บทถอดความฉบับเต็มของ Decoding Psychedelics with Dr. Grace Blest-Hopley from Decoding Women's Health

times. We might hear things or perceive things or see things, and we have these very transformative experiences in terms of how we feel while we're under the influence of the substance. Now that's the psychedelic experience in itself, but there's actually so much more that goes on. And as I said, you know, they engage a number of different receptors in the brain, and so beyond the kind of experiential part that we have under psychedelics, we see biochemical changes that come about after psychedelic use, and what we're talking about there is essentially changes that happen on a cellular level that can increase things like neuroplasticity, so the ability for the brain brain to kind of grow and change and make new connections, which is what we need in order to make new memories or to form new thought patterns. And we also see changes in things like neurogenesis, so actually you know, starting to produce new proteins and new cells potentially even within our brain. So there is this incredible kind of after glow effect that goes on for depending on the psychedelic you know, days weeks after. So that's largely what we're talking about when we talk about classic psychedelics. 00:07:32 Speaker 4: But as you're right. There are a number of. 00:07:33 Speaker 3: Other things that substances that are very similar and what we might call non classical psychedelics, and that includes things like ketamine, MDMA, cannabis even and when we think about them, they have quite different mechanisms. MDMA is probably the most similar to classic psychedelics and that it also works through the serotonergic system, but it doesn't work quite in the same way, so we don't quite get the hallucinatory parts. We'd often call that more of an en pathogen. So often the feelings that we have on MDMA are more associated to this reduction in fear and increased feeling of connectedness perhaps with the people that we're with, and that's why we use MDMA in a lot of psychedelical system therapies that involve sort of talking about potentially traumatic incidences that have happened, or in couples therapy for instance, where they able to empathize with each other on a different level, and it can be very beneficial there. Ketamin is a drug that has some of the hallucinatory effects I suppose of classic psychedelics, and a lot of the benefit people get from ketamin can be about the experience in a similar way that it is in classic psychedelics, but it actually works in a very different way. And so though it can be similar in how it can sometimes feel, it is quite different mechanistically. And finally, cannabis is always the huge argument is cannabis is psychedelic or not. I think I've been persuaded it is. Why is that, I think because the endocannabinoid system is very complicated in itself, and that's the primary system within our brain by which cannabis works, and it can have a number of these sort of you know, multi system effects that can then lead to having these experiences that can

feel like a psychedelic experience. And also, because we now know as well just quite how many other neurosystems in the brain that cannabis and cannabinoids can affect, so they are also having this sort of multi level engagement with various different brain substrates, I suppose, So so. 00:09:32 Speaker 1: Fair to say that a psychedelic is kind of unlicks the brain, so it can communicate in ways that are typically suppressed. So it's taking the breaks off our brain a little bit and allowing it just to expand and have different communication networks. 00:09:46 Speaker 4: Yeah. 00:09:46 Speaker 3: Absolutely, And you know, we have to really think of our brain as you know, a very kind of fine tuned machine and part of what it has to do. You know, we often always associate more with better, but actually more is not always the most efficient, and so our brains are evolved and adapted to only really recruit the parts that it needs in order to. 00:10:07 Speaker 4: Complete the task. 00:10:08 Speaker 3: Now, that's fine if the part of the brain that is recruiting those other parts in is very plastic and adaptive and has sort of good blueprints I suppose, with which it is wanting to engage other parts of our brain. But when we see things like depression, anxiety, and post traumatic stress disorder, what we often see often built in from very very foundational you know, early early childhood years in some people, that this part of the brain can start to become very rigid. I like to think of it a little bit like if you think of a small stream that comes to a beach and is going into the ocean, and it just dives one very deep groove within the sand, and when we take a psychedelic a huge wave comes and washes over the beach, and those deep grooves get kind of filled in a little and they allow the water to now potentially take other roots down to the sea. And that is sort of what happens with the way that the structure of how our brain communicates changes under a psychedelic. 