endlessness said:
Alright let's take a moment to talk about this discussion a bit.
First of all, notice that jbark was not blindly trying to censor discussion (neither is he a mod, as he said himself), but he was doing something we should be thankful for, which is to look after people here, wishing nobody gets hurt from irresponsible use of psychedelics.
I appreciate that he jbark has good intentions but he was curtailing discussion that could help suicidal people. Resulting deaths from censorship of helpful information are as real as any that that could be caused by a bad trip. I do very much appreciate where you are taking the conversation.
Let's just imagine the following hypothetical situation: someone here recommends taking psychedelics for a suicidal person, who ends up killing themselves. That would be horrible, a loss of human life... But not only affect that person, let's say this forum is now put in the spotlight by the person's family who decides to blame us for recommending it. Maybe we end up getting shut down..
That's a fair point, so I think people should be careful not to tell others what to do. However, sharing experiences and discussing research isn't the same as telling someone what to do, and it certainly isn't the same as loading a vape and saying, "hit this." Obviously some people are going to take psychedelics and kill themselves, the same as some are going to do so after taking mood stabilizers or SSRIs. From a website CYA perspective, it might be good to say, "we don't allow such and such discussions here for such and such reasons. But to say "suicidal people should never take psychedelics" IS advice the same as saying "suicidal people should never take lithium."
Also, can you please point out where in the publication you first posted is saying that psychedelics diminished suicide rates by 30%, I couldn't find it.
Sorry, I thought I linked it,
It wasn't suicide rates that went down >30% but past year suicide attempts.
Lastly, from ayahuasca being anti-depressant to dmt being anti-suicide is a very long jump.
I wouldn't describe it as a long jump at all. We both know DMT is a large component of ayahuasca, and suicide and depression are highly positively correlated. Decrease depression and you are probably decreasing the rates of suicide. Does DMT work as well as ayahuasca? Does ayahuasca work as well as DMT? Answer unknown, but well worth talking about.
If you read the methodology of the study claiming anti-depressant effect of ayahuasca, it was being done with people who were treatment-resistant in the first place, which is different than deciding to use it as a first option (specially without medical guidance).
I'm unaware of any research suggesting that what works for "treatment resistant" depression will not work for regular depression, or that regular depression and treatment resistant depression are qualitatively different at all. If anything "non-resistant" depression is likely milder and more likely to respond to placebo effects as both cognitive behavioral therapy (CBT) and drug treatments are having a VERY hard time showing themselves more effective than active placebo treatments. And both drug and CBT trials showing reporting effectiveness have been found to be substantially influenced by poor trial quality and publishers bias. And then you have to wonder if your local psychiatrist/psychologist is up on the research, or if he's still stuck using what he learned in school years ago, which was probably dated then. Not a lot has changed since Leary concluded with psychotherapy that 1/3 get better, 1/3 get worse, and 1/3 stay the same.
To turn things more positive yet unrelated to drugs, this guy's (who I don't know)
multifactorial treatment plan does seem legitimately evidence based and you can buy his book used for $4. His 6 components off the top of my head were:
1) Fish oil
2) Cardiovascular Exercise
3) Early morning sunlight (or bright light therapy, or more modern would be blue light therapy)
4) Social support
5) Adequate Sleep
6) DON'T RUMINATE!
He didn't talk about psychedelics but I expect they would help. I also expect that if you went to Peru and did an ayahuasca journey, even if you got a good dose much of the potential benefit would be lost if you went home to your single bedroom apartment, stayed up late watching TV, overate, and thought about your problems.
Also, they had accompanying from medical professionals before, during and after the experience, and those with severe depression at baseline could remain under care for several days. This is very different than a person simply taking at home by themselves as would possibly be the case of people the OP was talking about.
Such supervision is awesome to have, but most people do not have such access. However, reading that paper one looking to self treat with psychedelics might reasonably conclude it best to do so in the company of caring friends at least. Those caring friend might be wise to read the MAPS publications on how to best handle someone going through a bad trip.
In any case from the data we have gathered so far it seems to me that psychedelics like ayahuasca could, given the right set and setting and accompanying before and after with integration, help as a part of the treatment of mental illness that may be behind potential suicide attempts. That being said, if I had to guess, I'd say that smoked DMT would probably not be as effective, or even be counterproductive, due to the lack of the pharmacological mechanisms that make ayahuasca unique in this sense (serotonin platelet transporter upregulation from THH, MAOI anti-depressant effect), as well as due to the abrupt nature of the experience which is harder to integrate with daily life IMO.
You could be right. However, not everyone likes vomiting. Plus vaped DMT is of short enough duration you can do it more often. One person I know with a history of depression reported it didn't cure you, but it gave you a glimpse of what it was like to be cured and that hope was enough to get over the lethargy depression gives you preventing you from doing the 6 steps above. And nothing says a person has to go for a breakthrough either. In the experience of some, just 5 mg is enough to make the world seem better and lets you down so light that you aren't sure where it ends, "instant afterglow" was the quote.