Nutritional status can be clinically relevant for people living with depression or anxiety. Low dietary magnesium intake and low blood levels of some nutrients have been associated with depressive symptoms in observational research, but these associations do not establish that a particular deficiency is the cause of an individual’s symptoms (Tarleton & Littenberg, 2015; National Institutes of Health Office of Dietary Supplements [NIH ODS], 2022).

Research on B vitamins and vitamin D as adjuncts to standard depression or anxiety care is still developing. A systematic review of randomized controlled trials found potentially helpful results in some studies, while also noting that outcomes vary by nutrient, dosage, clinical context, and study design (Borges-Vieira & Souza Cardoso, 2023).

At Soft Reboot Wellness in Menlo Park, California, we offer vitamin infusions as supportive care within a broader, physician-led integrative approach. It is important to understand where nutritional IV therapy may fit—and where its limits are.

Vitamin Infusions as Supportive Care

Vitamin infusions are not independent treatments for depression or anxiety. In the context of mental health care, they may be considered as adjunctive support when an individual’s health history, nutritional status, symptoms, medications, and relevant laboratory findings suggest that nutritional repletion should be part of the broader clinical picture.

Soft Reboot Wellness also offers IV ketamine therapy and Stellate Ganglion Block for patients who may be appropriate candidates. Nutritional IV therapy should not be presented as a replacement for evidence-based mental health treatment, psychotherapy, medication management, or a comprehensive medical evaluation.

What Nutrient Research Can—and Cannot—Tell Us

Magnesium, B vitamins, and vitamin D all have recognized roles in normal neurological and metabolic function. However, the relationship between nutrient levels and mood is complex.

For example, very low magnesium intake has been associated with depression in population research, but that finding does not prove that magnesium supplementation will improve mood for every person with depression (Tarleton & Littenberg, 2015).

Vitamin D is also relevant to overall health and brain function. Some studies have identified an association between lower vitamin D levels and depression risk, but clinical trials have not shown that vitamin D supplementation prevents or consistently eases depressive symptoms (NIH ODS, 2022).

Vitamin B12 deficiency can contribute to fatigue and neurological changes, and some studies have found associations between low B12 status and depression. Identifying and treating a confirmed deficiency is important medical care, but B12 supplementation should not be assumed to improve mood or cognition when a deficiency is not present (NIH ODS, 2025).

When IV Delivery May Be Considered

IV delivery is one route of nutrient administration. It may be considered when a clinician identifies a specific clinical reason for parenteral treatment, such as a documented deficiency or concerns about absorption.

IV therapy is not automatically superior to oral supplementation for every patient. For vitamin B12, for example, high-dose oral supplements can normalize serum B12 levels for many people, including some with absorption-related concerns (NIH ODS, 2025).

The appropriate route, formulation, and frequency depend on the nutrient involved and the person’s individual health needs. IV delivery does not itself establish a mental health benefit.

Vitamin Infusion Options at Soft Reboot Wellness

Soft Reboot Wellness currently offers several infusion and injection options, including B-complex vitamins, NAD+, vitamin C, glutathione, methylated vitamin B12, vitamin D, alpha lipoic acid, hydration, and multi-nutrient IV formulations.

The appropriate option should be determined through individual clinical assessment. Dr. Sara Herman, MD, ABOIM considers the broader medical and mental health picture when discussing whether nutritional support may have a meaningful role in care.

Appointment length varies by formulation and treatment plan. NAD+ infusions, for example, are administered more slowly than some other infusion options.

Vitamin Infusions and Ketamine Treatment

For patients undergoing ketamine treatment, nutritional status may be one aspect of a broader care plan that also includes sleep, nutrition, therapy, integration, medication review, and ongoing support.

There is not enough direct clinical evidence to say that vitamin infusions improve ketamine outcomes. Nutritional IV therapy should not be presented as a method for enhancing ketamine’s effectiveness. Instead, it may be considered when there is a clear clinical reason to address nutritional needs as part of individualized care.

Cost and Treatment Planning

Vitamin infusions and injections may involve out-of-pocket costs, and coverage can vary. We discuss pricing transparently so patients can decide whether nutritional support fits their overall treatment plan.

The goal is not to add interventions for their own sake. It is to consider whether an option has a clear and appropriate role in your individual care.

If you are already a patient at Soft Reboot Wellness or are considering treatment, you can discuss questions about vitamin infusion support during consultation.

FAQ

Are vitamin infusions a treatment for depression or anxiety?

No. Vitamin infusions are not established standalone treatments for depression or anxiety. They may be considered as supportive care when a clinician identifies a nutritional need that is relevant to your overall health and treatment plan.

Which vitamins and minerals are typically included in your infusions?

Soft Reboot Wellness offers options that include B-complex vitamins, NAD+, vitamin C, glutathione, methylated vitamin B12, vitamin D, alpha lipoic acid, hydration, and multi-nutrient IV formulations. The appropriate option depends on individual clinical assessment.

Why use IV delivery rather than oral supplements?

IV delivery may be considered for certain documented deficiencies or absorption-related concerns. However, IV therapy is not necessary for everyone, and oral supplementation may be appropriate in many situations. The best route depends on the nutrient, your health history, and your clinician’s assessment.

How often would I receive vitamin infusions?

Frequency depends on the specific infusion or injection, your health history, relevant laboratory findings, and clinical goals. A schedule should be individualized rather than based on a standard mental health protocol.

Can vitamin infusions improve the effectiveness of IV ketamine therapy?

There is not enough direct clinical evidence to say that vitamin infusions improve ketamine outcomes. Nutritional support may be discussed as one component of a broader care plan when clinically appropriate.

Key Takeaways

• Vitamin infusions may serve a supportive role within broader medical and mental health care, but they are not standalone treatments for depression or anxiety.
• Nutritional deficiencies should be identified and treated when clinically indicated, but an association between nutrient status and mood does not prove that an infusion will improve psychiatric symptoms.
• Research on B vitamins and vitamin D as adjuncts to mental health care is still developing and varies by nutrient and clinical context.
• IV delivery may be appropriate for some patients, but it is not automatically superior to oral supplementation.
• Soft Reboot Wellness offers individualized conversations about whether nutritional support has an appropriate role in a patient’s broader care plan.

Conclusion

Addressing nutritional status is not the whole answer to depression or anxiety. For patients with a documented deficiency or specific clinical need, however, it may be one piece of a more complete care plan.

At Soft Reboot Wellness in Menlo Park, vitamin infusions are considered within the context of individualized, physician-led care. To discuss whether nutritional support may be appropriate for your situation, please speak with your provider and contact our team.

References

• Borges-Vieira, J. G., & Souza Cardoso, C. K. (2023). Efficacy of B-vitamins and vitamin D therapy in improving depressive and anxiety disorders: A systematic review of randomized controlled trials. Nutritional Neuroscience, 26(3), 187–207.
• National Institutes of Health, Office of Dietary Supplements. (2022). Vitamin D fact sheet for consumers.
• National Institutes of Health, Office of Dietary Supplements. (2025). Vitamin B12 fact sheet for health professionals.
• Tarleton, E. K., & Littenberg, B. (2015). Magnesium intake and depression in adults. Journal of the American Board of Family Medicine, 28(2), 249–256.

About Dr. Sara Herman

Dr. Sara Herman, MD, ABOIM, is a Harvard-trained, board-certified anesthesiologist and board-certified integrative medicine physician. She founded Soft Reboot Wellness to provide individualized, physician-led care for patients exploring ketamine therapy, Stellate Ganglion Block, and supportive integrative options.

Her clinical approach emphasizes informed decision-making, careful assessment, and treatment plans that consider the full medical and mental health picture.

Medical Disclaimer
The content provided on this page is for educational purposes only and does not constitute medical advice. Vitamin infusions are not established treatments for depression or anxiety. Individual results vary, and nutritional IV therapy may not be appropriate for every patient. 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 Vitamin Infusions for Mental Health Support: What Bay Area Patients Should Understand appeared first on Soft Reboot Wellness.

Roughly one in three people with major depressive disorder experience treatment-resistant depression, commonly defined as an inadequate response to at least two adequate antidepressant trials (McIntyre et al., 2023). For people who have spent years cycling through antidepressants without meaningful relief, learning that a different biological approach exists can be an important part of the conversation.

At Soft Reboot Wellness in Menlo Park, California, we offer physician-supervised IV ketamine therapy for treatment-resistant depression. Dr. Sara Herman, MD, a Harvard-trained anesthesiologist, has guided more than 10,000 patients through anesthesia, pain management, and ketamine therapy. We want patients across the Bay Area to understand what this treatment actually involves.

A Different Biological Approach to Depression

Treatment-resistant depression is not a diagnosis of hopelessness. It is a clinical category that describes inadequate relief from prior treatment, not a prediction of what is possible next.

Unlike antidepressants that primarily target monoamine neurotransmitter systems, ketamine works through a distinct biological mechanism. Its proposed antidepressant effects involve NMDA receptor antagonism in the glutamate system, along with downstream changes in BDNF signaling and synaptic plasticity (Abdallah et al., 2016). Landmark research and later randomized trials found that antidepressant effects may emerge within hours to days for some patients, rather than over the weeks often associated with conventional antidepressants (Berman et al., 2000; Murrough et al., 2013). To understand this mechanism in greater depth, our educational ketamine science resource offers a thorough overview of how ketamine interacts with the brain.

Off-Label Use and Individual Candidacy

It is essential to be precise: IV ketamine is used off-label for psychiatric indications. It is not FDA-approved for the treatment of depression. Published evidence has supported its use in some treatment-resistant mood disorders, while expert consensus also emphasizes careful screening, informed consent, monitoring, and attention to the limitations of the available evidence (Sanacora et al., 2017).

