What if psychedelics' hallucinations are just a side effect? | Hacker News Reader

What if psychedelics' hallucinations are just a side effect?

theatlantic.com

53 pointsandsoitis74 comments

The central bit:

"psychedelics are silently doing something even more remarkable than warping reality: They are rapidly inducing a state of neuroplasticity, in which the brain can more easily reorganize its structure and function. (...) For the first time, researchers have purposively developed psychedelic drugs that appear to bring about neuroplastic effects without producing a trip. These drugs stimulate the same serotonin receptor as traditional psychedelics (...) nontrip psychedelics will have at least one major advantage over their trip-inducing analogs: They can more easily be placebo-tested. Classic psychedelic research has been bedeviled by the simple fact that it is virtually impossible not to know that you are taking a classic psychedelic"

> the brain can more easily reorganize its structure and function

What's that actually mean? That sounds like something with lasting effects...?

https://en.wikipedia.org/wiki/Neuroplasticity

That's the idea. It's why you encounter many people who talk about therapeutic applications of psychedelics.

In short, it often is. People who experience ongoing depression, especially when associated with long term/complex trauma, are essentially fighting against the structure of their brain.

The deeply ingrained defense mechanisms brought about by complex trauma were installed gradually and repeatedly (or suddenly and violently for other forms of trauma). Establishing new patterns of thought is possible but slow and sometimes excruciating. The possibility that psychedelics can put the brain in a state from which it can reform its conception of these events in a shorter period of time than traditional therapy is pretty incredible, and one of the reasons I’ve personally gotten very interested in this space.

There was a point after years of traditional therapy when I started to realize and understand I’m safe and can’t be hurt by events of the past. But even though I deeply “get it”, and this is a kind of victory on its own, my ever-active brain just keeps churning away, running the subroutines beat into me (sometimes literally) from an early age, and this manifests as anxiety and depression. It’s a frustrating place to operate from. Aware of why my nervous system does what it does, but often powerless to prevent it. Psychedelics seem to offer a much better chance of integrating these events.

The analogy I heard recently was a brain with chronic depression/trauma is something like a car with a bad engine. It is repairable and fixable, but it's a lot of work to tear everything down, and lots of times trying to fix or replace one thing snowballs into many things (e.g. you shear a rusty bolt, or as long as you have the timing belt out, you really ought to do the water pump). Other times you really need to address the broken rod before you can do anything else, but to get there you need to tear the whole engine down.

The problem is, you can't just tear your brain apart into individual pieces and leave it scattered across your garage as you work on each piece one at a time. Every new counseling session, every new day you're starting over and tearing down things and then when you're done, when you have to get back to the day to day of life, you have to put it all back together and hope it gets you through to the next one.

Psychedelics seem to give you a very brief window where you whole brain is just sort of "exploded" like a giant parts diagram. And you can poke at and work on one part at a time without all the tear down and without having to do all the other pieces because they just all got out of the way. It's not as good as if we could just tear everything down and do a complete rebuild over the course of a week. But given what we have, when things are really entangled and overlapping, it's a better / faster approach.

This remarkably well describes my experiences with mushrooms. I recall all of it, its not some brain fog like from alcohol or weed, but those experiences perceived by massively 'expanded' brain simply are not the same as when remembering it sober, its like seeing a tiny crop of an original picture, it may still make some sense but you are probably missing most of what actually happened.

But let me tell you, once I got into another trip, those memories from previous trip again made complete sense and they were very detailed, if only for that brief amount of time.

Anyway back to the topic, when tripping (alone, laying in bed with eyes closed, shamanic music in background, late evening), I felt I gradually lost all my senses (ie weird to keep 'seeing' as experiencing what was happening, yet organ of the eyeball was unreachable at that moment to my brain, and so were the others), all connection to my body. Heart rate went to very low mode (I held breath for what I referenced as few mins just to try this new situation, not more than 3, and I could 100% control all feedback from desperate body spasming for any air while I was casually observing it, not a worry in the world for that experiment - just to clarify I don't do any freediving or similar activity where you train to hold your breath). At the height I was a mist of atoms, dancing or more like swirling in the air in the music, nothing in nothingness. Those atoms were tiny parts of me, alone useless and incoherent, meaningless.

And once trip was ending, very very gradually (I'd say it alone took 90 min easily), coming down from that peak one step at a time, re-discovering senses and body. All those atoms joining one by one. I felt very strongly that if I had any major character flaw or unresolved issues, this would be the moment where putting back those atoms wouldn't work very well.

