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As hopeful as I am for unconventional drugs to have more medicinal uses, is it unreasonable for me to think there's no good medicinal depression cure? Is it unfounded to think depression generally has its roots in being disconnected from other people/society?
I've felt depressed before, but I've probably never had it as bad as many people. But generally I've felt depressed when my life felt too narrow. When I've felt like there was only one or two things holding me up. When I felt like nobody really understood what I was going through or I couldn't open up to others.
From what I understand, tripping on psilocybin inhibits your DMN, which apparently is the part of your brain most responsible for your sense of self and makes you feel less like there is a barrier between you and the rest of the universe.
If certain medicines help people cope with depression, I definitely don't want to detract from the progress those medicines have provided to those people. But does it go against prevailing wisdom to think the only cure to depression is other people? And that, if psilocybin gets people to connect more, it can be part of the cure. But that no drug, in and of itself, can "cure" depression?
Just thinking out loud. Please go easy on me. I'm just curious and want to know more.
I have had treatment-resistant major depression for eight years. During that time I have had long periods with extensive, frequent social interaction and bonding. My depression encompasses most of the time I've known my now-wife, repairing a broken relationship with my father, the acquisition of one new close friend, and the coming and going of many transient relationships.
I don't know what the cure for my own case of depression is, and I'm sure if I were isolated/disconnected my condition would be worse, but the evidence available to me indicates that simply connecting with people is not what's going to fix me.
My wife and mother-in-law are both counselors, and routinely successfully treat people with depression. They have never indicated that level of social connection is either a dominant cause or reliable treatment for depression.
If you want something to read up on, a very popular treatment methodology for depression is CBT (Cognitive Behavioral Therapy). The premise is that depression is often caused by harmful thought patterns about yourself or your life, and CBT trains you to arrest those thoughts and replace them with thoughts that are constructive or more accurate (less exaggerated, etc.). It's not the treatment I need, but it works for an awful lot of people, and its solution isn't built around social connections (though it may reveal social connections as a problem in individual cases).
First, agree with everything you said (and it must be frustrating to deal with poptart* psychology like this).
>but it works for an awful lot of people
I know CBT is awfully popular on HN. But it is worth reading into the stats on CBT. Even if you take them at face value, it certainly does not work for everyone. It is of course, most effective when there is a clear cause and effect, very effective with anxiety, and also generally with children in particular. But has been shown to be ineffective or even dangerous when used with certain cohorts, ie. significant trauma background, clinical mental illness including depression, psychosis etc.
There have been more studies on CBT than any other form of therapy, and those studies suffer from the same replication crisis that the rest of social science research does.
So if it is your first exposure to getting help (and don't get me wrong, it is good to try as a first response) and it doesn't work for you, it is not your fault. You are not 'treatment resistant', more just at a 'treatment deficit'. Generally speaking, if your counsellor says you are treatment resistant, it is time to get a new counsellor and maybe if it is warranted a referral in combination with other medical expert like a psychiatrist. Each case is different though, and you are always your own best expert in yourself.
*like pop psychology, but it burns your mouth.
>There have been more studies on CBT than any other form of therapy, and those studies suffer from the same replication crisis that the rest of social science research does.
More studies showing the same results means they aren't suffering from the replication crisis, even if the exact same study isn't being replicated.
CBT isn't for everyone, that is true. And you shouldn't worry or blame yourself if it didn't work, there are more options available. But I wouldn't cast doubt's on it's overall efficacy or claim it's junk science.
Seriously?! I never claimed it is junk science.. didn't even allude to it. I certainly wasn't casting doubt on research figures where they have been replicated and proven.
Truth is, some CBT studies have repeatedly passed replication and others yet have failed. CBT studies in lots of areas where it is used have shown relatively low efficacy, but close to alternative options. Even across anxiety disorders, where is it most effective, it is with an average-ish 70-80% success, and often only a few points different with alternative options. Meta studies have shown it to be ineffective within certain sub-cohorts, even in general areas where it is shown to be effective. Lots of CBT studies are performed differently or with different cohorts to how or with whom they are instituted in practice.
None of this means it is junk science, it just means you have to be very careful to understand the precise limitations of the science. You cannot separate the outcomes you like from the replication issue, you have to test it all. You also cannot generalise the very real successes of CBT across areas where they have not been shown to be effective, or shown to be ineffective. It is worth keeping these things in mind.
This information is almost never shown to clients. Clients are told 'CBT works', with the implication (or outright claim) that if it doesn't work for you it is your fault. It is popular with clients and it is popular with the profession, because it sets expectations early, it is cheap, it is targeted, and it works for the majority of people with the majority of issues people seek counselling for (ie. anxiety and depression). If this doesn't work for you, and this is all your counsellor offers, they are doing a massive disservice.
> More studies showing the same results means they aren't suffering from the replication crisis, even if the exact same study isn't being replicated.
Not specific to CBT, but as a general point, replication crises are behind the scenes. Publication bias means only positive results get published, even if it's only the occasional lucky studies (or ones with overt cheating or innocent bad statistics) which come out positive. Researchers know about it and grumble privately, because they wasted months or years of effort before figuring out it's largely false. But this knowledge isn't generally what goes into archival publications.
> CBT trains you to arrest those thoughts and replace them with thoughts that are constructive
This part is useful to everyone well beyond the scope of depression. Simply becoming aware of one's thoughts is a revelation. Our ability to ride a stream of thoughts without being actively conscious to them is unfortunate; it must have some evolutionary reason, but it also means we can repeat and experience many bad feelings and thought patterns without recognizing that we have some choice in whether to allow them to run free or to shut them down/replace them.
_> Our ability to ride a stream of thoughts without being actively conscious to them is unfortunate; it must have some evolutionary reason_
I suspect that the evolutionary reason is rather mundane; introspection (thinking about thinking and feeling) is expensive, and while it may confer some small epistemic benefit toward constructing and maintaining a theory of mind, the main benefit is in masking the downsides of other traits (like neuroticism, depression, anxiety, paranoia), which, to be frank, don't usually have much in the way of an upside. Historically (and likely prehistorically) it is simpler on a population basis to select against the traits that introspection would mask, which leaves introspectiveness as a trait that isn't strongly selected _for_, and at least slightly selected against in most situations.
This calculation flips in any situation where neuroticism, paranoia, etc. confer an advantage, which probably happens often enough to keep those traits (and introspectiveness) from dying out, and of course much of the stress of modern living exacerbates any neurotic etc. tendencies, which may give introspectiveness a boost even as those tendencies are selected against more strongly. But on an evolutionary timescale, I'd place a bigger bet on human culture(s) becoming less stressful, rather than on people evolving to better withstand stress.
Much of this speculation, TBH, is a handwavy just-so story. And since a theory isn't much use unless it has predictive power, here is a prediction: low-trust societies are where you would expect to find some minor advantage to neuroticism associated traits _and_ a corresponding greater advantage to an even marginally better theory of mind, so we might find a correlation to greater introspectiveness. I am not aware of any research that addresses that question (although on an individual basis, neuroticism is by definition negatively correlated with trust, since trust is a facet of agreeableness)
Is this a coincidence, that CBT is also an abbreviation for Cock & Balls Torture?
