Can MDMA Help With Anxiety or Depression?
It’s hard to read about the developments in psychedelic therapy and psychedelic medicine without coming across MDMA. Currently in Phase 3 clinical trials as a treatment for PTSD – MDMA is showing promising clinical results and the power to help individuals heal themselves and return to wholeness.
As other psychedelic compounds, including ketamine, LSD, and psilocybin, are demonstrating themselves to be powerful interventions for a host of mental health conditions like anxiety, depression, obsessive-compulsive disorder, and others – the question naturally emerges as to whether MDMA can help with anxiety and depression as well.
This article explores the history, science, and potential for MDMA as a psychedelic medicine in the treatment of anxiety and depressive disorders.
MDMA, alongside legal ketamine treatment, currently finds itself among the poster children of psychedelic medicine. Spearheaded largely by the Multidisciplinary Association of Psychedelic Studies (MAPS), MDMA is currently the closest medicine to receiving FDA approval as a valid therapeutic modality.
Particularly for PTSD, though equally relevant to our discussion of anxiety and depression, MDMA is uniquely suited to help individuals enter a state where they can revisit and reframe challenging emotional moments through their history.
Through entering an altered state, whether the psychedelic experience of the classical psychedelics, or the highly empathetic, open, and positive state engendered by MDMA – individuals are more open and receptive to revisiting emotional blocks, taking on new perspectives in their lives, and seeing a more positive outlook for themselves and their futures.
MDMA is currently being studied specifically for psychedelic-assisted psychotherapy, meaning that the dosing sessions will be included as part of a holistic psychotherapy program, complete with several preparation sessions beforehand, and integration discussions between the dosing sessions. MDMA, and psychedelic medicines at large, create an internal and emotional state that is highly conducive to therapeutic containers and discussions. Given the early results so far, and its continued progress through the regulatory process, MDMA is proving itself as an effective ally for individuals with PTSD, anxiety, depression, and related conditions.
For a more comprehensive overview of MDMA, particularly investigating the key differences between MDMA and Ketamine, see this article.
It provides an introduction to MDMA as a medicine:
“MDMA is known as “Molly” or “Ecstasy” in recreational circles, and “3,4-Methylenedioxymethamphetamine” in the scientific and clinical communities. It was first synthesized in 1912 by Merck laboratories, and subsequently popularized and released by Sasha Shulgin, a legendary chemist, biologist, and early pioneer of MDMA and other psychedelic compounds. Before becoming a Schedule 1 substance, it was used therapeutically under the supervision of clinicians/therapists from the mid 1970’s-80’s.
MDMA is often included in the list of psychedelic therapy medicines, though it may be better described as an empathogen or entactogen . This means focused on emotions, feelings of empathy, and/or connection with self, others, and the world. This is because the subjective experience of MDMA differs in kind from the traditional definition of a psychedelic medicine, and does not include the hallmarks of a psychedelic/mystical experience.
MDMA works primarily in the brain by acting on the serotonin system, activating these pathways and preventing the reuptake of serotonin. By increasing the levels of serotonin (and also norepinephrine) in the system, this leads to the subjective and hallmark experiences of MDMA: increase in energy, increase in empathy, mood elevation, and altered sensory experiences such as more vivid colors and sensitivity to physical touch.”
Despite the different mechanism of action versus the classic psychedelics, that can be a great support when working with MDMA. It keeps you grounded in reality, in the here and now, in your body – but with a more open, more receptive, more empathic disposition.
It is this state, uniquely and reliably brought about by MDMA, that allows for significant and powerful progress to be made. In traditional psychotherapy, particularly for individuals managing PTSD or complex PTSD, revisiting charged emotional memories or traumatic events can cause the individual to shut down, slowing or interrupting the pace that the therapy can move at.
MDMA helps with this by creating a lived experience of safety and openness, so that the work can be done to revisit and reframe these experiences, helping individuals let go of the weight of the past and move forward towards the rest of their lives.
How MDMA Can Help Anxiety/Depression
While MDMA has been primarily studied as a medical and therapeutic intervention for PTSD, there are many reasons (and some existing evidence) that make MDMA a powerful medicine experience when dealing with anxiety and/or depression disorders.
Some of the key reasons that MDMA can help with anxiety/depression include:
Deep emotional processing
The MDMA experience puts individuals in a safe, receptive, open state – this allows them to go towards the memories and experience that may challenge or scare them, and to see them from a more compassionate perspective, and to reframe their story into a more loving and empowering one.
This deep emotional processing helps to resolve the root causes or generators of anxiety and depression. Over the long-run, MDMA helps provide individuals the strength and love they need to do the work they need to do to heal and move back towards wholeness themselves, on their own time.
