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Psychedelics could heal brain cells in people suffering from depression: study (independent.co.uk)
367 points by pmoriarty 39 days ago | hide | past | web | favorite | 231 comments



Lately, all this media attention to psychedelics reminds me of this Terence McKenna quote:

"[W]hy this[psychedelics] is not four-inch headlines on every newspaper on the planet I cannot understand because I don’t know what news you were waiting for, but this is the news that I was waiting for. It’s an incredible challenge to human understanding to try and make sense of this."

from https://www.asktmk.com/talks/Rap+Dancing+Into+the+Third+Mill...

https://youtu.be/adDRsqEj4PU?t=1641


"[W]hy this[psychedelics] is not four-inch headlines on every newspaper on the planet"

Psychedelics might reveal to you that the neat little reality that you thought you had all figured out is a lot stranger and different from from what you thought it was, that your understanding of it might be all wrong, and that your place in it might not be all that cozy and secure. The experience could put everything in to question for you.

A lot of people feel threatened by that, so they try to push it away, lock it up, turn it off, or dismiss it.

Contrast that reaction to that in some other societies with a long tradition of psychedelic use. Psychedelic experiences there usually confirm the world view of the society, and tend to be very positive and accepted.


Another Terence McKenna quote I'm reminded of!

"The British enzymologist, J. B. S. Haldane in the 1920s, in an essay, said, "The universe may not only be stranger than we suppose; it may be stranger than we can suppose," and I suggest to you that as we look back over human history, every pinnacle of civilizationf whether it be Mayan or Greco-Roman or Song dynasty, has believed that it was in possession of an accurate description of the cosmos and of man's relationship to it. This seems to go- this seems to go along with the full flowering of a civilization. But, from the point of view of our present civilization, we regard all those conceptions as, at worst quaint, at best half right, and congratulate ourselves that our civilization, at last, has its finger on the real description of what is going on. " from https://www.asktmk.com/talks/Psychedelic+Society?query=stran...


Eh, I'm not saying we have a full picture of what's going on, but the scientific method is much more effective at helping us arrive at a real description of what is going on than any arbitrary religion of the past.


The scientific method is the most important tool that humanity has ever developed, without question.

That being said, the belief that the scientific method can build up arbitrarily accurate models of any observable phenomena is without foundation, yet some behave as if it is obviously true.

Until we have something like a unified model of physics, there is no reason to believe that statement to be true.

(and in fact, the scientific method has led to results like Gödel’s incompleteness theorem, which makes it perhaps more likely for it to be false)


I question that the scientific method is the most important tool humanity has ever developed.

Maybe numbers and language (especially written) are more important. Oh ya, and fire.

But the scientific method is way up there in important, no argument there.


Mmm. I don't disagree, but I do think it's possible to overstate these things too. The scientific method is extremely effective at getting scientific answers to scientific questions.

Often though, we try to (or pretend we are applying this method to achieve unscientific questions (a la Karl Popper's criticisms of Scientism) or try to add up scientific answers in an unscientific way.

When we do that, we are using the (well earned and underappreciated) cultural authority of science in ways that do not promote truth seeking.


So we believe, for now.


Asimov wrote an essay to counter that point: https://chem.tufts.edu/answersinscience/relativityofwrong.ht...


None of the earlier ones had lasers though.


> A lot of people feel threatened by that, so they try to push it away, lock it up, turn it off, or dismiss it.

You hit the nail right on the head.

It reminds me about how we want and need security, particularly around our beliefs. What I think is true in that regard is what Adyashanti, a spiritual teacher, once noted: "The magical part is that the more you let go, the better it feels. The more you step into insecurity, the more you notice how secure and safe it is. Where you just stepped out of was unsafe. Everyone is so miserable because they seek security in things that are limited and always moving and changing unpredictably."


I've always felt that this philosophy, and others like it, ultimately boil down to "you're going to lose no matter what, so try not to care about the game."


That's really not it at all. Have you heard the story "who knows what's good or bad"?

Something happens, and we judge it good and feel good about it. Then something else happens, and we judge it bad and feel bad about it. And so on. Our feelings are put on a roller coaster according to our judgements. But we don't have enough information to judge anything good or bad. It always remains to be seen. Deeply internalizing this results in equanimity.


There are plenty of things that are pretty unequivocally good or bad. When we anticipate one of these things happening, our emotions change accordingly and this helps to guide our actions in avoiding or encouraging the thing in question. That's what emotions are for. If you have any control over the course of events that affect you, you should experience an emotional response. Anything else just seems like learned helplessness.


> There are plenty of things that are pretty unequivocally good or bad.

Could you name one? For maximum utility in this conversation, can you pick something likely to happen more than once in an ordinary life, some common case?


I am not the GP but I will give it a try. Unequivocally bad:

Death of a loved one.

Unequivocally good:

Birth of a child.

Most people tend to experience these things more than once in a normal life. They represent a reality more real and more final than even psychedelics could manage: life and death. Impermanence.


> Unequivocally bad: Death of a loved one.

Imagine how it would be if we didn't die. So is death good or bad?

I have a family friend whose first wife died of cancer. After mourning for years, he found another woman and married her. Unlike his first wife, she was insistent on having a baby. When their baby was born, he told us that, having held his child in his arms, he understood now that it would have been a huge mistake not to have had a child as he originally planned with his first wife. So was the death of his loved one good or bad?

> Unequivocally good: Birth of a child.

My sister was born and it must have been a very happy event. When she died it was very hard for my parents. Was her birth good or bad?

This is what the story is getting at. It doesn't make sense to assign good or bad to things. We don't have enough information yet. And we never do. It perpetually remains to be seen.

It's not apathy or learned powerlessness to accept the fact of reality that you just don't know enough to say whether something is good or bad. It's wisdom.


You're being obtuse. If losing a loved one before their time isn't "bad" then your definition of the word "bad" is useless, or at least irrelevant to our current discussion.


What is "their time"? Do you know the correct time for each person to die?


It's closer to 'try not to be attached to specific outcomes'. It's fine to play the game, as long as you don't get so hung up on trying to 'win' that you can't enjoy your life along the way. It's highly unlikely that you'll get to a point where you think that now you've won and can just enjoy, so focusing too much on the game means you will eventually lose - you're not going to live forever. The 'wins' are happening along the way, and if you look, you'll find many of them at times when you're 'losing'.


Unfortunately, certain psychedelics have the effect of imbuing everything with significance, which results in apparently "earth shattering" revelations during an experience which later turn out to be dross. Unfortunately in some cases people carry on believing the dross.

It's like hearing a song or a joke in a dream which seems really beautiful or funny, and turns out to be utterly dull when you wake up and replay it.

So sure, altered perceptions give the lie to some of our assumptions about the world, and can lead to some interesting insights, but they also add a lot of new assumptions which are not healthy, and certainly aren't adapted to functional life in the non-psychedelic world.


I'd agree that it does make everything seem significant, at least for a period, but it's what comes after that has significance, after a period of integration. It creates an ability or a moment to come at a problem from a new angle, previously closed off to a person due to their established thinking patterns and past experiences. I think the important thing to consider here is that if a person goes into these experiences with a goal, it's likely they will gain new insight on that goal, at least from my experiences.

Curious though, what kind of new assumptions do you consider unhealthy?


I'd say persistent relations between unrelated ideas, magical thinking and schizotypal behaviour. Also potentially, fixation on "new perspectives" which might not actually be optimal.

That said, I largely agree with your perspective as well: "The opposite is also true".


> Psychedelics might reveal to you that the neat little reality that you thought you had all figured out is a lot stranger and different from from what you thought it was, that your understanding of it might be all wrong, and that your place in it might not be all that cozy and secure.

Distorting perception doesn't reveal truth, it simply allows you to experience something "other" than reality. It's not that this is bad, but I don't accept that it offers enlightenment or wisdom.


I'd argue that it allows you to experience a _different_ reality, which, when juxtaposed against the collectively agreed upon reality we all live in, offers insights. Though I'd be skeptical of anyone claiming enlightenment, I do believe some wisdom is possible, if not just very useful insight.


I'd need some argument for it being a different reality.

Brain in a jar/The matrix style VR perception altering technology could make me experience a different world - but it wouldn't be reality. I actually could still see this resulting in wisdom under certain circumstances, so I guess I have to cede that actually :)


> "Psychedelics might reveal to you that the neat little reality that you thought you had all figured out is a lot stranger and different from from what you thought it was"

Or for people that are severely depressed, that your broken reality and thought loops that are deeply ingrained can actually be healed without a major neuronal shift.


Psychedelics punch through the big illusion, as in maya. They give the game away. I feel people are subconsciously and collectively terrified of this.


The sudden lift of mood engendered by drugs should imprint the idea that "the depressive cycle can be easily dismissed and is not useful in anyway" when as you unwind, recalling that experience is a key to permanently removing negative cycles without drugs.


I completely agree. Once you know that you can break free from a mental pattern, the trick to getting yourself out of it in the future seems easier. Once shown, you learn.


Is it at all possible to explain this to a sober person? One who is neither consciously nor subconsciously afraid of having the illusion removed?


It's no more possible to do that than for a schizophrenic to explain his delusion.

The difference between a psychedelic experience and mental delusion is that the former brings a newly found perspective on and (knowingly or unknowingly) appreciation for the "big illusion". The latter usually reflects a degenerative condition and the delusion may never end.

Both no doubt lead to fascinating experiences but they're intrinsically non-sense. There are tantalizing connections to be made that are _just_ out of grasp, and always will be.

As a child I once had a fever so high that Lego blocks began to fall from the ceiling and stack up around my bed. I ran out of the room before I could be crushed. Also as I child I learned how to lucid dream; only marginally less non-sensical, though at least there's the interplay between conscious thinking and the dream world. I've also befriend a few far-gone schizophrenics over the years; quite fascinating but, again, it's pointless to try to unpack the delusion. For me these personal and recounted experiences _reinforce_ my appreciation for the "big illusion".

What bothers me about people who promote psychedelics is that they ignore the utter fragility of the human mind. Most people will come back from their experience but in others it can instigate or hasten mental decline (e.g. schizophrenia, psychological dependency). That may or may not have happened regardless, but if you want to promote self-knowledge, IMO the most important thing to _know_ is how precious and fragile the "big illusion" is, and maybe lead with that.

It's sort of like promoting fasting by exclaiming that hunger is awesome. I don't think starving people think hunger is awesome. Fasting isn't a way to learn that hunger is an illusion; it's a way to appreciate what you have and your relationship to it. (I've also experimented with fasting.)

I've never taken psychedelics and wouldn't do it recreationally because, frankly, I'm too scared. And it's unnecessary. More power to people who do but it'd be nice if they were less flippant about it.


> What bothers me about people who promote psychedelics is that they ignore the utter fragility of the human mind. Most people will come back from their experience but in others it can instigate or hasten mental decline (e.g. schizophrenia, psychological dependency).

