2 karmaJoined May 2021


Long comment; TLDR at the bottom.


Thank you all for doing this AMA. You three have done incredible things for the world of psychedelics. Michael—I loved How to Change Your Mind  and I'm looking forward to getting my hands on This is Your Mind on Plants when it comes out. Tim—I love your podcast and have been listening to it almost daily for the past two months. Dr. Johnson—your podcast with Lex Fridman was incredible.  


The question:


What are your thoughts on someone with Bipolar 1 taking psychedelics for non-therapeutic purposes? Assuming the person is on proper medication and has been very stable for several years, would it be relatively safe for them to take a psychedelic (psilocybin and to a lesser degree LSD in particular)? The intention would be an attempt at occasioning a mystical/spiritual experience, exploration of the self and mind, and as  Bob Jesse put it, the "betterment of a well person." You can also assume the individual has done significant research on the impact of set and setting, dosage, and read about the experiences of other people on these compounds. Would it be a good idea to start with 1-2 grams of mushrooms to gauge the experience? Would it be better to find an experienced guide like Michael did in How to Change Your Mind ? Do you think they would work with someone someone who has well managed Bipolar?å


Tim—You have mentioned you dealt with Bipolar (type 2) in the past and I'm wondering if could  shed some light on whether or not you think the potential benefits outweigh the risks?


Dr. Johnson—What does the risk profile look like for someone with well-managed Bipolar 1 when taking a psychedelic? I know the occasioning of a manic episode and to a lesser extent a psychotic break are the main risk factors, but how much of the risk would be mitigated by proper medication and years of stability? Have you ever met anyone with bipolar 1 who has taken psychedelics? 

(The medications are lamotrigine and bupropion—both of which have no known interactions with psychedelics). 


Michael—Given your work with experienced guides, do you think any of the underground professionals would accept someone with well-managed bipolar? Do you think working with a guide would help mitigate risk in this scenario? 


TLDR: What are your thoughts on someone with well managed Bipolar 1 taking psychedelics (psilocybin and to a lesser extent LSD in particular)? If the person is on the proper medication and has been very stable (0 episodes in either direction) for several years, would the level of risk be reduced to a level that taking a psychedelic would be acceptable? The goal of the trip would be the exploration of the mind and the "betterment of a well person," as Bob Jesse says—not treatment for Bipolar disorder. Would underground professionals work with someone who has well-managed Bipolar? If not, would trying a relatively low dose of 1-2 grams of mushrooms to gauge the experience without a professional guide be a good idea?