Psilocybin Trial Diary - Day three: Dosing day one (10mg)

Arriving in White City

I wake up at 6.30am, reluctant as ever to get up. I feel nervous and anxious about what the day holds but I also feel excited. In contrast to the last rainsoaked assessment day, the sun is out, the sky is blue and the trees are a lush inviting green. On my way to the unit, I realise why I was able to withstand being trapped in the scanner - years of practice on rush hour London tubes! I find my two inches of standing space and stare at the floor (so as not to have any forced romantic liaisons with my fellow commuters). The train empties out at Oxford Circus and I get a seat. I spend the rest of the journey to White City writing parts of this blog.

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I wait in the reception area having been signed in and then Robin comes and takes me to a patient/participant lounge. He breathalyses me (I'm not allowed to have had alcohol within the previous 24 hours), I provide the required urine sample and then fill in a couple of questionnaires, as is now customary. We then walk to the 'chill out room' - the ward room decked out with colourful sheets, plants and flowers, a scent vaporiser, as well as Mark and James.

We talk through things, my feelings and fears, and then at around 10.30am, I take two psilocybin capsules (equivalent to 10mg). We carry on chatting, over time my perception of colours alters slightly, things feel lighter, time ceases to exist but I still feel fairly similar to normal - it's just there's a slight glow to everything and the music sounds deeper and more open. Within around 45 minutes I can feel the affects more strongly. I carry on chatting to James and Mark - I feel quite analytical - before James suggests I put the headphones and eyemask on and immerse myself within the experience.

The fantastically well-selected ambient playlist fuels my visions, visions that I can see with my eyes closed or with my eyes open behind the foam-edged blindfold I'm wearing. I see kaleidoscopic patterns emerging from the darkness. Just outlines initially but becoming fuller and more colourful as the drug takes more of an effect. Images appear, then streak their patterns around me, infinitely repeated patterns that remind me of the fractal images that first fascinated me as a teenager. Every now and then a bright light surges above me - through me - and takes my breath away. Amongst the patterns are images of a million smirking Stan Laurels, the face of a toy Fisher Price phone on wheels - both of which make me smile.

There are also more-distinct scenes - me flying over various scenes, watching the aurora borealis flicker over mountain ranges. Then there are the images of, or representations of people. I see my love for my wife, visualising us as two curved lasers that fuse together and travel as one. I see my sister and feel love, empathy and sadness for her and what she's experienced in life. I see Mum briefly and try to understand her and her actions but still can’t so consciously move my thoughts on.

I see my friends as well and think, or know rather, that I must be a good person to have such good friends. It isn't arrogance or egoism but just a deep knowing. And I feel blessed to have such dear, close and genuine friends.

During all of this, the music really opens up, I can hear every note suspended in space as if it is a solid, tangible object. Every element of the music has its very own distinct space around me. The detail is astounding - as if I've zoomed in on it aurally by a million times - and I can hear every key of the piano pressed before it sounds and keys lifted as the note ends, I can hear the breath of the musicians playing wind instruments, I can hear people moving around the room during another track and mumbling just out of earshot. In hindsight I'm not sure if this was within the music or within the room around me, there was no distinction. I go on my first trip to the toilet and comment to Mark just how perfect the playlist is.

It certainly isn't all plain sailing though. My anxiety manifests itself as the experience intensifies. I find myself paranoid that I am going to lose control of my bladder and wet myself in front of the others. I also worry that I can’t roll over on the bed, in case I’m not allowed to, in case I turn my back on someone and they think I am being rude. I don’t mention these things until later on when the effects are wearing off.

The experience is like a very intense version of my normal thought processes - what if I do the wrong thing? What if I upset someone? What if I look stupid and humiliate myself? Can I trust everyone? That's when I feel 'locked in' and alone. I have support all around me but cannot, I believe, ask for it. They are going to judge me so all I can do is lie still on the bed, feeling increasingly uncomfortable, and flex my pissing muscle constantly to check I’m not going to wet myself by accident.

Do I ride through the negativity? Do I take evasive action by trying to calm myself? Don't Fight It, Feel It as Primal Scream once said. I’m not quite sure what the 'right' way to go is. During this darker period the music also takes on more dark and sinister qualities. The visuals become less colourful and more threatening. Can I see the devil? Is it my inner demons? I wonder to myself if they have put some dark elements into the music on purpose to draw dark feelings and thoughts out of me. Certain notes and instruments or melodies seem scary and dark.

I don’t request a comforting hand in the form of the non-romantic handhold we'd discussed previously. I am on my own and have to get through this on my own as thoughts of 'will I ever be normal again' come into my head to haunt me. Again, this is an intensified version of my normal thought processes - I have to be strong, I have to get through this on my own, I can't ask for help, I can't burden others with my fears, insecurities or problems.