I am apparently very sensitive to THC, because under what seem like mild doses to most people, I feel like I have lost my grip on reality in a deeply uncomfortable way. I have never tried more serious psychedelics due to fear for my safety and sanity.

I suspect many people have experiences that feel much more manageable. But I agree with your skepticism about the maximalist viewpoint.


Psychedelics produce their effects by modulating certain receptors in the brain and body so as to alter perception until they are broken down through metabolism.

We don’t yet fully understand exactly how these alterations work objectively. But they do suggest that our subjective constructions of reality are just that: constructions.

So the only illusion to lose is the entire nature of reality: in some sense there is more than one “reality”, as far as your brain is concerned.

I think this is the sober, science backed version of this notion and I think it is profound.


Sure. And it's also possible to explain to a homebody who is not afraid of traveling what another country is like, but nothing can replace going there first hand and experiencing life in that place.


Do not fall for the romantic tales of psychonauts to reach some kind of enlightenment. All these people suffer from psychosis.

The human experience of the world (thoughts, vision, audition, pleasure, fear,...) is triggered by the nervous system (including the brain) that reacts on bio-chemistry.

Changing the bio-chemistry changes the human experience but gives no super powers. Most likely your thoughts on drugs are less smart but appear smart to you. Similar to other drug intoxications that disturb the normal brain activity and the sober judgement of your thoughts and experience of reality.

Granted, some people have been able to solve some of their problems with psychedelics because they are strong destabilizers.

https://www.rollingstone.com/culture/features/how-doctors-tr...

I am in favor of using psychedelics as last resort medicine under supervision of a medical expert.

But I am against the promotions of psychedelics by people who are either lucky (no bad life changing effects for months or years because of drug induced trauma with PTSD or bad neuroplasticity) or suffer already from psychosis.


"Do not fall for the romantic tales of psychonauts to reach some kind of enlightenment. All these people suffer from psychosis."

Nothing like a blanket statement in your first sentence to immediately discredit your argument.

"All black people... All psychonauts... All Americans..." When you look at it yourself... doesn't it sound stupid to try to argue this way?

There are now hundreds of studies showing numerous benefits to psychedelics, from anxiety, depression, OCD, anxiety, Autism, etc.

What more evidence and data do you need?


> "Nothing like a blanket statement in your first sentence to immediately discredit your argument."

My opinion is as valid as the opinion of psychonauts. Maybe more so because I do not rave about great insights about the universe or gods or aliens or chakra or kundalini or third eye or old souls; New Age stuff whose proponents are famous for the promotion of altered states (!) by meditation or yoga or drugs.

> "There are now hundreds of studies showing numerous benefits to psychedelics, from anxiety, depression, OCD, anxiety, Autism, etc.

> What more evidence and data do you need?"

All noteworthy (positive) studies are published by medical experts.

All medical experts warn against the casual use of psychedelics. They all promote a therapy that might include psychedelics under supervision of a medical expert.

Only people who suffer from psychosis defend their delusions as real and important.

http://slatestarcodex.com/2016/04/28/why-were-early-psychede...

http://www.taraspringett.com/kundalini/kundalini-psychosis/

https://www.livescience.com/16287-mushrooms-alter-personalit...

https://www.rollingstone.com/culture/features/how-doctors-tr...

What more evidence and data do you need?


No chakras, gods or old souls are needed for you to agree to the statement that some aspects of reality are constructed by the human mind (cf. Kant). It explains, for instance, why you perceive what you're sitting on right now as a "chair" rather than the mere collection of atoms and molecules that it's actually made of. Nature outside of the mind has no concept of an object, and no concept of a subject. Acid may help one see reality that way, if one is curious and mentally stable enough to want to.

Disclaimer: NOT intended to be a substitute for professional medical advice, diagnosis, or treatment


You have no idea what you're talking about. The thing that makes psychedelics so good at curing depression is that they are able to consistently induce a new perspective in people that is much healthier than the one that results from all our modern "knowledge." It has nothing to do with random destabilization at all.


It is possible to explain this on a few different levels. Though obviously it will make more sense when you actually experience it.

For example, if you imagine the brain as a big Bayesian classifier, which is filtering and shaping the inputs through the prior "knowledge", then the psychedelics block the prior and let you experience the inputs in a different way from your sober, usual, daily experience. Now they don't completely block all the priors all the time, so you can consciously understand what's happening. Also, "inputs" don't come exclusively from the external world, they can be your thoughts, memories and so on. And without the priors blocking and shaping them, they re-surface (which is the basis of the name psychedelia) and show themselves in a new light. So you can process them again, in a better way, for example.


Well they should be. Lovecraft was right, human minds aren't well equipped to handle the true nature of the universe.


I recommend reading "How to Change Your Mind" by Michael Pollan if you're all interested in the history and details of psychedelics. https://www.goodreads.com/book/show/36613747-how-to-change-y...

Based my reading of that, what these researchers are doing is not prescribing psychedelics to patients with mental disorders and giving the whole "take one time a day with food". What these researchers are finding is that the drugs can be very effective in a therapeutic setting with a guide (trained therapist or otherwise) to coach and conform the experience to reach a goal. In other words to those familiar with these drugs, set and setting. That is, mindset and surroundings are at least as important as the drug itself to achieving anything. Without that, it's just a drug experience. This is very unique compared to the drugs we're used to.

No medication will ever be a miracle drug, and most drugs show a significant decline in effectiveness once they're out of small trials and methods have standardized. However, any drug or therapy that sees orders of magnitude of improvement over existing drugs and therapies is promising and not worth dismissing simply because of a moral panic from the 60s or the Puritan ideals of our Western culture. Given time and the leeway to experiment, hopefully we will find uses for this class of drugs that have gone shunned for decades for no reason other than someone's moral qualms.


The trouble is that talk therapy is already too expensive for most patients, and unless you plan to have people tripping with a therapist who is a complete stranger (not advised!) you're going to need to charge for some preliminary sessions. If a typical therapist charges $100 per hour -- and that's optimistic, in fact I've never paid less than $125 -- then the cost of treatment quickly runs into four figures.

That's already more expensive than a year on SSRIs, as crazy as that might sound. Human interaction is shockingly expensive.


The cost is something to consider, but let that not dissuade us from exploring the opportunity. There are many therapies that are covered by insurance due to their medical backing. Insurance companies would rather pay for life-saving procedures that are hundreds of dollars rather than trauma, end of life care, or life insurance payouts. The evidence needs to be persuasive, though.


I've always been curious about talk therapy, and as someone who hasn't tried it - or knows someone who has - what would you say are the perceived benefits?

How does it compare to an intelligent friend/partner?


"The trouble is that talk therapy is already too expensive for most patients"

Not necessarily. Under some insurance plans under Medi-Cal (the California Medicaid program), you get unlimited therapy (once a week) for free.

I strongly recommend that anyone who qualifies for Medi-Cal (ie. if your income is low enough) investigate this option, if you are looking for therapy. You actually get your own choice of therapists, as long as they accept your insurance plan.

Also, when choosing health insurance plans, make sure to take a look at how much therapy they cover. You might be surprised. Some plans definitely cover much more than others.


It would be much cheaper and much more effective to talk to trees.


Minor correction, the name is Michael Pollan

If you'd like an introduction to his work I'd recommend his post on planting the opium poppy, I really enjoyed it.

https://michaelpollan.com/articles-archive/opium-made-easy/


For further reading, LSD: My problem child by Albert Hofmann is also interesting


What is the effect size of the randomized controlled trial for psychedelic therapy?


I'm not sure (you can look it up as well as anyone), but from what I've heard (again, Pollan's book), controlled, randomized trials are very difficult if not impossible with psychedelics. It's obvious to both the patient and the observer who has received a placebo and who has not. That's part of the problem with studying this class of drugs, what we have considered the gold standard for clinical trials isn't effective here. So do we trust what results we do see or dismiss them because of their nature?

When a small study shows that 80% of smokers stop cold-turkey after a single session and 60% of them are still abstinent a year later (versus 30% for therapy), it's hard to discount the results so long as other trusted methods are used.

Study using psilocybin for smoking cessation: https://www.ncbi.nlm.nih.gov/pubmed/27441452 Study using CBT for smoking cessation: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4119230/


>Study using psilocybin for smoking cessation: https://www.ncbi.nlm.nih.gov/pubmed/27441452

N = 15. I understand that there are a lot of regulatory obstacles to performing large-scale clinical trials into psychedelics, but the overall quality of the research so far is indifferent. A great number of ineffective and mediocre interventions have been made to look miraculous by a handful of small open-label trials. The homeopathy community has produced a mountain of similar trials.

Psychedelics do indeed look promising and have a plausible mechanism for providing very large effect sizes, but it really is too early to draw any firm conclusions. The authors have registered a larger comparative efficacy trial, so I look forward to seeing their results if and when they are published.


> N = 15

Can you even judge the sample size separate from effect size?

If 15 out of 15 people register an improvement it's a lot more meaningful than 3 out of a 100 sample, despite the much larger sample size in the latter case.


Those are pilot studies.

There is one psilocybin study by Compass Pathways starting this year in 8 EU countries with I think about 800 participants which if successful will pave the way for legal use of psilocybin therapy of depression. MAPS is doing another one for MDMA for PTSD, that's FDA Phase 3 in 14 international sites.


So, precisely the wrong approach would be to block research of any kind by continuing the severe prohibition of these substances.


Perhaps we need a new category of prescription, e.g. "for use only under direct supervision of a qualified medical professional"

In other words it could be dispensed in a clinical setting, but not via a pharmacy or other "take home" pathways.

I'm thinking that must already exists for certain surgical anesthetics, etc.


Such a medical-use-only approach towards legal psychedelic use is indeed what we're moving towards. However, this approach is a controversial one in the psychedelic community.

There is a cognitive liberty argument to be made for the use of psychedelics (and all other drugs), namely that one should be free to alter one's consciousness as one sees fit, for whatever reasons one sees fit, without restriction.

Medical use is one legitimate use, but use as a sacrament for religious purposes is another, and so is use just for personal enjoyment.

Most people don't generally object to someone drinking alcohol for personal enjoyment (or using it as a religious sacrament, for that matter). One does not have to justify one's use of alcohol to anyone, one does not need to have a doctor's permission to use it, nor does one have to take it in a clinical setting. Despite the consequences of alcohol abuse arguably being much worse than psychedelic abuse, no one is seriously considering placing these kinds of restrictions on it.

It's true that too many people use psychedelics in frivolous, even destructive ways, and suffer negative consequences as a result. But I'm not sure if the best solution is to limit them to use under a doctor's supervision, as it narrows the potential of psychedelics and directs the narrative towards a medicalizing one: that the only legitimate use of drugs is medical. I'm not sure that's true. Drugs could be positively used towards for creative purposes, for enhancing love, for appreciating nature or one's own life, to enhance one's connection with others, independently of therapy.

