September 20th, 2022


Episode #59

Microdosing & Macrodosing for Healing
Depression with Dr. Erica Zelfand

Dr. Erica Zelfand joins Laura Dawn on the Psychedelic Leadership Podcast to discuss the science behind microdosing and macrodosing psychedelics for the treatment of depression and the importance of approaching mental health care from a more holistic and integrated framework for healing. 

What that data shows is that doing a macro dose or a “normal” therapeutic dose of psilocybin can significantly help with depression and anxiety. And a lot of this data comes from populations that were previously considered treatment resistant. So people that have already tried psych meds who have already tried therapy and who are still struggling, those folks can be helped with psilocybin and other classic psychedelics.
Dr. Erica Zelfand


About This Episode:

If you have questions about microdosing for depression or how to approach psychedelic experiences while on SSRIs, this episode is for you. My guest today is Dr. Erica Zelfand is a licensed family doctor trained in both conventional & natural medicine and takes a holistic approach to treating mental illness, recognizing psychedelic medicines as one tool among many to help support mental wellbeing. 

In this episode, we cover: 

  • What the research says: The science of psychedelics and how they help treat depression
  • Microdosing schedule for tapering off SSRIs 
  • How much to start with when microdosing
  • How to taper off SSRIs using psilocybin 
  • Microdosing for neurodegenerative diseases 
  • Her take on microdosing as a neurotropic 
  • The difference between psilocybin and LSD 
  • Her suggestion around what to microdose with if you’re more prone to anxiety
  • Difference in side effects between psychedelics and SSRIs

Core Themes

Explored in this episode:
  • Psychedelics
  • Depression
  • Mental Health
  • Burnout
  • Microdosing
  • SSRI's & Psychedelics
  • Entrepeneurship
  • Psychedelic Neuroscience
  • Psychedelic Integration

Links &

useful resources

Free 8 Day Microdosing Course


Episode Transcript

Episode #59: Microdosing for Depression with Dr. Erica Zelfand

Laura Dawn: It’s always this funny moment when I hit record and we’ve already been talking and I’m like, hi, 

Dr. Erica Zelfand: hi Erica. it’s like, it just feels like unnatural in 

Laura Dawn: that way. I just had this moment of like, how do we wanna start? Hi. So nice to see you. Thanks for coming onto the 

Dr. Erica Zelfand: show. oh, hello. I didn’t hear you walk in.

Dr. Erica Zelfand: um, thanks for having me, Laura. 

Laura Dawn: Yeah, I really appreciate your time. I’ve been really looking forward to this conversation and been tracking some of the work that you’ve been doing in the space. And I think for listeners who aren’t familiar with you and your background, and I’m also curious to hear too, a little bit of your professional background, especially coming from the medical side of things.

Laura Dawn: And when you started blending that and veering off as well into the path of, of incorporating psychedelics and microdosing into the work that you’re doing with people. 

Dr. Erica Zelfand: Sure. Well, I’ll say that my, my path, even to becoming a physician was somewhat of an unusual one in the sense that I, I realized as I was thinking about doing a career in medicine, that conventional medicine was really good at treating acute things at handling crises at really pulling heroics, but where it was maybe falling short was in the management of chronic illness, like autoimmune diseases, um, and mental health as well.

Dr. Erica Zelfand: And so I actually chose to go to apathic medical school. There were only five in the country. Um, and in my medical training, I was really, really taught to look at the whole person. And I was really taught to understand. There really isn’t much of a separation between what’s happening in the body and what’s happening in the emotional body what’s happening in the mind.

Dr. Erica Zelfand: Um, and that when you bring all of that together, you have a synergism and you have a person. So I was no stranger to understanding that how a person thinks and how they feel is gonna affect their physical health. And when I opened my medical practice, I opened as just a general family primary care clinic.

Dr. Erica Zelfand: I had an interdisciplinary clinic with acupuncturists and massage therapists, chiropractors, and a medical doctors as well. I quickly realized that a lot of my patients had depression and anxiety. And, you know, there’s this thing that we, we have all these memes about, about like the moms who are like barely holding it together.

Dr. Erica Zelfand: And then after their kids go to sleep, they drink half a bottle of wine. And then they joke about how much wine they drink. And I realized, I think we can be doing better. And I had a wonderful arsenal of tools in my toolkit cause I had conventional pharmaceutical medications plus herbal medications, nutritional supplements, homeopathic remedies, et cetera, et cetera.

Dr. Erica Zelfand: But I also realized that I wasn’t able to access an even deeper level, which was the level of the spirit and that I needed a better tool to help people do that. And I wasn’t about to go close my practice and go live in the jungle and prove for three years to become a shaman. You know, it just, that just wasn’t in the cards for me.

Dr. Erica Zelfand: Um, and so I was like, how, how can I help people heal on this level? And as it turns out, there’s a wonderful toolkit for that. And it’s in the psychedelic realm. It’s not the only way to do that. Of course. Um, but it sure is like a. Super highway for it. So, um, what started out as an academic interest then became really a big focus of what I counsel people on now and what I educate other healthcare providers and medical systems on, which is how we can integrate these medicines into the medical model, into our culture, um, and that they do have a place in healing.

Dr. Erica Zelfand: Hmm. 

Laura Dawn: And on your path towards becoming a physician, were you already having personal experiences with psychedelics or was it more that you were doing research and seeing things start popping up about depression and psychedelics that caught your attention and did that lead you towards starting to explore these substances on a personal level?

Dr. Erica Zelfand: It was a little bit of both. I felt like there were these two parallel processes happening where one, I. A relatively new business owner in, in private practice. And I, and I wanna emphasize private practice. I was not part of a big hospital. You know, I was not part of an HMO or a group practice. So there weren’t rules on how I had to do things, which was one of the reasons I chose to practice on my own, but I had all these patients coming in and I just felt like I, I, first of all, I was shocked at how many of them had mental, emotional imbalances.

Dr. Erica Zelfand: How many of them I felt like were walking around with their souls, kicking and screaming inside of their bodies. And I think homeopathy can help those people. I’m just gonna admit I’m not, I’m not a super strong homeopath. So there was that happening where I just felt like I needed something to help these people.

Dr. Erica Zelfand: And then the flip side of that was I was on the back end of medical school, followed by a medical residency, followed by opening a brand new. I was working 60 to 80 hours a week. I had bought my first home. I no pressure, you know, could barely afford the mortgage on my home. So I was doing Airbnb renting out rooms in my home.

Dr. Erica Zelfand: So I was coming home at like 10, 11:00 PM at night. And I really just kind of wanted to like sit in my underpants on the couch, eat vegan ice cream and watch cartoons to decompress. But I couldn’t do that cuz I had to be on in my home cause I was renting out rooms and I actually burnt out. And so my, my, my personal journey of healing paralleled me wanting something more professionally to help my patients and yada yada, yada, find myself deep in the throes of an IO Waka trip.

Dr. Erica Zelfand: one day. Um, and I just realized it was, it was sort of like something ignited within me before I even made the connection that it could help my patients. I realized, oh my gosh, this is fascinating. Why am I seeing fractals? Why are they rainbow colored? I have to understand how this is working on my brain.

Dr. Erica Zelfand: And then that led me down more of like an academic rabbit hole, where I just loved reading about psychedelic research, proposed mechanisms of action. Um, I was really more interested in the sciencey bit of it. Um, and that going down that road, that road kind of turned and brought me back to my patients and realized, oh, okay, now I understand how this works.

Dr. Erica Zelfand: I can see what the best applications of it might be. Hmm. 

Laura Dawn: Super interesting. What year was that? Generally? Cause even now the psychedelic space is so different than it was even three years ago. Let alone, yeah. You know, six or seven years ago. 

Dr. Erica Zelfand: for legal reasons. I’m not gonna say what year it was, but I’ll say it was early.

Dr. Erica Zelfand: It was, it was early on in my, in my medical practice days. Mm-hmm mm-hmm so it was, you know, they say tho those first few years of practice are really where you, you find your style as a provider mm-hmm . Um, and that I felt like I was kind of finding my stride what my style was. Um, but this, this work really at first, I wasn’t sure where, where it fit in.

Dr. Erica Zelfand: I didn’t think it did. And, and as after a while I realized like, oh, this is a big part of my style. Mm-hmm as a provider. Mm-hmm . Yeah. Even, even for the patients that I, I don’t ever say peep to them about psychedelics, maybe I, I don’t disclose that that’s something that I’ve done or I don’t even recommend it for them just having done psychedelics.

Dr. Erica Zelfand: I feel like I have, um, I just have a different approach now. Mm-hmm in how I. Receive a person in my practice on how I listen on how I hear their story. I pay attention to what I hear. I pay attention to what I don’t hear, and I can support them in with different modalities mm-hmm . But my work with psychedelic medicines has informed how I approach medicine now, and I think I’m a better doctor for it.

Laura Dawn: And do you recommend, do you put psychedelics on the table as an option for clients and is there legal risk in that? I mean, I’m so curious to, to hear that process, like, are you like, yeah, well maybe you wanna 

Dr. Erica Zelfand: do a, a deep dive with psychedelics. It’s usually not where I start with folks. Um, and in terms of, you know, the legal risk, I mean, I’m not an attorney mm-hmm , but I’ve consulted some and we do have a precedent for psychedelic work and the, the precedent is cannabis.

Dr. Erica Zelfand: So looking at cannabis as was explained to me by. A couple of other attorneys is that when doctors who were recommending cannabis were getting called to explain themselves or were getting their licenses challenged or were having to end up in court, they were ultimately winning those cases because of freedom of speech.

Dr. Erica Zelfand: I went into medicine to help people, sometimes helping people means me doing the tap dance of tapping around, you know, dancing around the laws. Um, I’m really careful not to just, I I’m, I’m, I’m really not interested in being a martyr, you know, mm-hmm so, you know, there’s a line between telling a patient. I think something like this would help you and aiding and abetting illegal activity.

Dr. Erica Zelfand: Mm-hmm and typically by the time people come to see me, I’m not the first doctor they’ve seen by the time they come to see me, they’ve already seen 3, 4, 5 other people they’ve already been on the meds. For 10 years or more, they’ve already tried this, that or the other thing sometimes, actually a lot of people who come to see me have already used psychedelics and had hard experiences and they still have problems.

