Tomorrow is the day. After weeks or months of research, a discovery call, and a consultation with Dr. Seif, you’re hours away from your first ketamine infusion, but your mind is running through a loop of anticipation, nervousness, and maybe a little excitement. The night before your first infusion is a unique emotional space: part eve-of-something-new excitement, part quiet hope that tomorrow might mark the beginning of something different. If you’re lying awake tonight wondering what to expect, you’re far from alone.
Normalizing the Night-Before Jitters
Let’s start with the most important thing: whatever you’re feeling right now is completely normal. Anticipatory anxiety before any medical procedure is one of the most human responses there is, and it’s amplified when the treatment involves your mental health—something deeply personal and often fraught with previous disappointments. Many patients at OC Ketamine Therapy describe the night before their first infusion as a mix of hope and fear that feels almost contradictory: wanting so badly for this to work while simultaneously bracing for another letdown.
The fears are understandable. You might be worried about the dissociative experience—what it feels like, whether you’ll lose control, whether you’ll say or do something embarrassing. You might be concerned about physical side effects like nausea or dizziness. Or you might be dealing with a deeper, more existential worry: what if this doesn’t work either? What if this was your last hope and it fails?
Here’s what we’ve observed across hundreds of patients: the anticipation is almost always more intense than the experience itself. Ketamine therapy in a clinical setting is gentle, monitored, and far more comfortable than most patients expect. The dissociative effects, while novel, are typically described as dreamlike and relaxing rather than frightening. And the care team at a quality clinic like OC Ketamine Therapy is trained to ensure your comfort and safety at every moment.
The Evening Routine: Practical Steps for Tonight
Your evening preparation begins with dinner timing and choices. Plan to eat a light, balanced meal at least four hours before your scheduled infusion time tomorrow. If your appointment is in the morning, that means dinner tonight serves as your last substantial meal. Choose foods that are nourishing but not heavy—lean protein, vegetables, and complex carbohydrates support stable blood sugar and won’t sit heavily in your stomach. Avoid rich, fatty, or spicy foods that might contribute to nausea the next day.
Hydration tonight sets the stage for tomorrow. Drink water consistently through the evening, then taper off about an hour before bed so your sleep isn’t disrupted by bathroom trips. Good hydration makes IV placement easier and smoother, which is a small comfort that makes a bigger difference than you’d think when you’re already nervous.
Prepare what you’ll bring to your session tonight rather than scrambling in the morning. Comfortable, loose-fitting clothing eliminates one decision from your morning and ensures you’ll be physically comfortable during the 40-to-60-minute infusion. An eye mask can deepen the inward, reflective quality of the experience, so we’ll have one ready for you. We also provide high-quality noise-cancelling headphones and a curated music selection to create an auditory cocoon that many patients find deeply comforting, though you’re welcome to bring a playlist of your own—instrumental music that is new to you tends to work especially well. Some patients also choose to bring a meaningful object—a photo, a stone, or something that connects them to their intention for the session.
Managing Your Mind Tonight
The night before a first infusion isn’t the time for deep internet research rabbit holes. You’ve already done your due diligence—that’s why you’re here. Reading random forum posts about other people’s experiences, particularly negative ones, serves only to fuel anxiety without providing useful information. Every person’s response to ketamine is unique, and someone else’s difficult experience is not a preview of yours.
Our intention is for you to have the experience that is meant for you—one that unfolds in a way that is supportive, meaningful, and aligned with your own healing process. Even if you’ve had challenging or negative psychedelic experiences in the past, there is no reason to assume this will be the same. The setting, the preparation, the dosing, and the therapeutic support are all thoughtfully designed to help you feel safe and guided. Many patients are surprised to find that an experience they approached with apprehension becomes not only manageable, but deeply beneficial and, at times, even beautiful.
This evening is an invitation to settle. Consider a brief mindfulness practice or a body scan meditation—nothing elaborate, just a few minutes of connecting with your breath and acknowledging the feelings present without trying to fix them. Some patients find it helpful to write a brief journal entry: what brought you to this point, what you hope for, and what you’re grateful for. This isn’t about performing a ritual; it’s about marking this moment with intention.
Catherine, a 43-year-old school counselor from Tustin, shares what helped her the night before: “I wrote a letter to myself. Not to the depressed me, but from the depressed me to whoever I might become after treatment. I told her what I’d been through and asked her to remember how hard it was. Reading that letter now, six months later, makes me cry for different reasons. That girl had no idea what was coming.”
Sleep: Give Yourself Permission to Rest Imperfectly
Here’s the honest truth: you may not sleep perfectly tonight, and that’s okay. The pressure to “get a good night’s sleep” before something important often becomes its own source of anxiety, creating a frustrating cycle of trying to sleep, worrying about not sleeping, and then really not sleeping. Instead, give yourself permission to rest without demanding unconsciousness.
Create a sleep-supportive environment: cool temperature, dark room, screens off at least 30 minutes before you want to sleep. If your mind is racing, try the 4-7-8 breathing technique—inhale for 4 counts, hold for 7, exhale slowly for 8. This activates the parasympathetic nervous system and is one of the few techniques that reliably induces relaxation even under stress. If sleep doesn’t come easily, rest with your eyes closed and know that a less-than-perfect night’s sleep will not derail your treatment.
Avoid alcohol tonight, even as a “nightcap” to help you sleep. Alcohol disrupts sleep architecture, can increase anxiety upon waking, and should be avoided for at least 24 hours before ketamine therapy. Melatonin at a low dose (1-3mg) is generally fine if it’s part of your usual routine, but check with Dr. Seif if you’re unsure about any sleep aids.
