What a bad trip is, and why it happens
A bad trip is a stretch of a psychedelic experience that turns frightening or overwhelming. What it feels like, how common it is, and what causes it.
A bad trip is a part of a psychedelic experience that becomes frightening, confusing or overwhelming. The Dutch public information service DRUGSinfo describes it as a circle that is hard to get out of: an unpleasant thought leads to fear or sadness, and that feeling brings up more unpleasant thoughts (DRUGSinfo). Researchers use the more neutral term challenging experience, because the same hours can feel terrible at the time and be described quite differently later.
The most useful fact for someone in the middle of one: it is caused by a substance, and the substance wears off. DRUGSinfo is plain about this. A trip cannot be stopped early, but the setting can be changed, someone trusted can stay close, and the bad trip passes once the effects end.
What it feels like
In 2016 a team at Johns Hopkins University built a questionnaire from the answers of people who described their most difficult experience with psilocybin mushrooms. The resulting Challenging Experience Questionnaire sorts these moments into seven recurring forms (Barrett et al. 2016):
| Form | How it tends to show up |
|---|---|
| Fear | Panic, dread, feeling trapped in the experience |
| Grief | Deep sadness, crying, old losses coming back |
| Physical distress | Nausea, a racing heart, pressure, feeling cold or hot |
| Insanity | The fear of going mad or of never coming back |
| Isolation | Feeling cut off from everyone, unreachable |
| Death | The conviction of dying, or that something fatal is happening |
| Paranoia | Distrust, the sense of being watched or plotted against |
The same paper lists confusion and the feeling of losing your sanity among the cognitive symptoms, next to panic, low mood, nausea and heart palpitations. In interviews with 50 Norwegian users, the key feature of a bad trip was the feeling of losing oneself or going crazy (Gashi et al. 2021).
Time is part of it. Psychedelics stretch time, so ten minutes of fear can feel like hours. FRANK gives 6 to 12 hours as the usual length of an LSD trip (FRANK, LSD); a trip on mushrooms or truffles is shorter, but still several hours.
How common bad trips are
Common. Almost all 50 participants in the Norwegian study had frightening experiences on psychedelics, and many called them bad trips (Gashi et al. 2021).
The largest survey so far asked 1,993 people about their single worst experience with psilocybin mushrooms (Carbonaro et al. 2016). Some of its numbers:
- 39% rated it among the five most challenging experiences of their life.
- 11% put themselves or others at risk of physical harm during the experience.
- 2.6% behaved in a physically aggressive or violent way.
- 2.7% received medical help.
- Of those whose experience lay more than a year back, 7.6% had sought professional help for psychological symptoms that lasted.
These are self-selected people answering online, so the numbers say little about how often a random trip goes wrong. They do show that a hard trip is a normal part of psychedelic use, and that a small share ends in real danger. The same study found that the risk of dangerous behaviour went up with the estimated dose, with how long and how hard the experience was, and when physical comfort and social support were missing.
What makes a bad trip more likely
DRUGSinfo names the usual causes: a dose that is too high, an unwanted set (your mood and state of mind going in) or an unwanted setting (a place where you do not feel at ease). Research and harm reduction sources add a few more.
Dose and dose uncertainty. In the Carbonaro survey, difficulty went up with the estimated dose. A Basel study comparing four doses of LSD found that the highest dose caused significant anxiety (Holze et al. 2021). The problem is that the strength of a blotter, a mushroom or a truffle is rarely known, so a trip can be much stronger than planned without anyone having chosen that.
Set. FRANK advises against taking LSD when you are depressed or in a bad mood, and warns that people have hurt themselves during a bad trip (FRANK, LSD). Stress, a recent conflict or a fear you brought along tends to come back louder.
Setting. Crowds, loud music, bright light, strangers and places you cannot leave easily all feed fear. So does being alone, or being with someone who is also tripping.
Combinations. Alcohol, cannabis and other drugs on top of a psychedelic make the experience harder to predict. Some prescribed medicines are dangerous with psychedelics: in an analysis of 62 online reports of lithium combined with a classic psychedelic, 47% described a seizure (Nayak et al. 2021).
Not knowing what you took. A blotter sold as LSD can carry another substance. NBOMe compounds, sold as LSD, have caused fatal poisonings (Zawilska et al. 2020). A reagent test shows whether the expected substance is there before anything is taken.
Personal and family history. Research guidelines exclude people with a personal or family history of psychotic disorders, because hallucinogens can occasionally trigger prolonged psychosis (Johnson et al. 2008).
Bad trip or emergency
Most bad trips are frightening without being physically dangerous. Some are emergencies. Call 112 (EU), 999 (UK) or 911 (US) when someone cannot be woken, has trouble breathing, has a seizure, is overheating and not cooling down, or is a danger to themselves or others. The emergency page goes through it step by step.
If it is a fear that will not let go, the page on getting through a bad trip has the steps. If you are with someone else who is struggling, start with trip sitting.
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Talk to someone
- Emergency112 in the EU, 999 in the UK, 911 in the US
- Fireside Project (US)Psychedelic support line, call or text 62-FIRESIDE, 11 a.m. to 11 p.m. Pacific
- FRANK (UK)0300 123 6600
- Drugs Infolijn (NL)0900-1995, weekdays 9:00 to 17:00