Microdosing For Depression
Apart from PTSD, depression - particularly Major Depressive Disorder and Treatment Resistant Depression (TRD) - is currently the mental health illness seeing the most official clinical research, trials, and studies out there.
The history of studies around psychedelics and depression dates back to the 1960s, with actual government funded studies showing success and promise before being shuttered due to the war on drugs, which is a vast topic for another time. But in recent times, there’s been an openness from many factions, including the government, to explore this again.
And there’s a good reason for this: our current depression treatments, particularly the medicines, are inadequate. Now I’m not one for the nonstop vulnerability-porn that is so popular to denote relatability and extract response these days, especially in this format, and I will do my best to not present what I’m saying in that light, but depression as a companion is something I have immense firsthand experience with, and it may help to get the Cliff’s Notes on my experience.
My Journey With Depression
I was diagnosed with major depressive disorder in my 30s. It was pretty much a no-duh moment, although I didn’t know there were scales of depression disorders at that time. Like many of us raised in a time when mental health wasn’t really believed in, I grew up with the idea that depression was something I could and should just get over. And, as I’m sure you know, that creates a spiral complex when, well, you just can’t get over it and when, in fact, it’s so dire that you feel the only way out is to not exist any more.
Once I was diagnosed, I explored all the ways to deal with depression. Therapy didn’t work so well for me, likely because I couldn’t find a therapist I gelled with. I dove into the natural ways to treat depression, herbal remedies, supplements, naturopaths. (A side note, this was what sparked my interest and study in herbalism). I did the standard wellness-world eat well, exercise, get a happy light, go out for walks, meditate, breathe routine that is sold to us as THE WAY by people who make money from it. And, not that there’s no merit to it - there’s tremendous benefit to everything I just listed - but my personal experience is that all of this stuff is additive, not curative.
When I’m already feeling good, the supplements and exercise help maintain the engine that keeps me there. But the best maintained engine in the world can’t prevent something from crashing into you. Not all fitness folks sell diet and exercise as a cure all, but to those who do I ask you to engage in adding more nuance and depth to your offerings.
Years after my diagnosis, I found a great psychiatrist with whom I basically went on a prescription medicine exploration of what worked for me and what didn’t. I was determined to do what I could to be as well as I could be. It’s not that I had been opposed to medication, it’s just that I had tried one and the side effects messed me up, so I stopped and didn’t try anything else.
Here’s what I’ve tried, and not for a week or two, for at least 3months and up for each and for some of them, various doses and strengths and release formats:
Lexapro
Parnate
Trazodone
Prazosin
Buproprion
I’m also going to lump ADHD meds in here as depression can be a symptom of, or aggravated by, ADHD:
Ritalin
Guanfacine
Adderall
Dexedrine
For what it’s worth, while I was diagnosed with Major Depressive Disorder, I actually fit the definition of Treatment Resistant Depression, which is considered to be people who haven’t responded favorably to two or more antidepressants.
My reason for exploring and training in psychedelic modalities was at least 50% fueled by my quest to just feel alright. And, all in all, it has been the most effective treatment and modality that I have experienced. Especially when combined with the additive aspects of exercise and certain supplements and prescriptions.
I tell you all this to, again, not indulge in relatibility-porn, but to say that, son, I really fucking know what I’m talking about here.
What Do The Studies Show?
When I mentioned that our current treatments for depression suck. I’m not just saying this.
Psilocybin, the active compound in magic mushrooms, has been labeled a break-through treatment for depression and mood disorders by the FDA. A breakthrough therapy designation means that the drug is not approved or licensed in the USA, but has shown substantial improvement over available therapies. As such, the development and review of the drug has been expedited to treat serious conditions.
This doesn’t mean the medication has been approved by the FDA, but it does mean that the studies are being supported and may be approved and available to the public faster. This also means that government funding can be applied to studies.
In short this means that mushrooms have clinically been shown to be much more effective than any other available depression treatments.
Here’s a quick study from 2022 specifically about microdosing. In it, a 43 year old man with TRD (treatment resistant depression) who had tried different medications, transcranial magnetic stimulation, electro-consulsive therapy, and more - the works really - decided to start microdosing and saw significant improvements of his symptoms. He was tested 6 months after starting and again 2 years later, and saw so much improvement that his depression was considered in remission. Importantly, he reported no side effects.
