Background on Climate Mental Health and Psychedelic Therapy Research

Written By Emily Willow

In my recent piece for the Washington Post on the intersection of climate mental health and psychedelic therapies, there were many things that didn’t make it into the final draft. Through the months long process of researching, thinking, planning, writing, editing and writing more, I realized how much more I have to share and also how much more I have to learn. Below you’ll find a bit of the background research on the field of climate mental health and psychedelic therapy clinical trials.

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How climate change affects mental health

Mounting research is highlighting the effects of climate change on mental health and the exploration of this phenomenon has led to the emergence of a new area of psychiatry and psychology. Climate mental health refers to the intricate relationship between climate change and the psychological well-being of individuals and communities. In an era marked by the undeniable impacts of global warming and extreme weather events, such as orange skies filled with wildfire smoke or enduring weeks of record-breaking temperatures, mental health has become a vital aspect of our response to these challenges. It encapsulates a broad spectrum of emotional and psychological responses to the changing climate, ranging from heightened anxiety and stress related to the uncertainties of the future to more profound existential concerns about the fate of the planet and its ecosystems.  It’s also important to note that climate mental health is not limited to anxiety about the future of our species and our planet. This field also looks to address the mental health consequences of displacement from extreme weather events, the mental health consequences of wildfire smoke, and the impact on vulnerable populations such as the unhoused and the severely mentally ill (who are negatively and disproportionately impacted by the local effects of climate change). Climate mental health also encompasses the anxiety and sense of powerlessness individuals can experience stemming from a displaced emphasis on personal responsibility and action, rather than the larger responsibility of corporations and governmental policy-making. 

In response to this growing need for support, an increasing number of mental health professionals are dedicating their careers to not only supporting patients grappling with what we are now naming eco-anxiety and climate grief, but also to educating and raising awareness more widely about the mental health consequences of climate change. At its root, this emerging field recognizes the interconnectedness of planetary health and mental health, acknowledging that the well-being of individuals is intimately linked to the health of the environment.  Organizations like the Climate Mental Health Network [1] and the Climate Psychiatry Alliance are the first of their kind in the United States to address these unique mental health impacts. Through educational resources for both care providers and patients, as well as directly engaging with communities, these organizations can help individuals feel supported and emotionally resilient.  

Climate grief and eco-anxiety are unlike other issues in psychiatry because the feelings extend to something greater than ourselves and our personal narrative, so understanding the context of these issues is an important part of supporting these patients appropriately. The impact of this can be profound and can mimic a type of trauma response or grief.  It’s in this unique space of supporting grief and trauma response where psychedelic therapies may have a growing role in relation to climate change. 

What research says about the safety, efficacy of psychedelics

Over the last decade, there has been a surge in research into psychedelic therapies to treat psychiatric illnesses such as depression and post-traumatic stress disorder, for which there haven’t been new treatments since the 1990s. Leading universities such as Johns Hopkins University [2], University of California at San Francisco [3] , New York University [4], and Yale University [5] have established dedicated research centers, contributing rigorous studies and attracting the attention of the broader medical community.

In recent years, numerous clinical trials have shown that psychedelic [6] therapies, namely psilocybin and 3,4-methylenedioxy-methamphetamine (MDMA), are safe and effective for conditions such as PTSD [7], depression [8], end-of-life anxiety [9], and alcoholism. [10] Results from a second, confirmatory Phase 3 clinical trial, published in Nature in July [11], marked a monumental step forward for MDMA-assisted therapy, bringing it closer to approval from the Food and Drug Administration, which could be as early as 2024.

While MDMA and psilocybin are not yet FDA approved, one notable medication already available is ketamine, [12]  which is a dissociative anesthetic with psychedelic properties. Ketamine is being used “off label” in clinical practices as a treatment for depression, often in conjunction with psychotherapy using a similar approach to MDMA and psilocybin treatment.

It’s also important to note that psychedelic therapies are not for everyone.  There are medical and psychiatric contraindications and they vary depending on the type of psychedelic medicine being considered.  If you’re interested in psychedelic therapy, check with your doctor to help determine if they are a safe and appropriate option for you.  

Recommended Resources:

References:

  1. https://www.climatementalhealth.net/mission

  2. Hopkins - Griffiths RR, Johnson MW, Carducci MA, Umbricht A, Richards WA, Richards BD, Cosimano MP, Klinedinst MA. Psilocybin produces substantial and sustained decreases in depression and anxiety in patients with life-threatening cancer: A randomized double-blind trial. J Psychopharmacol. 2016 Dec;30(12):1181-1197. doi: 10.1177/0269881116675513. PMID: 27909165; PMCID: PMC5367557.

