Magic Mushrooms to Treat Depression?

A recent piece in The New York Times Sunday Review put forward an argument for treating depression with psychoactive mushrooms. These picked up the nickname "magic mushrooms" once they spread as a recreational drug in the 1960s, and by 1968 they were banned. For decades after that, almost nobody studied the mushrooms themselves or psilocybin, the compound they contain. That has changed. Scientists have started examining what psilocybin does inside the brain, and the early findings point toward possible relief for depression along with a range of other psychological conditions. Whether it adds up to a sensible, reliable treatment is still an open question.

Brain scans comparing a sober brain against one on psilocybin show a striking difference. The second image lights up with far more scattered connections, new channels of communication between regions that normally stay separate. The question researchers keep circling back to is whether that reshuffling can do something useful for a suffering person.

Depression often traps people in loops. The same thoughts repeat, the same reactions fire off in response to stress, and over time this hardens into a pattern that shows up both in behavior and in the physical wiring beneath it. Neurons keep traveling the same routes, and those routes aren't always kind to a person's mood. Psilocybin, the hallucinogenic agent in the mushrooms, appears to nudge the brain into traveling along different pathways instead. The imaging work bears this out: normal brain activity looks one way, psilocybin-influenced activity looks another. If a dose can knock the brain off its usual track, the thinking goes, it might loosen the grip of the patterns feeding someone's depression.

A growing body of work hints at benefits beyond mood. Studies have raised the possibility that psilocybin could help with memory problems, bring back positive memories more readily, ease obsessive compulsive symptoms, address cluster headaches and PTSD, and soften the psychological weight carried by people with terminal cancer. All of this has convinced a lot of observers that psilocybin deserves serious study as an antidepressant.

I'm not fully convinced. Depression is an extraordinarily tangled condition. Its roots stretch from genetics to the way different medications interact, and two people with identical symptoms can arrive there by completely different routes. Neural pathways matter, no argument there, but they're one piece of a much larger picture. Given how much researchers already understand about depression, leaning on mushroom-derived psilocybin to reroute the brain and call that a cure feels like asking a great deal of a single mechanism.

There's also the point that existing antidepressants already lift neurotransmitter levels, which in turn encourages the brain to grow new neurons. With that in hand, I'm not sure an illegal substance is the obvious next step. Maybe as the research accumulates, psilocybin will earn a place alongside more conventional treatments. For now I don't think it belongs on the list of options, and I wouldn't tell anyone wrestling with depression to go try psychoactive mushrooms hoping to feel better.

Written by Tina Fuster, drawing on E. Bone's November 29, 2014 article "Can Mushrooms Treat Depression?" in The New York Times.