Advancements in Patient Care
Using Hallucinogenic Drugs to Treat Mental Illness
by Olivia Arkell
An emerging paradigm shift is on the rise in the mental health research and developmental setting. New molecular entities used for treating psychiatric conditions are taking the stage.
Imagine the following scenario. The pharmaceutical industry discovers an alternative to antidepressants for treating mental ailments such as depression, anxiety, substance and chemical abuse, and PTSD. This option is a huge breakthrough because it does more than exclusively decrease or limit symptoms. Rather, it physically changes the neurotransmitters and communication pathways in the brain, allowing the patient to recover from the illness or addiction. This transformative drug has the ability to alter and create new pathways for default thoughts to be sent and received. Typical antidepressants, such as SSRI’s, simply control the reuptake of serotonin and inhibit the receptor from functioning naturally. Not only is this new drug a breakthrough in the mental health industry, but it changes how we treat these illnesses.
Most importantly, this new drug promotes neuroplasticity. This is the brain’s ability to change, alter, or create new neural connections. Neuroplasticity is executed in the Default Mode Network while under the inꢀfluence of this alternative drug’s eꢁffects. This alternative drug would be administered in a strict medical setting by licensed practitioners. For some patients, just a single dose of the drug is needed to promote the neurological alterations needed to change particular patterns of thought and behavior. It’s quite eꢂfficient and eꢁffective when compared to prescribing antidepressants.
This new drug will advance the way we treat mental illnesses and provide an updated approach for mentally ill patients to redeem their sense of normalcy. Now, imagine if I tell you that this pharmaceutical drug is actually a hallucinogenic drug. Commonly known as magic mushrooms, psilocybin is a naturally occurring psychoactive compound that is produced in several species of fungi.
What is Psilocybin-Assisted Psychotherapy
Psilocybin-assisted psychotherapy, an emerging therapeutic approach for treating mental illness, has shown great eꢂfficacy for treating common mental health conditions such as major depressive disorder (MDD), treatment-resistant depression (TRD), PTSD, and anxiety. The term “psychedelic-assisted psychotherapy” refers to a psychotherapeutic intervention that involves the administration of a psychedelic substance. The eꢁffects of the drug, both neurobiological and psychological, play a signiꢃcant role in the outcome of the intervention. The Greek derivative of “psychedelic” translates into “mind-manifesting,” hence why psychedelics are known for their ability to induce profound changes in consciousness, perception, and self-awareness. Sitting in the same category as heroin, bath salts, and ecstasy, psychedelic substances are considered a Schedule I drug, defined as having “no medical use” and “high abuse potential”. Before all psychedelic related research was stopped in the late 60’s, LSD was prescribed to over forty-thousand patients for drug-assisted psychotherapy. Just as the LSD movement was blossoming in the research setting, it was shut down by the U.S. government during the counterculture movement once the drug became misused by hippies and drug fanatics. Consequently, clinical research and experimentation with psychedelics decreased and eventually came to a halt by the Controlled Substances Act of the Comprehensive Drug Abuse Prevention and Control Act of 1970. Psychedelics classifiꢃcation as a Schedule I drug has been argued as far from appropriate and suggested to have occurred as a result of the war on drugs. Existing literature suggests the abuse potential proꢃle of psychedelic compounds is weak and psychedelics administered in controlled clinical settings appear non-addictive.
How These Drugs Work
Past and current clinical trials using psychedelics have shown not only its eꢂfficacy, but also to be physiologically and psychologically safe when administered in a controlled clinical setting.
Psychedelics work to act as a 5-HT2A (serotonin) receptor activator. While under the inꢀfuence of psychedelics, serotonin levels are increased by deactivating areas in the brain where it is regulated. Serotonin inꢀfuences neurological processes such as mood, anxiety, cognition, and learning while at the same time regulating happiness. Hence why psychedelics have been said to have an impact on chemical and psychodynamic levels in the brain. In addition to the inꢀfluence it has on serotonin receptors, it also aꢁffects the intensity of communication between diꢁfferent regions of the brain. Vast network interconnectivity is induced, meaning areas of the brain that typically don’t communicate begin to make connections. On the ꢀflip side of things, the communication between the Default Mode Network (DMN) is decreased while under the inꢀfluence of the drug.
The DMN is one of the most important functional neural connectivity networks involved in unconscious and automatic thinking. While under the eꢁffects of psychedelics, it provides an opportunity for the patient’s brain to break away from constricted patterns of automatic thoughts about themselves and their circumstances. This allows the brain to create and engrave new communication pathways with the transformative information being received under the inꢀfluence of the drug.
Take into consideration someone who is clinically diagnosed with Major Depressive Disorder or Treatment-Resistant Depression. Their unconscious thoughts and automatic processing networks in their brain ultimately control their conscious state. These automatic thought processes are partially at fault for their depressive states, strongly identifying with their depressive cognition and self-critical, pessimistic, ruminative narratives, which are deeply rooted in past experiences and perceptions. Thus, making them nearly impossible to have control over. Decreased integrity of DMN in this case opens up the opportunity for one to break these patterns. All at the same time, neural plasticity in the autonomic neural pathways allows the patient to construct new pathways for messages to be sent and received. While the drugs’ eꢁffects dissipate over a span of several hours, the new pathways and traces in the brain still persist.
