To What Extent Can Psilocybin Mushrooms Cure Depression?
ISHR Extended Essay
G11
School Code: ######
Supervisor: Ms. Resmer
Table of Contents:
Introduction – Page#
Introduction to psilocybin mushrooms –
Legality –
What is psilocybin –
Introduction to study –
Body paragraph 1 – (What we know) – Page#
What we know about psilocybin –
What we know about depression –
Body paragraph 2 – (History of psilocybin mushrooms) – Page#
History of psilocybin –
Criminalisation of psilocybin mushrooms –
Body paragraph 3 – (The rising use of psilocybin mushrooms) – Page#
Rising use of psilocybin –
Dark side of psilocybin –
Body paragraph 4 – (Psilocybin mushrooms on depression study) – Page#
Psilocybin mushrooms on depression study –
How a psilocybin induced “trip” can be a life altering experience –
Using psilocybin mushrooms as a treatment for terminally ill patients –
Body paragraph 5 – (The war on drugs) – Page#
Introduction on war on drugs –
The dark truth of the war on drugs –
Why the war on drugs will never end –
Conclusion – Page#
How psilocybin could treat depression –
Why it should be legal, but probably will never be –
Introduction
The “magic” mushroom (Psilocybin mushroom) is a psychedelic drug that is seen as one of the most mentally disturbing psychedelic available. Due to psilocybin being unpredictable in its psychedelic properties, it can take ones mind to a very dark place while under the influence. There have even been cases of people taking psilocybin and having such traumatic experiences that they have killed themselves while under the influence. While this is extremely rare, it is the reason the Netherlands made psilocybin mushrooms illegal, and now have truffles instead, which are still psychoactive, but much milder than the traditional psilocybin mushroom. The active ingredients in Psilocybin mushrooms are psilocybin, and baeocystin. This works by the body converting the psilocybin into psilocin which has hallucinogenic properties that closely resembles Lysergic-acid-diethylamide (LSD), DMT, Mescaline, etc. Psilocybin mushrooms have been found to have implications on mental health disorders such as depression, which leads to the research question; To what extent can psilocybin mushrooms ‘cure’ depression? This research question allows me to touch on a very untouched subject, which is using a psychedelic, such as magic mushrooms, to treat patients with mental disorders (in a medically beneficial way). This topic is also very controversial due to the legality issues connected to magic mushrooms. They are illegal in most countries including the U.S. and Germany, but are slowly being accepted as a research drug in some progressive countries. It is only in a select few universities such as NYC that have been using magic mushrooms in a controlled manner to observe how it will affect a mentally ill person with depression (In this essay the term mentally ill will be used lightly). The way this essay will go about investigating this research question is by using quite a few new studies that have been featured on TedX and multiple other studies that investigate the implications of magic mushrooms on mental illnesses. Theses studies go into detail on how the mushroom affects patients, as well asl they work and for how long the effects of a psychedelic “trip” lasts after consumption. This essay will talk about the legality issues of magic mushrooms, and the war on drugs that surrounds it, while also talking about how depression works, and what we already know about it. It will talk about the science behind magic mushrooms and how it affects the brain, the history of psilocybin and how it has been used for decades, and how it has been rising in use in recent years. The TedX episode that featured the study completed by robin-carhart harris et al. talks about examples of people who have had chronic depression for up to 30 years, and how having a controlled Psilocybin trip, the symptoms of depression were greatly reduced, and in some cases completely cured.
What do we know about psilocybin?
The basic concept of how the psilocybin mushroom works, is that the psilocin affects the serotonin receptors in the brain, which in turn creates an enormous amount of connections between neurons, that have never before been activated or able to ‘communicate’. This allows your senses to be essentially connected, meaning they can communicate with one another, and they are sensitive to one another. The ‘trip’ (The trip is colloquial for while you are under the influence) can last up to six hours, and the effects can only be reversed by taking a benzodiazepine, although a lot of people do not do this due to the risk of becoming addicted to benzodiazepines. (https://drugabuse.com/worried-benzos/ )
While under the influence of psilocybin, it creates thousands of different connections between neurons, which changes the neurochemistry of ones brain, which could, in a high enough dose, change ones basic neurochemistry permanently. (http://www.iflscience.com/brain/magic-mushroom-chemical-hyper-connects-brain/ )This is not necessarily a bad thing. People have reported that a controlled psilocybin induced “trip” changed their life. This is due to its “ruthless” nature; The psilocybin can make you face your deepest fears and troubles personally, which can be much more effective than a psychologist trying to explain your troubles to you from an outside perspective. While in a psilocybin induced “trip”, you have no choice but to face whatever happens or whatever you see, which could be anything from seeing religious symbols or even talking to god, to seeing your deepest fear. This same reason is why psilocybin mushrooms are seen as the most mentally disturbing psychedelic available, and why the Netherlands eventually banned magic mushrooms, and replaced them with a much midler psychedelic, truffles.
