Emotional Effects

Emotions are part of the picture, in both directions

Studies and federal research summaries describe emotional effects that can be strongly positive or strongly negative, sometimes in the same session. This page describes what is reported. It does not suggest that anyone use a substance to change their mood, and a mood change in a lab study is not the same as a treatment benefit.

Evidence label used here: insufficient evidence (a point rests on one or two small studies). Every finding below is in humans.

What is reported across psychedelics

• A wide range. The National Institute on Drug Abuse (NIDA) says people who use psychedelic and dissociative drugs report strong emotions ranging from intense happiness and a feeling of connectedness to fear, anxiety and confusion. [1] For psilocybin it describes feelings from bliss to terror. [2]
• Moods can swing. In a double-blind study with 30 volunteers, psilocybin produced a range of acute perceptual changes, subjective experiences and labile (rapidly changing) moods, including anxiety. [3]
• Most healthy volunteers rated it pleasant. Pooled data from eight placebo-controlled studies (110 healthy people) found profound changes in mood, perception, thought and self-experience, yet most people described the experience as pleasurable, enriching and non-threatening. Strong dysphoria (a distressed, unhappy state) or anxiety and panic occurred only at the two highest amounts tested, in a relatively small share of people. [4]
• An earlier dose-effect study. In eight volunteers, psilocybin increased "emotional excitability", "general inactivation" and "dreaminess" on a mood rating scale, and only one person reacted with transient anxiety at the highest amount. [5]

These are healthy volunteers who were screened, prepared and supported in research settings. NIDA notes that outside research and clinical supervision, risks are higher. [2]

Social and emotional processing in the lab

• LSD. In two placebo-controlled studies (24 and 16 healthy people), LSD produced feelings of happiness, trust and closeness to others, increased emotional empathy on a test, and made it harder to recognize sad and fearful faces. It also increased the wish to be with other people. The authors suggest this "may be useful" for psychotherapy, which is a hypothesis and not a result. [6]
• Psilocybin and the brain. In 25 healthy volunteers, psilocybin lowered amygdala reactivity (the brain's response to threatening images, measured with fMRI), and the drop was related to a rise in positive mood. [7] This is an association in a brain-imaging study, not proof that the brain change causes the mood change or that it treats a disorder.

MDMA and ketamine are different again

MDMA is not a classic psychedelic. NIDA describes feeling happy, energetic, alert and closer to others, with effects lasting an average of about three hours; it also notes anxiety and panic attacks have been associated with MDMA use. [8] For ketamine, NIDA lists side effects such as feeling strange or "loopy". [9] For the esketamine nasal spray, anxiety was among the most common adverse reactions in the label's trials. [10] See entactogens and dissociatives.

"Emotional breakthrough"

Some trial reports use the phrase "emotional breakthrough" for a strong release of feelings during a session. We searched PubMed for the trial paper that defines and measures it but could not retrieve a readable version this session. Proper evidence not found on this page for how it is defined, how often it occurs, or whether it predicts benefit. For measures that were read, see mystical-type experience measures.

From emotional effects to clinical outcomes

A pleasant or intense feeling during a session is not an outcome such as lower depression scores. Clinical findings are in psychedelics for major depressive disorder. For distress, see acute anxiety and distress. If someone is in crisis in the US, call 988 (the US Suicide & Crisis Lifeline), or call 911 for immediate danger.