Magic mushrooms may one day treat anorexia, but not just yet
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Anorexia nervosa is a severe mental health disorder where people fear weight gain. Those with the disorder have distorted body image and hold rigid beliefs their body is too big. They typically manage this through restricted eating, leading to the serious medical consequences of malnutrition.
Anorexia has one of the highest death rates of any mental illness. Yet there are currently no effective drug treatments and the outcomes of psychotherapy (talk therapy) are poor. So we’re desperately in need of new and improved treatments.
Psilocybin, commonly known as magic mushrooms, is one such novel treatment. But while it shows early promise, you won’t see it used in clinical practice just yet – more research is needed to test if it’s safe and effective.
What does treatment involve?
The treatment involves the patient taking a dose of psilocybin in a safe environment, which is usually a specifically set up clinic. The patient undergoes preparation therapy before the dosing session and integration therapy after.
Psilocybin, extracted from mushrooms, is a psychedelic, which means it can produce altered thinking, sense of time and emotions, and can often result in hallucinations. It also has the potential to shift patients out of their rigid thinking patterns.
Psilocybin is not administered alone but instead with combined structured psychotherapy sessions to help the patient make sense of their experiences and the changes to their thinking. This is an important part of the treatment.
What does the research show?
Research has shown improved effects of psilocybin-assisted psychotherapy after one or two dosing sessions, a couple of weeks apart. Most research to date has targeted depression.
Psilocybin has been found to increase cognitive flexibility – our ability to adjust our thinking patterns according to changing environments or demands. This is one of the ways researchers believe psilocybin might improve symptoms for conditions such as depression and alcohol use disorder, which are marked by rigid thinking styles.
People with anorexia similarly struggle with rigid thinking patterns. So researchers and clinicians have recently turned their attention to anorexia.
In 2023, a small pilot study of ten women with anorexia was published in the journal Nature Medicine. It showed psilocybin-assisted psychotherapy (with 25mg of psilocybin) was safe and acceptable. There were no significant side effects and participants reported having valuable experiences.
Although the trial was not a formal efficacy trial, 40% of the patients did have significant drops in their eating disorder behaviour.
However, the trial only had one dosing session and no long-term follow up, so further research is needed.
A recent animal study using rats examined whether rigid thinking could be improved in rats when given psilocybin. After the psilocybin, rats gained weight and had more flexible thinking (using a reversal learning task).
These positive changes were related to the serotonin neurotransmitter system, which regulates mood, behaviour and satiety (feeling full).
Brain imaging studies in humans show serotonin disturbances in people with anorexia. Psilocybin-assisted psychotherapy is showing promise at modifying the serotonin disturbances and cognitive inflexibility that have been shown to be problematic in anorexia.
Research with animals can provide unique insights into the brain which can sometimes not be investigated in living humans. But animal models can never truly mimic human behaviour and the complex nature of chronic mental health conditions.
What’s next for research?
Further clinical trials in humans are very much needed – and are underway from a research team at the University of Sydney and ours at Swinburne.
Our trial will involve an initial 5mg dose followed by two subsequent doses of 25mg, several weeks apart. An initial low dose aims to help participants prepare for what is likely to be a new and somewhat unpredictable experience.
Our trial will examine the usefulness of providing psychotherapy that directly addresses body image disturbance. We are also investigating if including a family member or close friend in the treatment increases support for their loved one.
Data from other mental health conditions has suggested that not everyone sees benefits, with some people having bad trips and a deterioration in their mental health. So this treatment won’t be for everyone. It’s important to work out who is most likely to respond and under what conditions.
New trials and those underway will be critical in understanding whether psilocybin-assisted psychotherapy is a safe and effective treatment for anorexia, and the optimal conditions to improve the patient’s response. But we are some way off from seeing this treatment in the clinic. One of the big issues being the cost of this intervention and how this will be funded.
