My Brain on Ketamine: A Psychologist’s 48-Hour Diary

Introduction

When I first heard about ketamine infusion therapy, it sounded almost unbelievable: a decades-old anesthetic, long used in operating rooms and battlefields, now being repurposed as a rapid-acting antidepressant. As both a psychologist and someone who has battled with depression, I decided to take the plunge and undergo a full course of ketamine infusion therapy — six sessions over six weeks, followed by a maintenance infusion six months later.

This is not just a clinical report. This is my lived experience — what it felt like to “leave my body,” why I finally understood why you can’t drive home afterwards, and how it compared to Spravato (esketamine nasal spray). I’ll also discuss what the research shows, the underlying science, and the pros and cons of this treatment.

Psychedelics as One Tool in a Scientistʻs Toolbox:

The psychonaut’s path is not just inward—it is forward. Into the unknown. Into innovation. Into complexity. And into the integration of ancient wisdom with modern science. One of the major points of skepticism so many scientists received when experimenting with LSD in the 1970ʻs was that they were simply beatniks looking to get high and people started to question their credibility. None of these tools I explore in this blog—whether psychedelics, AI, neurofeedback, or mindfulness—are the point in and of themselves. They are vehicles. Lenses. Tools. Just as any other scientist might look through a microscope to gain a deeper understanding of something, he does not then go around the world with the microscope stuck to his eye.

As Alan Watts famously put it,

“When you get the message, hang up the phone.”

That’s the essence of true psychonautics. We explore altered states not to escape, but to receive insight, process it, and come back more grounded, more aware, and more capable of contributing to our relationships, our work, and our world.

In that sense, the psychonaut is not a wanderer lost in dreams—but a scientist of the soul, a disciplined explorer of consciousness, always returning with something real.

The Setup: Ketamine Infusion Basics

Ketamine has been used as a surgical anesthetic since the 1960s. In depression treatment, however, the dose is sub-anesthetic — typically 0.5 mg/kg over 40 minutes intravenously (Zarate et al., 2006). This means you receive just enough to dissociate, but not enough to fully lose consciousness. The idea is to place the brain in a state where entrenched patterns can loosen, opening the door for new associations.

Clinics usually recommend six infusions over two to six weeks, followed by maintenance “booster” infusions as needed. Each session costs around $600–$800 out of pocket in the U.S., since insurance rarely covers it. Compare that to Spravato, which many insurance plans cover, leaving patients with as little as a $25 copay per session.

My First Infusion: Like Waking from Surgery

I’ll never forget my first infusion. Within minutes of the IV starting, I felt myself slipping into an altered state. My body was heavy, my mind was light, and reality began to distort. At its peak, I was fully dissociated — I “left” my body. Some moments were euphoric, a pink cloud of peace and clarity. Others were terrifying, as I drifted into unfamiliar psychic territory. Some brought tears, revisiting painful childhood memories and still grieving the loss of my beloved dog Boodah of 14.5 years.

When the drip stopped, it was as if I was waking from anesthesia. My limbs were sluggish, my mind foggy. I understood immediately why patients are not allowed to drive home. For the rest of the day, I was exhausted, almost like recovering from minor surgery.

The Course of Six Infusions

As the sessions went on, a rhythm emerged. I would dissociate, float, and revisit emotional material. Some sessions were darker — waves of sadness, reliving failures. Others were cathartic, where I made powerful new associations. One particularly striking moment came when I realized how much of my lifelong anxiety around money stemmed from childhood experiences of scarcity. In the ketamine state, those knots loosened. It was as if the therapy allowed me to re-thread those old fears.

Here’s where my training as a psychologist collided with my personal experience. We often teach cognitive-behavioral techniques like the “so what?” method:

“So what if you get fired?” → “I won’t make money.”
“So what if you don’t make money?” → “I’ll be scared.”
“So what if you’re scared?” → “I might miss bills.”
“So what if you miss bills?” → “I might get late payments.”
“So what then? Will you lose your limbs? Will your children stop loving you?”

In ordinary therapy, patients intellectually understand this exercise. But ketamine seemed to make me feel it. My nervous system finally caught up to what my rational brain had long known: that the fear was disproportionate to reality. Depression could no longer hijack my entire emotional system — instead, sadness and fear became passing emotions, not existential threats.

Six-Month Booster

When I returned for a maintenance infusion six months later, I was struck by how quickly my brain “remembered” the dissociative state. The booster reinforced the earlier work, helping sustain the perspective shift. But it also reminded me of the costs: the exhaustion afterwards, the logistical hassle of arranging a ride home, and the price tag.

