Can Psychedelics Help Treat Depression?

Australia recently approved healthcare providers to prescribe psychedelics for depression and PTSD. Here’s a look at what the science says about this therapy, and the legal status of this potential mental health treatment.

For much of the past 50 years, psychedelics have been viewed as harmful drugs by mainstream Western culture and medicine.

However, over the past few decades, renewed interest in their potential medicinal abilities has sparked research into using psychedelics for mental health treatment.

Combined with therapy, psychedelics may be able to help treat mental health conditions like depression, anxiety, or post-traumatic stress disorder (PTSD), as well as substance addiction.

While the medical community is still figuring out the mechanisms behind psychedelics treatment, and what form that treatment could take, results appear promising.

Here’s an overview of current research and laws around using psychedelics to treat depression and other mental health conditions.

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What are psychedelics?

Psychedelics are hallucinogenic drugs. They can be derived from certain plants or synthetically produced.

The more well-known psychedelics include:

• LSD, commonly called acid
• MDMA, commonly called ecstasy or molly
• mushrooms containing psilocybin, commonly called magic mushrooms or shrooms
• peyote
• ayahuasca

Psychedelics alter a person’s perception of reality, causing visual, auditory, and sensory hallucinations, and changing thought patterns and feelings.

Naturally-occurring hallucinogens like peyote and ayahuasca have traditionally been used by indigenous peoples in religious, cultural, and healing ceremonies.

Outside of clinical settings, some people also use hallucinogens like peyote and ayahuasca as a form of self-healing or for self-exploration.

Western clinical research into psychedelics and mental health began in the mid-20th century, but was soon met with backlash from the United States and the UN. As a result, psychedelics have been banned since the 1970s. Up until recently, that is.

Can psychedelics help treat depression?

Much of the current medical attention surrounding psychedelics as treatment for mental health — also called “psychedelic-assisted therapy” — centers on MDMA and psilocybin (the magic mushroom compound).

While research is ongoing into whether psychedelic-assisted therapy can help treat depression, and how effective it is, studies conducted on these psychedelics over the last couple decades show promising results.

This 2023 systematic review analyzes studies examining the effects of psilocybin on symptoms of mental health conditions, including depression.

The review reports that, in all studies included, psilocybin treatment effectively reduced anxiety and depressive symptoms, and improved health-related quality of life — all without serious side effects.

Combining psilocybin and talk therapy brought symptom improvement in as little as 2–4 weeks following a psilocybin session. Improvements in mood lasted at least 6 months after psilocybin treatment had ended.

The review also underlines that more research is necessary to:

• continue testing the effectiveness of psilocybin-assisted therapy in larger studies
• determine who would most benefit from this type of treatment
• establish guidelines for treatment

How does psilocybin compare to traditional antidepressants?

This 2021 study examined psilocybin and escitalopram (Lexapro) in patients with moderate to severe major depressive disorder (MDD) over a 6-week period. It found no significant difference between the two, meaning the effectiveness of psilocybin treatment for depression was comparable to the effectiveness of antidepressant treatment.

This 2018 study explored amygdala response following psilocybin treatment in people with moderate to severe MDD.

The amygdala, located in the brain, is responsible for emotional processing. In people with depression, the amygdala can be hyper-sensitive to negative emotional stimuli, making it difficult to process negative or upsetting emotions. SSRI antidepressants help to ease depressive symptoms in part by dulling this overactive amygdala response.

Not only did the study find that psilocybin combined with therapy improved depressive symptoms, it also found that psilocybin users showed increased amygdala responses to both positive and negative emotional stimuli.

The study suggested that psilocybin may revive overall emotional responsiveness as compared to SSRIs, helping people with depression reconnect with, confront, and work through their emotions.

However, it’s important to keep in mind that taking higher doses of psilocybin and other psychedelics can make you “trip.” While this may work for some people, not everyone responds well to tripping, whether mentally, emotionally, or physically. In other words, psychedelic-assisted therapy isn’t for everyone.

Risks associated with psilocybin

Short-term mental health symptoms

• bad trips
• hallucinations
• euphoria
• confusion
• paranoia

Long-term mental health symptoms

• hallucinogen persisting perception disorder
• fear of flashbacks
• anxiety
• avoidance of situations that might trigger flashbacks
• poor sleep

How do psychedelics help treat depression?

