Breathe in. Breathe Out.

 

That’s not how it’s supposed to feel. Fuck. Let’s try again.

 

Breathe In. Breathe Out.

 

How much longer until the feeling subsides? Or until I feel like normal again? Perhaps all I just need is some relief. Somewhere to step off. Maybe something to cool down, or to soothe it all away. All I know is, I need something, stat(im, taken from the Latin word meaning immediately, commonly used in medical settings).

 

For the moments that seem as if everything in our periphery is overwhelmingly crumbling, where do we turn?

 

In 2015, a survey by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) found 10% of American adults have had a drug use disorder at some time in their life, amounting to more than 23 million adults. Drug-use disorders fall under the umbrella of addiction, defined as “a treatable, chronic medical disease involving complex interactions among brain circuits, genetics, the environment, and an individual’s life experiences” by the American Society of Addiction Medicine. An individual must exhibit at least two of the eleven reported symptoms to be diagnosed with a drug-use disorder, as defined by the Diagnostic and Standard Manual of Mental Disorders (DSM-5). These symptoms include withdrawal, cravings, negative interpersonal effects, increased tolerance (and thus, a need for greater amounts), among others.

 

The NIAAA study also found, perhaps more glaringly, that only about 25% of those diagnosed ever received care.  The idea of people hiding (or perhaps worse, ignoring) their mental illness is one we’ve all likely heard before. Many stories have addiction take form in the ways we’re heard about before – alcoholism and addiction – but also perhaps in other, more hidden ways seemingly imprinted into modern habits and lifestyles. With a constant influx of notifications coming in through text, email, social media, among countless other sources, multi-tasking is training the brain to regularly be seeking external stimulation, similar to a drug use disorder. Multi-tasking is also training the brain to lose focus, often times taking attention away from what we should be focused on, and instead favoring the excitement of receiving a new text message. This is so engrained in culture, it’s commonplace to reference a “phantom” vibration (of a notification) in your pocket.

 

In the instant it takes for our hands to whip out our phone, we find the home screen in the same spot we found it eight minutes ago. No new alerts. Our inner dialogue often reminds us, “they usually respond so quickly” or “they’ve had to respond by now.” This sense of yearning for reciprocated connection has almost become a fundamental part of the shared human experience. It feels like we crave this transactional form of communication, so long as it makes us feel connected, whether it’s a sense of triumph felt from hitting “send” or “reply” on an email or text, or a sense of connection by engaging with a post on social media. The more we respond, the more productive we feel. A 2014 study found more time spent email led to decreased level of focus and productivity. The more we “like,” the more connected we feel according to a 2017 study, which found a link between heavy social media use and social anxiety. Even without the studies cited, we know anecdotally for example, that social media doesn’t improve our sense of connection with the world, but sometimes we need a reminder.

 

It’s easy to forget. Addiction or multi-tasking often distracts us from the larger picture, whether it’s overlooking an important part of who we are or the world around us. Whether through neglect or mistreatment, addiction wreaks havoc on family and other important aspects of life.

 

Regardless of the stimuli – whether it’s responding to a notification or taking a shot of fireball – the brain receives a stream of reward hormones called dopamine. The dopamine reward not only encourages more of the same behavior, but also creates a sense of longing for it. This all happens in our prefrontal cortex, which involves the higher-level thought centers in the brain involved with our ability to schedule and plan. This part of the brain can, however, be easily distracted by the external stimuli involved in addiction. Over time, this prolonged sense of attachment to the satisfaction gained from external stimuli grows into an empty source of pleasure; knowing the behavior is bad in some way, but still choosing to do it, even if it’s not really that enjoyable anymore.

 

In pop culture both today and throughout the last century, we’ve seen the addiction story play out in those we look up to. Someone seemingly on top of the world is faced with the uninvited consequences of success. To simply create something that is widely shared is incredibly difficult, especially when there’s added pressure to perform at a high level. Many artists, in particular, have built careers around their vulnerabilities. Amy Winehouse, an English singer-songwriter known for her bluesy rich voice, had hits like “Rehab” and “Tears Dry On Their Own” that audiences around the world expected to hear on a nightly basis. Among the other challenges associated with recovery, Amy Winehouse also needed to revisit stories of her drug-abuse and broken relationships on a nightly basis given how much others resonated with those songs. Amy died of an overdose at the age of 27, five years after releasing those songs. Her story added to the history associated with addition and how it can deflect an artist’s attention away from doing what once made them happy (if not successful).

