Fresh off a tropical holiday getaway, Stacey Solomon’s inner world went dark.
The weeklong vacation in Playa del Carmen had been a rare opportunity for the 38-year-old to see her sister, Jen, who lived in New Jersey, halfway across the continent from the Kansas City suburbs where she lived. With their husbands and parents in tow, all four of their young boys–two per sibling–got together to play on the beach of their resort. The whole family of ten, their feet submerged in the foamy waves, posed for sunlit photos as a professional photographer snapped away. Stacey’s husband Matt held her tight as they posed for a couple’s portrait against a resort backdrop.
None of that mattered anymore as the world twisted, distorting like mirrors in a carnival funhouse. “Matt, I’m having bad thoughts again,” she told her husband. It was January 2018, and her all-too-familiar depression had begun to settle back in.
This wasn’t her first bout with major depressive disorder, the official diagnosis listed in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-V), the mental health world’s interminably changing bible of terminology. That episode, defined in the DSM-V as a period of two weeks or more, happened almost 15 years prior when Stacey was 24 and enrolled in a master’s program for social work in New York City. The first one that spring would culminate in Stacey’s first suicide attempt and hospitalization.
Pictured here at age 24, Stacey (right) and Jen (left) were almost twins. This photo was taken the day before she attempted suicide for the first time.
After she’d left the hospital, Stacey flew home to Kansas City, where she and Jen had grown up. There, living with her parents, she recovered, albeit slowly. She took newly prescribed antidepressants and attended daily intensive outpatient therapy. That was the summer she met Matt, then a newly minted lawyer studying for the bar.
This time in 2018, however, was different, she told her father. Steve Simon, 72, was a family medicine physician who lived near her in Leawood, a small city in the Kansas City metropolitan area. He had always been Stacey’s biggest champion, driving her to and from outpatient therapy, sitting in on psychiatrist appointments, and cooking meals for his son-in-law and grandkids when depression left her brain too clouded to put together a grocery list.
It was hard, when his daughter endured her first episode at 24, to believe that Stacey was depressed. Growing up as the younger of the two sisters, Stacey was the optimistic cheerleader to Jen’s pessimistic bitch–in Jen’s own words. At the dinner table, her parents would double over in laughter at the humor she brought out without even realizing it.
“Without making her sound like an airhead, she saw the beauty in things,” Steve says. Visiting Stacey during her first psychiatric hospitalization in 2005, he found his depressed daughter bright and upbeat as she cheered on other patients. “[The hospital staff] told me they hated to see her go, that she could turn [the patients] around,” he says, chuckling.
Stacey and her family on the vacation at the end of 2017–before her longest depressive episode set in.
After her first depressive episode, Stacey would go on to have four more, each accompanied by a suicide attempt. No particular antidepressant regimen, talk therapy, healthy diet, regular exercise–all evidence-based recommendations for managing depression–could keep the illness at bay forever. She had treatment-resistant depression (TRD), a psychiatric research term defined as when two or more different antidepressants don’t result in significant, lasting improvement in symptoms.
“This time is different,” she told Steve. At first, however, things seemed to follow a similar progression: As with the previous episodes, she tried to take her life, spurring hospitalization. Not long after they’d come back from Playa del Carmen, Matt found her in the boys’ bathroom with a bottle of Tylenol, swallowing pill after pill, and managed to stop her in time.
Since he’d met Stacey the summer of her first suicide attempt, Matt supported his wife through several depressive periods. Each time, she’d try to kill herself. Each time, she’d go to the hospital. Each time, she’d get better. “Part of me was relieved because of her pattern [when she was hospitalized],” he says. He thought this episode would yield the same positive outcome.
Released from the hospital with new prescriptions for medication and therapy in the late winter of 2018, Stacey struggled to keep herself alive. Both her parents–particularly Steve– lent help whenever possible, keeping a watchful eye in case her suicidal thoughts became action.
With Jen in New Jersey and Matt working full-time to support his family, Steve and his wife, Ileene, took it upon themselves to help their daughter recover and live a quasi-normal life. Still, Stacey’s depression persisted, conning her into thinking she couldn’t do anything right. Often, he would drive her to the grocery store. For Stacey, who worked as a holistic nutritionist shopping alongside her clients, to say, “Dad, I don’t know what to buy,” just broke him.
Matt and Stacey with their boys on their July trip to Utah’s Bear Lake in 2018. The summer vacation was one of the last few reprieves from her severe depression.
Aside from a brief reprieve during a trip to Utah’s Bear Lake with Matt and the kids, Stacey’s depression continued to worsen, and she was hospitalized for a second suicide attempt. The family toyed with the idea of electroconvulsive therapy (ECT), but Stacey vetoed the idea for fear of memory loss, one of ECT’s landmark side effects. Desperate and running out of options, her longtime psychiatrist suggested a new, experimental treatment: intravenous ketamine.
Originally an anesthetic synthesized in 1962, ketamine is a drug more commonly associated with warehouse parties and Erowid psychonauts channeling Timothy Leary. Despite its reputation as a recreational controlled substance, the drug is still widely used in medical practice as an anesthetic in humans and animals, the latter giving rise to a few of its street names like “cat tranquilizer” and “kitty flip.” In recent years, however, psychiatrists have begun to see ketamine as a new option in treating major depressive disorder and other mental illnesses.
