Clinical conditions

Specific diagnoses, specific evidence

These are clinical deep-dives on specific psychiatric conditions — DSM-5-TR and ICD-11 diagnostic criteria, evidence-based first-line treatments, how each condition differs from related diagnoses, and where ketamine fits within that specific clinical picture. Written for patients who want the clinical detail, not the brochure.

Ketamine is one option, not the only option. Each page describes the full first-line treatment landscape honestly — and where ketamine reasonably enters the picture (usually after standard treatments have been adequately tried).

Clinical condition

Dysthymia (Persistent Depressive Disorder)

DSM-5-TR 300.4 / ICD-10 F34.1

Persistent depressive disorder (PDD) — two or more years of low-grade depression that patients often mistake for personality rather than illness. Frequently treatment-resistant to first-line antidepressants. Distinct clinical picture from major depressive disorder.

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Clinical condition

Social Anxiety Disorder (SAD)

DSM-5-TR 300.23 / ICD-10 F40.10

Clinical social anxiety disorder — distinct from situational shyness. Performance anxiety, fear of judgment, persistent avoidance. SSRIs and CBT first-line; beta-blockers for performance subtype; ketamine as an option when standard treatments fail.

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Clinical condition

Panic Disorder

DSM-5-TR 300.01 / ICD-10 F41.0

Recurrent unexpected panic attacks plus persistent worry or behavior change between attacks. Distinct from isolated panic attacks (a symptom that can occur in many conditions). SSRIs, CBT, and exposure-based therapy first-line; ketamine relevant when standard treatments fail.

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Clinical condition

Agoraphobia

DSM-5-TR 300.22 / ICD-10 F40.00

Marked fear of two or more agoraphobic situations — public transport, open spaces, enclosed spaces, crowds, being outside home alone. Frequently comorbid with panic disorder. Exposure therapy is gold standard; ketamine may have a role when severity prevents exposure work.

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Clinical condition

Treatment-Resistant Depression (TRD)

No distinct ICD code — specifier on F33.x

Major depressive disorder with inadequate response to at least two adequate trials of antidepressants from different classes. Ketamine and esketamine (Spravato) are the FDA-acknowledged rapid-acting options. STAR*D outcomes inform escalation strategy.

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Clinical condition

Bipolar 2 Depression

DSM-5-TR 296.89 / ICD-10 F31.81

Bipolar 2 disorder — hypomanic episodes plus major depressive episodes, without full manic episodes. The depressive phase dominates the clinical course. Ketamine in bipolar 2 requires concurrent mood stabilizer because of mania induction risk.

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Clinical condition

Postpartum Depression (PPD)

DSM-5-TR 296.x with peripartum onset specifier / ICD-10 F53.0

Major depressive episode with onset during pregnancy or within four weeks of delivery (DSM-5-TR peripartum specifier). Brexanolone (Zulresso) and zuranolone (Zurzuvae) are FDA-approved PPD-specific options. SSRIs, psychotherapy, and breastfeeding considerations inform treatment.

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Clinical condition

Seasonal Affective Disorder (SAD)

DSM-5-TR — major depressive disorder with seasonal pattern specifier

Major depressive episodes with regular seasonal pattern — most commonly winter-onset depression with spring/summer remission. Light therapy is first-line; CBT-SAD has comparable evidence. Ketamine for resistant cases or summer-onset variants.

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Clinical condition

Complex PTSD (C-PTSD)

ICD-11 6B41 (distinct from DSM-5-TR PTSD)

ICD-11 recognized clinical entity distinct from DSM-5-TR PTSD. Cumulative or relational trauma producing classical PTSD symptoms plus disturbances in self-organization. Treatment is stage-based with longer trajectory than acute PTSD.

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Clinical condition

Treatment-Resistant Anxiety

No distinct code — specifier on F40-F48

Anxiety analog to TRD. Failure of adequate trials of multiple anxiolytics, SSRIs, and CBT in generalized anxiety disorder, panic disorder, social anxiety disorder, or related conditions. Less FDA-acknowledged than TRD but real clinical entity.

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Clinical condition

Premenstrual Dysphoric Disorder (PMDD)

DSM-5-TR 625.4 (N94.3) / ICD-11 GA34.41

Severe luteal-phase mood, irritability, and depressive symptoms that remit within days of menses onset. A distinct DSM-5-TR diagnosis — not "bad PMS." SSRIs (luteal or continuous dosing) and drospirenone-containing oral contraceptives are first-line. Ketamine is NOT a primary PMDD treatment.

