Depression is one of the world’s leading causes of disability, with over 264 million people living with depression globally. Depression can be characterized as mild, moderate, and severe, and it comes with a variety of symptoms. It can include psychological symptoms, such as low mood, feeling helpless and guilt-ridden, no motivation or interest, no enjoyment, and having suicidal thoughts. It can also include physical symptoms, such as moving or speaking more slowly, changes in appetite, lack of energy, and disturbed sleep. Depression can also affect social relationships and can include avoiding contact with loved ones and neglecting hobbies and interests. Because of its prevalence and the impact it has on individuals and society, finding a treatment for depression has been a priority for many institutions. One area of research that has become a very promising avenue is the use of psilocybin.
History of Psilocybin
Psilocybin is one of the active ingredients in hallucinogenic mushrooms (also known as “magic mushrooms”). Hallucinogenic mushrooms have been used in rituals for over 3,000 years, particularly in Mexico. They were recognized by Western science in the 1950s where psilocybin was isolated and then synthesized. In the 1960s, there was a surge in experimental research that used psilocybin as a treatment for a variety of mental illnesses. Unfortunately, because magic mushrooms became a popular recreational drug, they were made illegal in 1970, and research into psilocybin as a treatment for mental illnesses came to a stop.
Since the 1990s, however, research into psychedelics as a treatment for mental illnesses has been revived and psilocybin has been one of the most used psychedelics in human studies, due to how safe it is, how easy it is to administer, and because it is long-lasting. Since then, psilocybin has been studied as a treatment for anxiety, obsessive-compulsive disorder, addictions (e.g. alcohol and tobacco). One of the most promising areas of research is how psilocybin could treat depression.
Psilocybin As a Treatment for Depression
Psilocybin has been thought of as a candidate to depression because it binds to serotonin receptors in the brain. Lack of serotonin has long been implicated as a cause of depression and psilocybin’s ability to stimulate an increase in serotonin could help to treat depression. In fact, psilocybin’s impact on depression goes a lot further than its effect on serotonin, and it may make it a more effective treatment than common antidepressants.
There have been several recent studies about psilocybin as a treatment for depression that have shown promising results. In one, 20 patients with treatment-resistant depression (they had suffered from depression of an average of 18 years and had tried multiple treatments) that ranged from moderate to severe were recruited. They were given two doses of psilocybin seven days apart. The first was a low dose of 10mg and the second a higher dose of 25mg. They also received psychological support throughout and they were followed up after five weeks, three months, and six months. All of the patients showed an improvement in their depression symptoms after one week and this hit its peak at five weeks. The strength of the improvement was related to the strength of the psychedelic experience.
The patients in this study also had their brains scanned and these showed that the psilocybin seemed to reset the brain networks that are linked to depression, resulting in a loosening of the connections. There was also an increase in activity in the amygdala (the part of the brain responsible for fear). When the patients viewed unpleasant photographs, there was more activity in their brain than there was before treatment. The researchers suggest that, while this might seem contradictory, the patients reported that they felt the treatment worked because it helped them to stop avoiding their emotions.
Psilocybin Versus Other Depression Treatments
All of the patients in the study had tried talking therapy, such as cognitive-behavioural therapy, as well as common antidepressants, none of which had worked for them. One of the reasons for this could be that they approach the same problem that psilocybin does but in a different way. The goal of cognitive-behavioural therapy is to change thinking patterns, which can then change behaviour and emotions. For many of the patients in the study, they felt that the psilocybin treatment helped to break those thought patterns more effectively because they were able to become more open to recognizing and confronting destructive thinking by breaking down barriers and stopgaps.
Similarly, psilocybin may be more effective than classic antidepressants, such as SSRIs. SSRIs (selective serotonin re-uptake inhibitors) work by blocking used serotonin from being disposed of, which results in increased serotonin in the brain. Psilocybin may be more effective because rather than numbing negative feelings, it allowed the patients to feel those emotions fully without any attempt at repressing them so that they could be confronted and dealt with. SSRIs also take weeks to begin working, whereas the patients who took psilocybin saw results immediately. This could be especially useful in patients who are veering towards suicidal thinking. The psilocybin treatment was also four times stronger than SSRI treatment. Finally, SSRIs can have quite unpleasant side effects, such as dry mouth, insomnia, sexual problems, and agitation, none of which happened when taking psilocybin.
When psychedelics were made illegal, it stopped research into using them as a treatment for mental health problems in its track. Finally, more and more research is now being conducted that shows how effective these drugs really could be, in particular for depression. While the studies that have been conducted in this area have been quite small, the impacts on the lives of the individual patients were profound. Many changed their lives completely after being treated with psilocybin, were able to return to work, and felt optimism and joy for the first time in decades. After living with depression for such a long time, trying so many other treatments that failed, and feeling hopeless, being able to finally see the light at the end of the tunnel after taking psilocybin was an important experience for many. The next few years of research may well uncover even more uses for psychedelics that could change even more people’s lives.