People grappling with terminal illnesses frequently experience significant emotional distress, including depression, anxiety, existential crisis, and a feeling of lost purpose, which intensifies the complexity of their situation.
Existing interventions like counselling or cognitive-behavioural therapy (CBT) can provide relief but may not be effective for everyone. This has spurred researchers to investigate alternative, novel approaches to end-of-life care.
Emerging research suggests that psychedelic therapy could be an effective solution to alleviate existential distress in patients with incurable diseases. A review in Neuropsychopharmacol Biol Psychiatry posits that psychedelics can relieve depression and anxiety symptoms, improve quality of life, and lessen the fear of death in patients with life-threatening conditions.
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How Psilocybin Affects the Brain
The National Institutes of Health categorize psychedelics from shrooms as powerful substances that alter cognition. They affect mood and perception by engaging with the brain’s serotonin pathways.
Let’s examine what various studies have discovered:
| Researchers | Results |
| Department of Psychiatry and Behavioral Sciences, University of Texas | Psychedelics such as psilocybin affect serotonin 2A receptors that regulate emotions and perception. |
| A report from Mental Health News | Psilocybin, a naturally occurring hallucinogenic compound found in over 200 fungi species, may restructure the brains of depression sufferers, potentially paving the way to a cure. |
| Researchers at UC San Francisco and Imperial College London | Psilocybin can bolster connections between different brain regions in individuals with depression, possibly aiding them in overcoming excessive self-focus and rumination. |
| A randomized, double-blind study by John Hopkins University | High doses of psilocybin significantly reduced depression, anxiety, and fear of death, and increased quality of life, sense of life’s meaning, and optimism. |
| Clinical trial from New York University | Between 60% and 80% of participants reported decreased anxiety and depression following psilocybin therapy, which led to a reduction in existential distress. The study further found a correlation between these therapeutic effects and the psychedelic experience elicited by psilocybin. |
Clinical Research
The UCSF Weill Institute for Neurosciences’ researchers conducted 2 studies involving 60 participants, all of whom underwent fMRI brain scans.
Methodology
- First Study. Psilocybin was administered to all participants, who were suffering from treatment-resistant depression.
- Second Study. Participants who had less severe depression were not informed whether they were given psilocybin or an antidepressant placebo (escitalopram). All participants also received the same psychotherapy.
Scans were taken before and after the treatment to assess the effects.
Results
- Psilocybin treatment weakened connections within the brain areas linked to depression, including the default mode, salience, and executive networks. Simultaneously, it enhanced connections to less integrated brain regions.
- It lowered the impact of emotional avoidance and significantly improved cognitive functioning.
The effect of psilocybin on brain rewiring was sustained for up to three weeks after the second dose. Therefore, psilocybin presents a promising alternative treatment for depression, as it restructures the brain and reduces entrenched negative thought patterns associated with the condition. This result suggests that psilocybin works differently than traditional antidepressants.
Psilocybin Therapy – A Potential Therapeutic Approach
The regulated use of psilocybin in a therapeutic setting, referred to as psilocybin therapy, is typically combined with psychological support. This technique is increasingly being recognized for its potential to treat treatment-resistant depression, anxiety, and existential distress in patients with terminal illnesses.
A recent survey conducted by researchers from Université Laval’s Faculty of Pharmacy, McGill University, Université de Montréal, and UQAR aimed to gauge public opinion on the medical use of psilocybin for end-of-life care. According to the survey published in Palliative Medicine, nearly 4
1 out of every 5 Canadians supports the use of psilocybin to alleviate existential distress at the end of life.
Head researcher Michel Dorval notes that research shows psilocybin, when used alongside psychotherapy, can provide swift, robust, and lasting relief for individuals grappling with advanced cancer. He further emphasizes that psilocybin therapy can provoke a deep sense of insight and comfort that can persist for up to six months.
Moreover, the survey indicates that individuals with experience in palliative care or previous psilocybin use displayed more support. Dorval suggests that personal experiences with end-of-life distress could contribute to this receptiveness towards new approaches.
Despite prevalent biases against psychedelic drugs, the research highlights a growing acceptance of psilocybin therapy in Canada, particularly in palliative and end-of-life care situations. The authors expect that these results will improve the availability of this innovative treatment.
