Microdosing 101

Microdosing for Anxiety: Context and Considerations

We explore the science and research behind microdosing for anxiety and why alleviating symptoms of anxiety, as well as recommendations for best practices and things to avoid.

15
Min read
Rima Danielle Jomaa, MFT
March 29, 2023

Chances are, you’ve heard the recent excitement surrounding microdosing and all of its potential benefits. The reasons that you may choose to microdose are many. In this article, we explore the science and research behind microdosing for anxiety and why alleviating symptoms of anxiety or treating anxiety may be two of those reasons you have for wanting to microdose.

First, it’s important to understand what microdosing is, so let’s start there.

What is Microdosing?

At Retreat, we understand microdosing to be the consumption of a sub-perceptual dose of psychedelics, typically psilocybin mushrooms or LSD. People have microdosed countless various substances throughout history, including other psychedelics, herbs, spices, other plants, and more.

At Retreat, we focus on supporting those in learning about psilocybin microdosing, but we often reference and include research and studies on other types of psychedelics in both micro, recreational, and macro journeys.

A typical microdosing protocol asks you to ingest the substance a few mornings a week for the duration of several weeks for therapeutic benefits. One common rationale behind why you might choose to microdose is that you can get the mental health benefits offered by the psychedelic medicine without experiencing the hallucinogenic high, in a similar way as to why a person may choose CBD (which doesn’t produce a high but provides all of the medicinal benefits of marijuana) over a full-spectrum cannabis product (which includes THC and produces a high).

How Much is a Microdose?

What constitutes a microdose varies based on the substance used. Because we are focusing on psilocybin, we will explore just how many grams or parts of a gram a microdose is. To review, microdosing is commonly known as the act of taking a miniscule dose of psilocybin mushrooms. To be considered a microdose, you would take 1/10th to 1/20th of a macrodose. For comparison, a MACROdose could be anywhere from 0.5 to 5 grams, so a MICROdose is anywhere from 0.05 grams to 0.5 grams although 0.1 to 0.2 grams is the most common range. 0.5 grams could potentially produce high-like effects if the batch is very strong or if you are sensitive to certain substances so be mindful of exactly how much you are ingesting.

The Science Behind Psychedelics

In 1938, Albert Hofmann first synthesized lysergic acid diethylamide (LSD-25) in a laboratory, but psychedelic plants and fungi have been used by various indigenous traditions for medical reasons for millennia. It’s not until the 1950s, however, that modern-days scientists began researching psychedelics on a deeper level. Hofmann was also the first person to ingest his creation and later on, in the 1950s and 1960s, scientific and cultural interest into psychedelics exploded before the process of heavy regulation started in the 1970s and 1980s. 

Both private and public institutions and investors from all walks of life are showing interest in studies and clinical trials. Whether it's MDMA or psilocybin, PTSD or anxiety, there are studies being done seeking to understand more about the connections between psychedelics and mental health. For another great overview, Carhart-Harris and Goodwin explore the various therapeutic potentials that psychedelics have played in the past, present, and future in their article and include more history, as well.

Madsen et al. has shown that psychedelic effects might emerge through the stimulation of serotonin 2A receptors (5-HT2ARs) by psilocybin's active metabolite, psilocin. They reported the relationship between the intensity of psychedelic effects, cerebral 5-HT2AR occupancy, and plasma levels of psilocin in humans.

Two 2017 studies from Science Daily and from Cell found how the perception of meaning changes under the influence of LSD and that serotonin 2A receptors are responsible for altered perception. Stimulation of serotonin 2A receptors has been found to decrease activity in the default mode network of the brain. The Default Mode Network (DMN) is known as “the orchestra conductor of the brain because other parts of the brain interact with each other through it." Clinically, it mediates cyclical thinking, our patterns, and the mind’s ability to ruminate, all factors that contribute to anxiety when not in balance. It is found to be less active in long-term meditators and with psychedelic use. The idea of the DMN is a relatively new concept in neuroscience but dampening of it is thought to be what leads to the mental health benefits of psychedelics. Rewiring the  DMN with psychedelics might explain many of the benefits that psychedelic users often experience.

Carhart-Harris and his colleagues have conducted various studies looking into the effects of psilocybin on the brain and on mental illness. One study they conducted used MRI technology to capture the transition from normal waking consciousness to the psychedelic state. Their results suggest that the state of unconstrained cognition that results in the subjective effects of psychedelic drugs are created by decreased activity and connectivity in the brain's key connector hubs.

Microdosing vs Macrodosing: What’s the Difference?

