In this Post
- What Are Ketamine Infusions—and Why Preparation Matters
- Maximizing Benefits of Your Ketamine Infusion
- Setting Intentions Before Ketamine Therapy
- Processing the Experience Afterward
- How to Maximize Treatment for Depression and Low Motivation
- Is Ketamine Therapy the Right Choice?
If you’re scheduled for your first ketamine infusion – or you’re still on the fence about booking one, you probably want to know what to expect from ketamine therapy before you walk in the door. What does the infusion actually feel like? How do you prepare? What happens afterward? And how do you know whether you’re “doing it right”?
This guide is built on practical advice gathered from real Avesta Ketamine & Wellness patients across our five DMV-area clinics, paired with what our clinical team has learned over more than 16,000 infusions. The short version: ketamine itself does most of the neurological heavy lifting, but your mindset, your preparation, and how you process the experience afterward determine how much of that benefit you carry forward.
What Are Ketamine Infusions—and Why Preparation Matters
Ketamine is a dissociative anesthetic with mild psychedelic properties. Delivered at a precise sub-anesthetic dose in a clinical setting, it offers fast-acting relief for mental health , including depression, anxiety, PTSD, OCD, and chronic pain — often within hours rather than the weeks required by traditional antidepressants.
Two things happen during a ketamine infusion:
- The dissociative effect lets you step back from your normal thinking patterns and the emotions that come with them.
- The mild psychedelic effect (dose-dependent) makes it easier to look at long-held beliefs from a new angle.
Ketamine does the chemistry. What you bring to the session: your mindset, your intention, the items you bring into the room, and the work you do afterward, determines whether the changes stick.
What to expect during a ketamine infusion
Most patients are surprised by how gentle the experience is. Here’s the rough arc of a typical IV ketamine session at Avesta:
- Minutes 0 – 5: The infusion starts. You’re reclined in a comfortable chair in a private room. Within a few minutes, you’ll notice a soft, floaty feeling, almost like being half-awake from a deep nap.
- Minutes 5 – 35: This is the heart of the experience. You may feel your body soften, time may seem to slow or stretch, and your attention can drift to memories, images, or emotions you don’t normally have easy access to. Many patients describe it as “watching their own thoughts from a few feet away.”
- Minutes 35 – 45: The medication starts to wear off and you come back to baseline. You’ll feel a little tired, a little spacey, and usually noticeably calmer.
- After the session: A trusted adult drives you home. You rest. Some patients feel relief that same evening. Others notice the shift gradually over the next few days.
You will not be unconscious. You will not lose memory of who you are. And at every point, you can ask your provider to slow the drip or stop the session and the medication will clear your system quickly.
How to prepare for your ketamine infusion (the night before and morning of)
The patients who get the most out of ketamine therapy almost always treat the day of their infusion as a small ritual rather than another doctor’s appointment.
Establish a calm setting
Bring items that signal safe to your nervous system. Patients commonly bring:
- A favorite or weighted blanket
- A small trinket that holds personal value
- Noise-canceling headphones with calming music (more on this below)
- Eye mask
- A familiar essential oil
Eat lightly and hydrate.
Most patients are asked to avoid food for a few hours before the infusion to reduce the chance of nausea. Drink water throughout the day prior.
Plan your transportation.
You will not be cleared to drive after a session. Arrange a ride or rideshare home in advance.
Set an intention, but hold it loosely.
Think of your intention as a compass, not a script. You might intend to:
- Reconnect with gratitude
- Picture life without your depression or anxiety
- Explore a relationship or a recurring fear
- Sit with a feeling you usually avoid
Keep it simple, write it down, and then let it go. The most meaningful sessions often end up somewhere the patient didn’t expect.
Pre-infusion journaling prompts
Spending five quiet minutes with these the night before can change the quality of the session entirely:
What do I want to let go of? (“The guilt I’ve been holding about my past.”)
What feelings am I bringing into this session? (“I feel nervous but hopeful. I’m tired of feeling stuck.”)
What do I want to explore or reflect on today? (“I want to understand why I’ve been avoiding joy.”)
What would healing look like to me right now? (“Being able to wake up and feel motivated again.”)
What to expect during the ketamine session itself
When the medication takes hold, the most important skill is letting go. Here’s what it means in practice:
Trust your care team. Your provider is in the room or right outside. They’re checking on you regularly and can adjust your dose in real time if you become uncomfortable.
Release expectations about what the session “should” feel like. Some patients feel deep calm and joy. Some feel waves of emotion they didn’t see coming — grief, relief, anger. Some feel almost nothing the first time. All of those are valid experiences. Even challenging sessions tend to be productive. One long-time Avesta patient describes a single difficult infusion in a years-long course that, in her words, “broke open the thing my therapist and I had been circling for two years.”
Have a grounding mantra ready. If the experience becomes intense, gently return to a single word or phrase — “relax,” “let go,” “I’m safe” — to recenter yourself.
Music matters more than people expect. A calm, slow-tempo playlist (no lyrics is ideal for many patients) helps shape the experience. Avesta provides a curated playlist if you don’t have your own.
You can always ask for help. If anything feels overwhelming, tell your provider. They can lighten the dose or pause the infusion immediately.
What to expect after a ketamine infusion
This is where most of the long-term benefit actually comes from.
The first 24 hours. You’ll feel a little tired and a little spacey for the rest of the day. Most patients sleep well that night. Some experience their first noticeable mood shift within hours. Others don’t notice the shift until two or three days later.
