From 0 to 300K Sessions: Is Psychedelic Therapy The Ultimate Treatment for Mental Health Issues?

0:00All right, everyone, we've got Dylan, he's the founder and CEO of Mindbloom and a his company's amazing. B, he's got some amazing stories to share and I can't wait for him to share it with everyone. So Dylan, tell us a little bit about Mindbloom from the top and we'll kind of go from there. Mindbloom is the largest provider of psychedelic therapy in the United States today. We help people achieve life-changing personal and clinical breakthroughs through at-home ketamine therapy for anxiety and depression. We've done two big things in Mindbloom that we're really proud of. One is we've radically increased access to ketamine therapy treatment by using telemedicine to bring the cost down 80%, making it available to 85 % of Americans in 38 states, which is particularly important because 160 million Americans don't live in mental health coverage zones as it is.

0:50and really reduce the stigma and barriers by building the largest brand in psychedelic therapy and doing over 300 ,000 treatment sessions over the past four years. The second big thing that we've done is created products and services around psychedelic ketamine therapy to help people get the best clinical outcomes that have really ever existed in depression and anxiety. So just last summer, we published the largest ever peer-reviewed clinical study in 70 years of psychedelic therapy and 20 years of ketamine therapy history, along with physicians and researchers from NYU, UCSF, Cleveland Clinic, Houston Methodist, MAPS, who's running the MDMA clinical trials, demonstrating that our at-home ketamine therapy product is getting people a clinically significant improvement in anxiety and depression.

1:46like 40 % more frequently than SSRIs like Lexapro with 10 times fewer side effects and even blowing the clinical outcomes of in-person ketamine, which are five times the cost out of the water. Okay. Yeah. There's a lot to unpack there, but can you, I think the story that you have is really powerful. So kind of what's your relationship with psychedelics and how did this lead into starting MindBlue? So I'm a three-time tech founder now, I built two other what I'd call world positive companies, creating changes in areas that are deeply personal and meaningful to me. And I left my last company after five years, which is still the market leader in space five years later, to start Mindbloom for a couple big reasons.

2:28One is I think everybody knows that we're in a mental health crisis, but not everybody knows that it's largely considered the number one public health crisis in the United States today, and it's getting worse and worse every day. So to frame the problem, we've got a quarter of Americans, one-fourth, have diagnosable mental illnesses, and that number's increasing. Depression is the number one cause of disability worldwide. And suicides and overdoses have become the top two leading causes of death for Americans under 45. Overdose and suicide death number is particularly personal and meaningful to me because my mother and my sister are part of those statistics.

3:06My mother and my sister were both severely mentally ill, schizophrenic, bipolar, addiction, and we tried all of the traditional treatment options that we could find to try to get them help, and ultimately none of them worked for them. We tried antidepressants, anti-anxiety meds, antipsychotics, talk therapy, group therapy, inpatient rehab, all which was particularly challenging for us as a working-class family and the 70 % of Americans living paycheck to paycheck to afford access and even figure out what the hell to do. But it wasn't enough. My mother ended up spending 15 years homeless on the streets because we weren't able to help her manage it before dying of a fentanyl overdose a couple of years ago.

3:50My sister, I was essentially the same situation on and off, housed by my father and died of a fentanyl overdose last year, right after getting out of a three-month inpatient rehab facility. And through those experiences, I lived in a very turbulent, chaotic, oftentimes violent home that undoubtedly left some what you'd call like lowercase t trauma ingrained into me. So I had a lot of issues with anger, a lot of issues with how I related to and interacted with other people, and just a really toxic and unhealthy worldview. that showed up in terms of my mental health and well-being and the life I was leading.

4:36For me and my journey, I ended up discovering MDMA therapy about 16 years ago. And MDMA fundamentally changed my outlook on the world and how I relate to others and really catalyzed a personal transformation to make me a much better person for myself and a much better person for the people around me. and for that reason started mind bloom with this mission to transform lives to transform the world to help people become happier healthier and more resilient versions of themselves both for them but for also the ripple effect that that would have on the people around them their family their community and the work that they would do in the world got it well number one i appreciate you sharing that story um and just just how resilient you are and how you're taking that trauma and and how you're building stuff to have a positive impact on the world.