Microdosing is a smaller dosage of a substance (as you read above) that is usually LSD or psilocybin mushrooms, which are naturally occurring.  Whereas a macrodose refers to the full dose or the hallucinogenic dose of the substance. A macrodose is one that produces the classic psychedelic effects of whatever you’re taking. There are benefits to both styles of using psychedelics but  both also require knowledge, patience, and support from a professional throughout the process. If taking a macrodose is something you’re considering, we recommend you have a responsible sitter, guide, or therapist with you to ensure your mental and physical safety.

The Science Behind Macrodosing

Most of the research on psychedelics up till now has been on macrodoses for various reasons (the highly regulated nature of psychedelics since the 1970s, research focusing on more severe conditions, such as PTSD and depression, with macrodoses, and because microdosing happens over time, it’s more challenging to observe the effects in a controlled laboratory setting as researchers can do with a supervised macrodose which takes place over the span of hours instead of weeks). Therefore, much of what was said above about psychedelics applies here to macrodosing.

The Science Behind Microdosing

Lead mycologist Paul Stamets recently published a study on microdosing and their ongoing research, which can be joined here.

Rootman and his colleagues compared those who microdose psychedelics (mainly psilocybin) versus those who don’t and their levels of anxiety and depression. They looked at a range of microdosing practices in terms of dosage, frequency, and stacking (like with Stamets Stack protocol). Their results indicate health and wellness motives and perceived mental health benefits among microdosers, but they also highlight the priority in the field for further research into the mental health consequences of microdosing.

For a summary of the empirical research on microdosing published in 2022, check out Polito and Liknaitzky’s paper - “The emerging science of microdosing: A systematic review of research on low dose psychedelics (1955-2021) and recommendations for the field”. They looked at mood and mental health, well-being and attitude, cognition and creativity, personality, changes in the conscious state, and neurobiology and physiology.Overall, numerous reports show positive changes in cognitive processing and mental health.

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What Psychedelics are Good for Anxiety?

Researchers have been seriously studying the effects of psychedelic drugs on mood disorders, such as anxiety and depression, for about 15 years. A study published in the Journal of Psychopharmacology in 2016 by Ross et al. looked at the effects of psilocybin on anxiety and depression symptoms in patients with cancer. They found that “psilocybin produced immediate, substantial, and sustained improvements in anxiety and depression and led to decreases in cancer-related demoralization and hopelessness, improved spiritual wellbeing, and increased quality of life” (Ross et al.). Around 60 – 80% of participants found relief from their depression or anxiety, sustained benefits in existential distress and quality of life, as well as improved attitudes towards death in a 6-month follow up. Furthermore, the researchers found that the mystical experience that mushrooms produce mediated the therapeutic effect of psilocybin on anxiety and depression. They found that psychotherapy, in conjunction with psilocybin, brought these fast, powerful and long-lasting effects.

This paper published in Molecules in 2022 summarizes the therapeutic potential of psychedelic substances such as ayahuasca, DMT, LSD, MDMA, and psilocybin “as alternative therapeutic options for mood and anxiety disorders in a controlled, clinical setting, where the chances of adverse psychological episodes occurring are mitigated” (Lowe et al.). Psilocybin is one of the active ingredients in over 200 species of psilocybin fungi. And while just about every psychedelic can produce mental health benefits when sourced and taken in a safe and supportive way, we focus on microdosing psilocybin.

Can Psychedelics Give You Anxiety?

Psychedelics, and microdosing is an amplifier: it will amplify whatever is going on within you—bringing up trauma, surfacing challenges, and helping you work things out—if you create the structure, support, and process to do so. So, if you are feeling particularly anxious, microdosing may amplify that. Or, if you are slightly prone to anxiety and drink coffee, you may experience anxiety. 

Some people have reported an increase in anxiety symptoms when microdosing. Mushrooms can be very activating and depending on your sensitivity, mushrooms have a tendency to highten things that you’re already feeling. This can be due to many factors including the effects of the mushrooms themselves, caffeine intake, how you sleep, when you take your microdose (morning or night), how much you take, other events going on in your life, and more.

If you’ve previously taken psychedelics for recreational purposes and experienced increased anxiety, or if you suffer from severe symptoms of anxiety (such as anxiety attacks), microdosing may not be for you. If you’re unsure about your decision to microdose or not, it’s best to wait until you’re 100% sure as you are the best expert on you and there’s no need to rush into this. Take your time, do your research, and get a solid support system first to understand more about the common outcomes that can occur.

Additionally, microdosing while engaging in other anxiety-enducing substances, such as coffee and alcohol, will likely create anxiety. 

No matter what, taking a microdose is not a “quick fix” and will require you to do the work. It doesn’t mask your symptoms like a traditional pharmacuetical might do, so feeling an increase in anxiety for awhile as you work with a therapist to feel into it, release it, process it, and move on might be what’s needed. To work through your comfort zone means being uncomfortable (by definition) so focus on what you can do for yourself during this time, like eating well, getting lots of sleep, drinking plenty of water, exercising, and meditating regularly. Keep alcohol and caffeine intake to an absolute minimum (eliminating both, if possible) to help your chances of getting the benefits of microdosing.

