Psychedelics Versus Mindfulness: Who Wins For Treating Depression

Sarah Vallely

Today we are talking about psychedelics. However, we're going to begin with talking about depression. Depression affects 6% of us adult males, about 10% of adult females in the US are diagnosed with clinical depression. And 14% of people who are more than one race, are diagnosed with clinical depression, the worldwide stat on clinical depression is only 5%. So we are in general, still a little bit more depressed than other areas of the world.


And there is something called treatment resistant depression, which means that you've been diagnosed with clinical depression, but you don't respond to two or more different antidepressant medications. About 25% of those who are diagnosed with clinical depression, are considered to have treatment resistant depression. And so today is a little bit of a rivalry between mindfulness and psychedelics. Specifically for treating depression, I tried to find two different studies that were as compatible as possible. One is about treating depression with psychedelics. And another study is about treating depression with mindfulness, cognitive based therapy. So basically with mindfulness, so we will see who wins out here in this comparison.


Psychedelics are used to treat mental health conditions such as depression and substance abuse disorders. Ayahuasca is one that is used and is a psychoactive plant tea that's usually made of two plants. One is the vine of B. Cappy--B stands for a word that none of us can pronounce. And also in this tea are the leaves of P. viridis. If I'm pronouncing that correctly, the reason that they combine these two ingredients is so the ingredients stay active in your body for a longer period of time. It lasts between four and six hours with the peak effects between one and two hours after you ingest it.



I'm kind of the more straight and narrow one maybe of the two of us. So this is not a topic that I typically talk about. It's not one that I know a whole lot about. It's not something that I've done. I haven't experienced one of these ceremonies.


Jacob Derossett

I have not done Ayahuasca. I've heard a lot about it. I'm very much curious about. I like hearing a lot about ritual and ceremony in general. And then I like hearing about psychedelics and when they're combined, it's pretty cool. It's the whole idea of purging, which is pretty common. So it's pretty common practice in a lot of ceremonial type situations that give you a bucket, because a lot of people get very vomitus. And they get bowel issues and stuff. And that just does not sound fun to me at all.


But yeah, I really like the ceremonial type aspect of it, versus like MDMA and psilocybin based therapies, that's therapeutic. So it's usually just you and a therapist may be one other person in the room. So the idea of being in a group setting and having an experience like that sounds nice and different, and kind of more true to tradition.


Sarah Vallely

One of the things I was surprised about when I was reading these studies, people who do this, they do it a lot. There were some people involved in the study, who did it up to 130 times during a span of five to nine years. Yes, the purging part is a huge piece to this spiritual experience. Did you know that the reason people drink so much on New Year's Eve is because of an ancient purging ritual? So what people used to do at the end of the year, they used to take several bottles of wine per person, and they would actually go by themselves somewhere, and they would just drink and drink and drink until they started vomiting. Apparently, that's somehow connected to our now ritual of getting trashed on New Years, and maybe still vomiting.


Jacob Derossett

I would love to hear more about that. That's really interesting. I never heard that.


Sarah Vallely

On a neurological level Ayahuasca is helpful for our mental health because of the chemicals called 5HT and 5HT2a agonists. And what they do is activate receptors in the brain as if serotonin was activating the receptors. Serotonin affects mood memory, and cognition. So that's one of the reasons that the effects are so positive. And I was interested to read this today that 90% of your serotonin is produced in your intestines. Did you know that?


Jacob Derossett

I did not. I know that the gut brain connection is like very hot nowadays.


Sarah Vallely

I wondered if this had any connection to the vomiting aspect because of the serotonin receptors. Another neurological reason that the Ayahuasca treatments work is that it makes connections in our brain between the different neural networks. And that is very valuable to us, for example, it makes a connection between the anterior cingulate cortex, the ACC, and the posterior cingulate cortex, the PCC. The anterior cingulate cortex supports emotional processing and thinking and the posterior cingulate cortex is important to the default mode network. And the reason maybe that's important is when we are in the default mode network, which is when we're not really thinking about anything specific, we tend to move into rumination and worry. And that's what leads us to depression. So it's helpful to wake ourselves up and be alert, be mindful to keep us out of the default mode network. And lastly, Ayahuasca possibly grows the anterior cingulate cortex. Studies show Ayahuasca users have a larger thicker anterior cingulate cortex than people who were in control groups. So that's interesting.


Jacob Derossett

Yeah. Have you ever read Michael Pollan's book “How to Change your Mind?”


Sarah Vallely

No, no, tell me about that.


