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← Can magic mushrooms unlock depression? | Rosalind Watts | TEDxOxford

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Showing Revision 18 created 11/30/2018 by Rhonda Jacobs.

  1. This is Kirk.

  2. He suffered from depression
    for five years.
  3. He tried antidepressants, talking therapy,
  4. and nothing helped.
  5. In May 2015, in Imperial College,
    he was given psilocybin,
  6. also known as magic mushrooms.
  7. And since that time
    he's been depression free.
  8. This is Ben.
  9. He suffered from depression for 30 years.
  10. And in that time he tried everything:
    CBT, group therapy,
  11. a list of medications
    prescribed to him by his doctor,
  12. and nothing helped.
  13. In June 2015, he was given psilocybin,
  14. and since that time
    he has been depression free.
  15. Not only had the symptoms
    of his depression gone,
  16. but in the last year,
  17. he has done an acting course,
    a printing course,
  18. he's flown on a plane
    for the first time in a decade,
  19. and his career and social life
    are flourishing.
  20. I can't show you his face
  21. because magic mushrooms
    are an illegal psychedelic drug,
  22. and he's asked to remain anonymous.
  23. Magic mushrooms -
  24. you might think of the '60s, dropping out,
  25. jumping out of windows
    thinking you can fly.
  26. You might think of going crazy,
  27. quite the opposite of what magic
    mushrooms did to Ben and to Kirk.
  28. And despite its bad reputation,
    we need to ask the question:
  29. What does this mushroom
    know that we don't?
  30. What does it do that we can't?
  31. I'm a clinical psychologist
    at the psychedelic research group
  32. at Imperial.
  33. It's a vibrant group
    of scientists and clinicians
  34. asking these very unconventional questions
    in a most conventional way.
  35. It is led by Robin Carhart-Harris -
    he's a pioneering neuroscientist,
  36. and also overseen by David Nutt,
  37. who is a world-renowned
    psychopharmacologist.
  38. And together they cut through
    ribbons and ribbons of red tape
  39. so that we could do the first
    psilocybin for depression study last year.
  40. And in this study, 20 individuals
    with treatment-resistant depression,
  41. were given a high dose of psilocybin
    in a therapeutic setting.
  42. Now, the numbers of may seem small,
    but the results were remarkable.
  43. We kept seeing these drops
    in their depression scores
  44. after the psilocybin treatment
    over and over again.
  45. Their symptoms of depression
    were going right down,
  46. much bigger reductions
    in depression scores
  47. than you would expect to see
    in trials of conventional treatments
  48. like antidepressants and talking therapy.
  49. The depression scores
    were going right down,
  50. and they were staying down.
  51. Six months after the dose,
  52. six of them were still in remission,
    no symptoms of depression.
  53. Three of them didn't really
    respond to the drug,
  54. so there were small
    reductions in their depression
  55. but only for about a week.
  56. But for 11, their depression
    was greatly reduced for about two months,
  57. and then the symptoms of depression
    started to creep back again.
  58. Now, that might sound very disappointing,
  59. but with antidepressants,
    you have to take them every day.
  60. They have some unpleasant side effects;
    it takes weeks for them to work.
  61. And they are a palliative
    treatment, not a cure.
  62. But with psilocybin treatment,
  63. we were seeing immediate reductions
    in depression symptoms,
  64. immediate relief that last for months,
    without side effects,
  65. and it seemed to be working
    on the root causes
  66. rather than just suppressing symptoms.
  67. Depression is a relentless,
    haunting affliction.
  68. Winston Churchill called it the black dog.
  69. Patients in our study called it
    a concrete coat, a sack over the head,
  70. a locked box, a prison.
  71. They had tried between
    three and 11 types of antidepressants
  72. and six types of talking therapy,
  73. but nothing had released them.
  74. They were stuck in their individual
    prisons of depression.
  75. And they're not the odd ones out.
  76. We are entering an epidemic of depression.
  77. It's the number one cause
    of disability globally,
  78. and it will affect everyone in this room -
  79. either someone you care about
    or you directly.
  80. And we don't understand depression.
  81. We don't really know what causes it.
  82. And despite enormous scientific endeavor,
    we have not yet found a conclusive cure.
  83. We don't really understand it.
  84. It's a complex mixture
    of so many different factors.
