Ketamine Therapy Case Studies
Case Study: A First Responder’s Journey Through PTSD, Panic Attacks, and Ketamine Therapy
Patient: Jason S.
Profile: Male firefighter in his 40s from Gilbert
Treating Physician: Dr. Gregory Wong, MD
The Challenge
Jason came to our clinic struggling with migraines, panic attacks, anxiety, and depression. He had been dealing with depression, irritability, and anxiety for more than three years, but his symptoms had escalated to the point of frequent panic attacks and intense intrusive thoughts. When he experienced a headache, his mind would quickly spiral into catastrophic fears, such as believing he might have a brain tumor or aneurysm.
His symptoms had begun interfering with daily life and job performance. As a firefighter, he found that anxiety and panic were affecting his ability to function effectively at work.
Initial Emotional State
At his first visit, Jason was highly anxious and hypervigilant. He was also skeptical about ketamine therapy because of its negative street reputation, something that felt especially important to him as a first responder. Although he was interested in getting help, he had difficulty fully engaging in a comprehensive treatment plan at first.
He had never tried ketamine therapy before. What helped him take the next step was hearing from another firefighter who had completed treatment through our program.
What He Had Tried Before
Before coming to our clinic, Jason had only received limited treatment. He had done a small amount of cognitive behavioral therapy and had used benzodiazepines to help with sleep, but he had not undergone a more structured or intensive treatment approach.
Clinical Assessment
Jason completed a full medical intake along with standardized screening tools, including the GAD-7, PCL-5, and PHQ-9. His scores were:
- GAD-7: 19
- PCL-5: 40
- PHQ-9: 15
These findings supported a diagnosis of complex PTSD (cPTSD) along with significant autonomic nervous system dysregulation. His symptoms suggested an overactivated sympathetic nervous system, likely connected to trauma exposure associated with his work. He had not experienced these symptoms before entering the profession.
Why Ketamine Was Considered
Based on Jason’s presentation, both stellate ganglion block (SGB) and ketamine therapy were considered appropriate. The treatment goals were to help regulate his nervous system, reduce the intensity of trauma-related symptoms, and create an opportunity for deeper processing and healing.
Treatment Plan
Jason initially chose to begin with bilateral SGB only because he did not feel he had the time to commit to a full ketamine treatment program while studying for a career promotion. However, after his SGB series, his emotions became more activated, and it became clear that moving forward with ketamine treatment would likely be beneficial. At that point, ketamine therapy was initiated.
Response to Treatment
Jason’s path was somewhat atypical. He was apprehensive and delayed committing to ketamine treatment at first. But once treatment began, he responded quickly and meaningfully. In the first week, he reported feeling noticeably calmer, and important insights began to emerge. Trauma from work started coming to the surface in a way that he was able to process more effectively.
During treatment, he also experienced a temporary setback: after his second SGB, he had an increase in emotional lability and distressing thoughts. Because of that response, his ketamine timeline was advanced. Once ketamine therapy began, his care progressed much more positively.
Outcome
By the end of the program, Jason had made meaningful progress in emotional regulation, calmness, and trauma processing. His improvement was strong enough that he later referred several friends to our clinic for care.
Closing Note
Jason’s story reflects the complexity of trauma care, especially for first responders who may be hesitant to seek help. It also highlights how a personalized plan, careful assessment, and the right combination of therapies can open the door to meaningful healing.