finding your treatment: managing bipolar disorder through ketamine therapy
8 minute read
yollanda zhang has had 19 ketamine sessions and, so far, the results have been a "miracle."
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yollanda zhang’s mental health journey started with a misdiagnosis of depression when she was an engineering student at the university of waterloo. this diagnostic error led to an unnecessary antidepressant prescription—a medication that would shortly after bring on a bipolar hypomanic episode, leading to the discovery that she didn’t have depression at all. what she did have was bipolar disorder.
she spent the better part of the two decades that followed playing guinea pig, trying over 33 different medication combinations to curb symptoms and keep her mood stabilized so she could lead a joyful and healthy life with the mood disorder. unfortunately for zhang, those medications failed to do what they were created to do, and she spent around 23 years in a series of personal drug trials trying to find something—anything—that would help.
“each medication, you know, it would take time to ramp up, and then you have to wait, see how it goes,” zhang said. “and then it doesn’t work, you have to, like, ramp down, and then try the next one. so, 33 of those trials.”
during that time, she continued to experience the symptoms of her first bipolar diagnosis, bipolar ii, only to later be upgraded to bipolar i when she had a severe hypomanic episode triggered by pregnancy that led to her first hospitalization.
“that was definitely a big turning point in my mental health, becoming a mom,” zhang said.
following the birth of her daughter, zhang struggled with postpartum depression for about a year, which was followed by rapid cycling depressive episodes because of her bipolar disorder. things only continued to worsen for her as she continued to try all the medications to get things under control, and then the pandemic hit.
“during the pandemic, i got covid, and i was treated with a steroid, and so, the steroid triggered my second manic episode,” zhang said, later continuing, “i had really severe covid. like, i was sick for weeks, and i couldn’t speak. i couldn’t swallow. i couldn’t take my regular medications. so, it was a bunch of different things, like the perfect storm.”
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being forced to contend with the highs and lows of her bipolar disorder and the lack of effectiveness of the medications she was trying, zhang wanted to find a better way to treat her condition. it wasn’t until recently that she came across a newly available treatment modality that truly made a difference—ketamine therapy.
ketamine therapy for mood disorders
when people hear the word ketamine, their minds often go to “party drug”, but before it was made famous illegally, it had its own special place in the healthcare system. medical professionals and veterinarians have used ketamine as a sedating agent to induce unconsciousness in patients and animals that need specific procedures requiring sedation.
the term “being put under” was coined to casually describe the experience of being put to sleep using ketamine so that a medical procedure can safely take place.
more recently, researchers gained permission to try to use ketamine and other psychedelic drugs as a way to treat various chronic conditions, including bipolar disorder. this “off-label” use has shown great promise in the way of treating mental health disorders, but because of its storied past, many people are weary of the new treatment modality.
but not zhang. after trying what felt like every other option, including other breakthrough therapies such as transcranial magnetic stimulation (tms), and finding little to no relief from her cycling depressive episodes, she went for it. but not before looking into her brain using brain spect technology, figuring out what could be done, and learning all there is to know about ketamine and what it can and cannot do.
“toward the end of those 30 days (when she did tms therapy), i was already thinking this is not working. this is making me worse,” zhang said. “the doctor was like, ‘i think we need to try something really different, like maybe ketamine.’”
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zhang researched ketamine and the clinical trials associated with that and other psychedelic medicines before considering it as her next step in treatment, and what she found out sounded promising enough for her to take the next step.
“trying psychedelics was kind of scary for me because i’ve never tried it before. i guess i’ve always been, like maybe, more traditionally a good girl, you know? i’ve never done like drugs,” she said of her experience with illicit substances before considering ketamine treatment.
the mechanism of action behind psychedelics, and the reason why they’ve been so heavily investigated for use in mood disorders recently, is because of how they work inside the brain. once the drug is introduced into the brain, it activates receptors within brain cells that help create new brain cell connections.
it’s thought that these new connections and the effects the drugs have on neuroplasticity, or the brain’s ability to change its function and structure, act as healers within the brain, minimizing symptoms and helping people return to their regular selves.
running out of ohip-covered options
ketamine therapy isn’t covered under ohip. in the same vein, private insurance companies also fail to recognize ketamine as a viable treatment, so they, too, do not offer any coverage. this leaves patients who could benefit from it, those with treatment-resistant disorders, to pay out of their own pocket—and ketamine therapy isn’t cheap. for zhang, the price was a bit of a deterrent, but not so much so that she gave up on the idea altogether.
