Wednesday, March 20, 2024

By Courtney Wise

Good morning, MindSite readers. In today’s Daily, ibogaine helped traumatized Navy SEALs in a study and advocates want to step up the research – but others question its safety. Peer support specialists are trying to fill the mental health services gap. A psychologist worries about election and political despair. And more.

Navy SEALs say ibogaine helped them recover from trauma and TBIs. But, is it safe?

The traumatic brain injuries (TBIs) tanked his mental health and nothing provided relief – until he tried ibogaine. The psychoactive substance derived from the African shrub iboga has long been used in traditional medicine and religious ceremonies, and it helped heal him, too, Jones told the Washington Post. It reduced his desire for alcohol and rekindled his interest in pleasures he’d left behind. These days, he’s running, surfing, and enjoying better relationships with family. “For a disabled veteran, I can do some amazing [stuff],” Jones said. “I can’t believe I’m back in the water shredding waves.” 

Jones is one of 30 former Navy SEALs with TBIs who took part in a Stanford University study published earlier this year which found that ibogaine improved their symptoms of anxiety, depression, and post-traumatic stress disorder (PTSD). The findings buoyed the efforts of advocates who want to see the drug used in the U.S., especially to treat addiction. 

But ibogaine has been illegal in the U.S. since 1967, classified as a Schedule I controlled substance alongside LSD and heroin, with no accepted medical use and a high potential for abuse. Some people have traveled to Mexico, paying $9,500 to $15,000 at clinics there. The restrictions irritate advocates, who say ibogaine isn’t used recreationally because the trips it induces are so taxing. They also point to research by the National Institute on Drug Abuse (NIDA) in the early 1990s that showed rodents given ibogaine consumed less heroin, morphine and cocaine. Ibogaine “heals the brain,” by spawning growth of neural networks in damaged brains, said Deborah Mash, founder of DemeRx, a company developing addiction treatments from ibogaine compounds. 

But that same research showed that it killed brain cells and disrupted heart rhythms, sparking concerns about arrhythmias. Heart concerns led to NIDA ending its ibogaine studies in 1995. The risk is real, said Mark Haigney, director of cardiology at the Uniformed Services University. “To safely use ibogaine, you’d have to do a great deal of heart screening,” he told Kentucky lawmakers debating whether to allocate $42 million to a “research entity” to study ibogaine. He doesn’t believe the FDA will approve the compound, and even some supporters of ibogaine question the idea of providing money to a private firm. 

More research is needed  to determine its long-term efficacy and safety, said Alan K. Davis, director of the Center for Psychedelic Drug Research and Education at Ohio State University. “It may only help in the short term for most people,” Davis told the Post. “For many, ongoing clinical aftercare therapy and other forms of treatment may be needed.”

In California, Medicaid pays for peer specialists, easing the shortage of therapists

It’s a simple solution that ought to catch on: Amid a nationwide shortage of mental health professionals, California allows county Medicaid funds to pay for peer counselors – people qualified by their lived experience rather than specialized licensing. Having learned to recover from substance use or mental health disorders, peers tap into their ability to relate to patients  dealing with the same issues. Medi-Cal, as the state’s Medicaid program is called, funds peer counselors like Derrick Cordero at Holding Hope, who grabbed onto the lifeline offered by a peer group similar to the one he now leads. He’ll be eligible to be paid for this work, once he completes a peer training and certificate program, KFF Health News reports.

Cordero’s struggles began early in life, as he navigated the world as a child of Filipino immigrants. Crippling anxiety as a teen led him to consider suicide but not to tell his parents. “I had American problems for my parents and family who had a traditional Filipino paradigm,” he said. By his 20s, Cordero was diagnosed with borderline personality disorder and using marijuana and methamphetamine. Human services courses at Solano Community College allowed him to speak to high school students about mental health and kept him on a disciplined schedule. But when that program ended, he unraveled. 

