Depression therapy

Adrift on the Ocean

Psilocybin, the active ingredient found in certain mushrooms, expands the boundaries of the self and reduces anxiety. Psychiatrist Franz X. Vollenweider wants to harness this effect to treat patients suffering from depression.

Roger Nickl; English translation by Philip Isler

Halluzination
Halluzination
If psilocybin is taken in the right dosage, it can trigger a positively experienced "oceanic" ego-delimitation. (Image: iStock / rancescoch)


People with depression are overly focused on themselves. “They’re constantly occupied with themselves,” says Franz X. Vollenweider, “and not in a good way.” Depressed people live in a permanent state of self-loathing. They feel as though they’re never good enough, they feel useless and believe they never get enough feedback from others. They are caught in a maelstrom of negative thoughts and emotions, which saps them of all joy and motivation. Breaking out of this downward spiral is difficult. Only around half of patients with severe depression respond to conventional forms of therapy and antidepressants.

At the University Hospital of Psychiatry Zurich, Franz X. Vollenweider is working on a promising new method, which aims to improve the success rate of treating depression. A psychiatrist and neuroscientist, Vollenweider has been researching the psychological and neurobiological foundations of the human ego as well as diseases such as depression and schizophrenia for decades. His most recent therapeutic approach revolves around psilocybin, the active ingredient found in “magic mushrooms”. These mushrooms have been known to many cultures for a long time and have often been used as medicine in religious rituals. They also happen to grow on meadows in some regions of Switzerland. For a few years now, researchers have been investigating the mushrooms' active ingredient in detail for psychiatric purposes.

LSD’s little cousin

Psilocybin is often described as LSD’s little cousin, and like its chemical relative, it has a mind-expanding effect on those who ingest it. The research of Franz X. Vollenweider is concerned with how the drug affects our brain, emotions and sense of self. “The right dose of psilocybin, taken in a supportive therapeutic setting, can trigger a positive, ‘oceanic’ dissolution of the self,” says Vollenweider, “and when the boundaries between the self and your surroundings begin to blur, a deep feeling of unity with others and the world sets in.”

And that’s not all, as the professor of psychiatry’s research has also demonstrated that psilocybin reduces anxiety and has a positive effect on the regulation of emotions. This stands in contrast to the widely held belief that mind-expanding drugs such as LSD or magic mushrooms inevitably result in people having “bad trips”. The key to unlocking the positive effect is in the dose, believes Franz X. Vollenweider. It takes a considerable amount of psilocybin for one's coherent sense of self, along with the ego's integrating functions, to fall to pieces, as it were. This can result in people feeling uncertain as to whether they are still the originator of their own thoughts and emotions, which can cause fear or even panic – and indeed devolve into a bad trip.

With the right dose, however, psilocybin can reduce anxiety, even in patients suffering from depression, as trials in Vollenweider’s lab have shown. In one such study, he presented various images to healthy test subjects and observed their brain activity. Some of the pictures triggered positive responses, whereas others, for example scenes of an accident or angry or hate-filled faces, caused negative feelings. Patients with depression usually respond more strongly to such negative stimuli than healthy people. As it turns out, psilocybin not only moderated the response in the brain regions responsible for anxiety, but also subjectively softened the anxiety-inducing effect of the negative stimuli in the pictures. “Psilocybin enables patients to momentarily step back from what they’re experiencing,” says Vollenweider, “and it allows them to deal with emerging traumatic experiences and fears in different ways, and to reassess and integrate them.”

Less depressed

The effects of psilocybin last for about one and a half hours. Beyond this, however, the active ingredient also has a more long-term positive effect, as Vollenweider and his research team discovered. After receiving one to two doses of psilocybin over a period of three to six months, patients felt significantly less depressed than before. All these positive properties have convinced the psychiatrist to step up the use of psilocybin when it comes to treating patients suffering from depression. He also hopes to be able to help patients with severe depression who have so far not responded to conventional drugs.

However, he knows that the use of psilocybin alone cannot replace the traditional talk and behavioral therapies, but should rather support and complement them. “It opens an inner window to a different, more positive self,” says Franz X. Vollenweider. “Patients with depression have told me that it gave them a moment’s respite and stopped them from constantly pressuring and abusing themselves.” This is something psychological treatment could build on and attempt to bring over from the realm of the psychedelic into the real world – for the sake of allowing the tortured self to heal.

Roger Nickl, Editor UZH Magazin; Philip Isler, UZH Communications

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