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> Considering how often antidepressants tend to be a hit-or-miss game (not to speak of side effects), I am a bit annoyed psychedelics don't get more attention f

> Considering how often antidepressants tend to be a hit-or-miss game (not to speak of side effects), I am a bit annoyed psychedelics don't get more attention for medical use. Psychedelics are actually extremely hit-or-miss as well. Anecdotally, psychedelics don't always send someone in the right direction post-trip. If you scroll the comments in any popular psychedelics-for-depression post on Reddit, there are almost as many negative experience reports (including some long-lasting) as there are positive reports. The positive reports receive the bulk of upvotes, though, so you have to scroll down to see them. Perhaps less anecdotally, any medical professional will see a non-trivial number of people with significant negative effects of psychedelics, from worsening depression to HPPD to existential crises or psychoses. An actual doctor had a great comment on the previous discussion: https://news.ycombinator.com/item?id=30995831 https://news.ycombinator.com/item?id=30995831

renewiltord 5y ago
Most doctors have a massive fear of iatrogenic illness. It is understandable - they don't want to be responsible for a problem. So they will allow lots of suffering that cannot be linked to their action. That's the flip side of primum non nocere: suffering is permitted so long as it is not tied to my action. That's why they opposed cardiac catheterization research and it needed someone who would violate the ethics of the time to invent. Medicine progresses one renegade at a time. Fortunately, America now has alternatives. We won't suffer for long under the thumb of gatekeepers. The COVID-19 pandemic has moved lots of prescription to online providers who do the bare minimum to diagnose. This has moved power into the hands of patients. For long-tail conditions, this is a superior model to a medical professional. Since this is necessary to say: I'm not a doctor hater - my parents are both surgeons and almost everyone in the extended family excepting me is in medicine. EDIT: to vmception, I only said that because there's lots of people who have some sort of grudge against medical professionals for some reason or the other. I don't. I love my family and I'm quite happy in my belief that they're good at it. When I go to a doctor, I usually trust them. Can't reply since rate-limited.
- vmception 5y ago
  > my parents are both surgeons and almost everyone in the extended family excepting me is in medicine. I don't think thats necessary to say, I’ve heard the wildest fringe perceptions over the last two years from people who tried to qualify their post the same way, or by mentioning they were a nurse or medical professional. I think whatever you have to say has enough weight to the people that matter without the disclaimer.
pmoriarty 5y ago
"If you scroll the comments in any popular psychedelics-for-depression post on Reddit, there are almost as many negative experience reports (including some long-lasting) as there are positive reports." Those trip reports are almost never done in a therapeutic context. Psychedelic therapy is what research has shown to be very helpful with depression. When people trip on mushrooms outside of therapy, they often do so: - with a poor set and setting - without intention - with little if any preparation (almost certainly without therapeutic preparation) - while mixing them with other drugs - without trusted, experienced trip sitters (much less therapists) there to reassure and help out if need be - without any integration or therapy afterwards - without being 100% certain that they were getting real psychedelic mushrooms and not something else (like poisonous mushrooms) - while believing all sorts of myths about psychedelics (which might be cleared up by trained therapists in the pre-therapy preparation) So no wonder quite a few people have "bad trips". Even so, just because someone has a "bad trip" (or difficult/negative experience) doesn't mean that their experience couldn't be of value to them. It's quite common for people to report that their difficult experiences were actually very valuable to them. My own have been more valuable than my good experiences. The good experiences were fun and all, but the bad ones were incredibly insightful. When done in a therapeutic context, with trained psychedelic therapists and the right preparation, integration, and followup therapy, there should be many more positive outcomes than in the anecdotal trip reports that you'll read from people tripping casually.
- PragmaticPulp 5y ago
  > Those trip reports are almost never done in a therapeutic context. > Psychedelic therapy is what research has shown to be very helpful with depression. Exactly right, which is why I mention it. A lot of people are going to read this thread and head off to do some self-experimentation at home, alone. We need to point out that the research and therapy environment is extremely different than DIY.
  - pmoriarty 5y ago
    "the research and therapy environment is extremely different than DIY" True, but that doesn't mean that the DIY environment couldn't be brought closer to the therapeutic one. I strongly recommend James Fadiman's Psychedelic Explorer's Guide[1]. It has lots of great advice on how to use psychedelics therapeutically. [1] - https://www.amazon.com/Psychedelic-Explorers-Guide-Therapeutic-Journeys/dp/1594774021 https://www.amazon.com/Psychedelic-Explorers-Guide-Therapeut...
rileyphone 5y ago
I'd be curious to see one such thread, but pretty sure you're just talking out your ass. My experience, and recent search, indicates these are usually about 80% positive, and most negative experiences stem from predictable abuse patterns. Of course there are dangers, risks, and bad experiences, but psychedelics might well be qualitatively better for depression than traditional pharmaceuticals.
- asxd 5y ago
  > but pretty sure you're just talking out your ass This really isn't necessary. Assume good faith.
  - mistermann 5y ago
    It was inappropriate language, but I think there is a valid point to be made. Assuming good faith (ie: not lying) is similar but distinctly different from assuming that someone is speaking truthfully/accurately. >> Considering how often antidepressants tend to be a hit-or-miss game (not to speak of side effects), I am a bit annoyed psychedelics don't get more attention for medical use. > Psychedelics are actually extremely hit-or-miss as well. Anecdotally, psychedelics don't always send someone in the right direction post-trip. If you scroll the comments in any popular psychedelics-for-depression post on Reddit, there are almost as many negative experience reports (including some long-lasting) as there are positive reports. The positive reports receive the bulk of upvotes, though, so you have to scroll down to see them. > Perhaps less anecdotally, any medical professional will see a non-trivial number of people with significant negative effects of psychedelics, from worsening depression to HPPD to existential crises or psychoses. An actual doctor had a great comment on the previous discussion: https://news.ycombinator.com/item?id=30995831 https://news.ycombinator.com/item?id=30995831 Looking at some of the discrete claims: > Psychedelics [are actually] [extremely] [hit-or-miss] as well. This asserts that results (across all instances of usage, not only those that have been studied under formal conditions) are highly random/inconsistent, in fact. This is highly contrary to my personal experiences, as well as the reading I have done on others' experiences. (Of course: we should keep in mind that it is unknown what percentage of experiences get posted, whether positive trips are more likely to get posted than negative, etc. - but "both sides" suffer from these problems.) > Anecdotally, psychedelics don't always send someone in the right direction post-trip. This true statement notes that they don't always do something positive, but it might be interpreted as being logically supportive of the preceding assertion, even though it is not. > If you scroll the comments in any popular psychedelics-for-depression post on Reddit, there are almost as many negative experience reports (including some long-lasting) as there are positive reports. This makes a quantitative claim that is extremely inconsistent with my fairly substantial experiences reading trip reports, which lines up with what /u/rileyphone said: >> My experience, and recent search, indicates these are usually about 80% positive, and most negative experiences stem from predictable abuse patterns. - > The positive reports receive the bulk of upvotes, though, so you have to scroll down to see them. This seems to imply that the negative trip reports are hard to find, which leads to people having a false impression of what is true. If one reads forums regularly, it seems unlikely that all negative reports were downvoted to oblivion before being seen by regulars, which is inconsistent with my experience on most forum software.
after_care 5y ago
> HPPD I've had some experience with HPPD but luckily mine went away. My experience ranges from 'oh that is pretty cool to look at' to 'this visual distortion is hurting my ability to focus on an important conversation'. I wish we better understood HPPD.
- postingposts 5y ago
  I’d like to recommend a book to you: https://mitpress.mit.edu/books/trees-brain-roots-mind https://mitpress.mit.edu/books/trees-brain-roots-mind

