Major depression is a common mental health disorder in the U.S. for which many have been prescribed antidepressants. Results from a small study using the mushroom compound psilocybin coupled with psychotherapy revealed 67% of participants had a positive response to the intervention by the first week of treatment and 71% by the fourth week.1 This is a better and faster response than in those taking antidepressants.2
In 2017, the National Institute of Mental Health estimated 17.3 million adults living in the U.S. experienced at least one episode of major depression, which was 7.1% of all adults.3 The prevalence was higher in females than in males and highest in those aged 18 to 25 years. Yet, as arresting as those numbers are, in the current pandemic, experts believe the numbers are rising even further.
As early as April 2020, just three months after the first confirmed case of COVID-19 in the U.S.,4 a mental health index showed 27% of people surveyed were uncertain of their ability to cope with the coming changes.5 The same index gave America a mental health score of 67, which places a typical American in the lowest 7% of a customary benchmark.
A study published in August 2020 by the U.S. Centers for Disease Control and Prevention also showed rising numbers of people experiencing mental health concerns. In their survey, 40.9% of the respondents were struggling with anxiety, depression or symptoms of trauma- and stressor-related disorder (TSRD) attributed to the pandemic.6
Disturbingly, 13.3% reported new or increased substance use as a way of managing stress and 10.7% of the adults surveyed said they had seriously contemplated suicide within the past 30 days. Mental health deterioration has also increased the use of sleep drugs to the point some experts have named the condition COVID-somnia.7
Psilocybin Helps Treat Major Depression
Psilocybin is a hallucinogenic compound found in certain mushrooms.8 When improper doses are administered, the compound can produce a list of side effects, including nausea and vomiting, panic attacks, muscle weakness, lack of coordination, psychosis and even death. However, a recent study shows that the compound can be useful in certain situations and when carefully monitored.
A small randomized clinical trial used psilocybin coupled with psychotherapy in patients who had a major depressive disorder (MDD). This study followed other studies that have suggested one or two administrations of psilocybin coupled with psychological support could generate antidepressant effects.9
The trial was conducted at Johns Hopkins Bayview Medical Center with 24 adults aged 21 to 75 who had a diagnosis of major depressive disorder. The participants were not on antidepressant medications at the time of the study and did not have a history of psychotic disorders, a serious suicide attempt or hospitalization.
The participants had two sessions using psilocybin coupled with supportive psychotherapy. The primary outcome measure of the study was the severity of depression assessed in the participants using a rating scale, comparing preintervention with post-intervention and again at one week and four weeks after treatment.
In the group, 67% of the participants demonstrated clinically significant responses to the psilocybin at one week and 71% at four weeks. The researchers believe the:10
â€œFindings suggest that psilocybin with therapy is efficacious in treating MDD, thus extending the results of previous studies of this intervention in patients with cancer and depression and of a nonrandomized study in patients with treatment-resistant depression.â€�
Follow-Up Shows Antidepressant Effects Over Six Months
The scientists plan to follow the study participants over a year to determine how long the effects of the intervention might last.11 A past study published in The Lancet also administered two doses of psilocybin seven days apart in 12 individuals who had been diagnosed with treatment-resistant major depression.12
The study had no control group and, like the current study, the participants received psychological support along with the mushroom compound. Assessments made from one week to three months after treatment revealed the symptoms were significantly reduced within one week and remained consistent after three months. The participants also reported â€œmarked and sustained improvements in anxiety and anhedonia [inability to feel pleasure].â€�13
The participants in the study were evaluated for adverse events during the sessions and in their subsequent follow-up appointments. The researchers found no serious or unexpected adverse events. A second study was published with data from six months post-treatment, finding no unexpected adverse events and continued positive results with reductions in symptoms of depression.14
In 2018 and 2019, the U.S. Food and Drug Administration granted â€œbreakthrough therapyâ€� designation for psilocybin.15 Breakthrough therapy designation by the FDA was developed to speed the development of drugs for serious or life-threatening conditions and the subsequent review by the FDA.
To achieve the designation, there must be early clinical evidence the drug produces substantial improvement on at least one endpoint measure over other available therapies.16 Alan Davis, Ph.D., was one scientist in the study who is quoted in a Johns Hopkins press release, saying:17
â€œThe magnitude of the effect we saw was about four times larger than what clinical trials have shown for traditional antidepressants on the market. Because most other depression treatments take weeks or months to work and may have undesirable effects, this could be a game changer if these findings hold up in future â€˜gold-standardâ€™ placebo-controlled clinical trials.â€�
Roland Griffiths, Ph.D., director of the Johns Hopkins Center for Psychedelic and Consciousness Research, said he was pleasantly surprised by the results since â€œthere are several types of major depressive disorders that may result in variation in how people respond to treatment.â€�18
Effectiveness and Adverse Events With Usual Treatment
Conventional treatments for major depressive disorders typically have limited success and difficult patient compliance â€œas demonstrated by the number of patients failing to achieve remission.â€�19
In one literature review of interventions that are typically thought of as â€œtreatment as usual,â€� data from 38 studies, including 2,099 people, were broken into three groups, depending on how many quality criteria the studies met.20 Overall, the analysis found a range of 27% to 33% of patients responded to treatment.
