[HN Gopher] Study suggests mechanism through which psychedelics ...
___________________________________________________________________
Study suggests mechanism through which psychedelics may alleviate
depression
Author : gmays
Score : 165 points
Date : 2022-04-13 15:12 UTC (7 hours ago)
(HTM) web link (www.ucsf.edu)
(TXT) w3m dump (www.ucsf.edu)
| lampshades wrote:
| I took a large dose of mushrooms about 11 years ago and haven't
| had depression since. My life was on track to nowhere and now I'm
| doing great. Hard to not give mushrooms a bit of the credit, the
| results were immediate.
| vincentmarle wrote:
| Question: wasn't psilocybin recently legalized in California? How
| does one get it? Asking for a friend..
| TaylorAlexander wrote:
| Decriminalized in Oakland and Santa Cruz. My friend was able to
| buy psilocybin capsules at a shop in Oakland, though I forget
| the name.
| greyface- wrote:
| https://zidedoor.com/ ?
| TaylorAlexander wrote:
| oh yah thats the one!
| jmacd wrote:
| I had dinner with two psychiatrists who are working in this field
| both with adults as well as one of them who is doing work in
| paediatric psychiatry. They have both taken LSD, Psilocybin and
| ketamine as part of their work so they would be able to introduce
| it to patients properly.
|
| One key component that seems to be missing from a lot of the
| excitement about these treatments is how important an ongoing
| therapy or other behavioural support component usually is. A lot
| of patients find some relief from a ketamine or other therapy but
| it can open up a host of issues they have not dealt with or it
| can resurface old behaviours.
|
| One example was a patient who had a long history of abuse which
| was more or less hidden by their severe depression and suicidal
| tendencies. They had a series of ketamine treatments by an
| anesthesiologist and it cracked that past right open. The place
| they were taking the treatment was not equipped to support that
| and they did not have immediate access to psychiatric or even
| good psychological support and it did create a bit of a spiral.
|
| I don't think any of that comes as a surprised to people in the
| field, but each patient and circumstance is different. The sooner
| we can bring these treatments in to mainstream health research,
| the more holistic the approach to patient health can be.
|
| Lots of interesting stuff to learn. I am just bystander-
| fascinated by it and am not professing any expertise here.
| mise_en_place wrote:
| > They have both taken LSD, Psilocybin and ketamine as part of
| their work so they would be able to introduce it to patients
| properly.
|
| While I think there might be potential for psychedelics in
| therapy, let's be honest here. That would be like a Wall Street
| guy saying he snorted 3 lines of cocaine to better advise his
| clients on investments
| pmoriarty wrote:
| Unfortunately, a lot of people can't afford therapy... and
| insurance doesn't tend to cover psychedelic therapy.
|
| Hopefully one day it will, but we're not there yet.
|
| This will, at least in the short-term, unfortunately lead to
| widening inequality, where relatively wealthy people will be
| able to afford therapeutic treatment, while the poor will be
| left to their own devices.
| bencollier49 wrote:
| Earlier discussion: https://news.ycombinator.com/item?id=30991278
| mattbaker wrote:
| Oregon will be formalizing their program to provide therapeutic
| access to mushrooms in controlled settings soon.
|
| I have mixed feelings and some potential fears about the
| execution, but it's still going to be absolutely fascinating to
| watch and I've got my fingers crossed it could become a really
| positive treatment option for residents here. I bet we'll see
| some articles about it on HN in the years to come!
| rubatuga wrote:
| Just from working with a few psychiatrists for the past month,
| none seemed to be enthused about trialing or studying
| psychedelics for depressed patients. I think we will need a lot
| more case studies and a comprehensive list of harms and adverse
| reactions before convincing them. Worth mentioning this treatment
| also requires more work on the therapist/psychiatric side.
| Something that doesn't need a lot of therapy sessions is ECT
| which is very effective for treatment resistant depression.
|
| Lastly, psychedelics used to be researched for military purposes
| and mind control, wondering if this is still a risk factor for
| patients?
| lampshades wrote:
| I think the largest risk factor is to the wallets of
| psychiatrists.
| siloed wrote:
| The parent comment draws an important difference between the
| use of psychedelic therapy and, say, ECT. I support this
| research but "Big Psychiatry just wants the cash!" is a
| reddit-level of nuance we can do without please.
| philosopher1234 wrote:
| Or perhaps its just another round of hurting people being
| taken for a ride by massive pharma companies, and
| psychiatrists aren't thrilled about it.
| lampshades wrote:
| You can grow a mushroom in your closet.
| philosopher1234 wrote:
| Sure, you can, and feel free to try it. But thats not the
| reason for psilocybin's sudden popularity with pharma
| sponsored studies.
| TaylorAlexander wrote:
| It's fun too!
| pmoriarty wrote:
| _" Just from working with a few psychiatrists for the past
| month, none seemed to be enthused about trialing or studying
| psychedelics for depressed patients."_
|
| How old are these psychiatrists?
|
| Many psychiatrists grew up during the days of prohibition and
| paranoia about psychedelics, and their training exclusively
| focused on treating depression with non-psychedelic
| antidepressant drugs.. not to mention all the kickbacks that
| psychiatrists received from the pharma companies peddling those
| antidepressants.
|
| So I'm not at all surprised to hear skepticism from some of the
| more conservative ones.
|
| That said, there's been an overwhelming amount of research
| showing the effectiveness of psychedelics on treatment-
| resistant depression -- effectiveness that dwarfs the effect of
| antidepressants. So many other psychiatrists and therapists are
| much more open to trying them than the psychiatrists you met
| with.
|
| _" psychedelics used to be researched for military purposes
| and mind control, wondering if this is still a risk factor for
| patients?"_
|
| They were not found to be effective at "mind-control" and the
| "research" (if it could be called that) was abandoned. All such
| abuse resulted in was traumatized, broken people. Really
| horrific stuff. See the history for MKUltra[1] for details.
|
| It's still a concern that you might be unlucky enough to work
| with an abusive psychiatrist or therapist.. so you should
| really be vetting the people you work with very carefully. That
| said, there are training, certification and licensing
| procedures and organizations that are there to help prevent
| abuse and deal with it if/when it happens. For example, see:
| [2]
|
| Also, at least with MDMA therapy the standard is to have two
| therapists with you at all times, to decrease the chance that
| one of them will abuse you. Also, at least in the studies, it
| has been common to videotape the sessions, so there is a record
| of what happened, which should decrease the risk of people
| completely getting away with abuse.
|
| But, yeah, it's still a risk and I don't think any therapy will
| be completely risk free... especially not psychedelic therapy,
| where the patient is so incredibly vulnerable and suggestible
| during the session. That's why, again, it's very important that
| you vet the therapist you're working with to best of your
| ability before you trust them with your mind.
|
| [1] - https://en.wikipedia.org/wiki/Project_MKUltra
|
| [2] - https://maps.org/safety/
| clsec wrote:
| Both my psychiatrist and therapist are open to the idea. In
| fact, I'm pretty sure everyone who works in the clinic I go to
| are open to it. This is in San Francisco though, so YMMV.
|
| And since it's not yet legal in CA, I've thought about joining
| a UCSF study (last I checked they had 4 ongoing). Haven't acted
| on it yet though.
| karpierz wrote:
| > placebo that turned out to be escitalopram, an SSRI
| antidepressant.
|
| How is this a placebo?
| weego wrote:
| My assumption and this article is badly worded. The wording
| suggests the second group are not treatment-resistant, and
| considering the loading and expected timeline of any kind of
| effect of Escitalopram it may well have been their current
| medication. Especially as from my experience loading an SSRI
| has a very unmistakable physical unpleasantness which would be
| a give-away.
|
| There's also the ethical limitations of taking someone off a
| medication they need for their wellbeing to try something else,
| which is largely not allowed which makes trialing certain
| alternatives difficult and complex.
| isoprophlex wrote:
| I guess it's poorly or incompletely worded. This is an "active
| placebo".
