Understanding the Come-Up and Come-Down of Psychedelic Journeys
Article Title: “A Qualitative Analysis of the Psychedelic Mushroom Come-Up and Come-Down”
Author: Ari Brouwer, Joshua K. Brown, Earth Erowid, Fire Erowid, Sylvia Thyssen, Charles L. Raison, & Robin L. Carhart-Harris
Publication Date: 2025
Background
Psychedelic therapy has gained increasing attention as a potential breakthrough treatment for various mental health conditions, including depression, anxiety, and PTSD. While much research has focused on the peak psychedelic experience—often described as mystical, insightful, or emotionally transformative—less attention has been given to the early (come-up) and later (come-down) phases of the journey. This study explores how these phases influence the overall psychedelic experience, particularly in the case of psilocybin mushrooms.
The researchers hypothesised that the come-up phase is marked by discomfort and stress, resembling an acute stress reaction, while the come-down phase offers a sense of relief and resolution, akin to recovery from illness or distress. This perspective could provide new insights into how psychedelic experiences contribute to long-term emotional and psychological healing.
Study Overview
The study analysed self-reported experiences of psilocybin mushroom use from the Erowid Experience Vaults, an extensive online database of first-hand psychedelic trip reports. Researchers conducted a phenomenological, thematic content, and word frequency analysis on 2343 reports, with a specific focus on:
- The Come-Up Phase (47 detailed reports)
- The Come-Down Phase (83 detailed reports)
- Timestamped Experiences (279 reports analysed for word frequency trends)
Thematic content analysis identified recurring emotional, physical, and cognitive themes in these reports. Word frequency analysis was used to verify how commonly certain experiences occurred at different time points in the trip.
Key Findings
The Come-Up Phase: Discomfort and Anxiety
The early phase of a psilocybin mushroom trip often involves unpleasant physical and emotional sensations. Commonly reported themes include:
- Nausea (34%)
- Anxiety (28%)
- Restlessness (21%)
- Confusion (17%)
- Tingling sensations (15%)
- Cold sensations, heaviness, or lack of coordination (9%)
Many users described feeling an acute stress reaction, similar to what might be experienced during illness or psychological crisis.
Some participants actively avoided engaging with the unpleasant feelings, while others found that embracing them led to deeper emotional breakthroughs later in the experience.
The Peak Experience: Transition from Challenge to Transformation
- As the peak effects set in, users often moved beyond the initial distress, reporting:
- Mystical experiences
- Profound insights
- Emotional catharsis
- A sense of connectedness
The Come-Down Phase: Relief, Reflection, and Gratitude
The latter phase of the trip is frequently described as calm, insightful, and emotionally rewarding. Key themes include:
- A sense of peace and relaxation (34%)
- Positive reflection and insight (17%)
- Increased social connectedness (16%)
- A feeling of accomplishment and emotional resolution
Some users reported a feeling of “returning home”—both in a literal sense as the effects faded, but also metaphorically, as if they had gone through a meaningful inner journey and emerged with newfound clarity.
Discussion
The study suggests that the emotional trajectory of a psychedelic mushroom experience mirrors a natural process of stress and relief. The challenging come-up phase may act as a psychological and physiological reset, setting the stage for emotional breakthroughs and the subsequent peaceful resolution of the come-down phase.
This aligns with theories that propose psychedelics engage the brain’s stress-response system, temporarily intensifying distress before allowing the individual to process and release it. This mechanism could explain why psychedelics are effective in treating mental health disorders like PTSD and depression.
The findings also support previous research suggesting that the most transformative psychedelic experiences often involve an initial phase of discomfort, which may be necessary for deep psychological healing.
Implications
This study suggests that the emotional trajectory of a psychedelic mushroom experience mirrors a natural process of stress and relief, which could have significant implications for therapeutic frameworks. The findings highlight that temporary distress during the come-up may be a necessary precursor to transformation, much like the way emotional breakthroughs occur in psychotherapy. For psychedelic-assisted therapy, this reinforces the importance of preparing participants for early discomfort while ensuring they have support to move through it effectively. Therapists and facilitators can use this knowledge to design sessions that provide reassurance and grounding techniques during the come-up, rather than pathologising the initial anxiety. Additionally, the concept of temporary challenge leading to long-term relief may be useful in other mental health treatments, such as exposure therapy for anxiety disorders. Understanding the full arc of the psychedelic experience, from discomfort to relief, can also help shape integration practices, guiding individuals to reflect on how they navigated the come-up and what insights emerged during the come-down.
Potential Application
The findings have direct relevance for psychedelic retreats and guided experiences, particularly in how facilitators prepare and support participants. Before a session, facilitators can educate individuals about the typical phases of the psychedelic journey, ensuring that they understand the initial distress is temporary and often leads to emotional breakthroughs. During the session, providing grounding techniques such as breathwork, body awareness exercises, or gentle reassurance can help ease participants through the more challenging come-up phase. Creating an environment of safety and trust is essential to help individuals surrender to the experience rather than resist it. In the integration process, guiding participants to reflect on the transition from challenge to resolution can enhance long-term therapeutic benefits. By applying these insights, psychedelic retreats can offer more structured, supportive, and transformational experiences, ensuring that participants are fully prepared for the psychological journey of psilocybin.
Conclusions
This study sheds light on the often-overlooked phases of the psychedelic journey, showing that the come-up is frequently difficult, while the come-down is often peaceful and rewarding. Understanding this trajectory can help optimise psychedelic therapy and retreats by preparing individuals for the full experience and integrating insights gained along the way.
These findings reinforce the idea that temporary distress is a crucial step toward transformation, offering valuable lessons for both individual users and the growing field of psychedelic-assisted therapy.
Reference:
Brouwer, A., Brown, J. K., Erowid, E., Erowid, F., Thyssen, S., Raison, C. L., & Carhart-Harris, R. L. (2025). A qualitative analysis of the psychedelic mushroom come-up and come-down. npj Mental Health Research, 4(6). https://doi.org/10.1038/s44184-024-00095-6
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