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Regulators at the Food and Drug Administration have designated MDMA, the drug known as ecstasy, and psilocybin, the psychoactive compound in psychedelic mushrooms, as “breakthrough therapies.” That label means the two drugs, which have been used in clinical trials to treat patients with post-traumatic stress disorder and severe depression, may offer substantial improvements over existing therapies. Both are widely expected to get FDA approval for mainstream clinical use by 2024.
The theory at the heart of this research is that psychedelics can induce quick and profound changes in mood and outlook, seemingly by stimulating key receptors in the brain. Scientists theorize that by disrupting routine patterns of thought and memory processing, psychedelic trips often yield profound insights and a reprieve from the obsessive thought loops often associated with mental illness.
depression can be a symptom of an atrophying brain, which gradually loses the ability to reason, keep perspective, and regulate emotions.
often people are left with profound insights about the nature of their suffering and gain an ability to make valuable associations and inferences about their past. Neurologists refer to this as a period of enhanced neuroplasticity, a reference to the brain’s ability to make new and stronger connections. With support from a skilled therapist, this state of disruptive thinking and perception can be extraordinarily clarifying and therapeutic, setting in motion long-lasting, and at times permanent, changes in outlook and behavior,
Psychedelic—which blended two Greek words—psychḗ and dēleín, or “mind manifesting”—
The implicit deal you make on this path is to periodically set aside time and energy to lean heavily into your darkness in order to morph pain and trauma that have been repressed.
our genes shape a person’s risk for depression.
epigenetics
considers how a person’s environment and behavior—and even those of their parents and grandparents—affect the expression of their genes.
Ayahuasca is marketed today as a shortcut to happiness, a means to get ten years’ worth of therapy in a couple of nights.
we get to take on the pain of others, to share the burden of losses, big and small, of the regrets and the split-second horrors that diverted a person’s destiny. With that comes a realization that we are less alone than we presumed, less likely to be stigmatized than we feared, less atypical in our ambivalence about staying alive.
when you’re administering psychoactive drugs to people in distress, a lot can go terribly wrong.
when people are seriously hurt, there’s often little recourse.
“You really have to make an effort finding meaning in things and having a lust for life because you have been clouded for so long that you forgot there was something out there to live for.”
Suicide or depression
Toni said there are three stages in life: the past, the present moment, and the future. Suffering stems from a tendency to ruminate incessantly about the past, far beyond what is useful to heed its lessons, and to fret about the future, getting caught up in loops of indecision. “We must learn to live in the present moment,” he said. “The past is in the past.” Regarding the future, Toni said, it’s necessary to be at once optimistic and decisive, “without fear or doubt.”
Jonathan posits that each person is a soul that gets deposited on earth for a learning experience that is shaped by past lives, or our karma. Suffering, he writes, is a means to learn the lessons we are meant to learn in each lifetime. And the only way to lessen our “karmic imprint” is to master the hard but indispensable act of forgiveness—by learning to forgive ourselves and others.
Suddenly, it felt plausible—
that we can have a direct relationship with God, the numinous, the mystery—call it what you will!—and that cultivating it gives clarity to our thinking and purpose to our actions.
“We heal when we make peace with the thoughts that torment us,” I wrote. “It takes practice to disarm them, to let them be, but quieter, gentler—until they are no more. And that is exactly what we are here on Earth to do. We’re here to practice.”
suppressing symptoms of unprocessed trauma does not make it go away. And one day, the coping mechanisms stop working.
ayahuasca often seems more prone to hand out assignments rather than to accept requests.
The way psychoactive substances like ayahuasca affect memory retrieval and reconsideration remains poorly understood,
there is growing evidence that psychedelics, by sparking periods of disruptive thinking, create an opportunity to “reconsolidate” memories. In practice, he said, that means gaining the ability to reassemble a set of facts in a way that fundamentally shifts how you understand them and how they make you feel. Obsessive, recurring thoughts—which depressed and traumatized people often struggle with—can suddenly become elements of a clearer narrative, which loosens their grip. “Reconsolidation is like changing the way the memory was initially encoded,”
a field that has seen no major breakthroughs since the advent of antidepressants in the 1980s,
Just how vital is the role of psychotherapy in harnessing the healing potential of mind-bending sessions?
psychedelic trips appear to generate a period of enhanced “cognitive flexibility.” For people who have been in the grip of obsessive or fatalistic thought loops, that can generate a “window of opportunity that can allow people to make substantive changes in their patterns of thinking and behavior,” she said. “Your entire worldview can change.”
first academic certificate program for psychedelic therapists in the United States.
Years of clinical practice have led Janis to believe that the most substantive type of healing happens when patients find the tools and wherewithal to do profound introspection. The best therapists have mastered the art of being a “midwife for that work,” Janis said, steering patients gently as they discover what has been at the root of their distress and what they can do about it.
ketamine, an anesthetic that can be prescribed off-label for treatment of psychiatric conditions. At low doses, it induces a dissociative, psychedelic-like state.
Ketamine was produced in the 1960s by drug developers seeking to create an anesthetic with fewer side effects.
there was no inkling the drug could treat mental health conditions until the 1990s. Researchers at Yale University discovered that ketamine provided some people with depression immediate relief, making it a potential game changer in psychiatry.
ketamine’s patent expired in 2002,
strongly hyped and aggressively marketed psychiatric drug starting around 2018.
inject eighty-five milligrams of ketamine into my right biceps.
Say yes to everything.”
“Part of the healing comes from approaching that which is uncomfortable or even disturbing.”
through good times and bad, we retain the capacity to love and to be loved. That makes staying alive worthwhile. With love, she said, “we can weather the storms.”
Dr. Bryan Roth, a prominent pharmacologist and psychiatrist who has been consumed by a fascinating mission to end depression as we know it.
Bryan began studying psychedelics decades ago,
“I thought they would be a window into the brain, into consciousness,” Bryan explained. “If we ultimately understood how psychedelics work, we would understand this hard problem of consciousness, of awareness, of perception.”
Bryan was among the first scientists who discovered that psychedelics enhance neuroplasticity, making the interconnectedness of neural links richer. That phenomenon is now widely assumed to be at the heart of why psychedelic trips can have immediate and long-lasting therapeutic effects.
Awful memories often set the trajectory of extraordinary lives.
Like me, they have come to see depression as a misfortune that can be a powerful teacher, a curse that often offers blessings. It took years to reach that conclusion.
when administered by a steady, wise guide, in a safe setting, I have seen psychedelics transform lives—including my own.
Depression, at its core, is a disease of tormenting thoughts that become the building blocks of our belief system. When deluded beliefs shape our choices, we inevitably create fresh sources of suffering.
my depression, at its peak, was a clarion call of unmet needs.
