Your Role Matters More Than You Know
When someone you care about begins ketamine therapy, you may feel uncertain about your role. What should you do? What should you say? How can you help without overstepping? These are natural questions, and the fact that you are asking them shows how much you care.
As a caregiver — whether you are a partner, family member, or close friend — your support can make a real difference in your loved one's treatment experience and outcomes. This guide gives you the practical knowledge and emotional tools to be the kind of support they need.
Understanding What They Are Going Through
Before you can support someone effectively, it helps to understand what ketamine therapy actually involves.
What Ketamine Therapy Is
Ketamine is a medication that has been used safely in medical settings for over 50 years. In recent years, it has emerged as a powerful treatment for depression, anxiety, PTSD, chronic pain, and other conditions — particularly for people who have not responded to traditional medications. It works differently from conventional antidepressants by promoting neuroplasticity, which allows the brain to form new connections and break free from entrenched negative patterns.
What Treatment Looks Like
Depending on the treatment plan, your loved one may receive ketamine through an IV infusion at a clinic, as a nasal spray (Spravato), or as sublingual tablets at home. The initial treatment phase typically involves multiple sessions over two to three weeks, followed by maintenance sessions at longer intervals.
What They Experience During a Session
During a ketamine session, your loved one will experience an altered state of consciousness. This might include feelings of floating, dissociation from their body, dreamlike imagery, and shifts in how they perceive time and space. This altered state is a normal part of the treatment. Afterward, they may feel drowsy, emotionally tender, or simply different than usual.
Practical Ways to Help
Before Sessions
- Help with logistics. Offer to drive them to and from appointments. They will not be able to drive after treatment, and knowing transportation is handled removes a significant source of stress.
- Support their preparation. If their provider has recommended fasting before sessions, help by adjusting meal plans. If they need to avoid certain foods or medications, offer reminders.
- Be understanding about scheduling. Treatment sessions require time, and they may need to adjust their responsibilities. Offer to take on tasks or manage household duties on treatment days.
- Help create a calm environment. If they are doing at-home sublingual therapy, help set up a comfortable, quiet space. This might mean dimming lights, turning off the TV, managing pets, and ensuring children are cared for.
During Sessions
If you are present during an at-home session (as a "sitter"), your role is to be quietly supportive:
- Stay nearby but do not hover. Your presence is reassuring, but they do not need constant interaction. Be in the room or nearby, available if needed.
- Keep the environment calm. Minimize noise, turn off phones, and let the household know to keep things quiet.
- Do not try to engage them in conversation. During the session, they are in an altered state. Let them have their experience without trying to direct it or pull them out of it.
- Monitor gently. If their provider has asked you to check their blood pressure or note any concerns, do so quietly and without causing alarm.
- Be ready to reassure. If they seem distressed during the session — if they reach out, seem agitated, or express fear — speak softly and remind them that they are safe, that the experience is temporary, and that you are right there with them.
- Know when to call for help. Have the provider's contact information handy. If they experience severe distress, persistent vomiting, difficulty breathing, or anything that concerns you, contact the provider or call 911.
After Sessions
- Give them space to rest. After a session, they may want to sleep, sit quietly, or simply decompress. Follow their lead.
- Do not push them to talk about it. They may want to share their experience, or they may not. Let them decide. If they do want to talk, listen without judgment. Avoid saying things like "that sounds weird" or "are you sure this is working?"
- Handle practical matters. Prepare a light meal for when they are ready to eat. Make sure they have water. Take care of any responsibilities they would normally handle that day.
- Watch for emotional shifts. In the hours and days after a session, they may be more emotionally sensitive than usual. They might cry, feel reflective, or seem quieter. This is a normal part of the process.
Emotional Support Throughout Treatment
Validate Their Decision
Choosing ketamine therapy often comes after a long, exhausting journey through other treatments that did not work. Your loved one may feel vulnerable about this choice — worried about stigma, uncertain about the outcome, or simply tired of trying new things. Validating their courage in pursuing treatment is one of the most important things you can do.
Simple statements go a long way:
- "I am proud of you for taking this step."
- "I support you in this, whatever happens."
- "You deserve to feel better, and I am here for you."
Manage Your Own Expectations
It is natural to hope for dramatic, immediate improvement. And sometimes that happens — some patients feel significantly better after just a few sessions. But for many people, the process is more gradual. There may be ups and downs. Some sessions may feel more productive than others.
Try not to measure their progress session by session or day by day. Look at the bigger picture over weeks and months. And resist the urge to ask "do you feel better yet?" after every treatment. Instead, let them share their experience at their own pace.
Be Patient with the Process
Ketamine therapy is not a light switch. It is a treatment that works over time, often in conjunction with other therapies. There may be sessions that bring up difficult emotions before things get better. There may be periods of adjustment as doses or frequencies change. Your patience and steadiness during these moments are invaluable.
Take Care of Yourself
Supporting someone through mental health treatment can be emotionally demanding. You may feel helpless, frustrated, or emotionally drained at times. These feelings are valid and do not mean you are failing as a caregiver.
Make sure you are:
- Maintaining your own self-care. Exercise, sleep, social connection, and activities you enjoy are not luxuries — they are necessities.
- Seeking your own support. Consider talking to a therapist, joining a support group for caregivers, or confiding in a trusted friend.
- Setting boundaries. You can be deeply supportive without being responsible for their recovery. It is okay to take breaks, ask for help, and say "I need a moment."
What Not to Do
While your instincts to help are good, there are a few common pitfalls to avoid:
- Do not minimize their experience. Avoid dismissive comments like "just think positive" or "everyone gets sad sometimes." These undermine the seriousness of their condition and the legitimacy of their treatment.
- Do not research obsessively and then overwhelm them with information. It is good to be informed, but they do not need you to become their medical advisor. Trust their treatment team.
- Do not share their treatment details without permission. Ketamine therapy still carries stigma for some people. Let them decide who knows about their treatment.
- Do not compare their experience to others. Every patient's journey is different. Saying "my coworker's cousin tried it and it did not work" is not helpful.
- Do not express skepticism about the treatment. Even if you have doubts, voicing them can undermine their confidence and willingness to continue.
Recognizing Progress
Improvement may not look the way you expect. Watch for subtle positive changes:
- More willingness to engage in activities they had been avoiding
- Better sleep patterns
- More energy or motivation
- Less irritability or emotional volatility
- Willingness to make plans or look forward to things
- More presence and engagement in conversations
- A sense of lightness or humor returning
These small shifts can be more meaningful than dramatic breakthroughs. Noticing and gently acknowledging them — "I noticed you seemed to enjoy dinner tonight, that was really nice" — can reinforce progress without putting pressure on them.
You Are Part of the Healing
Your loved one's treatment team includes their medical provider, their therapist, and — whether it is official or not — you. The steady, patient, practical, and emotional support you provide creates a foundation that makes everything else possible. It is not always easy, and it is not always glamorous, but it matters profoundly.
References
- NIMH: Depression Overview — National Institute of Mental Health information on depression symptoms, causes, and how to support someone with depression
- 988 Suicide and Crisis Lifeline — National crisis lifeline available 24/7 by calling or texting 988 for emotional support
- SAMHSA: National Helpline — Free, confidential 24/7 referral and information service for mental health support
- NIMH: Anxiety Disorders — National Institute of Mental Health guide to anxiety disorders, symptoms, and treatment