The Power of Psilocybin Therapy for Depression

Psychedelic-assisted psychotherapy is reshaping mental health treatments. A recent study investigating the effects of Psilocybin Therapy (PT) versus conventional antidepressants like Escitalopram (Lexapro) in treating Major Depressive Disorder (MDD) challenged traditional approaches. It highlighted the unique psychological mechanisms underpinning psychedelic therapy's success.

DALL-E, 2024

PT, utilizing psychoactive compounds found in magic mushrooms, induces deep, meaningful psychological experiences. These experiences, particularly mystical experiences and ego dissolution, play a key role in the treatment's effectiveness. Unlike traditional antidepressants focusing on serotonin levels for symptom management, PT leverages acute psychological transformations for long-term healing.

This study's trial with a rigorous control and double-blind structure compared PT against Escitalopram, a commonly prescribed Selective Serotonin Reuptake Inhibitor (SSRI). Patients undergoing PT reported significantly higher levels of mystical experiences and ego dissolution, linked to a greater reduction in depressive symptoms.

The study also highlighted the role of music during PT sessions in enhancing these experiences, suggesting the therapeutic setting significantly influences the treatment's efficacy. This aspect distinguishes PT from traditional treatments, pointing towards a holistic approach that integrates environment, mindset, and "drugs" to catalyze healing.

One striking finding was the durability of PT's effects. Patients treated with psilocybin showed lasting improvements, suggesting the acute psychological experiences induced by the therapy lead to long-term neuroplastic changes, contrasting with the maintenance approach of SSRIs, which often requires ongoing medication to manage symptoms.

What makes this exciting for me as a psychotherapist is the validation that the research expresses in reinforcing the significant aspect of impactful psychedelic psychotherapy as the mechanism of change in conjunction with rewiring the brain. These medicines themselves, in particular in microdose levels, do not necessarily create any more change than what you would see in classic psychiatric pharmacology.

This study validates the effectiveness of Psilocybin Therapy and highlights the role of mystical experiences and ego dissolution in driving therapeutic change. It paves the way for a new understanding of mental health treatment, where transformative psychological experiences are used for profound and enduring healing.

Reference:

Weiss, B., Roseman, L., Giribaldi, B., Nutt, D. J., Carhart-Harris, R. L., & Erritzoe, D. (2024). Unique Psychological Mechanisms Underlying Psilocybin Therapy Versus Escitalopram Treatment in the Treatment of Major Depressive Disorder. International Journal of Mental Health and Addiction, 1-36.

Psilocybin in Bipolar II: New Study

A study led by Dr. Scott T. Aaronson, published in JAMA Psychiatry, offers new insights into treating treatment-resistant bipolar type II depression with synthetic psilocybin combined with psychotherapy. The study involved 15 participants, aged 18 to 65, who received a single 25mg dose of synthetic COMP360 psilocybin and psychotherapy sessions.

Significantly, 80% of the participants met the remission criteria 12 weeks post-treatment without experiencing an increase in bipolar II symptoms. These results indicate psilocybin's potential efficacy in treating bipolar II depression in a clinical setting. A controlled environment and the guidance of mental health professionals are important factors. They distinguish clinical applications from recreational scenarios.

"Individuals in this study displayed strong and persistent antidepressant effects with no signal of worsening mood instability or increased suicidality."​

The study indicates that psilocybin exhibits potential in treating specific mental health disorders within clinical settings. This research is hopeful about novel avenues in mental health treatment, particularly for conditions that have been difficult to manage with conventional therapies.

This study specifically excluded individuals with Bipolar I Disorder, widely recognized as a contraindication for the use of psychedelic medicines. However, if an individual with Bipolar I is not currently experiencing a manic phase, some researchers and clinicians believe that the use of such treatments may be acceptable under some conditions.

About Bipolar II

Bipolar II Disorder is characterized by a pattern of depressive episodes and hypomanic episodes, distinguishing it from other depressive disorders. Unlike Bipolar I, which involves more severe manic episodes, Bipolar II features milder hypomanic episodes that do not cause significant social or occupational impairment. This contrasts with Major Depressive Disorder, which involves depressive episodes without the accompanying manic or hypomanic phases seen in bipolar disorders.

For more detailed insights, you can access the full study here.

Paradox of the Sympathetic Nervous System and Sex

The human body is a marvel of biological engineering, including the intricacies of sexual response. A key player in this process is the autonomic nervous system (ANS), which consists of two branches: the sympathetic and parasympathetic nervous systems. These systems, while seemingly opposed, work in tandem to modulate sexual experience, but not without a fascinating paradox.

The Role of the Sympathetic Nervous System

The sympathetic nervous system, often associated with the "fight or flight" response, plays a surprising role in sexual desire. Its activation, contrary to what one might expect, can promote sexual desire. This is because sexual desire, at its onset, forms physiological curiosity as a motivator. The sympathetic system prepares the body for action, which, in this context, translates to the initiation of sexual desire.

For sexual activity to progress from desire to arousal and fulfillment, there's a need for a shift—a transition from the energy-driven sympathetic activation to a more relaxed state governed by the parasympathetic nervous system.

The Parasympathetic Nervous System and Its Role in Arousal

The parasympathetic nervous system is famously known for "rest and digest" functions. In the context of sexual activity, it translates to relaxation, which is essential for arousal and subsequent sexual performance. This shift facilitates increased blood flow, which is crucial for arousal and, for men and women, sexual activity.

The paradox lies in the shift between the sympathetic and parasympathetic nervous systems. While the sympathetic system triggers desire, its prolonged dominance can hinder the relaxation necessary for arousal, which is regulated by the parasympathetic system. Therefore, striking a balance between these two systems is crucial for a satisfying and healthy sexual experience.

Navigating the Paradox

Understanding this paradox helps people navigate sexual health. Techniques like deep breathing, mindfulness, and relaxation exercises can help activate the parasympathetic response when this doesn't occur organically. Additionally, being cognizant of one's mental state before and during sexual activity can help in managing the balance between these two systems.

The Complications of PTSD

This balance, however, can be particularly challenging for individuals with PTSD. PTSD often involves a heightened sympathetic response, making it difficult for the body to shift into the relaxed state necessary for arousal. This can lead to frustration and a sense of disconnection during sexual activities. Therapy and specialized treatment focusing on managing PTSD symptoms and training the body to activate the parasympathetic response can be instrumental in overcoming these challenges.

The sympathetic and parasympathetic nervous systems play vital yet paradoxical roles in sexual health. While the former ignites desire, the latter facilitates arousal and completion. Understanding and managing this balance is helpful, especially for individuals with conditions like PTSD.