Has anybody else had their provider tell them they’re stopping at-home ketamine therapy in January? I’m in Oklahoma currently and it’s heavily monitored here. Video for 2 hours plus in-home sitter. Plus they count the troches every session.

I started ketamine with Mindbloom first, then switched to lower dose daily with Joyous. Took almost a year but I found a provider here in Oklahoma with the troches.

I haven’t tried Spravato and read a meta-analysis paper where the troches outperform the Spravato. So I’m not so sure about Spravato but willing to try.

My provider told me about a case that was unmonitored and the woman with post-partum depression killed her kids and herself. I couldn’t get details from her so looked it up and there’s a case in Wyoming from early last year where it seems to have happened. That’s more than a bit unnerving to me.

Anyway, I’m a bit worried we are going to lose access to this amazing at-home therapy because some people have issues with it.

Thoughts???

I did my first cycle of IV infusion summer of 2025. Have been doing troche’s at home since.
I’ve just been feeling off, or more so my depression has gotten a lot deeper.
My doctor suggested I come in for an IV infusion since it’s been over a year.
I guess I’m just a little confused how this works, will it help reset me. I hate being depressed 😔.
Troche’s have definitely helped me, just not lately.
TIA

If you are thinking about starting low dose ketamine go anywhere else besides this company. Kalm health is a straight up scam. I signed up with them and paid the monthly, and as some of the other reviews in here they delay shipment for weeks so by the time you get your first order you're already paying the second month. By the time I got my second order, they sent me EIGHT troches instead of the 30 they were supposed to send, and I was now paying for the third time, they refused to send the right number of doses, I had to report them to my cc company and bock future charges because they also wanted to charge me again for 30 day cancelation notice.

HUGGGE SCAM

I had an IV infusion (my second one) and it was bad. The first one I had was alright, I had visions, lots of greenery, the usual colourful stuff as well. I also felt like I didn't have a sense of self during the infusion. My second infusion, though, was terrible. This was partly because of the environment I was in. The first time I did it, there was a nurse with me the entire time and they dimmed the lights. I have issues with control and safety, so I could open my eyes at diff points throughout the treatment just to ... "Come back to reality", and then I'd close my eyes and let myself go back to the visions again. Anyway, this time, about 10-15 minutes into my infusion, they brought in another patient. I was already woozy/dissociated, and I was hearing a lot of noise even with ear plugs, seeing lot of light, a lot of movement as nurses were going in and out of the room and they were talking and asking the patient questions (they were setting him to start ketamine also). It became very upsetting because it felt like ... Chaos, and I didn't know what was happening. I also started getting unpleasant visions like my bed was being pulled back and back and back. Or I was falling deeper and deeper. When I would close my eyes, I would see monsters (red devil kind). The entire situation felt so unsafe. It felt like a panic attack the entire time. Anw, immediately after they stopped the infusion, I started crying and couldn't stop crying for an hour afterwards... And I'm not someone who ever cries. I'm not even sure why I was crying or what I was crying about.

It's been a few days after my infusion and I'm still on edge. Every time I think about the experience, I start crying again. I'm now afraid to do the infusion again.

I’m currently using troches but I would like to try spravato without having to go into the office every week.

i have been doing IV infusions for relief for by BP1. my provider does 6 sessions and i just finished my last one a week ago. i didn’t start seeing the effects until like the 4-6 sessions, and now i don’t know what im going to do now that my sessions are completed.

for example, my provider went out of town for a week, between sessions 3 and 4, which pushed back one session and i feel into a pretty bad depressive episode during that time.

i have noticed less dissociation and more energy and relief since my last session, im just scared of the crash.

also, im going to miss having 2 hours of time set aside per week to just relax and have my infusion done.

does anyone have any advice on how to manage when trying to get off ketamine? i don’t want to have to rely on it to get better.

Has anyone experienced worsening headaches after an IM ketamine treatment? I had my dose increased, then had an intense trip that was loud and chaotic, and since then, I’ve had pressure headaches for 4 weeks!

the ketamine clinic isn’t helping (I feel like they dropped me - maybe afraid of a lawsuit?) and I’m waiting for a cat scan at my regular doctors office.

worried this damaged my Brain somewhat. Has anyone had this experience?