“i think the most challenging barriers for me and for people who don’t have a problem with taking psychedelics is just it’s costly and it’s time-consuming,” zhang said.
the cost of ketamine treatments varies significantly in the country, depending on where you go, how many sessions are needed, and the type of administration. according to braxia health, formerly known as the canadian rapid treatment center of excellence, canada’s first specialized ketamine clinic, the average costs for ketamine treatments range from $200 to $1,000 per session.
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the number of sessions required to feel long-term effects also ranges, with four to eight being typical. however, more sessions were needed for zhang to feel the effects.
“i have now done 19 different sessions of ketamine infusion. so, it’s a lot. i feel like i should get a sticker each time i go,” zhang joked. “because i hate needles, and it’s an iv injection.”
with her higher number of sessions, costs increase as well. for many, shelling out thousands of dollars for treatment—especially on a novel therapy with the same non-guarantee of efficacy as anything else—isn’t always feasible.
luckily for zhang, she did have access to the funds, but she believes that more needs to be done to make the treatment accessible to those who need it but may not fit the financial bill.
addressing the worst symptoms with ketamine
living with bipolar depressive symptoms is challenging, even for those who have milder cases. this is especially true for those like zhang who have medications, but they don’t work as they’re intended or don’t do enough to keep the depressive episodes at bay.
it isn’t just the symptoms that are hard to cope with, though, but rather the uncertainty of when a depressive episode will end, allowing people to return to themselves until the next time it happens. for zhang, ketamine helped curb those fears in a tangible way.
“i think ketamine is, especially for people like me who have had so many different kinds of medication trials and treatments that failed; it could be very discouraging,” she said. “you can lose hope very easily. because i’m like, ‘what other things can i try?’ so, if i’m still feeling like this, then there’s no hope for me in my life because i don’t want to live like this.”
according to research, as many as 25 to 60 per cent of people with bipolar disorder will attempt suicide at some point in their lives. because of the effects of the condition, people living with it are forced to contend with suicidal ideations during depressive episodes even if they don’t want their lives to end. for zhang, those were the darkest parts of her disorder that ketamine really helped with.
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“i could go in (to her ketamine sessions) with just the most severe suicide, not suicide, but the most severe depressive episodes, even suicidality. like, just very severe, very heavy depressive episodes,” she said. “and within a day or two, i would be back to myself again. that’s the upside of ketamine treatment is that it’s very quick.”
while suicide rates have decreased in the country over the course of the last two decades, the number of people driven to act on suicidal thoughts because of mental health disorders is still far too high. approximately 12 people die by suicide each day in canada, according to key statistics from the public health agency of canada.
one person’s results spark hope for a brighter future
ketamine therapy is still in its infancy, but clinical research is ongoing to determine its place in medicine. as for zhang, getting to utilize ketamine therapy for her bipolar disorder symptoms has been nothing short of life-changing, with her even going so far as to call it a “miracle drug” for her.
zhang’s future is looking brighter because of ketamine. while she doesn’t suggest that everyone run out and spend all their money on ketamine, she does hope that with time, research, and a positive reception to the treatment, more people will get to experience the results she’s had and access and affordability will be improved.
“keep an open mind and stay hopeful, because in those really tough times when you’re hit with a really bad depressive episode, you don’t know when you’re going to come out of the dark, and it seems endless. it could be really hard to stay hopeful,” zhang said. “and i think that’s what ketamine did for me is that—i don’t know if this is corny to say—but i kind of feel like i can get my life back again.”
if you are interested in learning more about yollanda’s experience with bipolar disorder and ketamine, you can join her “ask me anything” live session here.
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if you or anyone you know is struggling with a mood disorder and suicidal thoughts or actions, reach out to canada’s suicide and crisis hotline at 988, or call or text talk suicide canada at 1-833-456-4566 or 45645, respectively. other suicide resources can be found with the canadian association for suicide prevention.
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