How to recognize when you’re taking too many psychedelics

Tracking long-term effects of psychedelic drugs

When used effectively, hallucinogens can bring on altered states of consciousness that constitute immense therapeutic value. To reduce risk and ensure healing psychedelic sessions, users should exercise moderation, track their usage patterns, and monitor long-term effects. For this purpose, it is recommended that any psychedelic user keep a log of their psychedelic sessions, dosages, and experiences. This can be elaborated with journal entries, diagrams, and illustrations.

When self-medicating with psychedelics on a regular basis, it is not uncommon for the patient to find themselves managing significant emotional and psychological changes. This is sometimes accompanied by a double bind in which the psychedelic experience feels healing, but is overshadowed by an intensification of symptoms or life changes over an extended period. In these cases it is important for the user to stop, step back, and take notes of any impact psychedelics are having on various aspects of life:

  • Emotional well-being: Prioritize your journey towards joyful contentment. Remaining open to new experience, patience, a sense of belonging, kindness toward others, and loving acceptance of oneself
  • Social relationships: Be vigilant of any changes to relationships with family and longstanding friends. Associate with people who have your best interest in mind, and be wary of strangers that encourage irresponsible behavior. Befriend people who make you feel safe and offer to provide mutual support
  • Responsibilities: Keep track of changes to your attendance or performance at work and school. Be sure you are able to support yourself and those dependent on you. Aim to earn a life that is creatively, emotionally, and socially fulfilling
  • Neurological health: Strive to feel safe, secure, and comfortable. Note if you begin to experience scrambled thoughts, obsessive dwelling, increased dissociation, heightened startle response, hallucinations, or other persistent alterations to cognition. These may be signs that you could benefit from psychedelic integration therapy and complementary therapeutic practices, and are often signs to slow down drug intake
  • Physical health: Note changes to appetite, energy levels, and general well-being. Note muscle spasms, tightness, gastrointestinal upset, and other symptoms which can be invoked by regular drug use. Maintain a nutritious diet, do routine exercise or physical therapy, monitor changes to health, and care for one’s body as a vehicle for well-being

These considerations are adapted from systems such as Maslow’s Hierarchy of Needs and principles from Dialectical Behavioral Therapy.[1]

Adverse effects of psychedelic use

There are some common types of unanticipated behavior and symptoms that may arise from psychedelic use. These are described below. When dealing with any of the following complications, it is important to seek additional support to ensure one’s well-being.

In clinical psychedelic therapies, Cognitive Behavioral Therapy (CBT) and Dialectical Behavioral Therapy (DBT) are widely used for providing a therapeutic foundation adjacent to psychedelic therapy.[2] Complementary therapy practices and art therapy may be useful for managing flashbacks and other intrusive or overwhelming side-effects.[3][4][5] Experienced psychedelic therapist or organizations can offer additional support.

Hallucinogen persisting perceptual disorder (HPPD)

HPPD is among the most common side effects of psychedelic use. It consists of persistent changes to sensory experiences, most often visual. Effects of HPPD can include visual snow or static, halos or auras surrounding objects, trails left by moving objects, increased visibility of floaters, and intensified hallucinatory phenomena when entering or leaving sleep.[6][7] HPPD is frequently reported as benign or merely annoying, and with reduce intensity after several months of abstinence from psychedelics.

Psychedelic flashbacks

With repeated high doses, or after an extremely intense experience while on psychedelics, the user may acutely re-experience psychedelic phenomena throughout daily life. Unlike HPPD, these experiences are usually brief, non-persisting, and have the quality of a flashback. Psychedelic flashbacks are more likely with powerful psychedelics such as DMT or 5-MeO-DMT, but may occur with strong doses of other compounds. Environments, memories, or sensory stimuli that are reminiscent of a past psychedelic trip can sometimes trigger a flashback. Like HPPD, flashbacks are perpetuated by psychedelic use, and often subside over time provided sobriety, emotional stability, and self-care. Intense, persisting psychedelic flashbacks can occur in vulnerable individuals or with repeated high doses; this is may be managed through antipsychotic medication.