Dr. Erica Zelfand: And they’re like, now what mm-hmm or they’ve done psychedelics with the proper set and setting and intention and they still have the issues. And now they have despair. They’re like, well, psychedelics didn’t help me. Nothing else will. And that’s not true either. So I’m, you know, I, I know that as anything gets specialized in medicine, whether it’s psychedelics or intermittent fasting or testosterone replacement therapy, people become zeal about it.

Dr. Erica Zelfand: And doctors do too. And so, you know, sometimes I go to conferences and I meet these doctors and they’re like, oh, I’m a water fast doctor. I put all my patients on a water. Okay. Or, you know, oh, I’m a low dose naltrexone doctor. I prescribe a lot of low dose naltrexone. I prescribe a lot of TT. And when you’ve got there’s that saying, when you’ve got the hammer, everything looks like a nail.

Dr. Erica Zelfand: And I think that my most important job is to stay versatile is to actually look at the person in front of me and see what does this unique vessel carrying an intelligent mind and a radiant soul? What does it need right now in this chapter of its life, if it’s time on this planet. Um, and sometimes that does, I think the, the, the most healing supportive thing for them would be a psychedelic medicine.

Dr. Erica Zelfand: Mm-hmm . And I will also say, because you know, now if you Google my name psychedelics will come up on the first page. A lot of people consult with me because they wanna do psychedelics. And I tell a lot of them, I don’t think this is the right time for you to do this also. And why would that be, um, other things going on in their life support system might not be there?

Dr. Erica Zelfand: Um, I don’t, or maybe I don’t feel like they’re resourced enough to be able to roll with the punches. If things get Rocky mm-hmm before, during or after their psychedelic experience, mm-hmm, , you know, a psychedelic experience because of how powerful it is. It can really catapult somebody to the next level in a good way, or it can really unravel somebody in a, in a painful way.

Dr. Erica Zelfand: Mm-hmm and I wanna make sure that if that unraveling happens, there’s a container for it. Mm-hmm mm-hmm um, also, you know, some, some people chemically, I just think it would rock them a little too hard. There are of course different medicines, right. So it’s not like it’s not a yes or no, it’s a, okay. Which one?

Dr. Erica Zelfand: Um, sometimes. I think that the psych them seeking out a psychedelic is their bypass.

Dr. Erica Zelfand: also, it’s like, no, there’s this isn’t a, you know, eat mushrooms and all your problems are fixed. Mm-hmm , that’s, that’s applying the reductionistic Western model to psychedelics mm-hmm mm-hmm and that works about as well as that model being applied to synthetic pills, I think mm-hmm so also a lot of people come and they say things like, you know, I’ve had depression for 10 years.

Dr. Erica Zelfand: I’m tired all the time. Nothing brings me joy. Um, I wanna do psychedelics, like, okay. Has anyone ever checked your thyroid right. Has anyone ever looked at your iron levels? Um, you live in an old home ever been tested for like heavy metal toxicity. Those are the kinds of things that can cause physical and mental illness.

Dr. Erica Zelfand: that psychedelics aren’t gonna fix mm-hmm right. If you, if you have lead poisoning, psychedelic, medicine’s not gonna Keate metals outta your body. Mm-hmm , it’s just not, it can’t do that, which 

Laura Dawn: is that we know you bring such a, a unique perspective and this holistic framework and really looking at the whole person is so essential.

Laura Dawn: So it’s, it’s just amazing that you’re doing this work. I do really wanna dive into all things, psychedelics and depression. Specifically, you have an article on the psychedelic.support website that I’ll link in the show notes about microdosing for depression. What do we know about the research in terms of psychedelics and we’ll get into macro dosing versus microdosing mm-hmm, but just general research around psychedelics being efficacious for the treatment of depression.

Dr. Erica Zelfand: Mm-hmm we know quite a bit. For starters, we have better quality research on macro dosing than microdosing mm-hmm . Main reason for that is the FDA has said that these substances, you know, we’re talking about psilocybin, LSD, that these are schedule one substances. The schedule one substance is a substance with no medical use and high chances of becoming addictive or significantly hurting somebody.

Dr. Erica Zelfand: So other schedule one substances, just to give you a reference heroin as a schedule, one substance Oxycontin is not curiously, so we gotta change the laws we’re on it. Um, but so when you have a substance that the government has essentially deemed to be radioactive, right, or very risky, it’s gonna be really hard to get a study approved in which the person gets to go home with this substance, take it every day and be trusted not to divert it.

Dr. Erica Zelfand: It’s a lot easier to get a study approved where people come to a hospital or approved center, take the substance or observed for a period of time and then get sent home. So. For that reason. That’s the main reason we have a lot of data on macro doses. And what that data shows is that doing a macro dose or a, you know, normal dose and medicinal dose therapeutic dose of psilocybin.

Dr. Erica Zelfand: Uh, we have more data on L SD now, um, significantly can help with depression and anxiety. Hmm. In a significant way. And a lot of this data comes from populations that were previously considered treatment resistant. So people that have already tried psych meds who have already tried therapy and who are still struggling, those folks can be helped with psilocybin and other classic psychedelics.

Dr. Erica Zelfand: And I think the reason for that there, I think there are a few reasons for that. One is. Depression and other mood disorders is a habit. Your brain gets in the habit and it runs its loop. And it plays that loop over and over and over again. And every time you play that loop, you reinforce it and it gets stronger.

Dr. Erica Zelfand: It’s kind of like carving out a Riverbed and then the water flows that way. So it keeps carving that bed that Riverbed deeper and deeper and deeper. And then the water is gonna move, move down that way. And what psychedelics do is they temporarily fill in that Riverbed and they let the water flow in different directions.

Dr. Erica Zelfand: They let the brain try things on from different look at things from different angles, fire in different ways. Different parts of the brain can communicate with other parts of the brain. It normally doesn’t talk to. And it really helps push that person out of the rut out of that neurological rigidity that they have been stuck in, in playing and replaying and helps their brain go, oh, what if we sent the water this way?

Dr. Erica Zelfand: What if we carved a river bed that way and sent the water in this direction, in that space, people also have an opportunity to do a deeper reconciliation of whatever may be at the root of their ailment. So whether it’s a traumatic event or a story in the, uh, course of miracles, they call it the tiny mad idea.

Dr. Erica Zelfand: So sometimes people come and they’re like, I don’t understand, like what’s going on. You know, I had a, a pretty good childhood and. My parents were there for me and they didn’t get divorced and I was never assaulted or molested and like what what’s going on. So I’m gonna share another case with you. So this is the case of a young man with a very severe neurological condition that is causing paralysis in his body.

Dr. Erica Zelfand: And he actually, his prognosis is not good. Um, so by the time he had his first psychedelic experience, he was, he could still walk, but he needed assistance. And he realized through the psychedelic experience that because he was a middle child and people talk about middle child syndrome and they joke about it that somewhere along the line, he had picked up this little crazy idea that because he was a middle child, his parents didn’t love him.

Dr. Erica Zelfand: There’s no. Data or evidence in his life story to support this statement. And yet he picked it up and carried it in his nervous system. Hmm. And his psychedelic experience was all about confronting that little crazy idea and being like, Hey man, get outta here. Thanks for trying to help me. But that’s not the truth.

Dr. Erica Zelfand: I’m so loved. My family loves me a lot and I’m claiming some, I’m claiming a different story for myself now. Right. And this was someone who came from like super loving, awesome family parents, still married, affluent suburb, good schools, you know, summer cancel that jazz, but it’s hard being a human. It’s hard being a human and our brains are like Velcro and they pick up and stick to weird things and we have negativity bias.

Dr. Erica Zelfand: We know that, um, and psychedelics can really help challenge all of that. 

Laura Dawn: And did it improve his neurological condition? 

Dr. Erica Zelfand: It improved his attitude about it because having such a severe diagnosis, it can really affect one’s quality of life. So what has changed is that the diagnosis doesn’t stop him from enjoying his life.

Dr. Erica Zelfand: So he’s a happier person. Now he’s having more meaningful connections with his family, more meaningful connections with his friends. He’s having a hell of a lot more fun. He’s feeling grateful. It’s horrible. He has this diagnosis, but how wonderful that he has a wonderful family and parents that let him move back in and who are paying for his medical expenses.

Dr. Erica Zelfand: Mm-hmm so it’s shifted his outlook. Mm-hmm it’s too soon to say what it’s gonna do for his physical health. If anything mm-hmm it’s possible. It will help his physical health. It’s possible. It won’t. I don’t know. But did the psychedelic experience help this person, undoubtedly? Yes. Without a doubt. 

Laura Dawn: It’s so funny to hear you say this story too, because, uh, the first thought that came to my mind, it’s like, everything’s fine.

Laura Dawn: I had a loving childhood, no trauma, but why am I depressed? And it’s like, when you look at like the state of the planet right now, it’s like moving through a multi-year pandemic. People are being squeezed by inflation. I mean, it’s just like everyone is feeling it, you know? So it’s like, yeah, there’s just also the context of like, These are times of change.

Laura Dawn: We haven’t really learned how to actually make peace with change, how to make peace with impermanence, how to grieve what no longer is, you know? So there’s all these other factors that I feel like also play such a big role in what we’re experiencing. Stress is correlated to depression. Burnout is correlated to depression, which isolation, 

Dr. Erica Zelfand: isolation mm-hmm , uh, inflammation.

Dr. Erica Zelfand: Mm-hmm it’s like what this pandemic did was it took a problem we already had, which is that people are isolated and disconnected and it cranked that amp to 11 to quote one of my favorite movies. Mm-hmm it turned up the dial. And what did we do to people when they sought out connection during the pandemic in person connection, we shamed them.

Dr. Erica Zelfand: Hmm. And we know that rejection by the tribe is one of the most painful traumas. That a living organism can experience rejection by the tribe. Biologically is death. It’s a death sentence because when it, when a pack animal is rejected by its tribe, it means you need to go into the woods alone and, and you’re gonna die alone out there.

Dr. Erica Zelfand: Mm-hmm and that’s exactly what happened to individuals who didn’t want to be isolated during this pandemic was they got ostracized and pushed and scapegoated, frankly. . 

Laura Dawn: I was watching a talk by Dr. Robin cart Harris and on one of the slides. And it really struck me because he, he had the five HT two, a receptor.

