Personal anecdote: 2 years of "research", 2 trips on psilocybe (one month apart), proper set & setting & guide & a lot of talking about it later with a trusted person ... decades-long cripling neurosis/anxiety disorder gone, addictions gone, depression receding, worldview changed, rated as one of the most influential experiences.
Depression is (imho) not to be healed with "here, swallow a pill", structural changes to one's life are necessary. Psychedelics can help to show the way, not to solve it.
From personal experience, I think one of the reasons psychedelics can help with depression is that when you are severely depressed, it feels permanent, like nothing will ever get better or even meaningfully different.
But then you have a psychedelic experience, and for a brief moment, things are very much different. And if the experience is even slightly positive, it reminds you that it’s still possible to feel something good, and that glimmer of hope can chip away at your entrenched fatalism.
That describes my outlook after taking MDMA... anxiety has been a constant through my life, and molly showed me what it was like to not feel it. Ever since I have used that as a benchmark in my own quest for healing, and the closer I can get to that feeling without assistance, the further along I know that I am in my journey.
Of course, it's a nice to visit with molly every once in a while. But the real progress is in how I reframe life. Too bad that finding quality MDMA nowadays is so tough.
>anxiety has been a constant through my life, and molly showed me what it was like to not feel it
This is so interesting to read, because I had exactly the same experience - primarily with social anxiety.
I sat on a hill at a festival with a friend after taking MDMA for the first time and imagined just walking up to a food van and ordering food… and didn’t feel the automatic anxious reaction.
It showed me what was there, and what life could feel like without it. I found that it started a positive feedback loop afterwards, where I’d do something social and automatically steel myself against the incoming anxiety… only to feel none! It was absolutely beautiful.
I've never done psychedelics (at least not the kind that are experimentally used for mental health; I did Molly once but fuck that comedown), but I spent years depressed, anxious, guilty, etc. and then I started using weed. I went a little TOO hard for a while, because it was the first time in years I'd had my body and brain giving me primarily GOOD feelings.
Which led to me ending up in therapy and actually addressing my PTSD, because then I knew that feeling shitty wasn't just how I was programmed to be biologically because something was Wrong with me.
The 'too hard for a while' is probably why these things should be done under medical supervision. I basically spent 8 months blazed out of my mind.
I mean mental health is never just one thing; in your case, weed was a gateway drug to therapy (I'm simplifying to try and keep things light). PTSD and C-PTSD are underdiagnosed or ignored a lot, I think, but there are treaments available. One is EMDR [0] that, anecdotally, was very effective in treating my GF's cptsd.
And also: wait what? It’s possible to reverse blindness?? I’m totally ignorant on the subject but I’d b interested to know more if you care to elaborate.
I had really bad strabismus plus vision bad enough that it wasn't possible to correct my vision before I had surgery to fix my eye muscles. Since that didn't happen until I was 4, I spent my first 4 years with vision so bad my dominant eye is classified as 'can see movement' and my non-dominant eye is 'can see light'. Then I had surgery and they could correct my vision.
I'm not sure why it wasn't done earlier.
I have some visual issues related to this early period. I'm terrible with crowding [0], have no depth perception, have trouble with facial feature recognition (I recognize my loved ones based on their auditory cues), rely more on other senses than sight, etc.
My life can basically be broken down into periods based on what medical oddity I dealt with, looking back. Yikes.
Giving general anesthesia to babies/toddlers can be tricky, so that might be a key reason. Our two year old recently went under general anesthesia, and luckily things started going wrong early enough that they could abort and back out without doing any serious damage. Scary situation though.
Then there is also this: Classical psychedelics are profoundly immunomodulating. All serotonin receptor 5-HT2A activators (agonists) reduce systemic inflammation. Generally in very beneficial ways.
Systemic inflammation and depression are intimately related.
(Of course, care should be taken not to suppress inflammation when it is needed. People probably ought not to take psychedelics when fighting off an infection.)
That fits with the analogy that I use, that psychedelics are like a helicopter - they allow you to zoom out and realize that there is a path to the top of the mountain (assuming you're stuck/walking in circles). But once the effects wear off it's up to you to remember where to go
I'm writing a book about exactly the point you're getting at: that there is no better questions that get at the experience of being human than our ability to ask ourselves the following two questions:
(1) Where am I? / What the heck is going on?
(2) Where am I going to go next? / What am I going to do about it?
Sorry if this seems overly esoteric, but I really appreciate seeing applications of my thesis in the wild. Cheers
This is exactly why anti-depressants and anti-anxiety medications are prescribed - to help people realise what an "undepressed" state of mind feels like. Even with "talk" therapies, like Cognitive Therapy (that have proven to be as effective as anti-depressants, and actually better than it in the long term), psychiatrists still prefer to combine it and start treatment with such medications as it really helps you to understand how different you think and feel when you are not depressed.
Please note that if you are depressed it is better to start with well researched medications like anti-depressants (whose working are still not fully understood) than psychedelics. To be safe, consider shock therapy or psychedelics only as a last resort, after you have exhausted both anti-depressants and Cognitive Therapy under a good therapist and are really desperate.
> This is exactly why anti-depressants and anti-anxiety medications are prescribed - to help people realise what an "undepressed" state of mind feels like.
This is so real it hurts, I had two doctors diagnose me with severe anxiety without telling me — like they just put it in my chart thinking I already knew. And then one day I did one of those depression anxiety screens and failed so hard genuinely believing it was normal my doc, who I guess assumed it was managed, was like, “hey have you ever taken anything for mood.” And I was like “no, why would I do that?”
For literally the first time in my life I felt what “not anxious” feels like. I was in disbelief for months bracing myself for the pangs of anxiety I got in response to different triggers and… they just never came.
I am genuinely interested in this subject - Would you mind sharing what you were prescribed and if you experienced any side-effects? Are you taking it long-term? If not, how do you feel and cope after stopping the medication?
But can't that experience be had under different circumstances - like a meditation retreat, or travel to a completely new country?
Meditation practice under a guide, can rewire your brain much like psychedelics.
Not to diss on psychedelics - but there is way too much hype about it being a miracle cure for all your psychological ailments.
Psychedelics are wonderful but dangerous and to be used under the right set and setting, a bad trip can induce psychosis and my fear is people with existing mental ailments will start popping psychedelics - not paying much attention and end up in a far worse place than they started.
The same is true of some existing meds and even meditation is known to trigger psychosis and anxiety. Most antidepressants come with a warning that they may trigger suicide
This absolutely happened to me, except with a physician's prescription of Xanax rather than psychadelics. I was severely depressed, experiencing daily panic attacks, etc.
I stopped taking them pretty quickly because I'm prone to addiction, but your experience mirrored mine completely.
Coke and heroin form a stronger dependency faster, and then you’ve created a new & very distracting problem.
Weed dependency is understated by many, but it typically takes longer to form a strong dependency, and the withdrawal symptoms are usually much milder than the other two.
So, I agree that your logic could apply in some cases… in the more typical case (like op’s) of someone stumbling into this experiential eye-opening organically, if it happens via coke/heroin it’ll probably be a much rougher road.
Edit: Probably why psychedelics work well… the experience is very different but has very weak habit-forming pull (it’s not easy to do casually because it’s an ordeal)
Well, if the reason Heroin doesn't help depression is because the body quickly adjusts to it and then you end up needing to use it just to maintain your previous baseline. If it didn't cause chemical dependence and retained its initial efficacy long term it would probably be extremely valuable.
