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The Role of Ketamine Therapy in Addressing PTSD and Anxiety in Personality Disorders

Writer: Demian Gitnacht, MD, MPH, FAAFPDemian Gitnacht, MD, MPH, FAAFP

At Kalea Wellness, we work with individuals facing complex mental health challenges, including those with personality disorders. These disorders shape how a person perceives themselves and the world, often leading to distressing emotional patterns, difficulties in relationships, and struggles with self-identity. Many individuals with personality disorders also experience co-occurring conditions such as complex PTSD and severe anxiety, which further impact their well-being.


Personality disorders are categorized into three clusters based on their characteristics. Cluster A includes disorders marked by eccentric or odd behaviors, such as Paranoid, Schizoid, and Schizotypal Personality Disorders. Cluster B consists of disorders characterized by intense emotions and unpredictable behavior, including Borderline, Narcissistic, Histrionic, and Antisocial Personality Disorders. Cluster C encompasses disorders involving chronic anxiety and fear-based behaviors, such as Avoidant, Dependent, and Obsessive-Compulsive Personality Disorders. Individuals within these clusters often experience persistent and ingrained ways of thinking and behaving that can lead to emotional distress and difficulties in daily life.


While personality disorders are deeply embedded in a person’s psychological framework, ketamine-assisted psychotherapy (KAP) has emerged as a promising approach for alleviating co-occurring symptoms of PTSD and anxiety. Traditionally, personality disorders have been considered resistant to rapid pharmacological treatments, as they are longstanding patterns rather than episodic conditions. However, KAP offers a unique opportunity for individuals to experience shifts in perspective, which can support therapeutic work in managing trauma and anxiety.


Ketamine functions by binding to NMDA receptors in the brain, increasing the secretion of glutamate, and triggering the release of growth factors that foster new neural connections. This process creates a "reset" effect, which has shown benefits in mood disorders, anxiety, and PTSD. Although KAP does not directly modify personality disorders, it can significantly reduce the intensity of PTSD and anxiety symptoms, providing patients with a temporary reprieve from their usual emotional patterns.


For individuals undergoing KAP, these sessions can provide moments of detachment from habitual cycles of fear, self-criticism, and distress. This temporary relief can be invaluable, allowing for deeper therapeutic exploration and helping individuals revisit traumatic memories with reduced emotional reactivity. When integrated into a broader psychotherapeutic strategy, KAP supports patients in reshaping their understanding of trauma and managing its lasting effects.


Prior to KAP, many individuals with personality disorders and co-occurring PTSD or anxiety struggle with emotional regulation, unstable relationships, and challenges in maintaining consistent routines. Their daily lives are often punctuated by intense mood swings, fear of abandonment, and episodes of emotional turmoil. Through KAP, they may experience moments of clarity and calmness, which, while not a cure, serve as crucial windows for meaningful therapeutic engagement and long-term healing.


At Kalea Wellness, we recognize the complexity of each individual’s journey. Our approach to KAP is tailored to support those managing symptoms intersecting with personality disorders rather than attempting to alter personality structures themselves. By integrating KAP into a comprehensive treatment plan, we aim to help individuals navigate their challenges with greater stability and resilience.


Mental health care continues to evolve, and we invite you to explore how KAP may complement existing therapeutic strategies for complex conditions. At Kalea Wellness, we are committed to providing compassionate, innovative care that meets the unique needs of each individual. Reach out to us today to learn more about our approach and take the next step toward healing and well-being.


Together, we can embrace the path to wellness, one step at a time.


Woman with a personality disorder

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