Psilocybin and PTSD Treatment

Introduction to Trauma

Trauma, also known as psychological and emotional shock, refers to serious psychological reactions that occur after being exposed to a damaging or stressful event. Trauma is the result of distressing and stress-inducing events that undermine an individual’s sense of safety, leading to feelings of danger and helplessness. Psychological trauma engulfs an individual with anxiety, unsettling emotions, and distressing memories that do not improve over time and do not fade away. It can also lead to numbness, disconnection, and a lack of trust in others. We all experience trauma at some point in our lives, but our well-being depends on how we manage the impact of such traumatic events. It is estimated that around 70% of adults worldwide experience at least one traumatic event during their lifetime. Around 20% of individuals develop trauma following exposure to a distressing event, and approximately 13 million people are affected by trauma-related disorders each year.

Who Experiences Trauma?

The emotional and psychological symptoms commonly associated with trauma-related disorders include:

  1. Excessive anxiety or worry in safe situations.
  2. Feeling unable to maintain calmness.
  3. Guilt for surviving while others did not.
  4. Holding a negative self-image.
  5. Nightmares or night terrors.
  6. Engaging in risky behaviors.
  7. Intense reactions and severe fear in safe situations.
  8. Intense personal distress disproportionate to the severity of the stressor.
  9. Disruption of an individual’s life by stressors.
  10. Difficulties in establishing or maintaining relationships.
  11. Thoughts of self-harm or harm to others.

The physical symptoms of trauma include

  1. Insomnia or nightmares.
  2. Fatigue.
  3. Easily being startled.
  4. Rapid heartbeat.
  5. Dizziness and irritability.
  6. Muscular tension and pain.
  7. Sweating.
  8. Feeling jumpy.
  9. Digestive disturbances.
  10. Impaired concentration.

Trauma symptoms typically last from a few days to several months and gradually fade away. However, even during the treatment process, individuals may occasionally experience distressing memories or emotions, especially in response to stimuli such as anniversaries of the event or triggers that remind them of the trauma. One of the most important and common types of trauma is post-traumatic stress disorder (PTSD), which we will delve into further.

Post-Traumatic Stress Disorder (PTSD)

PTSD, short for Post-Traumatic Stress Disorder, refers to a condition that occurs in individuals who have experienced a traumatic event or in other words, a trauma. PTSD can affect individuals of any age, gender, or cultural background. It is a complex condition that can impact different individuals in various ways.

Examples of traumatic events that can lead to PTSD include:

  1. Exposure to war
  2. Physical violence during childhood
  3. Sexual violence
  4. Physical abuse
  5. Threats with a weapon
  6. Accidents

Other events such as fires, natural disasters, robberies, plane crashes, torture, kidnapping, diagnosis of a life-threatening illness, terrorist attacks, and other dangerous incidents can also trigger PTSD. The prevalence of PTSD is estimated to be around 5% to 10% of the population, with a higher prevalence among women than men.

Risk factors for developing post-traumatic stress disorder (PTSD) include:

  1. Experiencing long-lasting and severe psychological trauma
  2. Having a history of previous psychological trauma, such as childhood violence and abuse
  3. Engaging in a profession that increases the risk of exposure to traumatic events, such as military personnel and emergency responders
  4. Having other mental disorders, such as anxiety and depression
  5. Substance abuse disorders, such as excessive alcohol and drug use
  6. Lack of support from family and friends
  7. Having a family history of mental disorders, such as anxiety and depression

Symptoms and Diagnostic Criteria for PTSD

Post-Traumatic Stress Disorder is a complex phenomenon. The initial step in diagnosing the disorder is obtaining a detailed history from the patient. Sometimes, describing the nature and intensity of the traumatic event can be challenging for the patient, and they may avoid discussing it. However, the patient’s presentation of their condition and the duration of symptoms is crucial for an accurate diagnosis. Any mental disorders in the patient, such as depression or anxiety, suicidal ideation or attempts, substance abuse, and other critical conditions, should be thoroughly evaluated by a physician. Subsequently, significant functional impairments in various areas of the individual’s life should be assessed to gain a precise understanding of their mental state and social functioning. Psychological tests such as the Posttraumatic Checklist (PCL) and the Davidson Trauma Scale (DTS) can assist in the initial diagnosis of this condition.

