Mind-Bending Mental Health Treatment
By: Alex Giarretta
Tags: Science, Therapy, Drugs, Mental Health, Future

Psilocybin and LSD are two of the most popular psychedelic drugs, with psilocybin being derived from mushrooms containing the substance. Since psilocybin and LSD are two of the most-studied out of the more popular psychedelic substances, there is a good amount of information indicating that psilocybin and LSD can be useful in helping treat anxiety and depression specifically. Regarding anxiety and depression in terminally ill patients, multiple trials have come to the conclusion that single doses of LSD/psilocybin (alongside psychological support) helped reduce anxiety and depression and “increased quality of life, life meaning, death acceptance, and optimism, and these effects endured from some weeks to six months after drug intake” (dos Santos, Hallak). On top of easing anxiety and depression in patients, the combination of psilocybin/LSD and psychological support also led to few major side effects, with the worst symptoms being temporary anxiety, illusions, and headache, nausea and vomiting. Recent studies have also found that psilocybin can be useful in treating major depressive disorder (MDD), acting as an alternative treatment for those unable to find help through traditional channels. In one specific study, 12 volunteers who had treatment-resistant MDD were given two doses of psilocybin 7 days apart from each other, first receiving a 10 mg dose and then a 25 mg dose. While under the effects of the psilocybin, the volunteers were provided with psychological support, and positive effects were reported. In this study specifically, participants noted a decrease in anxiety and depression, with the decrease taking place over both a short period of time (1 week after dosage) and over a longer period of time (three months after dosage). It is because of studies like this one that the FDA recently decided that psilocybin was worthy of receiving a Breakthrough Therapy Designation for the treatment of treatment-resistant MDD, as studies are beginning to show the effectiveness of the drug in therapeutic sessions.

Photo by Simon Rae on Unsplash

Another major psychedelic drug that has been the focus of many researchers in more recent times is MDMA (also sometimes known as ecstasy), with researchers finding that the drug is effective in treating PTSD. Though PTSD is an illness that can be caused by a wide range of traumatic situations, a recent study has looked mainly at using MDMA in order to treat PTSD in military veterans and first responders. In said study, 19 military veterans and first responders (who participated in a clinical trial investigating the efficiency and safety of MDMA-based psychotherapy) were interviewed in order to gain insight into the effects of MDMA on treating their PTSD. From the interviews conducted on the subjects (who received the trial a year prior to being interviewed), 79% reported significant decreases in their PTSD symptoms. On top of decreases in PTSD symptoms, many also reported other positive changes in their lives, like improvement in self-awareness and an increase in social skills and relationships with others. All of the participants reported that using MDMA in therapy sessions helped them gain insight into their experiences, which enabled them to come to a greater level of self-understanding. In the context of PTSD specifically, one participant noted that a higher level of self-awareness helped her to control her PTSD to a greater degree, with her reporting that “I’m just better at recognizing and managing…[I recognize that] there’s actually an underlying medical condition that’s affected the way that my brain has been wired, and I’m working on rewiring” (Barone, William, et al.). By using MDMA, the subjects were able to loosen their inhibitions and somewhat shed their negative experiences, using the drug (alongside the psychological therapy) to delve deeper into themself while being uninhibited by their past traumas. The idea of undergoing a “breakthrough” is not uncommon with psychedelic drugs, and many share the same experience of psychedelics helping to tear down the ideas that one has of themselves, with the user undergoing an event known as “ego-death.” While it is not certain that the participants in this study underwent a full ego-death, one of the positives of psychedelics is that it helps people come to terms with who they truly are, enabling them to get past some of the mental disorders that hold them down.