Re-exposure to traumatic memories

Psychedelic possess the ability to increase connectivity between brain regions, exposing their user to unusual thought patterns and ideas. This increased connectivity can also invoke suppressed or traumatic memories. During therapy sessions, the guide or therapist may encourage the participant to trust in their inner resources when re-experiencing traumatic associations. Integration therapy may help ensure that the participant is able to successfully translate intense psychedelic sessions into constructive and worthwhile experiences. Participants who manage traumatic memories through art therapy may prefer to keep their artwork private, depending on their comfort level.[8]

Escapism

Hallucinatory landscapes and omnipotent intelligence are among many fantastic things that may be elicited in altered states. Because of the novelty of these states, some users may become dependent on psychedelics to chase cognitive, aesthetic, and spiritual highs. Users often seek escapism due to difficult life circumstances or mental illness, which can also indicate increased psychological risks with regular psychedelic use. Delirious or obsessive thinking

Although they can elicit incredible thought connectivity and epiphany, psychedelics also may elicit delirious or obsessive thought patterns in some individuals. This can occur due to a vulnerable mindset that was overlooked during participant screening, or as a result of adverse events during the psychedelic experience itself. Integration therapy and complementary therapy practices are helpful for organizing confusing memories and ideas within a stable conceptual framework. Some users with obsessive thought patterns also exhibit a compulsion to write, draw, perform, or otherwise express themselves; creative expression may be especially relevant for these patients’ integration process.

Dissociative symptoms

For some individuals psychedelics can invoke dissociation, depersonalization, or derealization. These conditions are frequently regarded as traumagenic or neurodevelopmental in origin, and like disorganized thinking, may be brought on or intensified by psychedelic drugs. When dealing with this set of symptoms, complementary therapy practices that are strongly focused on reducing dissociation are strongly recommended.

Works cited

[1] McLeod, S. A. (2018, May 21). Maslow’s hierarchy of needs. Retrieved from https://www.simplypsychology.org/maslow.html

[2] Reed, G. (2019, August). Psychedelic therapy. Effect Index.

[3] Pifalo, T. (2007). Jogging the Cogs: Trauma-Focused Art Therapy and Cognitive Behavioral Therapy with Sexually Abused Children. Art Therapy, 24(4), pp.170-175. Retrieved from https://archive.org/details/ERIC_EJ791441. 10.1080/07421656.2007.10129471.

[4] Chapman, L., Morabito, D., Ladakakos, C., Schreier, H., & Knudson, M. (2011, Apr 22). The Effectiveness of Art Therapy Interventions in Reducing Post Traumatic Stress Disorder (PTSD) Symptoms in Pediatric Trauma Patients. Art Therapy, 18:2, 100-104. https://doi.org/10.1080/07421656.2001.10129750.

[5] Schouten, K. A., de Niet, G. J., Knipscheer, J. W., Kleber, R. J., & Hutschemaekers, G. J. M. (2015). The effectiveness of art therapy in the treatment of traumatized adults: A systematic review on art therapy and trauma. Trauma, Violence, & Abuse, 16(2), 220-228. http://dx.doi.org/10.1177/1524838014555032.

[6] Hermle, L., Simon, M., Ruchsow, M., & Geppert, M. (2012). Hallucinogen-persisting perception disorder. Therapeutic advances in psychopharmacology, 2(5), 199–205. doi:10.1177/2045125312451270

[7] Hallucinogen persisting perception disorder. (2019, May 31). PsychonautWiki. Retrieved from https://psychonautwiki.org/w/index.php?title=Hallucinogen_persisting_perception_disorder.

[8] Gidron, Y., Peri, T., Connolly, J. F., & Shalev, A. Y. (1996). Written disclosure in posttraumatic stress disorder: Is it beneficial for the patient? Journal of Nervous and Mental Disease, 184(8), 505-507. http://dx.doi.org/10.1097/00005053-199608000-00009


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