Anxiety is the most common mental disorder in the United States. It affects about 20% of adults and 32% of teens, and those numbers have been growing over the last couple of decades. 1 Researchers are looking into psychedelics for anxiety, particularly in the form of psychedelic-assisted psychotherapy—using psychedelic drugs to make therapy work better.
Early research on psychedelics and anxiety is promising. Results suggest that, in a controlled setting, psychedelic-assisted therapy may help relieve anxiety long-term. However, other studies show that psychedelics can increase anxiety for some people.
Here’s a look at what researchers know so far about psychedelics for anxiety.
Types of Anxiety
Anxiety comes in many different forms. The most common anxiety disorders are:
- Generalized anxiety disorder (GAD)
- Social anxiety disorder (SAD)
- Obsessive-compulsive disorder (OCD)
- Posttraumatic stress disorder (PTSD)
Generalized anxiety disorder
People with generalized anxiety disorder (GAD) experience general, ongoing worry about daily events. There’s no specific cause of their anxiety, and it’s bad enough that it interferes with day-to-day life.
About 3% of adults in the United States have been diagnosed with GAD. 2
Social anxiety disorder
Social anxiety disorder (SAD) involves anxiety about social judgment from others. You may be afraid of social rejection, embarrassing or humiliating yourself, offending others, or acting outside social norms.
People with social anxiety often feel anxious about:
- Meeting new people
- Having a conversation
- Being observed (eating or drinking in public, for example)
- Performing in front of others (e.g. giving a speech)
SAD affects about 7% of adults, making it the most common anxiety disorder in the United States. 2
Obsessive-compulsive disorder
Obsessive compulsive disorder (OCD) involves repetitive, intrusive thoughts or fears (obsessions) that lead you to act out compulsive behaviors (compulsions). They may have a common theme (cleanliness or repeating things a specific number of times, for example) or they may be more general.
Common examples of OCD behavior include:
- Fear of contamination or dirt that leads to compulsive cleaning
- Repeatedly organizing objects or spaces, and becoming distressed when things aren’t perfectly neat
- Fear of disease that leads to compulsive hand-washing
- Compulsive praying
- Trouble tolerating uncertainty, to the point that you obsess over controlling situations
- Checking things multiple times—for example, repeatedly checking to make sure you turned off the lights, turned off the stove, or locked your door
- Following a strict routine and feeling intense anxiety/panic when you break it
- Repeating actions a specific number of times
OCD affects about 1% of the U.S. population. 2
Posttraumatic stress disorder
People with posttraumatic stress disorder (PTSD) have lasting negative psychological symptoms after experiencing or witnessing a traumatic situation.
Most of PTSD’s symptoms are rooted in anxiety, and as a result, the American Psychiatric Association classifies PTSD as an anxiety disorder. Symptoms include:
- Exaggerated startle response (being easily startled or frightened)
- Hypervigilance (always being on alert for possible danger in your environment)
- Flashbacks to the traumatic experience (a sense of being outside your body, reliving the experience that traumatized you)
- Self-medicating behavior, such as excessive drinking or drug use
- Angry or aggressive behavior
- Guilt or shame
- Trouble sleeping
- Trouble concentrating
PTSD affects 3.6% of the U.S. population. Women are five times more likely to be affected than men, according to recent self-reported survey data. 2
Psychedelics for Anxiety
Early research suggests that psychedelic-assisted therapy may help treat anxiety. Different psychedelic drugs seem to work for different types of anxiety. Here’s a look at the research on several of them.
MDMA for PTSD
Technically, MDMA is not a psychedelic. However, MDMA has psychedelic-like effects and similar therapeutic benefits, and it’s usually classed alongside traditional psychedelic drugs.
Clinical research suggests that MDMA-assisted therapy can help treat PTSD. Results are promising—so promising, In fact, that in 2017, the U.S. Food and Drug Administration (FDA) gave MDMA Breakthrough Therapy status for treating PTSD—making it easier for scientists to obtain the drug and use it for research purposes.
The theory is that MDMA makes it easier for you to explore and resolve traumatic memories. MDMA causes a dramatic increase in positive emotion, euphoria, and empathy. You feel so good on MDMA that you aren’t afraid of facing past traumatic experiences. 3
A 2020 review found that MDMA-assisted therapy is signifcantly better than standard psychotherapy at reducing PTSD symtpoms. In addition, significantly more patients went into full remission (i.e. no longer had any symptoms of PTSD) after MDMA therapy. 4
MDMA for social anxiety
Early-stage research suggests that MDMA-assisted therapy may help people with social anxiety disorder (SAD).
