Book Rex: On psychedelics and depression
Michael Pollan's "How to Change Your Mind" and the growing science of how psychedelics can help improve your mental health
Earlier this year, for the first time in my nearly 10 years struggling with depression, I went on antidepressants. It was something I should’ve tried long ago — depression is caused by many things, and there are often many components to treatment (therapy, exercise, cutting back on alcohol, getting fresh air, overthrowing capitalism, etc.) — but in spite of what the Scientologists say, antidepressants have helped a lot of people and have saved a lot of lives.
I have not been one of them.
The reason is that, while I have experienced some of the positive benefits of antidepressants, I have had with each one I’ve tried, side effects that have made it impossible to live my life in the way I need to. With the first drug, fluoxetine (brand name Prozac), I found it too difficult to concentrate on reading. This, as someone who reads and writes for a living, is a non-starter. The second drug, bupropion (brand name Wellbutrin), has given me pretty bad insomnia. This, as the father of two small kids, is out of the question.
At the same time this year, on the heels of my home state of New Jersey legalizing pot, I began taking sativa cannabis edibles about once a week as part of a night of rest and relaxation. If I had to pick one drug that’s been better for my mental health this year — fluoxetine, bupropion, or cannabis — I’d pick the cannabis, far and away.
Psychedelics and treating mental illness
There is a growing body of evidence that psychedelic drugs1 are going to be the psychiatric miracle drugs that we once thought SSRIs and other antidepressants would be. Psychedelics have been shown to be extremely effective in treating depression, anxiety, PTSD, and drug addiction in ways that frankly dwarf the effectiveness of SSRIs. Michael Pollan’s excellent book How to Change Your Mind is an account of that growing body of science, and what it might mean for the future of mental healthcare.
Pollan’s account of the psychedelic revolution is a history, a memoir, and a science book on how we got to this point. Before they became the recreational drugs of the counterculture, scientists in the early- to mid- 20th century were getting wildly impressive results treating addicts and depressives with psychedelics, to the point where they were being heavily funded by institutions like the CIA2.
But in the 1960s, this all changed when Timothy Leary, a renowned Harvard psychology professor, left academia in a fantastic scandal that turned him into the world’s foremost evangelist of LSD, encouraging kids to “turn on, tune in, and drop out” with drugs as a way of waging a sort of spiritual revolution against the status quo. Psychedelics became a focal point of the culture wars of the 60’s, Leary became an international fugitive3, and Richard Nixon started the war on drugs as a way of marginalizing and disenfranchising his most militant political opponents.
As a result, the drugs were driven underground for decades. It has only begun to reemerge as legitimate science in the past decade or so.
The subjective experience of drugs
Pollan’s book takes a break in between the history and the science to reflect on his experiences with three different types of psychedelic drugs, and it is not the most interesting part of the book: it’s never particularly interesting hearing about other people’s trips, just as it’s not particularly easy to explain your own. But it does make a valuable point — that the strength of psychedelic drugs is in the subjective experience of the trip, which can often induce mystical experiences in the mind of (to use Pollan’s preferred term) the psychonaut. These mystical experiences can reveal truths that, when spoken to someone outside the experience, seem incredibly cliched or trite (“love is all you need,” “we are all one,”) but which to the person experiencing the trip, is monumental, often life-changing.
The problem modern scientists face is that there is no real accounting for how these experiences change people (you can’t measure subjective experience), but the point is that they demonstrably do — after one or two sessions, terminal cancer patients come to peaceful terms with death, lifetime smokers throw away their cigarettes and never look back, and the chronically depressed feel relief from decades old symptoms for up to a year.
But this new resurgence of psychedelic research has something at its disposal that scientists in the 40s and 50s didn’t: brain imaging technology. With these tools, scientists have begun to identify much about how not only the brain, but consciousness in general may work.
One theory that has been gaining traction thanks to brain imaging is that psychedelics quiet the part of our brain known as the “Default mode network,” which is late-developing part of the brain that helps keep our minds efficient. It is the part of our brain that uses patterns and experience to help us solve problems — the door is locked, the solution is to unlock the door rather than, you know, start smashing it with a hammer or jumping through a window.
The Default mode network is nonexistent in children, who have far more malleable, adaptive minds. They still do not have the patterns and experience that adults do, so they solve problems in a far more outside-the-box type of way. As a result, four-year-olds can be better at solving some outside-the-box problems than adults.
By quieting this part of the brain, psychedelics basically turn us back into kids. (The flip side to this, Dr. Alison Gopnik points out in the book, is that “babies and children are basically tripping all the time.”) This is valuable when the experiences and patterns adopted for efficiency’s sake by the Default mode network are actually causing us problems. Depression, anxiety, addiction, and PTSD are all characterized by a certain rigidity in thinking, an inability to find creative solutions to old problems. Psychedelics break the hold of these rigid perspectives and give us access to something new.
The political risks of psychedelic science
The thing about Richard Nixon and Timothy Leary: they weren’t wrong about the politics of psychedelics. The drugs do have a tendency to disrupt hierarchies. People who took acid did often become opposed to violence and war. The drugs also connect people to nature, they reduce egotism and individualism. These are potentially revolutionary tools.
What’s more is that modern psychiatrists have found that they have to develop a whole new paradigm to engage with psychedelics — you can’t do “objective” studies of the drugs in stripped down white labs, because a major component in a trip’s success is, as Leary put it, the “set and setting.” In other words, your experience is heavily influenced by your mindset going into the trip, and also the physical and psychological setting in which you do it. If the setting feels cold and impersonal, you’ll likely have a bad fucking time. If it feels warm and loving, you’re far more likely to have a positive, meaningful experience.
Which means the doctors administering and studying these drugs have to cross lines with their “subjects” that most people operating within the scientific method would find appalling. The role the researchers take, as many uneasily admit in the book, is more “shamanic” than scientific. They are more of a spirit guide than an austere clinician.
None of which invalidates the findings. But psychedelics blur the boundaries between the subjective world of experience and the objective world of science. With every astounding study showing how these drugs really, genuinely help people, science is being backed into a corner where it may have to reconsider the objective/subjective divide upon which its very existence is founded upon.
For my part, I took shrooms once in my friends basement when I was 24 years old. It was a really, really, really good experience. It was intense and sometimes scary, but I came out of it with a clearer sense of myself and my place in the universe than I’d ever had, and the effect lasted for several years before the onset of my depression. Given the positive experiences I’ve had with the far milder (and not technically psychedelic) drug of cannabis, I hope I’ll someday soon be able to legally go on a trip and feel good about my place in the universe once more.
Cannabis is not, strictly speaking, a psychedelic drug. Taken in edible form in particular, it can give you really intense highs that resemble psychedelic trips, and cannabis has a long history of being used as an entheogen, a spiritual drug, to help people access an altered state of consciousness and perhaps a different perspective on the universe. But it is notoriously hard to classify, sometimes operating as a depressant, other times as a stimulant, and other times as a hallucinoge, often dependent on the strain, the person taking it, and the context in which it is taken. My experience of sativa edibles with a bit of sensory deprivation thrown in has strong echoes of my single psychedelic trip on psilocybin mushrooms though, and so I lump it in here with more established psychedelics like psilocybin, LSD, DMT, or mescaline.
The CIA, rather bleakly, hoped to use the drugs as either chemical weapons or mind-control drugs, and in their own experiments in what’s now known as Project MK ULTRA, dosed people without their knowledge or consent, leading to at least one death.
His story is wild, I recommend John Higgs’ excellent biography of Leary titled I Have America Surrounded.