A Really Good Day(4)

Once I understood the cyclical nature of my sleeplessness, I could wean myself off sleeping pills, and throw away most of my pharmacopeia. For a while, I was far better able to control my moods. I still cycled, but because I could anticipate my rages and my periods of sadness, I was able to plan for them and deal with them. I monitored my calendar the way a pilot monitors her cockpit controls, not only to determine when to start taking my medication, but also so that I could schedule important meetings and events to coincide with less volatile days of the month. Dr. Brizendine requires her patients’ partners to take the initiative during the premenstrual period, urging them to stop all arguments, jot down the subject on a piece of paper, and reintroduce it later in the month, when it can be dismissed without rancor. My husband kept track of my cycle and developed a bland and pleasant tone in which to ask the question “Do you think you might need an SSRI today?” I did my part by neither defenestrating nor decapitating him, but instead taking my pill.

For five years, things were predictable and peaceful. Then the inevitable happened. I entered perimenopause, and my period became irregular. Some cycles lasted thirty days, others twenty. Sometimes I’d skip a period or two altogether. With my period behaving like an ambivalent Victorian suitor who drops his visiting card rarely and on no discernible schedule, I could not time my SSRIs. My doctor convinced me to overcome my trepidation and try a low-dose estradiol patch to combat my shifting moods. The patch, however, did not provide the instant and profound relief I was used to. More troublingly, the use of unopposed estrogen—estrogen taken alone—is associated with an increased risk of endometrial and uterine cancer. This risk can be eliminated by adding progestin, but that’s been associated with an increased risk of breast cancer. Furthermore, progestin has a marked negative effect on mood, especially in women with PMS or PMDD. Since the only reason I was wearing the patch was to ameliorate my low moods, I was not about to add a medication that would make me depressed and possibly give me cancer.

And then things took a turn for the worse. I found myself in a state of seemingly perpetual irritability. I seethed, I turned that fury on the people around me, and then I collapsed in shame at my outbursts. These alternating states of anger and despair came far more frequently than before, and made me feel hopeless. I couldn’t seem to find pleasure in my life, or even contentment. I saw the world through a sad and dingy scrim. I knew there was light and love on the other side, but I couldn’t manage to lift the grimy curtain of my unhappiness.

My husband, who had been dealing with my vicissitudes of mood for years, seemed finally to be exhausted by them. We fought, and we seemed to take far longer to recover from our altercations. Or perhaps that’s more of my despondency talking. Perhaps he was no less patient than before, but my depression made me newly terrified that he would once and for all pack his bags and leave me alone with my ugly self.

It was in this state of mind that I stumbled across James Fadiman’s book.

Before becoming a writer, I was a federal public defender and law professor with a particular interest in criminal justice reform. For many years, I taught a seminar called The Legal and Social Implications of the War on Drugs at the UC Berkeley School of Law, and was a consultant to the Drug Policy Alliance, an organization dedicated to the reform of U.S. drug laws. However, though I have experience and expertise with drug-policy reform issues, I knew very little about psychedelic drugs. I had never taken LSD, and my experience with other hallucinogens began and ended in my freshman year of college, with a pleasurable but somewhat disconcerting few hours spent languidly spinning on a tire swing after consuming a very small quantity of psilocybin in the form of “magic mushrooms.”*5 I have always been too afraid of enduring a terrifying bad trip or suffering lasting psychiatric harm to experiment further. But microdosing seemed different, less frightening. The doses Fadiman discussed were sub-perceptual, so small that there was no possibility of any kind of hallucination, positive or negative. Not so much going on an acid trip as going on an acid errand.

The individuals whose reports Fadiman presented in his book experienced “joy and gratitude,” increased focus, better mood. I wanted that. They reported rarely losing their tempers, becoming more fun to be with. I really wanted that. They experienced that most seductive and elusive thing: a really good day. I needed that! None reported any negative experiences, but, then, the book was hardly a thorough research study. It provided, however, a glimmer of hope. With reservations, of course.

There has never been an officially sanctioned study of microdosing. The closest thing to research is Fadiman’s anecdotal data collection, assembling reports from individuals who reach out to him. There is, however, a tremendous amount of data on LSD. Before the drug was criminalized, it was thoroughly studied. Thousands of doses were administered in therapeutic and research settings, with very few negative effects. LSD has a very low toxicity level and a large safety range.*6 This means that even massive doses are not physically dangerous. Microdoses have no discernible biological effects at all.

I contacted James Fadiman and received a memo entitled “To a Potential Self-Study Psychedelic Researcher.” The document makes clear that it is not meant as an encouragement to engage in illegal activity but is, rather, a set of cautions and procedures designed to minimize harm, should you engage in illegal activity without the encouragement of James Fadiman.

The protocol is simple. To participate in the international self-study group on the effects of sub-perceptual doses of LSD on normal daily functioning, a “self-study psychedelic researcher” is to take microdoses of LSD on repeating three-day cycles. The suggested dose is ten micrograms, one-tenth or less of what a person would have to take in order to experience an altered state of consciousness. The idea is to take a dose so small that you don’t actually feel anything unusual. Or at least nothing immediately tangible. On Day 1 of every cycle, participants are to take ten micrograms of LSD. They are to keep to their normal schedules of work, leisure, meals, coffee, naps, exercise, and social life. They are instructed to monitor mood, physical strength, symptoms, productivity, and the ease with which they do their work, and to “write a few notes about how [the] day went.” On Days 2 and 3, participants are to take no LSD, but merely to continue monitoring and noting.