Psilocybin for major depression granted Breakthrough Therapy by FDA
newatlas.com
newatlas.com
The one thing I'll say is that it seems like these drugs affect the brain in a way that's more akin to a super-placebo, rather than being therapeutic on their own. In other words, you would need to use the drugs in combination with therapy to obtain good results.
In my personal experiences with psychedelics, these drugs remove mental heuristics, allowing the mind to think unimpeded by usual thought patterns, simply accepting raw data as it comes in. This was striking in sensory information, if you closed your eyes or just stared at something long enough, you observed incredibly different visual input, geometric patterns, greatly strengthened colors (a strawberry was INCREDIBLY beautiful, I almost felt bad eating such a beautiful entity). There was also an incredible inter-disciplinary thought process, I felt the musical, mathematical, computational, logical, natural, all these parts of my mind mixed together wonderfully.
LSD was much longer lasting, around 12 hours, whereas psilocybin was around 6 hours. Psilocybin enhanced my connection with nature, the flying bugs, a handful of berries, and the plants all around me caused an effusion of love and connection. Whereas with LSD, I felt an extremely powerful visual stimulation, the changing fall leaves were extremely vibrant and beautiful, it was akin to 12 hour, mentally-clear cannabis high. I didn't experience any "flashbacks" per se, there was a positive glow in my mood and thoughts for around 5 days, and the day after LSD I still had lingering effects...I also wonder if I will evermore look at the surface of ponds and lakes differently, they have an incredible dynamism and vitality that I appreciated even more on first trip.
For anyone considering psychedelics, do it thoughtfully and methodically. Read the book mentioned in the parent, practice meditation, explore your mind, and really ensure your mindset ("set") is positive and open. Further, plan to occupy a peaceful, quiet place, hopefully lacking too many strangers/social interaction ("setting"). If set and setting are good, you're in for a wonderful time.
This experience made me realize how much of our outlook on things is dominated by whatever mode of thinking we happen to be in, and that mode is more shaped by custom and habit than anything approaching logic and reason.
William James uses the analogy that our set of habits are like an irregular polyhedron resting on one of its faces. Everyday experiences may rock it up onto an edge, but it will usually come to rest where it was, or perhaps on a neighboring face.
A more singular, meaningful experience has more “push” to it, overcoming the force of habit in a way that no amount of daily prodding would, rolling the whole thing onto a new face that would take ages to land on otherwise. He was writing about religious conversions at the time, but there seems to be a lot of overlap with the effects of a psychedelic experience.
I gave up on it doing anything about an hour after eating the first cube. Got dropped off at home .. had to go skiing with best and his mom. Vaguely remember running through my neighborhood at 3am, waking up a different friend, and leaving minutes later.. being in the bathroom at my house, and being in my friends mom's car the next morning.
Later in life I returned to mature versions of this activity and found incomprehensibly beautiful visuals, patterns, self realizations about state of mind, perspective, the meaninglessness of "cool", purpose of building things(socially, as a species, not regarding myself). For me lsd is about the thoughts that result from the general "high".
While I have only done it 6 or so times and may never again. . I believe it has amazing properties for some people and not so good for others. Some old pals are from last I saw them ...quite literally fried, but perhaps due to other activities.
#dothingslikeanadult
This is the best way to describe reasonable (small) doses of LSD. It's like the purest sativa possible; as if somebody removed all of the earthiness and stoniness and then amplified the psychoactive.
Sometimes if I get too high I get a decent amount of anxiety. Always wanted to try LSD or Shrooms but worried something like that may happen. Generally it comes from me feeling a strange sensation in my body which leads to a slight bit of panic. Or if I get really high I just don’t feel there entirely.
Always thought about taking LSD or Shrooms with some CBD incase I get a bit of anxiety.
But they're really very different experiences.
Alcohol does accentuate psilocybin, acceptably.
But combining marijuana with either, especially LSD, can be frightening. Your short term memory drops to a few seconds, so you can forget who (or even what) you are, where you are, etc. Some people panic, and fear that they'll never be sober again.
Asking this due to wildly different subjective experiences.
Even though this episode was decades ago, I still, kind of, experience the scent of that flower as the colour purple.
So, I've heard that people make a big deal about choosing a mantra, but my thinking was it can be anything, and somehow I got into the habit of visualizing a blank field of a particular color. The nice thing about focusing on a color was that if my visual imagination distracted me, I could concentrate on "seeing" the color, while if I was imagining words or sounds, I could focus on the name of the color too. So it was like having an object to focus on that had all the different angles available.
I'm not sure I've never experienced synaesthesia, but I'm pretty sure I haven't been perceiving smells or sounds as having color recently.
In certain settings psychedelic experiences are even possible without any chemical ingestion. For example on meditation retreats and ultramarathons.
So I don't think it's incorrect to call psychedelics a super placebo. The mental states they bring you to are entirely achievable without their use, albeit with far greater effort.
It's absolutely not a placebo. That, or the definition of the word is being stretched such that all meaning is lost.
I like "removing mental heuristics" as a good way of describing what is happening at the physical level. Articulating (or, communicating with high fidelity) what happens at the experiential and emotional levels is much more tricky.
An analogy I would draw is, imagine or recall how you may have felt during a major event (usually negative), say the death of a loved one, or the ending of an important romantic relationship, or imagine how you might feel if you are on your death bed, reviewing your choices and actions throughout your life....do you have any regrets, would you have done anything different if you had it to do all over again, etc. Imagine the feeling of clarity of thought, and deep intellectual and emotional appreciation of the gravity of the situation involved in such experiences.
This is how (but only in part) I would describe my experiences with psychedelics. Of course each person experiences these things in different ways, but despite such differences, extremely deep profoundness is an extremely common takeaway.
A simpler explanation, I would say that it kind of "shocks me into reality". And you may think you know what that means, but if you haven't experienced it, you really don't. Even I don't fully appreciate the meaning of what I'm saying at this very moment; I am largely going on faith, based on a very low fidelity memory of the experiences - such is the strange, ineffable nature of these medicines.
