By: Jane Lopes
Some names in this piece have been changed.
It was a Sunday night when I got the text from Mary. We hadn’t talked seriously about mental health in the past, but since I’d opened up about health struggles (mental and otherwise) in my 2019 book, she trusted I could relate.
“One day I’d like to sit with you and talk,” she texted.
“Klonopin and Zoloft haven’t been kind lately along with my other medications. I’m tired of faking it but I’m also not open to letting the rest of the world know how fucked up I am. 15+ cuts on my arm last night landed me in voluntary commitment… I think of you and how you do it cause I don’t think I can right now.”
I immediately responded and we hopped on the phone soon after. I was terrified by how Mary was talking: she felt hopeless, she was mortified at the thought of anyone finding out she was cutting herself, and she didn’t think she was worthy of living.
If you haven’t experienced serious mental health struggles, it’s hard to accurately convey how desperate they can feel. Rational thinking fades when your mind and body are screaming that something is terribly wrong. That you are terribly wrong. And most of the magic-bullet solutions that we try (and are sold) - like Klonopin and Zoloft - aren’t always as effective as we’d like. And they often come with side effects and can pose risks for the long-term.
Klonopin was the potential solution that became my struggle. In 2012, I was prescribed the drug, a member of the benzodiazepine family, to help with my anxiety. By late 2013, I’d built up a tolerance that rendered the drug ineffective and was given the choice to increase the dosage or discontinue use. I chose the latter, embarking on a multi-year, debilitating withdrawal process which left me with worse anxiety than when I started taking the drug.
It took me years to stop yearning for a magic bullet. I finally came to the realization that mental health was a process. There are tools that can help with the process – therapy, medication, exercise, nutrition, to name a few – but, ultimately, I had to take responsibility for accepting my disposition toward anxious thinking and do the work to not let those thoughts become me.
But getting to that realization was years in the making, and I worried that Mary didn’t have that time. She had tried prescription medicines and talk therapy, but she was still in a dangerous place. She needed a boost.
Years before, I had read Michael Pollan’s How to Change Your Mind, where he quotes psychedelic researcher Mendel Kaelen, comparing the mind to “a hill covered in snow, and thoughts as sleds gliding down that hill. As one sled after another goes down the hill, a small number of main trails will appear in the snow. And every time a new sled goes down, it will be drawn into the preexisting trails, almost like a magnet… in time, it becomes more and more difficult to glide down the hill on any other path.”
The solution to this rigidity of thoughts? “Think of psychedelics as temporarily flattening the snow,” Kaelen continues. “The deeply worn trails disappear, and suddenly the sled can go in other directions, exploring new landscapes, and literally, creating new pathways.”
Psychedelic drugs as mental health treatment may seem like a new idea, but LSD and psilocybin were originally adopted by the psychiatric community in the 1950s, and the drugs were used to treat a variety of disorders, including alcoholism, anxiety and depression. “For most of the 1950s and early 1960s,” Pollan writes, “many in the psychiatric establishment regarded LSD and psilocybin as miracle drugs.”
“The dark side of psychedelics,” he continues, “began to receive tremendous amounts of publicity - bad trips, psychotic breaks, flashbacks, and suicides - and beginning in 1965 the exuberance surrounding these new drugs gave way to a moral panic.” By the end of the decade, these promising psychiatric tools were illegal and underground.
In the 1990s, interest to reexamine the once-shunned psychedelics began to grow. Research and debate has gone mainstream in the last five years, with prominent exposure from Pollan’s 2018 book, and a variety of blog posts from author-influencer Tim Ferriss, who regularly updates his million-plus followers on the status of psychedelic medicine (and has invested millions of dollars into nonprofit psychedelic research around the world).
The four most promising substances currently being researched for mental health optimization are: LSD (Lysergic acid diethylamide, a molecule synthesized in 1938), psilocybin (a compound produced by more than 200 species of mushrooms), MDMA (commonly known as ecstasy) and ketamine (traditionally used as a horse tranquilizer).
As an avid rule-follower, I had never sought out the still largely illegal psychedelic substances for my own use. But if there was something that could help Mary, I wanted her to know about it.
Within a few weeks of her experimenting with micro-doses (small doses that do not produce a hallucinogenic effect) and macro-doses (larger doses that do) – under the guidance of her therapist – Mary was sending me much more positive texts. It was not a magic bullet – there were still hard days, and a long road ahead to build up positive mental health – but it was exactly what we hoped it would be: a boost. A tool for Mary to find her own way forward.
