8 ms·

I’m really worried about the subset of the population with preexisting mental disorders such as manic depressive disorder, schizophrenia, and depression who wil

• nonbel 8y ago
  >"mental frailty...they begin to question everything" As opposed to blindly "believe everything"? I would say the ability to question everything is evidence of a strong independent adult mind. The ability to just believe everything you are told isn't really "frail" (which I associate with old age and wisdom), but still weak in a childlike sense.
  • koube 8y ago
    Over time people build up useful heuristics. There is a difference between questioning authority vs questioning why tuesdays exist and if maybe it's sunday for dogs.
    • nonbel 8y ago
      >"questioning why tuesdays exist" I don't see a problem with this line of questioning. There is lots interesting to consider there. Just some stream of thought: What does tuesday mean anyway, why do we have weeks, why 7 days per week, what is the exact definition of day, could there be planets without "days", do dogs recognize a weekly cycle, would they if "freerunning" without human companionship, what about wolves who "howl at the moon", does that mean they recognize the lunar cycle, in that case maybe they also mentally divide it up into subsets greater than a day but less than a full month, how could we study wolf behaviour to try to figure this out, why exactly do I feel like there is a difference between sunday and tuesday, just because one is during the weekend or something more, do wild packs of wolves/dogs take regular days off from hunting/etc, what do they do in their free time?
      • godelski 8y ago
        > why do we have weeks, why 7 days per week Because it is useful to divide up things into increments. 7 because there are 7 visible celestial bodies visible to the naked eye. Which the names derive from. > What does tuesday mean anyway Mars's day > what is the exact definition of day A singular rotation of the planet. Also known as a sidereal day. Or more simply put: sun goes up, sun goes down. > could there be planets without "days" Yes, these are known as tidally locked. Some planets have long days. Venus has a longer day than year (rotation of planet around parent star) > I don't see a problem with this line of questioning. There is lots interesting to consider there. Yes, but answers are also reasonably found. Don't just stop and think, but also seek. That's why we think differently about the person who is like "wow man, what even is Tuesday" and the person that discussed the historical reasoning and mythos that led to the naming of Tuesday and why having a seven day week is so pervasive throughout the world, leading back to ancients looking up at the sky (which was better than what most of us see, considering light pollution). Sometimes things are extraordinary and sometimes they are mundane. There's a lot of usefulness into relying on historical knowledge. That's why we advanced so far. And by finding the breath of our current understandings you will find new and deeper questions. Tldr: don't just question, find answers.
• s-shellfish 8y ago
  > I’m really worried about the subset of the population with preexisting mental disorders such as manic depressive disorder, schizophrenia, and depression who will suffer a psychotic break from the use of these substances. I honestly don't think we have the capacity to test existing psychiatric medication to the extent that we can provably demonstrate that over the long term, psychiatric medication + negligence (or simply, variance - controlled lab conditions versus real world) in mental health care is not a direct cause (more nicely, a contributory factor) of psychotic breaks for patients. So yes, it's a risk, but it's not one that doesn't currently exist with what we do now.
• alexandercrohde 8y ago
  Here's a podcast episode of a guy who tries microdosing http://www.gimletmedia.com/reply-all/44-shine-on-you-crazy-goldman http://www.gimletmedia.com/reply-all/44-shine-on-you-crazy-g...
• cf498 8y ago
  I am not sure about the percentage affected or what the preconditions have to be, or what other measures to detect them are, but personally I never tried psychedelics recreationaly due to their extremely long duration of effect. I know there is a good argument about setting, mindset and support being the relevant factors, but the possibility of multiple hour horror trips always made me think again. And again. Which in itself is a huge problem for people who get complications because of that fear. There are some drugs who work similar to an "allergy test". Salvia divinorum for example has an extremely short duration of effect. A few minutes (<10) in comparison to the same amount of hours. With proper supervision the potential to detect people at danger without lasting complications looks extremely promising to me. Sadly I dont think anyone will care for such safety measures as long as the whole benefit of psychedelic drugs is illegal at the moment.
  • eip 8y ago
    Everyone who smokes Salvia is at danger. Salvia is the worst.
• empath75 8y ago
  So you haven't done it, you have no studies to back this idea, but you just assume it's going to be a problem somehow.. So-called "bad trips" can be tremendously beneficial afterwards. They're "bad" because you get into the kind of deep, uncomfortable introspection that most people would want to avoid naturally. You learn things about yourself and the world that you probably wouldn't have wanted to know. That doesn't mean that you're going to go crazy afterwards. A lot of people come out better on the other side.
