Understanding the Psychiatric Element of Ketamine Therapy

Ketamine therapy is quickly gaining recognition as a new and effective approach to treating mental health conditions, especially for those who haven’t found relief with traditional treatments. It’s showing real promise for people struggling with a broad range of conditions, including alcohol addiction, treatment-resistant depression, anxiety disorders, and post-traumatic stress disorder. What makes ketamine stand out is not just how it works but how quickly it takes effect, offering hope to those who have been stuck in the cycle of medications that just simply are not effective for everyone. However, the therapeutic process is an essential part of its effectiveness.

This article discusses the psychiatric side of ketamine therapy, how it impacts mental health, why proper therapeutic support matters and key considerations.

The Psychiatric Element of Ketamine Therapy: An Overview

Ketamine, originally developed as an anaesthetic in the 1960s, has emerged as a fast-acting antidepressant with psychiatric implications.

Serotonin reuptake inhibitors (SSRIs) can take months to show effects; ketamine can provide significant symptom relief within hours or days. This rapid action is particularly valuable for patients with severe depression or suicidal ideation.

Ketamine therapy operates primarily through the glutamatergic system, enhancing neuroplasticity and encouraging new neural connections. And, although this biological effect is an important part of its overall efficacy, the psychiatric element involves much more than just neurochemical changes. It includes:

  • The subjective experience during a ketamine session.
  • The psychological integration of these experiences.
  • The role of therapy in maximising its benefits.
  • Potential risks and limitations that need to be managed.

What Does Ketamine Do to the Mind During Therapy?

Ketamine is often classified as a dissociative anaesthetic. This means it can create altered states of consciousness.

At therapeutic doses, patients may experience:

  • A sense of detachment from their body or surroundings (dissociation)
  • Changes in perception of time and space
  • A dreamlike or hallucinogenic state
  • Heightened emotional insights or memories

For many patients, these experiences can be highly reflective and healing, leading to new perspectives on their emotions, past traumas, or deeply held beliefs.

Some report a sense of ego dissolution, where they temporarily feel detached from their sense of self, which can be transformative in breaking rigid patterns of negative thinking.

However, for others, these experiences can feel quite confronting at first, particularly if they evoke unresolved trauma or existential fears. This is why psychiatric guidance and therapeutic support are absolutely essential in ketamine therapy. The altered states induced by ketamine should not be viewed as mere side effects but as integral to the healing process when appropriately managed.

Why Psychotherapeutic Integration Is Important

Ketamine can provide relief from depressive symptoms, but its benefits are at their most effective when coupled with psychotherapeutic integration. This refers to the process of reflecting on, making sense of, and applying the insights gained during ketamine sessions to everyday life.

Integration therapy helps patients:

  • Process emotional experiences that emerge during ketamine treatment
  • Identify thought patterns and behaviours that may need to change
  • Develop real coping strategies to sustain improvements in mood and functioning
  • Navigate any challenging or confusing aspects of the ketamine experience

Without this integration, the insights gained from ketamine sessions may fade, limiting their long-term effectiveness. Therapists who are specially trained in ketamine-assisted psychotherapy (KAP) play a key role in guiding patients through this process, helping them translate their experiences into meaningful psychological growth.

Psychiatric Approaches Used in Ketamine Therapy

The psychiatric element of ketamine therapy will usually involve the structured application of psychiatric principles and treatments alongside the drug’s effects.

Ketamine is never used in isolation in this form of treatment. It is incorporated into psychiatric care models, often within a framework of psychotherapy and clinical monitoring.

Medical Psychiatric Supervision

Ketamine therapy is administered under the supervision of psychiatrists or psychiatric professionals, who assess a patient’s mental health history, diagnose conditions, and determine the suitability of ketamine as a treatment.

They monitor responses, adjust dosages, and manage potential side effects or risks.

Psychotherapy (Ketamine-Assisted Psychotherapy – KAP)

A psychiatrist, psychologist, or therapist guides the patient before, during, or after treatment.

The altered state of consciousness induced by ketamine can make individuals more receptive to therapeutic interventions, helping them process trauma, depression, or anxiety.

Psychiatrists often incorporate cognitive and behavioural approaches, such as cognitive behavioural therapy and acceptance and commitment therapy, as a core part of ketamine treatment. These therapies help patients reinterpret their experiences, reshape negative thought patterns, and reinforce positive cognitive restructuring.

These professionals will also be responsible for carefully managing sessions in which ketamine is used. They assess its interactions to develop a safe and effective treatment plan tailored to each patient’s needs.

Ketamine Therapy for Specific Psychiatric Conditions

Treatment-Resistant Depression (TRD)

One of the most compelling uses of ketamine is for treatment-resistant depression, where conventional antidepressants have failed.

