Mushroom Roulette: Hallucinogens, Anxiety, and The Youthful Brain
Sarahm216 Asks ...
I recently tripped on mushrooms for the second time about 2 months ago. I had eaten maybe 2 grams of them soaked in orange juice and maybe 15 minutes later started to feel the effects. At this point I was in the car with 5 friends, 2 of which had eaten mushrooms as well. The other 2 were just there to watch over us. As I started to feel my body react to the mushrooms I asked my friend to take me home to get some cigarettes because I started to feel a little anxious. In the car my friend pulled out a joint and we all smoked it, after we smoked I started tripping very intensely. We got to my house and I had gone inside to get my things, by the time I had come out of my house my friend who was tripping as well was tearing up and just started on walking down my street. At that moment I knew I was in for a really bad time. We followed my friend and her boyfriend both of whom were tripping and got them in the car. My friend had pleaded to go home and I had no choice but to continue my trip at her house where both of her parents would be. When we got to her house everything was overwhelming. I had felt psychically I'll, nauseous, shaky, and nervous. I had had these disturbing thoughts of vomiting in my head (I'm an emetophobic) it was almost like a movie playing over and over of me being sick and vomiting on myself and being out of control. At this point I was fluttering and walking around just waiting the trip to end. My visuals were wavy and intense and I couldn't see straight. I had sat outside quietly with my eyes closed clinging to one of my sober friends in fear. I did this for about an hour just trying to calm down. While I had swirly intense closed eye visuals. I kept on thinking that we are all one and we are all connected and some part of my mind considered death as a positive thing. I was convinced that it wouldn't matter if I was dead and that nothing really mattered at all because we are all connected. After that I stopped feeling my body. I felt as if I was blowing in the wind, I kept on saying that I was going to blow away. I couldn't feel my body at all. Maybe 3 hours in I started to grasp reality a little better but my mind was still anxious and I was pacing back and forth laughing and then crying and so forth. One of my older friends showed up and at that point I was ready to go home so I called my mother and told her what was going on. She was furious with me. Then my sober friends drove me home. I went home and watched a movie and finally fell asleep. I woke up fine and was glad that my trip was over. The next weekend the same friend I had tripped with invited me to the beach. As we were there she pulled out some mushrooms and suggested we try again just eating maybe one or two. So we did. At first the trip was minor I only felt a little euphoria and that was all. By the time we had driven home maybe 2 hours after eating them the car lights started to become brighter and I felt like I was in a space ship. I started to panic a little and asked my friend to take me home, she did and she stayed at my house and fell asleep. I went outside because I started to have the anxious feeling again. Pacing around not knowing what to do or how to take my mind off of it. I just waited it out. Maybe 2 weeks later I was in the car on the way to pick up some weed with my sister, we were both heavy smokers. In the car I started to get a little anxious. Then I started to think about the shroom trip I had at my friends house. My fingers and hands started tingling and I started to almost feel as if I was tripping again. Embarrassed, I didn't tell my sister as she went into the shop. I waited for 10 minutes during which I had a full blown panic attack and called my mother. I had never had a panic attack that strong before, I had been diagnosed with anxiety and the age of 9 but only had minor anxiety attacks when I felt sick or nauseous. After the car ride I had several panic attacks. Maybe 1 or 2 every hour. Mostly because I was terrified of having another one i ended up giving them to myself. A week or two later I started breathing and learning how to cope with these attacks and at the first sign of one I could control it. I could not smoke weed anymore since it was make me feel some similar effects to the mushrooms and triggered panic. I started to isolate myself and started to have major depression and anxiety. Not panic attacks but more of a lingering anxiety. The moment I woke up it was as if I had a whole day ahead of me just to try and fight my way through hours of despair. Time started to become a fear of mine. I started to dread it, since I was just sitting on my couch waiting for the hours to pass by which went very slowly. I started to worry about the future and how much time I had on my hands. As if every hour was a day that I had to try to fight. The bought of tomorrow and a whole new day to fight was unbearable. I never left the house and found it hard to have relationships and friendships. I had even broke up with my boyfriend of four years because I had not felt the same towards him. I had these intrusive thoughts that I could not control. If something made me anxious or worry, it became a trigger and therefore I could not be around that thing or