Anxiety after a bad trip: why it happens and what helps

Here are some practices people generally have reported to find helpful to cope with challenging psychedelic experiences:

• Speaking to friends and family or attending a peer support group
• Speaking to a therapist, especially one who is familiar with psychedelic difficulties (CBT is often effective for anxiety and panic problems, although some also say they are helped by somatic therapy exercises that help regulate their nervous system).
• Cognitive practices like compassionate self-talk, cognitive distancing, and especially meditation and prayer
• Embodied self-care practices like exercise, yoga, walking in nature or body relaxation
• Finding useful information online and in books (e.g. the work of Stanislav Grof’s or “Breaking Open: Finding a Way Through Spiritual Emergency” by Jules Evans and Tim Read)
• Journaling
• Engage in creative activities like writing, art-making, or music
• Some people find medication helpful.

It is essential to explore and integrate these strategies in a way that resonates with personal preferences and needs, seeking support from professionals or trusted sources as needed.

When to seek professional help

Anxiety after a bad trip often eases on its own, but it’s worth talking to a doctor or a therapist who understands post-psychedelic difficulties if:

• your anxiety or panic has lasted several weeks and isn’t easing, or is getting worse
• you’re avoiding places, people or being alone because of fear
• you’re struggling to sleep or eat, or are losing weight
• it’s making it hard to work, study or look after yourself

Our practitioner directory lists therapists and clinicians experienced with post-psychedelic difficulties, and our free monthly online support group is a place to talk with others who understand.

Get urgent help straight away if you have thoughts of harming yourself or ending your life, or if you or people around you notice signs such as hearing or seeing things others don’t, or holding strong beliefs that others find very unusual. Call your local emergency number or go to the nearest emergency department.

Julie’s story: anxiety and panic after ayahuasca

Julie, a 60-year-old mental health counselor from Idaho, became interested in psychedelics as potential interventions for trauma, anxiety, and depression. She decided to explore Ayahuasca after trying mushrooms and MDMA in therapeutic contexts. Julie and her husband Jeff attended an ayahuasca retreat in Peru. The first two ceremonies were manageable though intense, but during the final ceremony, she experienced overwhelming physical and emotional trauma. Julie described the sensation as being “at the mercy of this energy,” saying:

It was just like bolts of energy or electricity convulsing through my body, and I just laid there… My body did not feel like a safe place.

The overall experience left her shaken and, on the plane home, she experienced her first panic attack. Upon returning home, the challenges got worse. She struggled with anxiety, panic attacks, and a severe loss of appetite, resulting in rapid weight loss. She recounted:

I just had such a hard time eating. I went from what was closer to 120 [pounds] in a matter of, I think, a couple of weeks, down to 104… Eating became a chore, and that was really hard because that’s one of the pleasures of life.

The physical symptoms were compounded by relentless anxiety, which she described as unlike anything she had experienced before:

It was traumatic and very overwhelming. I felt hostage… It was paralyzing, and my body suddenly was no longer safe.

Her mornings were particularly difficult:

I would wake up, and my husband would hold me or rock me… I just felt like I had lost a part of myself.

Julie also experienced intrusive thoughts that felt reminiscent of her childhood fears growing up in a strict Mormon community with alcoholic parents: ‘It activated a part of myself that was just based on fear and anxiety.’

Her coping mechanisms, including yoga and meditation—tools she had previously taught—felt inaccessible during this acute crisis. This disconnect brought an additional layer of shame: ‘I was teaching an eight-week meditation course on campus… but practicing it myself was really hard.’

Julie sought help from various sources, including counselors, integration therapists, psychiatrists, and even shamans. Unfortunately, many encounters were disappointing. Some therapists shamed her for using medications like Ativan or dismissed her trauma as her own failure to “surrender” to the experience. She recalled one healer telling her: ‘You need to get straight with your God, and you’re getting in your own way.’

This lack of understanding left Julie feeling isolated and unsupported. She also experienced social withdrawal, further exacerbating her sense of isolation: ‘I couldn’t tolerate social stuff, and my world got so small.’

Her husband, Jeff, became her primary support system, helping her regain some sense of stability. He described the difficulty of witnessing her suffering: ‘There were so many days when it was just minute by minute… I was really worried. I didn’t know if she was going to live.’

Julie’s path to recovery

Julie’s recovery was slow and nonlinear. She found some relief in small lifestyle changes, such as taking cold showers, maintaining physical activities like skiing and running, and trying different medications. Over time, her sleep and weight began to stabilize. She eventually started Lexapro for depression, which helped her regain emotional balance:

By July, I started on Lexapro… It helped me stop crying and manage the morning anxiety.

Despite her progress, Julie remained cautious about anxiety and its triggers:

I’ve had to befriend certain things again, like anxiety being a normal part of life, but I never want to go back to that place.

She emphasized the importance of having supportive people around her, saying:

You have to find one or two people that you can connect with and who can reassure you that you’re okay.

She says staying in her job, despite finding it very hard, was crucial – it gave her a schedule and stopped her world shrinking too much. She was also helped a lot by finding similar stories of people who had gone through such crises and emerged the other side, and by the support of a counsellor, and above all by her husband Jeff. They both say this was the hardest experience they ever went through (including having lost a baby).

Julie’s story underscores the need for greater transparency and preparation in the psychedelic industry. She reflected on the lack of adequate warnings and aftercare from the retreat center, saying:

It’s not necessarily over when it’s over… We’re dabbling in something we don’t completely understand.

She also criticizes the culture of shaming those who experience difficulties:

There’s this pressure to do it again, to face your fear, but that’s not the whole story. It can just be traumatic in and of itself.

Her advice to those struggling with post-psychedelic difficulties is simple: ‘You’re not alone… You are going to get better. The hard thing is the unpredictability of it.’

Frequently asked questions

Is it normal to have anxiety after a bad trip?

Yes. Anxiety and fear are among the most common extended difficulties people report after psychedelics. It can feel very isolating, but many others have been through it and recovered.

How long does anxiety after a bad trip last?

For most people in our research, it lasted up to six months before passing, and sometimes only a few days. If it lasts longer, professional support can help.

Can a bad trip cause PTSD?

A very frightening experience can leave a trauma response, and some people are diagnosed with PTSD after a bad trip. A trip can also bring earlier trauma to the surface. A therapist familiar with post-psychedelic difficulties can help you work out whether trauma is part of the picture.

I’m afraid I’ve damaged my mind. Will this fear go away?

Fear of going mad or of permanent damage is itself one of the most commonly reported fears after a difficult trip. Many people found it eased as their other symptoms did, and that hearing from others who had recovered was reassuring.

Can medication help?

Some people find medication helpful, alongside other support. If you’re considering it, talk it through with a doctor. There is no shame in using medication to get through a hard period.

Where can I find support?

You can join our free monthly online support group, find a practitioner in our directory, or contact the Fireside Project’s support line for emotional support during and after psychedelic experiences.