Transcript: EP 343 – The Rise of Plant Medicine and How it is Shifting the Mental Health Pandemic with Dr. Sam Zand
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Dr. Zand: What I saw in my clinic was a profound response. People were actually getting much better, much more quickly. We were able to tap into therapeutic growth in a way that patients were less guarded, more open, more flexibly minded. When I saw that in clinic, I thought, “How can we advance this, make it more scalable, and make it more affordable?”
Dr. Taz: Hi everyone, and welcome to Super Woman Wellness. I’m Dr. Taz. I’ve made it my mission throughout my career in integrative medicine to support women in restoring their health using a blend of Eastern medical wisdom with modern science. In this show, I will guide you through different practices to find your power type and fully embody the healthiest and most passionate version of you. I’m here for you. I can’t wait to get started. This is a Soulfire Production.
Welcome back, everyone. Welcome back to another episode of Super Woman Wellness, where you know we’re determined to bring you back to your super-powered self. Mental health issues is on the rise. We’ve been talking about that quite a bit on the podcast. Anxiety, in particular, is the number one mental health disorder, and it’s dominant in women. This is an appropriate guest and an appropriate topic. I want to introduce you guys to Dr. Sam Zand. He’s a practicing psychiatrist and the chief medical officer and founder of Better U and applies his expertise in neuroplasticity to assist patients in addressing the underlying causes of their issues and cultivating new thought patterns.
After conducting initial research on psychedelic medicine at Johns Hopkins University, Dr. Zand began clinically treating patients with ketamine in 2019. He currently educates psychiatry residents and medical students through psychedelic medicine rotations and serves as an advocate and spokesperson for FDA-approved Ketamine SPRAVATO.
Welcome to the show. He’s got so many more great accomplishments, but I really want to use our time to get into this topic because I know how much anxiety and depression is out there. I have patients of my own that come through our practices that are treatment-resistant, or maybe they’re not treatment-resistant, but the side effects are so extreme that the medication… There’s a cost-benefit issue with many of our conventional psychiatric medications. Super curious how you got into this, and then lots of questions about psychedelic medicine, for sure.
Dr. Zand: Yeah, absolutely. Well, thank you for having me. I really do think this is such an important topic that affects all of us, not just a select few who are going through deep anxiety/deep depression. These are human experiences that we all go through. To be able to learn why we experience these things and how to improve that… I hope we can gather that from this conversation.
Dr. Taz: Definitely. You’re a practicing psychiatrist. What got you interested in psychedelic medicine? Then, to piggyback off that question, too, this idea of neuroplasticity, that we can change our brain, how does psychedelic medicine play into that?
Dr. Zand: Yeah. I like to say, as a psychiatrist, I’m a little bit anti-psychiatry. I think, traditionally, we over-diagnose, we over-prescribe, and we miss some of the core contributing factors that really we need to pay more attention to when it comes to our mental and emotional well-being. Going through the academics and learning psychiatry and learning all the traditional methods… It was a little bit disenchanting because I think we hyper-focus on the chemical side of things. There’s so much more to our mental, emotional, and spiritual well-being than just the chemical side. As I created my practice six/seven years ago, our focus was really on the holistic measures within mental health. That’s where we look at things from every perspective: biologically, psychologically, environmentally, and even spiritually.
When we go to traditional antidepressants and things like that, which still have their value and their benefit. But if we only focus on that, I think we’re missing the full picture. My practice was always holistic by nature. But then, in 2019, medication called SPRAVATO, a form of ketamine in a nasal spray, became FDA-approved for treatment-resistant depression. When this first came across, I learned about ketamine probably years prior because a patient came in to see me and said, “I left my last psychiatrist.” I said, “Why?” He said, “He kept trying to give me ketamine.” I thought, “This sounds negligent. Should we report this doctor?” I didn’t have the education or understanding.
But when it got FDA approved and as a psychiatric community, we started to realize there’s something different here. Instead of taking a pill every day, you come in once a week. You have more of an experience than a passive treatment. What I understood of it/what I saw in my clinic was a profound response. People were actually getting much better, much more quickly. We were able to tap into therapeutic growth in a way that patients were less guarded, more open, more flexibly minded.
