While results may vary wildly, the fundamental answer to your question starts with the fact that these molecules very, very closely mimic serotonin. Given the right dosage, setting, and guidance, these substances can do more to rewrite bad connections in the brain than anything else known to man.
Over time, our brains develop dysfunctional pathways because of PTSD, depression, anxiety, and other unhealthy pathways that happen because the brain starts building superhighways to facilitate the type of thoughts we use the most.
It has been said that brains on hallucinogens mimic the type of random, disorganized brain activity more often seen in children under the age of 8. By randomizing or just varying the types of neural pathways in the brain, psychedelics could be said to create a more plastic, childlike brain. I think everyone can remember how much more happy we were as children, back before our brains settled into thinking in very certain, rigid ways.
Used therapeutically, psychedelics can sort of trick the brain back into a plastic state and this can be used to downregulate unhelpful/harmful pathways like those seen in depression, anxiety, and PTSD.
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