As the least understood and researched psychedelic of the bunch, DMT is a drug that requires much more observation before solid conclusions can be formed. However, some experiments have shown that DMT does have a positive effect on people, with its history dating back hundreds of years. Though today it is possible to administer pure DMT after synthesizing it in a lab, indigenous groups of South Americans have historically consumed DMT through ayahuasca, a hallucinogenic herbal brew. These natives were not using ayahuasca simply to get high, though, and the drink is very closely associated with therapeutic rituals. In the modern day, ayahuasca is still used by many indigenous South American peoples in rituals, and its popularity has spread beyond just South America. Because of its increase in popularity, ayahuasca (and pure DMT) has caught the attention of scientists who wish to study it, believing that its therapeutic properties could prove to be especially useful for treating mental illness. In studies that have been conducted on patients suffering from major depressive disorder, results point to the possibility that ayahuasca can be used effectively as an antidepressant. In an experiment performed by Brazilian researchers, patients with treatment-resistant major depressive disorder (MDD) were given low doses of ayahuasca, leading to significant decreases in anxiety and depression within a few hours of administering the drug (which subsequently lasted for 3 weeks) (dos Santos, Hallak). On top of the significant decrease in symptoms, the only negative side effect was that 47% of those treated had to deal with vomiting (a common side effect of ayahuasca use). The potential for treatment does not stop at depression, with 4 (out of 5) studies showing that ayahuasca use can decrease dependence symptoms/substance use among drug addicts (dos Santos, Hallak). As mentioned earlier, psychedelic drugs are famous for providing users with the opportunity to examine their minds thoroughly, with an increase of introspection leading to positive personality developments. With ayahuasca, researchers noted that use of the drug led to a decrease in shyness, an increase in confidence, optimism, and an overall acceptance of oneself and others (dos Santos, Hallak).

The findings of these studies concerning ayahuasca (and DMT) are very promising, but it is important to note that this research is still limited. Without proper backing from the government, researchers are unable to effectively research some of these psychedelic compounds, leading to the full potential of these substances being untapped due to overly strict and outdated laws. When psychedelics can be freely experimented with, they are able to show off their abilities as tools to combat mental illness, like ketamine.

Originally used as an anesthetic during the Vietnam War, ketamine is a type of psychedelic that has found more use in recent years as a club drug. When used in high quantities, ketamine can produce psychedelic-like effects, and ketamine “trips” are characterized by an inability to move (due to sedation) and the presence of hallucinations/dissociation. Unlike all of the other psychedelics described so far, ketamine has the potential to be addictive, leading to it being abused by some. While it is an addictive drug, researchers have shown that ketamine can be extremely effective at treating severe cases of depression. As a result of these findings, the FDA permitted the production of an esketamine nasal spray in 2019, being provided to specialist’s offices under the branded name “Spravato” (FDA). Since the drug sedates those who take it, sufferers of treatment-resistant depression are only allowed to receive treatment at their doctor’s office, with the drugs never leaving designated therapy centers. In trials where patients were given either Spravato or a placebo (alongside an orally administered antidepressant), the subjects who received Spravato as treatment saw significant decreases in levels of depression when compared to the placebos (FDA).

The legalization of ketamine nasal spray for treatment-resistant depression is important for the future of psychedelic therapy in many ways. Most obviously, this development in mental health treatment is greatly necessary for beginning to enter psychedelics into the mainstream regarding treating mental illness. As time goes on, the number of clinics using the ketamine spray will hopefully increase, with positive results from patients making a greater case for the legalization of other forms of psychedelic treatment. Just as importantly, the FDA approval of the procedure to administer Spravato sets a strong precedent for the potential legalization of other psychedelic therapies. In order to ensure that psychedelic therapy is safe and effective, it is absolutely necessary that patients are being carefully watched over by their doctors while under the influence of certain drugs. Without the guidance of professionals, the full therapeutic power of psychedelics cannot be properly unlocked. Contemporary models of psychedelic therapy can involve two main forms of therapy: cognitive behavioral therapy (CBT) and motivational enhancement therapy (MET). With CBT, subjects are counselled before taking any drugs, and their therapist takes the time to clearly define the goals of the subject and help them get what they want from their psychedelic experience. For instance, a therapist helping a heavy smoker to quit cigarettes would be sure to define the smoker’s desire to quit their habit. While under the influence of drugs, the subject would then be reminded of their desire to quit smoking, and CBT would serve the purpose of replacing behavior patterns like smoking with something else (Garcia-Romeu, Albert, Richards). MBT is another form of therapy that is used during psychedelic therapy sessions, and it is slightly different from CBT in that it attempts to look at patients’ motivations to better themselves (like wanting to quit drinking). By using MBT in sessions, psychedelic therapists can reinforce patients’ motivations to quit, taking advantage of the psychedelic state to reach deeper into the subject and empower them to make a change in their lives (Garcia-Romeu, Albert, Richards).

