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Self Administered Psilocybin Depression Therapy Journal
I feel lead to write this to thank you for all your help in the last few months.
As this will be a rather long "trip report" (through I would very much rather self title it "Report of Psychedelic Depression Therapy"), I will post it 11 parts.
I am 38 years old and have suffered from major depressive disorder for nearly all my adult life. My depression is characterized as treatment resistant (recalcitrant), in that despite taking a wide variety of antidepressants and taking part in a variety of other therapies over the years, I am not cured. I have a family history of this general type of depression. My depression is not in the category of bi-polar or schizoaffective disorder. I also have a low level anxiety from time to time, though this is much less debilitating than the depression itself. My depression is not the "winter blues" (SAD - seasonal affective disorder), though I do live in a northern State.
Recently therapy-wise, I have gone to general professional counseling. I year or two ago I went to a class in Mindfulness Based Stress Reduction (MBSR), and started practicing that on and off. I exercise approximately 3 times per week. I eat moderately healthy (which means moderately unhealthy too). I drink alcohol regularly, perhaps 0 to 3 beers per day. I drink approximately 2 cups of coffee per day. I also pray and meditate in the Christian religious tradition. The most recent prescription meds I have taken are Gabapentin, Lamotrigine (Lamictal), and Escitalopram (Lexapro), though in the last 4 months I have only been on the latter two of these.
Another issue I have along with my depression (co-morbid with it) is chronic lower back pain. I have been to many many doctors and tried a variety of therapies, remedies and medications. I mention this because often chronic physical pain tag teams with more mental/behavioral health issues, as is the case with me. (From about 2001 to 2003 I was also on a opioid (Kadian) for my back pain.) It would take a book to record all the treatments, therapies, remedies and medications I have partaken for the lower back pain. I have been to acupuncturists, physical therapists, occupational therapists, neurologists, massage therapists, accu-pressure, sub perceptual electro stim, reiki therapy, faith healers, have gotten ex-rays, cortisone shots, CAT scans, MRIs, etc.
It should also be known that I lead a rather normal, "boring" life. I am married with no children, and a cat named Palantir. I work full time one on one with an adult with autism in a home setting. I did my share of pot and shrooms in college, but have not partaken in either for about 15 years.
Earlier this year I watched the documentary, Neurons to Nirvana on Netflix, and was very impressed. I then read an amazing booked called The Psychedelic Explorer's Guide, by James Fadiman, which I highly recommend. I also did some reading about the recent resurgence of psychedelic medicinal research around the world, and its potential for such varied maladies as Post Traumatic Stress Disorder, OCD, helping terminal cancer patients with the anxiety involved in their impending death, major depressive disorder, etc. (The cancer study was done at Johns Hopkins, the top medical school/center in the US.)
Decisions to Go Forward, and Prep for Therapy (Set and Setting).
I spent a considerable amount of time pondering, journaling and even praying about whether to self administer a psychedelic medicinally. I also spent a good amount of time talking through the pros and cons and potentials and details with my wonderful wife. She is always good at cutting through the bull and bringing me down to reality when I run to the latest impulsive idea or crazy fad.
I also spent countless hours online reading the unofficial anecdotes and "research" of countless people seeking cures from everything from cluster headaches to allergies, and reading their experiences, both successful and not successful.
I did and do very purposefully think of this whole possible experiment as therapy, so I have used those words, as opposed to recreation trip, or spiritual entheogenic voyage. Not that I judge the legitimacy of these uses. I only say this to show that my personal goal has been to embark on this experiment for medical and behavioral health purposes. The mushrooms I took in college were for recreation, and I don't regret this. Yet, this time around, nearly 20 years later, my focus was healing - and going outside the mainstream medical route was only because that route had yielded only limited results. Meaning I had already tried the first line of therapies and remedies, and was only using this as a last result, so to speak.
I prayed to my Higher Power about it the acceptability of this venture, and came to the conclusion that I was not violating my conscience or religion by this medicinal usage.
