December 27, 2022

Dear Brian,

Well, shit.  It's difficult to know where to begin, here. Aside from my letter to you last July, it's been a few years since I've written. Years!! It's certainly not for a lack of material as in that span of time I've changed jobs... there was a global pandemic that shut the whole world down... there was a presidential election and several months later, thousands of ignorant assholes attacked the U.S. Capitol in an attempt to overturn the results of said presidential election. I spent the better part of a year trying to figure out some bizarre health issues (consisting of, but not limited to: too much of my hair falling out, my hands and feet going numb, heart palpitations, loss of appetite, nausea, excessive dizziness and fatigue, my heart rate shooting up anytime I stood up, starting out each work day with an hour of dry-heaving into the garbage can underneath my office desk, night sweats and excessive sweating throughout the day, unbearable brain fog, chest pain and 60 pounds falling off without trying, etc.) In the last year, I also resumed mental health treatment and have been back on psychotropic meds, have been attending weekly individual and group therapy sessions and I even got myself back out into the dating world! I'm surely forgetting about a hundred other things, but I'm not going to spend any amount of time trying to remember them all; and quite honestly, anything I have forgotten I'll assume was the result of my own mind doing me a solid and sparing me the discomfort of recalling those details.

While I've enjoyed an increase in good mental health days overall, I've still been experiencing very deep lows and decided to pursue another treatment option: ketamine infusion therapy. It's been a profoundly moving experience that is virtually impossible to describe to anyone who hasn't experienced it firsthand. The goal is to create a dissociative state in which your body and mind are essentially disconnected.  Though ketamine was approved as an anesthetic over 50 years ago and is legal when prescribed by a physician, it is not yet approved by the FDA... but they've had success with many people suffering from various mental health disorders such as Treatment Resistant Depression, Major Depressive Disorder, PTSD and chronic suicidal ideation, all of which have been a great struggle for me.

So far I've completed 6 infusions and will continue to get sporadic "booster" infusions for possibly the next month or so.  For starters, I've been incredibly blessed with a very special friend/neighbor that has taken me to all of these appointments which not only are an hour away, but the session itself takes a solid hour-and-a-half so it's a massive time commitment for which I am immensely grateful; without that help, or without a job that affords me the time off to attend these appointments, this therapy wouldn't even be an accessible option for me.

The session itself begins with receiving a dose of Zofran to help to reduce any nausea that may occur during the session.  As they are preparing my infusion, I get myself comfortable by taking off my shoes, covering myself with a comforting blanket I bring from home and reclining back in the chair as I put in my Air Pods and cue up some wonderfully trippy meditation music to help me clear my mind for the journey and finish by pulling my soft sleep mask over my eyes.  After the IV infusion is all hooked up, the nurse shuts off the light and leaves the room; I have a call button if at any point I require any assistance.

About 10 minutes in to the procedure, I can begin to feel the changes in my mind and, more notably, in my body.  It's almost as if I can feel the exact moment at which my mind detaches from my body; like I can actually feel my spirit being lifted out of my physical body. It's such a calm, relaxed, cared for and safe feeling that I've never experienced in my waking life... ever.  I value these treatments so much because for that 90 minutes, I don't worry about a damn thing, and that feels fucking incredible.  The imagery I see in my mind as I'm "traveling" is so hard to describe; it's not as though I'm seeing clear and immediately decipherable images like a serene pond or a mountainside sunset... but more like a series of shifting shapes and layers and opaque colors... the only way I can verbalize it is that it feels like I'm reduced to only my consciousness and am being shown a "behind the scenes" look at the very fabric and makeup of our universe...as though I'm a tiny atom floating around in space that just becomes part of the energy that makes up our entire world.  It's a humbling, but very freeing feeling.

The first meaningful theme that kept coming up for me was, "It doesn't matter."  Going in to that initial session, I had been wrestling with an interpersonal issue that was really working me up into a needy, anxious ball of nerves.  However, the message I received back from my consciousness was, "Let it go.... just let it go.  In the big picture, this interaction doesn't really matter, you're letting the things that don't matter take up too much space in your mind."  It sounds silly, but I left that session feeling instantly better about that situation that had had me in tears the night before.

What I've since learned about these sessions is that behind the scenes, while I'm relaxing and floating, the ketamine is restoring electrical activity and repairing lost neural connections.

From an article I found on www.albanyketamine.com: According to research, mental illnesses tend to interfere with neuronal connectivity in the brain’s areas responsible for emotional processing, stress regulation, and memory. These changes can make it difficult for people with mental illness to experience positive emotions, cope with stress, and remember good memories.

Ketamine is thought to work by restoring balance in these areas of the brain. As an NMDA receptor antagonist, ketamine helps increase neural activity and repair damaged neuronal connections by increasing the levels of neurotransmitters like glutamate and GABA.

In other words, ketamine helps to “rewire” the brain by increasing communication between neurons. This improved communication restores normal brain function and helps relieve symptoms of mental illness.

Additionally, ketamine also increases levels of BDNF (brain-derived neurotrophic factor), a protein that helps support neuroplasticity and neurogenesis. BDNF is vital for the growth of new neural pathways and the survival of existing neurons. This means that ketamine not only helps to improve current brain function but also has the potential to promote brain healing and regeneration.

While I have certainly noticed some positive mental and emotional changes and moderate changes in the intensity of my suicidal ideation since starting this ketamine journey, there are also some other effects that I won't say are bad or good, they just are. One such effect is related to my suicidal thoughts.  Those haven't become more intense, but they have changed.  After feeling what it must be like to exist as just "energy" without the heaviness of the physical body or the difficulty of life existing among other humans, I will say that I wish I could experience that feeling always.  So admittedly, there are moments where I do still feel that pull from the "other side" and wish I wasn't still here.  After a whole lifetime of always feeling an unrelenting desire to die, I'm finding it hard to believe that I'll ever be able to experience a life where those thoughts aren't present.  I'm hopeful, but it still feels out of reach just yet.

Some of the things I'm continuing to work on in my therapy center around my interpersonal dysfunction. My brain is still so hard-wired for knee-jerk trauma responses which still result in self-harm episodes; not as frequently as before, but it's still happening. I'm trying harder than I've ever tried in my life and it hurts, dude.  Many days, while I'm missing you and Moomie, I'm envious of your early departures from the pain. And I sometimes think if I were to pass on, that few people would truly be affected by it.  I mean, people might be upset for a little bit, but their lives would not be interrupted in any real way because I genuinely don't believe that I matter to anyone as much as you and Moomie mattered to me.  I have people in my life who care and all, but it's not the same as feeling as though you truly belong. It's not that I believe people don't care about me, I know they do; it's that I can't believe that anyone could ever love me that much. I'm trying so hard to unlearn my toxic ways of thinking-- believing that I'm just a burden and that people just tolerate me to be kind but eventually tire of my presence.  My mind is like a tornado-- it swoops in and picks up these random thoughts like a twister picks up debris.  The thoughts get pulled up into the vortex and are whipped around and around and around in my brain getting bigger and bigger.  I want to reach up and pull some of those thoughts out of all that swirling anger and hurt, but it's going too fast and it feels impossible.

I really should get back into the habit of writing these letters to you more. It helps me to get my thoughts out and I've learned over the years that people appreciate my honesty as it's helped others feel less alone in their own similar struggles.

Thanks for listening, dude.  I look for you and Moomie in every sunset and soft breeze... I know you're listening.

Love,
Laura