I'm not sure if everyone's ready for that... we certainly need a lot more education on how to use drugs constructively rather than destructively. But if prohibition has taught us anything it's that people that want to will use drugs regardless of any artificial restrictions put on by the state. So perhaps the most constructive way forward is towards full legalization plug increased education and the offer of help for those that need it.


> I'm thinking that must already exists for certain surgical anesthetics, etc.

Correct. You can get cocaine when you're at your ophthalmologist, but not from your pharmacy.


For that matter, heroin is used as a morphine alternative in some UK hospitals, and morphine itself is another example.


Loosening the restrictions on the DEA Diversion program would accomplish this - there is a set quota of how much of each scheduled substance can be used for research each year.

Unfortunately, this is likely politically challenging as the DEA has a strong self-interest incentive to make drug laws as restrictive as possible, so they can get more funding and successfully prosecute more people.


I agree that experienced guides are important for high doses, but microdosing is safe for DIY.


And note that a microdose is like 5ug, not 25ug. Just to state the obvious. (100ug being a standard strong tab)



I would have serious concerns that if a law/rule was made that allowed this, it would require the subject to take these tests in a sterile lab type environment. I could not imagine having a psychedelic experience in a lab/hospital/etc. That would absolutely freak me out. I would want to be outdoors in nature preferably.


That’s how I’m able to get Botox injections for my migraines. There’s a thorough process in place for in office treatments already across many fields of medicine. This would be no different and plenty of money. I doubt Botox costs 1500 to manufacture a dose.


Yes - the FDA is (surprisingly?) receptive and psilocybin (among others) could be approved in the next few years, maybe up to a decade depending on results. https://www.nature.com/news/psychedelic-compound-in-ecstasy-...


The headline of the article is "Psychedelics could heal brain cells in people suffering from depression: study" So it appears that research into psychadelics is not blocked! The substances in question are classified as research chemicals meaning that scientists are indeed allowed to perform research on them.


That is precisely correct. The current framework has already destroyed countless lives, targeted minority populations disproportionately, and enriched drug companies peddling opiates (which are much much worse than recreational marijuana).


I recommend reading the LSD Clincial Handbook:

https://www.maps.org/resources/responding_to_difficult_psych...

LSD changed my life, and continues to do so.

If you live in California, check out MAPS and Psychedelic Seminars.

I’m a huge advocate because I have experienced first hand the profound transformation that occurs as a result of a psychedelic experience.


Not to negate this anecdote, but just to point out your mileage may vary. The research on this subject is still in its infancy.

I know a lot of people are looking for that "magic-bullet" panacea for all their small woes (social anxiety, minor depression, etc) and have tried everything under the sun (exercise, all kinds of diets, all kinds of books). It's been my experience with the people I knew personally who did acid/psylocibin didn't always improve as much by my measure as they did by self-report.


I hear ya. My anecdote is unique. If I provided more context, and told you my life story, it might make better sense. And it’s impossible to assign responsibility solely to psychedelics, but after years of hospitalizations and addictions and depression and suicidal attempts and witnessing a few friends suicides, there was a turning point in my life, and it conincided with my experimentation of LSD and mushrooms, something I only put together years later in hindsight.

I think the psychedelics nurture the ability to recognize that feelings and narratives are not representative of reality, that there are multiple realities bound up in which perspective you possess, or which one possesses you.

The ability to detach from self, to recognize a spectrum of truth, of perception, is one of the greatest benefits of psychedelic experiences.

I’ve used LSD for years off and on, and I can’t tell you how many times I’ve taken it. So many I lost count long ago. It’s a beautiful experience, and it helps me and everyone I share it with to this day.

I have friends who remark what a profound life changing experience it was for them years after our trip together, and it always catches me off guard. You never know how profound it affects a person. Sometimes it takes years to recognize the shift that took place.

Either way, I think there is so much promise. I’m a huge advocate, and I think people who struggle with mental health issues should definitely explore psychedelics (I would caution those with schizoid tendencies/ family histories). Anyone with anxiety, depression, addictions, compulsive thoughts... there is much promise there.


>I think the psychedelics nurture the ability to recognize that feelings and narratives are not representative of reality

>The ability to detach from self, to recognize a spectrum of truth, of perception

It sounds a lot like meditation and buddhist practice. I mean, I already hear that everywhere and there are some clinical trials with meditation too. But your narrative fits nicely. That's cool.


Yes. In his book Waking Up, Sam Harris (yes, that Sam Harris), makes this same connection. He does it in a very sensitive way too, without suggesting psychedelics as a shortcut to mindfulness.

Edit: I've never experienced psychedelics myself, but have had been using mindfulness/meditation to come to terms with these same ideas.


Research has been conducted since 1950 (With a gap period of a few decades). It's pretty clear it works effectively, there are several meta analysis' done on modern and historical studies.

I agree that many normal things help even simpler, such as good sleep, exercise, good diet, meaning work, connection to community/society/family, etc.

You are absolutely correct that there is no panacea.


I could see this seriously being a net positive in the care of people say dying from cancer, depression from paralysis etc. Not all of us can lift weights or simply go for a walk, but our minds yearn to be free.


This is already being done. In Switzerland.

Summary: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4086777/

The MD's website [in german]: http://www.petergasser.ch/


I've had great experiences with LSD, experiences that may have even changed my trajectory in life.

That being said I would never recommend LSD to someone undergoing serious mental health issues. IMO not safe at all, you can really end up in a bad place.


A clinical setting is far different than giving someone some tabs and letting them loose at a concert or house party.


A clinic, concert, or house party are all terrible settings for taking LSD. They are confined, crowded spaces. You want something wide open, in nature. Try the mountains, or the desert.


Well, just don't get lost. I've taken LSD hundreds of times and the worst was undoubtedly in nature (it was my fault, but I'm sure I'm not the first to make this mistake). I've done it plenty of times at house parties and it's been fine. My objection to a "clinical setting" is being alone with someone you don't know that well, and like you said, being confined and expected / forced to stay with that person.


> A clinic, concert, or house party are all terrible settings for taking LSD.

That's certainly the main reason for "bad trips". People just don't bother to read up on everything properly before the trip. So they do stupid things. And then it's the substance's fault.


My definition of clinical setting certainly includes nature, though I don't think that's required. The important part is professionals that first screen people (weed out people deemed to be high risk for bad episodes) and guides the process. A captain to steer the boat if you will.


A clinical setting sounds like a total nightmare when using psychedelics.


I'm not talking about a sterile windowless room with bright lights and various people walking in and out telling you to do things. More like a therapy setup, similar to how they're experimenting with MDMA. Someone who knows what they are doing guiding things, helping you explore your mind.

LSD is probably not the best drug for this simply because it lasts for so long, but guided trips using psilocybin are definitely doable (and currently happen).


"I'm not talking about a sterile windowless room with bright lights and various people walking in and out telling you to do things. More like a therapy setup, similar to how they're experimenting with MDMA. Someone who knows what they are doing guiding things, helping you explore your mind."

Indeed. I highly recommend reading "The Secret Chief Revealed"[1], about Leo Zeff, a pioneering psychedelic therapist. His "clinic" was not a hospital with whitewashed walls, but more like a cozy apartment (it might have even been his apartment.. I don't have the book on hand myself right now). Here's an excerpt from the book that I wrote down. It doesn't talk about the setting much, but reveals some of his approach:

"Zeff did not like to refer to psychedelics as "drugs" rather "medicine". It could be used properly or improperly, just as morphine or antibiotics. Working as a Jungian therapist Zeff believed he was there to basically assist his clients in finding their own solutions, more of less waiting it out. With LSD the solutions came much quicker, often with a single trip. In therapeutic use of LSD Zeff had his clients agree to a basic set of rules: 1. they would not leave the house or place where the trip was taking place without his permission, 2. they agreed that there would be no physical harm or violence to them, him or anyplace they were, 3. reiterate the security agreement - they must agree that they will never reveal to anybody else where and with whom they had the experience without his prior approval, 4. there would be no sex during the experience, 5. the client had to agree to follow Zeffs directions no matter what, the client had to agree to follow his commands without question and have faith in him. Prior to taking the medicine they would then read a prayer aloud. The clients were asked to bring in photographs of family and important people and places in their lives as well as personal articles which would stimulate a therapeutic conversation which would take place prior to the effects of the medicine. Once the medicine took effect the client would lie down, put a cover over their eyes and headphones on so that they could listen to music.

"Music was played the entire time during the experience. Zeff believed this to be very important. This is one area in which I wish the conversation/text had delved deeper. The music which was considered so important is barely discussed other than to say that it was always on. It is mentioned that the music would very based upon the clients tastes, the impression I get is that classical or jazz were the main genres."

Here is the beginning of a much more recent account of psychedelic therapy (I encourage reading the full article[2], as it is excellent), the methodology of which is clearly influenced either by Zeff or other early psychedelic therapy pioneers:

"When Mettes arrived at the treatment room, at First Avenue and Twenty-fifth Street, Tony Bossis and Krystallia Kalliontzi, his guides, greeted him, reviewed the day’s plan, and, at 9 A.M., presented him with a small chalice containing the pill. None of them knew whether it contained psilocybin or the placebo. Asked to state his intention, Mettes said that he wanted to learn to cope better with the anxiety and the fear that he felt about his cancer. As the researchers had suggested, he’d brought a few photographs along--of Lisa and him on their wedding day, and of their dog, Arlo--and placed them around the room.

"At nine-thirty, Mettes lay down on the couch, put on the headphones and eye mask, and fell silent."

[1] - https://www.amazon.com/Secret-Chief-Revealed-Myron-Stolaroff...

[2] - https://www.newyorker.com/magazine/2015/02/09/trip-treatment


I read another article recently (posted on here I think) saying that most of the clinical protocols are borrowed from the rituals and advice of underground new age healer types. These people likely have the most experience in avoiding a bad time.


Doubtful, most clinical practices are very unaware of how their setups affect the results. They understand “set and setting” intellectually, but not viscerally. So they act surprised when patients dosed DMT in a hospital experience contact with bizarre alien entities that coincidentally resemble hospital workers. (See nick sand’s critque of strassman’s DMT study as one example)


Check our Michael Pollen's new book, How to Change Your Mind: What the New Science of Psychedelics Teaches Us About Consciousness, Dying, Addiction, Depression, and Transcendence, if you're interested in getting a stronger historical context of the use of these drugs in all sorts of settings.


Psychedelics show promise for some mental health conditions (like depression and addiction), but no one would advocate giving a bunch of LSD to someone teetering on the edge of schizophrenia... It's about focusing on the right diseases that are safe to treat with these drugs. Plus, trials would be done under controlled conditions by professionals. That seems the safest possible environment for having a psychedelic experience.


