1 00:00:15,200 --> 00:00:19,480 I was the roots of a tree and I was underground 2 00:00:19,480 --> 00:00:22,200 and I was connecting with everything out there. 3 00:00:22,200 --> 00:00:23,840 Wow. Goodness me. 4 00:00:23,840 --> 00:00:28,000 I flew into my body and I was just looking around 5 00:00:28,000 --> 00:00:30,200 this beautiful cathedral. 6 00:00:30,200 --> 00:00:32,600 Everything just looked, like, alive, 7 00:00:32,600 --> 00:00:35,720 which is the opposite to how I felt about everything. 8 00:00:36,760 --> 00:00:41,280 In 2019, a pioneering drugs trial began. 9 00:00:41,280 --> 00:00:45,560 I felt trapped and then I flew high up into the sky, 10 00:00:45,560 --> 00:00:48,320 and it was just this kind of beautiful moment 11 00:00:48,320 --> 00:00:50,320 of feeling...feeling free. 12 00:00:50,320 --> 00:00:52,280 HE LAUGHS 13 00:00:52,280 --> 00:00:55,080 A radical new treatment for depression. 14 00:00:55,080 --> 00:00:58,360 So when you're ready, climb on board. 15 00:00:58,360 --> 00:01:02,400 Depression is the leading cause of disability in adults 16 00:01:02,400 --> 00:01:05,800 in the Western world, more than cancer, more than heart disease. 17 00:01:05,800 --> 00:01:08,000 A significant number of sufferers 18 00:01:08,000 --> 00:01:10,680 report no benefit from antidepressants. 19 00:01:10,680 --> 00:01:14,640 Now a team of British researchers are convinced psychedelics 20 00:01:14,640 --> 00:01:16,000 could be the answer. 21 00:01:16,000 --> 00:01:18,600 Why did it take so long to do this research? 22 00:01:18,600 --> 00:01:20,840 Because these drugs are illegal. 23 00:01:22,920 --> 00:01:25,760 For the first time, a leading antidepressant 24 00:01:25,760 --> 00:01:27,920 will be pitted head-to-head 25 00:01:27,920 --> 00:01:30,960 against one of the oldest drugs known to man... 26 00:01:30,960 --> 00:01:32,760 Here are the capsules. 27 00:01:32,760 --> 00:01:34,440 ..magic mushrooms. 28 00:01:34,440 --> 00:01:35,840 There is huge potential 29 00:01:35,840 --> 00:01:38,560 and there is also huge risk, but it is very exciting 30 00:01:38,560 --> 00:01:41,320 that something that grows in the ground can do this. 31 00:01:41,320 --> 00:01:45,400 Synthesised from a Mexican mushroom over 60 years ago, 32 00:01:45,400 --> 00:01:49,040 psilocybin is a Class A hallucinogenic drug. 33 00:01:49,040 --> 00:01:51,920 Supplying it can get you a life sentence. 34 00:01:51,920 --> 00:01:54,520 Only very few people are allowed access to the pharmacy, 35 00:01:54,520 --> 00:01:56,960 so it's very secure. 36 00:01:56,960 --> 00:01:59,560 Will just two single doses of psilocybin 37 00:01:59,560 --> 00:02:01,880 alongside intense psychotherapy 38 00:02:01,880 --> 00:02:05,640 give new hope to people suffering from depression? 39 00:02:05,640 --> 00:02:08,080 I didn't know what was going to unfold. 40 00:02:08,080 --> 00:02:09,960 Wow. Crikey. 41 00:02:09,960 --> 00:02:12,400 I just embraced it. 42 00:02:12,400 --> 00:02:14,240 HE LAUGHS 43 00:02:14,240 --> 00:02:16,520 I'd been subatomically picked apart. 44 00:02:16,520 --> 00:02:18,120 THEY LAUGH 45 00:02:18,120 --> 00:02:20,560 I was just looking around like, "Wow!" 46 00:02:20,560 --> 00:02:22,200 That was extraordinary. 47 00:02:22,200 --> 00:02:24,200 Why am I doing this? 48 00:02:24,200 --> 00:02:26,440 Why do I want to make myself a guinea pig? 49 00:02:26,440 --> 00:02:27,920 When you're ready... 50 00:02:27,920 --> 00:02:30,560 If psychedelics can change the world, 51 00:02:30,560 --> 00:02:32,520 let's put it to the test. 52 00:02:32,520 --> 00:02:34,360 See you on the other side. 53 00:02:46,800 --> 00:02:49,960 I have something very special here you might not have tasted before. 54 00:02:51,600 --> 00:02:53,320 They're mulberries. 55 00:02:53,320 --> 00:02:54,880 All right, aren't they? 56 00:02:54,880 --> 00:02:57,920 Yeah, they're good, actually. Oh, that's so yummy. 57 00:02:57,920 --> 00:03:01,040 I've given a lot of drugs to human beings. 58 00:03:01,040 --> 00:03:04,200 I've probably given more different kinds of drugs to human beings 59 00:03:04,200 --> 00:03:06,720 probably than anyone alive, or ever, maybe. 60 00:03:06,720 --> 00:03:10,320 In fact, almost every class of drug that we know of 61 00:03:10,320 --> 00:03:15,160 that affects the brain I have studied over the last 40 years... 62 00:03:15,160 --> 00:03:17,160 There. Go on, son! There it is! 63 00:03:17,160 --> 00:03:19,560 Quick! Go! Good boy! 64 00:03:19,560 --> 00:03:23,160 ..and that gives you insights into how you might then develop a therapy 65 00:03:23,160 --> 00:03:25,960 to deal with a disorder like depression. 66 00:03:25,960 --> 00:03:27,600 Not that ball, this ball. 67 00:03:27,600 --> 00:03:30,720 In January 2008, Professor David Nutt was appointed 68 00:03:30,720 --> 00:03:34,680 to oversee the Government's Advisory Council on the Misuse of Drugs. 69 00:03:34,680 --> 00:03:36,040 NEWS: ..Professor Nutt, 70 00:03:36,040 --> 00:03:38,320 who's an expert in the effect of drugs on brains... 71 00:03:38,320 --> 00:03:40,560 A year later, he was sacked. 72 00:03:40,560 --> 00:03:42,120 He has been sacked after insisting 73 00:03:42,120 --> 00:03:44,400 that alcohol and cigarettes are more dangerous 74 00:03:44,400 --> 00:03:46,040 than cannabis and ecstasy. 75 00:03:46,040 --> 00:03:48,720 The Home Secretary, Alan Johnson, said he no longer had confidence 76 00:03:48,720 --> 00:03:50,960 in the advice being given by Professor David Nutt. 77 00:03:50,960 --> 00:03:54,680 I had to go anyway because I just couldn't bear to mislead the public. 78 00:03:54,680 --> 00:03:57,000 They wanted me to support their policies 79 00:03:57,000 --> 00:03:58,840 and their policies were so wrong. 80 00:03:58,840 --> 00:04:01,480 So, no, I couldn't do it. 81 00:04:01,480 --> 00:04:04,360 Since then, David has continued to campaign 82 00:04:04,360 --> 00:04:07,400 for an evidence-based approach to drugs policy, 83 00:04:07,400 --> 00:04:10,840 and the current trial is his most ambitious to date. 84 00:04:13,760 --> 00:04:19,440 So the trial is a comparison of two potential treatments of depression. 85 00:04:19,440 --> 00:04:21,280 One is an established treatment. 86 00:04:21,280 --> 00:04:23,440 It's called escitalopram. 87 00:04:23,440 --> 00:04:26,560 That's the latest and probably the most powerful of what we call 88 00:04:26,560 --> 00:04:30,960 the SSRIs - selective serotonin reuptake inhibitors. 89 00:04:30,960 --> 00:04:33,360 And they are the sort of mainstay 90 00:04:33,360 --> 00:04:35,720 of modern first-line treatment of depression. 91 00:04:38,160 --> 00:04:41,920 What we're doing is, we're looking to see how psilocybin as a treatment 92 00:04:41,920 --> 00:04:45,960 for depression compares with this gold standard. 93 00:04:45,960 --> 00:04:47,600 So, the lead scientist is Robin. 94 00:04:47,600 --> 00:04:50,080 Come up through the ranks, PhD student, 95 00:04:50,080 --> 00:04:53,720 and now he's running the psychedelic centre in Imperial. 96 00:04:53,720 --> 00:04:58,120 What defines us is our focus on psychedelic phenomena, 97 00:04:58,120 --> 00:05:01,600 and the depression trial is the most ambitious trial 98 00:05:01,600 --> 00:05:03,680 that we've ever attempted. 99 00:05:03,680 --> 00:05:06,200 It's very much our flagship study. 100 00:05:10,480 --> 00:05:12,760 Then we have a lead therapist, who's Ros Watts. 101 00:05:15,240 --> 00:05:17,920 Ros is now training other psychologists. 102 00:05:17,920 --> 00:05:20,680 She's a clinical psychologist. 103 00:05:20,680 --> 00:05:24,960 I don't even think there is a title, actually, for what I do yet. 104 00:05:24,960 --> 00:05:29,640 So I guess I am a kind of prototype psychedelic therapist, 105 00:05:29,640 --> 00:05:32,080 but it's quite new, so... 106 00:05:33,760 --> 00:05:36,440 Yes, there aren't many of us around. 107 00:05:38,360 --> 00:05:42,880 If we can pull it off, then it really does bring psilocybin 108 00:05:42,880 --> 00:05:46,920 into the treatment arena as something to be considered. 109 00:05:46,920 --> 00:05:50,960 If the trial turns out to be positive, that could open up a door 110 00:05:50,960 --> 00:05:53,440 to a revolution in the treatment of depression. 111 00:05:59,000 --> 00:06:00,920 HE EXHALES 112 00:06:00,920 --> 00:06:03,360 DIRECTOR: Cool. So nice and relaxed. No pressure. Cool. 113 00:06:03,360 --> 00:06:06,440 It's a small sample size for a clinical trial - 114 00:06:06,440 --> 00:06:09,760 59 carefully screened people with long-term depression 115 00:06:09,760 --> 00:06:11,880 have been recruited for this radical new 116 00:06:11,880 --> 00:06:14,240 double-blind drugs trial. 117 00:06:14,240 --> 00:06:16,560 I've had depression right from the start. 118 00:06:16,560 --> 00:06:18,720 It came and went like the weather, 119 00:06:18,720 --> 00:06:21,760 and I seem to have no control over it and no understanding of it. 120 00:06:21,760 --> 00:06:25,480 It's an all-consuming blackness that just sits on top of you 121 00:06:25,480 --> 00:06:27,760 and you can't talk yourself out of it. 122 00:06:29,440 --> 00:06:32,760 Over a six-week period, the participants will be split 123 00:06:32,760 --> 00:06:36,800 into two groups. No-one will know who is on which treatment, 124 00:06:36,800 --> 00:06:39,080 not even the clinicians. 