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Ketamine therapy is gaining significant attention in mental health treatment as a breakthrough option for conditions resistant to traditional medications. Unlike conventional antidepressants that target serotonin, ketamine works through different neural pathways, offering rapid symptom relief—often within hours rather than weeks. This alternative approach shows particular promise for treatment-resistant depression, anxiety disorders, PTSD, and chronic pain conditions, with success rates of 60-70% in patients who haven't responded to standard treatments.

Innerwell offers expert-guided ketamine therapy for mental health—discover our Innerwell ketamine programs.

Ketamine therapy involves using ketamine, a medication traditionally used as an anesthetic, to treat mental health conditions. First developed in the 1960s and approved by the FDA as an anesthetic in 1970, ketamine has a long history of safe use in medical settings. Its unique properties allow it to induce anesthesia while maintaining respiratory function, making it valuable in emergency and surgical settings.

In the early 2000s, researchers discovered ketamine's rapid antidepressant effects, leading to its off-label use for mental health conditions. Off-label prescribing—using FDA-approved medications for non-approved purposes—is common and legal in medical practice when supported by scientific evidence.

What sets ketamine apart from traditional psychiatric medications is its mechanism of action. While conventional medications primarily target serotonin, norepinephrine, or dopamine systems, ketamine affects the glutamate neurotransmitter system.

As an NMDA receptor antagonist, ketamine may disrupt patterns of negative thought and behavior associated with depression, explaining why it works quickly—often within hours—compared to traditional antidepressants that take weeks to show benefits.

These are the mechanisms of action that affect the brain:

The primary mechanism of ketamine's action is as an antagonist of N-Methyl-D-Aspartate (NMDA) receptors. These glutamate-activated ion channels play a crucial role in excitatory neurotransmission in the brain. Ketamine blocks the NMDA receptor channel in its open state, preventing ion conductance and altering glutamate signaling.

This blockade is particularly potent in certain receptor subtypes. GluN2C/D-containing NMDA receptors appear more susceptible to ketamine's effects compared to GluN2A/B-containing receptors. This differential sensitivity contributes to ketamine's unique profile of effects.

Beyond its immediate effects on neurotransmission, ketamine enhances neuroplasticity and synaptogenesis. It increases the production of brain-derived neurotrophic factor (BDNF), a protein that promotes the growth and differentiation of new neurons and synapses.

This enhanced neuroplasticity may explain why ketamine's effects can persist beyond its immediate presence in the body. It potentially "resets" dysfunctional neural circuits involved in depression and other mood disorders.

While ketamine blocks NMDA receptors, it also paradoxically increases glutamate release in certain brain regions. This leads to activation of AMPA receptors, another type of glutamate receptor. This AMPA receptor stimulation triggers molecular cascades that promote synapse formation and strengthen neural connections.

The complex interplay between NMDA receptor blockade and downstream glutamate signaling appears central to ketamine's antidepressant effects.

What Conditions Does Ketamine Therapy Treat?

Ketamine has been proven effective for several conditions, including:

Treatment-Resistant Depression—For patients who haven’t responded to at least two antidepressants, ketamine offers fast relief—helping most of them experience significant improvement, sometimes after just one session.

Major Depressive Disorder (MDD)—Effective not only for treatment-resistant cases but also for broader MDD, with 50–70% response rates and rapid symptom relief.

Anxiety Disorders (GAD, Social Anxiety, PTSD)—Emerging research supports ketamine for anxiety, especially PTSD. Ketamine-assisted psychotherapy (KAP) may deepen emotional processing and introspection.

Bipolar Depression (Not Mania)—Can reduce depressive symptoms in bipolar disorder when carefully managed alongside mood stabilizers to prevent mania.

Obsessive-Compulsive Disorder (OCD)—Some evidence suggests ketamine may quickly reduce obsessions and compulsions by targeting glutamate pathways, though results can vary.

Chronic Pain (CRPS, Migraines, Fibromyalgia)—Ketamine’s pain-relieving effects may benefit chronic pain conditions, especially when depression and pain overlap.

Types of Ketamine Therapy: How is Ketamine Administered 

Ketamine is administered through a variety of routes, such as:

Intravenous (IV) infusion is the most common and well-studied method for ketamine's psychiatric use. Typically, doctors administer a dose of 0.5 mg/kg over about 40 minutes, though dosages may range from 0.1 mg/kg to 0.75 mg/kg depending on patient response and clinical needs.

IV administration provides 100% bioavailability, allowing for precise dosage control and rapid onset of effects. This method requires a clinical setting with medical supervision throughout the infusion.

Intramuscular injections involve administering ketamine directly into a muscle, typically the deltoid or thigh. This method offers rapid absorption similar to IV, though with slightly more variable bioavailability.

