Does Ketamine Therapy Help Self-Esteem? Outcomes, Comparisons, and How It Works

Can Ketamine Therapy Improve Self-Esteem?

Yes. A growing body of research shows that ketamine therapy can improve self-esteem as part of depression treatment, and Mindbloom's newly published retrospective analysis adds a robust body of real-world data to it. Among 18,741 Mindbloom patients who started at-home ketamine therapy feeling bad about themselves most days:

• Severity of low self-worth dropped 62% on average by Session 6, about six weeks in (Carter et al., 2026).¹
• 87% improved, meaning their answer dropped at least one step on the 0 to 3 scale.¹
• 31% no longer reported feeling bad about themselves at all.¹

These findings line up with clinical studies in which ketamine eased self-dislike and self-criticism, made people's automatic sense of themselves more positive and, paired with brief self-esteem training, kept depression scores low for 30 days (Hasler et al., 2020; Price et al., 2022; Eken et al., 2024).⁴⁻⁶

How Depression and Low Self-Esteem Feed Each Other

Low self-esteem can take many forms. It can look like replaying one awkward comment for days, or like brushing off a compliment because you are sure you did not earn it.

That inner critic is one of the most common parts of depression:

• A core symptom: feeling bad about yourself, or like a failure, is one of the nine symptoms on the PHQ-9, the standard depression questionnaire (Kroenke et al., 2001).⁸
• About half of patients: Mindbloom's analysis of 36,847 adults starting at-home ketamine therapy found that 51% felt this way most days when they began (Carter et al., 2026).¹
• Self-blame is common: in one study of 132 people with a history of major depression, most reported self-blaming feelings such as self-disgust, guilt or shame during their depressive episodes (Zahn et al., 2015).⁹

The link runs both ways. A meta-analysis of 77 long-term studies found that low self-esteem predicted later depression and depression predicted later drops in self-esteem, with the first effect about twice as strong as the second (Sowislo and Orth, 2013).⁷ In daily life, that can feel like a loop: feeling like a failure makes it harder to do the things that might prove otherwise, and each setback reads as more evidence.

Low self-esteem can also outlast the depression itself. In a large Dutch study, people who had recovered from depression or anxiety still reported lower self-esteem than people who had never had either (van Tuijl et al., 2016).¹⁰ That is one reason researchers have looked for treatments that work on negative self-beliefs directly, not only on overall mood.

None of this is a character flaw. Low self-esteem is not a diagnosis on its own, but when it comes with depression, it is a symptom that can be measured and treated.

Self-Esteem, Self-Worth and Confidence: What Each Means

These words often get used interchangeably, but they point at slightly different things:

• Self-esteem: your overall opinion of yourself, whether on the whole you feel you are good enough.
• Self-worth: the sense that you matter as a person, apart from what you achieve. In this article it also names the depression symptom of feeling bad about yourself or like a failure.
• Confidence: belief in your ability to handle specific things, like a presentation or a hard conversation. It can be low in one area while self-esteem is steady, and the reverse.
• Self-compassion: treating yourself with the kindness you would offer a friend when you fall short (Neff, 2003).¹¹ Lower self-compassion is strongly linked with depression, anxiety and stress (MacBeth and Gumley, 2012).¹²

How Researchers Measure Self-Esteem

Self-esteem can be measured in more than one way, and the studies in this article use different methods. Explicit measures capture what you say about yourself on a questionnaire. Implicit measures capture split-second associations between "me" and good or bad words, timed by how fast you sort them, and a person can score differently on the two (Greenwald and Farnham, 2000).¹³

The PHQ-9 question is a single item rather than a full self-esteem scale, so it shows how often people feel bad about themselves, not every part of self-esteem.

What the Research Shows About Ketamine and Self-Esteem

A growing body of research shows that ketamine therapy can be highly effective for low self-esteem in depression, and Mindbloom's newly published real-world retrospective analysis expands that evidence to 18,741 patients treated at home. Mindbloom patients who started out feeling bad about themselves most days saw the severity of low self-worth drop 46% on average by Session 2 and 62% by Session 6, about six weeks in (Carter et al., 2026).¹ By Session 6, 79% had gone from feeling this way most days to only occasionally or not at all (Mindbloom analysis of Carter et al., 2026).¹⁴ See all nine symptoms in Mindbloom's full PHQ-9 analysis.

Real-world preprint data (Carter et al., 2026), posted October 2026; sublingual and subcutaneous routes combined. 18,741 patients at the start; 1,329 completed the Session 6 check-in.

Published clinical studies point the same way:

• Ketamine plus self-esteem training: in a trial of 154 adults with treatment-resistant depression, an IV infusion followed by brief computer training in positive self-associations kept depression scores low for 30 days, while ketamine with sham training drifted back up (Price et al., 2022).⁵
• Automatic self-view: in the same trial, ketamine plus training made implicit self-associations more positive, a shift linked with longer relief (Eken et al., 2024).⁶
• Self-criticism: in a small open-label study, a single IV infusion improved self-dislike and self-criticism in patients whose depression responded, and the change held a week later (Hasler et al., 2020).⁴

It should be noted that these findings come from people with depression, and the real-world analysis rests on a single PHQ-9 question rather than a full self-esteem scale, so some of the change may reflect mood lifting overall. Even so, the signal is consistent: for many people, ketamine therapy brings real relief from the feeling of not being good enough.

Ketamine Therapy vs. Other Self-Esteem Treatments: Antidepressants, Esketamine, TMS and Therapy

Mindbloom's at-home ketamine therapy results on self-worth were comparable to esketamine, sertraline and TMS on the same PHQ-9 question, and higher than those reported for talk therapies designed for low self-esteem.