Jacob Derossett

So it really changed the landscape because Michael Pollan was not a person who wrote about psychedelics--he mostly has written about plants, but he got very curious and started researching. He was a journalist for The New York Times for a very long time--he found out about this underground, therapeutic psychedelic network of doctors that were administering psychedelics in a therapeutic setting, and people were just getting absolutely profound, life changing results. Now there's government funded agencies that are administering psychedelics for people.


So long story short, if somebody's listening to this, and they don't know anything about what happens with any of the brain stuff that Sarah just mentioned, Michael gives it an amazing analogy. When you are a kid and is a snow day and you go down the road to the hill in your neighborhood where nobody snow sleds, you got to get there as early as possible. So there's a fresh blanket of snow on the ground.


The worst situation is somebody in the house has taken too long and you show up and the hill is covered with tracks. What happens when the hills are covered with tracks, when you go to snow sled, you try to pave your own way. And as soon as you start down the hill, you'll slide into somebody else's track. The analogy is, that's how our thinking is, as we age. You have an experience and then you have another experience, you have another experience--And pretty quickly as you age, your mind starts to put things in categories and tracks due to the experiences that you've had. Well, when you have a psychedelic experience, and this is just an analogy, it essentially puts a fresh blanket of snow down across all of your thought processes, you will see things for the first time, it will literally change everything about your experience.


Sarah Vallely

I love that analogy. I love the snow-covered hill with all these sledding in foot feet tracks all over it, and then you get into these ruts. And then you do something like psychedelics, and t's just a fresh hill, and you can route your thinking in all different new ways. Yeah, that's great. And that's exactly what mindfulness does. When you're practicing mindfulness, you’re constantly letting go of old thinking patterns. And so it produces that same result.


Adding on to that, one of the reasons why Ayahuasca promotes better mental health is it causes decentering, which is the ability to take a detached view of one's thoughts and emotions, considering them temporary, and simply just thoughts. The Experts also believe Ayahuasca supports better cognitive flexibility, which is the ability to shift our perspective or our approach, depending on the circumstances. So basically, that means it allows us to be more adaptable, which in turn allows us to be happier, more joyful people.


And I thought this was interesting, Ayahuasca temporarily disrupts the neural hierarchies in our brain networks. That leads me to believe we have brain networks, and there's this hierarchy to it—a certain network activated during certain situations, and this other network is activated in these other situations. But what that Ayahuasca does is it activates a network that we wouldn't normally be using. And so it jumbles everything up and you have a new different outlook, a new way to approach your thinking.


The experts say when these networks are disrupted, it actually forces us to not think so much. So we're relying on less thinking. Overall, I think Ayahuasca, helps us tolerate our distressing thoughts better, and tolerate our emotions and our circumstances better because we are less judgmental.


What does that sound like? Mindfulness, same deal. So if we want these results, which are awesome, right? Do we learn mindfulness or do we go and do some psychedelics? Guess that choice is up to you. But here's some research. There is a published study published in Psychological medicine in 2018. The subjects were mostly in their 30s and 40s--more women than men, and they were diagnosed with treatment resistant major depressive disorder, and they weren't taking any antidepressants when they did this. They took one milliliter of ayahuasca, which had .36 DMT. And they had two groups. They had the group that took the ayahuasca and then they had a group that took the placebo.


Rapid antidepressant effects of the psychedelic Ayahuasca in treatment-resistant depression:a randomized placebo-controlled trialPsychological medicine 2018

Jacob Derossett

it's very difficult to do a double blind placebo controlled trial with psychedelics, because people know if they got psychedelics or not, I believe that they essentially gave people a form of amphetamine, so like an Adderall type drug.


Sarah Vallely

Yeah, that makes total sense. And that's not what they did in this study. They made tea out of oregano. They were trying to get somebody that was bitter tasting. The people were in a room for eight hours. And I think that they were in the room by themself. I think they were individually in rooms and they had someone in the next room, a professional that could help them if they needed help.


They took an assessment for depression, before they went into the experience. And then they took the same assessment afterwards, and then they took it seven days later. One of the assessments that they took was called the Montgomery Asper Depression Rating Scale. Comparing before the treatment and seven days later, their depression decreased by 72%. That's crazy. And they took another assessment as well called the Hamilton ratings Scale for Depression, the HAMD, and that showed that their depression decreased by 63%. After the seven days. Some of the questions on that scale were about guilt, suicide, insomnia, as some examples, I guess the question is how long does that last--that was seven days? Did it last a month?


Jacob Derossett

Mindfulness as a meditation practice is really important for integration after using psychedelics in a therapeutic way. Typically, from a therapeutic standpoint, you do a couple follow up visits, and then you would have an at home practice to help integrate the lessons and experiences that you had microdosing. It's got absolutely unbelievable results--very similar to that specifically with like psilocybin and LSD. If you read any literature on it, it's just mind boggling.