Luckily, while it seems difficult to see into (remember) one's experiences in that world, the opposite is not true - when under the influence of psychedelics, my experience is that I can experience kind of a simultaneous existence of two states of mind: that of clarity of thought (normal biases due to heuristics largely removed), but also clear (if not clearer) memory of thoughts and emotions related to specific scenarios in the normal world. This seems to facilitate for a very productive self-help scneario, the so-called "five years of therapy or psychoanalysis in a few hours" effect that some people speak of.
I should also note that I am speaking of experimentation in the medium dose range of psilocybin. While there are other things to be discovered at the higher doses, for my purposes medium dose trips seem to be much more beneficial. YMMV.
Set has so much to do with the experience--though I've had fun with it out with friends at a bar in dark of winter, its true power is sorely wasted unless I'm in nature, especially when my wife and I are taking it together.
I know with zero uncertainty that it acts as almost a forceful, powerful therapy with even a modest amount of mental input--it's as if your brain is forced into a state of deep meditation where you can't help but improve your mental station (barring the notably rare "bad trip"--though I've taken it with so many people, I do believe it happens less frequently with ALD-52 on account of its mental clarity).
Some of the best days of my life have been while tripping on ALD-52, wandering wild goat trails, exploring the vibrant innards of canyons, weaving among mountain pines.
RE your experiences with water, I've had the same experiences. One of the most memorable moments of my life was returning from a short high desert hike, to sink to the bottom of a salt water pool, look skyward, and watch the desert sun dance and play with colors on the water's surface. I've never looked at water the same since. I'm cheerfully captivated with its beauty in a way I probably haven't since I was a child.
Which brings me to my final observation. The effects of psychedelics, perhaps owning to their serotonergic effects or their disabling of the default mode network re-imbue you with a wonder in the world around you that has slowly, inconspicuously eroded little-by-ever-so-little each year into adulthood. Year by year, the world becomes more bland, less exciting, less, well, full of wonder. Remember those magical memories of childhood? Perhaps running towards the ocean, arriving at summer camp, having a picnic in the park, diving to the bottom of the pool, playing with a new toy on Christmas, the excited anticipation before a sleepover, your first crush? The magnitude of those feelings are often so muted or jaded as an adult. The right psychedelics can bring those feelings rushing back, unfettered, unadulterated, pure. Suddenly you realize how much of that you've lost, while simultaneously getting to feel them again in full force. Some of that stays with you during sober times, which is lovely. Dosing periodically keeps that magic alive in you--what a joy, a gift.
Humans have taken psychedelics as part of daily lives for tens (if not hundreds) of thousands of years. The shaman is little more than an elder trip-sitter and therapist. Our highly complex brains have evolved alongside such chemicals and experiences to help define meaning and seek happiness and it's a crying shame that waves of prohibition have stifled that nigh fundamental human experience. It makes me happy to watch that damage slowly be undone with news like this.
"How can I have these results without loading on the mechanism?"
I can understand drug aversion but what's the aversion to breathwork, which is cheaper and shouldn't carry stigma?
> Is there a way to induce this feeling without the aid of psychedelics or breathwork?
Depends on what you means by "induce". (Usually) many, many years of practice (if ever)... https://en.wikipedia.org/wiki/Kensh%C5%8D
In my limited experience (2 trips) there was no negative aspect to psychedelics. There were things that were already negatively valenced, like riding in a car or visiting a friend's messy house briefly, however I had no inkling of a bad trip or any scary/demonic/overwhelming sensations.
That's interesting, but it sounds like a plausible description of how schizophrenia works too, maybe even one that I've read before, and yet my impression is that "natural" psychosis is different.
Y'all aren't disagreeing.
I hear ideas like this (and "In other words, you would need to use the drugs in combination with therapy to obtain good results") repeated all the time, but I'm curious where they come from.
If one spends any time whatsoever in enthusiast communities, the overwhelming sentiment is that these compounds are incredibly helpful even when used alone. This is not to say that individual results wouldn't be even better with therapy, or that there aren't some people who have negative experiences, but these being true also in no ways logically implies that significant benefits cannot be realized by independent usage.
The precise answer to these and other questions, at this current point in time, is: we don't know, with extremely high certainty. But this doesn't mean we don't know anything. Reality is independent of man's understanding (peer reviewed studies) of it - a tree falling in the forest does not require the presence of a scientist.
While it's always a good idea to exercise caution, I suspect advice like "do not use these substances except under professional guidance" is likely more harmful than helpful. It will be years if not decades before formal treatments are available, for many people that may be too late, not to mention the exorbitant price tags these treatments come at. I am more of the mind that people educate themselves on the topic, proceed with caution, work with those who have experience, and proceed slowly and with caution, starting with low dosages and working your way up over time. There is very little trustworthy evidence that I know of indicating there is any kind of substantial risk, and even then that has to be weighed against not just the benefits, but also the risk of doing nothing.
Everyone says this and it's little more than bro science. So if you have a bad experience from the drugs, it was because you weren't in a positive headspace? Sounds like No True Scotsman.
You can always test out this hypothesis by doing a tab of LSD from the same batch twice while controlling for your headspace. One day, you do it with a positive headspace, and another day you do it with a negative one. If you had a great experience the first time and a bad experience the second time, clearly the headspace alignment made the difference.
Yes, this kind of testing isn't as rigorous as it would have been for a legitimate scientific trial (which I bet we will see in the future as the research into the area accelerates), but imo it is more than just a No True Scotsman backed by broscience.
And of course, no one says that a negative headspace is the only reason for someone to have a bad experience, there are others for sure. For example, certain people with predisposition for schizophrenia probably should abstain as well. AFAIK psychedelics won't cause a schizophrenia in an otherwise healthy person, but I heard it might kick off an early onset if you were going to get a schizophrenia in a few years without any psychedelics anyways.