Magic mushrooms are being slowly being accepted, as a research drug and as a recreational drug. The mushrooms have not been found to be physically, or psychologically addicting, meaning users who try the drug, or users who have used the drug multiple times, will not become addicted to it. This is mostly due to how psilocin increases the tolerance level in a user, although it is only temporary. (https://en.wikipedia.org/wiki/Psilocybin_mushroom#Effects )There have been found to be some negative physical and psychological consequences of taking magic mushrooms. Some of the physical consequences related to taking/eating psilocybin mushrooms include, nausea, vomiting, headaches, muscle weakness (feeling really heavy), and a loss of coordination (including time orientation). Some of the psychological consequences that can be associated with taking psilocybin mushrooms, can include, but are not limited to, trauma, and even suicidal tendencies. This is only a list of negative consequences that are associated with taking psilocybin mushrooms. There are a lot of benefits that are being researched and have been found to be very good for treating certain psychological problems. One example of this is people with terminal illnesses, such as incurable cancer, have had a psilocybin induced trip, and have actually helped them accept death, and have reportedly never been happier in their life.(https://www.independent.co.uk/voices/psychedelic-drugs-lsd-magic-mushrooms-new-study-psychiatry-mental-illness-terminal-cancer-patients-a7449331.html )
Obviously every ‘trip’ is subjective and will vary from person to person, but there are some things that researchers do to increase the chance that they will have an enlightening trip rather than a scary and traumatising trip. The most important things that need to be considered before taking magic mushrooms, is the patients set, and setting. One’s set is basically how they are feeling about their life at the time, which could either be great because they are happy and their career is going good, or it can be bad, for example when someone just got out of a relationship, or have recently lost a job. Setting is the geographical place that the patient is in; If a patient takes magic mushrooms and is around a lot of new people, those very people could turn into demons or the patient could think those people want to hurt the patient in some way.(https://en.wikipedia.org/wiki/Set_and_setting ) This is the only thing that a researcher can control. If a patient is in a comfortable place and have music that calm them down, that patient has a much higher likelihood to feel safe and therefore have a beneficial ‘trip’.
Psilocybin mushrooms have been used for as long as humans have existed. There are drawings in caves that date back to six thousand years ago, depicting the use of psilocybin, showing that humans have used psilocybin mushrooms for all of human history, but has only been made illegal in the past forty years. (https://www.newscientist.com/article/mg20928025-400-earliest-evidence-for-magic-mushroom-use-in-europe/ ) The first action that was taken against magic mushrooms and its use, was when the UN made psilocybin mushrooms a class 1 drug in 1971, meaning they have a high potential for abuse or they have no medical purpose. The united states then followed this trend by creating a similar act called the “Psychotropic substances act” in 1978, which also put psilocybin and psilocin as a class 1 drug (Canada followed twenty years later in 1996 by creating the Controlled drugs and substances act). (https://en.wikipedia.org/wiki/Legal_status_of_psilocybin_mushrooms ) Although most major countries have banned magic mushrooms, this does not mean that all countries have made them illegal. A lot of countries have only decriminalized magic mushrooms, meaning if a user or seller is found selling or using magic mushrooms, they are not put in jail or put on trial, but simply given a fine (amount varies with countries). There are only two countries that have completely legalized magic mushrooms, which is Brazil, and Jamaica. (https://mic.com/articles/110344/14-years-after-portugal-decriminalized-all-drugs-here-s-what-s-happening#.2KBwPxY1y ) Including portugal, over 14 countries have decriminalized the use of psilocybin, while some have interestingly decriminalized the possession of magic mushrooms but not the consumption of the drug (Cyprus, British Virgin Islands etc.).
What do we know about depression?
Google’s definition for depression is “Feelings of severe despondency and dejection”. Some synonyms that simplify this definition include: unhappiness, misery, sadness etc. According to a study conducted by Columbia University's mailman School of Public Health, depression has been rising, mostly in teens, since 2005. (https://www.sciencedaily.com/releases/2017/10/171030134631.htm ) Scientists and psychologists do not seem know the reason to why people get depression, or why it has been rising lately in the past 15 years, but do have some theories and hypothesis. Treatment for depression did not start until the 1970’s, and was not even fully recognized until a german psychiatrist, Emil kraepelin, reported on manic depression (now known as bipolar disorder). (https://www.verywellmind.com/who-discovered-depression-1066770) Although it is extremely hard for psychiatrists to interpret depression, and treatment for depression, they generaly conclude to “Behavioural and cognitive strategies can have a significant effect on depression” (Rehm and Kornblith, 1979) (Williams). Cognitive and behavioural strategies include finding the root of the problem (cause of depression), self-statements to counteract negative thoughts (Writing good notes about one’s self), and learning to enjoy and see happiness in everyday life.(https://www.everydayhealth.com/hs/major-depression-living-well/cognitive-behavioral-therapy-techniques/) The reason why these strategies can help is because the most common problem for manic depressives are that they dont allow themselves to feel happy emotions (contrary to popular belief that they simply cannot feel happiness). The strategies used in cognitive and behavioural psychology helps the patient become more intune with their positive emotions, and not only their depressive emotions.