|
| Another example would be determining something about mystic
| experiences and testing amphetamine against psilocybin. You
| need something active, because otherwise even a drug-naive
| participant quickly groks they're on sugar and not an actual
| drug
| luckydata wrote:
| placebo controlled studies are not really possible for
| psychedelics anyways. There's literally no way someone takes a
| high dose of it and doesn't figure out they have taken
| psychedelics. You need slightly different tools for this type
| of studies so I think they are comparing effectiveness instead.
| pmoriarty wrote:
| Actually, I've heard a researcher say that in the MDMA
| studies they ran, some people who were given placebos
| experienced a full breakthrough, with lots of emotion,
| crying, and therapeutic benefit and swore that they were
| given MDMA.
|
| It probably also helped that these were people who'd never
| tried MDMA.. so they didn't really know what to expect.
|
| Also, in microdosing studies, I think even sugar pills could
| be very effective placebos.
| PragmaticPulp wrote:
| Technically an "active control", though the patients appear to
| be selected to have been SSRI-resistant:
|
| > The open-label trial had the additional criteria of TRD, as
| defined by no improvement despite multiple courses of
| antidepressant medication (mean = 4.6 +- 2.6 past medications;
| range, 2-11)
|
| If i'm reading the study properly (disclaimer: I may not be)
| then the patients in the open-label trial had already failed an
| average of 4.6 typical antidepressants. So it's unlikely that
| they'd be responding to a starter dose of another SSRI (10mg
| escitalopram, though some were on 20mg perhaps by body weight)
| BossingAround wrote:
| If that was sugar, it's pretty easy for me, as a study
| participant, to tell whether I've been given mushrooms or not
| (i.e. am I feeling drugged or not). I suspect that played a
| part of the reasoning to use a psychoactive compound instead of
| sugar pills as a placebo.
| linguistbreaker wrote:
| I think other studies have used Nicotine and other substances
| to provide an initial flush of feeling like you took
| something. That being said, "feeling drugged" is pretty dose
| dependent so plenty of studies could use a truly inactive
| placebo alongside a lower dose.
| pmoriarty wrote:
| _" I think other studies have used Nicotine and other
| substances to provide an initial flush of feeling like you
| took something."_
|
| Niacin, not nicotine.
|
| See the so-called "niacin-flush" response:
|
| https://en.wikipedia.org/wiki/Niacin#Flushing
| TheBlight wrote:
| IIRC, AstraZeneca did a similar thing when testing their
| covid-19 shots. In one of their trials the placebo was a
| meningitis vaccine.
| cnity wrote:
| Isn't the term "control" more accurate than "placebo" in
| these contexts? I thought that a placebo was inactive,
| while a control is used to set a baseline for judging
| improvement. A placebo is a type of control, but not vice
| versa.
| bragr wrote:
| A placebo doesn't have to be inert, it's more that it has
| to have no therapeutic value. Meningitis vaccine doesn't
| protect against covid so it's an effective placebo for
| testing covid vaccine for example.
| arghwhat wrote:
| A placebo does not need to be completely inactive, it
| merely needs to not exhibit the effect you are trying to
| test for.
|
| Using an anti-depressant as placebo for a test regarding
| anti-depressive effects does seem a bit odd, but it is
| fine if the test is for effects or durations exceeding
| the capability of placebo drugs.
| macksd wrote:
| To help keep it as blind as possible, studies sometimes use
| something that is better understood and gives you the side-
| effects you might expect if you weren't on the placebo. Like
| the Pfizer COVID study used the meningitis vaccine as a placebo
| IIRC.
|
| edit: see another comment suggesting that control is the right
| term for this rather than placebo - face palm moment.
| luto wrote:
| These days many studies use existing medicines as a placebo as
| opposed to just nothing in the form of sugar.
|
| see also
| https://en.wikipedia.org/wiki/Placebo#In_research_trials
| meowface wrote:
| If it's a psychoactive molecule, it's not really a placebo,
| in my opinion. I don't think the section you linked refutes
| this:
|
| >Some suggest that existing medical treatments should be used
| instead of placebos, to avoid having some patients not
| receive medicine during the trial.
|
| It discusses medical treatments used instead of placebos,
| rather than as placebos.
|
| I think the more accurate term here would be "control", not
| "placebo". It arguably could create or enhance a placebo
| effect with respect to psilocybin, but I think "control"
| would be less confusing terminology to refer to the non-
| psilocybin substance. Then again, they're the research
| university and I'm a random internet commenter, so they
| probably have more authority on this than I do.
| tokai wrote:
| Your opinion is not worth anything regarding this, as it
| goes against the common understanding of reseachers. The
| concept of an active placebo is from the 60s and is well
| know in medical studies.
| meowface wrote:
| My understanding is that an active placebo generates some
| expected effects so that the patient is more likely to
| believe that they took _something_ :
| https://en.wikipedia.org/wiki/Active_placebo
|
| >An active placebo is a placebo that produces noticeable
| side effects that may convince the person being treated
| that they are receiving a legitimate treatment, rather
| than an ineffective placebo.
|
| >An example of an active placebo is the 1964 work of
| Shader and colleagues who used a combination of low-dose
| phenobarbital plus atropine to mimic the sedation and dry
| mouth produced by phenothiazines.
|
| >Morphine and gabapentin are painkillers with the common
| side effects of sleepiness and dizziness. In a 2005 study
| assessing the effects of these painkillers on neuropathic
| pain, lorazepam was chosen as an active placebo because
| it is not a painkiller but it does cause sleepiness and
| can cause dizziness.
|
| Here, it seems like an example active placebo might be
| something that induces nausea, since psilocybin is known
| to induce nausea. SSRIs are not just an active placebo
| but something that actually attempts to treat the primary
| symptom: depression. The above paragraph suggests
| lorazepam would be a good active placebo for testing
| painkillers because it is not a painkiller; here, an
| antidepressant is being compared with an antidepressant.
|
| So I was wrong to say that it's not a placebo if it's a
| psychoactive molecule. I just don't think it is if it's a
| psychoactive molecule that's treating the primary symptom
| you're attempting to find a treatment for.
| mateo1 wrote:
| What happens with regards to informed consent? Do you give
| them permission to administer you with literally any drug?
| jrowley wrote:
| No, in the informed consent document they should describe
| you will be given an active placebo or the investigational
| drug. The IRB would approve the specific drug / dose that
| is administered, as outlined in the trial protocol.
| PragmaticPulp wrote:
| Link to actual paper:
| https://www.nature.com/articles/s41591-022-01744-z
|
| These open-label studies also need to be carefully evaluated
| within the context of their selection criteria. One of the
| biggest challenges with open-label studies for psychedelics is
| that they tend to collect "true believers" who are already
| convinced that psychedelics _will_ cure their depression. They
| seek these studies out specifically for the opportunity to
| receive psychedelics, often because they 've read books and news
| articles telling them it will be successful. Notably, 1/4 of
| participants admitted to past psychedelic use (and I suspect the
| actual number is much higher, given that study participants often
| lie if they think a certain answer might exclude them from
| receiving the drug they want)
|
| The study also explicitly required treatment-resistant patients
| to have tried and failed multiple antidepressants in the past,
| which explains the low response rate to the SSRI arm:
|
| > The open-label trial had the additional criteria of TRD, as
| defined by no improvement despite multiple courses of
| antidepressant medication (mean = 4.6 +- 2.6 past medications;
| range, 2-11)39. Patients were asked whether they had previous
| experience of using psychedelics. In the open-label trial, 25%
| had previous experience. Similarly, in the DB-RCT, 31% of
| patients in the psilocybin arm and 24% in the escitalopram arm
| had previous experience.
| ProjectArcturis wrote:
| There's also an ongoing problem in the analysis of MRI
| functional connectivity. About 2010, someone had the idea to
| apply concepts from graph theory to fcMRI. That is fraught with
| a number of heroic assumptions (fcMRI correlations do not
| necessarily represent physical connections, and continuous
| relationships must be binarized with arbitrary thresholds). But
| most importantly, there are so many different graph theory
| metrics, and ways to tweak the analysis, that a determined
| postdoc is basically _guaranteed_ to find something that can
| reach statistical significance. I suspect something like that
| has happened here.
