TL;DR: This blog delves into the topic of end-of-life anxiety in patients with terminal illness and explores the potential of psilocybin-assisted therapy as a promising approach for mitigating existential distress. Drawing on research studies, it discusses the challenges of addressing anxiety in terminally ill patients and highlights the positive outcomes observed with psilocybin, LSD, MDMA, and ketamine. The unique characteristics of psychedelic-assisted therapies compared to conventional medications are emphasized, shedding light on the potential of this novel approach for improving end-of-life care. However, further research is needed to better understand the limitations and long-term effects of psychedelic-assisted therapy in this population.
End-of-life anxiety is a frequent concern for individuals who are nearing the end of their lives due to terminal illness. These patients must grapple with the existential challenge of confronting the uncertainty of what comes after death, or the potential loss of their sense of self. This can be a daunting and often terrifying experience, as they face the unknown landscape ahead.
For some, end-of-life anxiety may be experienced as rather mild, characterized by a lingering sense of restlessness and irritability. While, for others, end-of-life anxiety can be more severe, manifesting in disconnection, an inability to focus, crippling insomnia, and a heavy feeling of impending doom.
For example, it is common for cancer patients to develop seriously debilitating psychiatric distress, with rates of anxiety and depressive disorders as high as 40% in hospital settings.
Clinically significant anxiety and depression among cancer patients are associated with a variety of negative outcomes, including decreased quality of life, decreased cancer survival rates, decreased treatment adherence, prolonged hospitalization, and increased suicidality. The mental distress experienced by those facing their departure from known life is also associated with demoralization, hopelessness, isolation, and a lack of meaning.
Unfortunately, medical providers may sometimes be unaware of the mental toll of imminent death, or may be deceived by the outwardly composed facade of patients who take pride in maintaining a brave front. As a result, symptoms of existential distress may go unnoticed or inadequately addressed.
The fear of dying can manifest in covert ways and may be expressed through symptoms that may not immediately seem related to one's mortality. This can make it challenging to identify and address the underlying existential distress experienced by terminally ill patients.
Several factors can exacerbate or add to the complexity of one’s anxious state. Not talking about what is happening out of fear of negatively affecting loved ones, for example, although entirely understandable, may have the unintended consequence of compounding feelings of agitation, irritability, and helplessness.
Lingering debt, dispiriting regrets, and religious quandaries, too, can taint one’s final months or years with unwanted confusion and stress, not to mention the crippling pain that so often accompanies life-threatening illnesses like cancer.
Experts agree that it is normal for individuals to experience anxiety when confronted with the novelty and uncertainty of death. However, it is crucial to differentiate between common end-of-life anxiety and pathological end-of-life anxiety, which can be profoundly debilitating.
Regardless of its severity, prompt treatment is essential for end-of-life anxiety, and psychedelic-assisted therapy shows promise as a potential therapeutic approach.
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5-MeO-DMT (5-methoxy-N, N-dimethyltryptamine) is a short acting, serotonergic psychedelic, found naturally in the venom of the Sonoran Desert Toad (Bufo Alvarius). 5-MeO-DMT is gaining popularity as an effective tool for spiritual exploration and healing due to its extremely powerful psychoactive effects.
What is unique about ayahuasca is that it is a concoction of two plants, the combination of which is essential for the ayahuasca experience. Combining two plants to use as medicine may not seem groundbreaking in and of itself, but the fact that if one is taken without the other, the experience is entirely different, and arguably non-existent, is what makes the discovery of ayahuasca so surprising.
For millennia indigenous-American tribes have consumed N,N-dimethyltryptamine (DMT) as a key ingredient in sacred botanical brews, such as ayahuasca, and snuffs, such as yopo, as part of religious ceremonies in Central and South America.
Ibogaine is a naturally occurring indole alkaloid derived from the roots of an threatened species of perennial rainforest shrub called Tabernanthe iboga. Ibogaine, which is believed to have potent anti-addictive properties, has been used by the indigenous peoples of central west Africa for centuries.
Though ketamine gained a reputation for being dangerous and easily misused and abused, it wasn’t until 1999 that the US classified it as a Schedule III controlled substance. While it is often associated with the party scene, ketamine therapy is helping change the lives of many with severe depression, PTSD, OCD and even chronic migraines.
In 1938, a Swiss chemist by the name of Albert Hofmann, working out of Sandoz Pharmaceuticals, became the first man to synthesize Lysergic Acid Diethylamide (LSD). Active at the microgram level (one-thousandth of a gram), LSD is the most potent psychoactive drug known to humankind.
The MDMA molecule bears structural resemblance to stimulants and some psychedelics, invoking feelings of euphoria, empathy, and boundless energy. MDMA also intensifies sensory perception, enhancing one’s appreciation of music and color which makes it one of the most popular drugs among festival-goers and electronic dance music fans alike.
In the 16th century, Spanish chroniclers attempted to eradicate ritual use of peyote cactus among indigenous American cultures, which led to the plant’s eventual prohibition in 1720. In the face of adversity, several indigenous communities righteously persevered, continuing and preserving their sacred practice in clandestine secrecy, and even managing to spread it widely over the last 150 years.
Peyote is a green spineless cactus that contains the classic psychedelic compound mescaline. Numerous Mesoamerican cultures, including the Huichol (Wixárika), the Cora (náayeri), the Tepehuanes, the Tonkawa, the Mescalero, and the Tarahumara (Rarámuri) have long regarded the plant as sacred, using it in spiritual and healing ceremonies for millennia.
While shrooms were initially used for ceremonial purposes and spiritual awakenings, they have gained popularity for recreational use and current research on shrooms effects in a therapeutic setting is promising.
Since prehistory, San Pedro has been instrumental to Peruvian cultural traditions. in northern Peru in particular, it has been a tool to facilitate the shaman’s ‘‘journey’’ for healing purposes. Throughout this period, the visionary cactus has been known by many names, including huachuma or achuma.