Why Psychedelic Drugs Could Be a Treatment For Mental Illness

January 18, 2017

Estalyn Walcoff arrived at the nondescript beige building in Manhattan’s Gramercy Park neighborhood on a balmy August morning, hours before the city would begin to swell with the frenetic energy of summer tourists. She was about to face a similar type of chaos — but only in her mind.

Pushing open the door to the Bluestone Center at the New York University College of Dentistry, Walcoff entered what looked like an average 1970s living room. A low-backed brown couch hugged one wall. On either side, a dark brown table held a homely lamp and an assortment of colorful, hand-painted dishes. A crouching golden Buddha statue, head perched thoughtfully on its knee, adorned another table closer to the entrance.

Months before, Walcoff had volunteered to participate in a study of how the psychedelic drug psilocybin, the main psychoactive ingredient in magic mushrooms, affects the brain in cancer patients with anxiety and depression. The promising results of that five-year study, published in December, have prompted some researchers to liken the treatment to a “surgical intervention.”

The researchers believe they are on the cusp of nothing less than a breakthrough: A single dose of psychedelic drugs appears to alleviate the symptoms of some of the most common, perplexing, and tragic illnesses of the brain. Because depression is the leading cause of disability worldwide, the timing seems ideal.

In people like Walcoff, whose depression and anxiety strike after a cancer diagnosis like a powerful blow, one dose of psilocybin seemed to quiet her existential dread, to remind her of her connectedness with the world around her, and, perhaps most importantly, to reassure her of her place in it.

And these results don’t seem to be limited to people with cancer or other life-threatening illnesses. Participants in a handful of other studies of psychedelics consistently ranked their trips as one of their most meaningful life experiences — not only because of the trip itself, but because of the changes they appear to produce in their lives in the months and years afterward.

Still, the existing research is limited — which is why, scientists say, they so badly need permission from the government to do more.

Clark’s story

1990 was a year of life and death for Clark Martin. His daughter was born, and he was diagnosed with cancer.

Over the next 20 years, as his daughter took her first steps, experienced her first day of school, and eventually grew into a smart, fiercely independent teenager, doctors waged a blitzkrieg on Martin’s body. Six surgeries. Two experimental treatments. Thousands of doctor visits. The cancer never went into remission, but Martin and his doctors managed to keep it in check by staying vigilant, always catching the disease just as it was on the brink of spreading.

Still, the cancer took its toll. Martin was riddled with the effects of anxiety and depression. He had become so focused on saving his body from the cancer that he hadn’t made time for the people and things in his life that really mattered. His relationships were in shambles; he and his daughter barely spoke.

So in 2010, after reading an article in a magazine about a medical trial that involved giving people with cancer and anxiety the drug psilocybin, he contacted the people running the experiment and asked to be enrolled.

After weeks of lengthy questionnaires and interviews, he was selected. On a chilly December morning, Martin walked into the facility at Johns Hopkins, where he was greeted by two researchers, including Bill Richards, a psychologist. The three of them sat and talked in the room for half an hour, going over the details of the study and what might happen.

Martin received a pill and swallowed it with a glass of water. For study purposes, he couldn’t know whether it was a placebo or psilocybin, the drug the researchers aimed to study.

Next, he lay back on the couch, covered his eyes with the soft shades he’d been given, and waited.

Within a few minutes, Martin began to feel a sense of intense panic.

“It was quite anxiety-provoking,” he said. “I tried to relax and meditate, but that seemed to make it worse, and I just wanted everything to snap back into place. There was no sense of time, and I realized the drug was in me and there was no stopping it.”

Martin, an avid sailor, told me it reminded him of a frightening experience he’d had when after a wave knocked him off his boat, he suddenly became disoriented and lost track of the boat, which was floating behind him.

“It was like falling off the boat in the open ocean, looking back, and the boat is gone,” he said. “And then the water disappears. Then you disappear.”

Martin was terrified and felt on the verge of a “full-blown panic attack.” Thanks to the comfort and guidance of his doctors, however, he was eventually able to calm down. Over the next few hours, the terror vanished. It was replaced with a sense of tranquility that Martin still has trouble putting into words.

“With the psilocybin, you get an appreciation — it’s out of time — of well-being, of simply being alive and a witness to life and to everything and to the mystery itself,” said Martin.

Lots of things happened to Martin during his four-hour trip. For a few hours, he remembers feeling at ease; he was simultaneously comfortable, curious, and alert. He recalls a vision of being in a sort of cathedral, where he asked God to speak to him. More than anything else, though, he no longer felt alone.

“The whole ‘you’ thing just kinda drops out into a more timeless, more formless presence,” Martin said.

As his trip slowly began to draw to a close and he began to return to reality, Martin recalls a moment when the two worlds — the one in which he was hallucinating and the reality he could call up from memory — seemed to merge. He turned his attention to his relationships. He thought of his daughter, his friends, his coworkers.

“In my relationships, I had always approached it from a ‘How do I manage this?’ How do I present myself?’ ‘Am I a good listener?’ type of standpoint,” Martin said. “But it dawned on me as I was coming out of [the trip] that relationships are pretty much spontaneous if you’re just present and connecting.”

That shift, which Martin said has deepened since he took the psilocybin in 2010, has had enduring implications for his relationships.

“Now if I’m meeting people, the default is to be just present — not just physically, but mentally present to the conversation,” he said. “That switch has been profound.”

While he felt himself undergo a shift during his trip on psilocybin, Martin says the most enduring changes in his personality and his approach to interacting with those around him have unfolded in the months and years since he took the drug. For him, the drug was merely a catalyst — a “kick-start,” he likes to call it. By redirecting his perspective for a few hours, the psilocybin unleashed a chain reaction in the way he sees and approaches the world, he said.

This squares with what researchers have found by looking at the brain on psilocybin.

Taking the road(s) less traveled

Ask a healthy person who has tripped on psychedelics what it felt like, and they’ll probably tell you they saw sounds. The crash-bang of a dropped box took on an aggressive, dark shape.

Or they might say they heard colors. A bright green light seemed to emit a piercing, high-pitched screech.

In actuality, this “cross-wiring” — synaesthesia, as it’s known scientifically — may be one example of the drug “freeing” the brain from its typical connection patterns.

This fundamental change in how the brain sends and receives information also might be the reason the drugs are so promising as a treatment for people with mental illnesses like depression, anxiety, or addiction. To understand why, it helps to take a look at how a healthy brain works.

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