The brain is in a similar state while under the inꢀfluence of psilocybin as to meditation. Many contemplative traditions like mediation explicitly aim to dissolve the sense of self by eliciting altered states of consciousness. Psychedelics are also known to produce signiꢃcant disruptions of self-consciousness, this phenomenon is known as drug-induced ego dissolution (Carhart-Harris & Roseman, 2018). Meditative practices have been developed in many diꢁfferent cultures and spiritual practices over many years, yielding over 100 varieties of meditative practices. Psychedelics have been adapted in many diꢁfferent spiritual practices and traditions in various cultures due to the similar states of consciousness induced by the drug. They’ve been used with the intent of healing, similar to meditative practices. Since using psychedelics in traditions and rituals are outside of Western culture norms, we’ve developed a negative stigma against them. It wasn’t until recently where psilocybin-assisted psychotherapy was introduced into Western culture and medicine.
Scientists and researchers are still discovering more and more associations between the neurobiological mechanisms of psilocybin, disorders it can treat, and the therapeutic outcomes. As far as the neurobiological impacts of psilocybin, a combination of neurotransmitter modulation, increased communication across the brain, decreased integrity of Default Mode Network (DMN), and neuroplasticity seem to be primary mechanisms for inducing a transformative and therapeutic experience. Due to the increasing amount of disorders and diseases psilocybin has shown to potentially be useful for, this has led researchers to suggest psilocybin is a compound with a transdiagnostic mechanism of action.
Receiving the Therapy
Psilocybin-assisted psychotherapy is a therapeutic process where the patient ingests a certain amount of psilocybin in a comfortable and positive environment with a licensed therapist and practitioner. As mentioned, the drug is administered in a strict medical setting. Throughout this process, the patient has the opportunity to discuss and digest thoughts and feelings with a nearby therapist and practitioner, if they will. The hallucinogenic
eꢁffects will persist as the patient is often covered with a blindfold and headphones to limit external stimuli. The subjective eꢁffects of psychedelics include “positive attitudes about life and/or self, positive mood changes, altruistic/positive social eꢁffects, positive behavioral changes, and well-being/life satisfaction,” (Schmid, Yasmin & Liechti, Matthias 2018). While there are many diꢁerent chemical and psychological processes that occur during psychedelic-assisted psychotherapy, these are just a few aspects of the healing beneꢃts of psychedelics.
As research and speculations on psychedelics in the medical setting prevail, there is still a stigma attached to the drug itself despite the great amount of data and research supporting that psychedelics could hold a transformative and advanced approach in the mental health industry.
Understanding the processes that make psychedelics useful for mentally ill patients would naturally decrease stigmas and negative associations that seem to be attached to the drug itself. The empirical support is overwhelmingly strong and promising. Nonetheless, a social shift is essential in order for psychedelics to be utilized medically. This includes changing preconceived, outdated and uneducated biases held by the public, political ꢃfigures and high up medical oꢂfficials. Changing psychedelics acceptance in medicine today is incredibly important because we are in dire need of an updated and evolutionary approach to treating mental illness (which just so happens to be on the rise over the last decade). It is our responsibility and duty to continuously explore, experiment and evolve. More importantly, why would we ever want to stop adapting to society’s needs?
Aside from the negative associations attached to psychedelics, there are further barriers that seem to inhibit our ability to get rid of these discriminations. It’s not an easy task to convince people that psychedelics have great potential to be a useful alternative to antidepressants. First oꢁff, it’s diꢂfficult to gain the attention of someone when they’ve already got a preconceived bias the moment you mention psychedelics. Additionally, the majority of individuals don’t have a general understanding of neuroscience and psychotherapy. This lack of education makes it hard for individuals to comprehend the language and terminology used to understand the chemical and neuronal processes that take place. In turn, this makes it more diffiꢂcult to get people to support it.
There is a great amount of available information and research that could answer the public’s questions and concerns regarding psychedelics in the medical setting. It’s important for the general public to have a scientiꢃc understanding of what actually occurs on the neurological level while under the administration of psychedelics if we want to utilize it in a medical setting. In order for someone to hold a strong opinion on anything, I believe
they should be required to be educated on the matter.
Lastly, utilizing psychedelics in a medical setting could also serve to decrease chances of people abusing psychedelics recreationally. Making alterations to cognitive processes using psychedelics should not be taken lightly and done outside of a medical setting. There are various precautions taken into account to ensure positive and transformative alterations while undergoing the therapeutic process in a medical setting. Recreationally experimenting with psychedelics outside of the medical setting will not provide these results because the same precautions are not taking place.
In an attempt to explain these complicated processes in a very general context, I am hoping there was an “ah ha” moment, where the readers’ initial uniformed biases were conformed to a narrow scientiꢃc understanding of the benefiꢃts and processes of psychedelics and psychedelic-assisted psychotherapy. Being aware of negative associations towards stigmatized topics of discussion and striving to educate or familiarize oneself on scientiꢃfic research is the ꢃfirst step in utilizing goods such as psychedelics to evolve as a society.
I believe it is our obligation to explore cognitive enhancements and breakthroughs in medicine, similar to ones that psilocybin can promote.
Olivia Arkell is a recent graduate from Hamline University who studied psychology, philosophy, neuroscience, and political science. She has a strong interest in biomedical ethics and the psychotherapeutic value of psychedelics. Olivia is always looking for ways she can expand her understanding on how we can transform the way we treat mental illness in the clinical setting. She demonstrates this passion through researching and interpreting literature then translating it into a short article/blog form that is easy, reliable, and comprehensible for the general public to read. Olivia joined the editorial team at Today’s Patient in spite of initiating important conversations on topics related to wellness, mental health, neuroscience, and psychology and educating people on patient rights and advocacy.
April 2022 page 6