How to help someone after a drug induced panic attack (bad trip)
Drug induced panic attacks can happen on any drug.
Usually people who post here with aftermath problems used a Psychedelic, cannabis or MDMA.
This is not written by a medical professional, just someone who has attempted to help many people recover from bad trips both in real life and on the internet. Unfortunately because of the illegality of many drugs there is simply no substantial information available on many topics, including this one. This is especially unfortunate in this case, as we shall see the main problem people have is in understanding their experience and normalising it. If they had some idea of what a bad trip really was, perhaps that could be significantly avoided. Unfortunately, it is often that bad trips are utterly surprising that they take hold of someone and traumatize them to the extent of having lingering psychological issues. This is yet another problem caused by the illegality of drugs.
The advice they need is not usually dependant on which drug they took. The situation is almost always the same, at least in its core. A drug-induced panic attack is often the first time a person experiences a panic attack. In the context of a drug-experience, it can be intensified in terms of the physical and mental severity. Also in the mix is the fears people have about drug use - adulterated substances, mental breakdowns & death. There are also fears based in myth like the possibility of brain damage.
Their mental state after such an event consists of acute anxiety. They have come online in search of answers and have probably been searching a while before finding Drugs-Forum, perhaps reading various horror stories or being concerned at finding little information, worried that something disastrous and abnormal has happened to them.
They may have heard of bad trips - but they may not have realised that lingering psychological issues like anxiety can occur after a bad trip.
Their mindset when posting can range from an anxious sense of urgency at wanting help dealing with what they vaguely understand to be a bad trip to utter desperation, anxiously doubting at any possibility that anyone even knows what happened to them.
Normalise the experience
Help them see that their fears and anxieties are just symptoms of their temporarily traumatized mindset
Answer all their questions
Normalising their experience. The idea that the bad trip was something abnormal is often a source of anxiety. To negate this, tell them you've heard stories like theirs before. Tell them you've heard bad trips involving similar aspects / hallucinations / fears / negative beliefs.
Normalise their lingering psychological issues. Just being told that their anxiety is normal helps a lot. The most common fear is of permanent mental damage. This is of course just anxiety in disguise. Explain that their fears are just anxiety, and explain that anxiety is the normal result of a traumatized mind. It's no different to trauma they might experience after being in a car accident or witnessing a car accident. In those situations they would not be surprised if they were mentally traumatized. They just need to realise that they shouldn't be surprised at being mentally traumatized by a bad trip too. This prevents a lot of the self-perpetuation of anxiety.
Assure them. No brain damage is possible, mental illnesses can not be caused. Their friends are not controlling them through evil alien computers built by the devil, etc.
Help them see that their fears and anxieties are just symptoms of their temporarily traumatized mindset. They will often be focusing on some negative aspect of the trip which they communicate as an negative thought. They could be simply unable to stop thinking about the negative thought and how negative it was, or they might even believe it or at least be worried about it. There is of course huge variation in the extent a person worries about such a thing, which should correspond to the extent you should focus on trying to alleviate it. It doesn't matter what their negative thought is. Perhaps they had a significantly negative encounter with someone and are worrying about it, perhaps they are concerned that they are going crazy, they could fear possession by the devil or aliens. It does not matter, because this is simply a product of a negative, anxious mind which has been temporarily traumatized. You need to help them realise that. Whenever they raise concerns about these fears, you simply remind them that their thoughts have this origin. Encourage them not to take their negative thoughts seriously. When a particularly negative thought arises, they should get into the habit of doing breathing exercises to clam themselves. Their goal should be to catch negative thoughts before they take hold. Instead of thinking "X is a negative situation", they should think "I am experiencing an anxiety reaction." In other words, they must not believe the fear. This will prevent some of the impact of the anxiety on the mind as well as impeding the anxiety's self-perpetuation. It can be difficult for them to adopt the correct perspective, because when the mind is anxious it so easily believes these negative anxious thoughts. It's even hard to notice them arising, because they just flow so naturally from the general state of negativity.
Show empathy. Empathy is of especial importance in helping someone in this situation. Of course, empathy is always good when helping vulnerable people in a negative mindset. However it is common for people in this situation to feel alone and isolated, and that no one could help them because no one would understand what is happening to them - even they themselves mightn't understand it. Empathy is best given in conjunction with normalisations of the experience for this reason. Every time you normalise a part of their experience, try to add a point of empathy there involving for example your recognition of some element or aspect of their bad trip or lingering psychological issues as well as a recognition of how they feel about it and offering of sympathy. Normalising the experience will help them appreciate that someone else really understands what they are going through, which opens up the door for reception of empathy because it is empathetic in itself.
Give them the prognosis. The length of lingering psychological issues is of course utterly impossible to judge properly. However, generally the more severe a bad trip, the more severe the lingering issues. They can make things easier for themselves by abstaining from all drugs, living healthily, ignoring negative thoughts as much as possible and attempting to live normally as much as possible. However, they should understand and accept that this will be a difficult time for them. It's a difficult time for everyone who goes through this. It's very unfortunate and sad that such things can happen in life, however its something that the mind is very good at recovering from. The purpose of this is to give them hope by seeing light at the end of the tunnel. It's also an attempt to inspire confidence and normalisation of the experience by contextualising it in a timeframe.
Remind them not to use cannabis. Not only is cannabis the most frequently mentioned cause of bad trips, if someone uses cannabis after they've had a bad trip, they can experience a flashback or re-living of their bad trip. Although cannabis bad trips are not (usually) as devastating as bad trips on psychedelics, nonetheless it can seriously impede recovery. While in such a traumatised mindset, the last thing anyone needs is more trauma. This is so often reported. People need to know never to use cannabis after they've had a bad trip.
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