The Morning Of: A Gentle Start
When morning arrives, simplicity is your friend. Follow your our fasting guidelines—typically nothing to eat within three to four hours of your appointment, and clear liquids only up to your appointment. If you normally take morning medications, Dr. Seif will have already discussed which ones to take and which to hold for today. For a full overview of what to expect throughout the pre-treatment process, reviewing our guidance on how to prepare for your first ketamine infusion can help you feel grounded and confident.
Move gently through your morning. A brief walk outside, even just around the block, can help settle pre-treatment nerves. Avoid caffeine or keep it minimal if your appointment is later in the day. Get dressed in the comfortable clothes you laid out last night. During the drive to the clinic (ideally with someone who helps you feel calm), avoid heavy conversations or news and instead listen to calming music or ride in silence—whatever feels most centering for you.
Arrive a few minutes early. Give yourself time to settle into the space, use the restroom, and let your nervous system adjust to the calm environment of the clinic. The team at OC Ketamine Therapy is accustomed to first-time patients arriving with butterflies, and they’ll guide you through every step with warmth and patience.
A Word About Expectations
One final thought for tonight: try to hold your expectations loosely. Some patients have a deeply profound experience during their very first infusion. Others describe their first session as gentle and unremarkable, with the therapeutic effects emerging gradually over subsequent sessions. Neither experience is better or worse. Ketamine’s antidepressant mechanism works at a neurobiological level that doesn’t always correlate neatly with the subjective experience during the infusion.
What may be most helpful to carry into tomorrow is the simple recognition that you are taking an active step toward healing, and that matters regardless of what happens during the infusion itself. You’ve chosen to try something different after exhausting conventional options. That takes courage, and it deserves to be honored.
You might also consider approaching tomorrow with a spirit of curiosity rather than expectation or evaluation. Curiosity softens fear. Instead of wondering, “Will this work?” or “What if I don’t like the experience?”, you might gently ask, “I wonder what my mind will show me,” or “I’m curious what this will feel like in my body.” This subtle shift moves you out of judgment and into observation, which is a far more supportive mindset for the neuroplastic and introspective work ketamine makes possible. Curiosity doesn’t demand a specific outcome—it simply stays open to whatever unfolds, trusting that even unexpected moments can hold value.
The first infusion is not a test you either pass or fail—it’s the beginning of a process. Ketamine works not only through the experience itself, but through the neuroplastic window that opens afterward, when the brain is more flexible and receptive to change. What you notice in the days and weeks that follow—subtle shifts in perspective, a little more space between you and your thoughts, a slightly easier time engaging in therapy or daily life—often matters more than what happens during the infusion itself. This perspective can take some pressure off tomorrow and allow you to simply show up, receive the treatment, and let the process unfold over time.
Tomorrow begins a new chapter. Tonight, rest as best you can, prepare what you need, and know that your team at OC Ketamine Therapy in Newport Beach will be there to support you every step of the way. Sweet dreams—and welcome to the start of something different.
References
Sanacora, G., Frye, M. A., McDonald, W., et al. (2017). A consensus statement on the use of ketamine in the treatment of mood disorders. JAMA Psychiatry, 74(4), 399–405. https://doi.org/10.1001/jamapsychiatry.2017.0080
Dore, J., Turnipseed, B., Dwyer, S., et al. (2019). Ketamine assisted psychotherapy: A systematic narrative review. Journal of Psychoactive Drugs, 51(2), 113–122. https://doi.org/10.1080/02791072.2019.1587556
Loo, C. K., Gálvez, V., O’Keefe, E., et al. (2016). Placebo-controlled pilot trial testing dose titration and intravenous, intramuscular, and subcutaneous routes for ketamine in depression. Acta Psychiatrica Scandinavica, 134(1), 48–56. https://doi.org/10.1111/acps.12572
About Dr. Dina Seif
Dina Seif, MD, believes that with the right mindset and support, every one of us has the potential to transform and heal our minds. She specializes in creating a personalized plan for each patient and is committed to providing a supportive healing environment for your journey.
Dr. Seif is a member of the American Society of Ketamine Physicians and was recognized as a Physician of Excellence by the Orange County Medical Association. Dr. Seif has 15+ years of experience with ketamine in the emergency setting and founded one of the first ketamine practices in Orange County in 2019. She has administered thousands of infusions and cared for hundreds of patients from around the world, bringing deep clinical experience to those struggling with severe depression and guiding them toward renewed hope and well-being.
Dr. Seif is board-certified in Emergency Medicine. She is a graduate of the University of California, Irvine, where she attended college, medical school, and business school.
After an internship in Internal Medicine at St. Vincent’s Medical Center in New York, she returned to California for Emergency Medicine residency at LAC+USC Medical Center where she also completed a fellowship in Emergency Ultrasound and was a Professor of Clinical Emergency Medicine at Keck School of Medicine of USC for 5 years.
Medical Disclaimer
This article is for informational purposes only and does not constitute medical advice. If you are experiencing a mental health crisis or having thoughts of self-harm, please call 988 (Suicide and Crisis Lifeline) or go to your nearest emergency room immediately. The information provided here is not intended to diagnose, treat, cure, or prevent any disease or condition. Always consult with a qualified healthcare provider before starting any new treatment or making changes to existing treatment plans. Individual results may vary, and what works for one person may not work for another.