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16 February 2017updated 18 Feb 2017 4:51pm

Could “microdoses“ of LSD be used to help depression?

In A Really Good Day, Ayelet Waldman tells her story of self-medicating with LSD.

By Philip Maughan


It’s possible you’re already familiar with microdosing – “the hot new business trip”, according to Rolling Stone, “the drug habit your boss is gonna love”, according to GQ, and the subject of enough neo-gonzo trend pieces to make writing about it almost a genre unto itself – but in case you aren’t, allow me to help you catch up.

The term refers to a regimen in which “sub-perceptual” doses of the psychedelic drug LSD – generally around ten micrograms, about a tenth of the dose consumed for recreational purposes – are ingested once every three days in a glass of water with breakfast, in the belief that this will improve cognition, reduce distraction, aid productivity and alleviate depression, without any of the more disruptive side effects associated with dropping acid.

Although Albert Hofmann, the Swiss chemist who first synthesised LSD in 1938, suggested that “very small doses” might one day be used as “a euphoriant or antidepressant”, the idea began to generate mainstream attention only after the publication of The Psychedelic Explorer’s Guide in 2011, a handbook by the American psychologist James Fadiman for those with an interest in “safe, therapeutic and sacred journeys”. It features a short chapter, close to the end, which asks: “Can sub-perceptual doses of psychedelics improve normal functioning?”

The answer appears to be yes. Fadiman’s book contains just a handful of accounts from users claiming that regular, low-level doses of acid or psilocybin (the “magic” compound in “magic mushrooms”) have improved their lives, but he has continued to solicit responses. He wrote and distributed a memo entitled “To a Potential Self-Study Psychedelic Researcher”, offering practical advice within the tricky scientific and legal framework. LSD has been illegal in the United States since 1970 and in the UK since 1971. Fadiman’s guide is prefaced by a disclaimer (“Nothing contained herein is intended to encourage or support illegal behaviour”) beside a dedication to “Ken Kesey, Tim Leary and Al Hubbard – destroyers of structures and complacency, who made it all both possible and impossible”.

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Fadiman has now received hundreds of testimonies, the latest of which runs to more than 200 pages and comes from an unlikely source: “a good, Jewish, middle-class, upwardly mobile, anxiety-ridden mother”, the writer and former criminal lawyer Ayelet Waldman. A Really Good Day, Waldman’s new book, tracks changing laws and attitudes to mind- and mood-altering substances in the US. At the same time, it is an autobiographical account of how drugs have affected her life, both as a public defender representing those who have fallen foul of America’s staggeringly punitive drug laws and as a mentally ill woman, driven by desperation into trying something new.

In the prologue, Waldman makes a list of the prescription drugs that were given to her to treat what was first diagnosed as bipolar disorder but later rediagnosed as a form of PMDD (premenstrual dysphoric disorder). She also struggles with insomnia and a frozen shoulder, conditions for which fluoxetine (Prozac), amphetamine (Adderall), diazepam (Valium), zolpidem (Ambien) and THC (marijuana), to name but a few, have proven problematic or insufficient.

Noting the irony that Waldman, a nerdy mother-of-four who distrusts all things countercultural, can remain law-abiding and “drug-free” while consuming “a shit-tonne of drugs” is the first step to understanding the hypocrisy of the situation. ­Reflecting on this, she plucks up the courage to make contact with the mysterious “Lewis Carroll”, an ailing university professor introduced to her by a friend. He sends her a tiny “cobalt blue bottle” of “vintage” stuff through the mail.

Official research was largely halted in the early 1970s, and so much of how the drug actually works remains a mystery. We know that psychedelics stimulate the 5-HT2A serotonin receptors in the brain, which in turn increases the transmission of glutamate: a powerful neurotransmitter that supports memory, learning and adaptive thinking, as well as feelings of happiness and well-being. An experiment carried out at Imperial College London in 2016 (paid for in part by a grass-roots crowd-funding campaign and the Oxford-based Beckley Foundation) used fMRI machines to monitor the responses of healthy subjects to 75 microgram doses of LSD. Waldman describes what the scans revealed: “a kind of hyperconnectivity within the brain, allowing unrelated and usually discrete regions to communicate with one another”.

Although she experiences “a slight increase in insomnia and an occasional irritable mood on Microdose Day”, Waldman is mostly positive about her results. She has moments of joy that are “nearly, though not quite, euphoric”, gains a “heightened awareness” of the world around her and has fewer fights with her family. More straightforwardly, she looks back over a month of “really good days”, in particular where work is concerned, staving off procrastination and completing her daily tasks with “ease and pleasure” (though it is not possible to know if this was the result of the ­microdoses, or just a placebo effect).

At times, the chummy prose style (“Teenagers are really good liars,” a rather lame footnote reads, “especially to their parents”) seems at odds with the subject matter. Waldman was criticised heavily in 2005 after suggesting in an essay that she loved her husband, the novelist Michael Chabon, more than she loved her kids. Her frankness about family life is admirable. It’s just difficult at times to see how these revelations relate to LSD.

In the end, Waldman writes, it isn’t happiness that microdosing brings, but insight: “a little space to consider how to act in accordance with my values, not just react to external stimuli”. As for the future, she explains that her experiment has come to an end. Her rationale is simple: she is quitting not because microdosing doesn’t work, but because it is a crime. Despite a loosening of regulations that has enabled new research into the therapeutic possibilities of MDMA (Ecstasy) for veterans with post-traumatic stress disorder, or psilocybin in end-of-life care, the reality remains the same. In a country where “somewhere between 8 and 10 per cent of the population are on antidepressants alone”, Waldman writes, “the one drug I have found that actually helps me I am forbidden to take”.

A Really Good Day: How Microdosing Made a Mega Difference in My Mood, My Marriage and My Life by Ayelet Waldman is published by Corsair (231pp, £13.99)

This article appears in the 15 Feb 2017 issue of the New Statesman, The New Times