Finding healing under the influence: this is how magic mushrooms work against depression

Lightheartedness had escaped her life. Instead, emptiness, depression, infinite darkness. That changed when Johanna (name changed) went on the journey: “It was overwhelming, I cried and at the same time I had so much love in my heart,” she says. Days later, the wonderful feelings resonated.

It has been more than six months since the woman in her mid-40s first treated herself with psilocybin, the mind-altering and intoxicating substance found in so-called magic mushrooms. She bought a bag of the psychoactive mushroom called “Mexican Bald Head” from a Dutch online store. According to the Narcotics Act, this is prohibited, but Johanna accepted the illegality. She had suffered from moderate depression for several years, from which she did not recover even after a hospital stay. From antidepressants, she especially felt the side effects – insomnia, nausea, sexual function disorders. Her own body felt strange, she says.

“Antdepressants can work like a club,” says psychiatrist, psychotherapist, and neuroscientist Gregor Hasler. The professor, who teaches at the University of Freiburg, explains: “In many cases, they promote emotional numbness.” With hallucinogenic substances it is exactly the other way around: they expand consciousness, make the brain more sensitive to feelings and arouse interest in the environment and other people. Hasler says:

He is one of the few professionals in Switzerland authorized by the Federal Office of Public Health (BAG) to use selected psychedelics in psychotherapy. He has just published a popular science book on the subject entitled “Higher Self.”

Psychedelics include a variety of substances, including psilocybin, LSD, one of the most powerful hallucinogens known, MDMA, popularly known as ecstasy, and ayahuasca, a hallucinogenic potion originally used by South American natives of the Amazon basin to raise awareness (see box) .

Psychedelic treatments are most commonly used to combat treatment-resistant depression, followed by post-traumatic stress disorder and anxiety disorders. Hope is also pinned on the treatment of conditions such as autism, eating disorders, obsessive-compulsive disorders and addictions.

The spectrum of patients Gregor Hasler cares for is broad, from 25 to 75 year olds, men and women. The therapy is not suitable for children and people with a psychotic or manic disorder.

The patients he receives experience the intoxication under his supervision, not in a cold clinic room, but in a cozy room with carpets. Sometimes music plays in the background during the session, which lasts up to eight hours, after which the experience is elaborated into therapeutic conversations. This is time consuming. “Psychedelics are not magic pills,” says Hasler.

Experts agree that the close exchange between the therapist and the patient is essential. They discourage self-experimentation. Embedded in a controlled setting ensures that the substance is pure and administered at the correct dosage. It is also important to take care of the patient if the psychedelics cause unpleasant feelings such as fear, panic or paranoia.

Previous studies show that medically supervised therapies are relatively safe, so psychotic episodes or overdoses are rare. It could also be refuted that the substances cause addiction.

In addition, psychedelics protect against a side effect otherwise feared in psychotherapy: retraumatization. Retraumatization is when a patient relives a trauma during talk therapy and their condition worsens instead of improving. Such cases are well documented in research, for example as a result of immediate psychotherapeutic care following natural disasters or accidents.

Hasler compares psychedelic protection against retraumatization to a helioscope, an instrument for observing the sun. The helioscope reveals colors and contours of the sun that are hidden from the naked eye. At the same time, the instrument protects against harmful direct sunlight.

He tells of a patient who, as a child forced into marriage, was brutally raped by her then-husband. In therapy, she initially didn’t want to talk to Hasler about her past, it would “burn like a charm,” she said. But due to the administration of MDMA and the helioscope effect, she was finally able to process the traumatic story in the following sessions, says Hasler.

Despite the encouraging experiences, psychedelics are still stigmatized by the general public. That wasn’t always the case. In the 1950s and early 1960s, psychedelics were touted as paradigm shifting agents in psychotherapy. Promising scientific studies fueled hope and media coverage was overwhelmingly positive.

But then the tide turned as psychedelics went mainstream and gained popularity in the hippie movement. Now the media read about people going crazy, becoming homosexual, going blind from staring at the sun for too long, or even dying because they thought they could fly. Dubious studies have reported that LSD is neurotoxic and damages DNA. Some scientists have criticized the “moral panic” that followed, which led to the banning of all psychedelics.

As a result, serious research virtually ground to a halt. That intoxicants can have a medicinal effect has long been proven in the case of cannabis. The ban for medical purposes was lifted in Switzerland in August 2022 and since 2021 it has been allowed to be sold as part of pilot tests for “consumption purposes”. When asked, the BAG indicates that this is currently not planned for psychedelics.

But since the mid-2000s there has also been a rethinking of psychedelics and more and more researchers are looking into these substances. Numerous studies on LSD and Co. of recent years have provided an increasingly clear picture of their effectiveness. Accordingly, psychedelic substances achieve a convincing effect in severe psychological problems. But it’s weaker than smaller studies initially suggested. In addition, not all patients respond equally well to the drugs.

One of the reasons for the sometimes sobering results is that the mechanism of action of psychedelics in the brain cannot yet be understood. So says Katrin Preller, neuropsychologist at the university and at the University Hospital Zurich. It is certain that psychedelics improve the so-called neuroplasticity. This is the name given to the brain’s ability to reconnect itself by growing nerve cells and synapses and forming new connections. Preller says:

It is known from laboratory studies and animal experiments that psilocybin and LSD activate a specific serotonin receptor, the 5-HT2A receptor. This creates a signaling effect that causes new processes and branches to be formed in nerve cells. “If we understand these underlying mechanisms in detail, we can improve treatment,” the neuropsychologist is convinced. Because if you know what happens in the brain reorganization phase, you can tailor the accompanying therapies to what to avoid in the critical phase, what to focus on in talk therapy, and when and whether the parallel administration of other psychotropic drugs would be beneficial. are. A better mechanistic understanding could also contribute to the synthetic development of better psychedelics.

Microdosing is becoming increasingly popular. It involves people taking small amounts of a psychedelic substance on a regular basis in the hopes of increasing their creativity and promoting their personal development. Only: So far no studies indicate that microdosing has a clinically significant effect. “In general, the more you feel the intoxication, the better the effect,” says psychiatrist Gregor Hasler. As a result, many professionals are skeptical of the idea of ​​some scientists wanting to develop new drugs that negate the psychedelic experience but still provide therapeutic benefits.

It is also currently uncertain whether taking a low dose for a long time has undesirable side effects. “More studies are definitely needed on this topic,” says neuropsychologist Preller. In Basel, among others, research is currently being done into the effectiveness of microdosing in patients with attention disorders. The results are expected this fall.

No drug agency in the world has ever approved a psychedelic as a drug. Professor Gregor Hasler from Freiburg believes that MDMA has the best chance of treating post-traumatic stress disorder, followed by psilocybin for depression. According to him, this should happen in the next five to ten years. “Switzerland probably won’t lead the way,” he says. But it’s important that she follow suit when the U.S. Food and Drug Administration (FDA) classifies the drugs as effective and safe and grants approval. Because: «The exemption in Switzerland cannot legally be extended at will. The practice is not set up to treat many people.”

It has been a month since Johanna took psilocybin for the second and last time. She is no longer on antidepressants. “The fear of a relapse is there,” she says. That she then resorts to psychotherapy is out of the question for her: “I feel comfortable in the world of mushrooms.”