125 00:06:39,080 --> 00:06:42,360 The first group will receive two high doses of psilocybin 126 00:06:42,360 --> 00:06:45,520 three weeks apart, and take home a course of pills 127 00:06:45,520 --> 00:06:49,280 that look like antidepressants but are just placebos. 128 00:06:50,720 --> 00:06:55,000 The escitalopram group receives two placebo doses of psilocybin 129 00:06:55,000 --> 00:06:58,840 and a six-week course of the antidepressant. 130 00:06:58,840 --> 00:07:02,600 Strict medical and therapeutic protocols are in place to ensure 131 00:07:02,600 --> 00:07:05,120 the safety of all the participants. 132 00:07:10,840 --> 00:07:12,560 Go on! 133 00:07:14,280 --> 00:07:16,320 Hey. Good girl. 134 00:07:16,320 --> 00:07:19,160 Steve has lived with depression for 25 years. 135 00:07:20,920 --> 00:07:24,200 I was first diagnosed shortly after I divorced. 136 00:07:26,840 --> 00:07:29,280 And it hit me pretty hard, 137 00:07:29,280 --> 00:07:33,360 and I had to try and come to terms with it in my own way. 138 00:07:34,720 --> 00:07:38,880 In 2000, he made the difficult decision to leave South Africa 139 00:07:38,880 --> 00:07:41,480 when his ex-wife relocated to the UK 140 00:07:41,480 --> 00:07:43,920 with their two young daughters. 141 00:07:43,920 --> 00:07:46,480 I didn't have a choice, really. 142 00:07:46,480 --> 00:07:49,760 I had to draw a line under what I was doing and come over myself. 143 00:07:51,920 --> 00:07:55,480 I'd run out of money. Literally, I had no more rent money. 144 00:07:55,480 --> 00:07:58,520 Things were so bad at times 145 00:07:58,520 --> 00:08:02,000 that I found it hard to put a foot out of bed 146 00:08:02,000 --> 00:08:06,160 in the morning. That's where I found myself. 147 00:08:06,160 --> 00:08:07,680 Do dogs like bean pods? 148 00:08:07,680 --> 00:08:10,320 These dogs, not so much. 149 00:08:10,320 --> 00:08:13,800 Now, 16 years into his second marriage, to Jane, 150 00:08:13,800 --> 00:08:16,200 he's still battling with depression. 151 00:08:17,640 --> 00:08:20,600 One feature of Steve that I've always found quite challenging is, 152 00:08:20,600 --> 00:08:23,120 he very rarely smiles... 153 00:08:23,120 --> 00:08:24,960 If you've got a fresh one, 154 00:08:24,960 --> 00:08:26,640 you can twist it. 155 00:08:26,640 --> 00:08:28,840 That looks a bit dodgy. 156 00:08:28,840 --> 00:08:30,880 ..and when Steve gets really stressed, 157 00:08:30,880 --> 00:08:34,720 he gets angry with people, including me... 158 00:08:34,720 --> 00:08:36,920 Do you want to get some bread? Mm-hm. 159 00:08:36,920 --> 00:08:39,440 ..and is very difficult to live with as well, 160 00:08:39,440 --> 00:08:41,400 because it's as if nothing matters. 161 00:08:41,400 --> 00:08:43,040 It's hot. 162 00:08:45,040 --> 00:08:47,360 And when he's in that state... 163 00:08:47,360 --> 00:08:48,920 You can. I'm hungry. 164 00:08:48,920 --> 00:08:54,280 ..it's very difficult for him to step away from it. 165 00:08:56,240 --> 00:09:00,280 A traumatic experience can lead to negative ruminative thoughts 166 00:09:00,280 --> 00:09:03,640 that go round and round, becoming all-consuming. 167 00:09:05,000 --> 00:09:10,120 People are internally focused on themselves and they're chewing 168 00:09:10,120 --> 00:09:12,800 over certain repetitive thoughts, like, 169 00:09:12,800 --> 00:09:16,320 "I'm worthless, there's no hope, it's all pointless." 170 00:09:16,320 --> 00:09:17,760 What time are you going off? 171 00:09:17,760 --> 00:09:19,800 Early. 172 00:09:19,800 --> 00:09:22,960 Like, I've got to be... I've got to be... 173 00:09:22,960 --> 00:09:26,760 Because I'm insular, I tend to close up. 174 00:09:26,760 --> 00:09:30,360 Perhaps I'm at fault here, but I don't share a lot of it 175 00:09:30,360 --> 00:09:32,120 with her or anyone else. 176 00:09:35,280 --> 00:09:39,240 Steve was on antidepressants for over a decade. 177 00:09:39,240 --> 00:09:41,120 Now he's looking for an alternative. 178 00:09:42,560 --> 00:09:44,840 I had to find a way out. 179 00:09:44,840 --> 00:09:47,840 I've got to find a different way of living with 180 00:09:47,840 --> 00:09:49,840 this feeling of joylessness. 181 00:09:53,920 --> 00:09:57,200 THEME MUSIC AND APPLAUSE 182 00:10:01,640 --> 00:10:03,480 Hello and good morning. 183 00:10:03,480 --> 00:10:06,960 Are you feeling depressed? Suicidal? 184 00:10:06,960 --> 00:10:10,240 Well, this pill could solve all of your problems. 185 00:10:10,240 --> 00:10:14,200 It's called Prozac, and it may mean the end of depression as we know it. 186 00:10:17,080 --> 00:10:19,320 Launched in 1988, 187 00:10:19,320 --> 00:10:22,960 the first successful SSRI was Prozac. 188 00:10:22,960 --> 00:10:28,200 By 2005, 54 million people had taken it worldwide. 189 00:10:28,200 --> 00:10:30,280 I can cope with the kids. 190 00:10:30,280 --> 00:10:33,000 I can cope with family life. 191 00:10:33,000 --> 00:10:35,400 I hold down quite a good job. 192 00:10:35,400 --> 00:10:39,240 Now over seven million people take antidepressants in England 193 00:10:39,240 --> 00:10:42,560 every day, but they can have unpleasant side-effects, 194 00:10:42,560 --> 00:10:45,440 and a significant number of sufferers don't respond 195 00:10:45,440 --> 00:10:47,320 to the medication. 196 00:10:47,320 --> 00:10:50,560 I've been on and off antidepressants for years. 197 00:10:50,560 --> 00:10:53,000 They've usually had quite a few side-effects. 198 00:10:53,000 --> 00:10:54,680 I felt kind of quite numb 199 00:10:54,680 --> 00:10:57,720 and I wasn't able to really fully explore my emotions. 200 00:10:57,720 --> 00:11:01,760 And in the end, I decided to come off them because it wasn't helping. 201 00:11:01,760 --> 00:11:05,200 As a clinical psychologist, I guess I saw more people 202 00:11:05,200 --> 00:11:07,480 who found SSRIs helpful. 203 00:11:07,480 --> 00:11:11,120 I'm very, very glad they exist, but I think we've probably maybe 204 00:11:11,120 --> 00:11:12,920 just overprescribed them. 205 00:11:19,160 --> 00:11:22,680 Ali, a paediatric nurse, has been on antidepressants 206 00:11:22,680 --> 00:11:24,320 for 12 years. 207 00:11:24,320 --> 00:11:27,000 The side-effects are awful. 208 00:11:27,000 --> 00:11:30,840 I put on, like, five stone in the year and a half. 209 00:11:32,720 --> 00:11:37,720 I had awful nightmares, sleep paralysis, horrible itching. 210 00:11:37,720 --> 00:11:39,760 It always brought more problems. 211 00:11:41,440 --> 00:11:45,240 Psychedelic drugs were not something she had ever considered. 212 00:11:45,240 --> 00:11:48,280 I knew a couple of people had taken magic mushrooms 213 00:11:48,280 --> 00:11:50,760 and they said it was a bit odd. 214 00:11:50,760 --> 00:11:54,040 So, yeah, it was not something I've ever been near 215 00:11:54,040 --> 00:11:56,480 or was intending to go near, ever. 216 00:11:57,840 --> 00:12:01,920 Five years ago, Ali's depression took a turn for the worse, 217 00:12:01,920 --> 00:12:05,000 and then her best friend Laura took her own life. 218 00:12:06,400 --> 00:12:09,280 We had a lot of laughs, a lot of fun. 219 00:12:11,400 --> 00:12:13,920 But we also really understood each other. 220 00:12:16,320 --> 00:12:19,680 The last five, six years have been just 221 00:12:19,680 --> 00:12:22,200 concentrating on staying alive, really, I guess. 222 00:12:26,840 --> 00:12:30,360 She's been off work for ten months. 223 00:12:30,360 --> 00:12:33,160 I didn't think I could concentrate enough. 224 00:12:33,160 --> 00:12:36,320 And I obviously wouldn't want to put patients' safety at risk. 225 00:12:46,200 --> 00:12:50,080 The drug trial represents a lifeline for Ali. 226 00:12:50,080 --> 00:12:53,920 I thought I would try it and give it a go. 227 00:12:53,920 --> 00:12:57,280 I'd kind of come to the sort of realisation that 228 00:12:57,280 --> 00:13:00,200 if it didn't work then I probably would end my life. 229 00:13:07,680 --> 00:13:11,600 All the participants have to stop their current medication six weeks 230 00:13:11,600 --> 00:13:14,120 before beginning on the trial. 231 00:13:14,120 --> 00:13:17,440 This is only ever done under expert medical supervision. 232 00:13:19,080 --> 00:13:23,000 The first day is preparation only. No drugs. 233 00:13:23,000 --> 00:13:26,160 If you have any uncomfortable sensations in your body, 234 00:13:26,160 --> 00:13:28,200 don't try to distract or avoid. 235 00:13:28,200 --> 00:13:30,480 They are taken on a guided visualisation 236 00:13:30,480 --> 00:13:33,280 to mentally prepare them for a psilocybin trip. 237 00:13:33,280 --> 00:13:35,360 Instead, try to really feel them. 238 00:13:35,360 --> 00:13:38,160 They're messages from your body that want to be heard... 239 00:13:39,760 --> 00:13:41,960 It uses the analogy of a psilocybin experience 240 00:13:41,960 --> 00:13:43,960 being like a deep-sea dive. 241 00:13:43,960 --> 00:13:47,720 ..and you have a torch. Shine your light on the murkier places. 