The clinical question for any individual patient is not whether ketamine works in general, but whether it is appropriate, safe, and likely to be beneficial for their specific situation. Our blog post on comparing ketamine versus SSRI treatment provides further context on how these approaches differ and when each may be considered.

Why Physician-Led Care Matters

This is where the physician you work with matters enormously. Dr. Sara Herman founded Soft Reboot Wellness after guiding more than 10,000 patients through anesthesia, pain management, and ketamine therapy. Her anesthesiology training and experience with ketamine administration inform the individualized dosing, physiological monitoring, and supportive care provided during each infusion.

Precision dosing, physiological monitoring, and proactive management of the infusion experience are central to a physician-led practice.

What an IV Ketamine Treatment Course May Involve

At Soft Reboot Wellness, an initial treatment course is individualized. Current protocols commonly involve four to six infusions scheduled weekly over four to six weeks, with treatment planning tailored to each patient’s symptoms, goals, and clinical response.

Sessions may run from approximately 45 minutes to two hours depending on the treatment protocol. During an infusion, patients may experience mild dissociation, visual or perceptual changes, and a dreamlike state. At subanesthetic doses, patients generally remain conscious, and the acute effects are expected to resolve before discharge (Sanacora et al., 2017).

Many patients find the experience more manageable when they are prepared and in a calm, supportive clinical environment. Our team helps patients understand what to expect during ketamine therapy and remains present throughout treatment to address discomfort if it arises.

Cost, Insurance, and the Infusion Experience

We hear two concerns consistently from patients considering IV ketamine in the Menlo Park and Peninsula area.

The first is cost. Insurance coverage for IV ketamine for psychiatric indications is inconsistent, and the out-of-pocket investment is real. We are transparent about our fees and discuss them fully during consultation. We also recognize that for patients who have spent years and significant resources pursuing mental health treatment without lasting relief, the cost-benefit calculation looks different. We respect each patient’s need to make that decision with full information.

The second concern is what the experience will feel like. Many people are unfamiliar with ketamine outside of its anesthetic or recreational contexts, and the prospect of an altered state can understandably feel anxiety-provoking. We address this directly in every consultation: the experience is time-limited, closely monitored, and discussed in advance.

Individualized Ongoing Treatment Planning

After the initial treatment course, some patients may benefit from periodic maintenance infusions to help sustain an antidepressant response over time. The frequency and duration of maintenance are individualized.

Results vary by individual, and we never guarantee specific outcomes. Our commitment is to provide an evidence-informed, carefully supervised experience and to partner with you in evaluating and adjusting your treatment plan. Please discuss all aspects of treatment planning with your provider, including how ketamine therapy may integrate with ongoing psychiatric care.

Whether you are in Menlo Park, Palo Alto, Redwood City, Mountain View, or elsewhere on the Peninsula, Soft Reboot Wellness is here to provide physician-level care for one of the most difficult mental health challenges patients face. We encourage you to schedule a consultation with our team.

FAQ

How quickly can I expect to feel a difference with IV ketamine?

Clinical studies have observed antidepressant effects as early as 24 hours after an infusion, though the timing and degree of response vary significantly between individuals (Murrough et al., 2013). Some patients respond gradually over the course of an initial treatment series.

Results vary by individual, and treatment is evaluated as a whole rather than based on the response to any single session.

Will I be awake during the infusion?

Yes. IV ketamine for depression is administered at subanesthetic doses, meaning patients generally remain conscious throughout treatment. You may experience dissociation or perceptual changes, but you are not expected to be asleep. Dr. Herman and the clinical team are present throughout each session.

Do I need to stop my current antidepressants to try ketamine?

Do not stop or change prescribed antidepressants on your own. Whether any medication adjustment is appropriate depends on your current regimen, medical history, and psychiatric history. Dr. Herman will review your medications carefully during intake and advise on any adjustments needed before treatment.

How do I know if I am a candidate for IV ketamine therapy?

A consultation with Dr. Herman is the appropriate starting point. In general, treatment-resistant depression commonly refers to depression that has not responded adequately to at least two antidepressant trials (McIntyre et al., 2023). Your complete medical and psychiatric history, current medications, and health status are evaluated during the intake process.

Key Takeaways

• IV ketamine engages the glutamate/NMDA receptor system through a mechanism distinct from conventional antidepressants and may produce rapid antidepressant effects for some patients with treatment-resistant depression.
• IV ketamine is used off-label for psychiatric indications and is not FDA-approved for depression.
• Soft Reboot Wellness in Menlo Park is led by Dr. Sara Herman, MD, a Harvard-trained anesthesiologist with experience guiding more than 10,000 patients through anesthesia, pain management, and ketamine therapy.
• A typical initial Soft Reboot Wellness protocol involves four to six infusions over four to six weeks, followed by individualized maintenance planning when appropriate.
• Results vary by individual; cost and the infusion experience are common concerns that Dr. Herman’s team addresses transparently during consultation.

Conclusion

For patients across the Bay Area who have not found adequate relief from standard depression treatments, IV ketamine therapy represents a biologically distinct, evidence-informed option that deserves serious consideration.

At Soft Reboot Wellness in Menlo Park, the focus is physician-led care that combines anesthesiology experience with individualized dosing and monitoring. If you are ready to explore whether IV ketamine therapy might be the right next step for your mental health, discuss your options with your provider and contact our team to schedule a consultation.

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.

Berman, R. M., Cappiello, A., Anand, A., Oren, D. A., Heninger, G. R., Charney, D. S., & Krystal, J. H. (2000). Antidepressant effects of ketamine in depressed patients. Biological Psychiatry, 47(4), 351–354. https://doi.org/10.1016/S0006-3223(99)00230-9

McIntyre, R. S., Alsuwaidan, M., Baune, B. T., et al. (2023). Treatment-resistant depression: Definition, prevalence, detection, management, and investigational interventions. World Psychiatry, 22(3), 394–412. https://doi.org/10.1002/wps.21120

Murrough, J. W., Iosifescu, D. V., Chang, L. C., et al. (2013). Antidepressant efficacy of ketamine in treatment-resistant major depression: A two-site randomized controlled trial. American Journal of Psychiatry, 170(10), 1134–1142. https://doi.org/10.1176/appi.ajp.2013.13030392

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.

About Dr. Sara Herman

Dr. Sara Herman, MD, is a Harvard-trained anesthesiologist who founded Soft Reboot Wellness after guiding more than 10,000 patients through anesthesia, pain management, and ketamine therapy. Her clinical experience in ketamine administration, pharmacology, and safety shapes every aspect of her practice, from the precision of each infusion to the monitoring protocols that support patients throughout treatment.

At Soft Reboot Wellness, Dr. Herman applies this combination of academic training and hands-on experience to the care of patients with treatment-resistant depression, offering a physician-led approach grounded in individualized assessment 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 is used off-label for psychiatric indications and is not FDA-approved for the treatment of depression. Individual results vary, and not every patient will experience the same outcomes. 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 IV Ketamine Therapy for Treatment-Resistant Depression in Menlo Park: A Physician’s Perspective appeared first on Soft Reboot Wellness.

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 is often described as a disorder of memory—not because patients are imagining their trauma, but because the brain’s threat-processing systems can remain activated long after a traumatic event has passed. PTSD may involve intrusive memories, avoidance, hyperarousal, and persistent distress that affects work, relationships, and daily life (National Center for PTSD, n.d.).

Evidence-based PTSD care commonly includes trauma-focused psychotherapy, such as cognitive processing therapy, eye movement desensitization and reprocessing, or prolonged exposure, as well as selected medications when appropriate (U.S. Department of Veterans Affairs & U.S. Department of Defense, 2023). Still, some people continue to experience substantial symptoms despite prior treatment. If you’re wondering what PTSD really is and how it is diagnosed, our overview covers the fundamentals.

At Soft Reboot Wellness in Menlo Park, we offer IV ketamine therapy as an off-label option for PTSD. For Bay Area patients considering this approach, it is important to understand both the emerging research and its limitations.

What the Research Says About Ketamine for PTSD

The research base for ketamine in PTSD remains limited and mixed, though several studies have reported rapid reductions in PTSD symptom severity following IV ketamine infusion.

A randomized clinical trial of a single IV infusion found lower PTSD symptom severity 24 hours after treatment compared with an active placebo (Feder et al., 2014). A later randomized controlled trial of repeated infusions also found greater short-term improvement in PTSD symptom severity in the ketamine group than in the control group, but the study included only 30 participants and called for further research (Feder et al., 2021).

Recent systematic reviews and meta-analyses suggest ketamine may have potential for PTSD, while emphasizing heterogeneity across studies, limited sample sizes, and uncertainty around long-term outcomes (Almeida et al., 2024; Sicignano et al., 2024).

Ketamine acts on the NMDA receptor and glutamate system. Researchers are studying whether its effects on glutamate signaling, neuroplasticity, and memory processing may help explain observed changes in some PTSD symptoms. These proposed mechanisms remain under investigation and should not be treated as established explanations for every patient response (Abdallah et al., 2016). For a deeper look at the neuroscience involved, our educational ketamine science page provides an accessible overview.

Important Limits of the Current Evidence

It is critical to be precise about what the evidence supports and where its limits lie. IV ketamine for PTSD is off-label. It is not FDA-approved for PTSD or other psychiatric conditions; ketamine itself is FDA-approved as an anesthetic (National Institute on Drug Abuse, 2024).

