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Difficult experiences after a ceremony: where to get help

BySafe Ceremonies

Most people come home from a ceremony tired, emotional and a bit unsettled, and feel more like themselves within a few days. Some don’t. Weeks later they’re still anxious, can’t sleep, feel cut off from the world, or can’t stop going over something they saw. If that’s you, you’re not alone, you haven’t done it wrong, and there are ways to get help.

This guide is about difficulties that last beyond the ceremony itself. It covers the forms they usually take, what the research says about how long they last, the signs that mean you need help today, and where to find it.

Get help now if

Call your local emergency number, or 988 in the US (call or text), if any of these are true for you or someone you’re with:

  • You’re thinking about harming yourself or someone else.
  • You’ve barely slept for several nights in a row.
  • You’re hearing voices, seeing things others can’t, or feel that people are plotting against you or sending you messages.
  • You’re too confused or distressed to look after yourself, eat or stay safe.
  • You have physical symptoms such as chest pain, a racing or irregular heartbeat, a seizure, severe vomiting or a high fever.

Veterans and their families can reach the Veterans Crisis Line by dialling 988 and pressing 1, or texting 838255. You don’t have to be enrolled in VA benefits or health care to use it.

What lasting difficulties look like

A 2023 study published in PLOS ONE collected accounts from 608 people who had difficulties lasting more than a day after using a psychedelic. Emotional difficulties were the most common, reported by three quarters of them, with anxiety and fear at the top of the list, followed by paranoia and panic attacks. Many also described problems with how they saw themselves, problems with thinking and concentration, and struggles with big questions about reality and meaning. Smaller groups described feeling that the world wasn’t real, or feeling cut off from other people.

A 2025 study interviewed therapists and others who support people through these difficulties. They described similar patterns:

  • Anxiety and panic, often with a frightening sense of having lost control.
  • Existential shock, when the experience has shaken your sense of what’s real and you have nothing to compare it to.
  • Changes in how you see yourself, from feeling special or chosen to feeling worthless.
  • Dissociation, meaning you feel detached from your body or feel that the world around you isn’t real.
  • Old memories or trauma coming back with a force you weren’t ready for.
  • Disappointment, when the change you hoped for didn’t arrive.

Some people also notice visual changes that persist after the effects wear off, such as trails behind moving objects, halos, afterimages or “visual snow.” When these keep coming back and cause distress, doctors may diagnose hallucinogen persisting perception disorder (HPPD), which is recognised in the DSM-5. A 2018 review describes it as rare and poorly understood; for some people it’s mild and passes, while for others it lasts longer and needs ongoing treatment.

How long it lasts

In the 2023 study, the length of people’s difficulties clustered at two ends: many lasted less than a week, and many lasted more than a year. About a third of participants had difficulties lasting over a year, and about one in six for more than three years. Longer difficulties were linked to more challenging experiences during the trip itself, and a wider range of difficulties to unguided settings.

Those figures come from people who chose to answer a survey about difficulties, so they can’t tell you how likely this is to happen to you. They do show that lasting problems are real, that some resolve quickly, and that waiting for them to pass on their own isn’t always enough.

The authors also found that people’s distress was made worse by not knowing what was happening to them. If you’re reading this because something feels wrong, that part, at least, you can start to fix.

What helps

When the practitioners in the 2025 study were asked what helps, the most frequent answers were:

  • Individual therapy, ideally with someone trauma-informed who understands psychedelic experiences.
  • Grounding and mindfulness practices that bring your attention back to your body and your surroundings.
  • Peer and community support, including integration groups, so you can talk with people who won’t be shocked.
  • Working on meaning, by slowly building a story about the experience that you can live with.
  • In some cases, short-term psychiatric medication to help with sleep, anxiety or stability.

Things you can start on your own today:

  1. Protect your sleep. Go to bed and get up at the same time, and keep screens out of bed.
  2. Eat regular meals and drink water, even if you’re not hungry.
  3. Move. A walk outside, ideally every day, is one of the simplest grounding practices there is.
  4. Cut back on things that stir you up, such as caffeine, and hold off on alcohol, cannabis and other drugs while you recover.
  5. Don’t take more of anything in the hope of “finishing” the experience. If someone suggests another ceremony as the cure, get an outside opinion first.
  6. Limit how much you read online about what’s happening to you. A little information helps; hours of searching at night usually doesn’t.
  7. Tell one person you trust what’s going on.

Talking to a doctor

Many people avoid telling a doctor because they’re embarrassed or worried about how they’ll be judged. Be as honest as you can about what you took, when, and what’s happened since. It changes what they look for, especially if you take other medicines. If your doctor seems unfamiliar with psychedelic experiences, ask for a referral to someone who is, or bring them this guide’s sources.

Medication is not a failure of your integration or a betrayal of the ceremony. Short-term help to sleep or calm severe anxiety can make the rest of the work possible.

Where to find support

  • Fireside Project runs a free, confidential psychedelic peer support line, 62-FIRESIDE (623-473-7433), by call or text from 11 a.m. to 11 p.m. Pacific time every day. It’s for during and after psychedelic experiences, including ones long past.
  • 988 Suicide & Crisis Lifeline, by call, text or chat, at any hour in the US.
  • Your own doctor, or a psychiatrist if things are severe.
  • A therapist with experience in psychedelic integration. Our guide on finding an integration circle or therapist explains how to check one out.
  • The center where you sat. Ask for the follow-up support they offered. Their response tells you a lot.

Dealing with the center

Follow-up is a normal part of careful practice. Safety guidelines from Johns Hopkins researchers call for one or more meetings after a session, typically the next day, partly to check for lasting effects such as changes in perception. A good center wants to know when someone is struggling and will help find support, even if it can’t provide it. A poor one may tell you that you “resisted,” that your ego is “fighting the medicine,” or that you need another ceremony. Responses like these can keep you away from the help you need. Our guide on red flags lists them.

If you were hurt by something someone did, such as unwanted touch, being pressured, or being left alone in danger, that’s a different problem from a hard experience, and it isn’t your fault. Write down what happened while you remember it. You can report a crime to the police where it happened, and a factual review can warn the next person.

If you’re supporting someone

Listen more than you advise. Help with practical things: meals, sleep, getting to appointments. Don’t argue with what they experienced, and don’t reinforce frightening interpretations either. Watch for the warning signs at the top of this page, and if you see them, help them get urgent care.

More guides

Honest reviews of how a center handled someone who struggled are some of the most useful things on the site. You can search the Safe Ceremonies listings, including places offering integration and aftercare and psychedelic-assisted therapy, and leave a review of your own when you’re ready.

Sources

Photo: King Tides, Oregon by Bonnie Moreland (free images), Public Domain Mark 1.0.

Safe Ceremonies
Author: Safe Ceremonies

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