Tag Archives: antidepressant withdrawal

Mary and the Mushroom: Psilocybin, Chronic Depression and Me (9)

Sobbing at the Symphony, an Amazing Film, and Other Trip Preparations

As the date of my first (only?) psilocybin dose moves closer, I find myself suspended between the relative certainty of what is happening now and the mystery of what will happen afterwards. This feeling of suspension (or should I say “suspense”?) is no doubt attributable in part to the aura of unreality that accompanies antidepressant withdrawal, and in part to my efforts to learn everything I can about psychedelic experiences in advance of actually having one.

It has been nearly three weeks now since I took my last dose of the SSRIs I’ve been on for several decades. The side effects of withdrawal, which I also described in my last post, continue, including the unwelcome feeling every few minutes that a series of little electrical-like pulses are shooting through my brain (aka “brain zaps”), a tendency to burst into tears at the slightest provocation, anxiety, and a more-easily-triggered impatience than is typical for me. I feel as though these side effects are diminishing (I hope so), but it’s also possible that I’m just getting used to them.

Tired of Thinking about my Self

Concurrently, I have been reading and listening to and viewing so much material that relates to psychedelic trips, mushrooms in general, and states and conditions of consciousness, that I am growing tired of the whole subject. I tell myself versions of the following: “This is ridiculous! People drop acid all the time without totally immersing themselves in the science, philosophy and history of it all and perusing narratives that chronicle the experiences of other people. Sure, maybe all they get is a little break from reality, but that is all they’ve asked for: they do not expect to emerge with dramatic alterations to their world views. These are just fungi, after all.”

Of course, there’s a fear of disappointment woven into all of this: after all of the preparation, what if mine is a one-day trip that takes me nowhere? Michael Pollan, whose latest book has become a core reference for those who are interested in how psychedelics can “change [their] mind,” emerged from his first two trips – one on LSD, one on psilocybin – feeling somewhat disappointed, and fairly certain that what had happened to him was not likely to have any permanent effect.

On top of everything else, my anxiety often presents itself as a form of self-castigation that I’m sure is familiar to most people who are dealing with mental health issues: What if I am just blowing everything out of proportion? (To which I answer, Of course I am. That’s part of what I am trying to stop doing.) (<– Circular thinking is another symptom of depression, but it also often seems to be a logical and compelling form of discourse.)

On the other hand….

I’m probably just experiencing information overload. The behaviour that’s led to this is typical of me: when I’m going on a real-life journey, I study as much as I can about the destination before I go, and even attempt to acquire a little of the language in advance. I admit that what I’m learning about psychedelics in general and mushrooms in particular has been interesting and useful no matter what the outcome, and writing about it has been helpful. And I’m happy to hear that it’s also helping others who are in similar circumstances.

The psychiatrist who is supervising “my” research study has suggested that, for a couple of weeks before the dose and at least a week after, I avoid engaging too much with the world on this subject (or most others), as I will want to think about my own expectations, and then about the effect the experience has had on me. To that end, I envision two more pre-dose blog posts – one a review of Pollan’s book, and the other an account of what I am looking forward to and concerned about as the dosing date approaches.

The Study

A few people have asked me what it’s like to be in this research study. Up to this point, the experience has primarily consisted of administrative steps (a blood test, a referral from my family physician, etc.) and completing a whole lot of questionnaires about my state of mind, and about the medications I am on and have been on. The same questions keep appearing on new surveys and seem to be designed for easy processing by computer: most of the questions are Yes/No or number-based (e.g., “For how many years have you been [xyz]?”). I expect the same questions will form a significant part of the follow-up as well: that’s how research works.

I get emails about once a week from the study coordinators asking how I’m doing, and I had a good conversation with the psychiatrist about the withdrawal symptoms. This week I received a list of appointments I am expected to attend before and after the dosing. There are about twenty appointments on the list, extending right through December – about half virtual and the rest in person.

A few appointments before the dose will involve discussing my expectations with the two-person team to which I’ve been assigned, and afterwards we’ll talk about how the experience has affected me. There will also be more surveys, and more blood tests.

Fantastic Fungi: A Fabulous Film

Thanks to several enthusiastic recommendations, including from a couple of biologists in the family, this week I watched a film called Fantastic Fungi. I recommend it to you with equal enthusiasm. (Check out the preview here; you can watch the film for “free” if you have Netflix.)

Fantastic Fungi does talk about psilocybin trips, but its primary focus is on the many other “magical” properties of mycelium and the mushrooms that emerge from it. Along with an explanation voiced by Brie Larson (Go, Captain Marvel!) of what fungi are and how they operate (“There is a world under the earth, full of magic and mystery…” she begins), the film features lay and scientific experts in the field of mycology, including Paul Stamets, Roland Griffith, Andrew Weil, Pollan, and nature and food journalist Eugenia Bone.