Cocaine doesn't really help because it just dramatically increases the intensity and energy of your current state, it doesn't really alter your thinking in a way that could introduce positive thoughts not already present.
If psychedelics had similarly severe downsides then they would likely not be effective at aiding depression in the long run, but fortunately it has relatively few issues with careful use.
Various stimulants can also have a different effect, depending on one's neurotransmitter balance. For example, Adderall is generally speed to someone without a dopamine deficiency. I would imagine even crystal meth would be far less harmful with a dopamine deficiency than without (although there are still the issues with purity and dose size that would make it inadvisable to experiment).
The day we can discover what someone's exact neurotransmitter balance is, I think we'll learn a huge amount about how the brain works via that mechanism. I think if we ever reach that day, we'll also learn that there is no such thing as "neurotypical"
Having done none of these, perhaps it's something about the quality of the experience? E.g. perhaps when you do cocaine/heroin, the quality of the high is so clearly unusual and extreme that you could never mistake it for being an accurate representation of "how things could actually be" without depression/anxiety? And maybe shrooms etc aren't nearly as extreme?
Are there any examples? These drugs are very dangerous and addictive but that doesn’t mean nobody anywhere has ever had a positive long term outcome from trying them. It just means that statistically a negative outcome is a lot more likely. There are always a few outliers.
I take your point, but I think the distinction is that some drugs can make you feel euphoric, but psychedelics affect you on a deeper, psychological level. You're not just feeling an absence of pain or a rush of pleasure (though that can happen, too), you're also thinking in a different mindset.
On high dose psychedelic, “you” are not thinking in a different mindset. The current “you” is completely obliterated. This is the difference between psychedelics and other drugs.
I'm confused how your first sentence appears to say that you completely solved your depression, addictions, anxiety, neurosis and worldview with two trips, and your second sentence says that depression can't be solved with a pill. These seem to be at odds, unless I'm missing something.
Even if you take psychedelics it won’t magically fix your problems bc most peoples problems are systemic. The system must change but the psychedelics allow the user to see the value in the change.
"A trip" is more than just a pill - set & setting are just as important. And what it gives you is an alternative perspective on your own life, which you still have to convert into actual change in your mindset/life afterwards.
I wonder if the same effects can be attained by someone who has used psychedelics recreationionally their entire life, from say 16 onward. is it the external guidance during the experience that really makes the difference? or is a life of experiences responsible for one not having anxiety or depression on those levels
It's difficult to explain if you haven't had that kind of experience yourself, but one way to describe it is that psychedelics (some more so than others) open up a window that allows for change. You are no longer stuck in your old ways of thinking that you took for granted.
But the experiences themselves don't change you. You still need to put in the work to make the changes. You can certainly do this without a guide. But if you take these drugs recreationally without such intentions and without putting in hard work pre- and post-session, nothing much is going to happen in the long term. A guide will help you to get the most out of the experience (while also helping with trip safety).
It's not about whether you use psychedlics or not, it's about how you take them.
"It's not about whether you use psychedlics or not"
"without putting in hard work pre- and post-session, nothing much is going to happen in the long term"
Sounds a lot like cognitive bias to me. It's ultimately a placebo if you still need to put the work in. Ergo, you could achieve the same results even without taking it. It's attributing personal growth to a drug rather than to your own willpower to do something.
>Sounds a lot like cognitive bias to me. It's ultimately a placebo if you still need to put the work in.
If you take a doping pill to run faster, you still need to train and to expand heavy personal effort during the race. Is the doping pill "placebo"?
Heck, if you have leg surgery after an accident, depending on the type of surgery, you often need (and are advised by the doctor, and asked to take it up with physiotherapist and such) to put in personal work and exercize properly for months, to be able to walk and regain use of your leg again. Is the leg surgery placebo?
Or how about a debugger. It wont solve your problem automatically. You still need to write the program yourself, to look into different places, and to know how to find a bug etc. Is the debugger a placebo?
Needing to put personal work to get a result is not what's the distinction between a placebo and a drug.
A placebo is not that which is only effective when combined with additional personal effort (that can hold for any regular drug).
A placebo is a neutral drug that does nothing at all itself (it's just water, or some neutral powder or saline solution, etc) and it's effectiveness is all about the belief that it helps.
Besides, psychedelics (even assuming what they do have no bearing at all to getting better from depression, etc, an assumption with which research disagrees), have huge immediate effects on mental state when taken. So they're not neutral in the way a placebo is even on that account.
Logical fallacy of composition/division. My comment isn't being applied to all these other scenarios, it is being applied to the topic at hand—psychedelics.
There is no logical fallacy. Your original comment is just wrong. If psychedelics improve the outcome, they are still worthwhile even if the therapy is still needed and not a placebo. You are just misplacing the bar. The analogy to performance enhancing drugs is actually quite good.
There absolutely is. They held up countless irrelevant examples that have nothing to do with psychedelics, thus casting a wide net.
My original comment is my opinion. When there's further studies done rather than anecdotal rubbish pertaining to woowoo in the comments, then I'll reconsider my stance.
The logic of the comment should hold for any analogous scenario.
You either have to argue why one or all of the above analogies doesn't hold (what element is crucially different, so that the same counter-argument can't apply to your psychedelics argument), or to argue that the points made for those other things are wrong.
Except if you believe that you've discovered some unique logic that only applies to a single specific case.
I don't have to argue, period. An analogy is unnecessary. We are talking about psychedelics, not doping in sports.
My opinion: people are likely commonly capable of working through things without the use of psychedelics, and we are crediting the substance and not the human being.
I'm not anti-drugs by any stretch, just feel like a lot more research needs to be done before we can start stating things like they're facts. Can you otherwise disprove that it wasn't placebo effect and the individual wouldn't have otherwise figured it out without a placebo or with a sugar pill he was told was a microdose of psychedelics that would unlock the secrets of the universe?
In fact I'd go a step further and say that it's not only difficult but impossible to assess since it's pretty easy for the test subject to discern whether he was given a placebo or not, especially considering that the benefits are suspected to come from the induced experience itself and not the drug as a substance in isolation.
You can't control if exercising is placebo either, can you? But the consensus is that it's physically and mentally beneficial. I don't think controlling for placebo is of great use here although it obviously has to be taken into account.
I’m not sure I agree, because people might put in the hard work without the psychedelic and not experience the benefit.
Michael Pollan’s “How to change your mind” talks about psychedelic studies where the more effective, longer lasting changes are seen by the people who had more “mystic” experiences.
It’s not just about good intentions, or just taking psychedelics, but seemingly priming your mind to use the psychedelics to (temporarily) change fundamental thought patterns.
By that definition, getting therapy is also a placebo. You could go to therapy "recreationally" without wanting to get better or work on yourself. But that's not going to help you. You still need to put in work. Does that make therapy a placebo?
This doesn't really make any sense, just because you still need to put in the effort doesn't mean it isn't highly affective at making it much easier for an individual to direct that effort positively.
> Sounds a lot like cognitive bias to me. It's ultimately a placebo if you still need to put the work in.
Say without drugs 20% of the depressed population gets better, and with drugs 80% of them. Why would you call this 'placebo' (which is an entirely different topic), and from this word deduce that it is bad? Nonsense.
Placebo? Situation changing day-to-day? Diet? All kinds of variables. But in this particular scenario, likely placebo.
