Anxiety disorders are among the most common mental health conditions in the United States. National survey data estimate that 19.1% of U.S. adults experienced an anxiety disorder in the past year, and anxiety can significantly interfere with work, relationships, and daily life (National Institute of Mental Health [NIMH], n.d.).

For some people, standard approaches such as therapy and medication do not bring adequate relief. At Soft Reboot Wellness in Menlo Park, California, we have seen growing interest from Bay Area patients—including professionals managing high-stakes careers while living with debilitating anxiety—in whether IV ketamine therapy might offer another clinical option.

What Research Says About Ketamine for Anxiety

The evidence base for ketamine in anxiety disorders is younger and smaller than the evidence base for depression, but it is growing. Systematic reviews have identified early evidence of anxiety symptom reduction following ketamine treatment in some anxiety-spectrum conditions, while also emphasizing the limited number of trials, small samples, and need for further research (Whittaker et al., 2021; Tully et al., 2022).

Published research has included patients with generalized anxiety disorder, social anxiety disorder, and anxiety symptoms occurring alongside depression. A small randomized trial in social anxiety disorder found greater symptom reduction following ketamine than placebo, but this was a proof-of-concept study rather than definitive evidence for broad clinical use (Taylor et al., 2018).

The mechanisms proposed to explain these effects overlap with those studied in depression: NMDA receptor antagonism, glutamate-related signaling, and downstream changes associated with synaptic plasticity (Abdallah et al., 2016). To understand more about the biological pathways involved, see our overview of the science behind ketamine therapy and its impact on mental health. The full relationship between these mechanisms and anxiety outcomes remains an active area of research.

What the Evidence Does and Does Not Support

It is essential to be transparent about what the evidence currently supports. IV ketamine for anxiety is used off-label, meaning it is not FDA-approved for anxiety disorders. Ketamine itself is FDA-approved as an anesthetic, while its psychiatric uses require individualized clinical judgment and informed consent (National Institute on Drug Abuse, 2024).

The clinical trials are promising but smaller and more preliminary than the depression literature, and the durability of anxiolytic effects from ketamine remains an important area of investigation (Whittaker et al., 2021; Tully et al., 2022).

At Soft Reboot Wellness, Dr. Sara Herman, MD discusses the current state of the evidence with each patient considering ketamine for anxiety—not to discourage treatment, but to ensure that the decision is fully informed. Genuine informed consent is a non-negotiable part of how we practice medicine. Patients who want to learn more about how ketamine compares to other pharmacological options can also explore our post on comparing ketamine versus SSRI treatment.

Anxiety in High-Pressure Environments

Many people seeking care for anxiety have managed their symptoms for years through a combination of therapy, medication, and sheer willpower. The productivity culture of Silicon Valley can create particular pressures for people living with health anxiety, social anxiety, perfectionism-driven generalized anxiety, or panic symptoms that have been carefully hidden from colleagues and sometimes from family.

When standard treatments have provided only partial relief, patients may begin considering interventional options and looking for information that is clinically grounded and honest about the limits of current research.

What an IV Ketamine Treatment Course May Involve

IV ketamine treatment at Soft Reboot Wellness is individualized. The number, timing, and pacing of sessions are determined through consultation, clinical response, treatment goals, and ongoing assessment rather than a fixed protocol for every patient.

During an infusion, patients may experience dissociation, visual or perceptual changes, and a dreamlike state. These effects are time-limited and monitored throughout the session. Dr. Herman personally administers and monitors treatments, with attention to both physiological safety and the patient’s experience.

Many anxiety patients find the anticipation of the infusion experience anxiety-provoking, which is understandable. Our team helps patients prepare for what to expect during ketamine therapy before their first session, including practical questions about the treatment environment, recovery period, and ride-home planning.

Considering Stellate Ganglion Block for Anxiety

Soft Reboot Wellness also offers Stellate Ganglion Block (SGB) as a separate interventional option for some patients experiencing anxiety, hyperarousal, chronic stress, or sympathetic nervous system dysregulation.

Not every patient is a candidate for ketamine, SGB, or a combined approach. Dr. Herman evaluates each person’s medical history, symptoms, medications, and treatment goals before making recommendations. The decision about whether an interventional approach is appropriate belongs in a thorough consultation, not in a blog post.