| extrememacaroni wrote:
| Funnily, I find the idea that a susbstance can influence your
| behavior so much rather depressing :( is there anything there
| that is fundamentally unchangeable no matter the chemistry that
| could be called a "self".
| pmoriarty wrote:
| _" is there anything there that is fundamentally unchangeable
| no matter the chemistry that could be called a "self""_
|
| The Buddhists don't think so. One of their fundamental tenets
| is "anicca" or "impermanence", which is often interpreted to
| mean that nothing is unchangeable or everlasting.
|
| Many materialists/naturalists/physicalists don't believe
| there's an unchanging self either.
|
| But those who believe in a soul, in resurrection, or in
| reincarnation might.
|
| It's not a settled question, and a lot depends on what you mean
| by "self".
| asdff wrote:
| Watching an elderly relative in cognitive decline is even more
| depressing. You won't be you forever even if your body is still
| around.
| barnabee wrote:
| Strange, I find the same idea immensely
| reassuring/satisfying...
| TaylorAlexander wrote:
| Every experience every day changes the self. Every time you
| form a new memory your brain changes.
| philosopher1234 wrote:
| Depressed people need therapy. Enough with the pills. The science
| backing up antidepressants or psilocybin is very weak.
| emadabdulrahim wrote:
| Do you have any data on the effectiveness of talk therapy for
| patients with depression? Any data on how long it takes for the
| patient to experience any noticeable relief?
| philosopher1234 wrote:
| No, sorry. I'm not a scientist, just summarizing the
| impressions I've gathered from reading folks who are.
| tomek_ycomb wrote:
| I believe a proper summarizing might be closer to "people
| need therapy AND drugs"
|
| The strongest results across the board are a combination of
| therapy and medication.
|
| My _personal_ opinion is to vouch for therapy the most, and
| push hard against the pill narrative.
|
| But I think it adds to the shame of pills to not
| acknowledge the potential role many people have for pills.
|
| Now disregarding the "ssris are more effective combined
| with therapy" i also want to point out that most of the
| psychedelic studies are also combining therapy. My personal
| conjecture and perhaps some other peoples would be that
| drugs can help enable the conditions in which talk therapy
| is more effective.
|
| The classic example is the mdma ptsd therapy trials.
| Therapists can't apply cognitive therapy techniques if
| someone's fight or flight kicks in too powerfully. Drugs
| can help to bring the person to a state where they can get
| therapy.
|
| I've also seen this with friends --> deep depression, ssris
| helped elevate to the point that therapy was more
| successful than deep depression would otherwise have
| allowed.
| pmoriarty wrote:
| My own impression (and I've been intensely interested in both
| therapy and psychedelics for several decades) is that
| psychedelics in combination with therapy (and sometimes even
| psychedelics alone) can be much more effective than therapy,
| antidepressants or their combination.
|
| A positive outcome from psychedelic therapy is not guaranteed.
| Some people don't benefit from it, but many more people benefit
| from it than other approaches. And when they do benefit, the
| benefit is often much more pronounced and also typically longer
| lasting.
|
| There's a lot of research on this, particularly on individuals
| with treatment-resistant depression.
|
| Psychedelic therapy is not a panacea.. and nothing that
| operates on your mind is going to magically fix the
| circumstances you're in or your relationships with others --
| you have to do that yourself. But the depression itself can be
| helped.
| rank0 wrote:
| There's definitely some benefit for some people but this headline
| is straight sensationalized.
|
| People need to be careful with psychedelics. The afterglow wears
| off pretty quick. I've met many people for which psychedelics
| actually reinforced "negative" aspects of their person...except
| now they believe to be enlightened from their trips.
|
| After dozens of trips myself, one of the things I've learned is
| that these drugs induce the feeling of profundity. The experience
| of a trip FEELS profound, regardless of the actual content of
| your thoughts. Sometimes it's great! -- When your new idea or
| outlook is truly beneficial for yourself and others. Not
| everybody gets that. My cynicism has been magnified.
| pmoriarty wrote:
| _" People need to be careful with psychedelics."_
|
| Absolutely. Psychedelics are incredibly powerful substances and
| they need to be treated with respect. Everyone considering
| doing them should educate themselves thoroughly beforehand and
| use them in maximally safe, constructive ways. James Fadiman's
| _Psychedelic Explorer 's Guide_[1] has lots of great advice on
| how to do this.
|
| _" The afterglow wears off pretty quick."_
|
| It really depends on the substance and how it's used. Ketamine,
| for example, commonly needs to be readministered relatively
| frequently (though some people have lasting effects), while
| many people get very long lasting effects from between one to
| three therapeutic MDMA or psilocybin sessions (sometimes
| lasting for years).
|
| It's people who tend to use psychedelics outside of a
| therapeutic context, to "party" and/or without constructive
| intention or post-trip integration that tend to lack lasting
| effects.. but even then it's not at all uncommon for the
| experiences to be life-changing.
|
| [1] - https://www.amazon.com/Psychedelic-Explorers-Guide-
| Therapeut...
| droopyEyelids wrote:
| It's not cynicism imo- psychedelics can help people with
| depression, but they add fuel to the fire for people with 'dark
| triad' personality traits.
| globalise83 wrote:
| Just thinking back to one of my happiest student memories:
| watching the sea water pouring off the tail of a breaching
| whale... on a poster on the wall of my friend's digs.
| Overtonwindow wrote:
| There was another discussion recently about this study because it
| was also reported in Bloomberg. From my own personal experience,
| shrooms was the greatest thing that ever happened to me. It was
| like someone flipped a switch on my depression and the depression
| magically went away. The study really validates what I
| experienced, and the truly life-changing effect that it had.
| BossingAround wrote:
| Interesting. Did the effects last? Are you still using it, or
| was it "one-and-done" kind of an experience?
| pigtailgirl wrote:
| when start to feel less motivated - don't want to go out -
| struggling at work- I take ~3 grams - usually lasts about 2
| months or so - find this much better than microdosing
| personally
| imilk wrote:
| For anyone who's never tried mushrooms before, 3 grams is a
| pretty large dose. If it's your first time start with 1
| gram or so. After all, you can always take more, but you
| can't take less.
| BossingAround wrote:
| Really. Here I was thinking a starting dose was 8 grams
| (from a documentary about magic truffles in Netherlands).
| Good thing I never had the opportunity to try mushrooms,
| that'd probably be a pretty wild, unpleasant trip :))
| starkd wrote:
| How do you measure out 3 grams? I would think it would be
| difficult to control that level of granularity.
| Karawebnetwork wrote:
| Three grams of mushrooms is easily 4 to 10 individual
| mushrooms. Usually people simply weight the entire
| mushroom and not the exact psilocybin content. This is
| not ideal since potency will vary but it's enough to give
| you a good idea of the dose when comparing to previous
| sessions. However, there are more and more legal services
| who can provide already weighted product with the exact
| psilocybin content on the label.
| vsgzusnex wrote:
| Probably just means 3g of actual mushroom fungi matter.
| Just need a food scale.
| abcc8 wrote:
| A kitchen scale works well for masses in this range.
| TaylorAlexander wrote:
| There's also 0.1 and 0.01 gram scales sold for like $15
| on Amazon.
| colpabar wrote:
| I have a similar experience. I first did shrooms in high school
| and enjoyed it immensely. But in the few weeks after the trip,
| I felt _great_. I was _way_ less nervous talking to people, I
| felt more confident, and just generally better about myself and
| life in general.
|
| But if you're interested, be aware: they taste _gross_ and it
| 's pretty common to feel really sick and throw up within the
| first 30 minutes. But after that, I promise you'll enjoy it, if
| you are in a good environment of course.
| greyface- wrote:
| > they taste gross and it's pretty common to feel really sick
| and throw up within the first 30 minutes
|
| FYI, if you make a tea instead of ingesting them directly,
| both of these issues can be avoided.
| MarcelOlsz wrote:
| Use a coffee grinder to crush it into a fine powder.
| Squeeze a lemon into a cup. Put the powder in and stir.