242 00:13:47,720 --> 00:13:50,800 So the idea of diving down into those deep waters 243 00:13:50,800 --> 00:13:53,120 and how dark and murky it can be... 244 00:13:53,120 --> 00:13:55,240 Explore everywhere. 245 00:13:55,240 --> 00:13:57,520 ..because people just don't have any frame of reference. 246 00:13:57,520 --> 00:13:59,600 They have no idea what to expect. 247 00:13:59,600 --> 00:14:02,560 I tried to pretend I was really cool about it... 248 00:14:02,560 --> 00:14:04,360 THEY LAUGH 249 00:14:04,360 --> 00:14:06,840 ..but I always felt pretty terrified, actually. 250 00:14:06,840 --> 00:14:09,840 I thought, "I can't do this. I really can't do this." 251 00:14:11,080 --> 00:14:14,000 If, tomorrow, you don't want to do it, that is totally fine. 252 00:14:18,000 --> 00:14:21,320 The next day is dosing day. 253 00:14:21,320 --> 00:14:23,560 Neither the participants nor the therapists 254 00:14:23,560 --> 00:14:26,720 know if they're getting a placebo or the full dose 255 00:14:26,720 --> 00:14:29,040 of the Class A hallucinogenic drug. 256 00:14:31,480 --> 00:14:35,400 Trial manager Bruna Giribaldi is responsible for delivering 257 00:14:35,400 --> 00:14:37,800 the drugs to the clinicians. 258 00:14:40,920 --> 00:14:43,960 Because we're working with an illegal drug, 259 00:14:43,960 --> 00:14:46,160 this place is very secure. 260 00:14:46,160 --> 00:14:48,560 Only very few people are allowed access 261 00:14:48,560 --> 00:14:50,720 to the pharmacy where it's stored. 262 00:14:51,920 --> 00:14:55,200 We also need authorisation from the Home Office. 263 00:14:56,880 --> 00:15:01,680 It took Bruna two years to get authorisation for this drug trial. 264 00:15:01,680 --> 00:15:04,520 Everyone in the study is blinded. 265 00:15:08,160 --> 00:15:12,200 In order to maintain this blind, every capsule and then every bottle 266 00:15:12,200 --> 00:15:14,720 containing the capsules looks identical, 267 00:15:14,720 --> 00:15:16,680 regardless of what's inside them. 268 00:15:24,680 --> 00:15:27,080 It's quite a special process for me. 269 00:15:27,080 --> 00:15:28,760 When I hold the bottles, 270 00:15:28,760 --> 00:15:32,120 I just think in my head how much suffering they're going through 271 00:15:32,120 --> 00:15:35,160 right now and how much potential this has to help them. 272 00:15:43,000 --> 00:15:46,040 Ros brought the capsules in in a little bowl, 273 00:15:46,040 --> 00:15:48,200 and I just held the bowl for ages, 274 00:15:48,200 --> 00:15:51,240 staring at them, thinking, "I don't know if I want to do this." 275 00:15:53,640 --> 00:15:57,720 Ros and a team of therapists and psychiatrists conducting the trial 276 00:15:57,720 --> 00:16:02,200 ensure all the participants are carefully supervised at all times. 277 00:16:02,200 --> 00:16:05,280 These drugs are not free of unwanted effects. 278 00:16:05,280 --> 00:16:07,680 The one that's most concerning is that you might trigger 279 00:16:07,680 --> 00:16:10,800 a psychotic reaction in someone predisposed. 280 00:16:10,800 --> 00:16:13,240 So we exclude anyone who's ever been psychotic, 281 00:16:13,240 --> 00:16:16,800 or anyone who has a close family relative who's got psychosis. 282 00:16:18,240 --> 00:16:19,440 Amazing. 283 00:16:19,440 --> 00:16:23,720 After I took them, we just talked for a while and looked through 284 00:16:23,720 --> 00:16:26,600 some books, and talked rubbish for a little while, I think. 285 00:16:29,640 --> 00:16:32,400 And then I started to feel a bit odd. 286 00:16:32,400 --> 00:16:36,680 Typically, it takes around half an hour for the psilocybin 287 00:16:36,680 --> 00:16:37,960 to start having an effect. 288 00:16:39,600 --> 00:16:42,840 I was getting a lot of weird, like, tingling sensations. 289 00:16:47,040 --> 00:16:49,200 And that was when I realised, "Oh, crap. 290 00:16:49,200 --> 00:16:51,680 "I think this might be a bit strong!" 291 00:16:51,680 --> 00:16:54,800 Go with the music. Go with wherever it takes you. 292 00:16:54,800 --> 00:16:59,520 So I kind of had to steel myself a little bit and remember everything 293 00:16:59,520 --> 00:17:02,120 that Ros had told me - like, you have to really commit 294 00:17:02,120 --> 00:17:03,160 and dive into it. 295 00:17:05,160 --> 00:17:08,200 I was still aware of my body at that point, so I knew, 296 00:17:08,200 --> 00:17:12,800 logically, I was safe, so I just had to kind of go for it. 297 00:17:12,800 --> 00:17:16,520 And then as soon as I did, that was when it all just went a bit mad. 298 00:17:23,440 --> 00:17:25,280 I flew into my body. 299 00:17:27,680 --> 00:17:30,520 I was just looking around this beautiful cathedral. 300 00:17:35,640 --> 00:17:39,320 I was just looking around like, "Wow!" 301 00:17:39,320 --> 00:17:43,160 It was just this really beautiful feeling, like, "Oh, I'm fine." 302 00:17:47,000 --> 00:17:50,200 I think that was when I felt welcomed by it 303 00:17:50,200 --> 00:17:51,880 rather than scared of it. 304 00:17:58,600 --> 00:18:03,960 Once it's absorbed by the body, the psychedelics' effect is fast. 305 00:18:03,960 --> 00:18:07,600 Psychedelics work on the 2A receptor, which is in the cortex. 306 00:18:07,600 --> 00:18:10,600 When you stimulate that receptor, the brain goes into the psychedelic 307 00:18:10,600 --> 00:18:13,920 state instantly, and that state, we believe, allows people 308 00:18:13,920 --> 00:18:18,280 to overcome their depression by reframing their relationship 309 00:18:18,280 --> 00:18:21,320 with the current stress and past stressors. 310 00:18:22,840 --> 00:18:27,240 The 2A receptors promote plasticity and learning in the brain, 311 00:18:27,240 --> 00:18:31,320 and when stimulated by psilocybin are believed to disrupt 312 00:18:31,320 --> 00:18:35,800 the negative ruminative thought patterns associated with depression. 313 00:18:35,800 --> 00:18:40,640 The psychedelics turn that button on very strongly, and that turns 314 00:18:40,640 --> 00:18:43,840 on plasticity very strongly. 315 00:18:43,840 --> 00:18:47,720 To increase plasticity is to say, in a sense, I CAN be changed. 316 00:18:50,400 --> 00:18:53,240 Yeah, I could really breathe and really feel space around me 317 00:18:53,240 --> 00:18:56,960 whereas I'd felt really crushed, I think, for a long time. 318 00:18:56,960 --> 00:18:58,920 PULSING 319 00:19:00,440 --> 00:19:03,840 And my heartbeat was really loud in my ears, and then it just got 320 00:19:03,840 --> 00:19:06,200 quieter and quieter really slowly. 321 00:19:10,320 --> 00:19:14,040 And my breathing just... I kind of didn't feel like I was breathing, 322 00:19:14,040 --> 00:19:16,200 but I didn't feel like I needed to breathe, 323 00:19:16,200 --> 00:19:18,920 I just felt really peaceful. 324 00:19:22,680 --> 00:19:25,120 I felt like myself 325 00:19:25,120 --> 00:19:26,480 and I was kind of... 326 00:19:26,480 --> 00:19:28,760 I was really happy to be myself 327 00:19:28,760 --> 00:19:30,760 and be there. 328 00:19:32,080 --> 00:19:34,160 Just a really incredible feeling. 329 00:19:36,880 --> 00:19:40,600 Where you're working towards is like a parting of the clouds 330 00:19:40,600 --> 00:19:42,360 in some way. 331 00:19:42,360 --> 00:19:44,480 Everything just looked alive, I guess, 332 00:19:44,480 --> 00:19:46,240 and colourful and interesting, 333 00:19:46,240 --> 00:19:50,120 which is kind of the opposite of how I felt about everything. 334 00:19:50,120 --> 00:19:52,560 Everything felt pointless when I was depressed 335 00:19:52,560 --> 00:19:55,360 so it was a real switch, like, instant switch. 336 00:19:57,400 --> 00:20:01,480 The next day, participants come in for an integration session 337 00:20:01,480 --> 00:20:03,360 where they work through their experience 338 00:20:03,360 --> 00:20:05,400 with a highly trained therapist. 339 00:20:05,400 --> 00:20:08,240 These sessions play a fundamental role in the treatment. 340 00:20:08,240 --> 00:20:10,800 The more you thought everything's going to be OK, 341 00:20:10,800 --> 00:20:14,400 the more it actually did get OK? Yes... 342 00:20:14,400 --> 00:20:17,120 The psilocybin session is opening a door to something 343 00:20:17,120 --> 00:20:20,160 and the integration session is everything that comes after that 344 00:20:20,160 --> 00:20:23,840 to help somebody create some meaning 345 00:20:23,840 --> 00:20:26,480 from what they saw when that door was opened 346 00:20:26,480 --> 00:20:28,080 and bring it back to their lives. 347 00:20:31,160 --> 00:20:35,800 The way it changed how I felt was a lot stronger than I'd anticipated. 348 00:20:38,960 --> 00:20:42,520 It's different to anything I can imagine being able to experience. 349 00:20:42,520 --> 00:20:46,680 Yeah, just, yeah... Mad. 350 00:20:49,120 --> 00:20:53,680 I would consider most medical treatments for depression 351 00:20:53,680 --> 00:20:56,920 as managing the symptoms of depression as best they can. 352 00:21:01,000 --> 00:21:04,680 And then I would see psilocybin therapy as more about 353 00:21:04,680 --> 00:21:07,240 opening people up so they can receive 354 00:21:07,240 --> 00:21:09,520 much, much more from the world. 