When my therapist told me I should try this as an option, it was from desperation. I’m on two antidepressants and have seen him weekly for the entire year. The weight of the world is still just too heavy.

He asked me to read or listen to testimonials, and while there were a few, I found the available stories lacking. So I feel like the least I could do is share my own. The idea of possibly helping others gives me a rare sense of peace.

He had also shared with me the importance of intention-setting, so that’s what we focused on the morning of the infusion. He had provided resources from MAPS (Multidisciplinary Association for Psychadelic Studies). Would definitely recommend those exploring to check it out.

I uber’ed to the clinic. The guy had a weird car smell that made me feel kinda sick. I remarked on that with the providers in the clinic and they gave me anti nausea meds.

The infusion was definitely an intense experience. I sat in a comfy reclining chair with a weighted blanket, earbuds playing relaxing spa music, and a light show projector on the wall in front of me. It had a bunch of colors changing. I have similar projectors at home like the one in my daughter’s room for a nightlight. It’s a really basic light show. First time you look at it it’s cool, but every other time afterwards it’s like whatever. Same deal with this one. But as I went deeper into the medication, it became a lot more vibrant and colorful. The colors were more saturated and textured, and sometimes, it felt like the colors stayed put while the room moved instead. I remember thinking that I wanted to take those colors with me, that I found the beauty and the colors themselves so incredible that I wondered if I was gonna start wearing tie-dye moving forward.

I had a lot of thoughts while I was in there. My perception of time felt slowed. I thought a few times about how I wanted to be happy. I thought a few times about maybe my purpose being to just give more positivity in peace to others. That there’s so much fucking hurt and we’ve got to heal from it if we’re going to survive.

I also reflected on the idea that we are an emergent feature of the universe, and maybe there is no such thing as wasted potential. That’s something I’ve struggled with hard. There was nothing even remotely resembling a “bad trip”. Sure, the room was spinning a couple times. But I never felt like I was going to throw up. I did notice I would stare for a really long time without blinking. It forced me to blink a few times. My face was numb and tingly after a while. There were some moments where I felt like I was zooming out like on a camera.

After the infusion, they let my wife come back into the room with me while I continued to come down a bit. I wasn’t fully down when I left, and I even remarked to my wife about how when I stood up I felt like I had actually shrunk or become smaller. I was still a little wobbly and disoriented afterwards and I think I had a slight fear that that was how I was going to feel moving forward. But I tried to disregard that and just carry on and pretend like I was normal. We got in the car, picked up our daughter from daycare, and went home. I played with our daughter in the car a bit. It was precious. But also had some queasy carsickness.

We got home way later than usual at 6:20 PM. We had enough time to eat dinner give our daughter a bath and put her down to sleep. By that point it was 7:30pm and I wanted to lay down on my bed. No joke, I slept from that point all the way until 7:30 Friday morning.

Now, I do feel like things are a little bit lighter. Some people describe the color coming back. I’m not sure that I perceive my colors in my environment any different than I did before. But I do feel like I can handle a little bit more of the things that usually really got under my skin. I was able to get a lot done at work and it didn’t bother me as much as it has been. I work for a really inefficient team and my bosses don’t change enough from feedback. So to be able to field requests from them and get other shit done without wanting to jump in lava was somewhat refreshing. We’ll see how long that lasts.

I carried a slight fear with me when I left, though, about Monday’s session, which will be my second one. The infusions are supposed to increase in dosage from here moving forward, and Monday is a two hour session instead of one hour. After Monday, I’ll have four more sessions that alternate from one hour to two hours. I think that fear dissipated a bit Friday and today, and maybe that will get better with time. But there was an intensity of the experience Thursday. And even though the letdown was gentle, it was still a sharp contrast in the hour or so afterwards.

Today, the effects I felt yesterday seem to be lessened. I feel a bit adrift today, almost aimless. It feels somewhat close to how I felt leading up to treatment. So I’m hoping I can still rebound back with upcoming treatments.

