What do magic mushrooms do to your brain? A midflight crisis raises questions.

A bizarre mid-flight incident involving an off-duty Alaska Airlines pilot has raised questions about the effects of psychedelic mushrooms, sleep deprivation and psychosis.

The pilot, 44-year-old Joseph David Emerson, was on board as a passenger and is accused of trying to cut the engines midflight, before being subdued by the flight crew. Later, Emerson reportedly told police he had taken psychedelic mushrooms 48 hours before the flight, was in a mental health crisis, dehydrated and had been awake for 40 hours. He has pleaded not guilty to numerous legal charges.

While details about Emerson’s mental health and experience with mushrooms aren’t known, The Washington Post spoke to experts on psychedelics to learn more about how the drug can affect brain and behavior. Here’s what they had to say.

What are psychedelic or ‘magic’ mushrooms?

Magic mushrooms contain psilocybin, a naturally occurring chemical substance that can be found in hundreds of types of mushrooms. A synthetic version of psilocybin can also be created in a laboratory.

How is psilocybin used to treat mental health disorders?

Although psilocybin is a controlled substance, mushrooms have been used as a recreational drug for years. But more recently, a growing number of researchers are studying psilocybin as a potential treatment for a range of conditions, including depression and alcohol use disorder. It’s also being studied to help people quit smoking, and for obsessive compulsive disorder, anorexia, post-traumatic stress disorder and anxiety. The drug is only allowed to be used in research settings and hasn’t been approved for any treatment.

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In treatment studies, researchers use synthetic psilocybin so that they can control the dose. Generally speaking, the larger the dose, the more someone’s degree of consciousness will be altered. In wild mushrooms, the amount of psilocybin can be unpredictable.

“Even two of the same type of mushrooms grown next to each other can have wildly different amounts of psilocybin,” said Fred Barrett, center director of the Johns Hopkins Center for Psychedelic and Consciousness Research. “Nobody should be seeking out mushrooms to treat themselves.”

The circumstances under which the Alaska Airlines pilot allegedly took mushrooms isn’t known.

How long do the effects of psilocybin last?

The pilot claimed to have taken mushrooms about two days before the flight.

Psilocybin tends to enter the brain quickly and if it is ingested orally, the effects peak about 60 to 90 minutes after taking it, experts said. Most of the time, experts say the active effects of psilocybin last about four to eight hours, and the drug is completely gone from your body after 24 hours. “We haven’t had evidence of anyone having a prolonged reaction to psilocybin,” Barrett said, referring to the acute effects of the drug.

How does psilocybin affect the brain?

Psilocybin binds to specific serotonin receptors, which seems to have a number of effects that aren’t fully understood. But, serotonin is a neurotransmitter that plays a role in a number of bodily functions, such as sleep regulation and our sense of appetite, said Michael Silver, faculty director at the Center for the Science of Psychedelics at the University of California at Berkeley.

Neuroimaging shows that after someone takes psilocybin, “brain regions that don’t typically communicate with each other start to communicate in new ways,” Barrett said. Researchers believe that these types of changes could help treat people with psychiatric issues or mental health conditions.

“Patients with psychiatric disorders, usually their brain is stuck in a circuit that they can’t get out of, and psychedelics break that cycle,” said Charles Nemeroff, the co-director of the Center for Psychedelic Research & Therapy at the Dell Medical School at the University of Texas at Austin.

Some of the changes that psilocybin causes during a psychedelic experience include changes in the ways that people process sensory information, so that they start to see kaleidoscopic imagery, or may feel like time has slowed down to a stop.

The substance can also cause changes in the way that they make decisions or allow people to think about traumatizing memories differently, helping them work through negative feelings, experts said.

Research also shows that psilocybin seems to reduce activity in an area of the brain involved with generating a sense of self, which can cause some people to feel more connected to the people and the world around them, Barrett said.

Psilocybin also appears to affect the default mode network, Barrett said, which is the part of your brain that is activated when your mind is wandering, and you may start thinking about future plans or reminisce on a past memory. It plays a role in crafting our internal narratives about ourselves and the world around us, Silver said.

Research suggests that in people with anxiety or depression, the default mode network can become overactive or underactive. This means it could generate a negative feedback loop where someone can’t stop worrying or break out of unhealthy thoughts, Silver explained.

Psilocybin’s effect on the default mode network may explain why it appears to help mental health conditions when coupled with professional therapy, but further research is needed, experts say.

Can psilocybin cause psychosis?

There is a risk that taking psilocybin can trigger psychotic episodes in some people, Nemeroff said.

Risk appears to be higher in people who have a family history of conditions associated with psychosis such as schizophrenia or bipolar disorder. Other people who may be at higher risk for a psychotic breakdown from magic mushrooms or psilocybin include those who have a history of substance abuse, people who are mentally unstable, and anyone having suicidal thoughts, Nemeroff said.

Importantly, these types of episodes can last far beyond when the drug is actually in the body. “When a psychotic episode is triggered, it’s not about the effects of the drug at all,” he said. “It takes on a life of its own.”

Josh Woolley, an associate professor in the department of psychiatry and behavioral sciences at the University of California at San Francisco, said if the off-duty pilot took mushrooms 48 hours before the incident on the plane, “he very likely did not have any psilocybin or other active ingredients in his body at the time . . . but that doesn’t mean that his experience was not related to his mushroom use.”

Researchers who study psilocybin generally screen out people who have family or personal history of psychosis, schizophrenia, mania and bipolar disorder, and because of that, Barrett said, they don’t tend to see any prolonged negative effects from the drug.

Does psilocybin affect sleep?

The impact of psilocybin on sleep has not yet been thoroughly researched, experts said. But, psilocybin has stimulating properties, Woolley said. This means an individual’s blood pressure and heart rate can go up, which could affect sleep.

“People feel energized,” he said. “It can cause insomnia, difficulty sleeping, especially the night after you use it.”

It’s also unknown whether sleep deprivation could change the effects of psilocybin, but in general, sleep deprivation tends to make things like depression, anxiety or psychosis worse, Nemeroff said.

Can psilocybin leave you dehydrated or cause other side effects?

There’s no evidence or research showing that psilocybin causes dehydration, but sometimes, people become so caught up in a psychedelic experience that they forget to drink, Nemeroff said.

“This is why we administer psychedelics in a controlled setting, so that we can make sure people stay hydrated and we can monitor their heart rate,” he said.

When you take a magic mushroom, the dose matters, said Boris Heifets, an assistant professor of anesthesiology, perioperative and pain medicine at Stanford University. When taken at a high enough dose, there can be body symptoms like an upset stomach, nausea and sensory changes, Heifets said. “You start seeing patterns in things that maybe you didn’t see before,” he said.

Emotionally, psilocybin can also cause harrowing experiences, with deep and overwhelming fear, panic or distress, and can cause people to make bad decisions, which is why experts say it should only be taken under the supervision of trained therapists and medical professionals.

Why do people take psilocybin?

Simply put, it’s because people like it, Woolley said. “They have deep insights,” he said. “They feel it’s incredibly personally meaningful.”

Some people do it for exploration. Others do it for the purported health benefits.

“The people who are often most vulnerable - patients who have mental health issues that have been failed by the conventional mental health system - are often in desperation and they’re looking for something that’s going to work,” Heifets said.