About 17 million Americans are estimated to have depression, a mood disorder defined by feelings of sadness and hopelessness, and a loss of interest in normal activities. (Prototypical depression is technically called major depression, and it’s one of six different depression disorders.) There are well-established treatments for depression, including psychotherapy and various antidepressants. But for people whose depression is treatment-resistant or especially severe, doctors sometimes pursue less conventional solutions. Enter: ketamine.
Originally developed in the 1960s as a surgical anesthetic, ketamine later became a popular party drug thanks to its hallucinogenic and euphoric effects. More recently, doctors have been prescribing ketamine infusions as an off-label treatment for PTSD, chronic pain and, most notably, depression. Ketamine appears to work well, even when other depression treatments don’t. One study found that up to 85% of people who try ketamine for depression say it’s effective. It also works really fast, alleviating symptoms within days or sometimes hours. Doctors typically don’t administer ketamine themselves. Instead, patients go to freestanding ketamine clinics periodically — anywhere from every week to every few months, depending on the severity of their condition.
There’s some evidence to suggest ketamine alleviates depression by increasing the available supply of serotonin in the brain. Another theory says it helps recreate neural pathways damaged by depression and stress.
What’s it actually like to take ketamine for depression? We talked to five people who’ve done it. Here’s what they had to say.
“After two treatments, I noticed I was laughing again.”
Alice, 40, Virginia
Alice started seeing a psychotherapist at five years old for low-grade depression and generalized anxiety. But her life-long mental health struggles worsened in her mid-20s, when she began experiencing suicidal ideation.
Then, in 2016, she endured her worst-ever depressive episode. “I couldn’t stand the reality of being alive,” she says. Around the same time, Alice, who’s a journalist, learned about ketamine while writing a story about the use of electroconvulsive therapy (ECT) for treatment-resistant depression. While the potential side effects of ECT were too worrisome, ketamine piqued her interest.
Alice reached out to a doctor, whom she also found while doing research for her story, and they prescribed ketamine. She did seven infusions total — two per week for three weeks, plus one booster session a few months later. At first, the process gave her anxiety. “But after two treatments, I noticed I was laughing again,” she says. Alice received her final infusion in October 2018. She’s stable today, she says, but she still takes an antidepressant and sees a therapist weekly.
“The ketamine is carrying all the weight here.”
Trevor, 47, Calgary
For Trevor, depression and chronic pain have always gone hand in hand, each exacerbating the other. Several years ago, he was struggling to find medication that worked to boost his mood. His psychiatrist recommended ketamine infusions, but said actually finding them might take a while. Ketamine was an approved treatment for some conditions in his Canadian province, but depression wasn’t one of them.
Around the same time, a pain management specialist diagnosed Trevor with complex regional pain syndrome, a form of chronic pain in the arms and legs that typically emerges after an injury. That doctor’s proposed treatment? Ketamine. The next day, Trevor went to a pain clinic for his first infusion. His pain improved drastically — and so did his depression. He began weekly treatment.
“I was experiencing major relief for my pain, but what really amazed me was that on my treatment mornings, my kids were so excited to come have breakfast with me,” Trevor says. “They were starting to get their dad back.”
These days, Trevor feels better than he ever expected to. He still gets ketamine infusions about every two months. He also takes a low dose of an antidepressant, which he plans to stop taking soon. “My family doctor said it’s such a low dose, it’s arguably not doing anything,” he says. “The ketamine is carrying all the weight here.”
“It was like I finally saw a bit of light at the end of a dark tunnel.”
Sam, 35, Toronto
Sam’s depression first hit around age 14, when she was forced to give up competitive figure skating. She developed an eating disorder and anxiety around the same time. After several years of ups and downs, her therapist and dietitian encouraged her to see a psychiatrist. Though Sam was eager to feel better, none of the antidepressants she tried worked. In fact, she had a bad reaction to nearly all of them. “It was a really sad way to live,” Sam says.
That’s when her primary care doctor, who was treating her eating disorder, mentioned ketamine. Against her parents’ wishes, Sam decided to try it. Her doctor found a ketamine clinic, and they set her up for three back-to-back infusions starting the following week.
That was September 2017. A week after her first infusion, “It was like I finally saw a bit of light at the end of a dark tunnel,” she says. She ended up going to in-patient treatment for her eating disorder shortly after starting ketamine. There, as her mood started to drop without it, she began getting infusions again. Between those treatments and ED treatment, which involved psychotherapy, Sam saw major improvements in her mental health. For a few years, she got ketamine infusions every month throughout the US, depending on where she was living.
Now that she lives in Canada, where ketamine isn’t as readily available, she plans to travel to the US for maintenance doses when she can — ideally, once a month. She’s also finally found a depression medication she can tolerate, which helps her get by between infusions.
“It showed me it’s possible to find enjoyment and pleasure in life again.”
Jack, 38, Tennessee
At 22, Jack was hospitalized for five days after having a nervous breakdown at work. His psychiatrist prescribed antidepressants, anti-anxiety medications and antipsychotics. Still, over the next few years, Jack checked himself back into the hospital multiple times. He also saw several different psychotherapists for his depression and shuffled between ineffective medications.
About a decade after his first hospitalization, Jack’s father died and he slipped into another depressive episode. He began researching other treatment options and learned about ketamine.
He found a local ketamine clinic and did six infusions in the span of two weeks. While he noticed a general attitude shift almost immediately, he says the real effects started the morning after his sixth treatment. Everything felt less nerve-wracking and depressing. “I hadn’t felt like that in over a decade,” he says.
Jack still struggles with depression and anxiety, for which he currently takes psychiatric medications. He hasn’t had a ketamine infusion in over a year because the treatment is too expensive. But even knowing ketamine exists as an option, he says, gives him hope. He’d get more infusions if he could afford them: “It showed me it’s possible to find enjoyment and pleasure in life again.”
“It’s a night-and-day change.”
Kendall, 32, Virginia
Kendall had been taking antidepressants for 15 years when her psychiatrist told her about ketamine. While she’d managed to overcome an eating disorder, her depression persisted through every antidepressant she tried — and she’d tried pretty much everything out there. At one point, she recalls asking her psychiatrist, “How long do you expect me to stick around for a life that’s not worth living?”
In 2019, she and her doctor found an ER physician who’d opened a ketamine clinic. She noticed a major change in her mood hours after her first infusion. “I’m at the point where I’ve had two years of regular infusions and I don’t really see a dip in my mood anymore,” she says.
Currently, Kendall gets an infusion every five weeks. She also takes an antidepressant, at a much lower dose than she did before ketamine, and continues to see the therapist she’s been seeing for the last five years. When depression creeps up — which it sometimes does — she’s able to rationalize her way out of low moods instead of spiraling further. “With ketamine, I can use the tools I’ve learned to help alleviate my depression,” she says. “It’s a night-and-day change.”
My Doctor may be too busy to tend to his patients. It seems he wants to be more of a tv entertainer. I need a new Doc for many reasons anyway.