I have to disagree with you here. Psychedelics help people - the idea that they should only be taken by individuals who are in a 'good' place is missing so much of the point IMO. I began experimenting with psychedelics during the darkest period of my life and it was absolutely the right decision. Yes, there are things that can go wrong - even to a 'healthy' mind. To those out there in all-encompassing pain and darkness - don't think that a trip will necessarily amplify your current mental state - I argue that psychs are a ladder to help you climb out of whatever hole has you trapped. FWIW I believe marijuana has a higher risk of throwing someone into nasty thought loops than psychedelics.


I would actually advise against anyone undergoing moderate mental health issues to avoid LSD, psilocybin and especially DMT (in fact, DMT should only be tackled by people with considerable experience with psychedelics and ONLY when it a good mental space, even then it can easily be a terrible and jarring experience).

Instead I'd probably nudge them towards MDMA perhaps under proper medical treatment until they can work through their issues and actually get to the underlying problem (if it is in fact something that therapy can work through and not some chemical imbalance that needs treated by chemical means).


On top of the clinical supervision mentioned in the other comment, therapeutic dosage is probably much lower than the ones used to go on a trip (same is true for many other hypothetically abusable medication that is already being prescribed for a whole range of mental illnesses).


I've been reading Michael Pollan's new book on this (How to Change Your Mind - really good read, incidentally) and according to him it's actually the opposite in some of the clinical trials he looked at. In the book he describes clinical settings that involve relatively large doses of psychedelics, primarily psilocybin but also DMT and LSD, because the goal is to induce "ego death" and/or a profound or mystical experience. This tends to correlate with the type of dosage where you are basically not inhabiting your familiar reality/not aware of your body for several hours at a time.

To put that in perspective, I've probably taken psychedelics around a dozen times and only truly achieved something I would call "ego death" once (a truly fascinating and moving experience, but that's for another time!). And a lot of the people I know would take fairly low doses and do things like go to parties or walk around Central Park. By comparison, the clinical amounts Pollan is describing make it virtually impossible to move around or talk in a coherent way, let alone go out into the world.


I am guessing that by "out into the world" you mean primarily into a human-made / urban / artificial built environment with other people in it, as opposed to out into the natural world (i.e. wilderness), which I think many would argue could be the most ideal setting for the types of experiences that you're discussing.


This is why they are studying it


I'm very excited to see the results of this study [1], testing the effects of a one-time dose of psilocybin (magic mushrooms) on a sample size of 400+ suffering from treatment-resistant depression.

The podcast episode referenced in the article is also well-worth listening to. They talk about the current state of the research, the regulatory process, getting funding, etc.

[1] https://boingboing.net/2018/05/23/depression-the-psychedelic...


Highly recommended:

The Psychedelic Explorer's Guide, by Jim Fadiman (http://www.psychedelicexplorersguide.com/)


If you're interesting in taking psychedelics, this is the best book to read beforehand. I seem to remember Neal Goldsmith's Psychedelic Healing book also being good, but it's been too long since I've read it.


This is an excellent book, and I second its recommendation. I'd also recommend The Secret Chief Revealed[1], about Leo Zeff, an early psychedelic therapist.

[1] - https://www.amazon.com/Secret-Chief-Revealed-Myron-Stolaroff...


I’m really worried about the subset of the population with preexisting mental disorders such as manic depressive disorder, schizophrenia, and depression who will suffer a psychotic break from the use of these substances. Maybe I’m wrong, but from what I’ve heard and read it seems like there’s no way to know what will happen until you try it. A certain percentage of the population goes to hell in the most literal sense of the word possible. Anecdotally, the people I personally know who have tried psychedelics (maybe 6 or 7 people, all who did no know one another) seem to have a weird mental frailty to them, where because their ego disappeared(?) briefly and psychedelics were allowing mental connections that wouldn’t have arisen without psychedelics, they begin to question everything, almost like a rebuilding of their fundamental axioms from scratch. There’s also a strange fervor for others to try it, even from people who have had bad trips.

Joe Rogan had Michael Pollan on recently[0], who wrote The Omnivores Dilemma and a new book How To Change Your Mind[1] which talks about the benefits of hallucinogens. They also briefly talk about the psychotic breaks some people will experience as a result of widespread use and shrug it off like it’ll be fine. Aldous Huxley wrote a book about his use of mescaline called Doors of Perception[2] which felt almost unintelligible and very strange to me as a person who has not (and will not, as my mental health is great but I’m certain I’m at risk of a psychotic break from hallucinogens due to family history) done psychedelics.

[0] https://m.youtube.com/watch?v=tz4CrWE_P0g

[1] https://www.amazon.com/Change-Your-Mind-Consciousness-Transc...

[2] https://www.amazon.com/Doors-Perception-Heaven-Hell/dp/00617...


If it helps, here are a couple of things that you might consider:

- you likely know a lot of people who actively or in the past were experimenting with psychedelics, but you don't know that you know them because it is socially taboo and their experiences aren't super relavent to how you are interacting with them

- if you can accept that idea, then you might also consider that given a larger population of people who've tried it with few ill effects your anecdotal sample might not be an accurate representation of the psychedelic experience.

That second point would reconcile the "strange fervor for others to try it, even from people who have had bad trips."

There are indeed plenty of people mental health issues floating around, and while it's true that you may or may not know if these drugs will trigger a larger episode, that kind of life altering aspect of psychedelics not very common in my experience as a person who knows hundreds of people who have worked or played with these substances.

Those ideas are also based in my anecdotal experince, and perhaps it comes from a willingness to question some "fundamental axioms from scratch", but at the same time maybe that's a) not always a bad thing to do from time to time, and b) if your fundamental axioms are good there is no reason that you won't come back to them.


I have permanent visual disturbances and suffered long-term panic attacks and anxiety as a result of psychedelic use. Things got better over time, but not completely back to normal. I'm not advocating for the continuation of our current legal strategy, but I feel like these drugs need to come with strong cultural wisdom about their appropriate use and potential for abuse.

Anyone who's been in a psychedelic community for long(stoners, deadheads, etc) knows at least a few people who have been temporarily(1 day - 1 year) or permanently fried from having experienced one or many trips. I feel like there is often a backlash against our regressive legal approach which tends to accentuate the positives and diminish the negatives but really we need information. These drugs can permanently change your personality in some ways that will generally not be seen as positive. Yes, they can have many good effects but that comes with a small risk of extreme side effects.


Are these people "fried" because they used those substances, or because of how they used them, or how they viewed, integrated (or not-integrated) their experiences?

A visual distortion is a good example. When experiencing a visual distortion, it is possible to feel anxious about the appearance of such a distortion, or instead one could be indifferent to it, or even enjoy and welcome it. It need not be negative.

More research is certainly needed on the negative experiences people sometimes have with psychedelics (so far, most of the research has focused on the positives), but I have a strong feeling that how people approach their experiences, what they expect to happen, and how they interpret what happens plays a very critical role on whether the experience is positive or negative for them. This is the old "set" (or "mindset") part of "set and setting" that's critically important for their constructive use.

Also, it may be possible to work through any anxiety or negative effects one experience with a therapist. Panic attacks and anxiety, for instance, are things that therapists tend to be actually really good at treating.


Visual disturbances affected my ability to read books for years. I am no longer a speed reader thanks to psychedelics. For years after my first big trip, walls breathed and floor tiles became 3d. It is hard to be indifferent to such things.

My set going into the trip was that I was expecting to have a great time with friends. I was young and very positive towards psychedelics. I did not have a 'bad trip'. The effects came later.


Depends on the distortion. A visual distortion means that you aren't seeing things as they really are. That could be problematic for your ability to drive, or to ride a bike, or any number of other activities. You could be indifferent to that, but it could still be a genuine problem for your ability to function.


Even without visual distortions, none of us ever see things as they are :)

As a fun fact, you can drive on LSD if you’re experienced with psychedelics and know you can trust yourself, at least under doses <150ug. Absolutely not recommending it to anyone, but the visuals don’t really get in the way. (I’ve only driven on acid once, when I witnessed a really, really bad skateboarding accident and had to rush a stranger to the ER).

IME most people handle psychs fine, some can handle practically anything, and some will lose connection to reality and basically forget how rational thought works on an eighth of mushrooms. There’s little indicators that have given me an idea of how someone might react, but you never know for sure. Thus why the advice to have a trip sitter is always given - personally I’ve never needed a trip sitter, but I’ve seen people who absolutely did.


"you can drive on LSD if you’re experienced with psychedelics and know you can trust yourself, at least under doses <150ug. ... Absolutely not recommending it to anyone, but the visuals don’t really get in the way."

It's not just the visuals that are the problem. Temporal distortions are common -- you can feel like time has stopped or slowed down or sped up or gone backwards. Also, you might get disoriented or confused -- not understanding where you are or what you're doing or how a steering wheel works while you're on the freeway is probably not the wisest or safest thing to subject yourself or others on the road to. Or you might get irresistibly entranced by a fleck of paint on your dashboard, which could look like a whole animated world to you, while you should be keeping your eyes on the road, etc, etc, etc.

You know how there's a warning not to drive or operate heavy machinery on some medications? Well, that warning should be on psychedelics, only times 1000.


Yes, I experienced being 'fried' for a couple of years after excessive MDMA and LSD use. My experience mirrors yours.


MDMA is neurotoxic though. It's strange if only hallucinogens triggered problems in the other poster. LSD is not as far as I read.


Out of curiosity do you have colorblindness?


Nope(sorry I'm OP but using my home account). I'm nearsighted. I was eventually diagnosed as slightly bipolar(agitated depressed), but that was after my experience with psychedelics. FWIW, I believe the life changing experience was caused by something other than LSD. A friend got tie-dye blotter from the Grateful Dead parking lot around '90. I took two tabs. It lasted around 21 hours, which is odd for LSD. Definite LSD-like effects(time dilation, huge trails, tunnel-vision in the early stages...). It was blotter though, so it limits the number of RCs it could have been.

Also I ended up with essential tremor, ticks, and restless leg syndrome. That runs in my family though. I probably have mutations in my dopamine system.


"I'm really worried"

The first rule of psychedelics: don't worry.

How to not worry? Relax. Keep the body at peace. Be simple. Stay in the heart (stay with how you're feeling, not just with what you're seeing/experiencing). Let go. You cannot lose yourself because you are always yourself. Be grateful for the incredibly valuable experience you're having, even if it's difficult.


> I’m really worried about the subset of the population with preexisting mental disorders such as manic depressive disorder, schizophrenia, and depression who will suffer a psychotic break from the use of these substances.

I honestly don't think we have the capacity to test existing psychiatric medication to the extent that we can provably demonstrate that over the long term, psychiatric medication + negligence (or simply, variance - controlled lab conditions versus real world) in mental health care is not a direct cause (more nicely, a contributory factor) of psychotic breaks for patients.