When I saw that in clinic, I thought, “How can we advance this, make it more scalable, make it more affordable, make sure that it’s safe/convenient?” With the FDA-approved version, you have to come to the office. You can’t drive home. You have to have a ride. There’s a lot of logistical hurdles to get through. But we created a program where we can actually see you virtually, especially in the time of COVID that was important, and be able to give you the guidance, the insight, the safety measures, and the therapeutic compassionate support to then do the work on your own at home under virtual care. That’s where Better U, as a company, came from. We started with ketamine therapy, and now we’re really rolling out a lot of holistic measures.
This concept of neuroplasticity that you brought up… This is the key point that I think is so important. It’s become trendy now that we’re learning more about the neuroplasticity of the brain, which, what that means is, if you remember the old adage, “Don’t kill a brain cell, they don’t grow back.” We used to think the brain stopped developing in our early twenties. That was science. That was, 20/30 years ago, what the scientific community thought.
Recently, in the last 10 years or so, we started to really understand the brain continues to regenerate/continues to create new neural pathways. What that means is we can develop new thought patterns. We can develop new ways of being. But in many ways, our brain is hardwired. It’s an uphill battle. When you go to therapy and you’re trying to see things from a new perspective, the hardwired belief system that we hold onto hinders that ability to see things more flexibly. Psychedelic medicine has taught us that we can have this neurological reset. We increase fertilization of new neurons. We create new pathways/new connections. With that, we’re able to accelerate the work that we traditionally do in therapy.
It’s become this mental lubricant that makes us more flexible-minded. It makes us more open to new perspectives. For many people who have been through rigid patterns of anxiety and depression, all of a sudden, they just feel refreshed. They feel brand new. They feel like they can see their lives from a perspective without that filter of deep anxiety and depression that’s been getting in their way. Sometimes within the first or second treatment, they just notice that day and night shift. Sometimes it takes a little bit more time, but with this modality, it’s just been such a breath of fresh air to have something a little bit more cutting-edge and more effective than some of the other modalities we’re used to.
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When you refer to treatment with psychedelic medicines, you’re referring to SPRAVATO primarily, which is the ketamine. What about some of the other stuff we’re seeing out there, like mushroom therapy or CBD or all these other things that are out there? What is the toolbox in the world of psychedelic medicine?
Dr. Zand: Yeah. Well, we started with SPRAVATO as ketamine because it was FDA-approved. As physicians, we like to learn that this has clinical trials and efficacy. The next thing was that ketamine, as a generic compound, has been around for 50 years. While there are some hurdles to get insurance approval, and, like I said, you have to go to the office, and you have to have a ride and all these things, generic ketamine can still be prescribed off-label. The standard of care with the American Psychiatric Association and a lot of different groups has normalized generic ketamine for mental health issues like anxiety and depression as well.
While we start where it’s legal and it’s prescribable with ketamine, what we’re going to see in the future is probably a combination of both. An increase of FDA approvals for psilocybin, a magic mushroom compound, for MDMA, it’s in phase three clinical trials for PTSD, for derivatives of LSD. These are all in the pipelines that, 2/3/4/5 years down the road, we might see more utilization of. On the other side, there’s going to be some both recreational and therapeutic use that’s not guided by a physician. Right now, in Oregon and Colorado, you can actually go have a therapeutic session with psilocybin. It’s not by a doctor. It’s a government-approved program. We teach some of these programs as well, but still federally illegal. There’s some gray areas there that, in certain states, it works out. I think when we fast-forward, in the future, we’re going to see a much more widely accepted view of a lot of these different tools in the psychedelic umbrella.
Dr. Taz: I was going to say I think it’s already being used recreationally. But it’s a side story. But I’m curious what your thoughts are. MDMA, LSD, what is it doing to the brain? What’s happening there? Even the mushrooms, even psilocybin, what’s happening exactly?
Dr. Zand: Right. The concept of neuroplasticity that I outlined is the key fundamental common denominator here, where they all have this ability to increase fertilization of new neurons/increase new neural connections. Now, they do it in different ways. While ketamine, I like to say, is a very gentle introduction to psychedelic medicine because, in low doses, it’s quite meditative. It’s a dissociative drug, which means you separate a little bit from your mind and body and the normal occurrence of things. As you separate with the right guidance, you start to see things from another perspective.