As someone who used to be diagnosed with clinical depression and eventually got over it with a combination of therapy and sheer determination ...
... eh, being with people is the most reliable way to trigger a depressive episode. It makes me realize how much of traditional "This will make you happy" advice just doesn't click with me. Groups of friends make me feel lonely and disconnected.
I feel my best when I'm on my own. Or with 1 or 2 very close friends for short periods followed by lots of recovery time.
Who we are with is very important. For some people (myself included), the percentage of people who are beneficial to be around is very low compared to the general population.
And since so few people result in positive experiences (and since solitude doesn't usually cause feelings of sadness, but rather freedom), I would usually choose to be alone.
Given a choice, I would like 60% total solitude, 10-20% general human interaction, and the rest ideally the good meaningful, connective relationships.
Yes, it does go against prevailing wisdom to think that the only cure to depression is other people; it's generally considered that (at least part of) cases of clinical depression can not be solved solely by psychological or social means as they involve problems with, so to say, literal brain chemistry; social and emotional connections with other people are helpful to manage symptoms and assist recovery but they aren't sufficient to fix the underlying cause. And also for psychological problems which can be helped with non-drug therapy such as CBT and the likes, "other people" are again a helpful, perhaps necessary, but not a sufficient factor, they don't replace actual treatment.
In general, the boundaries of what people call "depression" is very fuzzy and usually far wider than what doctors would call "depression". I can certainly agree that there are a lot of "what-people-call-depression" cases which could in fact be helped by a change of company and habits and literally connecting more with other people. But there are also a lot of people for whom suggesting "connect more with people" is the literal equivalent of telling a person with broken legs to "walk more", as their current ability to connect with people in a functional and rewarding way is simply not working properly right now. Unhappiness is not depression; depression can involve things like feeling subjectively unhappy or even suicidally miserable during experiences that the depressed person agrees are really rewarding and positive, it's just that their happiness/reward system is broken currently.
You’re describing situational depression. A lot of people have chronic depression, where he only hope for managing the depression involves pharmaceuticals.
As someone who used to suffer from chronic depression, that's simply not true. Treatment is difficult, and pills are the easiest solution, but claiming they're the "only hope" is bordering on industry propaganda.
Pharmaceuticals on the market today don’t have a great track record in treating chronic depression. The first time a depression victim takes a drug it has a 66% failure rate:
https://www.webmd.com/depression/guide/treatment-resistant-d...
Drugs like MDMA are being evaluated as a potential treatment as well:
https://www.medicalnewstoday.com/articles/mdma-depression
33% success rate on first try is better than I'd expected.
Anecdotally, I've heard it usually takes several tries to find an antidepressant that works for any given patient. But once you've found a drug that works, that helps a lot.
*clinical depression which could easily stem from long-term, chronic situational depression, life circumstances, etc.
Which is completely irrelevant in many cases. Depression can be caused by serotonin deficiencies, and once you’ve got depressed (pun intended) values, it’s difficult to return to baseline without medical support.
> clinical depression which could easily stem from long-term, chronic situational depression, life circumstances, etc.
It could as easily not stem from it.
Treatment resistant depressive here.
After three decades of trying different therapeutic treatment avenues, including many pharma and non-pharma options, I think that refractory (treatment resistant) depression is a phenomenon rooted in biochemistry. At least for me, disconnect from other people/society doesn’t play a role (plenty of connections, happily married, etc.).
In my case, pharma pretty much works, non-pharma hasn’t. This doesn’t exclude non-pharma therapies’ being effective - for example, they may modulate underlying biochem to good effect in some- but only that such treatments haven’t worked for me.
I’m following the pscilocybin work closely. So far, it’s encouraging. I plan to experiment in 2021.
I completely agree. The structure of our society actively deprives people from human connection which is essential to happiness. Individuals do suffer from depression at different rates, but it pops up the same way popcorn pops when you turn the heat on. The direct cause is the atomization of modern life, not some chemical imbalance in the brain.
The reason people treat depression as an individual problem to be addressed by individual means (medication) is that we are totally unwilling to acknowledge the complete emptiness of modern life. And also because modern life teaches us to treat everything as an individual problem. The symptom is itself the mechanism.
While lack of human connection can be one cause or contributing factor for depression in individual cases, and may make a lot of people "depressed" in the informal coloquial sense, the notion that major depressive disorder across the spectrum and across society is singularly caused by lack of human interaction (or singularly caused by anything at all) is not a notion evidenced by any literature on depression I'm aware of, and is not a notion espoused by any of mental health professionals I've encountered who routinely successfully treat people with depression.
Of course therapists don't define it that way... their definition is limited by what the treatment options are. Those options basically amount to prescribing drugs or becoming a friend for hire, not changing the structure of society.
And there are plenty of therapists (and researchers) who would definitely say that the quality of the relationship with a depressed patient makes or breaks treatment, in many cases it actually is the distinguishing factor. At the very least, it's a necessary one.
"The literature" isn't even clear on what major depressive disorder is. Well, the clinical definition is clear: literally sadness/low mood for at least 2 weeks. But what does that mean?
I guess what I really mean to say here is that we have essentially created a situation where people are pushed toward being alone. Then when a whole bunch of them feel empty about their state of being, we assign the label of "depressed" on them and give them drugs that are only barely effective. The lucky ones can afford to buy someone who basically takes the place of a close friend or parent. We have no framework to describe this state of affairs because every single one of us only has our permanently modern society as a point of reference.
It's easy to forget that the human brain is not designed to live the way we live. It's designed to spend every waking moment together with a very small group/family, always outdoors together, always doing something entirely tangible and physical together. Seeing a stranger was a rare occurrence. Imagine that!
"Sadness" happens when someone close dies. "Depression" happens when a huge number of human relationships that the brain needs get replaced by vastly inferior alternatives -- coworkers, social media, video game friends, service workers, etc. Nothing else but modern society creates this.
I think the quality of the human connection is important. The Dodo Bird Verdict[1] states that the relationship and connection between a therapist and client is the true healing factor. Indeed, a strong causal factor on client outcomes is the attitude of the therapist; whether they are warm, caring and genuine. The therapist-client relationship accounted for 7% of the variability in outcome, whereas adherence to a specific treatment accounted for 1%.
On an individual basis, the specific treatment matters, but statistically the human connection matters more. Your standard “what did you do on the weekend” friendship won’t cut it.
[1]
https://en.m.wikipedia.org/wiki/Dodo_bird_verdict
> The structure of our society actively deprives people from human connection which is essential to happiness.
(Clinical) depression isn't the same as unhappiness.
The lack of energy to do anything and the general hopelessness are quite different to feeling unhappy or sad.
I believe it was the late and great George Carlin that said something along the lines of:
"Before you go on any powerful psychoactive medication, just do a quick head count of all the people around you. Are most of them assholes? You may want to just take a nice long vacation, permanently"
P.S. If anyone has the link to that part of whatever stand-up it was, that would be really great to see!
Apparently, SSRIs work really well for some people. I know a person who is night and day difference on them. She was crying a lot and sluggish without them, down right jolly with them.
As far as the default mode network, I've seen research that claims hyperactivity of the DMN causes rumination, which puts you in a downward spiral. So perhaps a bit of inhibition is good.
