Ketamine Infusion

A careful, supported path back to yourself

Sometimes depression isn’t just sadness. It’s a narrowing of life. A dimming of color. A quiet disconnection from your own spirit, your relationships, your creativity, your body. And when you’ve tried medication, therapy, lifestyle changes, and you’re still stuck, it can start to feel personal. Like you’re the problem.

You’re not.

Ketamine is one of the most rapid-acting biological treatments we have for treatment-resistant depression and suicidal thinking. For many people, relief begins in days rather than weeks. It may also help some people with anxiety, trauma-related symptoms, or obsessive patterns, though we evaluate those situations carefully and individually.

At MBLDN Psychiatry & Wellness, ketamine is not offered as a quick fix. It’s offered as a supported experience in a calm, medically supervised setting where your nervous system is cared for, your story is honored, and your healing has room to land.

How ketamine works

Your brain can learn a new way

Ketamine works differently than standard antidepressants. Traditional antidepressants often nudge serotonin or norepinephrine systems and can take weeks to show full effect. Ketamine primarily works through a different pathway, one tied to glutamate, the brain’s main “learning and change” messenger.

What is glutamate?

Think of your brain as a living network of trails in a forest.

• Glutamate is one of the brain’s most important chemical messengers. It helps neurons “talk” to each other.

• It’s especially involved in learning, memory, and adaptation. It is how the brain updates itself based on new information and experience.

• When glutamate signaling is healthy and balanced, the brain can shift gears, form new connections, and respond flexibly.

When someone has long-standing depression or chronic stress, the brain can become more like a forest with only a few over-worn trails, loops of hopelessness, dread, numbness, or self-blame that feel hard to escape. Ketamine appears to temporarily change signaling in this system, setting off downstream changes that support synaptic growth and neuroplasticity (the brain’s ability to form new connections). Many researchers describe this as creating a “window” where the brain is more able to shift out of stuck patterns.

In other words: ketamine doesn’t just mute symptoms. It may help the brain become more capable of change.

What might you feel during treatment?

Some people experience a gentle sense of distance from ordinary thought patterns and even their body, called dissociation. This can feel like stepping back from your usual mental storyline and seeing things from a wider view. For some, it’s meaningful and clarifying. For others, it’s simply unusual, neutral, or hard to describe.

This experience can be part of the process, but it’s not required for ketamine to help.

Ketamine can feel dysregulating sometimes and that can be part of it working

“Therapeutic Bends”

There’s something important people don’t always hear upfront:

When depression begins to lift, it can create a period of emotional readjustment, almost like taking off a heavy cast and learning how to move again.

In ketamine therapy, this is sometimes described as the Therapeutic Bends, a phase where change is happening quickly, and the nervous system is reorienting.

People might feel:

• emotionally raw or tender

• unusually aware of feelings they’ve been disconnected from

• a little unsteady, anxious, or “stirred up”

• reflective, flooded, or suddenly confronted with truths they’ve been avoiding

This doesn’t automatically mean something is wrong. Often it means something is finally moving. The key is support and integration, so you’re not left alone to make sense of a rapidly changing inner landscape.

Is ketamine safe?

IV ketamine has been used in medicine for decades. In mental health treatment, the dosing and protocols are different than anesthetic use, and safety relies on appropriate screening, medical monitoring, and thoughtful follow-up.

Common short-term effects can include temporary changes in perception, dizziness, nausea, headache, fatigue, or a brief increase in blood pressure and heart rate during the infusion. These effects typically resolve the same day or by the next day. Long-term data is still evolving, which is why we take a careful, individualized approach and avoid unnecessarily frequent ongoing dosing.

How effective is ketamine (IV vs IM)?

Ketamine can be very effective for treatment-resistant depression and suicidal thinking, and for many people it works quickly. In research studies of IV ketamine for depression, response rates (often defined as ~50% symptom improvement) commonly fall around 50–70%, with remission rates often around 30–40%, depending on the study design and population.

IV ketamine (intravenous):
IV is the most studied route in psychiatry. It has 100% bioavailability and allows the most precise control of dose and timing. In one well-known study of a 6-infusion series for treatment-resistant depression, the overall response rate was about 70% by the end of the series (with many people relapsing over subsequent weeks without maintenance infusions).

IM ketamine (intramuscular):
IM ketamine is also used clinically and has high bioavailability (around 93%). Head-to-head data are more limited than for IV, but research supports that both IV and IM can produce rapid antidepressant effects. The main differences are typically about dose precision and “smoothness” of onset rather than whether one “works” and the other doesn’t.

A helpful way to think about it:

• IV is like turning a dial with fine precision.