| Wait 20 minutes, add some orange juice or water and take it
| down. Activates instantly and you sidestep the nausea from
| your stomach where it feels like if you move a muscle
| you'll hurl.
| colpabar wrote:
| I have not done this but I'd probably recommend not using
| that coffee grinder for coffee anymore :^)
| Acutulus wrote:
| In general this is excellent advice! Having said this, I
| wager some of us don't mind drawing a soft wildcard
| before heading to work :)
| imilk wrote:
| Put them in a peanut butter sandwich (with jelly/bananas/etc)
| and you taste them way less
| newman8r wrote:
| as a reminder, california SB-519 could decriminalize this
| substance in 2022
| https://leginfo.legislature.ca.gov/faces/billStatusClient.xh...
|
| I'm not sure what the best way to support it is, but I'm
| following the progress closely and it isn't getting much coverage
| - I figure I might as well spread the word whenever I can.
| coding123 wrote:
| maerF0x0 wrote:
| > They are Hmong
|
| How is this relevant?
| alan-hn wrote:
| Race is always relevent to racists
| jjulius wrote:
| >... I have to smell weed pretty much all the time now.
|
| Life could be worse.
|
| >They are Hmong...
|
| Why is this at all relevant?
| coding123 wrote:
| Just whatever.
| alan-hn wrote:
| Ending prohibition would mean that criminals would no longer
| be involved in drugs, because people can buy them at the
| store.
|
| It doesn't work super well if the regulations and taxes make
| legal drugs more or as expensive as legal drugs, so that
| needs to be managed well for things to work.
| pmoriarty wrote:
| Spreading the word about the bill and also being open with your
| family, friends, and possibly even coworkers about your own
| psychedelic use are some of the best ways to support this
| initiative.
|
| We really need a lot more people to come out of the psychedelic
| closet.
|
| Also consider contacting and supporting groups like MAPS[1] and
| Decriminalize Nature[2].
|
| [1] - https://maps.org/
|
| [2] - https://decriminalizenature.org/
| krylon wrote:
| Once upon a time, I took a (by my standards) pretty large dose of
| mushrooms while rather depressed (although I did not realize it
| at the time). The trip itself was rather dark, but the next day,
| my depression was entirely gone, I was actually _happy_ for the
| first time in months, and it lasted for quite a while.
|
| The first time I took LSD, my mood was significantly improved for
| weeks afterwards, even though I don't think I was depressed
| before. But I did notice that things that normally annoy me
| tended to annoy me less, and things that made me happy made me
| happier. Again, this lasted for at least a month.
|
| Considering how often antidepressants tend to be a hit-or-miss
| game (not to speak of side effects), I am a bit annoyed
| psychedelics don't get more attention for medical use.
| dangom wrote:
| I have a pet hypothesis that "curing" depression is an active
| endeavor, instead of a passive one. Just like being healthy in
| general requires at least a moderate regard to nutrition and
| exercising. No amount of medicine can replace those.
|
| From anecdotal reports, it seems that mushrooms forces one into
| an active thought space (like dropping someone of at the gym
| with a program for them to follow), such that one is more
| likely to engage with ones own thoughts, and is capable of
| interpreting them, recasting them, accepting or letting them
| go.
|
| The idea of "rewiring" seems a bit too far, since rewiring
| cannot be achieved instantly.
| fsloth wrote:
| Have you been depressed? I can tell from experience that a
| depressed mind is quite active. In a bad way - constantly
| hurting itself with dark thoughts and hence reinforcing the
| bad stuff constantly.
|
| You can't exercise depression away. At least for those
| situations I am familiar with.
| throwawayboise wrote:
| To me the point being made is that there will never be a
| "cure in a pill" for many things, including depression.
| Medication may help, but really getting past it will also
| take active effort.
|
| If you're overweight, you can't get lean and fit by taking
| a pill (much as many would like it to be true). You will
| have to make some effort by eating less (actively resisting
| feelings of hunger) and getting more physically active.
| dangom wrote:
| Active is a bad word to describe what I meant. I don't mean
| to say that a depressed mind is not thinking, just that it
| may not be able to get itself out of the place it is in
| without "active" effort (as in therapy - self-therapy or
| mediated by others). The conundrum is that putting in that
| effort may not possible because all energy is already spent
| - as you pointed out. My suggestion is that psychedelics
| opens space for these thoughts to be actively dealt with in
| a productive way.
|
| There is also mounting evidence that depression is a
| symptom and not a single disease, and the symptom may be
| originating from multiple causes. This view is supported by
| the extreme between-subject variability seen in imaging
| studies [1]. That being the case, maybe not all causes
| would require an "active" approach, just as maybe not all
| will respond to psychedelics.
|
| [1] https://www.nature.com/articles/s41386-020-00789-3
| athorax wrote:
| A similar situation for me. At the beginning of covid I had
| been struggling with depression and my own mortality. I took a
| large dose of psilocybin and during my trip I witnessed myself
| dying, decomposing, growing into flowers, being pollinated,
| being reborn, etc. Over and over again. The trip itself was
| uncomfortable and at times terrifying, but the results were
| immense and lasting. I came to terms with a lot of what I had
| been struggling with.
|
| Most of my other experiences have been along similar lines. "Oh
| hey, you know that uncomfortable thing you have been avoiding
| thinking about and dealing with? Yeah... Buckle up"
| nabla9 wrote:
| Same for me. What happens during the LSD trip may be relatively
| insignificant from the therapeutic perspective (not always).
| It's the aftermath when the drug is out of the really
| interesting system.
|
| I think annealing is a good metaphor for how the process feels.
| Psychedelics "break the structure" and "shake up" the brain
| (the trip). Then there is recovery and recrystallization into a
| state with less internal stresses.
| pmoriarty wrote:
| _" What happens during the LSD trip may be relatively
| insignificant from the therapeutic perspective (not always)"_
|
| I doubt that's the case, since we know a lot of subconscious
| material tends to surface during a trip.. and such material
| can be very fruitful material for all sorts of therapeutic
| approaches (except maybe behaviorism and its offspring).
| nabla9 wrote:
| The therapeutic effect from the trip seems to happen in
| first few times or after taking "heroic dose". If you have
| taken 5 trips over a 1-2 years, I don't think you get much
| material. Psychedelics seem to have hard limits of what
| they can reveal.
|
| I have found that the good after effect comes even from low
| doses. Microdosing or just relatively low dosing that don't
| bring anything into surface.
| pmoriarty wrote:
| _" If you have taken 5 trips over a 1-2 years, I don't
| think you get much material. Psychedelics seem to have
| hard limits of what they can reveal."_
|
| I've never seen any studies to suggest this is the case.
| Just anecdotes of people saying they stopped taking them
| after a while because they weren't learning anything new.
| But usually such anecdotes have no information on just
| how they were taking them -- with intention? In a
| therapeutic context? What did you actually deal with in
| your life and what didn't you deal with?
|
| I suspect that those that stop getting results aren't
| integrating what they learn during the trip in to their
| lives, so they're stuck on repeat.
|
| _" I have found that the good after effect comes even
| from low doses."_
|
| The research on microdosing is just getting started. It's
| quite possible that reported effects from microdosing are
| due entirely to the placebo effect.
| dreen wrote:
| I was effectively in isolation for months due to some health
| issues (pre covid). I knew I was depressed as well and decided
| to take some LSD. I've taken it a few times before, never had a
| bad time. This time, I had. I repeated this a few times with
| the same results, its gonna be some time before I try it again.
|
| Nobody should just expect psychodelics "cure depression". Its
| possible they can deepen it in some conditions and we do not
| really understand it (I hope we will thanks to studies like
| these). They can help, but the lesson I got from this is they
| cannot replace support from fellow humans.
|
| Best advice I can give is try to only do this with some good
| company, outside on a sunny day, and it is highly likely it
| will be an overwhelmingly positive experience.
| mistermann wrote:
| > They can help, but the lesson I got from this is they
| cannot replace support from fellow humans.
