Why 'Microdosing' LSD & Other Hallucinogens May Be The Saving Grace For People With Severe Depression & Anxiety
What if your brain on acid, 'shrooms and Molly isn't such a bad thing after all?
Branislav Belko on Unsplash Many might consider lysergic acid diethylamide (LSD), also known as "acid", taboo (and possibly even passé), yet the currently illegal and unregulated drug is rapidly gaining popularity, as well as media scrutiny and attention within the medical community.
The widespread illegality of these substances means little scientific data exists regarding their potential short and long-term positive or negative effects on either mental of physical health, but this time around, the trendy way of dropping acid and other hallucinogenics such as psilocybin "magic" mushrooms and 3,4-Methylenedioxymethamphetamine (MDMA, aka "Molly" or "ecstasy") involves a practice called "microdosing."
As one report in Scientific American explains:
"Microdosing involves taking roughly one-tenth the 'trip' dose of a psychedelic drug, an amount too little to trigger hallucinations but enough, its proponents say, to sharpen the mind. Psilocybin microdosers (including hundreds on Reddit) report that the mushrooms can increase creativity, calm anxiety, decrease the need for caffeine, and reduce depression."
Georgia (not her real name) was nine years old when her father was murdered.
Even at that young age, she says, “I hit a really hard trauma wall and I never really came out of it.”
She was consumed with anger, went four months without speaking, and had a severe depressive episode at 13.
The now 29-year-old, who works at a Washington, D.C. nonprofit, was diagnosed with persistent depressive disorder (dysthymia) — defined as a "continuous, long-term (chronic) form of depression" — four years ago.
At the time, she was prescribed the antidepressant Wellbutrin, a norepinephrine-dopamine reuptake inhibitor (NDRI), which was effective in treating her depression. But after she left her job and lost her health insurance, she could no longer afford prescription medication.
During a trip to New Orleans for Mardi Gras the following year, she tried microdosing LSD for the first time — and the experience opened up a new world for her.
Georgia was dating a "Burner" (someone involved in the subculture associated with the annual event known as Burning Man) at the time. He taught her how to prepare sub-hallucinogenic (i.e., "below the dose that would cause hallucinations") doses, or microdoses, of LSD in an attempt to treat her depression.
Several months and a good amount of research later, Georgia put one tab of acid in a liter of distilled water, a process known as volumetric dosing.
For the past two and a half years, she has been microdosing LSD regularly, taking two shots of the liquid each week, spaced out days apart.
While some people only microdose in short spurts, Georgia has chosen to microdose for the long term. She believes that she can build a tolerance to the type of LSD she buys, so she diversifies the source of the drug occasionally.
“It gets me through the week,” Georgia explains of its effects. “I can see color. It lifts the weight.”
She doesn’t experience any euphoria, but feels more energetic. She is also back on a lower dose of Wellbutrin.
“[Microdosing] really changes my ability to get my work done and feel good about it,” she says. Otherwise, she feels weighed down by self-doubt.
“I’m not saying everyone should DIY their medication," Georgia adds, "but it works really well for me.”
As psychedelic drugs are being used more frequently in new ways and by new audiences — in research labs, doctor’s offices, and private homes — they are bringing along with them an evolving meaning to the term “self-medicating”.
Renewed interest is growing among those in the medical community regarding these once-taboo substances and their potential effects on the brain.
Many hope further research will lead to the development of new treatments for difficult-to-treat mental health conditions with symptoms as severe as suicidal ideation, including substance use disorders and post-traumatic stress disorder (PTSD).
As Ben Sessa explains in The Lancet:
"A noticeable shift in attitudes from the mainstream medical community has seen increasing publications in high-impact journals in recent years and a major UK conference in 2011, Breaking Convention."
Just last month, the U.S. Food and Drug Administration (FDA) approved Spravato (esketamine) nasal spray — a "chemical cousin" of the heavy-duty surgical anesthetic and party drug ketamine, sometimes called "Special K" or just "K" — for treatment of severe depression.
The drug is quick-acting, unlike other antidepressants, and is meant to be prescribed only after all other forms of treatment available have failed.
According to the FDA's press release, the nasal spray is intended for people "with major depressive disorder who, despite trying at least two antidepressant treatments given at adequate doses for an adequate duration in the current episode, have not responded to treatment are considered to have treatment-resistant depression."
"Because of safety concerns," the press release continues, "the drug will only be available through a restricted distribution system and it must be administered in a certified medical office where the health care provider can monitor the patient ... The patient self-administers Spravato nasal spray under the supervision of a health care provider in a certified doctor’s office or clinic, and the spray cannot be taken home ... During and after each use of the nasal spray device, the health care provider will check the patient and determine when the patient is ready to leave."
