Athletic performance and mental health are closely connected. Athletes at every level may experience anxiety, depression, burnout, sleep disruption, injury-related distress, or concerns that affect both well-being and performance. These challenges deserve thoughtful, evidence-informed psychiatric care, not pressure to simply push through them (Chang et al., 2020).
At Initia Nova in Wilmington, Delaware, our sports psychiatry program brings together psychiatric evaluation, individualized treatment planning, and support that recognizes the realities of athletic life. For some patients, this may include ketamine infusion therapy or Ketamine-Assisted Psychotherapy (KAP) when appropriate.
We work with athletes as people first. Our goal is not to treat sports performance in isolation, but to understand the full mental health picture and help patients explore care that fits their needs, history, and goals.
The Mental Health Demands of Athletic Life
Beyond the Physical
Training, competition, public expectations, injury risk, travel, changing routines, and the pressure to perform can all affect mental health. Athletes may also face barriers to seeking care, including stigma, concerns about how symptoms could be perceived, or uncertainty about where to turn for support (Chang et al., 2020).
Sports psychiatry recognizes that athletic identity, team culture, performance expectations, and recovery demands can shape how mental health symptoms appear and how treatment should be approached.
Before assuming that persistent anxiety, low mood, sleep disruption, or burnout are simply part of training, we encourage athletes to seek a thorough psychiatric evaluation.
The Post-Injury Psychological Toll
A significant injury can affect much more than physical function. Time away from a sport may disrupt routine, identity, community, and confidence. Some athletes experience grief, anxiety, depression, fear of reinjury, or other symptoms during recovery.
Research has recognized that injury can trigger or worsen mental health concerns, reinforcing the importance of addressing both physical rehabilitation and psychological well-being (Putukian, 2016).
At Initia Nova Wilmington, we consider injury history, concussion history, current symptoms, and broader life circumstances when we evaluate an athlete’s mental health needs.
Performance Anxiety and Burnout
Many athletes experience normal pre-competition nerves. Clinical performance anxiety is different. It may involve persistent fear, avoidance, intrusive worry, panic symptoms, or distress that interferes with participation and daily functioning.
Burnout may also involve emotional exhaustion, reduced motivation, sleep disruption, irritability, or a diminished sense of connection to a sport that once felt meaningful. These concerns deserve individualized assessment, especially when they occur alongside depression, anxiety, trauma-related symptoms, substance use concerns, or insomnia.
Ketamine Therapy in the Context of Sports Psychiatry
Why Ketamine May Be Relevant for Athletes
Ketamine therapy is not a performance-enhancement service, and we do not recommend it simply to improve athletic results, speed physical recovery, or help someone return to competition.
However, an athlete may have a psychiatric condition that warrants a discussion of additional treatment options. For example, ketamine has been studied as an option for some adults with difficult-to-treat depression, while research into its use for PTSD remains promising but still evolving (Seshadri et al., 2024; Almeida et al., 2024).
At our practice, we consider ketamine only after a comprehensive psychiatric and medical evaluation. We review diagnosis, symptom severity, previous treatment history, current medications, substance use history, cardiovascular considerations, concussion history, and other factors that may affect safety and appropriateness.
Ketamine used for psychiatric care is an off-label application. Individual results vary, and it is not appropriate for every athlete or every mental health condition (Sanacora et al., 2017).
Ketamine and the Integration Window
Some patients choose to pair ketamine treatment with psychotherapy. At Initia Nova, KAP combines ketamine with structured therapeutic support, preparation, and follow-up when that approach is clinically appropriate.
For athletes working through trauma, injury-related distress, avoidance, anxiety, or changes in identity, psychotherapy may be an important part of the broader treatment plan. The evidence on how best to combine ketamine and psychotherapy is still developing, and existing studies vary substantially in treatment protocols and outcomes (Kew et al., 2023).
We do not assume that KAP is the right fit for every patient. We discuss it individually, including the potential role of an established therapist or coordinated outside care. Patients can also review our KAP FAQs before scheduling an evaluation.
NAD+ Therapy and Athletic Recovery
NAD+ therapy is available at our Wilmington location as a separate supportive option. We do not present NAD+ IV therapy as a treatment for athletic performance, mental health conditions, injury rehabilitation, or return-to-play decisions.
Whether NAD+ therapy belongs in a patient’s overall plan is considered separately from psychiatric treatment. We encourage athletes to discuss questions about recovery, nutrition, training load, concussion care, and physical rehabilitation with the appropriate medical and sports medicine professionals.
