Psychedelics, Therapy
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The Increased Usage of Psychedelics for Anxiety Disorders

Psychedelics have been known to have a promising future in the treatment of anxiety disorders. However, this hasn’t always been the case. In the early 1970s, psychedelics were criminalized which led to a halt in the research. The resurgence of research into the multitude of benefits offered by psychedelics in the treatment of psychiatric disorders in the past 20 years has resulted in a paradigm shift. There are still a lot of challenges faced by the field of psychedelic medicine, such as barriers on the regulatory level, the stigma around mental health, lack of education, cost, and shortage of specialized professionals.

Psychedelic-assisted psychotherapy

Initially, the use of psychedelics and subsequent research was based on the perceived ability of psychedelic substances to reduce ego defenses and the psychoanalytic understanding of mental illness. In psychotherapy, depending on the severity of your anxiety disorder, you will be given low to moderate doses of these substances. Through this drug experience, usually LSD, the specialist will be able to get an enhanced psychodynamic experience of your symptoms.

It was in the 1960s that a radical model started to take base in the medical community. It had a vastly different approach, structure, and conceptualization. The psychedelic-assisted psychotherapy at this time took inspiration from transpersonal psychology. In some cases, it also was inspired by spiritual or quasi-religious traditions.

To treat anxiety disorders, psychedelic-assisted psychotherapy requires a high degree of preparation combined with an extensive therapy session. You will be subjected to a high-dose drug session, followed by therapy sessions where you will be required to interpret what happened during your psychedelic experience. A therapist will be present at all times. To augment your internal experience, they will ensure that you are experiencing the “high” in a calm environment. The decor of the room might be accompanied by music to accentuate your experience.

In this case, the set is the expectations or mindset with which you came to the session and the setting refers to the comfortable environment where you experience the psychedelic experience and interpret what transpired at that time. It is important to pay attention to the set and setting.

This model has been in work since the 60s and almost all the clinical studies today follow the same. However, it is possible that some studies might combine psychedelic-assisted therapy sessions with the existing psychological programs, like motivational therapy or cognitive-behavioral therapy. As long as drug-administering sessions are considered, they retain this non-directive model.

Psilocybin for treating anxiety

Recently, there has been a hype around psilocybin, commonly known as magic mushrooms, as a possible treatment for mental health conditions like anxiety and depression. They are known to cause changes in perception and hallucinations. So, you might think that they increase anxiety instead of relieving it. And it is true to some extent. Some people experience paranoia and anxiety after taking mushrooms. However, research suggests that psilocybin offers long-lasting benefits by reducing anxiety and depression.

Psilocybin is the hallucinogenic compound present in mushrooms. It has some similarities with serotonin, a chemical that helps with mood regulation. Having imbalance or low serotonin levels can lead to depression and anxiety. However, controlled usage of mushrooms can have a positive effect on the serotoninergic system of your body so that it can balance the serotonin level.

It is important to note that all the clinical trials on the usage of psychedelic drugs for anxiety disorders have been performed under highly controlled and circumscribed conditions. Because of this, interpreting results can be difficult. It is possible that the treatment showed benefits because of the carefully-coordinated experience. Another challenge for these trials is the placebo control as these drugs are known to have powerful effects.

And, let’s not forget the risks. In rare instances, LSD and psilocybin have been known to cause a lasting psychotic reaction. It is more common in people that have a family history of psychosis. This is why people with schizophrenia have been excluded from these trials. Other drugs like MDMA have a risk of abuse.

Psychedelic-assisted psychotherapy for treating other mental conditions

Apart from anxiety disorders, psychedelic-assisted psychotherapy can also provide relief for other debilitating mental health conditions, such as major depressive disorder, PTSD, anorexia nervosa, and alcohol-use disorder. These conditions kill thousands of people every year in the US. Furthermore, these conditions have been known to impact the productivity of millions of people all over the world.

Psychedelic-assisted psychotherapy is still considered unexplored grounds by researchers, especially for the treatment of anxiety disorder. The most popular drugs that are used for treating anxiety and depression today can be bought at a local pharmacy store. However, for psychedelic-assisted psychotherapy, you will have to use a powerful substance under the close eye of a trained specialist. This is done to ensure that it is safely implemented.