As is the case with all psychotropic drugs — defined as "any drug capable of affecting the mind, emotions, and behavior" — microdosing hallucinogens may work for some and not for others.
In addition, as The New York Times explains, the potential side-effects can be serious.
"Esketamine, like ketamine, has the potential for abuse, and both drugs can induce psychotic episodes in people who are at high risk for them. The safety monitoring will require doctors to find space for treated patients, which could present a logistical challenge, some psychiatrists said."
As research on potential medical uses for hallucinogenic substances grows, scientists hope to gain new understandings regarding who might benefit from them when given which dosages and under what conditions.
As another example, MDMA-assisted psychotherapy is currently in clinical trials to evaluate its potential effectiveness in treating PTSD. This is a great sign of progress for those who believe therapy utilizing MDMA may hold hope for more effective future treatment methodologies.
All of that said, the search for better, more effective treatment of mental health conditions isn't the only reason people are choosing to microdose psychedelics.
Increasing numbers of people are coming to believe microdosing increases creativity, as evidenced by it's popularity among the Silicon Valley crowd.
(This may come as a surprise to people who think of unemployed hippies twirling around Woodstock, Deadheads, or punk kids as those who take acid or shrooms.)
One study conducted in Europe looked at whether microdosing psychedelic mushrooms could boost creativity and problem-solving skills.
According to the findings published in Psychopharmacology, the "Official Journal of the European Behavioural Pharmacology Society (EBPS)" the goal of this research was to "quantitatively explore the cognitive-enhancing potential of microdosing psychedelics in healthy adults."
While the authors declare this to be the first naturalistic study "to quantitatively show that microdosing psychedelics could improve creative performance, possibly by means of inducing a state of unconstrained thought allowing for increased novel idea generation," it's important to note they also acknowledge multiple limitations within their work.
"Future studies should seek to validate our findings using a lab-based randomized double-blind placebo-controlled experimental designs and take the subjective strength of the experience into account as a covariate," the authors caution.
Beyond the tech crowd, microdosing is showing up with increasing frequency throughout popular culture.
It was even touted as the next trend in wellness by actress and founder of lifestyle website GOOP, Gwyneth Paltrow.
When asked for her opinion on "next big thing" during an interview with the New York Times, Paltrow responded, "I think how psychedelics affect health and mental health and addiction will come more into the mainstream."
That said, in reponse to the follow up question regarding her own experiennce with psychedelics, the actress replied, "I’ve never done it. I’m terrified."
Hallucinogens also showed up as part of a plot line on the CBS show The Good Fight, in which the main character, Diane (played by Christine Baranski), tries the treatment to deal with extreme stress.
The Atlantic explains, "The show resisted the impulse to demonize substance usage (or to explicitly condone it), instead offering Diane’s micro-dosing and the attendant consequences as one part of a larger look at her attempts to cope with the new administration and the hostility its policies and rhetoric engender."
And indie folk rocker Father John Misty says he uses LSD to boost his mood.
Misty, whose real name is Josh Tillman, shared his reasons for microdosing acid with the New York Times, joking about the current legal status of his choice of treatment.
"I’ve been diagnosed with PTSD by three therapists,' he said. Mr. Tillman has such severe depression and anxiety, he can’t take vacations. In lieu of anti-depressants, he self-medicates with micro-doses of LSD. 'Acid really helps,' he said. 'I probably shouldn’t talk about this, because Jeff Sessions will come after me.'"
Returning to the medical world's perspective on miscrodosing, researchers at Johns Hopkins University have also noted the potential health benefits of some hallucinogens.
So much so, in fact, they are requesting that psilocybin be reclassified by the United States Drug Enforcement Administration (DEA) from a Schedule I drug — defined as "drugs, substances, or chemicals ... with no currently accepted medical use and a high potential for abuse", such as cocaine and heroin — to a Schedule IV drug — "defined as drugs with a low potential for abuse and low risk of dependence" — alongside sleeping pills and pain medications like the ever popular anti-anxiety drug popped by moms and CEOs everywhere, Xanax.
The DEA's current scheduling/ranking system became effective in 1971, having been passed by Congress and signed into law by President Richard Nixon under the sweeping federal drug policy called the Controlled Substances Act (CSA) — Title II of the Comprehensive Drug Abuse Prevention and Control Act of 1970.
