Advice from a Ketamine Patient

One of our patients shares some tips to help others get the most out of their ketamine infusions:

Making the Most Out of Your Treatment Session

• During the infusion, it can be helpful to start with the intent to reflect on something. Here are some patient suggested ideas:  
  • Recall what you are grateful for. What motivates your feelings of gratitude?
  • Envision your future. Consider your objectives and motivations. Imagine what else might be possible.
  • Explore your feelings about on topics you might normally avoid. A ketamine infusion is an opportunity to explore your thoughts and memories that would usually provoke a strong emotional response. The dissociation from the ketamine helps buffer you from being overwhelmed by the pain that you may associate with certain memories.
  • Recall doing activities that you have enjoyed in the past. What made it enjoyable?
  • A simple mantra that you can return to; for example, “relax.”
• During the infusion, your mind will wander. Let it.  You may start with one intention but end up someplace completely different.  Just try to be present for the experience.
• Ketamine infusions are regularly relaxing and enjoyable for patients. Vary rarely, however, an infusion may be seem unpleasant; however that does NOT indicate it was a bad session.  Sometimes sessions can be very emotionally powerful; sometimes those emotions can be unpleasant.
  • However, this can be an integral but difficult part of the healing process.
  • Consider the significance of these emotions and consider what there might be to learn from that powerful experience.
  • Otherwise, if you do experience discomfort, distress, or fear, you can always immediately notify your provider. Once the infusion is complete, you can discuss your concerns with the provider with a much clearer head. 
  • As described earlier, though, ketamine is an extremely safe and effective drug, and one unpleasant infusion does not indicate how subsequent infusions will go.
    • For reference, a patient who has been regularly receiving infusions for over three years has had only one difficult session (less than 1%), and despite that experience, they have continued treatment because of the positive impact ketamine infusions has had on their life.
  • During the infusion, you may have the feeling of achieving great insight or understanding. That is great!  However, do not expect to replicate the complicated thought patterns or logic once your session is complete.  These moments are still important though because often the sense of clarity or resolution will persist.  The more complicated thoughts during an infusion will be difficult to articulate once you have completed your infusion.
  • Ketamine can also act as a mild amnestic, so when the ketamine beings to wear off, you may experience the same feeling that you might after waking up and trying to remember a dream. Like a dream journal, though, using the time while the ketamine is wearing off to journal some of your thoughts can be very helpful.
  • Don’t try to fight or attempt to control the effects of the Ketamine. You are in a safe space.  Providers will check in periodically, and they are always there if you need them.  During your infusion, give up being behind the wheel of the car, and instead sit in the passenger seat.  You will get the most out of the ride by choosing and enjoying the music, looking out the window, and reflecting.
  • Ketamine infusions are both profound and enjoyable. Anticipating a good experience will put your mind in the best state to have a positive experience.

Suggested Reflections During Ketamine Infusion Therapy:

An infusion session often feels like it can be a catalyst for major change.  Sometimes, though, it can be difficult to retain the profundity of your newfound perspectives once the medication wears off.  If so, it may be helpful to set an intention or a reflection when you begin your infusion.  By being conscious of this intention or reflection before you begin, then using that as a focus or starting point during your infusion, and then recalling the intention or reflection when the infusion is over, it will help you retain some of the thought processes and perspectives you had during the infusion. 

Reflections on Motivation and Anhedonia:

A near universal struggle for those suffering from depression is low energy, low motivation, and the loss of pleasure or reward (anhedonia).  During an infusion, the dissociation can provide a useful level of perspective.  When there is a degree of detachment from depressed mental processes, it can be significantly easier to recall or envision having motivation, being excited, or feeling enjoyment.  If there are specific behaviors or situations that are the most troublesome, consider the following suggestion for your infusion.

Write down a specific behavior or situation that is problematic because of depression-related numbness and/or lethargy.  Note some of the emotions you have that relate to those issues.  For each aspect of the behavior or situation that you are struggling with, you can either jot down a memory that relates to that situation where you can remember feeling energetic, motivated, enthused, or gratified, or if a memory does not come to mind, then envision yourself successfully overcoming the immediate difficulty—not by interminably suffering through the depressive stupor, but overcoming the difficulty with the energy, motivation, and gratification upon completion that the depression has currently muted.  If that is difficult, look at the emotions attached to the behavior or situation that is bothering you.  Try to connect with the polar opposite emotions that you should feel when overcoming these issues. 

During the infusion, reflect on the behavior or situation that has become problematic because of the exhaustion, stupor, and numbness associated with your depression.  As you consider and reflect on this issue, start reminding yourself of those memories and visions of yourself unhindered by depression.  Try to recall how it felt to be motivated, excited, etc. or how and why you expect to feel motivated and gratified.  Reflect on the dissonance between the two states:  the depression-yoked behavior or situation that is causing you problems and the memory or vision of yourself feeling motivated, determined, and gratified for overcoming the problem.  Try to remember how that version of you felt and try to feel how it felt.  This reflection may not instantly cure or fix any particular issue; however, remembering how it felt to function while healthy and also feeling just a modicum of hope that the darkness of depression can lift can serve as a potent boost to mood and motivation.

Pre-Infusion Journal Ideas

List some feelings you are having towards ketamine therapy 

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 What are some changes you want to see in yourself/your life? 

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4.

What are some areas you are stuck in in your life?

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What do you expect/want to get out of ketamine therapy?

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Reflections During Ketamine Induction

Infusion 1

Date: _________

Pre 1

Overall Mood?

Intention?

Post 1

Insight/ What you learned?

Any challenges/difficult memories/thoughts during treatment?

Determining if Ketamine is Right for You

Ketamine infusions are a big commitment.  It is important to be able to make the most of your infusions.  At Avesta Ketamine and Wellness, with locations in Bethesda, MD and McLean, VA, we are here to help you make the right decision for you.  Contact us for a free phone consultation with one of our practitioners where we can answer your questions about our ketamine process.

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