Psychedelics and Schizophrenia

The relationship between psychedelics and schizophrenia is a complicated one. When first exploring LSD for its therapeutic potential, researchers thought its effects mimicked the symptoms of schizophrenia, labelling it as a “psychomimetic.” This perception changed rapidly, and by the late 1950s, a range of psychedelics, mainly LSD and mescaline, were being researched and utilized for treating psychological problems and alcoholism. By the late 60s, though, a complex mess of political and social factors, as well as profound ethical failures, led to the prohibition of psychedelics and the end of most research on them for the next 40 years.

Fast forward to the current “psychedelic renaissance,” and universities and corporations are exploring the use of psychedelics for a wide range of psychological issues as well as developing new medications and therapeutic approaches. Research suggests that psychedelic-assisted therapies, particularly utilizing psilocybin, can be effective for problems such as treatment-resistant depression, existential anxiety, and smoking cessation.

The prohibition of psychedelics is also changing. In Canada, special permission has been given for patients to use psilocybin to help alleviate end-of-life anxiety, and there is a push to expand the Special Access Program to include currently restricted drugs. Non-commercial possession of psychedelics (along with all controlled substances) has been decriminalized in Oregon by Measure 110, and Measure 109 allows for the medical use of psilocybin in that state. Natural entheogens such as magic mushrooms, ayahuasca, and mescaline have been decriminalized in the District of Columbia. Varying levels of city-wide decriminalization have occurred in other areas of the US, including Oakland, Denver, Cambridge, and Ann Arbor. 

As psychedelics become mainstream, interest in them is increasing, even in places where legal therapeutic access is non-existent, and decriminalization has not yet taken hold. Since more people will be coming into contact with psychedelics, it’s a good time to look at their relationship with disorders such as schizophrenia, and be aware of the risk factors so that we can make properly informed choices about our mental health.

Can psychedelics cause schizophrenia?

Whether or not psychedelics can cause schizophrenia is contested, and a dearth in research persists around risk factors for the condition (more on that later). The science seems to support the idea that psychedelics increase the risk of schizophrenia in people who were already at higher risk of developing it, rather than causing it in people who have no risk factors.

Because of the gaps in the scientific understanding of schizophrenia, how this happens is unclear. Scientists have hypothesized that changes in serotonin, dopamine, or glutamate systems in our brains are associated with the symptoms of schizophrenia, and classic psychedelics do temporarily affect the first two of these. Something about these changes could precipitate problems in someone with an underlying risk – but the science of this is not settled.

Another way of looking at this is to think of psychedelics as psychological amplifiers, an idea pioneered by Stanislav Grof in his 1975 book, Realms of the human unconscious: Observations from LSD research. When you take them, what you were already thinking and feeling is boosted in intensity and shaken up. Feelings that you have consciously suppressed can become impossible to avoid, and thought patterns that you weren’t even aware of might suddenly and unexpectedly rise to the surface of your awareness.

How to determine if you’re at risk of schizophrenia

Many risk factors are somewhat correlated with schizophrenia, and the exact way they fit together isn’t apparent at this time. These include fetal hypoxia and folate deficiency, cannabis use, childhood trauma or abuse, urban birth or upbringing, and migration. However, the most significant risk factor for schizophrenia is genetic heritability. In the general population, the risk of developing this condition is about 1%. But if someone has any first-degree relative with schizophrenia, this rises to about 10%. If both parents have been diagnosed, it rises again to 50%. 

It’s important to remember that many people who have a relative – even an identical twin – with schizophrenia never develop it, so it’s not all genetics, but it is the one risk factor to be aware of. While it can be hard to know every relative’s mental health history, one should aim to find out if there is any history of schizophrenia and psychosis in parents, siblings, grandparents, aunts, and uncles. The greater the number of close relatives one has with the condition, the higher their risk of developing it. 

Can psychedelics cause other kinds of mental illness?

The amplification that psychedelics cause seems to be linked to other latent psychological issues, particularly bipolar disorder. This is why researchers screen out people with bipolar and personality disorders from psychedelic clinical trials. 

These intensification and neurological effects of psychedelics aren’t all bad though – they’re what makes them such potentially powerful tools for therapy, personal development, and spiritual growth. This also highlights the benefit of getting help with integration, as an experienced professional can help a client work through anything difficult that psychedelics bring up for them and identify if more serious therapeutic support is warranted.

While the scientific community continues to investigate important questions around psychedelics and their impact on mental health, there’s likely much that the field will gain from their inclusion into treatment for a wide range of individuals. Research on large groups of psychedelics users has found no link to increased mental health problems or increased suicidality. Likewise, lifetime use of psychedelics is associated with less psychological distress and fewer suicide attempts. 

The keys to staying safe

If one has any family members who have schizophrenia, their risk markedly increases, and the closer the relation, the higher the risk. Bottom line, if someone has a first-degree relative with this condition, avoid psychedelics.  

Being aware of moods, thought patterns, and actions is essential too. Early warning signs of schizophrenia can include:

• Depression, social withdrawal
• Hostility or suspiciousness, extreme reaction to criticism
• Deterioration of personal hygiene
• Flat, expressionless gaze
• Inability to cry or express joy or inappropriate laughter or crying
• Oversleeping or insomnia; forgetful, unable to concentrate
• Odd or irrational statements; strange use of words or way of speaking

These aren’t specific to just schizophrenia and could indicate other issues. If you or someone you know is experiencing these signs, the best thing to do is seek psychological or medical help.

Outside of knowing your family’s mental health history, and being aware of the warning signs above, the best way to manage this risk is to pay attention to set and setting, follow good integration practices, and consult with a medical or therapeutic professional when necessary.

Disclaimer

The following material is provided for informational purposes only and is not designed to prescribe, diagnose, or treat any physical or mental illness. None of the information presented here should be treated as medical or professional advice. Mindleap does not condone the acquisition nor consumption of illicit psychotropic compounds.