Preliminary research says psychedelic therapy can treat chronic mental health issues like depression and anxiety, which largely impact women. Does it actually work or are practitioners just trippin'?
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When news dropped last month that Department of Health & Human Services head Robert F. Kennedy Jr. aimed to get psychedelic therapy into clinical use within a year, scientists, advocates, practitioners, and users buzzed with both excitement and trepidation.
Psychedelics are indeed a potential medical breakthrough, especially for women. Preliminary research suggests that psychedelics like psilocybin — a chemical produced by more than 100 species of mushrooms worldwide, referred to as magic mushrooms, or “shrooms” — hold the promise as a treatment for widespread, often chronic mental disorders including depression and anxiety, which overwhelmingly affect women.
“Many mental health disorders have both biological and narrative dimensions. Psychedelic therapy done well can open space for reprocessing those stories in ways that feel embodied and empowering,” says Shandra Brown Levey, PhD, an associate professor at University of Colorado Anschutz Medical Campus in Aurora, Colorado.
Others hail psychedelics as a cure for spiritual malaise. Licensed psychedelic-assisted psychotherapist in Boulder Heather Lee works with patients one-on-one and conducts retreats abroad. Women over the age of 50 comprise almost all her clients.
“A lot of women are carrying heavy baggage. They want to let stuff go and move lightly into the next phase. My clients say, ‘I feel less caught by politics, less caught in the family drama, I feel a lightness of being,’” Lee says.
But many experts fear that a rush to integrate psychedelics into care can lead to overhype, adverse events, and regulatory blowback without enough due diligence. Researchers are still figuring out how the drugs work and whom they might help. Treatment needs safety guardrails including trained facilitators, health screening, informed consent, mental preparation, and an environment that fosters security for maximum benefits and to avoid harm.
“Psychedelics are not a replacement for meditation and contemplation and therapy, all of which can open and gently prepare you for expanded states of consciousness. In a psychedelic experience, you might meet God and it might scare the shit out of you,” says Rohini Kanniganti, M.D., a family physician who also works at the Integrative Psychiatry Institute in Niwot, Colorado.
The Psychedelic Brain Shift
Psychedelics hold the tantalizing possibility of being effective drugs with the potential side effect of a thrilling, life-altering experience. Based on studies to date, so-called classic psychedelics such as shrooms, LSD, and DMT — the chemical in ayahuasca — mainly activate brain receptors that regulate serotonin. (A note here: Some consider MDMA a psychedelic because it has mind-altering properties. Ketamine is classified as a dissociative drug.) Psychedelics disrupt activity in the default mode network (DMN) — a part of the brain related to self-reflection, and promote connections between an array of brain regions that don’t typically interact. There’s a big shift in how the brain processes emotions, thoughts, and perceptions.
Users can lose sense of space and time. They might see ultra-vivid scenes or have fantastical hallucinations, accompanied by a sense of bliss, awe, connection, and insight. Effects may be long lasting: Studies suggest the drugs can promote neuroplasticity, affecting brain regions that support learning and growth.
Ideally, people are screened for health conditions before taking such a leap. The substances have a low level of toxicity, and are not likely to cause breathing problems or a heart attack, but there are concerns that they can exacerbate some mental conditions, like schizophrenia or psychosis. There’s also little data on use during pregnancy and potential harms to a developing fetus. The most common risk is a bad trip with feelings of extreme fear, anxiety, panic, or paranoia, which is why the right setup matters.
“Psychedelics are amplifiers. They intensify what’s present internally and relationally, which means the therapeutic container really matters. Poor preparation, lack of trauma-informed care, and unsafe power dynamics can all cause harm, even when the medicine itself is well tolerated,” Brown Levey says.
In many Indigenous cultures, psychedelics are used in settings that emphasize ritual, community, and reverence for the medicines. Clinicians and researchers can honor these traditions by creating an intentional and supportive environment around psychedelics, she adds. For example, Indigenous cultures in the Amazon have held Ayahuasca ceremonies for centuries. The event requires a sacred space and preparation for the body and mind such as dietary restrictions, prayer, and contemplation.
