Transcending Depression Without a Script

Didn’t the people in Brazil warn you about antidepressants and ayahuasca?” my friend asked as we sat down at the sushi bar in Berkeley. She’d already had several revelatory nights drinking the psychedelic tea with a Peruvian shaman.

“Not a word,” I replied.

“Well, you need to stop your antidepressants seven weeks before you try ayahuasca. Otherwise, it could kill you.”

I dropped my chopsticks.

“Seven weeks!” I exclaimed. “The retreat is in three weeks and I have a nonrefundable plane ticket.”

My friend reached across the table and touched my arm.

“If I were you,” she said, “I’d wait.”

Waiting is not something I do well.

So I rushed home, went online, and found all manner of opinion about what a person should do before embarking on an ayahuasca journey. Some websites warn about antidepressants and ayahuasca. Others say you shouldn’t have sex for a week before drinking the tea, or watch TV, or eat raisins, or dairy, or meat, or gluten. According to some, you should only wear white. The usual avalanche of information on the Internet raised more questions than answers. How does one separate the science from all the superstition swirling around ayahuasca?

As it turned out, I’d already met the scientist who did the research that first warned about a potentially fatal “serotonin surge” that can occur when ayahuasca meets antidepressant. That would be Charles Grob, MD, a researcher in the Department of Psychiatry at the UCLA Medical Center and coauthor of several important studies on the history, pharmacology, and current use of ayahuasca in the Amazon Basin. “I generally advise people not to combine ayahuasca with any antidepressant, though not everyone agrees with this approach,” he told me. “I tend to err on the side of safety, particularly medical safety.”

Psychedelics and antidepressants both work by affecting the flow of serotonin, a brain chemical and key neurotransmitter that regulates an array of psychological and physical processes—everything from our cardiovascular system to our moods, feelings, and ability to sleep. The good news from Professor Grob was that the type of antidepressant I was currently taking, Bupropion SR, did not require a seven-week hiatus. Grob thought I could safely cut back on my dosage and stop taking the medication in time to join the ayahuasca circle in Brazil.

Grob and I had met several years ago when I was doing interviews for a magazine article on the new wave of scientific research into the mental-health benefits from psychedelic drugs taken with a trained therapist or clinician. Another professor I know, David Presti, a neuroscientist at UC Berkeley, had already told me that he thought a few sessions with ayahuasca could be just as effective as a daily dose of antidepressant. Nobody knows exactly how ayahuasca works, Presti said, but “there may be some kind of hard rewiring that goes on in the brain.” Psychoactive plants and chemicals, he said, “may increase neuroplasticity—make the neurons more susceptible to forming new connections.”

Presti pointed out that there is a lot of resistance to this idea from the pharmaceutical industry. “The last thing it wants to see is a substance people only use once or twice. They want us to use something every day for the rest of our life. That’s how they make money.”

Two dozen of us, dressed all in white, sit in a circle under an expansive thatched roof temple in the Amazon jungle. Above, a high-tech light and sound system has been built into the massive support structure holding up the thatch. Four pulsating globes of light dangle from the ceiling, like bright stars showing us the way.

This circular centerpiece of the retreat center has no walls or windows, a design that protects us from the elements while keeping our connection to the natural world. We’re about two hours from Rio’s chaotic bustle, but that insane, beautiful city seems light years away. Right now, we’re deep into the night. The only sounds we hear are the hum and the buzz of the jungle—a pulsating symphony composed by the bugs, birds, snakes, frogs, and other creatures that call the rainforest home.

Time slows, stops, and starts again. It’s been perhaps four hours since we took our first psychedelic communion, maybe two hours since the second drink. The men sit on one side of the circle, the women on the other. We’d approached the altar individually—alternating between the men and the women, walking up to our Master of Ceremonies, who pours the ayahuasca tea, a viscous brownish-orange liquid, from a glass pitcher into cordial glasses. The tea is room temperature, bitter, and acidic, but we all manage to keep it down—at least for now. In an hour or two, another symphony will be performed as half of us start moaning and retching, vomiting into the blue plastic buckets laid out for The Purge.

