January 8, 2025 • 24 mins
DJ Quam is in recovery from a substance use disorder but experienced ongoing depression and occasional anxiety. After discussing options with his partner and sponsor, he decided to try ketamine therapy. He discusses his experience and results. The FDA has warned that ketamine and compounded ketamine products aren’t approved to treat any psychiatric disorders, although a ketamine-derived drug called esketamine is approved for some people as part of treatment-resistant depression in a certified clinical setting. More information about the use of ketamine for treatment-resistant depression can be found here: https://www.health.harvard.edu/blog/ketamine-for-treatment-resistant-depression-when-and-where-is-it-safe-202208092797 and here: FDA warns about compounded ketamine for psychiatric disorders. DJ’s previous podcast can be found here: We Have a Problem - Avoiding the Addiction Affliction
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Mike (00:12):
Welcome, everybody.
This is Avoiding the AddictionAffliction brought to you by Westwords
Consulting and the Kenosha CountySubstance Use Disorder Coalition.
I'm Mike McGowan.
Perhaps you've seen the billboards,they're in a lot of places, or
articles online about ketamine therapy.
Seems like just a little while ago we werediscussing ketamine as a drug to avoid.
(00:35):
About a year or so ago, we hada conversation with DJ Quam, my
guest today, about his recovery.
When I heard that he had triedketamine therapy, I asked him
to come back and talk about thatexperience and he generously agreed.
Welcome back, DJ, how are you?
DJ (00:49):
I'm doing well.
How are you?
Mike (00:52):
I'm great.
Now we're going to put a link to our lastpodcast, which I think was like a year and
a half or so ago, at the bottom of this.
But just so that people who aretoo lazy to go back (chuckle) and
listen, refresh us a little bit.
How long have you been in recovery now?
DJ (01:09):
I have been sober from alcohol for just about four years.
January will be four years.
Mike (01:15):
Congratulations.
That is great.
DJ (01:17):
Thank you.
Mike (01:18):
And that was your drug of choice as I recall, right?
DJ (01:21):
Yeah.
And actually, yeah, I mean, thatwas my drug of choice and I didn't,
I didn't actually use reallyany other illicit substances.
Yeah, I was pretty vanilla in thesense that I just had alcohol.
Mike (01:35):
(chuckle) Well, okay.
So since you went through that,I assumed since we're talking
about ketamine therapy, youhit some kind of a little wall.
Like what made you want toconsider ketamine therapy?
What was going on?
DJ (01:51):
I have you know, an actual, you know, diagnosed history with depression
and anxiety as probably many people do.
In 2018, I was actually hospitalized for apretty you know, acute anxiety situation.
So I've always kind of known that myI'm somewhat at risk for, you know,
very stressful situations triggering.
(02:14):
It's usually anxiety type attacks.
Other times it kind of putsme into a depressive funk.
But earlier, yeah, I guess earlierthis year, 2024, I had you know,
nothing too out of the ordinary,but at work I got a new boss.
I wasn't really clear how I stoodwith my new boss and, you know,
of course work was, was stressfuland, it was, it was just building,
(02:39):
you know, compounding, compounding.
And, you know, even though I'm, I am, Iam and was, and continue to be sober, but,
you know, I was not necessarily makingtime for, you know, some of my outlets,
you know, downhill skiing for me ridingmy bicycle, rock climbing, et cetera.
(03:00):
So I just remember one day I waswalking my dog with my partner.
And we had driven to a park and somethingthat the dog, the dog was just like,
not behaving real well on the leash.
And long story short, I ended uphaving like a full blown panic anxiety
attack in the backseat of the carat like the local park really from
nothing other than like the dogjust kind of doing his normal thing.
(03:22):
He wasn't behaving anything kindof out of the ordinary and had
kind of long suspected that eventhough I'm on an antidepressant,
that it wasn't quite enough.
I cycled through CBT,Cognitive Behavioral Therapy.
I'd probably seen threedifferent therapists over
the last five or six years.
(03:43):
And, you know, theywere modestly effective.
But I'd been in and out of CBT therapyfor the better part of the last 10 years.
And especially after my hospitalization,of course, that was a condition of my
discharge was to, to follow a plan.
And I did for probably two or threeyears, but I just knew like this
depression and anxiety wasn't reallygoing to be fixed with talk therapy.
(04:06):
And so my partner is you know,his day job is in healthcare.
Now he's not a psychiatrist, sohe doesn't necessarily follow
all the literature on ketamine.
But he at least was aware of thefact that ketamine has an off
label use for treating depression.
And so he kind of encouraged me to lookinto it, not necessarily suggesting
(04:27):
that I do it, but ultimately, you know,I'm a engineer scientist by education.
I do a lot with clinical andmedical work in my day job.
So I had read quite a few, it'spretty well cited, you know, well well
published articles on ketamine therapy.
And it was the evidence in terms ofits efficacy on depression was pretty
(04:50):
clear that the sort of the variabletends to be the how it's administered.
That tends to be the more you know,kind of up in the air variable piece,
but that's kind of where I landed.
I kind of ultimately just hit a wall in mydepression and after sort of, you know, an
informed thoughtful process that honestlytook probably three or four weeks before
(05:11):
I kind of went from panic attack to.
You know, like actuallyfilling out the online form.
It was probably four weeksof, should I do this?
You know, of course it'snot covered by my insurance.
So it was like, do I want tospend this much money on it?
And all of that.
So kind of a very long answer to yourquestion, but that was, that was it.
Mike (05:30):
Oh, that's great.
In fact, it answered someof the other questions.
So you did your own stuff.
And because you can find access to it.
So you didn't go through a physicianor a therapist, but there are
these online therapeutic things.