The current 2023 VA/DoD Clinical Practice Guideline suggests against ketamine as a primary treatment for PTSD because available research has not yet established clear enough benefit relative to its risks and side-effect burden. The same guideline recommends trauma-focused psychotherapies over medication interventions for PTSD treatment (U.S. Department of Veterans Affairs & U.S. Department of Defense, 2023).

This does not make an individualized consultation meaningless. It does mean that careful clinical selection, informed consent, and honest discussion of realistic outcomes are essential.

At Soft Reboot Wellness, Dr. Sara Herman, MD conducts a detailed intake evaluation that includes PTSD symptoms, treatment history, current medications, and relevant medical and psychiatric factors before making any recommendation.

PTSD in High-Pressure Professional Environments

The profile of people seeking PTSD care in the Bay Area is diverse. Some are professionals in technology, finance, healthcare, or other high-pressure fields who have lived with symptoms for years while continuing to meet demanding responsibilities. Others are veterans, first responders, or people whose trauma symptoms have not responded adequately to prior therapy or medication.

High-functioning does not mean unaffected. Many people manage PTSD symptoms privately for a long time before seeking additional support. Understanding how ketamine infusion therapy is helping patients with PTSD can be a useful first step for those who are still weighing their options.

What IV Ketamine Treatment May Involve

Ketamine therapy for PTSD at Soft Reboot Wellness is not a quick fix, and treatment plans are individualized from the beginning.

A standard initial protocol involves four to six IV infusions over four to six weeks, with the number and timing adjusted according to clinical response. Dr. Herman personally administers and monitors infusion sessions, including vital-sign monitoring throughout treatment.

During an infusion, patients may experience dissociation, altered perception of time, or dreamlike imagery. These effects are temporary and generally resolve before discharge. Patients need a ride home after each session.

Our team prepares patients for what to expect during ketamine therapy before the first appointment, including practical questions about the treatment environment, recovery period, and post-session planning.

Ketamine, Psychotherapy, and Ongoing Care

A common question is whether ketamine therapy can be combined with psychotherapy for PTSD. This remains an area of active research and clinical interest.

Some patients choose to continue working with an existing psychologist, trauma therapist, or psychiatrist while considering ketamine treatment. Soft Reboot Wellness can coordinate care with outside providers when appropriate and with patient consent.

Ketamine should not be presented as a replacement for established trauma-focused care. Treatment decisions should consider the full clinical picture, including prior treatment, current supports, medical history, and individual goals.

For a broader overview of the medication’s proposed effects and treatment process, see what ketamine therapy actually does.

Considering Stellate Ganglion Block for PTSD

Soft Reboot Wellness also offers Stellate Ganglion Block (SGB) as a separate option that may be discussed for patients experiencing PTSD-related hyperarousal or sympathetic nervous system dysregulation.

SGB is not interchangeable with ketamine therapy, and not every patient is a candidate for either treatment. Current VA/DoD guidance finds insufficient evidence to recommend for or against SGB for PTSD, so candidacy and expectations should be discussed carefully during consultation (U.S. Department of Veterans Affairs & U.S. Department of Defense, 2023).

Patients interested in learning more can review our overview of Stellate Ganglion Block for PTSD.

Schedule, Cost, and Practical Considerations

Two practical barriers are worth addressing directly.

The first is schedule. An initial infusion series requires time for appointments, recovery, and follow-up planning. Soft Reboot Wellness works to offer appointment availability that accommodates demanding professional schedules.

The second is cost. IV ketamine therapy for PTSD is off-label, and insurance coverage is not standard. We discuss pricing transparently during consultation so patients can make informed financial decisions.

Results vary by individual, and we do not make promises about PTSD outcomes. Our role is to provide physician-led care, transparent evidence communication, and individualized assessment for patients exploring their options.

FAQ

Is ketamine therapy for PTSD covered by insurance?
Insurance coverage for IV ketamine therapy for PTSD is not standard and varies by plan. Our team discusses fees and practical considerations during consultation so you can make an informed decision.

What PTSD symptoms does ketamine specifically target?
Clinical studies generally assess changes in overall PTSD symptom severity. Research has not established that ketamine will improve any specific symptom for every patient. Individual responses can vary.

Can I continue my current PTSD medications during ketamine therapy?
Do not stop or change prescribed medications on your own. Dr. Herman reviews your complete medication list during intake and will discuss whether any changes or additional considerations are appropriate before treatment.

How does ketamine for PTSD differ from ketamine for depression?
The infusion process may appear similar, but PTSD and depression involve different symptom patterns and evidence bases. Some people experience both conditions, and treatment planning should account for the full clinical picture rather than treating diagnoses in isolation.

Are there people with PTSD who should not receive IV ketamine therapy?
Yes. Candidacy depends on a person’s medical history, psychiatric history, current medications, trauma history, and other individual factors. A thorough medical and psychiatric review helps determine whether ketamine therapy is appropriate.

Key Takeaways

• IV ketamine for PTSD is off-label and is not FDA-approved for PTSD.
• Small randomized trials and systematic reviews suggest potential short-term symptom improvement, but the evidence remains limited and mixed.
• Current VA/DoD guidance prioritizes trauma-focused psychotherapy for PTSD and suggests against ketamine as a primary PTSD treatment.
• Soft Reboot Wellness offers physician-led IV ketamine therapy under Dr. Sara Herman, MD, with individualized monitoring and candidacy review.
• A typical initial Soft Reboot Wellness protocol involves four to six infusions over four to six weeks, with timing personalized to clinical response.
• Results vary by individual, and coordination with existing mental health providers is encouraged.

Conclusion

PTSD that persists despite standard treatment deserves serious, individualized clinical attention. For some people, a consultation about IV ketamine therapy may be part of exploring the full range of available options—but it should include a clear understanding of current evidence, established PTSD treatments, and the limits of emerging interventions.

At Soft Reboot Wellness in Menlo Park, Dr. Sara Herman provides physician-led evaluation and monitoring for patients considering IV ketamine therapy. To discuss whether a consultation may be appropriate, contact our team today.

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.

Almeida, T. M., Lacerda da Silva, U. R., Pires, J. P., Borges, I. N., Martins, C. R. M., Cordeiro, Q., & Uchida, R. R. (2024). Effectiveness of ketamine for the treatment of post-traumatic stress disorder: A systematic review and meta-analysis. Clinical Neuropsychiatry, 21(1), 22–31. https://doi.org/10.36131/cnfioritieditore20240102

Feder, A., Parides, M. K., Murrough, J. W., Perez, A. M., Morgan, J. E., Saxena, S., Kirkwood, K., aan het Rot, M., Lapidus, K. A. B., Wan, L.-B., Iosifescu, D., & Charney, D. S. (2014). Efficacy of intravenous ketamine for treatment of chronic posttraumatic stress disorder: A randomized clinical trial. JAMA Psychiatry, 71(6), 681–688. https://doi.org/10.1001/jamapsychiatry.2014.1435

Feder, A., Costi, S., Rutter, S. B., Collins, A. B., Govindarajulu, U., Jha, M. K., Horn, S. R., Kautz, M., Corniquel, M., Collins, K. A., Bevilacqua, L., Glasgow, A. M., Brallier, J., Pietrzak, R. H., Murrough, J. W., & Charney, D. S. (2021). A randomized controlled trial of repeated ketamine administration for chronic posttraumatic stress disorder. American Journal of Psychiatry, 178(2), 193–202. https://doi.org/10.1176/appi.ajp.2020.20050596

National Center for PTSD. (n.d.). PTSD basics. https://www.ptsd.va.gov/understand/what/ptsd_basics.asp

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

Sicignano, D. J., Kurschner, R., Weisman, N., Sedensky, A., Hernandez, A. V., & White, C. M. (2024). The impact of ketamine for treatment of post-traumatic stress disorder: A systematic review with meta-analyses. Annals of Pharmacotherapy, 58(7), 715–723.

U.S. Department of Veterans Affairs & U.S. Department of Defense. (2023). VA/DoD clinical practice guideline for management of posttraumatic stress disorder and acute stress disorder. https://www.ptsd.va.gov/professional/treat/txessentials/clinician_guide_meds.asp

About Dr. Sara Herman

Dr. Sara Herman, MD, is a Harvard-trained anesthesiologist who founded Soft Reboot Wellness after guiding more than 10,000 patients through anesthesia and ketamine therapy. Her clinical experience in ketamine administration, pharmacology, and patient monitoring shapes each treatment plan, from individualized dosing 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 PTSD is used off-label and is not FDA-approved for this indication. 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 PTSD in Silicon Valley: An Evidence-Based Overview 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.

As IV ketamine therapy has become more widely available across the Bay Area, patients may encounter meaningful differences in the clinical environments offering it. The qualifications of the clinician responsible for screening, administering, and monitoring treatment are important considerations.

For people in Silicon Valley considering ketamine therapy for depression, PTSD, or anxiety, it is reasonable to ask who will conduct the medical evaluation, monitor the infusion, and respond if a patient needs additional support during treatment.

At Soft Reboot Wellness in Menlo Park, care is physician-led. Dr. Sara Herman, MD, is a Harvard-trained, board-certified anesthesiologist who has guided more than 10,000 patients through anesthesia, pain management, and ketamine therapy.

What Anesthesiology Training Brings to Ketamine Care

Anesthesiologists are physicians whose specialty training centers on anesthesia, medication effects, patient physiology, monitoring, and responding to complications during procedures. That background is relevant to ketamine treatment because ketamine can affect perception, consciousness, blood pressure, heart rate, and other physiological functions.

