.

blue and yellow parrot

Ketamine Assisted Psychotherapy 2: The Ketamine Chronicles (Part 23)

Compared to my first KAP session, the second one was wildly more entertaining for me, but much less productive in terms of the number of words coming out of my mouth. KAP stands for Ketamine Assisted Psychotherapy. The idea is to utilize ketamine’s ability to lower your mental barriers in order to more comfortably talk about difficult topics with your therapist. I know that I was very nervous for my first session and likely fought the ketamine in an effort to stay in control, but I didn’t expect my slightly more relaxed approach this time to produce such a dramatic difference. I think I remember that there was a slight dose change from last time to this time, but I don’t think it was enough to really impact my experience. But, in a bewildering turn of events, being more relaxed actually led to me saying less. Rather than unleashing a flood of thoughts and feelings, I found myself being washed away by images and colors. My ability to imagine images certainly made my conversation with my therapist more bizarre, and most of the time, quite disjointed.

We started out by talking about bridges. I had tried to create a metaphorical bridge that crossed into my protected mental fortress during a previous infusion, but got stuck with a drawbridge that lifted every time somebody tried to cross. This time, I saw a fraying rope bridge with missing wooden slats. It stretched across a dark chasm with no visible bottom. It was a long bridge with not enough tension, making it sag in the middle. Despite its frayed appearance, the connections to the edge of the cliff on either side were sturdy. It would be a harrowing journey to the other side, but you could do it. Thinking about this as a lucid person, it strikes me that the metaphor breaks down at some point. Clearly, I have a well-protected area of mental privacy. I don’t open up easily, and I don’t tend to rely on many people. But to picture a dry, brittle rope bridge stretching across a dark chasm implies that it would be frightening to attempt to cross it. It’s scary for me to allow people to cross the bridge, but I certainly hope the crossing isn’t scary for them. Perhaps the drawbridge was a better metaphor for me. In any case, I only come up with bridges that are difficult to cross.

I found it extremely hard to stay focused on the topic at hand during this infusion, sometimes pausing and saying things like “the blood pressure cuff makes me think of fish being squished.” (The cuff periodically tightened, which distracted me and produced a feeling of what I imagined felt like raw fish being rolled and squelched under pressure.) If an answer to a question didn’t immediately pop into my mind, I found myself floating away from it – the room and the people within receding into the distance. At times, I remembered that I was supposed to be answering something, but wasn’t at all sure of how much time had gone by since my therapist asked the question.  Is she still waiting for me to answer? Are we still on that topic or did we move on already? I don’t think I remember the question. It was chronologically confusing – seconds slipped by without my notice like water flowing over stones, and yet the small movements of my therapist and doctor in the room were auditory markers of real time. How much time passed between my last thought and this one? It’s too hard to think in words. Better to just float. I don’t usually try to hold onto the real world during ketamine infusions, and it proved to take a lot of effort.

I also don’t usually talk during my regular ketamine infusions, so it was interesting to discover just how hard it is to describe the images I see. I can write about them in detail after the fact, but in the moment, they just escape description. Take, for instance, when I said I was seeing “a bunch of…cleaning things.”

What I actually was seeing was more like a set of rectangular brushes that fit together into a grid. They were a very light pastel range of purples and blues. Why was I thinking about puzzle-piece bristle brushes during my ketamine infusion? I have absolutely no clue. Part of what made it hard to describe was that the image was so enthralling that pulling myself out of it to come up with words was difficult. But part of it was that I knew that what I was saying came across as completely bizarre. Trying to describe why such a mundane-sounding image was so pretty just kind of stumped me.

The random and nonsensical images that I was trying to describe reminded me of “Drinking Out Of Cups“, a video from the mid ’00s of Youtube (contains profanity). I tried my hardest to explain it, but seeing as it’s a video about nonsensical things, I had a hard time putting it into words while lost in my own nonsensical world. I think I slipped into fits of giggles halfway through and had to finish up with “I dunno, I’m not doing it justice, but it’s really funny.” Also, “outta” is a really hard word to say when you’re on a mixture of ketamine and propofol. Just in case you wondered.

At some point, vials of colorful sand spilled into a desert, creating clouds of blowing particles with swirls of color. I was seeing it from above, and the drifts and valleys the wind created were captivating. It was a beautiful but rather lonely landscape. A parrot with no feathers appeared in the foreground, and when I mentioned this, my therapist questioned me for clarification. “Yeah, like a…a plucked chicken” I answered.

“Aw, poor guy,” she said. To which I then said, “No, h-he seems ok, though.” Well. That’s a relief.