5:29In one of your answers here in an interview that you did, you mentioned that depression is the number one cause of disability worldwide after all, and overdose deaths have 5x in the last 20 years. So the, because my experience with MDMA, the first time I did it was in like a, I went to an EDM festival, right, when I was like 20 years old. And it was life changing in that respect. But can you tell us how MDMA therapy is different than just taking it recreationally? Yeah. So when I started Mindbloom in late 2018, and this is for ketamine, but it's going to tie into your question about MDMA therapy.

6:07What I saw was that ketamine was this groundbreaking treatment for mood disorders, like depression, anxiety, but also a lot of research and studies around PTSD, OCD, and addiction, and other ruminative thought disorders. There have actually been over 100 clinical studies published on ketamine over the past 20 years, more than all other psychedelic medicines combined. But there are a couple of big problems with ketamine. One was the access problem. It's like $600 ,000 a session, which my working class family could have never afforded for my mother, even feels available back then. Is it$600 ,000?

6:43$600 to$1 ,000. Got it, got it. I was like,$600 ,000 is a really long. That's a little pricey. Yeah. Very few providers out there. Most Americans have access, a lot of fear and stigma. But another problem I saw was that it was stuck in what I called at the time ketamine therapy 1.0. It was often provided by an anesthesiologist or ER doctor, not a mental health care provider, provided in a sterile clinic or hospital room, looking up into some fluorescent lights with a needle in your arm. And 20 % of Americans are needle phobic. So that's a huge issue for a lot of people. And not to mention that that setting is really challenging for people, especially when they're about to undergo a psychedelic state.

7:26And third, maybe most importantly, there's generally very little to know, call it psychosocial support around the treatment. It's just a jab in the arm, send you on your way, hope it works, which it actually does. So I saw an opportunity to build what we call ketamine therapy 2.0, which is allowing people to use the psychedelic medicine in the comfort of their own home where they're in a comfortable, safe, physical setting to sort of calm their mind. gives them a psychedelic therapy modality to help them prepare for, go through, and integrate their experiences afterwards, and is actually delivered by mental health care providers.

8:06So Mindbloom, specifically psychiatrists and psychiatric clinicians, along with a specialized coach that we call a guide. So I say all that to get to your question around what's the difference taking MDMA and MDMA therapy. There are a few different permutations for what psychedelic therapy, whether that's ketamine therapy, MDMA therapy, or psilocybin-assisted therapy might look like. But generally, it orients around three pillars. One is preparation for the experience, what you do before it. Two is navigation of the experience, what you do during it. And three is integration of the experience, or what you do after.

8:44So for preparation of the experience, in a MDMA therapy modality, what people will really focus on, the providers will focus on, is helping patients, one, make sure that they're in a really sort of calm, expansive, well-prepared mindset going into the experience. Two, make sure that the physical setting that they're doing it in, so where they're at, who they're with, is really comfortable. And three, that people are sort of priming their subconscious mind before they go into the experience to help get the most out of it. That could be working with a provider or a therapist, or it could be what, say, Mindbloom clients do, which is writing out their intentions, making a journaling exercise ahead of each experience.

9:31The second is navigating the experience, what you do during it. And so there's a definite skill set to getting the most out of a psychedelic experience, whether that's MDMA or ketamine or psilocybin. And so at Mindbloom, one of the things we train our clients in is to, it's called TLO, trust, let go, be open, which is also often used in MDMA therapy. So giving them something to hold on to around trusting that the medicine's high quality and it's really safe and efficacious and it's going to work for them, most likely, Two, teaching them how to let go as experiences come up and not get caught into ruminations.

