Ecstasy and mushrooms are being used by the medical and psychiatric community to help heal depression, anxiety, and PTSD. Both these substances have recently been approved for further studies of their ability, with highly trained support in a controlled setting with active therapy, to help patients who have not found relief elsewhere.
A story in the New York Times today discusses the use of psilocybin, also known as magic mushrooms, in patient’s whose cancer brought them to a desperate place of depression and anxiety. While the researchers are not clear on how this drug works exactly, the trials thus far show it is effective, and after only one dose when administered in a controlled setting by psychiatrist and a social worker in a session lasting 8 hours. There were two small studies and both reported success with patients in whom traditional treatment had not led to improvement. There are also studies being done to look at its role in addiction treatment and non-cancer depression.
A story linked to in this same article discusses the use of ecstacy, or Molly/MDMA, in treating PTSD (post traumatic stress disorder). We think of this in soldiers who have returned from war, but it occurs in civilians with the same triggers- either a single traumatic event or repeated traumas like abuse. It seems that while the brain is under the influence of this medication, it can finally confront the trauma that caused the condition and this trauma can be dealt with during a therapy session much like the one used in the psilocybin trials. The brain and body overreact in an inappropriate way to a given stimulus and can’t stop- to the point where it interrupts the person’s life. This can manifest in nightmares or panic attacks or other reactions that make daily living incredibly difficult.
While psilocybin is a natural substance, and MDMA was created in a lab, both seem to allow the patient to look at themselves and their experiences from a detached perspective and examine thoughts and emotions. Despite a number of treatment approaches including medications and psychotherapy techniques, there is none that hugely effective in treating PTSD and many other mental illnesses. The FDA is allowing these studies to proceed in hopes of offering a cure, in a relatively short course of treatment, for illness that is resistant to conventional therapies. Moving these drugs off the most restrictive DEA schedules is essential to conducting clinical trials, just like what needs to be done for marijuana (which I wrote about last week). I’m looking forward to a day when all medications that have the potential to be medically useful are allowed to be fully investigated in clinical trials.
So the reality of our recent election is setting in. No matter how you voted, there is a lot of uncertainty ahead in the next few months. If the trend continues, it feels like anything could happen in the home stretch of 2016. We have seen horrible violence both abroad and domestically, and some of it has been been perpetuated by our own citizens against fellow citizens. I’ve had many friends ask me not-so-jokingly if I’ve had an increase in requests for xanax. They have symptoms of insomnia, crying, displaced anger and intense muscle tension. They tell me they may be in to see me soon as a patient.
- An anxiety state defined by our medical coding is “Apprehension or fear of impending actual or imagined danger, vulnerability, or uncertainty” (ICD 10 code 2016-17 where ICD means International Classification of Diseases). While generalized anxiety disorder is defined as persistent physical symptoms of anxiety for 6 months, an anxiety state may be temporary. If this temporary state is interfering with your ability to live your life you may need some short term medical help. In a couple of weeks I imagine some people will meet the criteria for an adjustment disorder or even depression. Here are two definitions from the ICD codes that qualify a diagnosis of adjustment disorder- they sound pretty relevant right now don’t they?
- A category of psychiatric disorders which are characterized by emotional or behavioral symptoms that develop within 3 months of a stressor and do not persist for more than an additional 6 months after the stressor is no longer present.
- Social, psychological, or emotional difficulties in adapting to a new culture or similar difficulties in adapting to one’s own culture as the result of rapid social or cultural changes.
The bottom line is that if you are concerned about how you’re handling the turmoil of this year, especially with the recent election, please talk to someone about it. We want to help you and throw you a life preserver if needed.