The Patient’s Guide to Ketamine & Spravato® at Lumin Health

What to expect, how to prepare, and why your setting — and your agency — matter

If you’re considering ketamine or esketamine (Spravato®), you probably have two parallel questions: Will this help me? and What will it feel like to go through it? At Lumin Health, we honor both — your hope for relief and your need for clarity. This guide offers a detailed, compassionate look at the ketamine and Spravato experience: the mindset many people bring in, what actually happens during a session, practical preparation, why a clinic setting can matter, how we structure treatment over time, and how therapy and neuroplasticity help turn insights into change. Our aim is grounded hope: ketamine can be a powerful tool — and your agency, intentions, and relationships are part of the medicine.  As we talk about ketamine and esketamine we’ll use the term “ketamine” for shorthand as, indeed, the experience is similar to both medications.

1) The Mindset People Bring In: Fear, Curiosity, and the Wish to Feel Better

Most people’s first concern isn’t the mechanics of dosing, it’s “What if I have a bad trip?” That fear is understandable. Ketamine can shift how you experience yourself and your surroundings — what clinicians sometimes call a change in subjectivity. Even if you want a different vantage point, the idea of not steering every moment can feel vulnerable. The good news: truly overwhelming experiences are uncommon in a clinical setting, and the arc of a session is time‑limited, monitored, and coachable. We prepare you for what may arise and stay with you throughout, so if anxiety shows up, you’re not alone in meeting it. 

When people ask, “What creates a ‘bad trip’?” the honest answer is that it’s usually anxiety about the unfamiliar — a difficult memory surfacing, the strangeness of not feeling like your usual self, or a fleeting conviction that you’re not fully in control. We normalize this ahead of time. And we frame the experience as shared control: You consent to bringing the medication into your healing experience.  In this way, even before the medication exerts influence, the primary driver of recovery is you.  Once you decide to bring the medication in as a partner, and once the session begins, the medicine becomes a co‑pilot for a defined period. You are neither powerless nor alone — but you may not be steering every turn. Knowing this going in tends to soften the anxiety. 

Put simply, patients who do best approach ketamine from an agentic stance (i.e., I am the “agent” of my own decisions and in control of them).  They permit a shared control, trust in the setting and the environment, and a curiosity about what arises. If the idea of not being in total control feels intolerable (especially for those whose safety once depended on never relinquishing control), we talk about it thoroughly before treatment. Your comfort with this relational stance — to the medicine, to yourself, and to the care team — matters. We’ll only proceed if the plan feels consented, collaborative, and wise for you. 

2) “Change in Subjectivity,” Explained (Without Jargon)

We often take for granted that the way we perceive the world is fixed  — because our brain is using the same machinery, day after day, to weave sensations, memories, meanings, and selfhood into a continuous sense of “me.” Ketamine temporarily alters how some of that machinery coordinates — not just mood or thought content, but the felt sense of being in a body, in a room, in a life. Words can’t fully capture this because it touches something so fundamental that we don’t usually name it. But people routinely describe shifts in awareness of surroundings, associations between memories and meanings, and the emotional tone attached to old narratives. The same memory can feel newly decoupled from a harsh interpretation, opening space for other possibilities. 

That decoupling can be a relief (“I can look at this without the usual sting”) or briefly disorienting (“If I’m not processing this the old way, who am I here?”). Both are understandable. Our role is to hold the frame: this is a medically monitored, time‑bound altered state, entered by choice, for care — not an unmoored experience. You can think of it as therapeutic concentration: the way a skilled therapist might invite you to see something from a new angle, except concentrated into an hour or two. That concentration is part of why we prepare carefully and stay present. 

3) What a Session Feels Like (and What We Do If Anxiety Spikes)

Before the medicine: We settle you in a private room, review intentions, confirm logistics (e.g., who’s driving you home), and orient you to the space. We’ll review grounding tools — breath, body awareness, grounding practices — and a brief mantra you can call on if needed: “This is time‑limited. I am safe. I invite what arises to my benefit.” That sentence alone gives many patients a reliable anchor. 

As the medicine begins: You may notice a warm drift or gentle detachment, a change in the felt distance to daily concerns, or heightened receptivity to music. Some people feel exhilaration or a lightness; others notice a hum of bodily activation that can be read as excitement or anxiety. We expect mild, transient changes in heart rate or blood pressure. All of this is monitored. If a difficult memory arrives, or a wave of worry, we coach you: slow your breathing, name your points of contact (feet, legs, chair), talk you through the experience, and orient. The Lumin Health team of experts is here for you. You are not doing this alone. 