10:14It's just to observe things coming and going and collecting those experiences. And three, being open and receptive and not sort of resisting and fighting those experiences. To help people get the most out of that, usually what's done, and this is what we do at Mindbloom, It's also in the MDMA therapy protocol. It's had people recline or lay down with an eye shade over their eyes, eyes closed, and headphones with a very particular and personalized and specialized music to guide the experience and overlay it. And so Mindbloom through our mobile app, which is like Headspace or Calm, but for psychedelic therapy, there are a number of different programs and pathways people can select for different mental health issues they're grappling with.

10:58We have a bunch and we're building out a whole library more. but things like anxiety, depression, grief, social anxiety, eating disorder, alcohol, use couples therapy, et cetera. And for every session, we have a library of guided sessions with different types of music and different types of spoken guided psychosocial support content to help take people through that one hour ketamine therapy session. Or in the case of MDMA, it might be more like three to six hours. And then the third, arguably some of the most important or highest leverage part of the entire process is integration. So what do people do after the experience?

11:36So what we know about psychedelics is that they open what's called the critical period, essentially a state of neuroplasticity in your brain where you're much more easily able to rewire your brain in healthier ways, healthier ways emotionally, healthier ways behaviorally. and we want to help people leverage that neuroplastic state as best as possible. Studies show that for ketamine, that neuroplastic state can be about a week per session. For MDMA, it can be about two weeks. For LSD, three weeks. For Ibogaine, four weeks. It seems to correlate with the length of the psychedelic experience. And so when people are in this neuroplastic state after their experience, it's a prime time to help them actually get a lot of the benefits.

12:26And so we do that by helping people really dive into what happened during the experience and understand it and make sense of it to helping people interpret what that means for them, what they're going to do about it. And then three, helping them create actual action plans for how they're going to make changes in their life and be held accountable to them so that they're not just having these interesting, neat experiences, but actually taking what they've learned and what's come up in this neuroplastic state and making concrete changes in their life that'll help propel them upwards. Okay. And what are some, I guess, let's talk, you said it would be$600 to$1 ,000 for a typical type of treatment for ketamine, right?

13:10Like what does it cost with MindBloom and how long is the treatment typically, all that type of stuff? So Mindbloom starts as a six-session treatment program. That's 195 a session. And that includes several hours of support for mental health care providers. So whereas a platform like HIMSS or ROE that looks a little bit more like an online pharmacy, you might work with a doctor for seven seconds or seven minutes. Our clients are working with our providers on average seven hours throughout the seven-session program. It also includes coaching from specialized coaches called guides that's both in a one-on-one setting and also a group setting called integration circles, which are probably one of our most popular features, allowing clients to share about their experiences facilitated by a guide.

14:00We also have all that content that we talked about and a really active patient community of people sharing about their experiences and helping each other sort of get the most out of the experiences and share tips and tricks and share their mental health journeys. The cost for this sort of complete solution, not just medicine, is$195 a session. So about 80 % more affordable than the average in-person ketamine clinic when I started the company. and for clients who decide to continue on treatment for subsequent programs that drops down closer to $120 per treatment. Got it. And is there, and you guys to be clear, so Mindbloom specifically focuses on ketamine treatment right now?

14:42Yes. Ketamine is the only legally prescribable psychedelic therapy in the United States today. MDMA is on track right now to be available to patients end of next year, end of 2024. And psilocybin is probably a couple of years after that. So it's an exciting time. Well, let's say if you, let's say that the law was no object here, which one would be the weapon of choice in your mind? So one, I'm not a clinician or a doctor, just I'm a tech entrepreneur, a psychedelic enthusiast and a psychedelic therapy patient myself. So my personal opinion, it would be MDMA therapy. I think ketamine is going to fundamentally transform the behavioral health system.

15:28We see that ketamine is essentially a 10X better product than SSRIs, anti-anxiety meds, and talk therapy. And for people, their mental health issues are usually their number one burning pain point in their life. Like our average client is 41 years old. We have more clients over the age of 57 in their 20s. And these are people who have suffered for a long time. They've tried a lot of things and nothing has really worked for them. That said, MDMA is so powerful in terms of the clinical outcomes it's getting, especially for things like PTSD, which are really challenging and tricky. And I think that ketamine has been slower to adopt because it has a lot more fear and stigma than MDMA.