Research into the mechanisms behind how psychedelics may help treat depression is also ongoing, but studies suggest that these drugs promote neuroplasticity, similar to certain antidepressants.

Neuroplasticity is the ability of the brain to form new connections between neurons. Essentially, it’s how our brains “rewire” themselves.

In people with depression and other mental health conditions, neuroplasticity may be restricted or even suppressed. When this happens, the brain is literally stuck in a loop: amplifying fear and sadness, worsening depressive symptoms, and causing the person to ruminate on upsetting emotions.

Now, back to the potential of psychedelics.

If psychedelics, like certain antidepressants, can help promote neuroplasticity, this may enable our brains to break out of that loop, grow new connections, and rewire themselves — and in the process, change thoughts and feelings, and ease symptoms of depression or other mental health conditions.

What’s the legal status of psychedelic-assisted therapy?

While research is ongoing into whether and how psychedelics may treat mental health conditions, some places around the world have decided they’re satisfied with current medical understanding.

First up is Australia, where psychedelics were recently approved as clinical treatment for certain mental health conditions.

As of July of 2023, psychiatrists in Australia can prescribe:

• MDMA to treat PTSD
• psilocybin to treat treatment-resistant depression

Certain requirements must be met for patients to receive psychedelic-assisted therapy, including the following:

• Psychiatrists must obtain special authorization to be eligible to prescribe psychedelics.
• Psychiatrists must demonstrate that other forms of treatment have been unsuccessful for the patient in question.
• Psychedelics can only be administered in strictly-controlled medical environments, meaning patients take the drugs in medical settings and under medical supervision.

Patients must also participate in talk therapy before and after psychedelics treatment, ensuring that they continue to receive ongoing complementary mental health care.

Swinging around stateside, psychedelics decriminalization and legalization measures have recently been passed in states like Oregon and Colorado, and cities like Oakland, Washington D.C., and Seattle.

However, there’s one crucial difference compared to Australia: no U.S. law currently authorizes medical treatment with psychedelics, meaning psychedelic-assisted therapy is not legal.

Take Oregon for example, the first state to legalize supervised adult use of psilocybin.

The Oregon law never uses the word “patient” — rather, participants are referred to as “clients.”

Before a psilocybin session, participants must sign a consent form acknowledging that “psilocybin services do not require medical diagnosis or referral and that psilocybin services are not a medical or clinical treatment.”

Psilocybin must be used in the presence of a “facilitator.” Facilitators play a purely supervisory role, not a medical or clinical one. They can’t treat or diagnose mental or physical health conditions, whether before, during, or after psilocybin sessions — even if they’re also a licensed medical professional.

Following psilocybin sessions, participants have the option to debrief their experience with their facilitator. However, this debrief isn’t therapeutic or clinical treatment.

What does this all mean for psychedelics in the United States?

Put concretely, while psychedelics have been authorized in certain settings in the United States, they’re not currently approved for medical or clinical treatment of any health condition.

In this way, current legal psychedelics use is comparable to other alternative treatment methods for depression and mental health conditions, like yoga or meditation. These methods may be able to complement clinical treatment, but they’re not clinical treatments in and of themselves.

Still, while U.S. laws regarding psychedelic-assisted therapy for mental health aren’t yet as wide-ranging as Australia’s, the FDA granted a “Breakthrough Therapy Designation” to MDMA for PTSD in 2017, and to psilocybin for treatment-resistant depression in 2019.

This special FDA designation helps expedite the development and review process for drugs and medications that show promise as effective treatment for serious conditions.

In other words, approval of psychedelics as clinical treatment for depression and other mental health conditions in the States could come sooner than we think.

The takeaway

Over the past couple of decades, renewed interest in the medicinal powers of psychedelics has prompted changes in the way Western medicine views these drugs.

Recent research has shown that psychedelics, in combination with talk therapy, may be able to effectively help treat depression and other mental health conditions.

In Australia, psychedelic-assisted therapy is now a clinical option for depression and PTSD treatment. Some places in the United States have also legalized or decriminalized psychedelics for supervised, non-medical use.

While psychedelics are not currently authorized as medical treatment in the United States, the FDA and research centers are exploring the possibility of this treatment method for mental health conditions.

Psychedelic-assisted therapy — in controlled medical settings, with healthcare professionals, and accompanied by talk therapy — may soon be an option.