My journey to working in a ketamine clinic

by Rachel Featherstone, WHNP, Ketamine Nurse Practitioner

Mental health has been a continuous thread in the story of my life, beginning even before I was born. 

I grew up with grandparents on either side of my family with mental health struggles.  My grandmother on one side was affected by both bipolar depression and alcoholism, and the stories of her life were passed on with a good degree of caution. You don’t want to grow up to be like her, I heard in between my mother’s words.  

My grandfather’s struggles were talked about less often, and with a greater sense of shame.  He never spoke about his episodes of delusional thinking or irrational behavior before he died–but my mother’s recounting of the events carried the lesson, You have to get help if you need it.  These things do not go away on their own. 

My working in mental health began with my own illness.

As an adult, the birth of my first son triggered an unbearable episode of depression, due to the trauma of birth and the rapid chemical shifts of the postpartum period.  I was in the military–far from home, with few other mothers to connect with, and going through a divorce. It was the lowest point of my adult life, and as I emerged from that darkness, I knew that I wanted to help others who were suffering in a similar fashion.

My focus after separating from the military was on becoming a midwife.  I envisioned myself shepherding birthing individuals and their families through this time of transition.  Given my military background, one of the first hospital jobs available to me was in an inpatient mental health unit. I was thrilled about the opportunity to touch lives in such a difficult time, to witness people’s stories and healing.  I knew my future was in women’s health, but I was eager to gain valuable experience at the bedside.

During my time in the behavioral health unit, I experienced a recurrence of my own mental health issues.  I miscarried my second pregnancy and struggled with losing weight as well as hope.  I continued on through nursing school, but with significant difficulty.  The same hormonal shifts of the postpartum period were exacerbating my grief over the baby I had lost, while I continued to parent a toddler, continue my nursing studies, and work in the inpatient unit.  When my usual support people were unable to fully understand my emotions, my coworkers were who I needed at the time. 

I began working in labor and delivery once I was a nurse and moved on from my nurse’s assistant job.  I thought I was saying goodbye to behavioral health and focusing on obstetrics, but rather I was just changing the patient population–mental health issues pervaded the walls of labor and delivery.  Substance abuse, depression, anxiety, and trauma were specters in many labors, not to mention the grief of stillborn infants.  So much of my work continued to be that of quiet witness and listener–much the same as my time in psychiatry.

As I moved into midwifery school, my life was basically consumed by my work.  Whole days on call for births, coupled with the grueling work of learning and long hours of clinic visits began to weigh on me. 

I loved my work, but it was an untenable pace

One of my wisest and kindest preceptors reminded me to look back at what brought me to midwifery, and explore if I could fulfill my calling in a more sustainable way.  After a lot of reflection, I admitted to myself that I loved building enduring relationships with my patients more than attending the births.  I changed tracks from nurse-midwife to nurse practitioner–learning a great deal about self-care and my own limits.

Upon graduating as a nurse practitioner, I struggled to find the right position where I could merge women’s health and mental health. 

I stumbled across a posting for a ketamine clinic

I had no knowledge of ketamine as a mental health treatment.  The more I researched it, the more fascinated I became.  The scientific literature was showing this dissociative anesthetic–and psychedelic–could rapidly and profoundly improve depression, anxiety, PTSD, and chronic pain.  I couldn’t believe I hadn’t heard of it beyond abuse as a party drug, during my fifteen years in healthcare.

There was no way I could have been prepared for the profound changes I saw in the patients that my physician partner and I treated when we first opened our clinic.  Our patients rapidly became a different version of themselves, after experiencing a rapid remission of their symptoms.  One young woman told me that it was like her “negative inner monologue” in the back of her head quieted down, and then stopped altogether. 

Another man, who couldn’t remember a time before his depression and anxiety, said that he had a sense of clarity about his emotions that he had never had before.  Family members often became tearful when they thanked us for ‘giving them back’ their loved ones.  It’s incredible to watch people be pulled from the depths of depression, after being stuck in loops of negative thoughts for years or more.  Their faces and speech change as their inner world changes, and the metaphorical weight on their shoulders lifts.

I feel like I’ve come full circle, back to when I was a nursing student on the behavioral health unit almost ten years ago.  I’m grateful that I work in a small clinic, where I get to devote as much time as necessary to work with my clients–not just conducting their ketamine infusions, but hearing their stories and getting to know them and their families on a level that most healthcare professionals simply can’t. 

From a historical perspective, the use of psychedelics for the alleviation of mental illness is far from new.  I feel incredibly lucky to be a small part of this modern psychedelic renaissance, giving back hope to those who are struggling with depression, anxiety, and PTSD.

Rachel Featherstone is a board-certified women’s health nurse practitioner and Army veteran. Her passion is at the intersection of gender, sexuality, and mental health. She has worked in healthcare in Richmond since 2005 and is the organizer of the Greater Richmond Maternal Mental Health Coalition. Rachel was born and raised here in Richmond, where she lives with her two sons and their dog, Amber. Alchemy Wellness.

Have you ever thought, ‘It will never get better?’