Mental illness is a growing global issue. One in five adults in the US experiences mental illness, and depression is the leading worldwide cause of disability.¹
A range of psychotherapy treatments and medications are available, but not all patients respond well, and some may not see improvements for years.
Renewed interest driven by rising mental illness, law reforms, and medical commentary is putting a spotlight on psychedelics.
Psychedelics are currently restricted and illegal in most cases, but some scientists believe they could play a key role in treating some forms of mental illness. They believe psychedelics could offer greater benefits than current treatments.
But are psychedelics the answer? Let’s dive into the research.
Psychedelics are a group of hallucinogenic drugs that can alter a person’s mood, cognitive processes, thoughts, and perceptions.
Some of these hallucinogens are found in nature, in plants like cacti, seeds, or fungi. Others are synthetic — made in laboratories from chemicals altered to create hallucinogenic effects.
Generally, psychedelics are legally restricted and unavailable to the general population. They are known, however, for recreational use and abuse and a history of being used in religious ceremonies.
Some commonly used psychedelics include psilocybin (otherwise known as magic mushrooms), LSD (lysergic acid diethylamide), peyote, ayahuasca, and DMT (dimethyltryptamine).²
Mental illness is a global issue. One in five adults experiences mental illness in the US alone, and serious mental illness causes an estimated $193.2 billion in lost earnings.¹
Depression is the leading worldwide cause of disability. In 2015, the World Health Organization (WHO) estimated 300 million people around the world experience depression. It is estimated that a similar number experience anxiety.
The pandemic appears to have contributed to more cases of mental illness worldwide. A 2020 systematic review of depression and anxiety disorders found global anxiety disorder rates spiked by 25% due to the COVID-19 pandemic.⁴
Mental illness can be very serious and affect daily life, work, and relationships. People who experience severe mental health conditions die up to two decades earlier because of preventable physical conditions.⁵
Mental illness is currently treated with psychological treatments (like cognitive behavioral therapy) and antidepressant medication.
The global rise in mental illness, decriminalization of certain substances, and expert opinions are driving interest in the use of psychedelics as an alternative treatment.
However, treating mental illness with psychedelics is not new.
Research began in the 1950s, and several studies were completed over the next two decades. Studies found promising results for the treatment of anxiety, addiction, depression, and post-traumatic stress disorder (PTSD). However, this research only involved small groups of participants and was not controlled.
Law changes in the 1970s put an abrupt stop to further studies. Now, controlled clinical studies show similar benefits to those completed in the 1950–1970s.
In 2014, for example, researchers found that LSD administration caused noticeable reductions in anxiety for patients with life-threatening conditions. Two LSD-assisted sessions resulted in sustained benefits at a one-year check-in, and there were no adverse effects lasting longer than a day after the session.⁶
A 2010 study found psilocybin administration led to an improved mood that reached significance at six months for patients with anxiety and advanced cancer.⁷
Research on the use of psychedelics in PTSD has also been promising. A randomized controlled pilot study of people with treatment-resistant PTSD found participants saw clinically significant results after receiving 3,4-methylenedioxymethamphetamine (MDMA).⁸ They also noted that participants didn’t experience any adverse effects.
The research, albeit in small group studies, has shown the use of psychedelics could be more beneficial and effective than other treatment options.
Antidepressants are the most common medication used in people with depression.
Antidepressants work very differently from psychedelics. They balance the neurotransmitters (chemicals) in the brain. Neurotransmitters tend to be too low or too high in people with depression or anxiety.
Psychedelics work differently. Psychedelics act on neural circuits in the brain, which can help stimulate serotonin. These effects occur in the prefrontal cortex, which is associated with cognition, mood, and perception. Other regions of the brain, particularly those associated with stress, are also impacted.⁹
Dr. Jerrold Rosenbaum, director of the Center for the Neuroscience of Psychedelics at Massachusetts General Hospital, says psychedelics work in a unique way.
“Psychedelics induce the brain to change transiently in ways that appear to allow a reset to take place and permit alterations in previously ‘stuck’ ways of feeling and thinking about things,” he said.¹⁰
In this sense, psychedelics may be able to rewire the brain.
Experts note one key advantage: psychedelics used to treat depression and anxiety may only be needed a few times. Antidepressants, on the other hand, usually have to be taken daily for months or even years. They may be helpful in some cases, but not all.¹¹
A 2022 study found patients with major depressive disorder who were administered just two doses of psilocybin experienced rapid and sustained antidepressant effects.¹²
A 2020 clinical trial also found positive effects. 24 participants with major depressive disorder who received psilocybin had improved depression outcomes.¹³ At a four-week check-in, 54% of participants were considered to be in remission.
Whether or not psychedelics are legal is a difficult question to answer. Laws vary state by state, with some allowing restricted medical use.
In 1970, the US Congress passed the Controlled Substances Act. In it, many hallucinogens, including LSD, were highlighted as having a high potential for abuse and no accepted medical use.¹⁴
The Psychotropic Substances Act of 1978 then banned all psychedelic drugs. Psychedelics are now labeled as “drugs of abuse” and are typically only used in restricted medical circumstances, like surgery.