The problem in my opinion is that not everybody counts as the people who can help you get better. Your social needs could be related to an idealised image of yourself that you can't achieve, a desired romantic relationship, a sense of being part of a group around your age, etc. It's entirely possible that you never meet those expectations due to your specific circumstances, which makes any effort to connect with people a failure.
Someone I know well has suffered from major depressive episodes effectively since she was a baby—and no, she didn't suffer from a broken home, uncaring parents, or any of the things that could have reasonable been expected to lead to such a thing at such an age.
So yeah, tell me how depression has no neurological root, and is purely a result of a dysfunctional relationship to society, when it can affect someone effectively from _birth_.
She is watching the emerging study of psychedelics for mental illness with great anticipation and hope. Nothing else has done more than reduce the frequency of symptoms. (She actually started trying IV ketamine a few years ago, when it became available, and it has helped to reduce both the frequency and severity of symptoms, but not eliminate them entirely.)
"Feeling depressed" is not what we call clinical depression. Clinical depression means you just cannot function on your own anymore. Seeing it happening to someone you knew for years is eye opening.
The problem with that theory comes when people who have all of that and more get depressed. I do think you have a point in that the cause can be external but I think to see it as social is far too limited. Then there are cases where it's entirely internal as well, depression being a symptom of various illnesses. I'm not sure if you know this but a lot of theraputic work does focus on solving external problems. You might also observe that there can be quite a catch-22 effect or bootstrapping problem here as well.
To me it seems happiness is basically a big AND-expression of fulfilled needs. If someone is lonely they need community, if someone is scared they need safety, if they are malnourished they need food etc.
Quick note that depression isn't simply "I'm unhappy" (existence of a negative feeling). Depression is characterized by many/all feelings being severely diminished or completely absent. People who think everything's going right in their life still get depressed, and it's something of a trope for some depressed people to wonder how they can be depressed when they can't point to anything in their life that should be depressing.
Again, many people who are depressed have all of their needs met and more.
"Depression" is a bit of an overloaded term.
Maybe the easiest way to think of it is an electrochemical circumstance in the brain. This circumstance could come about as a result of external stimuli (or lack thereof), or through some imbalance or other more internal issue. I think the technical terms are something like situational depression vs clinical depression.
Even with situational depression, a fresh perspective can often give people the bit of confidence and hope that they need to proactively break depressive cycles.
Some things in typical medicine have their roots in unconventional medicine. For example PSK came from Shiitake (I think), oyster mushrooms and walnuts have plant sterols which statins mimic, lions mane has shown effectiveness as a nootropic, and there are currently trials on the effectiveness of turkey tail extract in combination with chemo. And don't eat shaggy mane and drink alcohol - it will mimic antabuse.
I'm an amateur mycophile, if you couldn't tell.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2948609/
is a metareview of non-drug treatment for mood disorders in adults.
However, medication is very effective especially as short term treatment or for major depression.
In terms of non-pharmaceutical medication, there is evidence supporting the use of St John's Wort:
_A 2008 review of 29 international studies suggested that St. John’s wort may be better than a placebo and as effective as different standard prescription antidepressants for major depression of mild to moderate severity._
However:
_St. John’s wort was no more effective than placebo in treating major depression of moderate severity, an NCCIH- and NIMH-funded study of 340 participants reported in 2002._
https://www.nccih.nih.gov/health/st-johns-wort-and-depressio...
Feeling down is not always a medical condition; if it's an adequate reaction to the conditions you're in, it's not something to be cured or treated. May be in your case, or in cases you're taking about those people felt depressed because they didn't have enough social interaction, and they fixed it by being around other people more: then it's not a condition, just your brain doing exactly what it's supposed to.
Depression, on the other hand, is feeling down without any adequate reason to do so. If your life is objectively quite okay, save for depression itself, but you constantly feel as if you've lost a loved one, then it's a medical condition. It's like feeling physical pain when you're not actually getting hurt.
> is it unreasonable for me to think there's no good medicinal depression cure
There can be, but only for some people and not others. I've seen esketamine make a night & day difference. Sadly, it has horrible side-effects as well, as in someone nearly died from that and had to discontinue the trial.
There's some hope that a particular metabolite of ketamine that works on AMPA may offer relief without the side-effects, but I haven't seen it actually in a medical trial yet and even if it was, I don't know if our doctor would go for it or not, though it allegedly does avoid the psychosis.
I use ketamine for depression. I get it by IV every 2-3 months at a clinic, and the effect seems to last about that long. Haven't had any bad side effects so far.
Insofar as it's possible to generalise, I believe you're completely right, and what you say is very important. But IMO it's not possible to generalise completely, both because people's psychology varies so much and also because what people mean by "depression" varies so much (and yes, in "people" there I include psychologists and psychiatrists, whose approaches to diagnosis vary enormously in my experience).
As a completely unscientific anecdote, I have two friends who both happen to be microdosing right now, and the improvements to their general dispositions and engagement with daily activities are profound. It's not at all clear that the effects will be lasting however, and my friends tend to be outliers in any case.
note: they're taking far less than a recreational dose.
If depression really is a "software" rather than a "hardware" issue that makes it much harder to solve right?
You can't just toggle some biochemical switches and restore normal function.
But if you can rewire the software in just the right way then maybe
> If depression really is a "software" rather than a "hardware" issue that makes it much harder to solve right?
I bet you have the 3 scenarios:
- "hardware" only
- "software" only
- both
Broken computer. Could be hardware, could be sofware, could be both.
But even though there are common scenarios, each computer can also be broken in a different way.
you forgot the input data :)
Fix the source of the problem.
I imagine this drug can uncover the problem and help the person solve it.
> I imagine this drug can uncover the problem and help the person solve it.
Bang on the money there, speaking from experience with exactly this.
If DMN inhibition makes you feel more connected and less depressed, I would expect constant attention-grabbing distractions like cell phones to have the same positive effect - but they certainly don't.
You've been sad. It is unreasonable to draw any conclusions about depression from that experience.
Huxley in Brave New World came closest to describing modern day depression. It's a lack of meaning. So many people these days believe the entire existence of the human race was an accident, so of course many people will feel their existence is meaningless and doesn't matter and of course that will depress them. Pumping them full of soma doesn't change that fact for these people.
Full disclosure, I have severe clinical depression.
Multiple comments here have asked for double blind placebo trials. But you can't really do that with something psycho active, at least not ethically. I can appreciate wanting high standards, but that doesn't mean banning everything that doesn't fit the neat mold we use in other cases.
Also, suicide is the leading cause of death for multiple age/sex demographic groups in most of the western world. Literally number 1 killer. Current anti depressants are about the least effective medicines used in the Western world. So there is a good public health arguement to accept that we're in an emergency and try things without necessarily having 10 years of statistically significant results and followup and debate.
> Multiple comments here have asked for double blind placebo trials. But you can't really do that with something psycho active, at least not ethically.
There are no ethical barriers to including a control group.
The idea that double-blind, placebo-controlled trials are impossible with psychoactive medication is a strawman argument, because obviously we can still have a control group.
The control group doesn't even need to receive placebo. In a study like this one, they could have easily and ethically had one group receive therapy and a second group receive therapy plus mushrooms. Or the first group could have received therapy plus traditional SSRIs.
