Psychedelics and the aging experience

The notion of psychedelic-assisted therapy (PAT) as a viable treatment option for mental health disorders has gained traction in tandem with the increasing number of studies reporting groundbreaking improvements in patient mental health following its administration. Mental health conditions may evolve through exposure to a number of societal factors and experiences affecting an individual throughout their growth, with the impacts of such conditions not limited to a patient but extending to the entire scope of individuals within their sphere of care. So too should the scope of elderly health and wellbeing move to adopt a more holistic perspective, according to doctors from Harvard’s Dana-Farber Cancer Institute and Brigham and Women’s Hospital (Boston, MA).

Highlights of their editorial include:

  • PAT may help professionals, family members, and friends involved in elderly patient care who experience burnout and depression.
  • PAT may help elderly patient care through shifting caregiver perspectives of burden to those of solidarity and respect.
  • Group approaches may be effective in helping both young and old adults to navigate transitions in functionality that occur throughout the aging process.
  • PAT has demonstrated promising results in patients suffering from end-of-life anxiety through alleviating feelings of lost purpose and meaning.

Remarkable improvement has been evidenced following PAT for those with treatment-resistant psychiatric conditions such as depression, Post-Traumatic Stress Disorder (PTSD), substance abuse, and anxiety. Though no long-term complications have been reported in patients after receiving PAT, information regarding the safety of PAT in patients over the age of 60 is limited. Such is of concern for older patients who are more susceptible to the effects that certain psychedelics like methylenedioxymethamphetamine (MDMA) have on the body. Though demonstrating groundbreaking improvements in patients suffering with severe mental health disorders, MDMA may be avoided in older adults due to its immediate short-term impacts on heart rate and blood pressure. Psilocybin may instead be preferred due to its absence of similar effects while still offering the same mental health benefits as MDMA.

Such benefits often arise from the induction of a ‘mystical experience’ following psychedelic use. A mystical experience may stimulate a transition to acceptance, openness to new experiences, and a renewed sense of meaning for mental health conditions that create a chaotic sense of disorder in personal identity, ability, and self-worth. Feelings of peace, harmony, and self-reflection that are realized following a psychedelic mystical experience may markedly improve the status of those struggling to transition into a new stage of life.

Though a mental health disorder may incite a decline in self-esteem, such is also seen in those who may not meet the formal criteria for psychiatric diagnosis- many of whom are adults transitioning into old age. The psychological impacts of this transition stem from losses of functionality, life structure, and purpose that lead to negative feelings of self identity. Studies of PAT for end-of-life anxiety in the terminally ill and elderly have demonstrated significant improvements in existential distress related to loss of meaning and life purpose that last long after psychedelic consumption.

The effects of end-of-life anxiety are not limited to those grappling with death but extend to all who care for the dying, including family members, caregivers and clinicians who may suffer from burnout and emotional exhaustion- both risk factors for elderly abuse.  

PAT is suggested to potentially improve the attitudes and actions of those involved in elderly care through transforming feelings of alienation, burden, and frustration to those of solidarity and respect for a shared and inevitable human condition. The benefits of PAT may impact care on a societal level, where a focus on unity, shared discourse, and guidance for those transitioning to new phases in life harbors the potential to address conditions before they become debilitating. Such would markedly contrast from the current standard of care that is centered upon treatment for specific conditions presenting on an individual basis. Psychedelic experiences offer the arrival of new insights and perspectives which may be integrated with other alternative treatment modalities such as spiritual care and forms of therapy that guide  patients to identify and overcome the root of their feelings. Monitored PAT sessions currently only involve ‘nondirective’ therapy geared to support a patient through any immediate feelings that may arise during the session. The window of insight offered by PAT during these sessions, when combined with therapy of a more directive nature, may be leveraged to create a far more meaningful and longer lasting impact on well-being.

The experience of aging is a constant shared by all during every moment of life, therefore cannot be margined to contain a specific group, demographic, or experience. As treatment options change, so too should perspectives on how to treat transform.