At the center of this ayahuasca experience is the music. This ayahuasca priest is also a renowned Brazilian guitarist, and his steady guitar groove beats over ever-shifting Brazilian rhythms, his voice, lifting, lilting, soulful, childlike. We sing from a hymnbook in the form of call and response. Most of the lyrics are in Portuguese, but there are English translations on the opposite pages. Many of the hymns are drawn from Brazil’s Santo Daime spiritual network, an ayahuasca church that was founded in the 1930s and blends Christian and indigenous religious traditions. The songs are written in praise of the forest, the Spirit of the Vine, the Celestial Mother, the Great Spirit, and other saints, gods, and goddesses in the Brazilian pantheon.

Most of us—visitors from Germany, Britain, Switzerland, the Czech Republic, and the United States—have trouble keeping up with the music, and we stop even trying to sing along when the ayahuasca starts to work its magic.

After a half hour or so, the music starts to flow up from the base of my spine, following a spiraling, serpent-like course up through my body and outreached arms. The music comes alive, like an energy I can sculpt and channel by opening and closing the ever-shifting container of space between the palms of my hands.

There’s a visual pulsing as well. The temple floor starts to undulate in gentle waves, the various patterns of the colorful mats blending into one another, and the flowing white robes of the women also take on a life of their own.

More time passes, and I feel myself slowly coming down. If this was an LSD trip, I would say I had peaked. But just as I’m telling myself that, and feeling a bit disappointed that I didn’t have any life-shaking visions, something clicks in my mind.

Suddenly, I feel like I am inside the mind of my grandfather, my father’s father. But it’s my grandfather as a young man. I’m in New York City, circa 1915, and feel a sadness that I experience as an echo of his sadness. There’s no story attached to the feeling, just a feeling, and I sense that my melancholy somehow stretches back to his. As soon as I try to understand this rationally, to make it into a story, that feeling passes, but the sadness remains. My euphoria spirals down into that feeling I know as “depression,” but even deeper and darker.

More time passes. My dark night of the soul lifts as the light returns to the jungle. I feel, once again, totally connected with the world around me. The rainforest slowly comes to life. It’s a pulsating electric green, dripping with shimmering, glimmering, morning dew. Morning has broken, as Cat Stevens once sang, like the first morning.

Looking back, I’m not sure when I first started taking antidepressants. Sometime in the early 1990s, when I was feeling a bit more down than usual, my general practitioner suggested that I might try Prozac. Over the years, the doctors changed, as did the names of my medications—Zoloft for a while, then Wellbutrin—but I kept swallowing those little pills once or twice a day for what turned out to be 20 years. I didn’t experience any serious side effects, and I felt a little better. Or at least I thought I did. I mostly noticed the effect of these drugs when I tried to stop taking them. I’d become more irritable, melancholy, and prone to “negative thought loops.”

As I write this account, it’s been 14 months since I weaned myself off Bupropion and headed off to the Amazon. I’ve participated in four more ayahuasca circles over the past year: a second one in Brazil, and three with a group of mind-expansion enthusiasts led by a man who combines shamanic training and a humanistic brand of psychotherapy. Each time, I experienced the same kind of higher highs and lower lows, but came out of the experience with a more positive state of mind. These feelings of greater joy and connection last for a few weeks. After that, I’m able to get relief by tapping into the memory of the experience.

It is all, of course, completely subjective, but then so is that thing we call “depression.” For me, antidepressants level out the highs and lows. Ayahuasca supercharges them and allows me to fully experience the agony and the ecstasy.