Laura Dawn: We know that psychedelics are agonist to the five HT two a and he had that five HT two a equals. Essentially, if we distilled it into one word, we could say adaptability. And when I think about depression and addiction, and you mentioned, you know, ruminative thinking, I also think of it as like being a hamster in a wheel, just going around and round with self and it helps shake the neural snow globe, and we can choose a new thought we can step off the hamster wheel.

Laura Dawn: So I’m curious to know just about leveraging those windows of cognitive flexibility. I mean, that’s really what Dr. Robin cart Harris put on the table as, uh, the theory behind psychedelic assisted psychotherapy combining, you know, cognitive flexibility, enhanced flexibility with therapy. And I’m just curious to know.

Laura Dawn: If people aren’t combining it with therapy or are there other things that you recommend that people turn to and reach for so that they are doing the work, which is what you mentioned, you know, psychedelics aren’t gonna fix you, you have to show up and do the work. Um, so from a neurological level, it seems like there’s multiple ways that psychedelics might help treat depression.

Laura Dawn: I also wanna ask you about, uh, the correlation to mystical experiences, but on a neurological level, you know, what, what do we know about that? And how do we leverage that knowing to also combine it with other modalities to help treat depression? 

Dr. Erica Zelfand: Hmm. That’s a great question there, because when you look on the internet about this, there are a lot of zealots in this industry and the psychedelic medicine industry.

Dr. Erica Zelfand: There are a lot of zealots psychedelics for everyone all the time. It fixes everything. If you had a bad trip, it was your fault. Your set and setting weren’t right. Not true. Um, if psychedelic didn’t fix your problems, it’s because you didn’t integrate properly. And the only right way to do psychedelics is to integrate with psychotherapy wrong.

Dr. Erica Zelfand: No, , that’s not my experience in working with many, many people who are using psychedelics for healing. There’s no one path that’s right for everybody. And so what I have seen psychedelics do to use that Riverbed analogy, or I’m gonna do a slightly different analogy. Cause I think it’ll be easier to follow.

Dr. Erica Zelfand: Um, this one was not mine. Michael Paul came, I think, explain this one. It’s like, if there’s a hill with snow on it and you go sledding every day, you essentially, you make a groove in the snow and then your sled hits that groove. And then you end up taking that same path. Right? The psychedelic state is like a fresh snowfall.

Dr. Erica Zelfand: So now you’ve got flat mountainside you’re on your sled and you get to choose. Which direction, and you can choose a different path for that sled. The psychedelic state wears off. And if you want to change your brain, you need to keep choosing that different path with your sled and you need to reinforce it and reinforce it and reinforce it.

Dr. Erica Zelfand: Or like when you’re carving a Riverbed, you need to keep digging and digging and digging until it’s deep enough that that’s where the water flows until it’s deep enough that that’s where your sled automatically goes. And so that’s where the follow up work becomes important. So what is that follow up work for?

Dr. Erica Zelfand: Some people it’s talk therapy for other people. , it’s not for some people. For example, one woman had a psychedelic experience where she was a survivor of rape and she had done a lot of therapy already, but her psychedelic experience helped her realize the level of healing she needed now was at the body.

Dr. Erica Zelfand: So she did, she was very aware of her female reproductive organs of the parts of her that really physically make her, you know, a woman and the parts of her that were violated physically. And for her, her integration work had nothing to do with talk therapy. What she did was she did a few sessions of pelvic floor, physical therapy and a couple of sessions of Reiki.

Dr. Erica Zelfand: That was her integration so it looks different. It looks different for different people, but it’s essentially that you have an opportunity now to create a new habit. Mm-hmm . How are you gonna do it? Are you gonna do it through exercising every day? Are you gonna do it through a yoga practice? Are you gonna do it through body work, through talk therapy?

Dr. Erica Zelfand: I’ve also had people come B come back from psychedelic experiences and say, it became really clear to me on that experience that I need to go on meds. And who am I argue with that? 

Laura Dawn: Mm-hmm . And is there situations where actually psychedelics can, might cause depression in the weeks following such a big, you know, letting go and realizations and where it’s like, wow, I am in this job.

Laura Dawn: I’ve been in this job for 20 years that I don’t like, you know, ego disillusion on a certain level. You know, it’s not always more is better or ego disillusion is talked about as like the holy grail of what we’re going after, but is that always psychologically safe? 

Dr. Erica Zelfand: No, it’s not. And sometimes it’s exactly what a person needs and sometimes it’s too much too hard, too fast.

Dr. Erica Zelfand: And let’s not forget that a psychedelic experience, if it is too much, too hard, too ha too fast for a person. If it is registered in the nervous system as an assault, it can become a traumatic event. And this is why it really drives me bonkers. When people get gas lit online, when they talk about having a bad trip to me as a healthcare provider who specializes in mental health to tell somebody, oh, well, bad trips are always because of a, a problem with a sentence setting.

Dr. Erica Zelfand: Mm-hmm I think it’s a bit like telling somebody who was raped. Yeah. But what were you wearing? White. This isn’t always the right path for everyone at, at, at, at every point in their lives. Sometimes the nervous system needs something different or sometimes the person isn’t ready or what’s gonna come up and they need to be held.

Laura Dawn: What do you think is the correlation between people who experience a mystical experience and the reduction of depression and depressive symptoms? 

Dr. Erica Zelfand: Uh, well, according to the data, if somebody has a mystical experience, they’re far more likely to respond medically, psychologically, positively. So, you know, I, I love how we now have a way of actually measuring mystical experiences.

Dr. Erica Zelfand: There’s the, the, mEq the mystical experience questionnaire that’s been incorporated into these studies and long story short, you can really predict outcomes for patients based on how high they score on the mystical experience questionnaire after their psyche state. So I think it’s. if you wanna ensure a good outcome, you wanna do everything you can to enhance the chances of a mystical experience.

Dr. Erica Zelfand: Now what those factors are. Right. Okay. Science is on it. I’m sure Robin Carhart, Carhartt Harris is on it. Um, so we’ll see. 

Laura Dawn: And how do you interpret that though? Like what’s your personal read on why that is? 

Dr. Erica Zelfand: Because we’re because we’re not just machines, you know, because the body is here to do more than just shuttle around your brain.

Dr. Erica Zelfand: And what I really think is missing in mind, body medicine is the soul where in medicine, do we have room for the soul? Isn’t that like, kind of what this is all about, why we’re here, you know, your soul got this car to, to this cool machine to move around and, and it’s time on the planet. And isn’t it so nice to know that you’re not entirely alone here.

Dr. Erica Zelfand: Isn’t that so nice to know that there’s something greater than you holding you in this, that you’re connected in some way. Mm-hmm that you belong here. Mm-hmm , you know, this is like in it’s it’s what we were talking about with the pandemic, with the isolation, you know, this is the exact opposite of that.

Dr. Erica Zelfand: This is like, you have a place in the natural order of things. And the world is a chaotic place that has a lot of heartbreak and cruelty in it, but it also has a place that can hold you in a web mm-hmm and it’s also a place that has magic and beauty. Right. And how can you connect to that and have it not shift things for you, you know, once you see that mm-hmm , how can it not change your life?

Dr. Erica Zelfand: Mm. 

Laura Dawn: I wanna dive into some technical questions around psychedelics and depression, including microdosing mm-hmm I get this question a lot, you know, I have a, a free eight day microdosing course. I’ve done a lot of work with people around microdosing. I, I have noticed over the years more and more people come to me that say, I am on SSRIs, and I want to come off of SSRIs through microdosing mm-hmm

Laura Dawn: I have a whole slew of questions for you around this. Great. What do you think is the, the best way to support people who want to start microdosing and there is limited data, but have you noticed that microdosing can also be effective for depression? 

Dr. Erica Zelfand: Yes, absolutely. Microdosing. The little bit we know about it, it seems to work in actually quite similar ways to SSRIs.

Dr. Erica Zelfand: One of the ways that SSRI’s work is by influencing serotonergic activity. So the role that serotonin plays in sending signals in the nervous system, and as you said earlier, we know that psychedelics stimulate five H T two a, which is a kind of serotonin receptor. So we do have some serotonergic activity with antidepressants.

Dr. Erica Zelfand: So I, I’m gonna be a little bit of a snot here and say, so when all of those psychedelic people who are like, kind of zealots post on the internet, like, oh, did you see the new study that low serotonin doesn’t cause depression. That’s why pharmaceuticals are a lie and you should be using psychedelics.

Dr. Erica Zelfand: It’s like, ah, you’re psychedelics find serotonin receptors too. So why don’t you hold on their cowboy? okay. Wait, 

Laura Dawn: say that again? A little slower. What was that last part that you just said 

Dr. Erica Zelfand: psychedelics also? Yeah, psychedelics also act on serotonin pathways. Mm-hmm . So, if you say to me, pharmaceuticals don’t work because they act on serotonin pathways, you need to use psychedelics.

Dr. Erica Zelfand: I’m gonna come back and say, yeah, but psychedelics also act on serotonin 

Laura Dawn: pathways. Mm-hmm yeah. It’s the same. Aren’t they agonists for the and similar. Yeah. Right. SSRIs are very similar. 

Dr. Erica Zelfand: They’re similar. So let’s not throw away the baby with the bath water here. Mm-hmm so one way that microdosing works that we think is that it affects these serotonin receptors.

Dr. Erica Zelfand: Another way proposed mechanism of how microdosing can work is that it’s anti-inflammatory. Hmm. So our SSRIs mm-hmm and another way proposed mechanism that microdosing may work is by increasing neuroplastic. So the brain’s ability to learn and unlearn as well as neurogenesis, the, the brain’s ability to actually sprout new neurons.

Dr. Erica Zelfand: So if you think of the nervous system as a treat, it’s like it’s ability to grow some new branches. Mm-hmm mm-hmm . And so, you know, when we look at them side by side, it absolutely could be a reasonable plan for a patient to start microdosing, and then slowly taper down their SSRI. It’s like giving them a little bit of a cushion that microdose it’s support.

Dr. Erica Zelfand: It’s giving them something else to support them while you’re taking away the SSRI support. Mm-hmm . 

Laura Dawn: Before we go deeper into that, I saw a study around microdosing and BDNF brain derived neurotropic factor mm-hmm mm-hmm . Can you say anything about that correlation? Is that related to increased neuroplasticity?

