Psychedelics Are Not a Mental Health Panacea

psychedelics and mental health

As much as psychedelics hold great promise in alleviating all kinds of psychological distress, they are not a mental health panacea, which they are sometimes touted to be. Based on positive media stories surrounding psychedelic research and anecdotal reports of people being forever cured of chronic, severe mental illnesses, it’s easy to get the impression that a profound psychedelic experience is a silver bullet for every case of, say, major depression, and that once healed, depression won’t return.

However, this is misleading. In the BBC2 documentary The Psychedelic Drug Trial, which tracks the course and results of an Imperial College London drug trial comparing the effects of psilocybin versus escitalopram (a common SSRI antidepressant), the study’s lead clinical psychologist Rosalind Watts tells us that, for the participants taking psilocybin, depression usually returns after six months. 

Indeed, in the documentary, we find out that Ali, who had a deep and healing experience with psilocybin, found her depression eventually re-emerged. Some participants (like Steve) did, however, find that the antidepressant effects of psilocybin stuck around for longer, still feeling transformed nine months on. The fact that the antidepressant effects typically dissipate after six months does not mean the treatment is ineffective; in fact, having a treatment that you undergo once or twice, with substantial benefits lasting this long is actually pretty groundbreaking in terms of novel mental health treatments. The same results do not apply to antidepressants, the benefits of which can take weeks or even months to appear and which require daily dosing to maintain.

I explored some of the limitations of psychedelic therapy in a previous post, including the notion that psychological distress can commonly return after a psychedelic session because an individual returns to sociopolitical and cultural conditions that make them unwell. I think there is much more to explore with this topic; it is an essential reason why psychedelics cannot be a mental health panacea. 

Even when individuals work hard on integrating their psychedelic experiences and integrate them ‘successfully’ (from the point of view of the individual, their therapist, and others), sociopolitical and cultural determinants of mental illness can still be at play, factors which are more or less unconnected to an individual’s psychedelic experience. True, an individual – through their experience and integration of it – could change how they relate to these social conditions and work on changing them for the better, but I would argue that these determinants of mental illness are powerful, no matter what attitude you take towards them. In reality, healing psychedelic journeys are not a fix for the wider structural issues that underpin much of our psychological distress.

Firstly, let’s consider the political conditions that worsen our mental health. Many links have been made between the rise of neoliberalism and poor mental health. Much of our mental distress arises because we have human needs, such as connection and security, that are not being met by the alienating, competitive, and unequal social conditions in which we live. And the mental health industry is focused on helping individuals to feel well in spite of these conditions. As the cultural theorist Mark Fisher wrote:

The privatisation of stress is a perfect capture system, elegant in its brutal efficiency. Capital makes the worker ill, and then multinational pharmaceutical companies sell them drugs to make them better. The social and political causation of distress is neatly sidestepped at the same time as discontent is individualised and interiorised.

Could psychedelic therapies, like mindfulness meditation, simply help individuals feel fine about living in a social and political world that is antithetical to their human needs?

It is up for debate which specific social and economic factors contribute to worsening mental health in societies, and to what extent; however, if we accept that these factors can and do alter our levels of stress, anxiety, and depression, then it’s worth adding that psychedelics may have a quite limited effect on the social, economic, and political environment in which we are all embedded.

On the one hand, we find that the use of LSD in the 1960s was wrapped up with several progressive movements of the time: racial equality, the New Left, anti-war, gay liberation, feminism, and environmentalism. On the other hand, the Johns Hopkins researchers Matthew W. Johnson and David B. Yaden have stressed in a 2020 piece for Scientific American that the idea that psychedelics prompt substantial changes in political beliefs “is not supported by the current scientific data.” 

Johnson and Yaden underline that, while psilocybin has been shown to reduce people’s authoritarian political views, authoritarianism “does not fit neatly into a particular political party”, nor does it specifically apply to one particular style of government (since there are many examples of both left-wing and right-wing authoritarian governments). Moreover, the reduction in authoritarianism did not last: “At the 7–12 month follow-up the decrease was not significant,” state Johnson and Yaden. 

Psychedelics also lead to increases in the psychological trait known as ‘openness’ (in both a recreational and clinical context). Nevertheless, Johnson and Yaden emphasise that:

the correlation between openness to experience and liberal political views is small, accounting for only around 2 percent of the relationship between the two variables. In other words, the pathway from psychedelics through openness to experience to political belief change is, for all practical purposes, negligible.

There is a 1971 study that found an association between LSD use and a change in political belief, but Johnson and Yaden critically scrutinise this research as well. This particular study compared three groups: (1) people who had taken LSD as a medical treatment, (2) people who used LSD on their own, and (3) people who had not used LSD. The study discovered that only those who used LSD on their own indicated more support for policies like “individual freedom” and “foreign policy liberalism”. “It is possible that those who were willing to take LSD outside of medical treatment may have already been more influenced by the liberal hippie movement that encouraged these beliefs at that time,” note Johnson and Yaden. There were no differences in political beliefs between those who used LSD medicinally and those who did not take the drug.

Based on this finding, it might be true that if you take psychedelics in a cultural climate that fosters certain political beliefs, then that climate combined with a psychedelic experience could radically shift people’s political beliefs, ultimately affecting how they vote and engage themselves politically, which would lead to conditions more conducive to psychological well-being. The social justice and environmental concerns of the countercultural movement of the 1960s are now mainstream in this day and age, and psychedelic use is on the rise, yet it is also the case that we live in a neoliberal society and psychedelic users are still a minority. Would the use of psychedelics realistically ever become widespread and common?

