The Use of Psychedelics for Treating Trauma and Depression

What comes to mind when you think of psychedelics? 

If you’re over 50, you might remember being shown cautionary films about kids who dropped acid and listened to voices that told them to leap from rooftops. You might recall the Summer of Love, when throngs of young folks convened in San Francisco to hear Timothy Leary urge a crowd of 30,000 hippies to “turn on, tune in, and drop out.” 

This association between psychotropic drugs and freeloaders intent on pursuing their selfish pleasures via psychedelics and dangerous hallucinations created a bias against exploring drugs like LSD, MDMA, ketamine, and psilocybin as legitimate treatments for mental health diseases. 

One early attempt to study psychedelics’ effect on the human brain is where the whole journey got derailed. Leary, along with Harvard colleague Richard Alpert, launched some of the first psychological experiments to gauge the impact of mind-altering substances on cognition and perception. Soon after this research began, however, it came under scrutiny. Not only were Leary and Alpert administering psilocybin to undergraduates; they were taking the drug themselves while they collected the research data, and they were encouraging students to use psychedelic drugs recreationally. 

As a result, the Harvard Psilocybin Project lasted only a few years. By 1963, Leary and Alpert had both been fired, launching a backlash against psychedelic drugs that lasted several decades.

Only this century have major research institutions including Johns Hopkins, with its Center for Psychedelic and Consciousness Research, breathed new life into experiments like Leary’s and given them legitimacy. Hopkins received the first federal grant to study psychedelics in 50 years, signaling the government’s more receptive stance on finding a beneficial use for these drugs. There are now clinical trials investigating the efficacy of psychedelics in treating depression, addiction, chronic pain, anxiety, and PTSD taking place at major research universities across the United States and worldwide.

Read on to learn more about this potentially ground-breaking research.

How Do Psychedelics Work?

Two drugs are at the forefront of this ground-breaking research: MDMA and psilocybin. 

If you went to raves in the 1990s, you may be familiar with MDMA, also known by its street name, ecstasy. Short for 3,4-Methylenedioxymethamphetamine, MDMA induces feelings of euphoria and increases sensory perceptions. Because the chemical compound contains methamphetamine, the drug is not a “classic” psychedelic; it gives those who take it an energetic high.

Psilocybin is a naturally-occurring compound found in over 200 species of psilocybe mushrooms. The human body converts psilocybin into its active form, psilocin, which then attaches to the serotonin receptors. The drug affects users in a way similar to LSD—which is also derived from a fungus—causing hallucinations and altered perception. Due to its mind-altering potential, people have been using psilocybin in spiritual rituals and ceremonies for thousands of years.  

They Increase Brain Plasticity

Psychedelic drugs work by stimulating activity at the serotonin receptors, which modulate the brain’s “default mode network,” or the network the brain uses when a person is engaged in ruminative thought. Some psychedelics, like MDMA, also release norepinephrine and dopamine, feel-good neurotransmitters that modulate neural circuitry and produce a positive, social state of mind.

Psychedelics have the ability to interrupt and change the deep-seated patterns of thinking that can cause anxiety and depression by literally changing the way the brain processes information. They also allow individuals to form more lasting bonds of trust with others so that they are not left alone to combat their feelings.

At the cellular level, for instance, research shows that psilocybin can cause the formation of new neural connections by strengthening the dendritic spines on a dendrite, or the branching structure that extends from a nerve cell and reaches out to receive information from other cells. 

In a study conducted on mice, the dendritic spines of subjects given psilocybin grew 10% stronger, allowing nerve cells to form more new connections. The transformation to mice’s brain cells was both fast—it happened within 24 hours—and long-lasting. Mice retained these new connections for a month, the equivalent of many months for a human being. 

They Are Potentially More Effective Than Other Psychiatric Drugs

According to a recent study on the long-term effects of taking psychedelics, “enduring changes in personality/attitudes, depression, spirituality, anxiety, wellbeing, substance misuse, meditative practices, and mindfulness were documented.” Thus, patients who take psychedelics may not need a daily regimen of antidepressants or anxiety medications, which can lose their efficacy over time, cause dependency, and have serious side effects including the risk of dementia and Alzheimer’s Disease.  

