Viewing a single comment thread. View all comments

ifitfartsitsharts t1_j5ddrej wrote

I am a physician and would NOT recommend anyone with bipolar take shrooms. The risk of an adverse event is too high in people with psychiatric illness with psychotic features including bipolar disorder. Also, many people with bipolar/depression are on psychiatric meds and there isn’t much data on risks of things like serotonin sydrome and other complications like prolonged psychosis, precipitating a manic episode, etc. That being said, we need more objective data (with VALIDATED measures). I recently presented a Grand Rounds lecture on Psilocybin, its mechanisms, and current applications.

Edit: some highlights from the study design and results

  • Subjects were recruited via online advertisements on the CREST.BD website and social media.

  • “self-reported bipolar disorder diagnosis”

Sample bias and very likely including misdiagnoses and people with something not actually bipolar (personality disorder, mild schizophrenia, depression, thyroid disorder). There are a lot of people with “bipolar” self-diagnosed. And there are a lot of people who are older that have bipolar diagnoses that are not truly bipolar but were misdiagnosed in the past.

  • “On a five-point scale from “Not at all” to “Extremely harmful,” the participants rated the harmfulness of their psilocybin experience “.

Having a wide range of time from last use can affect the results. Recency/time bias, inaccurate recall of events and symptoms the further out they get. Also, not a validated measure.

  • “The most commonly cited reason for using psilocybin was to aid personal development, followed by to have fun.”

That’s cool, but I think that says something about the population under study. Patient recruitment methods likely influenced this.

  • “32.2% of participants reported experiencing negative or unwanted outcomes during or in the 14 days after a psilocybin trip. New or increasing manic symptoms were the most common side effect. Eighteen people reported the use of emergency services during or in the 14 days after a psilocybin trip.”

Well that doesn’t sound great.

  • “While our study shows that some people with bipolar disorder reported positive experiences of psilocybin use, others experienced significant bad outcomes, so using this substance can be risky.”

I don’t like this study and think it’s bad because of flawed methodology. But if it helps to get a clinical trial (which they say is underway), then I guess this weak and biased survey data is helpful. I expect that they would use validated symptom severity scales such as the Young Mania Rating Scale (YMRS) or Bech-Rafaelsen Mania Rating Scale (MAS) for future and ongoing clinical research.

For more info on bipolar diagnosis and symptom monitoring for those who are interested:


iicyysaberr t1_j5djv0t wrote

Finally, A educated comment. I also wanted to say people treating mental issues with Marijuana can be very bad too depending on the person.


ifitfartsitsharts t1_j5dksl7 wrote

Agree. Evidence is lacking for cannabis in most of what people say it is helpful for. If people find it helpful, that’s great! It’s still an exogenous psychoactive compound with its own set of risks.


iicyysaberr t1_j5dkzux wrote

Agreed, And we can do more testing if the government would federally legalize it but until then we can't fully test it. But for people saying it's a miracle plant and has not problems is absolute nonsense.


pineapplepredator t1_j5fj8d9 wrote

I never knew this but knew a guy who had some paranoia and delusion in his reasoning generally and he started smoking weed every day to help with his tantrums. It helped his moods while he was high but overall, his delusions and paranoia became way worse so that when he wasn’t high, he was acting psychotic more often than not. It was scary. If someone you know is having issues with their reasoning, keep them away from weed


RiChessReadit t1_j5dr9f5 wrote

If I smoke regularly for more than a week or two it can move my usual mild depression into suicidal territory. I also get really severe weeks long insomnia whenever I stop using it.

Finally had to swear off it completely.


New_Revenue_4_U t1_j5ev91j wrote

Agree. Have bipolar and smoked weed for over 15 year's. Never again.


iicyysaberr t1_j5f6j8m wrote

What happened when you smoked


roberto1 t1_j5fdzla wrote

The reason he is bipolar probably because of the weed..


New_Revenue_4_U t1_j5frjsn wrote

i actually don't know if it is drug induced but tbh i wouldn't discount the possibility.


