Methylenedioxymethamphetamine (MDMA), commonly referred to as ecstasy, is a psychoactive substance that has more recently been found to efficiently help treat PTSD. MDMA-assisted psychotherapy was certified as a breakthrough therapy by the Food and Drug Administration or FDA in 2017. Scientists, doctors, and the general public are becoming more interested in the therapeutic potential of drugs such as MDMA to treat post-traumatic stress disorder.
Over the last decade, there has been an increase in the number of studies on medications and other treatments that may help psychotherapy for PTSD work better. In animal models, MDMA has been demonstrated to modify fear memory reconsolidation, improve fear memory extinction, and boost social behavior through inducing serotonin release.
With mounting evidence to support its medicinal value, it's worth investigating MDMA-assisted psychotherapy and why it appears to aid persons who are struggling with PTSD. Today, we will be looking at how MDMA can be used in a clinical setting to treat PTSD, increase mood, and treat depression.
PTSD - Disorder of Emotional Memories
Exposure to profoundly traumatic situations, such as natural catastrophes, torment, war, extortion, assaults, and motor vehicle accidents, can cause survivors to develop post-traumatic stress disorder. People may acquire PTSD - a state of intense anxiety that involves nightmares, flashbacks, and aversion of any recollection of the trauma, depending on the type and intensity of the incident.
In neuroscience, PTSD is characterized as an emotional memory disorder in which remembering a traumatic experience causes severe anxiety as if the incident is occurring in real time. Individuals struggling from PTSD usually develop averse and sometimes visceral reactions to stimuli that reminds them of the experience. We can also think of PTSD as a context processing disorder: e.g. a person's internal response to loud sounds in a safe civilian environment is interpreted as equivalent to the battlefield.
What Exactly is MDMA?
MDMA is a synthetic substance that is well-known for eliciting feelings of exhilaration and empathy among users. It influences mood and perception, making one less conscious of the items and situations around them, and more intently focused on details of their experience. MDMA stimulates the brain, causing users to feel more active, euphoric, emotionally warm, and even aroused. Apart from that, MDMA can also heighten certain senses and distort one’s perception of time.
However, there exist concerns regarding MDMA’s capacity to develop dependency, however data is thus far inconclusive on whether this is actually the case.
How Does MDMA Assist With Psychotherapy?
MDMA can help with psychotherapy by lowering anxiety and defensiveness, elevating mood, and boosting feelings of relaxation. It can also aid in the formation of a stronger bond between the therapist and the patient. A person is potentially more likely to revisit difficult situations and cope with their feelings without being re-traumatized or withdrawing before finishing treatment.
MDMA may help alleviate the anxiety associated with accessing and sharing traumatic experiences. Negative memories may become less emotionally demanding, enabling the therapist and patient to conduct productive therapeutic sessions without triggering trauma due to stress.
When used in conjunction with psychotherapy, clinical research suggests that MDMA has potential to put the traumatized patient in a state of increased emotional safety. It also enables the patient to engage in empathic self-reflection, potentially for the first time in their life. In addition, patients can also interact with their traumatic memories without being weighed down by the damaging influence that usually comes with revisiting intense repressed trauma.
What Effect Does MDMA Have on the Brain?
MDMA, like some other mood-altering compounds, impacts the brain's reward region by stimulating the neurotransmitters that produce serotonin, norepinephrine, and dopamine, which are necessary for motivation, stress, and other feelings.
MDMA effectively parallels the effects of other stimulants, influencing brain and body processes such as sleep, emotion, mood, and energy. Because of the drug's stimulating effects on the mind and body, the most common side effects include agitation, panic attacks, and anxiety.
As a result of the saturation of neurochemicals expended by MDMA use, withdrawal symptoms are common in the hours and days following an MDMA experience, including:
- Feeling temporarily depressed
- Trouble concentrating
- Suppressed appetite
- Feelings of exhaustion
These symptoms are temporary, but prevalent enough to warrant their disclosure.
Therapy in a Controlled Setting
According to a 2019 clinical study on MDMA assisted psychotherapy, people with PTSD are unlikely to feel the common side effect of being "blissed out" after taking MDMA. According to the results of the study, patients in the trial had positive results, but didn't experience the exceeding euphoria that is indicative of the high of MDMA. This may be related to the abnormal hippocampal structure (and function) of those with PTSD.
If MDMA does gain approval for the treatment of PTSD in the future, experts believe MDMA will likely not be something that is readily accessible at a pharmacy. It is more likely that MDMA would instead be administered in specialist clinics under close monitoring upon approval.
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