It is not a muse, it’s not romantic, and it’s not purposeful; depression lacks creativity. It quietly bludgeons the self, recklessly bloodying and tearing from the inside out. Also, it’s very boring. There are only so many ways you can feel worthless, and the faucet-crying becomes almost a chore. It reminds me of my son’s beloved Peppa Pig where their cartoon tears spray almost horizontally from their snouty faces. For many, many years I couldn’t cry at all, probably because medication dulled my emotions. Now I’m unable to stop. 

The problem with treatment resistant depression is that each depressive episode is worse than the last. In January of 2025, while everyone else was properly mourning the state of the world, I was wrapped in an “insert metaphor here” of sad. Even words weren’t anything anymore, nor was the ocean, doughnuts, or god. Why would they create a human who doesn’t want to be alive? Incidentally, John McWhorter, it turns out, is a champion of the singular they/them. The famous, conservative linguist posits that gendered singular pronouns are a relatively modern convention of the English language, and that in the past English speakers relied on the plurals more heavily. So god, a they; why not? I know this detail because, on one of the dozen or so hallucinogenic trips I’ve taken, I piped his voice into my headphones, a podcasted interview about his latest theories. But I’ll return to the trips later.

What propelled the descent into lifelessness for me, this time? No reasons at all. And many, many reasons. All I know is that at fifty-one point five, I retreated and cried all the time. For months. Even my son was affected, as sunny as he usually is. And when I started a bunch of treatments, he took to telling strangers, in the most cheerful voice, “my mom’s brain is broken,” which made us all laugh. My daughter has had to watch her shell of a mom; it’s frightening and unmooring to see a parent in this state. Medication has always been a godsend, until it wouldn’t work anymore. I knew I was indulgent, a pathetic caricature of a woman, but despite my tradition of functioning well in public, at home I couldn’t pull myself together at all. The pure physicality of it, the state of feeling perpetually bereft, kept me up at night and in tears most of the day.

It turns out that shoving down all your pain, or writing it out, doesn’t do enough. Some shit luck genetically, some worse luck personally, add to the mix some childhood mini-traumas (really just flesh wounds) and too much self-medicating, and you have an illness. And when your SSRI of the day “poops out” (yes, it’s a term), there’s only so many more worth trying. 

The Zoom session with a psychiatrist was open and unhinged, all with a benevolent stranger. I’ve been here before, but I can’t remember such powerful thoughts. I kept repeating please help me and his intern, a soon-to-be psychiatric nurse, tried to smile reassuringly. 

“Have you heard of ketamine treatment?” 

“Yes. It’s a party drug. My friend takes a bump sometimes when she’s going out dancing,” I sobbed.

Laughing, he said, “I think you may have success with it. It’s done in a controlled setting, so you won’t exactly be partying.” He went on to describe the treatment: I would sit in a comfy chair in a cubicle, my blood pressure would be monitored periodically, and I’d snort the drug. For two hours I would experience a sense of detachment from myself, a hovering-above, and I would be dizzy and possibly nauseous. As a woman who endured morning sickness all day for the entirety of three pregnancies, even that caveat wasn’t enough to dissuade me. Nor was the prohibitively expensive cost of 1000 dollars per session. When I told my husband we had to wait for insurance approval, he practically leaped from his chair to call the doctor back. It was worth blowing through his healthcare savings account to ensure that I’d get some relief.

The first trip was both less and more intense than I expected. A very young woman took my blood pressure with a machine that had seen better days. The velcro of the cuff kept whining and straining against the pumped air. I snorted the first of two rounds – a starter dose – ate some melty mints to stymie the awful post-nasal aftertaste, and settled into the recliner. After thirty minutes, I hit the peak, at which my tiny pinholed self perched in the back of my head while the rest of my head, and body, began tripping balls. Of course I looked up that expression later, and it has nothing to do with testicles. It referred to these stretchy, pliable balls that acidheads in the ‘60’s played with while dosing. It’s the difference between a gerund and a participle, if you really want to get technical. Either way, I was sitting in a doctor’s office having audio and visual hallucinations, and I can’t believe they dole this out to unsuspecting patients without a better description. Lucky for me, I’d been here before in terms of mind-altering experiences, but I’m convinced a virgin would have utterly panicked.