One of the first times we did LSD with my friends in college, in the end we all were thinking "this is why they call it a trip. we all went somewhere together and came back".
Set and setting matter a lot and it isn't bro-science. You're talking about drugs that take your mental chatter and external stimuli and allow them to flow freely. Anything bad or anxiety producing will get amplified and without the proper experience, it might spiral out of control.
I'm not sure I have the stomach to try a psychedelic to try and treat it, as I've seen some success with exposure therapy, but the curiosity is there. I also had some pretty bad experiences with marijuana when I was younger (college), that have kind of scarred my ability to relax before taking any drugs.
There's a part in the book where it was either him on one of his experimental trips or maybe it was someone he interviewed, but while tripping, they were faced with some terribly scary images.
The person tripping said to their therapist guide that they were scared of whatever they were seeing and wanted to run away. The therapist suggested instead that they turn around and face head on whatever it was that they were seeing that scared them. Stare at it, observe it, take it in.
After they did so, the thing they thought they were so afraid of ended up not being so bad, and they sort of peacefully coexisted with it for a bit longer in the trip until the thing went away.
This is how I try and frame the scary things that run through my brain, it's normal to be afraid of bad thoughts, but also learning how to peacefully coexist with them is pretty healthy.
There's absolutely nothing placebo-like whatsoever about psilocybin, any more than a surgeon's tools are placebos. It's an extremely powerful tool that can be applied in a therapeutic context.
Great book btw. I highly recommend it anyone who is curious about the subject.
But specifically in this context psychedelics are generally introduced to individuals who haven't had prior experience with them, and may need additional support that therapists can help with (e.g. survivors of sexual assault, deep depression, anxiety regarding terminal diagnosis, PTSD, etc) and the therapist have been trained specifically in guiding these individuals in psychedelic trips. So they are like the best trip sitters you can have if you are trying to get out of rut.
It's not so much about how it works or why it works, it's mostly about the result.
As far as I can tell, from my own experience, lsd kind of make you see your own actions/thoughts as an observer[0], it's a very useful tool if you're into introspection. If you're not used to introspection it can be quite unsettling though.
[0] >50ug <400ug, after that you just look a the ceiling and enjoy the lights
That is a huge difference. 400ug is a big dose and 50ug barely noticable.
Anyone reading this without experience going for 400 is going to get knocked for six
Source: have worked directly with LSD crystal in the past. (Unfortunately anecdotes are king when it comes to illicit drugs otherwise I’d be able to cite an actual external source)
This is probably the best way to describe the therapeutic value in this situation. Hallucinogens (not just LSD), give you some distance from your headspace. It's not to the degree you feel depersonalized or have an out of body experience, but it allows you to examine your own thoughts without all those underlying assumptions that you hold yourself to subconsciously, every day.
Personally I tried it. A very low dose completely wipes out any depression or negative thought for weeks at a time. Way better than zoloft.
I'm surprised by the focus on large psychedelic trip doses and placebos in this thread. It's basically two opposing extremes.
I too have observed incredible effects of taking small below-threshold doses of psilocybin, with absolutely no negative effect whatsoever. It's tempting to incorporate half a stem into my regular morning routine like a vitamin.
So the chemicals trigger the mechanics, but the experience dictates the lasting effects.
I’ve done many trips on LSD and Psylocybin. A classic line you read about these experiences is they rank up as the most significant events in people’s lives such as the birth of a child.
However if you trip 100 times or more, how can all of those times be so incredibly meaningful? They can’t. and they won’t retain their power. and that’s a common feeing of a trip is it feels important and significant and intense in the moment, but a lot of the time you aren’t doing much on a trip. maybe you had a day at the beach. maybe you took it at a music festival. maybe you took it with friends you rarely see.
will some of those experiences have more lasting effects than others? yes. will they all feel significant at the time you’re on it? yes. but i don’t agree they don’t count as “good results” if there’s no professional therapy involved. a lot of what you get out of these trips depends on what you put into it. it’s entirely possible to go to a clinical trip and get little out of it. and as many people know you can trip without professional help and see impactful outcomes
That's essentially the case with any depression medication.
That's not what I was saying.
I disagree that psilocybin is any sort of placebo, but I think this captures the intent of the grandparent comment.
For optimal results, not good results. The compounds are fairly therapeutic on their own and can and have produced plenty of good results, in the same way that chewing on willow bark still helped with headaches before we concentrated into the convenient form of aspirin.
It's amazing how the same books get tossed around Silicon Valley, is their a book club i'm not aware of.
(just finished the above book, it's heavy on drug history which I dont care about but still well-written)
When the only thing that's changing is a state of mind, then placebo is actually the real deal.
I got good results and all I did was listen to music or walk around outside.
Don't forget esketamine was also granted breakthrough treatment status recently, but I have yet to find a doctor willing to try it because it's "so new". On top of that, it's still outrageously expensive even with insurance, if insurance will even cover it at all because it's "so new" and I haven't yet exhausted every compound that's ever existed. Sigh.
Ketamine, LSD, shrooms are all accessible, and recreational varieties are not expensive.
Most of us aren't willing to risk a criminal record.
I wouldn't know where I could obtain such items even if I wanted to buy them. If I can't buy something off the shelf at a retail store I'm simply not going to bother.
Sketchy/unknown supply chain.
Tons of us have jobs (or whole careers!) that we could lose for using illegal drugs, many of those jobs include random drug tests. I'm not risking my entire fucking livelihood without a damn good reason.
During the UK conservative party leadership contest earlier this year I thought it was pretty telling that all or most of the main candidates admitted to using illegal drugs at some point.
But sometimes I forget that there are people out there who are significantly more risk-averse or perhaps more generally obedient and who see the world very differently.
I guess my point is that I didn't think it was a ridiculous question.
I'd also point out that your use of "most" here might be unwarranted. There are surveys which demonstrate more than half of respondents admitting to the use of illicit drugs [1].
