Psychedelic Assisted Therapy & The Default Mode Network
Since 2020, the world has been witnessing a severe mental health crisis worldwide; some experts speculate that due to the existential themes of isolation that arose during the pandemic we are witnessing an uproar of mental health issues. According to a study published in The Lancet in October 2021, global prevalence of anxiety and depression increased by 25% during the first year of the pandemic. This surge is attributed largely to the isolation, stress, and uncertainty brought about by lockdowns and the health crisis.
In the same recent years we have also seen a resurgence in the interest and research into the use of psychedelics as a therapeutic tool in mental health care. This focus is partly driven by the ongoing mental health crisis exacerbated by the COVID-19 pandemic, which has highlighted the need for innovative and effective treatment modalities.
In this blog we will take a deep dive into how psychedelic therapy is used in Australia, focusing on the Default Mode Network (DMN) and its crucial role in the healing process.
What is Psychedelic Assisted Therapy?
Psychedelic therapy involves the use of substances like psilocybin (found in magic mushrooms) and MDMA in addition to psychotherapy to treat various mental health conditions. These therapies have shown promise in addressing issues such as treatment resistant depression and PTSD. In February 2023, Australia made a groundbreaking move by rescheduling certain psychedelics for therapeutic use. Psilocybin and MDMA were downgraded by the TGA from Schedule 9 (prohibited substances) to Schedule 8 (controlled medicines), allowing them to be prescribed by doctors for specific conditions. This change marked Australia as one of the first countries to formally integrate psychedelics into therapeutic settings, specifically for the treatment of treatment-resistant depression and PTSD.
The TGA rescheduling came with strict requirements to ensure safety and efficacy. Treatments must be administered in a controlled, clinical environment under the supervision of a trained therapist. Patients must also undergo a comprehensive screening process to determine their suitability for psychedelic-assisted therapy. This includes detailed assessments of their mental health history, potential for substance abuse, and any contraindications with existing medications or conditions. Additionally, these treatments are accompanied by supportive psychotherapy, ensuring that patients are properly prepared before the session and receive adequate integration support afterwards. This holistic approach aims to maximize the therapeutic benefits while minimizing risks, reflecting a cautious but progressive stance on the use of psychedelics in mental health care. The length of psychedelic treatment varies from each protocol applied, the protocol I was trained in structures the therapy in three blocks: Preparation, Dosing and Integration. Each of these stages is heavily supported with a trained therapist to maximize the therapeutic benefits of the psychedelic assisted therapy.
So what role does the Default Mode Network (DMN) play in Psychedelic Assisted Therapy?
The Default Mode Network (DMN) is a group of brain regions that are active when you are at rest (unfortunately laying down on our phone does not activate our DMN) in a short summary the DMN becomes active when we are NOT focused on the outside world. It is involved in self-referential thinking, daydreaming, and the stream of consciousness. In individuals with mental health conditions, this network can become overactive or dysfunctional, contributing to negative thought patterns and behaviors.
Psychedelic substances are known to temporarily disrupt the DMN, leading to a weakened sense of self and reduced ruminative thinking. This "reset" allows for new perspectives and cognitive flexibility, which can be incredibly therapeutic for people dealing with mental health issues.
Given the role of the DMN in mental health conditions, it is no surprise that psychedelic-assisted therapy is gaining traction as a potential treatment option. By temporarily altering the DMN, these therapies give individuals an opportunity to break free from negative thought patterns and gain new insights into their emotions and behaviors. This can be especially beneficial for those with treatment-resistant conditions or for whom traditional therapies have not been effective.
This DMN disruption allows for increased cognitive flexibility and the re-evaluation of personal beliefs and problems, which contrasts with how SSRIs (selective serotonin reuptake inhibitors) typically work. SSRIs primarily aim to increase serotonin levels to boost mood more gradually and maintain emotional balance but do not directly affect the DMN to the same transformative extent.
Studies have shown that when administered in a controlled, therapeutic setting, psychedelics can lead to rapid and sustained improvements in symptoms of depression, PTSD, and anxiety, often after just a single session. These outcomes may be more profound and faster-acting than traditional treatments, including SSRIs, particularly in treatment-resistant cases.
Integration is key to Psychedelic Assisted Therapy
It is important to note that the effectiveness of psychedelic treatments isn't just in the medicine itself but heavily relies on the process known as Integration. Integration involves structured follow-up sessions where clients process their experiences with a therapist, making sense of the insights gained and implementing changes in their everyday lives. This step is vital for ensuring that the benefits of the psychedelic experience translate into lasting psychological growth and personal development.
Integration is a crucial process for anyone who has had a psychedelic experience, whether in a clinical setting or otherwise, helping you make sense of your journey and weave the insights into your daily life. By engaging in structured integration therapy, people not only enhance the therapeutic potential of their experiences but also promote harm reduction, ensuring safer and more meaningful outcomes when psychedelics are used outside of formal therapeutic settings.
Looking to the future, there is a strong potential that the use of psychedelics as medicine will revolutionize mental health care. With the ability to profoundly alter consciousness and catalyze deep therapeutic insights and emotional release, psychedelics could reshape our approach to mental health, offering new hope to those for whom traditional treatments have fallen short. As research continues and societal acceptance grows, these substances might well represent a significant leap forward out of the mental health crisis we have found ourselves in.