355 00:21:11,240 --> 00:21:13,800 When I caught the bus on the way home, 356 00:21:13,800 --> 00:21:16,040 I had, like, a protective bubble around me. 357 00:21:16,040 --> 00:21:18,680 I was stood at the bus stop thinking, 358 00:21:18,680 --> 00:21:20,840 "I don't feel really anxious. This is really weird," 359 00:21:20,840 --> 00:21:22,520 cos usually I would be worrying 360 00:21:22,520 --> 00:21:26,240 about how I'm standing or just really overanalysing everything. 361 00:21:26,240 --> 00:21:29,040 And I just thought "I just feel really relaxed. 362 00:21:29,040 --> 00:21:30,440 "This is so weird." 363 00:21:33,880 --> 00:21:36,360 A lot of people watching this programme might say, 364 00:21:36,360 --> 00:21:39,520 "Why have we only just started studying these drugs as therapies?" 365 00:21:39,520 --> 00:21:43,080 That's a very pertinent question, because in the 1950s and '60s, 366 00:21:43,080 --> 00:21:46,240 psilocybin was a medicine, as was LSD, interestingly enough. 367 00:21:48,080 --> 00:21:50,960 Among these drugs, the hallucinogens, 368 00:21:50,960 --> 00:21:53,440 are included mescaline, 369 00:21:53,440 --> 00:21:55,920 a chemical taken from the peyote cactus, 370 00:21:55,920 --> 00:22:00,720 psilocybin, extracted from a variety of Mexican mushroom, 371 00:22:00,720 --> 00:22:04,960 DMT, synthesised from the compound tryptamine... 372 00:22:05,960 --> 00:22:08,520 ..and of course, LSD 25... 373 00:22:09,880 --> 00:22:12,560 The National Institute of Health in America 374 00:22:12,560 --> 00:22:18,400 funded 130 or more trials of psychedelics. 375 00:22:18,400 --> 00:22:21,440 40,000 patients, 376 00:22:21,440 --> 00:22:24,920 1,000 publications. And overall, 377 00:22:24,920 --> 00:22:26,920 the results were very positive. 378 00:22:28,240 --> 00:22:31,200 We gave them a larger dose individually, 379 00:22:31,200 --> 00:22:36,880 and have each one of them cared for by one of these teams. 380 00:22:36,880 --> 00:22:38,920 If you use them right, 381 00:22:38,920 --> 00:22:40,560 if you use them in a situation 382 00:22:40,560 --> 00:22:43,520 with trained therapists guiding people through their experiences, 383 00:22:43,520 --> 00:22:46,400 the outcomes are very, very positive. 384 00:22:46,400 --> 00:22:48,640 We bring these men back 385 00:22:48,640 --> 00:22:50,880 every four months for three days, 386 00:22:50,880 --> 00:22:53,200 and this follow-up is quite important. 387 00:22:58,400 --> 00:23:03,680 Psychedelic drugs were not just used for medical research in the 1960s... 388 00:23:03,680 --> 00:23:05,520 Turn on... 389 00:23:05,520 --> 00:23:07,640 ..tune in...drop out. 390 00:23:08,880 --> 00:23:11,400 ..they were also enjoyed for pleasure. 391 00:23:15,760 --> 00:23:19,120 But for some, it can be terrifying. 392 00:23:19,120 --> 00:23:21,760 It's like everything is falling apart. 393 00:23:21,760 --> 00:23:27,040 No matter which way I was facing, it was just real frightening. 394 00:23:27,040 --> 00:23:30,320 By the late '60s, in some sections of society, 395 00:23:30,320 --> 00:23:35,960 moral outrage against recreational drug use had reached fever pitch. 396 00:23:35,960 --> 00:23:41,440 America's public enemy number one in the United States is drug abuse. 397 00:23:42,920 --> 00:23:48,280 In 1971, President Nixon made 81 substances, including psilocybin, 398 00:23:48,280 --> 00:23:50,400 illegal in the US. 399 00:23:50,400 --> 00:23:54,880 The United Nations Convention on Psychotropic Drugs soon followed, 400 00:23:54,880 --> 00:23:59,760 and by the 1980s, the war on drugs was at full throttle. 401 00:23:59,760 --> 00:24:01,600 We're after you. 402 00:24:01,600 --> 00:24:04,640 The pursuit will be relentless. 403 00:24:04,640 --> 00:24:06,560 Relentless. 404 00:24:06,560 --> 00:24:08,880 The effort will get greater and greater 405 00:24:08,880 --> 00:24:10,720 until we've beaten you. 406 00:24:10,720 --> 00:24:13,960 Medical research became prohibitively expensive. 407 00:24:13,960 --> 00:24:16,600 Psychedelics were collateral in the war on drugs, 408 00:24:16,600 --> 00:24:19,400 and the criminalization and the banning of psychedelics 409 00:24:19,400 --> 00:24:21,440 is the worst censorship of research - 410 00:24:21,440 --> 00:24:23,520 not just medical research, of research - 411 00:24:23,520 --> 00:24:24,880 in the history of the world. 412 00:24:26,400 --> 00:24:30,000 It took half a century for medical research into psychedelics 413 00:24:30,000 --> 00:24:34,680 to restart in earnest, with Robin Carhart-Harris and David Nutt 414 00:24:34,680 --> 00:24:36,320 leading the charge in the UK. 415 00:24:38,120 --> 00:24:41,520 In 2012, Robin and David completed 416 00:24:41,520 --> 00:24:43,840 a ground-breaking brain imaging study 417 00:24:43,840 --> 00:24:46,480 into the effects of psilocybin. 418 00:24:46,480 --> 00:24:50,320 They revealed that psilocybin also disrupts parts of the brain 419 00:24:50,320 --> 00:24:52,560 known as the default mode network. 420 00:24:55,800 --> 00:24:59,920 The reason we started researching psilocybin in people with depression 421 00:24:59,920 --> 00:25:02,800 was because we had done the brain imaging studies, 422 00:25:02,800 --> 00:25:06,600 because we had shown that psilocybin disrupts 423 00:25:06,600 --> 00:25:08,880 the parts of the brain that cause depression. 424 00:25:12,520 --> 00:25:16,920 This default mode network does the most abstract of functioning. 425 00:25:16,920 --> 00:25:20,560 So, things like our ability 426 00:25:20,560 --> 00:25:23,640 to have a sense of self, a personal narrative - 427 00:25:23,640 --> 00:25:27,720 "This is me, I can imagine the future" - 428 00:25:27,720 --> 00:25:30,960 but it's most active when we daydream. 429 00:25:30,960 --> 00:25:33,800 They could have called it the daydream network, in a way. 430 00:25:33,800 --> 00:25:36,600 In depressed people, daydreaming can be 431 00:25:36,600 --> 00:25:39,520 very negatively focused and damaging. 432 00:25:39,520 --> 00:25:43,120 People come in with a very strong default mode network, 433 00:25:43,120 --> 00:25:46,040 which is very rigid, it's very entrenched. 434 00:25:46,040 --> 00:25:49,640 What psychedelics do, by deactivating the sense of self, 435 00:25:49,640 --> 00:25:53,800 they enable people to connect to everything else. 436 00:25:58,800 --> 00:26:01,840 It might feel quite challenging out here, navigating... 437 00:26:01,840 --> 00:26:05,240 I'll take it really slowly... There's no rush. 438 00:26:06,600 --> 00:26:10,000 Steve is just beginning his first dosing session. 439 00:26:12,000 --> 00:26:15,640 I have a feeling I should be saying something profound. 440 00:26:15,640 --> 00:26:18,520 Oh, no. See how it goes. 441 00:26:18,520 --> 00:26:20,520 There's no question I was nervous. 442 00:26:22,560 --> 00:26:24,600 You're taking a step into the unknown. 443 00:26:33,240 --> 00:26:37,160 It probably took 20, 30 minutes to feel the effects. 444 00:26:41,040 --> 00:26:44,920 And it was as colourful as anything you could imagine. 445 00:26:44,920 --> 00:26:48,800 Just colours that perhaps I'd never seen before, 446 00:26:48,800 --> 00:26:52,600 and I was seeing them all together at the same time. 447 00:26:52,600 --> 00:26:55,040 I was inside a kaleidoscope. 448 00:26:56,800 --> 00:26:59,120 And these colours were just playing out 449 00:26:59,120 --> 00:27:01,040 in the most extraordinary patterns. 450 00:27:03,160 --> 00:27:05,200 Beautiful and... 451 00:27:06,440 --> 00:27:08,880 ..wild. Wild beyond imagining. 452 00:27:11,440 --> 00:27:16,360 I felt that I'd been subatomically picked apart. 453 00:27:16,360 --> 00:27:19,600 The dandelion clock just shhh... Blowing away in the breeze. 454 00:27:19,600 --> 00:27:20,840 That's how I felt. 455 00:27:22,920 --> 00:27:24,920 And I was left with nothing. 456 00:27:37,720 --> 00:27:38,800 My goodness. 457 00:27:41,080 --> 00:27:44,520 I was the roots of a tree 458 00:27:44,520 --> 00:27:46,880 and I was underground 459 00:27:46,880 --> 00:27:49,280 and I was connecting with everything out there. 460 00:27:51,880 --> 00:27:54,920 And the thing that I really felt most... 461 00:27:54,920 --> 00:27:57,800 HE LAUGHS 462 00:27:57,800 --> 00:28:00,480 ..was a joy. 463 00:28:00,480 --> 00:28:03,360 Joy like I'd never experienced. It is... 464 00:28:04,520 --> 00:28:07,160 It is really, really, really powerful stuff. 465 00:28:14,440 --> 00:28:15,960 GENTLE LAUGHTER 466 00:28:24,640 --> 00:28:27,880 There was a point in the process where I was confronted with 467 00:28:27,880 --> 00:28:30,920 my own mortality really strongly. 468 00:28:30,920 --> 00:28:34,720 It was a felt thing. It was, "You are going to die." 469 00:28:34,720 --> 00:28:38,400 And I had a very real sense of being shown that... 470 00:28:38,400 --> 00:28:41,760 ..because I needed to be reminded to get on with my life 471 00:28:41,760 --> 00:28:43,440 and make the most of it. 472 00:28:53,080 --> 00:28:56,360 Mat is a photographer and film-maker who lives in London. 473 00:28:57,320 --> 00:29:00,320 You can be carrying this heavy burden with you... 474 00:29:03,840 --> 00:29:07,360 ..and people who don't know that you have that struggle 475 00:29:07,360 --> 00:29:09,320 might not even know that that's going on. 476 00:29:12,480 --> 00:29:15,280 It's something that I've had for the most part of my life. 477 00:29:22,720 --> 00:29:24,800 On the prep day... 478 00:29:24,800 --> 00:29:27,040 If you'd like to have a seat there, on that blue chair. 