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Grounded or High: A Stoner's Dilemma

Hello Doctor, I think i’m having a though time with a new anxiety problem.
In the past 3 years I tried mushrooms few times, I had a lot of fun and very profound experiences, but also a bad trip, then i tried mdma twice and had a bad trip the second time, i also am a heavy pot smoker and started way before «tripping ».
Since I had those trips i think my way of seeing life is different, better in my opinion but there’s things that i can’t handle, like it’s too much and i have a sort of existential anxiety, i constantly analyze tons of things and sometimes it makes me feel bad, i get anxious for not much.
Sometimes weed makes it even harder to handle and i had a few panic attacks (not very harsh but i really don’t like this feeling) since my trips, because tripping didn’t only change some of my perceptions of life, but also my way to deal with pot too, it can be more psychy in my mind sometimes.
But weed isn’t the problem here because i also have those anxious thoughts when i’m sober.
I get really anxious when i go out to see friends that i don’t see much (i don’t have problems with my 5-6 closest friends) if i have to get in a place fulled of people, or even just few « bad » or really « sad » people i just feel all the negativity and i feel bad.
Thinking about my future can also get me really anxious, I think i have so much analized myself that i know my insecurities and thinking about them make bad loops in my head (girlfriend,money,work,find my real passion in life, practice more loving life and enjoying it because i don’t enjoy it enough i could be way better in my opinion etc..)
Sometimes i have those thoughts alone also but i have no problem to deal with it if i’m in a good place (like places i know) I get really intense thoughts, but not only bad ones, i also feel all the possible love in the world and i can really love deeply (for what they are, not really falling in love) someone in a few moments or appreciate things about people i couldn’t before.
I also learned a lot about mushrooms, the scientific side and i think know quit a lot (but i need to know much more and have even more to learn about it and a lot is still unknown). I feel like i learned a lot trough mushrooms and they made me a better person in this world.
So by saying this, i am not sure if i have just a mild psychosis, an anxiety disorder, did my brain reprogrammed itself differently with mushrooms and made me even more sensitive than before..? i don’t know, i also think i am an empath, (i was before all this also, but even more now)
But i am not sure 100% to have a kind of hppd. (maybe not at all and its just anxiety but more deep)
I also tried Salvia, and had the weirdest experience of my life but challenging and interesting, but now with weed i feel depersonalization or derealisation (not sur about that either). It doesn’t bother me i enjoy it but maybe it’s also related to my anxiety because when i feel that state i think really deeply and with less of my ego, and i like it only in comfort zone.. i sometimes feel a lot through people’s eyes, i feel a lot by looking the sky or nature.
And i can’t fight my anxiety, my discomfort zone is really hard to leave so here we are, i am having a bad time going out with all that and it’s not fun i really want to enjoy life at it maximum and this is a wall to truly loving life.. i feel i « know » too much and feel all the negativity around me...

Dr. Richard Schultz Says...

Dear Nthrax,

Thank you very much for addressing your question to me. Or should I say predicament?

Based on your detailed adventures with substance use and experimentation, one thing is clear; you have very mixed feelings about your very mixed experiences. On the one hand, you enjoy pursuing a drug-facilitated sense of enlightenment, emotional attunement, and harmony with yourself and others, as well as the highly novel and stimulating sensory experiences that substances can afford. And at least some of the time, you seem to get what you’re after. The rest of the time, however, your drug experiences trigger worsened social and generalized anxiety, paranoid thoughts, depression, as well as possible social consequences. In addition, you worry about the possibility of longer-term psychological consequences of hallucinogen use, and there is no research or clinical data that can dispel these concerns.

And yes, you are correct in that we can be impacted cognitively, behaviorally, and emotionally by drug experimentation, just as we can be from other internal and external stimuli. All such experiences constitute one’s “learning history,” which is a strong predictor of subsequent functioning. Further, although some recent clinical research has begun to identify true therapeutic value in psychedelic mushrooms, the “trips” in those studies are conducted under controlled conditions, and are supervised by mental health therapists in the event the “patient” experiences any distress during or after the drug experience. Finally, there is no research to support the value of ongoing, habitual, or leisure use of mushrooms or any other hallucinogen.

That said, I am wondering how I can be of help here. It sounds like you have a fairly realistic awareness of the potential risks (that we know about) and benefits of substance use/abuse. More importantly, you don’t appear to be considering moderation or sobriety at this time. Readiness for change is a highly fluid concept, however, and your stance will likely shift significantly across time. In regard to abstinence or harm reduction, I can only tell you that there is absolutely no downside to either, and your risk of any further psychological difficulties associated with your drug use would be reduced to zero.

As noted above, I do understand that you are now suffering from clinically significant symptoms of anxiety, primarily of the social and generalized varieties, with a little panic thrown in as well. Your substance use is certainly a confounding factor in evaluating these difficulties, however, as the symptoms are notably triggered and exacerbated by it. By reducing or discontinuing your substance use, the anxiety may very well cease to be a significant problem. If it does not, I would strongly recommend that you consult a clinical psychologist to discuss treatment. In particular, I recommend seeking out a mental health provider who practices from a cognitive-behavioral perspective.

Although drugs are likely increasing your feelings of vulnerability and symptoms of anxiety, the underlying challenge of managing the firehose of discursive, unpleasant, scary, or self-critical thoughts confronts all humans (and a few other mammals) in the 21st Century.

The most effective practices for learning how to cope with the multitude of thoughts (which number 70k per day!) are mindfulness, progressive muscle relaxation (PMR), diaphragmatic breathing (DB), and cognitive therapy.

Resources for learning the above techniques include “The Mindfulness Solution” by Dr. Ron Siegel, “The Feeling Good Handbook” by Dr. David Burns, and “Get Out Of Your Mind And Into Your Life” by Dr. Steven Hayes. You can find many instructional videos on PMR and DB on Youtube.

I hope that some of what I have written here is of use to you. Please do follow-up with me to let me know of your progress, as this will be of great interest to others who may be struggling with similar quandaries.


Richard E. Schultz, Ph.D.

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Page last updated Feb 25, 2019

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