Naturalistic Psychedelic Use and Associations with Unintended Improvements in Depression Among Spanish-Speaking Populations

Background and Purpose: Recently, there has been increasing interest in using psychedelic substances as adjuncts in treating various psychiatric conditions, including depression (Davis et al., 2020). However, Spanish speakers are historically underrepresented in these studies, and we know almost nothing about psychedelic experiences in these populations (Garcia-Romeu, 2021). Therefore, the present study aimed to explore whether naturalistic psychedelic use was associated with unintended changes in depression among those that speak Spanish.

Methods: In this cross-sectional, international, observational study of Spanish-speaking people, we examined associations of psychedelic use (i.e., psilocybin, LSD) with subjective changes in depression. Respondents (n=442) completed an anonymous web-based survey assessing their experiences with a meaningful psychedelic experience. We asked respondents about their demographics and background characteristics, acute effects (e.g., mystical experiences, challenging experiences, psychological insight, ego dissolution) associated with their psychedelic experience, and enduring effects (e.g., changes in relationships, behavior, meaning in life) since their psychedelic experience. Additionally, we asked participants if they had depression before their psychedelic experience. For those that said ‘yes,’ we asked if they thought their depression changed (i.e., ‘better,’ ‘worse,’ or ‘no change’) after their psychedelic experience.

Results: Of the 442 participants in the study, 205 (46%) reported having depression before the psychedelic experience (Male=69%; Latine=81%). Of those, most (84%) reported that their depression improved following psychedelic use, and fewer said that their depression was unchanged (13%) or worse (3%). To explore associations with changes in depression, we compared those who reported improvement with those who did not report improvement (i.e., worse or no change). There were no demographic differences between those who reported their depression improved and those who reported no change or worse depression. Those that reported improvement also reported significantly greater intensity of mystical experiences (p<.05; Cohen’s d= -.64), ego dissolution (p<.05; Cohen’s d= -.67), and psychological insight (p<.05; Cohen’s d= -.79) compared to those who said that their depression stayed the same or worsened. Additionally, participants who reported improved depression reported significantly more persisting effects than those who said their depression stayed the same or worsened. For instance, compared to those who reported no change or worsened depression, those with improved depression believed to a greater extent that their psychedelic experience had led to persisting changes in their personal well-being or life satisfaction (p<.05; Cohen’s d = -.84); life’s purpose (p<.05; Cohen’s d= -.58); life’s meaning (p<.05; Cohen’s d= -.68); social relationships (p<.05; Cohen’s d= -.89); attitudes about life (p>.05; Cohen’s d= -.80), self (p<.05; Cohen’s d= -.89) and relationship to nature (Cohen’s d= -.41); behavior (p<.05; Cohen’s d= -1.19); spirituality (p<.05; Cohen’s d= -.63); attitudes about death (p<.05; Cohen’s d= -.50); and the true nature of reality and the universe (p<.05; Cohen’s d= -.60). There were no associations between depression improvement and the intensity of acute challenging physical/psychological effects during the psychedelic experience.

Conclusions: Prospective clinical pharmacology studies that control for factors contributing to minority stress should examine the safety and efficacy of psychedelic administration for relieving depression among Spanish speakers, a traditionally underrepresented demographic.