Alternate title: Acid Convinced Me I Am Exactly Who I Thought I Was

As the engaged and parasocially addicted reader I hope you are, you might remember that I’ve previously dabbled in mind-altering substances. If not, context you should have is that I'm a psychiatry resident who suffers from ADHD and a rather stubborn case of treatment resistant depression. Up until recently, however, my exposure to anything serious was strictly limited to psilocybin administered under clinical conditions.

I originally accepted the mushroom extract because I was depressed. It worked, in the sense that I spent the next four months and change feeling reliably not depressed. Psychiatry loves to invent tidy Greek and Latin wrappers for the chaotic human experience, and “euthymic” is the designated term here. It is a polite way of describing the baseline state the rest of us are desperately trying to claw our way back to. At the very least, it’s what I write down in my clinical notes unless you, the patient, are giving me serious cause for concern.

But the psilocybin eventually wore off, and the medical establishment won't just put you back in a clinical trial because you ask nicely. I was struggling badly again, so I turned to LSD.

My first foray was a trial run. The dealer advertised a 300 µg tab, which I conservatively cut in half. Going by subjective effect, along with the generally optimistic nature of street mathematics, it felt closer to 75-125 µg. There were no real visuals. The walls maintained their structural integrity, abstaining from the perceptible motion usually reserved for earthquakes or skyscrapers. I felt wired, more thoughtful, but mostly just myself.

Also, I was nauseous as all hell. This is to be expected from a chemical structurally adjacent to those that mushrooms evolved to keep annoying animals at bay. Unfortunately, much like with capsaicin, humans have proven to be deeply paradoxical creatures, eagerly seeking out the exact substances that burn their throats and make their stomachs churn.

Subjectively, that low-ish dose felt like a middle sibling between the sheer euphoria of MDMA and the hyper-focused disengagement of psilocybin. The only real downside was some manageable next-day dysphoria. Still, I was dissatisfied with the intensity. There was no immediate relief from the grey fog. I eyed the remaining half-tab, took extensive notes, and decided I was ready to do it again. And harder.

I did, and I almost regret it.

Set and Setting

A few days prior, I had received what could only be described as objectively good news. Not perfect news, but I felt a few British stone, or one Indian boulder, lighter. I genuinely felt eager to face the near future. Unlike my clinical trial, where the goal was to banish a treatment-resistant depression that had plagued me for a decade, this time I just wanted to make the happiness stick. If that didn't work, I'd settle for lasting contentment.

I’d learned my lessons from the trial run. I kept ondansetron on hand, a rationalist’s best friend for serotonin-receptor-induced nausea. I cleared my schedule. I found a quiet room, cranked up the aircon, turned down the lights, and queued up a good sound system. I took a full "300 µg" tab, expecting a real-world 200, and swallowed the anti-nausea medication alongside it. My two dogs, creatures of gentle breeding and absolute loyalty, snuggled in without complaint.

The effects arrived on schedule. The ondansetron performed a miracle, muting the jaw-tingling and ear-stuffiness associated with extreme serotonergic stimulation. The music sounded expansive; the colors popped. Two hours in, I decided I liked the trajectory enough to swallow the remnants of the first tab.

Then my friends arrived.

They were good friends, old friends, some I hadn’t seen in years. They knew about my situation, though they mostly weren’t psychonauts themselves. The most experienced among them had once trip-sat a guy who ended up defecating in a sink, an indignity I fully intended to spare them. I just wanted temporary companions, not babysitters. We’re getting older; we have jobs, wives, and kids. I also had family a phone call away, though I was resolved to only break that glass in an absolute emergency.

We laughed and caught up. The man I call my best friend dragged me out to look at nature, or at least the best shrubbery my suburban garden had to offer. It was a hot, sunny day. The leaves were very green. I was... whelmed. Very pretty leaves, sure, but ultimately just plant organs devoted to reasonably efficient photosynthesis.

Then, one of my friends surprised us by producing a joint of unusually high-quality weed. I dimly recalled reading that THC enhances the effects of psychedelics. I took a few measured puffs. I thought I was being sensible.

I was very wrong. Oh god. Oh fuck.

