The next big trend in mental health treatments? Psychedelic therapy
Magic mushrooms for your well-being? If you haven't heard about psychedelics being used as a treatment for mental health disorders, this year may change that.
While this type of treatment won't be accessible to everyone in 2022 (and will likely take a while to become widespread), experts say you should expect to hear much more about this emerging wellness trend this year and beyond.
"For a long time psychedelics have been sort of frowned upon," says Amy Morin, psychotherapist and editor-in-chief at VeryWell Mind. "We thought that they were more recreational drugs, but with a closer look, we've seen they can actually be really good treatments for things like depression, anxiety, even substance abuse issues."
Dr. Matthew W. Johnson, a professor of psychiatry and behavioral sciences at Johns Hopkins and acting director of the Johns Hopkins Center of Psychedelics and Consciousness Research, has seen a gradual increase in interest around this area since he began studying it in 2004, but says there's been a "dramatic increase in interest recently."
And in the next several years, he says, it's "only going to increase."
In their 2022 wellness trend forecast, Well+Good dubbed psychedelics as being "poised to change the course of mental health treatment." Institutions are also getting ready by opening up specialized centers to study these drugs in a mental health capacity.
Psychedelics first gained widespread popularity in the 1960s and 1970s, but went underground after being classified a Schedule 1 controlled substance by the federal government in 1970.
In 2018, best-selling author Michael Pollan helped bring psychedelics back into the nation's collective consciousness with his book, "How To Change Your Mind: What The New Science Of Psychedelics Teaches Us About Consciousness, Dying, Addiction, Depression, And Transcendence," where he shared his research experimenting with psychedelics.
Around the same time, psychedelics were starting to make waves in the legal realm, with voting for decriminalization and legalization taking place in different parts of the country. (Oregon legalized psychedelic mushrooms for therapeutic use in 2020.)
Today, interest is ramping up at a time when many Americans are struggling with mental health challenges brought on by the pandemic.
"It's understandable that it's taken a while to get past the stigma, but... I think within the next year, we're going to see more federal funding and less of a hesitation," Johnson says.
In 2021, even the director of the National Institutes of Health Francis Collins made headlines for praising psychedelics' potential as a therapeutic treatment option.
"Expect more of that flavor at the NIH, expect less risk aversion," says Johnson, saying it's shifted from being viewed as radical to a worthy avenue to explore given the promising evidence in treating depression and substance use disorders, especially in the context of a suicide and drug overdose epidemic.
"We're gonna feel more of that flavor over the next year—that this isn't crazy to explore this research, cautiously. It would actually be crazy to do nothing."
How does psychedelic therapy work?
Psychedelic therapy is more like an elevated talk therapy experience that requires special care and supervision than it is a typical psychiatric medication, Johnson explains.
"It's not just giving the drug," he says. "It involves a therapeutic relationship, where one is encouraged to dive into the experience and learn something from the experience they have on the substance and then to process it, integrate it (and) discuss it in the days afterwards."
The data suggests that the benefit actually comes from the experience someone has and their conscious reflection, he adds, unlike more traditional psychiatric medications, like antidepressants, which may make someone may feel better more automatically.
"It's not operating at the surface level... People come out with a story. 'This is what I learned about myself. This is how I view myself now, and this is how I viewed myself before,' and there's a shift there. And that's what you don't get with typical psychiatric meds."
Morin cautions there's a "difference between therapeutic use and the recreational use" of psychedelics.
"Sometimes people are using certain things as club drugs and they aren't necessarily getting better or they feel like they may have a bad trip or they have an experience where maybe whatever it is they're taking is mixed in with other things," she says. "Talking to a therapist and really figuring out how you make sense of what happened while you were under the influence of a psychedelic, that's where the real therapeutic benefit comes in."
While this form of therapy might be able to help those who aren't helped by other forms of treatment, Johnson says it's important not to see this as a replacement for other methods like (antidepressant medication); it's just another "tool in the toolbox."
What kind of drugs are being looked at?
Johnson says there are some "dramatically impressive results for a number of really difficult to treat disorders" through the use of psilocybin (a compound found in "magic mushrooms") and MDMA (also known as ecstasy or Molly).
"Results have looked really promising using psilocybin to treat cancer-related distress from only a single high-dose administration of psilocybin," he says, adding there's also work being done with major depressive disorders and addictive disorders.
"Multiple laboratories, including ours, have shown promising results that psilocybin causes large reductions in depression," he says. "We're (also) seeing very high success rates using psilocybin to treat tobacco addiction. And there's also really promising work using it to treat alcohol addiction."
While MDMA is "a little different as a compound" Johnson explains, there is also "very promising data using it to treat PTSD."
And ketamine's psychedelic properties are "really effective for a lot of people who have treatment-resistant depression," Morin adds.
What are the risks of psychedelic therapy?
Psychedelic therapy does, of course, carry some risks, Morin says.
"One thing we know is there may be a risk for people that have a family history of psychotic disorders. If somebody has a grandparent maybe with schizophrenia, he might not want to try psychedelics, he may have a genetic predisposition for psychosis," she explains. "So they're certainly not for everybody."
Johnson adds there are also "real dangers with these compounds if they're not handled appropriately" in terms of the therapeutic relationship.
"I've been in over 100 of these psychedelic sessions, and I've supervised hundreds of them. It can be very heavy being even associated with these sessions, where surprisingly frequently the person will say it's one of the most meaningful experiences of their life," he explains. "There's an incredible responsibility being involved with that as a professional to not take advantage of that."
He worries "the professional role of the therapist can become distorted."
"The kind of notion that these experiences are so big that the normal rules don't apply—that's very dangerous. It paves the way towards sexual abuse that paves the way towards therapists potentially setting up a cult-like atmosphere to their practice."
When will psychedelic therapy start happening?
Though Oregon is on the forefront of this method, Morin says, "it will probably be another year or so until they figure out exactly how we do this."
But some parts of the U.S. are already looking toward more access.
In 2021, Detroit decriminalized psychedelic mushrooms and other places like Denver have de-prioritized enforcement of the hallucinogen.
There are people trying things out in an underground fashion too, Morin says, but she hopes this will change with regulation and accessibility.
"My hope is in the future it'll become more regulated," she adds. "And then we can have more open conversations about how to safely acquire psychedelics and how to safely take them as well."
Though the exact timeline is uncertain, Johnson hopes, depending on continued positive research, to see "MDMA and psilocybin approved for medical use within the next few years."
Meanwhile, he encourages the public to be both "skeptical and open."
"Follow the follow the data and (don't) get ahead of it, but at the same time, recognize it is an exciting development," he says. "We really have to find a balance between promise and hype. On the one hand, there is data to be very excited about psychedelics as a new paradigm within mental health treatment that can really help a lot of people that are suffering who haven't been helped by existing treatments. On the other hand, it's never going to be a treatment that helps everybody. Nothing is. And like all other treatments, there are risks and it's critical that those be addressed."
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