Luteal-Phase Ketamine-Assisted Therapy for PMDD
Restoring Stability Across Your Cycle
Serving clients virtually in California and Washington and locally in Berkeley and San Anselmo
When PMDD makes you feel unlike yourself
Support for Cycle-Related Mood Shifts
Are you living with the intense emotional and physical shifts of Premenstrual Dysphoric Disorder (PMDD)? For many, PMDD can feel like losing access to yourself for up to two weeks each month—sudden despair, rage, intrusive thoughts, anxiety, relational strain, and a painful sense of disconnection from your own worth.
Ketamine-Assisted Therapy (KAP) is a supportive, adjunctive approach that works alongside treatment from a qualified psychiatrist, OB-GYN, or other medical provider. Ketamine may support the therapeutic process, helping you access and work with the deeper emotional and nervous system patterns that surface during the luteal phase. Rather than simply managing symptoms, this work may support deeper regulation, self-understanding, and a more compassionate relationship with yourself—especially during the most challenging phase of your cycle.
A CYCLE-INFORMED APPROACH
Luteal-Phase Ketamine-Assisted Therapy for PMDD
I offer cycle-timed Ketamine-Assisted Therapy (KAP) for individuals experiencing severe luteal-phase mood symptoms from PMDD and PME.
Ketamine sessions are timed during the luteal phase, when the emotional intensity of PMDD is heightened, allowing us to work directly with the PMDD parts carrying rage, despair, or hopelessness in a supported and resourced way. Ketamine may help reduce emotional intensity and support nervous system regulation, creating space to therapeutically work with underlying wounds, unmet needs, and protective strategies.
In medicine and integration sessions, we practice distress tolerance and nervous system regulation together using approaches like IFS, DBT, EFT tapping, and somatic psychotherapy.
The goal isn’t to “push through the luteal phase.” The goal is to help your system experience: “I can be with myself during this phase—and I have ways through.”
Building Cycle-to-Cycle Resilience
Potential Benefits of KAP for PMDD:
KAP can be especially supportive if your luteal phase brings intense emotional distress and dysregulation, making it difficult to maintain daily functioning.
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Stabilizing mood shifts
May support mood regulation during the premenstrual phase, helping soften depressive crashes, anxiety spikes, irritability, and emotional reactivity.
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Relief from intrusive thought patterns
May reduce rigid negative thinking, catastrophic beliefs, suicidal ideation, and sudden bursts of old thought patterns.
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Manage shame & rage
Can help create space to compassionately engage the parts that turn inward in self-criticism as well as the parts that turn outward in anger or blame.
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Nervous system regulation
May help calm heightened stress responses that can manifest as fight-or-flight, defensiveness, or sudden relational rupture.
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Reducing projection & Relational Distortion
May support the ability to pause before reacting, creating space between hormonal activation and interpersonal conflict.
06
Restoring continuity of Identity
May help reduce the “two different people” feeling by strengthening a stable sense of self across hormonal shifts.
support from someone who gets it
Why Work With Me
Hi, I’m Kiri, and like you, I live with PMDD
I understand personally how intense, cyclical, and isolating PMDD can be, and my own search for relief led me to study it deeply—both personally and professionally—in response to the limited trauma-informed support available.
Through this work, I have developed a specialized Ketamine-Assisted Therapy protocol for PMDD that intentionally works with the hormonal rhythm of the cycle.
You can learn more about my approach to working with clients with PMDD by clicking the link below.
Who is a Good Candidate for KAP?
You may be a good fit for KAP if you:
● Struggle with PMDD or other hormone-related mood shifts such as PME, postpartum depression, or perimenopause.
● Experience severe luteal-phase symptoms, including depression, anxiety, irritability, rage, suicide ideation, or intrusive thoughts.
● Have used or are currently using SSRIs, birth control, or other hormonal treatments and are looking for additional support.
● Feel stuck in therapy or are not receiving PMDD-specific support.
● Want to address the underlying patterns and trauma that surface during PMDD.
A STEP-BY-STEP GUIDE TO KETAMINE-ASSISTED THERAPY
The Luteal-Phase KAP Protocol
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If we decide to work together, we’ll schedule an intake session to assess your mental health history, treatment goals, and determine if KAP is a good fit.
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Schedule a medical consultation with my medical perscriber to be cleared medically for KAP.
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We will meet weekly for a minimum of 3 preparation sessions (50 minutes). During this time we’ll clarify goals, customize a treatment plan, prepare for your experience, practice coping skills, and do small bodies of therapeutic work to prepare your for the medicine sessions.
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KAP sessions are 2-3 hours long scheduled during the luteal phase of your menstrual cycle. You will do a ketamine lozenge session once a month during the luteal phase for 3-6 months to support PMDD when symptoms or most intense. These sessions can be held in-person in my office in Berkeley or San Anselmo or via telehealth.
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A few days after each ketamine medicine session, we’ll meet virtually for a 50-minute integration session to process your experience and explore how to bring its insights into your daily life in ways that support meaningful, lasting change.
FAQs
Your Questions, Answered
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You can book a 20-min complimentary intro call to learn more about the KAP treatment path and how I work. The next step is to schedule a paid 50-min intake session to assess appropriateness for KAP, clarify treatment goals, and determine if its a good fit.
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You’ll take your prescribed ketamine lozenges in a safe, supportive setting while lying down with an eye mask and music. I’ll be present the entire time, supporting you somatically and relationally. The healing process differs every time, and I adapt my approach to each person.
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Everyone’s healing path is unique. You are required to commit to a minimum of 3 preparation sessions, 3 ketamine lozenge sessions, and 3 integration sessions. I recommend 6 ketamine sessions for severe PMDD symptoms.
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KAP may be a good fit if you’re looking for additional support alongside other treatments, or if you’re wanting to work more directly with the emotional intensity and underlying patterns that emerge during the luteal phase. It’s not a first-line approach and is best used as part of a broader care plan.
A licensed medical provider will complete an assessment to determine whether KAP is appropriate and safe for you.
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Please refer to the KAP Fees & Policies page.
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I am currently out-of-network and do not bill insurance directly. However, I can provide superbills for you to submit to your insurance for potential reimbursement.
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While research on KAP specifically for PMDD remains limited, a broader body of research has examined ketamine’s potential effects on depression, anxiety, and suicidal ideation.
Learn more on the Clinical Research page →
download the KAP guide
Understand the process.
Know what to expect.
Receive an introduction to KAP, the treatment process, and my approach.
Let’s connect
Ready to Dive In?
I offer a free 20-minute consultation to learn more about my approach and services, and see if it’s a good fit.