Category

Health & Wellness

Category

Doctors Are Using Ketamine to Alter Our Sense of Time and Self

CALL OUT: Ketamine has been getting a lot of buzz recently. In March of 2019, the FDA approved Johnson & Johnson’s nasal spray, Spravato, for treatment-resistant depression. Spravato is technically esketamine, which is, molecularly-speaking, almost identical to Ketamine but three times as potent and can be given at a lower dose.

Maybe you know it as a horse or a cat anesthetic, or maybe you’ve heard of a K-hole. You could have also read the absolutely amazing Twitter thread where Irish writer Seamus O’Reilly slowly tells the story of doing Ketamine shortly before realizing he was scheduled to work, and it was the night the President of Ireland, Mary McAleese, was touring the venue.

Of the experience he writes, “By now, having been alone with my thoughts for the entire Cretaceous period, I am no longer mildly weird but deeply, extravagantly deranged. As the President of Ireland walks in, with my boss’s boss’s boss’s boss, my first impulse is to greet them like I own the place. It would be rude, surely, to not acknowledge their presence? Out of order even. Best thing to do would obviously be to say, ‘ello guys.’, like it’s my home and I live there, in this big white room, where I stand in the corner, alone, holding a tray of drinks, like you do at home.”

Though this seems, and is, a ridiculous anecdote, it does speak to Ketamine’s ability to completely alter one’s sense of time and self. As it turns out, it’s much more than a party and veterinary drug. It was approved as an anesthetic by the FDA in 1970. Since Ketamine does not slow breathing or stunt the gag reflex, it’s often considered a safer option than other anesthetics. The World Health Organization has consistently listed Ketamine as one of its “essential medicines” and it was widely used during the Vietnam War to immediately quell the pain of wounded soldiers.

I spent a late April afternoon speaking with Angela Ward BSN, RNC-Ob/EFM, CPTR and Clinic Nurse Lead at the Advanced Integrative Medical Science (AIMS) Institute in Seattle to get a professional opinion and insight into how Ketamine is used to help treat depression. “A lot of the things we’re seeing in the world, you may have heard them called ‘diseases of despair.’ There’s an epidemic right now of middle aged men suiciding,” Wards tells me. “People are really struggling, and a huge part of it is that we’re so disconnected. That’s why I was like, ‘let’s meet in person!’”

Ward takes me on a brief tour of the AIMS institute, which looks more like an expansive yet cozy mid-century modern home than a clinic. A delicate chandelier made from paper flowers casts a shadow above a framed picture of a dandelion. The shadow and the image combined make it look like dandelion petals are blowing across the white wall.“I could see myself getting high here,” I think, sinking further into the West Elm. Maybe I’m missing the point.

“Wine?” Ward asks, and I agree wholeheartedly. We take a short walk through the Eastlake neighborhood of Seattle to a quiet restaurant overlooking the water. Ward comes from a medical background in labor and delivery, so it’s not without a deep medical knowledge that she tells me, “It’s really fucking hard to do shit by yourself.” I laugh, then sensing, I think, that I may write this statement off as light humor, she adds, “There is something about being energetically in each other’s field, and able to breathe together, and I know that sounds hippie and woo-woo, but that’s how we’re wired.” With that, we toast our juice glasses filled with wine.

Ward continues by sharing with me a bit about her history, which includes the loss of her infant daughter. “I had a psychedelic experience within the safe and sacred container of a plant-medicine ceremony that was profoundly healing in response to the grief from losing my infant daughter.”

It was after this experience, she realized she wished to share this knowledge and experience with other people. “One of the things that ketamine does is it allows people to have an experience where they’re able to step away a bit from an emotional trigger. Let’s say any time you think about a particular person you immediately are angry. [Ketamine] takes it from this immediate experience and then puts it over here, like a concept. It gives you some space to experience something as a concept without the emotional flair.”

Over the course of our conversation, I begin to notice that when speaking about Ketamine, Ward often mentions that it creates space: space to separate the mind from what it perceives to be true (I will never be happy, for example), space between impulse and action, space between periods of suffering where pain may still be present but the sensation can change, and if it can change it opens the mind to the possibility that it may not be forever. Ward put it this way, “It might not be this wall that’s crushing you for all eternity.”

Ward continued by explaining how some people think the downfall of Ketamine is that it’s not a one-stop shop. Typically people do not go on a Ketamine journey and then never experience depression again.“We’re following the MAPS ( MDMA-assisted Psychotherapy) for PTSD model which says we’re creating the conditions for healing, and we’re awakening your eternal healing wisdom.” She explains to me an analogy first used by Michael Mithoefer of MAPS. ”If you were out riding your bike and you fell on some gravel and you had a cut on your leg, you’d go to the hospital, they clean up the wound, clean out the gravel and stitch the edges together, but they wouldn’t actually make your skin grow back together. Your body knows how to do that if you create the conditions for healing.” Ward continues, “[By using Ketamine] we create the conditions for healing the mind and I’ll say spirit, supporting you in making meaning of what’s happening to you.”

