When someone you love begins ketamine therapy for depression, anxiety, PTSD, or chronic pain, it can feel hopeful, exciting, and sometimes a little intimidating. Many spouses, partners, family members, and friends want to know what to expect and how they can best support the person they care about throughout the process.
Supportive relationships can play an incredibly meaningful role during ketamine therapy. Ketamine or Spravato treatment is not simply about receiving a medication, it creates a unique window of opportunity for healing, growth, and change. During this time, with a reduction in symptoms, patients may find it easier to process trauma, establish healthier habits, regulate their nervous system, and re-engage with life in a more meaningful way.
This article is designed to help loved ones better understand what their partner or family member may experience during ketamine therapy and Spravato and how to best support them throughout the induction phase of treatment.
Understanding How Ketamine Works in the Brain
Traditional antidepressants often work gradually over time by primarily affecting serotonin levels. Ketamine works differently, targeting the brain’s glutamate system, which plays a critical role in learning, memory, emotional processing, and neuroplasticity. Neuroplasticity refers to the brain’s ability to repair itself, form new neural connections, adapt to new experiences, and break free from unhealthy or repetitive patterns of thinking, feeling, and behavior.
Many people struggling with depression, trauma, anxiety, or chronic stress feel mentally and emotionally “stuck.” Negative thoughts can become relentless, emotional responses more rigid, and symptoms disconnect patients from the joy and meaning in their lives. Some become trapped in a chronic “fight-or-flight” state, where the nervous system remains constantly activated and unable to fully rest or feel safe. Ketamine can repair and strengthen neural pathways while helping to reset and regulate the nervous system, allowing the brain and body to become more resilient and responsive once again.
Ketamine therapy creates a unique window of opportunity where psychotherapy, self-reflection, emotional processing, and healthy lifestyle changes become more impactful and meaningful. At the same time, treatment reduces the debilitating symptoms of depression, anxiety, PTSD, or chronic nerve pain, allowing patients to more fully engage with life.
What to Know Before a Treatment Session
Your loved one has been advised to fast for approximately two hours before their ketamine infusion, while still remaining adequately hydrated to help facilitate comfortable IV placement. Staying hydrated after the session is important as well, as it helps the body process the medication and can improve overall recovery afterward.
Some patients may experience a mild headache following treatment, particularly if they are even slightly dehydrated. For this reason, we encourage patients to focus on hydration both before and after their infusion. If needed, they may also take over-the-counter medications such as ibuprofen or Tylenol afterward unless otherwise directed by their healthcare provider.
Your loved one will need transportation home after each treatment session, as patients are not permitted to drive afterward. An Uber or Lyft is acceptable if necessary; however, we strongly recommend that a trusted friend, family member, or loved one pick them up whenever possible, as patients are often feeling tired, emotionally open, or slightly disoriented after treatment. If you are picking them up personally, you will be asked to sign them out upon departure.
Communication Is Key Throughout the Process
One of the most important things you can do during the ketamine induction series is maintain open, compassionate communication with your friend or loved one. The induction phase typically involves six infusions over about two to three weeks. During this time, people can experience shifts in mood, perspective, energy, and emotional sensitivity. Some days they may feel hopeful and energized. Other days they may feel introspective, tired, emotional, or uncertain. The latter does not necessarily mean treatment is “not working.” Healing is rarely linear.
Encourage ongoing open communication throughout the process as their needs may change rapidly from day to day. Ask simple questions like:
– “Would you like to talk or to have some quiet space?”
– “Are there any tasks I can take off your plate today?”
– “What can I do to improve your day today?”
Sometimes your loved one may want to talk deeply about their experiences. Other times they may simply need silence, rest, or quiet reflection. The most important thing is creating an environment where they feel safe expressing whatever arises without judgment or pressure.
The ketamine experience itself is difficult to describe. It is often dreamlike, abstract, emotional, or deeply introspective. At times it may provide profound insight, clarity, or emotional release, while other sessions may simply feel strange, random, or confusing. Although the experience itself can sometimes feel therapeutic, the most important part is simply receiving the medicine and allowing time for the healing process to unfold within the brain, body, and nervous system. Patience is key, as the benefits often develop gradually throughout the treatment series and beyond.
Expect Them to Feel Tired or “Loopy” After Sessions
Ketamine infusion sessions can sometimes be physically and emotionally draining. It is very normal for patients to:
– Feel tired afterward
– Need a nap
– Want to go to bed early
– Feel mentally foggy or emotionally raw
– Seem quieter or more introspective than usual
Many patients describe feeling “loopy” or detached for several hours after treatment. This is expected and temporary. Try not to schedule demanding activities on treatment days. Keeping the recovery environment calm, quiet, and low-stress afterward is recommended. Some people enjoy relaxing music, dim lighting, a comfortable blanket, tea, or simply resting quietly at home with a good book.