Additional Benefits of Psilocybin Therapy
1. Treatment for Alcohol Use Disorder
In a double-blind, randomized trial that involved 93 individuals, published in JAMA Psychiatry in August 2022, it was found that the combination of psilocybin and psychotherapy led to a significant reduction in heavy drinking days over approximately eight months compared to a control group that received placebo therapy. The group that was given psilocybin also consumed less alcohol on the days they did drink.
2. Assistance in Smoking Cessation
Though quitting smoking is infamously difficult, a small pilot study carried out by researchers at Johns Hopkins University and published in The American Journal of Drug and Alcohol Abuse in January 2017, suggested that psilocybin, in combination with cognitive behavioural therapy (CBT), helped 10 out of 15 participants to stay smoke-free for a year. Subsequent research suggested that the psychedelic experience could potentially help reshape a smoker’s identity, thus enabling long-term abstinence.
3. Anorexia Treatment
New research suggests that psilocybin may be useful for individuals battling anorexia. A preliminary study published in Biological Psychiatry in May 2022 reported significant decreases in symptoms of eating disorders and anxiety in adults with anorexia who underwent psilocybin-assisted psychotherapy.
4. Alleviating End-of-Life Anxiety
Living with Terminal Illness
Anxiety and depression are commonly experienced by individuals diagnosed with terminal illnesses. Psilocybin therapy is a promising treatment that has shown potential in alleviating these symptoms. Research indicates that patients with life-threatening cancer have experienced significant reductions in anxiety and depression following psilocybin therapy.
What to Expect from Psilocybin Therapy?
Psilocybin therapy has the potential to provide effective healing benefits in a short time, with the possibility of lasting impact. Each therapeutic session is customized to suit individual requirements and adheres to specific clinic or trial protocols.
| Phase | Description | Duration |
| Preparation | The initial sessions aim to discuss any fears and treatment goals with a facilitator to foster a trusting relationship and a safe environment. | 1 to 6 hours |
| Therapy | The participant takes a dose of psilocybin in a comfortable setting, lying down with an eye mask on, listening to a chosen playlist, and under the supervision of a therapist. | 5 to 8 hours |
| Integration | Post-session follow-ups allow participants to debrief their experiences with the therapist, aiding in integrating the insights into daily life. | Multiple sessions, each lasting several hours |
Guidelines for Engaging with Psilocybin Therapy
- Identify clinics where psilocybin is legally administered and consider joining a waiting list if necessary.
- Choose a clinic that administers psilocybin treatment under the guidance of a therapist or a professional guide for a more beneficial experience.
- Interview prospective therapists about their qualifications, experience, therapeutic methods, and competence in handling mental health conditions.
- Be candid about your motives for seeking treatment, mental health status, medical history, and family mental health background.
- Consider therapists who specialize in your particular mental health condition and seek advice and training from organizations like the Psilocybin Assisted Therapy Association (PATA).
- Disclose your complete medical and mental health history, especially if there is a family history of schizophrenia or psychosis.
- Discuss your decision to undertake psilocybin therapy with your current mental health provider and inquire if they would be willing to collaborate with your psilocybin therapy team.
- Discuss the dosage, protocol, and the need to start Consider starting with lower doses particularly if you’re new to psilocybin therapy. It’s always best to prioritize safety, especially under the guidance of your psilocybin therapist.
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Frequently Asked Questions
Who should consider psilocybin therapy?
If you’re grappling with depression, anorexia, alcohol addiction, trying to quit smoking, or dealing with a terminal disease, psilocybin therapy might be a viable option for you.
However, if you have a history or family prevalence of schizophrenia or psychosis, mind-altering substances like psilocybin might exacerbate your symptoms. Likewise, individuals with bipolar disorder and borderline personality disorder are generally advised against it.
What’s the usual dosage of psilocybin in therapy?
The dosage typically fluctuates, often starting with smaller amounts in a therapeutic environment and adjusting according to individual responses. Clinical investigations have reported that a single 25-milligram dose of synthetic psilocybin, accompanied by psychological support, led to a decrease in depression scores in individuals with treatment-resistant depression.
Can psilocybin be utilized to treat PTSD?
While this is a rapidly progressing area of research, studies on MDMA, a non-traditional psychedelic with stimulant attributes used alongside psychotherapy for PTSD treatment, are more established. Trials involving this psychedelic have now reached phase 3 clinical trials, and it’s expected that MDMA may be approved for PTSD treatment within this year.