|
| I think what's lost in the shuffle is that the phrase
| "guaranteed to" - all drugs are not guaranteed to work for
| all people, what matters is what is the likelihood that they
| can help any given individual, also taking into consideration
| the associated risks (both of taking and not taking).
|
| I'm just noting this because it would be easy for someone to
| take away from this conversation the notion that psychedelics
| _are necessarily_ dangerous, as it is possible that they are
| as safe or even safer than the thousands of other medications
| people take, and, some people are in situations where _not
| taking_ a chance could very well end in death (suicide),
| especially those who live in areas where assisted trips
| (legal or not) are not available.
| PragmaticPulp wrote:
| > Considering how often antidepressants tend to be a hit-or-
| miss game (not to speak of side effects), I am a bit annoyed
| psychedelics don't get more attention for medical use.
|
| Psychedelics are actually extremely hit-or-miss as well.
| Anecdotally, psychedelics don't always send someone in the
| right direction post-trip. If you scroll the comments in any
| popular psychedelics-for-depression post on Reddit, there are
| almost as many negative experience reports (including some
| long-lasting) as there are positive reports. The positive
| reports receive the bulk of upvotes, though, so you have to
| scroll down to see them.
|
| Perhaps less anecdotally, any medical professional will see a
| non-trivial number of people with significant negative effects
| of psychedelics, from worsening depression to HPPD to
| existential crises or psychoses. An actual doctor had a great
| comment on the previous discussion:
| https://news.ycombinator.com/item?id=30995831
| after_care wrote:
| > HPPD
|
| I've had some experience with HPPD but luckily mine went
| away. My experience ranges from 'oh that is pretty cool to
| look at' to 'this visual distortion is hurting my ability to
| focus on an important conversation'. I wish we better
| understood HPPD.
| postingposts wrote:
| I'd like to recommend a book to you:
| https://mitpress.mit.edu/books/trees-brain-roots-mind
| pmoriarty wrote:
| _" If you scroll the comments in any popular psychedelics-
| for-depression post on Reddit, there are almost as many
| negative experience reports (including some long-lasting) as
| there are positive reports."_
|
| Those trip reports are almost never done in a therapeutic
| context.
|
| Psychedelic _therapy_ is what research has shown to be very
| helpful with depression.
|
| When people trip on mushrooms outside of therapy, they often
| do so:
|
| - with a poor set and setting
|
| - without intention
|
| - with little if any preparation (almost certainly without
| therapeutic preparation)
|
| - while mixing them with other drugs
|
| - without trusted, experienced trip sitters (much less
| therapists) there to reassure and help out if need be
|
| - without any integration or therapy afterwards
|
| - without being 100% certain that they were getting real
| psychedelic mushrooms and not something else (like poisonous
| mushrooms)
|
| - while believing all sorts of myths about psychedelics
| (which might be cleared up by trained therapists in the pre-
| therapy preparation)
|
| So no wonder quite a few people have "bad trips".
|
| Even so, just because someone has a "bad trip" (or
| difficult/negative experience) doesn't mean that their
| experience couldn't be of value to them.
|
| It's quite common for people to report that their difficult
| experiences were actually very valuable to them. My own have
| been more valuable than my good experiences. The good
| experiences were fun and all, but the bad ones were
| incredibly insightful.
|
| When done in a therapeutic context, with trained psychedelic
| therapists and the right preparation, integration, and
| followup therapy, there should be many more positive outcomes
| than in the anecdotal trip reports that you'll read from
| people tripping casually.
| PragmaticPulp wrote:
| > Those trip reports are almost never done in a therapeutic
| context.
|
| > Psychedelic therapy is what research has shown to be very
| helpful with depression.
|
| Exactly right, which is why I mention it. A lot of people
| are going to read this thread and head off to do some self-
| experimentation at home, alone. We need to point out that
| the research and therapy environment is extremely different
| than DIY.
| pmoriarty wrote:
| _" the research and therapy environment is extremely
| different than DIY"_
|
| True, but that doesn't mean that the DIY environment
| couldn't be brought closer to the therapeutic one.
|
| I strongly recommend James Fadiman's _Psychedelic
| Explorer 's Guide_[1]. It has lots of great advice on how
| to use psychedelics therapeutically.
|
| [1] - https://www.amazon.com/Psychedelic-Explorers-Guide-
| Therapeut...
| rileyphone wrote:
| I'd be curious to see one such thread, but pretty sure you're
| just talking out your ass. My experience, and recent search,
| indicates these are usually about 80% positive, and most
| negative experiences stem from predictable abuse patterns. Of
| course there are dangers, risks, and bad experiences, but
| psychedelics might well be qualitatively better for
| depression than traditional pharmaceuticals.
| asxd wrote:
| > but pretty sure you're just talking out your ass
|
| This really isn't necessary. Assume good faith.
| mistermann wrote:
| It was inappropriate language, but I think there is a
| valid point to be made.
|
| Assuming good faith (ie: not lying) is similar but
| distinctly different from assuming that someone is
| speaking truthfully/accurately.
|
| >> Considering how often antidepressants tend to be a
| hit-or-miss game (not to speak of side effects), I am a
| bit annoyed psychedelics don't get more attention for
| medical use.
|
| > Psychedelics are actually extremely hit-or-miss as
| well. Anecdotally, psychedelics don't always send someone
| in the right direction post-trip. If you scroll the
| comments in any popular psychedelics-for-depression post
| on Reddit, there are almost as many negative experience
| reports (including some long-lasting) as there are
| positive reports. The positive reports receive the bulk
| of upvotes, though, so you have to scroll down to see
| them.
|
| > Perhaps less anecdotally, any medical professional will
| see a non-trivial number of people with significant
| negative effects of psychedelics, from worsening
| depression to HPPD to existential crises or psychoses. An
| actual doctor had a great comment on the previous
| discussion: https://news.ycombinator.com/item?id=30995831
|
| Looking at some of the discrete claims:
|
| > Psychedelics [are actually] [extremely] [hit-or-miss]
| as well.
|
| This asserts that results (across all instances of usage,
| not only those that have been studied under formal
| conditions) are highly random/inconsistent, in fact.
|
| This is highly contrary to my personal experiences, as
| well as the reading I have done on others' experiences.
|
| (Of course: we should keep in mind that it is unknown
| what percentage of experiences get posted, whether
| positive trips are more likely to get posted than
| negative, etc. - but "both sides" suffer from these
| problems.)
|
| > Anecdotally, psychedelics don't always send someone in
| the right direction post-trip.
|
| This true statement notes that they _don 't always_ do
| something positive, but it might be interpreted as being
| logically supportive of the preceding assertion, even
| though it is not.
|
| > If you scroll the comments in any popular psychedelics-
| for-depression post on Reddit, _there are almost as many_
| negative experience reports (including some long-lasting)
| as there are positive reports.
|
| This makes a quantitative claim that is _extremely_
| inconsistent with my fairly substantial experiences
| reading trip reports, which lines up with what
| /u/rileyphone said:
|
| >> My experience, and recent search, indicates these are
| usually about 80% positive, and most negative experiences
| stem from predictable abuse patterns.
|
| -
|
| > The positive reports receive the bulk of upvotes,
| though, so you have to scroll down to see them.
|
| This seems to imply that the negative trip reports are
| hard to find, which leads to people having a false
| impression of what is true. If one reads forums
| regularly, it seems unlikely that all negative reports
| were downvoted to oblivion before being seen by regulars,
| which is inconsistent with my experience on most forum
| software.
| renewiltord wrote:
| Most doctors have a massive fear of iatrogenic illness. It is
| understandable - they don't want to be responsible for a
| problem. So they will allow lots of suffering that cannot be
| linked to their action. That's the flip side of _primum non
| nocere_ : suffering is permitted so long as it is not tied to
| my action.
|
| That's why they opposed cardiac catheterization research and
| it needed someone who would violate the ethics of the time to
| invent. Medicine progresses one renegade at a time.
|
| Fortunately, America now has alternatives. We won't suffer
| for long under the thumb of gatekeepers. The COVID-19
| pandemic has moved lots of prescription to online providers
| who do the bare minimum to diagnose. This has moved power
| into the hands of patients. For long-tail conditions, this is
| a superior model to a medical professional.
