Note: This essay details one individual’s experience with a controlled substance. Medical decisions should never be made without contacting a professional.
It feels like the marketing campaigns for ketamine, the dissociative drug that was legalized in the U.S. in recent years to treat depression, are everywhere these days. They also seem to be especially targeted at women ― my female friends tell me I’m not the only one whose social feeds are plastered with ads promising me a better life through ingestion of what was once a ’90s rave scene favorite, and emphasizing the fact that it may help with menstrual issues like PMS and PMDD.
So I was intrigued when one of the many companies that offer at-home ketamine therapy approached me with an offer to try it for free, along with links to numerous studies detailing its potential long-term benefits, including getting over past trauma, as well as an overall more positive and improved outlook on life.
I have never been diagnosed by a clinician for anxiety or depression, but honestly, who hasn’t found the last couple years to be anxiety-inducing? Plus, the ads I’d seen on Instagram and Facebook made ketamine therapy look harmless, with images of smiling people living their happiest lives thanks to this life-changing drug. The ads sometimes referenced anxiety or depression, but many positioned ketamine as simply a general gateway to enhanced mental wellness and relaxation, akin to a shot of wheatgrass or a sound bath.
Even though it became legal in the United States in 2019 for mental health practitioners to provide ketamine to patients suffering from depression ― often through in-office infusion ― it’s still a regulated substance. But it’s grown progressively more common since then, and when the pandemic inspired a change of the laws regarding telehealth in 2020, numerous companies sprung up to offer ketamine therapy that could be conducted at home after being prescribed via a telehealth consultation.
Despite being called “at-home ketamine therapy,” the company I used didn’t offer any therapy by a professional to coincide with taking the drug ― I was going to be on my own for the entire affair (though it was strongly recommended that I had a friend present). Some companies have practitioners who guide you through the trip virtually.
To qualify for the treatment, I answered a short questionnaire online about my health history and had a telehealth appointment. The physician assistant I spoke with declared me a “great candidate” after just a few minutes into the session. None of the information from the health questionnaire I’d filled out was reviewed during the appointment.
I was a little taken aback to be cleared so quickly, but I was excited to be given the opportunity to try something so cutting edge.
The ketamine was mailed to me in pill form several days later. Since I’d never tried the therapy before, I chose to err on the side of caution and took only half a dose. It was so bitter that I almost vomited while waiting for it to dissolve in my mouth and I eventually chose to swallow the remaining bit. The ketamine kicked in approximately 10 minutes later.
I’d been told that the drug might make me feel separated from myself, and that memories from my past might arise. Other than that, I honestly wasn’t sure what to expect. For the duration of the “trip,” I felt quite relaxed. It was like my mind was swimming through a peaceful sea, and I had a sense that everything in the world was going to be OK. The physical sensations were fairly mild, but pleasant. I chatted contentedly with the friend I’d asked to join me. After about 45 minutes, the relaxed feelings wore off. Though I’d read that people tend to be sleepy after taking ketamine, by the time my friend left, I felt energetic and on high alert.
I spent the rest of the evening worrying nonstop. My brain hunted endlessly for things to stress about. My heart pounded fast in my chest, and I felt so deep in my own anxiety that I couldn’t even bring myself to tell my then-partner what was going on. I slept for just a few hours that night.
The next morning, I was shocked to find myself with boundless energy after so little and such poor sleep. I did an hour-long home workout. My partner and I went to get brunch, which I found myself unable to eat much of, and then we took a long walk. As soon as I slowed down, I was again overwhelmed with anxiety, so I stayed as active as I could that day. That night it was also difficult to sleep, and the next day I experienced more of the same manic energy.
Three days after my trip, I realized that I had felt this way before, many years ago, when my thyroid disease was first diagnosed and treated. I have hypothyroidism, and I take a daily dose of a T3 hormone that’s equivalent to 75% of the amount my own thyroid should naturally make. My condition has been well-managed for a dozen years, but in the early days of discerning the correct treatment, I suffered briefly from hyperthyroid symptoms when a dose was too high.
Everything I was feeling post-ketamine, from insomnia to tachycardia to anxiety, were textbook hyperthyroidism symptoms. So I looked up whether it’s safe for people with thyroid disorders to take ketamine.
I discovered that ketamine is what’s called a “sympathomimetic” drug, which means it stimulates your nervous system. This can be amplified in people with thyroid disorders, and because of this effect, The American College of Emergency Physicians “considers the use of ketamine in patients with a thyroid disorder or receiving a thyroid medication a relative contraindication.”