There are two different (theoretical) types of basic depression: Clinical depression (Endogenous depression), and situational depression (Reactive depression). Clinical depression is depression that does not rise from any event or action, but comes from usually a chemical imbalance in the brain (this is only a theory). Situational depression is depression that rises from an event such as the death of a family member or close friend. (https://www.webmd.com/depression/guide/depression-types) This is the most common type of depression. Almost every person in the world will experience situational depression at some point in their life, due to everyone going to traumatic experiences throughout their life. With Clinical depression, people who have experienced depression before, have a much higher chance of experiencing depression again. While the reason for this has not been proven, one theory is that it is due to the depressive knowing the feeling of being in a depressive state, therefore is very conscious of becoming depressed again, which could lead to a sort of ‘flashback’, which could make the depressive feel overwhelmed with feeling one felt when they were depressed (Williams). For example, with women an enormous reason for depression re-occuring, would be their menstrual cycle. While this will not, by itself, cause clinical depression, it could bring back memories of feelings they experienced while in a depressive state, which could bring on situational depression. An example of clinical depression would be waking up one day and simply feeling an enormous amount of dysphoria and hopelessness (Williams). A lot of research has been done to see if there are any biological markers that can be seen that indicate depression, and even to differentiate between the two most common types of depression. A study conducted by Free & Oei in 1989, was done to see if biological markers can indeed be seen with depressives. The study sadly did not show promising evidence. The test that was used was called the Dexamethasone suppression test (DST), and tested several depressives to see if a drug called ‘Dexamethasone’ would suppress or even “shut down or suppress the mechanism which controls natural cortisol output”. The drug was quite effective in clinical depressives, showing that there is something ‘wrong’ with a clinical depressive’s hypothalamic-pituitary-adrenal system, although this is not unique to clinical depressives (This is not unique to clinical depressives, there is also evidence showing that the hypothalamic-pituitary-adrenal system is also faulty for patients with mania, schizophrenia, anorexia nervosa, and dysthymic patients).
The way that some psychologists test if a patient has clinical depression, is by using a scale called the “Newcastle scale” (Carney et al. 1965). The scale includes an assortment of symptoms that each have a score, and scoring over a certain amount (6 or more) indicates clinical depression. A score of 5 or less indicates situational depression (a score of 0 indicates no depression). A lot of psychologists do not use this scale due to its very vague distinction between the two types of depression (endogenous and reactive depression). There is another ‘list’ that is used by a lot of psychologists called the Spitzer et al. list of symptoms used to diagnose major depressive disorder (1978)(This list is also called the PHQ-9 (Patient Health Questionnaire)). This list is more comprehensive but uses a similar method as the Newcastle scale, which is by asking a variety of questions about how the patient feels in everyday life, and has 4 different set answers. If a patient scores over a certain amount, they are either diagnosed as having mild, moderate, moderately severe, or severe depression. According to the Newcastle scale, at any one time about 5-6% of the human population will meet the criteria for clinical depression (Paykel 1988) (Page 5, Williams). On top of that, in any one year, about 1 out of 10 people will experience a period of depression (Amenson and Lewinsohn, 1981). To connect all this information back to my research question, psilocybin mushrooms would not be given as treatment for a patient who does not have clinical depression, or is not diagnosed with severe depression. Although since research on the effects of psilocybin on moderately depressed patients has not been thoroughly conducted, the use of psilocybin on such patients is not believed to have an effect, due to moderately depressives only feeling depressed for a limited amount of time, meaning they do not need to be treated for depression (at least not using psilocybin).