00:11:11 Speaker 1: So in terms of the impact the change and the impact of the change, how rapidly does one see that, Do you use a psychedelic and then three days later you feel more empathy and more at peace with the world, Or how long does it take for these changes to really impact how you feel or how you look at the world, And then how long do they last for. 00:11:31 Speaker 3: It can really be very dependent on people's experience and what they uncover, because sometimes as well, we go and we take these substances and what they are essentially are they are just. 00:11:41 Speaker 4: Catalysts to our own psyche right. 00:11:43 Speaker 3: They're not really bringing anything new, They're just unlocking doors that we are able to then access things that are already there. And so if you go with a problem that maybe you don't have any oversight of and you instantly are able to sort of see it and realize it, well, are you instantly then better? 00:12:00 Speaker 4: Well? 00:12:00 Speaker 3: Maybe probably not, because you probably have to now integrate that into your life and understand what it means and change you know the behaviors in your day to day living that allow you to become happier and healthier and you know, more connected and all the things that we know that are possible. So it isn't quite a case of you will take it and then suddenly feel better. 00:12:22 Speaker 4: Often people do. 00:12:23 Speaker 3: Often people have a really pleasant time in the experience, but sometimes as well, people do realize very deep and potentially hidden aspects of themselves, and that takes time to integrate. And so I like to think that that there are catalysts to getting better forever, as opposed to you will take it and then suddenly you will be healed. 00:12:46 Speaker 4: But if we look at what's happening. 00:12:48 Speaker 3: In clinical trials, if we look at the amount of people who've got treatment resistant depressions, for instance, who have had significant clinical improvement in their condition, we definitely are able to do that. And that is you know, normally, within you know, a month or so of having the treatment that they would do those follow up assessments. Now, in terms of the long longevity of it, again, like I say, how much you integrate this into your life. You can take a psychedelic and feel amazing and be dancing around having the most wonderful time. But if you don't do anything about what you potentially are learning about yourself during this experience, and you just carry on all of the same practices in two three four weeks time, you'll feel exactly the same as you did before you took the psychedelic and the same again if you ever do it in a very therapeutic way. And we do see this within these clinical trials. Now we're starting to get follow ups that are six months a year down the line. 00:13:48 Speaker 4: There's still a very good, meaningful. 00:13:50 Speaker 3: Benefit to a majority of people who've been in the trial, but people do start to regress back towards the baseline, and so you know, it's not this sort of one and done that perhaps we'd originally thought with psychedelics, and maybe you can just take it once and then you work at all your problems and then you never have to take it again. It's not really that, it's sort off. You take it and then you kind of stops the journey that you do need to pay attention to in order to maintain getting benefit in the long run. 00:14:19 Speaker 1: Coming up, we discuss the potential uses of psychedelics specifically tailored for women, and how these drugs may interact with our hormones more in just a moment. Whenever a new study is published on psychedelic assisted therapies, I find myself drawn to it. Typically, this type of treatment is taking place in a controlled clinical setting where trained therapist or clinical staff are involved before, during, and after the drug is administered, and training facilitators are part of the process, helping participants prepare

beforehand, staying with them during the experience, and guiding integration sessions afterward. The idea is that the drug alone isn't the treatment, it's actually the combination of the substance with the structured psychological support. I wanted to hear from doctor Bless Hapley about what conditions these types of therapies may be most effective for. So what types of conditions would midlife women women look for in terms of using a psychedelic The. 00:15:38 Speaker 3: List goes on and on. Right in oncology, there is some incredible work. There's some amazing work going on in neurodegenerative disorders, and obviously we know women are so much more prevalent to developing neurodegenerative disorders later in life. So I think that work is still in its infancy, but is extremely promising. So there's a long long list of things that they can be useful, but the primary thing with which they are being investigated for at the moment are largely mental health conditions and primarily depressive conditions, so things like treatment resistant depression or major depressive disorders. 00:16:10 Speaker 4: So interesting, but yeah, very interesting. 