I looked into the possible counter indications and safety considerations and concluded that I was not in any danger (such as from being on medications which would make therapy unsafe, or having a family history or behavioral diagnosis which would make therapy unsafe). (For example, I am not on Lithium or a MAOI or Tricyclics). Nor had I had any suicidal thoughts or tendencies. Nor did I, as Fadiman states, "desire to look deep into the darkness or into the nature of evil".
My conclusion was that there was significant potential in psychedelic therapy, but was careful to tell myself that it would be unlikely to be a miracle cure or magic bullet, which cures everything completely. Whether in the realm of politics, social problems, illness, disease, or behavior issues, rarely if ever does a complex problem have a simple solution. I am reminded of a magnet on a friend's fridge which says, "'For every complex problem there is an answer that is clear, simple, and wrong.' - H.L. Mencken"
With that disclaimer, did and still do see psychedelic therapy as a relevant piece of the mental health puzzle. For some, perhaps a small piece, for others a larger piece, but a relevant piece to consider either way. This means I believe psychedelic therapy alone is unlikely to work if not accompanied by other puzzle pieces.
I determined that my wife would not be the best guide (just like it is not generally wise to have a loved one operate on you). I chose a close friend, - a warm, trusting individual, who happened not only to share my faith tradition, but was sympathetic to this unorthodox type of therapy. He had also long ago taken mushrooms himself, which Fadiman recommends. My friend was also intimately acquainted with my issues and depression, and knew empathetically my plight and lack of success in mainstream medicine and therapy.
For location I chose my home, and centrally my living room. I used many of the suggestions of Fadiman's book, including pre-arranged musical selections - all of which did not have vocals. It was mainly Bach's cello arrangements, some Mozart, orchestral, The Passion of the Christ soundtrack, as well as some relaxation/meditation CDs. I got a bucket ready - in case of puking. I had ample fresh water, a blanket, and arranged 3 comfortable locations to sit or lie down. The house was free of distractions or anyone else but my guide. (I did however let Palantir the cat roam free.) A previous house guest had put blankets over some of our extensive window for sleeping, and I kept those up, but the room still had natural light. I got a few carefully selected pictures of myself and some loved ones ready. I got a small mirror ready. I have numerous plants in the house, but I still bought fresh flowers. I got eye shades ready. I turned off my phone and actually put it in a draw in another part of the house. I instructed my guide not to used his phone either. I also instructed him to bring reading material. He was to mainly keep silent and just be a comforting presence, not necessary to ask questions, or dialogue with. In this way he was more like a "sitter" than Fadiman's definition of a "guide".
I did significant journaling in the week prior to focus my attention on what I desired to accomplish, and what I wanted to think about in therapy. Yet, I was well aware that despite all the prep and desired focus in the world, things may turn in unexpected directions. I desired to focus on my depression, my anxiety, my low self image, my marriage, my job, my insecurities, my back pain. I also asked God (my Higher Power as I understand it) to reveal himself to me, reveal his love to me, to give me love for him, give me love for others, and to show me his presence. But ultimately, I knew my mind and my Higher Power would take me where they wanted regardless of my hopes and desires.
Of the various psychedelic options, mushrooms seemed the best choice for me personally for the following reasons.
- Mushrooms are a naturally occurring substance in nature.
- I could grow my own, and thus insure purity for safety reasons.
- Mushrooms work primarily on serotonin receptors, as opposed to LSD for example, which works on both serotonin and dopamine receptors.
- It is recorded that there are less adverse experiences with mushrooms, than say for LSD.
- A therapeutic mushroom "trip" is significantly shorter than for example LSD.
My Prescription Meds.
The following was done with consultation with my wonderful wife.
I concluded that Lamotrigine/Lamictal (LAM) 50mg would not effect my therapy one way or another, but that Escitalopram/Lexapro (LEX) 30mg would significantly reduce the therapy's effectiveness.
8 days before therapy, I therefore went down to 1/3 of my LEX dose, and then 5 days prior went off LEX completely. I stayed on my full dosage of LAM however.
The after therapy, I concluded to go back onto LEX but at 10mg (1/3 the previous dosage). This would help to gauge whether in 3 or 6 months the therapy had any lasting effect to counteract my depression.