16:11And so MDMA, I think it's going to sort of take the behavioral health market a lot faster and then also propel ketamine therapy behind it. Yep. I remember there was, I know Tim Ferris dropped this video, this has to be like five or six years ago, but it was, it was like four different people that had gone through different trauma stories and they were, they all went through MDMA therapy and it was like 80 % effective. And basically they would take the MDMA and they'd just sit with, um, sit with the doctor and then talk through kind of similar to what you're saying, right? Kind of talk through what's going on in their head.

16:52And, um, miraculously they were, they were cured afterwards. So I, I do kind of believe that. Um, and again, I, I'm not a doctor or anything either. I can just go through my, my experiences. So I can say, just say it's, it's been a positive experience. Um, okay. Let's say you're to stack rank it, right? You're, you're, So you would put MDMA first. Would psilocybin come in second or would it be ketamine? So I think the way to think about it is that like different molecules or substances work for different people for different things. And so if somebody is stuck in a ruminative thought or mood disorder, which is how a lot of mental health issues look like, where they have built over time unhealthy neural pathways and patterns of these positive feedback loops, they feed themselves over and over again.

17:46They get worse and worse and worse. So this is depression, anxiety, OCD, PTSD, addiction. Ketamine is actually incredibly effective for knocking people out of that, especially depression. One of the benefits of ketamine is that it only lasts about an hour and is generally quite gentle. And so it allows people to sort of stack these neuroplastic windows because they can do it more frequently to get progressive outcomes. Something like psilocybin is more potent generally for people. And so it can help people who need like a really huge breakthrough do it. But it's a little – there's a lot of friction just in terms of the intensity of the experience, in terms of how long it takes.

18:32And so ketamine can be used a little bit more as like – better as like an SOS system, right? Like somebody comes home and they're in like a deep, dark state. They're having a mini sort of relapse or episode, and the ketamine can help knock them out of it really quick. It's one of the reasons that ketamine is probably, based on the clinical research, the best treatment for suicidality today. Because you can get somebody who's having a suicidal episode ketamine very, very quickly and immediately, and it has these incredible remission rates. Example is after my sister died of a fentanyl overdose after getting out of three months of rehab late last year, my father, who's my hero, was in a deep suicidal depression.

19:18He was incapable of leaving his room showering or shaving for 20 days straight. So completely debilitated. He was suicidal. He was texting me things like, here are all my passwords in case something happens to me. Here's where all the silver is hidden in my condominium in case anything happens to me and would not let me come down and see him. And was taking a lot of steps that are, you know, like largely considered people preparing to potentially commit suicide. And so I had talked to my team, the mental health care providers, and essentially put him in like a 50-50 chance to survive the next one to two months.

19:56The upshot was this was sort of the rock-bottom catalyst that he needed to take the leap in the plunge and try ketamine therapy through Mindbloom, which is something I've been trying to get him to do since the day I started the company. And it was nothing short of transformational for him. Within a couple sessions, he had remission from suicidality, which 63 % of our patients who are suicidal have. And within several sessions, he sounded like a completely transformed person. exercising for the first time in years, eating healthy for the first time in years, decades, had started to develop goals around his relationships with others and finding a partner, spending more time with his friends, organizing and decluttering his house and just getting that activation energy for life.

20:43So that's something ketamine is extremely effective for and shows up in the clinical research. MDMA is extremely effective for trauma. There's a lot of studies around end-of-life care and palliative care for people who are in a deep depression. It could be cancer. It could be because they're at the twilight stage of their life. And psilocybin has been clinically shown to have transformational benefits to people's mental health and sort of coming to terms within finding meaning and purpose in their life. But we really still are just like at day one of figuring out how to help people get the most out of these neuroplastic drugs, how to help personalize the medicine and really match the right person to the right medicine for the right thing and the right way for them.

