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Accessibility statementSkip to main content Democracy Dies in Darkness SubscribeSign in Advertisement Close The Washington PostDemocracy Dies in Darkness Well+BeingMind Food Fitness Body Life Well+BeingMind Food Fitness Body Life Voices WHAT DOES KETAMINE FEEL LIKE? I KEPT A DIARY OF MY SIX TREATMENTS. By Annabelle Gurwitch March 23, 2024 at 9:04 a.m. EDT (Illustration by Laura Padilla Castellanos/Washington Post) Listen 9 min Share Comment on this storyComment Add to your saved stories Save As I considered ketamine therapy for anxiety, I wasn’t looking for spiritual rebirth. I just wanted a straightforward brain tuneup, like getting a car serviced. In 2020, I was diagnosed with Stage 4 lung cancer. My body was treated with targeted therapies, but emotionally, I was vacillating between existential dread and crippling anxiety. Antidepressants, talk therapy and meditation couldn’t make a dent. I couldn’t summon the willpower or prolonged attention span needed to tackle my taxes or the unfinished writing assignments strewn across my desk. WpGet the full experience.Choose your planArrowRight Maybe ketamine could help? I found my way to a Los Angeles-based clinic that specializes in ketamine therapy, using a form of the drug called esketamine. Story continues below advertisement Each visit would cost $675, and after three denials, I won approval for coverage of approximately 70 percent of the cost. Advertisement I told my doctor that I was skeptical of quick fixes and was not interested in psychedelic tripping. “Tripping is not an essential part of getting well with ketamine,” he said. A week later, I arrived for the first of six sessions, scheduled over a period of a month. Before each session, my anxiety and depression levels were measured through a questionnaire “scoring” system. I made an audio recording of each session and took notes afterward. Here’s my ketamine diary. SESSION 1 I aced my anxiety test! I got the highest score possible, only, that wasn’t something to celebrate. My score indicated “severe” anxiety. Story continues below advertisement I am in a windowless but pleasant treatment room painted a soothing robin’s egg blue, seated in front of a painting of a serene ocean with grassy dunes on what amounts to a comfortable dentist chair. Advertisement The doctor instructs me to inhale, but not too forcefully, to receive the 50-milligram dosage of esketamine, a nasal spray version of ketamine. The doctor tells me he will monitor my blood pressure, which will rise and then settle to a normal level during the hour we’ll spend together. He warns me that the ketamine will have an acrid taste which I can offset with a lollipop. He’s so thorough in reciting the choice of flavors, it has an almost liturgical quality: tangerine, raspberry, cherry, grape, chocolate, caramel. Story continues below advertisement I choose caramel. Nervous. “Talking relaxes me,” I tell him. Then 20 minutes pass. “I feel floaty, spacey, woozy — like a sea sponge, a collection of porous cells.” Should I close or open my eyes? Dizzy. Close eyes. Warmth. “I am aware I am speaking slowly,” I say. Open eyes. “The grasses on the dunes in the painting are sucking me in,” I say. Advertisement The doctor reassures me that I’m not hallucinating. “The canvas is three-dimensional,” he says. This painting seems ill-advised in a ketamine treatment room, I think, but don’t say out loud. Numbness. A disappearance of chatter. Am I a character in the psychological thriller TV series “Severance” or am I inhabiting my own life? I’m not sure. Story continues below advertisement “I can confirm that I’m not interested in an altered state,” I say, and ask if William Hurt in the movie “Altered States” actually devolved into a Neanderthal or did he just imagine it? “Do I still have all my fingers?” (I did.) “I’m not sure I can ever stand up again. (I could.) My head feels fuzzy when I stand up, and I’m glad I’d arranged for someone to drive me home. Afterward, I took a nap, continued with my day, feeling essentially unchanged. SESSION 2 My mood assessment test seemed to indicate less depression and a dramatic decrease in anxiety, but I’d left some of the form blank, instead scribbling in: “maybe a bit less anxious” and “less worrying.” Advertisement Story continues below advertisement This time I ask for a raspberry lollipop to mask the taste. The doctor suggests upping the dosage, but I want to proceed cautiously, so I snort the same 50-mg dose. Woozy feeling. Sea spongy. Slightly manic cocaine feeling (a remembered sensation from the 1980s). I am talking about myself. I tell him folksiness annoys me. “Macramé is triggering.” (I have no idea why I said this.) “I feel a flying feeling that I don’t like, thoughts are coming faster than usual.” “Do you think ketamine is an extreme thing to do?” He does not. Afterward, I took a nap, continued with my day, essentially unchanged. SESSION 3 Instead of filling out the mood assessment questionnaires, I write “having bird by bird issues,” a reference to Anne Lamott’s “Bird by Bird, Some Instructions on Writing and Life.” The title refers to there being no shortcuts, only slow and methodical due diligence in writing and, by extension, life. Advertisement Story continues below advertisement My doctor gently explains that the office staff is “flummoxed” by my refusal to fill out the multiple choice questionnaires. I try to explain that if I wasn’t already feeling overwhelming anxiety, checking off boxes on a test elicits the same panic I’d felt facing down the math portion of the SAT. Share this articleShare Flummoxed myself, and feeling