person in fear of having an anxiety attack. (My boyfriend became one of those things along with tv shows and foods). My thoughts were very irrational and I could not think straight at all. Sleep became an issue and I found myself awake till 5 in the morning watching tv. Which became one of the only things that could distract me and make me feel better for the time being. I was afraid to go outside and communicate, I feel a derealization as if I was in a constant dream state. Everything almost looked different and felt different like I was on a different planet. I became suicidal and even started threatening my mother not to leave for work because I would die if she wasn't with me 24/7. She was a good distraction for my mind and helped me with a lot. When she wasn't around I would constantly think and I would give myself panic attacks. I felt worthless, like a baby that needed someone to hold my hand or else I would have a mental break down. My family, scared and worried, told me I had to take medication (though I had a bad experience with taking lexapro a few nights earlier which gave me a panic attack instantly after I took it) so I forced myself to take lexapro every night right before I fell asleep. I would go through period maybe weeks of being anxious and not being able to leave the house. Then maybe a week or two of feeling normal and I could see my friends again. Then another week I was back in bed again feeling worthless. I don't understand what happens with me or how I can fix it or if I ever can.
Dr. Richard Schultz Says ...
Hello and thank you for addressing this inquiry to me.
I understand that you now find yourself in a place of greater confusion, insecurity, self-doubt, and worry than ever before in your life; I sympathize greatly with the distress you are experiencing, although it makes complete sense to me that you now feel as you do.
You did not specify your age, but I am guessing that you are in your late teens or early twenties. If so, I would expect that your confusion about yourself is only that much more pronounced, given that you are still in the process of really figuring out who you are for the first time in your life. So, as your brain is just getting to know you, you have have been bewildering the hell out of it with your behavior.
You may not have known this, but our human brains rely primarily upon the observations they make of our BEHAVIOR when calculating our most important feelings and thoughts about ourselves.
So. It sounds like you have quite a combo-platter going there for yourself; on the non-substance side is a pre-existing case of emetophobia (which, for those who are not aware of it, is an often debilitating fear of vomiting or being around someone else who is vomiting, or even just talking about it). Emetophobia rarely presents by itself, and so I will assume you do also experience some degree of other types of anxiety (even when sober), such as panic disorder, generalized anxiety disorder, or social anxiety disorder. On top of this, you are a young adult, facing a variety of perfectly normal but nonetheless challenging life tasks, such as individuating from your family, establishing your own adult persona, choosing a professional or creative or educational path to pursue, exploring your sexual identity, and perhaps discovering your spiritual self.
And all of that is for sure enough to keep you darn busy for a while, and can prove to be, on its own, a somewhat intense path, with lots of ups and downs, trials and errors, hits and misses.
But several other potentially destabilizing events have also been introduced into the cocktail that is your life. You have been using hallucinogens on a recurrent (and it sounds more like frequent..3 times in 2 months?) basis. You also use marijuana, alcohol, and nicotine to modulate your experience. With the addition of these substances, your already quite changeable daily life has become dominated by a set of extremely powerful thoughts, feelings, images, memories, and behaviors. By taking the reins off of your frontal lobe and cerebral cortex, you have turned your brain from a helpful servant into a cross between a cruel taskmaster, and a 110 pound toddler! As we have 70,000 thoughts a day, and as the majority of them are negative, you have practically let your brain loose to tell you anything it wants, no matter how true or outrageously false it is, and you are far more vulnerable to actually believing it! Yeah, it's nice when you have the thought about being connected to everyone, however the notion that being dead really wouldn't matter much, or that something is very wrong with you mentally or physically, are cognitive experiences that are NOT intended to be given free rein to run wild in your psyche, completely unchecked. When these kinds of odd or negative experiences occur to us while sober, we typically have the resources to shrug them off as "silly," however the dysmodulated brain has no such ability, and thus the tail starts wagging the dog. In short, you were initially playing the game, and now the game appears to be playing you. I infer this, in part, from your closing line, "I don't understand what happens with me or how I can fix it or if I ever can." In this way, the "cure" for your problems has done far more damage than the underlying "disease."
