A groundbreaking new study published this week in the Journal of Psychedelic Studies offers one of the clearest views yet into the lingering psychological challenges some individuals face after using psychedelic drugs like psilocybin, LSD, and ayahuasca—and what helps them cope. Researchers found that while anxiety and panic attacks are among the most disruptive post-experience effects, difficulties such as existential struggles and reduced self-esteem often last for more than a year, underscoring the need for better support systems.
The findings are particularly significant as global interest in psychedelics for mental health therapy grows, and clinical research expands into their use for conditions like depression, addiction, and PTSD. Although many clinical trials report positive results for assisted therapy, there has been far less discussion about persistent negative psychological outcomes experienced by some users. Previous research has shown that 5% to 25% of those who use psychedelics report lingering problems, sometimes lasting months or years after their initial drug experience. With interest in alternative mental health treatments also on the rise in Thailand, understanding these risks and coping mechanisms is increasingly important for both health professionals and the public.
The new study surveyed 159 adults who reported psychological issues that persisted for more than a day after a single psychedelic experience, sometimes occurring years in the past. The sample was mostly composed of educated participants from North America and Europe, but the research offers crucial insights relevant to global audiences. Participants described a wide variety of post-psychedelic difficulties: social disconnection (72%), anxiety or panic attacks (68%), existential struggle (65%), depression (61%) and feelings of derealisation (55%) were most common. Less frequently, paranoia and visual disturbances were each noted by about 21% of respondents.
Crucially, the research distinguishes which of these troubles are most severe and which tend to endure the longest. Anxiety and panic attacks were rated as most disruptive to daily life, often making work and relationships challenging. However, it was existential struggle and diminished self-esteem that persisted the longest, with average durations exceeding 15 months for both. “Some people who take psychedelics experience disorienting and disruptive difficulties pertaining to emotions, their sense of self or even sense of reality that can last for weeks or months,” said the study’s lead author, an associate professor of psychology at the University of Greenwich (PsyPost).
In examining how people overcame these difficulties, the researchers found that different strategies worked best for different problems. Self-directed education—such as reading, watching videos, or other research—was the most commonly cited helpful tool, especially for existential struggle, derealisation, and social disconnection. Many participants used professional therapy to cope with depression and low self-esteem, while support from friends and family was most effective for anxiety and panic attacks. Surprising even the researchers, informal interactions with peers were often seen as more helpful than speaking with therapists, which suggests gaps in current clinical training for dealing with psychedelic after-effects.
The findings highlight that recovery is not a one-size-fits-all process. For example, activities like meditation, breathing techniques, and physical exercise were also cited as useful, though preferences varied depending on the specific symptom (see original article for detailed findings: PsyPost). Some problems, such as depersonalisation, ongoing confusion, and sleep disruption, showed no strong preference for coping methods—suggesting individual differences play an outsize role.
The implications for Thailand are clear. As private clinics and research groups consider pilot studies of psychedelic-assisted therapy for mental health, awareness of adverse reactions and the diversity of their presentation is critical. In the Thai context, where mental health stigma can be significant and ayahuasca or other plant-based psychedelics are sometimes used in informal or spiritual settings, there is an urgent need for local resources and culturally attuned integration support. “Therapists are not yet well trained to handle the conundrum of working with psychedelics and associated difficulties,” the study’s principal investigator observed, pointing to a global shortfall in clinical expertise.
Thailand’s unique Buddhist culture, with an emphasis on meditation, mindfulness, and the resolution of existential suffering, may shape both the prevalence and the handling of post-psychedelic difficulties. Insights from local spiritual practices might offer potential additions to the coping repertoire for individuals struggling after psychedelic use—especially as existential and identity-based challenges align closely with concepts found in Thai philosophy. However, because the new research is based largely on Western participants, it remains crucial for local clinicians and policymakers to invest in Thai-specific follow-ups, potentially in collaboration with the ongoing Global Psychedelic Survey mentioned by the study authors.
Historical and legal context is also key: psychedelic substances remain classified as illegal narcotics in Thailand, except for some controlled clinical settings. Unlike countries such as Brazil or Peru, where ceremonial use is integrated into indigenous spiritual practice, Thais face different cultural and legal challenges—potentially exacerbating stigma and barriers to open discussion. Researchers and mental health officials in Thailand must consider these sociocultural factors when planning harm reduction strategies or future clinical trials.
Looking ahead, the study’s authors plan to track participants prospectively—starting before psychedelics are administered and regularly following up to monitor difficulties and resolutions in real time. They are also investigating whether childhood trauma makes certain individuals more vulnerable to long-term negative outcomes. Clinically, these efforts could help fine-tune patient screening and post-treatment care, both globally and in an emerging Thai context.
For Thai readers, the practical takeaway is clear: while most psychedelic experiences are reported as positive, a notable minority results in lasting difficulties—sometimes extending more than a year. Anyone considering or having recently used psychedelics should be aware of these risks. Those struggling after a psychedelic experience are encouraged to seek support from trusted friends and family, consider self-education to better understand their experience, and—where available—consult with therapists familiar with psychedelic integration. It is also important to maintain patience and self-compassion; some effects will dissipate with time, but prompt support can make the process easier.
As Thailand considers new mental health frontiers, including the clinical use of psychedelics, this research urges a balanced approach. Education, openness, and an investment in clinician training—incorporating both Western and Thai perspectives—are needed to ensure potential benefits do not come at the expense of unaddressed psychological harm. More local research and support systems, sensitive to Thai culture and law, will help prepare health professionals and the public for the increasingly complex future of mental health treatment.