[1] https://www.drugabuse.gov/national-survey-drug-use-health
No one is going to go to jail because you purchased a small amount of drugs. If you are the seller it's a different story.
But with unbeatable Major Depression you are dealing with a significant suicide risk, and the risk to your legal status may be worth the benefit to your overall happiness.
People who want to replace a little Prozac with Psilocybin can afford to wait 10-15 years for treatments to become standardized, legal and affordable.
I spent 15 years assuming that I would kill myself someday, and basically all of life was a delaying action to put suicide off as long as possible. So for me taking the plunge into illegal self treatment was worth it. A yearly Ayahusca session for me does more to combat depression that years of therapy and legal medications.
Naturally grown drugs like marijuana, mushrooms, even peyote and it's cousins are easy to identify, easy to dose safely and there is almost no risk of supply chain tampering.
It is ridiculous how "square" things have gotten in 2019 when you read things like this on a forum called "Hacker News." Have you ever heard of Mondo 2000? Or that time The San Francisco Examiner sent a reporter to SIGGRAPH because they could not believe the claims that so many people in computer graphics were doing LSD? Things were different in the Valley in the early 1990s.
The health risks aren't bad either. Psilocybin mushrooms have distinct properties which can be tested for with a white sheet of paper in a super simple test.
In other words, fortune favors the bold.
Testing is difficult because the common tests only test for the presence of LSD-25, not the purity, and not for the presence of substitutes. Someone who mixed the pure substance with some more dangerous derivative would be impossible to detect without lab grade tools.
This has stopped me from trying LSD for my whole life. I assume there are many others that don't want to take mind altering substances with unknown purity.
The psilocybin treatment is also reported as way more effective when administered as part of therapy. You are supposed to trip under the guidance of a professional.
I don’t think that this statement is technically accurate - fortunately. Studies have shown that following a certain protocol or setting will increase the effectiveness. That framework is published science.
I think the bigger moral issue with buying street drugs is that you are essentially funding organized crime.
It looks fairly legitimate.
Also, there are clinics in some major cities for ketamine treatment, but it isn't cheap. A couple grand for 6 infusions.
What worked for me was finding a doctor who specializes in treatment resistant depression, rather than a regular psychiatrist - they will be comfortable and open to prescribing many more 'difficult' medications such as strong MAOIs, transcranial stimulation, and ketamine.
I believe it's important to realize that the "magic" is not in the mushroom.
> "Of course, the drug dose does not produce the transcendent experience. It merely acts as a chemical key — it opens the mind, frees the nervous system of its ordinary patterns and structures. The nature of the experience depends almost entirely on set and setting. Set denotes the preparation of the individual, including his personality structure and his mood at the time. Setting is physical — the weather, the room's atmosphere; social — feelings of persons present towards one another; and cultural — prevailing views as to what is real. It is for this reason that manuals or guide-books are necessary. Their purpose is to enable a person to understand the new realities of the expanded consciousness, to serve as road maps for new interior territories which modern science has made accessible."
~ Timothy Leary, The Psychedelic Experience: A Manual Based on the Tibetan Book of the Dead
https://en.wikipedia.org/wiki/Set_and_setting
Drugs like LSD and psilocybin are the chemical equivalent of banging on the side of the box to make the TV work.
With proper set and setting you can get profound effects from e.g. a sweat lodge, or even just hyperventilation (I'm referring to Leonard Orr's Rebirthing breathwork. I would normally link to the wikipedia article on it but that's been defaced by capital-S Skeptics and reduced to a note crapping on the whole thing as "discredited". My dad actually worked for Leonard Orr for a bit and what he was doing was pretty profound whatever it was.)
On the one hand, it's great that the vindictive hysteria around psychedelic drugs is calming down, on the other hand I wish the scientific establishment had a little more epistemological sophistication when it came to investigating the inner world.
To sum up, the cure is not in the pill, it's in the set and setting. The pill just gives you an excuse. You can also use e.g. hypnosis, prayer, drumming, dancing, sweat lodges, or weird breathing, to effect the change you want, just to name a small sampling of the available modalities.
https://www.pnas.org/content/113/17/4853
Synopsis: no, actually the drug has a pretty powerful impact on your brain and is the main driver of the effect
Second, I would never begin to deny that "the drug has a pretty powerful impact on your brain", because that would be stupid.
Third which "effect"? Your linked study "sought to investigate the acute brain effects of LSD in healthy volunteers", we're discussing psilocybin for major depression. So... what's up doc?
What I'm saying is that getting high is not the best available therapy for depression.
But more to the point, you were asserting that the effects of the drugs were secondary to the therapy associated with them, to which I strongly disagree with. The action of the drug itself is main driver of its therapeutic potential, specifically that of "breaking" normal heuristic patterns of activity, suppressing others, and allowing more inter-region connections and plasticity to flourish where non existed before. Most people can't do that very easily, if at all , with just therapy, meditation, diet, and exercise or whatever. However, I -CAN- do that, quite easily and without effort, without the guidance of a therapist or anything else, by simply eating some mushrooms and letting them do their thing.
To heal.
> I don't think you know what psilocybin does to people.
I think I do.
a lot of Wikipedia is like this
I'm also experienced in non-chemical, uh, procedures that have a dramatic and reliable healing effect. In this connexion I should mention, I was cured of depression by a single intervention by a hypnotherapist. I've talked about it here: https://news.ycombinator.com/item?id=20371167
> To sum up, the cure is not in the pill, it's in the set and setting. The pill just gives you an excuse. You can also use e.g. hypnosis, prayer, drumming, dancing, sweat lodges, or weird breathing, to effect the change you want, just to name a small sampling of the available modalities.
I feel certain that you have far more background (than my zero) in these other fields, but despite fairly extensive reading on the matter, I have encountered very little that leads me to believe (and much that opposes the idea) that the magnitude of what can be practically achieved by the common man with these other techniques comes anywhere near to what can be achieved with an afternoon of reasonably organized psychedelic usage. To be clear, this isn't to say that I oppose such practices, or claim they have no value - I believe the exact opposite of that, they seem to also be tremendously valuable, but my intuition tells me that psychedelics have way better bang per unit of effort.
