We need to give psychedelics a fair chance, and sure after we can discount them. The article suggests at scale there is potential
No
People's lived experience is very useful
Empirically, they're usually not nearly as useful as people think. People are on average unreliable observers of their own experiences.
Much better than individual anecdotes are collections of anecdotes that are searchable and somewhat categorized. A lot of old school drug forums provide this.
Much better still is systematically varying data and taking statistics to separate signal from noise.
As for a relationship to death, it's difficult to generalise over all people throughout history, but for example in medieval Europe where you had a seemingly quite vivid belief in the possibility of hell after life, that could result in some extreme anxiety of the most inescapable kind. Maybe that accounts for some of the more extreme behaviours of those times, who knows.
You know that how exactly? We really do not have even remotely enough data to be able to make such boldly absurd claims.
Regardless I’ve heard stories of people having severe long term psychological issues from even relatively light doses, simply because of how their body in particular interacted with the drug.
You ain't right in the head to begin with, my friend. Oh wait, that IS your defining problem.
Anyhow I expect you to be fairly young so that explains it somewhat. If you're 50 though then it's double weird :)
That is WAY out of line.
If you don't want to be banned, you're welcome to email [email protected] and give us reason to believe that you'll follow the rules in the future. They're here: https://news.ycombinator.com/newsguidelines.html.
To me, it’s interesting to consider the inflammatory aspects – the immunomodulatory effects of LSD and other psychedelics on one hand and alcohol on the other.
It’s well established but little-known that psychedelics have a very significant inflammation-reducing effect which includes drastic reduction of neuroinflammation. (I’m fairly sure that this is a primary reason why they work for depression and anxiety; There’s basically always elevated inflammatory biomarkers with these disorders. Stress is directly causative of neuroimflammation.)
Here’s a really solid review paper from 2017 – today a lot more knowledge has been accumulated: https://www.frontiersin.org/journals/immunology/articles/10....
Alcohol is known to be pro-inflammatory.
I have a hunch that these two disjoint forces on the same physiological systems can have made things worse.
Anecdotally, ayuasca quite literally saved my life and helped me tremendously when I was spiraling into a deep depression. Psychedelics when taken responsibly in a controlled environment under supervision can help a lot of people.
What sort of physician diagnosed you with Serotonin Syndrome? What symptoms did you describe to them, and what criteria/evidence did they use to arrive there? Were they able to use differential diagnosis to rule out other conditions?
Did you return to the same physician after the symptoms ceased?
In fact, Wikipedia's fatal flaw is that we're forced to take medical claims at face-value when they're made by the subject himself.
Personally, my HCPs are very conservative and reluctant to diagnose -- particularly something they can't treat, and especially adverse, untreatable side effects such as "gynecomastia" or "tardive dyskinesia", etc. (Those could contribute to material grounds for lawsuits!) What physician in their right mind would formally diagnose "Serotonin Syndrome", other than one who's on the payroll of a tort/malpractice attorney?
It's interesting for me to balance a distinct tendency for Somatic Symptom Disorder (also shall never be formally diagnosed) with an impulse for self-knowledge, but an aversion to shitty "treatments" that invariably do more harm than good.
That is incredibly rare, so rare I can’t find any other documented cases
Edit: did you test it to make sure it was real LSD?
I wrote out a lot more detail for this comment, but pruned to just attempt to make these points 1) generalization here is (generally) not very helpful and also 2) I've come to believe "set, setting, & dosage" are typically listed in that order because that is the order of importance.
No, I stopped mostly after I’d recovered. And I definitely wasn’t “healthier” then, just addled.
https://www.frontiersin.org/journals/immunology/articles/10....
Personally I used psilocybin recreationally back in the days. Got once bad experience and ended up in a psychosis and to hospital. I got better in couple of days and long term effects were nonexistent.
Then I have couple of friends whose basic substances are just legal alcohol and cigarettes, and boy have they fucked their lives with those. It just takes a long time to do it that but psilocybin for sure does not lead to that kind of path.
Evidence based medicine is always better than layman opinions like 'psychedelics are a mental sledgehammer'.
FYI, same goes for SSRIs. The scientific consensus is that the serotonin deficiency theory of depression was wrong. When SSRIs actually work, we still don’t know why.
I’ve had bad trips, too. Very bad, but I still think that psilocybin (in a controlled, supportive setting) is a better bet. My bad trips were all due to being in bad settings and being completely unprepared for what could go wrong. I was young and dumb and just fucking around. But tripping in positive supportive settings was incredibly helpful. And if we do find a way to do this right, then people don’t have to take drugs for the rest of their lives. Psychiatric drugs are generally lifelong sentences, and negative side effects tend to compound over time, which often leads to polypharmacy, and more side effects.
