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Tripping Through Motherhood: How Some Women Are Using Ketamine to Treat Postpartum Depression

Glamour logo Glamour 6/23/2022 Melissa Whippo, Juli Fraga
© Design by Channing Smith

After her youngest child was born, Sam* struggled to find any joy in motherhood. “I felt like a ghost,” she says. At her lowest point Sam fantasized about getting in her car and leaving her baby forever. “When I couldn’t tell myself confidently that I wouldn’t get in the car and drive away and never come back, I told my partner and called psychiatrists begging for help.”

Sam is far from the only mother who has felt depressed, anxious, and traumatized after giving birth. In most cases, a combination of psychotherapy, social support, and antidepressant medication (when needed) helps ease harrowing symptoms like extreme sadness and hopelessness—all signs of postpartum depression (PPD), the number one complication of pregnancy, which affects up to 17 percent of mothers.

But for some, PPD doesn’t completely vanish.

Therapy and medication did help Sam recover enough to return to work and find moments of happiness, but she says self-critical jabs and feelings of hopelessness continued to taint her motherhood experience. Thoughts that made her feel trapped in “an escapable mental loop.”

“During my worst times [I told myself], ‘I’m a bad mom. I’m a loser. I’m a failure. No one likes me,’” she says. Hoping to shake this negative thinking and feelings of inadequacy, Sam spoke with her therapist, who recommended a novel treatment: ketamine assisted psychotherapy (KAP).

What Is Ketamine Assisted Psychotherapy–and How Can It Treat PPD?

In recent years psychedelics like ketamine have received a lot of airtime for their seemingly magical abilities to remedy pretty serious mental health concerns like post-traumatic stress disorder (PTSD), substance abuse, and anxiety when combined with talk therapy. According to researchers, this medicine can also help dial down negative or obsessive thought patterns, a common symptom of generalized anxiety and obsessive-compulsive disorder. While all psychedelics induce non-ordinary states of consciousness (NOSC), which are believed by many indigenous cultures—as well as some modern Western medical practitioners—to promote healing and wellness, ketamine is considered an atypical psychedelic rather than a classical one—like LSD, MDMA, psilocybin, or ayahuasca—and is classified as a dissociative anesthetic.

Now, some mental health professionals are starting to examine whether ketamine can also treat severe cases of PPD. While research is still in its infancy, there are some promising results. According to Miriam Schultz, M.D., a reproductive psychiatrist in Berkeley, California, “There is recent research demonstrating benefit of ketamine for postpartum depression—both prophylactically and for women who already had depressive symptoms or suicidal thoughts during their pregnancies. These studies looked at intravenous ketamine, often just a one-time administration. We need more research, but these studies confirm what I and others see clinically: that ketamine can work on postpartum depression quickly and effectively.”

With ketamine-assisted psychotherapy, each session is considered a “journey”—an opportunity to leave one’s conscious mind and discover what unfiltered thoughts, feelings, and images arise during the treatment. In a typical three-hour session, the journey begins with an invocation to support a departure from this realm into a transformational space. The medicine is then administered sublingually—that is, a rapidly dissolving tablet held in the mouth for 15 minutes—or intramuscularly as an injection.

For Sam's first journey, she took a ketamine lozenge, placed an eye mask over her eyes, and was instructed to relax and open herself to whatever came up—images, memories, feelings. Unlike a traditional therapy session, she did not talk about her struggles. Instead, she was invited to observe whatever emerged during her trip.

“My therapist said I would depart from my conscious mind and enter a transformational space of…‘non-ordinary consciousness,’” Sam explains. “I was a little nervous, but I trusted her.”

As the ketamine started working, Sam says her body felt heavy and she slipped into what she describes as a "dreamy state." She felt a little disoriented at first, until she remembered the words offered by her therapist and was able to settle deeper into the experience. She then recalls being greeted by a feeling she had never experienced: self-compassion. During her journey, she also saw herself as a baby and connected with her own sense of innocence. "I remember saying that I am lucky because I can mother myself.'"

Similar insights may emerge in talk therapy, but this can take a long while because the human mind is trained to avoid thoughts and feelings that elicit discomfort. With ketamine therapy, however, there can be an “ego dissolution” that allows these repressed feelings and memories to rise to the surface without the mind becoming stuck in reactivity, rumination, or judgment.

Sam’s self-critical thoughts went on hiatus during her journey, allowing her to create a fresh narrative about her maternal experience. "It showed me a new way to think about myself," she says. "Instead of spinning [in worry], I could listen to my gut feeling. I can’t even explain the freedom this shift has given me."

Some experts call this fresh perspective "new mind," and it can be one of the immediate upsides of KAP. The idea is that when mothers take a break from their worries, obsessions, and shame spirals, they can see that it's possible to think and feel differently.

How Can I Tell if KAP Is Right for Me?

When treating PPD, talk therapy, medication, and group support are still frontline treatments because numerous studies show they’re successful. However, for women with severe or recurrent PPD, ketamine is another medicinal tool, Dr. Schultz says.

And while plenty of research suggests that antidepressants can alleviate maternal depression, Dr. Schultz says they are not for everyone. Unwanted side effects like drowsiness and weight gain can be challenging to tolerate. “Ketamine's side effect burden is minimal and when it works, it tends to work rapidly," the psychiatrist adds. For this reason, it may be helpful for depressed mothers who haven't found relief with therapy or medication alone.

Birth trauma or childhood trauma often underpins maternal suffering. In these cases, KAP can help a new mother process her trauma by providing the space and distance necessary to cease re-experiencing the frightening triggers.

Because ketamine is a schedule III substance, mothers may understandably worry about becoming dependent on the medicine. However, all psychotherapy work with ketamine is closely monitored by a prescribing physician or nurse practitioners. That said, KAP’s ability to treat PPD remains very new, so all mothers should consult with their obstetrician or a mental health provider before making a decision.

How Can I Find a Provider?

If you're considering KAP, it's important to know that it requires specialized training and is legally only offered by mental health professionals who work alongside a physician.

At your initial consult, consider asking your therapist the following questions:

  1. How long have you been offering KAP, and where were you trained?
  2. What kind of follow-up integration care can I expect?
  3. If I'm breastfeeding, what are the recommendations and potential risk factors with KAP?

While Sam says KAP was life-changing for her, it was also a “very intense experience.” Because of this, she says it's vital to trust your therapist and your treatment team. If you're considering KAP for PPD, it's also crucial that your KAP therapist is trained to treat postpartum mood concerns. If you need a recommendation, websites like the Kriya Institute offer a list of certified KAP therapists in the U.S. and Canada.

It's also important to know that insurance doesn't always cover KAP, and sessions can cost over $1,000. However, some providers have been able to help patients receive reimbursement for the psychotherapy piece.

After her ketamine-assisted psychotherapy experience, Sam feels better than ever. Instead of swimming in self-doubt, she says she can now be light-hearted with her son. “It could make it easier for you to love yourself as much as you love your kids,” she says for others considering KAP. “It could give your kids the chance to see a mom that is free, silly, and self-loving.” While her ketamine journey was a breakthrough, she wants other mothers to know that it wasn't an automatic cure all: "I also continued with therapy to help integrate my KAP session into my role as a mom."

Melissa Whippo, LCSW, is a psychotherapist and certified yoga instructor in the California Bay Area who specializes in perinatal mood disorders, ketamine-assisted psychotherapy, and plant spirit initiations. 

Juli Fraga is a writer and psychologist in San Francisco who specializes in perinatal mood disorders and women's health concerns.

*Name changed to protect identity.

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