psychedelic experiences hold promise as a treatment for treatment-resistant depression, and may also improve the intentions of highly capable people who have not reflected much about what matters (“the betterment of well people”).
My rough model, from anecdotal evidence, is that there is such a thing as a short-term, several-month “honeymoon” from depression that a single use of psychedelics or especially MDMA can trigger, but that these are frequently not permanent cures. We have pretty solid evidence that a single use of ketamine can produce dramatic, but short-term and rapidly-fading, reprieves from treatment-resistant depression. Sometimes temporary isn’t bad—if temporarily having your depression lifted allows you to access insights that you can carry forward into the rest of your life. But I think we should expect that one-time trips are less likely to give permanent effects than drugs that you can take every day.
The “improving the intentions of highly capable people who have not reflected much about what matters” part seems roughly true to me. I think that psychedelics are especially valuable to people who want to understand what minds are like, so, roughly, people whose work intersects with neuroscience, psychology, AI, or philosophy. I think theories about minds are bound to be incomplete if they don’t include exposure to minds in very different states than the thinker’s own habitual waking life. Other stuff that you should be exposed to, ideally through practical experience:
How babies and young children think
How animals think
How mentally ill and cognitively disabled people think
How people think in states of meditation or religious ecstasy
How computer programs “think”
If you’ve ever read, say, Kant and thought “wow, has this guy literally ever played with a baby?! He’s obviously wrong about what cognitive processes are universal or innate” then you have some idea of what the benefits of exposure to different minds are. Empirical experience with what minds are like seems important for “universal” questions about what is worth valuing & pursuing. Note that scientific/humanist generalists like Oliver Sacks have deep experience with most of 1-5 (I don’t know that he ever studied computer science) as well as frequently having experience with psychedelics.
I agree that the evidence around psychedelics for treatment-resistant depression is slim & preliminary. The effect sizes in Carhart-Harris et al. 2016 are very large, so I’m optimistic that a sizeable (though smaller) effect will occur in larger studies.
Sometimes temporary isn’t bad—if temporarily having your depression lifted allows you to access insights that you can carry forward into the rest of your life.
The mechanism I’m most excited about re: psychedelics for depression is a high-dose psychedelic experience functioning as a catalyst for other behavior & worldview changes which, when taken all together, lead people out of their depression.
I’d like to push back on this a little.
I recently did a lit review (https://srconstantin.wordpress.com/2018/02/12/atypical-treatment-resistant-depression/) on what’s been shown to work for treatment-resistant depression, and while there is a study on psilocybin and it did show positive effects, it was small and uncontrolled, and fairly short-term (only three-month follow-up.)
My rough model, from anecdotal evidence, is that there is such a thing as a short-term, several-month “honeymoon” from depression that a single use of psychedelics or especially MDMA can trigger, but that these are frequently not permanent cures. We have pretty solid evidence that a single use of ketamine can produce dramatic, but short-term and rapidly-fading, reprieves from treatment-resistant depression. Sometimes temporary isn’t bad—if temporarily having your depression lifted allows you to access insights that you can carry forward into the rest of your life. But I think we should expect that one-time trips are less likely to give permanent effects than drugs that you can take every day.
The “improving the intentions of highly capable people who have not reflected much about what matters” part seems roughly true to me. I think that psychedelics are especially valuable to people who want to understand what minds are like, so, roughly, people whose work intersects with neuroscience, psychology, AI, or philosophy. I think theories about minds are bound to be incomplete if they don’t include exposure to minds in very different states than the thinker’s own habitual waking life. Other stuff that you should be exposed to, ideally through practical experience:
How babies and young children think
How animals think
How mentally ill and cognitively disabled people think
How people think in states of meditation or religious ecstasy
How computer programs “think”
If you’ve ever read, say, Kant and thought “wow, has this guy literally ever played with a baby?! He’s obviously wrong about what cognitive processes are universal or innate” then you have some idea of what the benefits of exposure to different minds are. Empirical experience with what minds are like seems important for “universal” questions about what is worth valuing & pursuing. Note that scientific/humanist generalists like Oliver Sacks have deep experience with most of 1-5 (I don’t know that he ever studied computer science) as well as frequently having experience with psychedelics.
Thanks for the great comment :-)
I agree that the evidence around psychedelics for treatment-resistant depression is slim & preliminary. The effect sizes in Carhart-Harris et al. 2016 are very large, so I’m optimistic that a sizeable (though smaller) effect will occur in larger studies.
The mechanism I’m most excited about re: psychedelics for depression is a high-dose psychedelic experience functioning as a catalyst for other behavior & worldview changes which, when taken all together, lead people out of their depression.