Emotional “Bubbling Up” Is Normal
One of the more surprising aspects of ketamine therapy is that emotions can sometimes temporarily intensify before improvement becomes obvious. Patients may experience what we often call a “bubbling up” effect. Feelings that have been buried, suppressed, or avoided for years may surface during the initial phase of treatment. This can sometimes include:
– Sadness
– Irritability
– Anger
– Anxiety
– Grief
– General emotional sensitivity
This can feel confusing to loved ones who expected ketamine to immediately make everything feel better. However, emotional release is part of the healing process. It is important not to shame, dismiss, or immediately try to “fix” these feelings. Instead, allow space for them to be acknowledged and processed. We encourage patients to sit with these feelings rather than push them away, and to process them in healthy ways through journaling, self-reflection, therapy, or conversations with trusted support people. Healing is not about feeling instantly happy, but finally being able to feel honestly.
If your loved one needs additional therapeutic support, our psychotherapist, Cindy Nelson, LMFT, is here to help. Please contact our office to book additional sessions with Cindy.
Neuroplasticity: A Unique Opportunity for Positive Change
During ketamine treatment, the brain enters a more neuroplastic and adaptable state. This creates a powerful opportunity to establish healthier habits and routines. This is one reason why positive lifestyle changes matter so much during treatment. The choices made during this window may carry greater impact than usual, and it’s easier to stick to new habits if they are started during this time period.
You can play an important role here as a supporter and motivator. Consider encouraging healthy activities such as:
– Evening walks together
– Spending time outdoors
– Journaling
– Meditation or breathwork
– Cooking healthy meals together
– Reading instead of scrolling on phones or watching TV
– Reducing overstimulation and stress
– Picking up old hobbies
Small healthy habits can become surprisingly meaningful during this period. The goal is not perfection, but gently moving life in a healthier more positive direction while the brain is more receptive to change.
Alcohol and Cannabis May Reduce Ketamine’s Effectiveness
Another important topic to discuss openly is substance use during treatment. Research and clinical experience demonstrate that both alcohol and cannabis may blunt some of ketamine’s therapeutic effects, particularly when used heavily or immediately around treatment sessions.
For this reason, patients are encouraged to avoid:
– Alcohol
– Cannabis
– Recreational substances
throughout the treatment series whenever possible, but especially:
– The day of treatment
– The evening after treatment
– The following day
Reducing these substances during the induction phase will help maximize the potential benefits of therapy and help ensure your loved one has the most robust response possible.
For more information about alcohol and cannabis use during ketamine therapy, be sure to read our article, Alcohol and Cannabis Use During Ketamine Therapy: Potential Interactions and Impacts on Effectiveness
Healing Is Often Subtle at First
One of the hardest parts for both patients and loved ones is that the earliest signs of improvement are often subtle. Many people expect a dramatic overnight transformation. While that can occasionally happen, more commonly the initial changes are small and subtle, slowly building over time. Loved ones and friends are often the first people to notice these shifts.
You may observe:
– More laughter
– Increased energy
– Better eye contact
– Increased motivation
– More emotional presence
– Less irritability
– More interest in daily life
– Completing simple tasks more efficiently
Patients themselves may not notice these small changes immediately. Depression and chronic stress can distort self-perception. Gently reflecting these observations back to them can be incredibly helpful.
Simple comments like:
“You seem a little lighter today.”
“I noticed you smiled more this week.”
“You seem more relaxed lately.”
“You handled that difficult situation really well today.”
can help reinforce progress and build hope.
Your Support Matters
Ketamine therapy can be the spark to ignite profound change, but it is not always a smooth or easy process. Your presence, patience, encouragement, and understanding matter a great deal. You do not need to have all the answers. You do not need to “fix” everything or wait on your partner’s every need like a butler. Often, the greatest support comes from simply being calm, compassionate, and willing to walk beside someone during a difficult chapter of healing.
At Innerbloom, we believe ketamine therapy works best when paired with intentional self-care, supportive relationships, psychotherapy, and meaningful lifestyle change. Recovery is rarely a straight line, but with support, communication, and patience, profound healing is possible.
About the author:
Libby Rivas serves as the Clinic Manager at Innerbloom Ketamine Therapy, bringing a unique blend of professional expertise, personal experience, and heartfelt compassion to her role. Married to Dr. Ray Rivas, Libby is deeply rooted in the health and wellness community, equipping her with a profound understanding of how to support others. With extensive experience in small business management and customer service, Libby ensures that every patient at Innerbloom receives personalized care and attention.
Medical Disclaimer
All content on this website, including but not limited to this article, blog posts, testimonials, and FAQs, is not medical advice and should not be considered as such. This website cannot diagnose or treat any medical condition. Only a licensed medical professional who is familiar with you and your medical history can provide medical advice, diagnosis, or treatment.
The information provided here is for educational and informational purposes only. It is not intended to replace a consultation with a qualified healthcare provider. If you are experiencing symptoms of depression or any mental health condition, please consult with a licensed mental health professional or your primary care physician.
If you are in crisis or experiencing suicidal thoughts, please call the 988 Suicide and Crisis Lifeline (call or text 988) or go to your nearest emergency room immediately.
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Has your antidepressant stopped working? Contact Innerbloom Ketamine Therapy at (805) 321-8471 or visit us at 100 Casa Street, Suite D3, San Luis Obispo, CA 93405.