Can Psychedelics Be Used to Better Our Mental Health? Doctors Explain
Keeping up with the surge of "cure-all" wellness fads is a job in and of itself. In our column Wellness Inspector, we do the work for you, closely examining these trends to see if they're worth your hard-earned pennies—or whether they're just hype.
Ever since the movement to decriminalize psilocybin (a popular psychedelic found in "magic" mushrooms) which occurred in the U.S. in the early 2010s, people have been pondering the benefits the drug (and other psychedelics like MDMA, LSD, DMT, and ketamine) may have on different aspects of life, particularly on mental health.
After years of rallying for psilocybin legalization, psychedelic lobbyists got their first real big win in 2019, when Denver, Colorado, became the first city to decriminalize the substance. Later that year, Oakland, California, joined the party, and in 2020 and 2021, Santa Cruz and two Massachusetts' towns, respectively, did as well. But those are individual ordinances. In 2020, Oregon became the first state to not only decriminalize psilocybin but legalize it for therapeutic use, too.
This is ultimately to say, all eyes are on psychedelics, and as they become more readily accessible (and less of a legal threat), folks everywhere are easing up on the idea of taking a taste, especially for their mental health. While that may have once seemed reckless, in today's day and age, doctors and experts in the field say a lot of good can come of it. Keep reading to find out why.
Psychedelics and mental health:
According to Dr. Mike Dow, an openly gay biracial psychotherapist from Field Trip Health, an organization that offers psychedelic-assisted therapy, ketamine, LSD, mushrooms (psilocybin), and MDMA are quickly becoming some of the most powerful tools in treating mental illness and optimizing brain health. "When you think about most old-school antidepressants like Lexapro or Wellbutrin, they boost serotonin and dopamine levels, respectively," he explains. "On the other hand, psychedelics combined with therapy help people to rewire and grow the brain—which is why they can help people to see their life in a new way, lose their fear of death, see new possibilities, and shed limiting beliefs."
While this mental health hype around psychedelics is just now beginning to become mainstream, board-certified adult, child, and adolescent psychiatrist, Dr. Sid Khurana, says that evidence of their therapeutic benefits first surfaced over 60 years ago.
"Back in the 1950s and 1960s, there was some evidence for psychedelics to help with alcoholism," he tells HelloGiggles. "Now, there is a growing body of research showing the efficacy of Psilocybin (found in some mushrooms) to help with treatment-resistant depression, and for MDMA (AKA Ecstasy/Molly) to help with post-traumatic stress disorder (PTSD) and treatment-resistant depression."
While the science surrounding these topics is still growing, Dr. Khurana points out that these treatments are still not FDA-approved. "But they are in the process of obtaining approval," he assures, noting that psychedelics are capable of helping with an array of mental health disorders, including anxiety, OCD, eating disorders, addictive disorders, autism, and dementia, as well as with coping with the stress of terminal illness.
Continuing on the subject, Ronan Levy, who is the founder of Field Trip Health, says that some studies have shown that a single psilocybin-assisted therapy session can provide antidepressant effects for five years or more. "Additionally, a recent FDA-approved Phase 3 clinical trial showed that MDMA-assisted therapy could provide a near effective cure for PTSD in up to 70% of people," he adds.
With this in mind, Dr. Dow says that "many people prefer a few therapy sessions with psychedelics, with effects lasting weeks or months, to a daily pill." That being said, he points out that psychedelics and medication aren't mutually exclusive. "In research, psychedelics can help old-school treatments work better," he says.
Benefits of psychedelic drugs for mental health:
The reason psychedelics are able to help alleviate the symptoms of such serious and widely-experienced mental health disorders is because, as Douglas K. Gordon, who is the CEO of Silo Wellness, a psychedelic therapy organization that offers retreats in Jamaica and Oregon, points out, they're able to rewire our neural pathways. "As such, they have promise to transform the lives of those with treatment-resistant mental illnesses, depression, anxiety, or foundational childhood trauma," he says.
When it comes to rewiring, Dr. Dow says, "Psychedelics can create a dissociative experience (leaving the physical body), which can help people zoom out from the subjective experience of ruminating in depression to a more objective and connected way of life."
In that way, Dr. Dow says that psychedelic-assisted therapy can elicit extreme awe.
