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Psychedelics and mental illness

stuartritchie.substack.com

121–130 of 165 posts

Re: Psychedelics and mental illness

#121

Earlier quoted context omitted.

I really hate the mental health questionnaires. They did a poor job of assessing my difficulties when I was in the thick of it (I’m doing much better now). I also found them quite stressful to fill out. I remember getting scores of “mild anxiety” or “mild depression” and just kind of sitting there confused and somewhat dismayed, thinking… “Why am I having such a hard time? What is actually wrong with me?” Turns out s…

Exactly, the reality of the mental health field is they know very little and their methodologies are largely flawed. I've been diagnosed with so many different things based on their "scientific methods" when at the end of the day they are just making rough guesses. I get really turned off by any article that acts like we have a clear understanding of these things. Most things are actually just reactions to trauma.

I definitely agree that scientific understanding mental health is pretty low, but I don't believe the methodologies are flawed. They are the best we have at the moment and they work well enough for the common cases. (Drugs vs therapy is a different problem.)

Anyone with a non-trivial case ends up in informed (or poorly-informed) guesses territory.

> Most things are actually just reactions to trauma.

I don't think this is quite correct. Mental illnesses have a lot of overlapping and contradictory criteria because all of the categories are rough patterns.

Many share the same symptoms of trauma and people with mental illness are more likely to have trauma.

This does not mean the majority of mental illness is caused by traumatic events.

Re: Psychedelics and mental illness

#122
post #11

The article makes a lot of good points. I'm a lover of psychedelics, I've apparently managed to be wired in a way that has made every single experience one that I don't regret (whether joyous, superficial, or intricate, unexpected), but I would never make the mistake of assuming my experience directly translates to other people's. Hype, cultists and people thinking in absolute only do a disservice to what we could ex…

Is it true what they say about psychedelics helping people to come to terms with their own mortality and death? Occasionally I'll get crippling anxiety when I think about how one day I'm going to stop existing and there's absolutely nothing I can do to stop that. I've heard people say that [some drug] has shown them how to no longer fear death and always wondered about that.

I don't think it's possible to make a broad statement like that about psychedelics. You'll always just hear one take from a person with their experience and the experience of the people they might have tried it with or even guided, but the spectrum of experiences is too vast to qualify and quantify it without the actual research.

My personal standpoint is fairly different from yours because my anxiety is permanent and a measure of the "agitation" of my existence, to which death is almost a relief really. From that standpoint I've never quite had to confront much of anything about mortality or death. In fact I've almost always felt more alive during trips, at peace with whatever flowing model of the self and existence experienced in the moment. Psychedelic effects can make our senses feel more 'salient' too (for me musical experiences can be very profound), which I've used to contemplate extremes (like noise-cancellation silence after a roaring musical piece).

The main regularly noticeable thing I experience after just about every trip (of various kinds of psychedelics) is severe depression being alleviated for anywhere between a couple days to a few weeks.

Ultimately though, most of what I would say is just likely to be whatever personal theory I've built up this unique stream of experiences. That's why we really need people to get in there and do the difficult work.

edit: also the "some drug" in question is most likely DMT, and I've had extensive experiences with it (on its own or not) and absolutely appreciate that others would have religious experiences, near-death experiences, etc.. but I don't think anybody with any experience of DMT that goes beyond a one-shot would testify to the reliability of trips of such nature. It can be a very volatile experience, as well as being much less predictable from person to person than the more mild stuff like low doses of mushrooms etc. Again, science might eventually come to the rescue :)

Re: Psychedelics and mental illness

#123

This argument seems disingenuous: > Just as you’d feel extra-sceptical if all the research showing that pork is unhealthy was written by Muslims who’d already decided for religious reasons not to eat pork, you should be worried about the sheer number of studies by psychedelic researchers who are themselves aficionados of the drugs. Perhaps a better analogy would be: just as you'd feel extra-skeptical if all the resea…

>There's nothing about the fact that psychedelic researchers are excited about psychedelics that by itself is suspicious, as we are strongly being led to believe.

It's also quite possible that they are excited about the potential to try a different method of reducing the suffering of patients with mental illness with more efficacy, or fewer side effects, or some other positive change. Anybody can be excited about something while doing another thing. Presumably at least some of these people wish to provide aid, um, when they are not reeling from acid, and grooving on E's, or apparently, assaulting patients, based on the article.

By the way, how does he know they use the drugs? He said some guy said he knew a lot of people who did. A valid concern with mental health is the difficulty of evaluating statements people make about their, or other peoples internal states, and for what reason they make such statements. Basically he's saying, "They're addicts! Some dude told me!"

That's literally hearsay, although this is not a court environment, I suppose. Still, I, for one, would prefer a bit more rigorous statement about this endemic drug use among researchers.

As for his example, lots of people don't eat pork, for a variety of reasons. If someone follows their procedure and replicates their results, then does it matter if they were Muslims? Skeptical? Have some bacon and do the experiment, see if you get what they got. Of course you wouldn't just take it on faith, my goodness! Not all, certainly, but some people don't allow their desires to supersede their professionalism. I don't know, are Muslims even that invested in not eating pork as to fake a bunch of studies to fool the masses into not eating back bacon?

Actually, given what we know about the replication crisis.. hmm.

But surely people who take psychedelics have their own subculture, right? Dr. Alice and Dr. Bob might spend long weekends listening to Cream and obviously Black Sabbath, and definitely some jazz, staggering high because they are trying acid to wean them off of the Oxy's they were into 3 years ago, or the boozing they did under quarantine ... but what if they got results that are worth looking into? Anybody who's known someone using psychoactive drugs surely... well the drugs available now sure seem sub-optimal.

