From Ritual to Science: Ayahuasca’s Journey Into Mental Health

Ayahuasca is a drink traditionally used by indigenous peoples of the Amazon and also in religious contexts. It can cause visions and changes in perception, and has been studied for its possible benefits for mental health, such as in the treatment of depression and anxiety. However, it can also cause negative mental effects, especially in people with a history of emotional problems. Despite this, many users report improvements in well-being, and some experiences considered difficult may actually be part of a healing process.

Ayahuasca is a traditional drink made from plants from the Amazon rainforest, long used by indigenous peoples of the region as part of healing and spiritual rituals. In addition, it is used as a sacrament in some Brazilian religions, which have spread to other countries in recent years.

In more recent times, ayahuasca has aroused international interest, both among mental health professionals and researchers. Its use has been studied mainly because of its possible positive effects on problems such as depression and anxiety. However, the possible risks and negative effects are still poorly understood.

Ayahuasca is made mainly by combining the Banisteriopsis caapi vine with leaves from plants such as Psychotria viridis or Diplopterys cabrerana.

The former contains substances that prevent certain compounds from being destroyed in the stomach, while the latter provides DMT, a compound that causes hallucinogenic effects by temporarily altering the way the brain processes information.

When ingested, ayahuasca can cause physical and mental changes: it can slightly increase blood pressure, alter hormones and change brain activity, as well as affect emotions, perceptions and thoughts.

Studies conducted in controlled environments and also in traditional ceremonies show that ayahuasca provokes a series of sensations, such as visions, feelings of well-being, introspection and even mystical experiences.

For this reason, it has been investigated as a possible aid in the treatment of various mental health conditions, such as depression, anxiety, grief, drug addiction and even lifestyle-related problems, such as high cholesterol.

Some research indicates that regular use can even slightly improve brain function and stimulate the capacity for mental adaptation, something called neuroplasticity.

Despite the promising reports, we still know little about the negative effects of ayahuasca, especially those that may appear shortly after use or over time.

To try to better understand this side, scientists conducted a large international study with more than 10,000 people who participated in ayahuasca ceremonies in more than 50 countries.

In this study, more than half of the participants reported some type of unwanted mental effect after use. About 12% sought professional help because of this, but only a small portion (4.4%) reported serious effects.

People who already had a history of mental health problems, such as depression or anxiety, or who participated in ceremonies outside the traditional context, were more likely to report these adverse effects.

However, not all intense or uncomfortable experiences were viewed negatively by the participants. Some sensations, such as hallucinations or visual distortions, were often interpreted as part of the healing or self-discovery process. In other words, what may seem like a side effect, in some cases, ends up contributing to the person's well-being.

In this latest study, the researchers wanted to understand whether these adverse effects were linked to the current state of users’ mental health. They also looked at the impact of factors such as the spiritual context of the ceremony, the intensity of the experiences, and feelings such as extreme fear.

To do this, the scientists used modern data analysis tools, combining traditional statistical methods with artificial intelligence. They found that people with a history of depression or anxiety were more likely to experience adverse mental effects after using ayahuasca.

However, overall, users showed similar levels of mental health to the general population.

Interestingly, the more visual experiences and the more times someone had used ayahuasca, the better their current mental health status was reported. Women reported more adverse effects, but this did not mean that they were in worse mental health.

These findings suggest that we need to rethink how we classify the negative effects of psychedelic substances. Some challenging experiences can actually help in the process of personal transformation, depending on the context in which they occur and the characteristics of each individual.

Therefore, it is essential to offer adequate support, especially for those who already have a history of mental disorders. This can help reduce risks and enhance the therapeutic benefits of ayahuasca.

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A new insight into ayahuasca’s adverse effects: Reanalysis and perspectives on its mediating role in mental health from the Global Ayahuasca Survey (GAS)

Óscar Andión, José Carlos Bouso, Jerome J. Sarris, Luís Fernando Tófoli, Emérita Satiro Opaleye, Daniel Perkins

PLOS Ment Health 2(4): e0000097.

https://doi.org/10.1371/journal.pmen.0000097

Abstract:

Ayahuasca is a decoction native to the Amazon, where it plays a central role in the traditional medicine of many local cultures and has expanded internationally over the last decades. Ayahuasca has also attracted the interest of scientists for its potential benefits on mental health, but its adverse effects are under-researched. We analyzed data from the Global Ayahuasca Survey, including 10,836 participants who rated predetermined adverse effects. Data were collected from March 1st, 2017, to December 31st, 2019, and accessed for analysis on November 30th, 2021. Only DP and JJS had access to identifiable participant data. Machine learning and statistical methods were used to examine the relationship between sample characteristics, post-ayahuasca adverse mental states, and mental health outcomes measured by the 12-Item Short Form Survey (SF-12). Among participants, 14.2% (767) had a prior anxiety disorder and 19.7% (1,064) a depressive disorder. Despite this, the median SF-12 score was 50.16, comparable to the general population. A history of anxiety or depression was associated with more adverse mental states after ayahuasca use. However, increased experiences of “visual distortions” and higher ayahuasca use correlated with better mental health. Women reported more adverse states but did not show worsened mental health. The classification of adverse mental states in psychedelic research should be reconsidered, as certain experiences traditionally labeled as negative may contribute to long-term psychological benefits. The context in which these experiences occur, along with individual factors, plays a crucial role in determining whether these states lead to positive or negative outcomes. Understanding these dynamics is essential for improving harm reduction strategies and maximizing therapeutic potential. Individuals with a history of depression require special attention, as they are more prone to experiencing post-ayahuasca adverse mental states and may benefit from additional psychological support.