Depression is my Achilles heel while the “black dog” has been at my heel for the whole of my life. The daughter of someone with Bipolar 1, I grew up recurrently visiting my father in a mental hospital after his numerous manic episodes, for which the treatment was to bring him down with one chemical cosh after another, with doses extreme enough to floor an elephant. Nothing worked. At 51 he lost his battle with this appalling illness and frankly given his circumstances this was a blessed release for him from his turmoil. Conventional treatments available through the NHS had undoubtedly led to his early demise- causing huge weight gain and blood clots which caused him to have a heart attack.
For those of us whose lives are blighted by having depression as a genetic inheritance, the existing treatments (SSRIs) enable us to exist and function but take away any joy from life. They cause numbness all over the body which causes sexual dysfunction, thus problems in relationships. Music leaves you cold as you feel completely inert. While others laugh and sing around you, the fount of your soul feels blocked.
The easiest chores like doing the washing up or folding your clothes seem like trials you would rather avoid because of the remorseless voice in your head telling you not to bother because whatever you do will be rubbish. So the junk mounts up, you berate yourself for being ‘lazy’ and your mood plummets more. Just trying to live feels like wading through black sludge. Every morning you wake up with dread at the thought of having to get through another day- instead of rising in the afternoon so that you have fewer hours to get through. Death in life. And this is when the illness is supposedly ‘well managed’ with high doses of SSRIs and psychological therapy! Well, work addiction in fact was my only therapy, the only distraction from the pain I felt, and the only motivation for getting out of bed in the morning.
So when I read in the book “Psychological” by Dean Burnett that the chemical serotonin (which SSRIs are designed to enhance) is only a very minor neurotransmitter in the brain and that instead
“Most data show that glutamate makes up ninety percent of the neurotransmitter presence in the brain synapses at any one time” (Meldrum 2000 as cited in Burnett, 2021, pp 152)
I was shocked, yet at the same time thought this made perfect sense as to why I was still functioning so badly after having been on anti-depressants for over 25 years. Burnett went on to describe how the drug
“ketamine works on glutamate receptors and neurons, those responsible for most of your brain’s activity. Ketamine stimulates a lot more of your brain, so far more of the sluggish neurons get a proverbial kick up the backside to get them firing again, bringing neuroplasticity back to normal levels much faster. To go back to the example of relighting a fire, if SSRIs are using a magnifying glass to focus the sun’s rays, ketamine is like dousing it all in petrol and throwing lit matches at it. Which would you expect to succeed first?” (Burnett, 2021, pp 154)
Intrigued, I googled to see if anyone offered this treatment in the UK and came across Dr. Yadhu’s website. Out of the three possible places to get this treatment his was the quickest and the most cost-effective. From experience, going through the NHS would have been like a Kafkaesque nightmare of bureaucracy necessitating an exact diagnosis of “Treatment-Resistant Depression” and I already had experienced 25 years of being stonewalled by NHS mental health. The other option was a clinic in Bristol that offered only a handful of infusions combined with psychotherapy for the sum of £6000.
Right from the get go I was struck by how much Dr Yadhu’s employees seemed to care about me, as an individual in a place of despair. Dr Yadhu immediately referred me to the clinic’s psychiatrist Dr Paul Robinson with whom I discussed my symptoms and diagnosis (EUPD) and who talked with me for an hour about my life story, medication and episodes of illness. This was to ensure that I was a suitable candidate for the treatment. I became reassured that this clinic upheld highly safe and ethical standards of practice and that its purpose was to offer hope to the thousands that felt let down by existing treatments-to save minds and to thereby save lives.
I underwent 7 infusions over a period of 3 weeks, with Dr. Yadhu personally overseeing each one. As he is an NHS Consultant Anaesthetist having administered ketamine to hundreds of patients over the years I always felt I was in safe hands. Indeed, I really looked forward to the treatment experience. A ketamine solution was gently infused into the bloodstream over a period of about 40 minutes while I lay in a state which was euphoric and blissful like lying on a cloud.
Music was played of my choice and if my eyes were closed shapes appeared and metamorphosed in my mind’s eye but there was nothing frightening or threatening. On one trip the shapes reminded me of a station platform with a moving train. On another infusion, I even kept my eyes open and watched YouTube videos of REM and Radiohead. I actually felt like I had gone through the screen, that 2D had become 3D and that I was actually at the concert with the singers onstage, much to my delight!
The effects after even the very first infusion were miraculous. That broken record of negativity, undermining everything I did was silent for the first time in years. I felt light in my movements instead of sluggish. I had more energy. I could actually laugh! The tasks that people take for granted like cleaning were suddenly seen for what they were- easily achievable and worth doing because I didn’t have that voice telling me that I would fail at them.
Indeed, this is exactly what Dr Yadhu had told me was one of the many effects of ketamine. As well as repairing damaged neural networks, he told me that ketamine also suppressed the default neural network of a depressive (that darkly ruminating voice) which is so powerful because its neural pathway has been endlessly reinforced and mapped out by constant negative thought processes over many years. Suppressing this default network enables a depressive to create new neural pathways founded on more positive lines of thought, something physiologically and neurologically impossible unless this powerful default network is first disarmed.
After the treatment, it was like waking up to the world in all its potential for joy and happiness. I found myself smiling at random people in the street only for them to smile back so that I lost my cynicism about everyone and everything.
It felt like a huge weight had been lifted off my shoulders. I realised that the positive people in my life were positive because they were not looking for epiphanies and signs from God about the meaning of life, but instead were content with finding joy in little things- dogs larking around on the beach, people and their funny little mannerisms, the magnificence of trees hitherto unnoticed because my eyes were cast to the ground.
As far as side effects are concerned, my partner has noticed more mood fluctuation since starting the treatment. This is something Dr. Yadhu pointed out would happen as subconscious trauma is released and painful memories are free to be processed. However, being able to cry is for me a positive since I always feel better afterwards and another burden feels lifted. When depressed, I found it difficult to cry, I just felt numb. I think this indicates the return of my brain’s neuroplasticity, as I am now able to recall and process traumatic memories, and properly mourn for the past in order to live in the present and look to the future.
It says in the Bible “knock, and it shall be opened unto you” (Matthew 7:7-8). But words cannot express my gratitude to Dr Yadhu for opening that door and giving me the confidence of knowing that if the dark days return, I have somewhere to go to where the light can be let back in.
Burnett, D. (2021). Psycho-Logical: Why Mental Health Goes Wrong & How to Make Sense of It. Uk: Guardian Faber Publishing.
Meldrum, B., 2000. Glutamate as a Neurotransmitter in the Brain: Review of Physiology and Pathology. The Journal of Nutrition, 130(4), pp.1007S-1015