Anxiety is a modern epidemic. Officially it affects around one in four New Zealanders but talk to anyone who works in our schools and universities and they will tell you the problem is far bigger than that.
Young people are suffering and mental health services are struggling to help. Last year, one US study showed the percentage of 18- to 26-year-olds suffering from an anxiety disorder had doubled since 2008. And it seems that women are far more likely to experience psychological distress than men.
What if there was a new therapy for anxiety non-invasive, no side effects, you'd barely even know you were on it except you felt calmer? What if that same treatment could work for depression and post-traumatic stress disorder, support the mental health of cancer patients, help in palliative care, control addiction, maybe even boost everyday mood and enhance work performance? Many people believe this potent remedy already exists it is called microdosing and currently, it is against the law.
Microdosing involves taking tiny amounts of illegal psychedelic drugs such as LSD or magic mushrooms, at about a tenth of the usual dose potentially all that is required to make changes in the brain.
It first took off in Silicon Valley where microdosing is one way high performing professionals are trying to give themselves an edge in a competitive business. They believe it boosts creativity and focus, increases productivity, improves sleep and helps them manage stress.
Despite its illegality, the practice is now becoming more widespread.
It may sound like microdosing is the latest and greatest life hack, but so far there isn't much solid scientific evidence to back it up, only a lot of chatter. The man who may be set to change that is Dr Suresh Muthukumaraswamy at Auckland University.
He has spent his career looking at how various therapies affect brain activity and this year will embark on a world-first study to see if microdosing really is as effective as enthusiasts claim.
It has taken a long time to get the ethics approval and funding needed, but partly thanks to a large donation from Silicon Valley, the project is set to go. Dr
Suresh says that while there are many interesting claims about the benefits of microdosing, the few laboratory studies so far haven't found any positive results. This may be due to the placebo effect people believe a drug is going to work and so it seems to but there is another possible explanation.
"Laboratory studies are tremendously boring," Dr Suresh explains. "You come into a sterile environment, take the dose and then you're monitored, probed and prodded for six hours. It's not a good reflection of what is happening when people take a microdose of LSD, then go out and engage with the world, do their job, live their life. If this drug is a platform that enhances experience, then perhaps you need to have an experience."
His University of Auckland trial will involve 40 healthy male volunteers no women this time round because the hormonal activity of the menstrual cycle creates changes in the brain and makes the testing process more complex.
For six weeks, half the men will take a microdose of pharmaceutical grade LSD and half a placebo, then they'll switch. No one will have any idea whether they are on the real drug or the fake, and crucially they will be allowed to take the pills home and experience microdosing "in the wild", rather than solely in the lab.
"People will be filling in nightly questionnaires about things like mood, wellbeing, concentration and any negative effects. And we'll bring them into the lab to do more involved assessments of brain function," says Dr Suresh.
Modern imaging techniques, such as fMRI, mean scientists can actually see what is going on in the brains of people who are taking these drugs. When he was based in the UK, Dr Suresh was involved in one trial where participants took a full dose of LSD and it was found that parts of the brain that don't normally connect with one another, started to communicate.
LSD, commonly known as acid, is a synthetic chemical that binds to the serotonin receptors in the brain. In small amounts, it produces mild changes in perception, mood and thought. When larger doses are taken it can cause visual hallucinations and an altered sense of time.
The heyday of LSD was the 1960s when the US psychologist and writer Timothy Leary urged people to take an acid trip to "turn on, tune in, and drop out", but humans actually have a far longer history of using psychedelics.
In South America, shamans have used a plant-based psychoactive tea called ayahuasca in traditional healing rituals and ceremonies for centuries. And there is archaeological evidence that shows people were taking magic mushrooms thousands of years ago.
In recent years there has been a renewed interest in the therapeutic use of psychedelics. Scientists around the world have been looking at how MDMA (ecstasy) might help patients with severe PTSD; at how ayahuasca might be used to treat depression; how LSD may be helpful for addiction and severe phobias; and how psilocybin, the active ingredient in magic mushrooms, might be a breakthrough for hard-to-treat health and mental health issues.
Aucklander Amadeus Diamond runs a Facebook page called Psychedelics New Zealand and has set up the Entheos Foundation with the aim of raising funds for local research and education.
Amadeus works in finance and isn't a microdoser himself, but is excited about the potential of these drugs to help those dealing with everything from addiction to PTSD and depression, and frustrated that their illegality is making it difficult for sufferers to access them.
"I want to help," he says. "I want to put the word out and get these things to the point where people can benefit from them."