Cost, Preparation, and Ongoing Care

Two barriers deserve acknowledgment.

First, some anxiety patients are concerned that ketamine’s dissociative effects will feel anxiety-inducing rather than therapeutic. The experience can be uncomfortable for some people, particularly those with significant anticipatory anxiety. Preparation gives patients the opportunity to ask questions, understand what may occur, and decide whether treatment feels appropriate for them.

Second, cost matters. Insurance coverage for IV ketamine for psychiatric indications is inconsistent, and the out-of-pocket investment requires honest planning. We discuss pricing transparently from the beginning.

Results vary by individual, and we do not make promises about anxiety outcomes. What we offer is physician oversight, honest evidence communication, and individualized care for patients who are ready to explore their options. Please discuss with your provider whether IV ketamine therapy is appropriate for your anxiety profile before making treatment decisions.

FAQ

What types of anxiety disorders might benefit from IV ketamine?

Published research has included patients with generalized anxiety disorder, social anxiety disorder, and anxiety symptoms occurring alongside depression. The research base remains limited, and whether ketamine is appropriate for a specific anxiety diagnosis depends on your individual history and is assessed during consultation with Dr. Herman.

How rapidly does IV ketamine work for anxiety?

Some research has observed anxiety symptom changes within the first day after treatment, although response timing varies substantially between individuals (Whittaker et al., 2021; Taylor et al., 2018). Some people experience more gradual change over an initial series of infusions. Treatment is evaluated as a whole rather than based on the response to any single session.

Could ketamine make my anxiety worse?

The dissociative experience during an infusion can be uncomfortable for some people, especially those with strong anticipatory anxiety. A careful intake evaluation, discussion of expectations, and ongoing monitoring help determine whether treatment is appropriate for your situation.

How does IV ketamine for anxiety compare to benzodiazepines?

They are distinct medications with different mechanisms, risks, dosing patterns, and clinical roles. Ketamine is administered in discrete, supervised infusion sessions rather than as a daily medication. Do not stop, start, or change prescribed medication without guidance from the clinician managing your care.

Should I combine IV ketamine with therapy for anxiety?

Many patients choose to continue working with an existing therapist or psychiatrist while considering ketamine treatment. Soft Reboot Wellness can coordinate care with outside providers when appropriate and with your consent. Discuss with your provider how any new treatment may fit into your existing care plan.

Key Takeaways

• IV ketamine has a growing, though still developing, evidence base for anxiety disorders and anxiety-spectrum symptoms.
• Ketamine for anxiety is used off-label and is not FDA-approved for anxiety disorders.
• Soft Reboot Wellness in Menlo Park offers physician-led ketamine therapy under Dr. Sara Herman, MD, with individualized monitoring throughout treatment.
• Treatment planning, including the number and timing of infusions, is individualized rather than based on a single fixed protocol.
• Results vary by individual; preparation, coordination with existing providers, and transparent cost discussions are part of the consultation process.

Conclusion

Anxiety that persists despite standard treatment is not a character flaw. For some patients, it may be appropriate to explore additional options with a qualified medical provider.

At Soft Reboot Wellness in Menlo Park, we bring physician-led care, individualized evaluation, and transparent evidence communication to conversations about IV ketamine therapy for anxiety. If you are a Bay Area patient living with significant anxiety despite medications and therapy, discuss your options with your provider and contact our team to explore whether a consultation is appropriate.

References

Abdallah, C. G., Adams, T. G., Kelmendi, B., Esterlis, I., Sanacora, G., & Krystal, J. H. (2016). Ketamine’s mechanism of action: A path to rapid-acting antidepressants. Depression and Anxiety, 33(8), 689–697.

National Institute on Drug Abuse. (2024, April 9). Ketamine. https://nida.nih.gov/research-topics/ketamine

National Institute of Mental Health. (n.d.). Any anxiety disorder. https://www.nimh.nih.gov/health/statistics/any-anxiety-disorder

Taylor, J. H., Landeros-Weisenberger, A., Coughlin, C., et al. (2018). Ketamine for social anxiety disorder: A randomized, placebo-controlled crossover trial. Neuropsychopharmacology, 43(2), 325–333. https://doi.org/10.1038/npp.2017.194

Tully, J. L., Dahlén, A. D., Haggarty, C. J., Schiöth, H. B., & Brooks, S. (2022). Ketamine treatment for refractory anxiety: A systematic review. British Journal of Clinical Pharmacology, 88(10), 4412–4426.

