Mary and the Mushroom: Psilocybin, Chronic Depression and Me (5)

A Brief Aside about Microdosing

A note to new readers: I have recently applied to be included in a Health-Canada-approved study into the use of psilocybin in the management of treatment-resistant depression (TRD). I have survived the first few stages of the screening process and I hope to join the study in a couple of months. I will share the experience with interested readers here. In the meantime, how I got to this point is the subject of this series of blog posts.

The continuing onslaught of absolutely bat-shit-crazy, apocalyptic-type news has probably driven almost every thinking person on the planet into a state of persistent anxiety and depression; such feelings are not exclusive to those of us with baseline life views that have more in common with Eeyore than Pollyanna. There are times when I almost envy people who seem to have found a new sense purpose and community in groups exchanging false information and conspiracy theories. (Kidding.)

These days, in short, most of us would probably welcome a magic pill that could, almost overnight, alleviate our depression and anxiety enough that we could stop doom-dithering and get on with the initiatives over which we do have some actual control. Such outcomes are, of course, among those promised by psychedelics. At times I find it beyond aggravating to know that such substances do exist, but that I am currently unable to access them.

As I’ve mentioned in previous posts in this series, one significant barrier to seeking immediate relief through psychedelics is the illegality of their use outside of clinical settings. This doesn’t stop a lot of people from giving them a try, but it does raise concerns about quality control for those attempting to source such products. In my case, there is an additional constraint: the researchers conducting the study in which I believe I am now registered require that participants not use psychedelics for a year before their experimental doses.

If I were free of constraints and concerns about experimenting with psychedelics on my own, before I wrote this post I would likely have started with microdosing. For one thing, the effects produced by a microdose do not lead you to states of mind where you are wise to have a coach or therapist on hand (as I intend to do the first time I try a full dose). Microdosing is “the action or practice of taking or administering very small amounts of a drug in order to test or benefit from its physiological action while minimizing undesirable side effects” (Oxford Languages). In the case of psychedelics, microdosing involves taking doses of LSD or psilocybin that are so low that they are “sub-hallucinogenic,” which means that they do not interfere with the normal activities of daily life.

Microdosing usually involves taking approximately one tenth of a “trip-inducing” dose of a psychedelic drug, once every two or three days. Anecdotal evidence suggests that several such doses may be necessary before the benefits are felt.

I first heard about microdosing on one of the many podcasts now available on the subject of psychedelics. Tim Ferriss’s podcast series, for example, includes an episode entitled “Microdosing, Mind-Enhancing Methods, and More.” It is a recording (with transcript) of a 2019 conference session moderated by Ferriss in which panelists explored psychedelic science and a range of related topics, including “investing opportunities, anecdotal personal benefits, legal challenges, and much more.”

This recording is an excellent general introduction to the use of psychedelics in mental-health contexts. Panelists describe the positive outcomes shown by large doses of psilocybin in relation to end-of-life depression and anxiety, and to drug, alcohol and nicotine addiction. They also explain how psychedelics work on the brain and their effect on consciousness: in contrast to anaesthetics, which lead to a drop-off in brain activity, brains on psychedelics show an increase in the richness of their activity.

The session also featured the anecdotal experience of Ayelet Waldman, who microdosed LSD to treat her long-term, previously untreatable depression. Author of A Really Good Day: How Microdosing Made a Mega Difference in My Mood, My Marriage, and My Life (a promising title if ever I heard one!), Waldman defines microdosing with a psychedelic drug as taking just enough to have an effect on the metabolism without any perceptual effects.

Waldman microdosed LSD every three days for a period of thirty days. She says that within just a few hours of the first dose, she was paying more attention to the beauty of blossoms outside her window and she was feeling happier. After decades of depression, “That was an experience that was really mind-boggling,” she says. During the period of time she was microdosing, her general life satisfaction and productivity increased. Her account of the experience is interesting, and similar results have been recounted by thousands of other adults who have microdosed psychedelics.

However, the evidence in support of microdosing is largely anecdotal. Unlike with full doses, there is little clinical evidence so far to support users’ accounts of improvements to their mental health. In fact, a very recent article in the New York Times reports that some scientists have come to the conclusion that the benefits recounted by those who microdose are no different than those given a placebo.

Hope, Emily Dickinson tells us, is “the thing with feathers – That perches in the soul – ” and it is a powerful counterbalance to depression. When it is absent, we feel as though all is lost, that everything is pointless. I suspect that hope plays a role in the similar outcomes reported among those who microdose psychedelics and those who think they are microdosing but are actually receiving a placebo. However, a study reported in the International Journal of Psychopharmacology suggests that hope is not enough to sustain the positive effects: twenty percent of those studied in their cohort stopped microdosing because they experienced no benefits at all.

With the way humanity seems to be self-destructing in every way imaginable, if there were clinical evidence that microdosing made people calmer, happier and more accepting of our differences, I’d start advocating for traces of psychedelics to be added to the water system. But then we’d have to worry about who was doing the dosing, and why. In Aldous Huxley’s Brave New World, the populace is given a soothing drug called “soma” to keep it docile. Sparknotes explains that “Soma is a drug that is handed out for free to all the citizens of the World State. In small doses, soma makes people feel good. In large doses, it creates pleasant hallucinations and a sense of timelessness.” Sound familiar?