If I tell someone that a tablet will make them able to do something and it's just a sugar pill, they'll likely be able to do it. The blocking factor is usually a confidence issue.
Psychedelics, LSD in particular, see their major use being a party drug. Coming from a personal experience, many people decide the "trip" they want to go on way before the trip starts. I am pretty sure there are non-zero amount of people who regularly take psychedelics, but have never been on that kind of "trips" that instead of going deep into your own mind, they just enjoy EDM, a party, perhaps a hike, paint something, watch a movie, play some sports outside, play video games, etc.
Edit: I wanted to amend this to say I don’t think people should use psychedelics regularly, which I think my original comment below might imply. Lots of downsides to regular use, occasional (every couple years) seems to have little risk and some benefits in my experience. Original text below is unedited.
I dunno, if you regularly use lsd or mushrooms, you probably have had a “wow that was more than I wanted” experience, that means you had complete ego loss, had the veil of reality completely pulled back so you could “see” the arbitrariness of society and human interactions. Your embarrassing actions you have been deluding yourself about come crashing down around you. You sober up and you rationalize some of it away but there’s a big nagging thing in the back of your mind screaming “maybe you should stop doing ____”.
At least this has happened to me on a couple of occasions and has led to me apologizing to people, changing my default behaviors, etc. I am not a super introspective person so the kick in the head that psychedelics occasionally provide has allowed for some personality changes that were necessary and good.
As an adult I now recognize that these experiences could be beneficial as therapy with the right person to guide you through it, that most people probably don’t get the full benefit these occasional experiences provide by themselves. I didn’t think this while young and just partying (though did have a bit of woo woo collective consciousness mind expansion mindset). Anything other than the recreation aspects of it were me trying to justify why it was ok, and getting high a lot is generally not ok. I actually sobered up for rest of my life after a strong mushroom trip left me thinking I was wasting my life and going down the wrong path.
In short, there’s meat here, but of course with all these things there will be people riding a fad and making a buck, but bad usually tags along with the good in some amount.
Not sure, but I have a friend who has plenty of experience with psychedelics, and he just had his first session of psychedelic therapy with ketamine (done by a medical professional trained to do it). After the session he said it was very different to anything he had done before and that he felt he made a ton of progress.
My guess is that the intention that you set before “the trip”, really impacts the experience and hence the results. As well as having a professional guide/sitter that knows how to guide you and create a therapeutic setting.
Buddy of mine recently did a two session psychedelic ketamine treatment with intensive pre and post-support therapy. The changes in his negative habits and ruminative thoughts were impressive. He had done LSD a few times, but he said the ketamine was a much more “safe” feeling experience.
I’ve been considering it myself, despite not being depressed or anxious, just to see what channels of growth it might open up.
> is it the external guidance during the experience that really makes the difference?
That's what psychiatrists using psycho active drugs say: without proper stage setting and guidance, the experience can be terrifying and traumatic in itself. Remember, not everybody has good trips, especially not people dealing with depression and trauma.
People confuse simple with easy. How to quit smoking? Simple. Don’t smoke. Easy? Not so much. Many things require mental willpower to make it happen.
Feels like those kind of therapies help make that happen. I know one person who was borderline suicidal and this kind of therapy helped her move life into a nice direction.
I'm glad for you, but the researchers involved in this story did an actual RCT with a cohort of patients and measured the effect, and the benefit of psilocybin was shown to be marginal. The study is linked in the first paragraph of the story.
Almost all RCTs involving depression throw a bunch of people diagnosed with "depression", but suffering a variety of conditions, all given that label, in a tank together. The treatment may help a few, harm others, and have no effect on the rest, and the treatment is then labeled "ineffective".
RCTs depend for validity absolutely upon precise, accurate diagnosis for validity. Bad diagnostics => meaningless results. RCTs are not magic. They can be as wrong as anything stupidly performed.
The larger-scale evidence is of much lower quality than an RCT.
I don't think the study is dispositive, but it's strong evidence, much stronger than a message board axiomatic derivation of why psilocybin should work.
I'm glad you had a good outcome. It's difficult to relate to your experience from the outside. Most of the time people talk about these experiences, they are vague and difficult to understand.
Sometimes in poor cases it can sound like gym-bro science where I should totally pop a supplement because this guy had a good experience on it and trust me bro.
I would love to know more specifically about the subjective experience is like, so we can pick out pieces that have a greater meaning to collective understanding.
Depression is an umbrella term for one experience caused by many, many different problems. Some chronic medical situations are going to allow your body to be re-depressed after a positive drug experience, so being able to see subjective reports in detail can allow the public to decide if it's worth doing a psychedelic treatment.
Not to mention we should probably map this experience out to slowly cut down on the same speculative questions every time drugs come up; about the divine/psychological/medical nature of a drug trip.
> Most of the time people talk about these experiences, they are vague and difficult to understand.
I’ve taken LSD a few times. When people ask about it I like to say that the experience is exactly like how people describe it, but nothing like what I expected. Trying to “map it out” in complete detail would be like trying to map out sex. I’m not convinced I can fully explain my experience, and even if I did, I bet your experience would be different from mine.
Maybe the best description I can give is that your mind stops suppressing a lot of thoughts. When I hear music on LSD my brain turns the music into a whole planet that looks like that music sounds. When I look in the mirror I see myself as a fey creature full of animus and life. The things that my sober self stresses about seem ridiculous - like the fears of a 5 year old. And I still feel trapped by my fears at the same time.
It’s a very unique experience. As Sam Harris says, if you take enough LSD it’s impossible to be bored.
> Trying to “map it out” in complete detail would be like trying to map out sex. I’m not convinced I can fully explain my experience, and even if I did, I bet your experience would be different from mine.
That's exactly right. I think of it like this: you've spent a lifetime building and entrenching filters around your perceptions and thought patterns to react to them. They persist because in evolutionary terms you being still alive means your behaviour is "adaptive" in a sense, irrespective of how you actually feel.
Psychedelics temporarily tear down most of those filters and
disrupt those thought patterns, allowing you to perceive things in very novel ways and react to hem very differently.
Nobody's thought patterns or filters are going to be the same and so nobody's psychedelic experience will be the same even though many of them will have similarities (we are the same species in the same culture after all).
It can be described. But its like describing sex, dreaming, music, the taste of delicious food or the feeling of grief.
Words are no substitute. The experience itself can't be expressed in language. Language can refer to it, but without a common reference point, language will always fall short.
> A fey creature full of animus and life, may be intense and full of subjective richness for you, we have seen this imagery before in pagan worship.
So? The imagery isn't the interesting part. The subjective richness is, and the imagery denuded of its subjective richness is just some boring pigments. I've seen that imagery before, but that didn't prepare me at all for my trip.
The imagery relates to the experience like a postcard relates to New York City.
If I had never felt pain before, do you think you could explain it to me? Do you think you could teach what the color blue looks like to someone who is colorblind? I don't think you can do it - but by all means, prove me wrong :)
I agree with what you say, but my point has been washed out. A description, no matter how poor gives us insight into the change and some subjective experience can be mapped to others.
Iron deficiency causes your leg to bounce.
CBT causes people to practice second order thinking.
Faith causes people to experience grace.
Your subjective experience has overlap with other phenomena, a description of the journey allows it to be mapped. People with medical grade depression can then decide if taking LSD is likely to resolve their problems.