I wonder if, despite being more relaxed this time, I had a harder time engaging with therapy because I don’t know how to filter my mental experience. Last time, I may have been so nervous that I just locked everything down indiscriminately and tried to function as “normally” as possible. I was more open to KAP this time, which left me free to be distracted by anything and everything that entered my thoughts. It seemed to take enormous effort to hold on to the real world while holding the door open for therapy. I’m imagining a large wooden door to Ketamine Land, and within the door to Ketamine Land, a smaller door labeled “therapy”. I think I accidentally opened the big door to Ketamine Land and was bowled over by the peculiar sights within. I should have only opened the door-within-the-door and accessed the loosey-goosey-ness of Ketamine Land in a smaller, more manageable way. I’m not sure how to do that, but perhaps it takes practice.

 

Moose Revelations & the Magic of Yes Day

In an effort to help me become more easy and breezy, Fridays have been dubbed “Yes Day” by my therapist. I’m supposed to not hesitate when I’m faced with a decision on Fridays – just say yes. I mentioned this in a recent post, in which a therapy session combined with ketamine saw the creation of No Nap Day, which was slipped past my steel sieve mind on Friday under the guise of a Yes Day opportunity. Just kidding- I knew exactly what I was agreeing to.

I had good reason to say “yes” to No Nap Day. My Yes Day adventures have already resulted in positive experiences, so it only follows that I should keep it up. I’m not generally a spontaneous person. I rarely do anything on a whim, and sudden changes to my plans make me anxious. Sensory processing disorder makes me strongly prefer routine over spontaneity. I know that I like all of the sensory aspects of my familiar routine; anything new is overwhelming and could be very unpleasant.

Then again – it could be wonderful, and by saying “no” to new things, I run the risk of missing out on some great stuff. Take last month, for example. I go hiking with my mom every week. We usually pack lunch, make frequent stops to look at wildflowers, and generally have a wholesome nature experience. I usually enjoy these outings a great deal, but on this particular day, I was tired. The fresh air and pre-hike coffee did not perk me up, and I trudged up the mountain with heavy boots.

IMG_6443

We reached the first of two lakes about 2 miles up the trail, and as we rested on a flat boulder, we discussed our options for the rest of the day. My mom wanted to continue on to the second lake and the glacier, but I was reluctant. Heading back to the car and going home sounded pretty good to me, but it was Yes Day, after all. So, I said “yes” to continuing on. Stella led the way up the trail, and although I was still tired, we got into our usual pace before long.

IMG_6464

Stella was awed by snow in July, we humans were awed by the views and the beautiful waterfall, and I managed to be distracted from my fatigue enough to enjoy myself. We almost made it to the glacier, but our second wind was fading in earnest, so we took in the view and then headed back down the trail.

IMG_6522

Going downhill is easier than uphill in some ways and much harder in others. Upon reaching the parking lot, we hurried to the car and got the AC going. Stella had her head out the window as we turned onto the road, and we all enjoyed the bliss of sitting down.

Almost immediately, we came upon a car stopped in the middle of the lane. We waited for a few seconds, and then my mom said “Maybe there’s a moose!” I admit – I scoffed.

“They’re probably looking at Google Maps, trying to figure out if they’re going the right way.” I said. We chuckled a bit as we crawled forward, until the driver of the stopped car waved us around them. As we passed, I looked to the right and blurted “There IS a moose!”

“What?! Really? Should I…”

“Yes, back up!” I urged her. We rolled backwards until we could see it. An enormous moose (all moose are enormous, I suppose) was standing calmly by the road. He was munching on the thick vegetation around him, ears flicking lazily at the gnats.

95412280-9BC9-4452-B4BE-E1F108DFE47F

His antlers were velvety and magnificent. They’re such strange-looking adornments – one might even say goofy – and yet they’re so sturdy and solid. They make an effective reminder that moose are very, very, very strong animals. This one was content to carry on chewing, paying no mind to the gawking humans. I think that’s part of what makes them so interesting to watch; they’re completely unbothered by activity around them. They’re not as skittish as white-tailed deer, not as pugnacious as, say, a brown bear. They just sort of…stand around. Not to say that they won’t charge and cause you serious bodily harm, but this one’s general demeanor was one of complete and utter boredom. He was so unimpressed with us that it was almost like he was thinking “Yeah, yeah, snap some pictures. Now go home, kids. I have important vegetarian work to do, here.”

My mom and I rode that excitement all the way down the canyon. Along the way, it occurred to me that I had Yes Day to thank for it. After all, we would not have seen the moose if we had turned around when I first wanted to. Instead, I said “yes” to the rest of the hike, putting us in exactly the right place and time to witness that moose’s dangly neck thing (I now know it’s called a dewlap) waggle above the leaves. Moose are so silly, and yet so distinguished. Truly a creature of contradictions.

male-moose-standing-in-profile-in-vegetation

yellow-flowers-in-field-on-sunny-day-with-blue-sky

A Ghost Town: The Ketamine Chronicles (Part 22)

I woke up a couple of hours after going to bed following my most recent ketamine infusion. It was around 1 o’clock when I began my slumber, so when Stella woke me up, looking like she needed something, I automatically fed her dinner because it felt like I had been asleep for a long time. Then I wandered into the living room, where it dawned on me that bright sunlight was streaming in through the windows.