Whittaker, E., Dadabayev, A. R., Joshi, S. A., & Glue, P. (2021). Systematic review and meta-analysis of randomized controlled trials of ketamine in the treatment of refractory anxiety spectrum disorders. Therapeutic Advances in Psychopharmacology, 11, 20451253211056743.

About Dr. Sara Herman

Dr. Sara Herman, MD, is a Harvard-trained, board-certified anesthesiologist and the founder of Soft Reboot Wellness. Her clinical experience in ketamine administration, pharmacology, and patient monitoring shapes each treatment plan, from dosing and preparation to physiological monitoring throughout the infusion experience.

At Soft Reboot Wellness, Dr. Herman provides a physician-led approach for patients exploring ketamine therapy, grounded in individualized assessment, informed consent, and evidence-informed care.

Medical Disclaimer

The content provided on this page is for educational purposes only and does not constitute medical advice. IV ketamine therapy for anxiety disorders is used off-label and is not FDA-approved for these indications. Individual results vary, and not every patient is an appropriate candidate. This information should not replace a consultation with a qualified medical provider. Please discuss with your provider whether any treatment described here is appropriate for your specific health situation. Soft Reboot Wellness serves patients in Menlo Park, CA and the greater Bay Area.

The post Ketamine Therapy for Anxiety Disorders: What the Research Says and Who May Benefit appeared first on Soft Reboot Wellness.

Post-traumatic stress disorder affects an estimated 3.6% of U.S. adults in a given year, and symptoms can range from intrusive memories and avoidance to hypervigilance, sleep disruption, and persistent distress (National Institute of Mental Health [NIMH], n.d.). Evidence-based PTSD care includes trauma-focused psychotherapies such as Cognitive Processing Therapy, Eye Movement Desensitization and Reprocessing, and Prolonged Exposure; some people, however, continue to experience significant symptoms despite prior treatment (U.S. Department of Veterans Affairs & U.S. Department of Defense [VA/DoD], 2023).

Stellate ganglion block (SGB), a nerve block procedure with a long history in pain medicine, has drawn growing interest as an emerging intervention for PTSD-related symptoms and anxiety. At Soft Reboot Wellness in Menlo Park, California, we offer Stellate Ganglion Block treatments for patients who may benefit from a physician-led evaluation of persistent fight-or-flight activation.

How Stellate Ganglion Block Works

The stellate ganglion is a collection of sympathetic nerves in the lower neck that is involved in regulating aspects of the body’s fight-or-flight response. An SGB involves injecting local anesthetic near this nerve cluster under image guidance.

The precise mechanism by which SGB may affect PTSD symptoms is not established. Researchers have proposed that temporarily interrupting sympathetic nerve signaling may influence stress-related pathways connected to brain regions involved in threat processing. A nerve growth factor-based explanation has also been proposed, but it remains a hypothesis rather than a confirmed explanation for how individual patients may respond (U.S. Department of Defense, 2021).

At Soft Reboot Wellness, SGB is performed using real-time ultrasound guidance. Dr. Sara Herman, MD, is a board-certified anesthesiologist and founder of Soft Reboot Wellness. Patients who want to understand whether PTSD is classified as a major mental illness and how that shapes treatment planning may find that background helpful before their consultation.

What the Research Shows for PTSD

The evidence base for SGB in PTSD is promising but still developing.

A 2016 randomized, double-blind trial did not find a significant difference between SGB and sham treatment for PTSD symptoms. A later multisite randomized clinical trial involving active-duty service members found that two SGB treatments, administered two weeks apart, were associated with greater reductions in PTSD symptom severity over eight weeks than sham treatment (Hanling et al., 2016; Rae Olmsted et al., 2020).

Because the trials have produced mixed results and remain limited in size and follow-up duration, the 2023 VA/DoD Clinical Practice Guideline concluded that there is insufficient evidence to recommend for or against SGB for PTSD (VA/DoD, 2023).