DJ (05:44):
Yeah.
So I used a service calledMindbloom, which is...
I did quite a bit of research in termsof which of the online providers had
a protocol that was, you know, wellvalidated and well sort of cited.
And I felt comfortable with the onecalled Mindbloom, which actually turns
out to also be one of the longest...
(06:06):
Like they've been around the longest,at least as far as I could recall.
Mike (06:11):
Did it make you at all nervous that the FDA still hasn't
certified it for official use?
DJ (06:17):
I would say no.
You know, so the FDA stillregulates it as a drug, right?
So it's a class, whatever,I think class two.
So it's still, you know, thephysical chemical is still regulated.
So that was going to be my firstconcern is like, am I going to be taking
something that's like, you know, waystronger or somehow, you know, had some
sort of other unknown compound in it?
(06:39):
So the fact that it's regulated bythe FDA in terms of its compounding.
And then of course I was workingwith an actual pharmacy that, you
know, has a registered pharmacist,you know, signing off on it.
So that was my biggest piece.
In terms of the comfort with the FDA nothaving sort of cleared it for the use.
(07:00):
You know, there's a lot of drugs out therethat people get prescribed every day that
if you actually look at the prescribinglabel, you know, I think when it started,
Viagra was for blood pressure, right?
So that didn't necessarily concern me.
And I also, you know, felt like I hadenough of my faculties to say, you know,
I'm comfortable taking that, that risk.
(07:20):
And of course you try it once and, youknow, there's no one forcing you to do a
second dose if you don't like it, right?
So.
Mike (07:28):
Did they prescribe you the oral, did they prescribe you the nasal spray?
DJ (07:32):
So I did the sublingual, which is under the tongue.
And they also prescribe ananti-nausea med so that you take an
anti-nausea med like an hour aheadof when you expect to actually dose.
And they actually tell you, like, it'ssort of formulated to dissolve in that's
typically done under the tongue, butthey said that and all of the videos,
(07:54):
they actually recommend you put itbetween your cheek and your lower gum.
And so it's very controlled.
You only let it kind of linger for sevenminutes and then you spit it all out.
So it's all through the tissue, the gumtissue is where all the sort of transfer
of the pharmaceutical agent happens.
And so it's pretty controlled.
They make it very clear.
(08:14):
Do not swallow.
And I have a story about that where Iaccidentally did not on my first dose.
It was much later, but Iaccidentally swallowed a little
bit and it does make a difference.
So yeah, it's in thatsense, it's very controlled.
Mike (08:26):
Well, okay.
Tell us the swallow story beforeI get into the rest of it.
DJ (08:30):
Yeah.
It was just very, it makesit much more intense, right?
So the uptake curve of, for as longas the medicine's in contact with your
tissue, they understand like how muchof the medicine enters your bloodstream.
But when you swallow it, you canbasically like double or triple your dose.
And so what had happened is my dogended up like jumping on the bed.
(08:54):
And you, I, you, they recommend thatyou actually wear like a sleeping
mask that completely covers your eyes.
They recommend you wearnoise canceling headphones.
Cause the program is coordinatedto like a soundtrack.
So you're pretty much sensory deprivedof what's going on around you.
But my dog got into the room, jumpedon the bed and it startled me enough
that like, basically I got a smallswallow of spit it's seven minutes.
(09:18):
A lot of spit builds up.
Didn't swallow everything, but enoughthat kind of felt somewhere between like
drunk and hungover for probably a goodfour hours, which was a very unusual.
This was not my first dose.
In fact, it was my seventh or eighth.
And so I had very much accustomed tofrom the standard experience was you
(09:39):
put the medicine on your tongue, youlet it sit for seven minutes, there's
a 1 hour, like little soundtrack thatyou listen to, and it's pretty much
that by the time the soundtrack ends.
You're back to normal.
And so the, this experience withthe swallow where it like lingered
for about four hours was like, okay,I don't want this to repeat this.
(10:00):
And in fact, I actually put offany other sessions for a while.
Cause I was like, it was just kind ofa, you know, it kind of like getting
a almost like food poisoning whereyou're like, that was just such a nasty
experience, but that is not normal.
Let me emphasize that.
Mike (10:15):
So it is one of those that when they talk about it online and in the
articles, the literature, they say, thisis where the ketamine therapy can help.
It helps with depression.
It helps if you're alreadyon an antidepressant.
And they said, you know, it justspeeds the process somewhat.
So how long between the doses andhow many did you end up taking?
DJ (10:36):
So the way it worked with my provider, you buy it in packages, right?
And so the packages that youpay for through this service
obviously includes all of theprescriber, so sort of the doctor.
You do Zoom sessions with them andthey do, you know, they obviously
go through a eligibility criteria interms of you know, they screen for
(10:59):
if you've had been prescribed anyother narcotics, they screened for
depression and suicidal ideations.
There's a pretty strict protocolthey follow, but once you
are delivered the medicine.
You know, this whole thing is predicatedon the concept that ketamine induces
neuroplasticity, which is this conceptthat when you are on ketamine and
for a short window afterwards you canessentially rewire parts of your brain.
(11:23):
And so a big part of the service that Iused was, sure, you know, they send you
the medicine, but it's very structuredthat in conjunction with the dosage of
the medicine, you meet with a guide.
And I think in a lot of ways, theguide is a term they use because
it's someone who isn't necessarilylicensed to be a therapist in your
(11:43):
state because a lot of this is like...
I worked with a guy who was based inUtah, and I think in Utah, he is a
licensed therapist, but because I was inWisconsin, they couldn't call it therapy.
So they kind of give it another name,but it's essentially, they call it a
processing hour or something where yousort of work through your sessions.