What day is it? Is it still daytime?

Perhaps I entered a different dimension where time passes more slowly. Or maybe I’m taller than the moon and therefore circling the sun at a different rate. I went back to sleep, but apparently woke up periodically to accomplish my nightly routine. Wednesday’s cubby in my pill organizer is empty, and I vaguely remember flossing my teeth. Half of what I wrote here was already done, which surprised me when I opened my laptop this morning to write. My phone informs me that today is Thursday, although it feels like several days have passed since yesterday’s ketamine infusion.

I usually go about three weeks between appointments, but my depression has made a comeback. Similarly to how I first began getting ketamine infusions, we decided to do a short series of infusions in quick succession to try to reset things and boost my mood. In addition to the short series, we’re also trying another medicine that can enhance the effects of ketamine. Scopolamine is an anti-nausea drug that comes in the form of a patch that you place behind your ear. I can tell that it did something; the infusion itself felt more enveloping than usual, and for hours afterward, I had this weird sense that I could feel my blood traveling through my blood vessels. It almost felt like being squeezed – like the boundaries of my body were working harder to keep everything contained within my skin.

I talked to Dr. Grindle (whose name frequently autocorrects to Dr. Griddle, which I think is hilarious) about our plan of action at the beginning of the appointment. My previous infusion was my first experience with ketamine assisted psychotherapy (KAP). The goal of it was to help me bypass the frustrating barriers to talking that I run into in therapy by having a ketamine infusion and a therapy session at the same time. It was a fascinating experience, but also a little overwhelming, so I decided to just do a normal infusion yesterday. I’ll revisit KAP another time.

I don’t remember much from this infusion. The addition of all these other anti-nausea and sedating medications makes it hard to remember what I thought about and saw during the infusion. They also make me crash when I get home, which lets whatever memories I do have fade away before I have a chance to write it down. One part that I can vaguely recall came from a suggestion made by my therapist. After our KAP session last week, we marveled at how much I resisted talking about particular topics, even while zonked out on ketamine. This week, she suggested that I imagine building a bridge across the moat that protects my mental fortress. I have yet to figure out why some parts of my everyday life show up in ketamine infusions and some don’t. The image of a bridge over a moat certainly stuck, although probably not in the way that my therapist hoped it would.

Thinking about castles and fortresses created an odd merging of memories and imagination in my mind. At first, I found myself thinking about the ruins of castles on the Danube River in Germany and in the rolling hills in Wales. I imagined the people who lived in those castles milling about and going about their daily lives. Then, I seemed to combine that train of thought with memories I have of going to Caribou, an old silver-mining ghost town from the 1870s. It’s situated not far from where I grew up.

We used to go up there and explore the crumbling stone structures and look for currants and wild raspberry bushes. In my distorted ketamine haze, I saw people working in the half-built structures. All of the trappings of normal life were there; a large pot in the fireplace, a sturdy wooden table on the dirt floor, women in long, pioneer dresses and aprons bustling around in the four walls under the open sky.

At some point, the ruins were surrounded by a moat, and a figure stood on the opposite side. Remembering that I was trying to let the person cross the moat, I conjured up a drawbridge. Interestingly, simply creating the bridge was not enough. I couldn’t seem to keep the drawbridge down; it kept raising over the water, leaving the moat impassable again. It was somewhat frustrating – like those dreams where everything keeps going wrong, no matter how much you try to find a way around it. I suppose next time, I should build any bridge but a drawbridge.

I feel a little bit better. When I’m awake, I feel more motivated to get things done, and my immediate reaction to being faced with an opportunity or an obligation is not automatically “Ugh. No.” This is one of the more frustrating phases of depression for me. I feel capable of doing things, I sometimes even want to do things, but I’m so unbelievably tired that I waste hour after hour asleep. I’m starting to wonder if that’s a normal depression symptom plus side effects of the medicines I take, or something else entirely. All I know is that it makes me feel enormously lazy when I wake up 5:30am and am struggling to keep my eyes open only three hours later. It hasn’t always been that way; when I was first diagnosed with major depressive disorder, I didn’t feel the need to take a nap until mid-afternoon, and I could limit it to something more reasonable. I’m not sure what happened besides a worsening of my illness and the meds I take, or if those factors explain it all. Something to ponder.