With psychedelics, education and preparation can make a difference in having a positive healing experience.
Psychedelics are psychoactive substances that induce altered states of consciousness. They can change the way you think, feel, act, and see in the short and long term.
In addition to centuries of anecdotal evidence, new research from leading health organizations like NYU Langone and Johns Hopkins suggests that psychedelics, such as psilocybin and MDMA, may have the potential to heal and treat certain mental health conditions, like depression and post-traumatic stress disorder (PTSD). The anesthetic ketamine is also being researched and used to treat similar conditions.
It’s natural to have many questions about exploring psychedelics if you’ve never experienced them before, such as:
- Will I see funky colors and visuals?
- How long will it last?
- Are psychedelics safe?
- How and where can I try them?
- Are psychedelics even legal where I live?
Being prepared with as much information as possible can be key to having a safe and successful first experience with exploring psychedelics or psychedelic therapy.
A note from Psych Central
Psychedelic substances are classified as controlled substances and are illegal in the United States and Canada. Currently, no physician or mental health professional may prescribe psychedelic substances to treat a physical or mental health condition.
Psych Central does not endorse the use of any illegal substances, and we recognize abstaining from them is always the safest approach. However, we believe in providing accessible and accurate information to reduce the harm that can occur when using.
There are many psychedelics out there, such as:
- psilocybin (aka magic mushrooms)
- MDMA (aka ecstasy)
- LSD (aka acid)
- cannabis (aka marijuana)
Each substance may offer unique healing benefits, affecting your mood and perception of life and your surroundings in different ways. But there are also some similarities between them.
“Psychedelics can serve as a catalyst for ongoing shifts in thinking in new and more open, curious, and creative ways,” says Dr. Carlene MacMillan, medical director at Osmind and founder of Brooklyn Minds.
“With MDMA, shifts can occur that allow people to think about past traumatic and other major life experiences through a new perspective,” she says. “Most notably for me as a psychiatrist, individuals will often describe suicidal thinking simply melting away or fading into the background almost immediately, [which] can be quite profound.”
Dr. Linda Strause, clinical advisor at Ei.Ventures says that the psychedelic experience can vary from easy and fun to dark and challenging, depending on many factors, like:
- the type of psychedelic
- the dosage or amount taken
- the amount of preparation or experience you have
- the setting you’re in
- the people you’re with
- if you’re ready to confront what comes up for you
“The goal for your first psychedelic experience should be to stay safe and learn how you experience psychedelics,” she adds.
Depending on the above factors, you may experience different visual, spiritual, or bodily sensations, like:
- time and space distortion
- increased blood pressure
- increased heart rate
- changes in body temperature
- dilated pupils
- synesthesia (seeing sounds or hearing colors)
- jaw tension or teeth grinding
- changes in pain perception
- changes in brain hormones, such as increased serotonin and dopamine
- a sense of euphoria
“These experiences can be unfamiliar and scary at first, but it’s important to remember that they are normal and will pass with time,” says Strause.
Going into your first psychedelic experience prepared can do wonders for relieving anxiety or fear of the unknown.
Here are a few important precautions and expert-backed tips on how to safely and mindfully approach your first time.
Know the risks
“There are certain health conditions and medications that have a greater risk of contraindication when combined with psychedelics,” says Levich. “Note that this doesn’t automatically disqualify someone from working with psychedelics, but they are significant risk factors.”
Psychedelics may not be recommended for people who:
- are under the age of 18
- have certain mental health conditions, like schizophrenia or bipolar disorder
- have a history of seizures or heart, liver, or kidney issues
- take SSRIs or mood stabilizers
- are pregnant or breastfeeding
“Alcohol, cannabis, and other drugs or prescribed medication can interact with psychedelics, affecting your experience. If you’re taking any medication, check to ensure they aren’t adversely indicated with the psychedelic you plan on taking,” says Strause.
“In addition, while psychedelics are increasingly being used to address treatment-resistant depression and suicidal ideation, they can at times paradoxically cause or worsen suicidal ideation and mood lability,” says MacMillan.
This is one reason why MacMillan believes supervision by a trained mental health professional is necessary.
If you’re considering trying psychedelics, be sure to speak with your doctor or therapist beforehand to discuss personal safety precautions and underlying risk factors.
If you’re feeling suicidal, remember that you’re not alone and resources are available to you. If you need to talk to someone right away, you can:
- Call the National Suicide Prevention Lifeline 24 hours a day at 800-273-8255.
- Text “HOME” to the Crisis Textline at 741741.
Not in the U.S.? You can find a helpline in your country with Befrienders Worldwide.