Thiel backed COMPASS Pathways which got breakthrough status last year. The Usona Institute, which just got breakthrough status this month, also for a use of psilocybin, is to my knowledge not supported by Thiel.
> Back in late 2018, the FDA granted Breakthrough Therapy status to the ongoing work from COMPASS Pathways investigating psilocybin, the key psychoactive compound in magic mushrooms, as a therapy for treatment-resistant depression. A large, multi-center Phase 2 trial spanning the US, UK and Europe is currently underway testing a variety of dosing strategies.
> This new FDA Breakthrough Therapy approval focuses on a seven-site, Phase 2 trial currently underway in the United States. Coordinated by a non-profit research organization called the Usona Institute, the trial is exploring the antidepressant properties of a single psilocybin dose in treating patients with major depressive disorder.
> “From generations of practitioners and researchers before us, we have received knowledge about these substances, their risks, and ways to use them constructively,” reads the statement. “In turn, we accept the call to use that knowledge for the common good and to share freely whatever related knowledge we may discover or develop.”
> It has been signed by 104 individual scientists, scholars, and practitioners, 21 research and service organizations, including MAPS, Heffter, Usona, and 12 psychedelic societies and integration circles. Compass has not signed.
Given Thiel's track record I think it's not very likely he is doing this for a "freedom of choice" but more as "Opportunity to get richer".
"Ask your doctor if tripping your nuts off is right for you."
Blind testing in this case seems silly. It’ll be obvious to both patient and doctor pretty quickly who got the high dose psychedelic and who got placebo
During my 20s-30s, I tripped with about 0.5 mg LSD more or less once month. It at least kept bipolar depression at bay.
But now I use lamotrigine/modafinil. Which is less fun, but also more effective and less disruptive.
I definitely wouldn't recommend LSD or other psychedelics for those with bipolar mania.
But with lamotrigine alone, I'm too "flat". I have no interest in doing anything. No energy. Not depressed, but just sort of "dead". So I take that at night.
And the modafinil (usually 100 mg/day) makes me interested in doing stuff. Mentally alive, full of ideas and solutions. So I take that in the morning.
And damn, I take two drugs with that potential side affect. And may be starting a third :(
But with the right amount of modafinil, I'm fine.
And without the lamotrigine, there's the risk that I'll go hypomanic. Which can get to be not fun for me and everyone around me.
It’s certainly not my experience with lamotrigine.
I loved peaking. That is, total ego death. Just being there. And the visuals, of course. Totally internal, with the external world just gone. It was like dreaming, except far more intense.
I would typically trip when the moon was full. I'd start in the late evening, with my usual beer or two and some marijuana. And then, just before falling asleep, I'd eat the LSD.
So I'd wake up peaking. And then spend a few hours in bed, "meditating". Eventually, I'd come down enough to shower and dress. Have a mug of ginger tea. Maybe a snack.
And then, a couple hours before dawn, I'd set out on my bicycle. Typically riding toward the setting Moon. I'd often end up at a small park on the west end of a large lake. So I could watch the Sun come up across the lake. Distant flocks of ducks made a trippy sight, skimming across the water.
Then I'd come home, eat, and sleep for maybe 15 hours.
You also have to factor in that street drugs are all over the charts as far as consistency in the dosing and the person you replied to may have been consuming a fraction of what they thought they were (even humidity and handling can reduce what is there).
But I had a steady high-volume supplier, and bought for resale. So I'd carefully test stuff before buying. I'd start with half the recommended dose. Then, a week later, a full dose. And then, a week later, 2-3 doses.
So what gave me a "standard trip" I considered 0.1-0.2 mg. And when I say 0.5 mg, I mean 3-4 times that.
I worked in a biochem lab, and so stored my LSD under vacuum at -70 deg C.
> It chronicles the long and storied history of psychedelic drugs, from their turbulent 1960s heyday to the resulting countermovement and backlash. Through his coverage of the recent resurgence in this field of research, as well as his own personal use of psychedelics via a "mental travelogue", Pollan seeks to illuminate not only the mechanics of the drugs themselves, but also the inner workings of the human mind and consciousness.
If we can compare an inferior treatment to placebo, and we can compare a breakthrough treatment to this established standard, we can evaluate the new treatment.
Remind me again, which illnesses alcohol cures?
Like fomepizole.
Mushrooms are a proven cure for alcohol and cigarette addiction.
But yeah, the war on drugs is, was and always will be a fundamentally stupid idea.
I wrote poems and drank milk, worked out fine. Being normal is for wimps!
Any loss for big pharma is a big win for consumers.
[1] https://journals.sagepub.com/doi/10.1177/0269881116675513
All plants are medicinal. The thing is if you use them like processed sugar you are fucked just like junk food that kills.
While human history is rich with tales of alchemy and mind altering substances, the usage was often ritualised and functioning in a "sacred" or communal context.
I personally experimented with some of these substances, and i intuitively see them as a potential great leap forward compared to the potential horror of opiates, benzodiazepines or life long SSRI use - but i also feel a vague dark undercurrent running through this newfound mainstream appreciation of psychedelics just as Mindfulness has become a utility or a tool removed from its context or even it's original meaning whatever that may be.
My own struggle with living a healthy life in 21. century "technocapitalist society" or whatever has led me to believe that most depression is not "just a chemical imbalance", "a lack of appreciation or gratitude" or a "lazy mindset" - instead depression is _often not always_ closer to an evolutionary mechanism telling you that "something is wrong" and you need to take radical steps to remove yourself from X situation whether it be social, about lifestyle or about geographic location - the opposite can also be true, that you need to be accepted by a tribe, reach out for guidance or establish new relationships.
