It Could Be Anybody

How can I—as a person, as an individual—help during Suicide Prevention Month?

Honestly, it’s about promoting awareness and removing the stigma around mental health. If someone you know is talking about feeling depressed and they’ve become withdrawn, disengaged, they’re struggling to sleep or sleeping too much—engage them in an open conversation about how they’re feeling, no matter how uncomfortable it might be. Openly discussing suicidal thoughts with someone that you think may be at risk can help them express what they’re going through and move them towards getting the help they need. It’s about not avoiding conversations. It’s about addressing it and allowing people to express their feelings. 

Listen with interest, patience, and understanding. Be supportive and non-judgmental. Be present. People who are in a suicial crisis feel hopeless and believe there is no solution except for suicide. Their thoughts can become narrowed, negative, and distorted. Encourage them, let  them know that they are important, they are not alone, and that there are options. Discuss finding a psychiatrist or mental health provider, seeking psychotherapy, cognitive behavioral therapy, possibly participating in support groups. Make sure they have the suicide hotline number and know that help is just a phone call away.

I think suicidal ideation is its own class of mental illness not just a symptom of depression.   There are many people out there who struggle with suicidal thoughts everyday. It’s a darkness that invades and consumes their thoughts, no matter how hard they try to push it  away. It’s an illness that they cannot control. 

So this awareness about ketamine, is that what drove you to start a ketamine infusion clinic? Can you tell me more about how you started this?

So, I first heard about ketamine therapy from a nurse that I worked with who suffers from severe depression and has been hospitalized on  several different occasions. She came back to work after she had received a series of ketamine infusions talking about how wonderful it was and that it had saved her life. I use ketamine on a regular basis in the OR, but had no idea that it was being used to treat depression and mood disorders. 

My son has treatment resistant depression, anxiety, post-traumatic stress disorder, and has struggled with suicidal ideation. He’s suffered since he was a teenager. He’s tried many different medications, seen psychiatrists, and nothing seemed to work. The medications seemed to have multiple unpleasant side effects and it would always take several weeks to determine if he’d have any positive results.  

So, when I heard about ketamine, I did my own research and was excited to find something that might be able to help him with minimal to no side effects. I found a local ketamine clinic and we scheduled a consultation. My son began infusions that following weekend.     

I remember driving home after his first infusion and he said, “I’m not sure why or how I know, but I just know that everything is going to be okay.”  

As he continued to go through his series of infusions, I could tell that he was having a positive response to ketamine. He was not as irritable and more motivated.  He began engaging and interacting in the simple things of daily life, whereas before he struggled with simple things. He talked about ketamine being a tool that helped him to see things from a different perspective and helped him reorganize his thoughts. It was a big change in how he dealt with life on a daily basis. 

While my son was going through his treatments, I started thinking about the possibility of opening up a ketamine clinic. To become a part of an industry that can have a positive impact on the quality of people’s daily lives, that would be amazing. It was as though I felt a calling – a window of opportunity to become a part of something that had helped my son and could potentially help so many others who struggle just like him. 

I had a conversation with another CRNA, Paul Colligan, who also has a vested interest in the potential benefits of ketamine for our community. We took a ketamine clinic start up course  and 10 months later we administered our first infusion, and that infusion was my son. He’s continued to receive infusions on a consistent maintenance routine and he continues to see results with each infusion.  

My motivation and the reason behind my passion surrounding ketamine is because of my son. Honestly, for me, he’s the reason that I’m a part of this clinic and the reason that I’m  a strong advocate for ketamine therapy.  I know how it feels to be the parent sitting in the chair, fearful yet hopeful that this treatment will work because you’re running out of treatment options. To have been on both sides as a provider and patient’s parent, I feel it gives me a better perspective on patient care, having empathy, humility, and compassion. It’s important to be able to connect to the very thing that has brought us together with patients at our clinic.

Obviously, this is a very unique story, but I think it echoes a lot of what I’ve heard from almost everybody I’ve talked to—that so much of what is known about ketamine right now comes from word of mouth. I mean, it sounds made-up, not… Just to be frank, it sounds like there’s no way that what you’re saying could be true because it works so well. And then somebody tries it, and it does.

Very true. We’ve seen it many times in our clinic. Patients come in completely hopeless with uncontrollable thoughts of suicide. They begin treatments and those impulsive thoughts are quieted. It’s been described as a reorganization of thoughts, taking something that was not manageable and finding new ways to make it manageable.