“I just dove headlong into substance abuse,” Cordero said. He neglected his family and physical health, developing diabetes complications that forced him to visit the hospital repeatedly. One of those visits led him to Holding Hope. He sought a therapist but none was available, so he was directed to a peer support group. He participated, and a year later, was invited to co-lead the group with marriage and family therapist Cheryl Akoni. The groups work because “you’re amongst your peers,” Akoni said. “You’re amongst people who have lived and shared experiences that you often might not get with your therapist because we have to keep our boundaries.”

At a time when 90% of California behavioral health agencies report difficulty recruiting licensed mental health professionals, peer mentors like Cordero are greatly needed. He knows how hard it is to recover while trying to repair damaged relationships with loved ones and continues to share those feelings with  group members. But he encourages them to reframe their painful experiences. Even anguish can get comfortable, said Cordero. “The path to pain is a well-carved path.” Peer mentors like him help people begin a new journey.

A therapist worries that despair about the election campaign is “crushing our mental health”

“Democracy is founded on the importance of having an informed citizenry, but what if we have reached the point where citizens find staying informed a challenge to their mental health? What I am hearing in my psychotherapy practice worries me deeply.”

So begins a guest commentary on the CNN website by Maggie Mulqueen, PhD, is a psychologist in Brookline, Mass., and the author of “On Our Own Terms: Redefining Competence and Femininity.”

They feel worn out, powerless and skeptical – as do 65% of respondents to a Pew Research Center survey, who said they always or often felt “exhausted” when thinking about politics. She advises people they can reply STOP to end the stream of unwanted political text messages. And she also encourages them to find ways to “actively participate in the election process rather than feeling victimized by it.” For some, she says, that can mean focusing their involvement on local politics, where they might actually connect with candidates. For others, it might mean writing postcards to other voters so they can feel they’re doing something productive.

Mulqueen’s challenge as a therapist is to help people take care of themselves psychologically while still engaging politically enough to be able to vote. “This will give them the benefit of knowing they participated even if they are unhappy with the outcome,” she writes. “As a country, and a people, we thrive when we have a sense of purpose.”

In other news…

Proposed settlement in class action against Allegheny County Jail: A proposed settlement filed in federal court could improve mental health staffing and training at Allegheny County Jail in Pennsylvania. The 4-year-old lawsuit charged the jail with forcing patients with mental health conditions into prolonged solitary confinement and using excessive force instead of providing treatment, CBS News reports. Under the agreement, which still needs a judge’s sign-off, the jail would force the jail to hire more mental health staff, better train correctional officers to recognize signs of mental illness and end excessive force and solitary confinement. Federal oversight of the jail will continue for a minimum of two years to ensure compliance.

Handwriting for a healthier brain? Perhaps. Over time, digital technology has become part of most areas of our lives. Students don’t write as much in school, and cursive handwriting hasn’t even been taught in some school districts for more than a decade. (This is confirmed by my 29-year-old cousin who cannot write in cursive, despite earning an entire master’s degree in computer science.) But the loss of handwriting, as practice and art, may be to our brain’s detriment. Studies show that people who write by hand retain more information, writes historian Scott G. Eberle in this column for Psychology Today. He says children who “played to write” were more excited about reading. 

What’s flourishing and who gets to do it? asks writer Allie Volpe in Vox. First, it’s the opposite of languishing, defined by the American Psychological Association as “the absence of mental health” – aka apathy, listlessness, general dissatisfaction, or living in a perpetual state of “blah.” Flourishing is all that languishing is not – “feeling good combined with functioning well,” says sociologist Corey Keyes. Best of all, it’s widely accessible to most of us, even those of us with less financial reserves. To flourish, focus on the following: 1) Help others. 2) Stay open to learning new things. 3) Whatever your religious beliefs, recognize and honor that being in this world connects you to something much larger than yourself. 4) Have random fun on purpose. 5) Relish in community with others.

If you or someone you know is in crisis or experiencing suicidal thoughts, call or text 988 to reach the 988 Suicide & Crisis Lifeline and connect in English or Spanish. If you’re a veteran press 1. If you’re deaf or hard of hearing dial 711, then 988. Services are free and available 24/7.