Studies show that approximately 60–70% of patients with TRD experience rapid improvement with ketamine, with some achieving remission within hours. The dissociative state induced by ketamine may help disrupt negative thought loops, providing a much-needed cognitive “reset” for individuals stuck in persistent depressive patterns.

Anxiety Disorders and PTSD

Patients with generalised anxiety disorder, social anxiety, and post-traumatic stress disorder (PTSD) may also benefit from ketamine.

Anxiety often arises from overactive fear circuits in the brain, and ketamine’s ability to promote neural flexibility may help break these patterns.

In PTSD, ketamine therapy has been found to reduce hyper arousal and intrusive memories, allowing patients to process traumatic events with greater emotional regulation.

Obsessive-Compulsive Disorder (OCD)

Emerging research suggests ketamine may help with OCD, especially when traditional treatments have failed previously.

By increasing synaptic plasticity, ketamine therapy may help with weakening rigid, compulsive thought patterns and increase cognitive flexibility, providing relief for individuals trapped in obsessive cycles.

Mood Disorders

Ketamine is showing promise in treating bipolar, particularly in individuals who do not respond well to conventional mood stabilisers or antidepressants.

Sometimes, medication can trigger manic episodes in bipolar disorder; short-term use of ketamine therapy appears to have a more balanced effect by enhancing mood regulation without significantly increasing the risk of mania.

For individuals with cyclothymia (which is a milder but more chronic form of bipolar disorder), ketamine therapy may help stabilise mood fluctuations and reduce emotional instability. However, careful monitoring is required, as ketamine’s effects on bipolar disorder are still being researched, and its administration must be done cautiously to avoid potential mood destabilisation.

Alcohol Addiction

Research suggests that ketamine therapy may play a significant role in treating alcohol addiction by disrupting harmful patterns of behaviour and reducing cravings.

Traditional addiction treatments typically focus primarily on withdrawal management which is paired with counselling and therapeutic avenues.

However, ketamine’s effect on neuroplasticity may help rewire brain circuits associated with compulsive drinking.

Studies indicate that ketamine, when combined with psychotherapy, can:

  • Reduce alcohol cravings and relapse rates
  • Improve emotional resilience in individuals struggling with addiction
  • Help patients confront underlying trauma that may contribute to their drinking

Because of the above, ketamine-assisted therapy (KAT) is now increasingly being explored as a tool for long-term recovery, particularly for individuals who have tried but struggled with conventional addiction treatments.

The Multicentre Investigation of Ketamine for Reduction of Alcohol Relapse (MORE-KARE) is the largest trial of its kind, aiming to assess the efficacy of combining ketamine with psychological therapy to help individuals overcome alcohol dependence.

Led by the University of Exeter and funded by a partnership between the National Institute for Health and Care Research (NIHR) and the Medical Research Council (MRC), this £2.4 million phase III trial is now being conducted across multiple NHS sites in the UK.

The study builds upon earlier phase II research, which indicated that participants receiving ketamine combined with therapy remained sober for 86% of the six-month follow-up period.

Potential Considerations of Undergoing Ketamine Therapy

While ketamine therapy holds immense promise, it is not without risks. For this reason, this form of treatment can not be deemed suitable for everyone.

Dissociation can be therapeutic, but it can also be unsettling. Some patients may experience feelings of depersonalisation or temporary confusion, which can be distressing if not correctly managed.

Clinical ketamine therapy is carefully controlled. However, some patients feel emotionally raw after a ketamine session. Without adequate support, this vulnerability may lead to confusion or distress. This is why ongoing therapeutic sessions are in place to help individuals navigate these emotions in a structured, supportive manner.

It’s also important to understand that ketamine is not a one-time cure. A single session may provide relief, but a series of treatments is often necessary to sustain benefits, which is why, at Eulas, finishing the programme in its entirety is absolutely essential.

The Key Takeaways

The psychiatric element of ketamine therapy is a critical part of any effective programme. It is deeply rooted in psychiatric assessment, supervision, and integration with established therapeutic practices. This is essential to maximise therapeutic benefits and ensure patient safety.

Ketamine therapy is a new way to treat mental health problems. It can quickly help with depression, anxiety, PTSD, and thoughts of self-harm. However, the ketamine element alone is not enough. The way a person feels during treatment, talking about their experience, and having support are all important for lasting results.

Patients considering ketamine therapy should approach it with an open mind, a willingness to engage in the therapeutic process, and realistic expectations.

Want to Learn More About Ketamine Therapy? Contact Us Today

At Eulas, we provide a comprehensive and structured framework that includes pre-treatment preparation, guided sessions, and post-treatment integration.

Find out more about our ketamine assisted therapy clinic today.

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Want to Learn More About Ketamine Therapy? Contact Us Today