Hallucinogenic drugs like MDMA, psilocybin, and DMT have received unprecedented scientific attention in recent years. After a decades-long hiatus, researchers around the world are finally studying the once-promising potential of these psychoactive substances to help difficult-to-treat mental health conditions such as depression, PTSD, and substance use disorder. Recent studies have also found that this group of drugs could ease anxiety among people with terminal cancer.
Clinical trials utilizing psychedelic-assisted therapy (where someone takes a psychoactive drug in the presence of a licensed psychiatrist) have shown such promise that many states have voted to legalize certain psychedelics for supervised therapeutic use. Last year, the White House stated that it anticipates federal approval of certain psychedelic treatments by 2024.
But what if there was no need for lifting decades old regulations on powerful drugs for psychedelic therapy? What if such therapy didn’t require psychedelics at all? What if a simple VR headset could fire the brain in a way that is therapeutic to the user, without drug-induced side effects? A small group of startups is counting on just this — with currently small, but promising results.
While the researchers don’t claim to duplicate the real thing, early studies suggest time spent with audio and visual experiences meant to mimic a halucinogenic trip in VR might have very real mental health benefits. A small study published in Frontiers in Psychiatry in March 2023 found that those who spent time using a program called Psyrreal, which attempts to mimic the hallucinogenic experience in virtual reality, had significant decreases in depressive symptoms two weeks after treatment.
Jaan Aru, a neuroscientist at the University of Tartu in Estonia who helped develop and test out the program, tells Inverse, “You could have said that it’s completely bonkers to think that virtual reality by itself could have any of these beneficial effects, that this is plainly stupid.” For him, the results of the small trial were “a positive surprise — hey, this works, to some extent.”
Which is to say, the results are a bit like drug-based psychedelic research: Scientists have only scratched the surface of understanding how psychedelics — particularly their therapeutic mental health benefits — actually work in the brain.
70 Years Of Psychedelic Research
People have used psychedelic plants for thousands of years for medicinal and cultural purposes, such as Buddhists who may have consumed hallucinogenic mushrooms to find enlightenment. But they’re relatively new to Western science.
In fact, the word psychedelic was coined by Humphrey Osmond, an English psychiatrist attempting to describe the mental effects of LSD, a novel chemical compound in the 1950s.
Around that time, psychiatrists and neuroscientists began looking into drugs such as psilocybin and LSD — which was accidentally synthesized in 1938 from fungus — as potential mental health treatments. But thanks to President Richard Nixon’s War on Drugs, disappointing trial results, and a dearth of funding, this research fizzled out in the 1970s.
It wasn’t until the early 1990s that psychedelic research made a comeback when restrictions on how these drugs can be used in research studies began to loosen. In the ensuing decades, scientists have investigated a wide range of therapeutic possibilities. They’ve also tried to understand how exactly these drugs work.
So far, studies have inspected the brain for changes in blood flow and electrical activity and identified regions potentially affected by trips. But because of a lack of research, and the fact that these drugs are so highly regulated, most of the work on identifying how they function in the brain are based on animal studies and human studies that involved a very small number of participants. We also currently don’t have a strong understanding of how the brain itself functions.
“We don’t really know how the brain and the mind work … and then people want to ask how psychedelics do what they do,” Albert Garcia-Romeu, a research psychologist who also works at Johns Hopkins, tells Inverse.
Many researchers have suggested that psychedelics work mainly by disrupting areas associated with self-perception, like the default mode network. This could allow us to step outside our usual sense of self and have some epic eureka moments while under the influence.
But Frederick Barrett, a cognitive neuroscientist at Johns Hopkins University, thinks the DMN has been overhyped in psychedelics research. He points to limitations in brain imaging studies; for example, researchers don’t always carefully control participants’ behavior for consistency.
And it isn’t clear how many of the conditions now targeted by psychedelics, such as depression and anxiety, even manifest in the mind.
Despite the unknowns, both academia and the tech industry have hopped on the VR train. These programs typically throw participants into a 360-degree trance-like environment with guided meditation. Drawing inspiration from psychedelic research, developers have added visuals like “kaleidoscopic light trails” and “technicolor textures,” along with distorted audio that mimics one’s altered sense of time while experiencing a trip.