It strictly regulates certain substances and designates them under five schedules or classifications with most psychedelics under Schedule I, like LSD, MDMA, and psilocybin.
Also on the Schedule I list are the short-acting but powerful drug N,N-Dimethyltryptamine (DMT), one of the active ingredients in ayahuasca tea, often used for ritual purposes, and well as the long-lasting psychedelic substance mescaline, found in the peyote cactus.
Prior to this legislation, psychiatric researchers had been freely testing the effects of psychedelic drugs since 1943, when Swiss scientist Albert Hofmann discovered the psychoactive properties of LSD.
But under President Nixon, a cultural war raged between the seemingly straight-laced mainstream and the "turn on, tune in, drop out" counterculture popularized by psychologist and writer Timothy Leary.
With the CSA, Nixon won — temporarily, at least. The act marked the beginning of the Dark Ages of research into the benefits of psychedelics.
Some scientists made strides after that time anyway, thanks to the support of several nonprofits, including Multidisciplinary Association for Psychedelic Studies (MAPS), which has facilitated this kind of research since 1986.
The organization is currently looking into the increasingly popular use of ayahuasca, perhaps best known as a spiritual drug used by indigenous people of the Amazon basin, as a treatment for substance use disorders and PTSD.
The shifting perceptions around and legal status of marijuana and CBD in recent years has been encouraging for researchers like chemical neuroscientist Dr. David Olson, who studies psychedelics as assistant professor in the UC Davis departments of Chemistry and of Biochemistry and Molecular Medicine.
Olson led a study that showed both potentially therapeutic and concerning effects microdoses of DMT can have on the neuronal structures of rats.
According to the press release, scientists observed some "potentially adverse changes in neuronal structure and metabolism" in rats, indicating the need for additional studies on the possible risks associated with DMT.
But primarily, the study's authors believe their findings should offer hope.
According to Olson, "Our study demonstrates that psychedelics can produce beneficial behavioral effects without drastically altering perception, which is a critical step towards producing viable medicines inspired by these compounds."
Studies like this are difficult to fund and undertake because they require certain approvals from the government and extra safety measures.
“That costs money and time that most researchers don't want to invest in,” Olson old me in an interview via telephone. “It’s definitely not for a lack of interest.”
His team chose DMT because they were looking for something that would be applicable to the broad range of psychedelic drugs.
“If you distill them down to their basic structural core, what you’re left with is DMT.”
He went on to further explain what makes treatments like these effective.
“These drugs tend to cause changes in (neural) circuits that are related to mood and anxiety and reward, and that’s why they seem to have these antidepressant and anxiolytic effects.”
Though he calls the FDA’s approval of esketamine “a huge milestone for psychiatry,” he believes drugs like it will be replaced with something you can keep in your medicine cabinet.
And while he believes it makes sense for patients with no other choice of treatment to use psychedelics like ketamine, he says long-term use of these substances is not ideal. There are too many unanswered questions about the effects these drugs have on the aging or developing brain, how low a dose is beneficial, the frequency of optimal dosing — and each drug needs its own research in order to determine the correlating answers.
“[Psychedelic drugs] produce these pretty profound changes in perception,” Olson explains. “I think these are incredibly powerful tool compounds for understanding the basic neurobiology of depression and anxiety disorders and I think we’ll be able to use that information to engineer better tolerated and more efficacious therapeutics."
Given that science is in such an early stage in regard to microdosing research, people like Georgia are turning to non-medical sources to learn how to use their hallucinogenics.
Many people interested in learning the ins and outs of microdosing on their own find answers to their questions on the online educational forum, Third Wave.
Twenty-eight-year-old entrepreneur Paul Austin launched what he calls a “wellness and cultural brand” in September 2015, with the goal of promoting psychedelic literacy and helping people find their own treatments. He has since figured out how to make microdosing into a business while fostering community among his audience.
The website’s name references this era as the third wave of psychedelic exploration — the first wave being “tribal” (indigenous) populations, and the second being the swinging 60s.
Austin asserts that he entered this third wave when he first experimented with full doses of acid and mushrooms at the age of 19, noticing they had a lasting “afterglow” effect.
“I was more disciplined, more focused. It was easier to create stuff,” he told me in an interview over the phone.
A couple of years later, while living in Thailand and working on a startup focused on teaching English to business people, he heard Tim Ferriss’ podcast interview with James Fadiman, author of The Psychedelic Explorer's Guide.
Inspired and seeing an opportunity, he cornered the market by launching his website and microdosing courses, writing Microdosing Psychedelics: A Practical Guide to Upgrade Your Life, and doing public speaking events and workshops on “the intersection of microdosing and leadership and creativity”.
