LSD for Depression? Absolutely.

I wrote this article for The Third Wave, where it originally appeared, as a response to an opinion piece in the New York Times from skeptical clinical psychiatrist Richard Friedman. I think it can help address the typical arguments that come from people of anti-psychedelic bias. Enjoy!

A recent article in the New York Times, penned by clinical psychiatrist Richard Friedman, attempts to scare his audience into thinking that LSD might not be a good treatment for depression, despite a barrage of recent studies suggesting otherwise. Friedman appears to be of the opinion that it would be wrong to offer these drugs to sufferers of disease; even though there is no evidence of harm from LSD or psilocybin when given in a clinical setting, and despite the growing body of evidence of the efficacy of these drugs in treating mental health conditions.

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Friedman himself mentions the debilitating nature of depression; between a third and one-half of all patients will never find relief from conventional treatments. Hundreds of millions suffer worldwide, and hundreds of thousands commit suicide every year. Most of those sufferers don’t have access to the expensive treatments most commonly handed out by psychiatrists in the developed world.

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It’s not all rosy – challenging experiences with psilocybin

Psychedelics can treat depression. They can treat anxiety, they can help you quit smoking, they can help recovering alcoholics and they can treat cluster headaches.

But these classic psychedelics, LSD and psilocybin, can also have a nasty bite. ‘Bad trips’ have been publicised since the psychedelic culture of the 60s, including (often fabricated) tales of people jumping off buildings or staring at the sun until blind. But it’s a reality that powerful psychedelic drugs can cause traumatic experiences if not used correctly.

In the most recent edition of the Journal of Psychopharmacology, Professor David Nutt introduces two new studies that add to the growing body of evidence suggesting that psilocybin can be used to help people with anxiety or depression related to terminal illness. It’s all exciting stuff, is already being covered by major news outlets, and will no doubt help to further the cause of the psychedelic reform movement.

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Psilocybin is helping people with terminal illnesses accept death

Included in the issue is a paper about ‘challenging experiences’ people encounter when using psilocybin outside of a clinical setting. It’s an interesting contrast to the unrestrained positive message we’ve been hearing about psilocybin in recent studies. Here, the authors point out that of nearly 2000 recorded ‘bad trips’, around 50 resulted in physical violence or hospitalisation. 152 of those surveyed felt they needed treatment for the long-term psychological effects of the experience, and three people attempted suicide.

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Can integrated information theory explain the psychedelic experience?

In our last blog post “Are we living in a conscious universe?” we looked at a new theory of consciousness called “integrated information theory”. IIT was developed in an attempt to understand the link between the physical world and our experience of consciousness.

In trying to understand what physical systems give rise to our experience of consciousness, IIT makes a basic assumption; that consciousness is part of the basic fabric of the universe. At first this may sound unscientific… but in fact we assume many fundamental laws in science. In physics we assume a fundamental link between matter and gravity without being able to see examine the link directly. James Maxwell had to assume some fundamental electromagnetic laws to develop a theory of electromagnetic fields. And in a similar way, IIT assumes that consciousness arises from physical systems due to some fundamental laws of the universe.

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The details of IIT are complex, and involve quite a bit of computational neuroscience. Overall, the basic idea is that any physical system that contains feedback systems has at least some level of consciousness. IIT predicts that our brains, with their highly connected and complex feedback systems, are highly conscious – which we can confirm from our own experience.

So what does IIT predict about the psychedelic state? What changes in the way that information is organised in our brains during the psychedelic experience, and how does that fit in with IIT’s model of consciousness?

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Quitting smoking with psilocybin

We’ve already seen the potential of psychedelics to help people with alcohol addiction; and next to alcohol, tobacco is the one of the most addictive and harmful drugs in the UK. Recent evidence suggests that psilocybin, a naturally occurring hallucinogen found in some species of mushrooms, could be used to help treat smoking addiction – and it could even be an improvement on current treatments.

