By Jeff Kronenfeld
Mental health has become one of the central themes of 2020 thanks to COVID-19 and the resulting societal shutdown. In fact, the psychological spillover from coronavirus is projected to evolve into an entirely separate pandemic, according to the Journal of the American Psychiatric Nurses Association (JAPNA). Like the virus itself, the “second pandemic” is nothing to ignore. The United Nations, World Health Organization and other academic sources such as the Journal of the American Medical Association have also sounded the alarm about a potential mental health crisis coming down the pipeline.
The JAPNA study, however, calls for the implementation of “new mental health interventions” and “collaboration among health leaders” in order to prepare for mobilization when the masses are seeking psychological assistance. While psychedelic medicines were not explicitly cited in the study, these drugs offer an array of treatments that just so happen to address many of the mental health issues brought on by the COVID-19 pandemic, including depression, anxiety, PTSD, and paranoia. Specifically, psychedelic-assisted psychotherapy, which is on the brink of legalization in Oregon, may serve as one such model to assuage the psychological fallout from COVID-19.
Causes of the Mental Health Pandemic
So, how can COVID trigger a mental health crisis? That answer is: Easily. At the time of writing, over 121,000 Americans have died from COVID-19 and more than 2.3 million have been infected, according to data from John Hopkins University. The authors of the JAPNA article note that survivors of ICU treatment face an elevated risk for depression, posttraumatic stress disorder (PTSD), sleep disturbance, poor quality of life, and cognitive dysfunction.
Those who contract COVID are not the only ones facing psychological trauma from the pandemic, however. Healthcare workers on the frontlines are at a heightened risk of experiencing severe trauma, PTSD, anxiety, and depression from COVID. Family members of coronavirus patients also face heightened distress, fear, and anxiety, all of which are likely aggravated by the restrictions on hospital visits and lack of testing. The rapid influx of COVID-19 cases also has the potential to decrease capacity for treating other patients, such as those experiencing psychological issues.
Moreover, even people who have not directly dealt with COVID may experience mental health troubles. A lot of anxiety exists around virus exposure, which is triggered when having to leave the house for basic reasons, such as going to the grocery store or bank. The media’s inconsistent, doomsday coverage of the pandemic adds to the confusion around what’s going on, resulting in extreme fear, information overwhelm, and hysteria.
The unintended consequences of a nationwide shut down is also proving to have a negative impact on mental health, according to a study published in European Psychiatry (EP). Lack of social interaction, specifically, is a well-known risk factor for depression, anxiety disorders and other mental health conditions. Further, the study warns that the longer such policies are in effect, the more risk they pose to those with preexisting mental health issues.
“Most probably we will face an increase of mental health problems, behavioral disturbances, and substance-use disorders, as extreme stressors may exacerbate or induce psychiatric problems,” the EP authors write.
News from the economic front is also concerning. The IMF projects global GDP will contract by 3 percent this year—the most severe decline since the Great Depression—with the US GDP predicted to drop by a whopping 5.9 percent. Data from the Bureau of Labor Statistics show more than 40 million Americans have filed for unemployment benefits since mid-March, a number that will likely increase. For many, job security means financial stability, which generally ties into one’s mental wellness.
Research published in Clinical Psychological Science found that people who lost their job, income and housing during the Great Recession were at a higher risk of depression, anxiety and substance abuse. This is particularly troubling considering the Great Recession only caused a .1 percent drop in global GDP, a decline 30 times less severe than the financial crisis caused by COVID-19. Moreover, suicide rates in the US are directly related to unemployment. In fact, for every unemployment rate percentage increase, the suicide rate rises 1.6 percent in the US, according to a study in the Social Science and Medicine journal.
Looking at all of these factors combined, a mental health crisis seems imminent. A report from the Well Being Trust predicts that COVID-19 and its associated stressors will cause anywhere from 27,644 to 154,000 deaths from alcohol, drugs and suicide. The results of a recent poll by the Kaiser Family Foundation suggest our trajectory could already be trending towards the worst-case scenario. The poll shows that 56 percent of Americans surveyed believe the outbreak has negatively impacted their mental health. But that number rose to 64 percent for those who experienced income loss.
How Can Psychedelics Help?
Psilocybin, MDMA and ketamine combined with psychotherapy show promise for treating an array of mental health conditions— many of which happen to be brought on by the pandemic.
