Why Trauma Becomes Physical
Trauma is not only a psychological event. When the brain perceives a serious threat, it activates the hypothalamic-pituitary-adrenal (HPA) axis — the body’s central stress-response system — triggering a cascade of hormones including cortisol and adrenaline that prepare the body to fight, flee, or freeze. In most situations, this response resolves once the threat passes. In traumatic stress, and particularly in post-traumatic stress disorder (PTSD), the response becomes dysregulated: the brain continues behaving as though the threat is ongoing, and the body carries that activation forward into daily life.
This shows up as hypervigilance (a state of chronic alertness and reactivity), intrusive memories, sleep disruption, and physical symptoms including chronic pain, digestive problems, and sustained muscle tension. Research increasingly points to the glutamatergic system — the brain’s primary excitatory neurotransmitter network, involving a chemical called glutamate — as a key pathway through which traumatic memories are encoded, maintained, and potentially disrupted. This is clinically significant because most first-line psychiatric medications target serotonin and norepinephrine, not glutamate. For patients whose trauma biology involves glutamate dysregulation, those medications may not reach the root of the problem.
What Clinical Treatment for Body-Stored Trauma Looks Like
From a clinical standpoint, releasing trauma from the body means interrupting the physiological patterns that keep the stress response activated — not just processing the narrative of what happened. Two approaches that work through biological mechanisms distinct from traditional antidepressants have a growing evidence base for this: IV ketamine infusion therapy and SPRAVATO® (esketamine nasal spray).
Ketamine is an NMDA receptor antagonist — meaning it blocks a specific type of glutamate receptor in the brain. This blockade triggers a downstream cascade that increases the brain’s production of BDNF (brain-derived neurotrophic factor), a protein that supports the growth of new neural connections, a process called neuroplasticity. In plain terms, ketamine may help the brain form new pathways that are not organized around the traumatic stress response — which is part of why it shows promise for treatment-resistant PTSD specifically.
A 2023 clinical review published in Therapeutic Advances in Psychopharmacology synthesized evidence across case reports, open-label studies, and randomized trials for ketamine in PTSD. The review documented encouraging signals of safety and efficacy, including studies combining ketamine with body-centered somatic psychotherapy that produced medium effect sizes for PTSD symptom reduction (d = −0.48) and statistically significant improvements in depression (d = −0.53) (Ragnhildstveit et al., 2023). A 2024 systematic review and meta-analysis published in Clinical Neuropsychiatry further supported ketamine’s promise in PTSD treatment, identifying glutamatergic activity as central to how ketamine may disrupt the encoding and reconsolidation of traumatic memories (Almeida et al., 2024).
These are not guarantees of outcome — results vary by individual, and not every patient responds. But the mechanism and the emerging evidence together provide a coherent clinical rationale for why ketamine, uniquely among available treatments, may reach trauma that other approaches have not. For patients interested in complementary body-based approaches, our post on trauma release exercises you can try at home covers accessible self-directed techniques that may support the broader healing process.
IV Ketamine Infusion Therapy at The Invictus Clinic
We offer IV ketamine infusion therapy administered in private, comfortable treatment rooms at our Marietta clinic. Our team — Dr. Brandon Grinage, MD (Anesthesiologist), and Wesley Karcher, MSN, CRNA (Certified Registered Nurse Anesthetist) — brings decades of combined anesthesia expertise, which matters significantly in this context. Ketamine dosing for mental health is a precision practice: the therapeutic window is specific, individual response varies, and safe administration requires clinical monitoring throughout the infusion. Both of our providers have that expertise as a foundation, not an add-on.
Mental health infusions typically run 40 to 60 minutes, with approximately 30 minutes of relaxation time afterward before a patient leaves. The initial series for most patients involves multiple infusions over a defined period, with the exact protocol determined through consultation based on your history and treatment goals. A family member or friend is welcome to stay during your infusion, and we can accommodate scheduling around most work schedules.
SPRAVATO® as a Covered Alternative
For patients who are candidates for SPRAVATO® — esketamine nasal spray, FDA-approved specifically for treatment-resistant depression and depressive symptoms in adults with major depressive disorder with acute suicidal ideation or behavior — we offer this as an insurance-covered option at our Marietta clinic. SPRAVATO® works through a similar glutamatergic mechanism as IV ketamine and is administered in-clinic under observation. We accept Anthem BCBS, Aetna, and Medicare, and SPRAVATO® coverage through these plans is available for qualifying patients. Discussing your insurance coverage with us before your consultation can clarify what’s possible financially before any clinical decisions are made.