“Though the company claimed to be sorry for my experience, it did not take any responsibility for what happened. A representative claimed ‘the risk was worth the reward.’ They never noted that I – not the company – should have been the one to decide that.”
Makers of thyroid medication Armour Thyroid, which contains the hormones levothyroxine and liothyronine, say that ketamine should be administered to thyroid patients cautiously “because concomitant use can cause marked hypertension and tachycardia.” I read that combining ketamine with thyroid medication can, at least in some patients, lead to exactly the symptoms I’d been having. “Alarming reactions” to ketamine by people on thyroid medication have been well-documented.
After realizing what had happened, I contacted the company and expressed concern that I had disclosed that I had a thyroid disease on an intake form but that it was never mentioned or referenced in my telehealth consult. At the very least, I felt they should have brought up the contraindication and let me make my own fully-informed decision about taking the drug. I would have declined.
Though the company claimed to be sorry for my experience, it did not take any responsibility for what happened. A representative claimed “the risk was worth the reward.” They never noted that I – not the company – should have been the one to decide that. They offered me a refund, but since I hadn’t paid for treatment, that was a moot point. Our email exchange ended with me feeling frustrated and believing that they hadn’t done their necessary due diligence to keep me safe.
It took about a week after taking the drug for my anxiety to dissipate, and I was left both physically and emotionally exhausted. It was weeks before I felt like my normal self again. Because I only see my thyroid doctor annually and felt I’d managed the situation acceptably alone, I didn’t reach out to her about this, and thankfully, I haven’t had any further issues.
Can I be certain that the interaction between the ketamine and my thyroid medicine was to blame for what I experienced? No. But after the extensive research I’ve done, I believe it was. Could someone else with the same condition and medication take Ketamine and have a different experience? Of course. No two people are going to respond to any drug or multiple drugs in the same way. Could the physician assistant have been new or made an error in not asking about my medical history or noting that I had disclosed my thyroid condition? Yes. Could this simply have been an unfortunate ― but decidedly rare ― mistake made by this specific company? Of course.
The issue for me is that these things did happen, and I’m willing to bet they have or will happen to others as well. While I know that ketamine can be a transformative drug for many people ― and I wholeheartedly believe that we should be researching how other psychedelics can help better people’s mental health and offer them in cases where they will be beneficial ― I worry that this controlled substance is being given to too many people without enough safeguards in place.
The barrage of glossy targeted marketing that presents ketamine as the latest wellness trend, on platforms that usually serve us ads for cute jewelry, is providing the impression that it’s a tool anyone can use to achieve vague self-improvement, rather than a powerful dissociative drug intended to help people struggling with diagnosed mental health disorders. Ketamine therapy isn’t like trying a new yoga mat or a CBD-infused soda, and it shouldn’t be taken lightly. Companies need to make sure that their priority is the health and safety of their patients, not their profits.
I also believe we need to take a step back and reevaluate wellness culture in general. The truth is, most of the time a better life is not just a click ― or a pill ― away. In recent years, we’ve been told that we’re unhappy or our lives aren’t as good as they could be because we haven’t bought the right supplement or listened to the right meditative podcast or tried the right hack. As a nutritionist who has performed consults for many individuals over the years, I can’t even count the number of clients who blamed their health issues on trendy health fads. They tried everything from colonics to juice fasts to achieve an aspirational level of wellness, and ended up suffering consequences from disturbing their body’s natural systems. While I appreciate that there are now more ways to approach our lives ― and trying to live our best lives ― sometimes the work we need to do can’t be done via an online purchase or watching a reel.
Is ketamine therapy right for you? Only you can decide that. But if you’re considering it, I urge you to do your research, ensure the company you pick has done its research, and consult your own medical professional before you do it. Ketamine appears to be an incredible substance that can offer incredible benefits ― it has been and could be life-saving for some people ― but it can also become addictive, be abused, and bring unforeseen dangers. It’s not a game, a toy, or merely a way to pass a Saturday afternoon. We should give it the respect and care it deserves, and stop treating it like just another harmless fad in our Instagram feed.
CORRECTION: An earlier version of this essay misidentified Armour Thyroid and the hormones related to it. The piece has been updated to note that it contains both levothyroxine and liothyronine.
Ariane Resnick, CNC is a special diet chef and bestselling author of five books. She has written articles about lifestyle, food, nutrition, identity and wellness for various platforms including Food & Wine and Health, and has been featured in media such as “The Doctors” on CBS and Forbes. View the full scope of her work at ArianeResnick.com.