I like to say if you ever give a friend advice… And it’s so clear for us to see what our friend is going through and give them the proper advice. But for the friend, it’s hard to receive it because they’re stuck in their emotions. They’re clouded by what they’re going through. These drugs give you an ability to see your life from a different perspective, an outer perspective, a more objective view, and then you can be your own best friend. The insights become so obvious because all of that clutter and background emotional charge is just dissolved in the moment. Then, therapeutically, you can work through that afterwards.
There are some fundamental differences. Ketamine is much more short-acting, meaning some people… The treatment is 30/45 minutes, maybe an hour/hour and a half, two hours at most. Psilocybin as a therapeutic might take longer, three to five hours. If we ever get there with actual psychedelic-level derivatives of LSD, these are very long-half lives. They might last for 6/7/8 hours. It makes it difficult to have a therapeutic session. While still possible, I think we’re going to see formulations that cut that time down and allow you to really have a focused therapeutic session.
Dr. Taz: Nootropics tropics are a part of the psychedelic medicine family, or are they the NMNs and the NADs and all of that stuff? Are they a part of it as well?
Dr. Zand: The word psychedelic… It really talks about expanding the mind and then seeing things from an altered perception. But we can interact with our emotions in a safer way. What you alluded to in nootropics and brain health medications and drugs… These are perhaps improving neuroplasticity, perhaps improving neuro connections. But they’re not causing a mind-altering feeling. I think there’s benefit in both. There’s a debate about do we need to have a mind-altering feeling or can it be sub-perceptual. I think there’s benefit when it’s sub-perceptual, certainly because we’re still getting that neuroplastic reset. But there’s also an enhanced benefit when we have this psychological experience of feeling a little altered, a little different. We enhance that. We lean into that. We encourage our patients to understand how they can approach that in a safe way and how they can learn from that experience.
Dr. Taz: Fascinating. As you’re even saying this, I mean, I would never be one to try a mind-altering… I’m just not like that. I’ve always wanted to be in control, control of my environment, control of my thoughts. Why is there more acceptance right now around this idea of having a mind-altering experience? Is it tied to our inability to get answers from conventional treatments? Where do you think the acceptance is coming from? I think there’s general acceptance, quite honestly, around herbal medicine and plant-based medicine too. But just curious what your perspective is on that.
Dr. Zand: Yeah, yeah, a few things. One, I think the acceptance comes from the evidence/comes from the results. We are seeing fantastic outcomes. Before this was even a medically approved treatment, it’s no secret that some world leaders and corporate execs, and high achievers have been using illicit psychedelic medicine because it wasn’t legal or allowed to advance their optimization, creativity, self-exploration. Now, it’s becoming normalized, I think. It’s not just a tool for those who have used it as an enhancer. Now, it’s a tool to really dive in and help everybody self-explore a little bit better.
Control is a very interesting part of this conversation because control is something we all struggle with, I think. We all want to be in control. We all want to have a strong mind and not let our mind get the best of us. What ends up happening, most of the time, is, for those who really want to hold onto control, this gives them a safe feeling and understanding of what life is like when they’re not in the driver’s seat, when they’re not controlling things, and they can have this beautiful passive journey through their subconscious mind.
When that happens, we actually are able to release emotional tension/conflict. We’re able to take those suppressed feelings that maybe we were trying to control before and interact with them and be okay with what’s going on because that layer of control, now that it’s taken away, we realize, “You know what? Perhaps it was getting in the way of us processing some of those deeper underlying feelings.” Then, afterwards, you’re back to normal. I think the stigma is, “Is this going to change me? Am I going to come out different? Am I going to have a bad trip, and that’s going to be that way for a week or a month or the rest of my life?” The answer is no. When you do this in a safe therapeutic way, unless you’re abusing the drugs, you come back to normal fairly quickly. It’s this temporary loss of control, if you want to call it that, and I think that can be quite cathartic to go through.