So yes, it's a risk, but it's not one that doesn't currently exist with what we do now.


>"mental frailty...they begin to question everything"

As opposed to blindly "believe everything"? I would say the ability to question everything is evidence of a strong independent adult mind. The ability to just believe everything you are told isn't really "frail" (which I associate with old age and wisdom), but still weak in a childlike sense.


Over time people build up useful heuristics. There is a difference between questioning authority vs questioning why tuesdays exist and if maybe it's sunday for dogs.


>"questioning why tuesdays exist"

I don't see a problem with this line of questioning. There is lots interesting to consider there. Just some stream of thought:

What does tuesday mean anyway, why do we have weeks, why 7 days per week, what is the exact definition of day, could there be planets without "days", do dogs recognize a weekly cycle, would they if "freerunning" without human companionship, what about wolves who "howl at the moon", does that mean they recognize the lunar cycle, in that case maybe they also mentally divide it up into subsets greater than a day but less than a full month, how could we study wolf behaviour to try to figure this out, why exactly do I feel like there is a difference between sunday and tuesday, just because one is during the weekend or something more, do wild packs of wolves/dogs take regular days off from hunting/etc, what do they do in their free time?


It’s incredibly mentally exhausting and you’ll miss several things that flag you as a comfortable human being in your own existence to others, thereby shortening your ability to function as a socially wholesome creature. (Note: I have an illness on the schizophrenia spectrum that works in a way requiring me to thoroughly examine fundamental aspects of reality. It is utterly exhausting.)


Some questions are purely abstract without any relation to self, personal identity, self image from others, affect on others as well as neither being interpretations of the past or predictions of the future.

I find those types of questions to be relaxing and interesting. As soon as I begin to connect those questions to either, their relation to my own awareness as a social being, that's when they become exhausting. That's because I stop thinking about the question as a pure question, and I begin believing I can know how both I and others think about it, in addition to any other number of details present (of which, not only are there thoughts to be had about how others think of those details, but how all of those thoughts will eventually influence how others think about all the minutia in addition to original thought, and how that will affect how you think eventually, and thinking about all of that - if you choose to, it doesn't end!).

When oneself thinks about how others think, oneself is still thinking about how oneself thinks. Not in the direct way, where oneself knows exactly how another thinks at a precise moment, but the thoughts oneself has about others influence the thoughts oneself has about oneself, eventually, even if you've thought all the thoughts you can besides the thoughts you've worked ridiculously hard to avoid, eventually oneself has to confront all the thoughts that remain, lest they prefer to just chant 'om'.

So gimme all the ridiculous, disconnected from reality problems you have. Because I absolutely loathe having to think about how my thoughts affect my thoughts and how my thoughts affect how others think their thoughts and how their thoughts affect their thoughts in the future and how those thoughts will eventually affect my thoughts. That's exhausting, you can't keep up with it. Even if you are right about how someone else thinks, they can always change how they think, for no reason besides they either know how you think, or they think they know you think they know how they think.

But otherwise. yea, I get that it seems like it can't be avoided. Because people seem to expect some degree of you thinking for them if they think for you, that's socially wholesome, I suppose. It's all absurd to me. Tuesdays.

Tuesdays are weird indeed.


>"I have an illness on the schizophrenia spectrum that works in a way requiring me to thoroughly examine fundamental aspects of reality. It is utterly exhausting."

Being forced to do anything will be exhausting, it is totally different from having the ability to do so if you so choose.


It becomes not optional and is a waste of time. People get stuck questioning everything and become useless piles of flesh. It happened to me for a couple of years after too much LSD.


> why do we have weeks, why 7 days per week

Because it is useful to divide up things into increments. 7 because there are 7 visible celestial bodies visible to the naked eye. Which the names derive from.

> What does tuesday mean anyway

Mars's day

> what is the exact definition of day

A singular rotation of the planet. Also known as a sidereal day. Or more simply put: sun goes up, sun goes down.

> could there be planets without "days"

Yes, these are known as tidally locked. Some planets have long days. Venus has a longer day than year (rotation of planet around parent star)

> I don't see a problem with this line of questioning. There is lots interesting to consider there.

Yes, but answers are also reasonably found. Don't just stop and think, but also seek. That's why we think differently about the person who is like "wow man, what even is Tuesday" and the person that discussed the historical reasoning and mythos that led to the naming of Tuesday and why having a seven day week is so pervasive throughout the world, leading back to ancients looking up at the sky (which was better than what most of us see, considering light pollution). Sometimes things are extraordinary and sometimes they are mundane.

There's a lot of usefulness into relying on historical knowledge. That's why we advanced so far. And by finding the breath of our current understandings you will find new and deeper questions.

Tldr: don't just question, find answers.


>"Yes, but answers are also reasonably found

You just picked the easiest questions and left out the rest...

>"the person that discussed the historical reasoning and mythos that led to the naming of Tuesday and why having a seven day week is so pervasive throughout the world, leading back to ancients looking up at the sky (which was better than what most of us see, considering light pollution)."

You should question this as well. Have you ever considered there was a period where the ancients could not see the stars, moon, or sun due to excess clouds, smoke or dust blocking the view? Perhaps an asteroid hit, or there was a lot of volcanic activity, or whatever.

Imagine if it was always cloudy, perhaps this even lasted for a generation or two so that no one alive had ever seen any of that, then suddenly the sun appears through a break in the clouds. This would explain why the bible claims that light was created before the sun.


> You just picked the easiest questions and left out the rest...

You were just saying you shouldn't directly trust people and I'm saying you should also dig. You asked a lot of questions, I don't have the answer to all of them, but somebody might. And that's why I say dig. Somebody might have already done the work. I for one am not omniscient, don't just counter everyone with "well you don't know everything", it isn't useful and is a non sequitur to the topic at hand. The answers were to illustrate a point, not to provide exactness. And your entire reply missed what I was saying because you were caught up in minutia.

> You should question this as well.

Are you talking about when the asteroid hit or are you suggesting a fictitious example? If the former I suggest looking at a timeline of human evolution and studying more about animal behavior. The latter, yeah thought experiments are fun. Who is saying they aren't? I'm definitely not. I'm not even disagreeing with your main point, I'm expanding on it. I'm literally saying don't just ask a question and stop. Ask a question and search for an answer! And you might like a story called Night by Isaac Asimov. It does discuss what is likely to happen with civilizations capable of communication, mythos (and included exaggeration).

> This would explain why the Bible claims that light was created before the sun.

We're taking about questioning things and you're taking the Bible as directly literal? Maybe you should question that.


Sure, I guess I don't understand why someone would only question without searching out answers... but you should dig, then dig further, then dig some more.

I mean there have been too many times when I learned about a topic (eg historical event) from one source and internalized it, but then another source that focused on different details (not even conflicting details) told an entirely different story.

Regarding the bible passage. I just cannot imagine a mindset that fails to make the connection between the sun and the source of light, so what in the world does that passage mean? Perhaps its just another bad translation (another way to totally change a story).


Clearly it is always Sunday for dogs.


Questioning everything is also child-like. It's more of a normal adult quality to learn what lines of questioning prove fruitful and what do not.


tbh many of the adults i know have no ability to judge which lines of questioning are fruitful or not specifically because they're so "on rails" or "adultlike".

for them a fruitful question is defined as something along the current trajectory. but they never ask if they're on the right trajectory because that wouldn't be something on the current trajectory.

see the issue?


Its not so much questioning everything that is childlike, instead that would be not knowing enough to avoid talking about it with people who don't know or care.


I don't think that's true. Think about the adjectives associated with curiosity and wonder - 'childlike' definitely comes to mind. 'Interest' is an adult word, though - that implies a trajectory and a path, where curiosity and wonder are general.


Clearly you've never experienced a psychotic break....


So you haven't done it, you have no studies to back this idea, but you just assume it's going to be a problem somehow..

So-called "bad trips" can be tremendously beneficial afterwards. They're "bad" because you get into the kind of deep, uncomfortable introspection that most people would want to avoid naturally. You learn things about yourself and the world that you probably wouldn't have wanted to know. That doesn't mean that you're going to go crazy afterwards. A lot of people come out better on the other side.


"So-called "bad trips" can be tremendously beneficial afterwards. They're "bad" because you get into the kind of deep, uncomfortable introspection that most people would want to avoid naturally."

While such uncomfortable introspection could certainly occur in a bad trip, it's far from the only kind of experience that could make a trip bad. You could also find yourself imagining you're in something like a horror movie or in hell, dead, or dying.

Terrence McKenna and Rupert Sheldrake coined the term "necrotogen" (a play on the much more common term "entheogen") for the common effect that psychedelics have of being confronted with death. Such an experience often feels very real, sometimes even "more real than real".

That kind of experience is much more than simply uncomfortable introspection, especially when it's combined with temporal distortions and confusion that is also common in psychedelic experiences -- where one feels like what one experiences takes years, decades, centuries, or millennia, or that one is stuck in a temporal loop of doing the same thing over and over again, or that one can't escape from the distressing situation that one is in, or that one doesn't know who one is or where one is or what is happening or what is real and what isn't.

Are you really dying? Did you just murder someone? Or are you being murdered or threatened in some way? Did someone call the police or ambulance? Are you in jail or being tortured or abducted by aliens or dead and experiencing decomposition, etc.

Despite all that, I fully agree that one could learn a lot from such very negative experiences -- for example, how to cope with them -- and the "bad" trip could wind up being one of the best trips one ever had because of what it revealed to you about yourself and the world.

Also, it's quite common for such a "dark night of the soul" experience and/or ego-death to be followed by an experience of rebirth and of very positive, life-enhancing and life-embracing revelation (incidentally, such psychedelic experiences bear strong similarities to shamanic initiation experiences, where sickness, bodily dissolution, and death prefigure and even legitimize the abilities and status of the shaman). But even without the latter, it could still be very constructive, and one could learn a lot.


Bad trip: Despair. Good trip: Delight.

Aren't these both apart of life?


I am not sure about the percentage affected or what the preconditions have to be, or what other measures to detect them are, but personally I never tried psychedelics recreationaly due to their extremely long duration of effect.

I know there is a good argument about setting, mindset and support being the relevant factors, but the possibility of multiple hour horror trips always made me think again. And again. Which in itself is a huge problem for people who get complications because of that fear.

There are some drugs who work similar to an "allergy test". Salvia divinorum for example has an extremely short duration of effect. A few minutes (<10) in comparison to the same amount of hours. With proper supervision the potential to detect people at danger without lasting complications looks extremely promising to me. Sadly I dont think anyone will care for such safety measures as long as the whole benefit of psychedelic drugs is illegal at the moment.


Everyone who smokes Salvia is at danger. Salvia is the worst.