00:16:12 Speaker 3: But I think, particularly for women, I think there is this amazing opportunity to explore how psychedelics could be useful for pre menstrual conditions. I've been thinking particularly around PMDD pre mensional dysphoric disorder, which is a pre mental disorder that is a very severe form of PMS. Essentially it affects up to eight percent of women and really is a very very marked change in their mood and behavior around the final week, sometimes even as long as the whole Luther your face, so final two weeks of their mental cycle. But one of the things that we do know about this condition, unfortunately it is highly associated with previous life traumas. We also know that PMDD seems to be associated with changes in sensitivity of things like our progesterone receptors, and that could be a lot to do with why women feel like like this and potentially to do with their stress responses and their HPA access, and these are all things that we are starting to think that psychedelics could interact with with HPA axis. 00:17:12 Speaker 1: Could you just define for our listeners what the HPA access is. I know what it is, but I don't. Lot of people probably don't. 00:17:18 Speaker 3: Yeah, the hypothermic pituitary access is essentially a feedback loop within our bodies that involves a couple of structures within our brains, and it's primarily the system that dictates our coursol and our cord sole release, and so our kind of stress response. 00:17:37 Speaker 4: Now cors soil is. 00:17:39 Speaker 3: Needed because if we didn't have it, we would struggle to get ourselves out of bed in the morning, and so we have a small spike every every morning. It's a kind of waking response. But we also have a spike when we have any stresses that come in our lives, and when we have repeated stresses or chronic stresses that are not tigers but in fact a never ending email chain or something, then we can start to get dysregulation in that feedback system, and that's when we start to see, you know, increases in things like anxiety disorders, insomnia particularly, and it's HPA access. It is the conductor to the orchestra, if you like, of dictating when we start releasing different hormones at different parts of our mental cycles. So if it becomes dysregulated through stress dysregulation, but when we do start to see people having issues with prematural symptoms and potentially changes in their mental cycle length or even their fertility. Maybe so knowing that psychedelics potentially can alleviate some of this dysregulation in the system could be very useful for women. But we need to investigate and understand that, I think in a way that we've not been very used to doing. 00:18:48 Speaker 1: How about the use of psychedelics for chronic pelvic pain, pulvic floor dysfunction, women with endometriosis who suffer from terribly Any work going on in that area in terms of women's health specifically. 00:19:01 Speaker 3: Yeah, absolutely, I even myself have been doing some work in to this around the idea of chronic pelvit pain and women. So things like endometriosis or volverdina for instance. Sometimes we forget that there are two sides to pain. There's the thing that is causing the pain and there's the thing that is perceiving the pain, and if the thing that is perceiving the pain, I er brains has gotten stuck on thinking pain is expected in those rigid ways that I talked about about earlier that we sometimes get in these control centers of our brain, then we are expecting to feel pain. And when we're expecting to feel pain, any pain that we do then feel, we will feel in a more intense way. So by being able to potentially change some of those pathways within the brain around pain perception, and some of the work we did in some military actions with chronic pain kind of showed this that perhaps although the pain in the actual limb itself, the aggrogreic gating factord not change their perception of the pain, and their relationship with the pain had changed as such that they no longer felt like they were in as much chronic pain or they were no longer bothered by it as much as they were previously. So I think there is a huge potential for women in this area. And also I think there's something about psychedelics that really allow us to kind of include things like embodiment practices where we can really start to actually connect our wonderful you know, all controlling brains, less them to our bodies, which actually have a lot more input, I think than we often give them credit for. And we know that within women particularly, we often do kind of dissociate away from our bodies, particularly when we've had a lot of unexplained chronic pelvic pains that maybe we've not been you. 00:20:42 Speaker 4: Know, listened to properly in our healthcare systems. 00:20:45 Speaker 3: And

so having the ability to also connect with our bodies and think about how movement practices can be used in collaboration with psychedelics or you know, as a kind of mindfulness practice could also be very very useful for these, yeah, particular conditions. 00:21:02 Speaker 1: So a lot of the midlife women have issues with sleep insomnia that sometimes aren't even corrected with proper hormonal management, application of psychedelic treatments or uses with chronic sleep issues and insomnia issues. 