Psilocybin Treatment for Depression

“If you are chronically down, itis a lifelong fight to keep from sinking”, according to Elizabeth Wurtzel,author of Prozac Nation. But forthose exhausted from fighting, there is hope on the horizon.

Most of us have felt down at somepoint in our life. Sometimes, all that is needed is a reset, a relaxing holidayor perhaps a change of job. But for many, these symptoms won’t go away, evenafter a few weeks on a sun lounger in Thailand. Depression doesn’t discriminateand can affect anyone, looming over every aspect of your life and generallyjust taking the joy out of living.

In recent years, severalscientific studies have reached promising conclusions on the effectiveness ofpsilocybin (the psychedelic compound found in some species of mushroom) totreat psychiatric disorders, including depression. Here we delve a little intothe facts to give you an overview of the findings of three studies by Robin Carhart-Harrisand his enlightened team of scientists at Imperial College London.

No ‘magic’ bullet, just scientific fact

According to their clinicaltrials, the use of psilocybin coupled with psychological support is a highlyeffective treatment for depression. And, what is more, it has proven to workeven in patients with treatment-resistant depression.

The astounding results are all todo with blood flow in the brain, particularly to the amygdala (that’s a tiny partof the brain for those of us without a science degree), which is overly activein people with depression. They say that using psilocybin causes ‘changes inresting-state brain blood flow and functional connectivity post-treatment…decreasedblood flow was found to correlate (in the amygdala) with reductions indepressive mood’.

The studies have shown that the‘after-glow’ phase following a psychedelic experience is characterised by moodimprovements and stress relief. Also, there seem to be lasting positiveeffects, even with only one or two doses and ‘reductions in depressive symptomsat 5 weeks were predicted by the quality of the acute psychedelic experience’ (Carhart-Harriset al. 2018, p399).

As you can see in Fig. 1, the results indicate that psilocybin is even more effective than traditional medication or therapy and there is still a marked improvement even 3 months post-use.

Graph of relative effect sizes of depression treatments
Fig.1. Source: Psychedelics: Lifting the veil | Robin Carhart-Harris | TEDxWarwick: https://www.youtube.com/watch?v=MZIaTaNR3gk

In an interview with New Scientist, Carhart-Harris statesthat participants often describe profound feelings of connectedness withinthemselves, to other people and to nature, as well as insight anddisintegration of the all-too-elusive ‘self’. This is often a process ofemotional release and catharsis. ‘Even people who have a bad trip feel changedfor the better afterwards.’

The team also suggest that contextof the psychedelic experience seemed to be important, for example theenvironment (think pleasant music and lighting) and rapport with those presentand guiding the trip, although further research needs to be done to explainexactly how this effects the result. Their rigorous preparation coupled withthe relative safety of psilocybin ensured that there were no serious adverseside-effects experienced by any of the patients.

So, in conclusion, administeredin a supportive environment, with proper psychological care, psilocybin can beused to ‘facilitate emotional breakthrough and renewed perspective.’

“Treatment with psilocybin produced rapid and sustained antidepressant effects.” Carhart-Harris et al., 2017

Although trials on a larger scaleare still needed to reinforce the findings, other studies from John HopkinsUniversity and New York University have reached similar conclusions. There is alsohuge interest in this research from the most distinguished scientists in thefield. In a special issue of the scientific journal Psychopharmacology dedicated to the subject, those contributinglooked like a ‘who’s who’ of American and European psychiatry, which shouldreassure any waverers that psilocybin treatment is well within the acceptedscope of modern psychiatry.

But what are the implications ofthese findings? Well, they could have far-reaching effects given theproliferation of depression and anxiety in our society.

In good company

According to the World HealthOrganisation, depression is the leading cause of disability worldwide,affecting over 300 million people. This results in many more millions of daysabsent from work and a loss of economic productivity. Mental health is becomingthe number one concern for manycountries, with around 1 in 4 people being affected in Europe each year.

Anti-depressants don’t work forup to half of people who take them. Far too many people have experienceddepression’s numbness or anhedonia (that’s just a fancy scientific word for theinability to feel pleasure in normally pleasurable activities). Do they notdeserve the chance to feel the pleasures of life once again, rather than beingfurther numbed with pharmaceutical drugs?

 “The largest part of what we call 'personality' is determined by how we've opted to defend ourselves against anxiety and sadness" - Alain de Botton

The research suggests thatpsilocybin gives people the ability to ‘reset’, even after years of negativethought patterns. The time is ripe to take psychedelics seriously for theirtherapeutic properties. With more research on the horizon from Carhart-Harris andothers, the conclusive evidence for the effectiveness of the use of psilocybinas treatment for depression will likely become difficult to ignore and indeed,if it reduces human suffering, should be embraced.

For people still enduring thisdebilitating condition, and for whom the pharmaceutical drugs do nothing butcreate side effects and numbness, this therapy could offer a much-needed alternative.

At the very least, psilocybin islikely to offer temporary relief from consistent negative thought patterns.And, perhaps, that is just the glimmer of hope that those suffering from depressionneed.

References

Carhart-Harris, R., Bolstridge, M., Day, C., Rucker, J., Watts, R., Erritzoe, D., . . . Nutt, D. (2018). Psilocybin with psychological support for treatment-resistant depression: Six-month follow-up. Psychopharmacology, 235(2), 399-408. See PDF.

Carhart-Harris, R., Roseman, L., Bolstridge, M., Demetriou, L., Pannekoek, J., Wall, M., . . . Nutt, D. (2017). Psilocybin for treatment-resistant depression: fMRI-measured brain mechanisms. Scientific Reports, 7(1), 13187-13187. See PDF.

Griffiths, R., Johnson, M., Richards, W., Richards, B., Jesse, R., MacLean, K., . . . Klinedinst, M. (2018). Psilocybin-occasioned mystical-type experience in combination with meditation and other spiritual practices produces enduring positive changes in psychological functioning and in trait measures of prosocial attitudes and behaviors. Journal of Psychopharmacology, 32(1), 49-69. See PDF.

Kyzar, E., Nichols, C., Gainetdinov, R., Nichols, D., & Kalueff, A. (2017). Psychedelic drugs in biomedicine. Trends in Pharmacological Sciences, 38(11), 992-1005. Link.

Lawton, G.(17 August 2017). Trip Advisor. NewScientist.

Rucker, J., Iliff, J., & Nutt, D. (2018). Psychiatry & the psychedelic drugs. past, present & future. Neuropharmacology, 142, 200-218. See PDF.

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