|
| Since this is necessary to say: I'm not a doctor hater - my
| parents are both surgeons and almost everyone in the extended
| family excepting me is in medicine.
|
| EDIT: to vmception, I only said that because there's lots of
| people who have some sort of grudge against medical
| professionals for some reason or the other. I don't. I love
| my family and I'm quite happy in my belief that they're good
| at it. When I go to a doctor, I usually trust them. Can't
| reply since rate-limited.
| vmception wrote:
| > my parents are both surgeons and almost everyone in the
| extended family excepting me is in medicine.
|
| I don't think thats necessary to say, I've heard the
| _wildest_ fringe perceptions over the last two years from
| people who tried to qualify their post the same way, or by
| mentioning they were a nurse or medical professional.
|
| I think whatever you have to say has enough weight to the
| people that matter without the disclaimer.
| luckydata wrote:
| Psychedelics used to be a fairly common treatment for
| depression and addiction in the 50s before the witch hunt of
| the US government against what was considered "street drugs".
| Leary didn't do them any favors either as he was essentially
| telling everyone to load up on psychedelics, which triggered
| the usual over the top uninformed response our dear elected
| officials are so fond of.
| iknowSFR wrote:
| Same experiences. Dropped drinking, started exercising. The LSD
| dose was much higher and the after effects listed lasted for
| weeks. However, the mushrooms dosage was lower and while the
| after effects were similar, it didn't last as long. Truthfully,
| I felt a deeper connection with the moment post-LSD.
|
| The LSD trip kind of hurt but after the first few hours, became
| a solid 6-8 hour span of self reflection. Mushrooms started out
| chill and evolved into a pretty painful experience before
| moving into that self reflection stage.
|
| What's happening during that self reflection stage is best
| described as a feeling of losing it all. Family, friends, etc.
| but not so much material items. In that moment, I felt complete
| loneliness and the fear associated with that loneliness. That
| fear led to asking what would make me be alone and the answer
| was my personal ego. It ultimately was a confrontation of
| personal flaws like narcissism or selfishness. Later in the
| trip, like 5-8 hours, a feeling of being content with who I am
| and where I need to improve to not lose the things that truly
| matter was the result.
|
| I don't know if I'll ever try either LSD or mushrooms again but
| the reset on my personal ego made me value a lot of important
| things that get backburnered in the grind and stress of life.
| sdedovic wrote:
| > What's happening during that self reflection stage is best
| described as a feeling of losing it all.
|
| This reminds me of a passage from Aldous Huxley's Doors of
| Perception:
|
| We live together, we act on, and react to, one another; but
| always and in all circumstances we are by ourselves. The
| martyrs go hand in hand into the arena; they are crucified
| alone. Embraced, the lovers desperately try to fuse their
| insulated ecstasies into a single self-transcendence; in
| vain. By its very nature every embodied spirit is doomed to
| suffer and enjoy in solitude. Sensations, feelings, insights,
| fancies - all these are private and, except through symbols
| and at second hand, incommunicable. We can pool information
| about experiences, but never the experiences themselves. From
| family to nation, every human group is a society of island
| universes...
| peteradio wrote:
| Try catching your wifes eye as you both watch your children
| play.
| siloed wrote:
| What's being described in the study is not self-reflection
| but serotonergic psychedelics' effects on the 5-HT2A
| receptors in the brain. For example, escitalopram (Lexapro)
| may help with self-reflection as well but this study was
| specifically studying patients with treatment-resistant
| depression.
| pmoriarty wrote:
| The study doesn't describe self-reflection, but that
| doesn't mean that the subjects of the study didn't engage
| in it.
|
| I'd be very surprised if they didn't.
| e40 wrote:
| _> The LSD trip kind of hurt_
|
| Can you explain that? I don't grok it.
| iknowSFR wrote:
| Your body feels exhausted but your mind is quite awake. So
| you're exhausted and energetic at the same time. Your
| joints can kind of feel tense if you're not moving. Walking
| is enough but then you can also feel overheated pretty
| easily. Hours 1-4 were largely uncomfortable for me on
| both.
|
| LSD gave me diarrhea for a solid 4 hours. I think that's
| rare but I felt better the next day than I had in years.
| Probably something to do with gut science but I have
| nothing to back that up other than my story here.
| e40 wrote:
| Wow. Thanks for sharing. We know there is a much stronger
| gut-brain connection that we ever though possible.
| Interesting stuff.
| pmoriarty wrote:
| Are you sure it was LSD?
| iknowSFR wrote:
| Fair question and yes. Received from a reliable
| individual and also personally tested. Even still, I'll
| admit that even after testing I Googled symptoms of meth
| use a few times during the early stages of the trip.
| postingposts wrote:
| You want to go to sleep but the final paper is due in 8
| hours and you haven't started. You are _going to write this
| paper_ and _nothing stops the paper from being written_. As
| you find yourself at hour 4 or 5, well past any joy of
| ideation, you realize that you must still finish the paper.
| Caffeine is pounding in your head and you have wrestled the
| entire day before, now your brain is thinking at full
| capacity whether you like it or not. Oh it's not a pain
| that can be seen but have a migraine and say that's not
| real or work a hard day and have to _walk more_. It's the
| hurt of causing your brain to be more active than it ever
| has. Similar to making someone who plays video games all
| day hike up a mountain. They're gonna feel it.
| agumonkey wrote:
| May I ask you about the kind of depression ? was it a slowly
| creeping in or one triggered by a traumatic change (something
| that is linked to symbols/memories in ones brain though) ?
|
| If it's the 2nd case I'd be even more curious about the effect
| of shroom chemicals on the upper layers of the brain.
| joeberon wrote:
| I had horrific and long lasting negative effects from LSD. My
| wife absolutely laments that she convinced me to take it the two
| times I did. I saw mortality and impermanence directly, I felt
| entirely alone, and also I got extreme motion sickness and was
| passing out in a mess of white fractals and intensity in my body.
| I developed severe flashbacks to the trip and every time I had
| one I became extremely suicidal. The only good thing that came
| from it is that it pushed me towards an actual solution for me,
| which is practising zazen (goalless sitting in the Soto Zen
| tradition of Mahayana Buddhism). Resting in this moment, as
| Buddha, unmoved by external conditions. If I did not learn this,
| my life would be over, and indeed taking a break from the
| practise for 6 months the old grasping mind returned and I found
| myself heavily desiring death again. I sit and this all goes. My
| life after LSD was so traumatic that I was forced to find a way.
| The worst part is that therapists had no idea how to even
| consider the cosmic horror I felt, they just said it was "weird"
| and tried to shift the focus to tangible things, but it was the
| ineffable infinity that I was scared of.
|
| Anyway, I always say that LSD fucked up my life so much that I
| had to turn to _religion_ to cope!! As a former militant atheist,
| that's an incredible thing to say
| jamal-kumar wrote:
| Ever hear of psychedelic integration therapy?
|
| There's a whole class of therapists who won't dose people on
| psychedelics because they feel the risks are too high
| (legally+medically) but will gladly take in people like you to
| help integrate the experience and helping with coming to some
| closure and insights.
|
| Might be worth a session or two. Also sounds like you took a
| really freakin high dose... Yeah acid has its own agenda and
| lasts waaaaaaaaaaaay too long, there's a reason a lot of the
| recent research is on psychedelics that don't blow you away for
| up to 12 hours straight.
|
| Can you believe some of us do that for FUN? Maybe it helps to
| be spiritually seeking to begin with. I think learning your
| lesson with these tools is kind of like getting in a fight. You
| might get your ass kicked but some of us throw hands
| professionally with a shit eating grin on our faces the whole
| time.
| pmoriarty wrote:
| I'm wondering if you are sure it was LSD?
|
| Did you test it yourself?
|
| Also, what context did you take it in?
|
| Did you have an intention for the trip? Were you with a
| trusted, experienced sitter?
|
| Did you combine the substance with any other drug?
| joeberon wrote:
| 8f2ab37a-ed6c wrote:
| So, how does one start DIYing this in the meantime?
