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Buying magic mushrooms in the Bay Area has always been about knowing where to go and who to ask. However, in the wake of Oakland’s 2019 decision to decriminalize naturally occuring psychedelics—including psilocybin, the active hallucinogenic compound found in shrooms—the options for obtaining the popular psychedelic have grown considerably.

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Can psilocybin treat depression and anxiety?

 
Psilocybin shows potential for helping people who have anxiety or treatment-resistant depression, Sackett says. The idea is to use it along with other therapies rather than as a standalone treatment.

Traditionally, psilocybin has been studied for its ability to ease fear and anxiety in people who have terminal illnesses, but recently researchers have been exploring how it could help people who have anxiety, depression or are dealing with emotional trauma.  

Studies from 2016 found that psilocybin can significantly and quickly reduce feelings of hopelessness, anxiety and depression in people diagnosed with cancer, while a small 2020 study found that it can also help people who have treatment-resistant major depressive disorder.

Sackett is currently working on a study with Dr. Anthony Back and others from the Cambia Palliative Care Center of Excellence to determine if psilocybin can help reduce distress in front-line healthcare workers who have been experiencing burnout due to the pandemic.

The profound mind- and perception-altering experiences psilocybin can induce are one reason it has potential for treating mental illness, Sackett says.

“The drug can act as a catalyst for the therapeutic process. A single dose of psychedelic-assisted psychotherapy can equate to multiple sessions of psychotherapy alone, and this session can bring up intense things and can lead to profound insights for people,” he explains.

The key to psilocybin’s effectiveness is its pairing with other therapies. In clinical trials and sessions with patients, the process typically goes like this, according to Sackett: The patient meets with a therapist to establish initial trust and talk about their goals, then the therapist administers the psilocybin and stays with the patient for the entire experience, which can last hours. After that, the patient follows up with the therapist for additional sessions that don’t involve the drug.  

“With any psychiatric pathology, over time it becomes increasingly difficult to get out of that mindset and it hijacks someone’s sense of self. Psilocybin allows them time to step outside of their internal narrative and see that something different is possible,” Sackett says.

Sackett, who specializes in treating addiction disorders, sees potential in using psilocybin to help people recover from addiction substances like alcohol, since psilocybin can help enhance someone’s motivation to change their behavior, which is one of the trickiest parts of recovery.


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What is psilocybin?


Psilocybin is a drug that occurs naturally in some types of mushrooms that grow throughout the world, including in the Pacific Northwest. It is a hallucinogenic at larger doses, which means it causes visual and auditory hallucinations. Taking psilocybin can also distort someone’s sense of time and how they perceive the world around them.  

People can have profound, life-altering experiences and realizations while on psilocybin, says Dr. Nathan Sackett, acting assistant professor in the UW School of Medicine Department of Psychiatry and Behavioral Sciences — but that doesn’t mean taking the drug always makes someone feel good.  

“The experience of being on psychedelics is not pleasure-inducing. It doesn’t necessarily feel good and it can be scary or uncomfortable or emotionally intense,” he says.

Since the ’50s and ’60s, American scientists have been studying magic mushrooms, which were brought to popular attention in part by María Sabina, an Indigenous Mazatec shaman who used psilocybin-containing mushrooms in healing ceremonies and shared her knowledge with westerners.  

The use of psilocybin may go back much further among some Indigenous cultures — though maybe not as far back as is typically believed.

Once psilocybin entered the public sphere as a party and casual drug and became part of counterculture movements, the federal government passed laws classifying it as illegal. Since then, psilocybin has been listed as a schedule I drug by the United States Drug Enforcement Administration (DEA).

Seattle’s decriminalizing of psilocybin doesn’t mean the drug is legal, but it does mean it isn’t a local law enforcement priority. So far the only state to legalize psilocybin is Oregon, which passed a law in late 2020 to make it legal in therapeutic situations.


Is psilocybin safe?



Though more research needs to be done to confirm psilocybin’s safety, the studies that have been done to date have found that it is, overall, safe.

Psilocybin can create some unpleasant but mild symptoms in some people, including things like headache, dizziness, nausea, anxiety, sleepiness or overresponsive reflexes.

This is where taking psilocybin with the help of a therapist is beneficial. Therapists can help people prepare ahead of time for how to respond to potential side effects and guide people through it if they occur.

For someone to get the full benefit from their psilocybin-induced experiences, they may need to experience and work through some anxiety or distress which, while unpleasant, shouldn’t be harmful if undergone in a safe, controlled environment, Sackett explains.

“In a way, some of the anxiety is part of the therapeutic effect. It’s like cognitive behavioral therapy and exposure therapy. Part of the therapeutic role is to sit with that discomfort and come to the other side and realize you’ll be OK,” Sackett says.