Inside the ketamine therapy boom: Depressed patients say drug has given them another shot at life

“You may feel like you’re going to die — but you’re not. Your body is right here in this safe place and we are monitoring you to ensure you are safe.”

That’s what Steph Mahrle, a 43-year-old stay-at-home mom from Bergen County, New Jersey, was told before her first ketamine therapy session at Nushama Wellness Center in New York City.

Mahrle had been battling complex post-traumatic stress disorder (C-PTSD) for years, and she was hoping the trippy drug would offer relief where other treatments hadn’t.

The warning from her integrationist — the person who helps patients prepare and then process what they went through — prepared her for when things got rough.

“When I felt like I was falling into an abyss of space, I would use my [wedding] ring as a totem of sorts to ground myself. Reminding myself that my very supportive and loving husband was waiting for me after my journey really soothed me at times,” she told The Post.

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Ketamine on the climb

Mahrle is just one of a growing number of Americans embracing the controversial drug to treat mental health issues that other treatments just can’t touch.

Clinics that offer ketamine therapy with medical supervision have increased in popularity in recent years, with some estimates putting it at over 1,000 in the US. There are at least a dozen in New York City alone.

But while this drug is being hailed by many of its users as a miracle cure for illnesses like PTSD and depression, and its use is supported by some doctors, it is still — experts caution — a powerful hallucinogenic.

“There’s a risk of people receiving infusions for ketamine without an appropriate diagnostic workup and [without] considering other factors which may be responsible for their symptoms, particularly psychological problems,” psychiatrist Dr. Simon Dosovitz told The Post.

“And I think that risk is increased because several providers who are administering ketamine aren’t actually psychiatrists — they are other professionals without as much training.

“It is a strongly dissociative drug.”

An anesthetic, ketamine can distort your senses and have hallucinogenic effects — hence why it was favored as a party drug in the ’80s and ’90s, making ravers see vivid colors and feel like they were floating.

But proponents say it can also rewire your brain if you’re dealing with depression or PTSD. That’s made it an attractive treatment for people who’ve tried just about everything else and still can’t get past their mental health slumps.

Mahrle is emphatic that her ketamine therapy has been worth it. By the time she started, she’d done over a decade of cognitive behavioral therapy and two years of an SSRI — and though she was in a better place than where she started, she had a ways to go.

“I was still suffering with regular nightmares, disassociating with environmental triggers, and hypervigilance. I felt like I needed a hard reset to calm my nervous system. No amount of intellectualizing seemed to offer me lasting relief,” she said

“[Ketamine therapy] is the only treatment I have found which calms my nervous system down enough so that I can actually reconcile the traumatic experiences I have survived.

“After a ketamine journey, I feel a deep sense of relief physically as well as mentally. That allows me time and space to reflect so that I can focus on my present more consciously.”

In another dimension

For 75-year-old Rita Vainius from Saugerties, New York, ketamine therapy was practically a last resort to treat chronic severe depression and trauma that had plagued her since her late 30s.

“I was in at least six hospitals and… had at least two or three suicide attempts,” she told The Post.

So when her psychopharmacologist recommended the ketamine, she was ready and willing to give it a shot.

Like nearly treatment-resistant depression, or severe depression that doesn’t improve with other treatments over a significant period of time. She’s been on antidepressants, but said she’d had “ups and downs” over the years.

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Her ketamine treatments had some ups and downs too.

“The treatment itself… can be quite intense,” her daughter, Iri Greco, said. “Sometimes she has so much fun. We’ve had silly conversations where we’re just goofing around. But we’ve also had some bad experiences. We’ve had crying. We’ve had a couple of arguments.”

“It’s very emotional and I sometimes start to go downhill,” Vainius added.

“I have had some wonderfully weird and healing dreamscapes. The music is much more intense! It feels like I am dancing with and between the notes.”

Karen Zechowy

“There is a definite altered state of mind where you perceive things visually differently. Everything is sort of magnified; everything is dimensionally different than normal. And in my case, I can get very emotional very easily.”

Vainius’ infusions typically last around 90 minutes, and she found that afterward, she needs time to regain full mobility and feel steady on her feet.

