Ketamine and Mental Health: Treating Dual Diagnosis at Holina

05 min read

Introduction: The Complex Link Between Ketamine Use and Mental Health
Is Ketamine a Cure or a Cause of Mental Health Issues?
Ketamine walks a controversial line in the mental health world. On one hand, it’s hailed as a breakthrough treatment for depression. On the other, it’s a recreational substance associated with psychosis, paranoia, and emotional instability. The truth? It depends on the context, dosage, and individual vulnerability.
Clinical Use vs. Recreational Misuse
In psychiatry, low-dose ketamine or esketamine is administered in controlled settings to manage treatment-resistant depression or PTSD. Recreational use, however, involves high doses in unpredictable environments, which can exacerbate existing mental health issues or trigger new ones. That’s where dual diagnosis treatment becomes essential.

Understanding Dual Diagnosis: Addiction and Mental Health Together
What Is Dual Diagnosis?
Dual diagnosis refers to the co-occurrence of a substance use disorder and a mental health condition. In ketamine users, this often involves a mix of:
Depression
PTSD
Anxiety disorders
Dissociation or depersonalization
Why It’s Common with Ketamine Users
Many people turn to ketamine to self-medicate:
To escape trauma
To numb anxiety
To ease existential discomfort
But instead of helping, ketamine often deepens the cycle of avoidance and emotional disconnection.
Most Common Co-occurring Disorders: Depression, PTSD, Anxiety
Depression: Can be both a trigger for use and a side effect of long-term abuse
PTSD: Traumatized individuals may gravitate toward dissociatives like ketamine
Anxiety: Short-term relief can mask worsening symptoms beneath the surface

How Ketamine Impacts Mental Health
Short-Term Euphoria, Long-Term Dysregulation
Initially, ketamine offers:
Feelings of lightness
Emotional detachment
Dissociation from stress
But over time, it disrupts emotional regulation and leaves the user vulnerable to:
Mood swings
Memory loss
Emotional numbness
Hallucinations, Paranoia, and Psychotic Symptoms
Some users report:
Auditory or visual hallucinations
Intense fear and confusion
False beliefs or paranoid delusions
These symptoms mirror psychotic disorders and can persist long after the high wears off.
Emotional Numbing and Avoidance Behavior
Instead of processing emotions, chronic ketamine users often numb out, avoiding meaningful relationships and inner healing. This fuels:
Isolation
Lack of purpose
Increased dependence on the substance
Clinical Ketamine Use in Psychiatry: Benefits and Boundaries
Off-Label Use for Depression: What the Science Says
Esketamine, a ketamine derivative, is FDA-approved for treatment-resistant depression.
Research shows rapid symptom relief—within hours—but results vary.
Long-term effectiveness and safety are still being studied.
Esketamine vs. Street Ketamine
Factor | Esketamine (Medical) | Recreational Ketamine |
Dose | Very low, precise | High, often unmeasured |
Environment | Clinical supervision | Clubs, homes, unregulated |
Risk | Low when monitored | High for addiction and mental harm |
Goal | Therapeutic | Escape, numbing, recreation |
Risk of Misuse and Misunderstanding Clinical Intent
Some individuals self-medicate with ketamine, confusing medical use with recreational abuse. This is dangerous, especially without therapeutic support or dosage control.
Holina’s Approach to Dual Diagnosis
Trauma-Informed Care at Every Step
Holina recognizes that mental health and addiction are deeply intertwined. Our treatment addresses both with compassion and professionalism. From intake to discharge:
Trauma history is respected
Emotional safety is prioritized
Personalized recovery is our mission
EMDR, CBT, and DBT for Mental Health Disorders
Holina offers:
CBT: To challenge negative thinking
DBT: For emotional regulation and distress tolerance
EMDR: For processing trauma and PTSD symptoms
These therapies are customized to the individual, ensuring effectiveness across various dual diagnoses.
Psychiatric Oversight and Medication Management
On-site psychiatrists and licensed clinicians:
Assess and treat mental illness
Monitor medication regimens
Adjust plans based on progress and side effects
This integrated care model reduces relapse risk and stabilizes emotional health.

Holistic Therapies Supporting Emotional Healing
Breathwork, Meditation, Art Therapy
These practices help clients:
Reconnect with their emotions
Express pain without words
Cultivate mindfulness and awareness
Somatic Release and Mindfulness Integration
Body-based therapies like:
Trauma Release Exercises (TRE)
Aqua tuning
Yoga
restore nervous system balance and reduce the stress response loop.
Peer Support, Group Circles, and Relational Healing
Clients process:
Shared trauma
Relationship wounds
Co-occurring disorders
in a safe, nonjudgmental space.
This builds resilience and breaks isolation.
Success Stories: Dual Diagnosis Clients at Holina
Mon (2025): From Ketamine and PTSD to Stability
“I had been using ketamine to escape from severe PTSD for years. Holina helped me understand my trauma, not avoid it. Through EMDR and breathwork, I found clarity. I left Holina stronger than I imagined possible.”
Steve R: Holistic Mental Health Recovery
“The therapists at Holina didn’t just treat my addiction—they helped me uncover the depression and childhood trauma that fueled it. Their approach changed my life completely.”
Frequently Asked Questions (FAQs)
Can ketamine worsen depression or anxiety?
Yes—long-term misuse can intensify mood swings, dissociation, and underlying mental health issues.
What is the difference between medical ketamine and street use?
Medical ketamine is administered at low, precise doses with psychiatric oversight. Recreational use is unregulated and far riskier.
How does Holina assess dual diagnosis clients?
Through comprehensive intake evaluations, including:
Psychological history
Trauma screening
Psychiatric assessments
Is therapy mandatory during treatment?
Yes—therapy is the foundation of dual diagnosis recovery at Holina. Every client participates in both individual and group sessions.
Can I get support for trauma even if I’m not addicted anymore?
Absolutely. Holina welcomes clients post-detox who want to address residual trauma and rebuild emotional health.
How long is the recommended stay for dual diagnosis clients?
A minimum of 6–8 weeks is advised to stabilize symptoms, develop tools, and begin trauma processing. Many opt for 12 weeks or more.
Conclusion: Healing the Mind and Body Together
Holina’s Vision for Integrated Recovery
True healing requires treating both the addiction and the underlying emotional pain. At Holina, we believe recovery is about integration—not isolation. We don’t just remove the substance—we help our clients rediscover who they are beneath the pain.
Begin Your Mental Health and Addiction Healing Journey
If you’re struggling with ketamine use and mental health issues, you’re not alone. Holina Rehab Thailand offers compassionate, professional care to guide you back to balance and wholeness.
📞 Call us today: +66 (0) 626 418 369
🌐 Learn more: holinarehab.com
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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