479 00:29:27,040 --> 00:29:28,400 I'll get you some water. 480 00:29:28,400 --> 00:29:32,080 ..I had no expectations, really, of what it would involve. 481 00:29:32,080 --> 00:29:34,480 I just kind of went into it with open arms, really. 482 00:29:46,480 --> 00:29:49,880 So why don't you tell me a little bit about...? 483 00:29:49,880 --> 00:29:54,200 So the prep day involved just chatting about how I was feeling, 484 00:29:54,200 --> 00:29:57,200 a bit about my depression history. 485 00:29:57,200 --> 00:30:01,440 I struggled a little bit in school through kind of bullying... 486 00:30:01,440 --> 00:30:03,080 Mm. 487 00:30:03,080 --> 00:30:05,680 ..and I think that affected my self-esteem. Yeah. 488 00:30:07,600 --> 00:30:11,520 Bullying at school was a really difficult time in my life. 489 00:30:11,520 --> 00:30:15,960 I wasn't well-liked, and I became very anxious and insecure, 490 00:30:15,960 --> 00:30:20,400 and life kind of went on with these feelings, really. 491 00:30:20,400 --> 00:30:22,640 Is there someone with you at the beginning? 492 00:30:22,640 --> 00:30:25,280 The whole way through. The whole way through this whole thing? 493 00:30:25,280 --> 00:30:26,880 Yeah. OK. Cool. Yeah, yeah, yeah. 494 00:30:26,880 --> 00:30:30,000 And you'd never be alone. Yeah. Always with two therapists, 495 00:30:30,000 --> 00:30:31,360 the whole way through. 496 00:30:31,360 --> 00:30:35,000 Reassured, Mat comes in for his dosing day, 497 00:30:35,000 --> 00:30:38,040 ready to embrace the experience. 498 00:30:38,040 --> 00:30:40,720 Do you want to get comfy? I was just thinking, do I need to...? 499 00:30:40,720 --> 00:30:43,160 Are they here? Have the drugs arrived yet? 500 00:30:43,160 --> 00:30:45,680 They've arrived, yes. They have arrived. 501 00:30:45,680 --> 00:30:47,760 OK, so we're ready to go, aren't we? 502 00:30:48,760 --> 00:30:51,080 VOICEOVER: I felt very relaxed. I felt very safe. 503 00:30:52,680 --> 00:30:54,320 This bed's so comfy! 504 00:30:59,400 --> 00:31:02,000 VOICEOVER: I just didn't hesitate. 505 00:31:02,000 --> 00:31:03,680 I just took the pills. 506 00:31:07,080 --> 00:31:11,800 And as the music started to evolve, 507 00:31:11,800 --> 00:31:14,360 I just started to go on this amazing journey. 508 00:31:18,200 --> 00:31:23,600 Initially, there was just a sense of just a kind of weight lifted. 509 00:31:23,600 --> 00:31:26,600 I almost felt like I was in a computer game. 510 00:31:28,080 --> 00:31:30,720 There were lots of patterns, and I felt like I was... 511 00:31:30,720 --> 00:31:33,320 I was travelling between different realms. 512 00:31:40,240 --> 00:31:44,680 There was a moment where I felt like I was in deep, deep water... 513 00:31:46,960 --> 00:31:50,400 ..and I was looking down into the abyss. 514 00:31:53,440 --> 00:31:56,080 And suddenly I had this sensation... 515 00:31:58,160 --> 00:32:01,760 ..I was an observer to my body being released to the deep. 516 00:32:05,640 --> 00:32:08,280 I just started bawling my eyes out. 517 00:32:08,280 --> 00:32:12,360 I haven't really cried properly for a long time. 518 00:32:12,360 --> 00:32:15,200 But I didn't feel scared or frightened. It felt OK. 519 00:32:16,440 --> 00:32:18,240 I was lying there, and I just... 520 00:32:18,240 --> 00:32:21,080 the tears were pouring out of my eyes, but they weren't sad tears. 521 00:32:21,080 --> 00:32:23,040 They were... They were joyful tears. 522 00:32:25,520 --> 00:32:26,960 Oh...fucking hell! 523 00:32:26,960 --> 00:32:28,960 Phew! 524 00:32:28,960 --> 00:32:31,840 VOICEOVER: I felt really happy, and I just... 525 00:32:31,840 --> 00:32:35,880 I remember thinking I could die in this moment, and it would be OK. 526 00:32:35,880 --> 00:32:39,360 People have psilocybin and they feel these things and trauma that's 527 00:32:39,360 --> 00:32:43,080 been repressed and held on to gets released, and the transformational 528 00:32:43,080 --> 00:32:46,080 moments where it is, where someone can suddenly release 529 00:32:46,080 --> 00:32:49,120 some pent-up tears that they haven't cried for 20 years, 530 00:32:49,120 --> 00:32:51,960 or someone can suddenly experience joy or beauty, 531 00:32:51,960 --> 00:32:54,400 or something that they haven't felt for ages, 532 00:32:54,400 --> 00:32:57,800 or suddenly feel a sense of forgiveness for something 533 00:32:57,800 --> 00:33:01,360 or love for something or hear a piece of music and it touches them. 534 00:33:03,800 --> 00:33:06,840 Whoever came up with this soundtrack is a fucking genius. 535 00:33:09,840 --> 00:33:12,560 VOICEOVER: There was a clear sense that depression and anxiety 536 00:33:12,560 --> 00:33:14,920 doesn't exist where I am now. 537 00:33:14,920 --> 00:33:18,480 We're here whenever you need us. You've done so well. 538 00:33:18,480 --> 00:33:20,320 Really brilliantly. 539 00:33:21,760 --> 00:33:24,400 I just felt beautifully at peace. 540 00:33:24,400 --> 00:33:26,080 You know, during depression, 541 00:33:26,080 --> 00:33:28,760 you ruminate and think about a lot of things. 542 00:33:28,760 --> 00:33:32,920 Psilocybin taught me that I'm so much more than thought. 543 00:33:32,920 --> 00:33:36,200 I am... I am separate to thought. 544 00:33:36,200 --> 00:33:40,520 Although some participants don't have such strong experiences, 545 00:33:40,520 --> 00:33:44,440 Mat wasn't alone in finding psilocybin revelatory. 546 00:33:44,440 --> 00:33:48,520 There has been a fundamental shift in myself, 547 00:33:48,520 --> 00:33:50,680 which has allowed more light to come in. 548 00:33:50,680 --> 00:33:56,480 You sort of lose your analytical, critical mind, or at least I did. 549 00:33:56,480 --> 00:34:00,440 I definitely had probably 30 years of therapy in that afternoon. 550 00:34:00,440 --> 00:34:02,840 I must have cried for six hours solid. 551 00:34:02,840 --> 00:34:05,120 Psilocybin opened my heart, 552 00:34:05,120 --> 00:34:09,920 which had been closed down and locked down for so many years. 553 00:34:09,920 --> 00:34:11,560 Thank you, psilocybin. 554 00:34:19,880 --> 00:34:23,760 Nadine is an artist who lives with her husband in East Sussex. 555 00:34:26,160 --> 00:34:27,880 In the last couple of years, 556 00:34:27,880 --> 00:34:31,040 I've been focusing on autobiographical drawings. 557 00:34:32,080 --> 00:34:35,560 It's almost like these characters have started emerging. 558 00:34:35,560 --> 00:34:39,000 It feels kind of almost like an eternal struggle 559 00:34:39,000 --> 00:34:41,040 or heaven and hell or something. 560 00:34:41,040 --> 00:34:43,040 I hadn't realised until recently 561 00:34:43,040 --> 00:34:47,280 how much it has reflected my depression and my anxieties. 562 00:34:48,400 --> 00:34:51,800 It's kind of almost like internally, I feel that inner sense 563 00:34:51,800 --> 00:34:53,400 of turmoil and flux. 564 00:34:55,480 --> 00:34:59,080 She was diagnosed with depression in her early 20s. 565 00:35:00,240 --> 00:35:02,880 It's a deep sense of sorrow and loss 566 00:35:02,880 --> 00:35:07,440 and sense that you're never going to amount to anything, 567 00:35:07,440 --> 00:35:10,920 and then you start spiralling over the same territory. 568 00:35:10,920 --> 00:35:13,360 You're sort of chewing over and over it. 569 00:35:13,360 --> 00:35:14,560 It's exhausting. 570 00:35:17,640 --> 00:35:20,440 VOICEOVER: You don't know what to do, and you feel a bit powerless - 571 00:35:20,440 --> 00:35:22,240 that's difficult. 572 00:35:22,240 --> 00:35:24,880 How do you actually impact that? 573 00:35:24,880 --> 00:35:26,120 How do you help? 574 00:35:26,120 --> 00:35:27,760 The plane's back. 575 00:35:33,880 --> 00:35:36,560 After years on and off anti-depressants, 576 00:35:36,560 --> 00:35:39,960 Nadine would like to try something different. 577 00:35:39,960 --> 00:35:42,840 Maybe it's possible with this psilocybin 578 00:35:42,840 --> 00:35:44,800 that actually, instead of numbing you, 579 00:35:44,800 --> 00:35:47,960 t maybe lights you up a little bit, you know, 580 00:35:47,960 --> 00:35:51,080 and I would really want to experience that. 581 00:35:51,080 --> 00:35:52,720 You know, I'm just curious. 582 00:35:55,320 --> 00:35:59,680 But taking that first step at Imperial College is a challenge. 583 00:35:59,680 --> 00:36:05,880 For me, being able to make decisions can be quite difficult. 584 00:36:10,400 --> 00:36:14,160 VOICEOVER: I'm thinking, like, why am I doing this? 585 00:36:14,160 --> 00:36:18,720 What would happen if I lost control, or if really dark things happened? 586 00:36:18,720 --> 00:36:21,360 Why do I want to make myself a guinea pig? 587 00:36:23,440 --> 00:36:26,680 Their depression is very, very severe, 588 00:36:26,680 --> 00:36:30,600 but somehow they're able to trust us enough 589 00:36:30,600 --> 00:36:34,360 to do this quite unusual thing that could hurt as well as heal. 590 00:36:34,360 --> 00:36:37,040 That's when it can be more challenging. 591 00:36:37,040 --> 00:36:39,440 That's when the experience can feel really uncomfortable. 