The general consensus is that this is an extremely small portion of the population, and that psychedelic use is only typically a premature trigger for a preexisting condition rather than a prime cause for these types of mental issues.


Do you have citations for the following?

• extremely small portion

• trigger for a pre-existing condition


I don't. I'm simply restating what seems to be general consensus amongst both users and mental health professionals. Actual data is hard to come by, since actual research has only recently begun to happen.

At this point though, any assertion that psychedelics cause anything more than a very slight increase in the background rates of diseases like schizophrenia would need a serious amount of evidence to back it up. Psychedelic use is common; something like 15—20% of the American population tries them in their life. And the general understanding of diseases like schizophrenia right now involves actual structural changes that simply aren't plausible consequences of infrequent psychedelic use. I won't speak toward long-term, frequent use, but by all the evidence I've personally seen, LSD in particular is extraordinarily safe for the population of people without a family history of schizophrenia.

I'd also like to point out that the original assertion—that psychedelics trigger psychotic breaks—itself doesn't come along with that much in the way of evidence. The original notion came about in the '70s when mental health professionals started seeing a higher proportion of their patents coming in after having tried psychedelics. I'm not sure if hard data was collected (or at least, I haven't been able to find any), but the most straightforward explanation for this is that this likely simply mirrored the increase in the background rate of people using psychedelics. If the background rate went from 1:10 to 2:10, then you'd expect that the number of people coming in with mental health issues will show a doubling in psychedelic usage rates. And in the fifty years since then, I've not seen much additional evidence for a causal link between the two.


> The general consensus is

Your consensus might be general among irresponsible psychonauts that are either lucky or accept psychosis.

http://slatestarcodex.com/2016/04/28/why-were-early-psychede...

The general consensus is to use psychedelics only as part of a therapy under supervision of a medical expert.

https://www.livescience.com/16287-mushrooms-alter-personalit...

> an extremely small portion of the population

https://www.nami.org/Learn-More/Mental-Health-By-the-Numbers

> typically a premature trigger for a preexisting condition

How does this reduce the danger of psychedelics in any way ? It increases the danger because you do not know in advance if the drug will trigger a mental disorder that you do not have yet.

A bad trip triggered by psychedelics might be your first trauma with PTSD.

https://www.reddit.com/r/Drugs/comments/36gj2h/can_ptsd_be_c...


> Your consensus is only general among irresponsible psychonauts that were lucky enough in the past.

You're using the words "irresponsible" and "lucky" here to trigger an emotional response that these kinds of risks are anything but rare, which simply isn't supported by any data. I "irresponsibly" crossed the street today. Am I "lucky" I wasn't run over by a bus?

> The general consensus is to use psychedelics only as part of a therapy under supervision by a medical expert.

And the general consensus is to always consult your doctor before beginning any kind of exercise program. This is a standard CYA position adopted by the medical profession.

> https://www.nami.org/Learn-More/Mental-Health-By-the-Numbers

Nobody is denying that mental health problems are real and prevalent. The link between psychedelics and the onset mental health problems is what's at issue. 15%–20% of the US population tries psychedelics in their lifetime, and 5% of US adults experience a serious mental illness each year. Mental illness is clearly a huge problem with or without psychedelics, and the zeitgeist of research into these substances in the past decade has been almost universally uncovering the ways they can be used to help the situation.

> How does this reduce the danger of psychedelics in any way ? It increases the danger because you do not know in advance if the drug will trigger your mental disorder that you do not have yet.

Many people have the underlying structural changes in their brain that indicate an imminent onset of symptoms of schizophrenia. In cases like this, it's theorized (but again, data is scant) that psychedelics like LSD can be a triggering event that brings about an onset of symptoms, but ones that were all but inevitable anyway. That's not to say that the loss of even a month or week of sanity isn't tragic, but I've seen very little in the way of evidence that occasional LSD use in particular is substantially more risky for the average mentally healthy person than any other recreational activity one might engage in.


Crossing the street is dangerous but mostly under your control. Unlike a trip. Anyway the comparison is lame.

The comparison with an exercise program is lame too. Of course an unusual big effort or training load is bad and might harm you or kill you.

A bad diet like paleo or keto might lead to an early death as well.

The numbers show that many people are prone to mental issues or have them. Not a small percentage but a big percentage concerning many millions.

Even responsible psychonauts warn against psychedelics in the wrong setting. But you do not know in advance if you will have good or bad trip.

All noteworthy positive studies are published by medical experts.

All medical experts warn against the casual use of psychedelics. Psychedelics should be considered as medicine and not as easy harmless miracle drugs or party drugs.


Here's a podcast episode of a guy who tries microdosing http://www.gimletmedia.com/reply-all/44-shine-on-you-crazy-g...


It's very likely the benefits being reported on in the article are present in doses far lower than the high recreational doses you're referring to.

Your concerns are more relevant to the higher, hallucinogenic doses.

All medicines have a dose:response curve with a dangerous response zone starting somewhere along the increasing dose axis.


As a person who has been to psychedelic hell, I can say a nice part about it is that it ends. Having people around you to help you assimilate complicated experiences is key. If you're on the edge of a manic episode, it can definitely be a catalyst, and I've seen difficult things come of it but sometimes difficult things are manifestations of things we need to deal with.

The benefits of responsible psychedelic usage greatly outweigh the risks. I haven't seen any evidence that permanent psychosis after psychedelic usage is statistically significant compared to psychosis in the general population. Honestly, riding your bike to work is more dangerous.

Something that's hard to quantify (because it's been illegal to study) is that people who use/abuse psychs before slipping into a permanent psychosis may have been on a manic upswing that led to the risky usage of the drugs. I've seen that happen to people in hypo mania with weed, alcohol, shopping, and the greatest offender and most predictable, cocaine. This can lead to PTSD and further self medication that can become a race condition that lasts a lifetime. The fear, shame, and personal loss can be crushing without the support to handle it.

Permanent psychosis or schizophrenia are so poorly defined. One of the hallmarks of schizophrenia is that it doesn't get better. So if you had an episode and they diagnose you then it does go away, well they guess you didn't have it. The more modern thinking is that schizophrenia doesn't exist[1]. There are so many factors that lead into an unmanageable mental state, not the least of which is our bizarre modern environment. IMO it's a miracle most of us are able to pass as sane well enough to keep the trains running on time.

I just don't buy the "don't do it, you might go crazy" though. But if you feel like it's not for you, it's probably not for you. Thoughtful enthusiasm is so important. Also knowing what you're taking and where it came from.

If you or someone you know struggles with mental illness coupled with drug use, there is real help for it and free resources. Cognitive Behavioral Therapy and it's Dialectical[2] cousin are showing amazing results. SmartRecovery[3] is a fantastic free resource. With free daily online chat groups (audio, video, and text) as well as in person meetups all over the world.

[1] https://www.psychologytoday.com/us/blog/psych-unseen/201603/...

[2] http://www.millercounselingserv.com/uploads/9/0/5/1/90518949...

[3] http://www.smartrecovery.org


"The more modern thinking is that schizophrenia doesn't exist[1]."

One of the main points of the article you link to is that schizophrenia does exist, with the caveat that it exists not as a single disease but as a disease spectrum:

"when Dr. van Os writes that "'schizophrenia' does not exist," taking care to place quotation marks around "schizophrenia," what he's mainly saying is that the term "schizophrenia" doesn't represent a single disease entity and should therefore be replaced with "something like ‘psychosis spectrum syndrome.'"

and

"saying that "schizophrenia" represents a variety of distinct disorders with different causes doesn't mean that it doesn't exist at all"

It concludes with:

"In the end then, the argument that "schizophrenia" doesn’t exist is far from compelling. Schizophrenia is a word we use in medicine to describe a familiar set of co-occurring psychotic symptoms, with potentially different causes, just like "anemia," or "hypertension," or "headache." In some cases, it can be useful to think of it as a categorical disorder, distinct from other forms of psychosis. In others, it can be best thought of as a spectrum condition, lumping it together with other psychotic disorders. A more enlightened view of schizophrenia acknowledges that both can be true."


Sorry, I should have been more clear. What I was trying to point out was that people seem to think of it as a disease like cancer and it's problematic to distill it to such a fine point. The fear that somehow you can open a door to losing your faculties much like how you can open a door to cancer via smoking is a mix of drug war propaganda and the overwhelming societal stigma against mental illness.

I very much agree with the conclusion clinically. However I've seen how the imprecise nature and the scarlet letter stigma of the disorder can feed into itself. Especially when coupled with (a lot of times secret) drug usage.

There are issues with co-morbid problems like autism spectrum+PTSD+psychiatric medications with unreported usage of substances that very much exhibit like psychotic spectrum disorders and because of a failure to identify the difference, people get the wrong care and sometimes it kills them. I tragically saw this play out with a friend of mine and in hindsight it was totally preventable.

I am definitely not denying that people have mental illnesses that need to be treated. Just saying that crazy isn't what most people think it is and crazification when it comes to psychedelics is something that fails to appropriately address a lot of factors. To think of psychosis in terms of absolute doesn't help people that struggle lead better lives and doesn't really cover the bases for self discovery and personal awareness either. In the end, not being critical of this kind of talk related to psychedelics makes it much harder for us to explore their massive therapeutic potential.


"I’m really worried about the subset of the population with preexisting mental disorders such as manic depressive disorder, schizophrenia, and depression who will suffer a psychotic break from the use of these substances."

Psychedelics have been used to treat schizophrenia and depression before. Here is an excerpt from a paper on "Treatment of Childhood Schizophrenia Utilizing LSD and Psilocybin"[1]:

The first patient we treated [with LSD] was an eleven-year-old girl who was dying of something akin to marasmus. Marasmus is a condition of wasting away of the body, where nutrients are not assimilated. It occurs in infants who have no human contact. They go into such an isolated mental state that not even intravenous feeding is effective..

The girl was actively suicidal and would make every attempt to destroy herself. She was in twenty-four-hour restraint. When let loose, she would batter herself: smash her eyes, smash her head against the rails. She looked like an old, wizened lady -- nothing but skin and bones, and battered black and blue.

So the psychiatrist said, 'Why don't you start with this girl. She's going to die anyway, so there is nothing to lose.' It was quite a challenge to take as my first patient someone who was in such a terrible situation. I was afraid that maybe she would die during the session. But I didn't have any alternative, because this was who I was given.

We didn't use low doses with any of the patients. My guess is that she got 300 or 400 micrograms [of LSD], and she weighed maybe fifty-five pounds. She was just skin and bones, and was totally incoherent. She screamed, babbled, and spat if you got near her. She was not in contact with anybody, nor had she ever been since she was hospitalized.

During the session she started wailing like a wounded animal -- it was the most chilling sound. Then she started screaming, and the pitch would increase and increase. We tried everything to make contact with her, to no avail.

