Studies show that compounds like LSD, ecstasy, and psilocybin mushrooms can be used to treat a range of mental health disorders, with participants in clinical studies often describing tremendous progress taming the demons of post-traumatic stress disorder, or finding unexpected calm and clarity as they face a terminal illness
It's not clear how the mind might be changed by the use of psychedelics.
A group of neuroscientists in London thought advanced neuroimaging technology could provide some answers. They included 43 people with severe depression in a study and gave them either the active ingredient in magic mushrooms or a conventional antidepressant, but they were not told which one they would receive. The day before the first dose and three weeks after the final one, functional magnetic resonance was taken of their brain activity.
The study was published in the journal Nature Medicine. Over the course of three weeks, participants who had been given escitalopram reported mild improvement in their symptoms, and the scans continued to show the signs of a mind hobbled by major depression. Neural activity was constrained within certain regions of the brain, a reflection of the rigid thought patterns that can trap those with depression in a negative feedback loop.
By contrast, the participants who received the therapy reported a rapid and sustained improvement in their depression, and the scans showed neural activity across large swaths of the brain that persisted for three weeks. They said that the heightened connection resembled the cognitive agility of a healthy brain that can be used to deal with a morning bout of melancholia, a stress day at work and an evening of revelry with friends.
The authors acknowledged the limitations of the study, but said that it appeared to have an effect on the brains of people with severe depression.
"Psilocybin, it would seem, allows you to see things in an entirely new light, particularly when you have a therapist who can help guide you through that experience," said Richard Daws, a cognitive neuroscientist and a lead author.
The results of the study provided a possible explanation for the anecdotal accounts about the benefits of psychedelic medicine, according to experts not involved with the study.
Patrick M. Fisher, a neuroscientist at the Neurobiology Research Unit in Copenhagen, said the findings could help explain why study subjects in psychedelic research often report long-term relief from psychological ailments.
The results highlighted the need for more study, according to other researchers. Dr. Stephen Ross, associate director of the N.Y.U. Langone Center for Psychedelic Medicine, cautioned against drawing conclusions from a relatively brief monitoring period of participants.
An experiment that was included in the Nature Medicine paper appeared to support the idea that psilocybin therapy could provide benefits. 16 patients were recruited for the trial because they knew they would receive the drug. Brain scans were taken a day after the final dose was administered. Many participants reported that the improvements to their depression had not subsided six months later.
The results are very promising, but no one should go out and try and get drugs without talking to a doctor or a therapist.
Drug policies in the United States prevented most scientists from investigating mind-altering compounds, which is why the field of psychedelic medicine is still in its infancy. As the stigma has faded and research funding has begun to flow more freely, a growing number of scientists have begun exploring whether such drugs can help patients suffering from a wide range of mental health conditions.
MDMA, also known as ecstasy, has been promising. In May of last year, a study in Nature Medicine found that a drug and talk therapy could reduce or even eliminate symptoms of post-traumatic stress disorder. The FDA could approve MDMA therapy for post-traumatic stress disorder as soon as next year, according to some experts.
According to the National Institute of Mental Health, depression is one of the most common and intractable mental health challenges in the United States, with an estimated 21 million adults reporting a major depression episode in 2020. Prozac and other S.S.R.I.s do not work for everyone and have significant side effects.
Mental health experts and patients have been impressed by the handful of small studies on depression.
Robin Carhart-Harris is the director of the University of California, San Francisco's Neurosciences Division and is an author of the Nature Medicine article. He suggested that the images might be better compared to the undulating pastoral landscape. He said that people with depression get stuck in the valley. Although S.S.R.I.s can make them feel better, the drugs do not appear to change the overall landscape of their brain, suggesting that the drugs do little more than ease the symptoms of their depression.
He said that the treatments with the drug, called psilocybin, seemed to provide a way out of those valleys by inducing a global increase in brain network integration, essentially touching off activity across parts of the brain that were previously cut off from one another.
It makes you move out of the valley.
He acknowledged that the two trials raised a lot of unanswered questions. He expressed caution against the headlong embrace of the drug without supervision.
It might sound trite to say, but I think it opens up the mind, and that's its strength.
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