By Dr. Dina Seif, MD | OC Ketamine Therapy | May 2026
Anxiety is everywhere. It’s in the waiting rooms of therapy offices, in the unanswered texts people send at 2 a.m., in the way a person can describe feeling paralyzed while everything looks fine on the outside. I’ve treated anxiety patients for over fifteen years, and the question I hear more often than almost any other is: “I’ve tried everything. Is there anything else?”
When most people hear about ketamine therapy in Orange County, they assume it’s only for depression. That’s understandable — most of the headlines focus on treatment-resistant depression, and the FDA approval pathway for esketamine (Spravato) was built around depressive disorders. But here’s what I think patients deserve to hear: the clinical evidence for ketamine and anxiety is growing fast, and for many people who’ve cycled through SSRIs, SNRIs, and benzodiazepines without lasting relief, it may be one of the most promising options they haven’t yet considered.
I want to talk about what the science actually says, what I’ve seen in my clinic, and what it means for someone living in Orange County who’s been told — over and over — that their anxiety is “just something they’ll have to manage.”
Not everyone with anxiety is a candidate for ketamine. But many are. In general, I think about ketamine more seriously when anxiety is persistent despite therapy or medication, when it’s paired with depression, or when patients feel stuck in patterns they understand intellectually but can’t shift physiologically.
How Ketamine Works Differently Than Anxiety Medications
Most anxiety medications — SSRIs, SNRIs, even benzodiazepines — work by modulating serotonin, norepinephrine, or GABA. Ketamine takes a fundamentally different path. It’s an NMDA receptor antagonist, meaning it blocks a specific glutamate receptor in the brain. This triggers a cascade: glutamate surges in the synapse, AMPA receptors activate, and BDNF — brain-derived neurotrophic factor — is released. Think of BDNF as fertilizer for neural connections. It promotes the growth of new synaptic pathways in circuits that anxiety tends to shrink and stiffen over time.
What does that mean practically? Whereas an SSRI might take six weeks to produce any mood shift, ketamine can initiate changes within hours. In patients with generalized anxiety disorder (GAD), social anxiety disorder, and panic disorder, researchers have observed rapid reductions in anxiety severity — sometimes after a single infusion (Yavi et al., 2022). That speed is not just a convenience. For someone who’s spent years fighting a nervous system that won’t quiet down, it can be profoundly meaningful.
Have you ever had the experience of your mind suddenly going quiet, just for a moment, and realizing you hadn’t felt that way in years? That’s something my patients describe after their first infusion more often than I expected. If you’re curious about what to expect, our post on what a ketamine journey feels like offers a detailed, honest account.
What the Research Actually Shows
The evidence base for ketamine and anxiety is smaller than the depression literature, but it’s been growing steadily, and the signal is strong. Yavi et al. (2022) published a comprehensive review finding that ketamine produced significant, rapid anxiolytic effects across multiple anxiety subtypes — not just as a secondary outcome of treating co-occurring depression, but as a primary effect in its own right. Importantly, for patients whose anxiety is intertwined with depression (which describes most of the anxious patients I see), ketamine addresses both simultaneously — a pharmacological two-for-one that standard medications rarely achieve.
There’s also the matter of how ketamine affects the fear response. The amygdala — the brain’s threat-detection center — is hyperactive in anxiety disorders. Research into ketamine’s neural effects suggests it modulates amygdala reactivity, reducing the hair-trigger response that keeps anxious people on constant alert (Fava et al., 2020). This is why some patients describe not just feeling less anxious, but feeling like they’re responding to the world differently. Less braced. Less anticipatory.
That clinical shift — from braced to open — is something I can see in the room during integration sessions after infusions. There’s a loosening that’s different from sedation. Presence. And it’s what makes the window after ketamine infusions so valuable for therapeutic work. For more on making the most of that window, read our guide on best practices for post-ketamine integration.
What About Cost and Insurance?
I want to be honest here. Ketamine infusions are not covered by most commercial insurance policies for anxiety, and cost is a real barrier. At OC Ketamine Therapy, individual infusions range in cost, and a typical initial series involves six sessions. That initial series is designed to create momentum — both biologically and psychologically — rather than approaching treatment as isolated, one-off sessions.
We offer financing options through CareCredit, and many patients use HSA or FSA funds. I believe strongly that the financial conversation should happen upfront and transparently — not after someone has emotionally committed to a course of treatment.
For patients with anxiety only (no co-occurring depression), I want to be clear that the evidence, while promising, is less established than for treatment-resistant depression. Ketamine is not a cure — it’s a catalyst. In my practice, we think about ketamine as opening a window — not fixing the system on its own. What matters is what happens next. That window of neuroplasticity is where patterns can shift, but only if it’s paired with intention, awareness, and integration. Without that, even a powerful biological intervention can fade. With it, the experience can translate into durable change.
Is it right for you? That’s something we evaluate together in a real consultation. If you’ve been dismissed, undertreated, or told your anxiety is “just how you are,” you aren’t out of options. The next step is to schedule a consultation with me to determine whether ketamine therapy fits your specific history and goals.
References
1. Yavi M et al. (2022). Ketamine treatment for depression: a review. Discover Mental Health. https://doi.org/10.1007/s44192-022-00012-3
2. Fava M et al. (2020). Double-blind, placebo-controlled, dose-ranging trial of intravenous ketamine as adjunctive therapy in treatment-resistant depression (TRD). Molecular Psychiatry. https://doi.org/10.1038/s41380-018-0256-5
3. Jha MK et al. (2024). Ketamine vs Electroconvulsive Therapy for Treatment-Resistant Depression: A Secondary Analysis of a Randomized Clinical Trial. JAMA Network Open. https://doi.org/10.1001/jamanetworkopen.2024.17786
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. Dr. Seif is board-certified in Emergency Medicine and 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 content is for informational purposes only and does not constitute medical advice, diagnosis, or treatment. If you are experiencing a mental health crisis or having thoughts of self-harm, please call or text 988 (Suicide and Crisis Lifeline) or go to your nearest emergency room immediately. Always consult with a qualified healthcare provider before starting any new treatment or making changes to your existing treatment plan. Individual results may vary, and no outcomes are guaranteed.