Susan Rossell, Director Clinical Trials and Professor Cognitive Neuropsychiatry Centre for Mental Health and Brain Sciences, Swinburne University of Technology and Claire Finkelstein, Clinical Psychologist and PhD candidate, Swinburne University of Technology
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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5 Ways To Avoid Hearing Loss
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Hear Ye, Hear Ye
Hearing loss is often associated with getting older—but it can strike at any age. In the US, for example…
- Around 13% of adults have hearing difficulties
- Nearly 27% of those over 65 have hearing difficulties
Complete or near-complete hearing loss is less common. From the same source…
- A little under 2% of adults in general had a total or near-total inability to hear
- A little over 4% of those over 65 had a total or near-total inability to hear
Source: CDC | Hearing Difficulties Among Adults: United States, 2019
So, what to do if we want to keep our hearing as it is?
Avoid loud environments
An obvious one, but it bears stating for the sake of being methodical. Loud environments damage our ears, but how loud is too loud?
You can check how loud an environment is by using a free smartphone app, such as:
Decibel Pro: dB Sound Level Meter (iOS / Android)
An 82 dB environment is considered safe for 16 hours. That’s the equivalent of, for example moderate traffic.
Every 3 dB added to that halves the safe exposure time, for example:
- An 85 dB environment is considered safe for 8 hours. That’s the equivalent of heavier traffic, or a vacuum cleaner.
- A 94 dB environment is considered safe for 1 hour. That might be a chainsaw, a motorcycle, or a large sporting event.
Many nightclubs or concert venues often have environments of 110 dB and more. So the safe exposure time would be under two minutes.
Source: NIOSH | Noise and Hearing Loss
With differences like that per 3 dB increase, then you may want to wear hearing protection if you’re going to be in a noisy environment.
Discreet options include things like these -20 dB silicone ear plugs that live in a little case on one’s keyring.
Stop sticking things in your ears
It’s said “nothing smaller than your elbow should go in your ear canal”. We’ve written about this before:
What’s Good (And What’s Not) Against Earwax
Look after the rest of your health
Our ears are not islands unaffected by the rest of our health, and indeed, they’re larger and more complex organs than we think about most of the time, since we only tend to think about the (least important!) external part.
Common causes of hearing loss that aren’t the percussive injuries we discussed above include:
- Diabetes
- High blood pressure
- Smoking
- Infections
- Medications
Lest that last one sound a little vague, it’s because there are hundreds of medications that have hearing loss as a potential side-effect. Here’s a list so you can check if you’re taking any of them:
List of Ototoxic Medications That May Cause Tinnitus or Hearing Loss
Get your hearing tested regularly.
There are online tests, but we recommend an in-person test at a local clinic, as it won’t be subject to the limitations and quirks of the device(s) you’re using. Pretty much anywhere that sells hearing aids will probably offer you a free test, so take advantage of it!
And, more generally, if you suddenly notice you lost some or all of your hearing in one or more ears, then get thee to a doctor, and quickly.
Treat it as an emergency, because there are many things that can be treated if and only if they are caught early, before the damage becomes permanent.
Use it or lose it
This one’s important. As we get older, it’s easy to become more reclusive, but the whole “neurons that fire together, wire together” neuroplasticity thing goes for our hearing too.
Our brain is, effectively, our innermost hearing organ, insofar as it processes the information it receives about sounds that were heard.
There are neurological hearing problems that can show up without external physical hearing damage (auditory processing disorders being high on the list), but usually these things are comorbid with each other.
So if we want to maintain our ability to process the sounds our ears detect, then we need to practice that ability.
Important implication:
That means that if you might benefit from a hearing aid, you should get it now, not later.
It’s counterintuitive, we know, but because of the neurological consequences, hearing aids help people retain their hearing, whereas soldiering on without can hasten hearing loss.
On the topic of hearing difficulty comorbidities…
Tinnitus (ringing in the ears) is, paradoxically, associated with both hearing loss, and with hyperacusis (hearing supersensitivity, which sounds like a superpower, but can be quite a problem too).