Psychedelics, Therapy
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Types of Psychedelic Therapy

Psychedelic therapy, also known as Psychedelic-Assisted Psychotherapy (PAP), is a psychiatric practice where you ingest a psychedelic substance for your psychotherapeutic treatment. In most cases, psychedelics are used in combination with talk therapy. Currently, there are a lot of psychedelic drugs, capable of altering your consciousness, that are used in clinical as well as non-clinical settings. There are also a lot of studies that are researching the therapeutic purposes of psychedelic drugs.

Some of these drugs come from plants, like ayahuasca, psilocybin (magic mushrooms), peyote, ibogaine, and DMT. There are some drugs that are chemical compounds, including LSD, MDMA, and ketamine. Let’s get into some of these substances and how they can help you:

  • Ayahuasca – Originated in South America, this brew can help you with anxiety, depression, and addiction. However, there might be certain side effects, including medication interactions and serotonin syndrome.
  • Lysergic Acid Diethylamide (LSD) – Taking LSD can result in altered perception, consciousness, and mood. This is why it can be used for treating anxiety and addiction.
  • Psilocybin – Psilocybin works similarly to LSD in altering perception, consciousness, and mood. Currently, there are studies conducted to treat anxiety, depression, and addiction.
  • Ecstasy (MDMA) – Even though MDMA is not considered to be a classic psychedelic substance, it is known to create ‘psychedelic effects’, such as altered perceptions, feelings of euphoria, increased sociability, and increased arousal. In fact, research has shown that MDMA has therapeutic potential to treat post-traumatic stress disorder.

For centuries, Indigenous people have used psychedelics for religious and therapeutic purposes. However, in the Western clinical setting, psychedelic therapy remains relatively new. And, now that certain psychedelic substances have been legalized, it has become even more popular. Psychopharmacological research hasn’t been as popular as one might expect. Combining this with the increase in mental health conditions makes psychedelic therapy an optimal treatment option.

However, it is important to note that psychedelic therapy is still an experimental treatment. So, if you want access to this treatment, you will have to undergo clinical trials. But, before you do that, you should know about the different forms of psychedelic therapies:

  • Psychedelics – In this, you will only be provided with a psychedelic drug. There won’t be any additional treatment.
  • Drug-assisted therapy – For this form of therapy, you will have to take psychedelics along with the traditional treatment.
  • Guided therapy – In this, you will be guided through the psychedelic “high”. The counselor will offer suggestions and help you stay calm.

If you have been considering psychedelic therapy for your treatment, you must know about one of the most popular variations of psychedelic therapy, microdosing. In this, you will be taking small doses of sub-hallucinogenic psychedelic substances. Studies have shown that even low doses of these substances can provide health benefits like decreased depression, increased energy, and enhanced performance. However, more research is required to understand the beneficial effects of microdosing.

How does psychedelic therapy work?

When it comes to mental health conditions, treatment can take weeks, especially if you are opting for only traditional medications. Also, most of these treatments work only as long as you take them. The research done on psychedelic therapy has shown promising improvements in the conditions of mental illness. However, the exact way how these psychedelics work is still unknown. Here are a few theories:

1. Psychedelic experience – Psychedelics have been known to provide intense, meaningful experiences which can cause your belief system and mindset to shift. You might start behaving and thinking differently.

2. Neurotransmitter changes – Mental health drugs work by acting on neurotransmitters directly to alter the mood. Neurotransmitters are the chemical messengers present in the brain. Some psychedelic drugs act on neurotransmitters to change the behavior of your brain and improve your mood.

Thanks to the excitement around psychedelic therapies, there are a lot of new clinics, therapists, international retreats, and gurus providing the service. If you want to try out psychedelic-assisted treatment, you need to find a professional. One way to do this is by checking the database of accredited therapies. The Multidisciplinary Association for Psychedelic Studies maintains this database.

However, you should remember that taking psychedelic substances can make you vulnerable to suggestions and alter your consciousness. Because of this, you might end up getting involved in some unethical or criminal behavior. You also need to note that even though research has shown that psychedelic therapy can help treat a wide range of mental health conditions, the exact mechanisms of action are still being explored. Further research on the same will help scientists understand which drugs are helpful for specific conditions, when you should avoid such treatments, and what doses you should use.

Psychedelics, Therapy
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Can Therapeutic Psychedelics Be Used to Address Eating Disorders?

Therapeutic psychedelics have come into vogue these days because of their medicinal properties. But, a new area of study that has emerged is the role medicinal psychedelics play in the management of eating disorders. In this article, we discuss whether therapeutic psychedelics can actually have a positive impact on people suffering from eating conditions.

What are eating disorders?