  • omarchowdhury 8y ago
    Bad trip: Despair. Good trip: Delight. Aren't these both apart of life?
  • pmoriarty 8y ago
    "So-called "bad trips" can be tremendously beneficial afterwards. They're "bad" because you get into the kind of deep, uncomfortable introspection that most people would want to avoid naturally." While such uncomfortable introspection could certainly occur in a bad trip, it's far from the only kind of experience that could make a trip bad. You could also find yourself imagining you're in something like a horror movie or in hell, dead, or dying. Terrence McKenna and Rupert Sheldrake coined the term "necrotogen" (a play on the much more common term "entheogen") for the common effect that psychedelics have of being confronted with death. Such an experience often feels very real, sometimes even "more real than real". That kind of experience is much more than simply uncomfortable introspection, especially when it's combined with temporal distortions and confusion that is also common in psychedelic experiences -- where one feels like what one experiences takes years, decades, centuries, or millennia, or that one is stuck in a temporal loop of doing the same thing over and over again, or that one can't escape from the distressing situation that one is in, or that one doesn't know who one is or where one is or what is happening or what is real and what isn't. Are you really dying? Did you just murder someone? Or are you being murdered or threatened in some way? Did someone call the police or ambulance? Are you in jail or being tortured or abducted by aliens or dead and experiencing decomposition, etc. Despite all that, I fully agree that one could learn a lot from such very negative experiences -- for example, how to cope with them -- and the "bad" trip could wind up being one of the best trips one ever had because of what it revealed to you about yourself and the world. Also, it's quite common for such a "dark night of the soul" experience and/or ego-death to be followed by an experience of rebirth and of very positive, life-enhancing and life-embracing revelation (incidentally, such psychedelic experiences bear strong similarities to shamanic initiation experiences, where sickness, bodily dissolution, and death prefigure and even legitimize the abilities and status of the shaman). But even without the latter, it could still be very constructive, and one could learn a lot.
• stouset 8y ago
  The general consensus is that this is an extremely small portion of the population, and that psychedelic use is only typically a premature trigger for a preexisting condition rather than a prime cause for these types of mental issues.
  • eganist 8y ago
    Do you have citations for the following? • extremely small portion • trigger for a pre-existing condition
    • stouset 8y ago
      I don't. I'm simply restating what seems to be general consensus amongst both users and mental health professionals. Actual data is hard to come by, since actual research has only recently begun to happen. At this point though, any assertion that psychedelics cause anything more than a very slight increase in the background rates of diseases like schizophrenia would need a serious amount of evidence to back it up. Psychedelic use is common; something like 15—20% of the American population tries them in their life. And the general understanding of diseases like schizophrenia right now involves actual structural changes that simply aren't plausible consequences of infrequent psychedelic use. I won't speak toward long-term, frequent use, but by all the evidence I've personally seen, LSD in particular is extraordinarily safe for the population of people without a family history of schizophrenia. I'd also like to point out that the original assertion—that psychedelics trigger psychotic breaks—itself doesn't come along with that much in the way of evidence. The original notion came about in the '70s when mental health professionals started seeing a higher proportion of their patents coming in after having tried psychedelics. I'm not sure if hard data was collected (or at least, I haven't been able to find any), but the most straightforward explanation for this is that this likely simply mirrored the increase in the background rate of people using psychedelics. If the background rate went from 1:10 to 2:10, then you'd expect that the number of people coming in with mental health issues will show a doubling in psychedelic usage rates. And in the fifty years since then, I've not seen much additional evidence for a causal link between the two.
  • gepi79 8y ago
• notnot 8y ago
  "I'm really worried" The first rule of psychedelics: don't worry. How to not worry? Relax. Keep the body at peace. Be simple. Stay in the heart (stay with how you're feeling, not just with what you're seeing/experiencing). Let go. You cannot lose yourself because you are always yourself. Be grateful for the incredibly valuable experience you're having, even if it's difficult.
• scarecrowbob 8y ago
  If it helps, here are a couple of things that you might consider: - you likely know a lot of people who actively or in the past were experimenting with psychedelics, but you don't know that you know them because it is socially taboo and their experiences aren't super relavent to how you are interacting with them - if you can accept that idea, then you might also consider that given a larger population of people who've tried it with few ill effects your anecdotal sample might not be an accurate representation of the psychedelic experience. That second point would reconcile the "strange fervor for others to try it, even from people who have had bad trips." There are indeed plenty of people mental health issues floating around, and while it's true that you may or may not know if these drugs will trigger a larger episode, that kind of life altering aspect of psychedelics not very common in my experience as a person who knows hundreds of people who have worked or played with these substances. Those ideas are also based in my anecdotal experince, and perhaps it comes from a willingness to question some "fundamental axioms from scratch", but at the same time maybe that's a) not always a bad thing to do from time to time, and b) if your fundamental axioms are good there is no reason that you won't come back to them.