The amnestic effect is real. Ketamine has mild amnestic properties, which means some of what came up during the session may already be fading by the time you get home. This is why journaling immediately afterward is so powerful. Treat it like recording a dream and write whatever comes, without editing.
Give yourself downtime. Avoid rushing back into work, social obligations, or stressful conversations for the rest of the day. The integration window is most active in the first 24–72 hours.
Integration practices that work:
- Journaling about images, feelings, or thoughts that arose
- Talking with a therapist or our ketamine integration coach about the session
- Expressing the experience through art, movement, or simply a long walk
- Revisiting your initial intention and noticing how it evolved
Post-infusion journaling prompts
- What stood out to me during the session? (“I felt like I was floating in warmth. I saw myself as a child again.”)
- Did anything surprise me or make me feel emotional? (“I cried when I thought about forgiving my mom.”)
- How do I feel now — physically, emotionally, mentally? (“Lighter, sleepy, calm.”)
- Is there anything I want to bring into my next session? (“That feeling of connection.”)
What to expect over a full course of ketamine therapy
Almost no one feels the full effect of ketamine therapy after a single infusion. Most patients begin with a series of six infusions over two to three weeks, then move to a maintenance schedule of boosters as needed (often monthly to every few months).
A typical patient trajectory at Avesta looks something like this:
- Infusion 1: Often the most exploratory. Many patients spend it getting used to the sensation. Mood improvement may be subtle.
- Infusions 2 – 3: The dissociative effect starts to feel more familiar, intentions land more deeply, and the first noticeable improvements in mood, sleep, or motivation typically begin.
- Infusions 4 – 6: This is where most of the durable benefit lives. The integration work done between sessions compounds.
- Boosters: Spaced based on how you feel, anywhere from monthly to every six months. Some patients also transition to Spravato (esketamine) nasal spray, which is FDA-approved for treatment-resistant depression and often covered by insurance.
Tips specifically for depression and low motivation
Depression and the anhedonia (loss of pleasure) that comes with it are the most common reasons patients walk through Avesta’s doors. A few patient-tested practices that compound the effect of ketamine therapy:
Before the infusion:
- Write down one specific situation where depression is holding you back — skipped meals, social withdrawal, a hobby you’ve abandoned.
- Name the emotion underneath it. Shame? Numbness? Sadness?
- Recall — or imagine — what it felt like to be on the other side of it.
During the infusion:
- Sit with the gap between how things feel now and how they could feel, with curiosity instead of judgment. Even a glimpse of a different reality can be a powerful catalyst.
After the infusion:
- Identify one small step you feel ready to take. Not a list, just one step: a 10-minute walk, a text to a friend you’ve been avoiding, or even something like folding the laundry. The window of motivation that ketamine opens can be narrow. Use it!
Is ketamine therapy the right choice for you?
Ketamine therapy is especially effective for:
- Major depressive disorder
- Treatment-resistant depression
- Generalized anxiety
- PTSD
- Suicidal ideation
- Chronic pain and CRPS
- OCD
- Substance use disorder (see our companion article on ketamine therapy for addiction recovery)
It is not appropriate for everyone. Patients with uncontrolled high blood pressure, active psychosis, certain cardiac conditions, or current pregnancy are usually not candidates. Patients with active, unmanaged substance misuse are evaluated case by case.
That’s what the consultation is for. Before you ever book an infusion, you’ll have a detailed conversation with one of our intake coordinators and a clinical screening. If ketamine isn’t right for you, we’ll tell you.
What ketamine therapy at Avesta looks like — and where to start
We don’t just administer infusions at Avesta. Our Bethesda and Columbia locations in Maryland, Tysons and Norfolk locations in Virginia, and Washington DC clinic include experienced professionals who guide you through every step of the process with care and deep respect.
We create space for meaningful connection, encourage collaboration with your outside providers, and offer services like integration coaching and small-group circles to support you between sessions. You’re also welcome to bring a trusted loved one or therapist to your sessions—for comfort, presence, and perspective.
Frequently asked questions — what to expect from ketamine therapy
What does a ketamine infusion actually feel like? A soft, floaty, slightly disconnected feeling — almost like a vivid daydream. You stay aware of your surroundings; you can ask for help at any time. Most patients describe it as far gentler than they’d feared.
How long does a ketamine therapy session last? The infusion itself is typically 40–45 minutes. Plan for about 90 minutes in the clinic to include intake, the infusion, and a brief recovery period.
What should I do the day before a ketamine infusion? Eat lightly that day, drink plenty of water, set an intention, prep a comforting item or two to bring, and arrange a ride home.
What if I don’t feel better after my first ketamine infusion? This is completely normal — and not a sign that the treatment isn’t working. Most of the durable benefit shows up after infusions 3–6 of the initial series.
Can I take my regular medications before a ketamine session? Generally yes, but with a few important exceptions (some benzodiazepines and lamotrigine can blunt ketamine’s effect). Bring your medication list to your intake and we’ll review it together.
Is the ketamine therapy experience the same as recreational ketamine? No. The dose, setting, and supervision are completely different. Medical ketamine therapy in a clinic carries a very different risk profile than recreational use.
Will my ketamine therapy session be private? Yes. You’ll have a private room, your own clinician monitoring, and your information is fully protected under HIPAA.
Can I bring someone with me to a ketamine infusion? Yes — we encourage it. A trusted loved one or your therapist is welcome to sit with you during the infusion if you’d like the company.
Where is the nearest Avesta clinic to me? We have five clinics across the DMV — Washington DC, Bethesda MD, Columbia MD, Tysons VA, and Norfolk VA. Call (301) 381-8381 and we’ll route you to the closest one.