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Clinical condition

Health Anxiety (Illness Anxiety Disorder)

DSM-5-TR 300.7 (F45.21) / ICD-11 6B23

Illness anxiety disorder — preoccupation with having or acquiring a serious illness despite minimal or absent somatic symptoms and reassuring medical evaluation. Formerly hypochondriasis. CBT and SSRIs are first-line. Distinct from somatic symptom disorder and OCD.

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Clinical condition

Generalized Anxiety Disorder (GAD)

DSM-5-TR 300.02 / ICD-10 F41.1 / ICD-11 6B00

Chronic, excessive, hard-to-control worry across multiple life domains for six or more months, with physical symptoms (restlessness, fatigue, muscle tension, sleep disturbance). GAD-7 is the standard screen. SSRIs, SNRIs, buspirone, and CBT are first-line; ketamine for treatment-resistant GAD with comorbid depression.

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Clinical condition

Adjustment Disorder

DSM-5-TR 309.x / ICD-10 F43.2 / ICD-11 6B43

A stress-response disorder — emotional or behavioral symptoms developing within three months of an identifiable stressor, out of proportion to the stressor, and resolving within six months of its end. Distinct from major depression and PTSD. Psychotherapy is first-line; usually time-limited. Ketamine is rarely indicated.

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Clinical condition

Obsessive-Compulsive Disorder (OCD)

DSM-5 300.3 / ICD-10 F42

Intrusive, unwanted obsessions and compulsive rituals performed to reduce distress — and where ketamine fits when SSRIs and ERP fall short.

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Clinical condition

Post-Traumatic Stress Disorder (PTSD)

DSM-5 309.81 / ICD-10 F43.1

Intrusion, avoidance, negative mood, and hyperarousal after trauma — and ketamine's emerging role for treatment-resistant PTSD.

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Clinical condition

Attention-Deficit/Hyperactivity Disorder (ADHD)

DSM-5 314.0x / ICD-10 F90

Inattention, hyperactivity, and impulsivity that impair daily function — why stimulants are first-line, and the honest limits of ketamine for ADHD.

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Clinical condition

Bipolar I Depression

DSM-5 296.5x / ICD-10 F31

The depressive phase of bipolar I disorder — why antidepressants alone are risky, and how ketamine is approached with mood-stabilizer protection.

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Clinical condition

Major Depressive Disorder (MDD)

DSM-5 296.2x / ICD-10 F32-F33

The most common depressive disorder — first-line care, what counts as treatment resistance, and where rapid-acting ketamine fits.

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Clinical condition

Chronic Pain

ICD-10 G89 / ICD-11 MG30

Persistent pain lasting beyond normal healing — its tangle with depression, and where ketamine fits for central, treatment-resistant pain.

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Clinical condition

Fibromyalgia

ICD-10 M79.7 / ICD-11 MG30.01

Widespread pain with fatigue, sleep, and cognitive symptoms driven by central sensitization — and ketamine's role for the refractory, depression-entangled cases.

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Clinical condition

Complex Regional Pain Syndrome (CRPS)

ICD-10 G90.5 / ICD-11 8D8A

Severe, disproportionate limb pain with swelling, color, and temperature changes after an injury — one of the better-evidenced ketamine pain indications.

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Clinical condition

Burnout

ICD-11 QD85 (occupational phenomenon)

Chronic work-related exhaustion, cynicism, and reduced efficacy — what it is, how it overlaps with depression, and where ketamine honestly fits.

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Clinical condition

Postpartum Anxiety

DSM-5 anxiety disorder, peripartum context / ICD-10 F41 with O90.6

Excessive worry, racing thoughts, and physical tension after having a baby — often overlooked next to postpartum depression.

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Clinical condition

Neuropathic Pain

ICD-11 MG30.5 (chronic neuropathic pain)

Burning, shooting, or electric pain from nerve damage or disease — and ketamine's NMDA-based role for refractory cases.

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Clinical condition

Migraine

ICD-11 8A80

Recurrent, often disabling headache with sensory and neurological features — its strong tie to depression and anxiety, and ketamine's narrow role in refractory cases.

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Clinical condition

Body Dysmorphic Disorder (BDD)

DSM-5 300.7 / ICD-11 6B21

Distressing preoccupation with a perceived flaw in appearance — an OCD-spectrum condition that is serious, common, and treatable.

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Clinical condition

Perimenopausal Depression

DSM-5 depressive disorder, perimenopausal context

Depression that emerges or worsens during the menopause transition — a distinct window of vulnerability with its own treatment considerations.

