Gratitude and Long Island Iced Teas

Once upon a time, several years ago, I attended a concert with some work friends at a bar called 3^rd and Lindsley in Nashville.  I was working at GBOD and invited a few work friends to go with me to see my new pastor, Sherry, sing with her old band, The Evinrudes. We had a great time and it was a great show. However, I may or may not have had one (or three)-too-many long island teas. I graciously accepted a ride back to our work building from my friend Suzanne. I hopped in the passenger’s seat and we headed back downtown. I was feeling nauseous, so I rolled down the window and hung my head out into the cool air. I yelled at random strangers and then I had this odd, warm sensation from my seat. I immediately worried that I had peed in Suzanne’s car, but I leaned my head back in and shouted, “Suzanne!! My ASS IS ON FIREEEE!!” She cackled, and then advised me that I had somehow turned on the seat warmer. Crisis averted.

There is a point to this story.

During my last treatment on Friday, everything went great. Nurse April performed her magic with the IV and I began my infusion. The first sensation I had was gradual warmth that started in my lower extremities and flowered out until it reached my fingers and toes. It was a pleasant feeling—not too warm—then came the marshmallow clouds. I wish I knew the words to use to describe this feeling, but I don’t. I wish I knew the words, because here I sit, compelled to find them. But, wherever those words exist, they belong to the Universe. What I can do is take off my shoes and recognize the presence of the sacred in this experience.

I won’t try to describe the specifics of this experience, because once again—it was a highly personal experience and I want to honor that by keeping it to myself. Besides—how does one truly describe the way a marshmallow separates into sinewy, sticky pieces when pinched and stretched by one’s fingers?

However, I will say this about the experience: I have curated the perfect playlist (for me) for a one-hour infusion. The songs I included are mostly classical piano. I cannot emphasize enough how important your music choice is for the experience. The music literally carries you through the one-hour journey in your mind. I recommend no lyrics, no fast-paced rhythms, nothing with an overpowering bass line. It took all six treatments and using trial and error to decide which songs worked best for me.

 Here’s the list of songs that make up my “perfect” one-hour playlist:

Moonlight Sonata (1^st movement)

Piano Concerto in A Minor, Op. 7: II. Romanze: Andante non troppo  con grazia

Clare De Lune (Debussy)

Chopin—Nocturne Op. 9 No. 2 in E Flat Major

The Well-Tempered Clavier: Book 1, BWV 846-869: 1. Prelude in C Major

Vivaldi Variation (Arr. For Piano from Concerto for Strings in G Minor)

Adagio Sostenuto

Gymnopedie No. 1 Lent et douloureux

Minuet in A Major, D. 334

Ave Maria-Charles Gounod, Yo-Yo Ma

Nocturne en mi bemol majeur opus 9 Ballade en sol mineur no.1

Liebstraume, S541/R211: No. 3: Nocturne in A-Flat Major

Suite bergamasque: Suite bergamasque: III Clair de Lune. Andante tres expressific

Piano Sonata No. 12 in F Major, K. 332: II. Adagio

Again, this is my personal playlist, so you should choose whatever works best for you. But I have found these particular songs to be the most helpful to keep me relaxed and to allow my mind to float with the rhythm of the music.

Now—what you’ve all been waiting for—the results…please hold your applause until the final results are read. JK. Clap whenever the hell you want to.

I am getting better. I have reached the point in my treatment where I have begun to see the light at the end of a long, dark, nightmarish tunnel. Last week when I started the treatments, I wasn’t even convinced that the light existed for me anymore. I was sure that all hope of ever seeing that light was gone. After all, it had been months of living in the dark and carrying around the weight of the heavy, deep depression.

I began the treatments without really believing they would work and planning on finishing them out and ending my life.

However, progressively, with each passing day and each treatment…I began to have something that I had been longing desperately for, for months on end. Hope.

Dr. Self believes that I am exactly where he expected I’d be after 2 weeks of treatments. It was his belief, and that of my nurses and family and friends, that I grasped with my heart and my hands and held on to with all my might for the past 2 weeks.

My general mood has become lighter—less irritable, less intense reactions to things. I feel calmer and less agitated. My hands still aren’t shaking—which in and of itself is a miracle. I wake up and my immediate thought is no longer wishing I had died in my sleep. I have more energy, I can think past the next “moment”, I can feel the difference in my body, mind, and soul.

