Persisting psychological complications following the use of classic psychedelics: A qualitative study of help-seeking experiences
Lisa Maria Jöbstl, Bente Lubahn, Ebru Kaya, Georg Leistenschneider, Marija Franka Žuljević, Thomas G. Riemer, Dario Jalilzadeh Masah, Derin Marbin, Barbara Stöckigt, Tomislav MajićBackground:
While growing enthusiasm for the therapeutic potential of classic psychedelics has led to a rise in non-clinical use, attention to persisting adverse effects has emerged with delay. A subset of individuals report persisting complications such as hallucinogen persisting perception disorder (HPPD), depersonalization/derealization disorder (DDD), anxiety and depression. Yet few medical services are equipped to address these complications.
Aims:
This qualitative study examines how societal, medical, and media discourses shape the experiences of individuals with persisting psychedelic-related complications, focusing on help-seeking trajectories.
Methods:
Thirteen semi-structured interviews with adults experiencing persisting psychedelic-related psychological symptoms (four women, nine men, age 19–49 years; HPPD (
Results:
Three interrelated themes emerged: (1) The dissonance between expectation and harm—idealized media and scientific portrayals of psychedelics shaped initial use and complicated recognition of adverse outcomes; (2) stigma, silence, and self-blame—prohibitionist discourse and internalized shame significantly inhibited help-seeking; and (3) between systemic absence and self-organized support—participants encountered clinical unpreparedness and epistemic dismissal, which often led them to rely on online peer communities and self-management strategies. Positive clinical encounters, characterized by professional expertise and non-judgemental engagement, were experienced as helpful.
Conclusions:
Adequate clinical and conceptual frameworks for persisting psychedelic-related complications are lacking. An interdisciplinary, experience-informed approach integrating realistic risk communication, clinician training, and destigmatization is required to support affected individuals.