Radically present gratitude
The entactogenic or empathogenic state that MDMA brings about is also very good at helping individuals see the beautiful and empowering parts of their current lives. Each breath, each opportunity, each friend or family member.
A deep reminder, and feelings of gratitude for the existing state of life can help break the thought patterns that so often accompany anxiety or depression. This brings individuals into the present in a positive manner, reducing the weight of the past or the uncertainty of the future. This momentary pattern-interrupt has both short-term mood benefits, and presents the opportunity for long-term beneficial behavioral change.
More productive psychotherapy sessions
As discussed earlier, MDMA is currently being studied and reviewed as part of a comprehensive psychotherapy protocol. Psychotherapy is a powerful healing modality, when it is able to continue and when the individual remains present and engaged in the process.
By helping surface core experiences and memories, and in helping shift mood and outlooks to more positive and loving dispositions, MDMA can considerably shift the pace and progress of psychotherapy protocols. This helps therapists and individuals alike to make more progress in their sessions, ingrain the changes and understandings more deeply, and accelerate the path to healing and wholeness for the individual.
Mood elevation and lessening of symptoms
While less discussed, MDMA does have a number of short-term or immediate biological and neurobiological benefits. Lessening the direct symptoms of anxiety or depression, such as energy and mood improvements, less tension from anxiety, are helpful at providing moments of reprieve for clients, so that they can rest, recover, and begin taking decisive action in their lives once more.
The biological impact of MDMA dosing sessions is another method whereby MDMA helps individuals tackle the lived experience, and the root causes, of anxiety and depression disorders.
While MDMA is going through clinical trials as a treatment modality for PTSD, there is existing evidence and strong reasons demonstrating the potential for MDMA to be a viable and powerful treatment for anxiety and depressive disorders as well.
Given the unique mechanism of action of MDMA over other classic psychedelic compounds, the highly empathetic, highly embodied experience of MDMA makes it uniquely suited to be an asset in psychotherapeutic interventions, as well as helping individuals revisit and reframe emotionally-charged experiences from their past.
While approval for the treatment of PTSD will be a major development for the psychedelic medicine space, there is still ample opportunity to study additional use-cases for MDMA in the treatment of a broad variety of mental health disorders. For several reasons mentioned, MDMA can also be a powerful treatment for individuals managing their anxiety and depression.
This article is for informational purposes only and is not intended to be a substitute for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment. If you are in a life-threatening situation, call the National Suicide Prevention Line at +1 (800) 273-8255, call 911, or go to the nearest emergency room.
Ketamine is not FDA-approved for the treatment of depression or anxiety. Learn more about off-label uses here.
Side effects of ketamine treatment may include: altered sense of time, anxiety, blurred vision, diminished ability to see/hear/feel, dry mouth, elevated blood pressure or heart rate, elevated intraocular or intracranial pressure, excitability, loss of appetite, mental confusion, nausea/vomiting, nystagmus (rapid eye movements), restlessness, slurred speech, synesthesia (a mingling of the senses).
Do not proceed with ketamine treatment if any of the following apply to you:
- Allergic to ketamine
- Symptoms of psychosis or mania
- Uncontrolled high blood pressure
- CHF or other serious heart problem
- Severe breathing problem
- History of elevated intraocular or intracranial pressure
- History of hyperthyroidism
- Other serious medical illness
- Pregnant, nursing, or trying to become pregnant
Ketamine has been reported to produce issues including, but not limited to, those listed below. However, lasting adverse side-effects are rare when medical protocols are carefully followed.
While ketamine has not been shown to be physically addictive, it has been shown to cause moderate psychological dependency in some recreational users.
- In rare cases, frequent, heavy users have reported increased frequency of urination, urinary incontinence, pain urinating, passing blood in the urine, or reduced bladder size
- Ketamine may worsen problems in people with schizophrenia, severe personality disorders, or other serious mental disorders.
- Users with a personal or family history of psychosis should be cautious using any psychoactive substance, including ketamine, and discuss potential risks with your MindBloom® clinician before proceeding with treatment.
- The dissociative effects of ketamine may increase patient vulnerability and the risk of accidents.
To promote positive outcomes and ensure safety, follow these ketamine treatment guidelines:
- Do not operate a vehicle (e.g., car, motorcycle, bicycle) or heavy machinery following treatment until you’ve had a full night of sleep
- Refrain from taking benzodiazepines or stimulants for 24 hours prior to treatment
- Continue to take antihypertensive medication as prescribed
- Avoid hangovers or alcohol intake
- Refrain from consuming solid foods within 3 hours prior to treatment and liquids within 1 hour prior to treatment
- Ketamine treatment should never be conducted without a monitor present to ensure your safety