Author’s note: I don’t condone the use of psychedelics for recreational purposes. I do recognize that there are psychedelics that can be used with positive outcomes for some psychiatric disorders. I am not a psychiatrist. You need to consult the proper medical person about using psychedelics. They should understand the proper use, and the protocols for their use.
In September I attended the Oxford trauma conference. It got me thinking about a question I’ve had for a while.
I want to talk about depression, trauma, and suicide. There are components of trauma in depression, and sometimes a person with depression considers suicide, and this is where it gets tricky. I’ll attempt to explain this dynamic.
When a person is depressed, their brain isn’t functioning correctly, and this is why finding the right drug is useful. The right drug will allow the brain to bypass the depression and cause things to work correctly. All of a sudden, when the pills kick in, neurons do what neurons should do. A person dealing with depression needs a pill to make it happen correctly. You can function again! I’m giving you the quick and simple explanation here. So, swallow the pill, and get out of bed to greet the day. This is when the cocktail you need to swallow works. You might need to adjust the cocktail periodically to keep things headed in the right direction. For most people, drugs and talk therapy are a good combination.
What do you do when the drugs don’t work? Some depression is treatment resistant. Some depression is caused by the environment the person lives in. If the depression is caused by environment, getting free of that place is a good beginning. It is possible that the body has learned to be depressed; a good psychiatrist can help you use drugs in a limited way to help break the cycle. You must leave the toxic environment and find a good therapist who you can work with on overcoming the conditioning of the environment.
With treatment-resistant depression, no matter what the psychiatrist tries, no matter how fancy the cocktail of drugs is, the person struggles with the daily activities of life. They function on a limited basis. Some days are good, and others aren’t. This is where trauma and hopelessness come into a person’s life. The world has begun to turn the shade of a muddy yellow-brown, and slowly that is how the world is seen: no rose-colored glasses for these folks. It is an ugly color mix. This is where danger lies. You are too depressed to really think, and you don’t have the energy to think everything through. The person is trapped in the sludge of life—think of it as really slow-acting quicksand.
At some point in time the mind begins to ask the question that leads down a path that many see as forbidden: suicide. This is where the real trauma seeps into a person’s life. How can I think this? The shock and horror that I could consider ending my life can breed trauma within the soul. How could this thought be present in me? The muddy place thickens, and if you voice these concerns, friends panic, therapists jump to make a suicide contract, which doesn’t really work for those serious about ending it, and the person having the thought might shut down due to fear and social stigma. This only deepens the traumatic process going on inside.
As a therapist I am legally bound to keep a person safe, and that means prevent harm to self or others. As a therapist I want to have you talk about and explore your thoughts and fears. My job is to offer you a safe place to be heard.
In many ways, the person is facing an existential crisis of epic proportions: to stay and live, or to shut it all down. When a person thinks in this way, they’ve entered the war zone of thought. I don’t want a land mine to be triggered. You defuse the land mine by gently digging in around it, getting the fuse, and defusing it. I don’t want to blow it up. In this case, that is the wrong method of destruction.
I believe in hearing a person’s story and allowing them to come to terms with who they are and what they must face in life.
I listen, and you tell me your story. We find a way in to defuse the stuff inside. Together, we clear land mines. We hope for healthy defusing.
And now, there is something wonderful happening for people who are depressed and traumatized.
With all the buzz about MDMA, and the hope around its legalization for use in treatment of psychiatric disorders, it will be interesting to watch what can happen with its ethical use. I’m aware of its use for several DSM (Diagnostic and Statistical Manual) disorders.
Used correctly, and with medical supervision, there might be a pathway into the mind that could relieve the trauma of depression for many who suffer.
Don’t jump yet. MDMA has a medical protocol, and it might not be right for everyone. Don’t run out seeking this on the street. It is dosage specific and needs to be administered in a safe environment, and with a therapist and psychiatrist supervising the process. Used incorrectly and recreationally, ecstasy can damage a healthy brain. Used with clinical degression, it can serve as a healing agent.
This brings me to the question I’ve been mulling over: Could Jon have found some relief with MDMA? My answer at this point in time is that it might have enabled him to have some relief from the deep trauma that the depression had caused, but he would not have been a good candidate for this type of therapy due to a preexisting bipolar diagnosis. The protocol would have screened him out because bipolar and drugs aren’t a good idea.
Here I sit with hope for some, and hope that someday there will be hope for so many trapped in the muddy place.
