Hi. I'm brand new here and have already spent several hours getting up-to-date on the research being done with psychedelics (that thread is an absolute treasure--thank you!). One cautionary tale I came across on the numerous links provided is found here: https://psychedelictimes.com/shane-mauss-psychonautics/ wherein Mauss recounts how the heavy use of psychedelics ultimately landed him in the psych ward due to a prolonged bout of mania/psychosis. I wasn't exactly surprised: a major principle in treating bipolar is to use antidepressants cautiously, and only when absolutely necessary to nudge someone who is stuck in a depressive episode toward a more normal mood. The risks of antidepressant therapy in this population are two-fold: 1) that it may induce a manic episode or 2) that it leads to a greater instability in moods--something referred to as rapid cycling (one misconception about bipolar disorder is that it is accompanied by rapid changes in mood, happy one moment, crying the next. While there are occasional presentations with this characteristic, it is not by any stretch a defining feature of bipolar disorder, and is more common in other disorders such as borderline personality disorder or as a concomitant to an already abnormal mood--in particular a mixed state where symptoms of depression and mania coexist--a dangerous state of affairs carrying a high risk of suicide. Rapid cycling is defined as FOUR or more significant episodes of depression or mania/hypomania (the latter being much milder and unlike mania, is not accompanied by psychotic symptoms) in a YEAR.
I also have had a personal experience that may be relevant. Late in life and relatively recently, I became severely depressed, much of it likely due to the 2016 election and subsequent events. I had on many antidepressants previously and if anything, found that the longer I took them, the more "meh" the response came and so was looking for a newer, perhaps atypical antidepressant. I was prescribed Viibryd (vilazidone) that acts as an SSRI, but is also a direct partial agonist at the serotonin 1A receptor. For a while things went well, then all hell broke loose, had a full blown manic episode with the usual features of increased energy, hypersexuality (this wasn't entirely unwelcome being 60 at the time), rapid speech, racing thoughts,flight of ideas, poor impulse control, decreased need for sleep, inappropriate behavior--the whole shebang. My judgement was certainly impaired as evidenced by my decision to take a large amount of mushrooms the same night when my mania became obvious--the familiar, God I am feeling great, lets really get jacked. The results were not pretty--frank and frightening visual hallucinations, ideas of reference, and having to crawl about, so fearful and weak I'd become. Even after discontinuing the Viibryd (it vibrates all right) and Seoquel, I enjoyed three years of mild hypomania that was most delightful after a lifetime of dysthymia. Now back to my dull baseline, and wondering if psilocybin is worth considering. ( Iam on Lamotrigine so am somewhat protected against mania).
Now in no way am I ascribing the manic episode to the psilocybin--I was already on the come-up of at least hypomania, and possibly a full blown manic episode--will never know. Three weeks of Seroquel (100mg/d) brought me back to sanity, and I only had to miss a few days of work (as a college prof). But I do wonder if it didn't make matters worse, maybe significantly. But most of all I wonder if like other conventional therapies, psychedelics are a risk factor, perhaps even a significant one, which is basically why I am asking for responses here. Anecdotal experience either first or second-hand is most welcome.
I also have had a personal experience that may be relevant. Late in life and relatively recently, I became severely depressed, much of it likely due to the 2016 election and subsequent events. I had on many antidepressants previously and if anything, found that the longer I took them, the more "meh" the response came and so was looking for a newer, perhaps atypical antidepressant. I was prescribed Viibryd (vilazidone) that acts as an SSRI, but is also a direct partial agonist at the serotonin 1A receptor. For a while things went well, then all hell broke loose, had a full blown manic episode with the usual features of increased energy, hypersexuality (this wasn't entirely unwelcome being 60 at the time), rapid speech, racing thoughts,flight of ideas, poor impulse control, decreased need for sleep, inappropriate behavior--the whole shebang. My judgement was certainly impaired as evidenced by my decision to take a large amount of mushrooms the same night when my mania became obvious--the familiar, God I am feeling great, lets really get jacked. The results were not pretty--frank and frightening visual hallucinations, ideas of reference, and having to crawl about, so fearful and weak I'd become. Even after discontinuing the Viibryd (it vibrates all right) and Seoquel, I enjoyed three years of mild hypomania that was most delightful after a lifetime of dysthymia. Now back to my dull baseline, and wondering if psilocybin is worth considering. ( Iam on Lamotrigine so am somewhat protected against mania).
Now in no way am I ascribing the manic episode to the psilocybin--I was already on the come-up of at least hypomania, and possibly a full blown manic episode--will never know. Three weeks of Seroquel (100mg/d) brought me back to sanity, and I only had to miss a few days of work (as a college prof). But I do wonder if it didn't make matters worse, maybe significantly. But most of all I wonder if like other conventional therapies, psychedelics are a risk factor, perhaps even a significant one, which is basically why I am asking for responses here. Anecdotal experience either first or second-hand is most welcome.