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Clinical condition

Prolonged Grief Disorder

DSM-5-TR 309.89 / ICD-11 6B42

Grief that stays intense, disabling, and persistent long after a loss — now a recognized, treatable diagnosis distinct from normal bereavement and depression.

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Clinical condition

Alcohol & Substance Use Disorder

DSM-5 substance use disorders / ICD-11 6C4

Compulsive use despite harm — and the genuinely emerging evidence for ketamine in alcohol and other substance use disorders.

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Clinical condition

Binge Eating Disorder (BED)

DSM-5 307.51 / ICD-11 6B82

Recurrent episodes of eating large amounts with a sense of loss of control and distress — the most common eating disorder, and treatable.

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Clinical condition

Trichotillomania (Hair-Pulling Disorder)

DSM-5 312.39 / ICD-11 6B25.0

Recurrent pulling out of one's hair causing hair loss, despite repeated attempts to stop — a body-focused repetitive behavior on the OCD spectrum.

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Clinical condition

Specific Phobia

DSM-5 300.29 / ICD-11 6B03

Intense, out-of-proportion fear of a specific object or situation — one of the most treatable anxiety disorders, with exposure therapy as the gold standard.

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Not a ketamine indication

Schizophrenia

DSM-5 295.90 / ICD-11 6A20

A serious psychotic disorder — and one where ketamine is contraindicated, not a treatment. Here is what schizophrenia is and what genuinely helps.

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Not a ketamine indication

Schizoaffective Disorder

DSM-5 295.70 / ICD-11 6A21

A condition combining psychosis with mood episodes — where ketamine is contraindicated because of the psychotic component.

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Not a ketamine indication

Active Mania (Manic Episode)

DSM-5 296.4x / ICD-11 6A60

The acute "up" phase of bipolar disorder — a psychiatric urgency where ketamine is contraindicated, not a treatment.

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Not a ketamine indication

Dementia

DSM-5 major neurocognitive disorder / ICD-11 6D8

A progressive loss of memory and thinking from brain disease — not a condition ketamine treats. Here is what helps, and where depression fits in.

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Not a ketamine indication

Anorexia Nervosa

DSM-5 307.1 / ICD-11 6B80

A serious, potentially life-threatening eating disorder that needs specialized care — not a condition for at-home ketamine.

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Not a ketamine indication

Borderline Personality Disorder (BPD)

DSM-5 301.83 / ICD-11 6D10.5

A treatable disorder of emotion regulation, identity, and relationships — where specialized therapy, not ketamine, is the core treatment.

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Not a ketamine indication

Autism Spectrum Disorder (ASD)

DSM-5 299.00 / ICD-11 6A02

A neurodevelopmental difference, not an illness to be cured — and not something ketamine treats. Here is what genuinely supports autistic people, and where mental-health care fits.

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Clinical condition

Suicidal Ideation

ICD-10 R45.851

Thoughts of suicide — a symptom that demands urgent care, and one of the few areas where ketamine can reduce the thoughts within hours.

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Clinical condition

Anxious Depression

DSM-5 MDD with anxious distress specifier

Depression with prominent anxiety — a harder-to-treat combination that responds to ketamine about as well as non-anxious depression.

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Clinical condition

Treatment-Resistant OCD

DSM-5 300.3 / ICD-11 6B20 (refractory)

OCD that hasn't responded to SSRIs and exposure therapy — where ketamine is an investigational option with promising but early evidence.

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Clinical condition

Treatment-Resistant PTSD

DSM-5 309.81 / ICD-11 6B40 (refractory)

PTSD that persists despite trauma-focused therapy and medication — where repeated ketamine has randomized-trial evidence.

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Clinical condition

Phantom Limb Pain

ICD-10 G54.6 / ICD-11 8E43.0

Pain felt in a missing limb after amputation — a neuropathic pain where ketamine's NMDA-blocking mechanism has been studied.

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Clinical condition

Late-Life Depression

DSM-5 MDD in older adults

Depression in older adults — frequently underdiagnosed and treatment-resistant, with growing randomized evidence for esketamine and ketamine.

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Not a ketamine indication

Bulimia Nervosa

DSM-5 307.51 / ICD-11 6B81

An eating disorder of binge-purge cycles — treated with specialized psychotherapy, not ketamine.

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Not a ketamine indication

Depersonalization/Derealization Disorder

DSM-5 300.6 / ICD-11 6B66

A dissociative disorder of feeling detached from yourself or reality — where ketamine's own dissociative effect makes it the wrong tool.