IM ketamine is useful when IV access is challenging and provides a practical alternative while maintaining the supervision and safety of a clinical setting.

Sublingual ketamine involves dissolving a lozenge or troche under the tongue, allowing the medication to be absorbed through the oral mucosa. This method offers lower bioavailability (approximately 30%) than IV or IM routes but can be more convenient for maintenance treatments.

Some providers prescribe sublingual ketamine for at-home use between in-office treatments, though this practice varies widely based on provider protocols and patient factors.

Intranasal Esketamine (Spravato®) — FDA-Approved

Esketamine (Spravato®) is a nasal spray formulation of the S-enantiomer of ketamine that received FDA approval in 2019 for treatment-resistant depression. It's administered in a certified healthcare setting with strict monitoring protocols.

It's important to distinguish ketamine from esketamine (Spravato), a related compound with FDA approval for treatment-resistant depression. Both work through similar mechanisms, but esketamine comes as a nasal spray with standardized protocols defined by FDA guidelines.

Oral ketamine tablets have the lowest bioavailability (approximately 20%) due to extensive first-pass metabolism in the liver. This route typically requires higher doses to achieve therapeutic effects.

Some clinics prescribe oral ketamine for at-home maintenance treatment, though this is less common than other methods due to the limited bioavailability and variable absorption.

Rapid Symptom Relief (Hours to Days, vs. Weeks for SSRIs)

Ketamine's most remarkable benefit is its rapid effects, delivering significant symptom relief within hours or days, unlike traditional antidepressants that typically take weeks to work.

For patients in crisis, this quick response can be life-changing and potentially life-saving, particularly for those experiencing suicidal thoughts or severe functional impairment.

Supports Neuroplasticity and Emotional Flexibility

Ketamine promotes neuroplasticity—the brain's ability to form new connections and reorganize itself. This enhanced flexibility may help patients break free from rigid thought patterns and develop healthier cognitive processes.

The neuroplasticity effects may contribute to lasting benefits beyond the immediate drug effects. By promoting the growth of new neural connections, ketamine potentially helps "rewire" dysfunctional brain circuits associated with depression and anxiety.

May Help Break Negative Thought Patterns and Rumination

Many patients report that ketamine helps interrupt persistent negative thinking and rumination. The dissociative experience can provide psychological distance from entrenched thought patterns, offering a new perspective on problems.

This cognitive flexibility can create a window of opportunity for implementing therapeutic techniques and developing healthier thought patterns.

Effective for People Who Haven't Responded to Traditional Treatments

For treatment-resistant depression—defined as failure to respond to at least two adequate trials of antidepressants—ketamine offers hope when other options have failed. Studies show approximately 60-70% of treatment-resistant patients experience significant improvement after ketamine treatment.

This effectiveness in otherwise treatment-resistant cases represents one of ketamine's most important clinical contributions.

Can Accelerate Breakthroughs in Therapy (Especially with Integration Sessions)

Ketamine-Assisted Psychotherapy (KAP) combines ketamine administration with psychotherapy, potentially enhancing the therapeutic process. The altered state ketamine induces can facilitate deep introspection and emotional processing, allowing patients to engage with their thoughts and feelings in new ways.

Many clinicians report that patients can achieve therapeutic breakthroughs more quickly when ketamine sessions are paired with skilled psychotherapy, particularly psychedelic integration therapy that helps process insights gained during ketamine treatments.

Potential Benefits for Suicidal Ideation Reduction

Research shows 55% of patients receiving ketamine experienced a ≥50% reduction in suicidal thoughts within a day. This quick action contrasts sharply with traditional antidepressants, which carry FDA black box warnings about potentially increasing suicidal ideation, particularly in young adults.

This rapid anti-suicidal effect represents one of ketamine's most clinically significant benefits, potentially creating a window of safety during which other therapeutic interventions can be implemented.

Risks and Side Effects of Ketamine Therapy

Common Short-Term Side Effects (Dissociation, Nausea, Dizziness, Increased Blood Pressure)

During and shortly after ketamine administration, patients commonly experience:

Dissociative effects (feeling detached from reality or one's body)

Perceptual disturbances (visual or sensory changes)

These effects typically resolve within hours after treatment, but can be distressing for some individuals. The dissociative experience, while therapeutically valuable for some patients, may be challenging for others, particularly those with a history of dissociative disorders.

Less Common but Serious Risks (Misuse Potential, Bladder Issues with Long-Term High Doses)

The long-term risks of repeated ketamine treatments for psychiatric conditions are still being studied. Concerns include:

Potential for Tolerance or Dependence: While ketamine administered in controlled medical settings appears to have low abuse potential, there are concerns about psychological dependence with repeated use.