renewiltord 5y ago

Most doctors have a massive fear of iatrogenic illness. It is understandable - they don't want to be responsible for a problem. So they will allow lots of suffering that cannot be linked to their action. That's the flip side of primum non nocere: suffering is permitted so long as it is not tied to my action. That's why they opposed cardiac catheterization research and it needed someone who would violate the ethics of the time to invent. Medicine progresses one renegade at a time. Fortunately, America now has alternatives. We won't suffer for long under the thumb of gatekeepers. The COVID-19 pandemic has moved lots of prescription to online providers who do the bare minimum to diagnose. This has moved power into the hands of patients. For long-tail conditions, this is a superior model to a medical professional. Since this is necessary to say: I'm not a doctor hater - my parents are both surgeons and almost everyone in the extended family excepting me is in medicine. EDIT: to vmception, I only said that because there's lots of people who have some sort of grudge against medical professionals for some reason or the other. I don't. I love my family and I'm quite happy in my belief that they're good at it. When I go to a doctor, I usually trust them. Can't reply since rate-limited.

vmception 5y ago
> my parents are both surgeons and almost everyone in the extended family excepting me is in medicine. I don't think thats necessary to say, I’ve heard the wildest fringe perceptions over the last two years from people who tried to qualify their post the same way, or by mentioning they were a nurse or medical professional. I think whatever you have to say has enough weight to the people that matter without the disclaimer.

