Paul F. Austin@PaulAustin3w
My personal prescription for depression:
Take 20 micrograms of LSD and go for a hike. 1-2x per week, ideally when it's sunny outside.
I posted this on X a few days ago, and it struck a nerve. Some people loved it, some thought I was reckless, & many were simply curious.
So let me explain the science.
A new paper just dropped in Discover Mental Health from Nicholas Fabiano, Robin Carhart-Harris, and colleagues. It's the first formal commentary arguing that exercise and psychedelics should be studied together for major depression.
Up to 50% of people don't respond to antidepressants or therapy. Exercise works for roughly 1 in every 2 people with depression, a stronger hit rate than most antidepressants. Psychedelics show effects comparable to antidepressants that persist after the drug leaves your system.
Both are powerful alone. But the real story is what happens when you layer them.
The paper (linked below) maps out complementary mechanisms. Psychedelics spike cortical neuroplasticity through direct TrkB receptor binding, producing rapid spinogenesis within hours. Exercise drives hippocampal neurogenesis and sustained elevation of BDNF over time. Psychedelics temporarily disrupt default mode network connectivity, breaking rigid thought patterns. Exercise normalizes that connectivity, locking in the gains.
They also converge on shared pathways: serotonin, glutamate/LTP, and dopamine signaling.
Different entry points, but basically the same downstream effect: a more plastic, resilient brain.
The behavioral data is just as compelling. In psilocybin therapy trials, up to half of the participants spontaneously reported improvements in diet and exercise.
Ayahuasca users are consistently more physically active. People with lifetime psychedelic use show lower rates of heart disease, obesity, and diabetes.
Psychedelics don't just change your brain chemistry. They actually change what you do with your body.
This is why I coined the term "hikrodosing." It's not just a cute portmanteau. It's a protocol built on the convergence of these mechanisms.
A sub-intoxicating dose of LSD paired with aerobic exercise in nature combines psychedelic neuroplasticity with exercise-driven BDNF, serotonin release, and hippocampal stimulation. Sunlight adds vitamin D and circadian regulation. The hike provides cardiovascular load. The microdose opens the plasticity window.
No clinic, no 6-week waiting period, & no sexual side effects (I'm looking at you, SSRIs).
The paper calls for formal research. I agree. But practitioners don't need to wait for an RCT to start moving their bodies on the days they microdose.
Hikrodosing. Look it up.
Or better yet, try it.