Let’s start by saying that regardless of which one it is, it can be a very scary and unpleasant experience, so it’s good that you’re getting informed! If you’re having a bad trip, you might feel paranoid or super anxious as a result of being overly intoxicated. The difference is that with a bad trip, these feelings are temporary, and generally go away after the effects of the cannabis wear off.
With an episode of psychosis, there can also be feelings of paranoia or anxiety, but it’s much more intense than that. A key feature of a psychotic episode is that the person is experiencing a disconnect with reality, which may feature hallucinations (like seeing, hearing, feeling, smelling or tasting things that aren’t there) or delusions (strong beliefs that aren’t true, like that everyone is out to get them). But the experience can also go in the opposite direction, where people emotionally don’t feel anything (they might feel numb). Both of these experiences can be incredibly stressful and unsettling.  In some cases, the person may become agitated, disorganized or less coherent than they usually are.
“It intensified existing hallucinations and thoughts, and then creates a mass amount of anxiety.”
If the person is experiencing distress that seems more in line with reality, it’s more likely to be a bad trip. Maybe they’re really sad and depressed, or maybe they’re stressed because their heart is beating so fast they think they’re going to have a heart attack (cannabis does increase heart rate, and although a heart attack is incredibly unlikely in people with no pre-existing heart conditions, this fear is more coherent with reality than, say, the fear of a government conspiracy against you).
“I feel like people are coming after me, really paranoid.”
Regardless of whether the experience was a bad trip or a psychotic break, it should be taken seriously as an indicator that maybe cannabis doesn’t work in that person’s favour.
If you’re reading this and thinking that your experience or that of someone you know might have been a psychotic episode, we discuss here what that could potentially mean for the risk of developing schizophrenia.