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How to Deal With Pre-Trip Anxiety During Psychedelic Therapy

Anna Wilde
Anna’s focus has been on alternative healing modalities, intentional living, sustainability, deconstruction, and the transcendent relationship between humans and the natural world, which she weaves into her compositions. She combines the two most important ingredients for purposeful writing: knowledge and imagination.

Dear seeker, fear not. You may be interested in or have already decided to voyage into the unknown by having a psychedelic experience. Maybe the purported therapeutic benefits lured you in, or maybe you are simply a curious soul desiring to expand into greater insights and awareness.

Taking psychedelics is like plunging into the center of the ocean—mysterious, adventurous, and possibly frightening at the thought of its great expanse. What awaits below is a mystery until you put on your gear and dive deep.

Substances like psilocybin, MDMA, and DMT are gaining popularity as potential treatments for mental health conditions or disorders like depression, PTSD, and end-of-life anxiety for terminal illnesses like cancer and AIDS.

Most likely, you have witnessed anxiety at some point in your life, given that anxiety disorders make up the most common mental health disorders in the US (Bandelow, 2015). Even though many people take psychedelics to improve anxiety, the mere prospect of consuming such a substance can induce an adverse level of fear before even making the actual plunge into the psychedelic realm.

In this article, we will explore the causes of pre-trip anxiety, how it can impact the journey, and provide tips and techniques for managing symptoms before an intentional psychedelic experience.

What is Pre-Trip Anxiety? Can It Affect the Psychedelic Experience?

Pre-trip anxiety is a state of fear or worry felt prior to a future psychedelic experience. People commonly feel pre-trip anxiety when it is their first time taking a mind-altering substance, or if they have had a “bad trip” in the past.

In previous articles, we discussed how to navigate a “bad trip” and address fear that may arise during a psychedelic experience, but for the sake of this article, we will be addressing pre-trip anxiety specifically. 

Some potential psychological symptoms from pre-trip anxiety include racing thoughts, feelings of overwhelm, excessive worrying, repetitively playing out worst-case scenarios, paranoia, and insomnia or difficulty sleeping. 

More physical symptoms of anxiety can manifest as headaches, nausea, digestive discomfort, muscle tension, difficult or shallow breathing, sweating, chills, increased heart rate, pacing, fatigue, and hyper-alertness. 

Pre-trip anxiety often intensifies and increases the duration of adverse effects during the journey itself given the connection between psychedelics and our internal narratives, which are often amplified by various substances.

Furthermore, anxiety is remarkably associated with an inability to let go and surrender, which could negatively impact the level of positive therapeutic effects sought out by the journeyer. 

On the bright side, with adequate preparation and support, anxiety can be addressed and minimized to ensure a more positive experience, but first, understanding the root cause of those fears may be helpful. 

Assessing Why You Feel Anxious About Taking Psychedelics

While feeling anxious can be unpleasant and difficult to overcome, remember that it can be a normal and healthy response leading up to important events. Nervousness can be an indicator that we are aware of the significance and power of something, showing that we are approaching with the same respect and reverence that we feel for the grandness of space or the ocean.

However, debilitating fear can negatively affect the coming experience or lead us to back out altogether. Acknowledging deep-rooted fears that could be driving your pre-trip anxiety is the first step to addressing them. 

The Fear of Losing Control

Fear of losing control can stem from being afraid of other deeper elements like fear of judgment, embarrassment, or even of going crazy. Acknowledge that a psychedelic trip is a time for vulnerability, raw expression, and, well, losing control a bit. Part of the healing lies in breaking through our emotional barriers and allowing a time for break-down. 

It is important to feel a base-line level of trust in yourself and the environment before traveling into the psychedelic realm. A crucial part of having a positive psychedelic experience is being in a state of deep surrender. 

A Fear of The Unknown Elements

Ah, the Great Unknown, the final frontier of the human psyche; It can be overwhelming to confront head-on. Psychedelics mean “mind-manifesting” indicating their faculty for showing users the deepest parts of the self. (Kelmendi et al., 2022).

In a 2016 survey done by Griffiths and colleagues, 30% of volunteers reported experiencing intense fear while on psilocybin, but more than 80% of volunteers reported benefiting overall from the challenging experience.

Regardless of what could be lurking in the shadows, taking psychedelics requires some playful inquisitiveness on the part of the user. Trust that the medicine is wise and will carry you where you are meant to go. 

The Fear of In-Ceremony Complications

Fear of something going wrong, whether in regards to setting, interactions, or the experience itself not going as planned, is a normal thing to be concerned with, and can easily be addressed. 

If you have adequately researched and prepared, embracing the risk is somewhat necessary. Once you know there are no rocks hiding in the water below, the next step is just taking the plunge. A common fear is that the trip-state will be permanent. Know that while time may feel distorted during the trip, it will always end and you will return to a “normal” or sober state eventually. 

The Fear of Resurfacing Old Wounds

Are you ready to confront whatever emotions are asking to be felt? Are you ready to discover answers that have been hiding in the dark? Approaching the medicine with humility and desire for truth shows your readiness to heal.