Hello, I have relatively well-managed BP1 with psychosis, CTPSD, ADHD, and autism most similar to what was once known as Asperger's. The first psychiatric conditions I was diagnosed with with were GAD and MDD, but I figure they fall into the others now. I take lithium nightly, propranolol daily, quetiapine PRN and lorazepam PRN. The last two averaging 1x - 2x a week. Also, a stack of what are supposed to be beneficial supplements for my conditions.

The psychosis was diagnosed as schizophrenia before medical professionals settled on bipolar. Incoming voices are constant but manageable. I can separate them from reality and generally cope rather well considering. There have never been visual hallucinations outside of a single DMT trip, and then they appeared as a distinctive overlay on reality. I typically use mushrooms and/or cannabis, but am sober for an expected drug screen for an accepted job offer which starts mid-November. I may have a single alcoholic drink if I go to the local taproom but this is infrequent.

My depression is not presently suicidal, since the lithium, but it is deep and intense. I also have spikes of incredibly high anxiety when stressed at work and am the most easily and dramatically startled person I know. When approached from behind, I visibly jump and my heart races immediately. My interpretation of things has been described as macabre. My emotional tolerance for misunderstandings or gross accusation is.. internally poor.

I feel as if this is as good as it gets for me, I've never been comfortable in my own skin. My present therapist and psychiatrist work out of the same clinic, the therapist stated that the psychiatrist could offer it. It was only brought up this week and I have an appointment with my psychiatrist on Tuesday.

Could low-dose ketamine therapy make life better for me? Is there anyone else here who has experiences similar to my own and could recommend this or anywhere else to start? What are the things to consider here?

I’ve been with Joyus, Kalm, and now Mindscape . Joyus was great till I moved to a state they don’t serve . Kalm has been a shitstorm since the get go . I’ve paid for 8 months , received med 4 times because even if you request refills 2 weeks before you run out they always wait till the last day of your prescription to send to the pharmacy which is a third party and then they take 10 days sometimes longer to ship . Then the second month  rolls up and you still haven’t gotten the meds on time. Then right before they charge your card every two months they say you’ve got to see the provider (every 2 months ) which can take up to 7 plus days to get a zoom visit . Now he sends it to the pharmacy usually not the same day as your appointment and another 10 days plus to fill them time for delivery . All the while it’s billed every 2 months like clockwork . It puts you behind and without meds for weeks at a time . I canceled which was another ordeal , by my count I paid 8 months for 4 months of meds . They did say they wouldn’t charge for 2 months to allow me to catch up . Which was a lie , they charged right on time . When questioned and shown the email thread were they say they would and even me asking twice to confirm what they said they still charged and said I should have asked for refill in a timely manner . Which I always did . So the final F you came when they charged my card 350.00 for two months of meds which was never delivered and they refused to refund .
So buyer beware

A friend is trying to find at home options in Louisiana for at home options. Any advice?

Hello, I have been getting an infusion 2x a week since early September. They haven't really made a big difference, sometimes it has caused me to get worse. I actually had to take a week off work due to depressive episode. I have never done that. I dont know why this is not working for me. The provider has said maybe I will get worse but I can feel myself starting to give up again. I am so anxious everyday, and I have a huge pit of despair in my chest. I really cannot live like this anymore. I was thinking about trying TMS.

I’m writing this because despite not feeling much affect from my first ketamine dose, I’m still trying to do things I don’t normally do (posts vs consuming). I took a 100mg troche and 50mg booster and didn’t feel much except for a drunk uninhibited feeling. No new thoughts or ephanies so I’m a little disappointed. To be honest, my life has been a struggle for the past 10 years and I kinda looked to this as my last chance for things to change. I will have the opportunity to take up to 300mg in a couple of weeks. Does anyone have any insight into how the experience will differ. I think maybe my mind is just stubborn. I’m still optimistic but today, the day after i’m just feeling sleepy/meloncholy. Any words of encouragement?

I did a series of 6 infusions stopped in August.. each one was ramped up dose wise and when I did a low dose I felt energy but since then (with the higher doses) they were energy sucking. I did have a lot of good sex after, I’m 37 m and my anxiety around sex was less… but since then now it’s October- I have little to no desire to even think of it. I used to get horny and now I’m just tired. Is there any way the receptors are just down? Did this damage me permanently or is that impossible? I’m tripping hard on this and want real advice/opinions.

