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Psilocybin to Treat Depression and Anxiety
Can a magic mushroom trip guide users into a less depressed state? For some, it is a safe option, but it might not be ideal for everyone.
MIND Mental Health
Can Magic Mushrooms Help Ease Anxiety and Depression?
McKenna Princing November 15, 2021 Fact Checked
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QUICK READ Mushroom magic?
Psilocybin, a hallucinogenic compound in some mushrooms, has therapeutic potential.
Research shows it could help people who have anxiety or treatment-resistant depression.
Taking it with the supervision and guidance of a therapist is the best approach.
People with psychosis or a heart condition shouldn’t take it.
Microdosing is not well studied and could be more harmful than helpful.
Magic mushrooms, which contain the hallucinogenic psilocybin, are having a moment. Psilocybin was recently decriminalized in Seattle, and researchers across the country have been studying it to see if it can help treat conditions such as depression and anxiety.
Microdosing psilocybin, which involves taking small doses of psychedelics to experience their potential beneficial side effects, has become trendy among people hoping to alleviate anxiety or increase creativity.
But is microdosing safe? Does psilocybin actually help treat mental health conditions? Here’s what you need to know.
What is psilocybin?
Psilocybin is a drug that occurs naturally in some types of mushrooms that grow throughout the world, including in the Pacific Northwest. It is a hallucinogenic at larger doses, which means it causes visual and auditory hallucinations. Taking psilocybin can also distort someone’s sense of time and how they perceive the world around them.
People can have profound, life-altering experiences and realizations while on psilocybin, says Dr. Nathan Sackett, acting assistant professor in the UW School of Medicine Department of Psychiatry and Behavioral Sciences — but that doesn’t mean taking the drug always makes someone feel good.
“The experience of being on psychedelics is not pleasure-inducing. It doesn’t necessarily feel good and it can be scary or uncomfortable or emotionally intense,” he says.
Since the ’50s and ’60s, American scientists have been studying magic mushrooms, which were brought to popular attention in part by María Sabina, an Indigenous Mazatec shaman who used psilocybin-containing mushrooms in healing ceremonies and shared her knowledge with westerners.
The use of psilocybin may go back much further among some Indigenous cultures — though maybe not as far back as is typically believed.
Once psilocybin entered the public sphere as a party and casual drug and became part of counterculture movements, the federal government passed laws classifying it as illegal. Since then, psilocybin has been listed as a schedule I drug by the United States Drug Enforcement Administration (DEA).
Seattle’s decriminalizing of psilocybin doesn’t mean the drug is legal, but it does mean it isn’t a local law enforcement priority. So far the only state to legalize psilocybin is Oregon, which passed a law in late 2020 to make it legal in therapeutic situations.
Can psilocybin treat depression and anxiety?
Psilocybin shows potential for helping people who have anxiety or treatment-resistant depression, Sackett says. The idea is to use it along with other therapies rather than as a standalone treatment.
Traditionally, psilocybin has been studied for its ability to ease fear and anxiety in people who have terminal illnesses, but recently researchers have been exploring how it could help people who have anxiety, depression or are dealing with emotional trauma.
Studies from 2016 found that psilocybin can significantly and quickly reduce feelings of hopelessness, anxiety and depression in people diagnosed with cancer, while a small 2020 study found that it can also help people who have treatment-resistant major depressive disorder.
Sackett is currently working on a study with Dr. Anthony Back and others from the Cambia Palliative Care Center of Excellence to determine if psilocybin can help reduce distress in front-line healthcare workers who have been experiencing burnout due to the pandemic.
The profound mind- and perception-altering experiences psilocybin can induce are one reason it has potential for treating mental illness, Sackett says.
“The drug can act as a catalyst for the therapeutic process. A single dose of psychedelic-assisted psychotherapy can equate to multiple sessions of psychotherapy alone, and this session can bring up intense things and can lead to profound insights for people,” he explains.
The key to psilocybin’s effectiveness is its pairing with other therapies. In clinical trials and sessions with patients, the process typically goes like this, according to Sackett: The patient meets with a therapist to establish initial trust and talk about their goals, then the therapist administers the psilocybin and stays with the patient for the entire experience, which can last hours. After that, the patient follows up with the therapist for additional sessions that don’t involve the drug.
“With any psychiatric pathology, over time it becomes increasingly difficult to get out of that mindset and it hijacks someone’s sense of self. Psilocybin allows them time to step outside of their internal narrative and see that something different is possible,” Sackett says.
Adults who microdose psychedelics report health related motivations and lower levels of anxiety and depression compared to non
The use of psychedelic substances at sub-sensorium ‘microdoses’, has gained popular academic interest for reported positive effects on wellness and cognition. The present study describes microdosing practices, motivations and mental health among a sample of self-selected microdosers (n = 4050) and non-microdosers (n = 4653) via a mobile application. Psilocybin was the most commonly used microdose substances in our sample (85%) and we identified diverse microdose practices with regard to dosage, frequency, and the practice of stacking which involves combining psilocybin with non-psychedelic substances such as Lion’s Mane mushrooms, chocolate, and niacin. Microdosers were generally similar to non-microdosing controls with regard to demographics, but were more likely to report a history of mental health concerns. Among individuals reporting mental health concerns, microdosers exhibited lower levels of depression, anxiety, and stress across gender. Health and wellness-related motives were the most prominent motives across microdosers in general, and were more prominent among females and among individuals who reported mental health concerns. Our results indicate health and wellness motives and perceived mental health benefits among microdosers, and highlight the need for further research into the mental health consequences of microdosing including studies with rigorous longitudinal designs.