Friends, there just aren’t words. Just like there aren’t words to accurately describe the whole experience of receiving ketamine infusions—there aren’t words for the changes I’m seeing happen in my own spirit. There is only deep, deep gratitude. Gratitude for the changes, gratitude for the doctors who collaborated to provide this treatment option, gratitude for the friends and family who have stood by and walked with me on this journey, gratitude for the many friends and family who have reached out to me over the past couple of weeks and offered your words of support, prayers, and kind thoughts. Specifically, gratitude for Sara—for if it had not been for her support through the worst weekend of my life—I would, without a shadow of a doubt—not still be here.

Thank you.

Thanks be to God for each and every one of you—and for this life that I get to continue on my adventures.

All You Need for a Tuesday

 My precious friend was my rock a couple of weeks ago. If not for her support, I can say without a shred of doubt, that I would not still be alive. She shared this on Facebook today and I’m re-posting because maybe someone who reads this will reach out to someone who will listen without judgment, allow them to be depressed, and remind them that there is light. 

“I hadn’t shared anything about Mark since his passing, because I haven’t spoken to him in 20 years. It feels strange to be so sad over the loss of a friend when you hadn’t been friends since entering adulthood. 

Mark lost his battle with mental illness. I know suicide is so hard for people to understand. It can seem selfish and thoughtless. The irony of the loss of Mark is that within those same days, I was in close contact with a sweet friend who was confiding in me that she didn’t think she had any fight left in her. Mental illness has weighed her down for years and there have been multiple times that she has wanted to give up. This time was different though. I knew she was holding on the the last shred of life she could. I knew she was serious. I knew that she was going to end things. Her treatments weren’t working. The system wasn’t working. And she was exhausted. From 2 different states, we talked extensively about her wanting to go and me wanting her to stay. We discussed who would hurt and how they would hurt if she left. We talked about the reality of her suffering and the hopelessness she was feeling. It was Saturday when she promised me she wouldn’t end it until Monday after her appointment with her dr. We talked about why she would keep that promise, and we talked about how I understood that Monday was all she could give me. I understood that there was no Tuesday for her. 

When Monday came, her dr heard her desperation and began her on a new treatment. She was given a little shred of hope, and because of that she found her Tuesday. She’s made it many more days since then, and she’s living again, not because she promised me she would, but because she again sees there might be a reason to keep going. 

I hadn’t talked to Mark in 20 years. But I know of at least 20 other people, who probably also hadn’t had contact with him that would have sat with him and made him promise to give us until Monday. I so wish he had known that so many of us would have sat with him. 

Mental illness is such a thief. It takes everything that it can. People don’t end things because they are selfish or thoughtless. They end them because they have stayed as long as they could possibly figure out how to. Those of us that don’t struggle this way can’t possibly understand how hard it is to keep going. And the system is hard and often not helpful and the illness is unrelenting. 

If you are struggling, please reach out. There are new treatments coming out that are making great strides in defeating devastating drug resistant depression. New advances are happening all the time. One tiny sliver of hope is all you need for Tuesday.”

Fix-A-Flat

I had my 5th of 6 treatments this morning. The experience was similar to previous experiences, but also equally different than any other thus far. 

Dr. Self came in and checked in with me. He said that my PHQ-9 scores have come down some from when we started and that I am exactly where he expected me to be at this point in the process. That was reassuring. I trust his judgment and if he believes I’m headed in the right direction, then I will try to believe it, too. 

Super Nurse April came in and twirled around in her cape before aptly placing my IV and checking my vitals. 

This began my treatment. I came up with a better description of the initial feeling from the treatment. Instead of marshmallow clouds, it’s like lying on your back in a shallow box with a lid, then having someone squirt fix-a-flat into the box so that it expands and covers every inch of your body. This probably sounds slightly terrifying for anyone with even a hint of claustrophobia--but trust me, it’s one of the most pleasant feelings I’ve ever experienced. It is in this encapsulated vessel that I travel from thought to thought to thought. 

Today’s trip involved thoughts about life, the vastness of humanity, and the incredible difference we each have the opportunity to make in our worlds. 

We left the clinic and ran a couple of errands. We came back to the hotel and mom went out to walk on the beach while I had my therapy session with Christina on the computer. 

At some point during my treatment with Christina, I began rating myself on a scale of 1-10, with one being the best possible and 10 being the worst. At a 10, I have lost all hope for a better future and want nothing more than to stop living--whatever that looks like. 