00:21:17 Speaker 4: Yeah, and insomnia is a really interesting one because there can be. 00:21:20 Speaker 3: So many reasons why, right why we are having insomnia problems. One of the common ones and women can be dysregulation of quartsole released and sometimes we're very stressed, we're releasing cortal at the wrong time, and then it's difficult for us to be asleep when that is happening. You know, that's very closely tied with anxiety, which is one of the main drivers for insomnia, and we know that psychedelics improve anxiety. And you know, the final women's specific kind of midlife psychedelic use that I wanted to come to is of course, that of perimenopause and menopause, and I think sleep is obviously a huge, hugely associated symptom within that field. And overall we've seen that the women who've gone and taken psychedelics at retreats have reported to us a vast improvement in a large range of menopause symptoms, including this, and the reasons for that I think could be manifold. 00:22:15 Speaker 4: With estrogen. 00:22:16 Speaker 3: We also know that it highly affects the serotonergic system, increases the amount of serotonin serotonin network activation, and it also has these hugely neuroprotective effects and effects that increase things like neuroplasticity, and so when we lose those effects during perimenopause and menopause, there can be very much correlated with the development of a number of issues with anxiety, sleep, depression, you know, even with things like cognitive performance. 00:22:46 Speaker 4: But there's also this wonderful opportunity. I think that as. 00:22:51 Speaker 3: Women going through perimenopause and menopause, there's a lot to rationalize with yourself. Right, You're going through a monumental change in your life stage and kind of potentially how you identify, and so taking psychedelics at this time has often been kind of reported as extremely useful to help women to process that change and to kind of accept often that they are now moving into postmenopausal phase. And so we don't always need to think about looking after ourselves on just biological and mechanistic level. We have to think about looking after ourselves on a spiritual level, and psychedelics are very good for that. 00:23:31 Speaker 1: Is there any intersection between how estrogen affects the impact of a psychedelic on a female brain in terms of should we be using if we are going to use a psychedelic to be used in a ludial phase, the follicular phase

perimenopause versus menopause, do you see different reactions any correlation there? 00:23:52 Speaker 3: Well, this is what I really am on a mission to find out, and we are slowly starting to gather bits of data and even develop the tools so we can even take the measurement. But just by theory, one would assume if we've got higher levels to be stood in them, we've got a more reactive soonergic system, therefore need less of a psychedelic to achieve the same effect. Now do we know that to be definitely true In terms of giving women psychedelics at different estrogen phases and seeing if it changed their effect, Well, we haven't been able to do that yet, and we hope that we will, but it does make sense mechanistically that there is going to be some kind of drug drug interaction, if you will, between estrogen and psychedelics. But for me, one of the most important aspects in terms of hormonal influence and psychedelics that should be taken into account is that of the effect of progesterone. And when we see progesterone dropping very suddenly at the end of our mental cycle, we see this huge change in what is actually an anziolytic effect that progesterone is giving us kind of chills es out. It's similar mechanism to alcohol, and so when we see this level drop dramatically at the end of our mental cycle, that's when we see huge increases in things like intrusive thought patterns and also you know, higher dysregulation with our dopaminagic systems. So all of these things increase the likelihood that our mindset it's going to be such that we are particularly anxious. Maybe we are having physical effects, you know, breast tenderness or pain, and if we gave a psychedelic, then they are internal amplifiers. If you feel terrible and you take a psychedelic, there's a good chance you can amplify that feeling. 00:25:35 Speaker 4: So for me, this effect of how changes. 00:25:38 Speaker 3: In hormones in women during the mental cycle effect their mood and their emotional processing. If it is severe, then we should not try and use high dose to psychedelics during that time. 00:25:50 Speaker 1: I love the reminder that pain isn't just physical, it's also mental, and that goes from major shifts like menopause too. It's so interesting to think about the ways that psychedelics might help with this emotional journey. After the break, doctor bless Happy and I talk about what's next in the field of psychedelic research, and we discussed some tips for people looking into options in the space Welcome back. So we've talked a lot about the research that's happening and what we're learning about how these drug assisted therapies may be useful to clinicians who are operating in safe and controlled settings. I was also curious to hear more about the world outside of that setting. To be clear, I'm a doctor and an advocate for safe and controlled settings, but I'm not naive. I know that people are curious and they're very capable of finding ways to experience or experiment with

