Self-treatment of depression and complex post-traumatic stress disorder with psilocybin and LSD-A retrospective case study

In medicine, psychedelics were initially considered as a tool for clinicians to understand psychotic states. Based on the presented case data, a reversal of that concept is proposed: psychedelics could be conceptualized as a tool for people chronically anxious and depressed since early childhood to understand ordinary states of mind (e.g. calmness, hopefulness, relaxation, and joy). The case concerns a young man who suffered from early-onset complex trauma due to daily abuse by his comprehensive school teacher and other pupils, resulting in severe anxiety and depression. He refused anti-depressive medication. Supportive psychotherapy failed to alleviate the situation, and interaction with psychiatric personnel subjectively experienced as rejection escalated his symptoms. At the age of 19, he resorted to unsupervised self-treatment with psilocybin. Occasional high-dose psilocybin sessions alone did not produce permanent outcomes in a constantly retraumatizing environment. After becoming unemployed at the age of 25, he dedicated himself to working with psychedelics more intensively, with gradually declining doses. The essence of his method was to relive the originally overwhelming traumatic events, maintaining a conscious focus on somatic sensations and avoiding getting overwhelmed again. In his own estimation, by the age of 30, he had resolved most of his early trauma but had been sensitized to the prevalence of trauma and its consequences (e.g. violence, racism) in the society, and his exposure to these continued to cause him suffering. Regardless, he had gained 'a foundational feeling of peace or stability that could provide safety in the middle of all this'. The information for this case study was acquired in the course of semi-structured retrospective interviews 2.5 years apart. The case illustrates that chronic treatment-resistant depression together with an unsupportive social environment may present a challenge for psychedelic therapy. As with ketamine, chronic administration may be necessary in some cases.