Life-time psychedelic use has been shown to have a positive effect on emotional reactivity, increasing internal state awareness and decreasing rumination and depressive tendencies (Orlowski et al., 2022).

Trust your capacity to handle intensity and navigate whatever bubbles up, which could very well be pure ecstacy and oneness. We need to restructure our approach with uncomfortable emotions, increasing our tolerance for them.

Techniques for Managing Pre-Trip Anxiety

Overall, facing one’s fears head on means embracing the unknown, embodying a curious and playful desire for truth, allowing deep vulnerability, and accepting support from one’s environment. Acknowledge that these fears are normal, however certain practices and techniques can help manage pre-trip anxiety so that the journeyer begins the voyage with a solid foundation.  

  1. Prepare for the Journey

Preparation is the game-planning stage. It is the anchor while diving into the waters of the psyche, whether the immersion is smooth or choppy. Taking the time to adequately prepare can alleviate uncertainty and disorientation.

This stage consists of consulting with experts and education about safety risks and benefits, deciding the logistical “how” of the ceremony such as music and location, and getting clear on the “why” through setting intentions. 

If feeling unprepared is contributing to your pre-trip anxiety, check out our preparation workshop with tangible tools and suggestions for at home practices, tips on setting the right container, navigating altered states of consciousness, and more.  

  1. Practice Relaxation Exercises 

Relaxation exercises like mindfulness meditation, deep breathing, thought restructuring, patience and gratitude, humming, and moving the body through dancing or stretching can be helpful in coping with pre-trip anxiety. 

Managing the somatic fear-response increases our capacity to sit with intense emotions and maintain a regulated state, leading to increased general well-being (Toussaint et al., 2021). 

When the waters of our emotions get choppy, certain tools help us maintain inner stability through creating space between the self and emotional turbulence. Remember these tools prior to a ceremony when anxiety arises.

  1. Transforming Fear Into an Ally

One of the most beautiful and significant parts of the psychedelic journey is that it is a leap into the unknown. Now is a good time to be honest with yourself about how ready you are to be immersed in the mystery.

Ironically, part of overcoming pre-trip anxiety lies in acknowledging the unknown elements of a psychedelic experience. Rather than fighting against the current, why not let go and float, seeing where it takes you? 

Once you’ve reached a certain level of regulation through the other tools in this list, try approaching any remaining fear as a teacher and ally, instead of seeking to irradiate it completely. A certain level of nervousness is to be expected leading up to a psychedelic experience. It means that you hold a healthy amount of respect for the medicine and for its experience as a whole.

  1. Honor Your Instincts

Ultimately, you as the journeyer are in the driver’s seat. Beginning with a foundation of trust lays the groundwork for a meaningful experience, approaching with curiosity instead of apprehension.

Before any big decision, one should weigh the pros and cons, give a reasonable listening ear to inner reservations, and decide from a clear mental space what is most conducive to your well-being. For those who are curious about the therapeutic benefits of psychedelics but don’t feel ready for a large-dose ceremony, microdosing can be a useful, transformative stepping stone. 

  1. Find the Right Support

A crucial piece to managing anxiety or encountering a big event is having adequate social support. When it comes to pre-trip anxiety, consulting with someone you trust elevates feelings of safety.

Whether reaching out to a trusted friend or consulting with a professional psychedelic guide, doing so allows a safe space for voicing your reservations and getting productive feedback. It’s important to speak with someone who isn’t going to interject shame, stigma, or make you feel judged or embarrassed for being interested in psychedelic therapy.

How Psychedelic Guides Reduce Pre-Trip Anxiety

Professional guides specialize in harm-reduction, calming practices, and are a neutral, judgment-free consulting party leading up to a trip. Discover the benefits of a psychedelic guide and how necessary one is.

Psychedelic-assistance allows the journeyer to relax deeper into the experience and know that they are safe and supported, whether needing help walking to the bathroom or guidance away from an anxious thought pattern.

Having a guide not only offers support during the trip itself, but provides a walking resource for in depth preparation as well as psychedelic integration and assistance in the different phases of healing post-trip

Ready to Embark on Your Healing Journey? 

If you are in need of support or are ready to journey into the psychedelic realm, book a consultation with one of our pre-vetted psychedelic facilitators with expertise in harm-reduction and navigating challenging mental spaces. 

More information and resources are available on our resources page if you are still in the educating phase or are curious about the latest research on the therapeutic benefits of psychedelics. 

Seeking psychedelic assisted therapy?

Take the first step and book a consultation call with us today. You'll get access to an exclusive network of pre-vetted facilitators. We'll match you with a trusted provider based on your unique needs.

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At Psychedelic Passage, we offer professional 1-on-1 guidance and companionship on your journey of healing. We simply can't sit back and let Americans continue to sit in silent suffering trying to battle mental health issues within a broken health care system, all while knowing that effective alternatives exist. We stand for the sacred, at-home, ceremonial use of psychedelics for consciousness exploration, which we believe to be a fundamental human right.

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