Dr. Erica Zelfand: Uh, yes. Neurogenesis specifically. So again, that brain’s ability to grow new branches. ketamine does the same thing by the way. So sometimes for, you know, a variety of reasons, the foremost being legal reasons, uh, I prescribe ketamine micro doses, cuz ketamine’s legal. Right? Mm-hmm so, um, for that reason, you know, I, I, you, I, you, you want the brain to be grow growing and learning new tricks, you know?

Dr. Erica Zelfand: Cause when the brain gets too rigid, you know, we get, we get some trouble, we get chronic pain, we get depression, anxiety, O C D mm-hmm . Um, you know, we also, the brain tends to get more rigid too as people age and that’s, you know, where we get grumpy old man syndrome, , you know, people kind of get more rigid as they get older.

Dr. Erica Zelfand: Um, and you know, BDNF can help them be a little bit more. 

Laura Dawn: Mm-hmm . Yeah, I just interviewed Connor Murphy who works for the flow research collective and he just finished his master’s degree on psychedelics and how they open up critical periods and looking at, you know, how there’s actually new research to show that these critical periods that are usually only open when we’re children can actually reopen.

Laura Dawn: And that’s how we can like, leverage those, those windows of heightened plasticity, heightened cognitive flexibility. Um, yeah, but just really wanting to stay focused on this topic of depression specifically. I. To my understanding. It’s also, and I’m curious to hear your perspective on this, but so many people say, you know, don’t go and drink Ika if you’re on SSRIs because of serotonin syndrome, to my understanding, there’s never actually been one reported case of serotonin syndrome.

Laura Dawn: And that yes, we do need to be very careful. Wakas different than talking about psilocybin or L S D. Um, I know some people who say you should be very careful microdosing or working with psilocybin if you’re on SSRIs as well. So I’m curious about the contraindications of, you know, SSRIs specifically and working with any of those substances.

Dr. Erica Zelfand: Sure. Iowaska is a whole other can of worms because it contains a mono mean oxidase inhibitor. Mm-hmm so sorry. Great time for my neighbor to start hammering um, it contains a mono mean oxidase inhibitor. So the. iowaska and antidepressants, as far as I’m concerned, that is a hard, that is a hard, hard and fast.

Dr. Erica Zelfand: No, , don’t combine the two in terms of antidepressants and psilocybin. We need more data, but I don’t think it’s a problem. I’ve never seen it be a problem. And I would say about half of the people that I work with who have done psychedelics, or are doing psychedelics about half them are on antidepressants.

Dr. Erica Zelfand: And if anything, I’ve just found that they need higher dose of the psychedelic in order to, to break through. Because what happens when you’re on a medication that affects your serotonin pathways? Like let’s say our own Prozac or another SSRI is part of how the brain adjusts to being on that medication.

Dr. Erica Zelfand: Is it down regulates the serotonin receptor, but we need that serotonin receptor because that’s what the psilocybins gonna bind to, to work. So because a person has fewer serotonin receptors or less sensitivity of those receptors. Sometimes they just need a higher dose of the psilocybin to actually mm-hmm have them have their experience typically about 30 to 50% higher than yeah.

Dr. Erica Zelfand: An unmedicated person. Mm-hmm um, in terms of microdosing haven’t again, I haven’t seen it be a problem. James Fatman also has been collecting data on people, reporting their experiences. Hasn’t been a problem. What may be a problem is combining, um, micro doses with lithium mm-hmm because of the risk for lowering the threshold for a seizure.

Dr. Erica Zelfand: Mm. 

Laura Dawn: it’s interesting that you said that because one of the things that I notice so much is that people who are on medications who are start working with, uh, psychedelics specifically psilocybin, um, but LSD as well is that they report for the first, like three or four or five, maybe sometimes even six journeys.

Laura Dawn: They’re like, I didn’t feel anything. Mm-hmm I didn’t notice anything. So, you know, I was gonna ask you about that, but you just spoke to that and having to actually go higher in the dosage so that they break through. 

Dr. Erica Zelfand: Yeah. Well, and the lovely thing with psilocybin, and this is where psilocybin is different than say, MDMA, we don’t have a toxic dose of psilocybin.

Dr. Erica Zelfand: There’s no lethal dose of psilocybin. So if somebody needs more mushrooms, they can have more mushrooms. You know, it’s not like, you know, with MDM a, we have the same issue where again, those receptors are less sensitive. So the person needs a higher dose. MTMA is neurotoxic. You don’t wanna go too high on that dose, you know, psilocybin, not so much.

Dr. Erica Zelfand: So the, the other myth I wanna bust here is this myth that you can’t stack your doses. You absolutely can. Meaning you can take psilocybin. Let’s say you’re on an antidepressant. You wanna have a psilocybin experience? You eat, I don’t know, four grams. You wait an hour, hour and 15 minutes. You’re like, yeah.

Dr. Erica Zelfand: I don’t really feel that I’m in it. Eat another two grams. people are like, no, no, no, you can’t do that. And it’s like, nobody. Yeah, no, you can though. You absolutely can. I haven’t actually 

Laura Dawn: really heard many people say about the, the myth around not stacking. Most people I know are all for stacking. 

Dr. Erica Zelfand: Okay, good.

Dr. Erica Zelfand: Great. Do 

Laura Dawn: you do lemon tech or do you recommend lemon? Teching mm-hmm 

Dr. Erica Zelfand: yeah. Um, for it for some people, I think more so for people who have already had an experience mm-hmm and have reported, you know, really slow in, in the onset, took a long time to kick in didn’t kick in super hard. I had to take more, you know, mm-hmm for those folks, I’d say.

Dr. Erica Zelfand: Yeah, absolutely. But, but what I, what I, the way I like to do the lemon tech and I actually need to give props to, um, Justin Townsend, cuz I picked this trick up from him is to not do the full dose as a lemon tech, but to have, you know, a third or half of the dose as a lemon tech, maybe like a third of the dose as a lemon tech and then the rest regular.

Dr. Erica Zelfand: So you’ve got the lemon tech to sort of kick off the experience. Because it comes on fast and hard, but it doesn’t last as long mm-hmm . And then by the time, you know, that the curve is coming down off of the lemon tech, you’ve got the, the rest of the medicine sort of kicking in and you can ride those waves back to shore mm-hmm and give you a lot more time in that in the, in the, in the mushroom space.

Dr. Erica Zelfand: Mm-hmm, , 

Laura Dawn: I’ll give a shout out to Michelle jank who wrote an article for double blind on lemon teching, which for people who are like, what the heck is lemon teching? I also did an interview with Michelle, uh, all about it. And so I’ll link that. Show notes as well. And it’s basically just soaking your psilocybin in lemon juice that kind of like cooks the psilocybin a little bit and like breaks down the walls and people report that it comes on stronger and faster for some people who get digestive upset or feel like it takes a really long time to come on.

Laura Dawn: That lemon tech could be an option for, for those people. 

Dr. Erica Zelfand: Absolutely. It’s kind of like your, your mushroom ceviche. exactly. Totally. Yeah. So SIL psilocybin, when you actually eat the mushrooms, your body then has to convert the psilocybin to SIL and SIC is what makes you trip mm-hmm . And so when you do the lemon or lime juices, citric acid in a cup with the mushrooms that conversion to SIC is already starting to happen in the cup mm-hmm so you’re taking more, you’re taking SIC as opposed to SIL.

Dr. Erica Zelfand: When you limit tech mm-hmm . 

Laura Dawn: So for people who are wanting to come off of SSRIs and they are choosing to use psilocybin microdosing for that, I usually recommend people actually work with their doctor, but not all doctors are informed about microdosing. It seems like more and more doctors are becoming informed.

Laura Dawn: Um, mm-hmm but if people feel like they the need to take it into their own hands, do you have any recommendations on titrating or should they be microdosing at a full dose of SSRIs their, their regular dose for several weeks? And then start slowly coming down over a course of X amount of weeks, for example.

Dr. Erica Zelfand: Sure. There’s no one right way to do it. Right. So customizing it as much as possible to the person that being said. There are some patterns, there are some general guidelines. Uh, I do work with people one on one to help them with this. I also work with healthcare providers. To mentor them and how to help their patients.

Dr. Erica Zelfand: And, um, I also teach courses, so I actually just started a nonprofit called right. To heal, to help kind of disseminate this information more effectively, but kind of just some general, general highlights, never, ever, ever, ever, ever, ever, ever stop your med school Turkey. That’s just not a good idea. No good can come of doing that.

Dr. Erica Zelfand: Also. I don’t think it’s a good idea to give yourself a deadline of, you know, I’m gonna be off by the end of the year. I’m gonna be off by November because that’s when an Iowasca ceremony is give it as much time as it needs. You don’t know how long it’s gonna take. You don’t know what your brain chemistry’s gonna do, how long it’s gonna take for it to come back online.

Dr. Erica Zelfand: The other thing I would say is don’t even go down a 10th, 10% of your dose until. You’ve checked your physical health. Are you anemic? How are your vitamin B 12 levels? How’s your vitamin D is your thyroid functioning properly? If you’re a guy, how’s your testosterone. If you are somebody who menstruates and your anxiety or depression is worse before your period, how are your progesterone levels?

Dr. Erica Zelfand: Are you pooping every day? Yes, that has a lot to do with it. So working ideally working with a healthcare provider, naturopathic doctors are amazing at this, but other healthcare providers can be good too, to make sure that the physical piece is locked in because depression is not just in your head.

Dr. Erica Zelfand: There’s a reason there often are organic physical causes. The number one organic cause of depression is hypothyroidism. Wow. Yeah, it has nothing to do with your mother. it’s your thy. Wow. And what about your number 

Laura Dawn: one? ACOs? I thought like your microbiome and your 

Dr. Erica Zelfand: gut, exactly your microbiome. What’s your gut doing the gut brain axis.

Dr. Erica Zelfand: There’s the vagus nerve runs from your brain to your heart, to your lungs, to your gut. And when I say that the, the nerve runs from your brain to your gut, it’s not a one way street, actually 90% of the fibers of the vagus nerve run upwards from the gut to the brain. Mm-hmm , which means what’s happening in your gut is influencing your focus, your attention, your mood, your sleep so much has to do with the gut mm-hmm

Dr. Erica Zelfand: So one of the questions I ask people who have depression is I say, I go way back to the beginning. Were you born vaginally or through a C-section? Were you breastfed? How many rounds of antibiotics did you have as a kid? How often do you take antibiotics now? Mm-hmm . How often do you poop? what do you eat?