And essentially you're using that.
(12:04):
neuroplastic window to kind of rewirethe connections and basically start
to unwire the things that are sort ofshort circuiting into depression, and
then you rewire your brain into thingsthat are a little bit more healthy.
And so the first six sessions, theyhave you do in pretty rapid succession.
So the first six that I did, Ifinished in a course of maybe
(12:31):
a little less than six weeks,somewhere between five and six weeks.
And then I chose to add on another six.
As sort of like an add on package.
And I did that more like once amonth, my second six, I did more
like month to month and like kind oflike a maintenance sort of concept.
The service is pretty rigidabout your first six being done
in a pretty rapid succession.
(12:52):
Cause they have some sciencethat says that they, if you.
Kind of put them back to back, likeevery five to seven days, you maximize
the neuroplastic window, and then onceyou've sort of hit your peak, then
you can kind of go into maintain mode.
And that's what I wasdoing in the second six.
Mike (13:09):
When you first did it, were you alone, alone?
Did you have anybody supervise you?
DJ (13:13):
No, no.
So, I mean, obviously this is on thehonor system, but the first session,
it's sandwiched where you start witha guide on Zoom and they kind of, they
go through, again, some safety thingslike they send you a blood pressure
monitor and you have to show the guidethat your blood pressure is in control
and there's some other factors thatthey do in terms of safety checks.
(13:33):
You have to have a friend or some sortof person with you who has to be a, you
know, my partner had to like come ontothe camera on Zoom and the guide, they
had a conversation about kind of safety.
In terms of like, if somethinghappens, here's what to do.
And then I go back with the guideand they kind of give you your final
instructions in terms of like, okay,you put the ketamine under your
(13:55):
tongue and then you hold it forseven minutes and you spit it out.
Then you actually do the first ketaminesession where my partner was checking on
me, I think once or twice during the onehour, don't quote me on that exact number.
And then you finish with the guide.
So your first session is the betterpart of like two hours long because
you start with the guide 60 minuteswith the medicine, and then you have
(14:19):
like a processing session afterwards.
After that the remaining fivesessions you do on your own, but
they are done where you log whenyou've been taking the medicine
and then you work with your guide.
I did a lot of my sessions over Zoom.
I think they offer kind of liketext or chat based processing.
(14:40):
They call it integration.
I chose to do it over Zoom.
That was my preference.
And at that point, like Isaid, it's kind of self paced.
But they give you prompts to remindyou, you know, to stay on schedule.
Mike (14:52):
Well, now there's a couple of really big questions out there.
First, what do you think, how'd it work?
DJ (14:58):
It worked.
Yeah.
I mean, my partner would be thefirst to tell you like, my mood
was pretty dramatically improved.
Mike (15:05):
Almost right away?
DJ (15:08):
Maybe within the first two, maybe three sessions.
Mike (15:10):
Really?
DJ (15:11):
Yeah.
Very, very rapidly.
You know, it's been a fewmonths since my last session.
I'm actually thinking I might up again,like re up and sort of buy another six.
Again, more like maintenance.
I don't necessarily feel like mydepression has, you know, resumed
into some terrible state, but Ican kind of see that my mood has
started to dip and I think I kind ofwant to keep it at a steady state.
(15:32):
But yeah, it definitely worked.
And for me, the real trigger to go afterthe ketamine therapy was for depression.
Although I would say it, for me, theketamine assisted therapy has had equal
benefit on both the depression, butalso kind of leveling out the anxiety.
Mike (15:53):
Have you measured that against the fact that now it's turning
into winter and there's always thatlayer added to it or now your boss
has been your boss for a while.
DJ (16:03):
Yeah, that's interesting
I mean, I'm sure there's some of that.
No, I'm also a freak thatI'm a downhill skier.
So I actually love the winter Sothe winter tends if anything, I tend
to have my depression state duringthe summer when I can't go skiing.
Mike (16:17):
Oh, okay.
DJ (16:17):
But no in general I'd say
I've been in the same job for anumber of years now where I kind
of have enough cycles to kindof be able to distinguish, okay.
Kind of separate out the bosseffect versus the depression effect.
And in general, I would stillstand by like, yeah, it's worked.
(16:40):
I think I would say, you know,there is a certain amount of
mindset impact where if you.
You know, you have tohave kind of intentions.
That's the one thing, at least theservice I used, to make a very strong
point to really make sure that yourmental head space is in a very neutral
(17:02):
to positive place before you actuallytake the medicine, because that's
kind of how you rewire your brain.
If you go in, and just take themedicine and you're in this nasty,
cynical, negative, whatever moodyou're going to basically reinforce
or at least kind of make it morelikely that you're not helping.
So there's a big process wherelike you sit down and you don't
(17:24):
just pop the medicine right away.
You actually kind of startwith, okay, it's journaling.
Then you set an intention andthen you pick your soundtrack.
And then every ketamine sessionends with some journaling.
Some of that is simply just likerecounting the visuals that you saw
and then it kind of flips into howdo you actually integrate that with
some of your goals for therapy, right?
(17:47):
Because that's, again, the service Iused, that was a very big component.
It's, yeah, the ketamine is a tool tohelp you with a broader set of goals.
And that is very well documented insort of my, frankly, my chart, right?
And they also like, I know for a fact,because they also are looking at like
my prescription history to make sureI haven't been prescribed a large
(18:08):
number of other controlled substances.
And I believe that if I had been havinga lot of controlled substances that I may
not have been a candidate, but I didn'thave any problems kind of navigating
the, you know, the medical legal side.
Mike (18:24):
Well, and it does have some disassociative properties,
and I think when you said youswallowed it, you went there.
