This First Person article is the experience of Julian Uzielli, Co-Producer of CBC Radio Podcast Playlist. For more information on CBC First Person Stories, please see Instructions.
When I recline back into the leather chair, I feel a heaviness in my extremities. The strong dose of ketamine I just took makes it hard to move, so I find it difficult to put on headphones and eye shadows. Soothing music calms me into deep relaxation, as my consciousness begins to float away from my body in a world of lights, colors and images.
I’m not into a freshman music festival, or an underground drug den. This fully legal trial is taking place under medical supervision at Field Trip Health in Toronto, a clinic that provides drug-assisted therapy to those with treatment-resistant mental illnesses such as depression and post-traumatic stress disorder.
The clinic, which was the first of its kind in Canada, opened last year. Since then, similar clinics have opened in Quebec, Alberta, Saskatchewan, British Columbia, and Nova Scotia.
Ketamine was first approved for use in Canada and the United States as a general anesthetic over 50 years ago. It has since gained a reputation as a party drug, with names like Special K or Vitamin K.
Today, it is increasingly used as a fast-acting and effective treatment for depression. But it is not without controversy.
I’ve dealt with bouts of depression and suicidal thoughts for as long as I can remember. By the fall of 2020, after months of isolation due to the COVID-19 pandemic, my depression was as bad as it had ever been.
I am no longer able to function normally. I struggled to perform simple tasks and lacked the motivation to take care of myself. Increasingly vivid thoughts of suicide began playing into a loop in my mind.
I was willing to try anything.– Julian Uzilli
“It was such a bad day that you weren’t able to get out of bed,” my wife Danielle said. “Literally being so depressed that you can’t move.”
In this case, I came across the Field Trip Health Clinic website for the first time. I was suspicious at first. I’m usually skeptical of anything you would put under the “alternative medicine” umbrella, and the site’s use of modern health phrases like “your healing journey” has raised some red flags.
And besides, I was willing to try just about anything.
Medically Punished Drug Trip
The treatment took place over three weeks, and consisted of six ketamine sessions with talk therapy sessions without treatment in between. Each session of ketamine lasted two to three hours.
At the beginning of each session, a paper cup with ketamine tablets was handed. I let them melt in my mouth and rinse for 10 minutes.
When the medication spread, I felt as if my consciousness had been separated from my body. remind me “the sunken placeFrom the horror movie of 2017 Get outHowever, instead of being intimidating, it was comforting and calming.
The experience was strongly influenced by the music carefully selected by the therapists. As he swelled to an escalation, I felt as if I was rising with him, on the tip of a rocket exploding into space. When I calmed down, I felt like I was floating.
By the end of the three weeks, I felt like a new person.– Uzeli
Strange as it may sound, this experience had a huge impact on my mental health. After the first session, my mood improved. After the second, I felt that my view of life was also improving. By the end of the three weeks, I felt like a new person.
Of course, like any medical procedure, this treatment does not work for everyone. And there are certain mental and physical conditions that can make you ineligible, such as schizophrenia or uncontrolled high blood pressure.
But for me the end effect has been the ability to fix my problems and heal my mental wounds – not just a bandage, as I’ve been doing with traditional antidepressants.
How it works
When I asked Dr. Yulia Kniahnitska how ketamine works as an antidepressant, she smiled and laughed.
“The very simple answer is that we actually don’t know, because it works on so many levels,” she said.
Knyahnytska — her patients call her Doctor K — studies the effects of ketamine on depression. She is a physician and scientist at the Center for Addiction and Mental Health (CAMH) in Toronto.
She said that when administered in a clinical or therapeutic setting, ketamine is able to safely and effectively relieve symptoms of depression in just hours.
But scientists do not yet fully understand how and why they are so effective.
One theory relates to synaptic plasticity – the brain’s ability to form new connections and repair existing connections. Ketamine is known to cause an increase in glutamate, a neurotransmitter found in more than 90 percent of synapses in the human brain.
“It leads to the production of new connections and improved brain connectivity,” she said. “How do you do that exactly? We don’t know yet.”
Dr. Ishirat Hussain, a scientist and psychiatrist at the Center on Addiction and Mental Health in Toronto, said Present Last March, while some studies of psychedelic treatments including ketamine were promising, they should be viewed with a “critical lens.”
He said many of the studies include a small number of patients as standard for clinical trials, often without the placebo group, or comparisons with available standard treatments.
Barriers and fears
Given what is currently known and unknown about the drug, scientists have mixed feelings about the recent rise in private ketamine clinics.
Unfortunately, the lack of regulation and lack of oversight can do some harm to patients.– Dr. Yulia Knyahnitska
“This is very difficult. People need treatment,” Knyanitska said, noting that the epidemic Paid depression rates to alarming levels.
“It is understandable that people are looking for treatment and that it is difficult to access and that people need something to feel hopeful about.”
Knyahnytska noted that when abused, ketamine can be addictive and can have unintended consequences such as psychosis.
“It’s not something we should take lightly,” she said. “The lack of regulation and the lack of oversight unfortunately can do some harm to patients.”
There is another problem: the cost.
My treatment set me back $4,700. It was worth it, but I know how privileged I am to be able to shell out that kind of cash in the first place.
Other clinics I searched in Toronto have similar prices. A handful of Hospitals I started setting up grant-funded programs that are free to patients, but waiting lists can take months.
Five months after I finished the program, the positive changes stopped – for now.
I no longer struggle to get out of bed and feel motivated to take care of myself. I have a more optimistic outlook, and I’ve been planning ahead – something that once seemed pointless to me. People around me have noticed.
My parents were “amazed”. My wife says I’m like a ‘different person’. My therapist even went so far as to use the word “miracle.”
Without long-term research on the effects of ketamine therapy, there is no guarantee that my depression will not return at some point.
But I learned first-hand how incredibly powerful this remedy is. So if and when my depression does return, I will be prepared for it.
About the product
This documentary has been blended and edited by Andrew Friesen, with Acey Rowe. Contains clips from Bojack Horseman, Trainspotting and “Passage to Silence” by Iceblink, The Harvard Divinity SchoolAnd “Doctors”, “Al Jazeera”, “Deputy”, “ABC” and “City News”.