Today, I rated myself at a 4-5. It’s the first time in several months that I’ve been anything less than a 6, with most of my days averaging around 7-8. 

Christina asked me how it felt to say that out loud. I told her it had been a hot minute, but that it felt really good. I also admitted that it was completely terrifying because it’s different than I’ve been for a long time and "what if it doesn’t last?"

She encouraged me to celebrate the moment and count this as a win. 

After my therapy session, I put on my bathing suit for the first time in 2 weeks and grabbed a towel and headed out for the beach...only to find that it had begun to rain. Go figure. 

When mom came back to the room, I asked her if she’d like to go out to Hobby Lobby. I wanted to buy some yarn so I could crochet while we’re here this week. We went to Hobby Lobby and I told my mom about how excited I was to be at a 5 or below today. We celebrated by stuffing ourselves full of garlic bread and salad at Olive Garden. 

We are back at the hotel and I am whipped. But, friends...I’m at a 5 today. 

A FREAKING FIVEEEEE. 

Praise the Lord and pass the bread sticks!

Chewing Concrete

Today’s treatment was...weird. Not great, not terrible...just weird. 

I got off from work at midnight and went straight to bed. At 4am, I woke up and used my index card list to make sure I packed everything and didn’t leave anything super important behind. (I once went snow skiing without packing pants.) Mom got to my house around 4:30am and we hit the road. She had laid the seats down in the back of her Murano and made a whole little bed.

Y’all. 

This woman. 

I crawled into the back of the car and laid down on the pallet my mom had made and conked out. I woke up around 8:30am, long enough to eat breakfast, and went back to sleep. 

When we got to Ormond Beach, it was around 1pm. We were too early to check into the hotel, so we grabbed lunch at La Catrinas. Let me tell you...guac to die for. 

After we ate, I went for my 4th treatment at Life is Ketaful. 

Dr. Self came in and checked in on how I’d done this weekend and whether I’d noticed any changes to my mood/affect. I told him that Saturday was a decent day. Sunday was miserable. I described the brief lifting of the weighted blanket I’ve been carrying around on my shoulders. He felt good about what I had to say and he said I’m pretty much where he expected me to be at this point. 

Today, we cranked the dosage up a bit more, but less aggressively. 

From the time I hit my head on the sun visor in the car before going into the building to the moment when that needle hit my arm—I was agitated, aggressive, irritated, and just plain grumpy. 

When the treatment started, I realized the playlist I had chosen was not going to work. Throughout this treatment, I changed playlists about 3 times. The music never was quite right. I think my vibe and energy going into the treatment was off, which made it harder to relax and allow myself to fully lean into the dreamlike wave that I have experienced during other treatments. 

At one point, my mom changed my playlist for me and I sat up straight and asked her, “are you mad at me??”

Of course, she wasn’t—but something was just “off” this time. It wasn’t as enjoyable as the previous times. 

At one point, I had a conversation with Bill W. and he told me that I have a voice and words that need to be heard. That was pretty damn awesome. 

After the treatment ended, mom and I left the clinic and headed to the hotel. 

I am literally feet away from the ocean at. This. Moment. 

Ocean therapy is a go. 

Also, there’s a badass pool right outside my room that faces the ocean. So I can swim in non-salty water and still have the beach experience. Most people think I’m salty enough. 

I am going to crash tonight and wake up tomorrow ready to face whatever Tuesday decides to throw at me. 

My Hands Aren't Shaking

 Again, much of Thursday is a blur of sleep, episodes of “The Great”, and, well, sleep. I slept a lot on the days when I didn’t have a treatment—I was making up for years of restless insomnia. Or—let’s be real—I was just freaking tired.

Friday morning, we packed up our hotel room and hit the road for the 10-minute drive to the “Life is Ketaful” clinic. We arrived and my treatment was started. This time, we were shooting for 90-95% dosage and I was more prepared for the experience than I had been either of the other times I had a treatment. I knew, somewhat, what to expect and I had made a playlist especially for this time.

The floating experience I had felt during the second treatment returned and I was carried from the room on a wave of classical music and marshmallow clouds. I also saw many pieces of crocheted yarn. They were beautiful, bold colors and they made up a dream-catcher that I felt was created especially for me.

I don’t want to describe the details too closely, because I feel that this part of my journey is incredibly personal and I don’t want to insinuate that anyone else’s experience should be exactly like mine. However, I will say that it was a unique, wonderful experience and I am thankful to have had it.