Playing the subjective-definition game is entry level stuff. There is real suffering that could be allieviated here with a little more insight and mapping.
the second time it cured me from depression, the healing process happened in around 10 minutes where i was taken from the worst to the best. felt like 100's of simultaneous orgasms and was in shock for the next three days.
i have read a single take can increase neuronal connectivity by 10% in rodents, which is not surprising after that experience.
I'd like to know this as well. I think this is one of the biggest hurdles to a first time user: If you're anxious or depressed, you're by definition not in a good "set". And with psychedelic therapists being rare as unicorns where to find that trip-sitter who isn't just a "That's groovy, man" weirdo that will shape your trip (and your malleable brain) into the bog-standard one with everything experience.
Is there a book you recommend for getting started with research? There is enough noise in this space that I find "search the internet" to be...difficult.
> Depression is (imho) not to be healed with "here, swallow a pill", structural changes to one's life are necessary.
Clinical depression rarely has anything to do with what you've done or events in the outside world.
Psychiatry has settled on treating depression with two strokes, a cocktail which is a chemical antidepressent, and a chemical stabilizer, and they expect you to take these daily and stay on it for the rest of your life. I have no evidence for it, but I assume this is some pharmaceutical company's agenda, to keep you a customer for the rest of your life. While it works, chemicals always have side-effects, and with so much exposure, daily, they are bound to compound, making it more difficult to consume.
Therapy alone can cure depression, it just takes a lot of time and effort. I don't think it is possible talk therapy could ever make things worse, but it just doesn't work fast enough. Still, recommended.
But I have discovered a way to cure depression relatively quickly in two ways.
First, chemically, but without a life sentence. I have discovered a substance that will cure depression overnight, not unlike an aspirin cures a headache. You get headaches, too? How would you feel about being told you need to take a daily medication for the rest of your life to cure it? No, one dose will do. The drug is unregulated, and is available OTC in cough gels. You won't find this in any PDR, but depending on the patient's weight, say for a 160lb. man, 900mg of dextromethorphan will cure depression overnight, and it has been for some time in many clinical studies exploring its potential as a fast acting treatment for treatment-resistant depression. You take the large dose with a pepsid, and go to bed, wake the next day depression free, and its depression-killing effects can last up to a year. It is an old and safe drug, and the lethal overdose is estimated, because it is unknown. Though it is an OTC remedy for cough, dextromethorphan has already been approved for treatment of emotional incontinence, which could be seen as sort of a cousin of depression.
The other cure, chemical free, is sunlight. Light in the eyes regulates mood. Not enough light will eventually cause depression. Too much light will cause mania (as we should have suspected from the exploits of Florida Man). Put enough sunlight in your eyes, it will cure your clinical depression. If daylight is not enough, get an artificial light that is an accurate simulator of natural sunlight, which is probably not LED, due to too much blue light, which also damages the eye and slowly blinds you, but you can't go wrong with halogen. Point it at your eyes. You can even close your eyes, light goes right through the eye lids and is still effective at fighting depression.
> Clinical depression rarely has anything to do with what you've done or events in the outside world.
Do you have any evidence for this? This contradicts some studies I've seen on the matter, for example, one where 75% of chronically depressed patients reported clinically significant histories of childhood trauma.[1]
Not to mention that your second cure, sunlight, is literally an example of things we've done or events in the outside world (i.e. time spent outside).
> This contradicts some studies I've seen on the matter, for example, one where 75% of chronically depressed patients reported clinically significant histories of childhood trauma
There is no contradiction here; the correlation you think you see is not causation. Generally, if there is an external trigger for depression, it is more immediate than having an abusive childhood decades ago, such as recently losing a loved one, or recently getting fired, or recently being physically abused. But in essence, our bodies make us feel the way we do, and more specifically, the brain and its electrical and chemical processes, no matter what external trigger we may want to point to for a cause, the reaction is fundamentally an internal process.
> Not to mention that your second cure, sunlight, is literally an example of things we've done or events in the outside world (i.e. time spent outside).
We evolved on a rotating planet. Daylight regulates mood as it does circadian rhythms. Sunlight will cure depression; it does not cause depression.
You've linked me to a summary article on depression by Verywellmind. Please provide actual specific evidence for your blanket assertion that depression is very rarely caused by lifestyle or life events. Remember, you've made this assertion as if it were fact, and I'm merely asking you to actually prove it. If you can't, then stop asserting it as if it were fact.
> There is no contradiction here; the correlation you think you see is not causation.
You're doing literally the exact same thing. You're pointing to chemical differences in people with depression and saying "there, that's causation! it has nothing to do with lifestyle or life events!". Consider that the chemical differences that result in depression could be caused by lifestyle factors and life events (and it's undisputed that these things cause chemical differences).
> You misunderstood. Daylight regulates mood. Sunlight can cure depression; it does not cause depression.
No, it's you who misunderstood me. If sunlight cures depression, then our basic actions in life are the issue, i.e. our lifestyle is a low-sunlight lifestyle (something very much in conflict with the environment our brains evolved in).
You simply haven't given enough evidence to back up your confidence on the idea that depression isn't caused by our actions in life, or life events. Yes, brain chemistry is involved, we know that. But our actions and experiences affect our brain chemistry. So you're going to have to work a lot harder than you have to rule it out.
The most I can see you saying is that the start of the causal chain (life events) doesn't matter because you only care about the end of the causal chain (brain chemistry). But this is a wildly different statement to saying that actions or life events aren't part of the causal chain, which you appear to be asserting.
You're basically saying "getting shot doesn't kill you, bleeding to death does!"
Dextromethorphan is now approved by FDA for treating depression. They use much less than 900 mg, though -- 45 mg -- and coupled with 100 mg bupropion, increasing to twice after tolerance is demonstrated.
This just happened a couple weeks ago. There are still ongoing clinical studies which are testing much higher doses for treatment-resistant depression.
Whether the potential of psychedelic therapy has been overstated or not, I think the bubble cannot be "about to burst" for the simple reason it hasn't had the timeframe nor the scale to even be called "a bubble", let alone for it to finish on such an intense note as "bursting".
«Is the psychedelic therapy spark about to fizzle out?» might have been a more apt analogy.
(I have no reason to opine either way regarding the answer)
I’ve dealt with depression for the better half of my life. I tried SSRIs for a decade with moderate results — they definitely helped, but more so in a way where the depression felt manageable than feeling really happy. I went off them at the beginning of the year to experiment with managing the depression other ways: therapy, meditation, exercise.
One day I got to work and noticed that for the first time in a while, I was feeling really happy. In a way where I realized that other times I thought I was happy, I was really just not-too-sad. This was what actual happiness felt like. I was kind of surprised, but thought “wow, I guess the meditation and exercise are finally paying off? It must be that… nothing else has been different recently…”
And then I remembered that I’d tried shrooms for the first time the day before.
So far, trips seem to pretty reliably have this effect for maybe 1-2 weeks. I suspect I’m also seeing some more durable benefits beyond that, but a little harder to be sure.
I don’t take psychedelics. But I’m convinced meditation and exercise can re-wire your brain.
Meditation trains the mind to learn to see when it is falling into maladaptive grooves. It doesn’t prevent it, just a raises awareness. Exercise for me seems to shift the baseline mood forward a bit. Kind of feels like my hormones are in the right place after 25 years.
As someone who's taken plenty of psychedelics, done lots of meditation, and gets tons of exercise, I'd agree that they can all re-wire your brain.