So my other questions, and I think thisis relevant for the conversation, is as
a recovering person, when you experiencethat altered sense, I'm sure you've
had some folks say, don't go there.
DJ (18:45):
You know, well actually I, so I, you know, I'm in AA, I think
we've talked about that before.
Mike (18:50):
Right.
DJ (18:50):
And I did actually talk to my sponsor before I agreed to do it.
And kind of said, isthis a really bad idea?
Is it an okay idea?
Now I was pretty well sold on the ideawhen I went and talked to my sponsor.
But I was sort of like, going forwardwith a, if there's a red flag here
that I haven't seen, please raise it.
(19:11):
Otherwise I'm going to go ahead.
I think in general, my rule withmyself, as someone who was in
recovery, like I only did it.
I only took the medicine whenmy partner was home and was
aware that I was doing it.
And of course, they only sendyou six doses at a time, and
it's very controlled, right?
So now, if I had really goneoff the deep end and really
(19:35):
developed an urge and a craving forketamine, could I have gotten more?
I don't know, probably.
But I chose to, you know, kind ofstick to it as a therapeutic regimen.
And I had that rule with myself that Iwould only be taking the medicine when
my partner was like, well, A, just likein the house for the sake of like safety,
(19:55):
but also like aware that I was takingthe medicine so that it didn't become
a drinking in the garage situation.
Mike (20:02):
Well, and you said that when you swallowed it accidentally, it left
you feeling intoxicated, more or less.
DJ (20:09):
Yeah.
Mike (20:09):
And that was your drug of choice, so.
You mentioned your sponsor.
You didn't bring it up in an AA meetingto take a vote, though, did you?
DJ (20:19):
No, I did not.
It was one on one.
Mike (20:21):
I wonder what would happen if you mentioned it.
I would love to be therefor that conversation.
DJ (20:27):
I don't know.
Mike (20:27):
Some people would probably, like your sponsor, say, well, as
long as you're safe, go for it.
And other people would be like, you know.
DJ (20:33):
I think there's also like a, you know, in the same way that there's like kind
of a stigma about being in recovery, Ithink there's also a stigma about using
ketamine for more legitimate things.
That's not like recreational.
I actually, I work with a professionalcoach and I mentioned this to my
professional coach and it was veryclear that she had a different view
(20:55):
that she did not feel like this wassomething that she would ever agree to.
And, you know, that's okay, you know,it's just someone else in my kind of,
my day to day life that's like, okay,well, that's how you feel about it.
For me, it was very helpful.
You know, I, I'm not going to make myhealth and wellness decisions based on
(21:15):
what my professional coach says, but,
Mike (21:17):
Well, we just had a discussion.
I had a discussion with somebody earliertoday about this, because we had somebody
on a while back talking about going toMexico for ibogaine, right, therapy.
To get off of opiates.
And, you know, the worldis a different place.
It's no longer black and white, whichis why we're having this discussion.
Does it, so, you know, youknow yourself well, so you may
(21:41):
need a tune up for lack of.
DJ (21:43):
Yeah.
Mike (21:44):
But does it also leave you open to other alternative forms of therapy.
When you talk about the brain we were in,I'm thinking of things like EMDR and some
of the other things we've talked about.
DJ (21:54):
Yeah.
I also did EMDR in therapy andit was effective to a point.
Honestly, more gave me aheadache than anything else.
Mike (22:01):
Did you tap or what were you doing?
DJ (22:04):
No, my therapist did the finger thing.
Mike (22:06):
OK, alright.
DJ (22:07):
Yeah, I mean, in general, I'd say I'm pretty open minded.
I'm also, however, like very much.
Show me the proof that it works.
And you know, I think that's one ofthe reasons where I kind of fell out
of favor with CBT was like, I've justdone this so many times and I've tried
very diligently to pick differenttherapists who have different sort
of approaches and inevitably theresults were only ever okay, right?
(22:31):
The results were never likeearth shatteringly profound.
They were okay, and I feelcomfortable saying that because
like I my sister's a therapist.
I know I've gone to a lot oftherapy and I'm pretty confident to
say that for me as an individual,CBT, if it was the only thing
available, yeah, I would still do it.
But knowing that there's other things.
(22:53):
I'm happy I tried it.
Now would I, you know, go jump onsome new, you know, pharmacochemical
agent that had very little evidence?
No, probably not.
You know, ketamine was kind of aknown entity in the sense that It's
been known for quite a while thatketamine had an anti depressive effect.
I think it's now really kind ofentering that mainstream of like,
(23:14):
A, a doctor can prescribe it to you.
It used to be that doctorscouldn't even prescribe it.
And there was like a safe supply chainin which to procure it that came with
the wraparound services like that I had.
And to me, that was the signthat it was probably, you know,
okay to jump into that pool.
Mike (23:32):
When you got it, did you get it from a local pharmacy?
DJ (23:35):
No, it was shipped from, like, New Hampshire or something.
Yeah.
No, I don't remember what all the laws arethat regulate that, but, like, it wasn't,
like, shipped in the dark of night.
It was, you know, prettyopenly disclosed what it was.
So, I don't necessarily, again,know the laws, but it didn't
come from a Wisconsin pharmacy.
Mike (23:54):
I think it's just fascinating.
I'm so glad you couldhave this conversation.
And I'm, first of all, I'm glad thatit has helped with the depression.
And you're still onyour other meds, right?
DJ (24:06):
Yep.
I'm still on a what is it?
Lexapro Escitalopram.
Mike (24:11):
And it just, it acted like a boost for you.
DJ (24:14):
Yeah, absolutely.
Definitely.
Mike (24:16):
Well, like all things, we keep learning all over and over again, right?
DJ (24:19):
Indeed.