Dr. Erica Zelfand: Do you drink alcohol? All of those things mm-hmm can affect your mental health. So what I like to do when I work with clients and I help people around the world is I like to get those physical pieces, if not completely dialed in at least on a path to getting dialed in so that as we start shifting the brain chemistry, we’re not just pulling the rug out from under somebody mm-hmm because these medicines do work.

Dr. Erica Zelfand: And a lot of the time they work by applying a bandaid over a different problem. And so when we take the bandaid off, we need to make sure the other problem is actually getting remedied mm-hmm or else the person’s gonna decompensate and say, oh, I have to be on this drug for the rest of my life, which isn’t true either necessarily.

Dr. Erica Zelfand: So first and foremost, get the physical health locked in. And secondly, tapering choosing the right time to taper. Middle of holiday season, probably not the best time anniversary of your brother’s death coming up soon. Probably not the best time. Uh, super tight deadline at work at the end of the fiscal year, find a relatively chill time in the year.

Dr. Erica Zelfand: I like summertime is usually a good time because schedules tend to be lighter and there’s more sunlight. The days are longer, but you know, what’s right for you and start tapering. Some people are like, oh yeah, I cut the dose in half for a week. And then I cut the dose in half again for a week. And then I just started taking it every other day and I’m like, oh my gosh, that’s not a plan for success.

Dr. Erica Zelfand: 10%. Just cut it back by 10%. mm-hmm 

Laura Dawn: over. Would you say intuitively or over a schedule of like week by week? 10%. 

Dr. Erica Zelfand: So I don’t like doing a week by week 10% because what happens if you cut it back 10% and you have some withdrawal symptoms mm-hmm and then you’re like, oh, but it’s been a week mm-hmm . Wait, wait until you’ve stabilized and don’t wait until you’ve stabilized for a day or two.

Dr. Erica Zelfand: Let that stabilized period lock in. Mm-hmm go, go slow, slow and steady, slow and steady. Once you feel like, okay, I cut it back 10%. It’s been a week. It’s been two weeks. It’s been a month, however long mm-hmm mm-hmm okay. I’m feeling all right, cut it back again or okay. I feel right. I feel, I feel good, but you know what?

Dr. Erica Zelfand: My high school reading’s coming up. Wait and then cut it back. Um, slow and steady. And, and sometimes people say, yeah, but my medicine only comes in a 50 milligram and a 25 milligram and you can’t cut the pill, open up the capsule and count beadlets and remove bead lit. Or if you’re working, if your prescriber’s on board, which I hope they are, you can go through a compounding pharmacy.

Dr. Erica Zelfand: You can have a compounding pharmacy, make you a 40 milligram capsule and then a 35 milligram capsules or a, you know, you can, you can really customize it. Mm-hmm . 

Laura Dawn: And do you recommend a microdosing schedule or are you more on the intuitive side of things? We have, like the stem it’s protocol and the Fatman protocol.

Laura Dawn: Do you, when people come to you, are you recommending try two days on and then a few days off 

Dr. Erica Zelfand: microdosing, it sort of depends on how the person’s wired, um, microdosing can be stimulating. So for example, you know, people with generalized anxiety disorder, sometimes they feel worse when they microdose mm-hmm

Dr. Erica Zelfand: So I tend to tell people, play around with it and figure out what feels, what feels the best to you. And that’s part of why it, it can actually be, you can make the argument to start microdosing before you taper. You know, play around with a few different regimens, see the one that’s the best for you. Get that routine down and then start your taper.

Laura Dawn: Do you notice a difference between psilocybin and LSD for depression? Specifically? 

Dr. Erica Zelfand: Most people are working with psilocybin cuz that’s usually what they can get their hands on. So when they try psilocybin and it doesn’t work well for them, then they have that extra motivation to go and find the LSD and try the L S D some for some people, the LSD works better for some people, the psilocybin works better.

Dr. Erica Zelfand: Um, for whatever reason, I have found that it, when microdosing makes somebody more anxious, that they tend to tolerate LSD better than psilocybin. I don’t know why it’s just what I’ve seen. I could be wrong, but that’s the pattern that I’ve seen. Um, So, yeah. You know, the, the, the funny thing with L S D it’s gotten so stigmatized, or it was so stigmatized and the, that we have a federal mandatory minimum sentencing for L SD.

Dr. Erica Zelfand: So people are spooked. People who wanna get medicine to people don’t really wanna make LSD mm-hmm because we’ve got that, that federal mandatory minimum sentencing, um, actually just like made a, an Instagram post about this, on how, um, a couple of people, um, William Leonard Picard and Timothy Tyler, those people were convicted of manufacturing, LSD mm-hmm , and they were both sentenced to life in prison.

Dr. Erica Zelfand: I know life in prison now. Thankfully they didn’t serve life sentences. Uh, William Leonard Bacard served, I think 24 years, uh, 20 years. And Tim Tyler served 24. 

Laura Dawn: I just watched William Leonard ARD speak at horizons. yeah. And it was amazing, right. Just, oh my God. You could yeah. Hear a pin drop during his talk.

Laura Dawn: Yeah, yeah, yeah. Yeah. 

Dr. Erica Zelfand: Um, in, in the meanwhile, the Sacklers who owned Purdue pharma, the company that made Oxycontin, the company that committed fraud and lied to the FDA, to the public and to healthcare providers about how addictive their drug is. And arguably fueled the op opioid epidemic, not a single one of them did anytime Purdue pharma had to pay billions of dollars in fines, but that was Purdue pharma.

Dr. Erica Zelfand: Not a single person was held personally, personally accountable. So unfortunately working in healthcare, I can only go so far working in healthcare without becoming political mm-hmm . Because, because I was taught in my medical training, a big, a big tenant of naturopathic medicine is identify and treat the cause of disease.

Dr. Erica Zelfand: Mm-hmm and a big cause of disease in this country is the absolute hypocrisy of our political policy around drugs. Mm-hmm which ones are bad and which ones are good, which ones we allow and which ones we. Mm, 

Laura Dawn: uh, Thomas Anderson put out the, the benefits and the risks or the, uh, I don’t think he used the risks, but it was like the benefits and the drawbacks of microdosing.

Laura Dawn: And one of the drawbacks that a large percentage of people reported was fear of, you know, in paranoia of legalities that I was like, wow, if you could remove that large chunk that people reported as like the number one detriment to microdosing, that that would just even significantly improve the upside.

Laura Dawn: And, oh my gosh. You know, and, and actually to come back to the difference between LSD and psilocybin, I’ve noticed, I’ve probably supported about gosh, over 400 people in microdosing at this point, right on. And so. I’ve noticed that microdosing with psilocybin is much more body based for a lot of people and a contraindication that we do need to be aware of and presence.

Laura Dawn: You mentioned it kind of briefly, but people who struggle with high anxiety, that that can actually be a contraindication. And that comes from Jim Fadiman’s work. And that I noticed that LSD is a little bit more like in the mind, like hyperfocused in that way. And when people micro Dobin who are not fully present with their emotions, which is why other modalities of, for example, meditation and learning how to sit with discomfort and emotional awareness practices are really helpful.

Laura Dawn: And somatic based practices are really helpful. I’ve noticed that people are like, wait, I wanted to microdose because I wanted to feel better, but this bringing up a lot of emotional. Baggage that I don’t wanna be dealing with right now. And so that even is just a big difference that I’ve noticed, which is why we need to work with people on this whole system’s approach.

Laura Dawn: And are you microdosing to bypass? Are you microdosing to make direct contact with what you’re feeling and do you have the tools to do that and the support system to 

Dr. Erica Zelfand: do that? Absolutely. Absolutely. And you know, I, I think that we can get a little bit sanctimonious about reasons that we think people should micro dose and reasons that people shouldn’t, you know, so for example, a lot of people in Silicon valley are microdosing.

Dr. Erica Zelfand: A lot of tech bros are microdosing so that they can like work longer hours mm-hmm and it’s like, yeah. Okay. Is your work actually helping you or the planet or anyone? Is it helping you do anything except make more money like you or none of my business, you know, mm-hmm mm-hmm mm-hmm but. But yeah, many, many roads, many roads.

Dr. Erica Zelfand: And there’s a reason that there’s so many medicines out there. Right. Mm-hmm because we need all of them. 

Laura Dawn: Do you notice that, have you noticed that sort of general categorization of, of psilocybin being a little bit more like emotional body, physical body and LSD, a little bit more mental cognitive mm-hmm 

Dr. Erica Zelfand: yeah, yeah.

Dr. Erica Zelfand: Um, a little bit more like, oh, when I microdose LSD, I hear people saying when I microdose LSD, I can get a lot of work done. Yeah. Yeah. 

Laura Dawn: I’m so over the, the whole, like microdosing for increased productivity I’m right there with you on that. 

Dr. Erica Zelfand: Yeah. Yeah. On that note, I actually have a really cute story. Um, so I, I was in Mexico.

Dr. Erica Zelfand: and, uh, I was staying with a dear friend of mine who just recently celebrated his 80th birthday. And, um, we were doing some, some beautiful work down there, uh, with folks. And one day he said, you know, you know what, I’m, I’m not, I’m gonna hang back today. I’m gonna stay home. Cuz I have a lot of work. I have a lot of emails I need to catch up on and I, you know, gotta do this and that.

Dr. Erica Zelfand: And I gotta file this paperwork and he’s like, I’m just, you know, I gotta, I gotta stay home and have a productive day today in the morning he’s like drinking his coffee. He’s like, I don’t know if there’s enough coffee to help me. And he’s like, you know what? I wanna microdose. I was like, oh, that’s great.

Dr. Erica Zelfand: You’ll get a ton of work done. If you microdose, you’ll be able to focus. And so he goes and pulls out the, his vial of LSD microdose. And this is during the dry season in Mexico. It’s all evaporated. No, cause the vials empty and I’m like, well, you know what? Like the vials empty, but there’s probably still some medicine like coding the inside of the vial.

Dr. Erica Zelfand: Like maybe we put some water vodka in the vial and shake it up. And so he fills the vial up with a little bit of water, shakes it up and then he’s like, well, how much should I take? And I’m like, well, I don’t know, because we don’t know how much is in the VI. I’m like, well, surely more than a drop or two because you know, mm-hmm so he ends up just like taking a swig off of the vial.