What To Expect

Patients are medically-cleared by their provider for treatment, then a patient meets with Ward or another member of the AIMS team and their medical provider to talk about what to expect. The Ketamine treatment itself consists of three sessions, called deep dives, where a patient is injected with the substance; the dosing is weight-based and typically works out to 1.6 milligrams per kilogram. A bit after the injection, people typically get a wobbly feeling, a feeling of floating not unlike the sensation of having the spins when you’re drunk. Once that feeling takes over, they’re ready to “launch.”

During post-launch behavior, “75 percent of people are very still,” Ward explains, “Some people will report to me what they’re feeling and then they’ll stop talking and then have an outburst of, ‘Wow,’ or ‘Amazing,’ or ‘I’m scared.’ Other people will move their hands, almost like pulling energy blocks off their bodies, big smiles, or sometimes they will cry these big releases. Some people are wild cats. Ketamine makes them move like crazy. They’re working some energetic thing out. [Their] eternal healing wisdom knows you need to undulate your arm this way.”

People on Ketamine lose their ability to trace thoughts, which means the last word that was said is often immediately forgotten. For some people this can be confusing, unsettling, scary even. “This is a huge part of the ego trying to be there,” Ward explains. “That’s okay. This is about trying to soften the ego so it can come back online in a way that’s healthier.”

Ward sits with patients on their deep-dive journey, what many would consider the “tripping” part of the process, which lasts 50-60 minutes. After this portion of the therapy, Ward steps out and the provider steps in, and they begin talk therapy. “We’re billing insurance which is unheard of in the rest of the work around Ketamine.

Following both portions of the therapy, patient care continues, “After about two hours and 15 minutes, the patient usually has to pee. We help them get to the bathroom. They usually keep their sunglasses on or wear an eye mask because Ketamine makes things bright, then they’ll have a snack or some tea, and that helps people come back into their body. We don’t let people drive home.”

I later talked to someone who preferred to remain anonymous that had recently undergone their first Ketamine deep dive at AIMS. I asked if anything about the experience had surprised her, “I think I was pretty prepared, I’ve taken hallucinogens recreationally. The weird thing was closing your eyes and tripping inside of your mind rather than interacting with the world, it’s much more of a journey. It took me a couple days to process. Nothing really popped up as a life-changing moment. It all just felt like a dream.”

This patient seems to have a genuine faith that more will be revealed in the two journeys to come, that the confusion she experienced initially will ultimately lead to an understanding, or at the very least, her experience could help other people experiencing the same things. Ward echoes a similar sentiment, explaining that creating a space of intentional healing with a focus on personal traumas awakens intuitive parts of ourselves. This space also shows others that healing is possible and that a meaningful life is attainable. “That helps people live. That helps people not kill themselves,” Ward emphasized.

In Portland, Ore. discerning vegans are meeting loyal locavores at a vegan prix fixe restaurant called Farm Spirit. From within an unassuming brick building in Southeast Portland, the restaurant serves modern, delicately-plated plant-based fare from ingredients 95 percent sourced within 105 miles. “We want to make food that leaves people feeling light. We want to make food that is wholesome, made with local ingredients,” says owner and chef Aaron Adams.

This restricted bioregion — which spans from Southwestern Washington to Central Oregon — has a long growing season and mild winters. It provides a wealth of both foraged ingredients, such as coveted Oregon white truffles from Doug Fir forests, and black trumpets from the coast, as well as unexpected farmed produce like citrus from propagation houses, and estate-milled olive oil. Solely relying on the bounty of such a small area requires the fruits and vegetables included in Farm Spirit’s “Cascadian Tasting Menu” to either be in season or preserved. In winter, Farm Spirit resourcefully relies on brassicas, root vegetables, and their delightful cache of dried, fermented, and canned goods from the summer’s bounty.

Fine Vegan Dining

Adams opened Farm Spirit in 2015 in a narrow space with seating for only 14 people at a chef’s counter. To accommodate popular demand, In January 2019 he moved the restaurant into a larger 1,000-square-foot space with room to seat 28 guests. Seats are procured by online reservation only, and the face-to-face “Chef’s Counter” tasting experience is often sold out weeks in advance. In keeping with the philosophy of using nearby resources, the new Farm Spirit restaurant also uses handmade pottery and decor from Portland artists.