That does not mean an individualized consultation lacks value. It means that candidacy, potential risks, realistic expectations, and established PTSD treatment options should all be part of the conversation.

For a deeper overview of this topic, see our article on Stellate Ganglion Block for PTSD.

What We Know About SGB for Anxiety

Research on SGB for anxiety is less developed than the PTSD literature. One published case series of 285 patients reported reduced anxiety scores after treatment, but case-series findings cannot establish that SGB caused the improvement or predict how another individual will respond (Lynch et al., 2023).

At Soft Reboot Wellness, anxiety-related symptoms such as hyperarousal, panic symptoms, chronic stress, and persistent fight-or-flight activation are evaluated in the context of each patient’s medical history, current medications, mental health care, and treatment goals.

SGB is not appropriate for every patient with PTSD or anxiety. A consultation is the appropriate setting to determine whether the procedure should be considered.

What the Procedure May Involve

SGB is an outpatient procedure and does not require general anesthesia. Patients remain awake while the physician uses ultrasound guidance to place a needle near the stellate ganglion and administer local anesthetic.

The injection itself is relatively brief, though the overall appointment includes preparation, monitoring, and recovery time. After treatment, patients may experience temporary effects such as drooping of the eyelid, facial warmth, dry throat, or mild hoarseness on the treated side. These effects are generally expected to resolve, but SGB is still an invasive procedure with potential risks that should be discussed in advance (Goel et al., 2019).

Soft Reboot Wellness asks patients to arrange transportation home after the procedure. Patients can learn more about practical preparation, the treatment environment, and recovery planning in our guide to what to expect with an SGB injection.

SGB Compared With Ketamine Therapy

A common question from Bay Area patients is how SGB compares with IV ketamine therapy for PTSD.

These are distinct interventions with different mechanisms, procedures, and evidence bases. SGB is a nerve block intended to affect sympathetic nervous system activity, while IV ketamine is a medication administered through monitored infusion. Neither option should be treated as interchangeable or as a replacement for established trauma-focused care.

Some patients may be candidates for one intervention and not the other. In some situations, Dr. Herman may discuss how different treatments could fit into a broader care plan. For a closer look at how ketamine has been studied in this context, our post on how ketamine infusion therapy is helping patients with PTSD provides useful background. However, there is not an established evidence base showing that a combined approach is appropriate or more effective for every person.

Schedule, Cost, and Expectations

SGB may be a practical consideration for people balancing treatment with demanding work or family responsibilities because it is performed as an outpatient procedure. Recovery instructions and return-to-activity timing are individualized.

Cost and insurance coverage are also important considerations. Insurance coverage for SGB related to PTSD or anxiety is not routine, so patients should receive clear information before deciding whether to proceed. Soft Reboot Wellness discusses SGB pricing during the consultation process.

Results vary by individual. Some patients report changes soon after treatment, while others may notice more gradual change or may not experience meaningful benefit. A second procedure may be discussed based on clinical response, but no patient should expect a guaranteed outcome.

For more information about timing and individual variation, read how long it can take an SGB to work.

FAQ

Is Stellate Ganglion Block FDA-approved for PTSD?
SGB is a procedure rather than an FDA-approved medication. Its use for PTSD or anxiety is an emerging clinical application, and the current VA/DoD guideline concludes that there is insufficient evidence to recommend for or against SGB for PTSD (VA/DoD, 2023).

Does the injection hurt?
The procedure includes local numbing medication, though patients may still feel pressure or brief discomfort. Temporary effects can include hoarseness, dry throat, eyelid drooping, facial warmth, or soreness at the injection site. Your physician should review both common temporary effects and less common procedural risks before treatment (Goel et al., 2019).

How many SGB procedures will I need?
The number of procedures is individualized. Some patients may discuss a second treatment depending on their response, symptom profile, and clinical assessment. No specific number of procedures is appropriate for everyone.

How quickly does SGB work for PTSD?
Response timing varies. Clinical trials have evaluated symptom changes over weeks rather than establishing a single expected timeline for every patient. Some people may notice changes earlier, while others may experience gradual change or no meaningful improvement.

Can SGB be combined with ketamine therapy?
A physician may discuss whether multiple interventions fit into your broader care plan. However, treatment decisions should be individualized, and current evidence does not establish a standard combined protocol for PTSD or anxiety.

