The medicinal potential of psychedelics for mental health care

Originally published on July 27, 2023

Psychedelics may support mental health care by accelerating insight, shifting entrenched patterns, and changing behavior after treatment. In Episode 231 of the WHOOP Podcast, Global Head of Human Performance, Principal Scientist at WHOOP Kristen Holmes speaks with Dr. Robin Carhart-Harris, professor of neurology and psychiatry at the University of California, San Francisco, about where the science is strongest, why support and setting matter, and how sleep, heart rate variability, and recovery data may help track what happens after therapy. If you want a clearer view of what psychedelic treatment is, what it is not, and why researchers are paying close attention to it, this conversation gives you a grounded place to start.

To listen to Episode 231 of the WHOOP Podcast, Dr. Robin Carhart-Harris: Medicinal Potential of Psychedelics, in full, head to the WHOOP Podcast on YouTube.

What does “psychedelic” actually mean, and what counts as a classic psychedelic?

Psychedelic originally meant a state of the mind becoming more visible to itself. In practice, Carhart-Harris uses the term most directly for classic psychedelics such as LSD, mescaline, psilocybin, and DMT, while also arguing that the deeper idea is broader than any single drug.

Holmes opened by asking for a clear definition, which matters because the word is often used loosely. Carhart-Harris traced it back to 1956, when psychiatrist Humphry Osmond and writer Aldous Huxley were trying to name a class of compounds that could reveal aspects of the mind that ordinary waking consciousness tends to keep out of view. That framing still shapes how researchers think about psychedelic states today.

He also drew a useful distinction between psychedelic drugs and psychedelic states. The drugs are one route in. The broader state is the important part. By that logic, psychedelics are not defined only by chemistry. They are defined by whether they make otherwise hidden mental material more available to conscious awareness.

That definition helps explain why the topic has become so important in psychiatry. If certain states make buried thought patterns, emotional reactions, or old memories easier to access, researchers have a plausible reason to study whether those states can help people change the patterns that keep depression, anxiety, addiction, or compulsive behavior in place.

Carhart-Harris put the definition simply:

What you should take away

• The word psychedelic was coined in 1956 to describe drugs that reveal otherwise hidden aspects of the mind.
• Carhart-Harris groups LSD, mescaline, psilocybin, and DMT under classic psychedelics.
• The key idea is the psychedelic state itself, which may make buried thoughts, memories, and emotions easier to access.

If you want to hear Carhart-Harris unpack the difference between psychedelic drugs and psychedelic states, listen to the full episode on Youtube.

How can psychedelic experiences support self-discovery and mental health?

Psychedelic therapy is promising because it may help people see the origins of recurring thoughts, emotions, and behaviors more clearly. Carhart-Harris described that process as self-discovery carrying improvements in mental health.

From there, the conversation moved from definition to mechanism. Carhart-Harris said many people live inside patterns they do not fully understand. A person may fall into depression, develop a trigger-specific anxiety response, or spiral into addiction without being able to explain why the same response keeps repeating. In some psychological models, the explanation is present on some level, but buried or repressed.

In the clinical setting he described, psilocybin is not used as a stand-alone event. The treatment includes preparation before the session, support during it, and integration after it. People usually take the drug in a controlled environment, with music and two mental health professionals present. In that setting, the session often brings a person back to formative moments or longer periods in life that shaped the path they later took.

That can feel clarifying, but it can also feel raw. Carhart-Harris said patients often experience an epiphany tied to strong emotion. In some cases, that marks the beginning of healing. In others, the experience opens wounds that still need careful psychotherapy and processing afterward.

This is one reason the conversation matters to WHOOP members interested in tracking behavior change over time. If a treatment increases insight, the next question becomes whether daily life changes after that insight. Sleep timing, exercise behavior, alcohol intake, and recovery patterns can all help show whether the insight led to durable action.