Guidelines for moderate procedural sedation emphasize appropriate patient assessment, monitoring, and the ability to recognize and respond when sedation becomes deeper than intended (American Society of Anesthesiologists Task Force on Moderate Procedural Sedation and Analgesia, 2018).

At Soft Reboot Wellness, Dr. Herman’s clinical background informs the practice’s physician-led care model, including individualized screening, treatment planning, and monitoring throughout the infusion experience.

Ketamine Safety Requires Individual Assessment

Ketamine’s clinical risks are real, even though serious adverse events have been uncommon in published studies of low-dose IV ketamine for treatment-resistant depression. Common acute effects can include dissociation, perceptual changes, nausea, dizziness, and temporary increases in blood pressure or heart rate (Wan et al., 2015).

The American Psychiatric Association’s consensus statement on ketamine for mood disorders emphasizes careful assessment of medical and psychiatric history, informed consent, monitoring, and clinician readiness to address adverse effects (Sanacora et al., 2017).

At Soft Reboot Wellness, treatment planning begins with a thorough review of medical history, psychiatric history, current medications, cardiovascular considerations, and treatment goals. This is more than a questionnaire. It is an individualized medical evaluation designed to help determine whether ketamine therapy is appropriate.

For a closer look at the treatment process itself, read what ketamine therapy actually does.

Monitoring During an IV Ketamine Infusion

During IV ketamine treatment, patients may experience a dreamlike or dissociative state. They may also notice altered perception of time, visual changes, or temporary emotional intensity. These experiences can be expected effects of ketamine, but each patient’s experience is different.

Soft Reboot Wellness describes its infusion model as physician-supervised and monitored, with Dr. Herman personally involved in clinical administration and monitoring. Vital signs are tracked during treatment, and patients remain in the office until they are ready for discharge.

Patients can learn more about the practical details of a session in our guide to what to expect during ketamine therapy.

Physician Oversight and Treatment Decisions

Physician-led care is not only about what happens during an infusion. It also involves decisions before and after treatment.

Ketamine may not be appropriate for everyone. Medical conditions, psychiatric history, medication interactions, substance-use history, cardiovascular factors, and other individual considerations can affect candidacy. These decisions should be made through a careful medical and psychiatric review rather than a standardized protocol alone.

No clinician or setting can guarantee a particular treatment outcome. However, patients should understand who is responsible for clinical decision-making, how the practice approaches monitoring, and how concerns are addressed throughout treatment.

Understanding Fees and What Care Includes

Physician-led care may involve a different fee structure than other treatment models because clinical evaluation, ongoing monitoring, and individualized treatment planning take time and expertise.

Patients should feel comfortable asking what a treatment fee includes, who will be present during the infusion, how medical concerns are handled, and what follow-up is available. Soft Reboot Wellness discusses pricing during consultation so patients can make informed decisions without relying only on line-item comparisons.

Results vary by individual. The goal of careful oversight is not to promise a specific outcome, but to support appropriate selection, monitoring, and treatment adjustments when clinically indicated.

Ketamine Therapy and Stellate Ganglion Block

Soft Reboot Wellness also offers Stellate Ganglion Block treatments. SGB is a separate interventional procedure that uses local anesthetic near a group of sympathetic nerves in the neck.

The practice performs SGB with real-time ultrasound guidance. Dr. Herman’s anesthesiology background includes patient monitoring, airway management, and ultrasound-guided procedural experience relevant to this type of care.

Ketamine therapy and SGB are distinct interventions with different procedures, evidence bases, and candidacy considerations. Some patients may be appropriate candidates for one option and not the other. The right approach depends on an individual clinical evaluation.

Questions to Ask When Comparing Ketamine Providers

If you are evaluating ketamine providers in Menlo Park, Palo Alto, Redwood City, or elsewhere on the Peninsula, consider asking:

• Who will conduct my medical and psychiatric evaluation?
• Who will administer and monitor my infusion?
• What vital signs or other clinical measures are monitored during treatment?
• How does the practice screen for medical or psychiatric contraindications?
• What happens if I experience distress, nausea, elevated blood pressure, or another unexpected effect?
• How will treatment decisions be adjusted if my response differs from expectations?
• How does the practice coordinate with my existing psychiatrist, therapist, or primary care provider?

At Soft Reboot Wellness, we welcome these questions. Patients can also review our ketamine therapy FAQ information before consultation.

FAQ

What does it mean that Dr. Herman is a Harvard-trained anesthesiologist?

Dr. Herman completed anesthesiology residency training at Harvard Medical School’s Brigham and Women’s Hospital and completed a cardiothoracic anesthesia fellowship at Columbia University Medical Center. Her training includes anesthesia, pharmacology, patient monitoring, and procedural care.

Is ketamine safer when administered by an anesthesiologist?

No clinician or treatment setting can guarantee safety. Ketamine can cause temporary changes in blood pressure, heart rate, perception, and consciousness, which makes appropriate screening and monitoring important (Wan et al., 2015). An anesthesiologist’s training is directly relevant to medication administration, physiological monitoring, airway management, and responding to changes during a procedure. Patients should ask any provider about their training, monitoring practices, and emergency-readiness protocols.

Does it matter what type of physician is overseeing my ketamine infusion?

It is reasonable to ask about a clinician’s training, experience with ketamine, approach to psychiatric and medical screening, and role during the infusion. Different physicians may bring different backgrounds to ketamine care. Patients should understand who is responsible for treatment decisions and monitoring before beginning a program.

How does physician oversight affect ketamine patient selection?

Patient selection involves reviewing medical history, psychiatric history, medications, cardiovascular considerations, prior treatment response, and individual goals. A physician-led evaluation can help identify factors that may affect candidacy, monitoring needs, or treatment planning.

Why does Soft Reboot Wellness also offer Stellate Ganglion Block?

SGB is an image-guided nerve block procedure that Soft Reboot Wellness performs with real-time ultrasound guidance. Dr. Herman’s anesthesiology background is relevant to the procedural assessment, technique, and monitoring involved in SGB care.

Key Takeaways

• Ketamine treatment requires individualized medical and psychiatric assessment, appropriate monitoring, and informed consent.
• Anesthesiology training is relevant to ketamine administration because it includes pharmacology, physiological monitoring, procedural care, and response to changes during treatment.
• Dr. Sara Herman, MD, is a Harvard-trained, board-certified anesthesiologist with experience guiding more than 10,000 patients through anesthesia, pain management, and ketamine therapy.
• Soft Reboot Wellness provides physician-led IV ketamine therapy and ultrasound-guided Stellate Ganglion Block in Menlo Park.
• Patients should ask clear questions about screening, monitoring, clinician credentials, costs, and coordination with existing providers before starting treatment.
• Results vary by individual, and no provider should guarantee a specific outcome.

Conclusion

Choosing a ketamine provider is an important part of deciding whether treatment is right for you. A thoughtful consultation should include discussion of your medical and psychiatric history, current medications, treatment goals, potential risks, and the clinical environment in which care is delivered.

At Soft Reboot Wellness in Menlo Park, Dr. Sara Herman provides physician-led evaluation and monitoring for patients considering IV ketamine therapy. To learn more or schedule a consultation, reach out to our team today.

References

American Society of Anesthesiologists Task Force on Moderate Procedural Sedation and Analgesia, American Association of Oral and Maxillofacial Surgeons, American College of Radiology, American Dental Association, American Society of Dentist Anesthesiologists, & Society of Interventional Radiology. (2018). Practice guidelines for moderate procedural sedation and analgesia 2018. Anesthesiology, 128(3), 437–479. https://doi.org/10.1097/ALN.0000000000002043

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

Sanacora, G., Frye, M. A., McDonald, W., Mathew, S. J., Turner, M. S., Schatzberg, A. F., Summergrad, P., Nemeroff, C. B., & American Psychiatric Association Council of Research Task Force on Novel Biomarkers and Treatments. (2017). A consensus statement on the use of ketamine in the treatment of mood disorders. JAMA Psychiatry, 74(4), 399–405.

Wan, L.-B., Levitch, C. F., Perez, A. M., Brallier, J. W., Iosifescu, D. V., Charney, D. S., Murrough, J. W., & Mathew, S. J. (2015). Ketamine safety and tolerability in clinical trials for treatment-resistant depression. The Journal of Clinical Psychiatry, 76(3), 247–252. https://doi.org/10.4088/JCP.13m08852

About Dr. Sara Herman

Dr. Sara Herman, MD, is a Harvard-trained, board-certified anesthesiologist and founder of Soft Reboot Wellness. She has guided more than 10,000 patients through anesthesia, pain management, and ketamine therapy.

Her clinical background informs Soft Reboot Wellness’s approach to individualized assessment, ketamine administration, physiological monitoring, and ultrasound-guided Stellate Ganglion Block procedures.

Medical Disclaimer

The content provided on this page is for educational purposes only and does not constitute medical advice. IV ketamine therapy is used off-label for psychiatric indications and is not FDA-approved for the treatment of depression, PTSD, or anxiety disorders. 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 Why Physician-Led Ketamine Therapy Matters: The Case for Choosing a Board-Certified Anesthesiologist appeared first on Soft Reboot Wellness.

How Ketamine Differs From Classical Psychedelics

Most people think of psychedelics in terms of substances like psilocybin or LSD, which work primarily by activating serotonin 2A receptors, a specific docking site on brain cells involved in perception and mood. Ketamine does something different. Its primary mechanism involves blocking NMDA receptors (N-methyl-D-aspartate receptors), which are part of the glutamate system, the brain’s main excitatory neurotransmitter network (National Institutes of Health). Rather than flooding the serotonin system, ketamine modulates glutamate transmission, triggering a cascade of downstream effects that researchers now understand to include rapid antidepressant action and new neural connection formation.