Refer to our guide on dosage to understand more about what to take, how much and tips to source it safely. If your doctor is open to talking to you about microdosing for anxiety, talk to them before taking psychedelics or find a doctor that will talk to you about it.

Psychedelics vs SSRIs, Benzodiazepines & Beta Blockers

Three of the most commonly prescribed medications for anxiety include selective serotonin reuptake inhibitors (SSRIs), benzodiazepines (Xanax), and beta blockers.  It’s not uncommon for someone to want to give microdosing a try after years of being on traditional medications only to find no long-term relief. One of the most common complaints of these medications is that they numb your anxiety symptoms but they’re not great at helping patients treat the root cause of their anxiety. They’re often perscribed by a medical doctor or psychiatrist who barely knows the person and doesn’t spend much time with them. Unless you actively seek therapy on your own and do your personal work alongside the medications, it’s unlikely you will experience true relief from your mental health struggles over time.

What Do SSRIs Do?

SSRIs have been proven effective at reducing the symptoms of anxiety. These drugs help to prevent the absorption of serotonin into neurons and they help your serotonin neurons more effectively transmit messages between each other. Since serotonin is the chemical that’s related to mood (amongst other things), increased connection between serotonin neurons can lead to a more relaxed and happier mood.

While this may provide temporary relief and make life more manageable in the short-term, there are a few downsides when it comes to SSRIs. 

It can take around a month to start feeling the effects of SSRIs. Plus, these drugs are also linked to numerous negative side effects, such as agitated, anxious feelings. 

What Benzodiazepines Do?

Benzodiazepines, referred to colloquially as benzos, work on the gamma-aminobutyric acid (GABA) receptors of the brain, producing a slowing of the central nervous system (CNS), which in turn induces a state of relaxation to the user. Benzos are relatively fast-acting and are known to provide quick relief to anxiety symptoms.

What Do Beta Blockers Do?

Beta blockers work by blocking different stress-related chemicals, like norepinephrine and epinephrine (adrenaline), from binding to the different beta receptors in the heart that receive messages from these chemicals. By doing so, the beta blocker reduces the amount of adrenaline rushing into the heart and slows the rate and intensity of the heartbeat.

Psychedelics or Common Anxiety Medications?

When it comes to choosing psychedelics to treat your anxiety or choosing the pharmacuetical route, there’s no one-choice-fits-all solution. If someone does claim to have all the answers, you’d better run for the hills. Ultimately, we believe you are the only one who can make medical decisions about your body and your mental health—and we encourage you to speak with a doctor and therapist. 

Humans have been using benzodiazepines, beta blockers, and SSRIs for decades to control their symptoms of anxiety. The effects of these medications (including the side effects) are well-documented. They’re not proving to withstand the test of time when it comes to anxiety relief as more and more people are looking beyond the “take a pill and forget about it” approach to wanting holistic, real-life solutions that provide valuable relief in their lives for the long run.

One of the best parts of using psychedelics is that, in psychedelic macrodosing trials, researchers found that participants didn’t need to continue treatment indefinitely to reap the benefits (like with traditional anxiety medications). Yet when it comes to microdosing for anxiety, we are lacking the hard data to show that this type of treatment can control anxiety long-term. For now, we will rely on the data from macrodosing studies and anecdotal evidence that microdosing has been effective in reducing symptoms.

Microdosing With Psychotherapy

As you’ve learned throughout this article, the more time, space, and energy that you put into your healing journey while using psychedelic medicine, the more benefits you will experience throughout your journey. This is true for both macro journeys and microdosing.

One big, important way to put a lot of energy into your healing is to work one-on-one weekly with a licensed psychotherapist before, during and after your microdosing experience. Whether or not they’re an expert in microdosing is as important as how you feel about working with them. Find someone who you trust, is supportive, is attentive, and is proactive in helping you address uncomfortable situations that come up as a result of microdosing and everyday life.

You may have heard of the term “Psychedelic Integration”, which usually refers to a process that’s done with a professional like a counselor or therapist who’s versed in psychedelic therapy. It can look similar to traditional talk therapy but with a deeper understanding of how psychedelic medicine, or in this case microdosing, plays into the growth process. If you’re already in therapy now, it’s important to share with your therapist that you will be microdosing. They may or may not ask you to get the support of another professional if they’re not sure on how to support you (which is totally normal in therapy).

How to Microdose for Anxiety

These are a few tips on how to microdose for anxiety, but be sure to check out our Free Guide to Microdosing and our Microdosing  Concierge PRogram for more in-depth information.