Sarah Vallely

So basically, you have all these beliefs in your head. Some of them are shame cycles, “I'm not good enough,” “I don't matter,” things like that, or resentments towards certain people, groups of people. And then you microdose or you go to an ayahuasca ceremony, and on some level that's just erased? Is that a good way to look at this?


Jacob Derossett

That’s not the word that I would use. In my experience, and the experience of people that I've talked to shame cycles are very loud before using psychedelics and then get just get quieter after. And then the things that you would want more of, come up. It's like that meme “all your bad fields turn into good fields.” These compounds have been used throughout human history--the Greeks and Romans would have mushroom ceremonies, Aztecs and Incans. It's just always been there.


Sarah Vallely

it's blowing my mind how similar this process is (using the psychedelics) to mindfulness. I mean, you're describing all the things that I do in my coaching sessions, I'm helping people become mindful of the shame cycles, aware of these ways of thinking that are leading them to anxiety and depression. Once my clients become aware of them, then they become quieter. They don't hold as much power over the person because you have woken up to it. And you realize that all this thinking, and this perception is not really true. And it's just this chatter that's going on and comes in and goes out. It's very interesting.


I this other published research is called, “The Effectiveness of Mindfulness Based Cognitive Therapy for Reducing Rumination and Improving Mindfulness and Self-compassion in Patients with Treatment Resistant Depression”. participants in this study, participated in eight mindfulness-based cognitive therapy sessions, and some of the things that they went over during those sessions was becoming mindful of being in autopilot mode (autopilot mode can lead to the rumination which leads to depression), self-awareness, and acceptance of circumstances. And seeing thoughts as simply a product of the mind and not really real. And some of the practices they learned are body scans, mindful breathing, mindful movement, stretching, and sitting meditation.


The effectiveness of mindfulness-based cognitive therapy for reducing rumination and improving mindfulness and self-compassion in patients with treatment-resistant depression Trends in psychiatry and psychotherapy 2020

In this study, the control and the experimental group were both given antidepressants. They used the Beck Depression Inventory, and depression was decreased 82%. That's pretty amazing. The mindfulness one was higher, but they're both really high. I think they're both winners here, the Hamilton Rating Scale ,the HAM-D, they took in both studies. So this is a good comparison with the Ayahuasca depression decreased by 63%. And with the mindfulness based therapy, the HAM-D showed depression decreased by 75%. Both really high, but I'm kind of competitive so I'm going to say that mindfulness wone out by just a little bit, but I think it's a win win situation.


Jacob Derossett

I mean, they both have their place. But if we're comparing psychedelics to mindfulness, first off, if you do psychedelic therapy, they are going to administer a mindfulness practice for integration anyway, so they're not exclusive. With that being said, some people always want a magic pill. That's why meditation apps became a thing. But how available is it to get into a psychedelic therapeutic setting that safe? Very, very difficult. It's very tough to find--it's a little bit exclusive. Especially if you have a family history of schizophrenia. You are not allowed to do psychedelics. Mindfulness is accessible to everybody. It's a steeper path. but it's a safer path and it is readily available. But if we're talking micro dosing, it's very different situation--that is much more inclusive but unfortunately, still an illegal endeavor unless you live in Colorado, I think Washington has also legalized mushrooms.


Sarah Vallely

Psychedelics isn't for everybody. There's certain obstacles. For some people, it could be a mental health history, obstacle, it could be where you live, it's just really hard to join a group that's a safe, sacred situation to engage in something like this. And also the legal limitations. If you're someone that has a job or just is concerned about getting into some kind of legal situation, then that would be another obstacle to psychedelics, but mindfulness is legal in every state! So there you go, I’m putting a big plug in for mindfulness. But mindfulness is the same thing, you need to be able to find the right teacher or the right therapist, and that can be an obstacle also, finding someone who is knowledgeable and who you really trust, and it feels like a good, a good fit. But I don't think we can deny the positive results that people are uncovering over and over with, with psychedelics. I mean, it's it's pretty astounding.


Jacob Derossett

Yeah, for anybody listening that has not looked into it. It's unbelievable. You know, take an hour and just do some some Google searches about the therapeutic benefits and then you could Google hangups as well. But if you do any amount of research about human history, and how psychedelics played a role in our history, they have been integral in our societies, and then just read Michael Pollan's work. It's just incredible.


Sarah Vallely

Is he the guy that wrote “Omnivore's Dilemma”?


Jacob Derossett

Yep, “Food Rules”.Yeah, he wrote “How to Change your Mind”. He wrote “This is your Mind on Plants”. That's his most recent book. I haven't read that one yet. But yeah, big fan.

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