Bipolar Disorder


What is Bipolar Disorder?

Bipolar disorder, formerly known as manic depression, is a mental health condition characterized by extreme mood swings. These mood swings go beyond normal fluctuations in mood. People with bipolar disorder experience periods of intense emotional states. These include episodes of mania (or hypomania) and depression and effects roughly 6 million US adults each year.

During manic episodes, individuals may feel overly energetic, euphoric, or irritable. They might have an inflated sense of self-importance, engage in risky behaviors, have racing thoughts, and experience a decreased need for sleep. Mania can impair judgment and lead to impulsive decisions. Hypomania is a milder form of mania where the symptoms are less severe. But, still significantly elevated compared to a person's baseline.

During depressive episodes, individuals may feel hopeless, sad, fatigued, have trouble concentrating, and lose interest in activities they once enjoyed. They might experience changes in appetite, sleep patterns, and even have suicidal thoughts.

Bipolar disorder is a chronic and complex condition that affects each person differently. The periods of mania and depression can last for days, weeks, or even months. Between these episodes, individuals may experience relatively stable periods. Although some people may experience rapid cycling, where they switch between mood states more frequently.

Cause of Bipolar Disorder

The exact cause of bipolar disorder is not fully understood. However, it is believed to involve a combination of genetic, environmental, and neurobiological factors. The disorder can be managed with a combination of medication, psychotherapy, and lifestyle adjustments. Early diagnosis and appropriate treatment can make a significant difference in managing the condition and improving overall quality of life.

How Does Ketamine Work to Treat Bipolar Disorder?

Bipolar disorder is a complex mental health condition characterized by extreme mood swings, affecting millions of people worldwide. Traditional treatments, such as mood stabilizers and psychotherapy, have been the primary approach to managing this disorder. However, in recent years, there has been growing interest in alternative therapies. One such treatment that has shown promising results is ketamine.

Originally developed as an anesthetic in the 1960s, ketamine has been used in medical settings for decades due to its fast-acting analgesic and dissociative properties. More recently, researchers have explored ketamine's potential in treating psychiatric conditions, including depression, anxiety, and bipolar disorder.

Ketamine operates through a unique mechanism of action, primarily targeting the glutamate neurotransmitter system. It antagonizes N-methyl-D-aspartate (NMDA) receptors, which leads to increased release of neurotransmitters, including glutamate, in the brain. This process enhances neural plasticity and stimulates the formation of new connections between neurons. By influencing various neural pathways, ketamine has been found to have profound effects on mood regulation and cognition.


Studies investigating the use of ketamine in bipolar disorder have shown promising results. In a 2018 clinical trial published in the American Journal of Psychiatry, researchers administered intravenous ketamine to individuals experiencing bipolar depression. The results were remarkable, with patients experiencing rapid and significant reductions in depressive symptoms within hours of treatment.

Moreover, a review of studies in the Journal of Affective Disorders suggested that ketamine infusions were not only effective in treating bipolar depression but also showed potential in alleviating acute manic episodes. This is particularly significant because managing manic episodes is often challenging and requires prompt intervention.

The Benefits of Ketamine Treatment

  • Rapid Relief: One of the most significant advantages of ketamine therapy is its rapid onset of action. Unlike traditional antidepressants, which can take weeks to show effects, ketamine can alleviate depressive symptoms within hours, providing much-needed relief to patients in distress.
  • Reduced Suicide Risk: Bipolar disorder carries a substantial risk of suicide during depressive episodes. By rapidly reducing depressive symptoms, ketamine treatment may play a crucial role in mitigating the risk of suicide and enhancing patient safety.
  • Treatment-Resistant Cases: Ketamine therapy has shown promise in cases where patients have not responded to conventional treatments. These individuals often experience what is known as treatment-resistant bipolar disorder, making ketamine a potential lifeline for those who have exhausted other options.
  • Extended Benefits: Some studies have suggested that the positive effects of ketamine treatment can last beyond the acute administration, with ongoing improvements in mood and overall well-being.

Ketamine Therapy Treatment Plan for Bipolar Disorder

For over two decades the most common protocol used to treat mood disorders in the setting of a ketamine clinic involves a primary series of six infusions. Research has shown that although one infusion can provide rapid relief, the benefits generally wear off quickly and for some the effects are very subtle. Using a series of infusions allows the ketamine to have a greater and longer lasting effect in the brain resulting in sustained relief.

It is important to bear in mind that the theory of how ketamine works in the brain described above is a process that takes time, and one infusion is not likely to provide long term relief. It is also important to know that ketamine provides life-changing benefits for many patients. But, it is not considered a cure and will almost certainly require ongoing maintenance infusions. The frequency can be variable from several weeks to several months in between treatments.

It is recommended to complete at least three infusions prior to deciding if the treatment is working for you. Most patients will be able to identify a clear benefit by then. If after three infusions, you do not feel that the treatment is providing any benefit at all then unfortunately you may be in a minority that do not respond well to ketamine therapy. This is very unfortunate, but it is essential to understand that it is possible you will try the treatment and not find the relief you are looking for. Ultimately, there is no way to know if ketamine will work for you without actually trying it.

Data Driven Ketamine Treatment for Bipolar Disorder

We use the data from published research to guide treatment. This often leads to using a treatment plan based on the “average patient”. There is merit in this approach but in reality, each patient is an individual and the response to treatment can likewise be very individual. Ketamine infusions are not a one-size-fits-all treatment. Some clients report amazing relief with just one infusion. Others find little benefit after three infusions. But elect to proceed and ultimately find good benefit after the fourth or fifth infusion. The point being that we always proceed one step at a time. NW Ketamine Infusion does not offer packages of infusions because there should be no pressure to proceed if the treatment isn’t right for you.

Caution and Considerations When Using Ketamine Therapy to Treat Bipolar Disorder

While ketamine shows significant potential for treating bipolar disorder, it is essential to undergo a thorough screening prior to initiating treatment. Most patients can safely receive ketamine therapy. There are a few medical conditions that might require treatment prior to beginning therapy or stop you from receiving this treatment. A few examples are uncontrolled hypertension, active substance abuse, pregnancy or unstable cardiac disease. Ketamine is not a first-line or stand-alone treatment for mood disorders and is intended to be one component of a multimodal treatment regimen.

Although the potential for addiction is extremely low, ketamine can be abused or misused. Close monitoring by qualified medical professionals is crucial during ketamine administration to ensure safety and appropriate dosing.


Ketamine therapy is a promising and exciting development in the field of bipolar disorder treatment. Its rapid relief of depressive symptoms and potential effectiveness in managing manic episodes make it a valuable option, especially for individuals who have not responded to conventional treatments. If you have tried other treatments and have not found the relief you are seeking, ketamine infusion therapy may help. Please contact us to schedule a free initial consultation to see if this treatment is right for you.