Learn more about managing that, here:
Tinnitus: Quieting The Unwanted Orchestra In Your Ears
Take care!
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Taking A Trip Through The Evidence On Psychedelics
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In Tuesday’s newsletter, we asked you for your opinions on the medicinal use of psychedelics, and got the above-depicted, below-described, set of responses:
- 32% said “This is a good, evidence-based way to treat many brain disorders”
- 32% said “There are some benefits, but they don’t outweigh the risks”
- 20% said “This can help a select few people only; useless for the majority”
- 16% said “This is hippie hogwash and hearsay; wishful thinking at best”
Quite a spread of answers, so what does the science say?
This is hippie hogwash and hearsay; wishful thinking at best! True or False?
False! We’re tackling this one first, because it’s easiest to answer:
There are some moderately-well established [usually moderate] clinical benefits from some psychedelics for some people.
If that sounds like a very guarded statement, it is. Part of this is because “psychedelics” is an umbrella term; perhaps we should have conducted separate polls for psilocybin, MDMA, ayahuasca, LSD, ibogaine, etc, etc.
In fact: maybe we will do separate main features for some of these, as there is a lot to say about each of them separately.
Nevertheless, looking at the spread of research as it stands for psychedelics as a category, the answers are often similar across the board, even when the benefits/risks may differ from drug to drug.
To speak in broad terms, if we were to make a research summary for each drug it would look approximately like this in each case:
- there has been research into this, but not nearly enough, as “the war on drugs” may well have manifestly been lost (the winner of the war being: drugs; still around and more plentiful than ever), but it did really cramp science for a few decades.
- the studies are often small, heterogenous (often using moderately wealthy white student-age population samples), and with a low standard of evidence (i.e. the methodology often has some holes that leave room for reasonable doubt).
- the benefits recorded are often small and transient.
- in their favor, though, the risks are also generally recorded as being quite low, assuming proper safe administration*.
*Illustrative example:
Person A takes MDMA in a club, dances their cares away, has had only alcohol to drink, sweats buckets but they don’t care because they love everyone and they see how we’re all one really and it all makes sense to them and then they pass out from heat exhaustion and dehydration and suffer kidney damage (not to mention a head injury when falling) and are hospitalized and could die;
Person B takes MDMA in a lab, is overwhelmed with a sense of joy and the clarity of how their participation in the study is helping humanity; they want to hug the researcher and express their gratitude; the researcher reminds them to drink some water.
Which is not to say that a lab is the only safe manner of administration; there are many possible setups for supervised usage sites. But it does mean that the risks are often as much environmental as they are risks inherent to the drug itself.
Others are more inherent to the drug itself, such as adverse cardiac events for some drugs (ibogaine is one that definitely needs medical supervision, for example).
For those who’d like to see numbers and clinical examples of the bullet points we gave above, here you go; this is a great (and very readable) overview:
NIH | Evidence Brief: Psychedelic Medications for Mental Health and Substance Use Disorders
Notwithstanding the word “brief” (intended in the sense of: briefing), this is not especially brief and is rather an entire book (available for free, right there!), but we do recommend reading it if you have time.
This can help a select few people only; useless for the majority: True or False?
True, technically, insofar as the evidence points to these drugs being useful for such things as depression, anxiety, PTSD, addiction, etc, and estimates of people who struggle with mental health issues in general is often cited as being 1 in 4, or 1 in 5. Of course, many people may just have moderate anxiety, or a transient period of depression, etc; many, meanwhile, have it worth.
In short: there is a very large minority of people who suffer from mental health issues that, for each issue, there may be one or more psychedelic that could help.
This is a good, evidence-based way to treat many brain disorders: True or False?
True if and only if we’re willing to accept the so far weak evidence that we discussed above. False otherwise, while the jury remains out.