Modern humans are in general pretty lonely, skin hungry, lack communal connection, touch, intimacy, a good proper diet, connection with nature, meaning/spirituality in a social context, have bad posture, are stressed out, have horrible sleep patterns etc. compared to our evolutionary blueprint or just compared to the societies of a few decades ago - without romanticising too much.
In other words; it's not weird that people are depressed in this day and age spending so much time inside, not being close to friends / family, not moving about enough . And i am not convinced that mainstream palliative care is sufficient or even the right approach the problem. It's about restructuring local community, our cities and our daily lives.
Anyway i currently se this as being very promising, and a am still endlessly fascinated by the philosophy and science of consciousness, meditative praxis and psychedelics, so i am not against that aspect but critical of the utilitarian mindset behind this type of use.
EDIT: I can see that i receive quite a lot of downvotes. Can anyone elaborate?
I wonder if it's a side effect of wishing for their legality? I mean, I am skeptical of psychedelics as a cure all. But I'll happily blow smoke up anyone's ass if it'll get it off the idiotic scheduling so I can enjoy them without risk.
Meditation has historically been around longer than mankind was writing, and has historically always been used to end psychological stress. So much so, Buddhism exists as a program for one to get "enlightened" which is the end of dukkha, and dukkha means psychological stress. Enlightenment is the end of psychological stress. It's a prehistoric therapy that is so helpful it continues to live on longer than just about anything else we know today.
Calling meditation a tool is actually the original use for it, as far back as we have documented. It's how it's taught in Buddhist circles. It's only a tool.
However, you're not entirely wrong either. Half of the teachings that revolve around ending dukkha is in the western world reserved to word of mouth teaching or deep dives into suttas (https://www.accesstoinsight.org/). It is rare to find a meditation teacher that will teach the other half. The reason for this is that process towards enlightenment, that missing half, is being replaced with working with a therapist. However, modern day therapy still has a ways to go when compared to the ancient teachings that are meant to be taught along side meditation instructions.
The default paths your brain takes when making decisions are obscured or flattened out, so you have more possibilities. If someone has depression, guilt, and ruminates on trauma psychadelics allow you to confront that trauma without the manufactured personality our ego has created to deal with the trauma. Viewing something objectively, or even subjectively but from a different perspective can vastly alter your "sober" perspective of that trauma / event / emotion.
tl;dr: Think of psychadelics as a tool that can allow the mind to introspect objectively
In other words: instead of fixing some of the symptoms caused by society, why not change society and the ways that we live?
There are strong parallels in western notions of mindfulness. In our society mindfulness/meditation are considered tools that helps us mitigate stress. The original intent was to stop the sources of stress and suffering by developing one's mind, but western interpretations fall far shorter of that, opting for a grotesquely simplified and amputated version of the original philosophy that aids in placating the masses rather than bringing about fundamental changes to the ways we live.
I even wrote that i tried them myself.
I just wanted to illuminate a certain aspect of mainstream, adoption that i find potentially problematic but apparently that's not something people really want to discuss at this moment in time i can se by the torrent of downvotes.
To elaborate it's the same dillema that widespread corporate Mindfulness presents, or the problem of using all kinds of other -in essence beautiful/profound measures- but in a decontextualised and corporate context to push depressed workers or the general standing reserve to perform better while the "true" solutions are actually about rights, real-wages, loneliness, painfully long work hours or other classical problems that psychedelics won't help you with.
A good "bad trip" can help you "wake up" and realise that your life circumstances are unnatural and bad and make you want to steer you life in another direction and that's beautiful.
But if psychedelics becomes a way to push an already stressed out population to find meaning and beauty in horrible conditions then that's not a good thing - just as weed as a life long sedative is also a bit depressing i my eyes.
Chop wood and carry water but don't remove the context of doing it. Just like rituals, myth, community and location worked as context for psychedelics.
This is - at least i think - is important to remember when re-introducing powerful concepts. It's because it's very very potent that we need to be critical.
It does feel like ineffectual knee-jerk firefighting. Yet I don't think psychadelics having utility to people nessecarily precludes fixing our lives and societies more generally.
So for 3.5g ≈ [8.05mg ; 31.5mg] And for 2.5g ≈ [5.75mg ; 22.5mg]
I haven't taken into account how psilocin & psilocybin are different or if there is typically degredation of the psychoactive compounds typically prior to ingestion (during transportation, handeling, etc.)
Combine that with the fact that guys like Joe rogan tell those with mental illness not to try hallucinogens, and it makes me wonder how will these solutions affect the brain chemistry of the mentally ill in the long run? What are the potential side effects and how does a pre-existing condition outside of depression change your risk factors?
Great Tim Ferris podcast with Michael Pollan that goes into the details on this subject.
Someone I know was on medication for anxiety, and they remarked how they'd go to see a movie at the theater, and would simply have no emotional reaction to it. A character sacrificing their life for a friend would have the same reaction as tomatoes being sliced for a hamburger.
The medication had an INCREDIBLE affect on them, and it really helped them out of a bad place. But the huge thing is they learned to identify the source of their anxiety and confront it, and no longer depend on the medication.
I just make circuits. Don't take this as medical advice.
But OP is right on one thing: it is not a substance the body needs. It's an artificially induced condition, and it's why it's important to take days off. Sometimes I take a week, not just the 1/2 days of the most popular protocols.
This way you can see if you are improving deep inside, and that it's not just the drug saying you are fine. Plus those substance allow it: no hard in stopping cold turkey. It's beautiful how positive this stuff is.
Up to now, I can attest than, yes, even when I'm not taking it, I'm better. Mostly because when I take it, I live a better life.
Obviously, I'm happy that you're suffering less. However, I'm highly skeptical that hallucinogens "solve" problems, instead of merely masking them. Hallucinogens may provide you with a feeling that you have a place in the universe, but they cannot provide an actual place for you. It takes work to find and create purpose in life. You can't create purpose with pills anymore than you can create strength with synthol injections.
Which is better -- a feeling backed by reality, or a feeling based on chemical reactions in your brain induced by a substance?