Thankfully, this passes. I do roll over slightly, even though my bladder paranoia continues.

I'm not sure when I had lunch, perhaps after the dark period, and ate some blueberries. They were genuinely amazing. The texture in my mouth, the taste, the way they gently squished and released their juice. It was like being hyper-present. I also ate a banana and an apple, very slowly. All I wanted to eat was fruit, it felt pure and refreshing. During lunch I also saw a face in one of the throws on the table. It was just there, not threatening or welcoming.

Romantic meal for two

Gradually I begin to come down. Having reached a 3.5 self-rating of intensity earlier on, this gradually subsides to a 2 and then a 1. These ratings (on a scale of one to four) and a blood pressure test are taken around once every 30 minutes by Mark. As I start to return to normality and people's faces start to normalise too I chat to James more about my sister and the rest of my family. I go back under the eyemask for a while afterwards and cry as I feel compassion and love for my sister and all that she's been through.

Once I am rating a 1, Robin gives me a couple more questionnaires to do - this time about the experience. Some of my answers seem contradictory - the experience is both stunningly beautiful and anxiety-inducingly scary. I then go and sit in the participant lounge feeling pleasantly blank as I wait for my wife to turn up to the weirdest date night ever - I eat roast chicken and she eats fish and chips.

We then go outside to wait for the taxi that Mark has booked. I feel strange with an underlying fear of whether I appear normal to others but this doesn’t cripple me or modify my behaviour. It takes a long time to get home, due to the traffic, but I am happy to sit and be once we get there (although I do tidy up some garden stuff without really worrying about it).

Psilocybin Trial Diary - Day two: First scan and prep.

Me in scrubs

The torrential rain starts just before I arrive. I’m given a green wristband by the receptionist and Robin then comes to meet me and takes me to the patient lounge. After a quick urine test, I put on scrubs, my identity disappearing with my clothes, and we then head to the scanner unit.

Robin guides me through everything. He says it'll be loud and may be claustrophobic. I have ear protectors on and a mirror above my eyes shows me the screen behind my head.

The first scans involve me having to keep my eyes closed for the whole time. Am I lying still? I'm trying to. I must relax my shoulders. Does that make my head move? I don't know. I've been told to focus on my depressed state so I’m thinking about my abusive dad, my childhood, how bleak and horrible it all was. God this is depressing.

After each scan I have to rate how I felt using buttons on a pad that's strapped to my arm and wrist. Left and right on the scale with the first two fingers, then select with my thumb. Each time I have to say how depressed/happy/anxious/motivated I was on a sliding scale.

I feel massively anxious during the first two or three scans. I feel like jumping out of the machine as it grinds and whirrs and groans and beeps around me. I imagine this is what it would be like if I was miniaturised and placed on my flatbed scanner at home - with another one on my left, my right and above me, all about an inch away from my skin. I reassure myself that I have the round squeezy panic button in the pocket of my scrubs and that just about keeps me going.

After every scan (lasting around 8 minutes each) I hear the voice of (her name escapes me, Adele?) who is in the scanner control room, asking me if I'm ok and telling me how long the next scan is and what I need to do. The final three scans involve clicking a button when a face appears on the screen, listening to a piano piece (my happiness rating went up but so did my anxiety - it was quite an emotionally varied piece) and the last one is just a physical scan of my brain rather the activity inside it.

This is where my 4am start kicks in (I had to take my Norwegian nephew to the train station) and I fall asleep. Apparently this is the perfect time to snooze if I need to as it would have messed up all of the scans aside from this one. (Can you be depressed in your sleep? Good question).

The dosing room

After I've filled in a couple of questionnaires on Robin's laptop, we then leave the scanning unit and head to what I can only describe as the chill out room. It's another private ward but has multicoloured fabrics hanging over the curtain rail that encircles the bed. There are fake candles that throw out a soft, welcoming light, pot plants and a nice snug blanket on the bed. This is where I will be given my doses. Robin tells me there will also be an aroma diffuser, fresh flowers and music when it comes to the dosing days.

This feeling of comfort increases as I get to know the two psychiatrists who'll be looking after/over me better. Mark and James are both warm, welcoming and disarming and we talk more about my family background and my struggles to make sense of it all and how I've desperately tried to 'fix' things (normally by trying to get unreasonable people to see reason - futile).

Empowerment and disempowerment seem to be themes. I often feel powerless. I can't change arseholes into better people, even though I try my hardest. Robin brings me a massive lunch and I'm left in the chill out/dosing room to eat and further acclimatise myself.