After about seven or eight hours I was exhausted, and so frustrated that I just yelled at her, "Nancy! When are you going to stop screaming! I can't stand it anymore!" [laughs] She stopped and looked at me. This was the first time she had made eye contact with anybody, and said, "I have a long way to go, so just stay out of my way." That was the first thing she ever said to anybody. Then she went back to screaming. That was our session.

Hers was an amazing story, which we subsequently published. Once she started speaking, it was possible to work with her more effectively. She was a very intelligent girl, perhaps an ancient soul. She was a challenge -- conniving and manipulative -- and she gave us a run for our money. Her bottom line was always that she had control over hurting herself; this became her ace in the hole. As she improved, she would eventually just carry a Kleenex around, put it on her hand, and say that the Kleenex was stopping her from hitting herself. So we would grab the Kleenex and hide it, and she'd say: "Damn you! Damn you! Give me that napkin!" There was a whole power struggle that went on for months.

Of course, during this time she was no longer in restraints, and she could move about on the ward. She struck up a companionship with one of the other girls in the program, and she was in constant contact with the staff.

She must have had eighteen or nineteen sessions spaced apart by two or three weeks, and every session was productive. Between these sessions, we had to develop a whole treatment program for managing her, as she was extremely bright and incredibly manipulative. One time she said to me, "Well, I can't fool the day staff, but I can still fool the night staff." Then as soon as she said it, I could tell that she was thinking, "Oh my God! I've given myself away!" I looked at her and said, "That's not going to last very long, is it?" And she said, "Damn you!" So, that night I got together with the evening staff and clued them in on what to do, because she was still manipulating the hell out of them. Talk about a tough patient! But she was no longer hurting herself. And although she remained in the hospital, she got well enough to attend school.

[1] - http://www.maps.org/news-letters/v07n3/07318fis.html


> She was a very intelligent girl, perhaps an ancient soul.

The author suffers from psychosis.

Many people accept psychosis as normal.

PS: Removed the word "religion" to prevent a religious flamewar.


Please don't break the site guideline against name-calling in arguments, and please especially don't take threads into religious flamewar.

https://news.ycombinator.com/newsguidelines.html


Sorry. I corrected my comment.

Can you uncensor it ?

Besides there is no "name calling" against the author of the post.


I know and appreciate that, but what we're trying to avoid is using pejoratives (which 'psychosis' is in this context) to make an argument louder without adding information. That's why that site guideline is written the way it is. It's about more than just avoiding personal attacks, though you're right that that's the most important thing to avoid.


i'm of the opinion that the psychotic breaks risk would be an engineering problem to overcome in the context of using psychedelics therapeutically.

besides, in a clinical context, it's highly unlikely any kind of psychotic break could get too far out of hand; an astute clinician would recognize the patient spiraling out of their control and administer a correcting dose of an anxiolytic, or, failing that, a trip-ender like an antipsychotic.


I agree in that psychedelics should be absolutely a last resort. That being said LSD was a miracle for me personally and saved my life.


So you are mentally ill. Yet you feel justified giving advice on the internet.


We've banned this account for breaking the site guidelines.

https://news.ycombinator.com/newsguidelines.html


the brain is a complex thing -- much mental illness is not well-understood, even though it is true that people suffer from dysfunction..


I tried Psychedelics for my depression, and my roommate has been self medicating similarly. I think they can help - but they're going to make the current opioid epidemic look like child's play. I have very carefully limited my intake - and I'm finding that I don't like a lot of what I've found. I'm definitely finding my roommate is becoming a worse person, and well on the way to all of the ugly things that we associate with drug use.


What are the ugly things associated with psychedelic drug use? I would think the 'worst' would be becoming a full blown hippie and remove yourself from society but still that would be a personal choice. What are the traits you see as a worse person?


Thats clever! Warp a persons mind with drugs and then chalk up any extreme behavior change to personal choice.


The adjective worse was what I was asking about. What is worse about a person that decides to live off the grid? or not care about materialistic things? Yes the decision/change was extreme and caused by the experience of the drug use but why classify it as worse? I'm not saying drugs are safe, just that I've never heard of people doing psychedelics and behaving like alcoholics, addicts of pain killers, etc. That is why I asked what examples of 'worse' did he notice, I want to hear from his experience maybe he is on to something.


Can I ask what psychedelics you're referring to?


Original article: "Psychedelics Promote Structural and Functional Neural Plasticity" https://www.cell.com/cell-reports/fulltext/S2211-1247(18)307...


I don't know how legitimate these stories are, but some folks swear that they've gotten rid of various addictions after their trips on Ayahuasca. This is apparently a mixture of plants that some tribes in South America have been using for self-medication for ages.


Absolutely. Many tribes throughout the amazon have different plant concoctions that end up producing some variant of DMT. While I haven't experienced DMT, I have tried mushrooms, and I can say without a doubt that it reshaped my mind and helped me see everything from a more positive, compassionate light.

I think the key for tribes in the amazon is the important ritual associated with these drugs. They aren't taken at a rave, they are taken with very serious purpose in mind.


Yeah, let's take medical advice from ancient intoxicated tribesmen. That will work out great.


excuse me sir, your western chauvinism is showing


I'm just a rational adult whose skeptical of practically everyone. My comment can be applied to all cultures throughout history.

Your thought-terminating-cliche however is clearly biased.


How's that aspirin working out for you?


Sam Harris just did a very interesting podcast with Micheal Pollan about this:

https://samharris.org/podcasts/127-freedom-known/

He wrote a book about it also: https://www.amazon.com/gp/product/1594204225


My experience tells me that excessive MDMA use makes the drug not work, and results in severe depression. I've experienced it, I've seen others experience it. Neurotoxicity would seem to be the explanation.


MDMA is not a "proper" psychadelic imo


For the future benefit of any readers, I encourage everyone to go read MisterYouAreSoDumb’s MDMA supplementation guide. It’a an incredible piece of work.

tl;dr: take alpha lipoic acid (ideally na-r-ala) when rolling to prevent a reactive oxygen species/inflammatory cascade


An interesting point is that since taking SSRIs LSD and mushrooms have a much more diminished effect on me which anecdotally seems to be common.


The SSRIs cause more circulating seratonin, which means there is less seratonin waiting to be released by the action of the LSD. Your high will be diminished, but also will last longer.


You're probably thinking of MDMA, which releases serotonin. LSD doesn't release seratonin, but it does have similar shape to serotonin and therefore can trigger the same receptors that serotonin does.


That's brain-chemistry-related, with psychedelics competing with the SSRI for your serotonin receptors.


The possibilities for psychedelic drugs to treat and shed insight into mental health issues are exciting. But I think it's worth pointing out (especially if you are a recreational user or are considering it) that we don't understand the side effects very well. Low resolution, we know they don't kill you or lead to addiction (though they can cause problems in people with underlying mental health problems).

But I'm concerned about the subtler, not-obviously-harmful-but-not-necessarily-desirable ways in which they permanently alter the brain. Slate Star Codex has a few recent articles that are worth considering:

http://slatestarcodex.com/2018/06/06/hppd-and-the-specter-of...

http://slatestarcodex.com/2016/04/28/why-were-early-psychede...


The risk of HPPD seems to be very related to frequency of use, dosage, how strongly the substance binds to the receptor, and the anxiety levels of the person taking it.

It's a risk that should be taken very seriously, but if you're just taking a low dose of mushrooms once a year or so it's not a huge risk.


This is a tough subject. Like the first link in GP's post notes, HPPD can't really be caused by LSD persisting in the body. The article presents another hypothesis, where LSD might kill off important neurons. But LSD and other psychedelics have been taken by millions of people, and the odds of getting HPPD seem fairly low, although significant.

Is it reasonable to assume a direct chemical action as the cause here? We accept that e.g. PTSD results from experienced trauma, and psychedelics like LSD can certainly induce very intense mental states. Could that not be enough to explain "flashbacks" etc?


> Is it reasonable to assume a direct chemical action as the cause here

I don't think so. There might be a chemical cause, but to me the correlation with anxiety makes it more likely that it's a state-shifting phenomenon, more like depression.


There's some evidence to suggest that they could also mitigate or repair TBI and other types of brain damage. Hopefully the NFL will throw some money at research and end up becoming a proponent of this type of cure.


>they could also mitigate or repair TBI and other types of brain damage. Hopefully the NFL

they could be especially effective in mitigating TBI if taken right before the game :)


It's just important to understand that it goes both ways. These drugs can also bring up mental issues. They are powerful in both directions.


But how can a drug company patent that?


That's exactly the problem big pharma has. They fear massive losses for their various anti-depressants. Revenues have been guaranteed up to now, as patients become dependent on them and have to take them for years. (With regards to depression for example, LSD often is a one-time application the effects of which last for months. Price tag: $10 max.)

So their strategy is:

a) eternal astro-turfing and fear mongering in forums such as this one.

b) developing new substances which may have similar effects to LSD etc. (even if less successful) and can be patented.


The LSD (Delysid) patent has long expired, however, there is no shortage of psychedelics yet to be patented.

The back market produces new drugs on a regular basis in order to work around legislation. Legitimate drug companies can do the same (but with proper studies) for the sake of patenting.

And even if existing molecules turn out best, there is always a small tweak that can be made. Adderall for instance is good old amphetamine, but with a specific isomer ratio and salts, so it can be patented.


It's pretty easy. You just get a specific version you patent through the FDA and that will be the only one doctors are allowed to proscribe because it's FDA approved.

http://slatestarcodex.com/2014/06/15/fish-now-by-prescriptio...


Tell that to Anthony Bourdain...


This is wildly speculative, as expected. Some mice grew dendrites. That doesn't mean anything about humans and doesn't come close to meaning anything about depression. It's not that simple.


I don't think the claim is 'it's that simple', but rather 'this warrants more research into the subject'. As usual. But that's not a bad thing.


Sure - if the underlying hypothesis that it's the plasticity that makes ketamine effective is true, these things also promote plasticity so it's worth looking into. Speculative news articles like this though mostly serve to have people debate and form opinions well before evidence is presented, though, as is what is happening in this thread.

There's a very long road between showing that these drugs promote neuritogenesis and proving their clinical effectiveness.


Read the article. They specifically talk about human brain cells.


Or one could lift weights, which is even safer and has many positive ancillary effects. https://jamanetwork.com/journals/jamapsychiatry/article-abst...


A lot of people just want a no-effort cure-all. Things like exercise, meditation, healthy eating--all of which can help with mental health problems--require concentrated effort over a long period of time, and thus are unlikely to be preferred over a pill.

Before anyone gets upset, I'm not saying that pills are bad, I'm just saying that many rely on them without making an effort to make other positive changes to their life.


"Mental health" and "making an effort" are two dangerous terms to combine in the same argument. Just getting out of bed every morning can already be a big effort for many people with mental health problems, much bigger effort than exercise is for many sane folks; it should be appreciated as such.


