Do psychedelics qualify as a new class of antidepressant?

MagicMushrooms — *Psilocybin cubensis* (magic mushrooms) growing in Maritime Forest on Long Island, NY. A pilot study found their active ingredient psilocybin was remarkably effective at lifting people out of treatment-resistant depression. Photographer: A. Hasan/Flickr

Clinical depression causes misery for hundreds of millions of people worldwide. Around one in five patients fails to respond to any treatment and even among those who do recover relapse rates are high and get progressively worse with each successive episode. The most widely used class of antidepressants, the selective serotonin reuptake inhibitors (SSRIs), can lift some people out of severe depression and help them stay well, but they don’t work for everyone and among the many side-effects are anxiety, weight gain and sexual dysfunction.

Since the SSRIs became available in the 1980s no new class of drugs has emerged, so the news that there may already be a more effective type of antidepressant in existence that is safe and well tolerated is tantalising. The catch is that to possess or supply these chemicals runs the risk of an unlimited fine or prison sentence …

This blogpost was published on the Guardian’s website, Tuesday 17 May 2016. Read on…

Continue reading “Do psychedelics qualify as a new class of antidepressant?” →

Everything is not going to be ok

Amaravati

My publisher recently sent me an audio clip of the opening paragraphs of my new book Siddhartha’s Brain (published in the US on 26 April and 2 June in the UK), spoken beautifully by the British actor Steven Crossley. If you fancy a sneak preview, I’ve embedded it below.

As I recall, that morning the nuns’ and monks’ chant in the Meditation Hall of Amaravati Buddhist Monastery actually moved me to tears, though it’s hard to recapture that emotion – or where exactly it came from – when you’re sat at your computer keyboard back at home. So I simply wrote that, far from finding the chant maudlin (“Birth is dukkha [suffering]; Ageing is dukkha; Death is dukkha; Sorrow, lamentation, pain, grief and despair are dukkha…”) I was strangely moved by its honesty.

We have social taboos about admitting publicly all the types of suffering that are inherent in the day-to-day experience of having a body and a mind. Perhaps this serves a purpose, I don’t know, but for me at that moment and in that special place, speaking the words out loud felt immensely liberating. It somehow opened the floodgates, and out came tears of relief and happiness.

Images: Jake Barnes

Hot off the press!

SiddharthasBrain

My new book about the mind-blowing new “science of enlightenment” – which is stuffed with neuroscience, psychiatry and psychology, but also some wonderful Buddhist stories and guided mindfulness meditations – will be published on 26 April in the US and 2 June in the UK. I received my personal copy through the post yesterday, so I couldn’t resist sharing a few quick thoughts.

One of my principal inspirations for writing the book was a long conversation I had in 2014 with a charming Buddhist monk called Ajahn Amaro, the abbot of Amaravati Buddhist Monastery in the little village of Great Missenden near Hemel Hempstead in the UK. Before his ordination into the Thai Forest tradition he trained as a scientist at the University of London in the 1970s, earning a degree in physiology and psychology. As we chatted it became clear he sees Buddhism as a kind of internalised cognitive psychology formulated in Ancient India by Siddhartha Gautama (the Buddha) – thousands of years before “science” had been invented. He believes that the role of his monastery is to carry on that tradition.

“We don’t run labs and such,” the abbot told me, “but our way of practicing and teaching meditation is very experientially based – it’s what actually helps people. We are working with the mind to understand it better and train it to be more malleable and function in a more balanced way.” He even went so far as to say we are “all mentally ill”. According to Buddhist philosophy, only perfectly enlightened beings can be considered 100% sane. Such people see the world as it truly is, stripped of the greed, aversion and delusion that clouds the untrained minds of more ordinary folk like you and me.

I followed up my conversation with Ajahn Amaro by interviewing many of the leading scientists investigating the neuroscience and potential benefits of meditation, including the two inspirational people who brought this whole new field into existence in the 1980s, Jon Kabat-Zinn and Herbert Benson. The more I learned about Buddhism and meditation, the more at home I felt with them, both as a sceptical (even cynical) science journalist, and as someone with a cranky human mind. I began to meditate myself and attend retreats.

Famously, Siddhartha told his followers:

“Don’t go by reports, by legends, by traditions, by scripture, by logical conjecture, by inference, by analogies, by agreement through pondering views, by probability, or by the thought, ‘This contemplative is our teacher’. When you know for yourselves that, ‘These qualities are unskillful; these qualities are blameworthy; these qualities are criticised by the wise; these qualities, when adopted and carried out, lead to harm and to suffering,’ then you should abandon them.”

In other words, “Take no one’s word for it” or Nullius in verba in Latin, which is the motto of the Royal Society. Stripped of its cultural baggage (there’s plenty of that, of course, after two and half millennia) Buddhism is the anti-dogma religion. You’re not expected to believe in a creator god or follow a creed, just investigate your own experience, carefully, objectively, with an open mind.

Siddhartha’s Brain brings together this ancient philosophy with the discoveries of rigorous, hi-tech modern science. I hope people will enjoy reading it as much as I enjoyed researching and writing it.

Ayahuasca boosts mindfulness

ayahuascaLarge Meditating can be hard, lonely work, but if recent research is to be believed there may be a quick-and-dirty shortcut to enlightenment: psychedelic drugs. According to an exploratory study, drinking the hallucinogenic brew ayahuasca can bring about improvements in mindfulness that would take years of dedicated meditation to achieve. The research found that ayahuasca raised mindfulness abilities to levels equal to or even greater than those of people who have been practising meditation for around seven years.