Personally, I've run the gamut on SSRIs and they never suppressed all emotion.
Being unable to feel joy or pain, being unable to cry when a loved on passed on; these were the hallmarks of my time on SSRIs. Never again will I subject myself to these drugs.
It took me twice as long to get off them as I was on them. Two years of prescribed meds, 4 years to get off them. Six years of my life spent as a literal zombie person.
We don’t know why they work or don’t. Our experiences are just anecdata.
Just?
Anecdotes matter
None of them had any suppressant effects on my emotions at all.
https://journals.plos.org/plosmedicine/article?id=10.1371/jo...
As well as the experience of many people close to me that used SSRIs.
I would like to see some actual data because my assumption has always been that most people have never tried any. I personally have not had any. I have always subscribed to the slippery slope theory of vice.
Me too
Come on over the skiing is great!
“Objection, assuming facts not in evidence”
The interactions between medications, as well as the patient’s individual response, are hard to predict. These reactions can change over time, too, as bodies and brains adapt, and lifestyles shift.
Yet, you often hear oversimplified statements like "depression means you have too little serotonin," "feeling sluggish means you lack noradrenaline," or "difficulty focusing means you have too little dopamine." These explanations are so reductive that they barely make sense.
The more I read about drug trials, the more I realize how little I — and even many professionals — truly understand about how these medications work and the best way to make informed treatment decisions.
Our selves are not immutable, steady states. Our experiences shape us. It's a lesson learned to guard that carefully and jealously.
Every general anesthesia I've had was basically "OK you'll start to get sleepy now" and then "ok we're finished" and zero awareness of any elapsed time.
Also this post has stuck with me through the years: https://news.ycombinator.com/item?id=24566568
Be sure to scroll down to the comment thread started by myself248.
As someone who was experienced with psilocybin some 20+ years ago, I always took fairly consistent doses (roughly 3 grams), as I could sense taking much more would be playing with fire. This was pretty much a given amongst my circle of a dozen friends who experienced these trips with me… hero doses were almost never a good or healthy idea. Fun to read about on Erowid though, mostly as cautionary tales.
My time with the substance ended after two bad trips (after a few dozen great ones over a period of 5 years), but neither produced any sort of even minor lasting effect.
Hindsight is 20/20 but often it’s not clear at the time if it’s a bad idea or how bad it can be. I think it’s not such a fair question to someone struggling to find effective treatment for mental health issues to make a mistake on dosing. Especially given both government and medical field have historically not amenable to openly communicating harm reduction or safe guidelines for experimentation with this particular medicine.
I would know, as my psychedelic mega dose stories are very different from this and also completely unique to me.
I’ve done 500ug of LSD and it was great fun. I scheduled a day off to rest ahead of time and was back to normal after that.
250ug of LSD + 1 full ounce of golden teacher psilocybe cubensis and had a somewhat spiritual experience, took a couple days before I wanted to resume normal life.
+ a dozen or more similar stories
There is a reason why “set and setting” is repeated so heavily when instructing people on how to use these substances. Any discussion of potential subjective benefits or harms of a psychedelic in the context of an experience without specific accounting for that is fundamentally incomplete.
That being said, if my experience sounds ridiculous to you, that’s because it’s unique to me, just as others’ are unique to them. There isn’t really much to be gained by talking about individual experiences other than it’s an entertaining topic of discussion. It gets everybody exactly nowhere closer to establishing the objective clinical value of these things, though.
I picked “great fun” as a description as a shorthand because, while I could write more about it, it had little to no net positive or negative impacts on my mental health. For the purposes of this discussion, “Great fun” is kind of meant to communicate that the story is neither a warning or a recommendation regarding depression or any other mental health condition.
I was very aware of and confident about the dosage and I had not had any psychedelics for months previous, so tolerance was impossible (also no medication or other drugs etc)
Volumetric dosing from a vial of known quantity.
I think there is a lot of bullshit around those substances, pushed by shamanic type of people who just invent and repeat nonsense to appear unique/interesting.
The "reports" on Erowid, while interesting in a way, are also so full of nonsense that it's largely irrelevant as a source...
shrooms feel kind of weak until you get to mega dose territory
I wouldn't recommend a shroom mega dose either, it feels too chaotic to take anything away from
The relative difference is because people generally don't process their shrooms very well and they take much longer to digest (slower release over time) and also its very impossible to judge the potency of the shrooms beforehand (so most go on the safe side dosage); as a starter shrooms are more unpredictable than truffles.