Antidepressants, Esketamine and TMS on the Same Question

These treatments have all been studied on the same PHQ-9 question Mindbloom used, so these are like-for-like comparisons. Mindbloom's figures are from Session 6, about six weeks in (Carter et al., 2026).¹ Here's how the results compared:

• Sertraline (Zoloft): Mindbloom's 62% average drop is comparable to the 59% drop with sertraline in a large primary care trial, and came in about half the time: 6 weeks versus 12 (Piazza et al., 2025).³
• A new antidepressant: the 87% of Mindbloom patients who improved by at least one point is higher than the 69% who improved after four weeks on a new antidepressant (Floden et al., 2022).¹⁵
• Esketamine (Spravato): the same 87% is comparable to the 82% who improved after a four-week esketamine induction alongside a new antidepressant (Floden et al., 2022).¹⁵
• TMS: Mindbloom's 62% drop is comparable to the 55% drop in a real-world study of TMS, with a fraction of the sessions: 6 versus at least 36 (Hutton et al., 2024).²

Self-Esteem Therapies

Talk therapies are the most common treatment for low self-esteem. Their studies use full self-esteem scales rather than the PHQ-9, so the closest comparison is the share of people who moved out of the low range by the end of treatment. For Mindbloom patients, that means going from feeling bad about themselves most days to only occasionally or not at all, which 79% did by Session 6 (Mindbloom analysis of Carter et al., 2026).¹⁴ Here's how the results compared:

• Competitive memory training (COMET): Mindbloom's 79% is about twice the 39% who reached the normal self-esteem range after eight weekly sessions of COMET (Korrelboom et al., 2012).¹⁷
• EMDR or group CBT: Mindbloom's 79% is about a third higher than the 60% who reached a clinically meaningful self-esteem score after 10 weekly sessions, in one small trial (Griffioen et al., 2017).¹⁸

These comparisons are directional, not head-to-head: Mindbloom measured self-worth with a single PHQ-9 question, while the therapy studies used full self-esteem scales such as the Rosenberg, in different populations and study designs.

How Ketamine May Help Change Negative Self-Beliefs

Ketamine therapy is a depression treatment that uses low doses of ketamine in a series of sessions with clinical monitoring. Most antidepressants target serotonin. Researchers describe ketamine's effect as starting with changes in glutamate, the brain's main excitatory messenger, that trigger growth signaling and new connections between brain cells, though the exact steps are still debated (Krystal et al., 2024).¹⁹

For self-esteem, the leading idea is about flexibility. Depression tends to lock in rigid, negative beliefs about the self (Dai et al., 2025).²⁰ Researchers have proposed that ketamine opens a short window afterward when thinking is more flexible, which may make those beliefs easier to update (Hardy et al., 2026).²¹ That is the idea the ketamine-plus-training trial tested, by giving self-worth training in the days after the infusion (Price et al., 2022).⁵ The window is still a proposed explanation, and researchers have not pinned down how long it lasts.

Why Pairing Ketamine With Self-Esteem Work Matters

In the ketamine-plus-training trial, people who had ketamine with sham training saw their depression scores drift back up over 30 days, while those who had self-worth training after the infusion kept their scores low (Price et al., 2022).⁵ This is part of why Mindbloom builds tailored programs around specific themes rather than only prescribing medication. Its Self-Love program, led by psychologist Elizabeth Lombardo, PhD, applies the same idea to low self-esteem: six sessions for people with depression, anxiety or PTSD who struggle with unworthiness, self-doubt and self-criticism, with video content and session audio that point each session at how you see yourself, from reflecting without harsh self-judgment to building a kinder inner voice.

Ketamine Integration and Therapy Alongside Treatment

Integration is the work between sessions of turning what shifted into everyday change, such as catching the inner critic and answering it the way you would answer a friend. Some people do this with a therapist trained in ketamine-assisted therapy or integration, and others continue with the therapist they already see. Self-compassion is a useful skill to practice here, since lower self-compassion is closely tied to depression (MacBeth and Gumley, 2012).¹²

Getting Started With Ketamine Therapy for Low Self-Esteem: Candidacy, Safety and Settings

Who May Be a Good Candidate

Ketamine therapy is prescribed for depression, anxiety and related conditions, not for low self-esteem on its own, so the starting point is a clinical assessment of your symptoms, history and medications. It may be worth raising with a clinician if feeling bad about yourself is a major part of your depression, including if it has held on through other treatment or you have treatment-resistant depression.

Ketamine therapy is not right for everyone. Uncontrolled high blood pressure, a history of psychosis or mania, serious heart or breathing problems, and pregnancy are among the conditions that rule it out, and your clinician will check for medications that interact with ketamine.

Ketamine Side Effects

Ketamine therapy is generally well tolerated by people who pass medical screening, and most side effects are short-lived. Mindbloom's peer-reviewed study of 11,441 patients taking sublingual ketamine at home found that no single side effect was reported by more than about 1% of patients at a check-in (Mathai et al., 2024).²²

Conclusion

Ketamine therapy can improve self-esteem as part of depression treatment. Mindbloom's 2026 analysis found that patients who started out feeling bad about themselves most days saw low self-worth drop 62% on average by Session 6 (Carter et al., 2026).¹ By then, 79% were down to feeling this way only occasionally or not at all.¹⁴ On the same PHQ-9 question, those results were comparable to esketamine, sertraline and TMS, and clinical trials suggest ketamine works best when it is paired with practice aimed directly at self-worth.