pmoriarty 5y ago

"If you scroll the comments in any popular psychedelics-for-depression post on Reddit, there are almost as many negative experience reports (including some long-lasting) as there are positive reports." Those trip reports are almost never done in a therapeutic context. Psychedelic therapy is what research has shown to be very helpful with depression. When people trip on mushrooms outside of therapy, they often do so: - with a poor set and setting - without intention - with little if any preparation (almost certainly without therapeutic preparation) - while mixing them with other drugs - without trusted, experienced trip sitters (much less therapists) there to reassure and help out if need be - without any integration or therapy afterwards - without being 100% certain that they were getting real psychedelic mushrooms and not something else (like poisonous mushrooms) - while believing all sorts of myths about psychedelics (which might be cleared up by trained therapists in the pre-therapy preparation) So no wonder quite a few people have "bad trips". Even so, just because someone has a "bad trip" (or difficult/negative experience) doesn't mean that their experience couldn't be of value to them. It's quite common for people to report that their difficult experiences were actually very valuable to them. My own have been more valuable than my good experiences. The good experiences were fun and all, but the bad ones were incredibly insightful. When done in a therapeutic context, with trained psychedelic therapists and the right preparation, integration, and followup therapy, there should be many more positive outcomes than in the anecdotal trip reports that you'll read from people tripping casually.

PragmaticPulp 5y ago
> Those trip reports are almost never done in a therapeutic context. > Psychedelic therapy is what research has shown to be very helpful with depression. Exactly right, which is why I mention it. A lot of people are going to read this thread and head off to do some self-experimentation at home, alone. We need to point out that the research and therapy environment is extremely different than DIY.
- pmoriarty 5y ago
  "the research and therapy environment is extremely different than DIY" True, but that doesn't mean that the DIY environment couldn't be brought closer to the therapeutic one. I strongly recommend James Fadiman's Psychedelic Explorer's Guide[1]. It has lots of great advice on how to use psychedelics therapeutically. [1] - https://www.amazon.com/Psychedelic-Explorers-Guide-Therapeutic-Journeys/dp/1594774021 https://www.amazon.com/Psychedelic-Explorers-Guide-Therapeut...

rileyphone 5y ago

I'd be curious to see one such thread, but pretty sure you're just talking out your ass. My experience, and recent search, indicates these are usually about 80% positive, and most negative experiences stem from predictable abuse patterns. Of course there are dangers, risks, and bad experiences, but psychedelics might well be qualitatively better for depression than traditional pharmaceuticals.

asxd 5y ago
> but pretty sure you're just talking out your ass This really isn't necessary. Assume good faith.
- mistermann 5y ago
  It was inappropriate language, but I think there is a valid point to be made. Assuming good faith (ie: not lying) is similar but distinctly different from assuming that someone is speaking truthfully/accurately. >> Considering how often antidepressants tend to be a hit-or-miss game (not to speak of side effects), I am a bit annoyed psychedelics don't get more attention for medical use. > Psychedelics are actually extremely hit-or-miss as well. Anecdotally, psychedelics don't always send someone in the right direction post-trip. If you scroll the comments in any popular psychedelics-for-depression post on Reddit, there are almost as many negative experience reports (including some long-lasting) as there are positive reports. The positive reports receive the bulk of upvotes, though, so you have to scroll down to see them. > Perhaps less anecdotally, any medical professional will see a non-trivial number of people with significant negative effects of psychedelics, from worsening depression to HPPD to existential crises or psychoses. An actual doctor had a great comment on the previous discussion: https://news.ycombinator.com/item?id=30995831 https://news.ycombinator.com/item?id=30995831 Looking at some of the discrete claims: > Psychedelics [are actually] [extremely] [hit-or-miss] as well. This asserts that results (across all instances of usage, not only those that have been studied under formal conditions) are highly random/inconsistent, in fact. This is highly contrary to my personal experiences, as well as the reading I have done on others' experiences. (Of course: we should keep in mind that it is unknown what percentage of experiences get posted, whether positive trips are more likely to get posted than negative, etc. - but "both sides" suffer from these problems.) > Anecdotally, psychedelics don't always send someone in the right direction post-trip. This true statement notes that they don't always do something positive, but it might be interpreted as being logically supportive of the preceding assertion, even though it is not. > If you scroll the comments in any popular psychedelics-for-depression post on Reddit, there are almost as many negative experience reports (including some long-lasting) as there are positive reports. This makes a quantitative claim that is extremely inconsistent with my fairly substantial experiences reading trip reports, which lines up with what /u/rileyphone said: >> My experience, and recent search, indicates these are usually about 80% positive, and most negative experiences stem from predictable abuse patterns. - > The positive reports receive the bulk of upvotes, though, so you have to scroll down to see them. This seems to imply that the negative trip reports are hard to find, which leads to people having a false impression of what is true. If one reads forums regularly, it seems unlikely that all negative reports were downvoted to oblivion before being seen by regulars, which is inconsistent with my experience on most forum software.

after_care 5y ago

> HPPD I've had some experience with HPPD but luckily mine went away. My experience ranges from 'oh that is pretty cool to look at' to 'this visual distortion is hurting my ability to focus on an important conversation'. I wish we better understood HPPD.

postingposts 5y ago
I’d like to recommend a book to you: https://mitpress.mit.edu/books/trees-brain-roots-mind https://mitpress.mit.edu/books/trees-brain-roots-mind