Can a Trip-Free Psychedelic Still Help People With Depression?

Can a Trip-Free Psychedelic Still Help People With Depression?

Shayla Love

During and after taking a high dose of psilocybin, the active ingredient in magic mushrooms, something changed. "It was like being on holiday away from the prison of my brain," one person said. "I was a ball of energy bouncing around the planet, I felt carefree, re-energized."

 

These testimonies came from a clinical trial for treatment-resistant depression at Imperial College London in 2016. As soon as one week after taking psilocybin—and for as long as three months after—the subjects' depressive symptoms were "markedly reduced," a paper on the results said. Since then, psilocybin and other psychedelics have been hailed as powerful and much-needed interventions for mental illness. Psychedelic research centers have been formed at Imperial College, and more recently at Johns Hopkins University in Baltimore, Maryland. In October 2018, psilocybin received Breakthrough Therapy designation from the Food and Drug Administration, recognizing it as a promising treatment for hard-to-treat depression, and potentially expediting the process for its approval as a legal medication. (Psilocybin is currently illegal at the federal level in the U.S. and the U.K.)

 

As scientists strive to understand exactly how these drugs lead to such dramatic outcomes, there's a growing desire to tease apart the experience of psychedelics from the drugs' other effects. Can the hallucinogenic trips that psychedelics induce be separated from other interactions the drugs might be having on the brain?

 

The experiences people have on psychedelics can be profound, emotional, painful, blissful, and seemingly transformative. One patient in an Imperial College study reported that they "had an encounter with a being, with a strong feeling that that was myself, telling me it’s alright, I don’t need to be sorry for all the things I’ve done. I had an experience of tenderness towards myself. During that experience, there was a feeling of true compassion I had never felt before.”

 

But what if this "trip" is just smoke and mirrors? A window dressing on a neurobiological process happening elsewhere that itself is reducing depression symptoms? Psychedelic drugs interact with receptors in the brain that cause the trip itself, but there are many other effects that are distinct from the hallucinogenic journeys people go through. For instance, they can create an increase in the connections among regions of the brain, and disruptions in other brain circuitry. Yet, up until this point, many experts have considered the entire psychedelic experience one single thing.