People with SAD often amplify negative social interactions and perceive positive social interactions as negative. For example, receiving a compliment may actually cause you anxiety because you’re afraid that you’ll have to live up to the same expectation in the future, and you won’t be able to. 5
As a result, social interactions feel negative across the board, and many people with SAD avoid socializing whenever possible.
MDMA-assisted therapy may alter the underlying brain mechanisms that cause social anxiety. MDMA causes a rapid, dramatic increase in serotonin, dopamine, and oxytocin, which mediate mood and anxiety, motivation and reward, and social bonding, respectively.
Essentially, MDMA makes you feel very social and primes your brain to feel the positive rewards of social interaction while minimizing negative ones. That experience can help people with social anxiety realize that social interaction can feel good—and according to early research, the results seem to last even after the MDMA-assisted therapy session ends. 5
A double-blind, placebo-controlled study from 2018 also found that MDMA-assisted therapy reduced social anxiety in autistic adults, and that the improvement remained six months after treatment. 6
Psychedelics for end-of-life anxiety
Several studies have found that psychedelics relieve end-of-life anxiety in patients with terminal illness.
In a double-blind, placebo-controlled 2016 study, patients with terminal cancer took two high doses of psilocybin (the compound in psychedelic mushrooms), spaced five weeks apart. There was no concurrent therapy—they just took the drug.
The researchers reported a “substantial and sustained [decrease] in depression and anxiety” in patients. At six-month follow-up, 80% of patients had maintained that decreased in both anxiety and depression. 7
In 2020, a review of 14 other studies found that LSD and ketamine produced similar reductions in anxiety for terminally ill patients. 8
Can Psychedelics Make Anxiety Worse?
Psychedelics seem to improve anxiety in many cases, especially when you take a psychedelic in a controlled research environment or in combination with therapy.
However, psychedelics can make anxiety worse in the short-term, especially if you experience a bad trip—a challenging or negative psychedelic experience.
High neuroticism—a personality trait that includes anxiety—may increase your odds of having a bad trip. 9 In other words, if you’re anxious before taking psychedelics, there’s a good chance you’ll feel heightened anxiety during your psychedelic experience.
However, that’s not necessarily a negative thing. While bad trips are challenging in the moment, they seem to cause positive changes to mental health in the long-term for the majority of people—although psychedelics worsen anxiety for a small percentage of people.
According to a 2016 survey, 84% of people who had bad trips said the experience improved their mental health long-term. About 7% reported increases in anxiety that caused them to seek therapy. 10
In summary: while there seems to be a good chance that psychedelics will improve anxiety long-term, there’s also a small chance that they could make it worse, especially if you take them in an uncontrolled environment. Whether or not you choose to take psychedelics is up to you.
If you do decide to take psychedelics, make sure you learn how to minimize your chances of a bad trip.
Frequently Asked Questions about Psychedelics for Anxiety
Here are some frequently asked questions about psychedelics and anxiety.
Which psychedelic is best for anxiety?
Early research has found that psilocybin, LSD, ketamine, and MDMA may all help reduce anxiety. MDMA shows promise in relieving social anxiety and post-traumatic stress disorder, while psilocybin, LSD, and ketamine reduce anxiety about death in people with terminal illness.
Can psychedelics cause anxiety?
Psychedelics may cause short-term anxiety, especially in the case of a bad trip—a challenging psychedelic experience that can include fear, panic, depression, paranoia, and other negative emotions. However, the anxiety usually ends when the drug wears off. The chances are low that a psychedelic will cause long-term anxiety.
Can magic mushrooms help with anxiety?
Early research suggests that psilocybin, the compound in magic mushrooms, can significantly reduce anxiety about death in patients with terminal illness. Other studies have found that taking psilocybin can improve mental health long-term, especially if you pair it with therapy.
Final Thoughts
Psychedelics show promise as a way to improve anxiety, especially when paired with therapy. MDMA relieves PTSD symptoms and may help with social anxiety, while psilocybin, LSD, and ketamine all may help with end-of-life anxiety in terminally ill patients.
We still don’t know whether psychedelics help with general anxiety, although clinical trials are currently underway in the United States. As more research comes out, we’ll begin to better understand exactly how psychedelics affect anxiety and other aspects of mental health.
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