Can magic mushrooms unlock depression? | Rosalind Watts | TEDxOxford

A clinical psychologist from Imperial College describes how magic mushrooms (psilocybin) when used in a therapeutic setting have been found to be a very effective treatment for depression. In this talk, she draws on her experiences of working as a therapist on the groundbreaking Psilocybin for Depression study and introduces us to some of the patients and their stories of transformation.

Dr Rosalind Watts completed her clinical psychology training at University College London. After six years of practising psychotherapy in the NHS, she joined a clinical trial at Imperial College, investigating psilocybin (magic mushrooms) as a treatment for depression. Her research explores patients' positive views of this intriguing therapy.

This talk was given at a TEDx event using the TED conference format but independently organized by a local community. Learn more at http://ted.com/tedx

This is Kirk.

He suffered from depression
for five years.

He tried antidepressants, talking therapy,

and nothing helped.

In May 2015, in Imperial College,
he was given psilocybin,

also known as magic mushrooms.

And since that time
he's been depression free.

This is Ben.

He suffered from depression for 30 years.

And in that time he tried everything:
CBT, group therapy,

a list of medications
prescribed to him by his doctor,

and nothing helped.

In June 2015, he was given psilocybin,

and since that time
he has been depression free.

Not only had the symptoms
of his depression gone,

but in the last year,

he has done an acting course,
a printing course,

he's flown on a plane
for the first time in a decade,

and his career and social life
are flourishing.

I can't show you his face

because magic mushrooms
are an illegal psychedelic drug,

and he's asked to remain anonymous.

Magic mushrooms -

you might think of the '60s, dropping out,

jumping out of windows
thinking you can fly.

You might think of going crazy,

quite the opposite of what magic
mushrooms did to Ben and to Kirk.

And despite its bad reputation,
we need to ask the question:

What does this mushroom
know that we don't?

What does it do that we can't?

I'm a clinical psychologist
at the psychedelic research group

at Imperial.

It's a vibrant group
of scientists and clinicians

asking these very unconventional questions
in a most conventional way.

It is led by Robin Carhart-Harris -
he's a pioneering neuroscientist,

and also overseen by David Nutt,

who is a world-renowned
psychopharmacologist.

And together they cut through
ribbons and ribbons of red tape

so that we could do the first
psilocybin for depression study last year.

And in this study, 20 individuals
with treatment-resistant depression,

were given a high dose of psilocybin
in a therapeutic setting.

Now, the numbers of may seem small,
but the results were remarkable.

We kept seeing these drops
in their depression scores

after the psilocybin treatment
over and over again.

Their symptoms of depression
were going right down,

much bigger reductions
in depression scores

than you would expect to see
in trials of conventional treatments

like antidepressants and talking therapy.

The depression scores
were going right down,

and they were staying down.

Six months after the dose,

six of them were still in remission,
no symptoms of depression.

Three of them didn't really
respond to the drug,

so there were small
reductions in their depression

but only for about a week.

But for 11, their depression
was greatly reduced for about two months,

and then the symptoms of depression
started to creep back again.

Now, that might sound very disappointing,

but with antidepressants,
you have to take them every day.

They have some unpleasant side effects;
it takes weeks for them to work.

And they are a palliative
treatment, not a cure.

But with psilocybin treatment,

we were seeing immediate reductions
in depression symptoms,

immediate relief that last for months,
without side effects,

and it seemed to be working
on the root causes

rather than just suppressing symptoms.

Depression is a relentless,
haunting affliction.

Winston Churchill called it the black dog.

Patients in our study called it
a concrete coat, a sack over the head,

a locked box, a prison.

They had tried between
three and 11 types of antidepressants

and six types of talking therapy,

but nothing had released them.

They were stuck in their individual
prisons of depression.

And they're not the odd ones out.

We are entering an epidemic of depression.

It's the number one cause
of disability globally,

and it will affect everyone in this room -

either someone you care about
or you directly.

And we don't understand depression.

We don't really know what causes it.

And despite enormous scientific endeavor,
we have not yet found a conclusive cure.

We don't really understand it.

It's a complex mixture
of so many different factors.

And when it hits, it can be
a wave of sadness shame and grief,

or it can be just a shroud
that kills all feelings.

And it's not an illness
that we can just test for and treat.

It's different for every person.

So how to unlock depression?

The key is never simple,
and it will be different for each person.

So, in our study,

we were originally looking at the effect
of psilocybin on the patients' brains.

So it makes the brain
go from rigid to flexible,

hyper-connected.

You could say that it unlocks the brain.

So in our study, we did these brain scans,

and we could see
this increased flexibility.

And we also included
a symptom measure,

so we could see that depression
symptoms were going right down.

But that doesn't tell the full story.

We wanted to know from patients
in their own words.

What was happening?

What was the psilocybin doing?

So we interviewed them all
six months after the dose,

and we analysed the interview transcripts
and came up with two themes

about what psilocybin was doing.

But before I get onto those themes,

I think maybe I should clarify
what a psychedelic experience is.

So psychedelics allow the unconscious
mind to become conscious.

Important material that has
been built up over the course of life

but that has been pushed out of sight
where you can't see it,

emerges, like -
it's kind of crumpled clothes

that you push to the back
of your wardrobe,

and it emerges, it comes out;

you don't just see it, you embody it.

Memories, emotions, pain, love, grief -

whatever has been hidden
emerges and demands you feel it.

It can be incredibly painful
and incredibly beautiful.

Patients in our study described overall
having three main types of experience.