Metaphors used to describe depression by patients include, being trapped in a mineshaft, feeling that the depressive can not move, because it will only make it worse. The way psychologists try to overcome this feeling is by using emotional assistance to help the depressive get over the fear of moving, and also professional help to get the depressive out of this metaphorical mineshaft. Another adjective used is falling down a spiral, where one depressed thought turns into another depressed thought, and it simply keeps going with this trend and does not end. Psychologists believe that a balance between emotional assistance and professional assistance to get them out of a spiraling depression is the key to end their spiral. (Williams) The feeling of being depressed is unlike any other feeling in the world, according to clinical depressives. It is described as being a prison that one cannot get out of, even with outside help. This is why psychologists believe psilocybin is a much more effective method of getting someone out of a depressive state. A psilocybin induced trip creates an effect of the patient being in a fight with themselves, so they can physically see the root to their problems, which is thought to be the first step to ‘curing’ depression (https://www.everydayhealth.com/hs/major-depression-living-well/cognitive-behavioral-therapy-techniques/).
To what extent can psilocybin mushrooms ‘cure’ depression?
The use of psilocybin has a potential beneficial use in the field of psychopharmacology and as a treatment drug for different mental health issues, including PTSD and depression. (https://sputniknews.com/art_living/201801071060562894-psilocybin-proven-an-effective-treatment/ ) According to the author of a study conducted by Leor Roseman, "I believe that psychedelics hold a potential to cure deep psychological wounds". A study that was published in the scientific trade journal which studies the neuropharmacological attributes of psilocybin and how it can be used to treat psychological problems, found that certain natural mushrooms (Different strain of the psilocybin mushrooms, which still include psilocybin) can treat depression by creating unused neurological pathways. This works because when new pathways are opened between the patient’s neurons, the patient then thinks in a different way, which could potentially make the patient see the world and themselves in a different way. This is how neuropsychologists hope to use psychedelics to ‘unlock’ depression. The studies that have been conducted, that test to see if psilocybin can be used to treat depression are quite new, meaning that the studies are not extensive enough to see the long term effects of the repeated use of psilocybin. What the studies have found is the semi-long term effects of the one time controlled use of psilocybin. One of the studies used was featured in a TedX episode, where a representative talks about the findings of the study, and the implications of the findings. Some of the studies are quite extensive when considering the patients, for example if the patient has a family history of mental illnesses, or if the patient has tried all available techniques for the treatment of depression (if the patient treatment resistant depression).
The main study that will be used in this section was conducted by Robin Carhart Harris et al. at Imperial college London. They tried to study if the use of psilocybin in a controlled therapeutic environment, would have an effect on treatment resistant patients with clinical depression. A small group of 20 participants each had an individual session, where they each got a controlled dose of psilocybin, in a controlled therapeutic environment. The results found were quite promising, but also relatively disappointing, due to some of the results not corresponding with each other. The method that the researchers used while in session with the participants was not outlined, but the findings were quite significant. 20 individuals with treatment resistant depression (Clinical depression), after being given psilocybin in a controlled environment, had severe drops in “Depression scores” (calculated using the PHQ-9). Over 6 participants, had reported feeling ‘cured’ from depression for over 6 months (A negative to this study is, it does not report activity that occurred after 6 months of ingestions). 3 Participants only reported feeling better for around a week, with 11 of the participants reporting feeling cured of depression for about a month, after which symptoms started coming back. (https://www.imperial.ac.uk/news/182410/magic-mushrooms-reset-brains-depressed-patients/) The way that magic mushrooms seem to cure/treat depression, is by “Resetting the brain”, which effectively creates an effect where the patient sees the world and themselves differently. This is because when under the influence of psilocybin, the connections between neurons in the patient's brain is immensely increased, meaning they can see things from a different view (metaphorically). Scans of patient’s brains before and after the day they received psilocybin, revealed changes in brain activity, that had been found in depressives, which reduced symptoms found. This finding is quite huge, but unfortunately cannot be verified due to the lack of patients, and the lack of a placebo-group.
Conclusion
In conclusion, there is not enough empirical evidence to back up the claim that psilocybin mushrooms can cure depression, but the evidence so far, shows promising results. Although there is not sufficient evidence to claim that psilocybin mushrooms can cure depression, there is definitely enough evidence to prove that psilocybin mushrooms are an effective treatment tool for people suffering from depression. This is very uplifting for people who suffer from clinical depression (treatment resistant depressives), because there is finally something natural that has the potential of treating them (without a long list of side effects), which could be the first step to their journey of escaping depression. The way that psilocybin mushrooms affects one’s brain (especially a depressive’s) is extremely unique, in that it can change one’s neurochemistry, to the point where one can view the world in a completely different way after a psilocybin trip. Even though magic mushrooms are banned in almost every country in the world, neuropsychologists across the globe are starting to see the potential benefits of magic mushrooms being used in a medically beneficial manner (to treat major depression disorders, and many other mental illnesses). The fact that studies are starting to be approved in order for researchers to investigate psilocybin mushrooms and their effects, is a huge step for neuropsychology, and the treatment of depression and other mental illnesses.