Studies show that psilocybin may be an effective treatment for body dysmorphic disorder (BDD).

Studies show that psilocybin may be an effective treatment for body dysmorphic disorder (BDD). Image source: Lea Dubedout via Unsplash

We’ve all had moments when we’ve looked in the mirror and hated what’s looking back. Our hair won’t do what we want or maybe our skin just looks terrible today. But for people suffering from body dysmorphic disorder, looking in the mirror is a daily exercise in revulsion, no matter what they look like. They see things others people don’t: ugliness where others see beauty or deformities on a normal body. They see horror in themselves.

Some estimates show that as much as 1% of the population suffers from body dysmorphic disorder (BDD) to one degree or another. While therapy and training are considered the most effective forms of treatment, there have been recent breakthroughs in mainstream science regarding a potential source for the disorder – and a potential cure. Meanwhile, psychedelic researchers have spent years investigating the use of psilocybin to alleviate the symptoms of BDD. Now these two strands of scientific thought can come together and potentially relieve the self-loathing pain of millions.

Understanding BDD and Psilocybin

When we said above that 1% suffer from BDD to one degree or another, that’s because there is no singular manifestation of the disorder. For some people, it involves obsessing over a perceived flaw, such as ears that they’ve deemed too big. They feel convinced that people see only their ears and judge them just as harshly. This isn’t merely self-deprecation to generate compliments. It’s a sincere disorder that poisons interactions and damages the sufferer’s inherent sense of self-worth.

Others see features in the mirror that aren’t there at all. They have a wholly-invented self-image, one that doesn’t correlate with reality. In one case, a man was convinced that he had sunken cheeks and that he appeared sallow and decaying. In reality, he had normal cheeks, but he would spend hours staring at the mirror, filled with self-loathing. He withdrew from society, unable to maintain relationships.

The subject here, called Mr. A, had attempted a lot of self-medication. But when he was clinically studied while under the effect of psilocybin, commonly known as magic mushrooms, he reported seeing a “regular” reflection instead of the beast born of his disorder. The psilocybin helped him to finally see his own face clearly.

The Australian scientists running this 1996 study hypothesized that BDD had a serotonergic root, meaning it’s caused by a problem with modifying serotonin in the body. They believed that psilocybin could have a positive impact on people with BDD, since the subject saw long-term improvement after the treatment, as if his brain had been jolted back into reality. In fact, they thought that “since psilocybin compounds psilocybin and psilocin are closely related to serotonin biogenetically,” this could be a potential cure.

BDD, OCD, and the Psilocybin Effect

The last 20 years have been kind to that theory, as we begin to learn more and more about the chemical causes of disorders like BDD. It’s now considered a part of the family of Obsessive Compulsive Disorders. There is debate as to whether it is on the spectrum of OCD, or if it just has similar symptoms, but there’s a growing consensus that these have similar roots: the serotonergic system.  

That’s been good news for people researching psilocybin and BDD since mushrooms have been studied closely to see how they can help others in the OCD family. Study after study has shown a drastic symptom decrease for people with OCD after controlled psilocybin tests, with both short and long-term benefits.

This shows again how deeply rooted psychedelic medicine is in the actual chemical makeup of the brain. Psychedelics have long been known to help people on both a spiritual and medical level, but it was little understood why, outside the helpful but not complete language of mysticism. To show that “(p)silocybin, LSD, and mescaline are extremely potent agonists at 5-HT2A and 5-HT2C receptors and their binding potency to these receptors is correlated with their human potency as hallucinogens” and that “potent 5-HT 2A/2C agonist hallucinogens lead to an acute decrease in the symptoms of OCD” is to wed the densely scientific with the lived reality of psychedelic benefits.

Just this month, a study came out that demonstrated how “overactivity of a single type of receptor for neurotransmitters—mGluR5, found in a brain region involved in compulsive behaviors—was the major driver for the abnormal behaviors.” The scientists in the study were able to inject mice with a compound that slowed down this overactivity. They are looking for a way to make it transferable to humans, which will take years of testing.

We’ve always known that hallucinogenic substances could make us see ourselves differently and the world more openly and fully. For people with BDD, that can mean seeing themselves they way they actually are. There is a deep and beautiful scientific basis in all our thoughts, even the ugly ones. Sometimes, those compulsive and damning thoughts are caused by a singular hyperactive malfunction. Psilocybin, when administered in a controlled and professional environment, can help still the activity and return you to yourself.