That distinction is not merely academic. It explains why ketamine can produce perceptual changes at therapeutic doses without fitting neatly into the classical psychedelic category. Some researchers classify it as a “dissociative,” others as a “psychedelic-adjacent” compound, and a growing number argue it belongs in its own class entirely. At Soft Reboot Wellness, Dr. Sara Herman and Dr. Natasha work with patients who have often spent years trying serotonin-targeting medications without adequate relief, patients for whom the glutamate pathway may be the missing piece.

The Psychedelic Experience Question

Even if the receptor mechanism differs, ketamine at therapeutic doses can produce experiences that overlap with what people describe in psychedelic-assisted therapy: altered perception of time, a sense of the mind loosening its grip on habitual thoughts, and occasionally vivid inner imagery. This is not a side effect to be managed. It is, in many respects, part of why the treatment works.

Research supports the integration of psychotherapy with ketamine, showing the combination may produce more durable and meaningful outcomes than ketamine alone (National Institutes of Health). This is precisely why our ketamine-assisted psychotherapy (KAP) program at Soft Reboot Wellness pairs in-office infusion sessions with preparation and integration coaching. Dr. Herman holds an Advanced Certificate in Psilocybin-Assisted Therapy from the Integrative Psychiatry Institute and has completed training in Internal Family Systems (IFS) combined with ketamine-assisted psychotherapy, credentials that reflect a genuine commitment to psychedelic medicine as a therapeutic discipline, not just a pharmacological one.

Why the Classification Matters for Patients

Patients searching “is ketamine a psychedelic” are often asking a more personal question underneath that one: will this feel strange, and is that strangeness safe? Both are fair concerns, and we take them seriously.

The perceptual effects of IV ketamine at therapeutic doses are time-limited, occur within a supervised clinical setting, and resolve completely by the time patients leave. Dr. Herman personally provides and monitors all treatment sessions. The dose used in mental health treatment is a fraction of what is used in surgical anesthesia, and the clinical environment at our Menlo Park clinic is designed for comfort and safety throughout. Vital signs are monitored continuously, and patients are never left alone during their infusion.

What the altered state offers, when approached with intention, is a window. Research on how psychedelic-type treatments promote healing suggests these compounds create conditions for neuroplasticity, the brain’s capacity to form new neural connections, by temporarily quieting entrenched patterns of thought and self-criticism (National Institutes of Health). For patients with treatment-resistant depression, anxiety, or PTSD, that window can be genuinely significant.

How Soft Reboot’s Approach Reflects the Science

We did not land on our current model by accident. Our practice is built around the understanding that ketamine’s mechanism (glutamate modulation, NMDA receptor blockade, downstream neuroplasticity) offers something that decades of serotonin-focused treatment have not fully delivered for a substantial portion of patients (Johns Hopkins Bloomberg School of Public Health). That is not a criticism of antidepressants; SSRIs help many people. It is an honest acknowledgment that the brain’s chemistry is more complex than any single system, and that the patients who find their way to us have typically already learned that lesson the hard way.

Our IV ketamine infusions follow a personalized induction protocol, typically four to six infusions over four to six weeks, with the specific number and timing calibrated to your clinical response and the input of your existing treatment providers. We use the Osmind EHR platform for mood tracking throughout your treatment so both you and your care team can see your progress objectively. Each infusion is paired with preparation and integration coaching as part of our ketamine-assisted psychotherapy (KAP) program.

Addressing the Cost and Scheduling Reality

Ketamine therapy is a meaningful financial commitment, and we want to be direct about that. IV ketamine for mental health conditions is considered off-label use, meaning it is an established treatment whose mental health applications have not yet received formal FDA approval for specific psychiatric diagnoses, and insurance coverage is inconsistent. We recommend contacting our team directly to discuss what financial options are available to you before your consultation.

The initial consultation at Soft Reboot Wellness begins by calling or emailing us directly. We send you an intake packet, Dr. Herman reviews it, and then determines whether to schedule a consultation. If you have an existing psychiatrist, therapist, or prescriber, we actively coordinate with them, with your consent, because we believe integrative care produces better outcomes than any single provider working in isolation. Results vary by individual, and we encourage you to discuss all options with your healthcare provider before deciding whether ketamine therapy is right for you.

Frequently Asked Questions

If ketamine isn’t technically a psychedelic, why does it sometimes produce visual or perceptual effects? Ketamine’s dissociative properties at therapeutic doses can produce altered sensory experiences, mild perceptual shifts, a floating or dreamlike quality, or vivid imagery, even though its mechanism differs from classical psychedelics. These effects occur because ketamine affects multiple neurotransmitter systems, not just glutamate. They are temporary, resolve fully within hours, and occur within a monitored clinical environment at our Menlo Park clinic.

Is ketamine therapy the same as recreational ketamine use? No. The dose, delivery method, clinical setting, and intent are entirely different. Therapeutic ketamine infusions are administered intravenously at sub-anesthetic doses by a licensed physician in a clinical environment with continuous monitoring. Recreational use involves very different doses, routes, and contexts. Our team screens all candidates medically and psychiatrically before treatment to ensure it is appropriate for each individual.

Does Soft Reboot Wellness offer psilocybin therapy? We do not currently offer psilocybin therapy as a clinical service. Dr. Herman holds an Advanced Certificate in Psilocybin-Assisted Therapy and stays current with the evolving research in this area, but our active treatment offerings are IV ketamine infusions, ketamine-assisted psychotherapy, stellate ganglion block (SGB), and NAD+ infusions.

How does understanding ketamine’s mechanism help me prepare for my session? Knowing that ketamine works through the glutamate system, promoting neuroplasticity and temporarily quieting rigid thought patterns, can help you approach your session with openness rather than anxiety. Many patients find it useful to set a simple intention before their infusion, something they want to reflect on or release, and to plan for rest and reflection afterward. Our integration coaching component is designed specifically to help you make the most of this window.

Can ketamine therapy be combined with my existing antidepressants or therapy? In many cases, yes, and we actively encourage coordination with your existing treatment team. The specifics depend on your medications and history, which we review during your consultation. We do not ask patients to discontinue existing medications without a conversation involving you and your other providers.

Key Takeaways

• Ketamine is not a classical psychedelic, it works primarily through NMDA receptor blockade in the glutamate system, not through serotonin 2A receptor activation.
• The perceptual effects some patients experience during treatment are a product of this multi-system mechanism and are temporary, monitored, and managed within a clinical setting.
• Research supports combining psychotherapy with ketamine to produce more durable outcomes. This is the foundation of our KAP program at Soft Reboot Wellness.
• IV ketamine for mental health is an off-label use, and insurance coverage is not standard; financial details are best discussed directly with our team.
• Results vary by individual, and candidacy is determined through a thorough medical and psychiatric review before any treatment begins.

Whether you think of ketamine as a psychedelic, a dissociative, or simply a medication that works differently than anything you have tried before, what matters most is whether it might help you. At Soft Reboot Wellness, we are here to answer that question honestly, starting with a conversation. Reach us at 650-419-3330 or email hello@softrebootwellness.com to get started.

References

1. National Institutes of Health. Ketamine works by blocking NMDA receptors in the glutamate system, producing rapid antidepressant effects through a mechanism distinct from traditional antidepressants. https://pmc.ncbi.nlm.nih.gov/articles/PMC5148235/
2. Johns Hopkins Bloomberg School of Public Health. Overview of ketamine’s history, from its origins as an anesthetic to its current use as a fast-acting treatment for depression. https://publichealth.jhu.edu/2024/what-to-know-about-ketamine
3. National Institutes of Health. Psychedelic substances promote neuroplasticity, which may underlie their therapeutic effects on mood, trauma, and addiction. https://pmc.ncbi.nlm.nih.gov/articles/PMC9665925/
4. National Institutes of Health. Research supports the integration of psychotherapy with ketamine treatment, showing that the combination may produce more durable and meaningful outcomes than ketamine alone. https://pmc.ncbi.nlm.nih.gov/articles/PMC9207256/

Medical Disclaimer: The information in this blog is for educational purposes only and does not constitute medical advice. Ketamine therapy should only be pursued under the supervision of a licensed medical provider familiar with your full medical and psychiatric history. Individual results vary. Off-label treatments like IV ketamine for mental health conditions carry risks that should be discussed thoroughly with a qualified provider before beginning. If you are experiencing a mental health crisis or thoughts of self-harm, please call or text 988 to reach the Suicide and Crisis Lifeline or go to your nearest emergency room.

Reviewed by Dr. Sara Herman

The post Is Ketamine a Psychedelic? Understanding the Science Behind Ketamine Therapy appeared first on Soft Reboot Wellness.

Who Is a Candidate for Ketamine Therapy

Ketamine therapy is not a first-line treatment, and we do not present it as one. The patients who tend to benefit most are those who have tried one or more standard antidepressants at adequate doses for adequate duration and found only partial relief or no relief at all. Research documents that ketamine produces rapid antidepressant effects in patients with treatment-resistant major depression who have not responded to other medications, a profile that fits a significant proportion of patients who find their way to our clinic (National Institutes of Health).

Beyond treatment-resistant depression, we treat anxiety and PTSD at Soft Reboot Wellness, and ketamine therapy has meaningful clinical evidence for both. The link between anxiety and depression is well-documented, a large proportion of patients have significant symptoms of both, and treatments that address both simultaneously have clear value (American Journal of Psychiatry). For patients whose PTSD carries significant physical hyperarousal symptoms, we also offer stellate ganglion block (SGB) as either a standalone or complementary option.

