Hey everyone, It’s been a month since my bad trip, and I finally feel ready to share my experience and thoughts on the mechanisms behind derealization and potential psychotic symptoms during or after using mushrooms—at least as I understand them.

First, a bit about me: I’m a doctor. I’ve struggled with depression and anxiety my whole life, and very few medications ever really helped. That changed when I tried psilocybin. After a few incredible, life-changing trips (3-5g doses), I felt significantly better and worked through more personal issues than I ever did in therapy. I’m a big guy, and even 5g doses (including PE) never felt overwhelming—I didn’t get many visuals, and I was mainly able to work with my thoughts, which was incredibly productive. Until the last time. Five weeks ago, I took 5.5g of GT, just like before. About two hours in, everything went to hell. It took me five weeks to feel normal again, and only now do I have the clarity and courage to describe what happened. I also want to share what I believe happened mechanistically for those wondering what a bad trip like this feels like—maybe it will help someone. It started when I went to look in the mirror—something I had done before. I saw that my body was just a body, but inside, there was a part of a greater whole that was inherently good. That felt amazing. But then I went back to lie down, and a thought popped into my head: What if this life isn’t real? What if it’s a simulation? And that was it—I couldn’t critically analyze the thought. My mind spiraled instantly. Within seconds, my entire life—my achievements, my family, my passions—became meaningless and unreal.

These thoughts didn’t just feel possible—they felt true, with all the emotional weight of reality. Imagine petting a cat—you feel its fur, and you just know it’s happening. There’s no analysis, no questioning—it’s just true for your brain. That’s what happened to me, but with the idea that nothing was real. I had zero control over this thought pattern. Moments later, I had the worst panic attack of my life. I was convinced I was stuck in this state forever, that my life was over, and that this was my new reality. It was without a doubt the worst experience of my life.

This was not ego death—this was derealization, and if you’ve never experienced it, trust me, you don’t want to. I took alprazolam, which calmed me down a bit, but the next five weeks were filled with anxiety and several panic attacks, each bringing a shorter but similar feeling of reality breaking apart. It eventually led me to start antidepressants, mood stabilizers, and anti-epileptic meds, and after five weeks, I finally feel okay. But not everyone has access to quick medical support—or, like me, the ability to prescribe themselves the right meds.

Derealization and the anxiety that comes with it are not psychosis. However, I’m convinced that the same mechanism that causes a bad trip can lead to psychosis. One of the key symptoms of psychosis is the inability to recognize that one’s thoughts and perceptions are abnormal. The moment you lose critical distance from your own thoughts, the experience becomes your reality.

I think this is exactly what happens on higher doses of psychedelics—when you no longer have control over your mind, when the trip feels like it’s coming from within you, rather than something external. That’s when it becomes dangerous. This is how people end up believing they are being watched, that there are cameras in their home, that they’re Napoleon, etc. Most of these effects are temporary, but for those with a predisposition to schizophrenia or psychotic disorders, I believe this is the mechanism that can trigger a lasting psychotic break.

If you’ve never had a bad trip, I hope this helps you understand what it’s like. Be careful—stick to low doses, set & setting, and always have a trusted trip sitter. If you find yourself spiraling like I did, my best advice is to try and form the thought: “These aren’t my real thoughts, this is just the drug, and it will pass.” Easier said than done, but it might just save you from going too deep. Stay safe, everyone.