To be clear, I’m not saying ayahuasca cured my depression. I may have been ready to get off antidepressants anyway, and just used ayahuasca as an excuse. Meanwhile, I’ve done other things to keep feeling alive and connected over the past year. I’ve tried to revive my meditation practice. I started singing and playing my guitar again, inspired, in part, by the music that accompanied my two Brazilian encounters with “the spirit of the vine.” For me, finding a new guitar teacher was a better mental health investment then hiring a trained psychotherapist. This jibes with what my friend Kevin Griffin says in his new book, Recovering Joy, when he writes, “Sometimes all it takes to make a shift in mood is to notice something you can enjoy right now.”

My efforts to feel connected and enlivened without antidepressants included one other unorthodox approach to mental health. Through a serendipitous connection, I encountered a physician who was offering his patients intravenous injections of ketamine, a powerful dissociative analgesic that has its own kind of psychedelic effects. This doctor had several patients who’d successfully stopped taking antidepressants after one or two ketamine sessions. He offered me a session, and after thinking about it for a few days, I decided to give it a try.

“Ketamine is a doorway, a portal, a way for people to achieve deep repose in their lives,” he said. “Who we really are has nothing to do with our stories of who we think we are. Our traumas and our dramas give us a false sense of identity. We think that’s who we are. We just keep running that story over and over again. That’s what I call ‘the small I.’ Ketamine delivers the story of ‘the big I.’ It connects you with Source.”

This rang true. What my previous doctors and therapists had labeled “depression” did seem like an overidentification with my story, with my “little I.” Talk therapy can only take me so far. Medication can help, but I need heavy artillery to bust through the ego and be here now.

One of the things that attracted me to this doctor was his holistic approach to medicine—how he seemed interested in both physical and spiritual health. He asks his ketamine patients to come to their sessions with an intention or a prayer. What insights were they hoping to get out of the experience?

My intention was to gain a deeper understanding of this thing called “depression.” As recommended, I put on the blindfold and noise-canceling headphones and lay back for what the good doctor said would be a fifteen-to-twenty-minute experience.

The needle was barely out of my arm when I felt the rush—like I was strapped to the side of Apollo 11. My mind and body rocketed into space. My skin ceased to be the boundary between me and everything else as my body expanded to fill the entire room, or perhaps the entire universe. It was such an overwhelming feeling that, for a moment, I began to freak out. For a few moments, the expansiveness of the ketamine experience seemed to make it impossible to breathe. Or maybe I didn’t really need to breathe if my lungs had expanded to fill the entire universe? No, I told myself, breathing is important. Don’t forget to breathe. Focus on your breath.

Once I did that, once I began concentrating on the slow and deep inhalation and exhalation of air into and out of my lungs, the terror lifted. An incredible sense of peace settled over my soul. My consciousness seemed to be hovering over my body like some kind of protective higher power. It was a sensation that I had briefly experienced years ago, in a less intense fashion, during a Zen meditation retreat. Suddenly, I was not wrapped up in my own story. My ego had dissolved. I was present—really present—in a whole new way.

Then, gradually, like a balloon slowly losing air, the extreme expansiveness subsided and I drifted back down into my body. I lifted my blindfold and looked at my watch. I could have been gone an eternity, but only 15 minutes had passed. I saw the doctor sitting at his desk, reading a medical journal. He looked up at me and smiled.

At the time, I could only think of one word to describe the experience.

“Wow.”

For the next few days, everything seemed a bit brighter. I felt more present. Getting back into the routine of daily living, I again began to feel the ups and downs of being human, but I felt less identified with those feelings.

Once again, I am not claiming that ayahuasca or ketamine cured me of depression. Nevertheless, there have been several recent scientific studies in the U.S. and Brazil, indicating that these psychoactive substances may be useful in treating some forms of that condition. That’s interesting, but for me, not so important. I know enough about the human condition—or at least my human condition—to
know that my depression is connected to my own self-centeredness. Ketamine and ayahuasca are not magic bullets, but they’ve helped me remember that there is more to life than what’s going on inside with my skin-encapsulated egotistical self.

Enough said about that. Time to pick up that guitar across the room. Time to start singing away the blues.