Feeling “Not Myself” — Understanding Dissociation in Ketamine/Spravato for Depression

The Brain’s Perception Systems — A Plain-Language Tour

Many patients describe a version of the same worry before their first ketamine session: “What if I don’t feel like myself?” In ketamine therapy, Lumin Health often calls this experience dissociation — and while it can be an unusual feeling, it is also part of what makes treatment effective.

Subjectivity and sense-making in ketamine therapy

Under ordinary circumstances, the brain’s “machinery of self” keeps our perceptions stable. We know where we are, who we are, and what our memories mean. Ketamine temporarily shifts that machinery. You may notice a different perspective on your surroundings, your thoughts, or even your sense of identity.  There can be a sense of distance from the persistent self-awareness and awareness of space that keeps us perpetually tuned to both our internal and external environments.  As above, we call this “dissociation.”

Memory and meaning can decouple

Sometimes ketamine changes how memories are held. A painful recollection — for example, a parent’s criticism — may appear without the old automatic meaning of guilt or shame. This separation can allow new interpretations to emerge. In this way, dissociation from our own habits of thought can allow us to recall specific events but without the typical interpretations.  What once felt “true” may now feel like just one perspective among many.

Why this can be useful

These shifts are not random. They can create a therapeutic opening: a chance to experience old material with less fear and more flexibility. For many, this leads to new insights, softened self-criticism, or a sense of possibility that depression had long shut down.

Safety and Grounding in the Ketamine Session

Breath, body, and orienting

If dissociation feels overwhelming, grounding techniques help. Patients are encouraged to take slow breaths, notice the sensation of the chair beneath them, or bring attention to their body. These simple acts remind the person that the experience is temporary and safe.  Going into the experience knowing that the changes to how one feels is temporary and relatively brief (about an hour for the most intense changes and around 2 hours to return back to the way one typically experiences themselves) and recognizing that this sense of dissociation is part of the ketamine and Spravato experiences can help make sense of things when engaging the experience.

Lumin Health staff support and monitoring

Throughout treatment, clinicians track blood pressure, heart rate, and emotional response. If anxiety rises, staff provide reassurance, medical support, or adjustments to the environment. Knowing that someone is present and attentive often reduces anxiety in the moment.

When to think about a dose change

Not every patient needs the same amount of medicine. If dissociation feels persistently intolerable, your clinician may discuss adjusting the dose. This is part of the normal process of tailoring treatment to your individual needs.

Ketamine Treatment: Aftercare and Integration

Normalizing the ketamine experience

After a session, it’s common to wonder, “Was that normal?” Dissociation can feel strange, but within the context of a Spravato clinic or ketamine clinic, it is a recognized and monitored effect. It does not mean something has gone wrong.

Talking about your experience with loved ones

Patients often find it helpful to share their experience — not in search of someone else’s interpretation, but as a way of making meaning. You might say, “I felt outside myself, and I’m still thinking about what that could mean.” Sharing invites connection, which supports growth.

Support-based follow-ups with Lumin Health

At Lumin Health, aftercare includes structured follow-ups and optional integration therapy — therapy directed at processing the experiences, themselves, and the changes that ketamine and Spravato compel. This helps patients link dissociation to real-life healing — carrying forward the new perspectives that emerged during treatment .

How Dissociation Impacts Ketamine Treatments and Spravato Sessions

Dissociation — the sense of feeling “not myself” — is a common and expected part of ketamine therapy and Spravato treatment. In the right setting, it is safe, temporary, and often useful. With grounding practices, clinical monitoring, and thoughtful aftercare, dissociation becomes less of a threat and more of an opportunity: a doorway into new ways of seeing yourself and your story.

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