 

The pressure to perform, particularly in today’s world, is further intensified by the central need to maintain an always-on digital presence to maintain relevance in a content-rich digital ecosystem. The choice to not participate could be a detriment to your livelihood. It’s a lot of pressure. So, it’s not unreasonable for someone to seek to a momentary sense of relief to get through the day, despite widespread awareness of its destructive nature. Except that this sort of behavior produces destructive, sometimes even fatal outcomes.

 

Harnessing The Pain?

 

Is there a worse pain than the feeling of seeing another human life needlessly falling apart by self-inflicted wounds? And asking for help can be difficult. It’s a far taller mountain to climb without the proper information and support to begin the recovery process, applicable to all sources of mental illness. Culture is one of the key differentiators between the more commonly recognized forms of addiction, like drug abuse, and a more hidden (or accepted) form, like multi-tasking. Productivity is often encouraged, while drug abuse carries a harrowing stigma to be avoided at all costs. But perhaps there’s a more productive way of looking at this problem.

 

Another key theme of addiction, based on the criteria in the DSM-5, is overuse, whether measured by time spent using or an increased level of tolerance to the external stimuli. The external stimulus highly pervasive in today’s mobile environment does, however, raise the question, could the effects of certain stimuli be, not only less harmful, but perhaps even beneficial, in a more controlled and measured environment?

 

A Revelatory Promise Ahead?

 

Early research relating to the effects of psychedelics as a form of (or at least a potent ingredient in some forms of) therapy have shown promising signs of efficacy among patients battling mental illnesses. Of note, psilocybin and MDMA have led to improvements in the mental health of PTSD and anorexia nervosa patients. Such accounts of their efficacy have more recently been drawn from clinical research settings, as a renewed interest in studying these substances have begun to loosen the legislature established in the late 21st century during the “drug war.”

 

It’s also important to note at this early stage in the research, psychedelics have not been found to be addictive substances; rather, it has shown to have the opposite effect. A pilot study from 2017 showed psilocybin decreased smoking levels in addiction treatment interventions, of which the authors attributed to personal insights gained related to identity from the experience.  Studies relating to the use of ayahuasca have found success in curbing addiction, with the well-established indigenous rituals serving a pivotal role.

 

Study participants often describe psychedelics a bit like magic. It’s not uncommon for people to laud their experiences as euphoric or even life changing. That said, these experiences can be a lot to take in, particularly for someone already dealing with mental illness. Many struggle to put their experience into words.

[An integration therapist is there to assist people through this very quandary, in clinical-based psychedelic integration therapy. This is slightly different from psychedelic therapy by itself, in which a trained psychedelic therapist is present in the room while the participant has their experience. In a nutshell, the role of the integration therapist is to both prepare patients for the experience and also help “integrate” patients back into their day-to-day life by exploring and deriving some level of meaning from what they experienced.]

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How psychedelics affect the brain may seem contrary to linear thinking. Dr. Aldous Huxley was one of the pioneers in this research around psychedelics and consciousness and wrote extensively about his psychedelic experiences. He theorized the brain as a reducing valve regulating the way we think, feel, or do, so as not to be overwhelmed by external stimuli. Huxley further proposes this decreased activity, brought on by psychedelics, enables the brain to work without constraint over the cognitive processes that help contextualize how we think about both ourselves and the world around us. Many years later, by way of fMRI (functional magnetic resonance imaging), Albert Huxley’s theories are being backed by the latest science. Instead of increasing brain activity, psychedelics have shown to decrease activity levels in the brain, thereby allowing the brain to operate without normal constraints.

 

These findings are exciting and could (one day) prove revelatory in the world of medicine, but it’s also worth acknowledging we’re only at the beginning of the story. The research around psychedelics, as well as how the brain operates, more broadly, is very much in its infancy. There’s still so much be learned.

 

The allure, however, is still there. Consider everything that orients you in this world, suppressed for a few hours. It’s a potent preposition; this notion that a single dose can, in a way, unlock the door to our mind, allowing it to roam without constraint for a few hours in exchange for what many refer to as a lifetime of insights.

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