Paradox of Psychedelics: From Mind-Bending to Mind-Mending

Scritto da Ceyda Sayalı

Once a symbol of 1960s counterculture, psychedelic substances are now at the forefront of modern scientific research with a focus on their therapeutic potential for mental health conditions such as, major depressive disorder, posttraumatic stress disorder and substance use disorder. Notable studies have highlighted the efficacy of psychedelics in treating these conditions. For example, in one study, 75% of people with major depressive disorder showed improvement after taking psilocybin, and 58% were symptom-free after a year (Gukasyan et al., 2022). For reference, typical response and remission rates for conventional treatments are 58% and 46%, respectively (DeRubeis et al., 2005). However, direct comparisons with standard antidepressants remain debated. In a recent head-to-head clinical trial, psilocybin was found to be comparable, though not superior, to the SSRI escitalopram (Carhart-Harris et al., 2021). Recognizing its potential, the Food and Drug Administration (FDA), a federal agency of the United States Department of Health and Human Services, has recognized psilocybin as a promising treatment for major depressive disorder by giving it a 'Breakthrough Therapy' status. Despite these breakthroughs, the underlying mechanisms of psychedelics' therapeutic effects remain largely unknown.

Perceptual and Emotional Effects

One of the most pronounced immediate effects of these substances is changes in how one sees or experiences the world (Swanson, 2018). These include intensifications, illusions, geometric and complex hallucinations, and altered sense of meaning. Reports of walls appearing to talk or dance, warped edges, and distorted space are common. The nature and intensity of these hallucinations vary with the type and dosage of the psychedelic substance, with complex hallucinations like perceiving entities being more common with drugs like Dimethyltryptamine (DMT), especially when users have their eyes closed.

Another crucial aspect of the acute psychedelic experience is the mystical experience, characterized by feelings of sacredness, ineffability, and transcendence of space and time (Griffiths et al., 2006). As such, people may feel a deeply personal and profound moment of being connected to something greater than themselves. The historical use of psychedelics in indigenous ceremonies (Fotiou, 2019), such as the use of ayahuasca by South American natives, reflects their long-standing cultural significance. In an effort to quantify the effects of psychedelics on mystical experience, in the 60s, Walter Pahnke (1969), conducted an experiment called the Good Friday experiment on students in a private chapel during the broadcast of the traditional Christian Good Friday religious service. In this study, 30–40% of participants in participants who received psilocybin reported significant mystical experiences compared to none who received a placebo.

Alongside changes in perception and deeply moving experiences, psychedelics profoundly affect emotional states (Bernasconi et al., 2014; Nichols, 2016). They tend to amplify emotions and bias them towards positivity. For instance, under the influence of LSD, individuals show reduced sensitivity to experiences that are typically considered negative such as social exclusion, a shift accompanied by reduced activity in brain regions typically associated with negative emotions (Preller et al., 2016). This bias towards positivity can be particularly therapeutic for individuals with depressive disorders. However, higher doses of psychedelics can also induce negative and challenging emotions (Griffiths et al., 2011), often due to a diminished sense of self-control, which paradoxically may also lead to therapeutic outcomes (Agin-Liebes et al., 2020).

Cognitive Effects

Cognition is another domain acutely impacted by psychedelics. These cognitive effects parallel the subjective experience of 'ineffability,' where volunteers struggle to accurately articulate their experiences. This difficulty in describing their experiences often comes with increased distractibility, making it harder to perform usual thinking tasks (Carter et al., 2005). Consequently, these substances notably impact cognitive functions essential for adaptable and goal-directed behavior (the ability to plan, make decisions, and pursue objectives in a flexible way), functions also commonly disrupted in mental health conditions.

Important mental abilities, such as controlling impulsive reactions, holding information in mind, and adapting to new situations, are significantly affected by psychedelics.

Numero della rivista 31 2025