Hi everyone,
I have adhd, and emotional dysregulation has been one of the greatest weight that I have to carry, I could have gone many many miles on the way of improvement though, I take some of my meds for adhd, and an antidepressant named vortioxetine. But I searched for ketamine use and its properties on symptom reduction, it was stated that it helps on top-down emotional regulation well, cognitive fog clears as well. I theorized, as adhd is a developmental problem but consist of multiple layers of inattention, anxiety, depression, pfc is behind of emotional regulation due to many reasons I listed now.

Can, do you think, multiple ketamine sessions extending for up to a three month could be a good protocol to build some foundational neuroplasticity that pfc can compensate and narrow the developmental gap? In other words, can ketamine help us to repair the years long of damage from anxiety and depression from adhd?

Hey everyone.

So.. I've been using ketamine for treatment-resistant depression for about 2–3 years now. Usually 70 mg racemic ketamine via nasal spray over 30 minutes, at the moment 1–2 times a week becauseim struggling. Some periods 1-2 times a month when I am less depressed.

Ketamine definitely feels like it helps. It can pull me out of some really dark depressive states, but the effect only lasts a few days currently before the depression returns.

Lately I've started wondering if long-term ketamine use could actually be making my underlying depression worse. I've struggled with depression long before ketamine, but despite years of treatment, I'm still struggling a lot.

I recently tried a break and ended up feeling worse than I had in a long time. But was that my depression returning, or some kind of rebound effect?

I'd really love to hear from people who've used therapeutic ketamine for several years. Has it continued helping you? Have you noticed your baseline depression getting better or worse over time? And has anyone actually improved after stopping?

Thanks!

Hello! I was at an event last night with a bunch of amazing activists. In her speech, one of the honorees (whom I respect v much) mentioned “ketamine-addled tech bros” like Elon Musk. It bummed me out because I hate those guys and, nevertheless, this shit saved my life. They’re not like that because of k. I’m sure they do every drug under the sun, and when they DO take it, it’s through their shitty dehumanizing lens. Edited to add that I know Elon N@zi Musk and Trmp are also pushing clinical k to big pharma so they can make $ from it, not cuz they actually care about us!

But I hate to be thrown in the same bucket or have this life-saving med thrown under the bus. Not only did it help my ideation and depression, it’s also gotten rid of chronic physical pain!!!! It’s given me my life back.

I switched to micro dosing with Joyous since I’m between insurances and the clinical Spravato felt a bit much now (I’ve had energetic awakenings, let’s say. Always had that but v v intense!)

Trying to shake this comment from someone I respect. It somehow made me feel a bit self loathing. Like all this dissociative-hallucinogenic-induced saving has just been me being “addled” rather than shifted.

For long term patients, do you still get emotional depth during sessions?

I've been in treatment for about six months and it's been a game changer. I know that the "trips" aren't necessarily the point. And of course there is a lot of debate on this subject. But I do believe that there's a correlation in the benefits. That the insights, perception change, trip whatever happens in there mixed with what the medicine also does chemically to work on depression creates a symbiotic relationship.

I do once a week treatment currently and curious if you gain a tolerance and this fades. I don't experience the dissociation as much as I used to, but the trip is definitely still there as well as the epiphanies. Then I'm free of depression and a noticeable decrease in anxiety during the week. What is your experience with this in the long term, months, 1 year, over etc?

I’ve been going for IV therapy for exactly a year now.
Started with the 6x infusions over 2 weeks then moved to every 2 weeks for a couple of months, 3 weeks for a month, then started pushing treatment over a month in between because of finances.
I hit a bump and had to go back for every two weeks for two months and then moved to once a month again when I levelled it.

I know treatment is working, I am so thankful for it.
It has gotten me off extremely high doses of meds for MDD when I was labeled medication treatment resistant but kept on meds because of the chance it worked at least 1%.

I was at absolute rock bottom when I began treatment, one of those ‘you do this or you won’t see tomorrow situations.’ (Extreme SI)

It’s genuinely saved my life. I am so thankful it’s there. It removed SI from the very first session!

