Comment by jgambier | Hacker News Reader

Comment by jgambier | Hacker News Reader

When I was going through a rough time and SSRIs weren't helping, read all the research on what other solutions were out there. Psilocybin seems to be the most effective but is only legal in Oregon and price quotes were $3,500 for one session. Ketamine coupled with TMS (Transcranial Magnetic Stimulation) was the second. Since both are legal and my insurance covered them, opted to choose these. I will say that the various meta-analyses have some conflicting results.

TMS seemed to be pretty effective for me. It feels incredibly silly to have your brain zapped and is a big time commitment (30 days, 1X a day for 10 minutes) but I can't argue with the results.

Ketamine was something else. I did it intravenously, which seemed to be the best way to manage dosage but required going into a clinic. The biggest downside to the whole treatment is that you'll be very drowsy and sometimes down after, and all I wanted to do was go to bed. Taking the Uber home is not pleasant. The esketamine nasal sprays allow you to do it at home at lower dosages.

Once you get over the feeling of leaving your body, it can be quite nice. Overall, it led to unblocking some life time hold ups I had, and made me a better person. I had 5 sessions, 4 of them were overwhelmingly positive. The last was a dark couple hours where I hyperfocused on all my internal fears and failures. It also led to a lot of existential thoughts and questioning the fabric of reality which isn't all bad in small doses. I can see how excessive use could start to be counterproductive, it's good to stay connected to this reality. I don't understand how people use this as a party drug.

I would absolutely recommend it in a controlled setting for limited treatment, but would caution those with addictive personalities to be careful, not to see it as a silver bullet or a crutch, to make sure you're in a neutral mental space and that you're comfortable wherever you're doing it. In tandem, I listened to a fair amount of buddhist podcasts from Joseph Goldstein that helped build out the spiritual/learning side.

I'd like to see psylocibin treatment be more readily available at a lower price across the nation as an alternative.

Ketamine felt like instant addiction -- after one semi-excessive late night spree I was certain I couldn't continue messing with it.

> Psilocybin seems to be the most effective but is only legal in Oregon and price quotes were $3,500 for one session

That's a completely ridiculous price, about 300-500 times the "street" price of shrooms. In countries that I have familiarity with (not USA), shrooms have always been "technically illegal" drug which law enforcement never actually actively enforced, either formally through procedure (with doses below 100 grams considered fine-only territory), or informally, because the cops just don't take it seriously.

So to me it seems like you're choosing to follow the law even though it would not hurt anyone and you would not get into any trouble, just out of pure principle. That's actually quite impressive.

> That's a completely ridiculous price, about 300-500 times the "street" price of shrooms

I'm not going to argue that the exact rates are justified, but chances are the person you're replying to was referring to psilocybin assisted therapy in clinical settings. So someone would be signing up to pay for having at least one therapist oversee the process, if not physicians and other staff as well. Factor in their time, operating costs, insurance, etc. it shouldn't be a surprise that the legal option will cost considerably more than buying mushrooms in a paper bag :)

> having at least one therapist oversee the process, if not physicians and other staff as well

You know, when they talk about "set and setting", that's exactly what they DON'T have in mind.

Absolutely. I'd never want to do stuff like this in an unfamiliar clinical setting. I'd want to do it at home where I'm safe and have my friends

no, some medical professionals do have a clue.. and many recreational drug users are unaware of rare but very serious health situations.. If some "clinical therapists" with zero empathy and background make a clean white room, then sure, agree.. but here in California, there are more aware medical professionals then you might guess at first

Some people have a very different risk profile to others around getting in trouble with the law. People on immigrant visas, people who would lose security clearance or their job, etc.

Even if you’re not a goody goody by nature, the rational behavior for a green card holder at a nuclear lab is to be good as gold, at high cost.

In most US states you would certainly not want to get caught by law enforcement with 99 grams of mushrooms.

$3,500 seems like they are catering towards an upper class customer with some kind of premium session. I am certain there would be many in Oregon of all places willing to play shaman for much less. The price of shrooms is not the cost though. How much would you need to get paid to trip sit a stranger for 5-6 hours? I am doing nothing this afternoon and $200 an hour doesn't sound worth it if someone offered $1200 right now. That is a lot to deal with. $3,500 is therapy session with a licensed therapist who is going to be very specialized.

Ha, I appreciate that!. My original intent was indeed to follow the law, as well as to have a "clinical" setting. Now, if you look at the pictures of what you're getting for $3,500, it leaves a lot to be desired. It's not even really a premium experience so the cost ratio made no sense.