Mike (24:20):
Yeah.
DJ, thank you for so much for beingwith us and talking about this.
As you all know, I'm going to putlinks on the podcast, not only the
DJ's podcast, but also a couplethat have articles about ketamine.
So that if you want to do a little bit ofyour own, it gives you a start for that.
You can all join us whenever you'reable and until you're able, stay safe.
(24:42):
Live well and keep an open mind.
Welcome, everybody.
This is Avoiding the AddictionAffliction brought to you by Westwords
Consulting and the Kenosha CountySubstance Use Disorder Coalition.
I'm Mike McGowan.
Perhaps you've seen the billboards,they're in a lot of places, or
articles online about ketamine therapy.
Seems like just a little while ago we werediscussing ketamine as a drug to avoid.
(00:35):
About a year or so ago, we hada conversation with DJ Quam, my
guest today, about his recovery.
When I heard that he had triedketamine therapy, I asked him
to come back and talk about thatexperience and he generously agreed.
Welcome back, DJ, how are you?
DJ (00:49):
I'm doing well.
How are you?
Mike (00:52):
I'm great.
Now we're going to put a link to our lastpodcast, which I think was like a year and
a half or so ago, at the bottom of this.
But just so that people who aretoo lazy to go back (chuckle) and
listen, refresh us a little bit.
How long have you been in recovery now?
DJ (01:09):
I have been sober from alcohol for just about four years.
January will be four years.
Mike (01:15):
Congratulations.
That is great.
DJ (01:17):
Thank you.
Mike (01:18):
And that was your drug of choice as I recall, right?
DJ (01:21):
Yeah.
And actually, yeah, I mean, thatwas my drug of choice and I didn't,
I didn't actually use reallyany other illicit substances.
Yeah, I was pretty vanilla in thesense that I just had alcohol.
Mike (01:35):
(chuckle) Well, okay.
So since you went through that,I assumed since we're talking
about ketamine therapy, youhit some kind of a little wall.
Like what made you want toconsider ketamine therapy?
What was going on?
DJ (01:51):
I have you know, an actual, you know, diagnosed history with depression
and anxiety as probably many people do.
In 2018, I was actually hospitalized for apretty you know, acute anxiety situation.
So I've always kind of known that myI'm somewhat at risk for, you know,
very stressful situations triggering.
(02:14):
It's usually anxiety type attacks.
Other times it kind of putsme into a depressive funk.
But earlier, yeah, I guess earlierthis year, 2024, I had you know,
nothing too out of the ordinary,but at work I got a new boss.
I wasn't really clear how I stoodwith my new boss and, you know,
of course work was, was stressfuland, it was, it was just building,
(02:39):
you know, compounding, compounding.
And, you know, even though I'm, I am, Iam and was, and continue to be sober, but,
you know, I was not necessarily makingtime for, you know, some of my outlets,
you know, downhill skiing for me ridingmy bicycle, rock climbing, et cetera.
(03:00):
So I just remember one day I waswalking my dog with my partner.
And we had driven to a park and somethingthat the dog, the dog was just like,
not behaving real well on the leash.
And long story short, I ended uphaving like a full blown panic anxiety
attack in the backseat of the carat like the local park really from
nothing other than like the dogjust kind of doing his normal thing.
(03:22):
He wasn't behaving anything kindof out of the ordinary and had
kind of long suspected that eventhough I'm on an antidepressant,
that it wasn't quite enough.
I cycled through CBT,Cognitive Behavioral Therapy.
I'd probably seen threedifferent therapists over
the last five or six years.
(03:43):
And, you know, theywere modestly effective.
But I'd been in and out of CBT therapyfor the better part of the last 10 years.
And especially after my hospitalization,of course, that was a condition of my
discharge was to, to follow a plan.
And I did for probably two or threeyears, but I just knew like this
depression and anxiety wasn't reallygoing to be fixed with talk therapy.
(04:06):
And so my partner is you know,his day job is in healthcare.
Now he's not a psychiatrist, sohe doesn't necessarily follow
all the literature on ketamine.
But he at least was aware of thefact that ketamine has an off
label use for treating depression.
And so he kind of encouraged me to lookinto it, not necessarily suggesting
(04:27):
that I do it, but ultimately, you know,I'm a engineer scientist by education.
I do a lot with clinical andmedical work in my day job.
So I had read quite a few, it'spretty well cited, you know, well well
published articles on ketamine therapy.
And it was the evidence in terms ofits efficacy on depression was pretty
(04:50):
clear that the sort of the variabletends to be the how it's administered.
That tends to be the more you know,kind of up in the air variable piece,
but that's kind of where I landed.
I kind of ultimately just hit a wall in mydepression and after sort of, you know, an
informed thoughtful process that honestlytook probably three or four weeks before
(05:11):
I kind of went from panic attack to.
You know, like actuallyfilling out the online form.
It was probably four weeksof, should I do this?
You know, of course it'snot covered by my insurance.
So it was like, do I want tospend this much money on it?
And all of that.
So kind of a very long answer to yourquestion, but that was, that was it.
Mike (05:30):
Oh, that's great.
In fact, it answered someof the other questions.
So you did your own stuff.
And because you can find access to it.
So you didn't go through a physicianor a therapist, but there are
these online therapeutic things.
DJ (05:44):
Yeah.
So I used a service calledMindbloom, which is...
I did quite a bit of research in termsof which of the online providers had
a protocol that was, you know, wellvalidated and well sort of cited.
And I felt comfortable with the onecalled Mindbloom, which actually turns
out to also be one of the longest...
(06:06):
Like they've been around the longest,at least as far as I could recall.