And here's a point of data for thought. I'm bipolar. In the United States, 2.8 out of every 100 people have the same diagnosis. Bipolar is highly genetic and largely incurable. Depression and anxiety disorders are far more common.
Yes, people can get anxious and depressed over life events but there are a great many people who truly need help because their problems don't have a known cause and there is no enemy to confront.
Perhaps the reason the current generations are "weaker" is we aren't hiding it anymore.
I have a "put on the brakes" mentality about hallucinogens, and it stems from a Christian worldview, where existential issues encompass both the brain and the mind/identity.
If anyone is interested in knowing, the reasoning about hallucinogens from a Christian worldview would probably go something like: (a) everything in life has a spiritual implication or connection; (b) we are created above all to know and love God; (c) knowing God comes above all through being grounded in truth and reality, centered in the word of God (scripture), prayer, and community; (d) while hallucinogens seem to have some positive effects on the brain, they also cause one to have intense personal experiences that are disconnected from reality, potentially opening oneself to negative or false spiritual influences; and therefore (e) the major risk of hallucinogens is that they can alter people's spiritual capacity to know and desire God.
As for using it to treat depression, anxiety, terminally diagnosed patients, etc. -- I would be the last to want to deprive distressed people of a straightforward cure. But I'd avoid recommending them anyhow: my fear would be that while hallucinogens might help temporarily (i.e. in this life), the effect in the next could be catastrophic because it may have contributed significantly to suppressing their innate human capacity to know God, find his love, grace, and forgiveness, and be satisfied in him. Meanwhile, there are other helpful ways to treat things like depression that God has given -- the beautiful natural world, for starters ("forest bathing" is a thing because it's a really good idea; modern cities contribute significantly to anxiety).
Remove those dangers, and remove most of the struggle (although we will always re-define what struggle is) and we're a bit like fish out of water. We're still trying to adapt.
I took Effexor (Venlafaxine) for a few years due to severe social anxiety along with a couple of other issues. It had an enormous impact on me, dramatically reducing virtually all anxiety. It did for sure remove emotion in a lot of contexts, particularly remote empathy type situations. On the flip side it made me much more rational -- suddenly remote risks and dangers just didn't raise alarm anymore.
I stopped taking it because it was making me sleepy almost all the time and....the anxiety never returned. It's like a medically-induced cognitive behavioral therapy, but I really worried about a return of those social and avoidant behaviors...but they never did.
I suppose this is a bit like that one theory of allergies and autoimmune disorders; they may be caused because we aren't exposed to parasites anymore. That part of the immune system thus never gets trained and can sometimes go haywire.
Whatever there is under the surface affecting you, it certainly isn't going to hide during a heroic trip. Quite the contrary, it gets amplified, taken to it's extreme - and if you accept it, you'll be shown the other side. And it starts loosing its power over you.
The "source" or your "problem" likely isn't what you thought it was at first either, according to a friend.
So it's not a drug that will make the pain go away. It will show you things through experience, which is a powerful way of learning.
People sometimes do as you are doing and seem to imply the medication is used instead of working out your problems. But it's really just one part of a whole.
I've been to a lot of psychiatrists in the last 15 years, and all of them made a point to tell me that I should also seek a psychotherapist.
From my experience with depression/anxiety, and hallucinogens like LSD/Psilocybin I would say that has the capability to put you in a state of mind where you can see yourself from a different perspective (because it makes you a somewhat different person for a short time). This lets you learn things about yourself that many people don't pick up on the day to day. In fact, in my experience with LSD I've found that if there's something in your life that your ignoring and it's causing you some emotional trouble it's almost guaranteed to come up when you trip.
On the other hand, the best way I've found to manage depression is simply going outside and running really fast for a long time.¯\_(ツ)_/¯. It's free and you don't have to wait for scientists to study it, politicians and activists to debate it, or find a dealer you trust to give it to you.
I might be wrong and please correct me if I am, but I'm interpreting you saying that as a bad thing. If you are saying that as if it's a bad, or perhaps 'crazy' thing, why? Why would turning to a natural compound that shows promise, be any different than a synthetic chemical cocktail that similarly interacts with the brain?
Yes I know, natural doesn't eman something is safe or good (I mean, all sorts of things are naturally fatal to humans) but I see this as an actual good thing. What limited exploration with such compounds as a means of treating (or curing) various mental issues looks promising and removing the legal barriers and stigmas associated with these 'drugs' to properly test them seems like a great thing
2. I wish antidepressants were as powerful as you think...
What I did was borderline reckless. The substance is illegal. Using it outside the context of carefully designed interventions has no evidence of improving the well-being over the long run. Despite these clear detractors, I feel sharing my experience may help others in their search for happiness.
My main concern was how to know if I was given the real thing or the right dose. I decided to go with dried, whole mushrooms and grind them up at home. For a month, I took around 150-250g every 3 days and took notes throughout the day. This helped me record how I was feeling (even on 'off' days) to assess how it was affecting how I felt. This could be considered microdosing, but not quite as somedays I noticed a difference: I was more aware of my emotions and what happened throughout my day. Intense anger, sadness, joy, beauty, the whole thing. I noticed details details I had never noticed in my daily commute.
This could have been due to the journaling. My main objective was to see how the substance affected me. After concluding the trial a friend asked me 'so, are you happier now?'. That was not the point. My takeaway was that the exercise made me more aware of my feelings - something I realized would be useful if I wanted to get to know myself better. After this, I was still scared to do a 'full dose' and left it at that.
After around 6 months, I decided to try it out. Felt I needed supervision but my close ones thought I was crazy for wanting to do this. Stupidly, I did something riskier and went on trying to find a 'healer' online. Luckily I found a nice lady (she had yelp reviews and all) who took care of me while I took 2g of dried shrooms. She didn't seem to do anything special, just make sure I had a nice/safe space to lie down while high. Again, the dosing was gradual: first 1g (4-5x what I had during the microdosing trial) then an extra one after a few hours.
