Depression, Consciousness, and Mushrooms

Warning: this might get trippy

Black dogs and whispering shadows

Important! If you are struggling with depression, or if you’re not sure whether you actually are, FIND HELP. Therapy, friends, family… Whatever makes you feel most comfortable (let’s be honest, least uncomfortable). Here’s a list of global crisis helplines.

It’s impossible to describe what depression feels like. Winston Churchill famously called it his black dog. (Not everyone agrees with the post hoc diagnosis of Churchill as suffering from depression, though.)

Someone whose bouts of severe depression are beyond doubt is Lewis Wolpert, a big name in developmental biology who struggled with clinical depression for big chunks of his life. He wrote a book about his experience - Malignant Sadness. You can read an excerpt of it here. In his words:

It was not just feeling very low, depressed in the commonly used sense of the word. I was seriously ill. I was totally self-involved, negative and thought about suicide most of the time. I could not think properly, let alone work, and wanted to remain curled up in bed all day.

One of the many challenging aspects of depression is that it is both frustratingly common and frustratingly unique. As this wonderful post by Our World in Data illustrates, the constellation of symptoms can differ substantially among patients and depression subtypes. Depression, as some have written, is not a consistent syndrome. Weight loss, weight gain, agitation, lethargy… All of these are possible symptoms.

I would suggest that there are some subjective commonalities, though. An ineffable feeling of despair, an invisible but very real weight on your shoulders, a hand on your throat, colors that lose their vibrance, and anhedonia - you may remember joy, but can’t feel it any longer.

While I recommend Wolpert’s entire (short) book, some of the science and data he draws on are outdated and new ideas about depression have emerged.

One such interesting idea is that depression is much more than ‘malignant sadness’, but rather that it might be a different and distinct state of consciousness altogether.

Modular brains and states of consciousness

This complicated mess of possible symptoms is interesting. The quantitative symptoms - the things we can measure - seem to differ substantially. The qualitative ones, though, all seem to revolve around an existential shift, a fundamental change in how you see the world and yourself.

With this as starting point, a recent proposal (here’s a link to a pdf of the scholarly paper) suggests that depression reflects an altered state of consciousness. It’s not simply feeling really low or sad, it’s not something you can solve by lifting your chin and puffing your chest - as people with depression are sometimes wrongfully told. It is also not something you can understand unless you’ve lived it.

Interesting mess number two: I came across this study, which suggests that the brains of people with depression are/become more modular. Your brain almost literally gets stuck in a negative loop. Pessimistic thought patterns, negative fixations, and so on are less attenuated by input from other networks. These changes in modularity seem most obvious in the default mode network and cognitive control network. Especially that first one - the default mode network - is linked to a lot of aspects of conscious experience. (We don’t know if it causes consciousness. Hug a philosopher friend and they’ll tell you all about how little we actually know about it.)

Let me repeat once more for the people in the back: depression is not simply feeling low or sad, and it’s very hard to imagine what it’s like if you’ve never experienced it.

Then what if we have something that alters our state of consciousness and blurs the mental lines between brain networks. Hello, psychedelics?

Mushroomy magic

Antidepressants and their use are often stigmatized, but they can help a lot of people with depression. Of course, lifestyle interventions, therapy, and so on all have their part to play in managing depression as well.

The tricky part about antidepressants is that not everyone with depression responds well to them. Depending on the population and the drug, we’re looking at roughly 10-30% of non-responders to the most popular anti-depressants. Those people with treatment-resistant depression have to take their recourse to (a combination of) other pharmaceuticals, different modes of therapy, lifestyle interventions, electroconvulsive shock therapy, magnetic seizure therapy…

Or psychedelics. (I am not promoting anything. Talk to your doctor. Don’t buy random stuff online. Etc.)

Thanks to a resurgence of scientific interest in molecules with psychedelic properties, their use in various conditions is being explored, and this includes depression. A recent study, which involved two trials, shows that the beneficial effects of psilocybin (magic mushrooms) on patients with severe depression were on par with commonly used SSRIs. (I wrote in a bit more detail about it here.) Unlike, the SSRIs, though, the mushrooms did their magic by decreasing brain network modularity and increasing network flexibility.

Using psilocybin (and a few other psychedelics) often leads to subjective experiences such as ‘ego dissolution’, feeling a connection with the world and others, and so on. Funny how that mirrors what seems to happen in the brain networks: less division, more connection. Also funny how these experiences - in some people - lead to a fundamental shift in perspective.

Or perhaps an altered state of consciousness?

This brings us full circle. Connection achieved.

(Obligatory warning: even psilocybin trips can go bad. Don’t ever take it alongside other drugs - including alcohol. Don’t buy random stuff online. Talk to your doctor. And so on.)

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Q: Despite affecting many millions of people, depression is still often misunderstood and discussed in hushed tones. Why do you think that is?

Q2: Do you think psychedelics deserve a closer look for the treatment of various mental health issues? Why (not)?

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