What Ketamine-Assisted Therapy Can Help With

I want to be upfront with you: I talk a lot about hormones, EDS, brain fog, and the physiological chaos of perimenopause. But there's another layer to midlife that we don't talk about nearly enough — the emotional weight. The quiet grief of feeling like you've lost access to yourself. The creeping numbness. The sense that you're going through the motions but not really present for your own life.

That's where I was. And it's why I decided to try ketamine-assisted therapy.

This is my story — plus a look at what ketamine-assisted therapy actually is, who it can help, and how to think about it as one tool (not a cure) in your healing toolkit.

So What Actually Is Ketamine-Assisted Therapy?

Ketamine is not new. It's been used safely as an anesthetic for over 50 years. What is newer is our understanding of what it does to mood, brain flexibility, and conditions that haven't responded to other treatments.

Ketamine works differently from traditional antidepressants. Instead of slowly nudging serotonin levels over weeks, ketamine acts on NMDA receptors and rapidly increases something called BDNF — brain-derived neurotrophic factor — which supports the growth of new neural connections. Think of it as fertilizer for a brain that's gotten stuck.[1,2] Many people notice a meaningful shift in mood within hours to days rather than weeks, though these effects do tend to fade over time, which is why most protocols include maintenance sessions.[3,4]

In a therapeutic setting, ketamine is given in a controlled, intentional environment — often with integration support afterward — to help people access difficult emotions, break out of stuck thought patterns, and reconnect with themselves.

It's also worth knowing that esketamine (Spravato), a related nasal spray, is FDA-approved for treatment-resistant depression — which may matter if you're thinking about insurance coverage.[5]

What Can It Actually Help With?

The research supports ketamine-assisted therapy for:

• Treatment-resistant depression — this has the strongest evidence, with meta-analyses showing significant benefit for people who haven't responded to multiple antidepressants[3,6]

• Anxiety and PTSD — including trauma that lives in the body more than in conscious memory[7]

• Chronic pain — there's meaningful evidence here, though it varies depending on the specific condition[7]

A few honest caveats: ketamine is not a magic fix, and it's not right for everyone. It works best as part of a bigger picture — therapy, lifestyle support, and for many of us, hormonal optimization. And while ketamine itself has solid evidence behind it, whether adding structured psychotherapy improves outcomes beyond ketamine alone is still an open question in the research.[8,9]

Why I Decided to Try It

I'm a nurse practitioner who specializes in menopause, hypermobility, MCAS, and dysautonomia. I also live with Ehlers-Danlos syndrome. I know what it's like to have a complex body and to feel let down by a healthcare system that often misses the full picture.

And still, I found myself in a season where I was present in body but not in spirit. Going to dinner with friends and mentally writing my to-do list. Watching my child play and feeling weirdly far from the joy of it. Doing all the "right things" — hormones optimized, sleeping reasonably well, moving my body — but still feeling like something was just out of reach.

I wanted to find my way back to myself. Not a dramatic transformation — just access. The ability to actually land in the moments that matter.

My Experience Working with Saumya Humpf at Seed Yoga Therapy

I worked with Saumya Humpf at Seed Yoga Therapy, and I want to share what that was like — not to tell you what to do, but because I think being open matters, especially when I'm asking you to trust me with your care.

What stood out about Saumya's approach was the intentionality. This wasn't just about the medicine. It was about arriving with a clear intention, being held well during the experience, and doing meaningful integration work afterward. My intention going in was specific: I wanted more capacity for presence. To actually access joy. To stop living at a slight remove from my own life.

The sessions reminded me of something I already know well — hypnotherapy. I'm not just a clinical hypnotherapist by training; I'm also a regular hypnotherapy client. I do parts work in my own sessions, and that ongoing practice has helped me get comfortable moving into dissociative states and using them as a doorway rather than something to resist. I genuinely believe that familiarity helped me go deeper in my ketamine-assisted therapy sessions than I might have otherwise.

Ketamine creates something similar to that hypnotic state. There's a loosening of ordinary, analytical thinking that — in the right container, with the right intention — allows you to access things that are harder to reach when your logical mind is running the show. The dissociation isn't a side effect to push past. It's actually a core part of how the therapy works.[10]

What came up in that space felt genuinely new. Not manufactured. Not forced. New.

I came out of those sessions with a clearer sense of what matters to me. Something softened. The distance I'd been feeling from my friends, from my family, from ordinary moments of joy — it didn't vanish overnight, but a door opened. And I walked through it.

Saumya's integration support mattered too. The insights from a ketamine session don't just automatically stick — you have to do the work to weave them into daily life. I want to be honest that the research hasn't yet confirmed whether that integration layer adds benefit beyond ketamine alone.[8,9] What I can tell you is that having that support made the whole experience feel purposeful rather than just interesting.

The Menopause Connection

The emotional flatness and disconnection I was experiencing has real overlap with what happens hormonally in perimenopause. Fluctuating and declining estrogen affects serotonin, dopamine, and GABA. Declining progesterone adds its own layer of neurological disruption.[11,12,13] The result can be a kind of depression or numbness that doesn't respond well to standard antidepressants — because the underlying driver is hormonal, not primarily psychiatric.[14]

Hormone optimization is always my first conversation. It's foundational. But for some of us — especially those with layered conditions, trauma histories, ADHD, MCAS, or EDS — hormones alone don't move every needle.

