When Simone Surgeoner returned to Melbourne after living in the United States for six years, she felt like her life had fallen apart.
“I was in a really, really dark place and I just couldn’t get myself out of it,” the 49-year-old therapist said.
“It felt like all the colours had been washed out of life … I just had no motivation.”
Ms Surgeoner had never taken any illicit drugs, but she was curious about whether taking tiny doses of psilocybin mushrooms — otherwise known as magic mushrooms — could help her clear the fog.
So, she started taking 120 milligrams — roughly 10 per cent of a standard recreational dose — of the hallucinogen a couple of times a week, an approach known as microdosing.
The dose was too small to trigger kaleidoscopic visuals or profound visions, but it was just enough to feel like the sun was shining again, Ms Surgeoner said.
“It gave me back days where I just went, ‘Oh, this is what it feels like to be happy and normal again,’” she said.
“It gave me the strength to get through those dark periods.”
Ms Surgeoner is among a growing number of people who are microdosing psychedelics, particularly psilocybin and LSD, to ease anxiety and depression, improve wellbeing, and boost creativity and focus.
While no-one knows how many people microdose in Australia or overseas, online discussion groups suggest the trend is picking up.
One Reddit microdosing community has grown to over 200,000 members since launching in 2013, and a Facebook group called “Psilocybin Microdosing 101” has gathered 14,000 members in two years.
Once the drugs of choice among hippies, music festival-goers and Silicon Valley workers, psychedelics have also caught the eye of researchers in recent years as potential treatments for mental health issues, including depression and anxiety.
In March last year, the federal government committed $15 million to support clinical research that will investigate whether psychedelics can treat debilitating conditions like post-traumatic stress disorder, depression, addiction, and eating disorders.
“Psychedelics have gone through this very interesting transition in the last few years from being something that is fairly taboo to something that people seem genuinely interested in,” said Vince Polito, a cognitive psychologist at Macquarie University.
Despite this wave of interest, psychedelics remain prohibited (Schedule 9) substances in Australia. Last year, the Therapeutic Goods Administration (TGA) rejected a call to downscale psilocybin (and MDMA, or ecstasy) to controlled substances.
What is microdosing?
While taking an LSD tab or taking a couple of grams of magic mushrooms triggers intense hallucinations and shifts in consciousness, taking a microdose — typically 10 to 20 per cent of a standard or recreational dose — often has a much subtler effect.
Jay (not their real name), a 25-year-old disability worker, said that for him, microdosing LSD is more like a “personal enhancer” than a full-blown trip.
He said taking small doses of the drug had helped him overcome his social anxiety and become more confident.
“[Microdosing] helps me connect with people on a social level, on an emotional level,” said Jay, who is based in Sydney.
“Whereas [a full recreational dose] almost muddles up my internals a little bit … I won’t be able to talk, I won’t be able to string my sentences together properly.”
A handful of recent studies reveal people are drawn to microdosing for a variety of reasons.
A 2019 survey of more than 1.000 people found that the most common reasons to try microdosing are to enhance performance and improve mood.
Another survey of over 400 microdosers revealed that more than half took minuscule doses of psychedelics to help them cope with depression, anxiety, and ADHD.
The same study found that others microdose to find relief from physical ailments, including migraines, chronic pain, and cluster headaches.
Some people may turn to microdosing because they don’t trust conventional treatments like antidepressant medications, or feel that they aren’t effective, said Stephen Bright, a psychologist at Edith Cowan University.
“There is some bad public sentiment towards ‘big pharma’ and antidepressant drugs,” Dr Bright said.
“People may have already tried an antidepressant drug and found that it wasn’t particularly effective.”
Another drawcard of microdosing is that it could be seen as more socially acceptable than taking a full-blown psychedelic trip, Dr Bright said.
“It almost feels like it’s a way of trying to make psychedelics fit within our current society.”
Does microdosing improve mental health?
Early results from trials on the therapeutic potential of large doses (macrodosing) of psychedelics have been promising.
So what about microdosing? Can tiny doses of psychedelics really lift depression, reduce anxiety and make you more creative and productive? The evidence we have so far is a mixed bag.
In May this year, Dr Polito co-authored a review of every single microdosing study that had been published between 1955 and 2021.
Dr Polito assessed the effects reported in the studies across various categories, from mood and mental health to creativity and cognition.
Several studies in the review suggested that microdosing psychedelics could indeed spark up your mood and reduce anxiety.
Another 2019 study on over 1,000 microdosers found that participants reported better moods, increased energy, and improved work performance.