So firstly, visiting past traumas;

secondly, having insights
about your life -

negative patterns and how to change them;

and thirdly, these experiences
of harmony and connection and unity.

And sometimes they would have
all three experiences

in the course of one dosing session.

So here's our treatment room.

And you would have the two therapists
either side of the patient.

They'd be given eye shades and asked
to sit back and listen to the music,

and just surrender to whatever comes up.

And they would have had sessions
with the therapists beforehand

so that they trusted them
and they felt safe.

But the therapist doesn't structure
the sessions at all

or direct the content in any way.

But there was a structure to sessions.

There was a beginning,
a middle, and an end,

and a flow of ideas and symbols
that built on each other

in the most sophisticated way,

as if it had been planned
by a most excellent therapist.

Now, in my previous work
as a non-psychedelic psychologist,

providing talking therapies in the NHS,

I would plan my sessions for my patients

and think, how can I help them
talk about traumatic experiences

or how could I help them
get a different perspective

or develop some self-compassion
or some motivation for change.

And I'd try and instill all these things.

But it's all coming from the therapist;

the patient experiences it
as somehow outside of themselves,

and it sometimes just misses the mark.

But with the psilocybin sessions,

I was witnessing patients
go on their own journeys of healing,

the ideas all came from inside themselves,

and they were powerful and transformative.

Because the lessons were planned
by the most accurate therapist there is:

themselves.

So, the themes:

What did the patients say
the psilocybin did?

The clicker is broken.

Can I have another clicker?

(Laughter)

Okay.

The next slide isn't coming up,
but I'll tell you what it says.

It says that the first theme
was of an inner unlocking.

So patients described going
from being emotionally locked up inside

to being emotionally liberated.

They described going
from being avoidant of emotion

to accepting emotion.

So, they talked about how in depression,

when stressful or painful things happened,

emotions were distanced or suppressed.

They - our society
doesn't really value suffering.

It's seen as a weakness.

So they'd learned to put
their feelings in boxes.

Sam remembered growing up
and being told 'Boys don't cry',

so he learnt to suffer in silence.

And many of the patients just -
they couldn't deal with their feelings

because so much
had happened in their lives,

they had so many years of hurt,

they just didn't have
the resources to face it all.

And they had many different
ways of avoiding their pain,

self-medicating through food,
through television, through painkillers

and then often through antidepressants,

which didn't really work
on the root causes of their suffering,

just numb the worst of the pain.

But they also numbed other emotions too.

And so many of the patients described
feeling numb and unable to feel.

Many of them had described

experiencing trauma in their life,
often in early childhood.

And they've never been able to process it
or think about what had happened.

And in their psilocybin experiences,
they were able to process these things.

John -

Where's John?

John here -

He had suffered from abuse in childhood,

and in his psilocybin dose,
he saw a great big cask,

and he knew that in that cask
with all of his pain and shame

that he'd never been
able to think or talk about.

And he grappled with it.
It was extremely painful.

But in the course of the session,

he was able to unlock that box
and accept his past.

And it was so powerful.

Many of them cried
for the first time in years.

This cathartic experience
of accepting emotion

and just being able to live it.

We saw in six hours what you would
often see in six years of therapy.

And now the second theme
is of an outer unlocking.

So, they described going
from disconnection to connection.

So, they talked about depression
as a gradual turning inward,

slowly becoming disconnected
from the people you love,

from your identity

and becoming just kind of
trapped in their minds,

trapped in a small corner of their minds,

locked there with constant negative
thinking attacking them all the time,

and the psilocybin
started a process of reconnection.

So Ben described it this way.

He said, 'It was like when you defrag
the hard drive on your computer.

I experienced things
being rearranged in my mind,

I witnessed it
as it was all put into order,

and I thought my brain is being defragged!

How brilliant is that?

And since that time my thoughts
make sense, and I ruminate less.'

And other patients
described the same process

but in a different way.

Some described it as the fog lifting
or being able to see clearly.

John said it was like turning
on the lights in a dark house.

And after that mental reboot,

they were able to connect to their senses,

they would connect
to their self, their identity.

Kirk said he felt like
he was gliding through life,

and they could connect to other people.

John went for dinner with his wife
for the first time in seven years,

said that they were like teenagers again.

Many of them felt a connection to nature.

They didn't just see nature
as a thing like a television or a picture,

but they felt part of it.

And they connected to a spiritual
principle for the first time -

some of them.

Overall, they went from being trapped
to being unlocked, expanded and free.

So, altered states of consciousness
have been held in high esteem

for thousands of years around the world.

But the scientific research
is in its infancy,

and we're excited to be doing
a bigger study this year.

But we're still treading carefully.

We don't know so much about it yet.

And it won't be right for everyone.

So, we're treading carefully,

and we're going to learn
so much over next five years

about how and when
psilocybin can help us.

But I believe that it could
revolutionize mental healthcare.

Patience in our study described
all these superficial treatments,

short-term therapies,
sticking plasters that didn't help.

Nothing had ever helped

because nothing had ever
got to the heart of their pain.

And in this epidemic of depression,
there are so many people in need,

so many people need help,

and the NHS can't afford
to provide long-term treatments,

years and years
of psychotherapy for everyone.

But I believe that
if we incorporate psilocybin

into existing short-term therapies
like the therapies I used to work in,

that we can make them so much
more effective, so much more powerful.

It's supplementing therapy with a medicine

that lets you find a way
out of your suffering

rather than just padding the cage.

So, can magic mushrooms
unlock depression?

The answer is 'no'.

It's not the mushroom
that unlocks depression,

it's the patient.

The mushroom just shows them the key.

Thank you.

(Applause)