A more mystical and insightful psychedelic drug experience, according to a new study, may be linked to a long-term reduction in anxiety and depression symptoms. The study was recently published online in the Journal of Affective Disorders. The data from nearly 1,000 survey respondents about their previous non-clinical experiences with psychedelic drugs was analysed using machine learning. People who scored the highest on questionnaires assessing the mystical and insightful nature of their experiences reported consistent improvements in their anxiety and depression symptoms, according to the findings.
The analysis also suggests that a difficult experience while using these substances, one that feels frightening or destabilising, can be beneficial, particularly in the context of mystical and insightful experiences. This could be useful for practitioners as they guide patients through clinical trials testing the therapeutic potential of psychedelics.
“Sometimes the challenge arises because it’s an intensely mystical and insightful experience that can, in and of itself, be challenging,” said senior author Alan Davis, assistant professor and director of the Center for Psychedelic Drug Research and Education in The Ohio State University College of Social Work.
“In the clinical research setting, folks are doing everything they can to create a safe and supportive environment. But when challenges do come up, it’s important to better understand that challenging experiences can actually be related to positive outcomes.”
The study is the first to identify and link subtypes of subjective psychedelic experiences to mental health outcomes. The data came from previous research Davis led, which included an anonymous internet-based survey of people who reported having a moderate to strong psychedelic experience in the past and the resulting changes in their anxiety and depression symptoms – regardless of the level of those symptoms prior to the psychedelic experience.
The 985 participants whose responses were analysed in this study described substances they had used and filled out questionnaires assessing how mystical (evoking a sense of pure awareness, positive mood, and/or transcendence of time and space that is difficult to describe in words), psychologically insightful (eliciting acute insight into memories, emotions, relationships, behaviours, or beliefs) or challenging their psychedelic experience was. The survey measured depression and anxiety symptom levels, as well as ratings of life satisfaction and psychological flexibility – one’s ability to act in ways that are consistent with their values regardless of any internal or external experience – before and after using the psychedelic.
Users of psilocybin (magic mushrooms), LSD, Ayahuasca, mescaline, peyote cactus, and 5-MeO-DMT, the natural psychedelic substance found in the venom of the Colorado River toad, were included in the study, along with the estimated dose level of the single drug use they recalled.
The data analysis revealed three distinct psychedelic experience subtypes:
- High score, combining high mystical and insightful assessment scores with moderate challenging assessment scores.
- Low to moderate scores on mystical and insightful experiences, as well as low scores on the challenging scale.
- Positive evaluation, with high marks for mystical and insightful experiences and low marks for the difficult assessment.
“The group that had the highest insightful and mystical experiences and low challenging experiences showed the most benefit in terms of remission of anxiety and depression symptoms and other longer lasting benefits to their life,” said first author Aki Nikolaidis, an affiliate of Ohio State’s Center for Psychedelic Drug Research and Education (CPDRE) and a research scientist in the Center for the Developing Brain at the Child Mind Institute.
When the researchers analysed only data from participants who had used psilocybin and LSD, the same patterns emerged: three distinct subtypes that were associated with the same outcomes, including mental health benefits even after a difficult experience. According to Nikolaidis, this replication demonstrates the importance of subjective experience for psychedelic users.
“Identifying subtypes that exist regardless of which psychedelic you take answers an interesting question,” he said. “But the fact that we found that they’re associated with specific outcomes, and replicated that finding, really shows why it’s important to understand the powerful nature of what is happening subjectively and its potential to yield a beneficial outcome.”
A few other trends stood out: Participants in the positive scoring group, whose experience could be considered optimal (high scores on mysticism and insight and low scores on challenges), were younger than those in the other groups. There was a higher proportion of people who had taken large doses of psychedelic drugs among those who scored highest on challenging experiences. Furthermore, the low-scoring subtype had lower psychological flexibility, anxiety, and depression scores prior to the psychedelic experience, as well as lower improvements in those symptoms and life satisfaction than the other two subtypes.
Davis said he’ll be interested to see if these subtypes of experiences are applicable in the clinical setting, where psilocybin-assisted therapy is being studied at Ohio State for the treatment of post-traumatic stress disorder in military veterans.
“Finding the variety of other outcomes that these subtypes might be related to is an interesting next step,” he said. “These could include adaptive or functional outcomes in people’s quality of life or well-being, or a better understanding of their life’s purpose or relationships.”