Sports Psychiatry at Initia Nova Wilmington
A Comprehensive Approach
Our sports psychiatry program is led by Dr. John Dougherty, a board-certified psychiatrist with a special interest in sports psychiatry and traumatic brain injury.
We begin with a comprehensive evaluation that considers mental health symptoms, athletic demands, injury and concussion history, sleep, stress, lifestyle factors, previous treatment experiences, and current goals. From there, we can discuss appropriate next steps, which may include psychiatric care, psychotherapy, medication management, ketamine infusion therapy, KAP, referral coordination, or another approach.
Athletes considering ketamine therapy can also review how to get ketamine treatment and our guide to choosing a ketamine infusion provider.
Confidentiality and the Athletic Context
We understand that athletes may have questions about privacy when considering mental health care. We encourage patients to discuss those concerns openly during the evaluation process so we can explain how care is coordinated and what information is shared only with permission.
A thoughtful psychiatric evaluation can help distinguish between ordinary performance-related stress and symptoms that may require more focused treatment.
Who May Benefit
Sports psychiatry may be appropriate for competitive athletes, college athletes, recreational athletes, former athletes, and others whose athletic identity or sports environment is a meaningful part of their mental health experience.
Patients may seek care for concerns such as depression, anxiety, trauma-related symptoms, sleep disruption, injury-related distress, substance use concerns, or difficulty adjusting to major changes in sport or life. The first step is always a thorough evaluation.
Parting Thoughts
Athletes deserve mental health care that recognizes the demands of training, competition, injury, recovery, and identity. At Initia Nova, we provide individualized psychiatric care for athletes who may be navigating depression, anxiety, trauma, burnout, or other concerns that affect their well-being.
For patients in Wilmington and the surrounding Delaware region, we are available to discuss whether sports psychiatry, ketamine therapy, KAP, or another approach may be appropriate. You can also review our ketamine treatment FAQs before scheduling a consultation.
Ready to take the next step? Contact us to schedule a consultation or call us at (302) 599-6286. You can also visit us at 3512 Silverside Road, Suite 13, Wilmington, DE 19810.
Medical Disclaimer
The information in this blog is for educational purposes only and does not constitute medical advice. Ketamine therapy, TMS, SPRAVATO®, and other treatments described should only be pursued under the supervision of a licensed provider familiar with your full medical and psychiatric history. Individual results vary. If you are experiencing a mental health crisis or thoughts of self-harm, please call or text 988 to reach the Suicide and Crisis Lifeline or go to your nearest emergency room.
References
Almeida, T. M., Lacerda da Silva, U. R., Pires, J. P., Borges, I. N., Martins, C. R. M., Cordeiro, Q., & Uchida, R. R. (2024). Effectiveness of ketamine for the treatment of post-traumatic stress disorder: A systematic review and meta-analysis. Clinical Neuropsychiatry, 21(1), 22-31. DOI: https://doi.org/10.36131/cnfioritieditore20240102
Chang, C., Putukian, M., Aerni, G., Diamond, A., Hong, G., Ingram, Y., Reardon, C. L., & Wolanin, A. (2020). Mental health issues and psychological factors in athletes: Detection, management, effect on performance and prevention: American Medical Society for Sports Medicine Position Statement-Executive Summary. British Journal of Sports Medicine, 54(4), 216-220. DOI: https://doi.org/10.1136/bjsports-2019-101583
Kew, B. M., Porter, R. J., Douglas, K. M., Glue, P., Mentzel, C. L., & Beaglehole, B. (2023). Ketamine and psychotherapy for the treatment of psychiatric disorders: Systematic review. BJPsych Open, 9(3), e79. DOI: https://doi.org/10.1192/bjo.2023.53
Putukian, M. (2016). The psychological response to injury in student athletes: A narrative review with a focus on mental health. British Journal of Sports Medicine, 50(3), 145-148. DOI: https://doi.org/10.1136/bjsports-2015-095586
Sanacora, G., Frye, M. A., McDonald, W., Mathew, S. J., Turner, M. S., Schatzberg, A. F., Summergrad, P., & Nemeroff, C. B. (2017). A consensus statement on the use of ketamine in the treatment of mood disorders. JAMA Psychiatry, 74(4), 399-405. DOI: https://doi.org/10.1001/jamapsychiatry.2017.0080
Seshadri, A., Prokop, L. J., & Singh, B. (2024). Efficacy of intravenous ketamine and intranasal esketamine with dose escalation for major depression: A systematic review and meta-analysis. Journal of Affective Disorders, 356, 379-384. DOI: https://doi.org/10.1016/j.jad.2024.03.137