Psychedelics are very different from the other two tho, just like exercise is very different from meditation.
They are all very worthwhile and can help you grow.
Meditation and exercise are best practiced regularly. Psychedelics are best used for singular cathartic events, saved for special occasions.
Psychedelics can change your outlook overnight, while meditation is a more gradual process. Excercise won't really change your outlook palpably, it will just keep you in a better head and body space.
They all can be difficult and rewarding. Its possible to harm yourself with any of them, but generally you come out well ahead if you do them responsibly. They can all make you a better person.
I think exercise is closer to improving hormonal balances than really “rewiring” your brain, but for sure I notice that it can help a bit. Maybe it does have some “rewiring” effects.
I do think meditation rewires your brain in a way that’s similar to psychedelics (there’s common themes you experience with both, like ego death), but I think it just takes much longer to achieve similar effects. I’d meditated daily for close to a year straight, and while it helped, I didn’t feel like I got anywhere close to how I felt either during tripping (kinda obviously maybe) or after tripping.
That said, while so far psychedelics seem safe, they’re at the very least more logistically “disruptive” than meditation, not to mention social stigmas, difficulty getting them, etc. Meditation does seem like a more sustainable long-term practice.
Some of the above is why I’ve become interested in trying ketamine therapy instead.
Not well versed enough in neurology, but I thought the “wiring” generally referred to which neural pathways are likely to be triggered, which I think is different than just changes in hormones?
I agree, learning to direct focus can shine valuable light onto (often unreflected) self-narrative processing.
Exercise never yielded the benefits I sometimes saw in studies for me but every time I manage to motivate myself to do the healthy/sane/right thing against inner resistance, it leads to a small boost in self-respect that accumulates over time.
This sounds very similar to my experience. I have persistent depression - usually pretty minor, but sometimes worse than others - and social anxiety, and recently started psychedelic therapy with ketamine (I’m still on my SSRIs, which keep things in check, but certainly aren’t a cure).
I didn’t experience any psychedelic effects, but my mood was significantly improved during the weeks after. Anxiety greatly diminished, confidence greatly increased and I for the first time in a few years, I feel like I have a path to conquering my impostor syndrome.
I’m not yet totally comfortable telling my social circle that I’ve been prescribed horse tranquilizers, but I’ve been an immediate convert to the possibilities of these courses of treatment. I can’t say it isn’t psychosomatic or the placebo effect at work, but I’ve been frankly shocked at how quickly it worked for me and how well it has seemed to work.
I have had the same after trips. For a few days I just felt good which is usually rare for me. It was good to experience how feeling good feels. I had almost forgotten.
> It was good to experience how feeling good feels. I had almost forgotten.
Good point.
I wonder what kind of interesting experiments could be designed around psychedelics, skilled counsellors & mediators, and people who've ended up with various "extreme" beliefs, political or otherwise.
Let's not forget, the bubble being about getting these substances back from being banned and considered to dangerous for society to research and otherwise deal with responsibly.
Fits the theory that this is a paid hit piece, obviously without evidential support. Remind me, could there be an industry financially interested to get psychedelics back into the box?
I'm not sure this is necessarily a hit piece. There have been a few high profile cases of psychedelic therapists in countries like Canada being investigated for questionable practice. At the moment we're in a bit of a wild west where the actual procedures surrounding the use of these drugs as treatment are not standardised.
What industry conspiracy are you trying to insinuate? Is it big pharma? Doubt it. Guess who would ultimately own the labs, run the clinical trials, and be first to market with a safe and precise FDA approved antidepressant based on a psychedelic active ingredient. Let's not forget LSD started as a research chemical in a drug r&d lab in Switzerland. Industry never wanted it criminalized.
It's not a good look to rationalise away all bad news as "paid hit piece".
It's not a rare or unheard of thing for an industry to attack solutions that are significantly better than their own (very profitable) solution.
Psychedelics _can_ permanently fix problems - anxiety, alcoholism, depression - that otherwise would make pharma companies huge amounts of money.
LSD is incredibly cheap to manufacture. There's no patent on it. Same with mushrooms and many others.
Now look at how much money those pharma companies made with Lexapro, with Prozac, with Risperdal. Even when they were caught marketing those drugs for unapproved uses, to children; and caught buying academics opinions, they made billions off the stuff.
Compare the list of side effects on their drugs to mushrooms or LSD. Compare the effectiveness. These companies aren't maintaining huge divisions of PR goons for the fun of it; they absolutely are out there on the internet, lobbying, and on traditional media, convincing people to form opinions like yours.
> It's not a rare or unheard of thing for an industry to attack solutions that are significantly better than their own (very profitable) solution
See Juul, attacked by both the smoking industry and anti-smoking lobby. Ecigs don’t have brand loyalty like “Marlboro”—and cigarettes cost only 6 cents a pack to manufacture. So, buy Juul, kill it, preserve the massive profit flow.
Yep. That's a pretty clear example, and it sucks to see people falling for it. Vaping is immediately and obviously far less bad than smoking, but they can't say that. The fear-porn around the issue is wild, and I'm certain legislators and media types are getting brown envelopes to demonize vaping.
Cannabis / hemp would be another. Alcohol giants, cotton, painkillers, and many more have a lot to lose to an alternative that's superior in many ways.
Fossil fuel companies spend huge amounts putting doubt into people's mind about nuclear and renewables, lobbying for themselves, systematically buying academics and news stories.
With the above examples, there are people dying thanks to the PR FUD.
Microsoft did similar stuff, buying and squashing competitors by any means necessary. Even the DoJ had to step in when they tried to own the internet. Some people think MS Office is still around because it's better than the competitors, lol.
Banks lobby to make business as awkward as possible for credit unions.
Bitcoin maxis smear superior tech with the most laughable arguments.
Juul was/is a tobacco industry scam to make vaping more accessible and more likely to lead to tobacco addiction.
Juul started with all kinds of flavors, but then they were banned and only tobacco extract flavors were allowed.
Those extracts are more than flavor. They contain the same psychoactives which make tobacco smoking so addictive compared to vaping freebase nicotine — which Juul is not because it is an extract of tobacco nicotine salts to begin with.
I use a Juul most of the time to vape. To keep myself in cartridges, I do have to buy the Juul ones, so I get a cart full of the magic Juul juice to keep me company.
Then I refill it a bunch of times with third-party nicotine salts which taste better. It's the same thing basically.
Juul popularized using salts at high concentration with less vapor. That's about it. The rest is good product design and a fad.
There's currently no patent on Lexapro, Prozac, or Risperdal either. "These companies" now have basically zero incentive to support them or to sic "PR goons" on their opponents.
Patent is actually kind of irrelevant here, it's discrete competition. How do you put your fingers into this when it takes all of 3 months to have a lifetime supply of therapeutic doses? But it does ostensibly (if effective) curtail sales of pharmaceuticals.
The originator pharma companies pay generic mfgs to not manufacture the drugs, ultimately the arrangement is such that both parties profit while maintaining the status quo allowing single-entity control of a given substance - in the US at least, which is the only place any of this matters. Not that that's the case with the previously mentioned medications.
