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What are the mental health effects of crystal methamphetamine?

People using methamphetamines (like crystal methamphetamine 'ice') can experience mental health symptoms while using the drug or during the 'comedown' or ‘crash’ phase. Symptoms usually last a few days to a few weeks. For some people mental health symptoms persist and develop into mental disorders in their own right. This can lead to a case of co-occurring health conditions (‘comorbidity’). Learn more about comorbidity.

The effects of ice on mental health can include:

Aggression mood swings

Insomnia

A 'comedown'

Anxiety and

Feelings of (a 'high')

  • Dependence on ice
  • Poor memory
  • Damage to attention span

What are the signs that someone might be experiencing a mental health disorder?

  • Signs of insomnia

    Methamphetamine use (including ice use) can lead to disrupted sleeping patterns, due to the effects of the drug. This can develop into insomnia-type sleep problems that persist even though the effects of ice have worn off.

    Those experiencing insomnia typically have difficulty falling asleep or may wake up several times during the night and find they can’t fall back to sleep. Prolonged insomnia can lead some to experience fatigue, poor concentration and headaches during waking hours.

  • Signs of anxiety disorders

    Methamphetamine increases heart rate which can cause the person using the drug to feel short of breath. Some people may suddenly feel very frightened or which can trigger Follow these tips for how to help someone who is having a panic attack or experiencing other side effects. Other common symptoms include restlessness, trembling, dizziness, sweating, dry mouth, muscle aches, headaches, nausea or vomiting. These symptoms can leave people using methamphetamine feeling agitated or nervous, particularly as the drug starts to wear off. If these symptoms persist for most days of the week, or for a few weeks or longer, it may be a sign that an is present.

  • Signs of depression

    As the effects of begin wearing off, it is common to feel very low and depleted for a few hours or even up to a few days. Some people who use methamphetamine regularly can experience depressive symptoms when they are not using the drug because it can deplete brain chemicals which are responsible for making us feel happy and excited. Those who have experienced before are at particular risk of experiencing these symptoms. These symptoms can persist for weeks or longer, and develop into a depressive disorder in their own right. If these symptoms occur for most of the day, for most days of the week, for 2 weeks or more, or if these occur when not using methamphetamine (or coming down from use), this is a sign that depression may be present.

  • Signs of psychotic disorders

    Heavy, consistent use of like ice can cause acute reactions in some but not all people.  This is supported by data from several sources. For example, the 2017 Illicit Drug Reporting System (IDRS) found that thirty-two (3.6%) participants out of 888 people who inject drugs reported a hospital admission for methamphetamine in the past year.

    Some symptoms of methamphetamine psychosis include:

    • Feeling suspicious (e.g. thinking you are being watched, picked on or that people are out to get you).
    • (hearing, seeing or smelling things that don’t exist e.g. feeling like you have bugs under your skin, hearing someone calling your name when no-one is around or imagining things are changing shape or moving when they are not).
    • Unusual thoughts (e.g. thinking other people are reading your mind or stealing your thoughts).
    • Repetitive compulsive behaviour (e.g. cleaning, assembling/disassembling objects, washing your hands repeatedly).
    • Muddled thoughts or incoherent speech.
    • Being hostile towards others.

    These symptoms can last a few hours or up to a few days. A small number of people may find these symptoms last much longer (e.g. more than a few weeks), or continue even when a person is not using ice. This might mean that an underlying psychotic disorder, such as is present.

The Comedown Phase

Man looking out window

A phase or ‘crash’ is often experienced by people who use ice as the drug starts to wear off. These feelings can last a few days and symptoms can include:

  • Feeling down
  • Decreased appetite
  • Exhaustion
  • Increased need for sleep
  • Irritability.

What is comorbidity?

‘Comorbidity’ is a term used to describe the circumstance where someone experiences two or more medical conditions at the same time. In this context it refers to when someone experiences both a on ice and a mental health disorder, or mental health symptoms, at the same time.

