Five Common Concerns About Psychedelic Therapy
It’s not always easy to make the decision to embark on a major transformative experience or healing journey. At Mindbloom we receive many questions from well-intentioned individuals with some concerns or confusion around the process, if this is the right fit, or if there is anything else that they should know.
This piece explores five common concerns about psychedelic therapy, and how to think through them on your own. Ultimately this decision is yours to make, it is for your process and your healing journey. Seeking out additional information like this to make an informed decision is a great first step to take.
“How Do I Know If Psychedelic Therapy Is Right For Me?”
You’ve explored traditional treatment options
Many people come to explore psychedelic therapy after they have exhausted other routes to alleviate symptoms of conditions such as depression, anxiety and PTSD. This could include traditional psychiatric medicines, such as SSRIs (selective serotonin reuptake inhibitors) or talk therapy. The first FDA designation for ketamine was actually for people who have tried several other treatments like SSRIs and not had a significant reduction of their depressive symptoms.
Aside from looking at the alternative treatment options out there, it could also be helpful to look at what you are doing currently as a form of treatment and your overall health. Have you spoken to your current prescriber about other medications or adjusting the dose of what you may be currently taking?
If so, has there been some effect, an unwanted effect, or little to no effect? Have you been on antidepressants, participated in a sleep study, changed your diet, or even explored herbal and other non-Western remedies? Have you had thorough medical evaluations that include things like lab work, genetic testing, or in some cases, digital imaging studies, to rule out possible medical reasons for your symptoms?
Evaluations by licensed practitioners are generally required for psychedelic treatment in a clinical setting. At Mindbloom, you will have an initial consultation with a clinician who will monitor your progress through your course of treatment to provide you additional support when needed, assure that the therapeutic benefits of the medicine are maximized, and assess your well-being.
You’ve considered the options
Just as with making medical decisions, it is important for you to do research, get multiple opinions, and weigh your options. It is likely that different medical professionals will have different medical opinions in regard to your course of treatment and even your diagnosis. Perhaps you will want to look for a psychiatric clinician who specializes in psychedelics, or a practitioner who thinks “out of the box” regarding traditional Western medicine, or maybe you have chosen to follow the more traditional models of psychiatric treatments.
At Mindbloom, we do not require you to have exhausted other treatment options and currently receiving other forms of treatment or therapy would not automatically disqualify you. What is important is that you approach this treatment opportunity with an open mind to the nature of this process and a commitment to yourself to do the growth work around the medicine, through integration, with the support of your clinician and guide team.
The opinions of medical professionals, friends, and researchers are indeed important. But, in the end, only you can decide what is right for you, and if you are ready to take a new step in your treatment.
You Have Set Intentions or Goals in Mind
Mindbloom believes in looking at ketamine treatment as an integrative process. Any insights you may experience during your hour-long sessions may become more therapeutic or longer lasting through journaling, meditation, talk therapy, and other proven integrative tools.
One of the integration exercises that Mindbloom asks of its clients is to set intentions before each session and for your overall treatment: how do you hope to grow or heal through this experience?
The same question may be used in choosing to explore psychedelic therapy. What has brought you to look at psychedelics as a therapeutic tool? What are your intentions for healing or behavioral change?
“How Do I Know Which Psychedelic is Best For Me?”
The Legal Options
You’ve decided that you are interested in psychedelic therapy. Which treatment or medication is best for you?
There are many factors involved in making an informed decision as to which is right for you, such as: availability, accessibility, legality, and methodology. Outside of participation in research studies, Ketamine is the only legal option currently available. Clinical trials that are using psilocybin and MDMA as a treatment for a variety of conditions are another legal avenue to explore these medicines. However, keep in mind that they follow rigorous selection protocols, defined by the nature of the study.
The discussion around psychedelics like these, and others such as LSD and ayahuasca, continue to be explored as the scientific community searches for safe and effective treatments for a variety of conditions.
If you want to try the route that is most readily accessible, ketamine therapy may be right for you. As of this date, ketamine is the only psychedelic approved by the FDA for therapeutic use, though FDA approval for psilocybin mushrooms and MDMA is currently in progress, and for some specific designations have been granted "break-through therapy" designation for specific indications in current clinical studies. Private companies like Mindbloom offer a professional, and safe experience, in the privacy of your own home.
