How to Handle a Bad Trip

A bad trip is one of the most frightening experiences a person can have, and the cruellest part is that you can't simply switch it off. With LSD or mushrooms it can run for hours; the fear, the paranoia, the sense that reality has come loose can feel like it will never end. It does end. I want to say that first and clearly, because the single most important thing to hold onto is this: what you are feeling is the drug, it is temporary, and you are not going mad or dying — even when every part of you is convinced otherwise.

First, the one truth to cling to

Almost everything that makes a bad trip terrifying comes from the same root: the fear that it's permanent, that something has broken that won't be put back. It isn't. The chemical wears off, the visions fade, the dread lifts, and your mind returns to itself. If you can plant one flag in the storm, plant this one — "this is the drug, it will pass" — and come back to it again and again.

Grounding: how to bring yourself back

When the fear rises, the instinct is to fight it or run from it, and both make it worse. Grounding works better. It pulls your attention out of the spiralling thoughts and back into your body and the room.

• Change the setting. So much of a trip is shaped by surroundings. Move to a calm, dimly lit, familiar space. Turn off harsh lights and chaotic music; soft sound can help, silence is fine too.
• Breathe, slowly. Long, slow breaths — in for four, out for six. Panic speeds the breath and the breath feeds the panic; slowing it breaks the loop.
• Use your senses. Hold something cold, wrap yourself in a blanket, sip water, feel your feet on the floor, name five things you can see. These small anchors remind your mind the room is still here and still ordinary.
• Let it move, don't brace against it. Fighting a trip is like fighting a wave — it tires you and doesn't work. Soften, breathe, and let the feelings pass through rather than clamping down.

If you're the sober friend

If you're looking after someone having a bad trip, you matter more than any technique. Stay calm — your steadiness is contagious, and so is panic. Keep your voice low and warm. Reassure them, over and over, that it's the drug, that it will wear off, and that they're safe. Don't argue with what they're experiencing or try to "snap them out of it"; stay close, keep them from harm, and be the calm anchor in the room. Reduce noise and light. Don't leave them alone, and don't give them more of anything to "level it out".

When to get medical help — don't hesitate

Most bad trips, frightening as they are, are weathered with calm, company and time. But a psychedelic experience can occasionally become a medical situation, and knowing where that line is matters. Ring 999 or 112, or get to an emergency department, if any of these happen:

• Chest pain, a racing or pounding heart that won't settle, or trouble breathing.
• A very high temperature, rigid muscles, fitting or seizures, or collapse.
• Violent agitation, or the person trying to harm themselves or put themselves in danger.
• An unknown substance, a suspected very high dose, or a dangerous mix — ayahuasca with antidepressants (SSRIs), for instance, can be genuinely dangerous, as I note in my DMT guide.

Please don't let fear of getting in trouble stop you calling. Medics are there to keep people safe, not to judge. A few minutes of embarrassment is nothing against the alternative.

Afterwards — and why it's worth pausing

A bad trip can leave a mark for days or longer: lingering anxiety, low mood, a shaken feeling, sometimes flashbacks. Take that seriously — if it doesn't settle, see your GP, and read my page on HPPD and flashbacks. It's also worth an honest pause. A bad trip is sometimes the mind surfacing something it's been carrying, and if you find yourself frightened, low, or reaching for substances to escape the aftermath, that's exactly the kind of thing it helps to talk through. There's more in my guides to LSD and magic mushrooms, and the door to a confidential conversation is always open.

Gary Clinton

Ireland's addiction specialist — CBT-qualified therapist, bestselling author of Never Give Up, and an ex-addict himself. Private one-to-one help for professionals, online and worldwide.