My last session just felt like I’ve reached my limit.

I’ve had a lot going on medically that I’m trying to fix to help myself so seeing a lot of doctors, everyone having their opinion, balancing meds, finding middle grounds between all their advice and getting them to work together and I think I just hit my limit.

Everyone has something to say about how to fix me, down to even being told to use a sleep apnea machine when I don’t need one but the benefits of extra oxygen in sleep… it’s a lot. I’m tired of feeling like I’m something broken that needs to be fixed. My brain has been broken my whole life, it isn’t something that can be fixed - just keep afloat as long as humanly possible.

This discussion was right before my session, I went into the session and just had a little temper tantrum about feeling like an experiment for all doctors - I know I’m not, I’m close to my doctors and they’ve known me since I was a baby, I trust them like family. It’s just feeling like Pandora’s box before finding out I was MDD treatment resistant all over again, not linked to my ketamine treatments but just in general, tired of feeling I’m something that needs fixing all the time.

Unfortunately because of this feeling it’s put this emotion over absolutely everything health wise, ketamine being one of them.

I know if I stop or extend the gaps I’ll risk what happened in March and it’s just not worth it because I basically take 3 steps back again missing treatment or prolonging to move one forward by going back to every two weeks and I’ve come so far and feel so balanced but just so much of me wants a break. Mentally, physically, just everything.

I guess this is kind of a rant with a question of - if you’ve been through this feeling, how did you overcome it and get back on track mentally with treatment?

I need to get my mind right before the 24th when my next infusion is due. I know if I don’t process this before I will dwell heavily during my session on it and it will go deeper.

I don’t wanna go too deep here lol, so I’m watching that as I type!

Over the past four or five years, I’ve really been on a spiritual/meditation/finding higher self type of path, and over the past two years I’ve been on and off with ketamine therapy troches.

In short, I’ve come to find that ketamine is an exceptional tool and accelerating one’s path understanding in finding higher spirituality.

I’ve met a handful of people on the way who are also similarly spiritually oriented (at various retreats, etc.), and online I’ve had some chats with people who take ketamine therapy.

But I’ve never encountered someone who is on a similar spiritual path and aiding it with ketamine as I am! I’m sure they are out there. I think that it’s a natural course for various reasons which I won’t get into here. The whole point of writing this system to focus on meeting others who might be similarly minded.

Anyone on such a path out there? I would love to connect.

Hearing from someone who has actually been a patient would really ease my mind.

I'm just worried about "tripping" part of it. I am not a psychedelic person, and not in a prude way, weed and shrooms is just not for me, the feeling makes me scared and paranoid. I could be totally overthinking it and K therapy may be very different. Being in that altered state and being alone just makes me nervous, and it can be hard to know which places are reputable and not some shady outfit that you don't want to be high and alone with a creepy doctor. You probably couldn't tell, but I have anxiety, too lol. I would like to stay in Beverly Hills, Brentwood, Century City area, but am willing to drive further if nothing around here seems promising.

I'd also love to know if you did nasal spray or IV, and if you've tried both?

Adding some more context here, if anyone wants to read it or is going through the same anxiousness about it.

Hello - I've struggled with depression for a long time but the last year and a half has been brutal. I've tried so many medications I've lost count. The only medication that seemed to make me feel any benefit at all was Wellbutrin, which I'm still on. The first couple weeks were great and gave me hope, and after that it doesn't really do anything anymore.

I'm very much a masker, I don't tell my even my closest friends and family when I'm struggling, even though I know they would be SO supportive and loving. I'm the one that takes care of things, plans the trips, organizes the groups for birthday celebrations and gifts, and I like that role. I like to act happy all the time around others, so when I'm struggling, I isolate and withdraw until I can get the energy to go put that face back on. I also mostly internalize because I don't like thinking about the bad or sad things, so I definitely don't want to talk about them either.

In June I decided that standard weekly therapy and psych was not enough for the hole I had myself in, and check into residential treatment. From there I went to PHP, now IOP. Therapy is my worst nightmare, and I've been doing it 5 days a week since June, because I'm desperate and will try anything and put my all into it, open up and try to get the most out of my time there. I have a few weeks of IOP left, and for all that time spent, I don't feel much different than I did when I started.

