This text is about the last straw and is not a recommendation. Only a fool would recommend walking through a minefield.
It is hard to imagine a situation where I would willingly enter a minefield, but I have to admit that it is possible. But what if: A cocktail of different antidepressants didn’t help, 4 psychotherapists, sports, music therapy, herbal mixes, a fortune teller, and an exorcist proved useless. The depression is not gone, there is no light at the end of the tunnel, and the tunnel itself is wet and ugly. Such a state of mind can be existentially challenging, to say the least.
There is good news and bad news. The good news: we are all going to die. The bad news: not everything is done, so it’s time to roll up our sleeves and try to claw our way into the light. There is a number of new – legal – ways to treat treatment-resistant depression: you can try TMS before resorting to extreme measures or wait for the next generation of antidepressants. Ketamine, used in anesthesia, is already part of the legal psychedelic therapy in the US to treat suicidal ideation or severe depression.
More and more information about the healing power of psychedelics is appearing in the media. Fifty years ago, they were banned in the USA and then in other parts of the world due to cynical political considerations.
In the last 10-15 years, neuroscientists and pharmacologists, after dusting off a large body of research from the hippie era, have been steadily bringing back the use of classical psychedelic compounds into the health care system. The world’s perception of substances such as LSD or psilocybin (hallucinogenic mushrooms) has changed dramatically with the international bestseller “How to change your mind” by the talented author Michael Pollan. The book revealed to readers the enormous revolutionary potential of psychedelic medical research and the inspiring story of the psychedelic experiences that improved the author’s life.
The 13-month experimental depression recovery therapy at Synthesis in Amsterdam, which is supervised by medical physicians, clinical psychologists, and psychedelic therapists, is not cheap. Its accessibility is hampered not only by the cost, the limited capacity but also by the quarantine restrictions of Covid-19.
Psilocybin (the active ingredient in hallucinogenic mushrooms) or LSD (lysergic acid diethylamide) are relatively safe, non-addictive classical psychedelic drugs with similar effects. Their use is strongly discouraged for persons with schizophrenia and psychotic traits. Even those with close relatives suffering from these disorders are excluded from clinical trials and experimental therapy programs. These psychoactive compounds are well known historically, and as more and more information about their therapeutic potential appears in the international media, the number of people trying to self-medicate is increasing. The non-toxic and non-addictive nature of these drugs can lead many users to resort to self-medication, which may not have the desired effect or, in the worst case, may have a tragic outcome.
Set and setting
The first danger of psychedelic self-medication is psychological. Classical psychedelic drugs are unpredictable, so no one can guarantee that the experience will be pleasant. In addition, their performance depends very much on the psychological disposition of the user and the environment in which they use psychedelics. An irresponsible attempt to take psychedelics in an unfamiliar, uncontrolled, unsafe environment can lead to serious psychological and physical consequences.
Both LSD and mushrooms of the genus Psilocybin produce the state of consciousness that resembles psychosis. You certainly don’t want to have a severe psychotic episode somewhere in the woods, on the balcony of a multi-story building. If you enter the psychedelic world of consciousness without feeling comfortable, all your fears can be amplified many times over, and you can find yourself in a psychological hell for 6-8 hours that you cannot stop.
Overwhelming psychological stress can cause anxiety disorders. Under the influence of the drug, you may forget that you have taken it, so that the difficult experience may never seem to end.
Mindfulness is very important as psychedelic drugs are used in therapy as a psychotherapy booster, or therapy on steroids. Using these drugs without psychological preparation is like driving a sports car without a steering wheel. A very large number of the psychonaut trips that have had sad psychological consequences have been recreational, without a safe environment, and without psychological preparation.
Losing grip on reality
Psychedelics temporarily increase the chaos (entropy) of brain activity. In the scientific publication “The entropic brain: a theory of psychedelic-induced states of consciousness based on neuronal imaging studies”, Robin Carhart-Harris and colleagues offer an explanation for the therapeutic mechanism of action. It is possible that some mental illnesses, such as obsessive-compulsive disorder, depression, and addictions, are related to an over-ordered brain: having learned certain behavioral patterns, using the same neural networks over and over again, they are unable to change due to a lack of neuroplasticity. Psychedelics, by creating chaos in certain parts of the brain, disrupt the normal – unchanging – the way it works, which provokes change.
A depressed person, with a big amplitude of recurrent negative thoughts and daily emotions that crush self-esteem, may experience significant benefits from an increase in brain chaos. Neural networks that have never communicated before begin to communicate with each other, making it easier to escape from the traps of the negative brain’s activity pattern.
Other disorders, such as psychosis or mania, can be states of increased brain chaos, so LSD, psilocybin, and other psychedelics can push the user further towards the edge of chaos. If the brain is already experiencing a storm, additional stimulation can trigger a typhoon that could provoke recurrent psychosis or even schizophrenia.
Another danger is the perceptual disturbance provoked by hallucinogens. Although not a frequent occurrence with the use of classical hallucinogens; the recurrent, long-term residual effects of visual hallucinations (such as flickering surfaces, fractals, strange colors) induced by the use of psychedelics can interfere with life. Neither the causes nor the treatment is yet known. There is not much information on the frequency of the disorder, but a study in the 1990s suggested that 1 in 50,000 users may experience it.
Toxicity of psychedelics
Although the likelihood of fatal overdose from classic psychedelic drugs (LSD, psilocybin, DMT) is very low, their use can lead to adverse health risks. There are scientific studies indicating that high doses of LSD damage the photoreceptors in the eyes. This psychedelic raises heart rate and blood pressure, so cardiological risks should be assessed before use. The health risks of taking a high dose and experiencing a ‘bad trip’ are compounded by the stress of the experience. Mushrooms of the genus Psilocybin have low toxicity (without being mixed with poisonous mushrooms), but can cause nausea. Classical psychedelics do not cause physical dependence, but psychological dependence is possible.
All classic psychedelics are banned and are therefore traded illegally. It is difficult to demand even the minimum standards of business ethics from an illicit drug dealer so that attempts to buy psychedelic drugs very often result in the purchase of possibly lethal compounds such as fentanyl and synthetic cannabinoids.
Ayahuasca in the jungle
DMT, a classic psychedelic compound, has become an important part of the New Age movement. More and more psychonauts are tempted to travel to South America, wherein the rainforest, with the help of local shamans, they drink Ayahuasca, a plant brew enriched with dimethyltryptamine and MAO inhibitors. Travelers mostly seek spiritual enlightenment, but less often they go to the ceremonies for treatment of addictive diseases or psychological problems. Where there is demand, there is also supply, which has led to the emergence of an increasing number of impostor shamans whose aim is not linked to a genuine desire to help.
In the Amazonian, there is an increasing number of cases of sexual violence against women by ‘shamans’ and deaths due to lack of timely medical attention. When choosing this type of psychedelic therapy, one should be very careful to gather information about the people who organize these camps.
Drug possession charges may carry penalties that cause negative social consequences. You should research local laws before buying illegal psychoactive substances. You can do this here.