Remembering what I was seeing and hearing took Herculean effort, along with trying not to vomit. 

a

plane taking off with the ascent not into a heaven

but surely another locale where color reigns 

supreme in all the hues

you wish you had words for

Iced cakes shift to rivers, then

into red tiles like the diamonds 

of a Moroccan rug,

my chair an infinitely sinking ship

White noise turned to song:

the left side in a crescendo chorusing

here is what you want

the right side descending 

this is what they want

and then a list of all the names of

everyone I ever loved 

On my third trip, I got the full dosage (three separate snorting requirements and lots of intermittent sniffing for the next twenty minutes), and at the peak I soured. It was a fascinatingly mellow nausea. Wondering, waiting, leaning forward, I reached for the trash can and promptly vomited. There was no pain and no disgust until I came down and saw the mess oozing warmly in the small plastic liner. Other people in other cubicles sat in different shaped chairs: a beach chair, a divan (like the kind Freud’s patients lay upon), several recliners, and a flat slab which seemed a bit like a gurney. I shouldn’t have worried about others’ judgement; everyone in the place was as out of it as I was. I heard some sniffing, throat-clearing, and rustling, but the white noise muted most everything. 

When the nausea receded, I could settle back in to watch the film on the back of my eyelids. Music still made me cry too hard, raw as am, but a podcast appealed to me. With blurry fingers, I scrolled around and landed on Adam Grant’s Rethinking, where he interviews folks from the perspective of an organizational psychologist. Into my ears flooded the voices of Mr. Grant and a Black woman professor discussing the illness that is cancel culture and how to stop the constant, giddy deplatforming. Among many other topics, she spoke about the rape crisis hotline she ran and about her own horrifying rape. I thought she sounded awfully slow, distorted and drawn, which I attributed to the ketamine.

I couldn’t hear her name in my addled state, but afterwards I read about her. Loretta Ross, a Black feminist who teaches about women & gender and has a gorgeous, unfixed and unapologetic gap-toothed smile. (I worried about the impropriety of mentioning this. But since she is championing the “call-in” strategy, I feel safer). Ross was impregnated at 11 by a cousin and later suffered sterilization; her IUD Dalkon Shield grew into a life-threatening infection and a hysterectomy was performed without her knowledge and consent.   Somehow, she endures, thrives, even.

“How are you feeling? Any better?”

“Well, I think I’m not crying as much.”

“That’s a step. We have only just begun with the possibilities. I promise you will get better.”

By the fifth trip it wasn’t exactly run-of-the mill, but I knew exactly what to expect. I even chatted with a woman in the waiting room, despite, or maybe even because of, the private, guilt-ridden hells that brought us both there. She mentioned that even ECT hadn’t helped her, but that ketamine was life changing. Her pocket-sized dog sat on her lap. I sometimes brought my own emotional support animal, my husband, into the end of the trip when I was especially chatty about what I’d seen. My mouth never worked well, lips large, anesthetized. 

Tapestry upon tapestry 

a soft circuitry of

spirals, vortexes

Sketching line-drawn homes 

one upon the next 

and a tiny lineman leans 

out of his window 

Sound is red triangles while blue is knowledge

Someone plays cello 

in a cubicle as

violets petal into braids 

city rising like a pop-up book

Let me be clear: This treatment isn’t meant to plumb the depths of my past, offer a spiritual journey, or enlighten me to the astounding vastness of the universe. It may do this for some people, but that’s not the point. Unlike therapeutic microdosing, where the patient trips with a companion therapist, revealing hidden truths, ketamine is used for the neurological shifts that it promotes. Neuroplasticity is the goal, where the brain revises and edits itself, opening the circuits to new perceptions. Ketamine works by altering the patterns of two particular neurotransmitters whose names I recognize from quizzing my daughter as she prepped for the AP Psych exam. Glutamate and GABA regulate mood, which in turn allow new neural pathways to develop.

Hard sciences were neither my forte nor my interest, but I‘ve always had a soft spot for biology. I was initially afraid to tell my older brother, he with the PhD in physics and eight years my senior, about the treatment. But he responded with enthusiasm; he’d read good things about it. After the trips were entirely familiar, and in some ways repetitive variations of the previous sessions, I tried to record what I was seeing. The only problem was that my thickened, woozy fingers couldn’t type well, and it increased my nausea to try. Speech to text was also out of the question. A notebook in hand, I wrote without looking at the paper, listing the sights and sounds as they sped by, including the open-eyed hallucinations where the gray walls were crosshatched or melting. My writing was skewed and overlapping, pencil lines mirroring my altered state. There was nothing revelatory in the lists.