After the treatment, mom and I left to come back to Dothan. It is a 7 hour drive, and we took turns driving. We stopped for coffee and I held up my hands in front of me. I looked at them—examined them in disbelief—and I said, “My hands aren’t shaking”. For the first time in years—my hands weren’t shaking from anxiety. I was mesmerized as I stared down at my still fingers and palms.

I was hesitant to say much else about how I felt because I was afraid that it wouldn’t last. The truth is, I felt lighter and as if the weighted blankets I’d been carrying for months had lifted off of my shoulders for a moment of relief. I knew the weight was still there and I knew that I wasn’t completely out of the dark, but for the first time in months, I also knew that light existed somewhere. I can’t put into words how it feels to go from believing that there is no light left in your world, to knowing deep within your soul that the light exists and there is hope of seeing it again one day.

Saturday and Sunday I was tossed—not-so-gently—back into the real world as I worked the two 16-hour shifts I was scheduled for on both days.

I have no idea what the future holds, but I feel like I’m headed in the right direction. I will get home at midnight tonight from work and my mom and I will leave around 4am heading back to Ormond Beach for the remaining 3 treatments I have left.

I am acutely aware of just how many people are praying, sending good vibes, and reaching out to me during this journey. I am incredibly blessed to have a wonderful support system, and I am immensely grateful.

Marshmallow Clouds

Tuesday was a blur. I slept most of the day away in the hotel room. Wednesday morning, I woke up early and showered and straightened my hair. It’s the first time I’ve felt like “getting ready” in a long time. Mom brought back a waffle from the continental breakfast and I devoured it before we headed to the clinic for my second ketamine infusion treatment. I was still feeling listless and didn’t have much hope that this treatment would be any different than the first one—which I felt had no effect at all.

At the treatment clinic, I went into the room with the recliner and mentally braced myself for a terrible experience with the IV placement. April, the wizard nurse, came in and before I could say, “ouch!” I was hooked up and receiving my infusion. This woman deserves a medal…or maybe a dipped cone from Dairy Queen. Either way, she’s golden in my book.

During this infusion, I had made a playlist of some classical music without lyrics and I played it when the treatment started. The room was dark, but not too dark. I leaned back in the recliner and allowed myself to be carried by the music.

The experience is a bit hard to describe. I felt like I was lying flat on my back and surrounded by a marshmallow cloud. I felt warmth throughout my body and my breathing was easy and relaxed. I don’t remember a time in my life when I felt more relaxed. My soul was at peace. I had a million thoughts going through my head, but they were all pleasant and curious. I repeated the word “marshmallow” in my head over and over—each time the word became more bizarre.

Marsh…mallow…mellow? Mallow…marsh…mallow…marsh—why marsh? Marsh…mallow.

I thought that the loss of control I was feeling would create anxiety for me, but it was just the opposite. I just leaned into the dissociation and allowed myself to be carried through the waves by the music, which was perfect.

At one point, I heard a loud scratching noise and was pulled out of my dream-like state. I heard a sloppy slurping sound and said to my mom, “What are you doing???” She was writing thank you notes and sealing them by licking the envelope.

Every one of my senses was incredibly heightened—including, or especially, my hearing. I leaned back into the chair and allowed myself to float away on the marshmallow clouds. Marsh…mallow…mallow…

After about 50 minutes of blissfully floating around in my brain, I began to “come down”. I would describe this feeling as a reality check. I opened my eyes and began to allow my vision to focus on things around the room. They still moved as if they were alive, but I could make out specific things around me. The curtains, the window, my mom in the chair across the room…

As soon as the treatment ended, it took me about 10 minutes to become less dizzy and fully present.

Immediately, I missed the feeling from the treatment.

I hopped out of the chair and was ready to go. My mom had promised me a pedicure in exchange for doing her a favor last week. This was my second “treatment” of the day.

The overwhelming feeling I felt for the rest of the day was exhaustion. I still didn’t feel like the treatment did much for my depression, but I was so exhausted, it was hard to tell.

That night, I resigned myself to the fact that I must fall within the 25-30% of people that ketamine is not effective for. I was extremely disappointed, but not devastated. I spent a lot of time in therapy and alone, preparing myself to set realistic and reasonable expectations. Although, there was a part of me that wanted to indulge the feelings of hopelessness and despair—I pushed through and tried to accept the fact that I’m just a weirdo and this wasn’t the right treatment for me.

