“All of my mom friends are microdosing mushrooms, and I want to try it, too,” one of my patients said during our therapy session.
As a therapist who specializes in psychedelics for perinatal mental health, I’ve worked with numerous such women who hope to treat their depression, anxiety and trauma with therapeutic psychedelic medicine. Many of them feel more comfortable taking something they feel is more “natural” such as psilocybin, which they don’t have to take daily, rather than a daily pill like Prozac, which is one in a class of drugs called a selective serotonin reuptake inhibitors (SSRI).
Microdosing, according to experts, is taking anywhere from 5 to 10 percent of a full dose of a psychedelic medicine such as magic mushrooms or LSD. A full dose of magic mushrooms that provides a psychedelic trip — often described as a dream state that frees people from ruminations, concerns, obsessions or fixations — ranges from 2 to 6 grams. A microdose could be 100 milligrams, taken every 48 to 72 hours, depending on the protocol. Most people take their microdose in capsule form.
Mushrooms are legal only in Oregon and Colorado. Different cities in the United States have decriminalized mushrooms, but it is illegal to buy, sell or consume outside those cities. Psilocybin is federally still a Schedule I substance.
While many people microdose for recreation, my patient thought it could amplify her psychotherapy. After her first child was born, she was plagued with crippling anxiety. At times, intrusive thoughts such as her baby falling down the stairs haunted her, making it hard for her to sleep and causing her to believe she was not cut out for motherhood.
While psychotherapy helped her feel better, the worries of harm striking her baby didn’t fully vanish, which sometimes kept her suspended in fear.
Microdosing for mental health
Perinatal mood concerns such as anxiety and depression affect up to 20 percent of new mothers, research shows.
Psychedelics are not accepted as robust evidence-based treatment for these disorders. But Sinmi Bamgbose, a perinatal psychiatrist in Los Angeles, said when it comes to treating these mental health concerns, as well as birth trauma, she is looking forward to having psilocybin as a legal medicine option to offer women who aren’t helped by medications such as SSRIs.
Brooke Novick, a licensed marriage and family therapist and co-founder of Axis Mundi, an online organization that offers support with intentional work with psychedelics, says microdosing can help people, but that doesn’t mean “the mushrooms do your work for you.”
“There is no magic pill or plant that allows you to bypass the healing 0f childhood trauma, symptoms of anxiety or depression.” Novick said. “This sacred medicine, when used with intention, respect and care, can powerfully support us on our paths of healing and evolution.”
When my patient began microdosing, she said she felt more uplifted and more grounded in her body. “When my first baby was little, I killed myself to do it all, and then last year, when my second baby turned 1, I decided to try psychedelics even though it went against what the societal idea of a mother is supposed to be,” she said. “I mean, we’re not supposed to be doing drugs.”
But before a recent gathering, that’s what my patient did. With her group of mom friends, who all microdosed, she said she had a good time sharing and connecting.
To support my patient in her microdosing treatment, I talked with her about her intentions, a dosing protocol and sourcing material. If you’re considering this type of treatment, here are four things to keep in mind.
Educate yourself about the research
While microdosing isn’t yet a legal treatment for postpartum mood concerns, research seems promising. In a 2021 study, researchers found that microdosing decreased symptoms of depression, anxiety and stress for women and men.
Pamela Kryskow, a physician and an author of the study, said we need to pay attention to how microdosing studies are designed when we interpret data. Many studies are not designed around how people microdose, she said. If study participants have to adhere to a research protocol such as dosing and then sitting in a clinic for five hours to be observed, they may report less positive experiences than if they are microdosing as part of their daily lives, Kryskow said.
Go through a medical evaluation
Working with any amount of psychedelic medicines in a responsible way means checking in with a trusted health-care practitioner about your medical history and any medications you take that may interact with psilocybin.
Find ethical sources of psychedelics
Psychedelics, particularly psilocybin, are very popular right now, which is why it’s important to consider their source. Try to be in a place of what many Indigenous practitioners of these medicines call “sacred reciprocity.” It’s the notion that, as Robin Wall Kimmerer writes in her book, “Braiding Sweetgrass,” “we neither give nor receive too much.”
Part of the benefit of working with psychedelics, as many Indigenous nations practiced it, was the connection with the earth and all beings and the feeling of oneness.
You need to ask who is making this medicine, where is it grown, who is benefiting from the sale and how the Indigenous people responsible for bringing these medicines to the West are benefiting. These resources can help.
- The Fireside Project is a help and harm-reduction site for people working with psychedelics.
- MAPS is a foundation working in clinical research Phase 3 trials for psilocybin and MDMA.
- The Beckley Foundation is a female-founded psychedelic research organization in the U.K. that also runs retreats in Jamaica, where psilocybin is legal.
- Erowid is a longtime online source of information for all things psychedelic, including sourcing and dosing.
- Reddit has several subreddits dedicated to psychedelics, including resource materials, sourcing and dosing.
- The Ancestor Project is a source of support for psychedelic use and integration focused on BIPOC (Black, Indigenous and people of color).
Get support in preparation and integration
Microdosing is sub-perceptual, which means people should be able to go about their daily activities unimpaired while microdosing. This is not the same as taking a higher dose of the medicine to produce a psychedelic journey.
Working intentionally with any amount of medicine can bring up unexpected memories of loss or feelings of depression and fear. Preparation for microdosing, as well as integration support for whatever comes up along the way, can make a big difference in how you benefit from it.
Psychotherapy is great for this, but individual psychotherapy is not accessible to all. Organizations such as Axis Mundi and Psychedelic Support provide direction with preparation and integration.
My patient reports that microdosing has helped reduce her anxiety and, in particular, her recursive musings about harm befalling her children. She finds herself more able to enjoy moments with them rather than pressuring herself to “do it all.”
Melissa Whippo, LCSW, is a psychotherapist specializing in women’s health and psychedelics in the Bay Area.
We welcome your comments on this column at OnYourMind@washpost.com.
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