“I’ve never tried to walk around … I wouldn’t be able to,” she said. “Even when I’m coming out of it, I’m still not steady on my feet, and that’s after it has subsided. You really don’t have the control over your body that you normally do. Your body doesn’t respond to your movements, or your movements don’t correlate to what your mind wants to do.”

A journey to a trip

Karen Zechowy, 52, was also not responding well to traditional treatments, with depression taking over her life.

“I was in isolation from the world,” she said. “I couldn’t even answer the phone, respond to an email, get to a Zoom meeting, pick up the mail. I had agoraphobia and did not leave my apartment… I could not do activities of daily living such as brushing my teeth or showering for over a year.

“I have been hospitalized several times for depression and suicide attempts. I’ve tried many, many medications since the age of 17 and several modalities of therapy. Ketamine was the first medication that treated my suicidal ideation.”

At first, her infusions lasted for hours, and she experienced sensations like numbness and visions — both of which are common with ketamine treatment.

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“After a few minutes, I begin to feel lighter,” she explained. “I would feel numb, happy and relaxed for an hour. Until recently, I would have periods of seeing a fun, electric, vibrant red.”

She’d pass the time by listening to music like Hugh Jackman’s songs from “The Music Man” and Weird Al, which led to an intense listening experience.

“I have had some wonderfully weird and healing dreamscapes,” Zechowy said. “The music is much more intense! It feels like I am dancing with and between the notes. The lyrics hit deeper.”

The relief Zechowy felt after her treatment outweighed the process of IV ketamine therapy, and even surpassed her previous experiences on medications.

“After suffering from all the side effects of psychiatric medications such as weight gain and even rage, it felt like a gift from above that my depression treatment could be such a wonderful hour,” she admitted. “The hourlong infusion felt like a vacation from pain.”

Doctor’s orders

While ketamine is a relatively newer treatment for mental health conditions, there are several advocates for the drug — especially those who provide it.

“When you look at the studies for ketamine on mental health, well over 90% of the clinical trials have specifically focused on clinical depression, including major depressive disorder or bipolar disorder,” said Dr. Nico Grundmann, MD, the co-founder and medical director of Ember Health, a ketamine therapy clinic in New York City.

“Ketamine was the first thing that gave me a glimmer of hope that I could change, that I could have a different life.”

Karen Zechowy

“We have 50% more studies on ketamine than we do on Zoloft at this point in time for clinical depression. As long as you’re treating one of those two diagnoses, you can be comfortable that this is an incredibly well-studied treatment process.”

But ketamine does come with side effects, including hallucinations, forgetfulness, euphoria and making the user feel disconnected or not fully in control — things both Mahrle and Vainius experienced.

While the hallucinations can be therapeutic, some patients can find them scary or anxiety-inducing. There are also some potential physical downsides, like nausea, vomiting, dizziness, fatigue, blurred vision, increased blood pressure and raised heart rate.

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It’s strongly recommended that sessions be supervised due to possible side effects and how patients respond to the drug.

“Clinics, if they’re following any of the legal frameworks or the regulatory frameworks, are monitoring patients until they’re medically dischargeable, that they’re safe to go back to New York after having been physically and mentally cleared because the ketamine is out of their system,” Grundmann said.

There’s also room for abuse, especially involving unscrupulous doctors or people with a history of addiction — as was the case for “Friends” star Matthew Perry.

Earlier this year, knowing he was “spiraling out of control with his addiction.”

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What comes next

Though Mahrle expressed immense gratitude at the relief she’s felt, she admits that ketamine isn’t for everyone — and you also need to keep doing “a lot of mental work” once you leave: “The day following the experience is all meditation and reflection for me.”

It’s not a one-and-done treatment, either. “Ketamine doesn’t prevent depression in the future,” Grundmann said. “It’s not a cure for depression in the sense that you’ll never need treatment again if you do this.”

It was, however, a fresh start and life-changer for Zechowy, something even her family noticed.

“I told my family it and they could clearly see the change in me,” she said. “Ketamine was the first thing that gave me a glimmer of hope that I could change, that I could have a different life.

“Ketamine gave me a shot at life. It was a second chance.”

Vainius looks forward to continuing her treatment, as ketamine therapy provided her with more relief than she could ever have hoped for.

“Ketamine therapy gave me my life back,” she admitted. “A life that mental illness — clinical depression and unrelenting anxiety — had totally stolen from me.”