I want to be transparent: there are no clinical trials yet specifically looking at ketamine-assisted therapy for perimenopausal depression. What I'm describing is a clinical extrapolation based on overlapping mechanisms — not a proven protocol. That's part of why I felt it was important to experience it myself before recommending it to others. Ketamine-assisted therapy may be a meaningful complement to hormonal care — but we're still learning, and I'll always tell you where the evidence ends and clinical judgment begins.

One more thing worth knowing: while ketamine has a long track record as an anesthetic, long-term safety data for repeated psychiatric use is still being gathered. Some researchers have raised questions about potential effects at higher doses or with frequent use.[15,16] This is another reason why working with a careful, experienced practitioner matters.

Is It Right for You?

Ketamine-assisted therapy may be worth exploring if you:

• Have tried antidepressants without meaningful relief

• Feel emotionally numb or checked out from your own life

• Carry trauma or grief that seems to live in your body more than your mind

• Deal with chronic pain layered with mood struggles

• Feel like you're going through the motions but not really living

It's generally not recommended if you have a personal or family history of psychosis, uncontrolled high blood pressure, or active substance use disorder.[17] As always, work with a qualified provider and make sure your healthcare team is in the loop.

I share my personal experiences because I think you deserve a provider who is also a human being — someone who does the hard and uncomfortable work too, and keeps looking for better answers.

If you're curious about ketamine-assisted therapy, I'd encourage you to explore it with good support. And if you'd like to talk through how it might fit into your overall hormonal and mental health picture, that's exactly the kind of whole-person conversation we have at Phases Clinic.

You deserve to be present for your own life. Let's find the tools that get you there.

With care,

Vanessa Weiland, NP, HT, MSCP

Founder, Phases Clinic

phasesclinic.com | @bendymenopause

References

1. Zanos P, Gould TD. Mechanisms of Ketamine Action as an Antidepressant. Molecular Psychiatry. 2018;23(4):801-811.

2. Marwaha S, Palmer E, Suppes T, et al. Novel and Emerging Treatments for Major Depression. Lancet. 2023;401(10371):141-153.

3. Marcantoni WS, Akoumba BS, Wassef M, et al. A Systematic Review and Meta-Analysis of the Efficacy of Intravenous Ketamine Infusion for Treatment Resistant Depression. Journal of Affective Disorders. 2020;277:831-841.

4. Phillips JL, Norris S, Talbot J, et al. Single, Repeated, and Maintenance Ketamine Infusions for Treatment-Resistant Depression: A Randomized Controlled Trial. American Journal of Psychiatry. 2019;176(5):401-409.

5. FDA Orange Book. Esketamine (Spravato) approval for treatment-resistant depression.

6. Marwaha S et al. Novel and Emerging Treatments for Major Depression. Lancet. 2023.

7. Drozdz SJ, Goel A, McGarr MW, et al. Ketamine Assisted Psychotherapy: A Systematic Narrative Review of the Literature. Journal of Pain Research. 2022;15:1691-1706.

8. Simpson RJ, Juruena MF. Effectiveness of Ketamine-Assisted Psychotherapy as a Treatment for Treatment-Resistant Depression: A Systematic Review. Psychopharmacology. 2026.

9. Veraart JKE, Schimmers N, Breeksema JJ, et al. Ketamine-Assisted Psychotherapies for Mental Disorders: A Historical Overview and Systematic Review. Clinical Psychology Review. 2026;124:102706.

10. Wolfson P, Vaid G. Ketamine-Assisted Psychotherapy, Psychedelic Methodologies, and the Impregnable Value of the Subjective. Frontiers in Psychiatry. 2024;15:1209419.

11. Joffe H, de Wit A, Coborn J, et al. Impact of Estradiol Variability and Progesterone on Mood in Perimenopausal Women With Depressive Symptoms. Journal of Clinical Endocrinology and Metabolism. 2020;105(3).

12. Nathan MD, Bondy E, Walsh M, et al. The Impact of Estradiol Dynamics During the Menopause Transition on Depression Risk. Biological Psychiatry. 2026.

13. Gordon JL, Girdler SS, Meltzer-Brody SE, et al. Ovarian Hormone Fluctuation, Neurosteroids, and HPA Axis Dysregulation in Perimenopausal Depression. American Journal of Psychiatry. 2015;172(3):227-236.

14. Brown L, Hunter MS, Chen R, et al. Promoting Good Mental Health Over the Menopause Transition. Lancet. 2024;403(10430):969-983.

15. Nikayin S, Murphy E, Krystal JH, Wilkinson ST. Long-Term Safety of Ketamine and Esketamine in Treatment of Depression. Expert Opinion on Drug Safety. 2022;21(6):777-787.

16. Li SW, Kumpf KT, Urrutia J, et al. Ketamine for Depression, but at What Cost? American Journal of Psychiatry. 2025.

17. Sanacora G, Frye MA, McDonald W, et al. A Consensus Statement on the Use of Ketamine in the Treatment of Mood Disorders. JAMA Psychiatry. 2017;74(4):399-405.