I had this without getting any info from more experienced users or research (those mushrooms I grew myself from growkit from Amsterdam, we talk about cca 2007), and the part about splitting into atoms and then combining them back together sounds similar to neuroplasticity you describe.

Just for the love of god don't do such strong stuff if you have some unresolved inner issues. There is a chance you can solve it for good via this, but the risk of something going wrong and ending up in catatonic nightmare, or even some (additional) permanent damage ain't worth it. If it would be long term legal and accepted and you would be able to have professional managing the set then this part should be without major worries.

Yup. That’s the main reason to take psilocybin for most people. The hallucinations are interesting but not really worth the trouble. After 30 minutes of a recreational trip I find I wish I could go back to sobriety, it’s very mentally taxing. And the effects last for maybe 5 hours. It’s like going on a really intense hike in your mind, but taking the drug plops you 10 miles into the wilderness and over the next few hours you have no choice but to hike back out. Micro-dosing is different as you can distract yourself from the effects fairly easily.

For me a trip is something that takes a certain amount of preparation. It feels like gearing up for a spring cleaning marathon that you can not stop once you start. So you get together a list of the parts of your brain you want to clear out, set aside a day and a half for the trip and the recovery, and dive in.

Yes, and some people come back from trips permanently wrong. It’s rare but it happens.

>> They can more easily be placebo-tested

yes, please!

psychonauts communities can be insufferable without this component.

“oh you had a side affect? you should have known you have a history of such and such in your family, the drugs are perfect stop talking!”

would love basic studies with control groups and hypothesis

You’re participating in the wrong communities. Bad people do bad things regardless of what tribe they belong to.

And every cult has idiots.

For a movement that loves the empathy improvements from their drugs, the phrasing here is lacking that and is still Exhibit A of invalidating and minimizing, not even an example of a community that does it better.

Edit: Additional capitalization added for the maturity goal post, let’s see if it pays off.

I haven’t taken a psychedelic since I was thirty. Do you think a recommendation for communities I haven’t been a part of for nearly twenty years will be of any use?

And finally, if you want to try to insult someone on the internet at least have the courtesy of using capital letters. I can’t expect maturity or even following the spirit of this site. But can I at least expect the most basic part of the written language?

Why do you feel qualified to invalidate and minimize if you aren’t a part of any community in question?

Users of DMT, or participants in the ayahuasca ceremony, often advocate for the drug because they claim that it really opens a portal to another dimension and godlike beings there. The trip is very much the point, not mere vague benefits like neuroplasticity or developing more empathy. Indeed, I can imagine some DMT advocates claiming that an approach of applying psychedelics without inducing an actual trip, is the man's attempt to intentionally deprive people of contact with those extradimensional entities.

Yeah, hallucinations without the other effects of the psychedelic sounds sort of useless, unless used as a weapon, torture or something on people who don't realize it.

Trips without heavy hallucinations are still useful, but hallucinations without the trip? Not sure what the point of that would be.

The point is treatment of psychiatric illnesses like depression without the potential for upsetting hallucinations.

Even SSRIs are now thought to work by inducing neuroplasticity, and they don't cause hallucinations either.

Just a small correction but you mean DMT: DHT is the hormone that causes hair loss.

Fixed, thanks.

Hey now,

I take propecia to make sure those portals to the demon world stay _closed_

To clear up the dissonance, I interpret that "Side effect" does not mean "Unintended consequence" in this case, it means "Not the root cause of brain changes". Sure, I intended to trip, but the trip was caused by something deeper.

As in: "The nice fuzzy warm feeling of sitting around a fire is a side effect of self-sustaining exothermic oxidization of organic volatiles in dried wood"

Of course I made a fire for the warmth on my face / clothes. It's just the warmth I feel is a side effect of a deeper process where the heat sustains the reaction. It just so happens I'm around to harvest some of the waste heat.

They are using it for another purpose - which is fine by me (tho usually not with LEO).

If my psychiatrist gives me medicine supposed to deal with my mental health problems, I don't necessarily want contact with extradimensional entities, I want to get better.

Different purposes. Some people drink beer to get drunk, some people drink alcohol-free beer for the taste. Same with decaf coffee.

It would be amazing to be able to learn like a kid again for a set bit of time. Imagine taking a neuroplasticity drug and then practice guitar, or Spanish, or whatever, for an hour or two.

Maybe I just have freakish neuroplasticity, but I find that getting better at learning more than made up for ease of learning. I traded rote for note, and am better off for it.

Now, combine that with a neuroplasticity pill...

