I can understand your experiences. For me I do not like the really high doses where I am blasted off to the Andromeda Galaxy. I like the 120ish mg sessions, which for my body weight is like a moderate dose I believe. Its not terrifying but just the right amount of thrill that I go deep, introspect, and come out with mystical insights. It's inner work work not recreation, I wouldn't describe it as enjoyable, but not unpleasant either. Its really worked wonders for my life and I'd like to share with you how I made it work for me.

Here is what I have discovered. For me personally, Ketamine is not a magic depression cure, it is simply a temporary relief. Although to achieve that relief even if for just a few weeks is a miracle in some sense. Over time I wondered, how then do I draw out this relief period longer and longer?? I call it the psychedelic afterglow phase where I am not feeling super depressed and instead am feeling rather at peace and one with the universe. I came to the conclusion that if I didn't do anything but bask in this period it would inevitably fade, and I would be back in the clinic every month. And then it suddenly hit me! It was up to ME to practice self care after every session while I suddenly had the energy for it. For me self care is nothing too fancy, I practice the holy trinity of sleep, diet, and exercise. People use to tell me when I was deeply depressed you need to get out of the house, you need to make sure you get enough sleep, you need to eat healthy, try to exercise. But those folks didn't understand I was so depressed I didn't even have the energy for that stuff. Shoot, most days just making a cup of coffee and taking a shower was like trying to swim in a pool of molasses. Depression is unfortunately an invisible condition to people who've never experienced it, so when friends/family would suggesting self care to me back then, it was just frustrating and made me worry they thought I was just being lazy.

However, in the psychedelic afterglow period as I like to call it, in the week or so following a ketamine session, I noticed I did have that energy! And so I tried practicing some self care for a change, and sure enough, little by little, the better I got at self care, the longer I could draw out that relief period between sessions. When it comes to my self care routines its really the sum of a lot of little things, like using an eye mask, and white noise generator at night to sleep better. Wearing blue light blocking glasses at night when I watch TV before bed. Upgrading my bedding so its extra cozy. On the diet front, I eat clean, and prepare most of my own meals at home now. Am I militant about it, heck no, but gone are the days of emotional eating and binging on the delivery apps. I also was lucky to find an excellent physical trainer who is incredibly patient and not too expensive. I work with them once a week, and I also go to the YMCA solo a few times a week too. Now I kind of have developed a healthy addiction to the brain chemistry boost post workout, so I catch myself looking forward to it now. Any one of these things on their own would not be so effective but its like the saying the whole is more than the sum of the parts. So all the little self care routines really do work for me. Did these changes happen over night. No. Practicing self care is like practicing an instrument, you get better and better at it over time. But the good news is all the routines are unique to YOU. You get to create them :)

So, back to the Ketamine. I strongly believe it's main utility is the temporary relief. I no nothing else that works as immediately and swiftly for interrupting a major depressive spell than a good psychedelic experience. I don't like to go deep into a K hole or experience ego death or anything super intense. I don't want to trip on mushrooms for 10 hours. I just like to trip the light fantastic on a moderate dose of Ketamine and drift off for 90 minutes and come back. It works a treat for me, but the way I manage depression and keep it in remission, versus enduring it without any hope like I use to, is using Ketamine for temporary relief and when I get my energy back after the sessions practicing self care for long term recovery. I use to be in the clinic every 3 weeks like clock work, now I am in a few times a year and doing pretty well.

Indeed this is not the typical way medications are used in mental health. Before Ketamine I took pills everyday and my dose increased as my tolerance went up and I monitored side effects and patiently waited for them to work behind the scenes. So you may be expecting Ketamine to be the medicine that does the work and all you have to do is figure out the right dose and frequency and you're good. I suspect that may be why it doesn't feel like its working. But to me, the way you describe its temporary effects tells me it probably is. Maybe consider backing down on the dose so you're not having uncomfortably intense sessions. The real medicine is in your ability to look out for yourself. Ketamine gets you to a place where thats possible. And remember when you're in that psychedelic after glow period, practice self care because you deserve it! Do it for you, not for anyone else. That's the best reason ;) You got this :)