Carhart-Harris framed the therapeutic logic this way:

"Improvements in mental health can be carried by improvements in self-discovery, understanding ourselves better."

What you should take away

• Carhart-Harris sees self-discovery as one of the main ways psychedelic therapy may support mental health.
• Clinical psychedelic therapy includes preparation, support during the session, and integration afterward.
• The session often surfaces pivotal life experiences that shaped current behavior, mood, or coping patterns.
• Insight during a session still needs follow-through in behavior and care after the session.

If you want to hear Carhart-Harris go deeper on self-discovery and why buried material can shape behavior, listen to the full episode on Youtube.

Why does setting and support matter so much with psychedelics?

Setting and support matter because the same process that makes psychedelic therapy useful can also make it risky. Carhart-Harris was clear that context can separate a therapeutic experience from one that becomes frightening, destabilizing, or harmful.

Once the therapeutic promise is clear, the next practical question is risk. Carhart-Harris contrasted supervised care with recreational use, where expectations are often badly mismatched to the experience. Someone may expect the loose, escapist feeling associated with alcohol and instead meet fear, grief, or a sharp confrontation with mortality and old memories.

That gap between expectation and experience is one reason psychedelic sessions are designed so carefully in research and clinical settings. Support is not decorative. It is part of the intervention. In Carhart-Harris's description, the patient is guided through the experience by trained professionals in an environment built to reduce unnecessary threat and help the person stay with difficult material long enough to learn from it.

This also explains why stories from music festivals or unsupervised use can distort public understanding. Those stories are real, and Carhart-Harris did not dismiss them, but they describe a very different situation from structured psychedelic therapy. In one context, a person is alone with an overwhelming experience. In the other, the person is prepared, supported, and helped afterward.

Researchers at places such as Imperial College London and Johns Hopkins Center for Psychedelic and Consciousness Research have helped shift the public conversation toward this clinical model. Public education also accelerated after Michael Pollan's How to Change Your Mind, which Carhart-Harris said gave the field major momentum.

Carhart-Harris summarized the risk-benefit balance in one line:

"What makes it so powerful and potentially beneficial is actually the same thing that could make the intervention harmful or dangerous."

What you should take away

• Psychedelic therapy depends on preparation, supervision, and integration, not just the drug itself.
• Recreational use can become risky when people expect a light or escapist experience and instead face intense psychological material.
• The same depth that can make psychedelic therapy effective can also make it destabilizing without the right support.

If you want to hear Carhart-Harris unpack why supervised care changes the experience so much, listen to the full episode on Youtube.

What has psychedelic research found so far, and where is it strongest?

The strongest signal so far is that psychedelic therapy may help across several major mental health conditions, often with faster effects and fewer dosing sessions than standard drug treatment. Carhart-Harris described that as a possible transdiagnostic effect, meaning one approach may work across multiple diagnoses.

From there, the evidence base becomes the key question. Carhart-Harris said the most promising findings are showing up in depression, anxiety, addiction, eating disorders, and chronic pain disorders. He also stressed that the field is still young, which is why he did not present psychedelic therapy as a cure-all.

What makes researchers pay attention is the combination of breadth and speed. In depression, Carhart-Harris said current treatments are often too slow and too inconsistent. Psychedelic therapy, by contrast, may show benefit within days or weeks, sometimes after only 1 or 2 dosing sessions, and in some people the improvement lasts for months. Trials such as Trial of Psilocybin versus Escitalopram for Depression helped move that question into mainstream psychiatry.

Carhart-Harris also gave a simple benchmark from the depression literature discussed in the episode. He said response rates in psychedelic trials were hovering around 70%, while antidepressant courses are often closer to half of people improving by the end of treatment, with placebo response and spontaneous remission complicating the picture. That does not settle the field, but it does explain why so many groups are studying it closely.