Studies show that psilocybin-assisted therapy decreases depression and anxiety in patients with life-threatening diseases, such as cancer. Participants reported reduced feelings of hopelessness, demoralization, and fear of death. Even 4.5 years after the treatment, 60 to 80 percent of participants still demonstrated clinically significant antidepressant and anti-anxiety responses. While we do not advocate for those sick with coronavirus to eat mushrooms, these studies suggest that psilocybin may be effective in treating the extreme fear, anxiety and depression activated by the virus and global shutdown.
MDMA-assisted psychotherapy also promises major relief from pandemic-related trauma. Multiple studies show that it is a profound tool in the treatment of PTSD for military veterans, firefighters and police officers with no adverse effects post-treatment. MDMA therapy could be particularly beneficial to healthcare workers, survivors of extreme COVID cases or those who lost a loved one to the disease— all of which can inflict significant trauma, and therefore, PTSD.
“We found that over 60 percent of the participants no longer had PTSD after just three sessions of MDMA-assisted psychotherapy,” says Brad Burge, the director of strategic communications at MAPS. “We also found that those benefits persisted and people actually tended to continue getting better over the next year without any further treatments.”
Ketamine (and the esketamine nasal spray) treatment, on the other hand, is already available in North America. It’s especially effective in assuaging the tension of treatment resistant depression, bipolar disorder, chronic pain, and PTSD —all of which could be exacerbated by pandemic-related stressors.
Keep in mind, however, that using psychedelics at home is different than receiving psychedelic-assisted psychotherapy. Catherine Auman, a licensed family and marriage therapist with experience in psychedelic integration, warns that now may not be the best time to use psychedelics, especially in a non-clinical setting. She worries that pandemic-related stressors could impact a patient’s psychological state.
“Psychedelics are powerful substances and are best to do at a time in a person’s life when they’re feeling more stable, not less,” Auman explains. “This is good advice whether someone is using them recreationally or therapeutically.”
Will COVID-19 Impede Psychedelic Research and Delay Public Access?
The pandemic has impeded both psychedelic research efforts and access to currently available therapies. We’re essentially at a standstill until COVID is controlled. MAPS is among few—if not the only—organization with FDA permission to carry on research, but at a reduced scale. When we first spoke with Burge for this story, MAPS was on its first session of Phase 3 MDMA clinical trials. More recently, however, the FDA allowed MAPS to end the first round of Phase 3 early with only 90 out of 100 of the planned participants enrolled. Burge confirmed MAPS is already preparing for their second and last Phase 3 clinical trial. He predicts the DEA could reschedule MDMA by as early as 2022.
Usona Institute temporarily paused all in-person activities related to its Phase 2 clinical trials looking at psilocybin for major depressive disorder, according to its April newsletter. Usona is still recruiting participants for clinical trials at five sites, however.
Compass Pathways is not currently accepting any new patients in its clinical trials looking into the impact of psilocybin on treatment-resistant depression, according to a statement. They continue to support already enrolled patients remotely, when possible within the protocol. Pre-screening of potential study participants continues where possible, too.
Field Trip Health is a recently formed network of clinics offering ketamine-assisted psychotherapy. The facility opened its first clinic in Toronto in March. But, after seeing one patient, it promptly shut down due to the accelerating spread of COVID-19.
The decision for Field Trip Health to close its clinic was relatively easy, according to Ronan Levy, the company’s executive chairman. They didn’t have large numbers of patients actively receiving treatment yet. But, the pandemic has forced the organization to quickly adapt. “We launched a digital online therapy program, so patients can self-refer or have referrals to our psychotherapists, who are trained in psychedelic-assisted psychotherapy, with specific protocols and behavioral therapies,” says Verbora, Field Trip Health’s medical director. “Long term, as these clinics start to open up again, we’ll have dual streams. We’ll be able to sort patients in the clinic for ketamine-assisted psychotherapy, but some of their care may be able to be done from home.”
While the COVID-19 pandemic has hampered research efforts in the short term and, the movement around the healing properties of psychedelic medicine is still going strong.
“The path to acceptance might be slowed down a little bit due to COVID,” Verbora says. “But the current path that’s being undertaken by a number of different groups and institutions is one that’s going to lead to profound changes in the way we approach mental health.”
The timing couldn’t be more perfect.
About the Author
Jeff Kronenfeld is an independent journalist and fiction writer based out of Phoenix, Arizona. His articles have been published in Vice, Overture Global Magazine and other outlets. His fiction has been published by the Kurt Vonnegut Memorial Library, Four Chambers Press and other presses.
For more info, go to www.jeff-k.com.