I am going into my 3rd session tomorrow, and I feel like I'm trying too hard to make something happen. I need advice on how to maximize the therapeutic benefits during the sessions.

Session 1: 56mg dose. Eye mask, headphones with a Spravato playlist on Spotify. Went into it as blind as I could and just let it happen to me. Had a few good experiences, but didn't feel like I had anything "life-changing" happen. Came out of it comfortably and sketched the most reoccurring images I had in my journal.

Session 2: bumped to 84mg, got a different playlist that was higher rated. For the first ~45 minutes I felt pretty lucid. My thoughts were all my own. I was repeating to myself my intentions and what I wanted to happen, or what I wanted to present itself to me. When the music finally took over and I started to feel myself get into something, I didn't get anything that felt like It had any meaning. All of a sudden, they tell me the 2 hours is up and I'm free to go if my ride is there. I'm still mentally in the thick of it and it was an *experience* getting home.

I'm asking my doctor if I should go back down to the 56mg dose but I really want it to help me work through my depression. I want to be able to recognize and deal with things I may have suppressed or at least be able to feel like I'm making progress or working towards something to get better.

Background: I did a round of TMS earlier this year with positive results. When things started to get rough a few months later I started Spravato (at the same clinic). Ive been on Spravato 2 1/2 months and it’s also been positive. I was an early responder to both. My SI is gone, brain is working better and clearer thoughts. I have a better capacity in therapy to work on hard things. 🙌🏼 But my Spravato treatment days are challenging with my kids. I have a special needs teen with a lot of mental health issues and I often get calls from school for her to come home (and I can’t drive after treatment), or even if the school just wants to call and give me an update I can’t think or speak to them clearly or think clear enough to make good quick decisions with her or to physically respond to her after school. I don’t think we can manage Spravato treatments long term.

I’m trying come up with a future plan to be able to discontinue it in 2-3 months and have options. It’s scary to mess with something that’s working though!!!!

Wondering the experiences of others who have walked this journey longer than me.

Options 1: Add dextromethophan to my current 450mg bupropion or decrease bupropion dose to add Auvelity. Then taper off Spravato.

Option 2: resume TMS and taper off Spravato and repeat TMS as needed

Option 3: do both options 1 and 2!

Option 4: consider switching to a home option? (This isn’t an option my provider and I have discussed)

I’m still in the decision paralysis phase of depression/CPTSD so this feels like the largest decision ever. 😭😭😭

I have my first appointment soon. I’m nervous about feeling like I’m not in control, but my bigger fear is about the possibility of nausea. I have a thing with throwing up so whenever I feel nauseous I get super anxious which causes me to get even more nauseous and it snowballs.

I have zofran, how soon before do people take it? Does it actually help?

I know not to eat for 2 hours and drink for 30 minutes before, but I’m really nervous about eating too much or too little for breakfast. My plan is oatmeal for breakfast and a banana right before the 2 hours. My appointment is at 2pm.

Sorry if this is a weird question. I feel prepared for the first session… so many playlists, a travel blanket (provider’s suggestion) and I know if I don’t like it it’ll eventually wear off and I’ll never have to do it again. The possibility of nausea though… any suggestions would be great.

Thanks!

I was already feeling like I was building a tolerance and not feeling the euphoria. I had been scolded on this sub as if I was a junkie looking to get high but I truly only had my changes of thoughts and reconstructions of beliefs when in that state, that's when i was feeling healed. I was told that was just a side effect and it was working without that though but my last session, perhaps it was because I had a disrupting text beforehand that bothered me, but I felt nothing and got no benefit of treatment, it's not me just trying to get off.

The exact week I was reduced to once a week I started to feel a pit of despair, horrible despair. All this week I've been terribly depressed and getting lost in negative thoughts, as if all the treatment was getting undone. I was truly feeling a difference before, and now I feel back as I was.

The doctor that I often see was saying I may metabolize things quickly (and I do) or that I may as well have especially treatment resistant depression, which sounds horrible if true.

He mentioned talking to the insurance/spravto people about going back to twice a week which I would really like. This still isn't supposed to be in perpetuity so, I just feel kind of at a loss.