Mike (06:11):
Did it make you at all nervous that the FDA still hasn't
certified it for official use?
DJ (06:17):
I would say no.
You know, so the FDA stillregulates it as a drug, right?
So it's a class, whatever,I think class two.
So it's still, you know, thephysical chemical is still regulated.
So that was going to be my firstconcern is like, am I going to be taking
something that's like, you know, waystronger or somehow, you know, had some
sort of other unknown compound in it?
(06:39):
So the fact that it's regulated bythe FDA in terms of its compounding.
And then of course I was workingwith an actual pharmacy that, you
know, has a registered pharmacist,you know, signing off on it.
So that was my biggest piece.
In terms of the comfort with the FDA nothaving sort of cleared it for the use.
(07:00):
You know, there's a lot of drugs out therethat people get prescribed every day that
if you actually look at the prescribinglabel, you know, I think when it started,
Viagra was for blood pressure, right?
So that didn't necessarily concern me.
And I also, you know, felt like I hadenough of my faculties to say, you know,
I'm comfortable taking that, that risk.
(07:20):
And of course you try it once and, youknow, there's no one forcing you to do a
second dose if you don't like it, right?
So.
Mike (07:28):
Did they prescribe you the oral, did they prescribe you the nasal spray?
DJ (07:32):
So I did the sublingual, which is under the tongue.
And they also prescribe ananti-nausea med so that you take an
anti-nausea med like an hour aheadof when you expect to actually dose.
And they actually tell you, like, it'ssort of formulated to dissolve in that's
typically done under the tongue, butthey said that and all of the videos,
(07:54):
they actually recommend you put itbetween your cheek and your lower gum.
And so it's very controlled.
You only let it kind of linger for sevenminutes and then you spit it all out.
So it's all through the tissue, the gumtissue is where all the sort of transfer
of the pharmaceutical agent happens.
And so it's pretty controlled.
They make it very clear.
(08:14):
Do not swallow.
And I have a story about that where Iaccidentally did not on my first dose.
It was much later, but Iaccidentally swallowed a little
bit and it does make a difference.
So yeah, it's in thatsense, it's very controlled.
Mike (08:26):
Well, okay.
Tell us the swallow story beforeI get into the rest of it.
DJ (08:30):
Yeah.
It was just very, it makesit much more intense, right?
So the uptake curve of, for as longas the medicine's in contact with your
tissue, they understand like how muchof the medicine enters your bloodstream.
But when you swallow it, you canbasically like double or triple your dose.
And so what had happened is my dogended up like jumping on the bed.
(08:54):
And you, I, you, they recommend thatyou actually wear like a sleeping
mask that completely covers your eyes.
They recommend you wearnoise canceling headphones.
Cause the program is coordinatedto like a soundtrack.
So you're pretty much sensory deprivedof what's going on around you.
But my dog got into the room, jumpedon the bed and it startled me enough
that like, basically I got a smallswallow of spit it's seven minutes.
(09:18):
A lot of spit builds up.
Didn't swallow everything, but enoughthat kind of felt somewhere between like
drunk and hungover for probably a goodfour hours, which was a very unusual.
This was not my first dose.
In fact, it was my seventh or eighth.
And so I had very much accustomed tofrom the standard experience was you
(09:39):
put the medicine on your tongue, youlet it sit for seven minutes, there's
a 1 hour, like little soundtrack thatyou listen to, and it's pretty much
that by the time the soundtrack ends.
You're back to normal.
And so the, this experience withthe swallow where it like lingered
for about four hours was like, okay,I don't want this to repeat this.
(10:00):
And in fact, I actually put offany other sessions for a while.
Cause I was like, it was just kind ofa, you know, it kind of like getting
a almost like food poisoning whereyou're like, that was just such a nasty
experience, but that is not normal.
Let me emphasize that.
Mike (10:15):
So it is one of those that when they talk about it online and in the
articles, the literature, they say, thisis where the ketamine therapy can help.
It helps with depression.
It helps if you're alreadyon an antidepressant.
And they said, you know, it justspeeds the process somewhat.
So how long between the doses andhow many did you end up taking?
DJ (10:36):
So the way it worked with my provider, you buy it in packages, right?
And so the packages that youpay for through this service
obviously includes all of theprescriber, so sort of the doctor.
You do Zoom sessions with them andthey do, you know, they obviously
go through a eligibility criteria interms of you know, they screen for
(10:59):
if you've had been prescribed anyother narcotics, they screened for
depression and suicidal ideations.
There's a pretty strict protocolthey follow, but once you
are delivered the medicine.
You know, this whole thing is predicatedon the concept that ketamine induces
neuroplasticity, which is this conceptthat when you are on ketamine and
for a short window afterwards you canessentially rewire parts of your brain.
(11:23):
And so a big part of the service that Iused was, sure, you know, they send you
the medicine, but it's very structuredthat in conjunction with the dosage of
the medicine, you meet with a guide.
And I think in a lot of ways, theguide is a term they use because
it's someone who isn't necessarilylicensed to be a therapist in your
(11:43):
state because a lot of this is like...
I worked with a guy who was based inUtah, and I think in Utah, he is a
licensed therapist, but because I was inWisconsin, they couldn't call it therapy.
So they kind of give it another name,but it's essentially, they call it a
processing hour or something where yousort of work through your sessions.
And essentially you're using that.
(12:04):
neuroplastic window to kind of rewirethe connections and basically start
to unwire the things that are sort ofshort circuiting into depression, and
then you rewire your brain into thingsthat are a little bit more healthy.
And so the first six sessions, theyhave you do in pretty rapid succession.
So the first six that I did, Ifinished in a course of maybe
(12:31):
a little less than six weeks,somewhere between five and six weeks.
