I’m not sure where you are based. I’m in the UK and there is only one place where you can have ketamine infusions (at an NHS hospital in Oxford, but you have to pay for it privately). It’s definitely not used unless you have pretty much tried everything else, but it was suggested as a possibility to me by my TMS doctor when the treatment didn’t work for me, actually TMS made things worse. Before TMS I was still able to do some basic things – take my dog for a walk around the park, go to a yoga class, go out for a meal with my husband – all of which I have not been able to do due to the extreme fatigue I’ve experienced from my TMS treatment. It’s been about 2 1/2 months since my last session and I’m beginning to be able to do a bit more the past couple of weeks. Not sure if I’ve just recovered a bit or it’s the new medication I’m taking, either way I’m grateful for any function I’ve regained. I’ve found a good psychopharmacologist so I’m hoping with his help I’ll find a combo that works for me as I’ve been in a severe depression that has left me unable to work or function normally for almost a year now. Hope things improve for you, but don’t give up. There are lots of options. My TMS doc and psychopharmacologist both said ECT is still solid option if medication and TMS fail.