The Science: Why Ketamine Works

Ketamine is not just about “tripping.” It induces profound neurobiological changes that help explain its rapid antidepressant effects:

Glutamate Surge: Ketamine blocks NMDA receptors, causing a surge of glutamate, the brain’s main excitatory neurotransmitter (Zarate et al., 2006).
AMPA Activation: This glutamate activates AMPA receptors, which in turn stimulate BDNF (Brain-Derived Neurotrophic Factor) release (Duman & Aghajanian, 2012).
Synaptogenesis: BDNF promotes new synaptic connections, essentially rewiring the brain at a structural level (Li et al., 2010).
GABA Modulation: Ketamine also affects inhibitory GABA pathways, balancing excitation and inhibition in brain circuits (Krystal et al., 2019).

This combination creates a window of plasticity, during which psychotherapy and behavioral changes may take root more effectively.

Comparing to Spravato (Esketamine)

After trying IV ketamine, I also experienced Spravato, the FDA-approved nasal spray version of esketamine. My impression? The difference was night and day.

With Spravato:

The dissociation was mild. I could check emails, scroll my phone, and even hold conversations.
The sessions required a two-hour monitoring period, but I didn’t feel “knocked out” like after IV ketamine.
Because insurance covered it, the cost was a fraction of IV therapy — often just a $25 copay.

“But here’s the rub: the effects were also much weaker. While IV ketamine felt like a full neurological reset, Spravato was more like turning the dimmer switch down on depression — helpful, but not transformative.”

Research backs this up: some studies suggest that IV ketamine may be more effective for treatment-resistant depression than esketamine nasal spray (Correia-Melo et al., 2020).

Pros and Cons of Ketamine IV Therapy

Pros:

Rapid, often dramatic antidepressant effects
Facilitates emotional breakthroughs
Neurobiological mechanisms support long-term changes
Can make CBT and other therapies more effective

Cons:

Expensive ($600–$800 per infusion)
Exhaustion and dissociation can be overwhelming
Requires a ride home and time off work
Not covered by most insurance
Risk of challenging or destabilizing experiences

Ketamine vs. ECT: A Surprising Comparison

Electroconvulsive therapy (ECT) has long been considered the “gold standard” for treatment-resistant depression. Ketamine, however, is approaching ECT in terms of effectiveness — but with fewer cognitive side effects (UK ECT Review Group, 2003; Andrade, 2017). The irony is striking: ketamine, a stigmatized “club drug,” may soon rival one of psychiatry’s most established (and controversial) treatments.

My Takeaway

Ketamine IV therapy was one of the most profound therapeutic experiences of my life. It wasn’t always pleasant — some sessions were frightening, some exhausting. But the perspective shift it created was lasting. I no longer feel depression as a suffocating, existential weight. Instead, I can view sadness as just another passing emotion.

For me, IV ketamine was far more impactful than Spravato. But the financial and logistical barriers are real, and that’s where many patients may find Spravato more accessible.

The bottom line? Ketamine therapy is not a miracle cure. But it is a powerful tool — one that can give people the energy and perspective needed to re-engage with life, therapy, and healing.

The Psychonaut’s Mission

As The Psychonaut, I will continue to explore these cutting-edge therapies, not only as a professional psychologist but also as a person seeking healing. This diary is one chapter in that journey — a commitment to report back honestly, blending science, lived experience, and psychological insight as I venture further into the unknown of the human mind.

Along the way, I’ll also share resources that have been especially valuable. For example, neuroscientist Andrew Huberman’s Huberman Lab Podcast has several excellent episodes unpacking ketamine, psychedelics, and brain plasticity Huberman Lab Podcast. Similarly, Tim Ferriss’s podcast has featured deep, thoughtful conversations with leaders in the psychedelic and mental health fields The Tim Ferriss Show. I’ve listened to and read a great deal on these subjects, and I can honestly say these are among the most comprehensive and insightful resources out there.

Have You or Someone You Know Tried Ketamine Therapy?

👉 Was it IV, Spravato, or another form? I’d love to hear your thoughts and experiences.

References

Andrade, C. (2017). Ketamine for depression, 4: In what dose, at what rate, by what route, for how long, and at what frequency? Journal of Clinical Psychiatry, 78(7), e852–e857.
Correia-Melo, F. S., et al. (2020). Comparative efficacy of racemic ketamine and esketamine for depression: A systematic review and meta-analysis. Journal of Affective Disorders, 276, 167–174.
Duman, R. S., & Aghajanian, G. K. (2012). Synaptic dysfunction in depression: Potential therapeutic targets. Science, 338(6103), 68–72.
Krystal, J. H., et al. (2019). Ketamine: A paradigm shift for depression research and treatment. Neuron, 101(5), 774–778.
Li, N., et al. (2010). mTOR-dependent synapse formation underlies the rapid antidepressant effects of NMDA antagonists. Science, 329(5994), 959–964.
UK ECT Review Group. (2003). Efficacy and safety of electroconvulsive therapy in depressive disorders: A systematic review and meta-analysis. Lancet, 361(9360), 799–808.
Zarate, C. A., et al. (2006). A randomized trial of an N-methyl-D-aspartate antagonist in treatment-resistant major depression. Archives of General Psychiatry, 63(8), 856–864.

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