And then I chose to add on another six.
As sort of like an add on package.
And I did that more like once amonth, my second six, I did more
like month to month and like kind oflike a maintenance sort of concept.
The service is pretty rigidabout your first six being done
in a pretty rapid succession.
(12:52):
Cause they have some sciencethat says that they, if you.
Kind of put them back to back, likeevery five to seven days, you maximize
the neuroplastic window, and then onceyou've sort of hit your peak, then
you can kind of go into maintain mode.
And that's what I wasdoing in the second six.
Mike (13:09):
When you first did it, were you alone, alone?
Did you have anybody supervise you?
DJ (13:13):
No, no.
So, I mean, obviously this is on thehonor system, but the first session,
it's sandwiched where you start witha guide on Zoom and they kind of, they
go through, again, some safety thingslike they send you a blood pressure
monitor and you have to show the guidethat your blood pressure is in control
and there's some other factors thatthey do in terms of safety checks.
(13:33):
You have to have a friend or some sortof person with you who has to be a, you
know, my partner had to like come ontothe camera on Zoom and the guide, they
had a conversation about kind of safety.
In terms of like, if somethinghappens, here's what to do.
And then I go back with the guideand they kind of give you your final
instructions in terms of like, okay,you put the ketamine under your
(13:55):
tongue and then you hold it forseven minutes and you spit it out.
Then you actually do the first ketaminesession where my partner was checking on
me, I think once or twice during the onehour, don't quote me on that exact number.
And then you finish with the guide.
So your first session is the betterpart of like two hours long because
you start with the guide 60 minuteswith the medicine, and then you have
(14:19):
like a processing session afterwards.
After that the remaining fivesessions you do on your own, but
they are done where you log whenyou've been taking the medicine
and then you work with your guide.
I did a lot of my sessions over Zoom.
I think they offer kind of liketext or chat based processing.
(14:40):
They call it integration.
I chose to do it over Zoom.
That was my preference.
And at that point, like Isaid, it's kind of self paced.
But they give you prompts to remindyou, you know, to stay on schedule.
Mike (14:52):
Well, now there's a couple of really big questions out there.
First, what do you think, how'd it work?
DJ (14:58):
It worked.
Yeah.
I mean, my partner would be thefirst to tell you like, my mood
was pretty dramatically improved.
Mike (15:05):
Almost right away?
DJ (15:08):
Maybe within the first two, maybe three sessions.
Mike (15:10):
Really?
DJ (15:11):
Yeah.
Very, very rapidly.
You know, it's been a fewmonths since my last session.
I'm actually thinking I might up again,like re up and sort of buy another six.
Again, more like maintenance.
I don't necessarily feel like mydepression has, you know, resumed
into some terrible state, but Ican kind of see that my mood has
started to dip and I think I kind ofwant to keep it at a steady state.
(15:32):
But yeah, it definitely worked.
And for me, the real trigger to go afterthe ketamine therapy was for depression.
Although I would say it, for me, theketamine assisted therapy has had equal
benefit on both the depression, butalso kind of leveling out the anxiety.
Mike (15:53):
Have you measured that against the fact that now it's turning
into winter and there's always thatlayer added to it or now your boss
has been your boss for a while.
DJ (16:03):
Yeah, that's interesting
I mean, I'm sure there's some of that.
No, I'm also a freak thatI'm a downhill skier.
So I actually love the winter Sothe winter tends if anything, I tend
to have my depression state duringthe summer when I can't go skiing.
Mike (16:17):
Oh, okay.
DJ (16:17):
But no in general I'd say
I've been in the same job for anumber of years now where I kind
of have enough cycles to kindof be able to distinguish, okay.
Kind of separate out the bosseffect versus the depression effect.
And in general, I would stillstand by like, yeah, it's worked.
(16:40):
I think I would say, you know,there is a certain amount of
mindset impact where if you.
You know, you have tohave kind of intentions.
That's the one thing, at least theservice I used, to make a very strong
point to really make sure that yourmental head space is in a very neutral
(17:02):
to positive place before you actuallytake the medicine, because that's
kind of how you rewire your brain.
If you go in, and just take themedicine and you're in this nasty,
cynical, negative, whatever moodyou're going to basically reinforce
or at least kind of make it morelikely that you're not helping.
So there's a big process wherelike you sit down and you don't
(17:24):
just pop the medicine right away.
You actually kind of startwith, okay, it's journaling.
Then you set an intention andthen you pick your soundtrack.
And then every ketamine sessionends with some journaling.
Some of that is simply just likerecounting the visuals that you saw
and then it kind of flips into howdo you actually integrate that with
some of your goals for therapy, right?
(17:47):
Because that's, again, the service Iused, that was a very big component.
It's, yeah, the ketamine is a tool tohelp you with a broader set of goals.
And that is very well documented insort of my, frankly, my chart, right?
And they also like, I know for a fact,because they also are looking at like
my prescription history to make sureI haven't been prescribed a large
(18:08):
number of other controlled substances.
And I believe that if I had been havinga lot of controlled substances that I may
not have been a candidate, but I didn'thave any problems kind of navigating
the, you know, the medical legal side.
Mike (18:24):
Well, and it does have some disassociative properties,
and I think when you said youswallowed it, you went there.
So my other questions, and I think thisis relevant for the conversation, is as
a recovering person, when you experiencethat altered sense, I'm sure you've
had some folks say, don't go there.
DJ (18:45):
You know, well actually I, so I, you know, I'm in AA, I think
we've talked about that before.
Mike (18:50):
Right.
DJ (18:50):
And I did actually talk to my sponsor before I agreed to do it.
And kind of said, isthis a really bad idea?
Is it an okay idea?