these drugs outside the doctor's office, oftentimes at retreats or with their friends. In addition to her research efforts, doctor Grace Blessed Hopley is engaged in education and advocacy around women's psychedelic retreats, So I had to ask her about what those are like and if she has any tips for women to keep them safe. But before we get there, I wanted to hear more from doctor Blesh Hopley about why she founded Hystealica and what she hopes her research, education and advocacy efforts yield in this space. So you founded a company called Hystalica. Tell us about it. Why did you start this company? What are you doing with it? 00:27:37 Speaker 4: Yeah? Absolutely? 00:27:38 Speaker 3: So, really is my babya and it's a nonprofit organization that really does have this mission around understanding women and psychedelics, and we're doing that in a number of different ways. And first and foremost, it's important that we provide education, and that's education for women about their own bodies. It's education for clinicians who are going to be using psychedelics and researchers who are trying to think about the questions that they should be asking. So we've really tried to make sure that everybody kind of what they need to make informed decisions that they. 00:28:12 Speaker 4: Might need to make now. 00:28:14 Speaker 3: But we also want to answer some of these primary questions that we don't have good answers to, and so for the last few years we've been conducted in research alongside King Scotish London, where I am still a researcher, asking women who've used psychedelics to share some of their experience with us, and that's enabled us to start to build a data set from which we can start to tease a part some of potentially the answers to these questions around when is it safe for women to take psychedelics? You know, what are the things that we need to explore more and understand more. 00:28:44 Speaker 4: And beyond that, what we try and do in Hystelica is to. 00:28:47 Speaker 3: Be an advocacy for this work and to highlight how important it is and to highlight other women in the space who are doing similar work, because it's not easy out there being an academic, and sometimes it can be really difficult, you know, if you're trying to convince people that it's important that we spend a lot of time and a lot of money on something that hasn't really been given very. 00:29:12 Speaker 4: Much respect before. 00:29:14 Speaker 3: It's a huge, huge hole in terms of the all of the previous biological knowledge that we have. It's largely based on male models, male animals, you know, males, and clinical trials, and so there's a huge amount that needs to be unpicked and rediscovered. So it's important that for me at Hystalica, we become a community for researchers and for women who are interested in understanding themselves and understanding how psychedelics can help themselves. 00:29:41 Speaker 1: Have you seen the perception of the use of psychedelics and the acceptance of the use of psychedelics and the state of the research has it you founded this company in twenty twenty two, is have you seen a change over the passport three year or four years? 00:29:55 Speaker 4: Oh? Yeah. Absolutely. 00:29:56 Speaker 3: I remember when I first signed the company and I was sort of try and sit there and explain to my mom and dad what I was doing over the Christmas dinner table, you know, And now my mom is sort of sharing the Instagram posts with her friends. I love. Yeah, there's definitely a huge change, and I think a real big change that is coming around in women. And I think a lot of that comes around, like I said, this idea of community. We often, in the lack of good healthcare options for women, do just sort of discuss with our girlfriends right about what maybe worked for them. And these conversations are often where we make a lot of our healthcare decisions sometimes. And we've definitely seen there's been this kind of ripple effect of women who are starting to talk about psychedelics in rooms and at the tables that perhaps they wouldn't have felt comfortable doing before. And that is sort of slowly trickling down as to who then says, maybe I. 00:30:52 Speaker 4: Will go on a retreat, and you know. 00:30:54 Speaker 3: The number of high quality psychedeltic retreats that are not available that are specifically designed for women is going up and up. Now I should caveat that with there's some not so good retreats, and we should always be very very cautious about about choosing to go and do any of the stuffs of people that we don't know, we don't have any background on, but people I would not have told them what I did before, and now have they come to me and ask me how it can get involved. 00:31:21 Speaker 4: So it's been remarkable great. 00:31:24 Speaker 1: What generally happens in a retreat, I'm fascinated by the retreats actually, but what happens like so you do you do a dose of psilocybin or do you do one journey or one trip days and weeks long. 00:31:36 Speaker 3: So not all retreats are the same. And obviously the substances that are used in retreats varies a lot. But if we were to say, take for example, a psilocybin retreat, So for instance, I partnered with a female retreat provider and we're going to do some retreats next year that are reasonably standard. What we primarily do is we get people kind of enrolled three four weeks before the retreat itself. Hopefully we will have a medical screening before you get onto the retreat, and then you will have a couple of calls where you'll meet the other people on the retreat, meet the facilitators, ask any questions, and then the retreats themselves are usually between four and five days long. 00:32:20 Speaker 4: They usually consist of one or two psilocybin. 00:32:23 Speaker 3: Ceremonies, and you will perhaps arrive on the first day, settle in, and then have some discussions in the evening. The second morning, maybe you have a kind of preparatory session