Right around this time, a new friend of mine, Sarah, had begun training to become a volunteer psychedelic peer counselor. My curiosity over psychedelic drugs, Sarah’s entrance into my life, Mary’s positive experience, and an overall dip in my own mental health all collided to convince me that maybe I could give psychedelic medicine a try as well.
Sarah put together a micro-dosing regimen for me, but she strongly encouraged me to do a session with her first (a macro-dose). She said that a lot of the takeaways of the psilocybin would be more strongly felt and internalized if I was able to have “the full experience.”
We – myself, my husband, and Sarah – convened at her Manhattan apartment one morning in April 2021. She had laid out a mattress and pillows on the floor and put out some light snacks, and we commenced to eat a selection of carefully weighed-out mushrooms.
From the outside, what followed would probably be described as a bad trip. I spent most of the morning and afternoon curled up in a ball on the floor, sobbing and wailing. But from the inside, once I got past the initial nausea, the experience was overwhelmingly positive. I went home that afternoon and reflected in my journal, as Sarah had recommended, about what had transpired:
“Certainly a shift. Still me, but with a softness. Greater ease. Being present felt easier. My attention kept being brought back to releasing tension in my muscles. I felt a layer emerging around my skin: resilience, a sense of self. I felt like I could notice moments of being myself in a manner that seemed to be at ease with my own happiness and that of those around me. I was at first very aware/concerned about myself in relation to others – What did they think? Was I a burden? – but finally came to realize there was nothing wrong I could do if I was authentic and myself.”
Many of the world’s most important research institutions (309 by this count, including Yale, Johns Hopkins, Stanford, and Northwestern) have conducted trials of psychedelic medicine. The overall consensus, supporting my own and Mary’s experiences, is that psychedelics show a lot of promise in treating stubborn mental health disorders.
The downsides of psychedelic medicine right now center on the fact that these drugs are still largely illegal: they’re expensive, access is difficult, and the substances aren’t controlled. Negative results arise because people aren’t taking the right doses, they’re receiving drugs that are laced with something else, or they’re unable to find an experienced guide.
Without long-term studies, researchers are also unsure if other problems may emerge: there’s evidence to suggest that micro-dosing psilocybin may cause heart damage over time, LSD has been known to cause aggression and poor grooming in lab rats, and there is even concern about the long-term sustainability of natural sources for psychedelics.
And another problem is arising, one that none of the major reports are considering: equity in psychedelic medicine. While many of the most famous proponents of psychedelic medicine, like Pollan and Ferriss, are white men, my personal connection to psychedelic medicine had been women of color (both Mary and Sarah). So, I wanted to know, what are the barriers to equity in the psychedelic medicine space?
I spoke with Robin Divine, of Black People Trip and The Black Psychedelic Equity Fund, about equity in this space, which as it becomes more mainstream, also risks becoming more exclusionary.
Divine, who in 2020 was suffering from depression compounded by the pandemic, sought out alternative treatment. She did her homework, found a guide, and did a psilocybin trip about two months later. “It wasn’t a cure-all,” she says, paralleling my experience and Mary’s, “but it was an opening. I saw a possibility of feeling better.”
But as much as Divine had had a positive experience with the medicine, her experience with the (white) guide left something to be desired. “The session was full of a lot of harm, a lot of microaggressions, a lot of just not understanding me.” So, she launched Black People Trip later in 2020, where she provides education on psychedelic communities, particularly aimed at overcoming the stigmas against drug use and therapy. She also educates guides and medical professionals on “how to hold space for Black people… there is a different level of care that is needed.”
She then launched the Black Psychedelic Equity Fund, to help cover the cost of psychedelic treatment for Black communities as well as cover the educational fees for Black future therapists. “My thing is just to lower the barrier to care, to education, and to therapy for Black folks in this space.”
With the novelty of research surrounding the wheel of psychedelics, there are spokes and spokes of moving parts, excitements, and concerns. And it’s all in the name of improving global mental health: a problem as stigmatized as it is insidious.
Part of what makes mental health treatment so difficult is the stigma around it. The more we try to hide our mental health problems, engendering shame and anxiety, the worse they become. It’s time for a new approach to mental illness: one that treats it as a legitimate health concern, rather than a character flaw; one that is open to all possibilities of treatments; and one that prioritizes equity. There is a great opportunity to check all these boxes with psychedelic medicine, if we take a justice-oriented approach from the beginning.