At higher dosages, it’s capable of inducing a trance-like, dissociative state of altered consciousness, known as a “K-hole.” In some cases, the drug can cause hallucinations and delusions. In smaller doses, however, ketamine induces a mild sedative, analgesic effect, and anesthesiologists still use the drug for its original purpose, albeit with careful monitoring.
When Stacey’s psychiatrist Dr. X* gave them the suggestion, longtime family medicine physician Steve was already well aware of ketamine’s medical potential. In his own practice, he’d even prescribed it orally, at low doses, to patients suffering from chronic pain and migraines. With her father’s input, Stacey agreed to start ketamine treatment in August 2018, seven months after her depressive episode began.
*The family declined to name the specific doctors.
Although the FDA would go on to approve Spravato, a nasally administered form of the drug in 2019, most ketamine patients received the drug intravenously, including Stacey. At these privately run ketamine clinics, doctors provide treatment based on research protocols in the absence of standardized dosing, monitoring and decision-making guidelines.
Since ketamine delivered intravenously is not FDA approved for treating depression, insurers typically don’t cover infusions. Dr. Y’s practice was cash-only. Though that fact sent Steve’s sense for hucksterism tingling, he and Stacey nurtured some amount of optimism. Fluent in medical literature, Steve availed himself of the large body of promising research on ketamine, growing more excited as he pored through summary findings. Among her patients, Dr. Y said she’d seen a 90 percent success rate–success defined loosely as any week-over-week improvement in symptoms according to a depression scale survey a patient takes at the start of each weekly visit.
Buoyed by research-backed hope and the clinic’s self-reported success, Stacey started ketamine treatment in August 2019, visiting for weekly infusions over the course of eight weeks. Within three weeks, her depression had improved by 25 percent, as measured by her self-reported assessments that she took at the start of every ketamine visit. But the relief was short lived. By the end of the treatment that September, she felt she was no better than before she’d started.
Stacey (center, in black and white striped dress) at a birthday dinner in August 2018. Since she was too depressed to complete everyday tasks, Steve (right) would help her with childcare and other errands.
The treatment had failed–or, in medical parlance, Stacey had failed IV ketamine. She was in the minority that saw little to no improvement. The hope she had gleaned over the two months of treatment went to nothing. Still, her family felt they weren’t out of options. They could always look for more options. They would find something that would work.
With Stacey’s consent, Steve arranged for another outside assessment for transcranial magnetic stimulation (TMS), a newer, gentler form of electromagnetic stimulation to the brain. The treatment looked promising, with a 50 to 60% effectiveness rate, and fewer side effects than ECT.
Before that could happen, Stacey Solomon was gone.
On October 10, Matt believed his wife had gone to the spa to finally use the spa certificate he’d given her a few months before. But several hours passed as his phone calls went unanswered. He checked in with Steve to see if Stacey was with him and Ileene. She wasn’t. Using Find My iPhone, Matt tracked down her phone’s location: a local gun shop.
He jumped into his car and drove over. When he got there, the scene had already been blocked off by police. Ambulance sirens blared. She hadn’t even left the parking lot before she pulled the trigger.
It was the worst day of his life.
Matt would tell his kids their mother had died of what he called a “single-car accident.” Messages from Stacey’s friends, clients, and neighbors poured into his inbox, people he’d never even met or knew existed, to tell him just how much Stacey meant to them. The next day, the TMS clinic called Steve to confirm Stacey’s appointment. “Are you still planning to come?”
“Well, I wish I could,” he said.
Stacey Solomon's Lifelong Battle with Depression
For the family fighting to keep Stacey alive, ketamine likely seemed like a wonder drug. For Stacey herself, it felt like the last thing she could throw at the condition that had lurked in the background for nearly her entire adult life. “Ketamine treatment was the last best hope in her mind,” Matt says.
After Dr. Y told her people felt better after the first or second treatment, Matt says she went in there thinking, “Maybe I’m one of those people.” When she wasn’t, it only added to the increasing sense of futility, that even this “last best hope” would not save her.
“We all wanted it to work. Of course we did,” Steve says. “We loved our daughter and wanted her to get back into life. She loved life.” He and Ileene, Stacey’s mother, both believe that she died because she felt like there was nothing else that could help her.
By best estimates, 17.1 million Americans, or 7.1 percent of adults, are diagnosed with some form of major depression in a given year. Of those, up to one third experience a treatment-resistant form of the disease, like Stacey. Despite a host of management options like antidepressant drugs and other psychiatric medications; and non-pharmacological interventions like therapy, yoga, and diet and exercise regimes, there is no one-size-fits-all cure for depression, one of the most common forms of mental illness.
To add even one more drug to the arsenal against depression, then, would seem a boon for patients and mental health providers alike. But when a drug associated more with the New York after hours scene and recreational use sees relatively widespread, off-label use for mental health purposes, there’s bound to be unintended second-order consequences.