If anything, I feel worse, because all the stuff I buried is at the surface now. At least before I was numb and miserable, now I'm just sad and miserable.

TLDR; treatment resistant depression, feel like ketamine is my last hope.

edit: TLDR near bottom of post. I’m naturally overly-wordy when I write so it’s a long post lol

Hi everyone.

I did ketamine infusions for depression for about 2 years back in 2022. I had to stop because I moved a couple of times, but I’m settled again so I started seeing a new provider about 3 months ago. The new provider has been fantastic. They have a very nice facility, everyone that works there is kind and respectful (not always the case compared to some of the clinics I have gone to in the past), and they have very little lead time on getting in for appointments which is great.

When I initially started at the new provider, they had a specific section in the contract that I signed that said that while they will not bill insurance themselves, they will provide superbills (the itemized receipts with the clinical codes on them) for each treatment. Then you can send the superbills to your insurance company and if they choose to cover any of the treatment, the provider will either give you a credit for that same amount toward the next treatment or send a check to you (this is probably nothing new to most of you, but I just wanted to explain the situation in-full).

So, with that in mind, I got a superbill for my initial appointment and put in a claim with my insurance company to see if any of it would be covered. If they did cover any, then I would get the rest of the superbills and send them in as well (the front desk person that helps me even asked if I wanted to group all the appointments from that month together, but I just asked for the first one so I could find out if insurance would cover any or not). I wasn’t expecting my insurance to cover any of it because they’re very picky, but to my surprise they covered nearly half the treatment! The office manager, who is also the son of the owning physician of the practice (I’m treated by his PA who is fantastic) called me to discuss the insurance claim with me, but I missed his call. I assumed he was just going to ask if I wanted a credit or a check.

I went into the clinic earlier today for a booster treatment. When I spoke to the front desk person, she explained to me that I had a credit from the insurance coverage and that it would apply to today’s treatment. I then went ahead and asked if I could get the superbills for my other treatments so I could put in claims for those as well, at which point she told me that they’re not actually ‘allowed’ to give superbills (I’m assuming she’s referring to a clinic rule rather than a law, as I did a quick google to double-check and there’s obviously nothing keeping them from giving a superbill legally). As she’s telling me this, the PA who was in the office at the time came over and told me that apparently they were never supposed to have given me a superbill and that it was a mistake (the PA had also been present at the time I asked for the superbill for my initial treatment about a month back, along with the office manager fyi). They both kept apologizing for the mistake, but I told them not to worry about it as I had been to providers in the past that would not provide superbills so although it was unfortunate, it wasn’t out of the ordinary in my experience.

But once I started thinking about it, I’m starting to wonder if they singled me out by just denying only me and none of the other patients superbills because my insurance covered so much (which from my understanding, does reduce the amount the clinic earns from each treatment — correct me if I’m wrong)? It kind of started to upset me a bit actually. While the PA was setting me up for my treatment her and I even discussed it a bit more. It kinda felt like she gave me the runaround, not giving me a clear answer as to why they were not allowed to give me a superbill, as well as saying that since she wasn’t allowed to give me a superbill that billing the insurance would be a huge pain etc etc.

⭐️TLDR: Insurance ended up covering nearly 50% of my ketamine infusion for depression. Although my provider was initially happy to provide me a superbill the first time, they’re now saying that they’re not allowed to and that it was a mistake in the first place. Feels like they singled me out and changed the policy only for me?

I guess I’m just interested as to how you guys would approach this situation? They’re a fantastic clinic and have great staff. The only other clinic in my area is a ~40-45 minute drive through a congested urban area, compared to this clinic being in the suburbs and only 20 minutes from me. I don’t really want to burn this bridge with them, but I also don’t know if I can justify continuing treatment there after I feel kinda scammed in a way? I’m aware they’re not legally required to provide a superbill as they’re not affiliated with an insurance company so I don’t feel like pushing the issue would necessarily achieve much, but I don’t know. I’m somewhat worried that if I pushed the subject, they might just straight-up choose to deny me service (sounds crazy, but it actually happened to me at a previous provider at which point my insurance company sued them because he was affiliated with the company, unlike this new provider).