One thing in its favor though is that while the evidence is weak, it’s not contradictory, insofar as the large preponderance of evidence says such therapies probably do work (there aren’t many studies that returned negative results); the evidence is just weak.
When a thousand scientists say “we’re not completely sure, but this looks like it helps; we need to do more research”, then it’s good to believe them on all counts—the positivity and the uncertainty.
This is a very different picture than we saw when looking at, say, ear candling or homeopathy (things that the evidence says simply do not work).
We haven’t been linking individual studies so far, because that book we linked above has many, and the number of studies we’d have to list would be:
n = number of kinds of psychedelic drugs x number of conditions to be treated
e.g. how does psilocybin fare for depression, eating disorders, anxiety, addiction, PTSD, this, that, the other; now how does ayahuasca fare for each of those, and so on for each drug and condition; at least 25 or 30 as a baseline number, and we don’t have that room.
But here are a few samples to finish up:
- Psilocybin as a New Approach to Treat Depression and Anxiety in the Context of Life-Threatening Diseases—A Systematic Review and Meta-Analysis of Clinical Trials
- Therapeutic Use of LSD in Psychiatry: A Systematic Review of Randomized-Controlled Clinical Trials
- Efficacy of Psychoactive Drugs for the Treatment of Posttraumatic Stress Disorder: A Systematic Review of MDMA, Ketamine, LSD and Psilocybin
- Changes in self-rumination and self-compassion mediate the effect of psychedelic experiences on decreases in depression, anxiety, and stress.
- Psychedelic Treatments for Psychiatric Disorders: A Systematic Review and Thematic Synthesis of Patient Experiences in Qualitative Studies
- Repeated lysergic acid diethylamide (LSD) reverses stress-induced anxiety-like behavior, cortical synaptogenesis deficits and serotonergic neurotransmission decline
In closing…
The general scientific consensus is presently “many of those drugs may ameliorate many of those conditions, but we need a lot more research before we can say for sure”.
On a practical level, an important take-away from this is twofold:
- drugs, even those popularly considered recreational, aren’t ontologically evil, generally do have putative merits, and have been subject to a lot of dramatization/sensationalization, especially by the US government in its famous war on drugs.
- drugs, even those popularly considered beneficial and potentially lifechangingly good, are still capable of doing great harm if mismanaged, so if putting aside “don’t do drugs” as a propaganda of the past, then please do still hold onto “don’t do drugs alone”; trained professional supervision is a must for safety.
Take care!
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The Path To Revenue – by Theresa Marcroft
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So many books about start-ups skip right over the elephant in the room: survivorship bias. Not so for Marcroft! This book contains the most comprehensive and unapologetic treatment of it we’ve seen.
Less “here’s what Steve Jobs did right and here’s what Chocolate-Teapots-For-Dogs-R-Us did wrong; don’t mess up that badly and you’ll be fine”… and more realism. Marcroft gives us a many-angled critical analytic approach. In it, she examines why many things can seem similar in both content and presentation… but can cause growth or failure (and how and why), based on more than anecdotes and luck.
The book is information-dense (taking a marketing-centric approach) and/but well-presented in a very readable format.
If we can find any criticism of the book, it’s less about what’s in it and more about what’s not in it. This can never be a “your start-up bible!” book because it’s not comprehensive. It doesn’t cover assembling your team, for example. Nor does it give a lot of attention to management, preferring to focus on strategy.
But no single book can be all things, and we highly recommend this one—the marketing advice alone is more than worth the cost of the book!
Take Your First Step Along The Path To Revenue By Checking It Out On Amazon!
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Dreams: Relevance, Meanings, Interpretations
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It’s Q&A Day at 10almonds!
Have a question or a request? We love to hear from you!
In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!
As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!