between you all, and then the first ceremony will usually happen on the second day, and that ceremony is around six hours long, and after the ceremony is finished, most people you'll just want to eat and go to sleep, and then the next day you probably take a day of integration, so that might look like again having group discussions, but journaling, often meditation practices, yoga massages, but really taking time slowly and just reflecting. And then the day after that often they will then do a second ceremony, and all the day after that again will be kind of integration and discussion and again practices of how you can take these things forward into your life. And then once you leave the retreat, that's when all the real work, real work starts, and integration is and often you will then stay in touch with your cohort for you know, three four weeks having group calls to try and integrate some of your process. But the whole retreat itself is really designed as a space, a held space where the facilitators and the people who are running the retreat are essentially there to keep a container during which you are able to kind of go through and you know, experience what you need to experience, express whatever it is you need to express, and they can be really magical environments. Have been extremely lucky to go to a number of retreats as not as a participant, but as somebody who is helping out with collecting research or similar and the atmosphere is unbelievably calm and really fosters this ability for us to do really deep reflective work. 00:34:17 Speaker 1: Do you collot data from Can you cuot data from these retreats? 00:34:20 Speaker 3: Yes, So we collect data as Hystalica, which is an open survey for any women who are going to any retreats, And what we do is we ask people are baseline so before they go, and then four weeks and twelve weeks afterwards. No, this particular piece of research is specifically looking at mental cycle symptoms and specifically looking at menopause symptoms. But I've done a lot of research, for instance, with military veterans, where we've done a similar thing, and we're looking at post mundic stress disorder, quality of life military to civilian conversions. But there's also a lot of real interest now and I completely get it in individuals who are going through psychedic retreats who want to you know, we all are clean on our own data, and we are, you know, all getting so good at integrating all of these wearable devices into our lives. And there are some really interesting programs that have popped out that you can sort of apply for subscription and sort of follow yourselves through your own psychedelic experience and see what kind of changes that it might occur. 00:35:23 Speaker 1: Integration and wearables. I love that, actually, I love that's really great. What trials and research right now do you find particularly promising? What do you see as the future the promising area of the future. 00:35:37 Speaker 3: There are

hundreds of clinical trials currently ongoing with psychedelics, so it's difficult to pick my favorite favorite one or my favorite indication, but for me, it has to be neurodegenerative disorders. And potentially things like traumatic brain injuries as well. With psychedelics, we're starting to think it could be possible that we have a mechanism that looks a bit like neuronal regrowth in traumatic brain injury. It's early days, it's all very pre clinical. Plus this anecdotal evidence of people who've taken psychedelics, but. 00:36:10 Speaker 4: We not have good answers for them at all at the moment. 00:36:13 Speaker 1: What women who should consider pursuing any type of psychedelic type of treatment. Who do you think benefits the most? Who should seek Who should say, hmm, maybe that's from me, Maybe I should pursue that. 00:36:26 Speaker 3: I think that there's a lot a lot of women would benefit hugely from it. You just sort of ask yourself the questions in terms of what that potentially would you like to discover about yourself? Or is there some part of you that you want to move past. And we don't always have to talk about this in terms of oh, I actually I feel very anxious, or I'm having sleep problems. It could be like I feel a real creative block between my work at the moment and I want to find out what is at the bottom of that, Or my children have all left home, and I want to now give myself the opportunity to re engage, you know, with myself and understand more. So anyone who has this sort of curiosity to try and understand themselves more, you know, potentially with this intention to improve in some aspect I think, is really ready to start thinking about doing it. It's fascinating to watch, as I say, people kind of come out the other side of it, and often the thing that they go in that they think is the thing that has been upsetting them, and it actually turns out that it's nothing to do with it at all, And then you can actually yeah, absolutely, and then you can address it and move forward, whereas if you don't, you'll spend your whole time looking at this thing, going why is this thing ruining my life? Not understanding it's nothing to do. 00:37:45 Speaker 1: With it's something in a different direction that's like, yeah, that's actually so interesting. Gives you better. 