Ritchie on his vast tower of scientific conceit totally fails to acknowledge the human element in all of this. These drugs are interesting because of their mechanism, but that mechanism isn't necessarily complimented well by the "therapeutic" setting; the drug in and of itself isn't necessarily the catalytic element, but rather the experience - itself derived from the set and setting:
In normal (particularly traditional use) practice it is unheard of to take a bunch of these drugs and hang out in a lab with a bunch of strangers. Anthropology shows us these drugs are uniformally used in group practices with familiars.
And this is something noted in the textbooks, you can have internal and external validity - and "internally" yes, it may not look great but that's kinda predictable because it's going to get railroaded into the narrow confines allowed by statistics and ethics. You can on the other hand hop on Erowid and read countless case studies from various perspectives to get a holistic view, but that's not "science" because it has nigh-zero internal validity. But to me that reads as a semantic difference and we could debate it all day - what I think really matters in this case is that in the wild, in real practice, it's efficacious.
> "These companies" now have basically zero incentive to support them or to sic "PR goons" on their opponents.
Bro. They have new drugs that are a molecule different which they sell instead. And your scorn notwithstanding, they do have entire division of goons, whose explicit purpose is to alter opinion online, in academia, in politics, etc.
> There are also legitimate concerns about biases in the evidence base for claims about the efficacy of psychedelics
Pfft. Same goes for pharma drugs.
> And yes, psychedelics have side effects:
I didn't say they don't. The side effects are on a different level though.
We're talking about companies that knowingly sold AIDS infected products, among other atrocities. You'd wanna be a little less naive.
But LSD was a "big pharma" solution and Sandoz tried to sell it as a pharmaceutical for at least a decade.
There is a lot of problems with "big pharma" but being against cheap and effective permanent solutions is not one of them, otherwise they wouldn't sell vaccines: many vaccines are cheap, one time use, effective and prevent profitable (?) diseases.
The pharmaceutical industry has ways of making money of cheap and out of patent drugs. For example, by patenting a 0.1% more effective derivative and selling it, or by simply jacking up the price when you are the only one making it (see the Epipen scandal). This, by the way is the problem with the pharmaceutical industry, they spend way too much effort making money with old medicine and finding patentable derivatives than researching new ones. If LSD turned out safe and effective by regulatory agency standards, they will definitely sell it, or maybe some slightly tweaked and patented variant of it.
In the case of the recent fast tracked FDA trials for MDMA assisted therapy, I believe those trials were being led by a non-profit organization, and they don't have any interest in patenting the drug, let alone selling it. Their interest is in the therapy aspect of it, for which cheap and readily available MDMA is a high priority. So yeah, the pharma industry isn't going to be profiting off of it, at least for MDMA.
> What industry conspiracy are you trying to insinuate? Is it big pharma? Doubt it.
There was another HN front page article today about how legalization caused a measurable decline in the stock prices of the big pharma companies. There's a long track record of cannabis replacing opioids for pain management. MDMA, psilocybin and ketamine are not patentable, and if they can displace regular, lifelong use of antidepressants with a small number of treatments, that sounds like serious threat to their bottom line. Seems pretty plausible to me.
> What industry conspiracy are you trying to insinuate?
What is wrong with insinuating an "industry conspiracy"? Industries are found guilty by judges and juries in massive lawsuits all the time.
> Guess who would ultimately own the labs, run the clinical trials
Big Pharma doesn't run most of its lab experiments. They use contracted research companies to do that. In the past this was done to evade responsibility and it doesn't seem to have changed. See the Pfizer Covid vaccine whistle blower article as an example of that: https://www.bmj.com/content/375/bmj.n2635
> and be first to market with a safe and precise FDA approved antidepressant based on a psychedelic active ingredient
They can't patent molecules found in nature or synthetic molecules they didn't create.
> Let's not forget LSD started as a research chemical in a drug r&d lab in Switzerland.
How is one lab in Switzerland representative of al all the other pharmaceutical companies?
> Industry never wanted it criminalized.
How do you know that?
> It's not a good look to rationalise away all bad news as "paid hit piece".
The health industry is a major source of revenue of all major US news publications.
If anyone with mental health issues is considering psychedelics on their own, outside a clinical setting: please be careful and do your research beforehand. They nearly completely ruined my life. Definitely do not do them if you are on an SSRI.
I am bipolar but was diagnosed incorrectly with depression and OCD, taking an SSRI. I was a regular marijuana smoker and took DMT which resulted in acute psychosis that lasted months. I'd had what I now recognized as hypomanic episodes before, but nothing this bad.
I will not get into details for privacy reasons but had to take months off of work or school. I alternately thought I was famous, being followed, could control cameras that were following me at all times - the works. I had visual and auditory hallucinations days after the DMT experience, auditory weeks to months later. I told friends strange things about my mental health history that were misperceived. It is a bit of a blur.
About a week after taking DMT, I was involuntarily hospitalized and only sent home with family supervision. They put me on strong antipsychotics with nasty side effects. They didn't help at all. I only got better months later, after I got off of all psychiatric drugs, and realized when talking with a friend that I was not famous. I then entered into a nearly year long depression and perceived that I had lost almost all my friends, although I now think that was not the case.
Now, I've been stable for almost 10 years, and am married with a great career. We have a dog, a house, and are looking to have kids soon. I'm incredibly happy and only recovered with the support of family, friends, and great doctors. I've been taking lamotrigine daily for bipolar. For me, it is a wonder drug. Bipolar is incredibly hard for psychiatrists to diagnose. It took them years to identify it.
Another friend of mine had acute psychosis due to another psychedelic drug and had a similar experience to mine with a hospitalization.
If you have any family history of schizophrenia or bipolar or are on psychiatric drugs, please really carefully consider the possible consequences of using psychedelics.
Thank you for sharing that.
That's a valid concern- people trying psychedelics on their own also run into the risk that what they're getting is altered, not what they wanted at all, or unintentionally taking a dose that will bring them bad outcomes.
Even with cannabis, back when it was completely illegal, I knew people who would sometimesb unknowingly get their hands on batches that had been laced with something else and end up having wildly unpredictable (and sometimes frightening) experiences.
Lamotrigine has been a wonder drug for me, I'm still early days on my treatment but can already notice the massive improvements!
just adding my comment so people see that getting help is perfectly fine (if you get the right treatment/diagnosis, it's a life changer for the best!) - mental health is still a bit taboo in some circles and I remember reading about the good experiences of people online made me finally jump into treatment :)
A friend of mine has a similar story. Still searching for his good ending. I’m glad you’re better.
I feel like we’re at the beginning of the opioid wave again, and the obvious and foreseeable negative consequences are just being shunted aside. We never learn anything.
I made friends with a woman who does something called integration therapy. She deals mostly with people who have gone and dosed themselves in the hope of finding themselves or whatever and just end up needing professional help because that's a very hard thing to do to yourself if you're already messed up.
The way I've always seen it is this - Learning your lesson with these things is kind of like learning your lesson because you just got your ass handed to you in a fist fight, except with psychedelics it's like getting cosmically beaten into a pulp by having your consciousness put into a cannon and fired across the universe and back. Some people are really attuned to this kind of thing and can just shake it off while laughing the entire time. Others, who have no idea what they're getting into, with stuff like pre-existing anxiety conditions? If anyone really thinks them going solo on these kind of journeys is going to make them better then they might as well send them down some rapids with no boating or swimming experience for a 'therapeutic' prank show.
The key thing this article and the researchers touch on is that it's the integration part of the therapy that works, the drug is something like a catalyst, and any hype around treatments which work without that component is likely to turn out to be a dangerous disappointment. I don't disagree with this at all.
