Introduction: A Mysterious Drug with Hidden Risks
Ketamine’s reputation is complicated. Known as both a powerful anesthetic and a party drug, its dissociative effects are often mistaken for harmless fun. But behind the “K-hole” allure lies a serious question: Can ketamine cause hallucinations or even psychosis?
At Holina Rehab Thailand, we work with clients every day recovering from ketamine misuse—including those navigating the psychological aftermath.
What Are Ketamine Hallucinations?
The “K-Hole” Explained
The infamous “K-hole” refers to a state of intense dissociation:
Disconnection from the body
Floating sensations
Time distortion
Inability to speak or move
While not all users enter a K-hole, those who do often describe it as hallucinatory—even frightening.
Types of Hallucinations Reported
Visual: Lights bending, colors melting, seeing people who aren’t there
Auditory: Hearing voices, echoes, or distorted sounds
Temporal: Feeling like time has stopped or looped
Spatial: Losing sense of where the body is in space
How It Feels vs. What’s Really Happening
Many describe the experience as dreamlike, but neurologically, the brain is undergoing extreme sensory misprocessing—not imagination.

Ketamine and Psychosis: Understanding the Connection
Can Ketamine Trigger Psychotic Episodes?
Yes. Especially in:
High doses
Chronic users
Those with family history of psychosis
Episodes may include:
Paranoia
Hallucinations
Delusions
Disorganized thoughts
Risks for Vulnerable Individuals
People with:
Schizophrenia
Bipolar disorder
Unresolved trauma
…are at much higher risk of a psychotic break or prolonged psychological disruption.

Medical Ketamine Use vs. Recreational Use
Controlled Clinical Doses
When administered medically:
The dose is small and brief
Patients are monitored in sterile environments
Sessions often include psychotherapeutic integration
Lack of Safety in Recreational Settings
Street ketamine use lacks:
Medical oversight
Dosage accuracy
Post-trip mental health support
This is where most psychotic-like side effects occur.
The Neurobiology Behind Ketamine-Induced Psychosis
NMDA Receptor Antagonism
Ketamine blocks NMDA receptors, which play a role in:
Learning
Memory
Emotional regulation
This disruption can cause cognitive distortion and sensory flooding—hallmarks of both hallucinations and psychosis.
Research Findings: Transient vs. Lasting Effects
Transient hallucinations: Most pass within hours
Lasting psychosis: Found in chronic or vulnerable users
Clinical studies (e.g., in Frontiers in Psychiatry) suggest repeated use may trigger schizophrenia-like symptoms, especially in youth.
Case Reports and Clinical Evidence
Documented Psychosis in Chronic Users
Reports include:
Paranoid delusions
Extended episodes of hallucination
Functional decline similar to drug-induced schizophrenia
Distinguishing Hallucination, Delusion, and Mania
Symptom Type | Description | Example |
Hallucination | Perceiving things that aren’t there | Hearing voices, seeing shadows |
Delusion | Believing false ideas strongly | Thinking you’re being watched or followed |
Mania | Elevated mood with risky behavior | Grandiosity, insomnia, racing thoughts |
Ketamine can cause all three—often in combination.

Holina’s Treatment for Ketamine-Related Dissociation
Trauma-Informed and Emotional Grounding
We help clients return to emotional presence through:
One-on-one therapy
Somatic processing
Group integration
Tools for Stabilization
Meditation and breathwork
Creative expression through art or music
Regulating nervous system with TRE and movement therapy
Clients are gently guided back to their bodies—often for the first time in years.
Frequently Asked Questions (FAQs)
Is it normal to see things on ketamine?
Yes—visual or auditory hallucinations can occur, especially in high or repeated doses. However, normal doesn’t mean safe.
Can one trip cause lasting psychosis?
Rare, but possible—particularly in people with mental health vulnerabilities. Most psychosis arises from repeated use.
Can ketamine worsen schizophrenia or bipolar disorder?
Yes. It can exacerbate existing symptoms or trigger episodes in those predisposed.
Is it safe to use ketamine if I’ve had hallucinations before?
No. Prior hallucinations may signal increased sensitivity or unresolved trauma—continuing use increases your risk.
What should I do if I or a friend is having a bad ketamine trip?
Keep the person safe from injury
Stay with them and speak calmly
Seek medical help if they lose consciousness or seem out of control
How does Holina help someone recovering from psychotic symptoms?
We offer:
Clinical oversight
Therapeutic grounding
Safe community support
Mind-body reintegration
Conclusion: Knowing the Risks Leads to Safer Decisions
Awareness is the First Step Toward Recovery
Ketamine can feel like an escape—but for some, it becomes a trap. Hallucinations are not harmless. Psychosis is not a myth.
Holina Supports Healing for the Mind and Soul
Whether you’re feeling detached, overwhelmed, or scared by past ketamine use—you’re not alone. Holina’s team offers the insight, safety, and support to reclaim your clarity and calm.
📞 Holina Admissions: +66 (0) 626 418 369
About Me

Ian Young
Ian Young is the Global Manager at Holina Care Centres in Koh Phangan, Thailand. Ian oversees the rehabilitation programs that blend the 12 Step model, NLP, and various evidence-based therapies with holistic healing practices. Holina Rehab treats addictions, trauma, anxiety, and depression, offering comprehensive care in a serene resort environment. Ian, a charismatic speaker and author of “It’s Not About Me,” leverages his own recovery journey from addiction to inspire and guide others toward a fulfilling, addiction-free life.
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