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In 2014, a group in Baltimore began a pilot study using psilocybin-assisted therapy to help people quit smoking, funded in part by the pioneering Beckley Foundation. They recruited 15 smokers, who on average had been smoking for thirty years and attempted to quit several times. The smokers went on a 15-week course of psychotherapy, during which they were given three doses of psilocybin. Six months after the study, 80% of the participants were abstinent from smoking – as indicated by physiological tests and questionnaires.

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Cluster headaches

We’ve all suffered from the occasional spontaneous headache. If you’ve experienced migraines before, you’ll know they’re a step up from normal headaches – they cause nauseating pain, blind spots in your vision and pain that can last for hours.

Cluster headaches go beyond even the debilitating pain of migraines. Clinically a different type of headache altogether, they are characterised by severe, excruciating pain focused on one side of the head. An episode can last several hours and can reoccur within a short time period, even several times within the same day. Around one in 500 people suffer from cluster headaches, and some report that their headaches are more painful than childbirth.

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Because clinicians don’t understand what causes cluster headaches, treating them is difficult. Current treatments are expensive, unpleasant or impractical – such as inhaling from an oxygen tank or frequent injections. Many medicines, especially preventative ones, cause unpleasant side effects including heart problems and gum disease. An estimated 10-20% of sufferers can’t find relief from any typical treatments. But psychedelic drugs may be able to finally provide relief for those unfortunate few.

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Turning up the creativity dial

Swirling colours, delirious patterns, groovy rhythms and otherworldly vistas. These are some of the first things that come to mind when we think about psychedelics. The unique fashion and culture of the 1960s was influenced by the popularity of psychedelic drugs like no other time in our history; the colours, patterns and hair-dos of that time stand out like a carnival in our recent timeline.

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Pink Floyd, Jefferson Airplane, The Rolling Stones, The Beatles… the list of bands influenced by psychedelics could go on and on. Aldous Huxley’s works, still hugely influential to this day, are clearly inspired by his experiences with mescaline and LSD. Steve Jobs took LSD in college, and called it “one of the two or three most important things I have done in my life”. The inventor of PCR, a breakthrough biomolecular technique that has revolutionised medical research, said that LSD gave him the intuition that allowed him to make the ground-breaking discovery. Artists and architects, authors and entrepreneurs have been finding inspiration in LSD, mescaline, psilocybin and DMT for decades.

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Psychedelics and end-of-life anxiety

Death is something we all have in common. Although we all think about death to different degrees and for different reasons, it’s something that ties us together. We can all empathise with a fear of death, even if most of us have not had to face it as starkly as others.

People suffering from life-threatening diseases have perhaps the most traumatic relationship with death. Knowing you have only months or weeks to live must produce an existential crisis of enormous intensity. In many patients, this can mean anxiety and depression 1, and can make the last part of their lives also one of the most distressing.

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Unsurprisingly, psychiatrists and therapists have turned to the classic psychedelics, including LSD and psilocybin, as a potential salve for end-of-life anxiety. Psychiatrists have known for half a century that these psychedelics can provide a new perspective on life, and result in meaningful and spiritual experiences. Early studies from the 60s and 70s suggested that psychedelics could reduce end-of-life anxiety, and help terminal cancer patients come to terms with their death.

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Classic psychedelics could open new doors in the treatment of depression

Psychedelics have huge potential to benefit society in a number of ways – but perhaps the most immediate is the treatment of suffering. From psilocybin as a salve for end-of-life anxiety in cancer patients 1, to LSD as a potential treatment of alcoholism 2, psychedelics are increasingly showing their medical value. Recently, a group of investigators from UCL headed by Dr Robin Carhart-Harris and Professor David Nutt, have released a handful of studies investigating psychedelics, supported by the pioneering Beckley Foundation. All together, these studies support the idea that classic psychedelic drugs like psilocybin and LSD could lead to new treatments for depression.

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Authors of the studies, Dr Carhart-Harris (left) and Professor Nutt (middle) with Beckley Foundation creator Amanda Fielding (right). Picture: Beckley Foundation.

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