On Tuesday, I ended up being grumpy and irritable again. I can’t say for certain whether I was irritable due to the treatment or my kids just being assholes. I suspect it was a combination of both. Regardless, I felt okay on Wednesday.

I underwent my third infusion Wednesday afternoon and I feel okay still. It’s Wednesday evening and my brain is firing on all cylinders, I’m not sleepy, but I am very “out of it.” I don’t feel “all here.” I know sleep will help rectify it but it will be interesting to discover whether I am irritable again tomorrow (a snowstorm that will keep my kid home is likely to do it) or if my mood is somewhat better. My mood rating according to my rating scale is a 7. My guess is that my doctor would like me to shoot for a 9 by my last infusion (happy) but I’m content to just be “okay.” I’m always “here.” I’m never doing great or feeling fantastic unless I’m manic. Is it possible to get the euphoria of mania without the downside of the crash? It would be nice to know. Although I do have more energy and motivation for things than I did before the infusions.

Most importantly, my baseline is whether I’m dealing with suicidal thoughts. I did suffer from a little depression 2 days after my first infusion but since then, I’ve been okay. Before my first infusion, I took the PHQ-9, and I scored a 17. Today, before my third infusion, I scored a 6. I’m not sure what the hell happened but I’ll take it.

I think my pain points will be trouble falling asleep and staying asleep and overeating. I’ve been having difficulty concentrating lately so that might also be a factor that may keep my PHQ-9 from dropping much more. And I’m also super restless. Like I have too much energy that I need to burn off. I’ll use my son’s words: “fizzy feet.”

I had my first infusion on Wednesday for an hour and it was certainly trippy. I listened to soft rock in a completely new way.

I was kind of hoping that effects would begin to take place soon after the infusion. Relief can start to take place within an hour of the first treatment. While I was not depressed or suicidal, I was not happy. In fact, I was irritable. Angry. My doctor and I are on guard to ensure that the ketamine doesn’t trigger mania since I actually have bipolar disorder and not unipolar depression. At this point, I feel like mania would be an improvement.

I’m already pessimistic about the treatment even though my doctor says it can take 3-5 infusions for relief to kick in. My next infusion is Monday. Well, there’s one thing: If I ever wondered whether I’d like doing drugs recreationally, I’ve gotten my answer by getting it legally. (That’d be a no.)

In the second episode of Michelle Obama’s podcast, she admitted to struggling with “low-grade depression.”

Not just because of the quarantine, but because of the racial strife, and just seeing this administration, watching the hypocrisy of it, day in and day out, is dispiriting.

The former first lady cited a routine as helpful, including “exercise, getting fresh air, and having a regular dinner time.”

According to a survey published by the Commonwealth Fund and Social Science Research Solutions, a third of Americans reported feelings of stress, anxiety, and sadness that difficult to manage on their own. Researchers posit that the lack of universal health care coverage, financial problems, and the government’s pandemic response has impacted the mental health of Americans in a negative manner.

The FDA has approved a nasal spray called Spravato to treat suicidal patients. The drug was approved for those with treatment-resistant depression last year, but has also shown promise to reduce symptoms in suicidal patients in conjunction with therapy and other antidepressants. The drug, while FDA approved, is only administered by a health care provider and is not approved for home use.

Suicides in Japan have decreased in light of the COVID-19 lockdown. According to The Guardian, “the suicide rate in Japan fell by 20% in April compared with the same time last year, the biggest drop in five years.” The stay-at-home mandates affected about 40% of suicide prevention organizations that shut down or reduced workers’ hours. Also seeming to contribute to this drop includes the lack of commuting vs many people working long hours in the office.

In May, The National Suicide Hotline Designation Act, a bipartisan bill, passed in the US Senate to make the national suicide prevention hotline a 3-digit number. Currently, the hotline is only accessible by the usual 10-digit number 1-800-273-TALK (8255). (If we’re honest, is not that easy to remember.) Should the bill pass in the House and get signed by the president, the number would be 9-8-8, however, the 10-digit number would still be valid.

A study published in General Hospital Psychiatry found that use of antidepressants among patients hospitalized with heart failure (HF) is associated with “minor depression, history of major depression, younger age, unemployment, white race, nonischemic heart failure, polypharmacy, and functional incapacity.” The study, held from 2014-2016, had 400 patients with HF enrolled and found that there was no increase in the patients with major depression taking antidepressants compared with those who did not have depression.

I hate taking my meds. I hate the process. I hate swallowing pills. I hate overcoming my gag reflex. I just hate everything about it. It’s the major reason why I’m noncompliant at times. Taking meds sucks.

However, I like the effects of the meds. I’m stable. I do well. They work. I just loathe taking them. And honestly, it’s a huge barrier to me being consistent in taking them.

I’m currently in intensive outpatient (IOP) therapy and we identify something called a “rose, thorn, and seed.” A rose is something positive that we can reflect on. A thorn is an area where we need support. And a seed is an intention that we set for ourselves.

While my rose and thorn can vary depending on the events of my days, my seed during my last session was to consistently take my medicine and be compliant. I need to continually set that intention for myself. How can I keep it up when it’s a task—a chore—I abhor?

Again, the effects of the meds are good. They help me function. Without them, I am an absolute mess. I suppose I just need to focus on how well I do as a result of taking them to overcome the laziness and repulsiveness I feel when it comes time for me to actually take them.