Addressing Two Real Barriers to Care
Fear is one of the most common things that keeps patients from pursuing treatment they’ve already researched. We hear it often: concern about dissociation during an infusion, about what ketamine “feels like,” or about whether the experience will bring up difficult memories in an uncontrolled way. We take those concerns seriously. During your initial consultation with Dr. Grinage or Wesley Karcher, we spend as much time as necessary answering questions — including the ones that feel uncomfortable to ask. You will not be rushed through that conversation.
Cost is the other barrier we address directly. IV ketamine ranges from $400 to $1,000 per treatment at our clinic, and we offer a 15% discount for patients who pay upfront for an initial series. Active military, veterans, and first responders receive a 25% discount on IV ketamine infusions. We also accept CareCredit for patients managing out-of-pocket costs, and our front desk team will walk through all financial considerations before any commitment is made. Reach us at 770-580-1042 or through our contact page to begin that conversation.
Frequently Asked Questions
Is ketamine the same as what’s used recreationally?
Ketamine has been used safely as an anesthetic in medical settings for over 50 years. At therapeutic doses administered in a clinical setting with continuous monitoring — which is how we use it — it functions very differently than recreational use. The dose, route of administration, clinical environment, and provider oversight are all distinct. Patients who have concerns about this are encouraged to raise them during their consultation so we can address them thoroughly.
Will ketamine work if I’ve tried antidepressants and therapy without full relief?
Ketamine works through the glutamatergic system rather than the serotonin or norepinephrine pathways targeted by most antidepressants — which is part of why it may help in cases where those approaches have not. Results vary by individual, and a thorough evaluation is necessary before treatment to assess whether you’re a good candidate. That evaluation is part of our consultation process.
How many infusions are typically needed to notice a difference?
Most patients complete an initial series of infusions rather than a single treatment, with protocols tailored to individual history and response. Some patients notice changes after the first few infusions; others respond more gradually. Your provider will discuss realistic expectations and what to watch for based on your specific situation.
Does ketamine treat trauma specifically, or just depression and anxiety?
Ketamine is primarily used off-label for treatment-resistant depression, anxiety, and PTSD. The evidence for PTSD is growing — several clinical reviews now document meaningful symptom reductions, particularly in treatment-resistant cases — though it is not FDA-approved specifically for PTSD. We evaluate each patient individually and discuss which of our services best aligns with your diagnosis and treatment history.
Is SPRAVATO® covered by my insurance?
SPRAVATO® is FDA-approved for treatment-resistant depression and carries broader insurance coverage than IV ketamine for qualifying patients. We accept Anthem BCBS, Aetna, and Medicare, and our team handles prior authorization and coverage verification before treatment begins. The best way to clarify your specific coverage is to contact us directly with your insurance information.
Key Takeaways
- Trauma becomes physiological — stored in the nervous system, stress hormones, and chronic muscular patterns — which is why psychological approaches alone may be insufficient for some patients.
- Ketamine works through the glutamatergic system, a pathway distinct from most antidepressants, which may explain why it shows promise for treatment-resistant PTSD when other treatments have not helped.
- Peer-reviewed research documents meaningful reductions in PTSD symptoms with ketamine, including studies combining it with body-centered approaches (Ragnhildstveit et al., 2023; Almeida et al., 2024).
- At our clinic, IV ketamine is administered by anesthesia-trained providers with continuous monitoring in private treatment rooms — clinical safety is built into the foundation of what we do.
- SPRAVATO® is available as an FDA-approved, insurance-covered option for qualifying patients with treatment-resistant depression.
Body-stored trauma responds to clinical treatment when that treatment reaches the right physiological pathway — and for patients who’ve tried other options without full relief, that distinction matters. If you’re ready to explore what may work when previous approaches haven’t, we’d welcome that conversation. Call us at 770-580-1042 or request a free consultation at theinvictusclinic.com to talk with our team about your history and your options.
References
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://pmc.ncbi.nlm.nih.gov/articles/PMC10979792/
Ragnhildstveit, A., Roscoe, J., Bass, L. C., Averill, C. L., Abdallah, C. G., & Averill, L. A. (2023). The potential of ketamine for posttraumatic stress disorder: A review of clinical evidence. Therapeutic Advances in Psychopharmacology, 13. https://pmc.ncbi.nlm.nih.gov/articles/PMC9989422/
Medical Disclaimer: The information in this blog is for educational purposes only and does not constitute medical advice. Treatment for PTSD, depression, anxiety, and trauma-related conditions — including IV ketamine infusion therapy and SPRAVATO® — should only be pursued under the supervision of a licensed provider familiar with your full medical and psychiatric history. Individual results vary. SPRAVATO® is FDA-approved for specific indications; IV ketamine for psychiatric conditions is used off-label. 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.