It felt like I had meditated for years. My deepest hour-long meditation does not come even close. Everything was peaceful. I felt all sorts of emotions, as if a color wheel and tried them out one by one and switched between them: deep sorrow, bliss, intense anger and many more as well as quick transitions and mixes I can't explain.
My life changed after this. I am a more conscientious coworker and husband. I am present. I am there for my loved ones. I love myself and stopped shaming myself for not working. I understood that the point of my life is just living it: no further instructions or expectations. This is something I needed to internalize and the session helped me.
After a few months I felt I had yet to discover more. Based on what I had read online, I knew the substance had the ability to make me feel other important things. I realized the lady just made me feel safe and I had already seen what 150mg-2g did to me, so I decided to do more on my own.
I locked myself up in my apartment, gave my best friend the key and told him to drop by just in case to check up on me. I worked my way up 1g at a time to 7.5g. I felt what many mention online. A quick way to summarize it is 'we'. I felt what it feels to not be myself. My big conclusion was that the only thing I could do was be grateful. I have taken to this feeling daily after that session.
To be clear: I already had a daily meditation practice and a habit of journaling my gratitudes before the trips. The conclusions under the substance may have just been things I had already been exposed and intensely prioritized in my life. But there's something about these experiences that made me feel more intensly and helped me internalize them - I 'felt' the conclusions, not just 'think' about them.
I am scared of the consequences of suggesting others to try this out. The feelings I experienced, the results I have seen in my personal life and the literature we have about this substance make me conclude that the risk is worth taking. Basic precautions can help mitigate the downside: small/trial doses, safe environment and some reading about the substance worked for me.
When I read what is happening with these trials, I can't help but hope we find a way to give this to everyone. I do not claim that what I did is safe or even desirable at scale. There's a chance if 100 people do what I did, some may accelerate or trigger some form of mental illness or harm themselves (I did think 'what if he kills himself?' (thinking about myself) and figured none of my loved ones would want to try shrooms if I did).
A world with more people who can feel 'we' is filled with love and compassion. I believe psilocybin can help us.
The FDA will review on priority if the clinical trial (details here -> https://clinicaltrials.gov/ct2/show/NCT03866174) succeeds.
For people outside of the US (like me) who don't know what "Breakthrough Therapy" is : "Breakthrough therapy is a United States Food and Drug Administration designation that expedites drug development that was created by Congress under Section 902 of the 9 July 2012 Food and Drug Administration Safety and Innovation Act. he FDA's "breakthrough therapy" designation is not intended to imply that a drug is actually a "breakthrough" or that there is high-quality evidence of treatment efficacy for a particular condition; rather, it allows the FDA to grant priority review to drug candidates if preliminary clinical trials indicate that the therapy may offer substantial treatment advantages over existing options for patients with serious or life-threatening diseases" [1]
Unlike having a broken leg or having the flu, depression seems to be something everybody has to a certain degree.
Is there any research on this available?
What you might be getting at with the comment that "everyone has it" is that modern society seems to cause depression just as surely as swimming in sewage will cause other illnesses. Much like society prior to germ theory, widespread depression will continue until we can learn more about the causes and mechanisms. People used to think other illnesses were moral failing or spiritual possession until we discovered that it was from drinking water that someone else crapped in. So how many things are crapping on your mental health? Are they really inevitable and necessary, or just bad cultural programming and assumptions about what society should look like? How much might be from strictly physical causes like air pollution? (There's research backing that.)
Depression has plenty of evidence
linking it to inflammation
One of the things that infuriates my wife, who suffers from clinical depression, is the conflation between "clinical depression" vs. the run of the mill use of "depression", eg, "I'm depressed because my team lost this weekend."
Many people think clinical depression is just like the trivial kind of depression but it the person can't shake it off. It is like telling a starving person that, hey, I was hungry a couple weeks ago but I simply got busy doing something and I forgot that I was hungry. You should try it!
My wife said this cartoon captures a lot of her own experiences.
https://hyperboleandahalf.blogspot.com/2011/10/adventures-in...
The author of that published an extended book of the same material.
"clinical depression" vs. the run of the
mill use of "depression"
If qualitative, it would be like a broken leg.
If quantitative it would be like high blood pressure.
I would be very interested if there is any research out there on this topic.
As for whether normal depression is adaptive, I think you would have to go back in time ~20K and see if pre-civilized humans suffered from it like we do.
It's entirely possible that civilization just kinda sucks and that's the whole reason so many people are so miserable. (E.g. https://en.wikipedia.org/wiki/Civilization_and_Its_Disconten... )
If you lose people in your life and everything you ever loved is now gone for whatever reason then how can you do anything to yourself physically to stop being depressed? You would need spend time rebuilding your physical world so that you can rebuild your mental health.
Although the definition of "disorder" seems to imply a spectrum of behavior and once it gets to a threshold where it starts causing you significant daily difficulties they call it a disorder. That doesn't mean it is fake. Just that the environment you are trying to interact with doesn't lend itself to the behaviors you are exhibiting.
People who have never experienced a mental illness often find it hard to understand what they are.
You don't take aspirin for a headache because it cures you. You take it so that you can function and do the things to want to do that day.
You also don't need to take medicine or do anything different just because you're sick. But it's worth studying and understanding what's going on.
Both, headaches and depression to me seem to have been "intentionally" developed by evolution. Pain has a reason: Tell you to not do certain things. Low energy / self esteem might also have a reason: Tell you to stay at home.
A broken leg on the other hand was not developed for a reason by evolution.
“Depression is agression turned inwards”.
He explains what our current understanding of depression is. I think you’ll have a whole new understanding of depression after watching this.
To see her suffering and struggle daily and to have some internet expert claim she has a moral deficit is more than a little aggravating.
Something has gone wrong in the control loops that keep her a healthy balance point. The brain/body connection is real, not some new age woo.
The brain is just a conduit for the soul and this connection is called the mind.