The placebo response rate in antidepressant studies is extraordinarily high. There is no good reason to omit a control group in studies like these, other than perhaps if the researchers were too underfunded to make it work.
The reason you cannot have a double blind study is that you can tell you've been given mushrooms. So, I expect, can the therapist and the researcher etc.
The moment anyone knows it's no longer double blind.
I'm happy to be corrected if there is some clever way around this. I have heard people suggest you give "control" group members so other psychoactive substance (MDMA was suggested). But that doesn't have the same effect as mushrooms. And also, it's ethically merky to give people other drugs they're not expecting/consenting to. Plus then you don't really have a control group, you have Mushrooms vs Other Drugs...
People have attempted controls in the past, and often it is a high dose of niacin. It causes flushing and increased HR. To someone who has experience with mushrooms they won't be fooled. To someone naive, they can think they got the real deal.
I guess (I'm no expert) we would want a little of both: A blind, Niacin trial that is not placebo controlled AND a Placebo controlled but not blind trial? I wonder what Tim Ferriss has gotten up to recently on this...
But how can you tell if someone has been fooled or is just saying they've been fooled? When a drug has a very clear and obvious psychoactive effect, double blind simply doesn't work.
Yeah, it’s a weird thing to test for. Sort of like trying to double-blind broken bone procedures with a hard cast for the experimental group, and an Ace bandage for placebo. All parties can tell the difference while it’s being applied.
Maybe it requires a different kind of experimental structure that still allows for single-blind follow-ups. Imagine the subjects talking a different set of therapists or researchers after 1 month, 3 months, 6 months. The patients/subjects would have to be instructed not to talk about whatever they experienced during the psilocybin/placebo phase, only about their personal development since then: outlook on life, lifestyle changes, etc. The therapists would have to self-invalidate if anything was divulged by a patient. It would probably have to be a large group, since with 1000 people you might only get 300 therapist-blind reports.
Indeed. Other trial designs may also be appropriate such as crossover or waiting lists. Depends on the aims of the study. Double blind RCT simply isn't feasible or appropriate in every circumstance.
_>waiting lists_
I'd be careful with that - waiting lists may have a nocebo effect, exaggerating the benefits of the treatment under test.
https://onlinelibrary.wiley.com/doi/abs/10.1111/acps.12275
Perhaps at low doses in total darkness?
Darkness won’t affect it. You’ll probably be able to tell either way. Microdosing probably wouldn’t make for an effective study, as it’s currently being touted as a way to increase “productivity”.
They're not taking mushrooms, they're taking raw psilosybin sans any of the other active components in the mushrooms such as the bits that act as MAOIs. That seem to help reduce the chance of having a bad experience while tripping. This is why the therapist needs to be involved. If you start seeing demons or negative other hallucinations and can't calm yourself down it can be a traumatic experience.
I don't see how it's unethical if you don't know if the drug even works or not. Sure if you were trying to figure out which of two wildly successful depression meds is more successful vs a placebo for a group of suicidal teenagers clearly there's some ethical violations, but if you don't even know if a medication is useful or not how is it unethical to do a double blind study?
Hey, just want to say, thanks for the comment. I hope you are getting the help you need. It's not easy these days, even for us 'normal' nerds, so thanks for being here.
Thanks, that means a lot. :)
In the correct setting, psychedelics can critically alter one's view on the world and themselves. This is very powerful, but very unknown. We must tread on light ground when approaching these substances. So, more research must be done under the right trip settings, but not in haste.
I mean, there should be at least some haste here. 50k healthy people a year die from suicide in the US alone. And that's the official number, it supposedly missed a lot of people who "fall" off of bridges and crash cars alone at very high speed into stationary, well lit obstacles while sober and healthy...
For comparison, AIDS kills about 13k. About 16k people died from (non suicide) handgun injuries. Even All Cancers caused 600k deaths. Curing depression would be the same as curing 1/12th of all cancers...
I agree, regardless of the numbers, there is a problem, but if SSRI's are not the problem, maybe getting people the help they need is the problem. Perhaps instead, many of those people hypothetically are chronic alcoholics, or maybe they are recovering opioid addicts who cannot deal with withdrawal and don't have the help they need ( Actually, psychedelics work wonders when trying to beat addictions ) .
My point is, you can't associate a rising number of suicide cases and believe there's a definite cause and solution.
It is not a black and white problem, and for that matter imho nether is "suicide and depression." Those two things are caused by so many infinite externalities in life, we cannot point to a solution with any sort of confident conviction.
In essence I see that and hear this:
"Oh look, that suicide statistic is caused by "XXX", and "YYY" is the solution.
It's more like...
"Oh look, that suicide statistic is caused by problems "X&$Y#", "DLKJER)(_", "DOEKDHT&", "$_%&DHTJ" ETC., and there are a ton of solutions for each problem.
TLDR:
we should legalize psychedelics for recreational use, not limited to medical purposes
This is fascinating. I'm glad that they're allowing psychedelics for certain types of treatment, but I hope that the choices open up further than psilocybin.
Back in my teenage years I took pretty much every psychedelic I could access, and trip-sat (like babysitting) for about two dozen of my friends over the course of a few years. I found in tripsitting that psilocybin was among the more difficult to manage psychedelics, especially for first-timers. I found that 2C-B/E, DOC and LSD were the best-tolerated substances among people that weren't "psychonaut veterans."
This is purely anecdotal and in no way meant to imply that I know what the hell I'm talking about. I only bring it up as a thought that popped into my head relating to the use of psychedelic drugs in therapy.
Also, no. I do not know where to get any of this stuff anymore. Haven't known for over a decade.
That's interesting. I think LSD (not micro, but full on) is probably the most "dangerous". I've seen people fall into full retard mode on LSD, never seen anything quite as severe from people taking shrooms. Personally, I've never had a bad trip on shrooms, definitely had one or two on acid. The nature of the trip is quite a bit different. I'd call LSD an "advanced" psychedelic, and shrooms way more beginner-friendly/benign. Writing none of this to disparage either, just interesting that you have a very different opinion/experience regarding their nature.
I'm very much biased by my own experiences (hence my disclaimer that I make no claim to expertise here.) I've personally experienced and witnessed shroom trips being more... primal and emotional? than LSD
To be fair, considering the importance of set and setting, my opinions on the subject may be entirely informed by what I was going through during my trips personally, and what my friends were going through during theirs! Again, not an expert haha
That's an interesting insight.
Could it be a product of the difficulty in dosing mushrooms in a private setting, though? I'd imagine trips to generally go smoother if it's possible to aim for an intended level of weirdness more precisely.
That absolutely could be the issue! Though I never took any myself, I do vaguely recall hearing that 4-aco-dmt (a prodrug for psilocin, just like psilocybin) was more manageable than mushroom consumption. I'd bet that might be due to ease of dosing.
The study used psilocybin as an adjunct to 11 hours of professional therapy.
This study is not the same as taking psilocybin or other psychedelic drugs in an ad-hoc manner.
Although previous studies have basically been "listen to music with a tripsitter" and have had little ill effects.
I agree! I don't know how all this works, I just had a related thought pop into my head.