Adams went vegan when he moved to Portland in 2005, finding that his morals were more in line with a plant-based lifestyle.“I had a big epiphany about how I wanted to comport myself and what my ethical boundaries were. One of those was not participating in the economy of animal agriculture,” he says. Excluding animal products from the menu not only avoids cruelty to animals, but it also lessens the environmental impact of his restaurant. It reduces the need for land dedicated to grazing and growing livestock feed and doesn’t contribute to the greenhouse gas emissions of the meat and dairy industry.

Using local ingredients also moderates Farm Spirit’s carbon footprint by limiting the fossil fuels used in transportation. Another great benefit; by buying nearby produce Farm Spirit is feeding the local economy and strengthening the farming community.

Fine Vegan Dining, organic food

The few supplies that don’t come from within a 105-mile radius include Kosher salt, evaporated cane juice, vanilla, and chocolate. Rather than focusing a plate on these non-local ingredients, Adams uses them as flavoring accents. He prefers to create a dessert with black garlic rather than chocolate. Diners will find many unexpected dishes like this at Farm Spirit, including carrot jerky, nixtamalized purple barley tortillas, filbert (hazelnut) yogurt, and a fermented sunflower crumble. Farm Spirit also offers beer and cider flights, along with natural wine pairings to go with each course.

A unique feature of this conscientious restaurant is a menu of nonalcoholic beverages for fine diners who abstain, but don’t want to miss out on the flavor pairing experience. The temperance menu includes fresh in-house juices, herbal teas, and attentively-crafted probiotic water kefir, kombucha, and shrubs. So that all might enjoy the unique horticultural cuisine of Farm Spirit, with advanced notice they can prepare gluten-free, nut-free, and other allergen-free tasting courses.

The former Farm Spirit space will become a fermentation lab, appropriately named Fermentor. This will house vegetable and fruit preservation processes, the brewing of beverages, and bread making, which Adams considers a form of fermentation. “We’ll be opening that up as a new little cafe with grab-and-go soon. It will have all sorts of yummy products that have some sort of fermentation involved in them,” Adams reveals.

Fine Vegan Dining

Farms Spirit is Adams’s second successful restaurant, and there is little doubt that the inventive fermentations in his newest project will allure the health-focused foodie culture of Portland. As Adams says, “I always feel better when I have a certain amount of fermentation in my diet.”

The apothecary is back. With a focus on natural remedies and local botanicals, apothecaries are popping up everywhere and are using plant-based alternatives to fix everything from skin woes — to headaches — to low libidos.

“If you dig deep enough into your own lineage, there’s plant medicine everywhere,” Max Turks, founder of Roots & Crowns Apothecary in Portland, Ore., says. “It’s part of the fabric of being human. It’s only in the past 100 years that it’s gone behind a veil because of the industrial revolution and the pharmaceutical industry.”

Apothecaries are trendy right now, like many things that resurface after a long absence. But the three apothecaries I interviewed for this story, Roots & Crowns, Blendily, and Sabia, transcend trend. Each store is at once modern and ancient, like the beautiful vintage rugs that hang from the walls of Roots & Crowns where I am spending this sunny March morning chatting with Max.

Max wears a black sweater and layered necklaces, one which reads “Aquarius” in delicate gold script, and is standing behind a polished stone counter. I feel calmer just being in her presence.

What apothecaries used to be is the medicine places of the town. What people don’t realize,” she says, “or maybe they do, is that pharmacies are literally the modern apothecaries. Unfortunately, it’s so far removed from what it used to be, but apothecary is medicine.

Blendily

The day before I had a phone call with Ivy Chaung, founder of Blendily, a skincare kitchen offering “all-natural skincare, bath and body care, and herbal remedies handcrafted with fresh, organic, and wild ingredients.”

In 2012 it was uncovered that Johnson & Johnson had the formaldehyde-releasing chemicals quaternium-15 and DMDM hydantoin in their baby products; Ivy had an infant daughter at the time. This was the news that prompted Ivy to pivot career paths, formalizing her education in aromatherapy and natural product formulation, and becoming a licensed esthetician. “I was pretty alarmed because [my daughter’s] first bath in the hospital just minutes out of the womb was with this baby wash. It’s an immensely popular product, even now,” she says.

I think what was most upsetting was that formaldehyde wasn’t listed in the formulation itself. I had a lightbulb moment. This can’t be how it used to be. I realized everything you[use to] groom yourself can be handmade, the ingredients can be botanical-based and understandable.

Sabia Apothecary

Not all modern apothecaries make their own products on-premise. Sabia Apothecary curates an inventory of high-quality products, many of which utilize local ingredients including myrrh and rose petals in the Royal Rose Honey Mask, and Inventive Organics Environmental Cleanser, made using ginger, grapefruit, and tea tree oil.