| pmoriarty wrote:
| Also see Alan Rockefeller's excellent videos on psilocybin
| mushroom identification: [1] [2]
|
| [1] - https://www.youtube.com/watch?v=pInqVRRva7M
|
| [2] - https://www.youtube.com/watch?v=VcL-7u80kjs
| rednerrus wrote:
| r/unclebens
| lvl102 wrote:
| I believe depression is not something you can resolve with drugs.
| Sure, it helps to numb it all away.
| siloed wrote:
| This is too broad a statement to support with evidence. This
| study was specifically about treatment-resistant chronic
| depression and the measured effects on the brain.
| Trasmatta wrote:
| "Numbing" isn't an accurate description of what psilocybin does
| to you. It's kind of the opposite, it puts you in closer touch
| with the thoughts and feeling that were already there. This can
| be a double edged sword, as it can also surface and magnify
| highly negative thought processes.
| bin_bash wrote:
| The way these drugs seem to work is they stop serotonin from
| being blocked in habitual ways. The resulting experience makes
| people see/feel things as if it was for the first time.
|
| "Numb" is a poor description for this phenomenon.
| philosopher1234 wrote:
| I'm not sure if "these drugs" refers to psilocybin or SSRIs,
| but the science does not support SSRIs as a solution to
| depression.
| weakfish wrote:
| Source on that statement? Considering they're the leading
| pharmaceutical treatment, the burden is on you to prove
| that claim
| siloed wrote:
| What? Do you mean SSRIs specifically? Or are you including
| SNRIs, a2 blockers, MAO inhibitors etc? Do you have any
| evidence to support this or just anecdotes?
| bin_bash wrote:
| I'm referring to psilocybin and other tryptamines but I
| suspect you knew that and simply wanted to take a jab at
| SSRIs for some reason
| ok123456 wrote:
| A drug can't cure alienation.
| spicymaki wrote:
| This is a really unpopular answer, but I whole heartedly
| support it. Unfortunately, many people are looking for a
| solution (a quick fix) in a pill. They don't want to hear that
| perhaps the way they are living or the society they live in is
| not conducive to happiness.
|
| Perhaps an alternative to intoxication is to work towards a
| world of human flourishing.
| TaylorAlexander wrote:
| The thing about mushrooms is the effect lasts well after
| "intoxication". And the effect of mushrooms is anything but
| numbing. Scientifically they actually allow the brain to see
| things in a new light and overcome blocks (they relax the
| "default mode network" tho I am not a scientist).
|
| Changing your behavior is of course very important but
| sometimes the mind gets stuck and it seems mushrooms can help
| get us unstuck.
| ashes-of-sol wrote:
| There are different types of depression. Some are related to
| how we live, either as a person or the society we find
| ourselves in. But others are related to physical brain
| imbalances which will absolutely benefit from medication.
| lvl102 wrote:
| And how many percentage of people suffering from depression
| do you think have this physical brain imbalance ONLY?
| Doctors prescribing depression drugs do not care nor do
| they have the tools to make such a diagnosis.
| Tenoke wrote:
| I've been asking for a while but what's going on with the less
| descriptive, previously(?) against the rules title
| editorializing?
| newbamboo wrote:
| I'm all for this but part of me gets a very "Brave New World"
| vibe. Are we all going to have to micodose shrooms to tolerate
| our prosperous progressive society? It's seeming increasingly
| likely.
| derbOac wrote:
| I don't know why this doesn't get more attention. It's a
| classic ethical dilemma in psychiatry, and ultimately the basis
| for many science fiction works.
|
| Let's say, for the sake of argument, you have a pill that can
| make people feel really positive and boundless, that they love
| their lives and nothing could make them feel better. This pill
| will work regardless of their circumstances. On the other hand,
| their environment is horrible: they are in poverty due to
| societal injustices and systemic failures, and loved ones are
| dying from completely preventable diseases due to those same
| societal failures.
|
| Works like The Matrix explored this theme in an extreme form,
| almost to a fault, where the premise is so absurd that it
| becomes dismissed.
|
| It's difficult to argue about treatments that will help people
| feel better and be better in their lives, whatever that means
| for them, but I can't help but be angry, even furious at the
| paradigm that underlies current behavioral biomedical research,
| where everything is seen as being a problem within the
| individual. It's not so much that there's something wrong with
| doing research like this, it's that other research, focused on
| more environmental factors, is seen as soft or unsexy, or the
| domain of some other field, or some such thing.
|
| I can't help but feel that our society is hurtling at
| astonishing speed toward an ethical crisis that gets almost no
| attention. What happens when we can alter behavior and
| experience with extreme precision and power, but still live in
| a worldview that treats individuals as the primary determinants
| of their own fate? What happens when withholding treatments or
| enhancements becomes a salient problem, when opportunity costs
| become a form of corruption?
| pmoriarty wrote:
| What you say is true, but are broken people who are barely
| able to take care of themselves (and who may be acting out in
| all sorts of destructive ways) supposed to pull themselves up
| by their bootstraps and make a positive change in the world
| (one which often requires a lot of resources, bravery, and
| long-term commitment)?
|
| Many of our leaders themselves are traumatized and
| dysfunctional in many ways, and do themselves deserve
| treatment.. treatment that may open their eyes to how
| dysfunctional they and the system they're part of has been.
|
| There's a good argument to be made that the in order to heal
| the world one should heal oneself first. It's like putting on
| an oxygen mask in a depressurized airplane before putting one
| on someone else. If you are incapacitated you will be unable
| to help.
|
| It's healthy, resilient people who will be best suited to
| both recognizing the problem and helping to fix it in the
| long-run.
|
| That said, it doesn't have to be one or the other. Those of
| us who are awake enough already can spread the word about
| what's wrong with the world, and those of us in good enough
| shape and with enough motivation to contribute should try to
| make things right (an important part of which, in my view, is
| to end the War on Drugs and give affordable access to
| psychedelic therapy to those who need it).
| emadabdulrahim wrote:
| You're talking about too many different points in one:
|
| 1. How much of someone's suffering and/or depression is due
| to brain chemical imbalance vs society and environment around
| them.
|
| 2. Would alleviating someone's depression and/or excessive
| anxiety would make them happy but with indifference to their
| surrounding, making them oblivious to the environment around
| them while being in a state of bliss.
|
| 3. The ethical dilemma of "fixing" someone by handing them a
| pill, instead of working on actually improving the real
| issues that may be contributing to their psychological pain.
|
| I think these are different issues that are not necessarily
| easy to answer one way or another. Non of these issues are
| self evidently clear which way should we go about them.
| derbOac wrote:
| So, I wouldn't argue that no one would benefit from a pill,
| or that there aren't situations and/or people who need a
| change of perspective, or an alleviation of pain so they
| can survive long enough to get through the storm.
|
| It's not so much that I think drugs are bad for treatment
| of psychological problems; it's that I think that of your
| issues (3) is radically neglected in contemporary
| psychiatry.
|
| "Treatment resistant depression" as an idea in studies such
| as this is sort of telling in that it assumes the problem
| is the pain, rather than whatever potential external
| problems someone is dealing with.
|
| A good analogy to me would be someone who keeps coming into
| the ER with bullets in their body every couple of months
| (maybe in a conflict zone like Ukraine), but where the case
| is construed in terms of the pain the bullet causes, rather
| than the fact there are bullets in their body and the
| person is in a situation where they keep getting shot at. I
| don't want to oversimplify things, as the environment and
| situation is generally attended to, but the paradigm as a
| field is to treat the disease as the pain the patient is
| suffering ("depression" as a disease), rather than the
| scenario as a whole, and to act as if the pain is an
| attribute of the patient rather than as part of an
| appropriate response to a problematic situation.
|
| So yes, depression as a phenomenon is a complex mixture of
| things, but I think in general, at least in the US, it
| tends to be seen as a disease that's a biological property
| of the person. There are historical reasons for this, some
| good and some bad, but I think it's had unintended
| consequences as a result.