I'm curious if we have insights into whether psychedelics' mental health effects work by changing something by a direct chemical interaction, or if they work by just encouraging the patient to rewire their own brain while tripping. If e.g. you administered psychedelics on someone in an induced coma, would you see the same benefit?
This study wasn't just about psilocybin. The patients received 11 hours of professional therapy. The psilocybin was used as an adjunct.
The theory is that psilocybin increases suggestibility and openness to new ideas, making the therapy easier to integrate.
Note that increasing suggestibility isn't a universally positive trait, especially for people doing ad-hoc dosing alone without therapy. In fact, it's uncommon to hear "bad trip" stories where people end up in prolonged depressive or anxious episodes following a trip.
There is no evidence here that taking psychedelics without therapy is positive for patients, so it's extremely unlikely that dosing someone who is sedated or in a coma would have any effect.
We always considered sleep to be the 'reset' button after taking acid or mushrooms.
For me, it made me lose my "ego" to a certain extent during the experiences, I was able to feel some (what I now know are very important) emotions I was struggling to feel or accept for many, many years after trying many different types of therapy and medicines.
Once I was able to feel and confront those emotions and discover what had me so wound up, upset and sad - I was finally able to start the process of healing.
IIRC there were studies done to that effect with subjects in comas with various psychedelics, where there were no effects. Regard this with a large grain of salt though, I read that somewhere a long time ago and don't have a source rn.
Sounds like an informed consent nightmare. How could this even happen? This wasn't even close to my area of legal practice though so it's I guess possible for there to be some sort of workaround.
Looks like a potentially interesting study here:
https://jme.bmj.com/content/45/5/299
I imagine next-of-kin have power of attorney when it comes to medical treatments done on comatose patients. That would probably include medical trials.
Link to actual study:
https://jamanetwork.com/journals/jamapsychiatry/fullarticle/...
Many people only read the headlines and assume that psilocybin is treating depression. The reality is that these studies psilocybin as an adjunct to 11 hours of traditional therapy.
These studies aren't showing that psilocybin is a promising treatment for depression. They're showing that _psilocybin-assisted therapy_ is a promising treatment for depression.
As someone with experience with both therapy and psilocybin (while severely depressed), I would guess the psilocybin is the main ingredient in this concoction, and the therapy is just being added to make the study more palatable, the same way medical cannabis use had to precede recreational cannabis use.
+ With (exceptionally) long term, positive effects when coupled with therapy before, during, and after strong psychedelic trips.
Ultimately, the research results (and anecdotal evidence) for psilocybin are too great to ignore. The next question is - How does it get legalized (which we're seeing the stirrings of) and who gets access to it and how when it is?
Just passed in Oregon: Oregon Measure 109. Legalize Psilocybin
Permits licensed service providers to administer psilocybin-producing mushroom and fungi products to individuals 21 years of age or older.
I forget. This done undersupervision, right? They aren't allowed to prescribe and send them home if I remember correctly.
Here's my issue with that:
Who are the service providers of the treatment and what training have they taken to do so? There is some available through folks who did original research (eg: John Hopkins) and now do talk and demo circuits but otherwise it's all largely undefined.
I'm paranoid of what this might lead to without strong community standards and ethics. A good first step, but lets hope it doesn't ruin it for others.
It's undefined because it's just getting started. You can't make a substance legal and have all the necessary training and infrastructure available from day 1.
So previously they were illegal and you bought dried mushrooms from some guy in a pool hall (maybe I'm dating myself). Its hard to imagine that legalizing them is a step back. People automatically see legalization as an excuse for more bureaucracy and regulation - how about starting with the premise that the world didnt end while people bought it illegally, and ease in a minimal way to ensure safety and quality, which must be well understood for all the other foods and natural products already sold, instead of doing the regulatory power grab of "oh we need a whole new framework!"
I believe they are taking two years to settle these questions
Initiative 81[1] passed in DC. Still not legal but it looks like the will is there.
[1]
https://decrimnaturedc.org/initiative-81/
I read "How to change your mind" last year and I tried this. It worked very well.
As many studies indicate, it temporarily disables/decreases DMN (among other effects) which is exactly what a depressed person would need: break the vicious self-destructive circle. Only then I could start making hard but necessary decisions and change my life completely. Depression is nowhere to be seen but that's because I actually changed things and didn't become complacent.
I'd not recommend to do it without spending a good time doing research. The aforementioned book is a great resource.
Note that depression is a highly variable disorder, and not every depressed person is in any kind of "vicious self-destructive circle".
As someone with major depression, it helps temporarily but doesn’t last.
Works for mine. I need to take a heroic dose (5 gr) and then it lasts about 3 months before I need to again.
Isn't that what the parent post said? Works temporarily but doesn't last?
Considering there's no evidence it's toxic and you can do it every month because that's how long it takes for your tolerance to wear off, 3 months is a lot of time.
Consider normal SSRIs where you feel like crap for a month, try N more (which could mean many more months) until you find one that suits you, then have side-effects, then try to get off them so that's another couple of months of misery.
That's countless doses, money, time spent in misery vs one day of mushrooms every 3 months.
Normal psych meds are to be avoided at all costs and only be used if absolutely necessary, after you have tried everything else; atleast in my opinion.
I think the primary reason for “normal” psych meds is they’ve been tested well for harm reduction first and foremost. That’s why the front line SSRIs are front line, they have less chance of a negative effect. Downside is it’s mild, and there’s plenty of evidence that the “low seratonin” theory of depression doesn’t apply to many.
Psilocybin is an intense acute experience. People can have negative effects. I hope we do studies to find how to use it most safely, or isolate the beneficial aspect without the intoxicating effects.
The research and anecdotal reports coming out about microdosing is pretty exciting for the field of depression treatment.
Though some take greater dosages, many people are finding relief from sub-perceptual doses: indicating that the typical hallucinations and disorientation associated with recreational psilocybe use is likely not necessary for achieving anti-depressive effect.
I've also read of some interesting work being done creating "anti-abuse" formulations, where the active ingredients are compounded with Niacin or other drugs that cause unpleasant physical side effects at high doses to discourage overdose/abuse/recreational use. "Stamet's stack" seems to be the most common of these.
Definitely needs much more research into these compounds, but seems a very promising frontier for antidepressant pharmacology.
> I've also read of some interesting work being done creating "anti-abuse" formulations, where the active ingredients are compounded with Niacin or other drugs that cause unpleasant physical side effects at high doses to discourage overdose/abuse/recreational use.
Of course they can’t just let us use the natural substance that has existed for most, of not all, of human history.
I don't usually log in at work, but I feel this needs to be said since there's a few people in my life struggling with this.
Psilocybin works great, and almost everyone I know with depression can attest to that- but without changing the circumstances that cause the depression it will likely always return.
Anecdotal example:
My sister is in disability care and is routinely abused by patients with severe disabilities (to no fault of their own) and she will slip into a severe depression that usually lasts a long period of time. Tripping helps her substantially deal with this, but psilocybin is for treating the effect and not for fixing the cause... If you kick a dead horse it (probably) won't wake up.
> Works temporarily but doesn't last?
I'd have assumed it meant a tolerance would kick in after a few rounds.
1 reset day out of every 100 does sound achievable/possible even with clinical administration, but needing it every 3 days wouldn't be.