But that's not all. Dr. Dow says that psychedelics can also change the way we consolidate emotionally charged memories. "That's why they can be so helpful in treating trauma," he says. "Psychedelics help people to dig deeper and access the root of their suffering."
From a scientific standpoint, Dr. Dow points out that, in research, ketamine-assisted psychotherapy can be effective even when multiple antidepressants have failed. "And, a recent study found that psilocybin was more effective than Lexapro in treating depression," he adds. (Though, it was established that longer and larger trials are needed to fully confirm this.)
Of course, science on the subject is still expanding. However, as Gordon sees it, psilocybin has been used for millennia by Indigenous practitioners and it's simply time for the science to catch up.
"Scientists, doctors, and researchers have been evaluating psilocybin's potential to treat mental illness for decades—yet most agree that more rigorous clinical trials are necessary to definitively determine the compound's performance compared to prescription SSRIs," he explains. "That's why I always come back to a  study conducted by researchers at the Centre for Psychedelic Research at Imperial College London—which compared the effects of two-guided psychedelic therapy sessions to a six-week course of escitalopram—a leading antidepressant in the SSRI class more commonly known as Lexapro. The results, published in the New England Journal of Medicine, showed that reductions in depression occurred more quickly and at more magnitude in the psilocybin group."
Part of rewiring neural pathways is offering users a more in-depth look at themselves. "Sacred Earth Medicine can be a powerful tool in peeling back the layers of self, and removing shame and judgment," says The Ancestor Project's co-founder, Charlotte James, who is a harm reductionist and psychedelic explorer. "Medicines like psilocybin have been shown to support re-routing the Default Mode Network or, the patterns that we have adopted over our lives as a means of survival. Sitting with these medicines helps to interrupt these patterns, and gives us the opportunity to create new ways of seeing and being."
To further explain the benefits of psychedelics, Mushroom Design, co-founder and CEO, Ashley Southard, dives deeper. "The Default Mode Network is a system of the brain that's active when we're thinking inward (as opposed to focusing on specific, external tasks)—it's what's active when we're recalling memories, thinking about the future, understanding others' perspective, and so on," she explains. "Hyperactivity in this network is often associated with depression and anxiety (and increased pain for people who experience chronic pain), and decreased connectivity among the systems that make up the DMN are correlated with ADHD. Psychedelics have shown to 'reset' a hyperactive DMN and even 'reconnect' a DMN."
In that sense, psychedelics can be a tool for meditation and self-exploration. However, more studies need to be conducted.
Who benefits the most from psychedelics?
Like all medicinal drugs, psychedelics aren't a solution for everyone. However, even if you don't have one of the disorders mentioned above, you may benefit from using drugs like psilocybin. As a general rule of thumb, Southard says that psychedelic plant medicines tend to be less harmful than synthesized drugs and have shown to alleviate symptoms of anxiety, depression, addiction, and PTSD (among others) and reduce the need for future consumption. (So, if you've been concerned about potentially developing an addiction to psychedelics, you can toss that thought.)
As with most drugs, psychedelic dosing is never universal—it all comes down to the user.
"There is no easy answer to any question about proper dosing of psychedelics, as doses for different psychedelics vary and each person's response to a psychedelic will vary," Levy elaborates. "But as with any medicine, it's always a good idea to 'start low and go slow.' At Field Trip, the first ketamine-assisted therapy session for each person starts with a lower dose and then slowly increases in each subsequent session so people can get comfortable with the experience. That comfort is important because it enables people to go deeper during each session, which helps them make the most out of the psychedelic experience."
While dosing is individual, Gordon shares that microdosing is one of the most popular approaches to psychedelics. "It's the practice of taking small doses of a psychotropic drug at a sub-perceptual level," he says. "The benefits of microdosing may include being able to witness a given drug's effects at a cellular and physiological level while minimizing its full psychological effects and any undesirable side effects associated with use."
From a numbers standpoint, Gordon says that a perceptual, but a sub-psychedelic dose of psilocybin usually consists of approximately 0.1 grams of dried biomass. "According to user reports, this dose often yields a slight body hum and a feeling of greater focus or creativity," she shares.