The same pattern is part of why Multidisciplinary Association for Psychedelic Studies supported large MDMA-assisted therapy for PTSD trials. Even though MDMA is not a classic psychedelic, the larger principle is similar: altered states paired with structured psychotherapy may help people shift entrenched patterns more quickly than conventional care alone.

Carhart-Harris described the depression data in specific terms:

"Across the depression trials, we're getting 70% response rates now, which is quite an improvement up on SSRIs."

What you should take away

• Carhart-Harris sees the strongest psychedelic therapy signal in depression, anxiety, addiction, and several related conditions.
• One reason researchers are interested is speed, with effects sometimes appearing within days or weeks after 1 or 2 sessions.
• Carhart-Harris described a possible transdiagnostic effect, where one therapeutic approach may help across multiple diagnoses.
• Early response rates are promising, but psychedelic therapy still leaves a substantial group of people who do not respond.

If you want to hear Carhart-Harris go deeper on response rates and the limits of current mental health treatment, listen to the full episode on Youtube.

How could WHOOP data help track sleep, recovery, and behavior after psychedelic therapy?

WHOOP data can help show whether a psychological shift is also showing up in physiology and daily behavior. Carhart-Harris said wearables may add biological objectivity to outcomes that are often measured only through interviews, rating scales, and self-report.

The conversation gets even more useful when psychological change is paired with real-world recovery data. Holmes shared small case work in veterans who underwent therapeutic psilocybin treatment and later showed changes in sleep architecture, HRV, resting heart rate, and sleep consistency. In one internal case series discussed on the podcast, Holmes said the group showed an 18% decrease in sleep debt, along with sleep consistency increases of 9% in one group and 6% in another. Those figures came from WHOOP case work, not a randomized trial, but they point to a question worth studying at scale.

WHOOP has already published related early observations in Mind manifested: how psychedelics for veterans with depression and PTSD impact WHOOP data. In that article, a small number of veterans showed higher HRV, lower resting heart rate, and shifts in sleep after psychedelic experiences. The same logic also connects with broader WHOOP reporting on the science of recovery, where changes in sleep quality and autonomic function are central to how recovery is understood.

Carhart-Harris said this is one of the major blind spots in current psychedelic research. Labs often have brain imaging and psychometrics, but they do not always capture what happens in a person's body after they leave the clinic. Wearables can help fill that gap by tracking what happens over days, weeks, and months.

He also highlighted the causal loop. Better mental health may improve sleep. Better sleep may help preserve mental health gains. WHOOP data is useful precisely because it can follow both sides of that loop instead of treating them as separate issues.

Carhart-Harris described the value of this kind of data directly:

"It adds some biological objectivity to the improvements."

What you should take away

• WHOOP data can help connect subjective mental health change with objective shifts in sleep, HRV, resting heart rate, and behavior.
• Holmes shared early WHOOP case work showing lower sleep debt and higher sleep consistency after therapeutic psilocybin in small groups.
• Wearables may help psychedelic research follow what happens after treatment instead of relying only on clinic-based measures.
• Sleep and mental health likely move in both directions, with each influencing the other over time.

When might psychedelic treatment be worth exploring, and what did Episode 231 say about legal access?

Psychedelic treatment may be worth exploring when standard care has not helped enough and a person is entering the process with stability, trust, and appropriate support. Carhart-Harris said readiness is less about a single diagnosis and more about timing, acute stress, and whether the person feels safe enough to let go during the experience.

From there, the practical question is who is ready. Carhart-Harris said one warning sign is serious acute life stress, where the ground under a person is already unstable. Another is intense agitation. Those states do not rule treatment out in every case, but they can make a large psychedelic dose harder to navigate. He kept returning to trust as the stronger predictor. If a person has confidence in the people guiding the session, readiness can rise with that trust.

He also linked readiness to a specific mindset: willingness to let go. In his description, people who fight the experience often experience more distress. People who can trust the process and stay open to what is happening may be better able to work with difficult material instead of being overwhelmed by it.

