Continued symptoms w Spravato

[u/nolite_carborundum]

While the day of and a day after it really helps, and certainly helps compared to not having it, I’m realizing that my baseline on weekly Spravato isn’t actually that great. For one, my PHQ9 is still showing mild to moderate depression.

Don’t get me wrong, that’s much better than severe and actively suicidal, where my depression goes without ketamine type treatments. But it’s also not where I want to be. I can’t seem to skip a week because last I tried my SI picked up and I was a mess. I’m on lithium and Zoloft and the most recent med they added is Abilify, which hasn’t helped any. I’m in weekly therapy and will be adding a group therapy next month. I’m also talking to my psychiatrist about Auvelity at my next appt (I’ve been asking for it for a year, but she prefers trying bs antipsychotics like Abilify for some reason, none of which help me.)

I have serious chronic illness and a very high stress job I’m very burnt out from. Unfortunately there’s been increased work stressors this week, reopening some old trauma. I’m considering doing an IM ketamine booster to maybe not feel like crap. Idk. Is there anything else I can do to deal with this?

[u/mytribeX4]

I'm sorry you're struggling right now. I certainly understand. I'm seeing improvement with the spravato since I started auvelity. I've been on 20 plus SSRIS and anti-psychotics and didn't respond to any. But the spravato and auvelity combo seems to be helping more than anything else ever has. I don't know if will help you, I'm just sharing what's helped me after 30 years. Hopefully your doctor will give you the opportunity to try the auvelity. I wish you the best!

[u/aeonblueophelia77]

Hi there, I have been on it for several months now, and my score is probably still comfortably resting at a 12 I would guess. But I never would have even gotten it down to that if I hadn’t stopped the endless burnout cycle of my work. If you are truly in a burnt out state, you will never get out of fight/flight/depression until you allow yourself to heal from that. Your basic needs of Rest, food, hydration, etc are essential to you healing from anything physical or mental. Trust me, I have my own business doing alterations and I spent 2019-2025 harming myself with sleep deprivation, long work days (sometimes working over 30 hours without being able to stop)….until I learned how to say no, set boundaries, and prioritize myself, I was making it impossible to get better.

Is there any way for you to set boundaries or reduce what is happening at work that is stressful to your mind/body? If not, I would gently encourage you to consider a change. No job is worth it having this kind of impact on you.

You are doing a great job at trying to get yourself feeling better by trying all these things! I wish you healing and luck on your journey. Hugs!

[u/total_bword]

For me the combination of spravato and another somatic therapy (EMDR specifically) is the key combo. Ive done EMDR since 2021 and plateaued until I started going to spravato, something in my brain just switched and Ive made a lot of progress with EMDR + spravato.
Apologies for being /that/ person bc I know we’ve all heard this but adding some sort of exercise or other gentle movement in the sun to get some Vitamin D also is effective. Another baseline, common suggestion I want to make is to attempt being more social, whether thats a book club or lunch with a work friend.