What makes someone a strong candidate is assessed individually during the consultation process. Certain psychiatric histories, active substance use disorders, uncontrolled cardiovascular conditions, and specific medication combinations may preclude ketamine therapy or require additional clinical judgment. We review all of this during the consultation, and we will tell you honestly if we do not think you are an appropriate candidate. Sending someone into a treatment that isn’t right for them serves no one.

The Silicon Valley Patient Profile

The Bay Area patient population that comes to Soft Reboot Wellness tends to have some consistent characteristics. They are high-functioning in professional terms, often still performing at work even while struggling significantly in private. Their depression or anxiety is frequently tied to chronic overwork, perfectionism, and sustained pressure to maintain performance across multiple domains. They have often tried therapy and medication already, sometimes for years, and are arriving at our clinic because those tools have not been enough. Our post on burnout treatment for Silicon Valley professionals explores this pattern in more depth.

For this patient profile, the speed of ketamine’s action has particular significance. A treatment that produces meaningful symptom change within days, rather than requiring six to eight weeks before you know whether it is working, has real value for someone who cannot afford extended periods of functional impairment (National Institutes of Health). The research on this is clear: ketamine restores pleasure-seeking behavior and mood ahead of other antidepressant actions, addressing some of the most functionally disruptive features of depression quickly.

The fear of stigma is also a consistent factor. Patients in high-visibility professional environments often hesitate to seek mental health treatment because of how it might be perceived. We treat that concern as legitimate rather than dismissing it. Our intake process is discreet, our clinic environment is private, and the conversations we have with patients about their treatment are handled with the same confidentiality as any medical care.

What the Logistics Actually Look Like

Soft Reboot Wellness is located at 825 Oak Grove Ave, Suite A101, in Menlo Park, accessible from across the South Bay, Peninsula, and San Francisco. We serve patients from San Francisco, Palo Alto, Redwood City, Mountain View, Los Gatos, San Jose, Saratoga, and the broader Silicon Valley corridor.

A standard ketamine induction series involves four to six IV infusions over four to six weeks. Sessions are scheduled once weekly. Each infusion session requires you to have a driver, you cannot drive yourself home afterward. Beyond that practical requirement, the disruption to your schedule is manageable: most patients return to normal functioning the day following each infusion.

The intake process begins by calling us at 650-419-3330 or emailing hello@softrebootwellness.com. We send you an intake packet, Dr. Herman reviews it, and determines whether to schedule a consultation. If you have existing providers, we coordinate with them, with your permission, throughout treatment. We use the Osmind EHR and mood-tracking app to document progress, so your response to treatment is tracked objectively across the full series.

Each treatment package includes a preparation session, two 2-hour in-office infusion sessions, integration coaching with a certified psychedelic integration coach, a Mindfold eye shade, a reflection journal, a personal Caretaker finger sensor, and ongoing Osmind access. The preparation and integration components are specifically designed around the 48-to-72-hour neuroplastic window that follows each infusion, the period during which the brain is most receptive to consolidating new patterns.

The Clinical Team

Dr. Sara Herman founded Soft Reboot Wellness after a career as a Harvard-trained anesthesiologist who trained at Brigham and Women’s Hospital and completed a cardiothoracic anesthesia fellowship at Columbia University Medical Center. She has personally guided more than 10,000 patients through anesthesia, pain management, and ketamine therapy. Her additional training includes an Advanced Certificate in Psilocybin-Assisted Therapy from the Integrative Psychiatry Institute and IFS combined with ketamine-assisted psychotherapy, credentials that reflect a genuine commitment to psychedelic medicine as a therapeutic discipline.

Dr. Natasha, our board-certified anesthesiologist who holds an MD from UCSF and brings more than 20 years of clinical anesthesia experience in the Bay Area, provides additional clinical depth to the monitoring and safety dimension of every session. Shade, our certified addiction recovery and psychedelic integration coach, trained by Being True to You and certified in hypnotherapy by the Palo Alto School of Hypnotherapy, supports the preparation and integration components of the KAP program. Paula, our registered nurse, rounds out the clinical team.

Every infusion session is personally administered and monitored by a physician. Vital signs are tracked continuously. You are never left alone during treatment. Learn more about our expert ketamine therapy approach and what distinguishes our clinical model.

The Cost and Insurance Reality

We believe in being direct about cost, because we know it is a deciding factor for many patients. IV ketamine therapy for mental health is an off-label treatment, its safety has been established over decades of anesthetic use, but its application to specific psychiatric diagnoses has not received formal FDA approval, and insurance coverage is inconsistent. We do not have a financing program to name at this time, but we encourage you to contact our team directly at 650-419-3330 or hello@softrebootwellness.com to discuss what treatment costs look like before your consultation.

If cost is a barrier, that is a conversation worth having rather than a reason to simply not pursue care. We also invite you to explore whether HSA or FSA funds may be applicable to your situation, and to ask your insurer directly about out-of-network benefits or superbill reimbursement for off-label psychiatric care.

Results vary by individual. Treatment is not appropriate for everyone, and we encourage all prospective patients to discuss their options with their existing healthcare providers before making a decision.

Frequently Asked Questions

Do I need a referral from my psychiatrist or therapist to be seen at Soft Reboot Wellness? No referral is required to begin our intake process. However, we actively encourage coordination with your existing providers, and having an established treatment relationship with a psychiatrist or therapist often strengthens the outcomes we are able to support. If you do not have outside providers, we will note that in our clinical planning.

How is Soft Reboot Wellness different from other Bay Area ketamine clinics? The clinical foundation here is distinctive in a few ways. Dr. Herman’s dual background in anesthesiology and psychedelic-assisted therapy is relatively uncommon, most ketamine clinics are staffed by providers trained in one or the other. Our active use of the IFS framework in KAP, our structured integration coaching, and our commitment to coordinating with outside care teams reflect a model built around therapeutic depth, not just infusion delivery. We also offer SGB, a treatment many Bay Area ketamine clinics do not provide, for patients whose presentation warrants it.

Is there a waitlist to get started? We recommend contacting us directly for current availability. Call us at 650-419-3330 or email hello@softrebootwellness.com, we’ll follow up promptly to discuss next steps and scheduling.

Can Soft Reboot Wellness treat burnout specifically? Burnout is not a formal psychiatric diagnosis, but the symptoms it produces, emotional exhaustion, cognitive fog, anhedonia, chronic dysregulation, overlap substantially with the depression and anxiety presentations we treat. Many of the Silicon Valley professionals we see describe their condition in terms of burnout, and ketamine therapy may help with the neurobiological dimension of that experience. We discuss your specific presentation during the consultation to determine what we can most credibly offer.

Key Takeaways

• Ketamine therapy is primarily appropriate for patients who have not responded adequately to standard antidepressants; candidacy is assessed individually during a full medical and psychiatric consultation.
• Soft Reboot Wellness in Menlo Park serves patients across the Bay Area and Silicon Valley, with logistics designed to accommodate demanding professional schedules.
• The clinical team includes two anesthesiologists, a certified integration coach, and a registered nurse; every infusion is personally administered and monitored by a physician.
• IV ketamine is an off-label treatment for mental health; insurance coverage is not standard, contact our team directly to discuss costs before your consultation.
• Results vary by individual; we encourage coordination with your existing care team throughout treatment.

If you are somewhere in the Bay Area, searching for something that works differently than what you have tried, we are a 650-419-3330 call away. You can also email hello@softrebootwellness.com to begin the process at your own pace.

References

1. National Institutes of Health. Studies show ketamine produces rapid antidepressant effects in patients with treatment-resistant major depression who have not responded to other medications. https://pubmed.ncbi.nlm.nih.gov/23982301/
2. National Institutes of Health. Research from the NIMH shows ketamine restores pleasure-seeking behavior ahead of other antidepressant actions, suggesting it targets core depression symptoms quickly. https://www.nimh.nih.gov/news/science-updates/2014/rapid-agent-restores-pleasure-seeking-ahead-of-other-antidepressant-action
3. American Journal of Psychiatry. Research confirms a strong bidirectional relationship between anxiety and depression, supporting the value of treatments that address both conditions simultaneously. https://psychiatryonline.org/doi/10.1176/appi.ajp.2020.20030305

Medical Disclaimer: The information in this blog is for educational purposes only and does not constitute medical advice. Ketamine therapy and stellate ganglion block should only be pursued under the supervision of a licensed medical provider familiar with your full medical and psychiatric history. Individual results vary. Off-label treatments like IV ketamine for mental health conditions carry risks that should be discussed thoroughly with a qualified provider before beginning. If you are experiencing a mental health crisis or thoughts of self-harm, please call or text 988 to reach the Suicide and Crisis Lifeline or go to your nearest emergency room.

Reviewed by Dr. Sara Herman

The post Ketamine Therapy in the Bay Area: What You Need to Know Before Starting appeared first on Soft Reboot Wellness.

Before You Ever Arrive: The Intake and Consultation Process

Ketamine therapy at Soft Reboot Wellness begins by calling us at 650-419-3330 or emailing hello@softrebootwellness.com. We send you an intake packet to complete, Dr. Herman reviews it, and then determines whether to schedule a consultation. That consultation covers your mental health history, prior treatments, current medications, and what you are hoping to address.

If you have an existing psychiatrist, therapist, or prescriber, we contact them, with your explicit consent, to coordinate on your treatment plan. We are not a replacement for your existing care team; we work alongside them. For patients who do not have outside providers, we work independently and document everything through the Osmind EHR platform, which also includes a mood-tracking app you will use throughout treatment. You can get a detailed overview of what to expect from our clinical process on our dedicated page.

