Contemplating versus having used psychedelics in bipolar disorder - What makes the difference?
Lauren N Vale, Maya Ibrahim, Leonardo Fávaro-pereira, Jair C Soares, Thomas D Meyer
Journal of affective disorders February 1, 2026 Peer reviewed DOI: 10.1016/j.jad.2025.120437 via PubMed
Summary
Individuals with bipolar disorder who have used classic psychedelics, like psilocybin or LSD, show more positive attitudes and greater openness to experience compared to those who are only considering use. Both groups share similar socio-demographic and mental health profiles, but experimenters endorse specific motivations for use more strongly. Contemplators express concerns about negative effects. The findings suggest that prior psychedelic experience influences perceptions and motivations, highlighting areas for discussion regarding potential use in clinical settings.
Study at a glance
| Design | observational study |
|---|---|
| Population | individuals with bipolar disorder who have used or are considering using psychedelics |
| Key finding | Experimenters with bipolar disorder demonstrate more positive attitudes towards psychedelics and greater openness compared to contemplators. |
Abstract
In recent years psychedelics have gained popularity and potential promise in the field of mental health, but for patients diagnosed with bipolar disorder (BD), fears of emerging manic or psychotic symptoms have caused investigators to exclude them from psychedelic research. In this observational study, we explore the motivations, expectations, and personality characteristics of individuals with BD who have either used (i.e., experimenters) a classic psychedelic (i.e., psilocybin, LSD) or were considering using (i.e., contemplators) in the near future. We compared so-called experimenters to contemplators across various sociodemographic, psychological, and mental health variables. The groups did not differ in socio-demographic variables or mental health, however, experimenters demonstrated more positive attitudes towards psychedelics and more 'openness to experience.' Furthermore, certain motives for use were more strongly endorsed while contemplators expressed concerns about potential negative effects and outcomes. These findings highlight that previous psychedelic experience is associated with more positive perceptions and motivations for use, which might have also been shaped by the actual experience. While we do not advocate for unsupervised use of psychedelics outside of a clinical setting, the study provides some information what areas need to be discussed with individuals with BD who contemplate using psychedelics, even in the context of a clinical trial.