Dr. Taz: Fascinating. I have this theory from the work I’ve done over time. We’re multi-dimensional. We have multiple bodies: the mental body, the physical body, the emotional body, the energetic body. Sometimes our experiences and our wounds get lodged in different places. To fix them, as doctors, we’ve been very trained to deal with chemistry and biology and numbers and all this other stuff. It doesn’t take practicing long to understand that that doesn’t always yield results. This is interesting that this is like a modality that almost helps you get the mind out of the way so that you can look at these emotional bodies a little bit better. But I think safety’s a big concern and doing it in a safe environment because I’ve heard lots of stories from friends where maybe the husband and wife goes and does psilocybin or does one of these things and because there’s not a guide necessarily… They’re doing it more recreationally. People get… They have really weird experiences, some of which have pulled them apart because people get locked into things.
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If someone’s interested in this after listening today and they’re like, “I think I want to try this,” what are their options? How do they find someone to facilitate a safe experience where they can understand their emotional body versus one that may just let things out of… You’re letting out of a Pandora’s box. It’s running, and there’s no guardrails around it.
Dr. Zand: Yeah. Great question. I admire your work. I really love that we’re bringing attention in the medical field to all of these different elements of life because I think there’s a hyper-focus in Western medicine on the physical body. There’s so much more. There’s the mental, the emotional, the spiritual. There’s parts of the science that are inexact and hard to define. We need to give those attention as well. While my work in psychiatry is often helping people become more holistic and understand that, my work in psychedelic medicine is to add more structure in science because it can be a little bit too… opposite side of that spectrum. The pendulum swings too far.
That middle ground is to understand, with structure and with supervision and with the right preparation, we can channel those energetic fields and those subconscious elements that often we don’t access. When we do, we have the coaching, the insight, the preparation, and the post-session reflection, integration, and therapy to really understand and piece it together. While many have probably advocated for benefits of these medicines when not done under clinical supervision, I would strongly suggest that if anybody wants, to try this to not try it on their own in the rogue fashion, but find an expert/find someone who can help them because it really does make a difference to have a little bit of guidance there.
The options right now… Briefly, this ketamine space started 10/20 years ago. It was infusion clinics. You go into the doctor’s office. They put a port in your vein, and they load you up. Very seldomly was there mental health integration. It usually started from pain doctors who were treating pain and started to realize, “Wow, this is really helping mental health.” These infusion clinics still exist. They’re very costly, though. Again, many of them don’t have therapeutic augmentation. It could be 1000 or 1500 a session. Now, the options out there, you can actually go through your insurance; find someone who is a provider of SPRAVATO. You can get insurance approval if you suffer from treatment-resistant depression. You have to go to the clinic. It’s twice a week for the first month; once a week for the second month. Then, once every one or two weeks after that.
We’ve developed a program where you can do this at home. Similarly, once or twice a week, you can have that check-in with yourself that really enhanced introspection. You’ve tried to really lower the cost. It’s less than a hundred dollars a session when doing this. Those are the legal options, right now, if you want a doctor to work with you. Now, a lot of doctors don’t understand this, and that’s really one of my passions is to help educate physicians on how to do this work. We’re teaching this in residency programs.
There is also Oregon, Colorado, where you can do psilocybin therapy for people who have been accredited through government training programs in other countries. We’re seeing ibogaine clinics in Mexico. We’re seeing all modalities, obviously the popular jungle ayahuasca retreats and things like that. I’m not sure where that’s legal because it’s not legal in the US unless there’s some exception or religious exemption. But these are the options available. It’s very accessible if we wanted to do ketamine therapy in office or at home.
Dr. Taz: Wow. I’m so fascinated by how much we’re learning about the brain and about the body and how it’s interconnected. There’s just so much more probably, too, that we’re going to continue to learn. Well, I wanted to ask you so much more. But we’re almost out of time. I know you also talk about the role of nutrition/the role of mindfulness. Maybe just touch on that briefly as an overall strategy when it comes to psychiatry and depression and mental health.