Before the marijuana, I had noticed a remarkably large pimple on my best friend’s forehead, but I hadn’t commented on it, because we’re men and it’s not my place to critique his skincare routine. I remember thinking it was remarkably large, but hey, it's his face and his business. Shortly after the marijuana, I looked at another buddy and noted that he had clearly been skipping leg day. His torso was swole; his legs were stick-thin. Taken aback, he explained he hadn’t been to the gym in years. I checked on my best friend, and found that the pimple was present, but not nearly as obtrusive. I squinted, recalibrated, and finally realized that visual proportions were simply no longer a metric my brain had a good handle on.

My friends looked alien. I knew this was an illusion, in the same way I knew my two dogs, currently busy barking at and humping each other, were not actual wolves. But the visuals and the noise were provoking a rising tide of anxiety.

I politely told them I needed to lie down. They didn't mind and kept chatting. Eventually, even the sound of their voices became too intrusive, and I had to ask them to leave.

I was alone, and I knew the weed had shifted gears. The subtle color-shimmering behind my eyelids had mutated into aggressive fractals. The walls swayed. My phone, my lifeline for timestamped notes, was folding and warping in a manner explicitly not covered by the manufacturer's warranty.

I knew I was fucked. I laid back and strapped in.

The Peak

I just kept falling. My body became leaden while my mind buzzed like a hive. The music transitioned from enjoyable into a tidal wave of synesthesia-adjacent masterpieces.

And then, I stopped thinking in words.

For the relentlessly analytical creature that I am, this is an unusual experience. The time-stamped notes ceased. Time itself meant very little. I felt my sense of self begin to fray at the edges, and I felt the universe, God, the Singularity, the collective oneness of all existence, attempting to force its way into my mind. I remember thinking, in totally alien non-words, that perhaps belief in a higher power wasn't so bad after all.

This seductive impulse didn’t whisper. It didn’t knock. It kicked down the door while I was on the shitter.

A part of me recoiled. The core of my identity rebelled. It is not a metaphor when I say I saw literal tendrils, soft white shoots, forcing their way into the cracks of my mind, offering me metaphysical solace and cosmic meaning. It is even less of a metaphor when I say that the little kernel of "me" that remained manifested a pair of scissors and snipped them away as fast as they sprouted. Buddy, I saw these things. Knowing you're hallucinating is not a robust cure for insanity.

Next, I saw myself as a knot, pulled taut and threatening to unravel under the tension of competing ontologies and bad epistemics. But it held firm. Even a heroic dose of mind-altering substances failed to break my stubborn, logically oriented materialism. Before the peak, I had written in my notes that any version of me returning from this trip with claims of metaphysical insight was, in a very real sense, no longer me. Now I had peaked, and my priors remained perfectly intact.

I saw God trying to fuck my brain through my eye socket, and my first instinct was to castrate him. Okay, this one is an actual metaphor, but it's one I came up with barely after the peak.

I realized then that there is an immutable, unshakable core beneath the masks I wear. Short of serious neurological degradation, I could trust myself to persevere through whatever slings and arrows life throws at me without losing my mind.

The Descent and the Meta-Self

Eventually, time began to make sense again. I became introspective. I felt sobriety slowly reconstructing itself from the wreckage of my mind, though it was a drawn-out process.

The peak was followed by a gentle, strange glide. I remember one version of me during the comedown who despaired of ever reaching sobriety, terrified of annihilation, begging not to die, terrified that his specific qualia would vanish into compressed digital journal notes and fading, imperfect memory.

The next iteration of me was highly meta, a journalist preoccupied with the act of journalism. He finally understood (in emotive terms, and not just intellectually as I usually do) that the entity I call “myself” is a gestalt, a series of 3D snapshots embedded in a hypercube stretching from the past to the infinite future. My life is a relay race, each past self rushing to pass the baton to the next. At times, this was a brisk walk, at other times, a sprint. During the trip, the poor bastards that are myself were rolling downhill in wheelchairs. But hey, they did their job. Now I do mine. The internal continuity I feel might lack objective grounding, but it’s a load-bearing construct nonetheless.

This meta-self chuckled at how pretentious I would find him once sober. He knew he’d be gone soon, and he wished me well. He observed that a mind without the filters and structures we rely on is fundamentally non-functional. Sanity is adaptive. He faded away with a smile, handing the wheel back to the next, slightly more sober guy. For what it's worth, I don't dislike him as much as he thought. I recognize that aspect of myself, and am mostly fond of it.

At some point, I remembered Scott Alexander’s short story Samsara. It is the one about the solitary materialist in a world where everyone else has succumbed to an Enlightenment memetic plague that genuinely makes them happier at the cost of their epistemics. I identified with and felt great empathy for the protagonist, but I also looked down on him. I had just seen the face of God and spat at it. I was perfectly content remaining in the cycles of Samsara, even if the upholstery needs some work.