It’s been hard to find scholarly and accessible articles about what happens to the brain when we hallucinate. I did discover one in a magazine unfamiliar to me, Quanta, called “A Math Theory for Why People Hallucinate,” that I’ve now read several times. In the late seventies, a mathematician at U Chicago tried to mathematically map the constants of hallucinatory visions. The visual cortex, even with our eyes closed, is affected by the drugs, altering the neurons’ electrical activity and thus producing images that would otherwise be quite distracting in our ordinary lives. Most startling for me was reading that there are four distinct patterns that appear with regularity: lattices/honeycombs, cobwebs, funnels/tunnels and spirals. I might argue that funnels and tunnels are pretty damn close in shape, but I’m not a scientist. According to the writer, “in that sense, what we see when we hallucinate reflects the architecture of the brain’s neural network.”

What? Holy moly. 

Despite our proclivity for imagining that we are each a unique invention, it turns out that everything I’ve been “seeing” has been viewed and documented for thousands of years. Equally fascinating is that the types of visuals that present themselves are similar to those of ancient cave drawings and have been captured by famous artists, such as Joan Miro. On my first trip, I saw artistry that brought Keith Haring to mind. Visual art is an endeavor about which I know nothing, and even that Haring’s name came to mind while tripping is nothing short of miraculous. Hilariously, I had to look him up afterwards just to be sure it was the right name. (I’m worse with names as I age, though in one memorable gaffe at a Woodstock reunion concert in the 1990’s, I asked my husband when Pete Frampton was coming on stage. It was Pete Townsend we were waiting for). Haring’s experimentation with LSD began in his teens, and the images mapped themselves right into his artwork, a perfect fit. 

Elsewhere, I read that the moments before death elicit a similar response. People who have had near death experiences commonly mention that they’re moving towards a light. I feel sorry to say that it may not have been god or heaven after all. Or it may have been god, because didn’t they create the chemicals of hope that soothe our way into death?

I often saw binary code or screens that looked like the circuitry of a computer. What equivalent did people see before the advent of computers? 

For many individuals, the first treatment provides an immediate fix. After the 7th session, when nothing was changing for me, I began to despair. But I kept at it, letting the drug work its way into my brain-furrows and hoping to an uncertain god that it would help me feel able to continue living.

“How are you feeling? Better, worse, the same?” It’s the language of an eye exam, my father and sister-in-law's specialty, but headier.

“I think I’m more stable. But also, not exactly manic, but too high-energy. All the chores and to-do lists that I want to tackle. Even some writing projects.”

“Yeah, that might be the low-dose antipsychotic. Or the Wellbutrin. Or the ongoing ketamine. Hard to tell.”

“I don’t think the Wellbutrin does a thing. But wait, actually, it seems to have cured my terrible stomach. So I can’t stop taking it.” I paused, listening to a persistent woodpecker outside. “I’m deeply sad. But there might be a slight crack in the Bell Jar now.”

“I’m not sure what a Bell Jar is?”

“Huh, really? It’s a bell-shaped dome thing that holds an object in place. Or gases. You don’t know The Bell Jar, by Sylvia Plath? The book I dog-eared and read a hundred times in high school? It’s a veiled autobiography of a poet who has major depressive disorder. The author killed herself. In high school, the yearbook staff who wrote the “last will and testament” page left me that novel, among other things.” My small smile writ large on the screen. “Fitting that it’s a list made before death, really.”

“No, I’m not familiar with it. That’s a heavy thing to leave someone.”

“You sure you’re a mental health provider?” We both laughed. “It was 1991. Not quite the peak of sensitivity. You’d think someone would have picked up on my misery, no?”

“I’m sorry.”

The trips concluded in June, six months after the initial depressive episode began. 

Stick figures walk in profile 

striding towards an orange-peach 

light that smells edible

In panel after panel of line drawings 

sewing machines close up into cupboards

This the architecture of the brain

Step into the elevator just as it starts to drop

step into the elevator just as it starts to drop

There’s a forest growing on the ceiling

the pointillism of uncomplicated love

In one pocket I am nothing but dust and ashes 

In the other pocket it is for me that the whole world was created