A Christchurch woman who felt life was no longer worth living has become the first person to take clinically prescribed psilocybin to help treat her depression. Gill Higgins reports.
For decades, Alice Brent has lived under the heavy weight of depression – a relentless illness that no medication, therapy, or effort could shift.
‘Everything ceased to exist’: Watch this story on TVNZ+
“I think I was first diagnosed when I was about 18,” she says. “It’s never gone away. It starts with feeling kind of devoid of any emotion… and it can get to a point where it’s just despair.”
There were times she thought the world, and her family, might be better off without her. “My husband wouldn’t feel this need to fix something he can’t fix. My children wouldn’t have to worry about what they say around me.”
Alice Brent went to see Christchurch psychiatrist Dr Cameron Lacey. He’s the first and only psychiatrist in New Zealand authorised to prescribe psilocybin (administered in a clinical setting) for treatment-resistant depression. His approval came after years of research into psychedelic therapy and a rigorous assessment due to its potential risks – for example, psilocybin can cause psychotic symptoms in vulnerable individuals.
But Brent felt lucky to be “with the right psychiatrist at the right time”. She was ready and willing to be the first person in New Zealand to legally receive psilocybin – the active ingredient in ‘magic mushrooms’ which until now has only been used recreationally and illegally – as part of her treatment for depression.
“Until now, nothing’s worked,” she says. “There were times I felt I had no future.”
Disrupting ‘entrenched, unhelpful patterns’
As for Dr Lacey, he welcomes the opportunity to have another therapy option for people who feel they have nowhere to turn. “If you think of depression as having entrenched, unhelpful thinking patterns about yourself and your connection to the world,” he explains, “psilocybin gives you the potential to see things from a very different perspective.”
He’s at pains to emphasise that the psilocybin pill is only one small part of the overall therapy. Unlike with recreational drug use, patients have several weeks of psychotherapy sessions leading up to the treatment day, followed by weeks’ more psychotherapy after the treatment to unpack the experience. The patient also has to carefully taper off antidepressants before dosing.
“It’s very intense,” says Lacey. “People can experience a whole range of challenging thoughts, emotions and memories, so they need to be carefully prepared and supported.”
On dosing day itself, the patient receives a “hero” dose of psilocybin. The single pill will transport them into a psychedelic state for around five hours. Brent says she was nervous. “I felt jittery. I hoped I’d done everything I could to make it work.”
While cushioned in a comfy chair with a warm throw, she swallowed the capsule, put on an eye mask and headphones, and lay back as two clinicians guided her through the session.
“Everything else ceased to exist,” she recalls. “It was like I was in a green, beautiful forest with dappled sunlight… and then the music changed, which really changes the dynamic. I felt sorrow. I felt anger. They were big emotions and I felt them to my core. There was a lot of crying. I think I was tripping for about five hours and I don’t think I was expecting the sorrow.”
The journey wasn’t easy but Brent has no regrets. “It wasn’t pleasant, but it was extremely insightful. I wouldn’t want to do it again. I really wouldn’t.”
‘This is where the hard work begins’
Two weeks on, Brent says the hardest work is still ahead. “I’ve been left at times thinking, I don’t know if I can do it but I don’t want to go back on antidepressants. I think this is where the hard work begins.”
Psilocybin therapy has already been approved in Australia and used by thousands worldwide, with about two thirds of patients reporting significant improvements.
Here, Lacey says about 40 patients have been referred for the therapy. Of these, 15 were found to be suitable following a strict screening process and seven are proceeding with treatment.
One barrier is the cost. A single course of psilocybin with the weeks of psychotherapy in this country can cost about $20,000. The high cost is largely due to the clinician hours for the talking therapy.
Alice Brent and her husband Jono say they felt it was worth it.
“I felt I was only sticking around because others wanted me to,” she says. “But I want to now. I want to see weddings and grandchildren and travel and see the world with Jono.”
She hopes others like her will get the same chance. “There will be people who feel there’s no hope, who look down the barrel of the rest of their lives and feel horror. I do feel this has given me enough insight into the cause to say, ‘Up yours, depression. We’re not doing this anymore.’”
‘Everything ceased to exist’: Watch this story on TVNZ+
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