My live notes from this exact moment read:

“I love feeling anti-Enlightened. Like that story Scott wrote, about the only materialist left on earth, who was tricked into becoming enlightened by virtue of his rejection of enlightenment. Hah. I'm still here. Bitch.”

Make of that what you will. I stand by it.

The Empty Quarry

The rest of the trip was an exercise in logistics and emotional housekeeping. I began to think and plan ahead, and regained opinions on the music, which gradually became less sublime. Along the way, I asked myself the questions I am usually afraid to answer out loud.

I noted my anxiety about the Singularity, which I believe is imminent on empirical grounds rather than faith. I fear death, and aging: for myself and those I love. I fear not being around to experience the end of the beginning. I want us to build heaven from the bones of an apathetic universe and forge something that cares out of dying stars. I genuinely think that is more likely than getting paperclipped, though not by a margin wide enough to bring me much peace.

I examined my anxieties about my career, my finances, and the lofty standards set by my parents. That I may or may not have the time to establish myself as a man, a husband and father, a writer, a doctor, before it becomes moot. I mused on how conflicted I feel about the trajectory of my life, even if I've usually lived up to my expectations and made my parents proud. I know I am not a bad person: I don't give my spare change away to save shrimp, but I do genuinely try to help. This was helpful to remember and also sincerely believe with most of my guard down.

I thought about my father, a surgeon who works harder than a human body should allow. He is not emotionally constipated; he cares deeply about my feelings. But quiet, relentless work is his love language. With tears drenching my cheeks, I realized he would work himself to death for us if he had to, and he’d die on his feet with a smile.

I don't want him to. I want to become so established that he can look at me, feel the safety of it, and finally slow down. At the same time, I notice I’ve inherited his drive. I work harder than I need to because I am already providing for the family I don't quite have yet: the wife yet unmarried, the kids yet unborn.

To my slight but enduring disappointment, it turns out my constant sober rumination and relentless introspection actually works. I already knew all of these answers. I could have produced them on minimal prodding when sober, even more easily if drunk and disinhibited. I have already done so, repeatedly.

Not even a heroic dose of LSD could help me mine for psychological insights that didn't exist; the quarry was already bare. I understand myself. I wouldn't trust any grand unified theories about the wider universe generated on acid, but I would have appreciated a slightly deeper glimpse into my own interiority. Like any good Bayesian, I am forced to treat this absence of evidence as evidence of absence. I am, almost certainly, exactly who I thought I was.

I wouldn’t ever like to be quite that high again. It felt dangerously close to bumping up against a glass ceiling of the psyche. I do intend to alter myself, physically and mentally, in the future, but psychedelics can only get you so far.

It is too early to tell if the contentment will stick, but the day after, I feel euthymic. It is quieter in my head. For someone with ADHD, this is a profound relief. As a delightful bonus, my usually omnipresent mild tinnitus seems to have vanished. If that proves permanent, the ordeal was worth it on those grounds alone.

I consider myself a better materialist for the experience. But note that I do not view the experience as self-flagellation, I didn't seek out... whatever the hell that was. The flagella of cosmic unity tried to force their way in, and I stayed the course. Can't let the team down; the ancestors and descendants are counting on me. If God or the administrators of the Ancestor Simulation want to talk to me that badly, they can send an email.

A Brief Note on Harm Reduction:

As clinical experiments go, my methodology was garbage. The clinician and the subject were the same person, and both of them were tripping balls in a manner they hadn’t realized was physically possible. I was already happier than I had been in a... very long time when I tried this. Nothing I have said or will say constitutes medical advice.

Do not take heroic doses of LSD unless you have a damn good reason. If you must, do not add cannabis unless you have meticulously researched the interactions. And if you do add cannabis, do not come crying to me when you find yourself castrating God with imaginary scissors to prevent Him from mind-fucking you. Or if you do get mind-fucked, for the matter, I will be sympathetic but less than useful. I've warned you. And I warn you again:

Some doors, once opened, cannot be closed until the half-life clears your system. Sometimes they stay ajar forever, no matter how hard you shove. From a mental health perspective, the evidence for psilocybin and ketamine is far more robust, and the latter is actually medically available in many jurisdictions.

I don't want to be this high ever again. But I am very glad to be back.