Similar for me. No idea of the gram dosage but... a lot. Effect lasted about 6 months, then tapered off slowly.
Repeated again roughly yearly. After 4 difficult and unpleasant trips I'm fine. Never reached the sense of utter well-being I have for the few months after a trip but I'm _fine_.
I will say that drinking any alcohol basically negates the positive effects for me for a while. As in, I'll have a cocktail and then won't feel "right" again for a month or so.
Have you tried ketamine? I suffered from major depression for years and it was the only thing that helped me. It was like flipping a switch.
I've struggled in past with major depression as well, and had a similar experience with ketamine. Though I had to resolve the life situations that contributed to the depression, ketamine lifted my existential apathy enough to help me get it done.
Did you find a doctor, or otherwise? I have severe chronic pain, and resulting depression that affects my pain perception, and am interested in trying this route.
Yes, I did it through my psychiatrist along with talk therapy and traditional anti-meds. I had been doing the others before, but adding the ketamine was life changing for me.
It’s a shame too. I had the best health care option from one of the largest public tech companies and I had to pay $450 out of pocket, twice a week for four weeks, and then moving down to every other week. This is on top of $6k they took out of my salary over the year.
It is extremely frustrating the amount of basic mental health care needs, which I believe depression is, that are simply out of reach for most of Americans.
In Arizona, with a chronic pain doctor, I was able to get pure ketamine liquid infusion via IV for 3-4 hours, while I listened to music. Felt like rebirth. My spinal pain was significantly decreased for the next few weeks, and my mood was ecstatic. Like the mushrooms though, it is short-lived. The doctor liked prescribing it because it is an NMDA agonist and decreased my opioid tolerance quite a bit, also helps with withdrawal symptoms. It is not covered by insurance -- $450 out of pocket. Spravato, the nasal spray, is cheaper but won't be as dramatic an experience [1]
[1]
Thank you.
I've had a very bad experience w/anesthesia so am always nervous while dealing with anything of that nature. Wonder if that predisposes me to a bad trip.
Not sure that would be worth it for just 2 weeks of relief.
Also not sure I'd be able to find any such doctor near me. Probably health care providers are much more open minded out West than it is here.
The nice thing about ketamine is that it is a sedative. I've done LSD, Mushrooms, and DMT. Ketamine is the most enjoyable and least risky in my opinion, due to its sedative nature. The doctors usually give an anti-anxiety drug before starting the infusion, a benzodiazepine such as midazolam. As I did more infusions, we increased the ketamine dose and decreased the midazolam. Find a good doctor and work with them. Ketamine is a really wonderful substance for pain and depression.
Eh... enjoyable is subjective. At subrecreational, subanesthetic doses, it can make you feel really fucking weird. It's not bad, and it's certainly survivable given that you're dissociated from it — but it makes me feel really weird.
As to monoideism's question: I'm not a doctor, but ketamine is more benign than many other anesthetics especially at the lower doses used in treating depression. Do your homework, but don't rule it out based upon prior experiences with other anesthetics.
Did insurance cover Spravato? I didn’t even realize it was available as a self-administered prescription drug.
You are right: Spravato has to be administered in office, it cannot be taken home. The doctors who were offering it weren't even covered by my insurance, so I'm not sure if the drug itself is covered.
No individual therapy lasted to cure my major depression, including mushrooms. It was a combination of therapies.
What kind of integration work do you do after a trip?
Does it last long enough that you get a period of normal functioning?
Are there any pharmaceuticals that provide permanent rather than temporary benefits?
Maybe vaccines or antibiotics (depending on how you define 'permanent'), but I don't think any psychopharmaceuticals fit this description.
This is what we call anecdotal evidence.
In the absence of clinical evidence, anecdotal evidence is all we can go on
Survivor bias alert; as someone who cured themself of clinical, multi-year depression with one, self-administered dose of Psilocybin in 2005... this is real. This can work.
And I will never, ever take Psilocybin again.
Would you be willing to share more about this? What was your experience? Why will you never take it again? How do you think it cured your depression?
Some experiences are not fit for words, so I won’t attempt to share my experience. I do not recommend you take an unguided, illegal street dose of psilocybin. Guided, therapeutic delivery is surely more effective. Still, I believe the affects were profound, terrifying, enlightening and Most importantly lasting, 15 years in my case. I think the studies do a better job justifying the science of efficacy.
Instead I will say those that struggle, first get your sleep, diet, work and community/relationships in order. Wellness is comprehensive and this tool is better viewed as a spirit guide than a magical cure.
24 participants?? as much as I want to know the effects / benefits of psychedelics, that seems like way too few people to make such a general statement
I wonder if there's a treatment modality for self-treatment. I find it increases circular thoughts/anxiety for a time, but may have a sort of cleansing effect on the serotonin receptors. That's a very subjective explanation.
If your issue is negative thinking it doesn't necessarily help .. I guess without a guide.
Is there any research on the adverse affects of quickly relieving depression medicinally, or the role of non-clinical depression in the psychology and function of a person? I ask because I realize the need and desire to relieve many people who suffer from clinical depression that totally derails their life or ability to function, but I always wonder at the possible function of some depression in the normal functioning of the psychology of a person. Does the effect of psilocybin wear off if used too often?
I can offer only firsthand anecdotal experiences from the late 60's and early 70's. Most psycho-active recreational substances, while fun in the near term, left you afterwards feeling like you'd been run over by a truck and your dog had died. But never silly-cybin. Vastly amusing, visually stunning and afterwards you always felt like a million bucks. Definitely my personal favorite. YMMV...
I was quite depressed as a teenager and also took mushrooms many times. I actually think it made my depression worse over time.
I mean alcohol will greatly and quickly relieve depression while you are drunk too. That is not solving anything though.
The obvious problem with this kind of study is it is hard to see this being done by objective researchers who are not quite biased towards finding benefits of psychedelic use.
_"Two psilocybin sessions (session 1: 20 mg/70 kg; session 2: 30 mg/70 kg) were given (administered in opaque gelatin capsules with approximately 100 mL of water) in the context of supportive psychotherapy (approximately 11 hours)."_
Curious if that's enough for the patients to have a psychedelic experience.
From wikipedia on Psilocybe cubensis:
"The concentrations of psilocin and psilocybin, as determined by high-performance liquid chromatography, are in the range of 0.14–0.42% and 0.37–1.30% (dry weight) in the whole mushroom"
My napkin math: 20mg is equivalent to roughly between 1.1g to 3.9g of dry weight (lots of variance in potency). This weight range is roughly equivalent to typical recreational dosages.
It its pure psilocybin, I'd imagine show. If it was mushrooms, that's not even a micro dose from what I understand.
That should be a medium dose, I think.
A new study of 24 adults with major depression finds that two doses of the psychedelic substance psilocybin, _given with supportive psychotherapy_, produced rapid and large reductions in depressive symptoms.
Notice that therapy is required. What are the odds people will look for the convenience of a pill while completely ignoring any required therapy and then blame everything else but themselves?
This is in no way a proof or even claim that therapy is required, although your overall point is valid.
I did not expect to see Tim Ferriss's name in an article like this. Interesting.
Yea. Tim Ferriss has put a lot of effort (and money) into this type of research. He has brought on several guests on his podcast to discuss this subject. He has also talked about his past depression which, I believe, drives his passion towards this work.