00:37:50 Speaker 4: Insight, huge insight about who you are. 00:37:54 Speaker 1: If somebody is embracing psychedelics in their life and using them and as having benefits from them, how frequently are they using them? 00:38:05 Speaker 4: Yeah, that's another great question. 00:38:07 Speaker 3: And I think as little as you need to, you know, as should be the answer with a lot of things that we take. But when it comes to big ceremonial doses, you know, if you do a ceremony properly, you shouldn't really want to go back to one in the near future. You know, they are big and they are a lot to process. It's always a concern for me when I see people jumping from one ceremony to

the next. It can often mean they're doing something we might call spiritual bypassing, where you're not really listening to the message you're getting, but the ceremony itself is making you feel kind of good enough, and that afterglow that you just keep jumping from one to the next. There's an excellent quotation, when you get the message hang. 00:38:48 Speaker 1: Up the phone microdocing. Tell us about microdocen What that is? What are the benefits? 00:38:54 Speaker 3: Yeah, well the jury is still allowed on the benefits, I'm afraid. But microdosing essentially is taking a sub perceptual sub pollucinatory amount of the substance. And I say, you know both those things there as we always used to say sub perceptual, but actually when we think about some of the what we would still classed as a psychedelic people are. They are noticing that something is different, but it's not in a way that would impair your ability to go about your everyday life. So you would still be able to. 00:39:33 Speaker 4: Work or move around. I won't say you would be able to drive, because these substances are illegal and you actually would be breaking the law. 00:39:41 Speaker 3: So when we talk about microdocing, what we're talking about is usually taking these substances in a way that might be much more recognizable to how people think about traditional pharmaceuticals. So we're taking these substances daily, though often with micro docing protocols we might say we'll take them every other day, for instance, and there's a lot of kind of thinking about you know, exactly what that should be, but essentially you do it for a prolonged period of time. Now, the reason that you might be doing that could be for all of you, you know, the improvements in serotoinlagic function, but also these improvements in europlus system the other kind of long you know, more kind of longer lasting effects of psychedelics. In terms of evidence we have, it's a difficult one because there's not been a lot of randomized control trials done and one of the things that is really important to remember is that the placebo effect is very, very real, particularly in mental health disorders, and the anticipation that people have that using a microdose of psychedelics is going to make their insert thing hear better is such that many people see a huge benefit when they start microdosing. Once we start to take that data and we apply control groups to it, we apply placebos and more rigorous testing in terms of what is actually changing, we see those effects actually come down a lot. And so the evidence base for microdocing psychedelics as a substance is the thing that is making your anxiety go away or improving your cognition or whatever else they have been testing, is that. Yeah, it's a bit it's a bit trickier to find once we add a randomized control trial in. And it could also just be that the pacibo response is so strong, yeah right, that it still works. It's just everyone the perceiver really thinks it works too, and so the effect size gets washed out. 00:41:39 Speaker 1: Washed out contraindications to psychedelics. Sure should not use a psychedelic. 00:41:46 Speaker 3: Yeah, Well, I think there's a lot of questions still around psychosis, and anyone who has any family history of psychosis and talking things psych schizophrenia or bipolar disorder. We do have some anecdotal evidence of people having taken psychedelics and it induced a psychotic episode in people who were already predisposed to this. So if you do have had any personal history of psychosist or have any immediate family members a brother or sister, a parent, an uncle and aunt, then I don't recommend that you take these substances. The other part is that these substances do put a strain on our systems and our physical bodies for the time in which we're under them. They increase our heart rate, our blood pressure, if you have any cardiovascular problems, again, it would not be advisable to take these substances. We know that women are a much higher risk for cardiovascular events postmenopause and so potentially are a group at higher risk for using psychedelics because of this particular aspect of them. And if you're currently taking medication, there's