592 00:36:39,440 --> 00:36:42,080 VOICEOVER: We want to make sure people understand how intense 593 00:36:42,080 --> 00:36:44,760 it can be and how they might go through the most painful experiences 594 00:36:44,760 --> 00:36:47,160 of their life. They might be experiencing them again. 595 00:36:47,160 --> 00:36:48,320 It's unpredictable. 596 00:36:51,240 --> 00:36:53,440 Obviously, I was quite anxious. 597 00:36:59,320 --> 00:37:02,800 But, yeah, I kind of took it sort of one by one. 598 00:37:08,000 --> 00:37:11,000 And then there's a certain point where you're told to get yourself 599 00:37:11,000 --> 00:37:14,080 comfortable and you have the mask on, and earphones, 600 00:37:14,080 --> 00:37:16,000 and you're listening to music. 601 00:37:18,120 --> 00:37:20,680 You become extra sensitive to yourself, 602 00:37:20,680 --> 00:37:23,440 "Am I feeling anything, or is that just a suggestion?" 603 00:37:23,440 --> 00:37:24,960 Who knows? 604 00:37:28,720 --> 00:37:32,440 But for Nadine, there are no noticeable effects. 605 00:37:32,440 --> 00:37:35,240 After about 20 or 30 minutes, 606 00:37:35,240 --> 00:37:39,120 I realised that really, if anything, it was very, very minimal. 607 00:37:39,120 --> 00:37:41,520 I couldn't really tell. 608 00:37:43,960 --> 00:37:47,440 If there's too much anxiety or stress or anything, 609 00:37:47,440 --> 00:37:51,640 it's very easy for it to tip over quite quickly into a position 610 00:37:51,640 --> 00:37:55,120 where I feel I need to kind of shut down or remove myself. 611 00:37:57,080 --> 00:37:59,200 And at that point, I was encouraged 612 00:37:59,200 --> 00:38:02,120 to kind of stay with it for quite a while. 613 00:38:04,360 --> 00:38:07,600 Nadine is in the Escitalopram group. 614 00:38:10,040 --> 00:38:12,360 I was very, very upset. 615 00:38:12,360 --> 00:38:17,600 I felt extremely disappointed, angry at the trial, you know, 616 00:38:17,600 --> 00:38:20,000 like I'm not in a great place. 617 00:38:20,000 --> 00:38:21,960 And this makes me feel even worse. 618 00:38:27,640 --> 00:38:31,240 She heads home with a course of antidepressants. 619 00:38:31,240 --> 00:38:35,240 SSRIs work to increase serotonin in a part of the brain called 620 00:38:35,240 --> 00:38:36,480 the limbic system. 621 00:38:36,480 --> 00:38:38,320 That's the emotional circuit. 622 00:38:38,320 --> 00:38:41,360 And that system is overactive in depression. 623 00:38:41,360 --> 00:38:46,200 By dampening down that system, you become incubated against stress. 624 00:38:46,200 --> 00:38:49,480 You become more resilient to the turmoils of life. 625 00:38:49,480 --> 00:38:54,360 General practitioners usually very quickly turn to antidepressants. 626 00:38:54,360 --> 00:38:59,000 So I was put on antidepressants to help stabilise the situation, 627 00:38:59,000 --> 00:39:01,040 which they did do at the time. 628 00:39:01,040 --> 00:39:04,520 I mean, there are times when I felt so low, 629 00:39:04,520 --> 00:39:06,960 taking antidepressants felt like a life-saver. 630 00:39:09,080 --> 00:39:13,360 Escitalopram is one of the leading SSRIs available. 631 00:39:13,360 --> 00:39:17,080 In numerous medical trials, it has been shown to lift the depression 632 00:39:17,080 --> 00:39:19,760 of around half of sufferers. 633 00:39:19,760 --> 00:39:24,000 It takes up to six weeks to start working. 634 00:39:24,000 --> 00:39:27,440 But Robin and David believe that psilocybin works better 635 00:39:27,440 --> 00:39:28,920 and it works faster. 636 00:39:32,280 --> 00:39:35,160 So when we set out to do this study, we realised that we were comparing 637 00:39:35,160 --> 00:39:38,320 two very different kinds of treatment. 638 00:39:38,320 --> 00:39:41,840 Escitalopram, you know, you give on a regular basis day after day 639 00:39:41,840 --> 00:39:43,280 after day for six weeks. 640 00:39:43,280 --> 00:39:46,640 Psilocybin, you give a shot day one, 641 00:39:46,640 --> 00:39:49,080 and the next second shot three weeks later. 642 00:39:49,080 --> 00:39:53,840 So we're trying to collect data that reflect both of those approaches. 643 00:39:54,840 --> 00:39:57,080 So we're using standardised scores. 644 00:39:57,080 --> 00:39:59,120 There are standardised scores for depression. 645 00:40:01,160 --> 00:40:03,400 We're also using patient-related outcomes, 646 00:40:03,400 --> 00:40:05,480 because these are becoming more and more important. 647 00:40:05,480 --> 00:40:07,640 It's all very well for the doctor to say you're better, 648 00:40:07,640 --> 00:40:09,720 but, if you don't feel better, you're not better. 649 00:40:09,720 --> 00:40:12,120 And now I get to the data analysis, which is really exciting 650 00:40:12,120 --> 00:40:15,200 because we get all the results and see how everyone's been doing 651 00:40:15,200 --> 00:40:17,520 and what the science tells us. 652 00:40:17,520 --> 00:40:19,240 Hey, Bruna, how are you doing? 653 00:40:19,240 --> 00:40:21,480 I'm good, how are you? Yeah, I'm good, thanks. 654 00:40:21,480 --> 00:40:24,720 It's two-thirds of the way through the trial, 655 00:40:24,720 --> 00:40:28,680 and Robin is keen to see the data Bruna has collected so far. 656 00:40:28,680 --> 00:40:30,320 We have lots and lots of data. 657 00:40:30,320 --> 00:40:33,120 They start by looking at suicidality - 658 00:40:33,120 --> 00:40:35,480 how suicidal the two groups felt. 659 00:40:36,840 --> 00:40:39,120 This is escitalopram. OK. 660 00:40:39,120 --> 00:40:42,120 The score went from 168 to 173, 661 00:40:42,120 --> 00:40:43,920 so a minor increase. 662 00:40:43,920 --> 00:40:45,040 Yeah. 663 00:40:45,040 --> 00:40:48,600 So that shouldn't happen with a treatment that 664 00:40:48,600 --> 00:40:52,000 is meant to be a top antidepressant drug. Yeah. 665 00:40:52,000 --> 00:40:54,160 Why isn't suicidality dropping? 666 00:40:54,160 --> 00:40:55,800 So what happens with psilocybin? 667 00:40:55,800 --> 00:41:01,160 With psilocybin, it goes from 157 to 96, 668 00:41:01,160 --> 00:41:03,080 so it does drop by a lot. 669 00:41:04,560 --> 00:41:06,360 Which is amazing. You can say that again. 670 00:41:06,360 --> 00:41:08,080 Yeah. Wow. 671 00:41:08,080 --> 00:41:12,240 But the bar any new medicine has to cross is extremely high. 672 00:41:12,240 --> 00:41:14,680 They have to prove that the difference in performance 673 00:41:14,680 --> 00:41:19,960 between psilocybin and escitalopram is statistically significant. 674 00:41:19,960 --> 00:41:22,800 It's not significant. 675 00:41:22,800 --> 00:41:24,240 So... Are you kidding me? 676 00:41:24,240 --> 00:41:25,240 Yes, it is. 677 00:41:27,320 --> 00:41:30,800 Despite a notable difference, with the current data, 678 00:41:30,800 --> 00:41:32,960 the difference isn't yet great enough. 679 00:41:32,960 --> 00:41:36,000 It doesn't actually count as significant. 680 00:41:36,000 --> 00:41:38,320 Oh, are you sure that's right? 681 00:41:38,320 --> 00:41:40,640 That just... 682 00:41:40,640 --> 00:41:41,880 ..doesn't seem right to me. 683 00:41:41,880 --> 00:41:42,960 What I did was... 684 00:41:42,960 --> 00:41:44,320 In a drugs trial... 685 00:41:44,320 --> 00:41:45,720 ..this data here... 686 00:41:45,720 --> 00:41:48,200 ..the key is to eliminate doubt as much as possible. 687 00:41:48,200 --> 00:41:52,280 All of these statistical tests are about how do you deal 688 00:41:52,280 --> 00:41:54,560 with uncertainty, really. 689 00:41:54,560 --> 00:41:59,800 And so what you...what you're doing is you're testing your confidence 690 00:41:59,800 --> 00:42:02,560 in the result. 691 00:42:02,560 --> 00:42:07,680 That is not a result that you could have got through just random events. 692 00:42:09,120 --> 00:42:10,760 The data is promising, 693 00:42:10,760 --> 00:42:13,800 but for the trial to stand up to scientific scrutiny, 694 00:42:13,800 --> 00:42:15,440 it has to be bulletproof. 695 00:42:15,440 --> 00:42:17,280 OK, so the criticism's going to come back. 696 00:42:17,280 --> 00:42:19,480 I'm going to be... You know, if I was to criticise this, 697 00:42:19,480 --> 00:42:22,320 I'd say you've undervalued escitalopram, 698 00:42:22,320 --> 00:42:25,400 because we know, in the real world, it does work as a licensed drug. 699 00:42:25,400 --> 00:42:26,760 You've shown it works, right? 700 00:42:26,760 --> 00:42:29,680 Then people could say, really, you're telling someone 701 00:42:29,680 --> 00:42:34,080 and their son or daughter who is suicidal that they have to wait 702 00:42:34,080 --> 00:42:36,120 in order to get an improvement? Absolutely. 703 00:42:36,120 --> 00:42:38,920 And then their suicidality score might not even drop, you know. 704 00:42:38,920 --> 00:42:41,080 And they have to deal with the side effects as well... 705 00:42:41,080 --> 00:42:44,040 You've got to be very careful you don't say escitalopram doesn't work, 706 00:42:44,040 --> 00:42:46,080 because it clearly does work. It's got a licence. 707 00:42:46,080 --> 00:42:48,560 Escitalopram is seen as a gold standard 708 00:42:48,560 --> 00:42:50,320 in the treatment of depression. 709 00:42:50,320 --> 00:42:52,840 Psilocybin will have to prove its worth. 