Cultivating Mushrooms for the Medicine.
It had been so long since college I actually didn't know anyone who could get me this medicine. I even asked a coworker to no avail! I then concluded that it would be safest anyway to cultivate it on my own, because I would be sure it was real and nothing dangerous was added to it.
Learning about cultivation took a great deal of online reading over the course of a few months followed by some trial and error. Overall I followed a combination of two or three beginners cultivation instructions (TEKs).
I used a pre-made starter substrate kit, used a strain of P. Cub, used a shotgun chamber, and kept a cultivation journal.
I ended up with no contamination, despite my wife telling me on a number of occasions that I was not being sterile/clean enough.
All in all the cultivation was quite fun. Sort of a like an intense short term hobby. And I was able to easily get more than enough mushrooms to take as medicine.
Keep in mind that using home grown mushrooms as medicine cannot be an exact science since every mushroom will have a slightly different amount of the active chemical compound (psilocybin) despite identical dry weight, even taking into account different growing conditions, different strains, different species, etc.
I looked back into the common therapeutic dosages back in the early research years of the 1950s and early 60s. I also looked into the modern research dosages, particularly those used in the Johns Hopkins cancer/anxiety research. In this latter research, in addition to the control groups given a placebo, there were two levels of therapeutic dosage - 20mg and 30mg pure psilocybin. I read that statistically significant benefits were reached at both dosages, however, (perhaps obviously) more benefit was realized with the higher dose, but also slightly more negative side effects. I therefore aimed for this high medicinal dosage equivalent. (If I had never done mushrooms before I may have opted for a somewhat lesser dosage.)
Now as I said, there is no exact science in converting an exact medicinal dosage of the psilocybin compound into the bone-dry mushrooms. But assuming that my species and strain was typical, I assumed 30mg was equal to 5m bone-dry. This medicinal dosage also turned out to be what is commonly referred to as a typical recreational and/or entheogenic "heavy" dosage.
The therapeutic plan was to take the medicine in the morning. I was sure to get a good nights sleep the night before. I also cut down significantly on my caffeine intake in the week prior. I had a banana and a glass of water for breakfast. I had heard that lemon juice helps accentuate things, so I cut up a fresh lemon and squeezed some in another cup of water. I didn't watch TV, or listen to the radio or any music that morning.
I had heard that pure cocoa helps accentuate the medicine, so I decided to take the medicine in cocoa. (I have since reconsidered the validity that cocoa accentuates psychedelics.)
I used a coffee grinder and powdered the medicine, put it to a cup a cocoa, along with honey and drank it about 9:15 AM. By the way, I think the medicine tastes terrible, but this concoction helped make it less terrible.
The therapy itself - the first 3 hours.
I had a fair amount anxiety that morning, sort of in the same realm as anxiety before you go to get a cavity filled at the dentist, if that makes sense. After ingestion I had a bit of difficultly sitting down and relaxing. I want going around the house cleaning things up, prepping things, my mind and body not wanting to relax and let things happen.
Eventually I sat down on my comfy recliner and put the eye covers on. Things kicked in fairly quickly, with visuals and coldness in my extremities. I eventually had my guide put a blanket over me. Palantir the cat decided to make her home in my lap but I barely noticed. At one point my guide asked if I needed a booster dose, to which I said not at all.
The first 2 to 3 hours (after I assume the first 30 minutes) were somewhat blurry to recall all the details. In part this was possibly because I tried to keep my eyes closed and focus internally. I was aware of music and colors, but did to focus on them, and tried to steer my mind towards contemplation. My goal was healing, and I thought focusing on fun patterns and colors would distract my mind from the task at hand.
I do remember imagining that I was on an operating table, half "put under", as is done in a lot of operations these days. (That is when you are still semi - conscious, while they cut you open.) So I was imagining that even though I was not rationally thinking through all my therapeutic concerns, "work" was being done. This is in line with modern research on psychedelics and neuroscience which is showing that psychedelics may facilitate neuro-plasticity and a rewiring of the brain. Meaning even while not thinking through my depression, the medicine was working to heal it by slowing down the overactive blood flow to the control centers of the brain.