It's something you can't understand without experiencing yourself. Always sounds pathetic from the perspective of people who have lived their lives having okay mental health.


Your point is taken, but one must remember that in the end we are all of us responsible for our own lives.

There's a reason why people who lift joke that the heaviest weight in the gym is the front door.

One approach that has worked well for many is establishing positive habits to displace negative ones. That takes a while, but there are tricks to help, like having a group to hold you accountable.


Accountability works for procrastination and things that, as you say, can be described as negative habits or character traits. Depression is a completely different beast.

Depression is like I'm sitting on your chest and tell you that breathing is easy and all you need is to do it rhythmically.

Depression is like that day your brain doesn't function properly after not sleeping during the night, but every day for years and regardless how much you sleep.

Depression is not a bad habit, just like the flu is not a warm and fuzzy feeling.


Agreed.

Furthermore, what is somewhat amazing is that, on a Good Day (or less depressed or in-remission day, or whatever one wants to call it), one can also look back on a Bad Day, just yesterday, and be mystified why that seemingly dead simple task [1], seemed completely overwhelming to the point of impossibility.

Like many diseases of the brain, including dementias and schizophrenia, the sufferer can seem and even be fully functional when the disease isn't (as) active, including being prone to falling for the same fallacies as everyone else.

In the throes of the symptoms, however, the brain just isn't working the same, so it's not fair, compassionate, nor reasonable to extrapolate about habit formation or responsibility from an unafflicted brain. It can get a bit too easy to blame the victim that way.

None of this is to say that encouraging good habit formation or increased patient self direction/determination can't be helpful, when possible. I'm just saying not to start with that as an assumption and that it likely isn't even possible for the more severe cases.

[1] taking out the trash, running the dishwasher, or even just getting out of bed


I'd argue that psychedelics aren't a no-effort solution at all. These experiences are at times very emotionally draining and uncomfortably introspective. The integration period then requires a further amount of the above. The interesting thing is, a guided experience tends to leads to the habits you listed above. In short, the experience can be seen as a catalysts to a maintainable lifestyle which facilitates recovery, not as the mode of recovery in itself.


Safer is arguable. We actually don't know how unsafe psychedelics are in a controlled, professional setting, but people get hurt exercising all the time.

If you think the two are anywhere near each other in terms of instantaneous effectiveness, you must be tripping. Exercise can take months to possibly help. A single good trip can fix years of depression, months forward.


> people get hurt exercising all the time.

Olympic weightlifting is actually one of the safest sports. But most people who lift are doing body building or more sport-specific training, which is where you see most of the injuries.


Olympic athletes are professionals. Anecdotally, my “yoked” coworkers frequently hurt themselves. Out of twenty people on my team, two hurt their backs so badly in the last month that they can’t sit or stand for more than an hour or two, among other minor injuries.

Meanwhile, I commute by motorcycle exclusively five days a week and have never missed work due to or come to work with an injury. The safeness of any given activity is relative to each individual and their training.


> Olympic athletes are professionals.

They're actually required to be amateurs, but otherwise yeah. :-)


Olympic weightlifting is just the name for a discipline which incorporates a specific set of barbell excercises. It's injury rate is indeed extremely low (From Hamill, B. “Relative Safeety of Weightlifting and Weight Training” Journal of Strength and Conditioning Research 8(1):53-57, 1994 https://imgur.com/a/0jI0CzK).

Your typical gym-goer does all kinds of other stuff though, like crossfit and similar nonsense, which is highly injury prone.

The "classic" (i.e. Olympic) exercises, is a very safe sport.


First, why 'or'?

Second, anyone who thinks psychedelics are a shortcut or an easy way to do something obviously haven't experienced them.


> anyone who thinks psychedelics are a shortcut or an easy way to do something

But this is how the early experiments with ketamine are being described - as a near instant treatment that takes a couple of hours and lasts for months.


I don't want to be overly pedantic here but Ketamine isn't a psychedelic. Instead it is a dissociative hallucinogen. In that line, Ketamine's mechanism for anti-depression is significantly more pharmacological than a classical psychedelic, which leads to a subjective experience that then leads to an effect.


I've never had ketamine, but its status as a hypnotic and its use in surgery suggests it's something that numbs the mind. Psychedelics do the opposite, in a very extreme way. It's an intense experience where certain mental barriers disappear, some of which are crutches which are taken away. Some things become unforgettable.

I highly recommend doing more research before pushing exercise as a more moral (or whatever, 'safer' if you prefer, but I suspect most opposition is on old-fashioned moral grounds) alternative. The hand-me-down moralisms about drugs have got to stop, especially in a world of legitimate alcohol and prescription drug use. It's time to question what the authorities have been legitimizing versus stigmatizing. The opioid crisis and long-time cannabis prohibition aren't enough to cause questions about the impartiality of the status quo?


You appear to have some kind of problem with morality.

I recommend ignoring such persons on the grounds that listening to them is likely to cause harm and unlikely to be beneficial.


It also takes a lot of commitment and time that not everyone has, and requires you to by physically capable of lifting weights which not everyone is.

On a more nuanced note, different things work for different people, and gyms aren't the optimal mental healing environment for everyone.

If you're gonna arrange everyone on a hypothetical comfort spectrum between gym and library, it seems reasonable that some people would be more likely to seek mental help if it came in the form of taking a tab under supervision from a qualified professional in a private room than they would if they have to go lift in the company of a bunch of loudly moaning middle-aged men hell bent on proving to the room at large that they are the highest quality specimen of humanity in the room. Lets not be elitist about the paths to mental health, options are good.


>It also takes a lot of commitment and time

It's about half an hour a day, that's all you really need. True, if you can't spare half an hour, then you've got greater issues.

The latter part of your argument I personally have never ever once experienced, nor have anyone I known experience it outside of the gym at high school. People grunt when exerting effort, everyone wears headphones anyway. And even then, you don't need to go to the gym to lift, calisthenics are perfectly fine for those with no access/no desire to go the gym.


>It's about half an hour a day, that's all you really need. True, if you can't spare half an hour, then you've got greater issues.

Unless you don't have a car, or live in a congested city, or live outside the city, in which case it can be half an hour of commuting time before you get your half hour of exercise. It's also ~$60 a month, which not everyone can spare. Your statement also assumes people aren't working two jobs, and aren't working shift work (or have access to a 24h gym, which not everyone does).


My statement also had a second part which you seemingly missed for the sake of your argument.

Calisthenics, or bodyweight, exercises are perfectly viable for becoming fit and require nothing than you being able to find a nice spot on a floor. If this hypothetical person is that strapped for time, then how do they even get any sleep? That's an even bigger issue than not being able to work out consistently.


[flagged]


Now that's just insulting for the sake of being insulting. I said if they cannot find the time for exercise, then that is the bigger hurtle they should overcome. Likely, that's the key contributor to their mental health problem over not being able to do a few push ups at night.


>I said if they cannot find the time for exercise, then that is the bigger hurtle they should overcome. Likely, that's the key contributor to their mental health problem

Oh, I see! You're proposing fixing the widening class gap in most western countries. Sign me up!


Sure, why don't you start by donating every cent above the median national wage.

Then we'll all follow your example.


Gyms are the most boring place to get exercise. Go out and enjoy nature, I am sure that will double the benefits of getting exercise if its in order to treat depression.


That's definitely true. I hike pretty regularly, I went hiking here just a few days ago:

https://tinyurl.com/yd58grex

However, you can really only do that between april and november here. There's four months of the year where going on any meaningful hike is absolutely only for people who are totally dedicated and have thousands of dollars of gear, plenty of experience and have been guided on that specific track during winter at least once. Those are the same four months when there's no sunlight and the seasonal depression sets in. I'm not in that league and I'm not embarrassed about it.

The whole "just exercise, it's great and easy" shtick is kinda naive and TBH vaguely annoying. Lots of people, even quite wealthy people, live in circumstances where it's actually just not easy, at least not all the time, and exercise kinda only works for mental health if it's regular. You should see the tires on the bikes that the cyclists who try to keep form during the winter here have to use just on city pavements.


So you have time to hike, but during the winter you don't because of poor weather conditions and lack of money to invest in good gear.

But then if you have that time, why not use it for bodyweight exercise at home?

It costs absolutely nothing, requires no equipment, and weather is not an issue. You could be getting quality exercise for free during the same time that you would have otherwise spent hiking.

If you're open to trying it, check out the bodyweight fitness sub on reddit[1] and their recommended routine[2].

[1] - https://www.reddit.com/r/bodyweightfitness/

[2] - https://www.reddit.com/r/bodyweightfitness/wiki/kb/recommend...


You don't need to sell it to me my friend. I walk around the city during the winter. Two layers, hat on, gloves on. It's nice, no one else is around because it's so cold, and the snow muffles all sound. Very peaceful, unless the wind is trying to remove your face.

What I'm arguing strongly against is the notion that exercise is a magical solution that can suit any lifestyle, any country and any economic situation. It's not been so long since I was working a job with a 2.5 hour commute each direction that I find it easy to listen to people with cozy and secure 9-5 jobs in lovely temperate latitudes condescendingly explain how there's no possible excuse for struggling to find time for regular exercise without calling them out on their shit. Offering better results-for-time options for mental health is not indulging the indolent.


It's pretty hard to do strength training outside of a gym. (please note I didn't say it's impossible)

For everything else I agree.


The treatment effects of exercise are often overplayed.

Exercise might help prevent mental ill health, and it's important because mental health meds have severe impact on physical health, but it's probably not a great treatment option, even if you can get people to comply with the treatment.

Exercise is moderately better than nothing, but only if you include weak studies. As soon as you only include good studies the efficacy drops off.

http://www.cochrane.org/CD004366/DEPRESSN_exercise-for-depre...


y not both

jotm 39 days ago [flagged]

Could be, maybe, let's just wait until thousands more die because they were denied access to these illegal drugs. Then we'll publish some "new" findings and maybe in 30 years, the filthy peasants will be allowed to use drugs under extreme supervision.


Could you please not post indignant rant-style comments like this to Hacker News? It isn't that you're wrong, but that the genre does more damage to the forum than the rightness of the comment does good. A lot more, actually, so we need people to just not do this.

https://news.ycombinator.com/newsguidelines.html


Hmm yeah, shadowban this account then I won't post anymore, at all. I'd be really grateful, too.


Having controlled psychedelics could be safer - especially in the raving community where too often deaths occur from dangerously mixed and pressed substances.

There has to be a more comprehensive study done on its neurotoxicity. Or more studies in general. But who will pay for it and why?


"too often deaths occur from dangerously mixed and pressed substances" - citation needed, compared to other risk factors


Can I please get my (giggle) medical LSD? I need to take my medicine before I go into the Flaming Lips concert. (giggle)




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