The medical and psychiatric consultation comes before any infusion is scheduled. Dr. Sara Herman or Dr. Natasha reviews your full history to determine whether IV ketamine therapy is appropriate for your specific situation. Not every patient who comes to us is a good candidate, and we will tell you honestly if we do not think we are the right fit. Ketamine is an off-label treatment for mental health conditions, meaning the FDA has not formally approved it for specific psychiatric diagnoses, and candidacy depends on a careful individual assessment.

The Day of Your Infusion

Plan to have someone drive you to and from your appointment. You will not be able to drive yourself home, this is a non-negotiable clinical requirement, not an abundance of caution. Most patients find it helpful to think of the infusion day as a rest day: clear your schedule afterward, have light plans for the evening, and arrive without rushing.

Eat a light meal two to four hours before your infusion and avoid alcohol for at least 24 hours prior. Wear comfortable clothing. You are welcome to bring music, many patients find it significantly shapes the quality of their experience, and we have recommendations if you want them. Our post on music as medicine explores how sound can support the ketamine experience.

When you arrive at our Menlo Park clinic, you will be settled into a comfortable infusion space. Dr. Herman personally administers all IV lines and monitors all sessions from start to finish. A small IV catheter is placed, typically in the arm, and the infusion begins at a slow, controlled rate. Vital signs are monitored continuously throughout the session.

During the Infusion

Effects begin within minutes of infusion onset. What you experience will be personal, no two sessions are identical, and no two patients describe them in quite the same way. That said, certain qualities are consistent enough to be worth describing.

Most patients notice a shift in how their thoughts feel. The relentless quality of anxious or depressive rumination, the loops, the self-criticism, the weight of it, typically softens. Some patients describe it as the mental noise turning down. There may be perceptual changes: a dreamlike quality, altered sense of time, mild visual patterns with eyes closed, or a sense of the mind becoming loosened from ordinary reference points. Some patients experience emotional content, memories, feelings, or imagery that feels significant. Others find the experience largely calm and interior.

The dissociation that many patients fear beforehand tends, in practice, to feel less frightening than anticipated. You remain aware that you are in a clinical setting, that the experience is temporary, and that the care team is present throughout. Research confirms that side effects from a single antidepressant dose of IV ketamine are mild and brief, supporting its safety profile in clinical settings (National Institutes of Health). The session typically runs between 45 minutes and two hours depending on your protocol, and the acute effects resolve fully before you are discharged.

For patients in our ketamine-assisted psychotherapy (KAP) program, the in-office infusion sessions are two hours each. The extended time is designed to allow for a fuller experience and a gentler return, with space for initial reflection before you leave.

Immediately After the Session

The hour following infusion is a transition period. Most patients feel relaxed, occasionally tired, and emotionally open. Some feel moved by what arose during the session; others feel simply quiet. You will rest in the clinic space until you are fully alert and your vital signs have returned to baseline, this typically takes 30 to 60 minutes following the end of the infusion.

After your session, your integration coach checks in before discharge. You go home with your designated driver, and we recommend a gentle evening: no major decisions, no demanding social commitments, no alcohol.

The Integration Window: 48 to 72 Hours After

Research shows that 48 to 72 hours after a ketamine session is the optimal window for integration, the period during which the neuroplastic changes initiated by the infusion are most active and the brain is most receptive to new patterns (American Journal of Psychiatry). This is not the time to push through a demanding workload or ignore what arose during the session. It is the time to pay attention.

Integration coaching sessions are timed around this window. We use the Internal Family Systems (IFS) framework, a model in which different internal states, memories, and protective patterns are understood as distinct “parts” of the self, to help patients engage with whatever surfaced during the infusion in a structured, compassionate way. Dr. Herman has completed training in IFS combined with ketamine-assisted psychotherapy specifically because we believe this window, when used well, is where much of the lasting therapeutic work happens.

For all patients, we encourage journaling, light physical movement, and continuing to log mood data in the Osmind app so we can track your response across the full induction series. Our integration inspirations page offers additional resources for making the most of this period.

What the Full Induction Series Looks Like

A standard induction series at Soft Reboot Wellness involves four to six IV infusions over four to six weeks. Research shows that starting with a series of six infusions produces longer-lasting symptom reduction than fewer sessions, though we calibrate the specific protocol to your clinical response, some patients need fewer, some may benefit from more (American Journal of Psychiatry). Sessions are scheduled once weekly.

The reduction in depressive or PTSD symptoms following the induction series typically lasts approximately five weeks on average, with a range of three weeks to two months for most patients. Subsequent single maintenance infusions, booster sessions, may be used to sustain symptom improvement, typically scheduled anywhere from three weeks to three months after the initial series depending on your individual response pattern.

Addressing the Scheduling and Cost Questions

A ketamine infusion session does not require days of recovery. Most patients return to their normal schedules the following day. We offer appointment times that accommodate demanding professional schedules, because we work primarily with Silicon Valley professionals whose time constraints are real.

IV ketamine for mental health is an off-label treatment, and insurance coverage is inconsistent. We do not want cost to be a surprise, contact us at 650-419-3330 or hello@softrebootwellness.com before your consultation to discuss what the financial commitment looks like for your specific treatment plan. Results vary by individual, and we encourage you to discuss your options with your current providers before beginning.

Frequently Asked Questions

What if I have a difficult experience during an infusion? Challenging experiences during ketamine infusions do occur for some patients, and our clinical team is prepared for them. Dr. Herman monitors all sessions in person and can adjust the infusion rate or intervene if needed. Patients are never left alone during a session. If difficult emotional content arises, this is sometimes part of the therapeutic process, particularly for patients with trauma histories, and our integration coaching is designed to help you work with it rather than simply wait it out.

How will I feel the day after my first infusion? Most patients feel rested or emotionally lighter the day after. Some feel temporarily more fatigued than usual, particularly after their first session. A small number of patients experience mild headache or nausea in the hours immediately following infusion, though these typically resolve quickly. The day-after experience tends to improve across the induction series as the body adjusts.

Can I go back to work the day after a session? For most patients, yes. The acute effects resolve fully before you leave the clinic, and most patients function normally the following day. We recommend not scheduling high-stakes professional obligations on the infusion day itself or the immediate evening after, but the following morning is generally fine.

How do I know if the treatment is working? We track your response through the Osmind mood-tracking app throughout your induction series, so your progress is documented rather than relying on subjective memory. You and our care team review this data together. Meaningful symptom changes typically emerge across the first two to four infusions, though the timing varies between individuals.

What happens at the end of the induction series? At the end of your induction series, we review your mood data and clinical response with you and discuss next steps. Some patients do well without further treatment for an extended period. Others find that occasional maintenance infusions help sustain the gains they have made. We work with you and your outside providers, if applicable, to develop a follow-up plan that fits your actual response pattern.

Key Takeaways

• Ketamine therapy at Soft Reboot Wellness begins with a thorough intake and consultation before any infusion is scheduled; not everyone who inquires is an appropriate candidate.
• Infusion sessions are personally administered and monitored by Dr. Herman; you will need a driver and should plan the treatment day as a rest day.
• The acute experience, altered perception, mental quieting, is temporary and resolves fully before discharge; for most patients it is calmer than anticipated.
• The 48 to 72 hours following infusion are the optimal integration window; our KAP program is specifically structured around this period.
• A standard induction series involves four to six infusions over four to six weeks, with maintenance sessions available afterward based on individual response.

Knowing what to expect removes one of the largest barriers to starting. If reading this has moved you closer to a decision, we are ready to continue the conversation. Call us at 650-419-3330 or email hello@softrebootwellness.com to schedule your consultation at our Menlo Park clinic.

References

1. National Institutes of Health. NIH research confirms that side effects from a single antidepressant dose of intravenous ketamine are mild and brief, supporting its safety profile in clinical settings. https://www.nih.gov/news-events/news-releases/side-effects-mild-brief-single-antidepressant-dose-intravenous-ketamine
2. National Institutes of Health. The National Institute of Mental Health highlights new research supporting ketamine as a rapid-acting depression treatment, offering hope for patients who haven’t responded to standard care. https://www.nimh.nih.gov/news/science-updates/2024/new-hope-for-rapid-acting-depression-treatment
3. American Journal of Psychiatry. Research shows that both single and repeated ketamine infusions can treat treatment-resistant depression, with maintenance infusions extending the duration of benefit. https://psychiatryonline.org/doi/10.1176/appi.ajp.2018.18070834
4. National Institutes of Health. Research supports the integration of psychotherapy with ketamine treatment, showing that the combination may produce more durable and meaningful outcomes than ketamine alone. https://pmc.ncbi.nlm.nih.gov/articles/PMC9207256/

Reviewed by Dr. Sara Herman

The post What to Expect During Ketamine Therapy: A Complete Session Walkthrough appeared first on Soft Reboot Wellness.

Why What You Bring to the Session Matters

Ketamine works in part by promoting neuroplasticity, temporarily loosening the brain’s entrenched patterns and creating a window of increased receptivity to change (National Institutes of Health). This window is not passive. What you choose to focus on, reflect on, or remain open to during and after the session can shape what the brain does with the new neural architecture the infusion creates.

Research on how psychedelic-type treatments promote healing points to the role of emotional processing and intention in determining outcomes (National Institutes of Health). Patients who approach their sessions with a defined intention, something specific they want to examine, release, or understand, tend to report more meaningful experiences than those who treat the infusion as something to simply endure or wait out. This is one of the central premises of our ketamine-assisted psychotherapy (KAP) program, which is built around the preparation and integration work that surrounds each infusion, not just the pharmacology itself.

