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Ketamine and Mental Health: Treating Dual Diagnosis at Holina

Avatar photo Ian Young
19 Aug, 2025
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

Avatar photo

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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