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Key points
- Forty percent of Americans with severe mental disorders do not receive treatment.
- Today’s major pharmaceutical inventions often take a myopic approach to mental and cognitive ailments rather than a holistic one.
- For the first time in decades, psychedelics offer a radically different approach to the acute challenge of mental health.
Now that COVID-19 seems to have been successfully curbed, thanks largely to the rapid distribution of safe, effective vaccines, it’s time to turn our attention to the next colossal public health crisis: Mental health.
How dire is it? The numbers tell a grim story: According to the Centers for Disease Control and Prevention, nearly 5 percent of American adults suffer from regular feelings of depression, and more than 11 percent report habitual feelings of anxiety. Even worse, a whopping 40 percent of Americans struggling with severe mental disorders do not receive any treatment.
Understanding this baffling statistic helps to know a little about the current state of pharmacology. Tell your doctor you’re suffering from depression or anxiety, and she’s likely to prescribe selective serotonin reuptake inhibitors, better known as SSRIs. You hardly need a Ph.D. to understand how they work: your body produces serotonin, a very complex neurotransmitter in charge, among other things, of your mood.
An efficient machine that thrives on balance, the body, produces transporters, proteins whose job is to remove excess serotonin and keep everything even-keeled. Enter SSRIs: By blocking these transporters, these drugs increase the amount of serotonin in your body for a short time. Put crudely, they’re like some sort of mood-modulating ice cream cone, making you feel good for a brief moment but doing nothing else to address the core issue that made you gloomy to begin with.
Sadly, with almost no exceptions, drugs targeting mental and cognitive ailments operate on a similar principle, targeting very specific mechanisms discovered in a lab somewhere while leaving the rest of the magnificent and complicated mechanism that is the human brain largely untouched. Unsurprisingly, this myopic approach has produced relatively few breakthroughs; while other conditions saw rapid growth in promising new treatments, mental health medicine moves at a far slower pace.
Even worse, the abundance of screens (from computers to phones) has made us significantly more susceptible to mental and emotional problems. As one recent study concluded,
More hours of daily screen time were associated with lower psychological well-being, including less curiosity, lower self-control, more distractibility, more difficulty making friends, less emotional stability, being more difficult to care for, and inability to finish tasks.
However, the horizon is not all cloudy and gray; one treatment category seems to hold an immense potential to approach the problem from a radically different direction: psychedelics.
After some early promises in the 1960s, hampered largely by the category’s place in the popular imagination as an affectation of the counterculture. Therefore less than a viable medical offering, new technologies, like FMRI studies, give us a much crisper understanding of how these substances can alleviate pathologies and deliver breakthroughs that other treatments simply cannot generate.
It's a relatively complex process, but imagine, if you will, one of the most popular psychedelic substances currently in use, MDMA: Like SSRIs, MDMA, too, interacts with serotonin transmission; but rather than merely blocking the transporters’ work, it induces a reversal of their action, sending serotonin out into the body instead of simply collecting what’s coming in. It’s not a permanent change but a much more acute one: Put bluntly, it forms new neural connections, literally rewiring your brain and opening up new possibilities.
It may not sound like much, but patients who have post-traumatic stress disorder, say, may benefit immensely: Because PTSD wires one bad memory into your brain, making you sensitive to certain things and resistant to any treatment that may try to address the root cause of your behavior, forming new neural connections in your brain may cause PTSD patients to grow more receptive to therapy, bringing down the boundaries that kept help at bay for just long enough for psychologists to swoop in and grapple with the actual source of the patient’s pain instead of just swatting away at the symptoms.
This is why some of our most prominent universities—including Yale, Stanford, and Columbia—are currently busy researching psychedelic health care applications. For the first time in decades, psychedelics offer a radically different approach to the acute challenge of mental health, attacking the problem from a different direction and venturing to quiet down afflicted minds just long enough for therapists to do their life-saving work.
Let us hope, then, that the future brings much greater investments—of resources, ingenuity, imagination—in psychedelic care and that the many suffering may soon receive succor from an unexpected direction.