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Not a ketamine indication

Postpartum Psychosis

DSM-5 brief psychotic disorder / bipolar, with peripartum onset

A rare psychiatric emergency after childbirth — where ketamine is contraindicated and immediate, in-person care is essential.

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Not a ketamine indication

Antenatal Depression

DSM-5 MDD with peripartum onset (pregnancy)

Depression during pregnancy — real and treatable, but not with ketamine, whose safety in pregnancy is not established.

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Clinical condition

Acute Stress Disorder

DSM-5 308.3 / ICD-11 6B41

The intense stress reaction in the first month after trauma — often a precursor to PTSD, and a window where early help matters.

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Clinical condition

Treatment-Resistant Bipolar Depression

DSM-5 bipolar I/II, depressed; ICD-11 6A60/6A61

Bipolar depression that persists despite mood-stabilizer treatment — where ketamine has randomized evidence, but only with mood-stabilizer cover.

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Clinical condition

Alcohol Use Disorder

DSM-5 303.90 / ICD-11 6C40.2

Problem drinking that is hard to control — with established treatments, and emerging (investigational) research on ketamine.

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Clinical condition

Cluster Headache

ICD-10 G44.0 / ICD-11 8A80

One of the most severe pain conditions known — with specific first-line treatments, and ketamine studied only for refractory cases.

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Clinical condition

Trigeminal Neuralgia

ICD-10 G50.0 / ICD-11 8B82.0

Sudden, electric-shock facial pain — where carbamazepine and surgery are first-line, and ketamine has only a narrow, limited role.

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Clinical condition

Insomnia Disorder

DSM-5 780.52 / ICD-11 7A00

Chronic trouble sleeping that affects your days — where CBT-I is first-line, and ketamine treats the depression that can drive it, not the insomnia itself.

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Not a ketamine indication

Dissociative Identity Disorder

DSM-5 300.14 / ICD-11 6B64

A complex, trauma-rooted dissociative disorder — treated with specialized, phased psychotherapy, where ketamine's dissociative effect makes it the wrong tool.

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Not a ketamine indication

Functional Neurological Disorder (FND)

DSM-5 300.11 (conversion disorder) / ICD-11 6B60

Real neurological symptoms — weakness, seizures, tremor — from how the nervous system functions, not structural damage; treated by FND-informed teams, not ketamine.

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Not a ketamine indication

Hoarding Disorder

DSM-5 300.3 / ICD-11 6B24

Persistent difficulty discarding possessions, with distress and clutter that impairs living — treated with specialized CBT, not ketamine.

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Not a ketamine indication

Somatic Symptom Disorder

DSM-5 300.82 / ICD-11 6C20

Distressing physical symptoms with disproportionate thoughts, feelings, and behaviors about them — treated with CBT and collaborative care, not ketamine.

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Clinical condition

Cyclothymia (Cyclothymic Disorder)

DSM-5 301.13 / ICD-11 6A62

A chronic, milder mood instability on the bipolar spectrum — where antidepressants and ketamine need mood-stabilizer protection.

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Not a ketamine indication

Psychotic Depression (MDD with Psychotic Features)

DSM-5 296.24/296.34 / ICD-11 6A70.x

Severe depression accompanied by delusions or hallucinations — a serious condition where ketamine is not appropriate and specialist care is essential.

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Clinical condition

Atypical Depression

DSM-5 MDD with atypical features specifier

A depression subtype where mood brightens with good news, plus oversleeping, overeating, heaviness, and rejection sensitivity.

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Clinical condition

Intermittent Explosive Disorder (IED)

DSM-5 312.34 / ICD-11 6C73

Recurrent, impulsive outbursts of anger or aggression out of proportion to the trigger — a treatable impulse-control condition, not just a "bad temper."

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Clinical condition

Chronic Fatigue Syndrome (ME/CFS)

ICD-10 G93.3 / ICD-11 8E49

A serious, long-term illness of profound fatigue and post-exertional crashes — a real physical condition, not depression, where ketamine has no established role.

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High-volume conditions: the most common diagnoses — depression, anxiety, PTSD, OCD, chronic pain — have their own dedicated pages. Ketamine for depression, anxiety, and PTSD cover the conditions most patients search for first. The pages here cover the more specific clinical entities.

Not sure where you fit? The eligibility assessment reviews your specific diagnosis and treatment history. A physician determines whether ketamine therapy is appropriate for your situation — these pages are educational, not a substitute for clinical evaluation.