If you’d like to read about studies and explore them more in depth, this link to Science Direct has a comprehensive overview and links to nearly every study that’s been done.
The types of studies that have been done fall into qualitative, retrospective, prospective, and lab studies. Of these, nearly all of them have shown improvements to depression via microdosing. The few modern lab studies that have been performed, however, haven’t shown this. However, the lab studies that have explored full psilocybin doses (aka an entire trip) have all shown improvements to mood disorders.
When you review the microdosing lab studies and compare them to the other more qualitative microdosing studies, what pops out is that the lab studies are conducted for a much shorter time (around 6 weeks) than people who actually microdose recommend in order to see substantial improvements. The lab studies also don’t titrate the doses, whereas many people who actually microdose do increase - or decrease - their doses in accordance with their specific goals and protocol.
If you look through the link to Science Direct above, in section 4.1.2 entitled “Effects found in self-report studies but not well investigated in lab studies”, you’ll find mood disorders.
This is significant. If you look at the quick 1 person study linked above, that person was tested after 6 months and 2 years. It doesn’t necessarily take that long, but it does take longer than 6 weeks to see a consistent change that sticks. Even with a large dose of psilocybin, while the mood may elevate for several months, it takes about 3 months of work with a professional to reform those pathways in a way that makes the change stick.
This is why I designed my group coaching microdosing program to be 10 weeks long, while my private microdosing coaching starts at a 9 week commitment, and my full plant medicine navigation & integration service requires a 3 month commitment. These are timelines that have been shown to impact actual change.
What About The Experiential Data?
Due to the current federal classification of magic mushrooms as a schedule 1 substance, official lab studies are difficult to perform, even with the breakthrough therapy classification of psilocybin. Any lab or organization that wants to study it has to go through a basketball league’s worth of hoops and work with a limited supply from a federally approved source resulting in time, cost, and bureaucracy that many aren’t equipped to deal with.
Luckily there are researchers, including ones from the original 1960s research era, that have amassed what can be called experiential data or citizen science. Two of those researchers, Paul Stamets and James Fadiman (both of whom have their own popular microdosing protocols) separately created platforms for people who microdose to report their results. While Fadiman (aka the father of modern microdosing), an original researcher from the 1960s, has amassed a ton of current data, his dataset includes primarily LSD microdosers, so let’s look at Stamets’ work which focuses on mushrooms only.
Stamets assembled a team of researchers to create an app called microdose.me that has gone through a medical review of ethics and currently has around 14,000 people subscribed. In this app people can test their memory and measure mood, depression, and anxiety during their microdosing journey. They also categorize based on dose range. Also included in their data set are people that do not and are not microdosing. In 2022 they released a study in peer-reviewed journals where the data set included 4050 microdosers and 4653 non-microdosers.
What the data showed is that over 30 days, microdosers demonstrated greater improvements in mental health and mood relative to the non-microdosing control group. In regards to depression and mood, measured with the Depression Anxiety Stress Scale-21 (DASS), some of the specifics they found were:
Greater improvements among microdosers across the DASS domains of depression, anxiety, and stress, a result that remained consistent when removing the outlier data within the study.
Microdose related reductions in depression were stronger amongst females than males, but the same for both with anxiety and stress.
Microdosers with mental health concerns saw a decrease in DASS scores for depression from 18.85 to 11.73. (with a lower score meaning a reduction in depression symptoms)
Microdosers without mental health concerns saw their DASS depression score decrease from 10.40 to 6.65.
Similar drops were seen across anxiety, stress, and general mood.
Keep in mind that this is 30 days across a massive group of people and, if you recall from earlier, it generally takes longer than that to see change that sticks. But, one of the things we do in my group coaching course is evaluate where you are after 30 days to see how we should approach the rest of the time working together. Most people do see change after 30 days, as that’s about how long it takes to really reform pathways. This isn’t just my observation, the 30 day time range came from researcher James Fadiman, who has likely seen more microdosing data than anyone to this day.
Again, my observations and work with clients shows that change stickiness takes longer than 30 days. When I talk about making the change stick, what I mean is that the benefits still hold even after you stop microdosing. One common reason the change stickiness takes longer is because often we get to that 30 day mark and realize that our former goal might not be our current goal. This happens much more often than not, which is why it’s to your benefit to have support and guidance while microdosing for change.
I’d love to listen to you and help with your specific questions about how microdosing can help you with your depression. Reach out for your free consultation.