The film shows us how fungi already fulfil roles in nature that we are only beginning to understand (they serve as networks of communication among plants and trees in very similar ways to those in which humans use the internet), how they can be used to solve immediate problems (termites in your house? Stamets has cultivated a fungus that will destroy them without harming the environment), and how they can help us to address long-term issues affecting the future of the planet (check out the segment that compares traditional ways of cleaning up oil spills and what happens when fungi are introduced to do the same: not only do they clean up the mess, they start whole new colonies of growth and life). There is convincing evidence that after we humans finish destroying ourselves and the environment, the mushrooms will be here to clean up and rejuvenate our planet – a mycelium staff preparing for the hotel’s next set of visitors, a staff that is fully equipped to survive and thrive on their own if new guests don’t show up.)

Fantastic Fungi is entertaining and educational, and watching it might well change your view of the world.

Fears of Tears

This past week I attended a truly magnificent production of Beethoven’s Symphony Number 9 that featured not only the entire Toronto Symphony Orchestra but also the superlative Toronto Mendelssohn Choir and four outstanding soloists flown in for the occasion from around the world. As the concluding movement approached, I felt a growing sense of apprehension: I was watching the hundred-or-so members of the choir sitting quietly above and behind the orchestra, clad in dramatic black-and-white, ecclesiastical-looking robes and black masks, awaiting the moment when they would stand and sing. As almost everyone in the building knew, this was going to happen in the fourth movement of the symphony, which includes the powerful and uplifting anthem to peace, “Ode to Joy.”

I knew that when they rose, my wobbly illusion of emotional stability was going to take a direct hit. I feared I would be so overwhelmed by emotion that I would be unable to avoid contributing loud tuneless sobbing and hiccoughing noises to the soundscape, seriously diminishing the pleasure of those around me.

As it turned out, I was right about the first part: given everything that is happening in the news, no power on earth or anywhere else could have stopped the tears from pouring down my face and into my mask as the movement began and the choir rose to sing. This waterfall continued beyond the final note and through the standing ovation, both extended and passionate, that seemed to launch itself unbidden on cries of “Bravo!!” from the audience. But to my relief, I did not make a scene.

Afterwards, I told my friend Ksenija – my TSO companion and a woman who has enjoyed superbly performed classical music since she was a child in Europe – that I had never been so viscerally moved by a concert, so unable to stop the tears. She said, “But Mary! Tears are perfectly natural when you hear great music.”

She’s right, of course. They are. And in retrospect I think that to have been able to listen to that monumental work in these hard times, and to have been able feel it all – my emotions unobstructed and undulled by antidepressants – was a gift that was both absolute agony and absolutely glorious.

I really hope that my guides choose less staggering music to play when I am launched into the psychedelic universe (music and eye masks are traditional components of a guided psilocybin experience), and that is one of the things that I now intend to ask about ahead of time. But in the meantime, no matter what happens to me as a result of ingesting psilocybin – and even if nothing does – I will have gained one unforgettable experience that I would never have had if I hadn’t become involved in this study.

So there’s that.

TSO and Mendelssohn Choir assembling before Beethoven’s Ninth.

Mary and the Mushroom: Psilocybin, Chronic Depression and Me (8)

An Update: Antidepressant Withdrawal, Brain Zaps and Other Pre-Tripping Diversions

When I was pregnant forty years or so ago, it seemed like the whole world was pregnant. Everywhere I looked there were baby bulges forcing apart the front openings of winter coats and women displaying the latest “maternity smock fashion.” I don’t notice pregnant women so much any more but these days, the same mechanism is at work when it comes to psychedelics. Perhaps because a lot of people are aware that I am planning and preparing for a psychedelic experience, they are referring me to articles, videos, scientific reports, and other materials that they know may be of interest to me. Many tell me stories of their own experiences. (One person told me that she’d been to a wedding recently where, at the reception, the father of one of the central players offered mushrooms to the guests. What??? I don’t think tripping promotes the kind of behaviour one anticipates at wedding receptions! Sociability is one thing, falling in love with the universe during the toast to the groom is another. Bad trips on the dance floor would also be a downer. But what do I know? I’m still a psychedelic virgin.)

On a more serious note, several people have reached out in person, in emails and on social media to say that my blog is relevant to their own depressions or those of loved ones, and has engendered hope in them for a prospective treatment. This pleases me considerably, because that is one of the reasons why I started to write this blog series in the first place.

But it’s not just material that is brought to me by others that I’m noticing: my awareness antennae are up in the same way as they were to “baby bumps” (not that we called them that) back in the day. Thanks to the growing public interest in psilocybin and LSD, these days it seems like I am seeing references to psychedelia everywhere. On May 19, for example, The New York Times Sunday Crossword offered a clue at 28 Down that read “Tab inits [initials].” My first thought was of computer tabs, so I tried “ESC” but I soon realized that the correct answer was “LSD.”

My husband and I watched Nine Perfect Strangers for at least one episode before twigging in to the fact that the plot revolves around the non-consensual administration of psychedelics to the clients at her “health resort” by a very peculiar healer (played to a T by Nicole Kidman), who has more method to her madness than it may at first appear. We did watch the rest of the series, mainly because we couldn’t stop watching it, and we were surprised that as critics we were ultimately satisfied with the outcome, but I was quite unsettled by a lot of it because the whole conceit was far more “oogie boogie” than I am interested in contemplating when it comes to my own psychedelic trip next month. Fortunately Melissa McCarthy was there to cut through the bullshit on a regular basis. (Note: I think there should be a warning to those who contemplate watching Nine Perfect Strangers: if you have endured the agony of losing a child, you should be aware ahead of time that this is an issue that is explored extensively in the series. I have since learned that people on LSD and psilocybin trips often feel as though they are in the company of friends and relatives who have died, but whether this is a beneficial or negative experience is certainly a personal decision.)