  1. Speak to a professional. Talk to the professionals in your life and/or find some who can support you during this process. Build community!
  2. Start low, go slow. Take only 5% to 10% of a full dose of psilocybin (a full dose is anywhere from 0.5 to 5 grams). We recommend starting at 0.1 gram or less for your first time as an exploratory dose to see how you react to it.
  3. Choose a microdosing protocol. Set up a microdose schedule—choose either the Stamets Stack or the Fadiman Protocol to start off and you can make adjustments based on your experience.
  4. Track your results. Use a mood tracking app or chart to understand how your moods shift overtime with microdosing. Also take note of the days you microdose, how much you take, when, and more. Become a scientist on you.
  5. Monitor and adjust your dosage. If you microdose for a few days in a row, you can increase dosage and then start back at your baseline on day 1 after taking a few days off (for tolerance purposes).

Risks of Microdosing for Anxiety

Although it’s rare for users to have a negative experience with microdosing, it is possible that side effects can occur. To be clear, when microdosing, you will only consume a sub-perceptible dosage, which means that you will not feel any psychedelic or hallucinogenic effects from the medicine. Microdosing is not appropriate for everyone, especially if the person is extremely sensitive to the effects of psychedelic compounds. No one should start a microdose regimen without first consulting a medical professional.

Schizophrenia or Severe Anxiety Disorders

If you suffer from a severe mental illness or are on antidepressants, you should be sure that you raise this in your consultation with your doctor before taking psilocybin. For people with a history of psychotic disorders, specifically schizophrenia, and bipolar disorder, microdosing is not recommended—in fact it’s strongly discouraged. For people with severe anxiety disorders, you may experience worsened anxiety symptoms, though for many people, microdosing reduces anxiety.

Patients taking SSRIs or other antidepressants are usually asked to stop taking their medications before engaging in clinical trials with psychedelics (or they’re not accepted into the trial because of their medication usage). This holds true for many retreat centers that serve psychedelics as well. The possibility of serotonin syndrome is one reason why. Serotonin syndrome refers to an adverse drug reaction that can occur when two compounds are taken together to raise serotonin neurotransmission, and cases range from mild to life-threatening. As of now, there is no empirical data on the interaction between psychedelics and antidepressants but because of their chemical properties it could be dangerous to mix psychedelics with any type of medication that increases serotonergic neurotransmission, especially Ayahuasca (as it contains an MAO-I). We recommend consulting your medical professional prior to starting a microdosing regimen to review all your current medications and to have a discussion regarding risk.

At Retreat, we acknowledge and are overjoyed by the recent increases in research around the benefits of psychedelics for depression. And, we are well aware of the health challenges presented by antidepressants and SSRIs. 

Because of potential interaction of psilocybin and antidepressants, extra care should be taken for those in the course who are navigating a desire to reduce antidepressants or begin a microdosing regimen while on SSRIs. If this is you, please discuss your microdosing journey with a healthcare professional prior to taking any dosages.

5 Tips for Microdosing for Anxiety Safely

1. Talk to a Doctor

It may be hard to find a doctor who is open to supporting you as microdose psilocybin but we recommend finding someone who can guide you medically in this process.

2. Consider Your Medical History

The use of psychedelics as a treatment for anxiety is a fairly new concept and should be do under caution and care. Read the section above about “Schizophrenia or Severe Anxiety Disorders” to know if you qualify as someone who should not be microdosing.

3. Let Someone Trusted Know

It’s important to let someone know the first few times you take psilocybin, even if it’s just a microdose. We are all human and human-errors can occur. You want to put safeguards in place in case you accidentally consume too much or don’t feel well. Make sure the first time is on a weekend or a day when you don’t need to drive or where you don’t have immediate responsibilities (if possible) so you an give yourself time to adjust to them. It’s good to let someone else know what’s going on with you so they can get you the support you need in the unlikely scenario that you take too much.

Psychedelics aren’t a solo activity. You don’t want to take psilocybin solo the first few times — just in case you accidentally take too much.

4. Use a Trusted Source

In our article “Magic Mushroom Dosage 101”, we discuss how to source your medicine safely so be sure to check it out!

5. Limit coffee, alcohol and high-stress situations.

Coffee and alcohol are known to increase anxiety, and as microdosing is an amplifier, it may increase anxiety.

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About the Author

Rima Danielle Jomaa, MFT

Rima is a licensed psychotherapist, hypnotherapist, & psychedelic integration specialist from Los Angeles but has been living in Santa Teresa, Costa Rica for close to a decade. From her home where the jungle meets the ocean, Rima has a virtual Psychotherapy practice, she hosts the “The Rima the Jungle Girl Podcast” and she leads plant medicine retreats. When Rima is not fulfilling her dreams through her work and service, she is probably surfing/somewhere under a waterfall, playing guitar/singing and/or laughing about something. Learn more at www.rimathejunglegirl.com.

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