Beginning depression treatment in November and December will likely be one of the most important decisions you make this year, and knowing what to expect during those crucial first weeks can reduce anxiety and help you commit to the process when symptoms are at their most challenging. The initial phase of treatment, particularly with advanced options like ketamine IV infusions or SPRAVATO® nasal spray, involves specific timelines, side effects, and milestones that are entirely different from traditional antidepressants most people expect.
Understanding Treatment Timelines and What Makes Ketamine Different
Expert guidelines detail what patients can anticipate during the first weeks of ketamine-based treatment, including expected timelines for symptom improvement ranging from 24 to 72 hours after initial administration, along with comprehensive safety protocols for monitoring and managing any side effects (McIntyre et al., 2021). This rapid onset differs dramatically from traditional antidepressants that require 4-8 weeks to show benefits, making November and December strategic months for beginning treatment rather than enduring the season while waiting for medication to work.
Dr. Derek Irons, who has administered thousands of ketamine infusions since founding Southern Ketamine & Wellness, often tells new patients that the first treatment feels nothing like what they expect. “Most people come in thinking it will be like starting Prozac or Zoloft—take it daily and hope it works in a month,” he explains. “With ketamine, you might feel different walking out of the clinic than you did walking in. That can be startling in a good way, but it’s important to understand what you’re experiencing.”
The Evaluation Process and Your First Treatment Session
The initial consultation and evaluation process typically takes longer than a standard doctor’s visit because your treatment team needs comprehensive information about your depression history, current medications, and specific symptoms to design an appropriate treatment plan. At Southern Ketamine & Wellness, this evaluation includes discussion of your previous treatment attempts, current life stressors, and specific goals for improvement. The VA background Dr. Irons brings to the clinic means thorough assessment of any trauma-related components to depression, which often influence treatment approaches.
For ketamine IV infusions, the first treatment appointment usually lasts 2-3 hours, including pre-treatment monitoring, the 40-minute infusion itself, and post-treatment observation. Many patients feel anxious about this time commitment, especially during the busy holiday season, but the clinic schedules appointments to minimize disruption to work and family obligations. Morning appointments often work well because the brief dissociative effects resolve by afternoon, allowing you to resume normal activities.
The dissociative experience during ketamine treatment surprises most people, even when they’ve been thoroughly prepared. Real-world clinical studies detail typical patient experiences, including temporary feelings of disconnection from surroundings, altered perception of time, and occasionally vivid thoughts or imagery (Włodarczyk et al., 2021). These effects are temporary and monitored continuously, but they can feel intense if unexpected. Most patients describe the experience as unusual but not frightening, particularly with proper preparation and clinical supervision.
SPRAVATO® nasal spray treatments involve different logistics but similar monitoring requirements. Each session requires 2+ hours at the clinic due to FDA-mandated observation periods, though the actual medication administration takes only minutes. The nasal spray format eliminates needles and IV equipment, which some patients prefer, but the monitoring requirements remain identical to ensure safety during the dissociative period.
Side effects during the first few treatments vary significantly between individuals, but common experiences include mild nausea, temporary dizziness, and fatigue following treatment sessions. These effects typically resolve within hours and often decrease with subsequent treatments as your body adjusts to the medication. Having realistic expectations about side effects prevents unnecessary worry and helps you distinguish between normal treatment responses and issues requiring medical attention.
The timeline for symptom improvement often surprises patients in both directions. Some people feel dramatically better after their first treatment, experiencing lifted mood and increased energy within hours. Others require 2-3 treatments before noticing significant changes. Most patients see meaningful improvement within the first week of starting treatment, which makes November timing advantageous for feeling better before holiday gatherings rather than struggling through them.
Practical Considerations: Costs, Scheduling, and Family Communication
Financial planning for treatment deserves honest discussion upfront. Ketamine treatments may be covered by insurance, particularly when documented as treatment for treatment-resistant depression, but coverage varies significantly between plans and providers. Southern Ketamine & Wellness helps patients research their insurance benefits and provides cost estimates before beginning treatment. Results vary by individual insurance plan, but many patients find coverage better than expected, especially for FDA-approved SPRAVATO® treatments.
The scheduling commitment requires advance planning, particularly during November and December when both work and personal calendars fill quickly. Initial treatment protocols typically involve 2-3 treatments per week for the first 2 weeks, then weekly maintenance treatments. This front-loaded approach maximizes symptom improvement quickly but requires flexibility in your schedule. Many patients find that prioritizing these early appointments leads to better holiday experiences overall.
Family and work considerations need proactive attention when beginning treatment during the holidays. Most patients can work normally on treatment days, though some prefer to avoid important meetings or demanding tasks immediately after appointments. Driving restrictions apply for the remainder of the treatment day, so arranging transportation prevents stress and ensures safety compliance.
The emotional aspects of beginning treatment during holidays often prove more challenging than physical side effects. Many patients feel guilty about focusing on mental health during family-focused times, or worry that needing intensive treatment means they’re failing at holiday happiness. These concerns reflect cultural messages about holidays rather than treatment realities. Addressing depression proactively often leads to more genuine enjoyment of holiday activities than trying to push through symptoms.
Communication with family members typically improves when they understand you’re taking positive steps toward feeling better rather than simply enduring another difficult season. Many relatives express relief when they learn you’re receiving professional help, especially if they’ve watched you struggle during previous holidays. Frame treatment as preparation for enjoying time together rather than an obligation that interferes with family plans.
Monitoring Progress and Taking Your Next Steps
Monitoring your response to treatment involves tracking specific symptoms and mood changes, not just general feelings of “better” or “worse.” Your treatment team will provide specific metrics to observe, such as sleep quality, energy levels, ability to concentrate, and interest in previously enjoyable activities. This systematic approach helps adjust treatment protocols for optimal results and provides clear evidence of progress.
Emergency support remains available throughout treatment, but most patients find they need crisis intervention less frequently as treatment progresses. Having your treatment team’s contact information easily accessible provides peace of mind, and knowing what constitutes a true emergency versus temporary treatment effects reduces unnecessary worry.
Three practical steps you can take this week include scheduling an evaluation appointment with a qualified provider who offers ketamine-based treatments for depression, preparing a list of current medications, previous treatments, and specific symptoms to discuss during your consultation, and arranging transportation and schedule flexibility for initial treatment appointments if you decide to proceed.
The most important thing to understand is that beginning depression treatment in November positions you to feel significantly better during traditionally difficult months rather than enduring symptoms while waiting for spring. Results vary by individual, but the rapid-acting nature of ketamine treatments means you could be feeling meaningfully better before Thanksgiving rather than struggling through the entire holiday season.
If you’ve been considering treatment for depression, particularly if traditional approaches haven’t provided sufficient relief, November and December offer strategic timing advantages rather than obstacles. The question isn’t whether you can manage to start treatment during the holidays, but whether you can afford to wait another season to feel better.
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References:
McIntyre, R. S., Rosenblat, J. D., Nemeroff, C. B., et al. (2021). Synthesizing the evidence for ketamine and esketamine in treatment-resistant depression: An international expert opinion on the available evidence and implementation. American Journal of Psychiatry, 178(5), 383-399. https://psychiatryonline.org/doi/full/10.1176/appi.ajp.2020.20081251
Włodarczyk, A., Cubała, W. J., Gałuszko-Węgielnik, M., & Szarmach, J. (2021). Dissociative symptoms with intravenous ketamine in treatment-resistant depression: Exploratory observational study. Medicine, 100(32), e26769. https://journals.lww.com/md-journal/fulltext/2021/08130/dissociative_symptoms_with_intravenous_ketamine_in.69.aspx