None of this means you need to have a plan for every moment. The session should not feel like a performance or an assignment. The goal is to arrive with orientation, a direction, not a script.

Setting an Intention Before You Arrive

In the days before your session, we encourage patients to spend some quiet time identifying what they most want to bring into the experience. An intention is not a goal in the productivity sense. It is not “fix my depression” or “resolve my trauma.” It is simpler and more personal than that.

Some examples of intentions patients bring to sessions at Soft Reboot Wellness: an openness to understanding where a particular emotion is coming from; a willingness to observe a chronic thought pattern without being inside it; a desire to reconnect with something that has felt inaccessible, joy, creativity, a sense of self that existed before the depression took hold. These are starting points, not destinations.

The Internal Family Systems (IFS) framework that Dr. Sara Herman has trained in offers a useful lens here. IFS treats the mind as a system of distinct internal parts, some that protect, some that carry pain, some that have been exiled. A session intention framed in IFS terms might sound like: “I want to meet the part of me that keeps me working beyond exhaustion and understand what it’s afraid of.” This is more actionable than “I want to feel better” and more honest than pretending the session is simply a medication administration.

Mindfulness practice in the days before your infusion can also be helpful, not because the session requires you to meditate, but because the skills of present-moment awareness and non-judgmental observation are genuinely useful when unusual internal experiences arise (Mindful.org). If you have an existing mindfulness or meditation practice, lean on it before your session. If you do not, even brief daily attention to breath and body in the days prior can create a more grounded starting point. Our post on five ways to turn inward offers practical techniques you can begin before your first session.

During the Infusion: Openness Over Control

Once the infusion begins, the most useful orientation is one of openness rather than control. The altered state ketamine produces, the quieting of ordinary thought, the perceptual shifts, the loosening of the usual mental categories, is working in your favor. Resisting it, or trying to steer the experience toward a predetermined outcome, tends to work against the therapeutic process.

If difficult emotions or memories arise, the most effective response is generally to observe them rather than either suppress them or intensify them. The IFS model is helpful here too: rather than identifying with a difficult internal state (“I am overwhelmed”), you can relate to it as information, a part of you that is asking to be seen. This perceptual shift is subtle but meaningful, and it is one reason Dr. Herman’s IFS training is built into the KAP program rather than treated as supplementary.

Some patients find it helpful to use music during their session, it provides structure to the experience and can serve as an anchor when the altered state becomes intense. Others prefer silence or nature sounds. We are happy to discuss music selection in your preparation session, because the choice matters more than most patients expect. Our post on music as medicine explores how intentional sound selection can deepen the therapeutic experience.

Above all: you do not need to figure anything out during the infusion. The neuroplastic work is happening whether or not you consciously direct it. Your role is less to think and more to receive, to stay present with whatever arises without forcing it toward resolution.

What to Do With What Arises

The 48 to 72 hours following a session are what researchers call the integration window: the period during which the neuroplastic changes initiated by the infusion are most active, and the brain is most open to consolidating new patterns and associations (National Institutes of Health). What you do in this window is not incidental. It is part of the treatment.

Journal. Not to produce polished writing, but to capture what arose, images, emotional residue, insights, questions. The specific language matters less than the act of externalizing what was internal. Patients frequently find that experiences that felt opaque during the session become clearer when written down in the hours afterward.

Move gently. Light walking, stretching, time outdoors, physical movement supports the integration process in ways that are not fully understood but consistently reported by patients. Avoid intense exercise, alcohol, and stimulants during this window.

Bring the material to your next therapy session if you have an outside therapist. Many patients find that a ketamine series deepens their ongoing therapeutic work in ways they did not anticipate, the loosening of habitual defenses that the infusion produces often makes previously defended emotional territory more accessible.

Integration coaching sessions are timed specifically around this 48-to-72-hour window. Our certified psychedelic integration coach, trained by Being True to You, works with you to make sense of what the session opened and how to carry it forward. You can explore additional integration ideas on our integration inspirations page.

Preparing for a Full Series, Not Just One Session

It is worth framing the experience correctly from the start: a single ketamine infusion is the beginning of a series, not a standalone event. Research shows that repeated ketamine sessions produce cumulative antidepressant benefits and extend remission periods, each infusion builds on the neuroplastic foundation laid by the previous one (National Institutes of Health). Approaching the series as a sustained commitment, rather than waiting for one session to produce a definitive result, tends to produce better outcomes.

This means the intention and integration work is not a one-time exercise. Before each session in your series, we encourage you to revisit your intention, it may evolve across sessions, and that evolution is informative. After each session, the journaling and integration practices apply again. Mood data tracked through the Osmind app across the full series gives you and our clinical team an objective record of your trajectory.

Results vary by individual. Not every patient finds the intention-setting or integration work immediately natural, and that is normal. Our care team is here to support this process throughout, not just during the infusions themselves. For a complete picture of what each session involves day by day, see our full post on IV ketamine therapy at Soft Reboot Wellness.

Addressing the Practical Before and After

On the day of your infusion, we ask that you avoid alcohol for at least 24 hours prior and arrive having eaten lightly two to four hours beforehand. Wear comfortable clothing. Arrange your driver in advance, you cannot drive yourself home afterward, and this is a clinical requirement without exceptions.

Plan to protect the afternoon and evening of your infusion day. The most common post-session experience is feeling relaxed and emotionally open, but scheduling demanding commitments for the same evening works against the integration process. The following day, most patients return to their normal professional routines without issue.

IV ketamine for mental health is an off-label treatment, and insurance coverage is not standard. The cost commitment is real, and we encourage you to discuss it with our team at 650-419-3330 or reach us through our contact page at hello@softrebootwellness.com before your consultation so it is part of your planning rather than a surprise. We also encourage you to discuss all treatment options with your existing healthcare providers before beginning. Results vary by individual.

Frequently Asked Questions

What if I don’t know what my intention should be before a session? That is completely normal, especially before a first session. Our preparation session is specifically designed to help you identify a workable intention. It is a facilitated conversation, not a test. Arriving with openness and genuine curiosity is itself a strong starting point.

Is there anything I should avoid thinking about during a session? Rather than thinking in terms of avoidance, we suggest thinking in terms of orientation. Trying to suppress specific content tends to amplify it. A more effective approach is to hold a broader intention, openness, curiosity, compassion toward whatever arises, and let the session unfold from there. If something difficult comes up, the most useful response is to observe it rather than fight it or pursue it.

How do I know if my integration practice between sessions is working? Progress in integration is rarely linear or dramatic. Signs that it is working include: finding habitual thought patterns slightly more available for observation, noticing emotional states with a little more space between stimulus and response, or simply feeling incrementally more present in daily life. The Osmind mood data gives you an objective reference point alongside these more qualitative signals.

What role does my outside therapist play during the ketamine series? We encourage patients with existing therapists to bring the material from their ketamine sessions directly into their ongoing therapeutic work. The neuroplastic window opened by ketamine often makes previously defended emotional territory more accessible in therapy, many patients describe a ketamine series as accelerating months of therapeutic work into weeks. We coordinate with outside therapists with your consent throughout treatment.

Key Takeaways

• What you bring to a ketamine session, intention, openness, willingness to observe what arises, shapes the therapeutic outcome alongside the pharmacology.
• Setting a simple, honest intention before each session gives the neuroplastic window opened by ketamine a direction to work with.
• During the infusion, openness over control is the most effective orientation; resistance and forced steering tend to work against the therapeutic process.
• The 48 to 72 hours following infusion are the integration window, journaling, gentle movement, and reflection during this period are part of the treatment, not afterthoughts.
• Our KAP program at Soft Reboot Wellness is structured specifically around preparation and integration as clinical steps, not optional add-ons.

Preparation is how you meet ketamine halfway. If you are ready to start thinking about what this process might look like for you, we are glad to be part of that conversation. Call us at 650-419-3330 or email hello@softrebootwellness.com to schedule a consultation at our Menlo Park clinic.

References

1. National Institutes of Health. Research explores the neurological mechanisms behind psychedelic-assisted therapy, including how these treatments promote emotional processing and neuroplasticity. https://pmc.ncbi.nlm.nih.gov/articles/PMC10786285/
2. National Institutes of Health. Ketamine promotes neuroplasticity, the brain’s ability to form new neural connections, which may explain its rapid and sustained antidepressant effects. https://pmc.ncbi.nlm.nih.gov/articles/PMC8190578/
3. National Institutes of Health. Research supports the integration of psychotherapy with ketamine treatment, showing that the combination may produce more durable and meaningful outcomes than ketamine alone. https://pmc.ncbi.nlm.nih.gov/articles/PMC9207256/
4. National Institutes of Health. Multiple ketamine infusion sessions have been shown to produce cumulative antidepressant benefits and extend remission periods in patients with depression. https://pmc.ncbi.nlm.nih.gov/articles/PMC6236511/
5. Mindful.org. An accessible overview of mindfulness practices and their documented benefits for mental health and stress management. https://www.mindful.org/what-is-mindfulness/

Medical Disclaimer: The information in this blog is for educational purposes only and does not constitute medical advice. Ketamine therapy should only be pursued under the supervision of a licensed medical provider familiar with your full medical and psychiatric history. Individual results vary. Off-label treatments like IV ketamine for mental health conditions carry risks that should be discussed thoroughly with a qualified provider before beginning. If you are experiencing a mental health crisis or thoughts of self-harm, please call or text 988 to reach the Suicide and Crisis Lifeline or go to your nearest emergency room.

Reviewed by Dr. Sara Herman

The post What to Think About During Ketamine Therapy: Preparing for Your Session appeared first on Soft Reboot Wellness.