Persistent Altered States: Psychological Treatment of Psychedelic Adverse Effects
Bjørn Holmøy, Kristoffer Andreas Aamodt Andersen
Tidsskrift for Norsk psykologforening December 1, 2025 DOI: 10.52734/hgsn7664 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Narrative literature review Peer reviewed |
|---|---|
| Topics | Anxiety |
| Keywords | Feeling Existentialism Context archaeology Adverse effect Mental health Narrative Phenomenology philosophy Psychotherapist Clinical psychology Death anxiety |
| Citations | 3 |
| Key findings | Three domains of enduring mental health problems after psychedelic use are anxiety and feelings of unreality, persistent changes in perception, and existential distress. |
Abstract
Interest and use of psychedelic substances is on the rise in the general population. Research has mainly focused on therapeutic applications in formal treatment settings, and little is known about persistent negative effects in naturalistic use. The aim of this paper is to present a clinically relevant overview of the phenomenology and symptoms of enduring mental health problems after psychedelic use. Three central domains of post-psychedelic difficulties are presented, informed by clinical work on this subgroup and a narrative literature review: (a) anxiety and feelings of unreality, (b) persistent changes in perception, and (c) existential distress. These are broad groupings and intended as suggestive rather than authoritative on the breadth and nature of complications after recreational psychedelic use. Challenges and recommendations for psychotherapeutic work with this subgroup is discussed in the context of principles for evidence-based practice. Keywords: psychedelics, negative effects, adverse reactions, HPPD, existential distress
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| Study | Year | Design | Participants |
|---|---|---|---|
| Mindfulness-based interventions: an overall review General (healthcare, schools, workplace) | 2021 | Review | |
| A Consensus Statement on the Use of Ketamine in the Treatment of Mood Disorders | 2017 | Review and consensus statement | |
| Sudarshan Kriya Yogic Breathing in the Treatment of Stress, Anxiety, and Depression: Part II—Clinical Applications and Guidelines | 2005 | Review | |
| Mindfulness Meditation and Psychopathology | 2018 | Review | |
| Management of Treatment-Resistant Depression: Challenges and Strategies | 2020 | Review |
Citations in the library
Cited by 3
- Extended difficulties after psychedelic experiences: Prevalence and associations in a global, multilingual sample. Research Square April 8, 2026
- Symptom-Specific Nuances in Psychedelic Integration: A Qualitative Study of Insights from Therapists Supporting Extended Difficulties in Naturalistic Settings Research Square May 21, 2026
- When Therapy Falls Short: A Qualitative Study of Psychotherapy After Challenging Psychedelic Experiences
Cites 59
- Human hallucinogen research: guidelines for safety. Journal of Psychopharmacology July 1, 2008
- REBUS and the Anarchic Brain: Toward a Unified Model of the Brain Action of Psychedelics Pharmacological Reviews June 20, 2019
- Survey study of challenging experiences after ingesting psilocybin mushrooms: Acute and enduring positive and negative consequences Journal of Psychopharmacology August 31, 2016
- Predicting Responses to Psychedelics: A Prospective Study Frontiers in Pharmacology November 2, 2018
- Classic psychedelic use is associated with reduced psychological distress and suicidality in the United States adult population. Journal of Psychopharmacology March 1, 2015
and 54 more in the library