Dr. Erica Zelfand: And then, you know, I go to work and I come back at the end of the day and I find him sitting on the back porch with a, with, um, a glass of water, just big like smiling ear to ear. And I’m like, how is your day? You get some work done. He. I got nothing done. I didn’t get anything done today. He’s like I called, I called up a friend that I’ve been waiting to call and I talked to him on the phone for three hours and I just, like, I just realized I love him so much.

Dr. Erica Zelfand: so great. I love that. So funny. Oh, he had an anti productivity day. Thanks to LSD. Was very happy about it. years 

Laura Dawn: ago with like a couple of Xes ago. At this point I was in Mexico and we had traveled with same. It was like an empty, we had gone through the LSD bottle. It was an advising bottle and it was empty.

Laura Dawn: And, but there was still actually quite a bit on the walls of it. And so we, we opened it up, like we tried to squeeze it out of the, the little pinhole and there was like nothing coming out. But when we opened it up, actually like a few sort of, of bigger drops came out into the water and we ended up. You know, sharing what was left in there.

Laura Dawn: And it was like one of like the most powerful journeys of my life. Like we journeyed for over 40 hours. Like I think, I think I ended up, we ended up taking like several full hits each and we were just like really in it. And so, but it was, that’s what you had signed up for. And, but it was, I was actually, uh, we are very experienced.

Laura Dawn: Trips at that point. So it was easy for us to roll with it and it was really significant journey. Anyways. Uh, I digress. I wanna come back to this question that actually just came to me. My, my new sweetie, who is in my life, his father is struggling with Parkinson’s and, um, my mother, her, her husband is, I, I don’t wanna say it’s Alzheimer’s, but it’s like early signs of that.

Laura Dawn: And so I’m kind of curious about neurodegenerative disorders and what you know about microdosing for that. And it seems like the people that I know are actually really open the, the older people that I know who are struggling with neurocognitive decline are really open to other options like psilocybin, microdosing, 

Dr. Erica Zelfand: I think it’s a great idea.

Dr. Erica Zelfand: Mm-hmm yeah. Um, I think it’s an area in which we’re gonna see a lot more research and years to come, but based on the little bit that we know about these substances so far that, you know, they’re, anti-inflammatory that their neurologically seem to soThe the inflammation in the nervous system that they support neurogenesis, that they support neuroplasticity.

Dr. Erica Zelfand: Um, I think it’s a great idea. I think it’s a great idea. And actually I have, uh, some friends in Tijuana, Mexico, they have an iboga center called new, be V neurogenesis. And they work specifically with veterans who have head injuries and people who have Parkinson’s and they actually use iboga because there’s been some, some.

Dr. Erica Zelfand: Um, studies and some great evidence there on that front. Um, but absolutely, and we, and we need more approaches for people with neurodegenerative diseases because you know, the, our, our, our pharmacological cornucopia is great and robust and we still need more. Mm-hmm , we, those people still need more help.

Dr. Erica Zelfand: And, you know, El dopa works great until it stops working. And then what, you know, 

Laura Dawn: and then what do you recommend combining microdosing with neutropics lions main? And what’s your, what’s your take on niacin like this sta stack? Do you, do you stack things together? 

Dr. Erica Zelfand: I usually find it’s not necessary. Mm-hmm but I think it’s a great, I think it’s a great idea.

Dr. Erica Zelfand: I have no objections to it and, you know, I, I love and often leverage synergy. in how I, you know, work with people and absolutely makes sense to me that there would be a synergistic effect of stacking psilocybin with other mushroom species, other medicinal mush, medicinal mushrooms, using niacin to help with the penetration.

Dr. Erica Zelfand: Although I don’t really feel like we need it. I feel like it really gets in there. Mm-hmm gets in there just fine. Mm-hmm um, and Nin, you know, it comes with the flush, which is unpleasant and, um, and often, you know, people who have neurogenerative diseases have a leaky, like it’s like leaky gut, but it’s in the brain.

Dr. Erica Zelfand: They have a leaky blood brain barrier. And so like this, wasn’t your question, but it’s kind of related people argue all the time about GABA supplements because they say, oh, you know, there’s no point in taking GABA supplements because GABA can’t penetrate the blood brain barrier unless you have a leaky blood brain barrier.

Dr. Erica Zelfand: Well guess what, everyone who needs GABA probably has a leaky blood brain barrier. So, um, long story. , uh, I don’t find that the Nin is necessary. I don’t think it hurts to do it if the person tolerates it well, mm-hmm . Um, but ultimately we don’t have studies on any of this. So ultimately everyone is just using deductive reasoning at this point, myself included.

Dr. Erica Zelfand: So take everything I say with a grain of sodium chloride. Mm-hmm , you know, mm-hmm I could be wrong. 

Laura Dawn: Well, and I do think that there are quite a lot of anecdotal reports coming in that we can glean from, you know, thousands and thousands of people pointing in a certain direction. What was your, your read on the microdosing and placebo study that came out of Imperial?

Dr. Erica Zelfand: My read was, I think it Warren’s repeating mm-hmm yeah, repeat it. See what happens. Mm-hmm and, uh, I personally don’t think it’s this a placebo effect I’ve played around with microdosing myself. Um, I. What you could call a highly sensitive person. Um, and I I’ll actually tell you, I can’t microdose. I feel horrible when I do it.

Dr. Erica Zelfand: So, um, you know, that could have been placebo, but listen, nobody who has a placebo effect going on thinks is a placebo effect, right. Myself included. right. But, but, um, I think the, one of the, the lovely things that we have with microdosing data is one of the things that makes it weak data is that it’s self-reported.

Dr. Erica Zelfand: But one of the things that makes it strong data is how many people have self-reported. And based on those self reports, looking at patterns, looking at themes, you know, this is where we get the pattern or the theme that the psilocybin may be more body connection oriented. The LSD may be more cognitive focus productivity, right?

Dr. Erica Zelfand: If a number of people are reporting these same effects, there, there could really be something there mm-hmm . 

Laura Dawn: Why do you feel horrible? What, what’s your 

Dr. Erica Zelfand: experience? Um, well, just a little bit of context. I, I, I’m the kind of person I can’t drink coffee. Like when I drink co like even half a cup of coffee, like I start sweating, my B smells awful.

Dr. Erica Zelfand: I get palpitations. And I feel like everyone’s, I’m like, are you mad at me? Like, I get really nervous that like, I’ve done something to upset everyone. And everyone’s mad at me Uhhuh, like, or I’ll get a text from a friend, like, Hey, could call me when you get a second. And I’m like, what did I do? She’s mad at me.

Dr. Erica Zelfand: that’s, that’s where I go on coffee. So, uh, microdosing is a bit like that for me where I’m just a little bit like who ha ha everything is moving too fast. yeah. 

Laura Dawn: Uhhuh. And is that at like 0.1 of a 

Dr. Erica Zelfand: gram? Yeah, like it’s either it’s either so little that I notice nothing or it’s enough that I just feel too, too revved up and anxious.

Dr. Erica Zelfand: Mm-hmm um, With LS, that’s with S Sabin with LS. D I feel a little Cy boggy, like, like when I was an undergrad, sometimes I would, you know, like abuse, Adderall to stay up late and study, you know, mm-hmm, , it feels a little bit like that for me, when I use LSD, like, okay, I need to work on my website, like for 10 hours straight and not talk to a simple person, you know, mm-hmm, a, a microdose may help with that.

Dr. Erica Zelfand: But then like, if somebody calls I’ll be like really annoyed with them, cuz they’re like interrupting so that’s so funny. My, my medicine is more like kava, kava tea with honey. got you. I got that’s. That’s more, that’s more, that’s more what I need. That’s better medicine for me. I’m yeah. I, I need things that make me more chill.

Dr. Erica Zelfand: Not, mm-hmm not more neurotic. I, I don’t need any help with neuroticism. I’ve got that one dialed in. I’m kinda curious. 

Laura Dawn: Do you go deeper? Do you do deeper dives with any plant medicines? And do you have sort of like a primary plant teacher that you work with? 

Dr. Erica Zelfand: I do, I do go deeper. And actually I feel like my, my own personal journey with psychedelic medicines yes, has helped me become an advocate for this work.

Dr. Erica Zelfand: But it’s also largely informed my sort of negative Meli reputation within this industry too, of like, Hey guys, doesn’t help with everything. Mm-hmm Hey guys sometimes makes things worse. Um, so, you know, I’ve had some really difficult journeys. I’ve had some journeys in which I got a lot of downloads of frankly, garbage data and had really hard time making sense of them and then leaned a lot on, you know, psychedelic gurus for support and felt gas lit by them.

Dr. Erica Zelfand: And so I’ve 

Laura Dawn: had, who are these psychedelic gurus? 

Dr. Erica Zelfand: I’m not gonna name anyone here. I’m like psychedelic gurus. Okay. Yeah. but, but, uh, and. I’ve also had some journeys that were wildly profound, wildly healing on personal levels and also wildly inspirational. And in which I felt I’m gonna sound a little, a little, um, self-aggrandizing year, uh, God forbid a woman believes in herself.

Dr. Erica Zelfand: Right. But, um, I’ve had some trips in which I felt like I was summoned to talk to my patients about this work, to talk to my colleagues about this work, to stop hiding and put on a suit and go stand in front of, uh, you know, Ambi theor, full of psychiatrists in a hospital and present for eight hours a day long intensive on psychedelics, you know, and psychedelics convinced me of their efficacy and placed medicine.

Dr. Erica Zelfand: And psychedelics also convinced me that I could be a voice for that. Mm-hmm mm-hmm . Hmm. And psychedelics also convinced me that they can’t heal everything. 

Laura Dawn: I think that’s a good middle middle path. I, I, I definitely hold that perspective. Mm-hmm 

Dr. Erica Zelfand: before 

Laura Dawn: we close the, the microdosing sequence of questioning, do you usually start people at 0.1 grams?

Laura Dawn: Is that where you recommend people start? 

Dr. Erica Zelfand: Depends on their sensitivity mm-hmm so if it’s someone who tends, so I, so I just ask, you know, typically when you take medicine, are you the kind of person, and I don’t mean psychedelics necessarily, although mm-hmm , it can be the case, but in general, you know, are you the kind of person who like a little bit hits you hard?

Dr. Erica Zelfand: Are you the kind of person who needs an average dose? Are you the kind of person who needs like a dose high enough to kill an ox before you notice any effect? You know, you kind of gauge what that person’s sensitivity is. And if it’s the kind of person who says like, oh, I just have to look at a medication or like, I just, I just have to, you know, Look at a pill of di flu can, and I get a yeast infection.