( What about their kids? They're trippin with the kids? Really? REALLY? )

You know, I'm quite unsure about this assumption that the researchers need to spread their drug of choice to people claiming ( skepticism about the afflicted seems to be a theme in the comments? I guess they should just snap out of it? ) mental defect to a third party, which is a life changing decision.

I'm not saying that these things are impossible, or inconceivable. Unfortunately. I question the number of people who act like this, while maintaining well enough to author research papers and do Guardian interviews, vs the number of people who are enthusiastic about reducing suffering and are pursuing a surprising and somewhat promising avenue to do so. They would be in a great position if this work led to a better way of treating mental illness. Seems exciting.

Re: Psychedelics and mental illness

#124
The author points out a bunch of problems that are present in basically all research involving human behavior. He implies that it is particular to research involving psychedelics (except for I think a single example involving diet), and that is false. He should take a look at the dumpster fire that is Social Psychology...

Re: Psychedelics and mental illness

#126
post #54

Earlier quoted context omitted.

What if the subject doesn't realise they're unhappy because they've never been happy and have nothing to compare against? Your statements seem to assume everyone has the same perspective to measure against, but in reality people's perspective can be radically different

Like I said, you can make that argument, but then you need to provide a criterion for saying someone is unhappy. That's where behavioralism or functionalism or something similar comes in. > Your statements seem to assume everyone has the same perspective to measure against, but in reality people's perspective can be radically different On the contrary, I think people have different perspectives. Two people can be in…

It seems that we agree

We definitely need to make judgements based on both behavior and subjective thought processes rather than just one or the other

Re: Psychedelics and mental illness

#127

I know a lot of cannabis fans (and count myself as one). Very, very few of them acknowledge that cannabis affects people inconsistently; one person's reaction to it can be very different than others. This is inconvenient for calling it a "medicine" so let's just ignore it. Psychedelics are even worse. The same dose of the same drug can produce wildly vary effects in the same person depending on factors we have troubl…

Medicines in general can effect people very differently based on their individual biochemistry/proteome

Re: Psychedelics and mental illness

#128

It’s easier to market “psychedelics” than meditation, prayer or something like DBT. We should learn from that and try to make more things as popular as psychedelics. “Put this little square of paper on your tongue” is much less of an ask than “sit in chair for 30 minutes everyday and be mindful of your breathing.” It’s like the McDonald’s approach to mental health, and who doesn’t love McDonald’s! Over a billion serv…

If it works, and that's all it takes, that's fantastic! But you have an incredible solution too it seems?

“sit in chair for 30 minutes everyday and be mindful of your breathing.”

Now this is great advice for everybody. Unless during these quiet times the weight of the world lays upon you, or your grasp over your inhibitory system is not sufficient to find stillness, never mind finding discipline of the breath.

What about the people who's affliction is not due to some implied lack of industry or effort? What if the problem is not ... sloth?* ... but actually a flaw in the brain, or imbalance?

I guarantee you that there are not a billion people who are gagging for psychedelics as a solution to their mental problems. The question is: Are they in fact a solution?

Prayer: Unless you are praying to some entity who publishes regularly, I feel this avenue has been tried and found to be lacking.

[*] I do not endorse this concept. I don't think you can just "apply yourself" and heal your mind, any more than you can do could with your lung cancer. Sure it helps, but we'd like to minimize the suffering, not endure as much as possible.

Re: Psychedelics and mental illness

#129
post #16

I like the article. With psychedelics, it's clear that much of the excitement comes from people (including scientists) who have used them and found their experiences helpful. That's not science but that doesn't mean it's wrong. Not everything is amenable to clinical study and this doesn't mean we should disregard it. And the issue isn't just psychedelics being hard to study. Mental health is hard to study. An overwei…

> Lots of people used LSD in the 60s and 70s and as far as I can tell they didn't usher in a new age of love, peace, and tolerance

There's a documentary on UK late 90's rave culture that noted that perhaps 60-100,000 people in the USA indulged in LSD during the period you mention. By contrast, somewhere on the order of 10-20 MILLION people dropped MDMA/ecstasy during the heyday of UK rave culture.

The documentary went on to note that there are a lot of professional, retail and public spaces in the UK that have been built in the last 15 years that show particularly strong connections to the "chill out room" vibe that became significant during the ecstasy+rave period. Even real estate agent office (realtors in the US) design is claimed to show many elements of chill out aesthetics.

Re: Psychedelics and mental illness

#130

Earlier quoted context omitted.

Listen, your comments on all these threads make it clear you’re seriously pessimistic about psychedelic medicine, and that’s perfectly ok. What bothers me is the incessant pushing of this agenda: > anyone ending up in a psychedelic research study is doing so because they think psychedelics are promising for mental health and they want to try it out > maybe the real reason psychedelics show efficacy in depression is t…

I am curious: is it actually possible, even in principle, to have a blind placebo controlled psychedelics study? How can you not be aware of whether you have consumed a psychedelic substance or a sugar pill, assuming we are not discussing something like micro-dosing?

It’s a valid concern and many folks have raised it here on threads concerning this topic.

The short answer is yes: beyond mannitol, niacin, and even bespoke substances designed to mimic the organoleptic properties of ayahuasca have been used effectively as placebos.

At modest dosages (above the threshold of perception but within the therapeutic window) the side effects can be surprisingly similar in the general population, and thus difficult to distinguish for the average joe.

Of course studies vary widely in quality and rigor, so one must critique experimental design on a case by case basis.

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