I (and many people I have talked to) have come to a similar conclusion. What's really interesting is that going on a weeklong or so meditation retreat where you are meditating for 10 hours a day feels phenomenologically equivalent to microdosing LSD or (if you can remember) generally how you felt when you were happy as a child. This makes me think that the "trippiness" is a side effect of neurogenesis. Speaking with other people in the retreat-junkie/psychonaut/happy-childhood community agree only has helped me be more sure that this is the case.

Neurogenesis gets thrown around a lot in this community. I have had success with ketamine treatments. The basic science research is there, but the clinical evidence so far remains pretty vague.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6082376/

On the “I feel it so it works,” thing… yeah but it makes me uncomfortable to believe in it like a faith.

Something like neurogenesis feels anecdotally correct, but can anyone accurately describe their own brain function based on sensation from inside their brain?

Without data, it could equally be the feeling of brain cells (that made you feel unpleasant) dying forever. Would that be a worse treatment?

I don’t know, but more research is needed. Sign me up ;p

Research in mice actually showed psilocybin reduces the rate of new neurons appearing.

I was very unhappy as a child, which may have to do with why I find hallucinogenics very anxiety-inducing.

I think "happy as a child" here really refers to awe and excitement around experiencing things for the first time. It is certainly not referring to reliving one's literal feelings from their personal youth.

That is an interesting hypothesis. I hope you are much happier as an adult.

Don't do them unless with very good person managing the whole set of the trip, better sober. The risks are not worth potential gains. Its kind of self-feeding - once you got paranoid/uncomfortable, it gets much easier to get into that place on further trips, since its usually just one mental muscle 'move'.

In contrary if you would manage to find a reliable good setter, you could move from that anxiety. But I don't know your details so take this with a massive pinch of salt, very unhappy childhood can mean many things including those that probably don't work well with psychedelics, ever.

> or (if you can remember) generally how you felt when you were happy as a child.

Is this common? I mostly remember feeling frustrated as a child.

Here's how I'd describe what I think they are getting at.

At least for me, psychedelic drugs create a feeling of novelty and wonder surrounding everything I experience when I take them, as if they flip some kind of lightswitch of novelty which makes every experience appear novel again.

This is similar to memories of my childhood, where the most fond memories are those where I felt the novelty of experiencing things for the first time. Psychedelic drugs seem to recreate that effect.

Maybe you haven’t taken them enough. Of course everything seems different and novel the first couple dozen trips. You’re feeling new sensations and seeing things in a new way, sort of a “hello world” for your psyche. But after a few hundred, the novelty may wear off and the experience may be more somatic.

It's possible, but I like to think I'm a pretty experienced drug user (I estimate that I've tried maybe 10-20 different psychedelics, maybe 30-40 times in total) and this has been a consistent hallmark effect of all psychedelics for me.

I personally had no desire to continue with any of them after a handful of times? Things like LSD especially just got completely redundant, and annoying, and deeply deeply fatiguing. I could never understand people who had done it more than 5-10 or so times?

Pleasure-hedonism drugs like MDMA, sure, I get it. Though I have seen how it can ruin lives, too.

I think people that do psychedelics to an extreme degree, like Cary Grant it seems, are probably self treating or self medicating in some way. That’s different from experimentation, or recreation. Makes me wonder about shamans, and the cliche that psychiatrists have more mental health problems than the average person.

It's also similar on a qualia level though. That's what I was getting at. In the same way how something may taste spicy or something looks blue there is a certain distinct set of feelings/mode-of-consciousness I have only ever felt in childhood, during retreat, and when on LSD.

No disrespect, but you speak of it like a fact when in fact it's a nice anecdote.

> This makes me think that the "trippiness" is a side effect of neurogenesis

It doesn't have to be either/or. Tripping could also be forcing your brain to adapt to correct the distorted senses. If that's true, psychedelics without the trip could induce neurogenesis by other means, but not as much as ones with the trip.

"Recent experiments show that 2-Br-LSD, like LSD, relieves depressive behavior in mice."

Haven't been down this road in 25 years, but I don't think I've ever felt as deep of depressive symptoms as the week or so after taking LSD. I have suffered depression my entire life, but LSD certainly never helped, and probably worsened. Buyer beware.

I get very wary of some of the coverage of this stuff, it all seems very reductionist and simplistic.

I suspect that the positive effects people are having from these things ultimately comes down to two things:

1. the revelation that they can feel a different way, as a result of having the emotional and perceptive aspects of their brain all frazzled (in somewhat random ways) for a period of time.

2. the genuine upside that some psychedelic experiences can and do show how beautiful the world can be. Standing in a quiet field in the spring, or in some mountains, or in a forest in the fall is and watching a flock of birds fly by and hearing the insects sing etc is always an amazing experience, but these chemicals can make you far more sensitive to perceiving that, for a time. And in a way that can stick with you your entire life. Being reminded that the world can be beautiful, and experiencing that at a deep emotional level... may be the best antidote to depression for me.