At the Center Origin in Denver, psychedelic experiences involve two preparation sessions that include intention-setting, an administration session by a licensed facilitator, and an integration session, which is a 10- to 15-hour process. Clients say the experience is transformational. They report feeling awakened, more like themselves and better able to handle what life throws at them, says co-founder Elizabeth Cooke.
Transformation isn’t cheap. Packages at the Center start at around $1,500 for group sessions and go up to $3,500 for a one-on-one journey. Cooke points at high regulatory fees, insurance costs, and security as potential barriers for licensing and expansion.
“Our license cost 40 times more than a liquor license. You can go to a bar and get smashed, but you can’t get affordable mental health treatment,” she says.
Many women have embraced microdosing shrooms or LSD as a lower-bar alternative. A microdose is typically 5 to 10 percent of a recreational dose, low enough so that people don’t hallucinate. Blaise Allysen Kearsley, a writer who lives in Brooklyn, New York, started microdosing during the pandemic.
“I was between therapists, and it was a bad time to not be in therapy. It helped me focus on one thing at a time. I could still work, but things were making me laugh. And that felt like a really good place to be,” Kearsley says.
Still, research on the effects of microdosing shows mixed results. And there may be a strong placebo effect, which is when a person’s expectations of how a treatment will work affects how it actually does. It’s even harder to mask the effects of a full psychedelic dose in a clinical trial by comparing it to dummy drugs. People can generally tell when they’re tripping.
“Some people have tried everything and come in with huge expectations of benefit. I won’t say I’m not enthusiastic, but it’s very difficult to disentangle those expectations from the actual pharmacological effects of psychedelics,” says Luana Colloca, PhD, who studies the role of placebo effects and expectations in pain treatment at the University of Maryland in Baltimore.
Sex Hormones and Psychedelic Effects
Sex hormone differences might also affect treatment results. Estrogen affects the same serotonin receptors in the brain as do psychedelics. Some research suggests that hormone fluctuations during menstrual cycles could affect how psychedelics work. That might not turn out for the better. Say a woman with premenstrual dysphoric disorder (PMDD) goes on a retreat at a sensitive point in her cycle — that could greatly affect her experience.
“There’s going to be teething issues getting this into clinical practice. We’ve got a real blind spot in terms of where these substances may come in contact with women’s hormonal cycles,” says Grace Blest-Hopley, PhD, neuroscientist and founder of London-based psychedelics research, education and advocacy organization Hystelica.
Because estrogen and serotonin systems affect many of the same systems in the brain, some researchers theorize that psychedelics could help treat conditions where hormone shifts impact symptoms and behavior, like anxiety, depression, PMDD, postpartum depression, eating disorders and substance use disorders. Blest-Hopley has also tracked reports of post-microdosing improvements in symptoms of menopause.
But hormone differences have historically been ignored in medical research, and work on psychedelics hasn’t been much different. Scientists stress that the field needs more rigorous, inclusive research that takes hormone levels into account in dosing and looks at biomarkers like blood and brain data along with subjective effects.
“I am hopeful that these treatments will be helpful for women, especially for those working through difficult diagnoses such as postpartum depression. But I worry that people are going to start positioning psychedelic-assisted therapy as a cure-all. There is much work to be done as a field to really make sure these treatments work for different medical indications and to do everything we can to reduce negative outcomes,” says Molly Sullan, PhD, an assistant professor at Anschutz.
Evidence will follow, but many who use shrooms say they’ve seen enough to know that the drug can profoundly change the way women see themselves and the world, for the better.
As Lee says, “There’s a reason they’re called magic mushrooms. It’s not just things you can see on an MRI. There’s no other way to frame this than as psychospiritual. It’s an awakening of women’s wisdom that we need now.”