  85. And when it hits, it can be
    a wave of sadness shame and grief,
  86. or it can be just a shroud
    that kills all feelings.
  87. And it's not an illness
    that we can just test for and treat.
  88. It's different for every person.
  89. So how to unlock depression?
  90. The key is never simple,
    and it will be different for each person.
  91. So, in our study,
  92. we were originally looking at the effect
    of psilocybin on the patients' brains.
  93. So it makes the brain
    go from rigid to flexible,
  94. hyper-connected.
  95. You could say that it unlocks the brain.
  96. So in our study, we did these brain scans,
  97. and we could see
    this increased flexibility.
  98. And we also included
    a symptom measure,
  99. so we could see that depression
    symptoms were going right down.
  100. But that doesn't tell the full story.
  101. We wanted to know from patients
    in their own words.
  102. What was happening?
  103. What was the psilocybin doing?
  104. So we interviewed them all
    six months after the dose,
  105. and we analysed the interview transcripts
    and came up with two themes
  106. about what psilocybin was doing.
  107. But before I get onto those themes,
  108. I think maybe I should clarify
    what a psychedelic experience is.
  109. So psychedelics allow the unconscious
    mind to become conscious.
  110. Important material that has
    been built up over the course of life
  111. but that has been pushed out of sight
    where you can't see it,
  112. emerges, like -
    it's kind of crumpled clothes
  113. that you push to the back
    of your wardrobe,
  114. and it emerges, it comes out;
  115. you don't just see it, you embody it.
  116. Memories, emotions, pain, love, grief -
  117. whatever has been hidden
    emerges and demands you feel it.
  118. It can be incredibly painful
    and incredibly beautiful.
  119. Patients in our study described overall
    having three main types of experience.
  120. So firstly, visiting past traumas;
  121. secondly, having insights
    about your life -
  122. negative patterns and how to change them;
  123. and thirdly, these experiences
    of harmony and connection and unity.
  124. And sometimes they would have
    all three experiences
  125. in the course of one dosing session.
  126. So here's our treatment room.
  127. And you would have the two therapists
    either side of the patient.
  128. They'd be given eye shades and asked
    to sit back and listen to the music,
  129. and just surrender to whatever comes up.
  130. And they would have had sessions
    with the therapists beforehand
  131. so that they trusted them
    and they felt safe.
  132. But the therapist doesn't structure
    the sessions at all
  133. or direct the content in any way.
  134. But there was a structure to sessions.
  135. There was a beginning,
    a middle, and an end,
  136. and a flow of ideas and symbols
    that built on each other
  137. in the most sophisticated way,
  138. as if it had been planned
    by a most excellent therapist.
  139. Now, in my previous work
    as a non-psychedelic psychologist,
  140. providing talking therapies in the NHS,
  141. I would plan my sessions for my patients
  142. and think, how can I help them
    talk about traumatic experiences
  143. or how could I help them
    get a different perspective
  144. or develop some self-compassion
    or some motivation for change.
  145. And I'd try and instill all these things.
  146. But it's all coming from the therapist;
  147. the patient experiences it
    as somehow outside of themselves,
  148. and it sometimes just misses the mark.
  149. But with the psilocybin sessions,
  150. I was witnessing patients
    go on their own journeys of healing,
  151. the ideas all came from inside themselves,
  152. and they were powerful and transformative.
  153. Because the lessons were planned
    by the most accurate therapist there is:
  154. themselves.
  155. So, the themes:
  156. What did the patients say
    the psilocybin did?
  157. The clicker is broken.
  158. Can I have another clicker?
  159. (Laughter)
  160. Okay.
  161. The next slide isn't coming up,
    but I'll tell you what it says.
  162. It says that the first theme
    was of an inner unlocking.
  163. So patients described going
    from being emotionally locked up inside
  164. to being emotionally liberated.
  165. They described going
    from being avoidant of emotion
  166. to accepting emotion.
  167. So, they talked about how in depression,
  168. when stressful or painful things happened,
  169. emotions were distanced or suppressed.
  170. They - our society
    doesn't really value suffering.
  171. It's seen as a weakness.
  172. So they'd learned to put
    their feelings in boxes.
  173. Sam remembered growing up
    and being told 'Boys don't cry',
  174. so he learnt to suffer in silence.
  175. And many of the patients just -
    they couldn't deal with their feelings
  176. because so much
    had happened in their lives,
  177. they had so many years of hurt,
  178. they just didn't have
    the resources to face it all.
