One of the biggest questions patients have is: “What is a ketamine session actually like?” It’s normal to feel a bit nervous when considering a new treatment, especially one that involves an IV and an altered state of consciousness. Knowing what to expect can calm these anxieties and help you approach ketamine therapy with confidence. Here’s a step-by-step look at how we typically conduct ketamine therapy for depression at Arka’s integrative psychiatry department in JP Nagar, Bangalore.

Your ketamine journey begins with an initial consultation and assessment. On your first visit, you’ll meet with our integrative psychiatrist or a mental health professional who will review your depression history, previous treatments tried, and current symptoms. This is a thorough discussion – we want to understand your unique story. Feel free to ask questions and share your treatment goals. If ketamine therapy is agreed upon as a good option, the doctor will explain the procedure in detail and address any concerns. You may also undergo some baseline tests (like checking blood pressure, and if needed, basic bloodwork) to ensure you’re in a stable physical condition for the infusion.

Prior to the day of infusion, you’ll receive some preparation guidelines. Typically, we advise patients to avoid eating or drinking for a few hours before the session (to prevent any nausea/vomiting during the treatment). Wear comfortable clothing on the day, and arrange for someone (a family member or friend) to drive you home afterward – driving is not allowed on the same day after a ketamine session because the medication can impair reflexes for a short time. Many patients find it reassuring to know a loved one will be there post-session, as the experience can be profound and you might feel a bit groggy after. Mentally, it helps to come in with an open mind and a positive intention – you might simply hope “This treatment will help me heal” or any personal intention. At Arka, we also incorporate mild breathwork or mindfulness exercises before starting the infusion to help you enter a calm state. Our approach is very much about setting the right “set and setting” – a term often used in psychedelic therapies that refers to your mindset and the physical environment. The room will be quiet, softly lit, and you can choose to have gentle music if you like, or silence. We want you to feel safe and comfortable.

When you arrive for the actual treatment, you’ll be greeted by our nursing staff who will get you settled in a recliner or bed in our infusion room. We’ll start an IV line, usually in your arm – it’s just a tiny needle pinch (most patients barely feel it). The ketamine dose is prepared specifically for you (tailored based on factors like your body weight and previous response, if any). As the infusion begins, which typically lasts about 40 minutes to an hour, a trained medical professional will be by your side the entire time, monitoring your vital signs (pulse, oxygen levels, blood pressure) continuously. This isn’t like being left alone in a hospital ward; it’s a very one-on-one attentive process. You’re welcome to talk or ask questions during the infusion, though many people prefer to just relax and focus inward.

Within minutes of the infusion starting, you’ll likely begin to feel ketamine’s effects. What does it feel like? Many patients describe a pleasurable floating or “disconnected” sensation – as if the ordinary concerns and environment drift away. You might feel your mind exploring memories or emotions from a new perspective, or you might simply experience deep relaxation and altered perception of time. Some people see mild visual patterns or have dream-like thoughts. This dissociative state is the medicine working in your brain to help alleviate depression. It’s often not scary, just different. In fact, some patients later report that the ketamine experience itself helped them gain personal insights or a break from negative thought loops.

Physically, aside from the floating feeling, you might notice tingling in your limbs or some lightness in the body. A few patients experience mild nausea or dizziness – if that happens, we’re prepared to give anti-nausea medication right away to make you comfortable. Your blood pressure and heart rate might rise a little (that’s normal with ketamine), but we are monitoring it closely to ensure it stays in a safe range. Typically, doses for depression don’t induce full anesthesia, so you remain conscious (though in an altered state). You won’t “pass out” or lose control of your breathing – you continue to breathe normally on your own throughout. You are also free to speak or signal if you need anything; our staff will check in quietly to ask how you’re doing. Some patients prefer to wear an eye mask and go deeply inward, while others keep eyes open – there’s no right or wrong way, and we guide you based on what makes you most at ease.

The environment is designed to be healing: some patients like soft instrumental music or nature sounds during the ketamine session, which can enhance the therapeutic experience by guiding your mind to a calm place. (Research has shown that pairing ketamine with a positive therapeutic setting, sometimes called Ketamine-assisted psychotherapy, can augment the benefits so we pay attention to these details.) If any moment you feel uncomfortable or anxious, know that we are right there to support you – sometimes just reassurance helps, or adjusting the music, or in rare cases we can slightly adjust dosing. But those instances are uncommon. Generally, patients find the ketamine experience profound yet relaxing. It’s often the first time in months that their brain “quiets down” from depressive thoughts, which can be very relieving.

The ketamine infusion itself is just the beginning of the healing process. Once the infusion is complete, we will stop the IV and then have you rest in the clinic for around 30-45 minutes as you come back to your usual state. The dissociative effects fade pretty quickly – most people find that within half an hour, they feel mostly back to normal, just perhaps a little tired or “spacey.” We’ll continue to monitor you during this recovery period. You can sip some water, have a light snack if you’re up for it, and discuss the experience with the psychiatrist or nurse if you want. Some people like to share what they felt; others prefer to quietly reflect – again, it’s a personal process. We do encourage you to journal about the experience later in the day, as it can help integrate any insights or feelings that arose.

When it’s time to go home (usually within an hour after the infusion), remember you cannot drive or operate machinery the same day. This is why having a friend or family member to take you home is important. You might still feel a bit dreamy or wobbly on your feet right after, so we’ll escort you to your vehicle. Plan to take it easy for the rest of the day – most patients simply go home and relax. You can resume eating normally (in fact, you should eat a healthy meal later to regain energy).

In terms of side effects, ketamine doesn’t have ongoing side effects once it’s out of your system, unlike traditional antidepressants which can cause daily side effects (like weight gain, sexual dysfunction, etc.). After a ketamine session, mild fatigue is probably the most common after-effect. You might feel a bit drained or sleepy, which is natural after an intense therapeutic experience. A small number of people might have a mild headache or continue to feel slightly off-balance for a few hours. Generally by the next day, you should feel physically normal. Emotionally, many patients report feeling lighter or more optimistic the next day – the depressive heaviness may be markedly reduced. It’s quite possible you’ll wake up the next morning thinking, “I actually feel okay…is this what not being depressed is like?” That relief can sometimes be felt within 24 hours or even within 1–2 hours post-infusion for some.

We’ll schedule a follow-up appointment or call to track your progress. Ketamine’s antidepressant effect can be noticed quickly, but the duration of relief varies. Some people have several great days after one infusion and then symptoms start creeping back; others might get a few weeks of relief. Because depression is complex, ketamine is often done as a series of infusions – a common protocol is 6 infusions over 3–4 weeks, then maintenance sessions as needed. At Arka, we personalize the plan: after your first session, we’ll discuss how you felt in the days following. If you responded well, we’ll likely continue with more sessions to solidify the improvement. If your response was mild, we might adjust the dose or frequency, or consider complementary therapies to enhance the effect.