Around 3 o’clock in the morning, I woke up. I was startled because I had woken myself up cackling. To this moment—I have NO idea what was so funny, but I was laugh-snorting in my sleep so hard that I woke myself up. This may seem insignificant enough, but let me explain why this was such a gift. I have terrible nightmares called night terrors. I wake up crying, screaming, or panicking (or some combination of the three) a majority of the time that I sleep. To wake up laughing was a welcome, hilarious surprise.

Maybe there was something to this…maybe this meant that the medicine was doing something in my brain that I couldn’t feel or process yet…maybe this meant that there was hope.

Life is Ketaful

My first ketamine infusion treatment was Monday August 31, 2020. Mom and I traveled from Andalusia to Ormond Beach and checked into the hotel before heading to the clinic for my treatment. I was extremely anxious--particularly about the IV (I have lived horror stories when I’ve had to have IV’s placed before). I was fearful about the ketamine treatment, but I had done plenty of research and I fully trusted Dr. Handal’s referral to this specific clinic near Orlando. 

When we arrived at the clinic, my first impression was how good the room smelled--like real lavender--not the fake shit you spray from a can into the air. I met Shannon, the administrative person, and April, the nurse. They took me to a room with a single reclining chair and a small chair for my mom to sit on. I saw the machine and lots of wires and tubes and my anxiety was cranked up a notch. Dr. Self came into the room and introduced himself. He was very patient and very kind as we asked (what had to be the same as hundreds of other patients) questions about the treatment and what the next couple of weeks would be like. He explained that the first week we would spend titrating to the full 100% therapeutic dose that we would be using during the second week of treatment. He said that we would start about halfway with a 50% dose, increase the next session to around 70-75%, and end the week on Friday with a 90-95% dose. By the time he finished answering--mostly my mom’s--questions, I was less anxious and more ready to get started with my first treatment. 

The nurse came in and I warned her that starting an IV may be tricky, but she pulled out some kind of Harry Potter wizard shit and before I knew it, my IV and treatment started. After about 8 minutes, I began to feel like the room was spin-y. I took the advice of the articles I had read and flushed it all down the toilet. I decided that I knew better than those people and I would prove that I was unaffected by the ketamine "trip". I began texting my friends. I told my best friend in the whole world that in a picture where she was sticking out her tongue; her tongue looked like a penis. I advised another dear friend that I was going to stop texting her and go breathe--because clearly one cannot text and breathe at the same time. I called my sister who lives in California. The one time she ever answered--it was this time. She heard some random mumblings about how the medicine was a miracle drug and that I wished I could live this way in real life. The nurse came in and offered my mom a separate room to take her phone call--and then she realized it was me on the phone. I explained--sort of--that it was my sister and she lives in California. I say sort of because I was trying to speak, but my mouth felt like concrete. I apologized for being on the phone and quickly hung up on my sister. I handed my phone to my mother and relaxed and closed my eyes. 

This is when I began to feel as if I was "coming down" from the wave I had been riding. Unfortunately, I spend the rest of the treatment--about 40 minutes--on this "downside" of the wave and I didn’t return to the height I had been at for the remainder. This was disappointing, but the doctor assured me that it was perfectly normal. He also encouraged me to ditch the phone for the next treatment and play some music without lyrics to maintain the ethereal yet pleasant feeling I had felt during the first treatment. I left the clinic, slightly embarrassed to have wasted the better part of my first treatment fighting the dissociation and clinging to the world via my phone. 

I had spent hours talking about and preparing myself for the realistic possible results from the first treatment. However, the pink kid in me clung to the articles that talked about an immediate effect and how their depression had faded completely within the first session of their infusion treatment. It was these articles that precipitated the disappointment that I felt that evening when I realized the heaviness was not gone and the darkness was still palpable. 

I was exhausted--physically, mentally, and emotionally. I felt like giving up, but I decided to stick with it and see what would happen over the course of the next couple of weeks. I slept most of Tuesday--so much for being a beach bum and pool bunny. I didn’t leave the hotel room for more than 24 hours. I decided on Tuesday night to force myself to enjoy the view and watch the ocean from the balcony for a little while. 

Before beginning my treatments, I was convinced that the depths of depression I had been experiencing could not be any more horrible. I think that feeling the hopelessness of having been through the first treatment and not experiencing some miraculous baptism into mental wholeness was as devastating as what it felt like to lie on the floor at my job, sobbing, desperately clawing the concrete because I didn’t know what to do with my hands. 

Thankfully, this is not the end of my story.