If a “bad trip” moment comes: We don’t fight the content.  Rather, we contain the experience and help you remember what’s true: it will pass and it may hold meaning. Patients sometimes worry, “What if it never ends?” It always ends. The experience is finite, tied to the pharmacology, and will ebb. This is where the clinic setting matters: you have trained people tracking your safety and helping your mind and body down‑shift if needed. Afterward, we make meaning together — often the very moment that felt worst becomes a source of insight. 

One meaningful example: someone who’s felt suicidal for years may, during a difficult moment, feel a sharp fear of disappearing — frightened by the idea of not being here. That fear can reveal an attachment to life that had been buried by despair: “If that felt scary, maybe part of me still wants to live.” That discovery can be a hinge — turning an awful moment into motivation for change. 

4) Preparation: A Practical, Patient‑Centered Checklist

The day before / day of:

• Map the route and arrive a bit early; rushing spikes arousal. Plan for unhurried time after.
  
  
• Clothing: Comfortable layers you can relax in. Bring socks or a light sweater — body temperature perception can shift.
  
  
• Food & drink: Avoid food for 2 hours and liquids for 30 minutes before. This reduces the risk of feeling nauseated and throwing up a good meal.
  
  
• Sound & light: Bring headphones and an eye mask if you have them; Lumin Health is also happy to provide both. Familiar soundscapes help many people settle.
  
  
• Support person: If bringing someone, talk about their role — quiet presence, reassurance, or simply being there. We’ll orient them to supportive companionship in this context.
  
  

Intention‑setting (simple, honest, yours):

Intentions create an inner orientation. They mark the time of treatment as distinct from the rest of your week — a protected space devoted to healing. Your intention can be humble: “I’m open to what helps.” It can be directional: “I want to soften self‑criticism,” or explorative: “Show me what I need to see, gently.” Write it down if that helps you hold it. Intentions are not commands to the experience; they are invitations to yourself. 

“But if I’m not fully in control, will my intention matter?”

Think of it like choosing a ski route, a stretch of whitewater, or a roller‑coaster: for a defined time, you can’t stop or steer every moment — but you can decide why you’re there and how you meet the ride. Your intention is the why, your presence is the how. This is shared control: the medicine sets conditions and you bring attention, willingness, and care. That partnership is the heart of the work. 

5) Why the Setting Matters (and Why Lumin Chose a Medical‑Hospitality Model)

There are many models for ketamine care: at‑home troches, retreats, infusion suites, and full clinical programs. We built Lumin around a simple premise: when you’re sharing control with a medicine, you deserve both medical safety and human warmth. That specific combination changes what’s possible. 

Safety: the Lumin Health clinicians are medically trained and licensed — physicians, physician assistants, social workers, nurse practitioners, and nursing staff (to name a few) — all focused on mental health. That means real‑time monitoring, knowledge of how to down‑shift a distressed nervous system, and the ability to intervene medically if needed. In vulnerable moments, that reliability matters. 

Warmth: Hospitality isn’t an add‑on, it’s intrinsic to our clinical model. Many who come to us struggle to extend warmth inward — “I don’t deserve care; I’m a burden.” We meet that belief with predictable, unconditional regard: private rooms, one‑to‑one attention, space where it’s okay to cry, laugh, or speak with a loved one without feeling exposed. Warmth functions as therapeutic practice — a stable embrace that lets you venture into uncertainty knowing you can return to steadiness, an ability to hold the truth of a person’s value when that individual may be struggling to experience it, independently. Over time, being treated as worthy can soften the parts of you that believed otherwise. 

A corrective experience with healthcare itself: Many people arrive after years of feeling let down by systems — rushed visits, rigid rules, the sense of being a number in so many settings. We designed Lumin to feel different: we want you here. We answer one question or a hundred. We set boundaries that keep the operation healthy, and within that frame, we will work with you on “how” when, previously, a person might have experienced “no” — to clarity, to accessibility, to human contact. It’s remarkable how much farther people can go in self‑discovery when they trust they won’t be dropped. 

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6) What Sets the Lumin Experience Apart (Point‑by‑Point)

• Private, quiet rooms (not bays with curtains): space to feel without being overheard.
  
  
• 1:1 clinical attention throughout a session: your clinician isn’t juggling multiple patients.
  
  
• Trauma‑informed stance: we track your arousal, pace interventions, and rely on choice and consent at every step.
  
  
• Medical oversight: monitoring and the capacity to intervene if bodily arousal runs high.
  
  
• Intentional hospitality: “You are wanted here” shows up in small, concrete ways — from how we greet you to how we follow up.
  
  
• Integration mindset: session content becomes fuel for therapy and life decisions, not just “an experience.”
  
  

We also hold a balanced view of other models. Retreats and coaching‑based settings can be meaningful for some. Our choice of a medical‑hospitality clinic is about fit: the environment we think best supports shared control, depth, and safety for most people who seek us out. 

