This is an excerpt from my upcoming book, We Get Better: 48 Treatment Options for Chronic Depression.
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Treatment option 12: Taking therapeutic psychedelics
The hippies were onto something: when properly taken, psychedelics–ketamine, magic mushrooms, LSD, MDMA and others–can provide significant (and fast) relief from depression for many people. They are especially recommended for people with severe, treatment-resistant depression.
The effectiveness of these substances comes from their ability to quickly and dramatically alter the user’s neural pathways. When taken in a carefully crafted therapeutic environment that includes professional assessment, planning, oversight, and counseling, they can help people replace unhelpful stories and perspectives with new, vastly different ones. History is rewritten.
According to current studies and Michael Pollan’s excellent, comprehensive book How to Change Your Mind: What the New Science of Psychedelics Teaches Us About Consciousness, Dying, Addiction, Depression, and Transcendence, psychedelics are not addictive and have a low risk of physical harm. However, mental harm such as paranoia or psychosis can occur, and people with bipolar disorder, schizophrenia and certain other mental disorders should not take them. Consult with your mental health provider on legal and safe use.
Ketamine is a legal psychedelic commonly used for starting and maintaining anesthesia during medical procedures. Recently, anesthesiologists across the U.S. have set up clinics to administer ketamine off-label for mood disorders. Other medical providers specially trained in psychedelic-assisted therapy are offering ketamine treatment in smaller, private settings. These treatments can be expensive, and are rarely or never covered by insurance at the time of this writing. However, like other psychedelics, ketamine’s effect on depression is reportedly swift and significant. In clinics, it is administered intravenously.
Esketamine is a legal psychedelic that is almost identical to ketamine on a molecular level. It is approved for use in the U.S. as an antidepressant when prescribed by a properly credentialed psychiatrist, and it is not as expensive as ketamine. It is administered in the form of nasal spray.
Psilocybin is the active ingredient found in magic mushrooms and magic truffles. Research on psilocybin for depression is in its early stages, but is quite promising.
Though MDMA is shown to have similar efficacy as that of other psychedelics, it is often sold as ecstasy or molly, and these drugs are unsafe. They sometimes contain methamphetamine, a highly addictive substance. In addition, some research has shown that repeated use of MDMA can lower one’s baseline mood, though this finding is controversial. Finally, it is known for creating a next-day hangover effect in some people, in which users experience depression, irritability and lack of motivation for a day or more following their use. Still, psychedelic advocates are currently seeking the legalization of MDMA and other psychedelics in addition to ketamine.
Before trying a psychedelic, read about its possible long-term effects, which for some might include psychosis and suicidal thoughts. Do not purchase these substances illegally, and carefully follow your prescriber’s recommendations regarding dosage, substance interactions and more.
If desired, add “consider psychedelic therapy” to your depression treatment plan. Then decide on next steps, such as finding a provider, and write them on your short-term and/or long-term to-do list.