  179. And they had many different
    ways of avoiding their pain,
  180. self-medicating through food,
    through television, through painkillers
  181. and then often through antidepressants,
  182. which didn't really work
    on the root causes of their suffering,
  183. just numb the worst of the pain.
  184. But they also numbed other emotions too.
  185. And so many of the patients described
    feeling numb and unable to feel.
  186. Many of them had described
  187. experiencing trauma in their life,
    often in early childhood.
  188. And they've never been able to process it
    or think about what had happened.
  189. And in their psilocybin experiences,
    they were able to process these things.
  190. John -
  191. Where's John?
  192. John here -
  193. He had suffered from abuse in childhood,
  194. and in his psilocybin dose,
    he saw a great big cask,
  195. and he knew that in that cask
    with all of his pain and shame
  196. that he'd never been
    able to think or talk about.
  197. And he grappled with it.
    It was extremely painful.
  198. But in the course of the session,
  199. he was able to unlock that box
    and accept his past.
  200. And it was so powerful.
  201. Many of them cried
    for the first time in years.
  202. This cathartic experience
    of accepting emotion
  203. and just being able to live it.
  204. We saw in six hours what you would
    often see in six years of therapy.
  205. And now the second theme
    is of an outer unlocking.
  206. So, they described going
    from disconnection to connection.
  207. So, they talked about depression
    as a gradual turning inward,
  208. slowly becoming disconnected
    from the people you love,
  209. from your identity
  210. and becoming just kind of
    trapped in their minds,
  211. trapped in a small corner of their minds,
  212. locked there with constant negative
    thinking attacking them all the time,
  213. and the psilocybin
    started a process of reconnection.
  214. So Ben described it this way.
  215. He said, 'It was like when you defrag
    the hard drive on your computer.
  216. I experienced things
    being rearranged in my mind,
  217. I witnessed it
    as it was all put into order,
  218. and I thought my brain is being defragged!
  219. How brilliant is that?
  220. And since that time my thoughts
    make sense, and I ruminate less.'
  221. And other patients
    described the same process
  222. but in a different way.
  223. Some described it as the fog lifting
    or being able to see clearly.
  224. John said it was like turning
    on the lights in a dark house.
  225. And after that mental reboot,
  226. they were able to connect to their senses,
  227. they would connect
    to their self, their identity.
  228. Kirk said he felt like
    he was gliding through life,
  229. and they could connect to other people.
  230. John went for dinner with his wife
    for the first time in seven years,
  231. said that they were like teenagers again.
  232. Many of them felt a connection to nature.
  233. They didn't just see nature
    as a thing like a television or a picture,
  234. but they felt part of it.
  235. And they connected to a spiritual
    principle for the first time -
  236. some of them.
  237. Overall, they went from being trapped
    to being unlocked, expanded and free.
  238. So, altered states of consciousness
    have been held in high esteem
  239. for thousands of years around the world.
  240. But the scientific research
    is in its infancy,
  241. and we're excited to be doing
    a bigger study this year.
  242. But we're still treading carefully.
  243. We don't know so much about it yet.
  244. And it won't be right for everyone.
  245. So, we're treading carefully,
  246. and we're going to learn
    so much over next five years
  247. about how and when
    psilocybin can help us.
  248. But I believe that it could
    revolutionize mental healthcare.
  249. Patience in our study described
    all these superficial treatments,
  250. short-term therapies,
    sticking plasters that didn't help.
  251. Nothing had ever helped
  252. because nothing had ever
    got to the heart of their pain.
  253. And in this epidemic of depression,
    there are so many people in need,
  254. so many people need help,
  255. and the NHS can't afford
    to provide long-term treatments,
  256. years and years
    of psychotherapy for everyone.
  257. But I believe that
    if we incorporate psilocybin
  258. into existing short-term therapies
    like the therapies I used to work in,
  259. that we can make them so much
    more effective, so much more powerful.
  260. It's supplementing therapy with a medicine
  261. that lets you find a way
    out of your suffering
  262. rather than just padding the cage.
  263. So, can magic mushrooms
    unlock depression?
  264. The answer is 'no'.
  265. It's not the mushroom
    that unlocks depression,
  266. it's the patient.
  267. The mushroom just shows them the key.
  268. Thank you.
  269. (Applause)