A lot of people here are claiming that Big Pharma is suppressing the truth about psychedelics so that they can make money from SSRIs. But remember: Big Pharma isn't making much money on SSRIs anymore, now that they've gone generic. If anything, it's the movement against SSRIs and in favor of new treatments that may be motivated by profit.
Psilocybin is still something that can be grown/synthesized outside of a lab. Sure, major pharmaceutical companies could synthesize pure psilocybin and sell that as a new treatment in some kind of ideal form but it seem that from a lot of anecdotes posted here as well as many other stories I’ve heard, “normal”, non-lab-produced psilocybe mushrooms can have a profiundly positive effect. This might be what big pharma is seeing as a potential opportunity loss and therefore funding studies that skew results in a less positive way.
The issue is that your doctor can't write a prescription for the mushrooms themselves, so those aren't likely to become a mainstream treatment.
The more likely outcome is that the industry will create a synthetic analogue of psilocybin, conduct the trials needed to get it FDA-approved as a depression treatment, and then market it widely, making it more readily available and widely known than psilocybin itself.
This isn't necessarily a bad thing: such an analogue might (say) have fewer side effects or work more reliably. But it will result in the pharmaceutical industry getting the bulk of the profits.
Big Pharma has more money to make from psychedelics than from suppressing them. They're already selling ketamine and ketamine-adjacent drugs for depression.
How is this a bubble if it's actually helping people with mental health issues. A lot of universities have begun studying this. These should never have been illegal in the first place.
Is this not the opposite of a bubble? It seems like public opinion and public policy are actually making significant shifts into making psychedelic treatments more mainstream. From which I expect a large industry to emerge.
You are literally stating what makes it a bubble: the narrative according to which psychedelics are now being rehabilitated into treatments due to very promising results.
But this narrative is getting old now, and the promising results in question are actually quite slim, in a field which is historically riddled with treatments that have a low effectiveness (when they work at all)
I know an anecdote isn’t data, but I’m a pretty straight laced guy who’s never used an illegal drug other than pot, so no prior experience with any psychedelics (except for taking an Ambien on an empty stomach lol). I started ketamine therapy a few weeks ago, and while I obviously can’t prove that it isn’t the placebo effect at work, my mood was tremendously and noticeably improved immediately after my first course of medication. And it’s had an immediate beneficial effect on my regular/traditional therapy sessions. It just feels like it was a missing piece to a puzzle I’ve been working on for a long time.
I want to see the science continue to study these drugs and psychedelic therapy, but for me there’s no doubt in my mind this has been significantly more beneficial in the short term than any other medication I’ve ever taken (i.e., been prescribed). If the science shows it isn’t right for everyone or most people - so be it. But it has been a game-changer for me.
> the promising results in question are actually quite slim
Promising results that occur outside of formal scientific settings still occur, although consciousness (possibly amplified by various pre-existing beliefs) can make it appear as if they do not. As luck would have it, psychedelics can be very helpful in sorting out one's thinking on such things.
I don't think that makes it a bubble. A bubble is when my mom starts talking about it.
Who has access to these psychedelics outside of research? They are not mainstream at all. If I wanted some I couldn't get any.
This is true. I should have said that it seems to be a slowly but sustainably growing market. When I think of bubble, I think of a rapid boon followed by a bust. I don’t think this industry will have either.
1) This is nothing compared to when Prozac® was introduced in the 90's. The idea that Prozac was going to cure Western mental health ills was quite popular and viral. It was a dawn of a new age according to some. Now SSRI's are still used when appropriate, but no one thinks they are a cure all for depression.
2) There's a distortion at work here. Many people, including myself, thing that natural growing mushrooms or other plants containing hallucinogens should not be illegal. The problem is that it appears the only way to legalize at the current time is to force them into a doctor/patient therapeutic relationship. This is causing people to twist themselves into a knots trying to explain why this small step towards legalization should be allowed. Many exaggerations and false claims are being made. And who wants to always have to do their trip with a doctor sitting by their side?
My hometown of Santa Cruz California is on the right track. Decriminalize for personal use and move on to more important issues.
Santa Cruz decriminalizes magic mushrooms and other natural psychedelics, making it the third US city to take such a step
Other cities have followed, for example Ann Arbor in Michigan - making mushrooms the lowest priority for police (effectively decriminalizing them).
One thing stands out: Oregon decriminalized all drugs in 2020 - it feels like a not well-known fact.
Another side-note: because mushroom spores do not contain the psychoactive ingredient, they are not illegal to ship across state lines, so it's entirely legal to purchase spores on the internet ("for microscopy use only"), and then use "Uncle Ben Tek" to grow your own mushrooms (this part is illegal).
Mold is the most difficult part. Even being what I thought was very careful lead to nothing but fuzzy mold covering everything. Uncle Bens Tek helps a lot with the colonization phase, but the spawn to bulk always turned nasty for me.
If only 2) were true; the process that pot went through didn't turn out that badly. My fear is that it's exactly the opposite, and medicalization will turn psychedelics into the new class of drugs that a medical degree anoints you to deal, like opioids. Still very illegal, but everyone is on them.
That's what I was trying to say. They want to do it differently than they did with pot. With pot you could easily get a doctor to write a prescription and you used THC and CBD as needed in the comfort of your own home. With hallucinogens it sure seems like they want you to take them under the supervision of a therapist, who will guide your experience in a therapeutic direction. A few reasons come to mind for why they might be doing this
- To reassure the legal authorities that the use of them is properly supervised and safe
- To bring them to a wider audience, such as a depressed grandma who needs to accept her approaching death but would never take them on her own
- For their own status, power and money needs. It worries me that once they achieve this, they will fight legalization for recreational use
That's all fine, but don't tell me I can't take them for my own pleasure and purpose when I want, such as at a music festival, on a hike in the woods, or just because. I really don't need a therapist to guide my trip, thank you very much.
Edit: Another thing, I've raised the issue on Twitter that doctors and therapists who used them in therapy settings should have some experience with hallucinogens. They shut me down really quick. It's the elephant in the room apparently. How are you going to guide someone when you have no experience with them?
I happened to watch the 'Ecstacy' documentary on Prime last night. I was surprised to see the guy who brought MDMA to the world was sad that it had become a party drug as he believes it's primary purpose could have been to help people psychologically. Definitely worth a watch.
There's no mismatch between being a party drug and helping people psychologically [1]. The only people who think so are the same kind of sad, dull people who were upset at the Finnish prime minister dancing - and since MDMA turned out to be an awesome party drug they had to ban it and punish the ones who had fun.
[1] For me, for example, I didn't have any major traumas before I tried MDMA (so therapy would have been pointless), but I were really shy. MDMA at a party setting helped me realize deeply that there's no reason for being scared of talking and connecting with people.
> The findings were somewhat lackluster: it found that the psychedelic was only marginally better than traditional treatments at relieving depression.
Err, what? What could possibly be lackluster about that? A one time (or few times) treatment does marginally better than a daily pill? Even if taken at face value, that's a spectacular result.
> In this trial the primary outcome did not differ significantly between the trial groups.
> Secondary outcomes generally favored psilocybin over escitalopram; however, the confidence intervals for the between-group differences were not adjusted for multiple comparisons, and no conclusions can be drawn from these data.
