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Naturalistic psychedelic use and changes in depressive symptoms
Otto Simonsson1, Peter S Hendricks2, Caroline M Swords3
1Center for Social Sustainability, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Solna, 171 65, Sweden; Center for Healthy Minds, University of Wisconsin-Madison, Madison, WI 53703, USA.
Journal of Affective Disorders
|July 11, 2025
Summary
Naturalistic psychedelic use may worsen depressive symptoms, especially in risky contexts. Challenging experiences during psychedelic use are linked to increased depression, highlighting the need for careful consideration of use settings.
Area of Science:
- Psychiatry and Mental Health
- Epidemiology
- Psychedelic Research
Background:
- Growing evidence suggests psychedelic-assisted therapy's antidepressant potential.
- Limited understanding of psychedelic effects on depression in naturalistic, non-clinical settings.
Purpose of the Study:
- To evaluate the longitudinal relationship between naturalistic psychedelic use and changes in depressive symptoms.
- To investigate the impact of 'risk context' psychedelic use on depressive symptoms.
Main Methods:
- Observational cohort study of US residents aged 18-50.
- Longitudinal evaluation of depressive symptoms and self-reported psychedelic use.
- Covariate-adjusted statistical models to analyze associations.
Main Results:
- Psychedelic use was associated with modest increases in depressive symptoms.
- Psychedelic use in a 'risk context' showed moderate increases in depressive symptoms compared to no use.
- Challenging psychedelic experiences mediated the link between 'risk context' use and increased depressive symptoms.
Conclusions:
- Naturalistic psychedelic use may not be universally therapeutic and can worsen depressive symptoms.
- Context of use, particularly 'risk contexts,' significantly influences outcomes.
- Further research is needed on factors contributing to adverse outcomes from naturalistic psychedelic use.
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