Psychedelics have been the subject of much scientific and cultural interest over the past few decades, with numerous studies suggesting that these substances may hold significant therapeutic potential for various mental health conditions. One area of particular interest is the use of psychedelics in treating trauma, a pervasive and often debilitating condition affecting millions of people worldwide.
In recent years, researchers have begun to explore how psychedelic substances such as psilocybin, MDMA (3,4-Methylenedioxymethamphetamine), and ayahuasca may be able to help individuals process traumatic experiences and overcome the long-lasting effects of trauma. This blog will delve into the science behind these potential treatments, the history of psychedelic use for trauma, and the future of this promising field.
Why Psychedelics?
Psychedelics were considered and used for mental health treatments as early as 1947. However, this ground to a halt in the 1970s when the US government passed the Controlled Substance Act. More recently, the interest in this subject has been renewed, and many studies have examined the medicinal uses of substances such as MDMA, psilocybin, and ketamine.
Trauma can be incredibly resistant to traditional forms of treatment. Some people may not respond to medication, and others may not feel comfortable talking about traumatic events to a therapist. Psychedelics can improve mental health and trauma symptoms in several different ways:
- Neuroplasticity – Neuroplasticity is the brain’s ability to form new pathways and associations when we have new experiences and learn new things. Psychedelic substances can enhance neuroplasticity and enable people to reformulate how they think and feel more easily.
- Communication in the brain – Psychedelics can improve communication between parts of the brain that do not ordinarily communicate.[1]
- Fast-acting antidepressants – Traditional antidepressants can take several weeks to work, whereas psychedelics are incredibly fast-acting and can take effect much quicker.
Psychedelics are controlled substances regulated by the government. Although research is still being undertaken into which psychedelics may have therapeutic benefits, the results are promising, and more treatments are being tried and legalized.
Ketamine and Treatment-resistant Depression
In 2019, ketamine was the first psychedelic substance to be approved for medical use. It is incredibly effective in treating depression, especially in cases where it cannot be treated with antidepressants. It is estimated that up to 30% of those with major depression have treatment-resistant depression.[2]
Ketamine binds to receptors in the brain that produce glutamate. Experts have not yet determined glutamate’s exact role in depression, but they do know it is key for mood regulation, and it is thought that low levels can contribute to depression. By introducing controlled amounts of ketamine, glutamate production is stimulated, alleviating the symptoms of depression.
It also stimulates the production of the brain-derived neurotrophic factor, a protein that plays a key role in neuroplasticity.[3] Ketamine can help people change negative thought patterns associated with depression and change people’s outlooks on life.
Multiple studies back up ketamine’s benefits for depression and mental health, showing a significant decrease in depression and its symptoms that is fast-acting and long-lasting.[4]
How Can Psychedelics Address Trauma?
Trauma is prevalent throughout society, caused by experiences of warfare, assault, and abuse. It is a complex issue that doesn’t have a one size fits all treatment approach.
When people are prescribed antidepressants to assist with PTSD symptoms, they’re often given SSRIs (Selective Serotonin Reuptake Inhibitors). They work by increasing the amount of serotonin available to bind to specialized receptors in the brain, improving mood regulation. However, they can also have significant side effects, including insomnia, limiting their effectiveness. Research into psychedelics points towards evidence that they also act on serotonin receptors. They may also work with fewer doses than SSRIs and fewer side effects.
Additionally, one study that utilized brain imaging technology showed that psychedelics could help change the network of cells that allows us to understand who we are and where we are in time and space, known as the default mode network. Trauma can dysregulate this network, contributing to flashbacks so intense that people can feel like they are back in the traumatic event. Psychedelic substances can potentially help to regulate this and provide relief to those with PTSD.
Psilocybin, the compound found in various mushrooms, induces visual and auditory hallucinations. When applied in a therapeutic environment, psilocybin can increase empathy and fear extinction, which can aid in talk therapy while also increasing insightfulness, mindfulness, and creative thinking.[5] It can also decrease amygdala activation during emotional processing, assisting trauma survivors in integrating traumatic memories. Similarly, MDMA helps facilitate talk therapy by reducing fear and anxiety around traumatic memories, so people can tolerate them better and therefore work through them.[6]
It is important to note that psychedelic medications should only be used under the guidance of trained professionals in a controlled and safe setting. In order to better understand their efficiency and potential risks, more research is needed.
The growing interest in psychedelic-assisted therapy is a promising development in the field of mental health treatment. These substances may be able to treat a wide range of conditions beyond trauma-related disorders in the future.
Sources:
[1] Höflich A, Hahn A, Küblböck M, et al. Ketamine-dependent neuronal activation in healthy volunteers. Brain Struct Funct. 2017;222:1533-1542. doi:10.1007/s00429-016-1291-0
[2] Jaffe, D.H., Rive, B. & Denee, T.R. The humanistic and economic burden of treatment-resistant depression in Europe: a cross-sectional study. BMC Psychiatry 19, 247 (2019). https://doi.org/10.1186/s12888-019-2222-4
[3] Woelfer M, Li M, Colic L, Liebe T, Di X, Biswal B, Murrough J, Lessmann V, Brigadski T, Walter M. Ketamine-induced changes in plasma brain-derived neurotrophic factor (BDNF) levels are associated with the resting-state functional connectivity of the prefrontal cortex. World J Biol Psychiatry. 2020 Nov;21(9):696-710. doi: 10.1080/15622975.2019.1679391. Epub 2019 Nov 4. PMID: 31680600.
[4] Mandal S, Sinha VK, Goyal N. Efficacy of ketamine therapy in the treatment of depression. Indian J Psychiatry. 2019 Sep-Oct;61(5):480-485. doi: 10.4103/psychiatry.IndianJPsychiatry_484_18. PMID: 31579184; PMCID: PMC6767816.
[5] Krediet, Erwin; Bostoen, Tijmen; Breeksema, Joost; van Schagen, Annette; Passie, Torsten; Vermetten, Eric (2020-06-24). “Reviewing the Potential of Psychedelics for the Treatment of PTSD”. International Journal of Neuropsychopharmacology. 23 (6): 385–400. doi:10.1093/ijnp/pyaa018. ISSN 1461-1457. PMC 7311646. PMID 32170326.
[6] Wang, Julie B.; Lin, Jessica; Bedrosian, Leah; Coker, Allison; Jerome, Ilsa; Feduccia, Allison; Lilienstein, Alia; Harrison, Charlotte; Heimler, Elizabeth; Mithoefer, Michael; Mithoefer, Annie (2021-06-23). “Scaling Up: Multisite Open-Label Clinical Trials of MDMA-Assisted Therapy for Severe Posttraumatic Stress Disorder”. Journal of Humanistic Psychology: 00221678211023663. doi:10.1177/00221678211023663. ISSN 0022-1678. S2CID 237792283.