as though I’ve let the office staff down, I accidentally switch off my recording before receiving the ketamine. My notes are spare. Back to caramel. Sea spongy. SESSION 4 Despite my doctor’s admonitions, I leave the majority of the form blank, noting, “Still having looping thoughts but perhaps (I feel) a bit of relief.” Caramel lollipop. Story continues below advertisement We raise the dosage to 60 mg. After 20 minutes, I am in the film adaptation of Frank Herbert’s “Dune,” the 1984 version. Why am I in a movie that was universally panned, I wonder? Advertisement In the film, characters ingest a psychotropic substance and have visions of beads of oil dropping into a pool of water. I’m inside the drop. I’m in a shower. The water raining down on me is flecked with gold. I’m swimming with my sister in the warm tranquil water off the Atlantic coast at Martha’s Vineyard. I am standing in the sand, gentle waves lapping at my toes. Or am I the sand? I’m inside a wave, a churning tunnel of water. I feel tipsy. “This is awful,” I say. The doctor instructs me to make my way back to calm water. I’m able to do that, but now my head has turned into a lava lamp. A tsunami-like blood orange blobby wave splashes across my field of vision and washes my brain away. Story continues below advertisement “My looping thoughts have disappeared, but so have all my thoughts,” I say. “I’m not here to get nirvana in nasal spray,” I tell him. But I get it anyway. Advertisement “I’m the happiest sea sponge in the ocean,” I say. I am everything, and I am nothing. A few minutes pass. My skull, which had melted away, hardens back into a protective shell. “I don’t think I can endure this anymore,” I say. The doctor doesn’t upsell me. He suggests I review my notes and circle back. SESSION 5 I skip the questionnaire and scrawl: “probably feeling a bit of a lift.” Caramel again. I snort the 60 mg. “I really don’t like the druggy experience. I’m not looking for anything recreational.” “Some clinics advertise it as such, but that’s fraudulent,” my doctor says. He tells me the goal is “turning down the volume on anxiety.” When the ketamine kicks in I feel a little manic. “I need to stretch my tolerance of fear. Physical pain, getting IVs, the unknown timelines for my treatment scare me,” I say. Advertisement “I’m able to experience joy, but I need to recalibrate how to live an ordinary life.” “I don’t want to be doing this on a regular basis,” I say. Afterward I nap, the day proceeds uneventfully. SESSION 6 The assistant inks a large question mark instead of tallying a score because I’ve left most of the assessment form blank. We’ll always have caramel. “I’m not sure the ketamine is enough of a game changer to consider further treatments,” I say, 20 minutes into the session when the drug hits and my brain begins to melt. I ask how his other patients know the treatment has worked. “People report that they can take things more in stride,” he says. “I’m not doing a happy dance, but I’m handling things,” I respond. I am talking too quickly. “I don’t enjoy this,” I say, when the spongy feeling dissolves the space between me and the world. “This will be the last time I see you for a while,” the doctor says, and I laugh, momentarily unsure if I am on a date and being broken up with, or with a therapist. “I woke up feeling different [today] … maybe better?” I am talking too slowly. I say that I have run out of willpower between “managing the disease and being a creative person.” At the end of the session, the doctor says he hopes I will see benefits and will check in with me in a few weeks. AFTER THE TREATMENT During the next months, I watched and waited for notable changes in my brain function. I was surprised to see that on my final assessment form, I’d reported feeling (maybe) 10 percent better than at the start. But was that a placebo effect or wishful thinking having invested what represented a significant amount of money and time? A friend who uses ketamine under medical supervision and recreationally described that “floating along on the current” feeling as “peaceful,” and “liberating.” After his sessions, he feels as though “the muck of inaction has been removed, culling the little voice in my head that tells me I’m stuck and will stay stuck forever.” A year later, I’m still not convinced that the ketamine infusions benefited me in any measurable way. I did attend to my taxes, and I did finish that stalled writing project, but I had to do it “bird by bird.” I am still facing my mortality and being the happiest sea sponge in the ocean, albeit briefly, didn’t make it any easier. The only thing that’s helped is an acceptance that it’s hard. Annabelle Gurwitch is an actress and author whose most recent book is “You’re Leaving When? Adventures in Downward Mobility.” READ MORE FROM WELL+BEING Well+Being shares news and advice for living well every day. Sign up for our newsletter to get tips directly in your inbox. Vitamin B12 for fatigue has no proven benefit unless you have a deficiency that causes anemia. Flashes, shimmers and blind spots: Here’s what migraine aura looks like. Sparkling water is a better choice for your teeth than most popular beverages. You can help your brain form healthy habits and break the bad ones. Our 7 best tips to build an exercise habit. Share 571 Comments Loading... Subscribe to comment and get the full experience. Choose your plan → Advertisement Advertisement TOP STORIES World news Essential reporting from around the world What to know about Senegal’s wide-open elections Five holy events and holidays are packed into late March. Here’s why. 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