Dr. Zand: Yeah. I think it’s the most important thing when we look at what are the factors that really affect our mental/emotional well-being. I alluded briefly. The biological is not just chemical. It’s our sleep patterns. It’s our nutrition. It’s our activity. It’s the substances we put in our body/the toxins that are in our foods. In your work, I’m sure you counsel your patients on learning about the preservatives and metals, and chemicals that we’re actually ingesting in foods that might even appear to be healthy. They have the organic tag on it. But still, there’s food coloring in there that’s causing ADHD and cancer and things like that. I think eliminating toxins is such an important part because the body wants homeostasis. The body wants to be balanced. If we can remove the toxins physically, then it’s much more easy for our body to maintain that chemical hormonal balance.
Beyond the physical side, there’s psychological. When we speak with patients, psychologically, we go through trauma, self-esteem, self-image, thought systems, belief systems, thought patterns. Understanding where they came from and being able to shape that is that psychological work. Then, one thing we saw in the last few years, profoundly, because of this whole COVID pandemic, was the social and environmental factors that affect us. Now, you have body, mind, and environment, where that is something that still pertains to our medical health. We are not having healthy social rhythms if we’re not having communion and community. If we’re not having healthy social outlets, this affects us. We need to bring attention to toxic work environments, toxic relationships, having a clean and happy home life. All of this is important work in mental health.
Then, the fourth category that some people still feel a little bit taboo about is spiritual health. I think spiritual health is really number one, dealing with the understanding of life and death and mortality, aging, illness, and injury. How do we all, as humans, who… We know what the ending is going to be. How do we process that? How do we accept and explore death from a place of empowerment/from a place of learning other than a place of fear? When we tap into that spiritual unexplainable side of life, then we also unearth mystery and awe and all of these questions of why are we here? What’s the point of all this? What’s the meaning we assign?
In our work, it’s not to preach any spiritual doctrine but to allow a platform for self-exploration and then align with those universal feelings of… Life is beautiful. Life is fragile. Where did this come from? Can I show appreciation/gratitude and then give back and connect with nature and connect with community? It’s a big part of our mental health as well, is to tap into that spiritual side. All of these categories, I think, is what we need to focus on.
As providers… I love the work in Eastern medicine because that’s a large focus that we’ve lost in Western medicine. Bringing that all back, I’m excited that psychedelic medicine has helped cause a bridge for this, where people are more eager after their first ketamine session. Before, they’re usually like, “Spirituality… I don’t really want to talk about that.” Afterwards, they’re like, “Wow. I felt something profound that I can’t really explain.”
Dr. Taz: Wow.
Dr. Zand: I think words limit us. Sometimes when we’re in therapy and we’re trying to put everything into words, we can actually express and share more through energy. When we’re tapping into that part of life that is metaphysical and science can’t quite describe, we’re actually able to unleash more healing in that way.
Dr. Taz: Oh, my gosh. You’re speaking my language. I love it. I love that there is maybe a glimmer of a scientific movement towards it. That’s super exciting for the future. My dream… And I don’t know how to exactly invent this. But literally, you would walk in, and we would get an energetic, spiritual, emotional, mental, physical assessment. I have some tools that do that in practice. But I never say that they’re 100% accurate or academic or anything along those lines. But they’re just guides to help us. But I think that’s where medicine hopefully will shift to in the future. I think it’ll bring a lot of healing for a lot of people. Fascinating topic. I love it. Thank you so much. You’re in Europe. Thank you so much for pausing. What I’m assuming is a vacation to come talk to me about this.
Dr. Zand: It’s been a pleasure.
Dr. Taz: If anyone wants to learn more and wants to connect with you, what’s the best way for them to do that?
Dr. Zand: Yeah. Our website is betterucare.com with just the letter U. You can go on and learn more about holistic mental health, ketamine therapy. My social is just @drsamzand. I encourage everyone to really check in with themselves, understand their emotional, mental, spiritual circumstances, and be able to just move away from this illness/disease state model in mental health and medicine that we’re so accustomed to. Realize that none of us are actually sick. None of us are ill. There’s nothing wrong with us. Let’s learn to love what’s right with us. Let’s learn to enhance self-exploration and realize if there’s areas of our life that need a little bit more attention. Okay, well, let’s find that balance and harmony. These are the methods that I think can really help.
Dr. Taz: Fascinating. Well, thank you so much for taking time out today to join us. I really appreciate it. For everyone else watching and listening to this episode of Super Woman Wellness, which might be one of my favorites, we will see you guys next time.