Full transcript of clinical psychologist Rosalind Watts’ TEDx Talk: Can Magic Mushrooms Unlock Depression? at TEDxOxford conference.
Rosalind Watts – Clinical psychologist
This is Kirk. He suffered from depression for five years. He tried antidepressants, talking therapy, and nothing helped.
In May 2015, in Imperial College, he was given psilocybin, also known as magic mushrooms. And since that time he’s been depression free.
This is Ben. He suffered from depression for 30 years. And in that time he tried everything: CBT, group therapy, a list of medications prescribed to him by his doctor, and nothing helped.
In June 2015, he was given psilocybin, and since that time he has been depression free. Not only had the symptoms of his depression gone, but in the last year, he has done an acting course, a printing course, he’s flown on a plane for the first time in a decade, and his career and social life are flourishing.
I can’t show you his face because magic mushrooms are an illegal psychedelic drug, and he’s asked to remain anonymous.
Magic mushrooms – you might think of the ’60s, dropping out, jumping out of windows thinking you can fly. You might think of going crazy, quite the opposite of what magic mushrooms did to Ben and to Kirk.
And despite its bad reputation, we need to ask the question: What does this mushroom know that we don’t? What does it do that we can’t?
I’m a clinical psychologist at the psychedelic research group at Imperial. It’s a vibrant group of scientists and clinicians asking these very unconventional questions in a most conventional way. It is led by Robin Carhart-Harris — he’s a pioneering neuroscientist, and also overseen by David Nutt, who is a world-renowned psychopharmacologist. And together they cut through ribbons and ribbons of red tape so that we could do the first psilocybin for depression study last year.
And in this study, 20 individuals with treatment-resistant depression, were given a high dose of psilocybin in a therapeutic setting.
Now, the numbers may seem small, but the results were remarkable. We kept seeing these drops in their depression scores after the psilocybin treatment over and over again. Their symptoms of depression were going right down, much bigger reductions in depression scores than you would expect to see in trials of conventional treatments like antidepressants and talking therapy. The depression scores were going right down, and they were staying down.
Six months after the dose, six of them were still in remission, no symptoms of depression. Three of them didn’t really respond to the drug, so there were small reductions in their depression but only for about a week.
But for 11, their depression was greatly reduced for about two months, and then the symptoms of depression started to creep back again.
Now, that might sound very disappointing, but with antidepressants, you have to take them every day. They have some unpleasant side effects; it takes weeks for them to work. And they are a palliative treatment, not a cure.
But with psilocybin treatment, we were seeing immediate reductions in depression symptoms, immediate relief that last for months, without side effects, and it seemed to be working on the root causes rather than just suppressing symptoms.
Depression is a relentless, haunting affliction. Winston Churchill called it the black dog. Patients in our study called it a concrete coat, a sack over the head, a locked box, a prison.
They had tried between three and 11 types of antidepressants and six types of talking therapy, but nothing had released them. They were stuck in their individual prisons of depression. And they’re not the odd ones out.
We are entering an epidemic of depression. It’s the number one cause of disability globally, and it will affect everyone in this room – either someone you care about or you directly.
And we don’t understand depression. We don’t really know what causes it. And despite enormous scientific endeavor, we have not yet found a conclusive cure. We don’t really understand it. It’s a complex mixture of so many different factors.
And when it hits, it can be a wave of sadness, shame and grief, or it can be just a shroud that kills all feelings. And it’s not an illness that we can just test for and treat. It’s different for every person.
So how to unlock depression?
The key is never simple, and it will be different for each person. So, in our study, we were originally looking at the effect of psilocybin on the patients’ brains.
So it makes the brain go from rigid to flexible, hyper-connected. You could say that it unlocks the brain. So in our study, we did these brain scans, and we could see this increased flexibility. And we also included a symptom measure, so we could see that depression symptoms were going right down.
But that doesn’t tell the full story. We wanted to know from patients in their own words. What was happening? What was the psilocybin doing? So we interviewed them all six months after the dose, and we analyzed the interview transcripts and came up with two themes about what psilocybin was doing.
But before I get onto those themes, I think maybe I should clarify what a psychedelic experience is. So psychedelics allow the unconscious mind to become conscious. Important material that has been built up over the course of life but that has been pushed out of sight where you can’t see it, emerges, like – it’s kind of crumpled clothes that you push to the back of your wardrobe, and it emerges, it comes out; you don’t just see it, you embody it.
Memories, emotions, pain, love, grief – whatever has been hidden emerges and demands you feel it. It can be incredibly painful and incredibly beautiful.
Patients in our study described overall having three main types of experience. So firstly, visiting past traumas; secondly, having insights about your life – negative patterns and how to change them; and thirdly, these experiences of harmony and connection and unity. And sometimes they would have all three experiences in the course of one dosing session.
So here’s our treatment room. And you would have the two therapists either side of the patient. They’d be given eye shades and asked to sit back and listen to the music, and just surrender to whatever comes up. And they would have had sessions with the therapists beforehand so that they trusted them and they felt safe.
But the therapist doesn’t structure the sessions at all or direct the content in any way. But there was a structure to sessions. There was a beginning, a middle, and an end, and a flow of ideas and symbols that built on each other in the most sophisticated way, as if it had been planned by a most excellent therapist.
Now, in my previous work as a non-psychedelic psychologist, providing talking therapies in the NHS, I would plan my sessions for my patients and think, how can I help them talk about traumatic experiences or how could I help them get a different perspective or develop some self-compassion or some motivation for change.
And I’d try and instill all these things. But it’s all coming from the therapist; the patient experiences it as somehow outside of themselves, and it sometimes just misses the mark.
But with the psilocybin sessions, I was witnessing patients go on their own journeys of healing, the ideas all came from inside themselves, and they were powerful and transformative. Because the lessons were planned by the most accurate therapist there is: themselves.
So, the themes: What did the patients say the psilocybin did? The clicker is broken. Can I have another clicker?
Okay. The next slide isn’t coming up, but I’ll tell you what it says. It says that the first theme was of an inner unlocking. So patients described going from being emotionally locked up inside to being emotionally liberated. They described going from being avoidant of emotion to accepting emotion.