Yeah. I only caught a few comments from him and then when I started go ogling it, he's actually pretty big both in funding this work and in fund raising and raising the profile of it. He had (has?) pretty bad depression so...
A study of 24 participants seems pretty flimsy.
Is there any way for me to actually try this in the USA?
it's currently decriminalized in Oakland and probably other cities.
there are grow kits you can buy to ensure you're getting the real deal. shroomery.org probably can help you out
I think the therapy portion of this is crucial. I've heard stories of "underground" psilocybin therapists, but finding them would take some sleuthing.
I want to know how republicans that take it feel.
People using throwaway accounts (maybe they have to) to comment, and then there is this 'depression' ICD, wonder if there is any connection.
HN of course is a wonderful place. But there is a stigma on this everywhere. I would much rather seek the support of real world friends than face the judgement of internet denizens.
My idea was, that even online, people can't seem to afford to speak their mind, so I guess in real world this could be even harder.
Is monitoring a patient wearing eye coverings and headphones essentially what psilocybin assisted therapy is? This doesn't seem like something one actually needs a therapist for..
New study finds psilocybin greatly and quickly relieves depression
Nope, it doesn't. The study wasn't placebo controlled. The placebo effect will have a large effect in a study like this, so we have no idea what effect the psilocybin had.
How about we read the paper first before jumping to conclusions.
https://jamanetwork.com/journals/jamapsychiatry/fullarticle/...
Findings In this randomized clinical trial of 24 participants with major depressive disorder, participants who received immediate psilocybin-assisted therapy compared with delayed treatment showed improvement in blinded clinician rater–assessed depression severity and in self-reported secondary outcomes through the 1-month follow-up.
Meaning This randomized clinical trial found that psilocybin-assisted therapy was efficacious in producing large, rapid, and sustained antidepressant effects in patients with major depressive disorder.
From the guidelines:
> Please don't comment on whether someone read an article. "Did you even read the article? It mentions that" can be shortened to "The article mentions that."
From the paper:
> Strengths and Limitations ... Further research with ... a placebo control is needed to better ascertain the ... efficacy of this intervention among patients with MDD.
> Conclusions ... Further studies are needed with active treatment or placebo controls
The paper explicitly mentions that there's no placebo control, so I'm not sure what you're trying to point out with your comment.
What kind of placebo could you use to stand in for a treatment that normally has immediate and obvious side effects like this one?
You don't need placebo. That's a common misconception.
They could have used an active control group that received traditional antidepressants.
This study wasn't actually about psilocybin, it was about psilocybin-assisted therapy. So they could have simply had one group receive only therapy and the other group receive therapy plus psilocybin.
>They could have used an active control group that received traditional antidepressants.
Traditional antidepressants take days or weeks to have an effect, and the effect is very different from psilocybin.
>So they could have simply had one group receive only therapy and the other group receive therapy plus psilocybin.
That still wouldn't tell you if the psilocybin itself had any effect over and above the placebo effect.
Probably the control should be some other psychoactive substance that also has some noticeable hallucinogenic effect, but is not believed to have curative properties.
The other way (which is close to what they have done) is to compare and contrast the therapeutic effects of different dosages - if the patient feels the expected sideeffects in both cases, but the normal dose achieves measurably better results than a minimally low dose, then that's some evidence about the effectiveness of the active ingredient.
They’ve used Ritalin as well, since it has obvious psychoactive properties and also causes some of the same physical effects as psilocybin (increase in heart rate, sweating, etc).
https://www.discovermagazine.com/mind/do-magic-mushrooms-mak...
You can just use the standard sugar pill placebo. But of course make sure the placebo group get the same treatment of lying on a couch and listening to music with their eyes closed. I am sure the psychedelic effects of shrooms would increase the placebo effect greatly, so sugar pill placebo might not correctly show the placebo effect, but it is a start.
> so sugar pill placebo might not correctly show the placebo effect
The lack of good placebo options seems to be why they chose not to have a placebo. The paper mentions:
> Although placebo and active treatment controlled designs are widely used in therapeutic trials, they too have limitations owing to the highly discriminable effects of psilocybin.
That seems a bit of copout though. Yes, sugar pill will not have a as high placebo effect but it is still useful as setting a lower bound on the placebo effect.
Wouldn't it complicate things by introducing a new variable to consider, i.e. how gullible is each participant / how affected were they by the placebo? For what it's worth, it seems more useful to not have that variable. That way, if the effect was from the psilocybin acting as placebo, at least you know they were all affected equally. There were too few participants too. Having a control group with a placebo would make the experimental sample even smaller.
How about the combination of the drug and the experience is the treatment? In that case the placebo is telling someone with depression to sign up and stay at home. Which is still important.
One early study of psychedelics used niacin as the placebo. All the patients were in the same room (not a great study design IMO) All of the control patients experienced niacin flushing before the treatment patients started having effects, so many treatment patients initially thought they were in the control group.
You couldn't use a placebo, but you could use a different psychoactive drug such as ketamine which is also being tested for use on depression.
Yeah this objection is a red herring. You need to look at the effect size.
If you have found a protocol where (according to the study author) "the magnitude of the effect we saw was about four times larger than what clinical trials have shown for traditional antidepressants on the market", if it's just a placebo, that sounds like a great placebo to be giving!
As noted above I seriously doubt the concept of a placebo is even well-formed for psychedelics.
I quite like Scott Alexander's take on this issue:
> Actual carefully-researched psychiatric drugs are exquisitely selected for having few side effects. The goal is something like an SSRI – mild stomach discomfort, some problems having sex, but overall you can be on them forever and barely notice their existence. In the grand scheme of things their side effects are tiny – in most placebo-controlled studies, people have a really hard time telling whether they’re in the experimental or the placebo group.
> Nobody has a hard time telling whether they’re in the experimental or placebo group of a trial of high-dose MDMA. I think this might be the difference. If you go for large effects – even if you don’t really care what direction the effect is in – you’ll get them. And if you go for small, barely perceptible effects, then you’ll get those too.
https://slatestarcodex.com/2017/06/05/is-pharma-research-wor...
Also see
https://slatestarcodex.com/2018/01/31/powerless-placebos/
> All three looked at studies comparing a real drug, a placebo drug, and no drug (by the third, over 200 such studies) – and, in general, found little benefit of the placebo drug over no drug at all. There were some possible minor placebo effects in a few isolated conditions – mostly pain – but overall H&G concluded that the placebo effect was clinically insignificant.
> What happened? Probably placebo effects rode on the coattails of a more important issue, regression to the mean. That is, most sick people get better eventually. This is true both for diseases like colds that naturally go away, and for diseases like depression that come in episodes which remit for a few months or years until the next relapse.
>if it's just a placebo, that sounds like a great placebo to be giving!
Even for antidepressants, the placebo effect makes up 67.6% of the effectiveness [1], so the placebo is always much more effective than antidepressants.
>Also see
https://slatestarcodex.com/2018/01/31/powerless-placebos/
Hmmm, that seems to be a review from 2004. Newer data [2] shows that placebos can affect autonomic, neuroendocrine and immune responses and pain responses.
