After a bad trip, the next day and the weeks that follow

Feeling tired, shaky or on edge for a while after a bad trip is common. DRUGSinfo notes that a bad trip passes once the substance has worn off, but that someone can still feel anxious for some time afterwards (DRUGSinfo). For most people that settles in days. For a small group it lasts longer, and that is when professional help is the right step.

The first night and the next day

• Sleep when you can. Leave a lamp on if the dark feels uneasy. It is normal to lie awake for a while after the effects have faded.
• Eat something simple and drink water. Many people have barely eaten during a trip.
• Do not drive or cycle until you are fully clear. In the Netherlands, the Road Traffic Act forbids driving any vehicle, a bicycle included, under the influence of a substance that impairs driving (Wegenverkeerswet 1994, art. 8).
• Keep the day small. No big decisions, no difficult conversations, no alcohol or other drugs to take the edge off.
• Have someone around. The person who sat with you, or a friend who knows what happened.

Talking it through

Most people who have a hard trip want to understand it afterwards. In interviews with 50 Norwegian users of psychedelics, almost all described frightening experiences, and many had turned them into stories they could make sense of (Gashi et al. 2021). A few practical ways to do that:

• Write it down while you still remember: what you took, when, where, who was there, what turned it, what made it easier.
• Talk to the person who was with you. They saw things you did not. Ask what they noticed and when.
• Talk to someone you trust who was not there and will listen without judging.
• Use a support line. In the US, the Fireside Project takes calls and texts from people trying to make sense of a past trip, at 62-FIRESIDE (623-473-7433), 11 a.m. to 11 p.m. Pacific (Fireside Project). In the Netherlands, the Drugs Infolijn answers on 0900-1995, weekdays 9:00 to 17:00, and by chat and mail (DRUGSinfo contact).

You do not have to find a meaning in it. Some bad trips were simply too much of something: too strong, too loud, too many people, or the wrong substance. That is useful knowledge for next time too.

Feeling unreal: depersonalisation and derealisation

Some people feel detached after a trip: as if their body is not their own (depersonalisation) or as if the world and other people are strange or unreal (derealisation). DRUGSinfo describes both as a known reaction to very intense fear, says they can be frightening, and notes that they usually pass on their own (DRUGSinfo).

If the feeling stays, or keeps you from working, studying or sleeping, talk to a doctor.

Flashbacks and visual changes (HPPD)

Some people see parts of the trip again after the substance has left the body: shapes, flashes of light, intense colours, trails, moving or vibrating objects, rings around things. When this lasts, it is called hallucinogen persisting perception disorder, or HPPD. DRUGSinfo advises contacting the Drugs Infolijn when these symptoms go on for a longer time. FRANK notes that flashbacks can cause great distress and that very little is known about why some people are vulnerable (FRANK, LSD). Research guidelines tell investigators to ask about HPPD in follow-up contact after a session, which shows it is taken seriously even if rare (Johnson et al. 2008).

A doctor is the right person to see when flashbacks keep coming back. Tell them what you took; in most countries doctors are bound by medical confidentiality.

When to get professional help

In the large survey of people's worst mushroom trips, 7.6% of those whose experience lay more than a year back had sought professional help for psychological symptoms that lasted. Three cases appeared to be linked to the onset of lasting psychotic symptoms, and three to attempted suicide (Carbonaro et al. 2016). Those numbers are small, and they are real.

See a doctor if, after the trip:

• the fear, low mood or sense of unreality has not eased in the weeks after the trip, or gets worse
• you hear or see things that are not there, now that the substance has worn off
• you have beliefs that friends find alarming, such as being watched or followed
• you cannot sleep for several nights in a row
• daily life, work or study is suffering

Get help today if you have thoughts of hurting yourself or of not wanting to live:

• UK and Ireland: Samaritans, call 116 123, free from any phone (Samaritans)
• US: 988 Suicide and Crisis Lifeline, call, text or chat 988, around the clock (988 Lifeline)
• Netherlands: 113 Zelfmoordpreventie, call 113 for free (113)
• Anywhere, if there is immediate danger: 112, 999 or 911

Before you use anything again

Give yourself time. FRANK notes that tolerance to LSD and mushrooms builds quickly (FRANK, magic mushrooms), and a trip taken while you are still shaken by the last one starts from a worse set. Nothing here suggests that another trip will resolve the last one. If you do decide to use again, the page on before next time covers testing, choosing a milder option and the legal position.

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