How ‘Russian Doll’ flirts with psychedelic therapy

The show's nod to ketamine is subtle, but the drug underscores the cycle of life, death, and life-changing revelations.

Netflix’s Russian Doll is a psychedelic trip consisting of death and rebirth, gritty humor, easily digestible Borgesian sci-fi themes, and a relatable portrayal of New York City. The show, which was released last week, follows the endearing Nadia Vulvokov (Natasha Lyonne) through the city’s East Village as she’s constantly reborn following a string of different deaths, with no idea about why she can’t kick the bucket for good. The show is also an intriguing navigation through depression and past trauma. Nadia’s journey involves a chance encounter with ketamine, which in recent years has been used as a component in psychedelic therapy for dealing with trauma, depression, anxiety, and other mental health issues — an element on which the show doesn’t focus, but nonetheless underscores some of what we’re seeing.

Russian Doll begins with Nadia smoking a joint presented to her on her 36th birthday, a night on which she becomes older than her mother ever was. The joint supposedly contains marijuana and cocaine — “like the Israelis do it,” her best friend Maxine informs her — but after a night filled with booze and sex, which concludes with her death and unexpected rebirth, she begins to think it’s got a little bit of something else. Eventually tracking down the dealer, she learns the joint was also laced with ketamine, or “this new thing to help people cope with depression,” according to the chemist responsible for concocting it.

Ketamine is typically thought of as a club drug, but it’s been used legally by veterinarians and doctors as an anesthetic since the 1970s. In 1999, it became a Schedule III non-narcotic substance under the Federal Controlled Substances Act, meaning it’s illegal to carry the drug without a prescription but still available for medical use. It has also been designated a “breakthrough therapy” for major depressive disorder by the Food and Drug Administration, and there are doctor’s offices around the country solely focused on administering ketamine to treat physical pain as well as mental health issues.

The knowledge of ketamine’s specific benefits as an antidepressant began with a Yale study conducted in 2000, which concluded that the drug improved symptoms of depression. Since, ketamine has been found to rapidly decrease PTSD for patients and the World Health Organization even lists the drug as an “essential medicine.” Bloomberg recently reported that the drug has been found to help those considering suicide, so much so that Johnson & Johnson may release the first ketamine-based antidepressant drug as soon as next month.

How does it work? As Alice Levitt writes for Vox, “[ketamine] users retreat into their minds and experience hallucinations, sometimes reporting religious experiences or even a feeling some compare to rebirth. Drawbacks of recreational use of the drug include risk of overdose, dependence, and high blood pressure. But for someone experiencing intense depression, that ‘rebirthing’ can be therapeutic.”

In Russian Doll, Nadia initially wonders if her experience with ketamine sets off her rebirth; though that turns out not to be the case, it’s still a more poignant choice of additive than the initial cocaine she believes she’s smoking. She continues living and dying, but she isn’t alone on her trip: she meets high-strung do-gooder Alan (Charlie Barnett) in a plummeting elevator, where they discover they share a common bond in their inability to die. Nadia’s childhood was fraught: her mother had mental health issues, often resulting in physical violence and mentally abusive behavior, which is both alluded to and made very explicit in flashback scenes. Alan, meanwhile, suffered from a life-changing episode when his long-term girlfriend broke up with him the night he planned to propose. Following this, he died by suicide, beginning his own death loop.

Though Nadia’s done ketamine before, part of what’s different about this trip is that it begins on her birthday, as she’s thinking more about the death of her mother (Chloe Sevigny), which is hinted as a suicide. Alan discovers that Nadia keeps photos of her mother under her bed, and she chews him out when he tries to display them above her desk. In flashbacks, we watch her mother scream, turn violent, and berate Nadia, who then begins hallucinating her younger self. In one flashback, Nadia’s mother makes a reference to “getting free”; in the second-to-last episode, as Nadia lies on the floor dying what should be her final death in the loop, her younger self stands over her body and whispers, “this is the day we get free.”

The night plays out the same way it did the first time; to truly end the cycle Nadia has to release herself from the guilt she feels about her mother and reassure Alan not to commit suicide. She has to do more than only care about herself, but turn outward and help another person. It’s a therapeutic revelation brought on by the process of rebirth — just as advertised by the drug, even as there’s other elements at play.

In the end, Nadia and Alan finally close the cycle or, at least, they stop dying. The show’s conclusion is just vague enough to allow the possibility of more. “Did they stop the loop, or were their minds just expanded a little bit more, and so now because they understand a little bit of what multidimensionality is, and the fact that we don’t have just one reality, does that mean anything to them?” co-creator Leslye Headland told Polygon. “Does it not?” In the same interview, Headland indicates that the first season was meant to feel complete. It does, but the show is tentatively set for two more seasons. Like a typical psychedelic trip, it’s a a completed journey that has further to go.

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