Since the publication of US writer Michael Pollan's book, How To Change Your Mind: The New Science of Psychedelics in 2018, he says there has been a surge in interest.
"I'm getting six or seven messages a week from people saying, 'I have PTSD' or 'I'm depressed' or 'A family member is suffering from depression, please help.' And it breaks my heart when I have to say I can't. All I'm able to do is point them in the direction of the best research.
"I can't help them source illegal drugs and I can't encourage them to self-medicate because that would be irresponsible."
Illegality notwithstanding, there are other reasons why self-medicating with hallucinogens could be a bad idea. Drugs sold as LSD may actually contain other substances, some of them more dangerous and stronger, so it is easy to take too much.
Pick the wrong mushroom and rather than it being 'magic', it could paralyse and kill you. If you are taking other drugs such as SSRIs or have mental health issues, it might make things worse rather than better.
For Laura*, those risks appear to have been worth it. Since she was a child, she has struggled with anxiety. Her panic attacks were sometimes so severe that she would black out.
"There didn't seem to be a trigger," she recalls. "It would happen randomly while I was at school or walking down the street. Then a couple of years ago my anxiety got so bad I didn't want to leave the house."
Laura, a South Island mother with a corporate job, knew she needed help. She went to her GP who prescribed a class of anti-depressants known as SSRIs that increase levels of the mood-regulating hormone, serotonin, in the brain.
Laura had tried taking them previously while suffering post-natal depression and the drugs hadn't agreed with her. Still, she didn't think there was another option.
"Then, after I started taking them, I couldn't get out of bed for a month," she says.
So her doctor took her off the anti-depressants and Laura made the decision to leave her stressful job and study psychology. That was when she started learning about the healing potential of psychedelic drugs. Laura was most interested in the idea of microdosing.
"I did a lot of reading and got information on how to go about it," she says. "I was lucky there was someone I knew and trusted who had access to LSD and they sold me some."
The first time she tried it, Laura microdosed for a week and there was a real impact on her anxiety. "Suddenly I wanted to go out of the house again. I had conversations where I didn't feel awkward. Probably the biggest thing I noticed was that I wasn't ruminating about the past or feeling anxious about the future."
The beneficial effect lasted for five weeks. Since then, Laura has tried microdosing twice more and says her panic attacks are now a thing of the past. "It's made a huge difference to my life," she says.
LSD is a class A drug and possession can result in six months' imprisonment, a $1000 fine, or both. "Still, I wouldn't hesitate to do it again," Laura admits.
Even if the University of Auckland study does find solid evidence of benefits from healthy men taking microdoses of LSD, the research will need to be repeated with women, and then mental health patients, to see how it is going to affect the wider community.
"With science you've got to do it one step at a time," he says.
Currently, a third of people with serious depression are unable to find a drug that eases their symptoms. Dr Suresh believes that for mental health disorders, a variety of different treatments is required, as patients tend to respond to one and not another.
Some day microdosing may be among the options. In the meantime, it worries Dr Suresh that people out there are taking the risks of self-medicating, when there is no real evidence yet that it works and his own trial might not find any benefits.
"Still, we have to chase the knowledge and find out," he says. "We'll never know unless we do an effective study."
Wellington's Rebekah Senanayake is willing to talk openly about having tried microdosing. She is planning to study for her master's in the traditional cultural uses of psychedelics and has a part-time job looking after the social media for an organisation called the Chacruna Institute which researches and educates around psychedelic plant medicines.
Rebekah was travelling in South America when she had her first experiences with ayahuasca. "It helps you think of things in a completely different way," she says. "Afterwards, I felt a lot clearer in my mind and body, my interactions with other people were better and I could think more deeply."
But ayahuasca is also not without risks. In 2015, New Zealander Matthew Dawson-Carke died while taking it on a retreat in Peru.
Rebekah spent 10 days in the jungle going through a guided ritual with a shaman that involved clean-eating before drinking it several times and says she never had any sort of bad experience.
Since then Rebekah, who is in her mid-twenties, has microdosed with huachuma (or San Pedro), a cactus that originally comes from Peru and has been used for thousands of years in sacred ceremonies.
"I took a tiny, tiny dose every morning for about three months," she says. "That was really interesting because you don't go fully into the experience, you just feel some of the effects. You're still in control, you can do everything you normally do, it's just at a different level. You think about one thing at a time," she says.
Convinced of the potential of these plant medicines to help people when used in the right way, Rebekah hopes her future career path will involve psychedelics. But there is still a long way to go before they are likely to be accepted by mainstream medicine.
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