Key Takeaways

• SGB is an image-guided nerve block procedure that may be considered for PTSD-related hyperarousal, anxiety, and persistent fight-or-flight activation.
• Research on SGB for PTSD includes mixed randomized trial findings, and current VA/DoD guidance concludes that evidence is insufficient to recommend for or against it for PTSD.
• Research on SGB for anxiety remains limited and is based largely on observational evidence.
• Soft Reboot Wellness offers ultrasound-guided SGB in Menlo Park under physician supervision.
• Candidacy, risks, timing, cost, and expected outcomes should be discussed during an individualized consultation.
• Results vary, and SGB should not be presented as a guaranteed or universal solution for PTSD or anxiety.

Conclusion

For Bay Area patients living with PTSD or persistent anxiety, Stellate Ganglion Block may be one option to discuss within a broader, individualized treatment plan. The procedure has generated meaningful interest, but current evidence still calls for careful patient selection, realistic expectations, and ongoing research.

At Soft Reboot Wellness in Menlo Park, Dr. Sara Herman provides physician-led SGB consultations and treatment using ultrasound guidance. To explore whether a consultation is appropriate for your situation, contact our team to schedule a consultation.

References

Goel, V., Patwardhan, A. M., Ibrahim, M., Howe, C. L., Schultz, D. M., & Shankar, H. (2019). Complications associated with stellate ganglion nerve block: A systematic review. Regional Anesthesia and Pain Medicine, 44(6), 669–678.

Hanling, S. R., Hickey, A., Lesnik, I., Hackworth, R. J., Stedje-Larsen, E., Drastal, C. A., & McLay, R. N. (2016). Stellate ganglion block for the treatment of posttraumatic stress disorder: A randomized, double-blind, controlled trial. Regional Anesthesia and Pain Medicine, 41(4), 494–500.

Lynch, J. H., Mulvaney, S. W., Bryan, C. J., & Hernandez, D. (2023). Stellate ganglion block reduces anxiety symptoms by half: A case series of 285 patients. Journal of Personalized Medicine, 13(6), 958.

National Institute of Mental Health. (n.d.). Post-traumatic stress disorder. https://www.nimh.nih.gov/health/statistics/post-traumatic-stress-disorder-ptsd

Rae Olmsted, K. L., Bartoszek, M., Mulvaney, S., McLean, B., Turabi, A., Young, R. A., & others. (2020). Effect of stellate ganglion block treatment on posttraumatic stress disorder symptoms: A randomized clinical trial. JAMA Psychiatry, 77(2), 130–138.

U.S. Department of Defense. (2021). Stellate ganglion block for posttraumatic stress disorder. Psychological Health Center of Excellence. https://health.mil/Reference-Center/Publications/2021/04/26/PHCoE-Evidence-Brief-Stellate-Ganglion-Block-for-Posttraumatic-Stress-Disorder-508

U.S. Department of Veterans Affairs & U.S. Department of Defense. (2023). VA/DoD clinical practice guideline for the management of posttraumatic stress disorder and acute stress disorder. https://www.healthquality.va.gov/guidelines/MH/ptsd/VA-DoD-CPG-PTSD-Quick-Reference-Guide.pdf

About Dr. Sara Herman

Dr. Sara Herman, MD, is a board-certified anesthesiologist and the founder of Soft Reboot Wellness. Her background in anesthesiology informs the individualized assessment, ultrasound-guided technique, and monitoring approach used for Stellate Ganglion Block procedures.

At Soft Reboot Wellness, Dr. Herman provides physician-led care for patients exploring interventional options for PTSD, anxiety, and nervous system dysregulation.

Medical Disclaimer

The content provided on this page is for educational purposes only and does not constitute medical advice. Stellate Ganglion Block may not be appropriate for every patient with PTSD or anxiety. Individual results vary, and this information should not replace a consultation with a qualified medical provider. Please discuss with your provider whether any treatment described here is appropriate for your specific health situation. Soft Reboot Wellness serves patients in Menlo Park, CA and the greater Bay Area.

The post Stellate Ganglion Block for PTSD and Anxiety: What Bay Area Patients Should Know appeared first on Soft Reboot Wellness.