Carhart-Harris described that predictor this way:

"We do see in the data that trust is a very strong predictor of the kind of experience someone has under the drug and then how they do afterwards as well."

At the time of Episode 231, Carhart-Harris described legal access in the United States as limited and uneven. Classic psychedelics such as psilocybin and LSD were still illegal federally, while supervised adult psilocybin access had opened in Oregon through the state's psilocybin services program. He also pointed to Colorado's policy changes and said federal approval timelines for psilocybin and MDMA therapy were still years away. Because the legal picture continues to change, people interested in access should check current state law and licensed clinical pathways before acting.

For people thinking about recovery after a major emotional intervention, WHOOP can help track whether the basics are moving in the right direction. Sleep timing, sleep need, HRV, resting heart rate, and behavior patterns can show whether the weeks after treatment look steadier or more dysregulated than baseline. That is especially relevant for people already using the WHOOP app to understand sleep, recovery, and strain across longer periods of time.

What you should take away

• Carhart-Harris sees readiness, trust, and lower acute instability as major factors in whether psychedelic treatment is worth exploring.
• Letting go during a session appears closely tied to trust in the people and environment surrounding the experience.
• Legal access was still limited and state-specific at the time of Episode 231, with Oregon as the clearest supervised psilocybin pathway discussed.
• Tracking sleep, HRV, and resting heart rate after treatment can help show whether change is holding up outside the clinic.

The bottom line

• Psychedelics were defined in the episode as substances that can reveal aspects of the mind that are usually outside conscious awareness.
• Carhart-Harris said psychedelic therapy may improve mental health by improving self-discovery and helping people understand the origins of recurring emotional and behavioral patterns.
• The structure around psychedelic therapy, including preparation, supervision, and integration, is part of the treatment itself.
• Carhart-Harris described promising research signals across depression, anxiety, addiction, eating disorders, and chronic pain disorders.
• In the episode, Carhart-Harris said depression trials were showing response rates around 70%, with benefits often appearing within days or weeks after 1 or 2 sessions.
• Holmes shared early WHOOP case work suggesting that therapeutic psilocybin may coincide with lower sleep debt, higher sleep consistency, higher HRV, and lower resting heart rate in small groups.
• Carhart-Harris said wearables may improve psychedelic research by adding biological objectivity to outcomes that are often measured mainly through self-report.
• Trust, timing, and lower acute instability were presented as major factors in deciding whether psychedelic treatment is worth exploring.

Frequently asked questions about things discussed in this episode

How does WHOOP measure sleep changes discussed in this episode?

WHOOP tracks sleep duration, sleep stages, sleep need, and sleep consistency, which makes it useful for seeing whether an intervention is followed by steadier sleep over time.

What does WHOOP do for tracking HRV after a mental health intervention?

WHOOP tracks nightly HRV trends against your baseline, which can help show whether recovery patterns shift after a major psychological or medical intervention.

How does WHOOP help you spot changes in sleep consistency?

WHOOP measures sleep consistency by tracking how stable your sleep and wake timing is across days, which Holmes said is closely associated with psychological functioning in WHOOP research.

What does WHOOP show about resting heart rate during recovery from stress?

WHOOP tracks resting heart rate overnight, which can help you see whether your body is settling into a calmer baseline or staying elevated after stress.

How does WHOOP support longer-term behavior tracking after therapy?

WHOOP helps track longer-term behavior patterns by showing changes in sleep, recovery, strain, and logged habits across weeks and months instead of only during a clinic visit.

What does WHOOP measure that is relevant to autonomic function in this episode?

WHOOP measures signals such as HRV, resting heart rate, sleep, and recovery trends, all of which are relevant when people want to understand how the autonomic nervous system may be changing over time.

When people want to know whether a shift in mental health is also showing up in the body, WHOOP can make sleep, HRV, resting heart rate, and behavior patterns easier to follow week by week.