His crowd includes other startup guys, like those from Silicon Valley, interested in ramping up their creative thinking and even their leadership skills.
Austin compares microdosing to meditation or yoga — “it’s just helping us maintain a higher level of presence” — and believes, when done properly, it’s less dangerous than other modern habits, like eating fast food or drinking alcohol. In contrast, he believes most people who microdose are “generally taking good care of themselves.”
In his opinion, while microdosing currently treats only the symptoms of trauma and depression, the larger movement will ultimately gain enough knowledge to develop a full dose psychedelic model capable of “curing” the root causes.
“Hopefully, what microdosing is teaching us is we all have agency, we all have responsibility for our health and well-being and it’s up to us to take ownership of that and not just to give that away to a doctor to tell us to do this and this, when they’re just giving you generalized advice,” Austin says. “It’s about cultivating a relationship with yourself.”
For many, it’s also about saving money and avoiding mainstream pharmaceuticals.
When mushrooms are decriminalized, Austin says he wants people to harvest the fungi themselves, instead of paying a pharmaceutical company like Johnson & Johnson for a theoretical medicine to be made with them.
“The key to all of this is education. How educated are we as a populace about what’s cheap and what’s more expensive and how can we do this on our own? I think the DIY method is critical to making sure that accessibility remains open for as many people as possible,” Austin explains.
Cheap and accessible is also key for Georgia.
When she couldn’t afford to buy her prescribed Wellbutrin without insurance, she noticed that “it’s shockingly easy to get every other drug in the world.”
Georgia only has to acquire 3 tabs a year for her at-home treatment, which adds up to about $45 — much less than paying for the antidepressant with or without insurance.
Even if pharmaceutical companies found a way to make LSD legally, she says she still wouldn’t buy it from them.
“It couldn’t possibly be cheaper than the way I make it myself.”
There are, of course, known risks associated with ingesting psychedelics, which are explored in detail on Third Wave.
"The main physiological concern with microdosing," they say, "is that we don’t know what frequent low doses will do to your body. Introducing any substance to your system in a chronic fashion will undoubtedly cause changes to your physiology. Some of those changes could be damaging.
"We know that frequent, high-doses of MDMA can cause valvular heart disease ... The big question we’re left with is, 'Does psychedelic microdosing cause damage to the heart over long periods of time?'"
As for psychological concerns, Third Wave also makes clear that people with a history of schizophrenia, psychosis, or anxiety disorders should use caution or even avoid psychedelics altogether, as it's been proven that larger "recreational" doses can trigger psychosis, severe anxiety and mania, "sometimes to the point of affecting sleep patterns and digestion."
Additionally, they caution microdosers to remain alert to the potential for psychological addiction.
Another important factor to consider is that these drugs are largely illegal — although this doesn’t concern Georgia or Austin.
Georgia is aware of her privilege as a white woman who has never been drug tested (and LSD wouldn’t show up in a regular drug test), and she recognizes that drug tests are used as weapons against people of color. Also, her access to LSD through communities like the Burners allows her to purchase the drug discreetly.
Medical marijuana is now legal in 33 states and recreational cannabis is legal in 10 states and Washington, D.C.
Austin assures, “Psychedelics will likely follow a similar path.”
As he sees it, drug policies will soon replicate those in Portugal, which decriminalized the consumption of all drugs in 2001.
“We’ll basically dismantle the entire infrastructure of the drug war,” Austin insists.
As this expanding field of both culture and science finds its shape, science will take cues from those on the ground, the people paving the way outside of the medical community — and it won’t be the first time this has happened.
As an example, Dr. Olson references how researchers were turned on to the positive effects of anabolic steroids by bodybuilders.
“[They] had been using these substances a long time and they knew a lot about them and it took the scientific community a little while to catch up,” he explains, “I think that’s where we are with psychedelic science, as well.”
As the war on drugs winds down, this new trip into psychiatry and wellness is definitely going to be a mind-bending and, at times, symbiotic experience.
The biggest hurdle, beyond adjusting the DEA's schedule of drugs to allow for more clinical research into hallucinogens, will be re-educating the American public about the potential healing powers to be found in these substances.
It may just be time to move past the tired "tripping hippie" cliché and into a new age of wellness and medicine using advanced treatments created with, and bolstered by, research into hallucinogenics.
Liz Tracy is a writer and editor whose articles have been published by The New York Times, The Atlantic, Refinery29, W, Glamour, Vice, and other publications. Follow her on Twitter or visit her website for more.
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