| pmoriarty wrote:
| _" A good analogy to me would be someone who keeps coming
| into the ER with bullets in their body every couple of
| months (maybe in a conflict zone like Ukraine), but where
| the case is construed in terms of the pain the bullet
| causes, rather than the fact there are bullets in their
| body and the person is in a situation where they keep
| getting shot at."_
|
| Interesting analogy, but if my body was ever riddled with
| bullets and I was taken to the ER, I'd definitely want
| the doctors to treat the damage the bullets made, remove
| them from my body, and relieve the pain.
|
| If the ER ignored the bullets in me and assured me they'd
| instead be sending a police car to the neighborhood in
| which I was shot then I'd yell, _" no! please treat me
| first!"_
|
| There's a lot to be said for symptom relief. Of course,
| the underlying causes should also be addressed, and there
| is evidence that psychedelics allow therapists to do just
| that. In particular, MDMA appears to allow patients to
| face and deal with their trauma without the pain and
| aversion that trying to face their trauma ordinarily
| causes. It also allows many to forgive themselves or
| their family, to experience love for the first time, and
| resolve family issues. This is treating the cause, not
| just the pain.
|
| Of course, traumatising external circumstances must also
| be changed, when possible. I believe psychedelics can
| help here too, by making people aware of them
| (psychedelics often have the effect of opening people's
| eyes to just how screwed up our society is) and by making
| people more empathetic and connected to others and to
| nature.
|
| They will not magically solve all our problems, but they
| can play an important role in helping us to solve those
| problems ourselves -- if they are used constructively and
| in the right context.
| raxxorraxor wrote:
| The trick is that these reservations vanish after being
| shroomed.
| replygirl wrote:
| drugs that make you feel good about spending all day in your
| ego will do that
| greatpostman wrote:
| I tripped and it reset my brain in fundamental ways. Felt like
| an operating system reinstall.
| Overtonwindow wrote:
| Dis you trip while also on other medication? I was on
| Wellbutrin and Zoloft, but 3 grams didn't do anything for me.
| Four grams did, but only mildly, that was enough to have
| significant therapeutic relief.
|
| I suspect depression medications may inhibit the effect?
| DrBoring wrote:
| > I suspect depression medications may inhibit the effect?
|
| When I was on Wellbutrin, it stopped the mental effect of
| alcohol. When I imbibed, there was no loss of inhibition
| normally associated with alcohol use. However, I did still
| lose physical coordination.
|
| Zoloft did not have the same effect.
|
| The brain is a crazy thing.
| tomek_ycomb wrote:
| I agree 100% brain is a crazy thing.
|
| In general I think this is most pronounced even within
| antidepressants of the same class, with similar binding
| affinities, some people report limited success with one
| or the other seemingly similar drug.
|
| All this said, wellbutrin is a very different drug than
| zoloft. It have more dopamine and norepinephrine activity
| iirc.
|
| Also for anyone else, try to avoid alchohol and
| wellbutrin or take it knowing that your seizure threshold
| goes down on wellbutrin so its easy to black out and do
| worse than you realize (also related to the reported
| effects above)
| Stevvo wrote:
| Yes, depression medications inhibit the reuptake of
| serotonin whilst psychedelics bind to your serotonin
| receptors.
| at_compile_time wrote:
| I've read that SSRIs interfere with them. It feels like a
| pretty cruel irony.
| hackingthelema wrote:
| Depends on the antidepressant, but SSRIs like Zoloft do
| suppress the effect. MAOIs, on the other hand, tend to
| increase the effect. I'm not sure about Wellbutrin.
|
| There's some charts floating around about it on the
| internet: https://wiki.tripsit.me/wiki/Drug_combinations
| pmoriarty wrote:
| Be very, very careful about combining MAOI's with
| psychedelics (or other drugs).
|
| Educate yourself thoroughly on what effect such
| combinations could have before you even think of doing
| this.
|
| Combining drugs in general is often a very bad idea, and
| many overdoses and other adverse reactions have been due
| to this.
| hobs wrote:
| After a quick skim https://mind-foundation.org/psychedelic-
| antidepressant-inter... is worth reading - in a nutshell I
| have personally seen this:
|
| 1. Someone taking SSRI's and psilocybin finds that the
| dosage... simply doesnt work. I had one individual who ate
| up to 8! grams before seeing and feeling things that I
| would see in normal people at about 1.5.
|
| 2. This might be really bad for you! There's some evidence
| that mixing that level of both drugs might be not good for
| your liver and might get you into toxic levels, and
| suggests tapering - I honestly dont suggest tapering your
| anti-depressants unless you are working with a medical
| professional because well, suicide.
|
| 3. If you really want an undenyable trip, just take some
| salvia (properly), 15 minutes and many of the same after
| effects.
| throw93232 wrote:
| SF folks will now support microdosing for homeless, because it
| may cure their depression, and help them of the streets :)
| asdff wrote:
| Humanity has always been getting intoxicated on drugs and
| alcohol though. Society practically evolved to organize the
| brewing of beer in Mesopotamia and Egypt. It's only recently
| that human societies have gotten so conservative with these
| things.
| DrBoring wrote:
| I would argue that many people today already have their own
| form of Soma. Alcohol being the most popular one due to its
| abundant supply. A lot of people just need to step out of their
| own minds every now and then.
| PragmaticPulp wrote:
| Microdosing - definitely not. Regardless of what the proponents
| say, even small doses of psychedelics induce some degree of
| impairment (please don't microdose and drive!)
|
| But you touched on one of the key problems with psychedelics:
| We can't really expect people to trip every few months forever.
| If psychedelics are used, I would expect them to be in the
| context of intense therapy. Many of the studies will require
| patients to go through 10 or more therapy sessions before,
| during, and after their psychedelic dose.
| vermarish wrote:
| I always understood BNW's soma as a drug that is administered
| regularly to provide an escape and instill complacency. Modern
| examples might include alcohol, Netflix, and cushy salaries.
| Psychedelics are the opposite; they provide perspective and
| they make you yearn for something greater.
| dkarp wrote:
| Opioids and Benzodiazepines (Xanax) are even closer to what I
| imagined Soma was
| Trasmatta wrote:
| Shrooms had the opposite effect on me, where I suddenly became
| much more cognizant of the damaging aspects of our society, to
| an almost unbearable level. It made me overall less capable of
| operating in society, not more. Can't say I was really a fan of
| its effects on me.
|
| Psilocybin seems to induce a highly plastic state of mind, and
| so the results can be somewhat unpredictable.
| colpabar wrote:
| Did you take them alone? Did you go outside at all? I think
| your environment really affects your experience. I always
| tell people to go outside as much as possible, ideally on a
| nice sunny day. Walk around in a park or the woods and I bet
| you'd have a different experience. If you're alone and
| indoors, you'll most likely end up going deep inside your own
| head, which isn't necessarily a bad thing, but things can
| definitely start getting dark.
| Trasmatta wrote:
| I took them alone, but did go outside. Going outside was
| the best part of the trip. It wasn't a "bad trip" (had
| those on DXM before, this was much different). It was more
| that it opened my mind more fully to the amount of
| suffering in the world, and how much of it is caused by
| humans. Something we usually have to suppress in order to
| function from day to day. It was probably overall a good
| thing to have those realizations, but it was highly
| challenging, and it was detrimental to my mental health
| over the following months. But the lessons were probably
| just as important as a trip filled with just love and joy
| (never had one of those).
| pmoriarty wrote:
| _" Shrooms had the opposite effect on me, where I suddenly
| became much more cognizant of the damaging aspects of our
| society, to an almost unbearable level. It made me overall
| less capable of operating in society, not more."_
|
| It's important to connect with others who've had similar
| realizations of the dysfunction of our society. Together we
| are stronger, can support each other, and work together for
| positive change.
|
| Don't go it alone.
| BossingAround wrote:
| The alcohol, cigarettes, caffeine and sugar that helps us cope
| doesn't give you a "Brave New World" vibe?
| replygirl wrote:
| to me, getting a box of macarons delivered is the same as
| taking small doses of a psychedelic at work
| imilk wrote:
| Is there psilocybin in the macarons? That's really the only
| way it would be the same.
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