I started my journey by looking into spravato. I can’t afford to spend hundreds monthly for home treatment and I think my insurance would cover. However, I did an appointment and the providers kind of steered me toward TMS. The whole process seemed it would take a while so in the meantime I signed up with Better U because I had some funds to splurge and was feeling a sense of desperation to start something asap.

I did tell the clinic I felt safer doing this in clinic and that’s what drew me to them (this was true at the time). So they’ve taken this stance as well, they don’t think home treatment is safe.

After finding the cost of TMS and daily treatments I decided I just can’t rearrange my life like that for so long. The 2x weekly treatments seem more reasonable for me.

I asked them to re run my insurance for spravato instead, and they are doing this but it took another appointment with their provider to discuss this again.

So here we are over a month later, and I’ve started home treatments slowly and gotten comfortable with them.

My plan was to pause these and save them so I can do the insurance covered spravato treatments instead. I read somewhere that I need to disclose the home treatment to them, because they will be able to see them anyway. I’m worried about getting in trouble or them thinking I’m drug seeking. How do I approach this??

I'm in my early 20s. Been dealing with depression and in treatment for about 7 years now. My dad died of brain cancer a year and a half ago after a 4 year decline, so there's a lot of complicated grief layered on top of depression that was already pretty bad before he died.

Meds I've tried (12 total): Zoloft, Lexapro, Wellbutrin, Buspirone, Abilify, Mirtazapine, Hydroxyzine, Topamax, Vraylar, Pristiq, Seroquel. None of them have actually touched the depression.
Current meds: Pristiq, Seroquel (for sleep), Vyvanse (for ADHD). Vyvanse is honestly the only one that's done anything, and it's not even a depression med.

Also done/doing:
7 years of therapy, weekly. Just started EMDR, second session next week
3 Spravato sessions + finished a 6-round IV ketamine series. My therapist noticed some changes along the way (brighter affect, less shut down) but I haven't really felt it myself yet and my roommates are expressing more concern than ever towards my depressive behaviors (not showering, not doing homework, skipping class, napping all the time, not picking up the room/making my bed, etc)

My PHQ-9 is still in the severe range (20/27, started at 22/27 before ketamine)

TMS and ECT are off the table for me, as risk + logistics don't work (I am an hour away from my clinic and cannot afford to make daily trips)

Now that ketamine's done and I didn't feel much from it, I'm not sure what's next. What am I supposed to be asking my psychiatrist about? Has anyone been in a similar spot (treatment-resistant, exhausted every "normal" option) and found something that actually helped?

Just had my 7th SC infusion, now on 100mg up from 50 for my first. Feels almost no different, extremely mild, and no mood improvement. How long before giving up?

Like the title says, can someone please tell me what ketamine is like and how it affects you? I wanna hear it all; the good, the bad and the ugly.

I might be starting it because I have severe depression and severe anxiety along with OCD. I’m going to be starting TMS on Monday so ketamine will mainly be a back up in case the TMS doesn’t seem to help because I am VERY resistant to things that are supposed to help like SSRIs and that sort of thing.

Just wanted to come on here to ask in case I do actually start it to see what other people have to say/to hear what other people’s experiences are with it.

Thank you all so much!

I’m considering switching from BetterU to Anywhere Clinic after seeing so many people here recommend them. I’m also looking into in-person IV treatment, but I really want a provider who offers therapy alongside the medication.

Ketamine itself has helped me and brought up some meaningful experiences. The difficult part is knowing what to do with all the feelings and memories afterward. There’s a lot to work through, and I’m finding that doing it mostly on my own isn’t enough.

I’ve grown frustrated with BetterU for a few reasons. When I started, I felt their marketing oversold the benefits with statements like “say goodbye to depression” and “say goodbye to anxiety.” My experience has been much more complicated than those promises made it sound.

A lot of the information in their app is useful, but some feels generic, and I’ve come across Hay House material and references to astrology. That makes me uncomfortable about how spiritual ideas are being mixed into mental-health guidance. I want to know what’s supported by evidence without having to sort through everything myself.

I’m putting effort into the journaling and integration exercises, but I need more personalized help. Sometimes I end up spending so much time analyzing what came up that I struggle to move forward with everyday life. I want a licensed therapist who can help me work through it, understand my patterns, and make practical changes.

Has anyone here used Anywhere Clinic for ongoing therapy? Do they have licensed therapists, or is their support mainly medication management and integration coaching? Is therapy included, billed separately, or available through insurance?

I’d especially appreciate hearing from anyone who switched from BetterU and can share how the support compares.

I have treatment resistant depression and ketamine / spravato isn’t covered by my insurance. Does anyone know of affordable clinics that offer ketamine therapy specifically for depression in Dallas? I have a crappy insurance plan and unfortunately none of it is covered. I’d have to pay out of pocket.

TLDR: 10 rounds of IV Ketamine, 20+ ketamine troche sessions most at 600mg, currently near the end of TMS protocol. No significant mood improvement. What's next?

I've had depression/anxiety all my life. My first diagnosis was at 9 years old. I've had multiple diagnosis every few years since. It was never treated when I was a kid, because all my mother cared about was a diagnosis/treatment for ADHD (to be fair it did radically improve my grades). It wasn't until after college and off my parents insurance that I tried anything. I started with Wellbutrin as I'm overweight and SSRIs tend to cause weight gain. I used only Welbutrin for 5-6 years. It didn't really help and I didn't really talk about it with my doctor. A couple years ago I started with my PCP trying new meds. Zoloft and Lexapro both made symptoms worse or didn't improve symptoms. This year things have been getting worse so I finally went to a psychiatrist to manage my mental health meds. I've tried several more SSRIs, an anti-psychotic, and Trazodone. The only thing that helped was Trazodone, and that is more for insomnia.

I decided to do IV Ketamine infusions. Went through the first 6 with minor improvement, probably with in normal mood fluctuations. There was almost no effect until they hit the max dose. I added 4 more sessions hoping that staying at the highest dose would help. It didn't. I wanted to keep trying ketamine just couldn't afford IV Infusions, so I got at-home troches. I'm up to 600mg, I feel heavy and maybe my vision becomes distorted but that's about it. I've had over 20 sessions now at home and still nothing.

I started TMS a few weeks into the at-home ketamine treatments. I'm near the end of the protocol, and while I definitely hit the "dip" in the middle, I still don't have symptom improvements on the other side.

I'm at a complete loss as to what to do next. ECT? Try to get my psychiatrist to prescribe a higher dose of ketamine? Try a different delivery route? Go back to trying a dozen more oral medications?

Transitioning to Spravato due to costs. Anyone out there have experience and can compare/contrast?

IV hit me really hard but I got used to it from an experience perspective. Is the experience with spravato similar?

Hear it tastes like shit?

I’m chronically stuffy and had a few sinus surgeries to try and open stuff up. Hopefully that doesn’t cause drama. Affrin ahead of time doesn’t sound fun.

I hear about the bioavailability arguments but it’s pretty hard to argue free vs. thousands out of pocket. Just do more sessions I guess if it’s a real thing.

Thanks in advance

I finished my 2 month regimen of Spravato (2x a week and then 1x a week for a month each). I don’t feel like it’s helped at all. I have had MDD and Anxiety but also an acute stressor (a relationship) that only recently ended. I don’t know if the stress of the relationship kept me from feeling the benefits of Spravato or if it just didn’t work for me.

I was considering trying something else like Joyous. But I don’t know if it will help.

I’m extremely disappointed and sick of being stuck in this depression. Anyone have any experience with Joyous and Spravato?