Over the last 10 years there has been a dramatic surge in interest in psychedelics and other drugs in psychiatry. If you are interested in this area, I have tried to write a potted summary.
MDMA/ecstasy was commonly used at raves in the 1990s. It has been widely take and anyone who has taken it will tell you it is not a magic cure. It reduces the fear response and increases emotional empathy, towards yourself, as well as others.
It is being studied in PTSD treatment, to enable people to approach their trauma with a sense of self-love.
It is really important to understand that MDMA enhances the response to therapy but is not the treatment in itself. The therapy is what counts, MDMA allows you to face your trauma. The Multidisciplinary Association for Psychedelic Studies (MAPS) has conducted several Phase 3 clinical trials of MDMA-assisted therapy for PTSD, showing that this treatment can lead to significant symptom reduction, even in people who have not responded to traditional therapies.
There are two main potential problems with MDMA. Firstly you are opening up your unconscious mind and making yourself highly suggestible to your therapist. You need to consider who you are letting in there. In the US there have already been accusations of manipulation and sexual abuse from therapists. Even with the best intentions therapists can make mistakes and you can be left with distressing thoughts from off the cuff comments.
Secondly it is very very expensive. In my part of the world that means $30 000. No one has that kind of money where I work, so there has arisen a whole industry based on do-it -yourself. People are buying drugs online and taking them with unqualified experts, which can be disastrous.
Traditional psychedelics include psilocybin (the active compound in "magic mushrooms") and LSD. They are known for their ability to alter perception, mood, and cognitive processes. These substances can induce a state of altered consciousness, visual and auditory hallucinations, a sense of unity with the environment, and deep introspective experiences.
Studies have shown that psilocybin, when administered in a controlled, therapeutic setting, can lead to significant and lasting reductions in symptoms of depression and anxiety. A ground-breaking 2016 study at Johns Hopkins University found that patients with cancer-related anxiety and depression experienced substantial improvements in their mental health following a single dose of psilocybin. These effects persisted for months, with many participants reporting increased well-being and life satisfaction. Psychedelics are thought to promote neuroplasticity—the brain’s ability to form new neural connections—potentially enabling lasting changes in mood and behaviour.
But problems abound. Firstly bad trips can be appalling and the distress is just as persistent as a good trip. You have less control over the quality of your experience than you might like to think, although modulating the environment of the trip is sensible. Keep it as calm and positive as possible. The do-it-yourself industry is really into this area as well. Try to remember that online potions could contain anything.
Secondly the psychedelics can cause persistent visual hallucinations (Hallucinogen Persisting Perception Disorder HPPD) which may be untreatable and intrude into everyday function. Imagine being at a business meeting and suddenly seeing the world shift into whirling colours and shapes. Studies cite an incidence of 4-7% which is significant.
Many people using these substances have told me they are not addictive as they have taken higher and higher doses bought off the internet. They are not as addictive as nicotine but addiction is a tricky beast and can be psychological as well as physical. Needing more and more to get the same hit is a real problem.
Micro-dosing magic mushrooms is a popular pastime in my neck of the woods. People get the mushrooms, put them in the freezer and wack off a bit to chew when feeling low. Remember that the mushrooms can vary enormously in potency and you have no control over what you are taking. There is very little research evidence in this area particularly controlled trials, however psychiatrists are starting to look at this area closely.
So my advice at this stage is caution, caution, caution. But it is being investigated and may show promise. It will be restricted to wealthy individuals because of cost at least in the initial period but beware the internet. If you can get in a trial – great!
Lastly it is unlikely there is a simple answer to mental health challenges. It will always involve psychotherapy, exercise, healthy food etc. It is complex to be well.
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