In theory, treating mental illness with psychedelics produces demonstrative perspective changes and emotional breakthroughs that allow a person to reimagine their fear or trauma through a less threatening lens. Some patients experience meaningful improvement after just one 25mg dose of synthetic psilocybin.

What Mental Health Conditions Can They Treat?

Anxiety

In 2016, Johns Hopkins released the results of a small double-blind study designed to show whether psilocybin could reduce the existential anxiety cancer patients feel as they confront their own mortality. 

The study showed that a single large dose of psilocybin, administered in a controlled environment, had long-lasting benefits. Six months following treatment, about 80% of the subjects continued to show a significant decrease in depression and increased feelings of life satisfaction. Two-thirds of the participants even said the experience was one of the top five most meaningful events of their lifetime.

A subsequent collaboration between researchers at the University Hospital of Basel and the Liechti Lab in Basel, Switzerland showed similar results using LSD to treat anxiety. The psychedelic treatment was so effective that it had a crossover effect: When participants switched to a placebo, scientists were unable to detect the anticipated difference in reactions because the effects of a single dose treatment were so long-lasting.

Post Traumatic Stress Disorder (PTSD)

The Multidisciplinary Association for Psychedelic Studies (MAPS) recently announced that MAPP2, their second Phase 3 clinical trial of MDMA-assisted therapy, shows an improvement of PTSD symptoms in 88% of the subjects, with few adverse effects. (The subjects given a placebo with supportive therapy had a 60% improvement.) 

Moreover, 67% of the participants given MDMA-assisted therapy no longer met the criteria for PTSD two months after the end of the trial, as opposed to 32% of those who got the placebo.

The precursor trial, MAPP1, had similar results but did not represent a diverse enough population, something for which the second clinical trial was designed to compensate. MAPS now awaits a Food and Drug Administration (FDA) review of the findings with the hope of gaining official approval to prescribe MDMA for PTSD treatment.

According to MAPS, MDMA can help individuals with PTSD have decreased fear and defensiveness, increased interpersonal trust, a greater sense of wellbeing, and an alert state of consciousness. They believe MDMA will also prove effective at treating disorders related to PTSD, such as substance abuse and eating disorders.

Depression

In addition to their work showing the efficacy of taking psilocybin to treat anxiety, Johns Hopkins has undertaken research to show that the drug can be used to treat major depressive disorder (MDD) as well.

In 2020, a small, randomized clinical trial of adults with MDD were given two doses of psilocybin, in combination with supportive therapy. The experiment found that psilocybin-assisted therapy “was efficacious in producing large, rapid, and sustained antidepressant effects,” results that lasted up to one month after treatment. 

Johns Hopkins launched a follow-up study, the results of which were published in the Journal of Psychopharmacology in 2022. This time, researchers found that psilocybin-assisted therapy provided substantial antidepressant effects for at least a year in some patients. 

In fact, to research this article, I combed through dozens of abstracts looking for a study that refuted these conclusions and could not find a single one. The consensus is that psilocybin-assisted therapy shows great promise as a treatment for severe depression. 

Although most of the clinical trials reported no negative side effects as a result of psilocybin-assisted therapy, one study notes that a single 25mg dose of psilocybin, while more effective at reducing symptoms of MDD, did increase the likelihood of adverse effects.

Are There Risks in Taking Psychedelics To Treat Mental Health Disorders?

Although the films you may have seen in school were hyperbolic attempts to “scare you straight,” they contained a kernel of truth. Psychedelics can cause psychotic breaks in individuals with psychotic disorders or who are prone to them—i.e., have a family history of bipolar disorder or psychosis. Such individuals should not attempt treatment with psychedelic drugs.

Other risks include tachycardia (from ingesting the amphetamines in MDMA) and Hallucinogen Persisting Perception Disorder (HPPD), or “flashbacks,” as they are more commonly known. Taking psychedelic drugs can also cause intense feelings of stress and anxiety (the very conditions they are supposed to treat) but those tend to be situational and will pass once the effects of the drug wear off.  

Overall, studies report that participants tolerate psychedelic drugs with minimal negative effects. However, it should be noted that the treatment takes place in a supportive environment and is combined with psychotherapy. 

Final Thoughts

As studies with psychedelics proceed, we may continue to see promising results for the treatment of debilitating mental health conditions. Perhaps these treatments will someday bring relief not only to the individuals plagued by these conditions, but also to the loved ones who support them.

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