And a 2021 study on over 8,000 participants revealed that among those with mental health concerns, microdosers said they experienced lower levels of depression, anxiety, and stress than their non-microdosing counterparts.
But while the results seem glowing on the surface, it’s important to take them with a grain of salt, Dr Polito said.
“Most of the studies that have looked at mood and mental health show that people who microdose do report benefits — and sometimes quite striking benefits,” Dr Polito said.
“However, the majority of that research does come from self-report studies.”
Unlike lab studies — which are carried out in a controlled setting and often compare a drug’s effects with a placebo — self-report studies involve asking participants about their experiences through questionnaires, surveys or polls.
A benefit of this approach is that it offers a cheap, straightforward way to collect data from a lot of people, particularly for research on illegal substances, which are difficult to access due to regulatory hurdles.
But these kinds of studies come with their limitations, Dr Polito said.
“Typically, people that would be attracted to a study like that are people who are fans of microdosing … so there’s certainly a selection bias.”
Dr Polito said another problem with self-report studies is there’s no way of knowing for sure what, or how much, people are taking.
“[Self-report] studies rely on people’s honesty in reporting what they’ve taken, how much they’ve taken. Even if someone is being very honest, they may not always know,” Dr Polito said.
“Two people might say that they’re taking half a gram of psilocybin mushrooms, but the actual psilocybin content of those mushrooms might be very, very different.”
What have lab studies of microdosing found?
The controlled lab studies in Dr Polito’s review of existing research painted a less promising picture.
Three studies found no noticeable changes in depression symptoms on the day participants took their dose, while four found that microdosing seemed to increase anxiety and stress levels.
“There is a fairly consistent minority of people who say that it doesn’t make their mood improve … it actually makes them more scatterbrained and emotional.”
Other studies have shown there could be other forces at play. A 2021 placebo-controlled study on nearly 200 participants — the largest study of its kind on psychedelics — found participants did indeed notice a mental and emotional boost after taking microdoses of LSD for four weeks.
But those who received a placebo also noticed an improvement in their mental health, suggesting that even the thought of taking a small dose of LSD was as good as the real thing, a phenomenon known as the placebo effect.
“If people believe that it’s going to reduce their anxiety, improve their depression, assist them in being more task-orientated and concentrate, they’re likely to get that effect regardless of whether the drug gives them that effect,” Dr Bright said.
“The placebo effect is extremely powerful.”
So, does that hose down microdosing for good? Not necessarily, Dr Polito said.
He pointed out that it’s important to remember that most lab studies have so far only assessed microdosing over a few weeks, whereas real-life microdosers often take psychedelics for months.
“It may not be surprising that changes weren’t found in those lab studies,” Dr Polito said.
“If you gave someone three to six doses of a traditional antidepressant, you also wouldn’t see much difference.
“It’s only after someone has been taking those medications for six or 12 weeks that you see a difference.”
Dr Bright agrees it’s too early to tell if microdosing works or not, as most controlled studies have only been conducted on a small number of people.
“Before we can talk about whether [microdosing] is effective or not, there needs to be large clinical trials similar to those that we’ve already seen in the macrodosing space,” Dr Bright said.
Is microdosing safe?
Large, long-term studies would also reveal whether microdosing is safe enough to become the new therapeutic kid on the block.
Although microdosers may be less likely to have a bad trip, even a small dose of a hallucinogenic substance still has the potential to trigger psychotic episodes or other mental health issues, particularly for people with a history of bipolar disorder and schizophrenia.
Another concern is that taking psychedelics regularly over long periods could lead to heart issues.
A handful of studies have shown that psychedelics, including psilocybin, LSD and MDMA, activate a receptor called 5-HT2B, which plays a role in heart structure and function.
The activation of this receptor over long periods has been linked to valvular heart disease in high-dose MDMA users, but we don’t know whether microdosing carries the same risk, Dr Polito said.
“That is a question that hasn’t been answered yet. We really would need to do very long-term studies.”
Dr Polito and his team are currently conducting a double-blind, placebo-controlled study that will explore how microdosing psilocybin impacts the brain.
The researchers are aiming to recruit about 80 people to take part in two double-blind placebo-controlled lab sessions that will investigate whether reported effects, such as performance enhancement and improved mental health, can be confirmed in brain scans and blood biomarkers.
“We’re really trying to get at this question of whether there is really a pharmacological effect, or whether this is mainly based on placebo expectations,” Dr Polito said.
“If we find differences in neural activity between those two visits, that will be pretty good evidence that there are some physiological changes and that it’s not just people’s expectations.”
By Gemma Conroy, via abc.net.au