Breaking the mental health binary using psychedelics

Recently I was talking to a friend on the phone about an event in my life. I used the word “anxiety” to describe my feelings around the situation, to which they replied “oh but you don’t have anxiety. You just felt anxious.” This made me think. Is it possible to ‘have’ anxiety, or is anxiety just one feeling on the spectrum of human emotion? I tend to think the latter, but in today’s culture where people are increasingly well-versed in psychiatric language, ‘anxiety’ is increasingly becoming a buzz-term which people are using to self-diagnose their perceived mental abnormalities.

This medicalised approach to normal emotions could be an issue for concern. According to a British Medical Journal blog post by psychiatrist Derek Summerfield, anti-depressant prescriptions have increased from around 9 million in the 1990s to 64.7 million in 2016 — without any evidence that mental wellbeing has improved. To quote Summerfield:

[When] the language of psychological deficit is inserted into the public imagination. People come to see themselves not as normally stressed, but as “ill.”

Psychiatric language around mental health has become so entrenched in everyday speech that normal emotions are being characterised as innate deficiencies — you don’t feel anxious, you are anxious. Overtime these narratives become entrenched into the way we think about ourselves and our behaviour.

A few months ago I was at a party where I didn’t know many people. I felt uneasy, uncomfortable, so awkward that I couldn’t even make eye contact with anyone and just wanted to go home. This is something I’ve felt in various degrees of severity my whole life, but armed with the new language I’ve picked up from friends and the media I started telling myself that what I was feeling was ‘social anxiety.’ Naming this feeling had the effect of making me feel better (“I’m not alone in feeling this”), yet simultaneously creating a narrative in my head about the way future social events are going to go (“I have social anxiety, I’m going to avoid going to parties where I don’t know people in the future to avoid this.”)

In his book How to Change Your Mind: The New Science of Psychedelics Michael Pollan explains one of the reasons that psychedelics have been useful in treating mental illnesses like depression and anxiety is that they break people out of these narrow ways of thinking about themselves and their minds. Rather than reinforcing the narrative (“I’m mentally ill” “there’s something wrong with my brain”) psychedelics break down the ego and force a different perspective on the self. “The ego is stuck in these stories,” he says. Substances like psilocybin seem to work because “they dope slap people out of their stories.”

In the studies on psilocybin for mental health, participants often struggle to describe their experience using words. Perhaps it’s exactly because these experiences seem to transcend the narrow confines of our language that they are so effective. In this space, a person is no longer able to hang onto their narrative and is therefore finally able to reconceptualise their story.

At the end of the day, mental health is just a construct which humans have built up in order to rationalise their experience of the world. These boxes can be useful but it’s also important to get out of them every once in a while.