Urological Effects: Chronic, high-dose ketamine use has been associated with urinary tract problems, including a condition known as "ketamine cystitis". However, this appears rare at the doses used for depression treatment.

Cognitive Effects: Some studies suggest potential concerns about cognitive effects with long-term use, though research at therapeutic doses is limited.

Discover how ketamine acts on glutamate pathways to deliver fast symptom relief—often within hours—for depression, PTSD, anxiety, and chronic pain.

What Is Ketamine Therapy? Rapid Relief for Treatment-Resistant Depression

What is Ketamine Therapy

You may be wondering, what is EMDR therapy? Eye Movement Desensitization and Reprocessing (EMDR) therapy helps people process traumatic memories and difficult life experiences. Developed by Dr. Francine Shapiro in the late 1980s, EMDR has become a go-to treatment for post-traumatic stress disorder (PTSD) and other trauma-related issues.

EMDR works on the idea that many psychological problems come from unprocessed traumatic memories stored in our brains. Through a combination of bilateral stimulation (usually eye movements) and focused recall of difficult memories, EMDR activates the brain's natural healing.

Unlike traditional therapy, EMDR does not require you to recount traumatic memories in detail. Instead, EMDR focuses on altering how your emotions, thoughts, and behaviors respond to trauma, enabling your brain to heal naturally.

Major health organizations, including the American Psychiatric Association and the World Health Organization, recognize EMDR as an effective treatment

 for trauma. EMDR is now used for more than just PTSD, including treatment for anxiety, depression, and phobias too.

EMDR therapy follows an eight-phase approach that helps you process traumatic memories while reducing their emotional impact. The core technique involves using bilateral stimulation, typically eye movements, although taps or tones may also be used. During this process, the client briefly focuses on distressing memories which enables the brain to reprocess these memories in a way that diminishes their emotional charge.

The therapy is grounded in the Adaptive Information Processing model which posits that trauma disrupts your brain's natural healing process. The bilateral stimulation mimics REM sleep, helping integrate traumatic memories into broader memory networks, allowing for healthier emotional and cognitive responses.

Research shows that EMDR therapy leads to measurable brain changes, such as reduced activity in the amygdala (the brain's fear center) and increased activity in the prefrontal cortex, which is responsible for higher-level thinking and emotional regulation. 

While EMDR can often work faster than some talk therapies, the number of sessions required depends on the individual's specific situation and trauma history. Many individuals experience significant relief after just a few sessions.

What Conditions or Issues Does EMDR Therapy Treat?

EMDR therapy was initially developed as a PTSD treatment but its applications have since expanded significantly beyond that. Research and clinical practice demonstrate its effectiveness in addressing numerous mental health challenges.

EMDR remains a premier treatment for PTSD. It is particularly effective in helping people process traumatic memories and alleviate symptoms like flashbacks, nightmares, and hypervigilance.

EMDR effectively addresses various anxiety disorders, including generalized anxiety, panic disorder, social anxiety, and specific phobias. Studies indicate that by processing underlying experiences contributing to anxiety, EMDR significantly alleviates symptoms.

When depression is linked to challenging experiences or trauma, EMDR can be particularly beneficial. A study found individuals receiving EMDR improved more than those with standard treatments like fluoxetine.

Growing evidence suggests EMDR helps people with OCD, especially when compulsive behaviors link to distressing memories. In a case study, EMDR proved effective in treating an adolescent's OCD by addressing intrusive images of illness.

EMDR helps with substance use disorders by processing trauma and stressors that drive addiction. In a study, EMDR showed promising results for treating trauma-related symptoms in those with SUD and comorbid PTSD.

For eating disorders like bulimia and binge eating, especially when connected to traumatic experiences, EMDR combined with standard therapies improves outcomes. A study found that EMDR therapy is effective in addressing trauma-related symptoms in individuals with binge-eating disorder (BED), particularly in those with a history of childhood abuse and comorbid PTSD.

EMDR shows promise for chronic pain and unexplained physical symptoms. By desensitizing memories associated with pain onset or exacerbation, it can reduce pain intensity and improve quality of life.

Some studies show EMDR helps resolve sleep problems, especially nightmares and insomnia, by processing disturbing memories or chronic stress that disrupts sleep.

Athletes, artists, and professionals use EMDR for performance anxiety. By neutralizing distressing experiences that block performance, EMDR helps restore confidence and skill.

A 2021 systematic review of 90 articles on EMDR for non-PTSD conditions found positive effects across this diverse range of issues, demonstrating its versatility as a therapeutic approach.

EMDR therapy offers profound benefits for individuals dealing with trauma and other psychological challenges. By reprocessing traumatic memories, it creates meaningful emotional, cognitive, and physical improvements.