Prioritize set and setting
“Although these substances have the potential to be fun and transformative, they’re extremely powerful compounds that require thoughtfulness and care when engaging with them [for both recreation and therapy],” says Levich.
He notes that the keys to harm reduction involve understanding and optimizing your:
- Mindset: Consider your intentions — why you’re taking the psychedelic and your levels of preparation.
- Setting: The environment you’re in should ideally be a space that’s safe, comfortable, and works with your intentions.
- Substance: This is which psychedelic you’re trying and why.
- Dosage: How much you take should be based on your location and needs.
“As with all psychoactive medications, we generally recommend a ‘start low, go slow’ approach, and the same is true with psychedelics,” says MacMillan.
“If you’ve had one psychedelic experience, you’ve had one psychedelic experience. It really will be different for each person, and the set and setting matters each time,” she says.
Work with a professional
“I recommend [working] with a trusted and trained facilitator who has had structured training and mentorship through programs like MAPS, Fluence, or Psychedelics Today, and a mental health or medical professional to make the recommendation in the first place,” says MacMillan.
She suggests always asking the practitioner(s) you’re working with about potential plans if there’s a mental health or medical emergency, especially after hours.
“There are also resources like the Fireside Project, which has a hotline should individuals need additional assistance after or during a psychedelic experience,” she adds.
Strause says that it’s natural to feel apprehensive about an unfamiliar experience, like trying psychedelics for the first time. But, “good preparation can reduce the likelihood of unpleasant effects and make the experience more meaningful and impactful.”
There are many videos, podcasts, and books out there on the topic. Consuming educational and reliable information about psychedelics can help you feel more confident going into the experience.
Looking into organizations like Multidisciplinary Association for Psychedelic Studies (MAPS) and reading books like “How To Change Your Mind” by Michael Pollan can be a great start.
You can also talk with people who have tried psychedelics before to learn about their journeys.
“[Research] can help advance your evidence-based understanding of psychedelics, their risks and potential benefits, and how to best balance those risks and benefits to increase good health, quality of life, and vitality,” says Strause.
Trust the process
“Discomfort is common in psychedelics because you’re not in control of what comes up, which often results in facing your fears and confronting the unsavory aspects of ourselves head on,” says Levich.
He notes that any potential discomfort is actually part of the healing experience.
“Healing isn’t always comfortable, but it’s necessary to evolve. [It] requires being brutally honest with who we are and learning to embrace all parts of ourselves — especially the shadows,” he says.
Taking psychedelics can also be a great practice in letting go of control.
“There may be moments when you feel overwhelmed. And in those moments, you’ll have two choices: You can either hold onto whatever it is and ride it out, or let go,” says Strause.
“It’s best to just allow the experience to happen and to focus on removing any resistance or friction that may prevent you from having a full and complete experience,” she says.
According to Levich, there are certain signs that indicate you may be a good candidate for working with psychedelics, such as:
- You’re willing to face the parts of yourself that you don’t like.
- You’re ready to release thought patterns, emotions, and behaviors that no longer serve you.
- You’re willing to step into the unknown.
- You’re ready to let go of expectations around what the process “should” look like.
- You’re committed to a long-term process of growth and healing.
- You’re respectful, open-hearted, open-minded, and willing to surrender to the process.
“With respect to mental health conditions, if traditional oral antidepressants and therapy haven’t brought sufficient relief, psychedelics may be a good next step for treatment-resistant conditions,” says MacMillan.
“Individuals involved with palliative care and challenging end-of-life or chronic pain issues could [also] potentially benefit,” she says.
It’s important to remember that psychedelics are not legal throughout the United States. “While a few U.S. cities have decriminalized these substances, these cities are currently in the minority,” says Strause.
There are safe, legal ways to engage in your first psychedelic experience, though. You can:
- try psychedelic assisted psychotherapy (PAP) with a qualified therapist
- journey with a professional guide or “trip sitter” in a country where it is legal
- go on an international retreat where psychedelics are legal
- join a clinical trial with a university or organization
- check the ASKP.org directory for ketamine clinics
Psychedelics are powerful substances that have the potential to drastically alter your perception of life and the world around you. They may also be able to help with mental health conditions like:
Harm reduction can be key to having a good experience with psychedelics, for first-timers and veterans alike. Before you try psilocybin, ketamine, or any other psychedelic, consider the following tips:
- work with a trained professional, therapist, or guide
- research the psychedelic as much as possible
- consume an appropriate amount
- create a safe and comfortable environment
Above all else, you’ll want to prioritize safety, trust the process, and keep an open mind and open heart. If you do, you might just have one of the most healing and transformative experiences of your life.