But they can also really mess you up. I've watched a friend lose total contact with reality, start ranting incoherently, and begin trashing my apartment and wrecking my stuff. I've seen people become total anti-social assholes. I've seen it bring out severe paranoia. And, quite often, pronounced arrogance or elitism.

And I worry it's just more "this chemical will quickfix you", while in fact our brains are so social and community driven and that aspect gets ignored rather than dealt with... And on that note I'd argue that's probably one of the aspects of the positive effects seen in MDMA treatment, in that it definitely does encourage an empathetic and social focus from the individual, or at least it feels like it.... for a time. (But also at the same time, some of the most self-focused and shallow behaviours I've ever seen, so ...)

Or a more recent example, the pilot who suffered from depression having a psychotic break after taking mushrooms, because he thought he was trapped in a dream or hell, and attempting to crash an entire plane full of people as a result.

Mushrooms get this "harmless" reputation because, y'know, they're "natural" etc... There's now a big push to get them legalized somehow here in Canada, and full-on illegal stores popping up around that the police don't seem to be all that interested in shutting down.

But having been down that road... I'd say the side-effects from them were always more paranoia and reality-destructuring to me (and not usually in any kind of pleasant way) than LSD or other things I tried back when I was young and unwise.

The one advantage I suppose would be that they wear off after 4-5 hours. Not so LSD. Takes days to become normal after an LSD event. No thanks.

60 years old - just got back into mushrooms and acid (lsd). After 30 years of only booze, i drink less and regret avoiding the hallucinogenic for so long. YMMV...it's not all doom znd gloom, and the 'out of control-ness', that can happen is nothing compared to getting drunk but a certain amount of time should be allocated for reflection after a sizeable trip. Microdosing, which several of my friends do, seems to work for everyone. I prefer to get fucked up and take a week to think about things.

Yeah thats not what happened, if we are referring to the same incident.

He had had a close friend pass recently and he had, within the last few weeks, used mushrooms to help treat the depression/grief. Ie he did not crash the plane mid psychotic break slash psychadelic trip.

I never claimed that he was mid-trip? But by his own admission, the use of mushrooms induced some form of psychosis that distorted his ability to perceive time or understand what and what is not reality. I fully support decriminalization of psychedelics, but I also don’t think they’re free from harms, especially for those with mental health problems.

The fact that you've been downvoted to grey text shows that psychedelic user-promoters are in a thought bubble & refuse to acknowledge there are, in fact, potentially severe downsides.

I was involved with some pretty serious psychedelic users & dealers (dmt, lsd, ket, research chems, mushrooms, etc.) 1/3 of them have had irreparable personality changes for the negative, on a spectrum from 'paralysing social anxiety' to 'unable to parse reality in a standard way leading to relationship-ending disagreements with anyone he knows longer than 2 months'.

https://archive.ph/2023.11.11-051613/https://www.theatlantic...

Hmm. We’re having trouble finding that site.

Worked for me

They mention Ketamine and its perceived effect on mental health as a side effect of its primary action, but a recent study says it’s no better than placebo: https://www.science.org/content/article/ketamine-no-better-p...

So, it’ll be interesting to see if these effects from other drugs, will do better as we continue to study and learn more.

That's kind of a weird study though, it's saying that ketamine while you're on general anesthesia doesn't alleviate depression better than placebo. But to me that doesn't mean much because you don't have a chance to consciously address reasons that you're depressed if you're knocked out, or to experience not feeling like garbage.

So it's a good study because it's trying to assess why the medication does what it does. You could give me my antidepressants while I was under and when I woke up they would still work the same because it's a physiological change.

If it doesn't work when the patient is out it means that the experience of being high is the treatment.

Aside: Don't fall into the trap of assuming that depression always has a "cause" that's mental, emotional, or external. I stand as a testament to the "chemical imbalance" cause. I was still depressed and suicidal despite every aspect of my life being good and in otherwise good mental health.

Also, many people in tgat placebo group also had life changing reduction in depression.

> If it doesn't work when the patient is out it means that the experience of being high is the treatment.

I don't think we should rule out the possibility of synergistic effects

> You could give me my antidepressants while I was under and when I woke up they would still work the same because it's a physiological change.

I don't like this description because it implies a kind of mind-body dualism. Conscious processing also induces physiological changes, they're just of a different kind than the action of antidepressants. Your conclusion is basically correct though, that the conscious experience of psychedelics must be a critical component of their effectiveness.