Psyrreal, developed by the University of Tartu’s Aru and his colleagues, is among these apps. In its 2023 study, 13 participants with mild-to-moderate depression met with a psychologist, donned headsets, and embarked on an “immersive journey” through virtual environments aimed to reflect certain experiences people have while on psychedelic drugs, such as shots of the ocean and mountains mixed in with grids of lasers and floating blocks of light.
As they waded through these surreal worlds, the subjects listened to a psychedelics-inspired soundtrack that varies in tempo and intensity to amp up the experience. It even includes a famous auditory illusion meant to simulate the spiritual breakthroughs brought on by the drug DMT.
Two weeks after the initial experiment, 73 percent of participants reported a decrease in depressive symptoms. One finding was particularly interesting, according to Karl Kristjan Kaup, a physicist researching the mental health benefits of psychedelics who co-authored the study with Aru.
“What was quite surprising is the reactions of some of the people,” Kaup tells Inverse. “They really report things that are remarkably similar to psychedelic experiences — not everybody, but quite often.”
Aru and his colleagues acknowledge that the research is in the early stages, and they need to conduct much larger studies to confirm these results. Going forward, they don’t plan to commercialize Psyrreal — right now, anyone can use it for free online — but they hope to partner with non-profit clinics and other researchers.
While Psyrreal focuses on one’s individual journey, other VR experiences have group therapy in mind. That’s the goal for aNUma, a program that spun off from research at the University of Bristol.
“Shared experience is something transformative,” Joe Hardy, a cognitive psychologist who co-founded aNUma, tells Inverse. “That’s sort of the thread that we’re pulling on.”
The Marriage Of VR And Psychedelics
Some scientists want to combine virtual reality and therapist-guided psychedelic sessions. It could offer a safe way to explore greenery, which could boost the benefits of a trip, without actually needing to bear the elements.
“A lot of people claim that the best place to do a psychedelic is out in nature … frankly, it can be very challenging to administer a psychedelic safely out in uncontrolled nature,” Barrett says.
This VR-drug combo is currently in the works. Tripp, a “digital wellness” company co-founded by video game industry veteran Nanea Reeves, is currently running a study with a mental health clinic in California. There, subjects receive a VR session to ease anxiety before taking a low dose of ketamine.
“A lot of people claim that the best place to do a psychedelic is out in nature … frankly, it can be very challenging to administer a psychedelic safely out in uncontrolled nature,” Barrett says.
In the future, Tripp CEO and co-founder Nanea Reeves aims to support the roll-out of psychedelic therapy with VR technology in order to enhance the healing process.
Jacob Aday, a postdoctoral psychiatry researcher at the University of California, San Francisco, thinks VR could even work as either a tamer alternative or a solid option to prepare people for a real trip.
“A lot of people are excited about the potential of psychedelics, but they’re very scared about doing it themselves; it sounds like a very overwhelming thing, he tells Inverse. “It’s hard to predict how any individual is going to react to a psychedelic, so it’s understandable.”
Beyond getting into the right frame of mind, Romeu suspects that this combination could up the ante for people taking these drugs. “Using VR and psychedelics combined could sort of turn up the gain on the awe types of experiences or other types of ego-dissolution experiences people can have,” he says.
Once researchers try the tech on enough people, it could finally help scientists tackle the million-dollar question: how psychedelic drugs help people in the first place. For example, researchers could try to mimic a specific aspect of the psychedelic experience in VR and link it to specific regions of the brain that light up in scans.
“How do we use VR as a tool for understanding drug effects in the brain?” Garcia-Romeu says. “We’re likely to see a lot more of that going forward.”
With an American mental health crisis broiling — depression rates reaching new highs and pandemic-borne anxiety stubbornly holding onto the American psyche — therapy of any sort is needed, especially therapy that could lead to faster and more profound breakthroughs. Will psychedelics be the answer? Could VR prove just as effective? Will the marriage of the two be the norm in the near future? Researchers in the field are clearly optimistic and think a hopeful answer to these questions could arrive soon. The next few years will indeed be a long, strange trip.
THE FUTURE OF MENTAL HEALTH takes a deep dive into the technologies that may transform the way we think about and address mental health and where humanity could go if we succeed. Read the rest of the stories here.