• IM is like a strong, steady “wave” with less moment-to-moment adjustability.
  Both can be effective, the best route depends on your body, your history, your sensitivity to medications, and the clinical goals we set together.

Ketamine’s strongest evidence is in major depression without psychotic features, particularly treatment-resistant depression. Outcomes vary, and we’ll track your response carefully and adjust the plan thoughtfully rather than forcing a one-size-fits-all protocol.

How many infusions will I need?

Many protocols begin with a series of 6 infusions over about 2–4 weeks, because repeated infusions tend to create a more durable response than a single infusion alone. Some people notice meaningful changes early; others need several treatments before things truly shift.

After the initial series, some people choose maintenance infusions, spaced according to their unique nervous system, symptoms, and life circumstances.

Ketamine can open a window. Therapy helps you walk through it.

The role of therapy & integration

Ketamine can create a shift that feels like breath entering a room that’s been closed for a long time. For many people, it softens the grip of rumination, loosens the “stuckness,” and opens a window where the mind becomes more flexible. This window can be a powerful moment of change, but lasting healing usually comes from what happens after. Integration is the process of making meaning out of what shifts, so insights become choices, and choices become a life that actually feels worth living.

Integration is the bridge between an experience and a new way of living. It’s the process of taking what arises be it relief, clarity, grief, truth, tenderness, desire, boundaries, and then weaving it into your relationships, your self-care, your patterns, and your sense of identity. It’s how insight becomes behavior. How behavior becomes stability. How stability becomes a life that actually feels worth living.

Because I don’t provide psychotherapy as part of infusions, it is strongly recommended that you have a therapist you see weekly (sometimes more during the series). Professional organizations and clinical literature consistently emphasize that ketamine is most supportive when it includes preparation, ongoing psychological support, and integration.

When should I schedule therapy after an infusion?

In most cases, the best time for therapy is about 24–48 hours after your infusion. That timing tends to be the sweet spot: you’re usually clearer and more grounded than you are immediately after treatment, but you’re still close to the “window” where new perspectives, emotional shifts, and nervous system change can be more easily integrated into your real life.

If you can’t schedule therapy the next day, within 72 hours is still very helpful. If you see your therapist on the same day, I recommend a gentler, supportive, reflective, and grounding session with less deep analysis, so your system can settle and you can keep what opened without feeling overwhelmed.

Ketamine can sometimes bring up tenderness or emotional recalibration, the “Therapeutic Bends,” as your inner world begins to shift. Therapy during this window helps you metabolize what’s moving, turn insight into stability, and translate change into an emboldened life.

What to focus on in therapy during your ketamine series

Many people find it helpful when therapy during the series emphasizes:

• Grounding and safety: “What helps my body feel safe enough to change?”

• Meaning-making: “What is this shift asking for in my life?”

• Pattern interruption: “What loop feels less convincing now and what can replace it?”

• Micro-commitments: one small behavior change that reinforces the new pathway

• Support for relationships: how to communicate boundaries and needs as you change

Simple integration practices (24–72 hours after an infusion)

These are small, surprisingly powerful ways to stabilize what opens:

• Keep the day after your infusion light if possible (less conflict, fewer big decisions)

• Hydrate, eat gently, prioritize sleep

• Spend time in low-stimulation environments (nature, a quiet room, music)

• Journal for 10 minutes using prompts like:

  • “What feels a little different today?”

  • “What do I know now that I couldn’t access before?”

  • “What does my nervous system need this week?”

  • “What is one choice that would honor this opening?”

What treatment looks like at MBLDN

Step 1: Intake appointment
We start with a thorough evaluation so I can understand your story, your symptoms, your medical history, and what you’ve already tried. We’ll talk openly about whether ketamine is appropriate and safe for you.

Step 2: Your infusion series
A common schedule looks like this:

• Week 1: Two infusions

• Week 2: Two infusions

• Week 3: One infusion

• Week 4: One infusion

• Follow-up appointment the following week

Some people do 2–3 infusions per week depending on clinical need and scheduling.

Step 3: Follow-up + maintenance planning
I require a follow-up after your last infusion to assess progress and plan next steps. Many people benefit from a maintenance infusion around one month after the series, though timing is individualized.

Cost: Each infusion is $600. We can provide a superbill for possible insurance reimbursement (not guaranteed).

An invitation

If you’re exhausted from surviving, if you’re ready to feel your inner life begin to soften, brighten, and move again, ketamine may be a meaningful next step. Not because it erases what you’ve lived through, but because it can help you step off the worn, over traveled paths your mind has been stuck on and begin to move through your inner landscape with more freedom, flexibility, and a wider perspective on life.

Contact us to schedule an intake and find out if this path is right for you.