By Jenna Lebovits
My first introduction to ketamine was in 2009. My then-toddler brother had slipped off a rock at the park and broken his arm, and after being rushed to the hospital, had received a high dose of ketamine while the doctors reset his tiny broken bones. What would normally be an excruciating procedure, especially for a 4-year-old, was a calm and controlled experience. This is ketamine in its most classic application: a dissociative anesthetic. Food and Drug Administration-approved for medical use since 1970, and for mental health treatment since 2019, the substance has recently emerged as a potential—and highly promising—treatment option for an array of psychiatric conditions.
Today, ketamine is used to help treat anxiety, depression (especially in individuals who are treatment-resistant), PTSD, OCD, substance use disorder, suicidal ideation and more. It is the only clinician-prescribed psychedelic currently available on the market, and has over 100 studies spanning two decades supporting its efficacy. “Mental health is the No. 1 public health crisis today, and it’s growing worse because last-generation treatments like antidepressants and talk therapy aren’t getting the job done,” says Dylan Beynon, founder and CEO of Mindbloom, an at-home, guided ketamine therapy program. “Roughly 1 in 8 American adults take antidepressants and nearly 1 in 5 American adults go to talk therapy, yet studies show that less than half of people who take antidepressants or go to talk therapy actually respond to treatment.” (Editor’s note: because mental illness is complex, different types of therapy and medication can be implemented with varying results.)
Ketamine is believed to elicit its therapeutic effects via a few different mechanisms. “First, ketamine blocks NMDA receptors [glutamate receptors that play a key role in synaptic plasticity, the basis of memory formation] in the brain. This begins a cascade of events that leads to increased production of brain-derived neurotrophic factor, or BDNF. BDNF acts like fertilizer for the brain: It increases neuroplasticity, meaning that it helps you form new neural connections in the parts of the brain that regulate emotions and control learning and memory. Second, ketamine quiets the default mode network, or DMN. DMN is the part of the brain responsible for ruminations and many negative thought patterns,” explains Leonardo Vando, M.D., Mindbloom’s medical director and psychedelic therapy leader. “This combination allows people to break out of old patterns and form new, healthier habits and ways of thinking.”
I was introduced to Mindbloom by a friend. She is also a creative: a poet and director of an MFA program who was curious about psychedelic therapy and its potential to help her process grief, while also bolstering her creativity and easing her low-grade depression.
From the start, Mindbloom’s approach was warm and uncomplicated, and the at-home, self-guided process was appealing to me. Currently, ketamine therapy is available either in-clinic or at home and delivered via telemedicine. The latter is often more affordable and convenient, but requires the presence of a trip sitter (or a “peer treatment monitor,” as Mindbloom calls it). No kind of psychedelic therapy is entirely risk-free, nor is it for everyone. “Certain preexisting conditions might make ketamine therapy inappropriate for some people—e.g., certain respiratory problems, high blood pressure, heart problems and untreated or unstable substance use disorders,” explains Vando. “At Mindbloom, every client receives a full medical and psychiatric evaluation from a licensed psychiatric clinician to ensure that treatment is safe and appropriate for them.”
Mindbloom patients are not required to work with a therapist, but instead are supported throughout the program by a trained guide and licensed psychiatric clinician. To optimize safety and benefits, ketamine should be used in a guided or supervised therapeutic setting. Recreational use carries risks such as improper dosage, increased blood pressure and heart rate, and other unwanted side effects.
After responding to a brief online questionnaire, I was matched with a clinician for an initial psychiatric evaluation on Zoom. After it was determined that I qualified, the medicine and a Bloombox—which contained an eye mask, journal and blood pressure cuff—was shipped out to me. I was encouraged by the clinician to sharpen my intentions and reasons for seeking healing with Mindbloom over the next six weeks. I began to journal and visualize what my ideal life looked like—how I felt, what activities I participated in, where I lived—and what steps I needed to take in order to get there.
One early morning in September, I was greeted on Zoom by my guide. She had a positive and grounded demeanor, and led with “So, are you ready?” I closed my laptop, pulled the soft eye mask over my eyes, placed two dime-sized lozenges inside my cheeks and leaned forward. The medicine was bitter, and I was told not to swallow it. I played my preselected audio track, spit the medicine out after seven minutes, took a long, deep breath, and laid back in my bed.
Here’s what happened.
It took me about 20 minutes to notice any changes. I felt it first in my body. My limbs felt heavy, and a sense of calm washed over me as I sank deeper and deeper into my bed. A few moments later, I felt as though I was floating but I couldn’t describe where I was. Over the next couple of minutes, the space transitioned from a dark, void-like space to a colorful cosmic environment where I existed comfortably. I was greeted by beloved family members—my mother and grandfather—and was filled with feelings of love, warmth and gratitude. I’d never experienced anything like this before, but felt calm and curious. Then, all of a sudden, I was flying. My partner appeared and we were traveling, hand-in-hand, through breathtaking landscapes: mountains, rivers, valleys and streams. I felt an overwhelming sense of joy and freedom. I was happy to return to places we loved: the limestone mountains of Vietnam, the tranquil beaches of southern Thailand.
Several situations in my life appeared before me—an argument with a problematic parent, a painful teenage experience—but what followed was a new and positive thought. I was detached from the negative emotions I’d normally feel, and felt self-compassion for what I’d experienced. The effects were mostly emotional and cerebral, so much so that I nearly forgot I had a body.
The experience felt cinematic: It was as though I was sitting down in a theater watching my past and future unfold in front of me. I was often brought back to my childhood and teenage years. My grandmother, whom I loved dearly and had passed away in 2019, appeared. We hugged each other and she and I existed—for what felt like an eternity—in a temporary, timeless space. Feeling overwhelmed with emotion, I shed a happy tear for what felt like a beautiful reunion.
Each session was different, some more profound than others. Four sessions into the program, I attended an integration circle led by one of Mindbloom’s guides. I felt frustrated as I listened to seasoned “bloomineers” share their personal accounts of long-term change. While I had enjoyed my sessions and appreciated the insights I gained from them, I hadn’t noticed anything particularly long-lasting just yet. This is when I delved deeper into the concept of integration, a key tenet of psychedelic medicine. “It helps individuals assimilate insights and experiences from their therapy sessions into their daily lives,” says Vando. “This process involves bringing together different aspects of one’s self, uncovered or highlighted during therapy, to foster healing.” I committed to a daily journaling practice, and paid closer attention to my thoughts, reactions and behaviors. This, in conjunction with the ketamine, allowed me to gain even more clarity around my triggers and the roots of my mental health struggles.
Upon completion of the program, I was given three options: Continue treatment with a six- or 18-session pack, pause and integrate the experiences for a few weeks, or conclude treatment altogether. I decided to finish treatment and integrate the insights I gained in each of the six sessions.
Do I feel as though my occasional mental health issues are completely healed? No. But I better understand how I can continue to heal them. I feel more at peace about a painful, ongoing situation with a difficult family member, and feel that the positive feelings and beliefs that I hold for the world around me—and those I love—are affirmed on a deeper level.
Ketamine therapy, when used in conjunction with the proper preparation and integration techniques, can be a potent transformational tool for inner change. “In the next couple years, we’re going to see ketamine therapy quickly move into the mainstream of mental health, with study after study demonstrating its unique and superior results as a mental health treatment,” says Beynon. “The tools we need to fix the mental health crisis are right in front of us, we just need to let people use them.” mindbloom.com