In your account, you describe several signs of behavioral and psychological dysfunction, the majority of which seem to flow, not from your basic life circumstances, or your moderate degree of underlying anxiety, but from the act of adding drugs and alcohol to the mix. You have subsequently experienced recurrent suicidal ideation and imagery, desperate attempts to avoid being alone, aggressive, threatening, and perhaps even violent behavior (toward your own mother) in an effort to prevent such feared abandonment. Your basic life functioning has been notably disrupted, with prolonged periods of social isolation, avoidance of friends and others, and a reluctance to even leave the "safety" of your bed (I use quotes around safety because it just doesn't sound like it feels all that safe for you there).
Perhaps what I most want to tell you is that I am very concerned about you. Your willingness to take repeated risks with your physical and mental health, and lack of adaptive self-care, suggest that your judgment has gotten a bit bent by your choices and their consequences.
Give all of the above, I URGE you to immediately speak with a TRUSTED and TRUSTWORTHY adult caregiver, family member, teacher, spiritual advisor (priest, rabbi, youth minister, what have you), or friend about these difficulties. The goal in taking this step is to garner understanding and support for what you have gone through, and for what you must do to heal. Whether or not you take that first step, I also URGE you to consult a medical or mental health care professional as soon as possible so that you can be thoroughly evaluated, provided guidance in how to begin understanding the drivers and effects of your recent behavior, and to assess for the presence of any other underlying or accompanying medical or mental health conditions that may be relevant. I say this because the most common age of onset for schizophrenia is in the late teens and early 20's, and it often begins to emerge in the context of depression, unusual sensory and cognitive experiences, and accompanied by alcohol and substance abuse. In this regard, drugs and alcohol abuse is common among those beginning to experience prodromal symptoms of psychosis, as a direct attempt to neutralize or muffle the emerging disorder. Unfortunately, masking of the underlying disorder may indeed occur, preventing early diagnosis or treatment. And, of course, the substances themselves, and the incredibly challenging internal and external consequences to which they give rise, can also hasten the onset of another mental disorder (in addition to addiction).
Did I write this to scare you? In part, my answer is yes. Did I need to distort any facts of science in order to do so? Not at all. I know I probably have only one shot with you, my young friend, so I am making the most of it.
As difficult as things may be for you today, or even at this very moment, the fluid, impermanent nature of life, and the resilience and plasticity of our amazingly high tech brains, are solid proof of your ability to get to higher ground, and to a happier, more peaceful, and productive life. You had the freedom and ability to get from where you were before to where you are now, and you likewise have the built-in mobility to navigate to a far better place (None of us can ever get back to where we WERE, as that would require time travel, but we do have the ability to move into an even better future.
To quote "The Shawshank Redemption," an amazing film about internal and external imprisonment, we humans are faced daily with the option to "get busy living or get busy dying." And we have to remake that important decision every day of our lives.
I hope that some of what I have written here is of use to you, and I strongly encourage you to write back and provide an update on how you are doing. That will be of great help to others traveling the same difficult path, and it will also assist me in understanding what may have worked for you and what did not.
In the meantime, please review the several posts I have written in response to other young people with strikingly similar difficulties. You will know by reading the title of each post how relevant it may be to you. I point you to those posts because many of them flesh out more fully the mechanisms underlying the way substances and anxiety can interact and exacerbate one another, and what treatment for such difficulties would look like. You are of course welcome to follow me on Twitter (@mindsetdoc) or IG (@mindsetdude), or by subscribing to my blog (mindsetdoc.com).
Richard E. Schultz, Ph.D.