Tapering Antidepressants

I am now half way through the tapering of the antidepressants (duloxetine, the generic form of Cymbalta, which is a serotonin-norepinephrine reuptake inhibitor or SNRI) that I have been on for more than a quarter of a century. In the study I am in, going off them is a requirement before receiving a dose of psilocybin. “Tapering” is not fun, and as I must decrease my consumption from half of my former dose to zero at the end of this weekend, I don’t think it’s going to get any more fun for a while.

I am having the kinds of experiences one might expect from being depressed and not being on antidepressants: a tendency to burst into tears at just about everything personal or circumstantial; paranoia and anxiety (yesterday, I was desperately worried that something I’d said on Facebook had offended a dear friend. Fortunately it had not); and even more anger than I normally carry around with me. The news in recent weeks/months has not helped, of course: you’d have to be a psychopath not to be moved to tears and rage by a lot of recent news stories, and I know my response is not unique to those suffering from depression. But I can get into disproportionally massive twists over things I have little capacity to control: such as the fact that a lot of therapists are already making a lot of money from patients who now believe that ketamine is a psychedelic, which is isn’t. As I have said before, there is evidence that ketamine and MDMA administered therapeutically can alleviate depression for a few weeks or months, giving patients some breathing room in which they are able to undertake some cognitive-behavioural or other kinds of therapy, but these substances do not occasion the kind of dramatic and permanent change in awareness reported by many who have used psilocybin or LSD. They can also be addictive, which psilocybin isn’t. I will do whatever I can to straighten out people’s thinking on this subject, but if we can’t even get people to agree that masks prevent Covid transmission, I’m not making it my life mission. I might as well tilt at windmills. (Speaking of which, I wrote a novel a few years ago with my friend John A. Aragon that is based on the great Cervantes tale of Don Quixote. Entitled The Adventures of Don Valiente and the Apache Canyon Kid, it’s funny and heartwarming. Sorry. But I couldn’t just let the windmill metaphor go by without a plug for the wondrous DV, whom my co-author and I continue to cherish.)

Brain Zaps

The worst side effect of the antidepressant withdrawal is a phenomenon called “brain zaps,” a symptom I’ve never before experienced and with which I can’t wait to finish. They are explained at Medical News Today as “electrical shock sensations in the brain. They can happen in a person who is decreasing or stopping their use of certain medications, particularly antidepressants. Brain zaps are not harmful and will not damage the brain. However, they can be bothersome, disorienting, and disruptive to sleep.” The article goes on to say: “In a study that surveyed people who were experiencing brain zaps, people described them as:

  • a brief, electrical shock-like feeling in the brain
  • a short period of blacking out or losing consciousness
  • dizziness or vertigo
  • a zap paired with a buzzing sound
  • “hearing their eyes move”
  • feeling disoriented (a “brain blink”)

I am experiencing the first, third and sixth of these brain zap manifestations almost constantly (thank god I am not “hearing my eyes move”!), and I do not like them one bit. However, I know that with any luck they will go away after a few weeks of total cessation from the medication. The psychiatrist to whom I’ve been assigned in the clinical trial said if they were bothering me too much, I could increase my dosage again for a little while, but I’ve come this far and I am not retreating. I’ve withdrawn from much worse drugs than this (alcohol and nicotine). By the way, I am impressed by the support I have received so far by the investigators on the research team: they check in with me regularly to see how it’s going, and have offered a one-on-one zoom call with the psychiatrist about the withdrawal symptoms, which I have “happily” accepted.

It is only because I am hopeful (albeit also scared. More about all that in a future post) about the psilocybin treatment that I am willing/able to put up with how I feel at the moment. All I can do is move forward, one day at a time, and request the indulgence of my friends and loved ones as I go through this. (They are gentle, kind and understanding, and I am grateful.)

My hope has been fed recently by several things I’ve read. The primary one is Michael Pollan’s book, How to Change Your Mind, which I am reading slowly with an intent to review it in the next post here. Another was an article in The Guardian about the American writer William Brewer, who said of his most recent novel, The Red Arrow, “The writing really got going in 2019 after I finally underwent psychedelic therapy for the depression that had controlled my life for a long time. I was able to write in a way I hadn’t before because my brain had just been so clouded. [….] I was given a dose of psilocybin mushrooms at 10 in the morning, and by 4.30 in the afternoon it felt like a 50 lb tumour had been cut out of my back.” Brewer describes the experience thus: “It isn’t a wild and crazy light show so much as an elegant revelation of how things are connected. Psilocybin, especially, gives you this real sense of momentum, and I wanted that for the book.”

That sounds like an outcome for which I am willing to put up with a few weeks of brain zaps.