Dr. Erica Zelfand: Like people are super, super sensitive, then I’m like, okay, start at 0.1. If it’s sort of an average person, um, 0.2. And if it’s someone who needs a higher dose, I’ll say start at 0.2 anyways, and then just increase as you as, as need be. And you know, I, I tell people if you, if you take it, tell us, take, take it in the morning, especially at first when you’re figuring it out, if you feel like you drank too much coffee, that’s too high of a dose mm-hmm mm-hmm , you know, um, if you feel agitated too high of a dose mm-hmm , if you feel like you need to wear sunglasses, that’s just a normal side effect.

Dr. Erica Zelfand: Uh, 

Laura Dawn: right. Yeah. Some people like to be in like the threshold dose and some people really want it to be subception. So I feel like it also depends on what people are going for and what they have space for and how much time and space that they create for dropping into a practice. Do you recommend people work with microdosing within the context of a, a morning practice or are you more a like.

Laura Dawn: Yeah, it’s cool. Just take your microdosing capsule and 

Dr. Erica Zelfand: go to work whatever’s right. For the person or however they feel called to do it. Mm-hmm , you know, and some, some people really have like a, a spiritual connection and some people are like, they really just want a different pill. Mm-hmm and mm-hmm , you know, I, I, I’m not gonna, I can’t, I can’t convince them like, Hey, but you’re, but you’re a spirit with a body.

Dr. Erica Zelfand: Like, no. Okay. That’s not, that’s not where those people are at. They just want a different pill with a different side effect profile to help them with their add or whatever. And it’s like, okay, well then, then take your pill and go to work, you know, 

Laura Dawn: right. Which is what I’m curious about though. Cuz we spoke earlier about how similar psychedelics are to SSRIs.

Laura Dawn: So why not just recommend something that is more natural and are there less side effects with psychedelics than the side effects that we see show up with SSRIs? 

Dr. Erica Zelfand: Yeah, it’s a very good question for, for some people. Try try it instead. Mm-hmm, try it instead of whatever else you’re in addition to whatever else you’re using and, and see if you feel like it’s working for you and if you like the side effect profile, you know, mm-hmm and, you know, I, I remember when I, when I first started consulting with people on this, there was a woman who got very annoyed with me because I kept trying to bring it back to spirituality and I kept trying to bring it back to integrating.

Dr. Erica Zelfand: She had a very, very hard trip. She was terrified the whole time. Uh, she feels that she got like no messages or no learning out of it, but her depression was about 30% reduced. And I kept trying to go back to the trip and try and mine some gold out of it. And she got really pissed off with me cuz she was like, no, I just wanna understand the chemistry.

Dr. Erica Zelfand: It’s like, okay, mm-hmm , that’s that’s it’s your body and it’s your brain mm-hmm yep. You 

Laura Dawn: know, 

Dr. Erica Zelfand: mm-hmm yeah. So that, and, and you know, and if there are people who aren’t really interested in having that mystical experience, then I think. Microdosing would be a better choice in macro dosing. Mm-hmm because then they can keep it in that range.

Dr. Erica Zelfand: What would 

Laura Dawn: you say is the difference of the side effects between psychedelics and SSRIs? Oh my 

Dr. Erica Zelfand: gosh. Well, SSRIs, the list of side effects is long. , it’s a, it’s a laundry list of side effects, but you know, weight gain, low libido feeling like, yeah, there’s a floor to the sadness, but now there’s a ceiling to the happiness.

Dr. Erica Zelfand: By the way, if that happens to someone that means the dose is too high, it’s the wrong drug that, that shouldn’t be happening. Um, but

Dr. Erica Zelfand: different people tolerate things differently. Um, overall I find the side effect profile of microdosing to be much gentler, um, and a bit more predictable and a bit more like, Hey, I noticed this other benefit. Like my IBS is better. Mm-hmm um, I don’t usually hear people saying. Sometimes they do. I shouldn’t say that sometimes they do on SSRI, but I don’t usually hear people come back and say, oh, this other thing is better.

Dr. Erica Zelfand: That I didn’t think was related the way that I do with microdosing 

Laura Dawn: mm-hmm right. And also just teaching people like stress management tools, because, you know, because it sounds like stress is to my understanding highly correlated with 

Dr. Erica Zelfand: depression. Oh, sure. Sure. Of course. Yeah. And then when you’re depressed, you’re stressed.

Dr. Erica Zelfand: Mm-hmm because you like, see all the balls you’re dropping mm-hmm and then you’re like, well, what’s, what’s my motivation in getting better because when I get better, I have to go on an apology tour and run, you know, disaster relief on all the mess I’ve made of my life in this depressive state, you know, mm-hmm , it can be really hard to overcome that mm-hmm so, you know, um, I’m definitely a, a fan of using all the tools, use all the.

Dr. Erica Zelfand: Use all the tools you can get your hands on. Mm-hmm , you know, they’re all here for you. Yeah. 

Laura Dawn: For, for me and someone who’s struggled with depression, I’m, I’m pretty intimate and familiar with that mental space. I would say three core things really helped. And, and even to the point where I would say that saved my life psychedelics have played a huge role.

Laura Dawn: Pema Chodron and her teachings, Tibetan Buddhism has played an enormous role in my own healing of depression. And I would say the other thing was walking and exercise. You know, I, I kind of view walking akin to being like a miracle drug for depression. And I’m kind of curious, just your understanding of the research around movement and walking or exercise and depression.

Laura Dawn: Because when we were talking earlier about, you know, leveraging those windows of cognitive flexibility, I think really for me is like combining an establishing a new habitual pattern of daily movement, um, would be one of those things that I would put on the table for people who are especially struggling with low mood or chronic stress, for example.

Laura Dawn: So any amen anywhere you wanna go with 

Dr. Erica Zelfand: that, you mean everything you just said. Uh, exercise is hugely important. And I know a lot of people are scared of that at word. So I just say movement. When I talk to my patients about it, your body was designed to move. If you move every, if you take every joint in your body, through its full range of motion, once a day, a lot is gonna feel better in your body.

Dr. Erica Zelfand: In your mind, walking in particular is a really powerful drug for a few reasons. It’s not only movement, but typically it’s also done outside. So then you’re also having that synergy of time in the outdoors, getting fresh air, hopefully fresh air, uh, if it’s in nature even better, but also because if you’re doing it right, if you’re swinging your arms even a little bit, when you walk there’s something called bilateral cross crawl, and what that means is essentially walking or crawling on all fours.

Dr. Erica Zelfand: As your right foot comes forward, your left arm comes forward. As your left arm comes forward, your right arm comes forward. So it’s the opposite arm to leg. So this is the movement that we get. First of all, when we’re babies crawling, then as adults, when we’re walking, I love watching people walk. I love first of all, people watching in general, but I notice how people walk, people who don’t swing their arms when they walk.

Dr. Erica Zelfand: I’m like, Ooh, I bet they have cognitive issues. It’s really important. Um, roller skating, uh, cross country skiing, swimming the cross stroke. These are all movements that give you bilateral cross crawl. And what bilateral cross crawl can do is it can actually take emotionally charged thoughts, which are stored in the amygdala and move them to different parts of the cortex.

Dr. Erica Zelfand: So it can actually help. Declaw some of the intensity of anger, sadness, and other negative emotions, um, and help us just take the emotional charge back a bit on them. It’s huge. We also, as a side note, interesting, um, some interesting thought here that children who don’t crawl in child in infancy, um, may actually have a harder time learning to read Hmm.

Dr. Erica Zelfand: Later in their childhood. That, that, that cross crawl is cuz when you look at the way a toddler walks, like they’re not doing the arm swing, they’re not getting that, that cross crawl, but when they’re crawling on all fours, they really are. And that seems to be important for certain parts of the, the brain coming online and the ability to learn certain things.

Dr. Erica Zelfand: Hm. 

Laura Dawn: Right. And just managing stress in general. And you mentioned burnout. I feel like I’m sort of in recovery a little bit right now. I’m so yeah. Huge for huge for me. Um, yeah, you mentioned burnout as well at the beginning of this conversation. And for me, I’m I still feel like I’m in recovery. I’m like getting my over eight hours a night’s sleep right now.

Laura Dawn: I’m on the backside of just a lot of online programs. I’ve just finished graduate school this summer, uh, on the backside of the launch of grow medicine, which was a really big nonprofit launch. And so, you know, I’m, I’m really curious about how you navigated your own burnout and how you were on your own path of recovery.

Dr. Erica Zelfand: Yeah. You know, my own burnout, there was a real reckoning point for me in terms of realizing who, what I thought I could do and what I thought I could juggle day in and day out. is actually less than what I can. And so for, for me, there, there were, there was a period of beating myself up to try and make myself fit into the structure of what I thought I should be able to do and sustain.

Dr. Erica Zelfand: And at a certain point, I had to change all of that. And I realized actually, no, I had to change my life to fit me. And that was a very slow, acutely painful, and most UN graceful process. I did not do it smoothly. I did it with a lot of kicking and screaming. Um, but changing show up with more integrity, the things that I do.

Dr. Erica Zelfand: So, you know, there were some big changes I made like, um, I don’t practice full time now. I practice part-time and I balance my career with teaching speaking, writing, advocacy work. You know, I say no to a lot of things. Now I’m inundated with, with people reaching out to me, they want me on their show. They want me to speak at their conference.

Dr. Erica Zelfand: They want me to help be, oh, advisory board invitations. I can’t even tell you how many advisory board invitations I get. And my question is what’s in it for me. What’s in it for me. And nobody likes to answer that question when they ask it, Hey, will you sit on my advisory board? Yeah, what’s in it for me.

Dr. Erica Zelfand: Are you gonna pay me? Well, no, I typically, no. I mean, typically, no, we don’t pay people to be advisory board and then why the hell would I do it? I’m so dealing with this too, right now. It’s 

Laura Dawn: like, not even funny. Well, because it’s an 

Dr. Erica Zelfand: important cause. Yeah. 

Laura Dawn: Yeah. And then people like guilt and shame you and, you know, mixing of medicines with money and people come to me all the time with all of these things.

