Updated: Jan 9
Microdosing practice has been growing in popularity in the US for the past few years, thanks to a massive surge in consumer interest, growing cultural acceptance, FDA-sanctioned psychedelic research, and a growing body of evidence demonstrating its efficacy for treatment of various mental health conditions.
Psychedelic research has offered plenty of evidentiary confirmation on the efficacy of psychedelic substances in the treatment of depressive disorders, however, research on their anxiolytic qualities is few and far in between, especially as it relates to microdosing. In this article, we explore the potential benefits and challenges associated with psychedelics as an effective treatment for anxiety.
While some anecdotal reports by psychedelic practitioners suggest that psychedelics help with social anxiety, others report anxiety as a side-effect of psychedelic use. In the absence of adequate scientific research, efforts to identify the underlying mechanisms that produce different outcomes are purely speculative. With that said, some basic assumptions can be made to explain the varying experiences.
Psychedelics, whether in microdose or larger doses, offer a novel experience. Our brain chemistry is modified such that we are able to form new thoughts, see the world through a new lens, connect with our body and inner presence in a deeper and more meaningful way, and experience a sense of connectedness to all things not often accessible to us under ordinary circumstances. While these experiences can be liberating, joyful, and healing, due to their novel nature, they can also induce anxiety, especially in individuals with a limited psychedelic experience.
Our brains feel most safe and comfortable under familiar and predictable circumstances and psychedelic experiences are anything but familiar and predictable. Furthermore, psychedelic experiences are often paired with a sense of loss of control which can be triggering to individuals with past trauma history. When faced with unfamiliar and triggering conditions, our survival brains react by setting forth a sympathetic nervous system response which we often experience as stress and anxiety. While we can not override the survival mechanisms of our brains, there are simple action steps we can take to reduce the chances of experiencing anxiety under the influence of psychedelics:
Adequate preparation (clean diet, avoiding stimulants, rested body and mind)
Clear intention & positive mindset
A safe and nurturing environment
Professional facilitation or an experienced sitter
The hopeful fact is that for a large majority of psychedelic practitioners, anxiety tends to dissipate with practice and experience.
While psychedelic research on anxiety has been limited, there have been a couple of promising studies demonstrating the efficacy of psychedelic medicines in the reduction of anxiety symptoms:
A John Hopkins double-blind study published in 2016 demonstrated that "psilocybin produces substantial and sustained decreases in depression and anxiety in patients with life-threatening cancer".
Another double-blind study published by the Multidisciplinary Association for Psychedelic Studies (MAPS) examining the effects of LSD-assisted psychotherapy on terminally ill patients found that "anxiety was significantly reduced" and "reductions were sustained for 12 months".
Despite the promising findings of these research efforts, they were all conducted in clinical settings and with larger doses of psychedelic substances which arguably produce different outcomes than a microdosing practice. Further research is warranted to better understand the factors that produce different outcomes in different individuals as it relates to microdosing and anxiety.
In my work with microdosing clients who experience anxiety, I recommend the following approaches to mitigate anxiety:
Start with a smaller dose and gradually increase the dose to a proper microdose
Avoid stimulants (caffeine, sugar, Adderall, etc) while microdosing
Consider adding anxiolytic supplements to your diet while microdosing like ashwagandha and GABA
Take a moment to connect with your body and set an intention for your experience before dosing
If despite taking mitigating actions you continue to experience anxiety while microdosing, it is best to discontinue and consult an expert for support in identifying the underlying cause. If you have a diagnosed anxiety disorder, always consult y our doctor before consuming any substances as most substances have the potential to further exacerbate anxiety.