The diagnostic criteria for PTSD include:

  1. Trauma-related stressors: Exposure to death, injury, or sexual violence (experienced or threatened)
  2. Affected symptoms related to the stressor: Presence of one or more symptoms associated with the traumatic event and their onset after the trauma occurred
  3. Avoidance: Persistent efforts to avoid stimuli associated with a specific traumatic event
  4. Negative mood changes: Negative changes in mood that began or intensified following a traumatic event
  5. Increased arousal and reactivity: Heightened reactivity and increased arousal that started or worsened after a traumatic event
  6. Duration: Persistence of symptoms for more than one month

Pathophysiology of PTSD

In individuals with PTSD, despite persistent stress, the cortisol levels in patients are lower, while the level of corticotropin-releasing factor (CRF) is higher than average. CRF stimulates the release of norepinephrine by the anterior cortex of the brain (anterior cingulate cortex), leading to an increased sympathetic response. The sympathetic response manifests as increased heart rate, blood pressure, heightened reactivity, and responsiveness. Furthermore, some studies indicate alterations in the functioning of other neurotransmitter systems such as GABA, glutamate, serotonin, and neuropeptide Y in individuals with PTSD. As a result of these changes, serotonin concentration decreases, which affects the connectivity between the amygdala and hippocampus regions of the brain, influencing the individual’s psychological and cognitive functioning.

Management and Treatment Methods for PTSD

Early diagnosis and prompt intervention are crucial for effective treatment and minimizing the long-term consequences associated with PTSD. There are several treatment approaches available that can help individuals affected by trauma to cope with their symptoms and improve their quality of life. These methods include Cognitive-Behavioral Therapy (CBT), Eye Movement Desensitization and Reprocessing (EMDR), Narrative Exposure Therapy, Sensorimotor Psychotherapy, Acupuncture, and pharmacological treatment.

These treatments lead to a reduction in trauma symptoms, improvement in cognitive and psychological well-being, and enhancement of the individual’s quality of life. It is important to note that early trauma diagnosis significantly aids in expediting the treatment process. Studies have shown that treatment with antidepressant and antipsychotic medications may not be effective for individuals who have experienced chronic disorders or multiple traumas over the years.

Early diagnosis and prompt intervention are crucial for effective treatment and minimizing the long-term consequences associated with PTSD. There are several treatment approaches available that can help individuals affected by trauma to cope with their symptoms and improve their quality of life. These methods include Cognitive-Behavioral Therapy (CBT), Eye Movement Desensitization and Reprocessing (EMDR), Narrative Exposure Therapy, Sensorimotor Psychotherapy, Acupuncture, and pharmacological treatment.

These treatments lead to a reduction in trauma symptoms, improvement in cognitive and psychological well-being, and enhancement of the individual’s quality of life. It is important to note that early trauma diagnosis significantly aids in expediting the treatment process. Studies have shown that treatment with antidepressant and antipsychotic medications may not be effective for individuals who have experienced chronic disorders or multiple traumas over the years.

The Potential of Psilocybin for PTSD Treatment

With the recognition of various therapeutic approaches for trauma-related disorders, the therapeutic potential of psilocybin in reducing and improving symptoms of PTSD has gained attention among researchers since the late 1990s. Significant improvement and sustained alleviation of symptoms, including increased focus and mood enhancement in patients, are among the characteristics of PTSD treatment with psilocybin.

What is the impact of psilocybin on the brain?

A preclinical study conducted at the University of South Florida in 2013 demonstrated that psilocybin (a compound found in hallucinogenic mushrooms) leads to the creation of new neurons, particularly in the hippocampal region of the brain, and stimulates the center of emotions and memory. This substance helps overcome fear conditions and also stimulates the regrowth of nerve cells in brain regions responsible for emotions and memory.

Clinical Trials and the Efficacy of Psilocybin for PTSD Treatment

In a study published by Roseman et al. at Imperial College London, patients showed a greater inclination to accept all of their emotions, including negative ones, after treatment with psilocybin. Researchers believe that psilocybin facilitates the processing of negative memories and experiences and allows patients to “reconnect” with their emotions. The scientific community has also focused on studying the therapeutic potential of psilocybin in treating complex PTSD (C-PTSD). Complex PTSD symptoms can be similar to but more persistent and severe than those of regular PTSD, and they may not manifest until years after the traumatic event. Researchers believe that psilocybin can play a role in the recovery process of C-PTSD. The obtained results indicate the efficacy of psilocybin in clinical trials and promising advancements in the treatment of PTSD-related disorders. By raising awareness and encouraging individuals to access available treatments, concerns and symptoms associated with these disorders decrease, leading to increased adherence to the treatment process.