Post-lunch we have more time to chat and we do a dummy run of the dosing day. I lie down on the bed and listen to a (brilliant) selection of ambient music (is that Eno?) that will be played throughout my dosing. I then put earbuds in, which brings the music even closer, put a facemask on to block out the light and we practise a special handhold (which involves holding each others forearms). That's pretty much it for what was an interesting and at times testing (no pun intended) day.

Psilocybin Trial Diary - Day one: Assessment

I arrive in White City and arrive about 10 minutes late for my 1pm appointment at the Imperial College clinical research centre (or the Imperial Centre for Translational and Experimental Medicine to give it its full name). There I meet psychiatrist Mark Bolstridge and am led to what looks like a hospital ward.

We chat for a while and then move on to another room for a blood test, blood pressure measurement and urine test, taken by the nurse. I’m also weighed and have my height measured. I sit on the bed in the room with my shoes off, with my novelty socks on full display (today it’s Chief Wiggum from the Simpsons). No matter.

Later, I meet neuroscientist/psychologist Robin Carhart-Harris, who is managing the study (Professor David Nutt is in overall control). He asks me more questions, and asks me to fill in some questionnaires (I also filled in around 10 questionnaires over the weekend at home) and to take some tests. This includes a morphing face test where a neutral face morphs into an angry, happy, fearful, shocked or sad face, or remains neutral. It’s way too quick for me at times but I do my best.

Mark also runs a coordination test. Mark says, “Touch your nose then my finger.” Simple instructions that I misunderstand and end up sitting there repeatedly jabbing my finger on his finger until Mark steers me back to my nose! We then chat for a while and I talk through my background, my childhood, key issues that I have and my most recent depressed phase.

I’m writing this on August 13th so details are sketchy and I’m not 100% sure if I met the other psychiatrist, James Rucker, at this stage or the next one – I’ve been through a lot since the initial assessment! Anyway, I receive confirmation the day after from Mark that I have met the criteria to take part in the study.

Introduction - About This Blog

The Lagoon Nebula in the constellation of Sagittarius
(source NASA, ESA, J. Trauger)

My name is Ian and I’m writing this introduction on April 8th 2016 – around eight months after taking part in a study at Imperial College looking at using psilocybin to treat resistant depression (ignore the date above that I had to choose to make this blog entry appear first!). For those of you who may not know, psilocybin is the active ingredient in magic mushrooms, possession of which has been illegal in the UK since 2005 (in their fresh form – possession of dried or ‘prepared’ mushrooms was already illegal before this).

This has created numerous legal hurdles for former government drug advisor Professor David Nutt to overcome when it came to running the trial. Leading Professor Nutt’s team is Dr Robin Carhart-Harris, who I contacted in September 2014 after watching this video of a lecture he gave on the way psilocybin works in the brain.

To cut a long (life) story short, me and my sister were abused by our father when we were children which has affected both our lives in a multitude of ways from our self esteem and self image to trust issues and our choice of relationships. While I’m proud of my sister and myself, especially for facing our father in court in 2012 and ensuring he was sent to prison, we still struggle to deal with what happened and have both suffered debilitating depression throughout our lives.

I hit a particularly bad patch of depression towards the end of 2013 and life became completely overwhelming. I tried to carry on, plough through everything and keep working as hard as I could, even though the longer I ignored it the more depressed, angry and full of despair I became. I’d been on various antidepressants, had regular counselling, had started meditating every day and trying to force myself out of the house to go for walks in the park but nothing seemed to lift the cloud. Month by month I felt myself getting dragged lower and lower. I was desperate and spent much of my life in complete despair.

It was when I was looking at other treatments for depression that I came across Robin’s lecture. In February 2015 I received an email from clinical psychiatrist Mark Bolstridge asking if I was still interested in taking part in the trial and by the summer everything was in place for the study to begin.

What follows is a diary of my experiences, written during the trial itself. I’ve spent the time since wondering whether or not to share my experiences publicly, feeling fearful of how people I know may react due to the stigma that surrounds certain drugs. This has been outweighed by my belief in the study and the potential benefits psilocybin may have for many people suffering from severe depression – plus I’ve been nudged into action by my fellow study participant, Kirk, whose own experiences you can read about on his blog here http://mypsilocybin.blogspot.co.uk.

This blog will form a permanent record of my experiences and also form a space to express ideas, theories and thoughts relating to the insights and realisations I had during the trial. I hope sharing my experiences helps in some small way to make psilocybin a widely accepted medical treatment for depression.

Why the blog is called ‘In and through’ will become clear as you read through, as will the reason I chose the background image of a nebula from the far reaches of outer space (image credit- NASA, ESA, J. Trauger (Jet Propulson Laboratory)).