Psychedelic Therapy (from https://www.kcrw.com/culture/shows/life-examined/ancient-greece-psychedelics-mental-health-therapy/psilocybin-psychedelic-therapy-mental-health)

Since psychedelics have the potential to be immensely powerful mind-altering substances, it is essential that they are administered with the help of professionals. When people have adverse reactions to psychedelics, it is often the case that they are simply not in the proper state of mind nor in the proper environment to be taking said drugs. The stories of people walking out of 4th story windows on LSD and then dying upon hitting the ground are common tales meant to deter people from using psychedelics, and for the longest time they helped control Americans’ opinions on psychedelic drugs. Of course, these stories could be easily exaggerated or flat-out untrue, but the point still stands that psychedelics are not to be taken lightly. Because psychedelic experiences are very responsive to the emotions of those who take them, any sort of anxiety could manifest itself in a “bad trip” that could lead to a very uncomfortable experience. By legalizing psychedelic therapy, those interested in using psychedelics as a method of treatment would be granted access to trusted professionals who would be tasked with ensuring the comfort of their patients, greatly reducing the chance of enduring a bad trip. In fact, one of the only major downsides of psychedelic use is the potential to develop disorders like hallucinogen persisting perception disorder (HPPD). HPPD is a disorder that is very rare but still a possibility, and it mainly manifests itself in users seeing strange visual distortions long after using a psychedelic. As of 2016, there were no reported cases of HPPD among over 2000 participants in contemporary psychedelic trials, which could suggest that the composed atmosphere of modern psychedelic therapy helps lessen/prevent the unwanted side effects of psychedelics (Aday, Jacob S., et al.). Of course, more research is needed to confirm this suspicion, but results so far have suggested that proper therapy can circumvent some of the less-desirable side effects of psychedelic use.

Photo by Ehimetalor Akhere Unuabona on Unsplash

Despite all of this research, there are currently 0 clinics in the United States that are authorized to administer psychedelic therapy to the general public (except for ketamine). While attitudes on psychedelics today are generally positive, their inaccessibility as (legal) therapeutic tools can be traced back directly to the US government, with past presidents prioritizing politics over the health of their citizens.

Research surrounding psychedelics began around 1874 in the United States, with it being accepted like alcohol or cigarettes up until about 1962. In the 1950s and 60s especially, psychedelic research made huge strides and researchers were beginning to grasp the importance of using psychedelics in a medical context. Despite advancements in the field, amendments to the 1938 Food, Drug, and Cosmetics Act were passed in 1962, forcing psychedelics to have to go through the FDA before being able to be used in clinical studies. As a result of this new obstacle, many researchers were left without a supply of psilocybin (the main compound that they were testing). From there, it only got more restrictive, with the Drug Abuse Control Amendments of 1965 stating that “no person may sell, manufacture, compound, or process any depressant, stimulant, or drug with a ‘hallucinogenic effect,’ except those with special permits for certain restricted uses” (Marlan 2019). Just 5 years later, Congress would go on to pass the Controlled Substances Act, which placed many drugs into categories known as schedules, with many psychedelic drugs being categorized as schedule 1 drugs (associated with the highest level of punishment for possession). Though it is true that psychedelics can produce some adverse effects (especially if not administered in proper amounts or under safe conditions), many of these laws were mainly put into place in order to destroy the counterculture movement of the 1960s and to subjugate racial minorities. With the use of psychedelics by many young Americans during the Vietnam War, their quick adoption of “peace and love” attitudes led to them not believing in the cause. In the words of journalist Don Lattin: “chemically induced compassion did not help the military-industrial complex persuade us that it was a good idea to send hundreds of thousands of young men to the other side of the world to slaughter people in Southeast Asia” (Marlan 2019). As for racial minorities, black people specifically were also targeted by the war on drugs, with Nixon’s top advisor admitting that “by getting the public to associate hippies with marijuana [and psychedelics] and blacks with heroin, and then criminalizing both heavily, we could disrupt those communities. We could arrest their leaders, raid their homes, break up their meetings, and vilify them night after night on the evening news” (Marlan 2019).