[1]
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3130402/
[2]
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6013051/
Yeah, I'm going to want the same psychotherapy given to a group given psilocybin, a group given traditional antidepressants, and a group given placebo (with the psychotherapist blinded to administered drug).
it will be plainly obvious who got the placebo
I wonder about posts with studies like these when just earlier there was one about how to read scientific papers.
These articles about illegal drugs being miracle cures is just as bad as the fringe diet posts. Fortunately the diet posts seem to have died down but these persist.
How is this anything intellectual? It’s just conspiracy theory level pseudoscience like the fecal transplant stuff and the diet / vitamin stuff.
We have to be careful to prescribe these psychotropic substances willy-nilly to the general population. Cannabis has always initially worked well for me, but 1-2 months into using it, it causes schizophrenic/manic episodes. I cannot touch it anymore because of the possible permanent damage it could do.
Psychedelics have been researched since the 1960s, despite formidable legal obstacles. I'm not sure how much more "careful" you want them to be.
Cannabis is pretty heavily lobbied. I've never seen any labels indicating it can cause manic episodes on any packages. I just don't want to see that happen with anything else. We should inform people of potential side effects.
Making medical claims positive or negative invites the presence of the FDA.
https://en.wikipedia.org/wiki/Think_of_the_children
I believe many who have taken psilocybin for medical reasons would agree: they would never take it again. I did not find it not habit forming. (edited to make clear my opinion and not facts)
What do you mean? Can you elaborate?
I did not find my psilocybin trip pleasurable. With the exceptions of 1) micro-dosers and 2) those that seek mind altering experiences as a lifestyle ... the studies have reinforced my personal experience: once seems to be enough. (Edited to make clear my opinion vs facts)
I feel that you are posting some very irresponsible things in the comments here in a very authoritative tone. I would kindly invite you to refrain from doing so, since I disagree strongly with your various assertions. Perhaps you can offer your views as your personal perspective rather than objective truth.
Caffeine is a mind altering experience. Eating too much sugar is a mind altering experience. Drinking alcohol is a mind altering experience. I have had extremely pleasant and also terrifying psilocybin trips. They have all been constructive experiences for me.
They may be right when they say "is not pleasurable" - since it's not like a typical pleasure substance where it's nothing but good feelings. It's highly dependent on set and setting, as you no doubt know well; so the key thing here is to help usher people towards having good experiences and not just experimenting with something without doing their reading first.
Depression is a logical and natural reaction to something fucked in a person's environment. The proper solution is to fix the environment, not to drug yourself into living in a dreamstate. Quite frankly, the world being the way it is today, you should be worried about yourself if you are not depressed. Again, ignoring reality is not the solution.
Have you ever taken psilocybin/mushrooms? It's quite a remarkable experience. It makes you more sensitive in some respects, far from "drugging yourself into a dreamstate"
Really sick of these "drugs feel good" stories. If we were still behaviorists, we wouldn't pretend this was news. This is declaring a full remission of depression after four weeks in half of the subjects. This is pretend science, I absolutely guarantee that an all expenses paid weeklong camping trip (or trip to Paris for those afraid of bugs, or trip to Japan for those sick of Paris) would do the same thing.
Asking depressed people whether they're depressed in four weeks during which they've had two good, safe, legal drug sessions, and considering it meaningful, is moronic.
edit: I've been reading lately about saying things directly. _Of course drugs feel good, that's why people do them._
I can absolutely guarantee that when I was severely depressed, an all expenses paid weeklong camping trip would have:
- Not been enjoyable, as I was much less capable of feeling pleasure/joy
- Been way to difficult for me to accomplish, given that getting out of bed and showering was often too difficult for me to accomplish
- Would have had a negative effect on my depression
> Of course drugs feel good, that's why people do them.
Drugs can feel good, but that isn't universal and that isn't the goal of these drug-assisted therapies.
Often psychedelics can be scary and anxiety producing. An introspective trip often isn't "fun" but can lead to personal insight -- the internet is littered with such testimonials. That is the hope of these therapies, not to give the person a joy ride for a few hours.
You obviously have no idea about psychedelics, to position this as a “drugs feel good” story. Good chance at least one of the participants didn’t have a pleasurable trip. In fact, it’s a common psychedelic trope that it’s precisely the challenging, unpleasant, _bad_ trips that truly have the potential for restorative change. Myself, my most profound and helpful psychedelic experience was a DMT trip that went in a _very_ dreadful direction.
a mushroom trip isn't always fun. it's exhausting. But you usually feel good _afterwards_.
So these substances aren't like coke or heroin where it's bliss and euphoria while on them (though that can happen, too)
It's worth noting the study here involved long sessions of psychotherapy. This was not a study where they just gave them LSD and let them at it. The idea as I understand it is that the psilocybin makes it easier for one to integrate the work happening in therapy.
Of course, it's a very small sample size (as seems to be true with many of these studies) and appears to have lacked a control, although maybe I missed it.
Counterpoint
https://en.wikipedia.org/wiki/Comedown_(drugs)
Drugs only 'feel good' for that purpose in the few hours after they are consumed. If people's psychological state is influenced (either way) several weeks after the experience, then something else is at work.
Have you ever taken psychedelics? I've used mushrooms, lsd, and a few others probably over a hundred times and one of the things that really seperates these drugs from others such as caffeine, alcohol, mdma, amphetamines, etc. is that there's no noticeable comedown except that the experience fades away and I am tired (as I would be after any intense experience). On the contrary, I usually feel really good after taking psychedelics, often for a period of days or weeks afterwards.
People's experience will vary of course, and if you have a bad or unpleasant trip you won't feel good afterwards. However, in my experience, the majority of people don't experience comedown after taking psychedelics.
This has nothing to do with drugs "feeling good."
There has been substantial research recently showing that in some ways that I, at least, don't yet fully understand, various different psychedelics have the ability to "reset" the brain. This _appears to be_ an effective _long-term_ treatment for depression and anxiety—much, much longer-term than the direct effects of the drug—the trip, or any euphoria associated with it; in some cases, on the order of months, or even, for some lucky people, _permanently_.
So take your "this is pretend science" and shove it. Just because you don't approve of drugs that have been deemed illegal and immoral in the past doesn't change their very real benefits to some people—or the fact that depression is not, and has never been, something that can be cured by "an all expenses paid weeklong camping trip" or any other pleasant experience. Mental illness is serious and debilitating, and if psilocybin and other psychedelics can be more effective treatments than what we have now—which _very real science_ indicates is highly likely—then that's going to be amazing for millions of people all over the world.
You're welcome to go take your camping trip and ignore the news about it.
> edit: I've been reading lately about saying things directly.
If you're interested in experimentation, I recommend a series (say, 5 to 10) of mid-level-dosage psychedelic sessions, going in with the intent to study the nature of human consciousness and perception, keeping a journal of your experiences and thoughts. I would be surprised if you would still hold the opinions you've expressed here, but then mileage can vary quite significantly in some cases.
> Of course drugs feel good, that's why people do them.
Technically, that is only one of the reasons. Psychedelics seem to _usually_ feel good, but from time to time you can get the exact opposite effect, sometimes in very large quantities. Yet, anecdotes seem to suggest that even after extremely unpleasant trips, most people seem to consider the experience valuable and continue to use them.