Eating disorders refer to a variety of conditions that result in the formation of unhealthy relationships with food. People with eating disorders often exhibit either a severe aversion to or excessive dependence on food, combined with distressing thoughts about their self-worth. Some people may even experience intense feelings of anxiety and bouts of depression as a result of the eating disorder.

There are various types of eating disorders, such as –

  • Anorexia nervosa – A condition characterized by self-induced starvation to lose weight, leading ultimately to severe emaciation.
  • Bulimia nervosa – A condition where the individual deliberately vomits or otherwise expels any food eaten with the desire to lose weight.
  • Binge eating disorder – A condition where a person eats more than their bodily capacity in a very short period of time, to the point of severe discomfort.
  • Avoidant restrictive food intake disorder – A condition characterized by extreme pickiness in what is eaten and how much, often resulting in under-nourishment.
  • Pica – A condition where a person may compulsively eat things that are not considered food (such as pins, dirt, dolls, paper, etc.)
  • Rumination disorder – A condition characterized by compulsively regurgitating and re-swallowing food multiple times.
  • Other specified feeding disorders and eating disorders

Role of therapeutic psychedelics in managing eating disorders

Psychedelics are essentially items that have a natural chemical composition that can alter an individual’s mood, thought processes, and emotions. Doctors and researchers are now engaged in studying whether consuming such psychedelics can help alter the state of cognition and emotions that lead to anxious thoughts, unhealthy body image, and ultimately – eating disorders.

The idea behind researchers’ faith in therapeutic psychedelics is their ability to reduce the severity of anxious and depressive symptoms. These are often closely associated with low body image and may manifest as eating disorders.

Numerous studies have already shown how medicinal psychedelics can reduce activity in the default mode network (DMN) in the brain. This is the neural pathway that is active when we don’t consciously focus on the outside world and are instead focused on our internal mental state. This DMN is incredibly active in patients diagnosed with anxiety, OCD, and depression.

Additionally, other research has also shown that people with eating disorders like anorexia, nervosa for instance, have cognitive deficits, which manifest in –

  • Their inability to successfully handle any disruption/change in the way they think or act. (For example, a change in the menu can lead to immense physical and psychological distress).
  • Their tendency to be preoccupied with the smaller details and not see the bigger picture. (For example, thinking that starving oneself today will help them lose weight; while not realizing the long-term health implications).

Therapeutic psychedelics have been found to help patients with eating disorders reduce the severity of these cognitive deficits by reducing the activity in the DMN.

Some findings on therapeutic psychedelics for eating disorders

Of the many psychedelics available in the market, the four being studied for their potential use in managing eating disorders are –

  • MDMA
  • Ayahuasca
  • Psilocybin
  • Ketamine

Of these, Ayahuasca definitely has a more comprehensive role in eating disorder management than the others. A study conducted by Adelee Lafrance and colleagues, titled “Nourishing the Spirit: Exploratory Research on Ayahuasca Experiences along the Continuum of Recovery from Eating Disorders,” has explored the role of Ayahuasca as a potential treatment for eating conditions. Participants of the study – which involved taking part in the ceremonial ayahuasca drinking – stated that they noticed a positive shift in their perception of their own body image. Participants also recorded experiencing fewer anxious, OCD, and depressive thoughts and experiencing an improved relationship with food.

MethylenodioxyMetamphetamine (MDMA) is another psychedelic that has been observed to have therapeutic effects on people with eating disorders. Already MDMA is being used for PTSD psychotherapy, where it has found incredible success. In open-label, multi-site Phase 2 studies, MDMA is being tested specifically as a psychotherapy drug for managing binge-eating disorder and anorexia nervosa (restricting subtype).

Psilocybin is another therapeutic psychedelic that is being tested specifically for the management of anorexia nervosa. The brain’s executive control network (ECN) is a neural pathway that becomes active when memory, decision making, goal-directed behavior, and active focus on the outside world are involved. This ECN works inversely proportional to the DMN – rising when DMN activity falls and vice versa. This brain activity between the ECN and DMN is regulated by a part of the brain called the insular cortex. Research shows that patients with anorexia nervosa have disrupted insular cortex connectivity, which can lead to their cognitive deficits. Psilocybin is being explored to check if it has the ability to restore proper functioning and the relationship between the ENC and DMN. This can help reduce the cognitive inflexibility that people with anorexia nervosa often have.

Wrapping up

Therapeutic psychedelics have shown great promise in the management of eating disorders. More study and trials may one day help provide long-term treatments for these challenging conditions.

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