Ketamine treatments can also be shorter-duration experiences than the other psychedelics. Ketamine therapy typically lasts about an hour (not including the time spent on journaling, meditating, and integrating the experience), and the medicine’s effects wear off fairly quickly. The effects of other treatments such as psilocybin and MDMA could last for several hours.
There are excellent documentaries, podcasts, videos, and books to be found on each of the psychedelics, as well as on psychedelic therapy and concepts like microdosing, in general.
“How Do I Obtain Psychedelic Medication?”
If you have determined with your care team that a psychedelic medicine other than ketamine is the appropriate next step for you — you will need to apply and enroll in clinical trials. There are a number of ways to do this, view this resource for more information. Keep in mind that during COVID-19, clinics and trials may be operating in a different manner.
Another option, albeit one not likely during this time of COVID, is to seek treatment options outside the US, where other options may be available. But even in pre-Covid circumstances, this could be a costly and time-consuming endeavor.
Mindbloom, which currently provides ketamine treatment specifically, sends you a kit called a “Bloombox",” that has everything you will need: the medicine, a journal, an eye mask, and a heart monitor, as well as an online portal that serves as your digital guide with time sequenced integration exercise, education, and audio programming, as you progress through the course of treatment. Each session is accompanied by a curated soundtrack that aids in taking you through your journey.
“What Are the Risks?”
Potential Medical Risks During the Experience
As with any substance introduced into the body, it is important that you are screened by a medical professional to rule out risks and assure safety before continuing.
At Mindbloom, we follow a scientifically backed dosing protocol based on your weight and titrated based on specific clinical markers. Our ketamine is in the form of tablets that are produced by regulated compounding pharmacies that are held to the highest of quality standards.
There is great risk in self-medication through the purchase of ketamine via other channels, as there is no control for dosage and quality. More and more, substances such as ketamine when being sold on the "streets" are being cut with deadly, high potency, substances such as fentanyl. Various reports showing this occurring in as much as 40% of the supply.
If you are considering ketamine as a treatment option, we recommend you make an appointment to consult with a clinician. Psychedelics have a variety of physiological effects and during a consultation, the clinician will determine if any of these effects are possible risk factors for you. They will also provide you with the education, tools, and support to manage some of the side effects in a safe way.
Risks of Surfacing Trauma During, or As a Result of, the Experience
For some, the goal of psychedelic therapy is to find healing around traumas that may be buried deep within our psyches or up in the forefront of our consciousness. Maybe then, also finding relief from the secondary effects of the trauma that can be manifested in a variety of ways such mood (depression and anxiety), PTSD (which includes a collective of symptoms) and somatically (felt physically in the body). As Stated by Dr. Stanislav Grof, one of pioneer researchers and practitioners in the therapeutics of non-ordinary states of consciousness states, psychedelics can be understood as "non-specific amplifiers of the contents of consciousness."
In this context, we can understand how these medicines can, in a sense, stir things up from deep within us, bringing them to the surface. In many ways, this is the point. To access this content so that we can heal through closure, acceptance, change in perspective, and even just a release of pent-up psychic energies. For some, things may get worse before they get better. However, with proper support with set/setting, processing, and integration this does not have to be an unsettling process which is why professionally trained support along the way is vital.
People have a variety of experiences with these medicines. Some experience love, empathy, and a connection with something greater than themselves. When working with trauma, there is a possibility of coming into contact with a part of you where trauma lives which can be overwhelming without thoughtful set/setting and plans for processing and integration support.
This is one of the things that will be discussed during your consultation with a clinician prior to moving forward with treatment at Mindbloom. Based on your needs, your clinician may make recommendations to establish care with a therapist outside of Mindbloom prior to moving forward with this treatment. The first two treatments are facilitated by our guide and clinician teams. It is also a requirement that you have a trusted person at home with you when you take the medicine. This person is referred to as a “peer treatment monitor" and they are a vital component of safety in set and setting.
What if I Don’t Feel Any Benefits from Ketamine Treatment?
Some people do experience dramatic changes immediately after a single dose. But, for some, the benefits come later in the week, or after many weeks and multiple doses. Psychedelic therapy is often a journey of life-long healing work after the start of treatment.
Whether you continue to seek this treatment on a regular basis, or work with its potentially long-lasting benefits after your last session, it has the potential to reward you through lasting growth and behavioral change.
You will know when you feel you have gained benefits or not. And, if not, you may choose to try a different treatment. Like most things in life, we don’t always get it right the first time. But, also like life, the only way to know is to try.
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