When Psychedelics Make Your Last Months Alive Worth Living
“I am at peace with what’s next. The more I prepare to say goodbye, the more at peace I become with that reality."
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In the spring of 2018, Dan G. learned that the melanoma he had beaten 18 years earlier had returned and spread to his liver and lungs. After several months of chemo and immunotherapy, the 44-year-old decided the traditional treatments he’d been undergoing weren’t enough. The crippling side effects of the drugs had left him feeling hollow—and only exacerbated his already acute feelings of anxiety and depression. He often felt too decimated, both physically and mentally, to spend quality time with his wife and four-year-old son.
Unable to control what was happening in his body and discouraged by conventional treatments, Dan began to ponder the things he could control about his situation—namely his mental state—and started looking into options. The literature he found examining the correlation between improved mental health and psilocybin, the psychoactive compound in magic mushrooms, intrigued him, and his experiments with psychedelics over the next six months would significantly reduce the mental dread consuming his life.
Dan’s various caregivers weren’t encouraging when he asked them about alternative paths to managing his situation—they seemed to want to stick to oxycontin for his pain, and not much else. Desperate to alleviate his crushing stress, this letdown led Dan toward the decision to experiment with psilocybin. “I didn’t even consider something like tripping when I was first diagnosed in May,” Dan says. “However, there was a point in my treatment where I started to improve physically and felt strong enough to be willing to try it. Reading Michael Pollan’s book, How To Change Your Mind, and the research being done at Johns Hopkins gave me motivation.”
For more than 15 years, the Johns Hopkins Psychedelic Research Unit has been the foremost research team in the US for psychedelic studies. Key among the topics being explored were psilocybin’s effects on addiction, depression in the physically healthy, and the depression and anxiety brought on by a cancer diagnosis. Many of the results of this research have shown psilocybin to be an invaluable mental health tool, one unlike anything else in modern medicine.
“People with cancer who have substantial distress are stuck with thoughts of ‘why did this happen to me?’ and ‘life is meaningless.’ Very understandably, they become so obsessed with the cancer that they can’t enjoy the life they have left,” says Matthew W. Johnson, associate professor of psychiatry at Johns Hopkins University School of Medicine. “A lot of these people are physically healthy in the now, but their life is absolutely hell because they are so preoccupied with the cancer and can’t get past it. They’re not able to get up and enjoy the sunshine or their family because of these feelings.”
That was exactly what Dan was going through. “I very much wanted to be more present for my son and my wife, who are everything to me,” Dan says, his voice quivering with emotion. “My wife and I have had to have these conversations—when am I ready to die? When are you ready for me to die? She’s so great and loving but it’s like, how do you even figure these things out? That and the other negativity just consumes you.”
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Johnson says that the results of Johns Hopkins’s randomized cancer studies are profound. “Cancer patients show dramatic reductions of depression and anxiety that have lasted at least six months and sometimes a year—which is amazing,” he says. “It’s not just cancer patients either, our studies showed a similar improvement in depression in non-therapeutic subjects [subjects that don't have a specific disorder like tobacco addiction or cancer-related distress]. These results are unique to psilocybin as it’s medication, but it’s a medication that provides an experience. It’s like psychotherapy in a way.”
Determined to find a better way to treat his intense anxiety, Dan turned to old friends on a Phish message board, where he opened up about his situation and his search for psychedelic relief. Soon enough, Dan had what he was looking for and began to prepare for his journey. “My friends on Phantasy Tour ended up being one of my best resources, actually,” Dan says, laughing. “They came through with so many donations to my family’s gofundme and with so much great advice on everything from alternative medicines to their own experiences with cancer and psychedelics to funny stuff like ‘just dim the lights and turn on the Allmans.’”
Nervous but excited to try something new, Dan went about setting up a time and environment that would provide maximum comfort for his trip. Equipped with mushrooms a friend procured for him, Dan got himself set up for the journey—select music, noise canceling headphones, pen and paper to record his thoughts, comfortable and ample space to meditate—and then took the plunge. “In the moment I felt absolute joy and ecstasy as well as absolute anxiety and fear—at the same time. I think the ability to accept those two concepts and acknowledging the extremes about my situation is important,” he told me, awe in his voice. “It felt like pure nothingness, and I understood it to be a good representation of what dying itself is.”
“I had this epiphany, saying, ‘Enough already. I don’t need to pretend everything is fine.’ That was a real takeaway: It’s okay for me to step away from this constant optimism. I realized it was okay for me to think, ‘Well, actually, this sucks. I’m not going to get through this. I am going to die.' It helped me focus on what was real—time with my loved ones.”
Johnson was happy to hear that Dan had respected the process and focused on the inward significance of the experience, but adamantly reiterated the risks involved with taking psilocybin outside of a medical setting. Hallucinations, severe anxiety, and paranoia are among the negative side effects that could befall a user. He also pointed out the importance of having a specific intention for a trip.
“You can have these transcendent psychedelic experiences outside of clinical settings, and that can be very helpful, but it’s hard to truly let go when you’re at, say, a concert and you’re worried about your wallet and phone and the police,” Johnson says. “You probably don’t want to be crying in a corner about your mom at a party or something, but if you’re doing one of these studies, and you feel the need to cry about your mom, then that’s exactly what you should be doing.”
Though Dan says the bulk of that first trip was high anxiety, he praises the overall experience and says that from then on his perception of death was dramatically altered—but more importantly, so was his perception of the life he has left. “The power that I feel being able to accept death as a reality is truly a gift,” Dan says, “because this thing that’s happening to me then doesn’t have complete power over me anymore—that acceptance allowed me to take back that power and realign my focus.”
After the success of his first dose, Dan settled into a microdosing regimen ingesting .2-.4 grams every third day. The results were exceptionally beneficial for him. Basic functions like being able to eat were accessible to him again. Not only could Dan show up at the dinner table, he could be his old self again, however briefly. “I was able to sit down and have some of the last meals I’m ever going to have with my son and my wife. To be able to sit there and function... it's like, ‘Hey, daddy’s being silly and fun again,’ you know? I’m not miserable. I’m not totally out of it on pain pills.”
This ability to free the mind enough to be present in the moment is at the core of why Johnson and his colleagues are so excited about their findings. His team says that no other medicine has been able to produce results akin to those of psilocybin, both in the treatment of depression and addictions of all kinds.
It’s important to note that due to the experimental nature of the treatment, studies of this type have been relatively small and homogeneous thus far. Psychedelic research of any kind can be difficult for a variety of reasons—blinding is difficult to impossible, the substance in question is illegal, and this type of therapy and medicine hybrid treatment is uncharted territory. Despite promising findings, this type of research is still in its preliminary stages.
Still, Johnson is a bit frustrated with the public’s perception of psychedelic mushrooms as a recreational drug or “woo woo” remedy. “Some people may say it sounds like snake oil. But for me it comes down to the fact that these people are stuck, mentally and behaviorally, with addiction, or with something like depression,” he says. “There is so much benefit here.”
Colorado and Oregon are currently considering the legalization of mushrooms, and Dan hopes his story can help illuminate how much good this plant could do for someone going through depression. “There’s something out there that’s unexplainable, something that this taps into. I am at peace with what’s next,’ he says. “The more I prepare to say goodbye, the more at peace I become with that reality. My experience has provided me with a peace despite all this, a peace I’ve been able to share with my family in my final days.”
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