EMDR is particularly effective in providing emotional relief. Many clients report a significant reduction in distress about traumatic memories. The therapy helps individuals to:

EMDR helps reframe harmful thought patterns associated with trauma. Clients may experience:

Enhanced ability to challenge negative self-beliefs

A more balanced perspective of past events

While EMDR primarily targets psychological symptoms, physical improvements often follow:

Reduced physical tension related to trauma (like headaches or chronic pain)

Diminished physical stress responses to triggers

EMDR is often more efficient than some traditional talk therapies. According to the American Psychological Association, some individuals with single-incident traumas see significant improvement in just a few sessions. Complex trauma usually requires more treatment, but EMDR's structured approach often reduces symptoms more rapidly.

The benefits of EMDR generally persist over time. A study found that EMDR's positive effects remained during follow-up assessments, suggesting enduring improvements.

While created for PTSD, EMDR now addresses many conditions. The EMDR International Association reports benefits for anxiety disorders, depression, phobias, chronic pain, addictions, and performance anxiety.

By activating the brain's natural healing processes, EMDR offers a unique approach to trauma treatment that improves overall well-being.

What to Expect During EMDR Therapy Sessions

Starting EMDR therapy at Innerwell means understanding the structured process that ensures comprehensive treatment while prioritizing your emotional safety. At Innerwell, we provide a tailored approach to EMDR, using an eight-phase model designed to guide you through each stage of your healing journey.

Initial Sessions: History and Preparation

Your first few sessions at Innerwell focus on gathering background information and preparing you for the therapy. During this phase, your therapist will learn about your history, assess your readiness for EMDR, identify specific traumatic memories to work on, and help you build tools to stay calm and grounded during therapy. 

These tools may include relaxation techniques, mindfulness exercises, or coping strategies to help you manage any emotional distress that might emerge during the reprocessing. We work together to identify target memories and the emotions and beliefs tied to them.

The core of Innerwell's EMDR therapy involves using bilateral stimulation, typically through guided eye movements, to help you process distressing memories. This technique allows you to reprocess traumatic memories, replace negative beliefs with more positive ones, and assess your physical and emotional responses to ensure no distress remains.

Each session starts by reviewing your progress with the previous memory. If that memory feels resolved, we proceed to the next memory on your target list. This list evolves as therapy progresses, allowing us to address additional memories or emotions that may arise.

Sessions typically last 60 to 90 minutes with the number of sessions needed depending on your specific situation and trauma complexity.

During EMDR processing at Innerwell, you may experience:

Shifts in emotions or physical sensations

Vivid memories or new insights about past experiences

Temporary increases in distress while processing difficult material

These experiences are part of the healing process. Your therapist guides you through intense emotions and ensures you feel grounded before concluding each session.

Every session ends with a closure phase to ensure your emotional stability. Your therapist regularly assesses your progress and adjusts the treatment plan as needed, making sure that the therapy continues to align with your evolving needs.

Sessions 1-2: History-taking and treatment planning

Sessions 3-4: Preparation and resource building

Sessions 5-8: Active processing of traumatic memories

Sessions 9-10: Installation of positive beliefs and body scan

Sessions 11-12: Reevaluation and future template work

At Innerwell, we believe that EMDR therapy is a collaborative process between you and your therapist. Whether in-person or through online EMDR therapy, open communication about your experiences, concerns, and goals throughout treatment ensures a supportive and effective healing journey.

EMDR therapy can be a powerful healing tool, but it isn't suitable for everyone. Consider the following factors to help determine if it might be appropriate for your situation.

You experience distress related to trauma, PTSD, or troubling memories

Traditional talk therapy hasn't provided sufficient relief

You find it challenging to verbalize your traumatic experiences

You're receptive to a structured approach for processing difficult emotions

EMDR is particularly effective for individuals dealing with:

Single traumatic events (like accidents or assaults)

Anxiety disorders, including phobias and panic attacks

Depression, particularly when connected to past negative experiences

EMDR can be emotionally intensive since it directly addresses traumatic memories

You may temporarily experience increased distress during early phases of treatment

Commitment to the full treatment process is important for optimal results

Working with a qualified EMDR practitioner is essential. Whether you're seeking EMDR treatment in Illinois or elsewhere, the EMDR International Association (EMDRIA) recommends finding therapists with proper certification and training.

While EMDR is effective for many individuals, it's not an immediate solution. Some people experience significant improvement after a few sessions, while others require longer treatment.

If EMDR isn't the right fit, other therapeutic modalities, such as online therapy sessions, at-home Ketamine therapy or psychedelic integration therapy, may better suit your needs. Consulting with a mental health professional who can evaluate your specific situation will help determine if this therapy aligns with your healing goals and needs.

Discover how EMDR therapy uses bilateral stimulation to reprocess traumatic memories and relieve PTSD, anxiety, depression, phobias, and more—often in just a few sessions.

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