The trip ended days ago, but you have not quite landed. You feel on alert for no reason, you sleep badly, or you have the strange sensation of watching yourself from the outside and of the world having turned flat, as if it were behind a pane of glass. It is frightening, very much so. It is also one of the most frequently described aftereffects of a difficult psychedelic experience, and in most cases it subsides.
This article explains what is happening, what helps and what makes it worse, and where the line is beyond which it is advisable to seek professional help. It is no substitute for a medical assessment.
What is normal in the days that follow
During the first week a certain emotional hangover is common: heightened sensitivity, tiredness, mood swings, irregular sleep, moments of strangeness. It usually eases day by day and requires nothing special beyond resting and taking care of yourself.
The warning sign is not feeling odd things. It is that they persist or grow as the weeks go by, or that they keep you from getting on with your life.
Anxiety after a trip
It can show up as constant nervousness, panic attacks, fear of going crazy or dread that the trip will come back. It often feeds itself: you notice a strange sensation, you get scared, the scare produces more sensations and the loop closes.
In a PLOS ONE study on extended difficulties, with 608 people, emotional difficulties were the most frequently cited, with anxiety and fear at the forefront.
Depersonalization and derealization
These are two related experiences that often appear together:
- Depersonalization: feeling separated from yourself, as if you were observing your thoughts, your body or your actions from the outside.
- Derealization: perceiving your surroundings as unreal, distant, artificial or lifeless.
In that same study, around 15% of participants described each of them. Two things reassure most people. The first: those who experience them know that what they feel is a sensation and not reality, which means they have not lost their mind. The second: they tend to be closely tied to anxiety, so when one goes down, so does the other.
Their main fuel is monitoring. Checking every so often whether the sensation is still there keeps it alive.
How long it can last
Most often it improves within days or weeks. But it is important to be honest: in the study cited, whose participants had all had difficulties lasting more than a day, around a third still had them more than a year later. That is not typical among people who use, but it happens, and it is a good reason not to wait indefinitely for it to pass on its own.
In a Johns Hopkins University survey of nearly 2,000 people about their most difficult experience with psilocybin, 7.6% of those who had gone through it more than a year earlier had sought treatment for persistent psychological symptoms.
What helps and what makes it worse
What usually helps
- Sleeping at regular hours and eating well.
- Moving every day and spending time outdoors.
- Keeping up your routine and your obligations as far as possible. Normality anchors you.
- Directing your attention outward: concrete tasks, conversation, manual work.
- Telling someone you trust.
- Reminding yourself that this is a known reaction, that it has a name and that it tends to subside.
What usually makes it worse
- Cannabis, alcohol and any other substance, including taking another dose to try to fix it.
- Too much caffeine and lack of sleep.
- Isolating yourself and spending hours reading forums.
- Constantly checking how you feel.
- Long, introspective meditation practices, if you notice that they intensify the strangeness.
When to ask for help
Make an appointment with your GP or with a mental health professional if:
- The symptoms last more than two to four weeks without improving, or get worse.
- You cannot work, study, sleep or take care of yourself.
- The panic attacks keep recurring.
- There are persistent visual disturbances that worry you. We explain them in HPPD and flashbacks: what the evidence says.
- You have a personal or family history of psychosis or bipolar disorder.
- You are turning to alcohol or other substances to cope.
Go to the emergency room or call 112 if:
- You are having thoughts of harming yourself or taking your own life. You can also call 024, Spain’s suicide prevention helpline, which is free and available 24 hours a day.
- You hear voices, feel persecuted or hold strange convictions that you cannot doubt.
- You have gone several nights with almost no sleep, with a lot of energy and racing thoughts.
- You cannot tell what is real.
How to explain it at the appointment
State clearly what you took, how much, when, and what symptoms you have had since then. Healthcare professionals are bound by confidentiality and need that information to help you. If you take medication, mention it; you will find more context in psychedelics and antidepressants.
If you feel you are not being taken seriously or that they are not familiar with these conditions, you can ask for a second opinion. More and more professionals are familiar with the difficulties that can follow psychedelics.
What support can and cannot do
Emotional support and integration help you put what you experienced in order, understand what triggered it and regain confidence. They are no substitute for a clinical assessment when the symptoms are intense or long-lasting. The two can run in parallel.
At RILOFU we do not sell or supply substances and we do not make diagnoses. If what you need is medical care, we will tell you so. If what you need is a space to talk about what happened, you can start with how to integrate a bad trip weeks or months later.
→ Book a free first consultation
Sources
- Extended difficulties following the use of psychedelic drugs: A mixed methods study. PLOS ONE, 2023.
- Survey study of challenging experiences after ingesting psilocybin mushrooms: Acute and enduring positive and negative consequences. Journal of Psychopharmacology, 2016.