JonWinstonCarl t1_j5dxefp wrote

I feel like this study is very disconnected from its subject/audience. I have no medical background whatsoever, but Ive done a decent amount of mushrooms, and I would NEVER recommend them to somebody who exhibits manic behavior or uncontrollable thoughts. Just from an anectdotal standpoint, they amplify anything you are feeling so dramatically that I think if you had a downturn while tripping it would be a disaster. I absolutely love mushrooms, but I've recommended against my wife and friends doing them because they have depression issues and dont have a real medical expert to supervise them.


azorielios t1_j5g6dwj wrote

I am bipolar, and before being diagnosed I did a substantial quantity of shrooms. You’re right - it was intense. It was also incredibly cathartic, and for weeks afterward each time I was calmer and more stable.

I also recognize that the plural of ancedote isn’t data, so maybe I just seriously lucked out.


lizardlines t1_j5fu1el wrote

That was my experience taking psilocybin as part of a study on BD2. Amplified my obsessive negative thoughts and was a miserable experience. I’d try psilocybin again but never while severely depressed.


f4f4f4f4f4f4f4f4 t1_j5drj31 wrote

Thank you, Dr. ifitfartsitsharts! I thought that was funny, but really, thank you for looking into this, and warning people to not mix medications. Bipolar is scary and unpredictable enough as it is, ruining the data will make treating the condition even more difficult.


teatimewithbatman1 t1_j5dl10q wrote

Being on meds may be a problem given the pharmaceutical changes of biochemistry.....but we still don't really know what bipolar is. The most we've got is a chemical imbalance that fluctuates during the day, and paired with psychotherapy, different aspects of each day correlating with mental thought processes that push the chemical body into different responses.


lizardlines t1_j5ftfge wrote

I was part of a clinical trial for psilocybin use for BD2 where I was given psilocybin under observation. I was severely depressed at the time and the experience itself was miserable, just amplifying obsessive thoughts. In the long term it didn’t hurt but I personally would not do it again when severely depressed. But the PI said many participants had good results.


Captain_Peelz t1_j5h7h44 wrote

In your opinion, do you believe that people conflate the short term high and associated happiness with a perceived long term positive effect? Because I know several people who swear that it has helped them, yet they show no signs of improved happiness or stability. They just do drugs more frequently.


ifitfartsitsharts t1_j5hoqzg wrote

Yes, I think there is a component of that, which is why studies need proper design for the question and validated measurement tools that eliminate that kind of bias.


ayleidanthropologist t1_j5fzj48 wrote

Thanks for your input on this. I know it takes time to do write ups like these. But it is appreciated!


drakens6 t1_j5gkdic wrote

The critical thing to note about usage of serotonergics or dopaminergics when recommending their use for treatment is that people's baseline levels of those neurotransmitters, their receptor sensitivity, and theirability to convert/process precursors metabolically into active substances can vary wildly depending on a number of different pathological and developmental factors. Just as with anti-depressants, marijuana and psilocybin can be radically detrimental to individuals with specific conditions, and its use can result in real harm to those people

No medicine is beneficial every time, at every dose, to every person. Everything has it's drawbacks and diagnosis considerations, and safer administration protocols with proper harm reduction controls do exist and can be utilized, even in a non-clinical setting.


n3w4cc01_1nt t1_j5gmlrn wrote

If it were a professional treatment do you think keeping a fast acting sleep medication on hand could avoid this?


palsh7 t1_j5gngjw wrote

I was thinking, “people with bipolar disorder don’t always know what is real, let alone helpful.”


ClassyRedandGlassy t1_j5i35ev wrote

Nurse here and thank you for clarifying things to the general audience because I don’t think regular people should be experimenting with their mental health and psychedelics based on Reddit. I fear more self diagnosed people are trying to DIY their mental health these days and it’s having negative effects on their outlook overall. People are using these studies to justify its use but blindly going about doing so in an uncontrolled setting and I don’t support that. Regardless, I know right off the bat that a bipolar diagnosed person has tendencies to abuse substances, how is this any different? Will they not have more potential to become obsessive with the hallucinogenic properties? Seems like a mixed bag


omeyz t1_j5pvj2v wrote

Thank you, this is like bipolar 101. Psychedelics could sooo easily be a catalyst for a severe manic episode