I did have times of weeping and times of ecstasy. The ancient mantras - laughter is good medicine, and crying is good for the soul - are still around for a reason. I think it was beneficial to get my emotions supercharged, since normally I don't weep and I just as rarely have moments of pure explosive joy.
The therapy itself - continued.
A theme of gratefulness came across again and again. It wasn't like I was directly coming face to face with my Higher Power, but that I was seeing all of his creation in a renewed and brighter way. Sort of like a spotlight was on everything, to show the brilliance in the normal, to see the amazingness in the mundane.
I was grateful for my guide, for my wife, for the plants around me, for my house. And this is despite all the faults and imperfections of each of these things. I didn't see them as perfect, but as wonderful despite their brokeness. The lack of perfections would usually bother me, or keep me from really appreciating things. But in all these things I was content, at peace, in "shalom". I even noticed the floor was really dusty in places, but it was not bothersome to me.
For I while I listened intently to the soundtrack to The Passion of the Christ. (Disclaimer, I like the movie but in no way endorse Mel Gibson or some of his less than perfect views). I was able to appreciate the mystery of the historic Gospel narrative, its oriental nature, the ancientness, the exoticness, etc.
It was interesting that when deep in therapy I periodically realized that my guide was in the room and I was almost embarrassed. Perhaps because he was not "with me" in therapy it felt a bit strange. And I am very glad I had him there, in case of emergencies. But perhaps if I ever do therapy again, I would have him in another room.
I do remember my mind was in a way "racing", like I had ADHD or something. Perhaps this was due to the medicine's ability to remove a sense of time from my consciousness, but it seemed like I would have a thought - (deep realization, an intense focus on something or someone, or an idea, picture, feeling, or color), - and it would give way fully to another totally different one, again and again. And my brain was unable to keep focus on an object for too long. It was like watching tv while your friend flips channels excessively. Not that this bothered me that much.
The Therapy itself - continued; plus coming down and some insights I had.
I spent an extended time of looking at two photographs of myself and my wife, one from 11 years ago, and another from this year. This was extremely valuable. It was like I was seeing myself like I was looking from the outside at me. Not an out of body experience, rather a perspective which was totally unique. I had a massive amount of compassion, empathy and love towards myself and my wife. I could "see" problems in our lives, ways in which we have been hurt in life, problems in our marriage, etc. I was able to see us both as little children, in need of love and patience and healing. (If I ever do this kind of therapy again down the road I will be sure to have even more picture of people handy.)
I also looked for a while in the mirror. What was interesting is that 15 years ago when I did psychedelics recreationally I never liked the mirror. But now it was great. I really enjoyed how I looked. I even had an insight into who I was and the path I was on.
Eventually I started coming down a little. I was aware of a number of insights, which I wrote down (in no particular order):
- that deep breathing is good for me.
- that emotions are a gift to me.
- that strong emotions are not bad for me (see the movie Garden State).
- that my Higher Power is good.
- that there is an immense amount of beauty in the world (I was intellectually aware of this before, but I was now more emotionally aware of it)
- the importance of me making good lifestyle choices.
- that there is no magic bullet for me in life.
- that taboos and limits and moderation play an important role in a happy life for me.
- that I need to work though hard things either in counseling or in journaling.
- that focused, productive self reflection is essential to my healing
- that I need to listen to the still small voice
- that I need to be a better listener in general
After the fact I realized my attitude towards a particularly important issue was changed, even though I have no recollection of thinking upon the issue during therapy. I had for a long time felt insecure about my life success, as judged by the world's standards. I have a number of high school friends who have gone on to be very successful in their careers and business, and have compared them to myself, who earns a very modest living working with people with autism. Amazingly after therapy, this insecurity was no longer present. I now know that my life is not so bad, and I am not ashamed of not making much money compared to others or being as "successful".
Post Therapy - the rest of the day.
I did a lot of journaling about thoughts, in the style of stream of consciousness writing. I tried my best to recount as much as I could remember because I didn't want to waste the experience by fading memories.
