A recent study in the Journal of Psychedelic Studies sheds light on the lingering psychological challenges some people experience after psychedelic experiences and what helps most. The research highlights that while anxiety and panic attacks can be disruptive, existential struggles and reduced self-esteem often persist for more than a year.
As global interest in psychedelic-assisted therapy grows, these findings are timely for health professionals and the public, including those in Thailand where discussions about alternative mental health treatments are expanding. Prior work has shown that a portion of users—estimates range from 5% to 25%—continue to deal with psychological effects long after their initial experience. Understanding these risks is essential for Thai healthcare providers and communities.
The study surveyed 159 adults who reported ongoing psychological issues after a single psychedelic session, sometimes years later. Participants were primarily educated individuals from North America and Europe, but the insights are relevant worldwide. Common post-experience difficulties included social disconnection (approximately 72%), anxiety or panic attacks (about 68%), existential struggle (roughly 65%), depression (61%), and feelings of derealisation (55%). Paranoia and visual disturbances were less common, at around 21%.
The researchers identified which problems are most disruptive and which linger longest. Anxiety and panic attacks frequently hinder daily life and strain work and relationships. Yet existential concerns and diminished self-esteem tended to endure the longest, with average durations exceeding 15 months for both. The lead author, a senior psychologist at a prominent university, notes that some individuals face emotional turmoil, identity questions, or altered perceptions that can last weeks or months.
Coping strategies varied by problem. Self-directed education—reading, watching educational videos, and independent research—was the most common help, especially for existential struggle, derealisation, and social disconnection. Therapy helped many with depression and low self-esteem, while support from friends and family was particularly effective for anxiety and panic attacks. Interestingly, informal peer support often surpassed professional guidance in perceived usefulness, suggesting gaps in clinical training for psychedelic after-effects.
Recovery is not one-size-fits-all. Activities like meditation, breathing exercises, and physical activity were helpful for some, though preferences differed by symptom. Some issues, including depersonalisation, ongoing confusion, and sleep disturbance, showed no universally preferred coping method, underscoring individual differences.
For Thailand, these findings carry practical implications. As private clinics and research teams explore pilot psychedelic-assisted therapies, awareness of potential adverse reactions and the variety of presentations is crucial. In Thai contexts, where mental health stigma may be strong and plant-based psychedelics are sometimes used in informal or spiritual settings, local resources and culturally attuned integration support are urgently needed. The study’s lead investigator points to a global need for better clinician training on psychedelic after-effects.
Thailand’s Buddhist heritage, with its emphasis on meditation and mindful coping, may influence how post-psychedelic difficulties are experienced and addressed. Local spiritual practices could enrich coping options, especially for existential and identity-related challenges. Because the study primarily surveyed Western participants, Thai clinicians and policymakers should pursue local follow-up research—potentially in collaboration with broader global efforts on psychedelic research.
Legal and historical factors also matter. In Thailand, psychedelics remain tightly regulated, with limited use in controlled clinical settings. This legal context, plus cultural stigma, can complicate open discussions and access to care. Health authorities and researchers should account for these factors when planning harm-reduction strategies or clinical trials.
Looking ahead, researchers plan prospective follow-ups that begin before psychedelic administration and continue over time to monitor difficulties and resolutions. They are also examining whether childhood trauma increases vulnerability to long-term effects. Clinically, these efforts could refine patient screening and aftercare, benefiting patients globally and in Thailand’s evolving mental health landscape.
Practical takeaway for Thai readers: most psychedelic experiences are reported as positive, but a notable minority experience lasting difficulties—sometimes beyond a year. Anyone considering or who has recently used psychedelics should seek trusted support from friends and family, pursue self-education to understand their experience, and consult with therapists familiar with psychedelic integration when available. Patience and self-compassion are important, and timely support can ease the recovery process.
As Thailand contemplates new mental health frontiers, including potential clinical use of psychedelics, a balanced approach is essential. Education, openness, and investment in clinician training—integrating both Western and Thai perspectives—will help ensure benefits without neglecting psychological risks. Local research and culturally sensitive support systems will prepare health professionals and communities for a nuanced future in mental health care.