Limited decriminalization in some US states appears to be renewing interest in psychedelic use. In 2020, Oregon legalized psychedelic mushrooms. Denver and Detroit have also decriminalized the hallucinogen. Many other states allow limited use of psychedelics for medical purposes.
There is also some limited use of psychedelics to treat mental illness. Esketamine (Spravato) is sometimes used in people with depression who are not responding to other treatments. The drug can cause adverse effects and has the potential for abuse, so it’s only legally available through a restricted distribution system.
While not yet FDA-approved for depression, ketamine (which is FDA-approved as a general anesthetic) is used by some physicians at specialist clinics in the US.
The FDA has also granted therapy designations for some psychedelics, which could accelerate their pathway to FDA approval. These include the use of psilocybin for major depressive disorder and MDMA for PTSD.
Research is showing promising results, but it’s important to consider that psychedelics do pose some serious risks as they alter your state of consciousness.
For example, a case report detailed a woman’s “intense anxiety, panic, and hopelessness” under the influence of ayahuasca and in the three days following a ritual ceremony.¹⁵ The authors noted: “Ayahuasca should be used with caution in people with a history of anxiety disorders.”
One risk associated with psychedelic drugs is hallucinogen persisting perception disorder (HPPD), commonly known as flashbacks. However, the risk of flashbacks is thought to be low.
Psychedelic-induced “trips” — the different perspectives that psychedelics can create — can be terrifying for some people.
Some common side effects of psychedelics include:⁹ ¹⁶ ¹⁷
Mixed senses — the feeling of “hearing” color and “seeing” sound
Increased heart rate and blood pressure
Changing sense of time
Intensified sensory experiences — like seeing brighter colors
The authors of a 2015 journal article¹⁶ noted the critical importance of patient monitoring during psychedelic use as “fearful responses could lead to dangerous behavior.”¹⁶
Becoming dependent on psychedelics is another risk. This is a key reason why the substances are legally restricted. Dependent users of some substances can develop a high degree of tolerance to the drug’s effects. This means they need higher doses to produce the same results.⁹
Psychedelics offer promising avenues for mental illness treatment, but more research in larger studies is needed to prove mainstream medical use would be beneficial.
Most available studies are outdated or have been completed in small groups, meaning any wider effects are unknown.
Sufficient positive, rigorous, clinically controlled studies could lead the FDA to approve some substances for use in people with mental illnesses.
However, legalization may be held back by the risk of increased use and abuse outside of a medical context and questions about the morality of using these substances.
Even if psychedelics are legalized for mental illness treatment, people must be clinically monitored and should never take drugs on their own. Doing so is dangerous and could worsen symptoms.
The future of psychedelic therapy remains unknown, but it does offer some hope for the future of treatment.
Here are some key points about psychedelics as the next big trend for mental illness treatment:
Psychedelics can alter a person’s mood, cognitive processes, thoughts, and perception.
Psychedelics are typically illegal across the US, but laws vary in different states.
While psychedelics are historically associated with religious ceremonies, illegal use, and abuse, some research shows positive medical benefits for people with depression, anxiety, and PTSD.
With mental illness rates rising, there’s renewed interest in alternative therapies and a growing need for effective treatments.
Some research has shown that psychedelics are useful in mental illness and provide prolonged benefits.
Psychedelics may be a better alternative to antidepressants, with only a few administrations needed over a relatively short period.
More clinically controlled research is needed to prove the benefits and test the risks of mainstream psychedelic use as a treatment for mental illness. This may lead the FDA to approve some substances for treatment.
Psychedelics can cause adverse effects, so patients must be medically observed during and after treatment. People must never attempt to take substances on their own.
Taking psychedelics without medical supervision can lead to dangerous behavior and dependence.
Psychedelics could be the next big trend in mental illness treatment, offering real hope to people with debilitating conditions. However, more research is needed.
Mental health facts in America | National Alliance on Mental Illness (NAMI)
Hallucinogens and dissociative drugs research report: Common hallucinogens and dissociative drugs | NIH: National Institute on Drug Abuse
Depression and other common mental disorders | World Health Organization
Mental health: Overview | World Health Organization
The safety and efficacy of ±3,4-methylenedioxymethamphetamine-assisted psychotherapy in subjects with chronic, treatment-resistant posttraumatic stress disorder: the first randomized controlled pilot study (2011)
Hallucinogens and dissociative drugs research report: How do hallucinogens (LSD, psilocybin, peyote, DMT, and ayahuasca) affect the brain and body? | NIH: National Institute of on Drug Abuse
Back to the future: Psychedelic drugs in psychiatry | Harvard Health Publishing
Drug Scheduling l United States Drug Enforcement Administration
Hallucinogens DrugFacts l NIH: National Institute on Drug Abuse
Chloe Garnham is a writer exploring a broad range of topics, including healthcare, education, and technology.
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