The World Health Organisation (WHO) considers depression to be the leading cause of disability worldwide, and the second leading cause of death in 15-29 year-olds. It estimated that depression drugs like the widely prescribed selective serotonin reuptake inhibitors (SSRIs) work for a little more than half of those treated, and there mounting concerns over their side-effects, in particular the risk of suicide and violent behaviours in both children and adults. Moreover, since there is no recognised diagnostic test to determine a patient’s pre-existing levels of serotonin, SSRIs can actually cause excessive serotonin levels in some people, causing them to experience acute mania and psychosis, and in that actually creating new psychiatric admissions. The mounting criticism of SSRIs is speculated to have made pharmaceutical companies wary of investing the US$1bn it costs to bring a new drug to market. Luckily, there are world-renowned researchers that with the help of their private funders, have managed to instigate an extraordinary resurgence of above-board research into the physiological and psychological effects of Cannabis and so-called ‘street’ drugs. There are now several studies exploring the effects of Lysergic acid diethylamide (LSD), Psilocybin; the psychoactive component in ‘magic-mushrooms’, and Dimethyltryptamine (DMT) containing herbal brews such as Ayahuasca, all of which are predominantly known for their hallucinatory effect and recreational street use.
Can Cannabis Treat Depression?
The lack of traditional funding from pharmaceutical companies and governments is bringing in private investors. As such, researchers may be less biased when reporting their data, as sadly clinical research has seen its fair share of incomplete and even biased reporting, which not only has lead to an increase in patients’ suffering, but also to unnecessary deaths. In 2014, a comprehensive study reviewed all of the existing research into the association between Cannabis use and depression, and it concluded that indeed heavy Cannabis use placed an individual at moderate risk of developing depression. However, it was beyond the scope of the said study to look at whether it was the heavy Cannabis use that was causing the depression, or whether there is another association altogether between its use and certain social problems. For instance, it is well-known that heavy cannabis use is linked with other factors that also increase the risk of depression such as dropping out of school, criminal behaviour, and long-term unemployment. In fact, recently Cannabidiol (CBD), a non-psychoactive component of Cannabis, is gaining significant traction as a promising future therapeutic tool for hard to treat psychiatric conditions in adults and children alike.It is important to distinguish CBD from the psychoactive component of Cannabis, tetrahydrocannabinol (THC), which is associated with an increased risk of psychosis in about 10-20% of people.
The Psychedelic Trip: Last or First Resort?
It is estimated that a third of patients diagnosed with Major Depressive Disorder (MDD), do not respond to appropriate courses of at least three different antidepressants. For the people that fall in this category, many have out of sheer desperation turned to alternative ‘new-age’ practitioners, and have even travelled to the Amazon forest to take part in ceremonies led by shamanic healers in their quest for a cure. It is this exploration of alternative avenues and sacred rituals that may have inadvertently displaced the role of traditional research paid for by pharmaceutical companies. Instead it seems that a month does not go by without a new legitimate, board-certified study reporting the beneficial effects of psychedelics in a wide array of clinical populations. Most recently, a study noted that Psilocybin can relieve depression and anxiety in people with life-threatening cancer. In this study, a remarkable 80% of patients not only showed a significant reduction in the symptoms of both psychological disorders, but the results were sustained up to seven months after the single dose, whilst side-effects were minimal. Anecdotal reports of this kind of microdosing of LSD in depressed people tell a similar story. In comparison, the WHO recommends that people keep taking antidepressant medications for at least nine to 12 months following their recovery from depression.
Beyond Interventions: The Upside of Feeling Down
While we seek future cures, we should not lose track of what is ‘normal’ for us to feel. There is plenty of self-help literature out there to help us with our negative thinking patterns but is there enough explaining the evolutionary benefits of feeling momentarily like you are down with the blues? Are we at times too focused on suppressing our negative emotions. After all, our fast-paced lives leave no time to deal with anything that cripples our everyday functioning. It may be too stressful to take time out, and it is therefore more convenient to turn to interventions that medicate away unwanted feelings. Expressing negative emotions varies across cultures too, for instance the West vs. East narrative seem to prevail. Westerners have a tendency for hedonic emotion regulation, in that there is an up-regulation of positive emotions and down-regulation of negative emotions. It also interesting to note that studies frequently indicate that momentarily depressed people exceed at that solving social dilemmas, as they make a better costs and benefits analysis of the different options available to them. Likewise, it has been found that acute personal stress can actually jump-start our immune systems. A final thought to ponder is that if we never even allow ourselves to feel momentarily besieged by the complexity of our negative emotions, we may not achieve the level of personal growth we are capable of, or we might not reap the full biochemical benefits of the blues either. Perhaps then, the future for some depression treatment is not another pill but a momentary retreat and reflection from our daily lives.
 Dickersin, K., and Chalmers, I., 2011. Recognizing, investigating and dealing with incomplete and biased reporting of clinical research: from Francis Bacon to the WHO. Journal of the Royal Society of Medicine. 104(12), pp. 532-538. https://www.ncbi.nlm.nih.gov
 Lev-Ran, S., et al., (2014). The association between cannabis use and depression: a systematic review and meta-analysis of longitudinal studies. Psychological Medicine, 44(4), pp. 797-810. https://www.cambridge.org
 Trzesniewski, K.H., et al., 2006. Low Self-Esteem During Adolescence Predicts Poor Health, Criminal Behavior, and Limited Economic Prospects During Adulthood. Developmental Psychology, 42(2), pp. 381-390. http://dx.doi.org/10.1037/0012-16220.127.116.111
 Campos, A.C., et al., 2012. Multiple mechanisms involved in the large-spectrum therapeutic potential of cannabidiol in psychiatric disorders. Philosophical Transactions of the Royal Society B Biological Sciences, 367(1607), pp. 3364-3378. https://www.ncbi.nlm.nih.gov
 Palhano-Fontes, F., et al., 2017. Rapid antidepressant effects of the psychedelic ayahuasca in treatment-resistant depression: a randomised placebo-controlled trial. bioRxiv preprint, http://biorxiv.org
 Andrews, P. W., Thomson Jr. and J. Anderson., 2009. The bright side of being blue: Depression as an adaptation for analyzing complex problems. Psychological Review, 116(3), pp. 620-654. http://dx.doi.org/10.1037/a0016242