What Is Ketamine and How Does It Treats Depression

By Carmen Cook, LMFT | October 17th, 2025

Ketamine has gained attention in recent years as a promising treatment for depression—especially in people who haven’t responded well to traditional antidepressants. Originally developed as an anesthetic in the 1960s, ketamine is now being used in controlled medical settings to help ease severe depressive symptoms, suicidal thoughts, and anxiety.

Unlike traditional antidepressants that target serotonin or norepinephrine, ketamine acts on a different system in the brain—the glutamate system, which plays a role in mood regulation, learning, and memory. By interacting with NMDA receptors, ketamine helps stimulate the growth of new neural connections, which may help “reset” mood pathways and bring relief more quickly—sometimes within hours or days, rather than weeks.

In small, carefully measured doses, ketamine can lift depressive symptoms, reduce suicidal thoughts, and help people begin to engage more effectively in therapy or daily life. However, it’s important to understand that while ketamine can be powerful and effective, it also carries risks if not used properly.

Understanding the Difference Between Medical and Recreational Use

The difference between medical and recreational use of ketamine lies in dose, setting, and intent.

In medical settings, ketamine is prescribed and administered by trained clinicians—often through an IV infusion, nasal spray, or injection—under close supervision. Doses are small and precisely calculated to avoid unwanted effects, and the experience is carefully monitored to ensure both safety and effectiveness.

In contrast, recreational use involves taking ketamine in uncontrolled amounts and unsafe environments. It is often used for its dissociative or hallucinogenic effects, earning street names like “Special K.” At high doses, ketamine can cause users to feel detached from reality, experience hallucinations, and lose control of motor function.

Recreational use can lead to physical and psychological harm—including addiction, bladder problems, and cognitive issues—especially when used frequently.

When administered properly by medical professionals, ketamine therapy is safe, evidence-based, and not considered addictive in the traditional sense. But misuse outside of a clinical environment can quickly become dangerous and habit-forming.

Risks of Dependence and Addiction with Ketamine

While medical ketamine treatment for depression is designed to minimize risk, ketamine still has the potential for abuse and dependence.

Ketamine works by altering brain chemistry and can create a sense of calm or euphoria in some people. Over time, individuals who use ketamine recreationally—or take more than prescribed—may start to crave those feelings. This psychological craving can lead to dependence and, in some cases, addiction.

The main risks of dependence include:

• Tolerance: Over time, the brain becomes less responsive, requiring higher doses to achieve the same effect.
• Cravings: Individuals may begin to seek out the drug outside of medical settings.
• Withdrawal symptoms: Though typically mild, symptoms like anxiety, fatigue, or low mood can occur when ketamine use stops.

It’s important to note that under medical supervision, the risk of addiction is extremely low. Medical professionals carefully monitor dosing schedules and space out treatments to prevent the body from developing tolerance.

Still, ketamine is classified as a Schedule III controlled substance in the United States, meaning it has recognized medical uses but also a potential for misuse.

Signs of Ketamine Misuse or Abuse

Recognizing the early signs of ketamine misuse can help prevent more serious problems. Some red flags include:

• Using ketamine outside of prescribed sessions or increasing the dose without approval
• Visiting multiple clinics or providers to obtain additional doses
• Craving ketamine or thinking about it frequently
• Neglecting responsibilities or relationships due to ketamine use
• Feeling detached, foggy, or emotionally flat between doses
• Developing tolerance or needing more frequent treatments to feel relief
  If someone is misusing ketamine, they may also exhibit behavioral changes—such as isolation, secretiveness, or erratic moods. In more severe cases, physical symptoms like bladder pain, urinary issues, or memory problems may develop.

If these signs appear, it’s essential to seek professional help right away.

Mental and Physical Effects of Long-Term Ketamine Use

Long-term or excessive ketamine use can lead to both mental and physical health issues, especially when taken outside a supervised medical program.

