Psychedelics for Psych?
How Psilocybin Can Possibly Treat Depression and Anxiety
Unless you’ve been living under a rock, you’ve probably heard how the compound psilocybin (the hallucinogen found in magic mushrooms) has been used to treat psychological disorders.
An article earlier this year in the Seattle Times (read the full article here) explained that:
Psilocybe azurescens and Psilocybe cyanescens are two psychedelic varieties that grow in damp, wooded areas in Washington and Oregon and produce visual hallucinations when ingested. These mushrooms — while freely growing and with a centuries long record of use among Indigenous people — are also Schedule I controlled substances: illegal drugs up there with heroin and marijuana, according to the federal government.
Denver, CO was the first city to allow the use of magic mushrooms in an ordinance enacted in 2019 — this ordinance didn’t really ‘legalize’ the use of mushrooms but it prevents money from being spent to prosecute the offense for adults over 21 years of age. (FYI it remains illegal in Colorado as a whole and is prosecutable). The following month, Oakland, CA followed suit (along with peyote). Other cities have followed suit but it wasn’t until 2020 that Oregon became the first STATE to do so. As per Julia Naftulin in Business Insider:
Residents voted to pass Measure 109 on Election Day, allowing anyone access to the substance for therapeutic uses, even without a doctor’s note. For anyone who isn’t using the substance under the guidance of a therapist or other licensed facilitator, possessing psilocybin would still be considered illegal.
So what’s the deal with the mushrooms?
Roland Griffiths, Ph.D. was one of the first researchers in this area. He is on the staff of Johns Hopkins School of Medicine.
In a small study of adults with major depression, Johns Hopkins Medicine researchers report that two doses of the psychedelic substance psilocybin, given with supportive psychotherapy, produced rapid and large reductions in depressive symptoms, with most participants showing improvement and half of study participants achieving remission through the four-week follow-up.
Here’s Dr. Griffiths talking about his research:
and this is one of the participants talking about what it was like to participate in the study:
Why you might not want to jump on this bandwagon so soon…
(and certainly not without the appropriate supervision and clinical setting)
- There is no wisdom in drugs — I’ve said this before (and I did steal it from one of my graduate school professors) and I’ll keep saying it. Changing your chemistry does not necessarily do anything to change the things that got your chemistry to the state it was in. Sometimes it is necessary to make the biological change to allow behavioral and cognitive changes to take place (because when you have severe depression it literally is very difficult to make those changes). However, when you rely on medication without making behavioral/cognitive changes, you are setting yourself up to need the substance (whether it be mushrooms or a standard antidepressant) on an ongoing basis. Wouldn’t it be better to become more active, engaged with others, challenge your negative thinking to instead not need these external things? To me this is like deciding to just eat whatever you want if you have diabetes and take extra insulin — it just doesn’t make logical sense.
2. The participants were in highly controlled settings — Just as with any research, the lab setting does not always equate to what you would find in vivo. In this research, the participants were supported by a team of professionals in a highly standardized setting. They were on a comfortable couch, with professionals on hand to set up their expectations and to manage any discomfort, with soothing music playing, etc. This is not necessarily what you’d get if you decide to try this on your own. In fact, it has been noted on psychiatry.com that:
Bringing these findings together, classic psychedelic therapy for suicidality appears to be a promising avenue for further investigation. Despite this, the research and anecdotes about increased suicidality and other self-harm attributed to psychedelics, though evidently rare, remain a critical concern for this work to address. It is not known what factors might moderate if a suicidal individual benefits from a classic psychedelic treatment, or if it might lead to worsening symptoms.( — for full commentary click here)
3. Relatedly, at least as far as I know, they weren’t able to parse out the nonspecific treatment effects present — This might sound like my science training coming back but it’s important. Extraneous variables have not been accounted for. For example, in this study, the environment itself was unusual for the participants. Based on the description and the videos I’ve seen of it (not just the one above), the attention being paid to the participants during their treatment was intense. I don’t know about you, but even walking into a spa like environment brings on a sense of peace. We don’t really know about the participants involved in this study, but I highly doubt that this was usual for them — nor was having various people attentive to their emotions and needs for a two hour span likely to be typical. This honestly reminds me of a lighbulb study. It’s been years since I was first introduced to this study but I will paraphrase it as best I can here: Essentially a factory decided that they wanted to see if different levels of illumination would change the productivity of workers. So they changed all of the lightbulbs in their factory to something considerably stronger than what they had been using. Low and behold, productivity soared, they congratulated themselves and didn’t think much else about it aside from “job well done.” But the story didn’t end there, over time, productivity again declined and it was back to the level that was happening before the bulbs were ever changed. Someone suggested that the lights might be too bright so they dimmed them again and presto, productivity soared — at least for a time. What was really happening here is that the workers knew something was up and someone was paying attention to them so they were kicking it into gear when they noticed their surroundings change. This is like the equivalent of putting your heads down and getting to work when your boss is walking by. However, over time they habituated to the “new” and relaxed back to their usual levels of productivity. This may or may not be what’s going on with the psilocybin study, but so far (at least to my knowledge) they haven’t ruled it out with a good placebo control group (the group in the study were on a waitlist and not receiving the sorts of attention that the experimental group had).
So far the jury is still out (with a lot of studies to come I predict), but magic mushrooms may eventually have some place in treatment for (especially in my opinion) treatment-resistant depression. Have any thoughts about this topic, feel free to comment and start a discussion.