Sabia Apothecary began as a “sleepy neighborhood herb and essential oil shop” in the Hyde Park neighborhood of Austin in 1994, Katie Day of Sabia Apothecary tells me. “A husband and wife team had a passion for natural healing and body care that they manifested in the brick and mortar Sabia.” They changed ownership in 2004, and have grown to include various skin, hair, and body care brands as well as ingestible wellness potions and a full spa service menu.

I ask Katie what she sees as the role of the modern apothecary and she explains impassioned, “I think there’s something that just feels good about healing your body with plants and nutritional foods if it’s available to you. Our bodies respond readily and synergistically with botanical formulations as we share DNA with plants and are quite receptive to the healing powers of ancient herbs and botanical ingredients. [There is] heaps of this sort of information at our fingertips.”

It seems like every time you turn an Instagram corner, there’s another influencer touting a new natural product that will change your life, or at least your skin. It can be overwhelming. “This is where the modern-day apothecary can step in and provide guidance,” Katie says. “At Sabia, we are not exclusively one way or the other. Most everything we carry is ‘natural’, but there is definitely a wide range to satisfy a broad spectrum of customers.”

Modern apothecaries are a place to come for guidance and genuine connection. Sabia offers “an ambient space where one can come to relax, peruse a curated selection of healthful products, and leave with a bit of new knowledge on how to self-care.”

Natural vs. Organic

I ask Katie, Ivy, and Max to help me unpack the differences between the word “natural” and “organic” and they tell me almost the exact same thing; those words really have no widely agreed upon meaning.

“There is a common misconception that has arisen along with the interest in ancient remedies and natural products; [some people think] if something isn’t 100 percent naturally derived then it must be bad,” Katie explains. “If you want to add dermatologist-developed retinol to your regimen, then by all means! We have the options and offer you educated guidance so you get to decide.”

“I think organic can be a buzzword,” Max says. “Things can be organically grown or cultivated even if they are not certified organic. I’m going to be working with a hemp farmer who may or may not eventually get certified in organic growth, but they are growing organically which just means that they avoid the majority of pesticides, and they work to make sure that the soil’s not depleted.”

Similarly, other brands may be “natural” in the sense that they are free of synthetics, dyes, parabens, fragrances, and other ingredients, but might not have the Ecocert or Certified Organic stamp on the label. Katie says, “we still love them anyway, as this detail does not compromise the integrity of the products we have carefully selected to carry here. We carry several brands from overseas that do not have the same FDA organic standards as American brands but still utilize organically grown ingredients, thus are organic.”

“Natural is fluff word,” Ivy says with a laugh. “It sounds nicer than chemical-free which is misleading in that there are chemical constituents in natural products.” Ivy tells me, to my surprise, that in the cosmetics industry there’s little to no regulation on these words. In the U.S., regulations on the word organic are only for food, so if you see it on a cosmetics label it means some of the ingredients (olive oil, for example) have been through the food regulation process.

I ask Max what can be done by the average consumer who is seeking safer alternatives to everyday items. “The best thing you can do when it comes to ingredients is have a relationship with the source and be able to trust it,” she says.

Ivy tells me that many of her customers come into the shop saying they have sensitive skin, “which is interesting because sensitive skin is really skin that is having a reaction. When you purchase skincare products there are so many ingredients you don’t know what you’re reacting to.” She tries to limit all of Blendily’s products to 10 ingredients or fewer.

Max advocates a similar simplicity in her products. “If you look at the average person’s bathroom vanity or closet it’s full of shit that they don’t even touch. People are amazed when I say you can use this facial serum as a cleanser, moisturizer, even an exfoliant. There is no reason why you need to have a $700 beauty regime.”

Magic

The love Ivy, Max, and Katie all show for plants is a love I envy in its purity and its ability to occupy both the scientific and the mystical.

Ivy describes to me one of the facial oil serums she produces seasonally called Ruby Skies. It’s made by infusing St. John’s Wort into Sunflower Oil to form a blazing poppy red color. “I’m pretty enamored with that product because it gives off a such a beautiful hue. The flower is yellow and if you were to infuse the flower when it’s dry, it wouldn’t give off that color,” she says. “It feels like magic.”

And then the next day, Max is telling me about violets.

I can’t express the joy that I feel when I get to see the first violet of the year. I’m amazed that we get this year after year, it just comes back like a resurgence.” She says. “Violet medicine is often told to be a creative expression. It can be helpful for people who are shy and introverted if they want to open up. I think of how that is such a metaphor for what violets do at the end of a dark quiet season.

“What lessons can you observe from plants?” Max wonders, more to the collective you or perhaps to herself than to me. “These things that seem little but they’re not little and they’re everywhere if you notice them.” She pauses, takes a bite of the breakfast cookie she’s been nibbling on all morning.

“That’s magic to me.”