a lot of medications that do not mix well with psychedelics. As I mentioned, these are working on many different systems within our brain, primarily the serotonergic system, but also you know dopamine, glutamatic and so if you're taking any medications, particularly any psychiatric medications, it's really a good idea that you go. 00:43:16 Speaker 4: And speak to somebody. But we also know. 00:43:19 Speaker 3: That these psychiatric medications can take a long time for our brain to kind of bounce back in terms of receptor availability and things, and that can really impact the experience that you'll have, not that you'll have a worse experience, but often that the experience will be dulled in some way, will not actually have perhaps the effect that you would like. My final point was just to say, as well, anyone who's not serious about it, I don't think should do it. 00:43:43 Speaker 4: I think you know that they need. 00:43:45 Speaker 3: These substances are amazing, but they are very powerful and if you're not really in a position to take it seriously in terms of you know, checking in with yourself and making sure that you are mentally prepared to you know, take these substances and have thought about what integration might look like for you and how you might want to you know, you know, include certain practices going forward. All of those things are really really important in terms of in proving your chances of having a successful experience, but also your safety during the time. 00:44:20 Speaker 1: So resources in terms of best practices for women are anybody who wants to pursue this, what do you recommend to women who want to start on maybe this pathway. 00:44:31 Speaker 3: I have a couple of retreats that I know personally and I

trust, and I have them on my website. I also have on there a whole page that is taking you through the checklist of you know, what you should look for in a retreat and the questions you should be asking yourself before you go to retreat, so you know, ask yourself what your intentions are, but ask yourself what their intentions are. And I often like to think about when you kind of go through the process of being under the influence of psychedelic it's probably a little comparable to that of giving birth. And if you wouldn't trust that person to help you give birth, don't trust them to sit with you while you're on psychedelics. 00:45:12 Speaker 1: If women could take away one major point from our conversation today, what would you hope it to be. 00:45:19 Speaker 3: I'd like them to take away if they've not tried psychedelics, that maybe that this maybe this could be a gift that they give to themselves, and it could be this moment to think, actually when did her last check in with me and understand, you know, the route of perhaps my anguish in any way, and do something about trying to change that. And it doesn't have to be psychedelics, right, Maybe it's a yoga class, maybe it's meditation, maybe it's something else, But it's worth just taking time to check in and ask our bodies because modern Western science has not been designed, particularly with women, to make sure that we are looked after on you know, not just these kind of biological levels, but also these spiritual levels. 00:46:06 Speaker 1: I love what doctor Bless Hopley just said about taking the time to check in with our bodies, about finding ways through movement, through meditation, through whatever brings you peace and joy, and making room in your life for those things. It's clear that the field of psychedelics has a ton of promise. There's still a lot of research to be done, especially on how they affect women, which is why I'm so grateful that researchers are finally paying attention to this. And this conversation made me excited hearing that through these studies we're getting early indications of ways these drugs may be helpful tools. But it's important to keep in mind that psychedelics are a tool. They're not a magical cure. They may be a way to give your brain a chance to shift out of long standing patterns, or a way to manage depression when other options just haven't worked. But of course it's so crucial to check with yourself and do your research before undergoing any new treatments, especially in this space. Coming up, on the next episode of Decoding Women's Health, I'll be joined by a very special guest, my husband, doctor Richard Shapiro, for a conversation about how to best support your partner through menopause. Dacoding Women's Health is a production of Pushkin Industries and the Atria Health and Research Institute. This episode was produced by Rebecca Lee Douglas and Daphne Chen. It was edited by Amy Gaines McQuaid, mastering by Sarah Bruguer. Our associate producer is Sonya Gerwitt. Our executive producer is Alexandra Garreton. Our theme song was composed by Hannes Brown. Concept creative development and fact checking by Shabon O'Connor. Special thanks to Alan Tish, David Saltzman, Sarah Nix, Eric Sandler, Morgan Ratner, Owen Miller, Jordan McMillan, and Greta Cone. If you have questions about women's health and midlife, leave us a voicemail at four FI five two one three three eight five, or sends a message at Decoding Women's Health at Pushkin dot FM. I'm doctor Elizabeth Pointer. Thanks for listening. Until next time,