Unfortunately, ketamine is not a cure. It’s an alternative treatment. It’s a tool that will require maintenance infusions to keep the negative/suicidal thoughts at bay. We also encourage patients to seek psychotherapy and maintain their current treatments as part of a comprehensive approach.

What do you have to say about your commitment to keeping your patients comfortable throughout the infusion process?

Our clinic is patient-focused and patient-oriented. We do a lot of coaching, explaining what they can expect during the infusion and how to navigate each infusion. We discuss how to redirect your thoughts if it becomes negative or dark. We encourage clients  to consider using guided meditation or listen to music, bring a blanket, wear sunglasses. We monitor patients closely. Sometimes, we sit in the room the entire time with patients when they’re extremely nervous. It’s about us helping clients get through each infusion successfully. We focus on the present, one infusion at a time, one experience at a time.  

We also want our patients to know that they’re in a safe place. It’s our goal to make them feel comfortable and at ease, so they can concentrate on taking care of themselves.

They begin treatments and those impulsive thoughts are quieted. It’s been described as a reorganization of thoughts, taking something that was not manageable and finding new ways to make it manageable.

You recently lost your husband to suicide. Is there anything you’d like to share about how this condition affected him?

My husband and I started dating when we were teenagers and married at an early age. He’d struggled with depression throughout our marriage. He began taking antidepressants in his thirties and continued to take them up until the last few weeks of his life. I have reason to believe that he may have stopped taking them in the days before his death. I believe there is a genetic component that contributes to mental health disorders. Prior to his death, he had lost two brothers to suicide. There were six children in his family and when he took his own life, three of them died by suicide.  

My husband, Dave, was an extraordinary man, he loved his family deeply. He could do anything he set his mind to. He single handedly remodeled the entire basement of our house, he was restoring a 1965 Chevy pickup that originally belonged to my dad, and his coworkers said that he was always “the reliable guy that could do anything.” They described him as always laughing and joking, his boss said he’d been in their office the afternoon before his death and he seemed completely normal. They had no idea that he was in such a bad place. He hid it well from everyone. But when I think back about risk factors — including losing a loved one to suicide, having a family member that recently passed away, becoming disconnected, or just his depression in general — he was at high risk. We had recently lost my mom, who had lived with us for 7 years. She passed away only 18 days before he took his own life. He was very close to her, and I think that had a big impact on his decision.

I have often feared that he may take his own life just because of the family history. When you have that much history of suicide, it makes you worry about the potential. So, it was always something that was in the back of my mind. Always. That afternoon when the knock on my door came and I saw the officers standing outside… I knew, I just knew.

His depression had gotten worse over the last few years, but we were not prepared. No one can ever be prepared for such a devastating, life changing event. We didn’t see the warning signs. There wasn’t anything that was extremely different that would lead us to believe that he was thinking about it. We may have been so lost in our grief with my mom’s passing, that if there were warning signs, we didn’t recognize them. That’s the hard part, what could we have done differently? Could we have done something to change the events of that day? The darkness and despair of his depression had taken over his thoughts. 

Another thing that’s really hard is when people make comments like, “How could he do that to you? Why would he do that to you?” The reality is, he didn’t choose to do it to us. It had nothing to do with us. His death was about his pain and the inner struggle that we know nothing about. He kept that part of his life to himself, he rarely talked about his depression. He must have felt that this was his last resort, the best solution. 

It’s hard because our clinic had only been open for 4 months when he took his life. He helped get the clinic ready before we opened. It may seem strange, but it’s comforting because I still feel his presence in that space. We’d had conversations about him being assessed for ketamine treatments and seeing if it would help his depression and decrease his medications, and he said, “Maybe someday, I might consider it”… but someday never came.

So, could ketamine have saved his life? Very likely. But we’ll never know. That’s the thing, because he didn’t get the chance to try ketamine, he never made it into our clinic as a patient. I will always regret not being more perceptive, more insistent, more in tune to his mental health. How ironic that we had just opened our clinic to help people for the very thing that took my husband’s life, yet I couldn’t or wasn’t able to help him. That’s why it’s so very, very important to have those hard conversations. Even the hardest conversation will never be harder than losing someone you love to suicide. Know that you’ve done everything that you can before it’s too late.