Laura Dawn: And now I’m like, I need you to put a clear proposal on the table within five minutes. And if you can’t do that and also express to me like what the fair energetic exchange is, then why do you think it’s okay to just be using up my most valuable resource right 

Dr. Erica Zelfand: now? Absolutely. Yeah. And it, you know, I, I, I bump into this a lot with, with this counter argument of yeah.

Dr. Erica Zelfand: Yeah. But your work is so important. It’s like, does that mean because my work is important. Does that mean I’m not allowed to make a living doing it? Mm-hmm like, do I, do I really. Do I really need to go selling people, plastic crap made in China that they don’t need in order to be able to afford, to have a family in order to be able to have a, have a nice home, to have to buy a nice healthcare policy for myself.

Dr. Erica Zelfand: Because as a solo business owner, I have to buy my own health insurance through the American marketplace, which if you haven’t done that yourself, let me tell you don’t ever do that. If you can avoid it, , you know, just like what my, my work has to be degrading and meaningless in order for me to earn, earn a living, like, how is that fair?

Dr. Erica Zelfand: You know, how is that appropriate? Hmm. And I think a lot of people who work in the psychedelic industry either made a lot of money doing something else. Like they worked in tech for a while and then retired in their forties. And now have they have a lot to give because they’re secure. Right. I went into medicine, this is my primary.

Dr. Erica Zelfand: This is my gig. You know, this is my, this is my career. I have a quarter million dollars in student loan debt, you know, 

Laura Dawn: Which is just such a broken system to begin with, right? Yeah. That’s, it’s 

Dr. Erica Zelfand: crazy. Mm-hmm yeah. So, so realizing, and I think, and this is, and this is challenging as somebody who genuinely does care and genuinely wants to help.

Dr. Erica Zelfand: Also as a woman, it’s hard, it’s hard for me, but it was also really important for me to hit a point where I could start saying no to things mm-hmm and start saying, yes, I would love to do that. And here are my stipulations. Yes. I will speak at your conference, but you need to put me up in a hotel room.

Dr. Erica Zelfand: Mm-hmm with a window, the room has to have a window right, right. And I’m not sharing it with anybody else. Yeah. You know, um, and I’m gluten free is the food at your conference gonna accommodate my dietary restriction because if I’m flying across the country and I’m showing up jet lagged, I’m not gonna have time to run to the grocery store.

Dr. Erica Zelfand: I need the food to accomplish, you know, so, so things that I’ve really had to overcome this fear of seeming demanding, um, and just, um, and also really accept that not everybody gets to get a bite of Erica when they want it. You know, there’s a waiting list for my practice. Sometimes it’s close to new clients.

Dr. Erica Zelfand: I’m so sorry. But if I, if I, if I take on more, I’m gonna injure myself. And if I injure myself, I have to close the whole practice down, then I can help nobody. Mm-hmm so, um, and that’s where, you know, I’ve been shifting my, my focus on, instead of trying to help each person myself, maybe I can educate other healthcare providers so they can help me help all of these people.

Dr. Erica Zelfand: And so that’s part of why I created my online course called the science of psychedelics. It’s short, it’s eight hours, but it’s eight hours, you know, and it’s a great, anyone can take it. You don’t have to be a healthcare provider, but I really targeted it for healthcare providers, for therapists and prescribers alike because their, your patients have questions about psychedelics and you don’t wanna sound like Nancy Reagan when they talk to you about it, right.

Dr. Erica Zelfand: You wanna be able to ha to meet your patients where they’re at, and here’s a place to start. And, you know, I got it approved for continuing medical education, which if you’ve never done that before, by the way, I’ll say it’s really hard and really expensive. so I’m just gonna give myself props for doing it.

Dr. Erica Zelfand: Oh my gosh. Right. Um, yeah. And so a lot of now a lot of the work I do is I speak at conferences and yes, I ask for compensation. Um, I speak at medical conferences. I present at hospitals, um, and I write articles for medical journals and medical publications. because I’m gonna be able to help a lot more people.

Dr. Erica Zelfand: If I get other healthcare providers to start doing this work too. Mm-hmm . 

Laura Dawn: Yep. That’s great. Yeah. I so appreciate that. And so for people who are in the psychedelic space experience experiencing burnout, because I’ve noticed this conversation coming up a lot lately, mm-hmm um, quick tips say no more often, that’s 

Dr. Erica Zelfand: a good one.

Dr. Erica Zelfand: Say no more often. Yep. Um, have a different phone number and email address for work than personal don’t check the work stuff on the weekends. Don’t check the work stuff after 5:00 PM, nobody is going to make your boundaries for you. Mm-hmm and when you make them, you’re gonna piss some people off. And the people you piss off are probably not your target market.

Dr. Erica Zelfand: Anyway. Right. Let them go. You can’t help everyone. And actually there’s, um, I don’t love everything that Tim Ferris has to say, but I, I did glean a lot actually from his book, the four hour work week and something that really jumped out at me from that book was about 10% of your clients will take up 90% of your energy.

Dr. Erica Zelfand: Mm-hmm, identify that 10% and fire them. And I try and do that about twice a year and which I, I do a little bit more of a careful analysis. Some of my clients that take up a lot of my energy, I love them. I see they’re motivated. And I think what we’re doing is working and I find it rewarding those, those I keep around, but some I’m just like, Ugh, this freaking person mm-hmm yep.

Dr. Erica Zelfand: Yeah. Who’s rude to my staff and sent my secretary a nasty email because we had to reschedule an no. Yeah. Get her outta here. You know, like that’s so the same. I can’t help everybody zero tolerance for that. Yeah. You know, mm-hmm , I can’t, I can’t help everyone. Um, and you know what, there was a real, there’s a real ego trip with being a doctor.

Dr. Erica Zelfand: I’ll just be honest, you know, I don’t think that anybody goes into a career in medicine for entirely altruistic reasons, myself included I’ll own it. And part of that ego dissolution comes with realizing I actually can’t help everybody. Mm-hmm yeah. Mm-hmm I can’t. 

Laura Dawn: well, I so appreciate you for your time and your depth of knowledge and wisdom.

Laura Dawn: I do feel like we could still have you on for a whole other two hour conversation and just go. Maybe we will into all the things . And so the science of psychedelics, I love that you’re offering this course. I will definitely include a link in the show notes. I love that you offered earlier to offer the, the listeners a, a discount code.

Laura Dawn: So we’ll, mm-hmm, , we’ll make sure that that’s available. Great. And is there anything else that you wanted to share and wrap up with?

Dr. Erica Zelfand: I would just like the people who are listening to know that I really believe that there is a path for every person to heal and there’s that there’s a roomy quote, keep knocking in the joy side. We’ll open up a window and look out to see who’s there. So. if you haven’t found it yet, keep knocking, keep trying things.

Dr. Erica Zelfand: If you haven’t tried psychedelics, maybe psychedelics, if you had tried psychedelics, maybe something else and be open to being wrong, because I think it’s more important to heal than to be. Right. Hmm. Hmm. Thank you for that advice. Mm, thank you so much for having me. This was. Really lovely to connect with you.

Laura Dawn: Yeah. Really appreciate the work you’re doing. Thank you. And it’s so nice to just see you as a, a female entrepreneur in the psychedelic space, you know mm. Where you’re also juggling and balancing. You’re like, okay, I can’t do a lot of one-on-one fulltime, you know, one-on-one practice anymore. And then pivoting into the online courses and the conferences it’s just inspiring.

Laura Dawn: So, and literally balancing your own, you know, stress management and burnout prevention and still feeling fulfilled and managing personal life and professional life. It’s it’s no easy task. It’s 

Dr. Erica Zelfand: really full on it. Not it’s not, but you know, Laura, I can honestly say that. I love my job. Mm-hmm and that’s worth something.

Dr. Erica Zelfand: Yep. Yeah. That’s worth a lot. I don’t that for granted it’s worth a lot. Mm-hmm . 

Laura Dawn: I can say that too. You know, people ask me, it’s like, um, yeah, I was mentioning a little bit earlier about some of my own recovery from burnout and, and it’s like that this podcast too, you know, it’s like I do this podcast is almost like a part-time job. It’s like a full part-time job, 

Dr. Erica Zelfand: you know? Oh my gosh. I imagine editing these things. It takes way more energy than even recording them. So yeah, it’s a whole process to you. It’s 

Laura Dawn: a whole process, but I do love it so much. And I just love being in the space and, you know, doing the programs that I run and all of the things and retreats and yeah, I feel very grateful that this is my life.

So that’s how I balance that out. And also, you know, it, wasn’t sustainable for me to put out an episode every week. And so it’s like just being okay with doing two episodes a month and it’s no big deal and no 

Dr. Erica Zelfand: one will die. No, one’s it’s okay. No, one’s probably gonna notice yeah, yeah. Good for you. Well, you know, as, as one woman in this industry to. thank you. Thanks for what you do. And thanks for doing it in a way that takes care of you. Mm-hmm cause, cause we need, we need more people doing that cuz it gives others permission to do the same. Totally. 

Laura Dawn: That’s huge. Well, thank you for all your knowledge and wisdom and yeah. Let’s, let’s be in touch. I really appreciate just all of your perspective and the way you show up the way you communicate and uh, thank you.

Laura Dawn: Yeah. It’s it’s refreshing. 

Dr. Erica Zelfand: Hmm. Right back at you. Okay. Aloha. Bye 


Dr. Erica Zelfand


Dr. Erica Zelfand is a licensed primary care provider practicing integrative and functional medicine. She specializes in psychoneuroendocrinoimmunology (PNEI), the interaction between mental health, neurology, hormones, and the immune system.

In addition to seeing patients in her private practice, Dr. Erica is a medical writer and international speaker. She also trains providers in ketamine- and psychedelic-assisted healing through her online course The Science of Psychedelics and in person through Inner Trek

Dr. Erica is an author of a medical review of the potential of sodium ascorbate to reduce opioid tolerance and dependency. She is also a foodie, a fan of the em dash, and a group hug initiator.

To learn more and connect, please visit www.DrZelfand.com

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Episode #59 of the Psychedelic Leadership Podcast features a song called “Look Inside” by Ali Maya


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About Laura Dawn

Through her signature Mastermind Programs and Plant Medicine Retreats, Laura Dawn weaves together science with ancient wisdom. She teaches business and thought-leaders, entrepreneurs, and creative professionals how to mindfully explore psychedelics and sacred plant medicines as powerful visionary tools for inner transformation, fostering emotional resiliency and unlocking new depths to our creative potential.