7) The Arc Over Time: Index Courses, Cadence, and When People Pause

Racemic ketamine (off‑label, infusion/injection): We typically recommend what’s called an “index course” — two sessions per week for 3–5 weeks — then a pause to listen: how long can you go before you want or need another treatment? Some return every few months for one or two sessions while others prefer a steadier cadence for a time. We tailor this with you. Transparency matters: racemic ketamine for depression is off‑label in the U.S. - this means that the FDA hasn’t approved its use for the treatment of psychiatric conditions even while 25+ years of evidence has proven its efficacy.  We recommend it thoughtfully and discuss options candidly. 

Esketamine (Spravato®, FDA‑approved, a derivative of ketamine): Label guidance is twice weekly for four weeks, then once weekly for four weeks, then weekly or every other week thereafter. Many patients continue for months (sometimes longer), gradually spacing visits as stability improves. Over time, the intense “psychedelic” qualities often soften (a habituation or tolerance in the feel), while day‑to‑day benefits can persist between sessions. Patterns vary and at Lumin Health, we adjust collaboratively. 

Natural ebbs and surprising returns: Some long‑term Spravato patients describe periods where the experience feels steady and unremarkable — and then, unexpectedly, a session opens a fresh window that feels like the early days: vivid, clarifying, catalytic. That variability isn’t a failure; it’s part of how living systems respond over time. 

When people choose to stop ketamine or Spravato treatment:

• Insufficient benefit: If relief doesn’t emerge after a reasonable trial, many choose not to invest further. That’s valid — and we’ll help you pivot to other options.
  
  
• Dislike of shared control: Some don’t enjoy not being in authority over the experience. Even if sessions weren’t “bad,” the felt relinquishment isn’t for everyone. Also valid.
  
  
• A truly difficult experience: Uncommon but possible.  A few decide that’s enough. Many others, however, discover that a single hard session does not predict future ones, and they continue with careful support. We meet you where you are.
  
  
• A person feels a transformational change: Sometimes a person has such a strong response to treatment that the individual would like to pull back from treatment and see how they’ll feel independent from it.
  
  

8) Making Meaning: Turning Sessions Into Lasting Change

Ketamine can open a window of neuroplasticity — a state in which the brain more readily forms and strengthens new connections. But plasticity is a capacity, not a conclusion. What fills that window is experience and practice. That’s why we encourage pairing treatments with psychotherapy or intentional self‑reflection: journaling, values work, conversations that translate insight into action. The combination helps “lock in” what the session reveals. 

Many therapists and prescribers who refer to us report that their patients shift from survival mode (“just getting through the day”) to having bandwidth for deeper work: revisiting painful material, trying new behaviors, tolerating ambivalence, and integrating nuanced truths. When depression loosens its grip the mind can finally consider why the grip formed and how to live differently going forward. That’s where gains persist — because the life you build between sessions feeds back into the brain as ongoing evidence that change is possible. 

9) Working with Challenging Content (Including the “Fear of Death” Theme)

Not every meaningful session is soft or blissful. Some are honest: a flash of realizing how we’ve hurt a partner, or the startling fear that accompanies imagining not being here. The content itself isn’t the “cure” but how you relate to it and what you do next. If the session shows you a place for repair, you can act — apologize, set a boundary, seek support, change a habit. If it reveals that death feels frightening after years of suicidal thoughts, you can honor the part that wants to live and plan from there. Hard does not mean harmful — especially in a setting built for safety and follow‑through. 

10) Practical FAQs We Hear All the Time

“Will the dissociation during ketamine or Spravato last or become permanent?”

In a monitored clinical context, dissociative effects are short‑lived. You may feel altered during and shortly after a session; we keep you until you’re steady. If a moment feels overwhelming, we’ll help you orient and remember: this is finite and pharmacologic. 

“Can I prevent a bad trip?”

No one can guarantee content. But you can shape the conditions: arrive unhurried, set an intention, use familiar music, and trust the team and your own ability to persevere and extend compassion. If anxiety spikes, we’ll coach breath, body orientation, and gentle mantras. We’ll talk you through it.  The clinic’s reliability is, itself, an anti‑anxiety measure. 

“Is it okay if I cry? Or if I don’t feel anything?”

Yes and yes. Some sessions are emotional while others are quiet. We value authenticity over performance. If a session is muted, that’s information too — sometimes the benefits show up in the days after, in how you relate to work, family, or your inner critic. 

“What about bringing a support person?”

Welcome — if that feels supportive. We’ll orient them to the role you want them to play (quiet presence vs. gentle reassurance) so they become part of, not a distraction from, your work. 

