Anxiety DisordersDepressive DisordersAdolescentsMajor Depressive Disorder (MDD)Substance Use Disorders (SUD)Interpersonal Functioning & Social Connectedness

Effects of Naturalistic Psychedelic Use on Depression, Anxiety, and Well-Being: Associations With Patterns of Use, Reported Harms, and Transformative Mental States

In a cross-sectional online survey of 2,510 adults, naturalistic psychedelic use was associated with significant reductions in depression and anxiety and increased emotional well‑being, with larger (but ceiling‑limited) benefits at greater exposure and detectable improvement after a single use. Thirteen per cent reported at least one harm (those individuals reported smaller benefits), no single psychedelic showed clear superiority, and increases in mystical‑type experiences and prosocial perspective‑taking were linked to better outcomes, suggesting potential real‑world mental health benefits alongside risk for a minority.

Authors

  • Charles Raison

Published

Frontiers in Psychiatry
individual Study

Abstract

Survey-based studies suggest naturalistic psychedelic use provides mental health benefits similar to those observed in clinical trials. The current study sought to confirm these findings in a large group of psychedelic users and to conduct a novel examination of associations between amount of psychedelic use and behavioral outcomes, as well as frequency of harms ascribed to psychedelic use. A cross-sectional, online survey was completed by 2,510 adults reporting at least one lifetime psychedelic experience. Participants retrospectively completed a battery of instruments assessing depression, anxiety, and emotional well-being prior to and following psychedelic exposure. Participants also reported preferred psychedelic agent, number of uses, and harms attributed to psychedelic use. Psychedelic use was associated with significant improvements in depressive and anxious symptoms and with increased emotional well-being. These improvements increased in magnitude with increasing psychedelic exposure, with a ceiling effect. However, improvements were noted following a single lifetime use. Strong evidence for benefit of one preferred psychedelic agent over another was not observed, but enduring increases in factors related to mystical-experience and prosocial perspective taking associated with enhanced mental health. Thirteen percent of the survey sample (n = 330) endorsed at least one harm from psychedelic use, and these participants reported less mental health benefit. Results from the current study add to a growing database indicating that psychedelic use—even outside the context of clinical trials—may provide a wide range of mental health benefits, while also posing some risk for harm in a minority of individuals.

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Research Summary of 'Effects of Naturalistic Psychedelic Use on Depression, Anxiety, and Well-Being: Associations With Patterns of Use, Reported Harms, and Transformative Mental States'

Introduction

Psychedelics have rapidly moved from marginalised substances to the focus of substantial scientific, commercial and public interest, driven in part by a series of small clinical studies reporting rapid and durable improvements across several psychiatric and addictive disorders when these agents are administered with psychotherapeutic support. Previous large-scale survey studies have similarly suggested associations between lifetime psychedelic use and increased emotional well-being, reduced problematic substance use, greater connection with nature, and shifts in political and social attitudes, and have linked these effects to transformative acute states such as mystical-type or insight experiences. Despite this growing literature, the authors identify several gaps: few large surveys have used validated measures to examine associations with core symptoms of major depressive disorder and generalized anxiety disorder; no prior study has examined how the number of lifetime psychedelic experiences relates to changes in depression and anxiety; and the frequency and consequences of harms ascribed to naturalistic psychedelic use remain under‑characterised. Martinotti and colleagues designed the Psychedelics and Wellness Study (PAWS) to address these gaps. The study aimed to test whether past psychedelic use is robustly associated with current levels of emotional wellness—operationalised as depressive and anxious symptom severity and overall well‑being—while also examining how frequency of use, preferred agent, occurrence of transformative long‑term states, and self‑reported harms relate to those outcomes. The investigators framed the study as hypothesis‑generating, recognising the limitations of cross‑sectional, retrospective self‑report data but emphasising the value of a large sample with diverse naturalistic exposure patterns.

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Study Details

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