Mental health treatment is undergoing a rather radical transformation. Psychedelics –a class of drugs that have long been stigmatized and criminalized and includes the likes of “magic” mushrooms, ecstasy, LSD, and ketamine — are gaining recognition as an emerging treatment for mental illness, particularly in instances when conventional therapies have fallen short. This approach is referred to as psychedelic-assisted therapy (PAT), and represents a paradigm shift in mental health treatment — could it be the right fit for you?
PAT in mental health treatment: How does it work?
There are multiple mechanisms that contribute to psychedelics’ effectiveness as a mental health treatment. First is the neurobiological. Psychedelics primarily act on serotonin receptors in the brain, disrupting neural networks and allowing new connections to form. This process increases brain network connectivity, allowing communication between regions that typically operate independently, while simultaneously disrupting the part of the brain associated with rumination. Overall, this contributes to improved neuroplasticity of the brain which meaningfully improves the ability for behavioral change and learning.
Then there are the psychological effects of psychedelics. The mind-altering capabilities are characterized by feelings of unity, transcendence, and increased self-compassion and acceptance. The result is an increased psychological flexibility conducive to seeing new perspectives on longstanding problems, and reduced defensive mechanisms, allowing for open and authentic engagement.
Psychedelic-assisted therapy for mental health use cases
The studies that paved the way for PAT in mental health treatment focused on use of psychedelics in treating post-traumatic stress disorder (PTSD) and depression. Since then, however, psychedelics have been found to be effective as off-label treatments for a number of mental health conditions.
Illness Anxiety
For patients facing terminal illnesses such as cancer, psychedelic-assisted therapy has demonstrated effectiveness in reducing anxiety, depression, and existential distress. Psychedelics’ effects on serotonin receptors increases mental flexibility that effectively “relaxes” a person’s thoughts and beliefs.
Depression
Multiple studies have demonstrated psilocybin’s efficacy in treating major depressive disorder, particularly in treatment-resistant cases. Research indicates that psilocybin therapy can produce rapid and sustained reductions in depressive symptoms after just one or two administrations, with benefits lasting for months. These outcomes are particularly remarkable considering that the interventions typically involve only 1-3 psychedelic sessions, compared to daily medication regimens required by conventional antidepressants.
Post-Traumatic Stress Disorder (PTSD)
MDMA-assisted therapy has shown particularly promising results for PTSD, a condition that affects millions worldwide and has proven difficult to treat effectively with existing approaches.
Substance Use Disorders
Both psilocybin and LSD have shown promise in treating substance use disorders, including alcohol and tobacco dependence. Studies indicate that these compounds may help disrupt addictive patterns by promoting insights into behavior, enhancing motivation for change, and facilitating emotional processing related to substance use.
What to expect from Psychedelic-Assisted Therapy
Psychedelic-assisted therapy in mental health rehabilitation centers follows a structured protocol that typically consists of three essential phases.
- Preparation phase
Before administering any psychedelic substance, patients undergo thorough preparation to establish therapeutic rapport, set intentions, and address questions or concerns. This typically involves a comprehensive medical and psychological screening, education about what to expect from the experience, agreeing on goals for the treatment, and the setting of safety parameters.
The preparation phase usually consists of 2-3 sessions over several weeks, to allow time for the patient to build trust and prepare psychologically for the psychedelic experience.
- Using the psychedelics
Sessions typically last between 6-8 hours, depending on the substance and the dosage. Patients are monitored closely and usually accompanied by 1-2 trained therapists will be present during the session. Their primary function is to provide support throughout the experience and continuously monitor the patient’s vital signs and psychological state.
Equally important as the actual facilitation is the setting in which the psychedelic session occurs. Such spaces are carefully designed to be therapeutic environments that promote safety, comfort, and introspection. These spaces are very intentionally designed, often with comfortable furnishings, calming art, and minimal distractions. Eye shades and headphones with curated music playlists to facilitate an inward journey.
- Integration phase
Within the first 24 hours of a guided psychedelic therapy session, patients have an initial integration session with their therapist to process and extract insights from the experience. Together, the patient and provider will continue to meet over the following weeks to explore the symbolic and emotional content of their experience. The goal is to use this information to develop strategies to incorporate these insights into daily life.
Is psychedelic-assisted treatment legal?
Despite a decades-long history of being criminalized in the United States, the U.S. The Food and Drug Administration (FDA) has allowed several groups to continue research into psychedelics as potential mental health treatment with psilocybin and MDMA (the compound found in magic mushrooms and ecstasy, respectively) earning a breakthrough therapy designation.
Although psychedelics are still a controlled substance, today numerous practices like ketamine have already begun incorporating the power of psychedelics for treating mental illness. Talk to a mental health professional today to learn if you’d be a good candidate for psychedelic-assisted treatment.