Now I was pretty well sold on the ideawhen I went and talked to my sponsor.
But I was sort of like, going forwardwith a, if there's a red flag here
that I haven't seen, please raise it.
(19:11):
Otherwise I'm going to go ahead.
I think in general, my rule withmyself, as someone who was in
recovery, like I only did it.
I only took the medicine whenmy partner was home and was
aware that I was doing it.
And of course, they only sendyou six doses at a time, and
it's very controlled, right?
So now, if I had really goneoff the deep end and really
(19:35):
developed an urge and a craving forketamine, could I have gotten more?
I don't know, probably.
But I chose to, you know, kind ofstick to it as a therapeutic regimen.
And I had that rule with myself that Iwould only be taking the medicine when
my partner was like, well, A, just likein the house for the sake of like safety,
(19:55):
but also like aware that I was takingthe medicine so that it didn't become
a drinking in the garage situation.
Mike (20:02):
Well, and you said that when you swallowed it accidentally, it left
you feeling intoxicated, more or less.
DJ (20:09):
Yeah.
Mike (20:09):
And that was your drug of choice, so.
You mentioned your sponsor.
You didn't bring it up in an AA meetingto take a vote, though, did you?
DJ (20:19):
No, I did not.
It was one on one.
Mike (20:21):
I wonder what would happen if you mentioned it.
I would love to be therefor that conversation.
DJ (20:27):
I don't know.
Mike (20:27):
Some people would probably, like your sponsor, say, well, as
long as you're safe, go for it.
And other people would be like, you know.
DJ (20:33):
I think there's also like a, you know, in the same way that there's like kind
of a stigma about being in recovery, Ithink there's also a stigma about using
ketamine for more legitimate things.
That's not like recreational.
I actually, I work with a professionalcoach and I mentioned this to my
professional coach and it was veryclear that she had a different view
(20:55):
that she did not feel like this wassomething that she would ever agree to.
And, you know, that's okay, you know,it's just someone else in my kind of,
my day to day life that's like, okay,well, that's how you feel about it.
For me, it was very helpful.
You know, I, I'm not going to make myhealth and wellness decisions based on
(21:15):
what my professional coach says, but,
Mike (21:17):
Well, we just had a discussion.
I had a discussion with somebody earliertoday about this, because we had somebody
on a while back talking about going toMexico for ibogaine, right, therapy.
To get off of opiates.
And, you know, the worldis a different place.
It's no longer black and white, whichis why we're having this discussion.
Does it, so, you know, youknow yourself well, so you may
(21:41):
need a tune up for lack of.
DJ (21:43):
Yeah.
Mike (21:44):
But does it also leave you open to other alternative forms of therapy.
When you talk about the brain we were in,I'm thinking of things like EMDR and some
of the other things we've talked about.
DJ (21:54):
Yeah.
I also did EMDR in therapy andit was effective to a point.
Honestly, more gave me aheadache than anything else.
Mike (22:01):
Did you tap or what were you doing?
DJ (22:04):
No, my therapist did the finger thing.
Mike (22:06):
OK, alright.
DJ (22:07):
Yeah, I mean, in general, I'd say I'm pretty open minded.
I'm also, however, like very much.
Show me the proof that it works.
And you know, I think that's one ofthe reasons where I kind of fell out
of favor with CBT was like, I've justdone this so many times and I've tried
very diligently to pick differenttherapists who have different sort
of approaches and inevitably theresults were only ever okay, right?
(22:31):
The results were never likeearth shatteringly profound.
They were okay, and I feelcomfortable saying that because
like I my sister's a therapist.
I know I've gone to a lot oftherapy and I'm pretty confident to
say that for me as an individual,CBT, if it was the only thing
available, yeah, I would still do it.
But knowing that there's other things.
(22:53):
I'm happy I tried it.
Now would I, you know, go jump onsome new, you know, pharmacochemical
agent that had very little evidence?
No, probably not.
You know, ketamine was kind of aknown entity in the sense that It's
been known for quite a while thatketamine had an anti depressive effect.
I think it's now really kind ofentering that mainstream of like,
(23:14):
A, a doctor can prescribe it to you.
It used to be that doctorscouldn't even prescribe it.
And there was like a safe supply chainin which to procure it that came with
the wraparound services like that I had.
And to me, that was the signthat it was probably, you know,
okay to jump into that pool.
Mike (23:32):
When you got it, did you get it from a local pharmacy?
DJ (23:35):
No, it was shipped from, like, New Hampshire or something.
Yeah.
No, I don't remember what all the laws arethat regulate that, but, like, it wasn't,
like, shipped in the dark of night.
It was, you know, prettyopenly disclosed what it was.
So, I don't necessarily, again,know the laws, but it didn't
come from a Wisconsin pharmacy.
Mike (23:54):
I think it's just fascinating.
I'm so glad you couldhave this conversation.
And I'm, first of all, I'm glad thatit has helped with the depression.
And you're still onyour other meds, right?
DJ (24:06):
Yep.
I'm still on a what is it?
Lexapro Escitalopram.
Mike (24:11):
And it just, it acted like a boost for you.
DJ (24:14):
Yeah, absolutely.
Definitely.
Mike (24:16):
Well, like all things, we keep learning all over and over again, right?
DJ (24:19):
Indeed.
Mike (24:20):
Yeah.
DJ, thank you for so much for beingwith us and talking about this.
As you all know, I'm going to putlinks on the podcast, not only the
DJ's podcast, but also a couplethat have articles about ketamine.
So that if you want to do a little bit ofyour own, it gives you a start for that.
You can all join us whenever you'reable and until you're able, stay safe.
(24:42):
Live well and keep an open mind.
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