• mistrial9 8y ago
  the brain is a complex thing -- much mental illness is not well-understood, even though it is true that people suffer from dysfunction..
• pmoriarty 8y ago
  "I’m really worried about the subset of the population with preexisting mental disorders such as manic depressive disorder, schizophrenia, and depression who will suffer a psychotic break from the use of these substances." Psychedelics have been used to treat schizophrenia and depression before. Here is an excerpt from a paper on "Treatment of Childhood Schizophrenia Utilizing LSD and Psilocybin"[1]: The first patient we treated [with LSD] was an eleven-year-old girl who was dying of something akin to marasmus. Marasmus is a condition of wasting away of the body, where nutrients are not assimilated. It occurs in infants who have no human contact. They go into such an isolated mental state that not even intravenous feeding is effective.. The girl was actively suicidal and would make every attempt to destroy herself. She was in twenty-four-hour restraint. When let loose, she would batter herself: smash her eyes, smash her head against the rails. She looked like an old, wizened lady -- nothing but skin and bones, and battered black and blue. So the psychiatrist said, 'Why don't you start with this girl. She's going to die anyway, so there is nothing to lose.' It was quite a challenge to take as my first patient someone who was in such a terrible situation. I was afraid that maybe she would die during the session. But I didn't have any alternative, because this was who I was given. We didn't use low doses with any of the patients. My guess is that she got 300 or 400 micrograms [of LSD], and she weighed maybe fifty-five pounds. She was just skin and bones, and was totally incoherent. She screamed, babbled, and spat if you got near her. She was not in contact with anybody, nor had she ever been since she was hospitalized. During the session she started wailing like a wounded animal -- it was the most chilling sound. Then she started screaming, and the pitch would increase and increase. We tried everything to make contact with her, to no avail. After about seven or eight hours I was exhausted, and so frustrated that I just yelled at her, "Nancy! When are you going to stop screaming! I can't stand it anymore!" [laughs] She stopped and looked at me. This was the first time she had made eye contact with anybody, and said, "I have a long way to go, so just stay out of my way." That was the first thing she ever said to anybody. Then she went back to screaming. That was our session. Hers was an amazing story, which we subsequently published. Once she started speaking, it was possible to work with her more effectively. She was a very intelligent girl, perhaps an ancient soul. She was a challenge -- conniving and manipulative -- and she gave us a run for our money. Her bottom line was always that she had control over hurting herself; this became her ace in the hole. As she improved, she would eventually just carry a Kleenex around, put it on her hand, and say that the Kleenex was stopping her from hitting herself. So we would grab the Kleenex and hide it, and she'd say: "Damn you! Damn you! Give me that napkin!" There was a whole power struggle that went on for months. Of course, during this time she was no longer in restraints, and she could move about on the ward. She struck up a companionship with one of the other girls in the program, and she was in constant contact with the staff. She must have had eighteen or nineteen sessions spaced apart by two or three weeks, and every session was productive. Between these sessions, we had to develop a whole treatment program for managing her, as she was extremely bright and incredibly manipulative. One time she said to me, "Well, I can't fool the day staff, but I can still fool the night staff." Then as soon as she said it, I could tell that she was thinking, "Oh my God! I've given myself away!" I looked at her and said, "That's not going to last very long, is it?" And she said, "Damn you!" So, that night I got together with the evening staff and clued them in on what to do, because she was still manipulating the hell out of them. Talk about a tough patient! But she was no longer hurting herself. And although she remained in the hospital, she got well enough to attend school. [1] - http://www.maps.org/news-letters/v07n3/07318fis.html http://www.maps.org/news-letters/v07n3/07318fis.html
• newnewpdro 8y ago
  It's very likely the benefits being reported on in the article are present in doses far lower than the high recreational doses you're referring to. Your concerns are more relevant to the higher, hallucinogenic doses. All medicines have a dose:response curve with a dangerous response zone starting somewhere along the increasing dose axis.
• oldgeezr 8y ago
  I have permanent visual disturbances and suffered long-term panic attacks and anxiety as a result of psychedelic use. Things got better over time, but not completely back to normal. I'm not advocating for the continuation of our current legal strategy, but I feel like these drugs need to come with strong cultural wisdom about their appropriate use and potential for abuse. Anyone who's been in a psychedelic community for long(stoners, deadheads, etc) knows at least a few people who have been temporarily(1 day - 1 year) or permanently fried from having experienced one or many trips. I feel like there is often a backlash against our regressive legal approach which tends to accentuate the positives and diminish the negatives but really we need information. These drugs can permanently change your personality in some ways that will generally not be seen as positive. Yes, they can have many good effects but that comes with a small risk of extreme side effects.