Part of me is sceptical about the idea that the widespread use of psychedelics in the current system we live in is enough to enact the political changes we need to improve the sociopolitical determinants of mental health. Albert Hofmann, the Swiss chemist who first synthesised LSD, advanced the idea that psychedelics are “non-specific amplifiers” of consciousness: these chemicals amplify whatever is in your mind, which is influenced by the cultural milieu you exist in. Thus, if your mind is profoundly shaped by a neoliberal ethic of individualism and competitiveness, psychedelics may just enhance this attitude. Research has illustrated, for example, that when mindfulness meditation is taken out of its original context and adopted in American culture, it can make some people more selfish and less generous.

People do feel a greater sense of connection to others during and after psychedelic experiences, but it is certainly difficult to maintain these benefits when you return to a profoundly disconnected and isolating society. A change to cultural conditions alongside psychedelic use could, however, help to further realise the potential of these compounds.

In a piece for Chacruna on the connection between psychedelics and social change, the psychologist Geoff Bathje concluded, “The revolution will not be an unintended side effect [of medicalised psychedelics].” If psychedelics remain in the medical model and are only ever accessible in that context, then we may lose out on the socially transformative potential of these compounds. If we are specifically focused on using psychedelic therapy to tackle the high rates of mental health issues we see, I believe it is improbable that these therapies will be sufficient since they will not adequately address the social and political roots of mental illness. 

The literary critic Fredric Jameson famously said “It is easier to imagine the end of the world than the end of capitalism”, and this is even truer now, given the climate crisis we are experiencing. This quote is the essence of Fisher’s idea of capitalism realism, which is the sense that capitalism is the only viable political and economic system and that it is impossible to imagine an alternative. For those who use psychedelics, nevertheless, it might be possible, if inclined optimistically enough, to envision an end to capitalism. This was the point of Fisher’s unfinished work Acid Communism, the ‘acid’ part of which represents Fisher’s desire to imagine an alternative future, which psychedelics could allow us to do. Stuart Mills, a Behavioural Science Fellow at LSE, writes

The future has been cancelled because we are unable to imagine anything other than the present. To invent the future, to escape our myopia, we have to go beyond the present bounds of our imagination. This is acid communism.

This notion of acid communism, nonetheless, might be brushed off as an unrealistic, utopian wish. Those in charge of making policy decisions that affect our mental health are perhaps the prime candidates for psychedelic experiences, yet they may also be the most resistant to these compounds, and therefore unable to both imagine and invent a future beyond capitalism. Personal psychedelic use, if it got out in the open, could ruin a political career. Why would a politician risk this? On the other hand, we might get to a point where psychedelics are destigmatised enough that we at least don’t frown upon past use of psychedelics, use which may influence the attitudes of a new generation of politicians.

There is research demonstrating that psychedelics can result in long-term increases in one’s connection to nature (called nature relatedness). And nature relatedness is considered one of the strongest predictors of pro-ecological behaviour. This is relevant in a mental context since climate anxiety – distress related to ecological breakdown – is a growing problem. But if we can take active steps to tackle the climate crisis, then such climate-related distress can be eased. And if the evidence points to psychedelics as having the ability to increase our fondness for nature (or biophilia) and encourage pro-environmental behaviour, then psychedelics may at least play a role in remedying this source of stress, anxiety, panic, depression, and grief. 

But while individual lifestyle changes influenced by psychedelics can help protect the environment, the actors who need a change in attitude the most are those who wield the most power and influence. Would the individuals who have leading roles in the fossil fuel industry – the biggest contributor to climate change – take psychedelics? And can enough of them have the necessary attitude-shifting journeys in time to prevent runaway climate change? Furthermore, the climate crisis is deeply intertwined with capitalism, so we would have to tackle the problems of the latter in order to deal with those of the former, which, depending on your outlook, could be feasible but incredibly challenging, very unlikely, or downright impossible.

There are other social and cultural determinants of psychological distress that I’m not sure psychedelics can necessarily tackle. For example, overcoming social media addiction – or at the very least, unhealthy social media use – is difficult, no matter what kinds of psychedelic experiences you’ve had or how many. I don’t think any psychedelic rebooting of the mind will, by itself, counter the trend of the ever-increasing integration of social media into our lives and subsequent mental health issues.

Lastly, I think it is mistaken to believe that widespread psychedelic use will make everyone who uses them wiser and kinder people and thus more likely to opt for cultural and political change that betters collective mental health. As Pollan notes of the psychedelic guru Timothy Leary: “It is one of the many paradoxes of psychedelics that these drugs can sponsor an ego-dissolving experience that in some people leads to massive ego inflation.” Indeed, these compounds can engender a psychedelic ego, boosting narcissism and self-interest, a problem that also applies in the case of Buddhism, meditation, and other spiritual practices; spirituality can actually feed the ego rather than quiet it (a phenomenon known as the spiritualised ego or spiritual narcissism). This is why it’s important to keep psychedelic zealotry and evangelism in check.

My intention here is not to be pessimistic about the potential and future of psychedelics, only to cast doubt on the sense that psychedelics alone will change the world, that we should all take them, and that their use will become the norm. Given that psychedelics are non-specific amplifiers, psychedelic use alongside substantial social and cultural changes can be impactful. In a society that promotes community over ruthless individualism, psychedelics can strengthen bonds; in a society that promotes the opposite, psychedelics may improve connection to others but there will still be forces at play that frustrate both the endurance of this feeling, as well as its manifestation.

Generally, I am hopeful, based on the accumulating evidence, that psychedelics – whether used clinically or sensibly by individuals on their own – will be a net positive for mental health. But I maintain that psychedelics are not a mental health panacea. There are deeper, systematic, and ideological causes of psychological distress that psychedelics may encourage us to notice but which will fundamentally require other methods for changing attitudes and society at large.

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