Is ketamine therapy appropriate for performance anxiety?

Ketamine has not been studied as a treatment for music performance anxiety specifically, and we will not claim otherwise. The stronger evidence is in treatment-resistant depression, and there is research in anxiety disorders generally. If you have generalized or social anxiety that also appears on stage, that is a reasonable conversation. If stage anxiety is your only symptom, performance-specific approaches likely fit better.

How do I fit a six-infusion series around touring?

With planning rather than improvisation. An initial series typically runs six infusions over two to three weeks, so it fits best into a deliberate gap between runs. The hard constraint is that you cannot drive yourself home from any session, so transportation has to be arranged for each one. Bring your calendar to the consultation and we will build around it.

Will ketamine affect my creativity or my playing?

Most patients report the opposite pattern, describing a lifting of the anhedonia and flatness that had made the work feel inaccessible. That said, you should not schedule anything important on an infusion day. You will be dissociated during the session and generally foggy for several hours afterward, so treat it as a day off rather than a day you can record or perform.

Is treatment private, given how small this industry is?

We are a private outpatient clinic in Franklin, not a hospital psychiatric unit, and your records are protected like any other medical care. Because we do not bill insurance, no claim is generated to an insurer or plan administrator, which addresses the specific privacy concern many industry patients raise. The tradeoff is that treatment is paid out of pocket.

Can ketamine help if my depression is really about money and job insecurity?

Partly, and we want to be honest about the limits. Research on musicians identifies work insecurity as the strongest predictor of depression and anxiety, and ketamine does not change your contracts or your calendar. What it may do is reduce the depression sitting on top of those circumstances enough that you can act on them. That is a real benefit, but it is not the same as fixing the underlying situation.

Ketamine Therapy for Music Industry Professionals in Nashville

The occupational picture, in numbers

We are a ketamine clinic in Franklin, twenty minutes from Music Row, and a meaningful share of the people who walk through our door work in music. Not only artists. Engineers, tour managers, session players, publishers, front-of-house, merch, bus drivers.

The research on this workforce is unusually consistent. A study of 1,607 professional musicians compared against the general workforce, published in Psychology of Music, found psychological distress in 18% of musicians versus 8% of other workers, with depressive symptoms reported by 20.1% and anxiety symptoms by 14.7%. A study of 377 Australian professional orchestral musicians found depression symptoms in 32% and social anxiety symptoms in 33%.

The touring numbers are starker. A 2021 study in Psychology of Music of international touring professionals, in which 508 participants completed psychosocial measures, found that roughly half met criteria for high risk of clinical depression, and 39.4% scored high for suicidality. That population includes crew as well as artists.

What actually drives it

It is tempting to attribute all of this to the temperament of creative people. The research points somewhere more mundane and more actionable: the working conditions.

A 2022 study in Psychology of Music of 317 popular musicians found that 81% rated their financial stress as high or overwhelming, more than 36% screened positive for moderate to severe depression, and 33.5% for moderate to severe anxiety. Financial stress was significantly associated with both. A follow-up analysis published in 2024 broke occupational stress into components and found that work insecurity stress specifically carried the strongest association with both depression and anxiety, by a wide margin over other factors.

In other words, the strongest predictor was not stage fright or touring intensity in isolation. It was not knowing where the next work is coming from. Anyone who has strung together sessions, fill-in dates and a publishing advance will recognize the description.

Sleep is the other structural piece. A study presented in Sleep found musicians had a meaningfully higher prevalence of insomnia symptoms than a community comparison sample, tied to irregular hours, late-night performance and travel. Chronic sleep disruption is itself a well-established risk factor for depression, which we discuss in ketamine and sleep.

Performance anxiety compounds it. A systematic review in Psychological Medicine in 2019 covering 43 studies found music performance anxiety prevalence ranging from 16.5% to 60% depending on population and measure.

What ketamine addresses, and what it does not

We want to be careful here, because this is exactly the kind of article where a clinic could overpromise.

Ketamine has the strongest evidence in treatment-resistant depression, meaning depression that has not responded adequately to conventional antidepressants. If you have been through two or more medications without meaningful improvement, that is the population the research actually describes, and we cover it in ketamine for treatment-resistant depression. There is also evidence in anxiety and in anhedonia, the loss of pleasure and interest that many performers describe as the most disturbing symptom because it reaches the work itself. That is covered in ketamine for anhedonia.

What we have not seen is research establishing ketamine as a treatment for music performance anxiety specifically. It has not been studied that way. If you have generalized or social anxiety that also shows up on stage, that is a different and better-supported conversation, and we address it in ketamine for social anxiety.

Ketamine also does not treat an unpredictable income, an exploitative contract or a schedule that makes sleep impossible. Given that the research identifies work insecurity as the strongest driver, that limitation is worth stating plainly. What ketamine may do is lift the depression that has settled on top of those circumstances far enough that you can address them, which is not nothing. Burnout specifically is covered in ketamine for burnout.

The practical problem: a schedule that does not sit still

The logistics matter more for this population than almost any other we see. A standard initial series is six infusions over two to three weeks. If you are leaving for five weeks of dates, that has to be planned rather than improvised.

The firmest constraint is transportation. You cannot drive yourself home after an infusion, full stop, and we do not make exceptions. You need a ride arranged for every session. This is the single most common thing that derails scheduling for touring patients, and we explain why in driving and ketamine.

Beyond that, planning tends to work better than reacting. Patients who bring us their calendar and build a series into a gap between runs generally do better than those who start a series and then interrupt it. If a tour is coming, we would rather discuss maintenance timing before you leave than have you return to a faded response, which we cover in maintenance protocols.

Privacy, which we are asked about constantly

Nashville is a small industry town, and people worry, reasonably, about being seen. We are a private clinic in Franklin rather than a hospital psychiatric department, and treatment records are protected the same as any other medical care.

Because we do not bill insurance, there is also no claim generated to an insurer or a plan administrator, which for some patients is the specific concern. That is a genuine tradeoff rather than a pure benefit, since it means you are paying out of pocket. We explain the reasoning in why we do not take insurance, and the question of telling your employer gets its own article.

Honest expectations

Ketamine is FDA-approved as an anesthetic; its use for depression and anxiety is off-label. Esketamine is FDA-approved for treatment-resistant depression.

Not everyone responds. In the controlled trials, a substantial minority did not, and we tell patients that before they start rather than after. Ketamine also works considerably better as part of a plan that includes therapy and, where relevant, attention to sleep and substance use than it does as a standalone intervention.

Cost is a real consideration in a profession with irregular income. Sessions are $475, and the full breakdown including what an initial series involves is in what ketamine therapy costs. If money is the obstacle, say so at consultation. We would rather talk about it directly than have you start a series you cannot finish, since an incomplete series is the worst value in the entire treatment. More on the conditions we treat is under depression and anxiety.