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Psychedelic medicines hold great promise in the treatment of mental illness. And because they appear to be so effective in treating mental illnesses, they hold the promise of reducing and even eliminating the risk of suicide due to mental health conditions. One mental health condition that greatly increases the risk of suicide is bipolar disorder. Individuals with this mental illness are anywhere from ten times to thirty times more likely to take their own lives than individuals in the general population. When we look at psychedelic medicines and bipolar disorder we see both potential benefits and risks.

What Is Bipolar Disorder?

Bipolar disorder is a mental health condition characterized by dramatic swings in mood. Individuals spend much of their time being depressed. Then they swing into periods of high energy, less need for sleep, and loss of touch with reality. This is the manic phase of what has also been called the manic depressive disorder. Swings in mood may last days or months and commonly include periods of increased suicidal thinking. The precise cause of bipolar disorder is not known. It appears to be a mixture of environmental causes, genes, chemistry, and brain structure alterations. This is commonly a lifelong condition that may respond to psychotherapy and medicines. As with conditions of pure depression, bipolar disorder also increases the risk of suicide.

What Is Bipolar Disorder?

Bipolar Disorder and Suicide

Suicide risk in bipolar disorder can be as much as thirty times greater than in the overall population. As many as one in five individuals with untreated bipolar disorder made end their own lives. As many as three in five of these individuals may attempt to end their lives at least once. All of the known risks of suicide such as social isolation, financial difficulties, relationship breakups, and exposure to trauma simply add to the risk individuals with bipolar disorder have of ending their own lives.

Bipolar Disorder Treatment With Psychedelics

Research has shown that a safely conducted psychedelic experience within the confines of ongoing psychotherapy is helpful in treating standard depression. However, it is known that treating a patient with the psychedelic psilocybin has the potential to induce a manic state. This is the manic half of the manic depressive or bipolar disorder. Because of the perceived risk of precipitating a manic attack individuals with this diagnosis are typically excluded from research trials using psychedelics in general and especially psilocybin. Because of this “bias” researchers have had to look to self-reported experiences of individuals with bipolar disorder who have taken psilocybin.

Bipolar Disorder Treatment With Psychedelics

Self-reported Psilocybin Use in Bipolar Disorder Patients

This study included individuals over the age of 18 who reported suffering from bipolar disorder and who had used psilocybin for a “full trip” as opposed to “microdosing” psilocybin. The study included 541 people who met all study criteria for having bipolar disorder and having used psilocybin. Only individuals who were not taking other psychiatric medicines at the time of taking psilocybin were included in the study results.

Negative Effects of Psilocybin in Study

32% of these people reported having unwanted or negative experiences after using psilocybin including new manic symptoms in 14%, difficulty with sleep in 10%, increased anxiety in 9%, hallucinations in 8%, delusional beliefs in 7%, and depressive symptoms in 9%. Three percent of these individuals (18 people) visited the ER within two weeks of their psilocybin use. All but one went to the ER because of symptoms related to their psilocybin use.

Positive Effects of Psilocybin in Study

Study participants reported a range of positive effects that they attributed to their use of psilocybin. Interestingly, the reports of positive effects were the same in people who had reported negative effects and those who had no negative effects from psilocybin. While there were short term pleasant experiences such as positive mood, increased creativity, and pleasant images, there were many long term positive effects.  86 of the 541 study participants reported long term positive results from using psilocybin.

These long term benefits included less depression and less anxiety, reduced mood lability, and a reduced need to use other substances like drugs or alcohol. A subset of people reported that their depression and manic episodes did not change much they found themselves better able to cope with these episodes after using psilocybin.

Another subset of bipolar individuals who benefitted from taking psilocybin reported both psychological and spiritual growth. People reported being able to remember past trauma and to be able to process those memories more effectively.

Can Psilocybin Be Used to Treat Bipolar Disorder?

Two things are clear from this study. Even through many bipolar individuals have uncomfortable and unwanted side effects from using psilocybin, there appear to be no lasting harmful effects. On the other hand, there appears to be therapeutic value in using psilocybin to treat people with bipolar disorder who are at a huge risk of committing suicide! One would hope that this is taken into consideration in future investigations of psychedelics in general and psilocybin in particular.

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