710 00:42:52,840 --> 00:42:54,040 I'm not defending it. 711 00:42:54,040 --> 00:42:56,680 I'm just saying that we need to have an answer to that criticism. 712 00:42:56,680 --> 00:42:58,600 I'm looking for weaknesses... Yeah. 713 00:42:58,600 --> 00:43:01,040 ..because everyone else is going to! 714 00:43:01,040 --> 00:43:02,720 Thanks, everybody. See you soon. 715 00:43:06,080 --> 00:43:08,040 To investigate the optimal way 716 00:43:08,040 --> 00:43:11,560 of delivering psilocybin as a treatment for depression, 717 00:43:11,560 --> 00:43:15,360 the team have included a second dose three weeks after the first. 718 00:43:19,840 --> 00:43:22,840 Prepping my mind for the second dosing session was tricky, 719 00:43:22,840 --> 00:43:28,960 because themes had come up that I needed to maybe focus on. 720 00:43:35,960 --> 00:43:37,880 I almost knew what was coming. 721 00:43:40,920 --> 00:43:44,800 I took the tablets, and it felt like it took a little bit longer 722 00:43:44,800 --> 00:43:46,360 for things to start to happen. 723 00:43:49,800 --> 00:43:53,920 I remember initially feeling very, very tense and uncomfortable. 724 00:43:58,320 --> 00:44:01,480 And, as the effects of the psilocybin grew, 725 00:44:01,480 --> 00:44:05,520 I suddenly had this really strong vision. 726 00:44:05,520 --> 00:44:09,160 It was this little boy trapped in a box, 727 00:44:09,160 --> 00:44:14,040 and he was banging on the side, saying, "Get me out, get me out." 728 00:44:14,040 --> 00:44:17,800 And this morphed into this white bird in a cage, 729 00:44:17,800 --> 00:44:20,560 and it was flapping its wings, obviously in distress, 730 00:44:20,560 --> 00:44:23,560 and I had this real sense that that was me. 731 00:44:25,040 --> 00:44:26,520 I felt trapped. 732 00:44:28,000 --> 00:44:31,840 I was an observer to a scene that I was also in, 733 00:44:31,840 --> 00:44:33,760 and that kind of felt kind of quite strange... 734 00:44:35,800 --> 00:44:38,480 ..but, then, in a breath, I realised 735 00:44:38,480 --> 00:44:44,320 that I could just open the cage and let the bird out. 736 00:44:48,800 --> 00:44:51,640 And that felt so easy. That bird didn't need to be trapped, 737 00:44:51,640 --> 00:44:53,720 and I didn't need to feel trapped. 738 00:44:53,720 --> 00:44:55,880 I had the power to just open that door 739 00:44:55,880 --> 00:44:59,040 and just let that bird fly free, and I became that bird. 740 00:45:02,000 --> 00:45:04,240 I flew high up into the sky and... 741 00:45:06,520 --> 00:45:10,320 ..and it was just this kind of beautiful moment of feeling free. 742 00:45:12,760 --> 00:45:17,840 The essence of why this model is good is because it sees pain 743 00:45:17,840 --> 00:45:21,760 as something to be learned from, not something to be ignored. 744 00:45:21,760 --> 00:45:25,160 So, rather than suppress pain, you open yourself up to engage with it 745 00:45:25,160 --> 00:45:27,400 so that you can process it, move on from it, 746 00:45:27,400 --> 00:45:29,200 and also learn from it. 747 00:45:32,280 --> 00:45:37,320 Talking therapy helps you believe something to be true. 748 00:45:37,320 --> 00:45:40,160 Psilocybin helps you know it to be true. 749 00:45:43,000 --> 00:45:45,640 And I think that's why I felt, in my case, 750 00:45:45,640 --> 00:45:48,400 psilocybin worked well for me, 751 00:45:48,400 --> 00:45:51,840 because it showed me so much that I now know to be true. 752 00:45:56,600 --> 00:46:00,080 I just feel so much more optimistic about things. 753 00:46:04,760 --> 00:46:07,880 I just feel a little bit more in charge of my own destiny, 754 00:46:07,880 --> 00:46:10,040 and I'm just really going to enjoy that ride, 755 00:46:10,040 --> 00:46:14,720 because I just have this new insight into life, 756 00:46:14,720 --> 00:46:16,720 and I just want to make the most of it. 757 00:46:22,320 --> 00:46:24,960 When she returns for her second session, 758 00:46:24,960 --> 00:46:28,040 Ali's been off antidepressants for over two months. 759 00:46:31,200 --> 00:46:34,000 I wouldn't have said I was, like, depression-free 760 00:46:34,000 --> 00:46:37,240 after the first dose, but I wouldn't have said I was unhappy. 761 00:46:42,320 --> 00:46:44,400 I was kind of determined to keep going with it, 762 00:46:44,400 --> 00:46:48,840 but I wasn't sure if I would be able to actually do it. 763 00:46:55,720 --> 00:46:57,400 Going through a psilocybin experience, 764 00:46:57,400 --> 00:46:59,800 it's a very courageous thing to do, so for somebody like Ali, 765 00:46:59,800 --> 00:47:01,040 having gone through that, 766 00:47:01,040 --> 00:47:03,280 it's the beginning of the journey for her, I think. 767 00:47:09,240 --> 00:47:12,560 The second time, I think I felt the effects quite quickly. 768 00:47:12,560 --> 00:47:15,440 The beginning was pretty terrifying, the second one. 769 00:47:17,880 --> 00:47:20,160 I felt like my whole body was humming 770 00:47:20,160 --> 00:47:22,960 and bits were being pulled off of me. 771 00:47:24,560 --> 00:47:27,240 I knew that was kind of me just dying 772 00:47:27,240 --> 00:47:28,840 or falling apart, I don't know. 773 00:47:31,320 --> 00:47:36,960 And then I had this sensation which was kind of like a claw on my head, 774 00:47:36,960 --> 00:47:38,400 and it was just pushing me down. 775 00:47:41,520 --> 00:47:45,320 I was kind of holding on to Ros and Ashleigh for dear life, I think. 776 00:47:49,480 --> 00:47:51,040 You can feel like you're dying. 777 00:47:51,040 --> 00:47:52,880 You can feel like you've lost everything. 778 00:47:52,880 --> 00:47:55,040 You can have some quite frightening encounters. 779 00:47:55,040 --> 00:47:57,840 And if, deep down, there is a bedrock of trust, 780 00:47:57,840 --> 00:48:01,160 then no matter how frightening things become, 781 00:48:01,160 --> 00:48:04,280 there is that sense of the foundations are there 782 00:48:04,280 --> 00:48:05,680 and you're safe. 783 00:48:10,680 --> 00:48:13,120 I kind of had to make a decision to go down this one tunnel, 784 00:48:13,120 --> 00:48:15,560 which looked pretty nasty. 785 00:48:19,520 --> 00:48:24,520 There were lots of these kind of like orbs of colours all around. 786 00:48:25,960 --> 00:48:29,680 And I realised those were kind of memories and people 787 00:48:29,680 --> 00:48:32,040 and things that had happened. 788 00:48:34,240 --> 00:48:38,160 I've always had this sort of fear that maybe I'm an awful person, 789 00:48:38,160 --> 00:48:41,320 but I think that was telling me that, like, "You're OK." 790 00:48:51,760 --> 00:48:54,440 And then I came across this one colour... 791 00:48:56,160 --> 00:48:58,160 ..and it was a really lovely purple colour. 792 00:48:59,640 --> 00:49:01,480 And that was my best friend, Laura, 793 00:49:01,480 --> 00:49:02,880 who died a couple of years ago. 794 00:49:07,000 --> 00:49:10,000 I spent a lot of time with her, which was really lovely. 795 00:49:15,600 --> 00:49:19,600 And I kind of cried so much that I became a river. 796 00:49:19,600 --> 00:49:23,440 Then Laura joined me, and we just flowed along together for, 797 00:49:23,440 --> 00:49:25,280 it felt like hours. 798 00:49:29,680 --> 00:49:32,920 I just felt really lovely to be with her, 799 00:49:32,920 --> 00:49:35,600 and I felt a lot of grief. 800 00:49:39,880 --> 00:49:43,320 I just really didn't want to leave, but I knew I'd have to. 801 00:49:52,160 --> 00:49:54,320 I realised, coming out of the second one, 802 00:49:54,320 --> 00:49:57,880 that a lot of my depression the last couple of years was actually grief. 803 00:49:59,760 --> 00:50:01,800 That's why i's really good to cry. 804 00:50:03,000 --> 00:50:07,080 I think I was stuck in that phase of grief, and through the 805 00:50:07,080 --> 00:50:10,960 second experience, I felt like I'm able to move through that. 806 00:50:13,000 --> 00:50:15,800 I felt like a new person afterwards. 807 00:50:15,800 --> 00:50:17,440 It was brilliant. 808 00:50:27,800 --> 00:50:30,840 In that afterglow period, people are very sensitive, 809 00:50:30,840 --> 00:50:34,160 and they they can be quite raw emotionally, as well. 810 00:50:34,160 --> 00:50:37,200 On the bus, you probably can have a little quiet weep, 811 00:50:37,200 --> 00:50:38,600 and nobody will notice. 812 00:50:38,600 --> 00:50:40,640 It's difficult for me to say goodbye to people, 813 00:50:40,640 --> 00:50:42,640 because they're often feeling much, much better, 814 00:50:42,640 --> 00:50:44,840 and they're feeling in a great place and are inspired. 815 00:50:44,840 --> 00:50:47,920 And then, unfortunately, what happens without further sessions 816 00:50:47,920 --> 00:50:51,160 or further therapy, people tend to close up again. 817 00:50:51,160 --> 00:50:54,360 And promise me you'll get in touch if you're feeling really wobbly. 818 00:50:54,360 --> 00:50:58,240 The ruminations, the negative thinking starts up again gradually, 819 00:50:58,240 --> 00:51:00,400 and then usually after about six months, 820 00:51:00,400 --> 00:51:03,160 people describe their depression has come back again. 821 00:51:06,760 --> 00:51:09,760 For most participants, this isn't a magic cure... 822 00:51:09,760 --> 00:51:11,680 Morning, folks. How you doing? 