21:30And that's a huge thing we're doing here at Mindbloom is developing these products and services and trying to build applications to help maximize the outcomes and the quality experiences from these. You said you've had over 300 ,000 customers. Is that what it is? Oh, we've done 300 ,000 sessions. 300 ,000 sessions. Okay. When I first started my business, the overwhelm was real. I didn't have the tools to help me scale. If only I had Shopify from the start to handle all the behind the scenes work. Shopify is the platform behind millions of businesses globally from huge names like Mattel and Gymshark to the smallest brands just getting started.

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24:19okay and we're actually running a study right now follow on one that's going to be like seven times larger like nearly 10 000. it's truly massive and so what this study showed is that when you stack at-home ketamine therapy up to other treatments, it's truly, like I mentioned, a 10X product. So for instance, talk therapy works for about 40 % of people, which is about the same as a placebo. It seems to be like there are a small percentage of talk therapists that give people incredible outcomes, but in general, talk therapy doesn't work on average. Then you have SSRIs. So these are antidepressants, which 40 million Americans are prescribed, like Lexapro.

25:01And that's not much better. It works for like 40 to 47 % of people. But the downside is that like 30 to 50 % of people have severe side effects, weight gain, sexual dysfunction, insomnia, sometimes suicidality, sometimes severe anxiety. And you often hear from people, they also have severe emotional blunting that makes it almost untenable to be on because they become sometimes a shell of their former self. In addition, antidepressants take six to eight weeks to work. So if you're someone like my dad, or you're a suicidal, you might not have six to eight weeks for it to work. IV ketamine therapy in person, ketamine therapy 1.0 with sort of no cycle social support, just jab in a hospital room, actually works for 54 % of people.

25:42And at-home ketamine therapy with our protocol is working for 63 % of people. So that's 20 % more frequently than in-person ketamine and 40 % more frequently than SSRIs. But when people hear about ketamine, they think they have a knee-jerk reaction, like, wow, that sounds really dangerous though. So I think what surprises people isn't necessarily the efficacy, it's actually the safety of ketamine therapy and at-home ketamine therapy. As far as SSRIs, people are having these really severe side effects like 30, 40, 50 % of the time. Mindbloom patients are having side effects less than 5 % of the time, 4.7%.

26:15And they're pretty light, like nausea, grogginess, a little brain fog for a few days. And the amount of clients having like an adverse event, so something more severe than a side effect, it was like rounds to zero. It's like 0.3%, I think all which were resolved. I know we only have a couple minutes left, so I want to go kind of rapid fire here. So I'm looking at one of the responses here that you do. So the five things I wish someone told me before I started. So number five here, you put psychedelic therapy and you said you do mind blue one to two times a month and another psychedelic therapy experience about three to six times a year tell us about the second part what is the second part uh yeah i mean i have my own psychedelic therapy practice uh there are a lot of different things i've found that so i often get asked um dylan what's the best mental health tool technique trick uh and i think it's like similar it's like asking what's the best exercise trick, like it's really different things are going to resonate and work better for different people.

27:17And so to me, like the number one mental health habit or routine is really deciding that your mental health and wellbeing is a number one, non-negotiable top priority. And then from there, it's making that a big part of your life and actually prioritizing on other things and running experiments and tests to see like what works for you. So for me, psychedelic medicine is probably one of the two to five things that work best for me. And I have a sort of plant medicine and entheogenic practice where we'll use different plant medicines, whether it's ayahuasca or psilocybin, mescaline, to improve my mental health and well-being and have breakthroughs that improve not just how I feel and sort of low-income.

28:08level me up, but also how I show up for the people around me. I'd say one of the biggest motifs that I have when I have these psychedelic medicine experiences is being reminded over and over again about the importance of my relationships, my relationship with my partner in crime, Allie, my wife, who's our head of engineering here at Mindbloom, with my close friends, with my father, with my colleagues, and even just how I treat everyday people I interact with. To be clear, Dylan, so your father is still alive? Yeah. Okay. We'll never know if it was because of ketamine therapy or because of Mindbloom, but he certainly was suicidal, and I had him like 50-50 chance of making it.