Having now been very frustrated, I did actually follow up and organized my own session through my network. I found a contact who worked in psychedelic research, and who had led sessions with others with psilocybin, had a couple friends join and rented an amazing AirBNB in the woods, and was ready for a night of exploration. The chocolate bars the provider gave us... didn't work. I was left with an upset stomach and nausea, without any of the benefits. Our provider was really into psytrance as well, which if you've never listened to is an acquired taste. They were understanding about it all, but suffice it to say I haven't attempted anything since.

I did TMS a few months ago, and I'm not convinced it really did anything. It's a little frustrating, because no medication seems to work at all for me now.

This is going to sound silly, and I'm not a medical pro, but maybe try fermenting some vegetables and fruit and eat a bit every day?

It's very easy. You cut up vegetables, put them in salt water and let them ferment for a few days to a week. Fermented carrots are really good. I also absolutely love greens fermented in rice water with a little sugar. There are many recipes online, also for lightly fermenting fruit.

Anyway there is pretty strong research on the connection between gut microflora and depression.

Probiotic fermented foods (especially high fiber fermented foods) are a wonder.

>There are many recipes online

There are, and when I search I am overwhelmed by blog spam that does not describe it as simply as you. For those curious like me, can you point to a good resource? Or explain to salt water and ferment part - leave in a sealed jar on the counter? Thanks in advance

Two books to check out:

Sandor Katz: Wild Fermentaion

The Noma Guide to Fermentation

but really it can be as simple as some saltwater and veg in a jar, careful to have then mostly covered with brine. Have to manage releasing pressure, burping it a few times a day is fine. Of course, you can get much fancier if you want, the possibilities are endless.

> Have to manage releasing pressure, burping it a few times a day is fine. Of course, you can get much fancier if you want, the possibilities are endless.

I would at least go slightly fancier: get a lid intended for fermentation that lets gasses out on its own. There are several good designs out there, and your local Target or similar store probably carries a little kit, intended for use with a mason jar, that contains a high quality fermentation lid and a nice stainless steel or glass mechanism to hold your veggies down, for a few dollars.

You will want a lid anyway, and the coated metal two-part lids used for canning jam will be destroyed pretty quickly by regular use for fermentation.

Yes, definitely better to have a lid with an airlock

Here's my quick and dirty recipe for many things including peppers, carrots and kale/collard/mustard greens:

- 3 tablespoons salt to 4 cups non chlorinated water. (for greens I boil a handful of rice in water, discard the rice, add a teaspoon or so of sugar and use that water w/ same salt ratio).

- Cut up the veggies and pack them in a jar. No thick pieces (like a whole carrot is too thick, a carrot stick like your mom may have given you as a child is fine).

- Put a weight on top of the veggies to keep them submerged. A ziplock bag partially filled with water works or they sell special weights and spring loaded jar tops for this.

- Don't seal the jar, gas will be produced. Cover it with a cloth if you like although usually the baggie weight is covered enough.

- Leave it room temperature for about a week. 4-5 days is usually enough but longer produces a more sour taste. I've gone 2 weeks plus no problem.

Put it in the fridge (drain some water if you like), keep it sealed (no air) and that is it. It's pretty simple at the end of the day. Some people weigh things and add 2% salt by weight of veggies/water and there are other methods, but what I listed is how I do it and it works. Key is to keep veggies submerged.

Absolutely anecdotal, but I see a very strong correlated connection between what I eat (and the effect it has on my digestion) and my mood.

Having a regular quantity of fermented foods as part of my diet has a noticeable effect.

Fermented foods are worth trying out, but your milage might vary.

Same thing.

I notice a very strong correlation. Fermented high fiber "living" food and avoiding all preservatives really improves my outlook on life but yep, your mileage may vary.

Easy and cheap enough to try though.

I'm kind of terrified of giving myself botulism (or some other illness), though I do live in NYC, so I don't think it would be too hard to buy fermented pickles if I wanted them...

Chance of botulism is very low because of the salt (and acidity resulting from the fermentation), but yes, there should be live fermented veggies for purchase in NYC.

There are only about 200 cases per year of botulism in the US and most of it is infants (about 70% of the ~200 cases).

When fermenting foods, use water from good source (e.g. bottled water), you must boil water with salt (,sugar, spices ) first, let it cool, and then add it to cleaned, well washed vegetables or fruit. Use clean glass container. Fermenting procedure varies for different veggies / fruit. Maybe first try to buy readily available fermented foods to see if it works for you.

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