Mental effects may include:

• Memory problems or cognitive impairment
• Disconnection from reality (dissociation)
• Depression or anxiety when not using
• Emotional numbness or blunted affect

Physical effects may include:

• Bladder inflammation or pain (known as “ketamine bladder”)
• Urinary tract issues or incontinence
• Liver damage (in rare cases)
• High blood pressure or cardiovascular strain

These risks are primarily associated with chronic recreational use, not carefully managed medical therapy. Still, they highlight why ketamine should only be used as prescribed and under clinical supervision.

How Ketamine Therapy Is Monitored for Safety

When used for depression, safety and monitoring are top priorities. At clinics like Mana Recovery, ketamine therapy is delivered with strict medical oversight.

Here’s how safe administration typically works:

1. Comprehensive Evaluation: Before treatment begins, patients undergo a full psychiatric and medical assessment to ensure ketamine is appropriate for their needs.
2. Supervised Administration: Ketamine infusions or treatments are performed in a calm, controlled environment by licensed professionals.
3. Monitoring During Sessions: Vital signs, mood, and physical reactions are closely tracked throughout each session.
4. Post-Treatment Follow-Up: Patients are observed until the medication’s effects wear off and are encouraged to discuss their experience and progress in follow-up sessions.
5. Integrated Care: Ketamine therapy works best when combined with psychotherapy, lifestyle support, and wellness practices—helping ensure long-term emotional stability.

This structured approach dramatically reduces the risk of misuse or dependence while maximizing the antidepressant benefits of the treatment.

Alternatives and Complementary Treatments for Depression

While ketamine can be a valuable option for treatment-resistant depression, it’s not the only path to recovery. Many people benefit from combining ketamine therapy with other evidence-based treatments or exploring alternatives altogether.

Common alternatives and complementary approaches include:

• Cognitive Behavioral Therapy (CBT): Helps individuals recognize and change negative thought patterns.
• Medication management: Antidepressants, mood stabilizers, or other psychiatric medications can support long-term balance.
• Transcranial Magnetic Stimulation (TMS): A noninvasive treatment that uses magnetic fields to stimulate brain activity.
• Mindfulness and meditation: Encourages self-awareness, calm, and emotional regulation.
• Lifestyle changes: Regular exercise, sleep hygiene, and balanced nutrition can support overall mental health.
• Holistic approaches: Practices like yoga, art therapy, or nature-based therapy can help improve mood and resilience.

Mana Recovery’s holistic model integrates multiple therapeutic modalities to meet each person’s unique needs—whether or not ketamine therapy is part of their plan.

When to Seek Professional Help for Ketamine Concerns

If you or someone you love is using ketamine and showing signs of overuse, it’s crucial to reach out for help early. Warning signs include:

• Using ketamine outside medical supervision
• Feeling unable to cut back despite wanting to
• Experiencing cravings, tolerance, or withdrawal
• Struggling with mood swings or depression between treatments

Professional help can include medical detox, therapy, and structured mental health support. Treatment helps address both the physical and emotional aspects of ketamine misuse, as well as any underlying mental health issues driving it.

If your depression is worsening or you’re relying on ketamine as a “quick fix,” you don’t have to manage it alone—safe, compassionate support is available.

How Mana Recovery Supports Safe and Effective Depression Treatment

At Mana Recovery in Maui, we understand how complex depression can be—and how important it is to find treatments that are both effective and safe. Our program integrates the best of evidence-based care and holistic healing to support mind, body, and spirit.

Our team provides a comprehensive, individualized approach to mental health and recovery, including:

• Thorough mental health assessments before beginning ketamine therapy
• Licensed medical supervision for every treatment
• Integration with psychotherapy and life skills coaching
• Holistic therapies like mindfulness, movement, and nature immersion
• Ongoing monitoring to ensure continued safety and stability

We believe that healing should never come at the cost of new risks. At Mana Recovery, our focus is on long-term well-being, emotional resilience, and personal growth.

Whether you’re exploring ketamine therapy for depression or concerned about potential dependence, our compassionate team is here to help you make informed decisions and move toward balance and peace.

If you or someone you care about is struggling with depression or concerns about ketamine use, contact Mana Recovery in Maui today. Our team can guide you through safe, effective treatment options designed to help you heal and thrive—without fear of addiction or harm.