We have written extensively about how well psychedelic medicines work in the treatment of PTSD, depression, and substance abuse disorders. Another mental health problem that is helped by treatment with psychedelics is OCD or obsessive compulsive disorder. The psychedelic medicine that has been used in treatment of OCD is psilocybin. This is the drug that is undergoing advanced FDA trials for approval as an adjunctive treatment for depression. How does OCD treatment with psychedelics work?
What Is Obsessive Compulsive Disorder?
OCD is a mental health disorder. People get caught in a continual cycle of obsessions and compulsions. An obsession is an intrusive, unwanted through, urge, or image that brings on emotional distress. A compulsion is a behavior that a person uses as they try to get ride of their obsessions and the emotional distress that the obsessions cause. Established OCD is very disruptive to a person’s life. It is debilitating in that unwanted images, urges, and thoughts trigger compensatory behaviors. The behaviors are typically senseless in a larger context and very distressing to the individual who is afflicted by them. The bottom line is that OCD affects activities of daily life that are as simple as leaving home, engaging in day to day tasks, interacting with others, shopping, and doing one’s daily work. People with severe cases of OCD often become depressed and may entertain thoughts of suicide.
What Is Psilocybin?
Psilocybin is a compound found naturally in more than two hundred mushroom species. It has been used by indigenous cultures for thousands of years for its mystical experience. It turns out that this compound is similar to the brain neurotransmitter, serotonin. Because of this, psilocybin reacts with receptors in the brain where it produces several therapeutic effects. What a person experiences when they take psilocybin is an altered state of consciousness. Awareness is altered as are perceptions of the outside world. Emotional awareness is increased and the person may have auditory or visual hallucinations and a changed sense of what is real or not. Therapists note that the mindset of the individual who takes psilocybin has a strong effect on how well it works therapeutically.
Treatment of OCD with Psychedelic Medicines
The basic problem with treating OCD is similar to the problem with treating PTSD. Merely bringing to mind the issues at the root of a person’s OCD problem brings on an OCD attack. As with PTSD, psychotherapy and coaching have been tried along with antidepressants using serotonin uptake inhibitors. The results have been poor. As with the treatment of PTSD, depression, and substance abuse disorders with psychedelics, psilocybin is used as adjunctive therapy for OCD along with coaching or psychotherapy.
Psilocybin Treatment for OCD
First and foremost, psilocybin has been used in research settings to treat OCD and has been extremely effective. There are several ways that psilocybin treatment can help OCD symptoms. Psilocybin affects serotonin receptors in the brain. These include the ones responsible for OCD symptoms. Psilocybin enhances how serotonin receptors bind, increase their numbers, and increase activity. The end result is a reduction of OCD symptoms. These effects are improved with multiple doses and treatment sessions. The patient’s worries and ruminations about their obsession diminishes. Not only is this seen in reported patient symptoms but also in a type of brainwave pattern called ERN or error related negativity. Functional connections between different brain regions is enhanced by psilocybin therapy. This is especially true with the collection of regions called the default mode network. By altering how the default mode network works, OCD symptoms are significantly reduced.
In regard to the mystical experience that people have when using psilocybin there is good evidence that this experience increases psychological openness which, in turn, helps the patient develop insights and attitudes which are the goal of psychotherapy. As with PTSD treatment, the ability to consider the issue without triggering an attack is important for a positive therapeutic result.
Therapeutic Prospects of Psychedelics
Two psychedelic medicines, psilocybin and MDMA, are in advanced states of FDA trials and will eventually become standard treatments for severe depression and post-traumatic stress disorder. Research is ongoing for treatment of substance abuse disorders as well as OCD with promising results. Old folk medicines like ayahuasca have been used therapeutically for centuries if not millennia. For these medicines to be included as standard treatments for mental health conditions they will need to pass FDA tests for safety and efficacy. In the coming years we expect to see a deluge of psychedelic medicines to help with a broad range of mental health disorders.