The active part in the therapy was over after about 5 hours, by about 2:30 PM. I was surprised it was so quick, but possibly grinding the mushrooms before ingesting got them into as well as out of my system quicker than had I chewed them.
I got very hungry and ate a medium sized meal, of an apple and some chips and salsa, while talking with my guide about the experience.
We took a walk outside.
As I came out of therapy, my back pain came back into my consciousness. In other words it was hurting a lot. This is possibly partially due to the mushrooms and the experience itself, and partially due to being so sedentary for 5 hours. But the fresh air and walk did it some good.
I did have a headache, which was similar to a caffeine withdrawal headache, and after further reflection, I am pretty sure it was due not to dehydration, but the caffeine withdrawal.
My guide made sure I was ok on my own and I gave him my blessing to leave.
I journaled some more. I was and am committed to continue to journal daily about my thoughts, frustrations, and any continued insights. I have continued to journal daily. I am also committed to do Mindfulness (sitting still with eyes closed and focusing on the breath for 10 to 20 minutes per day, called MBSR).
In the early evening I decide to go to the gym for a light cardio workout. In part this was to get my blood flowing to help my chronic back pain.
I ate a lot that night and went to bed around 10 PM.
Initial Results - What I can tell helped and did not help, and other inklings (2 weeks post therapy).
(Note: This is still less than 2 weeks post therapy so according to the Fadiman book there may still be healing aftereffects to occur. Therefore, I hope to reply again to this thread in 3 to 6 months for a more long term followup.)
Depression - at least so far I do see a reduction in my depression. This is even considering that I am taking 1/3 the dosage of Lexapro I was taking prior to the therapy. I have more hope in general and less existential angst. I am willing to go back up on Lexapro if my mood takes a turn for the worse. I have heard a number of reports that these results may not last, either due to the afterglow wearing off, or our brains just resorting to their old wiring, etc. But so far so good.
Marital - my wife seems to think I am more patient with her and less judging.
Anxiety - in terms of anxious about events in life, maybe a bit lower. Yet I do feel my body still physically anxious. For example, when some one cuts me off driving I still get pissed off, yet am then able to reign myself in more quickly. I sometimes feel like I am sort of crawling out of my own skin a bit. But maybe this is just my body getting used to the lower dose of Lexapro, and my self feeling more emotions in general.
Sleep - the same.
Back pain - the same.
My Spirituality - unchanged in my understanding and relationship to my Higher Power. However, I do feel like I appreciate his world, his creation, and the beauty around me more.
Generally - the key I think is the phrase "slightly better". My outlook on life - slightly better. My depression - slightly better. My self image/esteem - slightly better. My view towards my wife - slightly better. My hope for the future - slightly better. My appreciation of beauty and the little things in life - slightly better.
I guess the puzzle piece analogy comes to mind again. This psychedelic therapy was slightly useful, helpful, beneficial (whatever word you want to use). Yet it is only one piece of the larger puzzle of self care and life treatment. For the therapeutic effects to have a chance at lasting I need to be sure to keep up with the other puzzle pieces. And for me those other puzzle pieces are daily Mindfulness sitting (MBSR), daily Journaling, regular exercising, continued devotion to my Higher Power and practice of my religious tradition, eating a fairly healthy diet, having healthy sleep patterns, listening better to my wife, knowing my limits, working through hard events and feelings in the journal, and increasing my self awareness - of feelings, emotions, reactions, thoughts.
I have no interest in taking another therapy session again anytime soon. In fact, looking back it is sort of terrifying (in a non-terrifying sort of way). But I am thankful for the experience, thankful for my guide, thankful for the love and support of my wife, and thankful for all the preparation help I got reading things online and in books. Perhaps in 6 to 12 months I will undergo another therapy session. For now I wish others like me the very best in their quest for healing, and only advise them not to take this sort of therapy lightly and to do lots of homework.
All that is gold does not glitter,
Not all those who wander are lost,
The old that is strong does not wither,
Deep roots are not reached by the frost.
Edited by CSTolkien (10/22/15 10:58 PM)