11) The Role of Intention, Revisited (Because It’s That Important)

Intention isn’t a way to control content, it’s a way to prepare your nervous system. It defines the “why” and the “how” that you carry into an experience not fully under your command. In this sense, intention is a practice of agency: you choose your stance toward uncertainty. You can step in with “I will meet what comes with curiosity,” and step out with “Here’s what I’m willing to do differently.” Over time, this stance generalizes.  Patients tell us they become a little more courageous in daily life: sending that hard email, making that appointment, speaking gently to themselves when they falter. Those are the bricks that build a different year. 

12) Why We Emphasize Warmth (and What That Looks Like)

Two reasons. First, many patients have difficulty extending it to themselves. Our warmth becomes a surrogate — a living mirror that says, You are worthy of care. Second, warmth is the safe “home base” from which exploration becomes possible. Like a parent’s steady presence lets a child venture into a new room, a warmly predictable clinic lets you venture into altered states without fearing you can’t find your way back. Concretely, that means: taking time to answer questions (one or a hundred), offering privacy, and treating you as a person whose comfort and dignity matter at every step. 

This is also a response to modern healthcare’s pressures. Systems must balance volume and acuity, and warmth can get crowded out. Lumin was built to flip the script where possible: we want you — not as a slogan, but as an operational principle. When patients touch a system that actually feels interested in their good experience, something softens. Often, that softening is what allows change to begin. 

13) Ketamine vs. Spravato® (and How We Decide Together)

Mechanistically, both ketamine and esketamine (Spravato) engage glutamate pathways in ways thought to support rapid neuroplasticity. Practically, they differ in formulation, regulation, and access. Racemic ketamine infusion/injection is an off‑label use for mood disorders, anxiety, OCD, and PTSD – these are conditions where ketamine has been most extensively studied; Spravato is FDA‑approved for treatment‑resistant depression (Major Depressive Disorder) and depression (Major Depressive Disorder) with suicidal thoughts with a structured, in‑clinic nasal spray protocol. Insurance coverage patterns often follow those regulatory differences. We discuss all of this upfront so you can choose the path that best balances clinical need, logistics, and cost. Our north star isn’t one molecule, it’s the fit between you and a thoughtfully designed course of care. 

14) A Note on Expectations: Relief, Not Guarantees

For many, ketamine or Spravato offers meaningful relief — sometimes quickly. For others, the gains are subtler, or they don’t arrive on the hoped‑for timeline. We won’t promise a miracle. We will promise partnership: careful preparation, attentive dosing, honest check‑ins, and a readiness to adapt or pivot. Sometimes the win is relief within the first few sessions or first few weeks. Sometimes the win is discovering that this isn’t your tool,  — and walking with you toward the next option. 

15) Putting It All Together: Your Role Is Central

Everything above points to one truth: you are not a passive recipient. Ketamine and Spravato may catalyze change, but you decide how to meet the experience, what to do with what you learn, and how to keep going. Your willingness to be curious, your patience with yourself, your relationships, your routines — these are not extras.  They are core elements of the treatment. In this model, medicine, psychotherapy (self directed and with a partner), and agency form a three‑strand cord, stronger together. 

16) A Step‑By‑Step Summary (For When You’re Ready)

1. Consult & align: Share your history, goals, and concerns. We’ll discuss ketamine vs. Spravato, safety, cadence, and support.
   
   
2. Prepare intentionally: Plan the route, set your intention, arrange after‑care. Bring headphones/eye mask or use ours. Avoid food for 2 hours, liquids for 30 minutes.
   
   
3. Session: Private room, monitoring, shared control. Use breath and orientation if anxiety rises.  Remember the mantra: time‑limited, safe, for my benefit.
   
   
4. De‑brief & integrate: Make meaning while it’s fresh. Consider therapy, journaling, values conversations, small behavioral experiments.
   
   
5. Cadence: If ketamine: complete the index course, then pause and tailor. If Spravato: follow label cadence and taper spacing as appropriate.
   
   
6. Reassess honestly: Continue if benefits outweigh burdens and pivot if they don’t. Either choice is a wise choice when it’s yours.
   
   

17) Ketamine and Spravato at Lumin Health: Grounded Hope

Treatment is personal. Ketamine or Spravato can be one evidence‑informed tool among many — most effective when paired with therapy, skills practice, and the steady support of people who know and care for you. If you’re curious, consider a consultation with a provider trained in these therapies to explore whether it may be a good fit for your needs. At Lumin Health, we’ll meet you with clinical precision and genuine warmth, and we’ll decide together — step by step — what path serves you best. We provide the setting, the safety, and the steady hands.  You provide your perseverence, curiousity, tenacity, and willingness. Let’s see what becomes possible when those pieces come together. 

Spravato® is a registered trademark of Janssen Pharmaceuticals. Racemic ketamine for mood disorders is used off‑label in the U.S.; we discuss options transparently so you can make an informed decision.  

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