Can magic mushrooms treat depression and anxiety?

Bethany Ao
Philadelphia Inquirer

When Marc Morgan tried lysergic acid diethylamide, better known as acid or LSD, for the first time as a teenager, he noticed that he could emotionally disconnect from traumatic memories of the sexual abuse he had suffered as a child.

“It allowed me to dissociate from the sharp pain that a lot of these memories can bring up, which caused me to shy away from processing them,” said Morgan, who has post-traumatic stress disorder (PTSD) as a result of the abuse. “I was able to confront the topic in a more analytical way that felt healthier.”

Years later, Morgan learned about microdosing — taking tiny portions of psychedelic substances, as little as a twentieth of a recreational dose, to get positive effects, like more focus and emotional balance, without negatives like hallucinations and disorientation. He realized that taking small doses allowed him to process his emotions without the stronger, visual effects and looping thoughts.

Doctors question whether LSD can help with PTSD in patients.

“It’s basically like taking a cup of coffee,” said Morgan, now 30. He said he takes a full dose once or twice a year, and microdoses about four times a year. “You’re just able to be a little more free and a little more honest with your emotions without breaking down. There’s more of a mental clarity.”

Morgan, who has lived in Philadelphia for the past decade, is part of a group of people who use both full doses and microdoses of psychedelic substances to process trauma, and better deal with depression. For some, it’s because conventional antidepressants haven’t worked for them. Others choose psychedelics because it’s a more affordable option than therapy or medication.

However, medical experts don’t recommend self-medicating.

“For people interested in a treatment who can’t get into a trial, this is not the only thing out there,” said Matthew Johnson, an associate professor of psychiatry and behavioral sciences at Johns Hopkins University who has studied psychedelics for over 15 years. “It’s one promising thing, and it’s important for people to stay in treatment.”

In recent months, the use of psychedelics for treatment-resistant depression, anxiety and PTSD — meaning patients do not respond to medication or therapy — has become a hot topic in the mental health field. The FDA approved a nasal spray for treatment-resistant depression (TRD) last March, which uses a derivative of the hallucinogenic ketamine called esketamine. It is the first new antidepressant in decades. (It’s currently offered at a handful of clinics in the Philadelphia area.)

In November, the FDA gave psilocybin, a hallucinogenic compound found in magic mushrooms, its second “breakthrough therapy” designation in just over a year. The designation fast-tracks the development and review of drugs.

In a 2017 study of psilocybin and depression, researchers at Imperial College London gave psilocybin therapy to 20 patients with treatment-resistant depression, who reported benefits as long as five weeks after treatment. The study found that psilocybin decreased activity in the amygdala, which processes emotions like fear and anxiety.

“We know that when someone is on a therapeutic dose of a psychedelic, there’s a dramatic increase in communication across brain areas,” Johnson said. “My theory is that what we’re seeing with psychedelic therapy is more like what we normally associate with talk therapy. Psychedelic therapy prompts a therapeutic process, and people learn something by transcending their sense of self and getting out of their own way.”

Much less is known about the science behind microdosing psychedelic substances, but a 2019 study by researchers at the University of California-Davis found that the practice can provide relief for symptoms of depression and anxiety in rats.

Additionally, a 2019 survey of more than 1,000 people from across the world who microdosed on LSD found that repeated microdoses were followed by “improvements in negative moods, especially depression” as well as increased positive moods and energy levels.

“There really hasn’t been substantiation of the claimed benefits of so-called microdoses,” Johnson said. “That’s not to say the claimed benefits aren’t possible.”

As a result of their research on how psychedelics can be used to help smokers and cancer patients, Johnson and others at Johns Hopkins have suggested that psilocybin’s FDA classification should be changed from Schedule I, which means that it has no known medical benefit, to Schedule IV, similar to prescription drugs.

“Having a mystical experience is correlated with actually getting more clinical effects,” Acero said. “Microdosing doesn’t recapitulate the mystical experience or ego death. Also psychedelic use … does not magically heal you, you have to put in work and effort to integrate your experience.”

Most people suffering from treatment-resistant depression, anxiety or PTSD won’t be able to access the new treatments for at least a few years, as research groups run clinical trials. The trials have a limited number of spaces — the Usona Institute, a nonprofit medical research group, recruited just 80 participants for a study that’s part of their Phase 2 clinical trial for psilocybin. Similarly, LSD is being evaluated in a Phase 2 clinical trial as a treatment for depression in Switzerland. MDMA, better known as ecstasy or molly, is currently in a Phase 3 large-scale clinical trial for PTSD. Upon FDA approval, the SoundMind Center will open in Cedar Park, offering MDMA-assisted psychotherapy to populations with higher rates of PTSD.

“It’s definitely easier to go to bed at night,” said Ali, who lives in Wilmington, Del. and works in King of Prussia. “I’m a little more focused, and I feel like I can smile and giggle in the moment. I can feel myself going through my day a little bit better, and the days after feel so much better.”