Continue reading “Ayahuasca boosts mindfulness” →

Go gentle into that good night

Weeds grow on a concrete pathway in a cemetery in Galveston, Texas

Do not go gentle into that good night,
Old age should burn and rave at close of day;
Rage, rage against the dying of the light.
Dylan Thomas

“How do individuals emotionally cope with the imminent real-world salience of mortality?” wonder psychologists in a recent paper. Or in everyday language, how do people manage when they come face to face with death? The psychologists’ research suggests that, even under the most challenging circumstances, most people manage surprisingly well.

Sarah Hirschmüller and Boris Egloff from Johannes Gutenberg University Mainz in Germany analysed the last words of people you might expect to bemoan bitterly their fate and “rage, rage against the dying of the light”: prisoners on death row just seconds away from execution. But in fact, more than 80% used a greater number of positive emotional words in their final spoken statements than negative emotional words. Continue reading “Go gentle into that good night” →

Meditation and psychosis

Meditation

There’s something weird going on in the field of meditation and mindfulness research. On the one hand there are voices warning that meditation can cause psychosis – leading people to lose touch with reality and experience symptoms such as hallucinations, delusions and disturbing thoughts – on the other there are equally persuasive voices claiming that it should be used to treat psychosis. Continue reading “Meditation and psychosis” →

Is this the brain’s mindfulness switch?

Journalists adore research that allows them to write stories along the lines of “scientists have tracked down the brain’s love HQ” or “researchers have located the brain’s god spot”. It is very satisfying to imagine that we can divide the brain into neat components with distinct functions like the parts of a car engine. We dream that one day, neuroscientists will be able to lift the bonnet (or the hood if it’s an American brain), point and say “here’s the valve that causes schizophrenia – we can readjust that with this chemical spanner. Here’s the tank that causes OCD when it overflows – we can drain that by turning this tap here. Over there are the spark plugs that we clean up to cure depression …”

Unfortunately the brain is a lot messier and more wonderful than your average motor engine, which is why we’re still standing over it scratching our heads trying to figure out how on earth it all works. It’s a tangle of connections, with myriad networks of components involved in creating thoughts, consciousness, sensations and emotions.

So it is with a mixture of excitement and wariness that I approach a study by researchers at Beijing Normal University in China that seems to point to a particular part of the brain that switches mindfulness on and off. It’s called the thalamus (shown in red on the animated gif), a pair of bulbous structures that sit at the top of the brainstem (yellow) on the midline of the brain. The thalamus plays a pivotal role as the brain’s switchboard, relaying information from all the senses apart from smell to the cerebral cortex, which is the thinking, conscious part of the brain. Continue reading “Is this the brain’s mindfulness switch?” →

Growing old stressfully: chronic stress and prematurely aged cells

Human chromosomes showing telomeres — Human chromosomes (grey) capped by telomeres (white). Photograph: public domain

Forty years ago, the Whitehall Study of men working for Britain’s Civil Service famously revealed that those at the bottom of the pecking order were much more likely to die prematurely than those at the top – regardless of other risk factors such as smoking. They had higher mortality rates from all causes, but especially heart disease.

So the lowly paid doorman, whether or not he was a heavy smoker, was more likely to drop dead than the clerk sitting at his desk all day earning more money. As ever, life was deeply unfair. But what was the biological explanation for this health inequality? One theory was that the stress and lack of control over their working lives experienced by men in lowlier jobs were putting their health at risk, though how that worked physiologically was anyone’s guess. Continue reading “Growing old stressfully: chronic stress and prematurely aged cells” →

Meditation or medication for depression? A reality check

Prozac (fluoxetine) antidepressant pills — Research has suggested meditation is as effective as taking an antidepressant for mild depression

There was good news last week about the effectiveness of mindfulness meditation for easing anxiety, depression and pain. Mail Online reported that a study had found “meditation ‘works just as well as anti-depressants’: half an hour a day offers as much relief as tablets”, while The Boston Globe said those who took mindfulness classes experienced improvement in mood after eight weeks “on par with the effect seen with prescription medications”.

This was all perfectly true. A review published in JAMA Internal Medicine had looked at all the best studies to date and concluded that there was “moderate evidence” of improved anxiety, depression and pain among patients. The effect on mild depression was indeed equal to that achieved with anti-depressants.

Like me, though, you may be a bit underwhelmed by that phrase “moderate evidence”. It’s hardly a ringing endorsement, but better than “low evidence” – which was what the reviewers concluded about the efficacy of meditation for improving stress/distress and mental health-related quality of life. Continue reading “Meditation or medication for depression? A reality check” →

Meditation for pain relief

Candle and Buddha — Pain is relieved by suppressing the “mental narratives” and “self-related processes” that usually exacerbate it

Pain is a fact of life: it can be dulled with drugs, but sometimes it’s just too intense or too persistent. Then we have to learn to live with it.

Buddhist monks are adept at doing this when they sit immobile in meditation, remaining straight-backed in the lotus position for hours on end. They are thought to achieve this by “uncoupling” the sensation of pain from their emotional reaction to it. This is more than just a parlour trick. Monks protesting the Chinese occupation of Tibet have shown they are capable of sitting unflinching as they burn to death. Continue reading “Meditation for pain relief” →