‘Transformative Insights’: Magic Mushroom Treatment for Depression

Mental health

Help for the many people in New Zealand whose depression is treatment-resistant may come in the form of psilocybin – the hallucinogenic compound in magic mushrooms

Opinion: A Class A hallucinogenic drug could hold the key to effectively treating New Zealanders with major depression where conventional treatments are failing.

The latest NZ Health Survey found 17 per cent – around 850,000 New Zealanders – have been diagnosed with depression. About a third of them are defined as “treatment-resistant” (283,000 people) because their depression does not respond to antidepressants.

New approaches to treating depression are needed because antidepressant drug addiction is not always effective.

Our team at the Department of Psychological Medicine at the University of Otago, Christchurch plans to launch Aotearoa New Zealand’s first study of psilocybin to treat major depression.

Psilocybin is the hallucinogenic compound found in magic mushrooms, an compound that binds to serotonin receptors in the brain to improve mood. It has been reported that psilocybin can potentiate the effects of evidence-based psychotherapies to provide lasting improvement in depression symptoms.

Psilocybin-assisted psychotherapies are a novel approach to try here, and while there’s no evidence as to which psychotherapy would best pair with magic mushrooms, we want to explore.

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By researching people’s experiences with magic mushrooms, we have found that the common elements of these experiences include intense emotional excitement, a sense of connection with oneself, others and the world, and transformative insights into the way one lives one’s life , were.

It is clear that a sea change is needed in the global treatment of depression – there has been no significant innovation in the treatment of mental illness in the last 40 years

There are two key elements to safely and effectively delivering psilocybin-assisted psychotherapy. These are the set (the psychological context) and the setting (the environmental context), both of which contribute to the safety and effectiveness of magic mushrooms.

Psychotherapy provides the psychological context by preparing the person for the psilocybin experience, providing a framework for interpreting the experience, and helping the person integrate it into their life to manage mood symptoms and make meaningful changes. The surrounding context provides safety and expertise to ensure the experience is therapeutic.

The psilocybin is administered in capsule form and the person is monitored by two people throughout their experience. The psychological and environmental context reduces the possibility of a “bad trip”.

The optimal choice of psychotherapy for this intervention has not been established, but it must have an evidence base and be consistent with the psilocybin experience.

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That means it must provide a framework for understanding emotional arousal, foster connectedness, and provide strategies for implementing lessons learned from the psilocybin experience.

It must support a sense of losing oneself, leading to greater self-acceptance and connectedness to others and the world.

Psychotherapy must also be supportive and provide an interpretation of the psilocybin experience specific to the participant’s symptoms and goals, and provide a framework for continued mood improvement.

Our research team, led by Associate Professor Cameron Lacey, has regulatory approval to use magic mushrooms with psychotherapy. Once we have received funding to start the study, we plan to enroll people who have tried two antidepressants for a reasonable period of time but have had no improvement in mood.

The study has ethical clearance to enroll 20 patients with strict, rigorous criteria – all must be referred by their GP or specialist mental health service, and all must be suffering from depression that has not responded well to standard medications and talk therapy.

We will provide two doses of psilocybin in a controlled environment over eight sessions of interpersonal and social rhythm therapy. The research team consists of a psychiatrist and experienced therapists who have many years of therapy experience. We are all striving to find innovative approaches to treating depression.

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We have successfully used Interpersonal and Social Rhythm Therapy to treat people with mood disorders for over a decade. The key processes of this therapy are a) improving social support, (b) reducing interpersonal stress, (c) facilitating emotional processing, (d) improving interpersonal skills, and (e) stabilizing daily routines at a manner that best suits the person’s lifestyle.

Therapy focuses on circadian rhythm disorders (sleep/wake cycle) associated with depression. Sessions will focus on strategies for integrating the transformative insights from the magic mushroom (psilocybin) experience into daily life, with a particular emphasis on strategies for coping with moods and social rhythms.

We’ve trained the therapists, created the right therapeutic environment, and imported the psilocybin capsules, so we’re now looking for funding to begin psilocybin-assisted therapy. There may be organizations, businesses, or individuals who have a philanthropic desire to help others struggling with depression.

It is clear that a sea change is needed in the global treatment of depression – there has been no significant innovation in the treatment of mental illness in the last 40 years. Psilocybin may offer hope for a breakthrough — a new tool in the toolbox that clinicians may consider when caring for people with treatment-resistant depression.

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