  3. UCSF - Mitchell JM, Bogenschutz M, Lilienstein A, Harrison C, Kleiman S, Parker-Guilbert K, Ot'alora G M, Garas W, Paleos C, Gorman I, Nicholas C, Mithoefer M, Carlin S, Poulter B, Mithoefer A, Quevedo S, Wells G, Klaire SS, van der Kolk B, Tzarfaty K, Amiaz R, Worthy R, Shannon S, Woolley JD, Marta C, Gelfand Y, Hapke E, Amar S, Wallach Y, Brown R, Hamilton S, Wang JB, Coker A, Matthews R, de Boer A, Yazar-Klosinski B, Emerson A, Doblin R. MDMA-assisted therapy for severe PTSD: a randomized, double-blind, placebo-controlled phase 3 study. Nat Med. 2021 Jun;27(6):1025-1033. doi: 10.1038/s41591-021-01336-3. Epub 2021 May 10. PMID: 33972795; PMCID: PMC8205851.

  4. NYU - Ross S, Bossis A, Guss J, Agin-Liebes G, Malone T, Cohen B, Mennenga SE, Belser A, Kalliontzi K, Babb J, Su Z, Corby P, Schmidt BL. (2016). Rapid and sustained symptom reduction following psilocybin treatment for anxiety and depression in patients with life-threatening cancer: a randomized controlled trial. J Psychopharmacol. 2016 Dec;30(12):1165-1180.

  5. Yale - Savalia NK, Shao LX, Kwan AC. A Dendrite-Focused Framework for Understanding the Actions of Ketamine and Psychedelics. Trends Neurosci. 2021 Apr;44(4):260-275. doi: 10.1016/j.tins.2020.11.008. Epub 2020 Dec 21. PMID: 33358035; PMCID: PMC7990695.

  6. Psychedelic therapies - Hendricks, P., Nichols, C., Cunningham, K, Geyer, M., Griffiths, R, Nichols, D. (2022). Past, present, and future of psychedelics: A Psychedelic Medicine roundtable discussion. Psychedelic Medicine. Published Online. October 28, 2022.

  7. MDMA PTSD meta analysis - Ching TH, Williams MT, Wang JB, Jerome L, Yazar-Klosinski B, Emerson A, Doblin R. MDMA-assisted therapy for posttraumatic stress disorder: A pooled analysis of ethnoracial differences in efficacy and safety from two Phase 2 open-label lead-in trials and a Phase 3 randomized, blinded placebo-controlled trial. J Psychopharmacol. 2022 Aug;36(8):974-986. doi: 10.1177/02698811221104052. Epub 2022 Jun 21. PMID: 35727042.

  8. Psilocybin depression - Gukasyan N, Davis AK, Barrett FS, Cosimano MP, Sepeda ND, Johnson MW, Griffiths RR. Efficacy and safety of psilocybin-assisted treatment for major depressive disorder: Prospective 12-month follow-up. J Psychopharmacol. 2022 Feb;36(2):151-158. doi: 10.1177/02698811211073759. PMID: 35166158; PMCID: PMC8864328.

  9. End of life anxiety - Griffiths RR, Johnson MW, Carducci MA, Umbricht A, Richards WA, Richards BD, Cosimano MP, Klinedinst MA. Psilocybin produces substantial and sustained decreases in depression and anxiety in patients with life-threatening cancer: A randomized double-blind trial. J Psychopharmacol. 2016 Dec;30(12):1181-1197. doi: 10.1177/0269881116675513. PMID: 27909165; PMCID: PMC5367557.

  10. Alcoholism - Bogenschutz MP, Ross S, Bhatt S, et al. Percentage of Heavy Drinking Days Following Psilocybin-Assisted Psychotherapy vs Placebo in the Treatment of Adult Patients With Alcohol Use Disorder: A Randomized Clinical Trial [published correction appears in JAMA Psychiatry. 2022 Sep 14;:]. JAMA Psychiatry. 2022;79(10):953-962. doi:10.1001/jamapsychiatry.2022.2096

  11. MDMA nature 2023 - Mitchell JM, Ot'alora G M, van der Kolk B, Shannon S, Bogenschutz M, Gelfand Y, Paleos C, Nicholas CR, Quevedo S, Balliett B, Hamilton S, Mithoefer M, Kleiman S, Parker-Guilbert K, Tzarfaty K, Harrison C, de Boer A, Doblin R, Yazar-Klosinski B; MAPP2 Study Collaborator Group. MDMA-assisted therapy for moderate to severe PTSD: a randomized, placebo-controlled phase 3 trial. Nat Med. 2023 Oct;29(10):2473-2480. doi: 10.1038/s41591-023-02565-4. Epub 2023 Sep 14. PMID: 37709999; PMCID: PMC10579091.

  12. https://www.washingtonpost.com/wellness/2022/09/12/ketamine-therapy-explained/

Emily Willow
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Reflections from Psychedelic Science 2023 Conference