The outcome measure was symptom reduction by at least 50%, well below the outcome found in the psilocybin study. The literature review also found 12% of the group experienced more severe depressive symptoms and a deterioration in mental health. Conversely, the results from the most recent psilocybin assisted intervention demonstrated no serious adverse events during the trial.21
Other non-serious side effects that were reported during the trial included feelings of fear or sadness, and physical effects such as trembling and mild to moderate transient headaches. Yet, â€œmost if not all antidepressants can cause bothersome adverse events,â€� and patients who stop taking the medication can be as high as 60%, which is â€œprobably governed by a trade-off between perceived benefits and drawbacks.â€�22
Measurements of depression in older adults before the pandemic showed from 10% to 15% struggle with depressive symptoms, even though they have not been diagnosed with major depression.23 A study published in The British Journal of Psychiatry found there had also been a major rise in the number of antidepressant medications prescribed for older adults, without a concurrent increase in the number diagnosed with depression.24
This study also suggests that seniors may be overprescribed antidepressant drugs. This may have serious implications for their health, based on the number of side effects associated with the drugs in combination with a population that also struggles with other physical and mental health concerns.
According to a 2013 study in Psychotherapy and Psychosomatics, major depression may be vastly overdiagnosed and overtreated.25 The data revealed of the 5,639 participants with clinician-identified depression, only 38.4% of them actually met the DSM-4 criteria for a major depressive episode, and in seniors over the age of 65, only 14.3% met the criteria.
What Is Major Depression?
Clinical depression or major depressive disorder is more than feeling a little sad. Symptoms occur nearly every day and can include feelings of:26
Lack of energy
People who are depressed may also experience:
- Slowed thinking and trouble concentrating and making decisions
- Sleep disturbances, including insomnia and sleeping too much
- Loss of pleasure and interest in normal activities such as hobbies, sports and sex
- Reduced or increased appetite
- Frequent thoughts of death or suicide
Major depressive disorder creates a long-term financial burden on society, the total of which is estimated to be close to $210.5 billion each year, rising 21.5% between 2005 and 2010.27 A 2019 study found those who experience relapse or recurrence of a major depressive episode had higher costs associated with an increase in inpatient services, emergency department visits and admissions.28
Dietary Changes That Lower Inflammation Help Major Depression
The positive results of using psilocybin to treat major depression have been achieved under supervision and only with accompanying psychotherapy during the intervention. It is crucial you donâ€™t try this treatment at home as other data reveal that the positive effects only happen with a quality experience that can be clinically managed.29
However, you have other options to help reduce your risk of depression. Since inflammation increases your risk of depression, one way to reduce your risk is to employ strategies that reduce the inflammatory response in your body. In one analysis, scientists reviewed the safety and effectiveness of anti-inflammatory agents in people suffering with major depression.
Agents that they found can play a role in reducing inflammation and ultimately symptoms of major depressive disorder included nonsteroidal anti-inflammatory drugs (NSAIDS) and omega-3 fatty acids.30 A second meta-analysis found similar results.31
Inflammation is the root cause of many conditions and reducing inflammation can help improve your mental and physical health, and there are nonpharmacological options that help to reduce depression by reducing the inflammatory response in your body.
As you consider the following suggestions, remember they do not have to be done all at once and you can achieve beneficial results no matter your age or current physical abilities. The journey to better health begins with taking small permanent steps.
â€¢ Exercise â€” Exercise normalizes your insulin and leptin sensitivity, which in turn reduces inflammation. For example, adipose or visceral fat produces proinflammatory responses in the body, but exercise helps reduce adipose tissue and subsequently inflammation. Exercise also increases vagal tone, which some experts believe has an influence on inflammation.32
As research from the University of California demonstrated, just one 20-minute exercise session could produce an anti-inflammatory response.33
â€¢ Sleep â€” In past articles Iâ€™ve covered some of the powerful effects sleep has on your health. Acute sleep loss increases inflammation. Even healthy subjects showed subclinical shifts in inflammatory cytokines after sleep had been restricted by 25% to 50% of an eight-hour slumber.34
Sleep also enhances your immune system. Sleep disturbances can have a significant effect on that regulation, contributing to an inflammatory response and dysregulation of the viral response.35
â€¢ Nutrition â€” There are several nutritional factors that affect your mood and emotions, not the least of which is eating too much sugar. Excessive amounts of sugar disrupt your leptin and insulin sensitivity,36 affect dopamine levels and damage your mitochondria,37 all of which affect your mood.
Nutrients such as omega-3 fats, magnesium and B vitamins influence your mood and brain health.
â€¢ Light therapy â€” Light therapy is an effective treatment for seasonal affective disorder, and researchers find it is also effective against moderate to severe nonseasonal major depressive disorders.38 One method is to use a white lightbox for 30 minutes each day as soon as possible after waking up.
â€¢ Mindfulness meditation or Emotional Freedom Techniques (EFT) â€” In one study of moderately to severely depressed college students, students were given four 90-minute EFT sessions.39
Those who received EFT showed significantly less depression than the control group when evaluated three weeks later. Mindfulness-based cognitive therapy also shows promise in helping to prevent recurrent episodes of depression.40