Another thing that stood out to me is that all participants actually received psilocybin, it’s just that one group took 25mg vs the ssri group that took 1mg. It’s certainly a very small dose, but it’s a powerful chemical that seems to have effects even at these microdose levels. It would have been nice to see a group that had no psilocybin at all.
It's a bit odd that this article doesn't even mention the fact that psychedelic treatments for depression, if widely successful, would likely destroy a major fraction of anti-depressant sales across the United States. That's an obvious reason the pharmaceutical industry would be pushing back against this.
Sometimes I wonder if SSRIs are one of those things that the industry overinvested in and now that there's plenty of momentum (and budget) to support the narrative that they are the cure it's hard to suggest that there may be simpler alternatives
I'm worried that the industry is stampeding into lionizing and monetizing another thing that ultimately statistics say may not be working better than placebo and has harmful side effects, but 20-50% of the population is on and is also responsible for a large percentage of health care spending.
SSRIs are that. Opiates are almost that (for long term pain management.) Statins are suspicious (and also held up as miracles by paid experts suggesting that we might add both them and lithium to the water supply like fluoride.)
I see a future of bare clinic rooms filled with beds, and on each bed someone who is being intravenously fed psychedelics (that are still illegal to grow, or take without a doctor's signoff and a nurse's supervision.) Each of them paying a $10 copay, while the facility bills the government and insurance $500/hr.
It'll be like the methadone clinic model, where we decided that to get people off heroin, we would addict them to a drug far harder to quit than heroin.
edit: I wish we would simply decriminalize psychedelics, and not do this thing again where something gets captured by a couple of oligarchs and sends their worth into the stratosphere, while every media outlet is fanning the flames. Really fucking dreading seeing the psychedelic (completely industry-funded) patients' rights organizations representatives getting interviewed while crying on tv about how party/politician X doesn't take depression seriously and is trying to genocide them by not letting five year olds trip.
> Afterward, participants received aftercare, known as “integration,” in which they process everything that happened during the trip.
Integration is definitely the key step. Without integration, the trip is no different than recreational use for fun. Integration requires sustained effort and guidance. If you don't have professional help, then meditation is the best DIY method. It usually leads to Spirituality. Pyschedlics tend to go very well with Buddhist and Vedantic spiritual practices. I think it best complements with Neo-Advaita. If Advaita is the theory, then psychedelics are the practicals.
The headline presupposes that a bubble exists. I would argue it doesn't. A psychedelic therapy bubble would have many commercial products that do basically the same thing, all competing for the same dollars.
I think you need some kind of framework in order to utilize psychedelics properly. Buddhist or other meditation oriented practices are very popular, but not the only path.
The important thing is to have something you can cultivate because otherwise what might happen is that you accidentally heighten your existing feedback loops, which are likely negative, leading to a bad trip and in the worst case possibly psychosis.
Having strong foundational positive feedback loops that you can use as a anchor or bedrock are useful not only during chemically altered brain states, but in general life as well in protecting your mind (a Patronus for your “defense against the dark arts” you might say).
The first bloom of the rose being marginally better than current antidepressants is a bad sign, seeing as right now it's going to be getting the most biased and cherry picked selections of studies it's ever going to get. SSRIs started off as miracles before they became possibly no more effective than placebo. Psychedelics are starting as marginally better than possibly no more effective than placebo.
I was totally struck by the sexual abuse perpetrated by therapists within research studies that this article talks about. It belies a need for much more careful scrutiny of the whole research enterprise, if you ask me.
I can't believe someone who wants to help someone else (and, by the way, try to demonstrate the power of psychedelics that they no-doubt believe in) would jeopardize the whole enterprise that way.
Surely you wouldn't suggest that research into the efficacy of automobile safety technology should continue unchanged were it determined that humans were being irreversibly harmed by said research.
What psychodelics seem to do, based on all the accounts of "feeling of connectedness" and "higher vision", is it does something to epiphysis cerebri in the brain to mute the lower triad of the human - body, emotions and mind - so the quiet voice of the true human, aka its soul, can be heard. There, above, connectedness of everything, as well as the clear vision of purpose and practical invincibility, are self evident realities. It gives you a glimpse into what the normal state of consciousness of a saint looks like. Meditation is a slow and safe way to get to the same state eventually, with an important difference - that state won't depend on a whim of some chemicals.
It seems like the bubble that’s been bursting for the last couple of years obvious to anyone paying attention is that microdosing is not equal to the sum of its doses.
The studies which show inspiring results on hard problems like PTSD and depression involve high dose, singular experiences, and because of the nature of that high dose, a lot of preparation takes place, weeks or months sometimes and a lot of care planned out via therapist.
I believe it was a Roland Griffiths study that showed that if the subjective and measured (brain scan) experience was not consistent with a deeply spiritual experience, the positive long term effects did not come.
I don’t think that anecdotal evidence benefits the evidence behind psychedelic therapies. I lost a lot of weight by eating gummy bears around the same time I started to exercise and eat less. Is that a convincing argument for gummy bears as a weight loss tool? They weren’t keto either.
The core complaint here seems to be that therapists abuse patients undergoing pyschedelic therapy - but I don't see any claims of evidence that abuse is more prevalent than abuse in any other therapeutic setting.
No, it hasn't even started, and it's not a bubble.
There is so much potential in this and so much catching up to do. Many who are familiar with the relevant substances know this.
Our various corrupt systems (political, financial, "health" care, media, etc.) have deliberately prevented this type of therapy from exploding for a very, very long time. It will massively reduce the pharma industry's revenues, among other things.
The health care industry would be overjoyed to administer psychedelics to you for the rest of your life, and politicians and media will be happy to be paid to allow you to do it, to subsidize your doing it, and to convince you to do it.
Whatever bizarre conspiracy theory that would convince you of the opposite is evidence that there's already lots of money being spent.
> There is so much potential in this and so much catching up to do.
And a whole lot of new risks to go with the potential. As the saying goes: it's important to keep an open mind, but not so much that your brains fall out.
Proper and wider research is important. Let's hope that these substances become more popular and available to be researched and tested, so that hopefully in 5-10 years we would know their risks and advantages. Then people could make educated decisions whether or not to try and use them.
"And a whole lot of new risks to go with the potential"
As long as alcohol is legal and easily available we shouldn't worry about psychedelics. I know plenty of people who have taken all kinds of psychedelics and seem OK. Psychedelics just don't seem very addictive for most people. I also know quite a few people who have been hurt by alcohol. They either hurt themselves or they hurt others while drunk.
Psychedelics are mostly illegal because Nixon didn’t like the hippies and federal agencies were looking for new budgets. It’s not as shameful as weed being illegal because the cops hired to enforce the prohibition needed new jobs and it mostly impacted poor communities and African American but it’s close.
The SNRI therapy bubble has already burst, now druggists are looking for alternatives. The tragic part is that psychologists have been prescribing mind-altering drugs for years that didn't treat depression. What makes psychedelics any different?
> The findings were somewhat lackluster: it found that the psychedelic was only marginally better than traditional treatments at relieving depression.
This is said early on. But then the article continues and the gist is that it's still early days for psychedelics. That is, they compared well tested therapies with a new one (i.e., it's possible the dosage isn't optimized yet).
Given that psychedelics have been around much longer, then it's actually the newer (propriety Big Pharma) therapies that are coming up short.
Depression is (imho) not to be healed with "here, swallow a pill", structural changes to one's life are necessary. Psychedelics can help to show the way, not to solve it.