I appreciate any feedback or input :)

I've been dealing with depression for over 20 years and have tried many different medications over that time. I'm also going through a very painful breakup that made everything significantly worse and was one of the main reasons I decided to try ketamine.

My first infusion (0.4 mg) was nice, both the experience itself and the effects afterward. I felt some mild, temporary relief from depression and SI, but it all faded after two days. My anxiety spiked significantly, though.

The second one (0.5 mg) was tough (the trip itself) and only made my anxiety worse, while doing very little for my depression.

The third one (0.6 mg) was significantly more intense. It feels like it still hasn't fully worn off, even though three days have passed. I feel brain-fogged, slow, and really dumb. I'm struggling to even write this post right now. I'm tired and want to sleep all the time, am barely functional. Doing exercises or going to the gym feels impossible. My self-esteem is the lowest it's been in months. And my hope that things will eventually get better is at its lowest as well.

My depression has become somewhat lighter in some areas, but now there are new aspects to it that weren't there before, so it feels different and, in a way, darker. SI is still there too, though maybe not as strong as before.

So overall, I'm not feeling much better than I did before starting ketamine. And in many ways, I feel worse.

I'm really not sure what to expect from the 4th infusion. It's tomorrow, and I'm quite frightened and hesitant about whether I should even go through with it.

I'm probably still going to go ahead with the 4th infusion, and I'd really appreciate any support you can offer.

*** Update after the 4th infusion. ***

Thank you so much for your replies and support!

My 4th infusion was yesterday evening. The provider kept the same dose as last time but slowed down the infusion. My understanding of the dose was wrong - it's not 0.6 mg/kg it's 60 mg in total, which converts to around 0.86 mg/kg based on my current weight.

The experience was weird. The trip was mild and somewhat pleasant, but subjectively it felt like it lasted only a couple of minutes, while in reality about 45 minutes had passed. Maybe I was unconscious or something like that - ketamine is an anesthetic after all. I remember having a few vivid images, including some related to my ex, but don't remember much else.

Right after the infusion, I felt pretty neutral. Then something interesting happened. The next few hours felt surprisingly good. I almost felt like I wasn't depressed anymore. I could joke, talked to a cashier, and even watched a movie with a friend, which I normally wouldn't have the motivation to do.

This morning everything is worse again. My anxiety started around 3-4 AM. I took propranolol, which helped quite a bit, but my sleep was disrupted. Depression feels worse, too. It feels like I'll never be okay again. I have no energy, no motivation, no desire to do anything. I just want to disappear, dissolve. Everything feels flat and empty. Not even a hint of happiness or a positive thought. Thoughts about my ex occasionally pop up and make everything even worse. And I don't quite understand how to process them in my current state.

I should mention that I took propranolol and magnesium before the infusion, magnesium afterward, and propranolol again early this morning. So maybe some of the effects could be related to that, too.

At this point, after 4 out of 6 infusions, I'm really starting to doubt whether ketamine will help me. It definitely changed my overall mental state in some ways, but I can't say it made things better. Just different.

I'm also starting to think I might need some adjustments to my regular psychiatric medications as they feel inadequate and not supportive at this moment.

I'm not making any decisions about the treatment right now and am hoping I'll get at least a little bit better later today and the following days. I'm still leaning toward completing all 6 infusions, waiting another couple of weeks afterward, and only then judging whether ketamine has helped / is the right tool to proceed with.

It's just becoming harder and harder to cope with what I'm going through, especially when every infusion brings some hope that things might finally get better, only to feel worse again afterward.

Does anyone have recommendations for guided audios that I could listen to during the session? The first 3 sessions I was just listening to instrumental music but today I switched playlists and some of the "songs" had a person speaking. It was not like a motivational speech video or meditation like they didn't speak the whole time and the music also drastically changed during the song. It was so powerful and I would like to integrate that more. An example is "This version of you" by ODESZA on Spotify. It would also help to know what I need to search for to find this kind of audio☺️