I had the same argument with a friend who gave me a bit of LSD (total dosage unknown, it was edible) and I tried a few days ago, it was basically the same as good shrooms. In fact, I believe the dose was on the low side, it was faster to take action but the "core" experience was shorter and "lower" than just 15 grams of good truffles.
The only thing with LSD is that it takes longer to completely clear out of your system (because it is already extracted in pure form, while shrooms have to be digested/processed by your system in a less efficient/effective way) but I don't like that very much because you end up in this in-between state where you are clearly not high anymore but also restless with secondary effects that are not really cool/interesting.
In any case it would be rather surprising if it was different, because molecularly they are extremely close.
Psilocybin/psilocin has different binding affinities than LSD, is metabolized differently etc. They are, quite simply, different drugs.
>The only thing with LSD is that it takes longer to completely clear out of your system (because it is already extracted in pure form, while shrooms have to be digested/processed by your system in a less efficient/effective way
This is borderline gibberish. The “purity” of the “extraction” (???) has nothing to do with metabolism, protein binding or excretion. The LSD expense typically lasts longer because… it is a different drug. Your body treats it differently than psilocybin because it is different from psilocybin.
And the molecules do not look that much alike, unless you think that all indoles look alike. Even if they did, molecules that look alike do not necessarily act alike (eg H2O and H2O2)
Psilocybin:
https://en.m.wikipedia.org/wiki/Psilocybin#/media/File%253AP...
LSD:
https://en.m.wikipedia.org/wiki/LSD#/media/File%3ALSD_Struct...
I want to touch on this. "You" never have any control of your thoughts, because "you" isn't really a thing. Psychedelics and meditation teach us this if you pay close attention. The thoughts arise from nowhere and we - the imagined, but illusory - self are mere observers along for the ride that is consciousness.
I can imagine that using a substance such a psilocybin could cause your thought patterns to have both short and long term changes in quality (in terms of substance, not of superior gradation), however. It's also possible that your experience led to your paying greater attention to the thoughts that did arise, and over time the feedback loop of consciousness along with taking better care of yourself led to greater moderation of their genesis.
There is voluminous writing in the area of monastic spiritually about this. On the one hand, they affirm that these thoughts aren't chosen, using the vocabulary of sinful thoughts introduced by demons. But it's also clear that change is possible through prayer/meditation (not exactly identical to modern ideas about mindfulness).
It is a random (but not totally random of course) process where one thought gives rise to new ones. I think that depression means being in an indirect loop of negative thoughts which amplify each other. Phychedelics might be a way to break out of such loops. But, I'm just speculating here of course.
There were indeed some "bad" trips, although I really do not like the term "bad". IMHO there is no bad journey, it is stuff that needs that wants to be seen.
Nor is the journey itself what counts, one cannot expect a quick fix from a 4 or 5 hour journey. What really counts is the preparation (4 to 8 weeks) before, and integration afterwards (again 4 to 8 weeks). In my case I also paired it with years of therapy and meditation.
It takes a lot of courage, especially to continue after an unpleasant experience (fear, grief and loneliness in my case). In my case I kept coming back and allowed myself more and more to let the bad experiences happen. Finally I just learned to be with what is, and accept things and myself the way it all is. With that came a measure of peace and insights I had not experienced before. Along with visions about the structure of existence.
But I'll stress again, just popping a mushroom won't get you there :)
I guess people with really bad experiences don’t talk about them as readily as the lucky ones. I don’t know the scale, but there must be some selection bias at work here.
The issue is that what people generally say, like, “oh sometimes you need to encounter your demons,” maybe that will be temporarily traumatizing—in general people recover from that. The real issues are…more complex. More complex than any diagnoses in the DSM can cover. The brain is very complicated, and everyone’s brain is a bit different, and we do not know, really, what goes on in there when you take a drug like Psilocybin. Sometimes something gets a little knocked out of place, and the system doesn’t fully recover.
The last time I took a very high dose of psychedelics I couldn’t think straight for a few weeks after. Thoughts came out of nowhere, I had no control over them; often the constant, unceasing flow of thought was distressing and uncomfortable. Thankfully I could still talk to people—talking made me better. I got plenty of sleep, cut out all drugs, even caffiene, got regular exercise and ate a very healthy diet: about a year and a half later I was back to my old habits. But it wasn’t an easy recovery, and certainly not one any psychiatrist could’ve treated adaquetely. But, now I know to be more careful in the future.