A qualitative analysis of the psychedelic mushroom come-up and come-down.
Ari Brouwer, Joshua K Brown, Earth Erowid, Fire Erowid, Sylvia Thyssen, Charles L. Raison, Robin Carhart-Harris
npj Mental Health Research February 7, 2025 DOI: 10.1038/s44184-024-00095-6 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Qualitative study Peer reviewed |
|---|---|
| Population | Self-reported psilocybin or psilocybin-containing mushroom experience reports submitted to Erowid.org |
| Intervention | Psilocybin |
| Topics | Psilocybin |
| Keywords | Stress relief Psychedelics Mental health Altered states Therapeutic effects |
| Citations | 5 |
| Key findings | The come-up phase of psychedelic experiences is more often characterized by negatively valenced feeling states resembling an acute stress reaction, while the come-down phase is more often characterized by positively valenced feeling states similar to recovery from illness or stress resolution. |
Abstract
Psychedelic therapy has the potential to become a revolutionary and transdiagnostic mental health treatment, yielding enduring benefits that are often attributed to the experiences that coincide with peak psychedelic effects. However, there may be an underrecognized temporal structure to this process that helps explain why psychedelic and related altered states of consciousness can have an initially distressing but ultimately distress-resolving effect. Here we present a qualitative analysis of the self-reported 'come-up' or onset phase, and 'come-down' or falling phase, of the psychedelic experience. Focusing on psilocybin or psilocybin-containing mushroom experience reports submitted to Erowid.org, we use phenomenological, thematic content and word frequency analysis to show that the come-up is more often characterized by negatively valenced feeling states that resemble an acute stress reaction, while the come-down phase is more often characterized by positively valenced feeling states of the sort often observed following recovery from illness or resolution of stress. The therapeutic and theoretical relevance of these findings are discussed.