Well, for me personally some substances had a lasting positive effect on my depression and it was because of some of the things I felt and understood while I was under their effect. It wouldn't have worked if I was unconscious.

Sometimes depression is a chemical imbalance but sometimes it has underlying reasons.

It seems like some of the benefits from psychedelics come from allowing people to process trauma, and negative feelings. They find much stronger benefits when patients are guided through integrating the experience with therapy.

I would say this can happen without hallucinations, e.g. PTSD patients find they are no longer afraid to process trauma on MDMA and can revisit painful experiences. However, there also seem to be cases, particularly with psilocybin, where the hallucinations themselves are obviously providing the patient a new story or framework to think about something troubling, e.g. the cancer patient who comes to terms with death in a new way, and has a story about the process. So I don’t think the answer is so cut and dry- it depends on the drug and the patient.

Drug laws are stupid and insane. The government declares that psychedelics have no medical value but the article clearly shows that the pharma industry believes they do. They just want to take the fun out of it and keep the money.

Yes, they have risk, but guess what? Alcohol has zero medical value and has shown to be harmful to the body and to society at large. Same thing with tobacco.

The reason these laws remain on the books is too many of our fellow citizens let it happen.

Yes, there are problems with creating a free for all with legalization (Portland, I'm looking at you!). But that's a problem with the failure to regulate drugs as well as a failure on medical/mental health services and housing.

It doesn't have to be this way folks.

It's not just laws. People like me that have had bad trips and never want to touch another psychedelic because of it (or just people that are afraid of it for other reasons) could benefit from drugs that have that same "reset" effect without the trip.

Absolutely. I should have been clear in my rant -- the work outlined in the article is incredible and should be celebrated.

My point is simply that we should have the choices ourselves, and the reason we don't is bullshit.

p.s., condolences on the bad trip. I did a lot of psychedelics recreationally in my youth and have had a couple "misadventures" and so I do not do so today. It's powerful stuff and I do plan on trying again but in a therapeutic/spiritual way and will not do so lightly.

Most experience psychonauts consider "bad" trips equally as valuable as "good" trips if your focus is self development.

Confronting the things that terrify you the most, that are the roots of deep insecurity that take over during a psychedelic experience are the things we need to confront to move on.

I've had my share of "bad" trips, but as I've matured I've realized those trips all contained very valuable information about anxieties I was not ready to consciously address.

It's hard to imagine a "reset" effect especially in the cases where a bad trip happens.

I think the bigger issue is that when people first try psychedelics they are left alone to deal with a "bad" trip without any guidance of how to process that experience. In which case it truly is a bad trip.

This is true, but I think it's important to not dismiss that maybe it just wasn't good for that person and they aren't going to get something positive out of it and it's not "their fault".

And there are rare cases where people are permanently damaged by it. I have guilt from introducing a friend to it back in the day and he apparently did too much (either dosing or frequency) and was never the same again (in a bad way).

> Confronting the things that terrify you the most, that are the roots of deep insecurity that take over during a psychedelic experience are the things we need to confront to move on.

This is exactly what you do in therapy too. I think psychedelics freak people out more because they feel less in control, not realizing they can control the variables that lead to an overwhelming/bad trip.

"Alcohol has zero medical value"

I'm not sure which of my medical certs I'd want to lean on for this, so I'll pick First Responder:

Alcohol ABSOLUTELY has medical value. It is one of the most basic sterilization tools utilized.

Is there a medical treatment where people ingest it? Maybe not including alcohol addiction withdrawal?

Before better analgesics were available it was used for pain management. Of course getting your gangrenous leg with a musket ball in it sawed off while blind drunk wasn’t a huge improvement, but evidently it was better than doing it sober.

Incidentally some modern analgesics have oddly similar effects. I came out of a minor procedure once and for about 10 minutes had markedly lowered inhibitions. I said pretty much whatever came to mind. Thankfully it was nothing awful, but still definitely had that not quite in control feeling.

It can induce bowel movements within minutes of consumption to relieve constipation.

Ethanol for Methanol poisoning.

Touché. But you know what I mean ;-)

Agree, pretty much everything has some medical value.

I suspect though that when most people use the term, they mean "contemporary groupthink medical practices would use this clinically." IMHO they should pick a new term since this one has prima facie meaning, but alas

Alcohol is incredibly useful. A 70% solution is a sterilizer, a solvent, a fuel, and in a serious pinch a better anesthetic than absolutely nothing. I’m sure there are plenty of other good uses for it too.

My point was as a drug that is consumed recreationally or medically.

It's not just accepted in that role, but celebrated. The hypocrisy of that is staggering.

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