823 00:51:11,680 --> 00:51:13,680 Make yourselves comfortable. 824 00:51:13,680 --> 00:51:16,000 If you'd like to hang your jacket, there is a rack... 825 00:51:16,000 --> 00:51:20,240 ..but for some, the effects can last beyond six months. 826 00:51:20,240 --> 00:51:24,040 I'm better. I never thought I'd say that. 827 00:51:24,040 --> 00:51:26,560 Back at work at his cafe, 828 00:51:26,560 --> 00:51:31,360 Steve is in no doubt what Psilocybin therapy has done for him. 829 00:51:31,360 --> 00:51:35,000 ..just go to the website. Fantastic. There you go. 830 00:51:35,000 --> 00:51:36,480 I'm not cured. 831 00:51:36,480 --> 00:51:39,280 I don't know if there is a cure for depression, 832 00:51:39,280 --> 00:51:42,800 but I think I have a better understanding of my depression. 833 00:51:42,800 --> 00:51:44,800 OK, whoa. 834 00:51:44,800 --> 00:51:46,400 That's a beaut. 835 00:51:48,480 --> 00:51:52,920 Having a better understanding of it has helped me deal with it better, 836 00:51:52,920 --> 00:51:54,840 and that feels like progress. 837 00:51:54,840 --> 00:51:57,000 I didn't get your name. Gabrielle. 838 00:51:57,000 --> 00:52:01,440 All of a sudden, he was smiling much more, as if it had taken off 839 00:52:01,440 --> 00:52:03,360 a big heavy lid, like the lid of a pressure cooker, 840 00:52:03,360 --> 00:52:05,320 that had been pushed down on him. 841 00:52:05,320 --> 00:52:07,120 Oh, yes. 842 00:52:07,120 --> 00:52:08,760 Would you like a treat? 843 00:52:08,760 --> 00:52:10,560 Taken it off and said, "No, it's OK. 844 00:52:10,560 --> 00:52:13,240 "What's in there, it's OK. You can let it out." 845 00:52:17,640 --> 00:52:21,160 I mean, it's almost miraculous, it really is. 846 00:52:21,160 --> 00:52:22,880 It's extraordinary. 847 00:52:31,960 --> 00:52:36,560 So I'll try and sit as back as I can... 848 00:52:36,560 --> 00:52:39,080 Nadine was in the Escitalopram group, 849 00:52:39,080 --> 00:52:42,480 and it's been six months since she finished the trial. 850 00:52:51,160 --> 00:52:53,880 I decided to stay on the Escitalopram, 851 00:52:53,880 --> 00:52:58,480 because I didn't really have any particularly horrible side-effects. 852 00:53:02,760 --> 00:53:07,560 What I noticed was that I was able to make decisions. 853 00:53:09,200 --> 00:53:13,720 I mean, I can't describe what being able to make decisions means, 854 00:53:13,720 --> 00:53:16,400 you know, because it gives you agency. 855 00:53:18,480 --> 00:53:21,520 I'm really pleased I did the trial, because I think, apart from anything 856 00:53:21,520 --> 00:53:25,920 else, there was a strong sense of validation of your experience, 857 00:53:25,920 --> 00:53:28,960 which comes by being accepted onto a trial like this... 858 00:53:30,480 --> 00:53:33,080 ..and that's been really powerful. 859 00:53:45,440 --> 00:53:47,320 The trial is complete. 860 00:53:47,320 --> 00:53:50,640 Robin is visiting David Nutt with the full data set 861 00:53:50,640 --> 00:53:52,480 to discuss the results. 862 00:53:52,480 --> 00:53:54,080 Hi, good to see you. 863 00:53:54,080 --> 00:53:58,040 We got these forest plots with all of the main outcomes. 864 00:53:58,040 --> 00:54:01,280 The depression outcome's at the top. Right. 865 00:54:01,280 --> 00:54:02,720 It's the moment of truth. 866 00:54:02,720 --> 00:54:06,160 OK, so we chose the self reported core depressive symptoms 867 00:54:06,160 --> 00:54:09,240 to be the primary outcome because we believe that the patient 868 00:54:09,240 --> 00:54:12,000 should be the person that tells you whether they're better off. 869 00:54:12,000 --> 00:54:14,680 The most important result in this study is the measure 870 00:54:14,680 --> 00:54:17,520 of the participants' self-reported depression scores. 871 00:54:17,520 --> 00:54:19,160 Better sexual functioning... 872 00:54:19,160 --> 00:54:23,120 These results reveal how effective each drug is at reducing 873 00:54:23,120 --> 00:54:24,800 the core symptoms of depression. 874 00:54:24,800 --> 00:54:28,920 It was much faster, the response with Psilocybin therapy. 875 00:54:28,920 --> 00:54:30,840 And that's actually interesting. 876 00:54:30,840 --> 00:54:34,480 Really rapidly, the patients reported a very powerful 877 00:54:34,480 --> 00:54:36,640 immediate effect, which is Psilocybin. 878 00:54:36,640 --> 00:54:40,280 It's just that Escitalopram caught up after six weeks. Yeah. 879 00:54:40,280 --> 00:54:43,440 The results suggest that Psilocybin is as effective 880 00:54:43,440 --> 00:54:46,680 as the antidepressant in reducing depression... 881 00:54:46,680 --> 00:54:48,400 Work and social functioning... 882 00:54:48,400 --> 00:54:51,200 ..and some of the other findings are even more promising. 883 00:54:51,200 --> 00:54:53,920 ..psychological flourishing, 884 00:54:53,920 --> 00:54:56,760 anxiety decreases more with Psilocybin. 885 00:54:56,760 --> 00:55:00,840 Remission rates, so no longer having depression. Right. 886 00:55:00,840 --> 00:55:04,080 That was 60% no longer having depression. At six weeks? 887 00:55:04,080 --> 00:55:06,720 At six weeks. 60% remitted at six weeks? 888 00:55:06,720 --> 00:55:10,760 Yeah. With Psilocybin, it was 30%. With Escitalopram... Twice as many? 889 00:55:10,760 --> 00:55:12,080 Yeah. Impressive. 890 00:55:12,080 --> 00:55:15,360 So we've got three or four depression rating scales 891 00:55:15,360 --> 00:55:17,560 significantly favouring Psilocybin. 892 00:55:17,560 --> 00:55:20,080 Wow. Yeah, very exciting. It is. 893 00:55:25,000 --> 00:55:29,920 With a sample size of 59, and only six weeks' worth of data, 894 00:55:29,920 --> 00:55:33,080 larger and longer trials are still needed, 895 00:55:33,080 --> 00:55:36,120 yet this trial clearly demonstrates the scientific worth 896 00:55:36,120 --> 00:55:38,200 of further research. 897 00:55:38,200 --> 00:55:41,760 What we've got here is the best proof yet of what I've been saying 898 00:55:41,760 --> 00:55:45,960 for 15 years, which is it is ridiculous to deny 899 00:55:45,960 --> 00:55:48,920 access of Psilocybin. 900 00:55:48,920 --> 00:55:50,760 It is a different way of treating depression, 901 00:55:50,760 --> 00:55:52,400 and that's hugely important. 902 00:55:54,640 --> 00:55:56,480 There is still a long way to go 903 00:55:56,480 --> 00:55:59,600 before this treatment is available in the UK. 904 00:55:59,600 --> 00:56:02,920 Mass testing will need to prove that Psilocybin, 905 00:56:02,920 --> 00:56:06,840 in combination with psychotherapy, is both safe and effective 906 00:56:06,840 --> 00:56:10,360 in the long term before government regulators can approve it 907 00:56:10,360 --> 00:56:11,920 for medical use. 908 00:56:15,960 --> 00:56:20,640 In Bristol, a year after taking part in the psychedelic drug trial, 909 00:56:20,640 --> 00:56:23,160 Ali's life has changed. 910 00:56:23,160 --> 00:56:27,360 I went back to work three days after I finished the trials. 911 00:56:27,360 --> 00:56:31,160 I'd been off work for nearly a year at that point. 912 00:56:34,360 --> 00:56:37,080 Just the last few months, I've actually started really enjoying 913 00:56:37,080 --> 00:56:39,800 work again and not dreading it, which is really lovely. 914 00:56:41,360 --> 00:56:45,520 Ali's depression hasn't gone, but it is more manageable. 915 00:56:45,520 --> 00:56:48,840 Now that I've experienced being depressed since the trial, 916 00:56:48,840 --> 00:56:51,720 and come out of it myself, that feels huge. 917 00:56:53,320 --> 00:56:57,240 I know I can deal with it now, so I'm really lucky. 918 00:56:57,240 --> 00:57:01,480 I just hope that it can become treatment that's accessible. 919 00:57:01,480 --> 00:57:04,560 I always think about my best friend Laura. 920 00:57:04,560 --> 00:57:07,560 There's just a lot of people struggling. 921 00:57:09,640 --> 00:57:12,800 I feel really confident that Psilocybin, when used 922 00:57:12,800 --> 00:57:16,520 in a scientific container with therapeutic support 923 00:57:16,520 --> 00:57:19,800 and great care for screening, and everything else that we did, 924 00:57:19,800 --> 00:57:22,840 that its effectiveness has been shown to me. 925 00:57:22,840 --> 00:57:26,920 Hopefully in future, things will move towards creating 926 00:57:26,920 --> 00:57:28,760 a fuller kind of therapeutic programme 927 00:57:28,760 --> 00:57:31,320 using Psilocybin therapy as its heart. 928 00:57:31,320 --> 00:57:33,480 Oh, that's a great response. 929 00:57:35,400 --> 00:57:38,000 One of the reasons I'm sitting here is that I think 930 00:57:38,000 --> 00:57:40,280 it's the way forward. 931 00:57:42,080 --> 00:57:44,120 More change has got to come. 932 00:57:44,120 --> 00:57:47,160 It's inevitable. That's the way I feel about it. 933 00:57:48,400 --> 00:57:51,360 I think if the government really wants to do something 934 00:57:51,360 --> 00:57:53,680 to help mental health and help the NHS, 935 00:57:53,680 --> 00:57:57,320 they can't ignore this as a potential treatment. 936 00:57:57,320 --> 00:57:59,040 It's changed my life. 937 00:58:01,840 --> 00:58:03,040 I just feel really grateful, 938 00:58:03,040 --> 00:58:06,880 and I'm ready to go another long, interesting life.