So, no question/request too big or small
❝I have a question or a suggestion for coverage in your “Psychology Sunday”. Dreams: their relevance, meanings ( if any) interpretations? I just wondered what the modern psychological opinions are about dreams in general.❞
We’ll indeed do that one of these Psychology Sundays! Thanks for suggesting it.
What we can say in advance is that there’s certainly not a single unified scientific consensus yet, but there are two or three prevailing views definitely worth covering, e.g. randomly generated, a by-product of reorganizing information in the brain, or expressions of subconscious thoughts/feelings.
There are also differences between a top-down/bottom-up approach to understanding dreaming, and efforts to tie those two together.
Watch this space!
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Savor: Mindful Eating, Mindful Life – by Thich Nhat Hanh and Dr. Lilian Cheung
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We’ve talked about mindful eating before at 10almonds, so here’s a book about it. You may wonder how much there is to say!
As it happens, there’s quite a bit. The authors, a Buddhist monk (Hanh) and a Harvard nutritionist (Dr. Cheung) explore the role of mindful eating in our life.
There is an expectation that we the reader want to lose weight. If we don’t, those parts of the book will be a “miss” for us, but still contain plenty of other value.
Most of the same advices can be applied equally to other aspects of health, in any case. A lot of that comes from the book’s Buddhist principles, including the notion that:
- We are experiencing suffering
- Suffering has a cause
- What has a cause can have an end
- The way to this end is mindfulness
As such, the process itself is also mindfulness all the way through:
- To be mindful of our suffering (and not let it become background noise to be ignored)
- To be mindful of the cause of our suffering (rather than dismissing it as just how things are)
- To be mindful of how to address that, and thus end the suffering (rather than despairing in inaction)
- To engage mindfully in the process of doing so (and thus not fall into the trap of thinking “job done”)
And, as for Dr. Cheung? She also has input throughout, with practical advice about the more scientific side of rethinking one’s diet.
Bottom line: this is an atypical book, and/but perhaps an important one. Certainly, at the very least it may be one to try if more conventional approaches have failed!
Click here to check out “Savor” on Amazon today, and get mindful!
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Body Scrubs: Benefits, Risks, and Guidance
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It’s Q&A Day at 10almonds!
Have a question or a request? We love to hear from you!
In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!
As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!
So, no question/request too big or small
❝I was wondering whether I should be using a body scrub in the shower, rather than just soap. What should guide me in the choice of a body scrub, and are there any risks to be aware of?❞
Body scrubs are great for giving skin a healthy glow, but are best used sparingly—over-exfoliation leads to the opposite effect (unhappy skin, premature skin aging, etc).
As for contents:
- microplastics are now banned in most places, but you might want to check any products (and their containers!) are BPA-free, pthalate free, etc.
- fragrances in body scrubs are usually a bad idea, and many essential oils have been shown to be endocrine-disruptors, which you do not want:
About the microplastics, harmful artificial chemicals in general, and what constitutes “etc”:
About the fragrances’ (including “natural” essential oils’) endocrine-disrupting shenanigans:
Endocrine-disrupting chemicals: an Endocrine Society scientific statement
So, what might you want to use instead?
If you’re feeling adventurous, you might like to try treating yourself to a pineapple-based mask instead (a muslin cloth soaked in pineapple juice will work just fine; please don’t waterboard yourself though), as the bromelain enzymes (found very generously in pineapple juice) break down dead cells without the need for scrubbing.
Another option is a homemade salt- or sugar-scrub. Put your salt or sugar into a jar, add enough warm water to cover it, leave it for about a day, adding more water if it seems in danger of drying out, until it recrystallizes with a high water content keeping it malleable to the touch; congratulations, you now have a very simple scrub. This should still not be used more than, say, once per week, though.
Last but not least, you might consider investing in a konjac sponge; they gently remove dead skin without damaging living skin. Here’s an example product on Amazon, for your convenience
For more on gentle-yet-effective skincare, you might like to read:
Clean: The New Science of Skin and the Beauty of Doing Less
Enjoy!
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