Venn diagram showing comorbidity as overlap of substance use disorder and mental health disorders or symptoms

  • Where to get support

    If you or a loved one are experiencing problems related to the use of ice, you can get support. It can be difficult to seek help, but in most cases the sooner you reach out for support, the better. You may want to discuss your concerns with a friend that you can trust. Your General Practitioner or family doctor can also be a good starting point – they can confidentially discuss your concerns with you and refer you on to other services if you need additional support.

    For more information on support services and how to get help for yourself or a loved one, visit the When and Where to Get Help and What type of help is available? sections.

    If you need emergency support, call Lifeline on 131 114 (a free and confidential 24-hour crisis helpline) or dial ‘000' for the police or an ambulance.
  • Key Sources

    Arunogiri, S., Foulds, J. A., McKetin, R., & Lubman, D. I. (2018). A systematic review of risk factors for methamphetamine-associated psychosis. Australian & New Zealand Journal of Psychiatry52(6), 514-529. https://doi.org/10.1177/0004867417748750

    Australian Institute of Health and Welfare. (2018). Alcohol, tobacco & other drugs in Australia, (No: PHE 221). Retrieved from: https://www.aihw.gov.au/reports/alcohol/alcohol-tobacco-other-drugs-australia/contents/introduction

    Darke S., Kaye S., McKetin R. & Duflou J. (2008). The major physical and psychological harms of methamphetamine use. Drug and Alcohol Review, 27(3), 253-262. DOI: 1080/09595230801923702

    Karlsson, A. & Burns, L. (2018). Australian Drug Trends 2017. Findings from the Illicit Drug Reporting System (IDRS). Australian Drug Trend Series. No. 181. Sydney, National Drug and Alcohol Research Centre, UNSW Australia.

    Leung, J.Mekonen, T.Wang, X.Arunogiri, S.Degenhardt, L., & McKetin, R. (2023). Methamphetamine exposure and depression—A systematic review and meta-analysisDrug Alcohol Revhttps://doi-org.ezproxy.library.sydney.edu.au/10.1111/dar.13670

    Massey, T., & Verikos, G. (2019). Australia’s ice crisis and the detrimental mental health effects of recent use.Economic Analysis and Policy, 64, Pages 26-40. DOI: https://doi.org/10.1016/j.eap.2019.07.004

    McKetin, R., Leung, J., Stockings, E., Huo, Y., Foulds, J., Lappin, J.M., Cumming, C., Arunogiri, S., Young, J.T., Sara, G., Farrell, M., & Degenhardt, L. (2019). Mental health outcomes associated with of the use of amphetamines: A systematic review and meta-analysis. EClinicalMedicine, 16https://doi.org/10.1016/j.eclinm.2019.09.014

    Duncan Z, Ward B, Kippen R, Dietze P, Sutton K. A narrative systematic review of associations and temporality between use of ecstasy/MDMA, or cocaine with or depressive symptoms. Addict Behav. 2024 Jun;153:107988. doi: 10.1016/j.addbeh.2024.107988. Epub 2024 Feb 17. PMID: 38394960.

    McKetin, R., & Black, E. (2014). Methamphetamine: What you need to know about speed, ice, crystal, base and meth. Sydney: National Drug and Alcohol Research Centre, University of New South Wales. Retrieved from: https://sydney.edu.au/content/dam/corporate/documents/research/matilda-centre/methamphetamine-resources.pdf

    McKetin, R., Voce, A., Burns, R., & Shanahan, M. (2019). Health-related quality of life among people who use methamphetamine. Drug and Alcohol Review, 38, 502-509. DOI: 10.1111/dar.12934

    Voce, A., Calabria, B., Burns, R., Castle, D., & McKetin, R. (2019). A Systematic Review of the Symptom Profile and Course of Methamphetamine-Associated Psychosis. Substance Use & Misuse, 54(4), p. 549-559. https://doi.org/10.1080/10826084.2018.1521430

Page last reviewed: Thursday, 12 October 2023