There was a ten-day gap between the day I found out Dr. D was willing to write me a prescription for ketamine and the day I actually had my appointment with her. Once I dropped off the prescription, it would be another ten days before it was ready since the pharmacist first had to order the ketamine and then compound it into a nasal spray. While many may assume I found this frustrating, desperately impatient to try this potential miracle cure for my depression, I was actually relieved.
I needed time to prepare. I needed to wrap my mind around the fact that my nightmare might finally be coming to an end, a possibility I had never envisioned before. Yes, I thought about all the beautiful things that might be coming my way, but I also thought about what that transition would be like, and the changes I would need to make. As excited as I was about the prospect of a new life, a normal life, I was equally scared. This would be something completely new and unfamiliar to me and although it was all that I had ever wished for, I wasn’t sure I’d know what to do if that wish were granted.
All these years, the structure of my life had been dictated by my depression. I lived in my cave and could not tolerate the stress imposed by being out in the real world for more than a few hours in a day. All of my friends lived in other states and other countries because I only had the strength to maintain a relationship through emails and phone calls. Although my friends were few, they were absolutely true and forgave me when I dropped off the grid for months, or even years, at a time. I had known all of them for many years, most for decades. They understood my limitations and they respected them.
Apart from showing up at school to teach classes for six hours each week and going to individual and group therapy sessions for three hours each week, I was safely ensconced at home– grading papers, writing, reading, and watching tv to pass the time and distract myself from the gray haze that had become my second skin. I had no friends in Miami; I had no social engagements; I had not been on a date in over nine years. I was an absolute hermit.
While this lifestyle was essential to my mental health, any outing or social interaction beyond the few I forced myself to endure would have caused me to lose the plot completely, it would be absolutely intolerable if I were no longer depressed. I would need more work; I would need local friends and social interaction. I would need a real life. I would want a real life.
I walked a careful balance between allowing myself to feel hopeful, making a list of the things I might want to do if I were capable, and not allowing my hope to build too much, lest the ketamine did not work. But my hope was impossible to contain; it was the first time I had tasted it in twenty years and as much as I tried to contain it, it swelled far beyond the limitations I tried to impose upon it. However, my depression managed to keep it in check; I was incapable of truly feeling anything. Emotions, positive and negative, that others take for granted, were like faint echoes in another room, barely audible and virtually indistinguishable from the surrounding background noise.
I began to wean off my daily dose of Zoloft a week before my intranasal ketamine compound was ready, as per Dr. D’s orders. Although Zoloft did not relieve me from my depression, it was effective enough to keep me from killing myself and get me out of bed every morning. By the time I went to pick up the ketamine, I was suicidal and the idea of it was the only thing that got me out of the house. However, as I drove home from the pharmacy, the bottle on the seat next to me, innocuously white and nondescript except for its carefully printed label bearing the title, intranasal ketamine, I began to weep with the prospect of hope. In less than an hour this nightmare that had consumed my entire life might be over. Tears streamed down my face as I smiled and even laughed.
This emotional outburst shocked me and forced me to acknowledge just how much I had come to believe in ketamine as my potential savior. I never had emotional outbursts. I did not have emotions. They had been trampled and flattened decades earlier by my depression and while the other women in my PTSD group sobbed and raged while discussing their traumas, I relayed mine in a flat monotone, occasionally flecked with nervous laughter as I saw the horror of my experiences reflected back at me through their emotional reactions to my words. On the rare occasion a tear or two managed to well up and run down my face, W and the rest of the group would erupt into congratulations and encouragement, sincere in their belief that I still had feelings, I just needed to learn how to access them. But I knew better. My emotions weren’t buried; they were gone, yet another human trait depression had stolen from me.
As quickly as the tears of joy had come, they turned into tears of desperation and terror. As much as I had tried to tamper my hope, had tried to remain focused and practical as I researched the use of ketamine to treat refractory depression, then took the steps to make it available to myself, I realized my heart had bet the house on ketamine. And now that the moment of truth had come, I was terrified I was going to lose the bet, lose the one oasis of hope I had stumbled upon in the Sahara of depression I had been banished to.