On the other end of the spectrum, if you're comfortable with the idea of a full psychedelic trip, Gordon says you can take what's known as a "hero dose," which is typically between three to five grams of dried biomass. "This dose leads to a full psychedelic and introspective experience," he says. "The benefits of these 'trips' may include rejuvenation, clarity, and potential positive mental health shifts. The downside of taking a hero dose is that some may experience undesired side effects of psilocybin." However, it's important to consult with a doctor before deciding to take psychedelics.
One thing to note when discussing dosing and consumption of psychedelics as a whole, is that all of the science and studies surrounding it have been done in a controlled environment. With that in mind, Dr. Khurana says that psychedelics should only be taken under the guidance of qualified mental health professionals. (Though, in today's experimental day and age, we all know that's rarely the case, which is why it's paramount that you read the next section.)
How to take psychedelics:
1. Psychedelics are still controlled substances in many jurisdictions.
Here's the thing: Decriminalization is not the same thing as legalization. The good news is that if you get caught with psilocybin in a place where it's decriminalized, your chances of facing legal action are significantly reduced so long as you're over 21 years of age (because psilocybin carries the same age profile that drinking does). While this is beneficial for the person carrying mushrooms, it's also beneficial for the governing forces within the area, as it prevents them from wasting resources on charges and law proceedings that could be better utilized elsewhere.
If you head somewhere where Psilocybin is decriminalized and want to give it a try, you can do so without major fear of it leading to a serious felony charge (unless you have tons and can be perceived as someone with an intent to sell, for that's still a no-go). That said, you might still walk away with a misdemeanor if caught, so, be aware of your surroundings if you choose to partake.
2. Surround yourself with the right people.
While psychedelics are generally very safe (given there's a very low rise of overdose), Levy warns that bad trips (ie: emotionally challenging hallucinations and flashbacks) are possible. "Having someone who is able to help you navigate a challenging experience in a constructive and safe manner will maximize the likelihood of a positive experience," he says. "If having a qualified professional isn't an option, look to digital tools to support your experience such as Trip (tripapp.co), which can help you prepare for, and integrate, your experiences as best as possible." But as always, make sure you're doing it with someone who you trust, and don't do psychedelics by yourself for the first time just in case.
3. Only trip in a "safe" space.
As fun as it may be to take MDMA at a concert or festival when it comes to psychedelics, it's often best to consume them in a smaller, more controlled setting. "It's important that you feel safe wherever you choose to have your psychedelic experience," Levy says. "The evidence shows that 'set and setting' (meaning the preparation you do, as well as the actual location of the experience) have an impact on the experience. So make sure you're in an environment where you feel relaxed and comfortable."
4. Plan your trip.
Beyond thinking about the people and location you want to be a part of your trip, Gordon says to consider your goal for the experience. That way you can choose whether to take a micro or macro dose and plan accordingly.
5. Talk with your group beforehand.
Before consuming any psychedelics, The Ancestor Project's co-founder, Undrea Wright, recommends having a pre-trip chat with the people you plan to embark on this experience with. "Set protocols and safety measures so that folx are supported," he says. "It is important to prepare yourself for the journey, set intentions, nourish your body with supportive foods, and, of course, hydrate." (If you are looking to create a ceremony for yourself, you can download The Ancestor Project's interactive guide for ceremony preparation, navigation, and integration here.)
The future of psychedelics:
Now that you have a better idea of how to safely interact with psychedelics, you might be wondering what's next. As Southard sees it, we're in the midst of a psychedelic revolution.
"This is evidenced by the many psychedelic companies going public on the exchanges; the research centers opening at historically conservative institutions (such as Mount Sinai, Massachusetts General Hospital [an affiliate of Harvard Med School]; and NYU Langone Health); and the feature of the benefits of (rather than the detriments and dangers of) psychedelics in extremely respected publications, including Forbes and the Times, and even on network news stations," she explains.
As more and more information and studies emerge on the topic, all of the experts we spoke with believe that psychedelics will soar. So much so, in fact, that Levy expects to see MDMA approved by the FDA for the treatment of PTSD by 2023 and psilocybin for the treatment of depression by 2025."That future is now," James says. "Just this week in California SB 519 passed the Senate and is on its way to the general assembly. This bill would decriminalize all psychedelics and plant medicine. There are also examples like Oregon where a model for psilocybin-assisted therapy is being developed. We believe that a return to ancestral practice and being in relationship with these medicines will be key in liberating all oppressed people."