Download PDF Article Open Access
Published: 18 November 2021
Adults who microdose psychedelics report health related motivations and lower levels of anxiety and depression compared to non-microdosers
Joseph M. Rootman, Pamela Kryskow, Kalin Harvey, Paul Stamets, Eesmyal Santos-Brault, Kim P. C. Kuypers, Vince Polito, Francoise Bourzat & Zach Walsh
11, Article number: 22479 (2021) Cite this article
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The use of psychedelic substances at sub-sensorium ‘ has gained popular academic interest for reported positive effects on wellness and cognition. The present study describes microdosing practices, motivations and mental health among a sample of self-selected ( = 4050) and non-microdosers ( = 4653) via a mobile application. Psilocybin was the most commonly used microdose substances in our sample (85%) and we identified diverse microdose practices with regard to dosage, frequency, and the practice of which involves combining psilocybin with non-psychedelic substances such as Lion’s Mane mushrooms, chocolate, and niacin. Microdosers were generally similar to non-microdosing controls with regard to demographics, but were more likely to report a history of mental health concerns. Among individuals reporting mental health concerns, microdosers exhibited lower levels of depression, anxiety, and stress across gender. Health and wellness-related motives were the most prominent motives across microdosers in general, and were more prominent among females and among individuals who reported mental health concerns. Our results indicate health and wellness motives and perceived mental health benefits among microdosers, and highlight the need for further research into the mental health consequences of microdosing including studies with rigorous longitudinal designs.
The substances now broadly classified as psychedelics have a very long history of salutary use among Indigenous peoples of the Americas/Turtle Island, including the Mazatec, Huichol, Shipibo, and other nations as well as the pre-Columbian Maya, Olmec, Zapotec, and Aztec societies1. These long-standing Indigenous health technologies have been subject to centuries of aggressive suppression, first through colonization and the Inquisition of the Americas and later by the US-led “war on drugs”2. Nonetheless, they have reemerged over the past several decades as medicines with the potential to address mental illness and enhance well-being among largely non-Indigenous communities. Although this interest has focused predominantly on doses sufficient to engender dramatic alterations in consciousness, the use of smaller absent from the profound sensory and cognitive effects that typify the psychedelic experience is also a topic of substantial interest in psychedelic interest groups3, popular culture4,5 and emerging scientific literature6. Indeed, whereas long-standing consumption of larger doses of psilocybin-containing fungi is well-documented among the Mazatec people in Mexico, the use of smaller microdoses to support the healing of physical conditions and emotional states such as sadness, anger, envy, isolation and agitation is also common amongst the Mazatec people7.
The exact parameters of what constitutes a microdose and the associated practice of regular microdosing have yet to be firmly articulated; however, microdosing has been generally described to involve successive self-administration within a limited time window, of doses of psychedelics that do not impair normal functioning and are predominantly sub-sensorium8. Psilocybin and LSD are the substances used by the vast majority of participants in observational and retrospective research on microdosing9,10,11,12,13,14,15. Reported microdoses identified in observational research typically range from 5 to 20 μg of LSD and from 0.1 to 0.3 g of dried psilocybin mushrooms9,12,13,14,15. Microdoses are most commonly used several times a week with various patterns of alternating days9,10,12,13,14,15,16,17. The lone study to compare microdosing frequency across LSD and psilocybin users reported equivalent use patterns across substances but did not examine differences in relative dosage13.
In addition to microdosing psychedelics alone, growing interest has focused on a practice referred to colloquially as which involves combining microdoses of psychedelics—primarily psilocybin-containing mushrooms—with other substances that are proposed to accentuate salutary effects. The use of such admixtures appear to have a long history; Aztecs combined cacao with psilocybin mushrooms in a practice referred to as "cacahua-xochitl", which literally means "chocolate-mushrooms"18, and psilocybin admixtures composed of honey, flowers and herbs have been noted in historical records among both Indigenous and non-indigenous peoples19,20. Following a similar profile, mushrooms, henbane (also known as nightshade, ), stinging nettles () and other active substances were commonly added to enhance the effects of beer during the Middle Ages until the passage, in 1516, of the German Reinheitsgebot, also known as the Bavarian Purity Beer Act21,22. Chocolate and cacao remain popular additions to psilocybin, whereas as adding Syrian rue (), Lion’s Mane mushrooms () and/or niacin appear to be more recent phenomena21.
Similar to the practice of microdosing more broadly, the popularity of likely emanates from the proliferation of positive anecdotal reports over the past decade rather than from a strong empirical basis. Indeed, to our knowledge no studies have directly tested potential synergistic effects of these substances when combined with psilocybin. As such, the proposed mechanisms of action, benefits and subjective effects of stacked psilocybin microdose admixtures typically follow from reports associated with the stacked substance in isolation. For example, the benefits of cacao23 and potential cognitive enhancing properties of Lion’s Mane mushrooms24 have been proposed to synergize with the putatively complementary qualities of psilocybin mushrooms25,26. Other rationales for stacking include observations regarding potential biochemical interactions. Specifically, both Syrian Rue and Lion’s Mane have been identified as inhibitors of monoamine oxidase (MAOI)27,28, and MAOI have a long history of use in psychedelic admixtures such as ayahuasca where they serve to extend and enhance the effects of 5HT2a receptor agonists29. In contrast, the flushing effects of niacin are suggested to facilitate psilocybin bioavailability and be prophylactic for abuse21. However, despite traditional practices, theoretical rationale, and contemporary anecdote that suggest potential benefits of stacking, empirical studies of most stacked substances are limited and largely involve animal models. As such, caution is warranted when interpreting claims related to the synergistic effects of stacked substances and psilocybin in humans.
What is Microdosing, and Does it Work?
Scientists are split over whether the benefits some microdosers experience are a placebo effect or something more.
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