  • pmoriarty 8y ago
    Are these people "fried" because they used those substances, or because of how they used them, or how they viewed, integrated (or not-integrated) their experiences? A visual distortion is a good example. When experiencing a visual distortion, it is possible to feel anxious about the appearance of such a distortion, or instead one could be indifferent to it, or even enjoy and welcome it. It need not be negative. More research is certainly needed on the negative experiences people sometimes have with psychedelics (so far, most of the research has focused on the positives), but I have a strong feeling that how people approach their experiences, what they expect to happen, and how they interpret what happens plays a very critical role on whether the experience is positive or negative for them. This is the old "set" (or "mindset") part of "set and setting" that's critically important for their constructive use. Also, it may be possible to work through any anxiety or negative effects one experience with a therapist. Panic attacks and anxiety, for instance, are things that therapists tend to be actually really good at treating.
    • AnimalMuppet 8y ago
      Depends on the distortion. A visual distortion means that you aren't seeing things as they really are. That could be problematic for your ability to drive, or to ride a bike, or any number of other activities. You could be indifferent to that, but it could still be a genuine problem for your ability to function.
• cryoshon 8y ago
  i'm of the opinion that the psychotic breaks risk would be an engineering problem to overcome in the context of using psychedelics therapeutically. besides, in a clinical context, it's highly unlikely any kind of psychotic break could get too far out of hand; an astute clinician would recognize the patient spiraling out of their control and administer a correcting dose of an anxiolytic, or, failing that, a trip-ender like an antipsychotic.
• stuntkite 8y ago
  As a person who has been to psychedelic hell, I can say a nice part about it is that it ends. Having people around you to help you assimilate complicated experiences is key. If you're on the edge of a manic episode, it can definitely be a catalyst, and I've seen difficult things come of it but sometimes difficult things are manifestations of things we need to deal with. The benefits of responsible psychedelic usage greatly outweigh the risks. I haven't seen any evidence that permanent psychosis after psychedelic usage is statistically significant compared to psychosis in the general population. Honestly, riding your bike to work is more dangerous. Something that's hard to quantify (because it's been illegal to study) is that people who use/abuse psychs before slipping into a permanent psychosis may have been on a manic upswing that led to the risky usage of the drugs. I've seen that happen to people in hypo mania with weed, alcohol, shopping, and the greatest offender and most predictable, cocaine. This can lead to PTSD and further self medication that can become a race condition that lasts a lifetime. The fear, shame, and personal loss can be crushing without the support to handle it. Permanent psychosis or schizophrenia are so poorly defined. One of the hallmarks of schizophrenia is that it doesn't get better. So if you had an episode and they diagnose you then it does go away, well they guess you didn't have it. The more modern thinking is that schizophrenia doesn't exist[1]. There are so many factors that lead into an unmanageable mental state, not the least of which is our bizarre modern environment. IMO it's a miracle most of us are able to pass as sane well enough to keep the trains running on time. I just don't buy the "don't do it, you might go crazy" though. But if you feel like it's not for you, it's probably not for you. Thoughtful enthusiasm is so important. Also knowing what you're taking and where it came from. If you or someone you know struggles with mental illness coupled with drug use, there is real help for it and free resources. Cognitive Behavioral Therapy and it's Dialectical[2] cousin are showing amazing results. SmartRecovery[3] is a fantastic free resource. With free daily online chat groups (audio, video, and text) as well as in person meetups all over the world. [1] https://www.psychologytoday.com/us/blog/psych-unseen/201603/schizophrenia-doesnt-exist https://www.psychologytoday.com/us/blog/psych-unseen/201603/... [2] http://www.millercounselingserv.com/uploads/9/0/5/1/90518949/dbt_skills_workbook.pdf http://www.millercounselingserv.com/uploads/9/0/5/1/90518949... [3] http://www.smartrecovery.org http://www.smartrecovery.org
  • pmoriarty 8y ago
• bfuller 8y ago
  I agree in that psychedelics should be absolutely a last resort. That being said LSD was a miracle for me personally and saved my life.
  • SJWDisagree111 8y ago
    So you are mentally ill. Yet you feel justified giving advice on the internet.
    • dang 8y ago
      We've banned this account for breaking the site guidelines. https://news.ycombinator.com/newsguidelines.html https://news.ycombinator.com/newsguidelines.html