Luigi Mangione, the accused assassin, experienced intense behavior and tried psychedelic therapy following his back operation.

Friends and family are trying to understand how Luigi Mangione, once a well-respected Ivy League student, ended up being accused of murdering UnitedHealthcare CEO Brian Thompson.

The 26-year-old suspect, who was apprehended at a McDonald’s in Altoona, Pennsylvania, reportedly experienced a mental breakdown following back surgery and began seeking unconventional psychedelic treatments for his persistent pain.

Friends said Mangione dropped off the radar when ‘everything changed’ after a surfing accident. 

‘I remember he said he had a back issue, and he was hoping to get stronger in Hawaii,’ former roommate R.J. Martin told CNN.

The experience was ‘really traumatic and difficult’ for him, the roommate said while adding that Mangione sent him X-ray images of his spine.

‘It looked heinous, with just giant screws going into his spine,’ Martin said.

Mangione suddenly went ‘radio silent’ while recovering. He sought alternative forms of pain management, including psychedelics and magic mushrooms.

His family was so concerned about him that he was reported missing on Nov 18, according to The New York Post. 

The Mangione family said they were ‘shocked and devastated’ in a statement released Monday night.

‘We offer our prayers to the family of Brian Thompson and we ask people to pray for all involved,’ the statement read. 

Mangione was charged with murder by NYC officials late Monday after his capture in Pennsylvania where he remains jailed on firearms charges. 

After his arrest, Mangione attempted to deceive the authorities by presenting a fake ID at the McDonald’s in Pennsylvania. When questioned about his recent whereabouts in New York, he reacted by falling silent and trembling uncontrollably.

In his backpack, police found a 3D-printed pistol and a 3D-printed silencer. Mangione was also carrying a passport and $10,000 in cash — $2,000 of it in foreign currency.

While his motive remains unclear, signs appear to show the alleged killer may have been self-medicating. 

On X, he had created a titled ‘psych’ full of tweets about psilocybin, also known as magic mushrooms.

On January 25 this year he added to his Goodreads a book called ‘Psilocybin Mushrooms of the World: An Identification Guide’, and ‘Mushrooms of Hawai’i: An Identification Guide’.

He also added a book called ‘How to Change Your Mind: The New Science of Psychedelics’. 

Jack Mac, a staffer at Barstool Sports, said high school friends of the alleged shooter claim he was ‘crazy’ after being injured.

‘Spoke with a source that had a lot of friends that went to high school with Luigi Mangione,’ he wrote. ‘What keeps coming up is a back surgery that “changed everything” for him and he went “absolutely crazy”.’

‘Back injury happened when he was surfing in Hawaii. Surgery didn’t go great. Moved to Japan. His contact with family stopped about a year ago. Recently the family reached out to his friends from high school asking if they had info on him.’

The suspected gunman reportedly referenced UnitedHealthcare in the handwritten document found on him. 

Mangione mentioned the $515.93 billion company in his manifesto noting the size of the company and how much money it makes, a senior law enforcement official who saw the document told The New York Times. 

Luke Goldstein, a writer at independent political magazine The Prospect, said that a mutual friend went to high school with Mangione and was on the wrestling team with him. 

‘Says he was the class valedictorian. He had back surgery a few months ago and went missing. No one had heard from him,’ Goldstein wrote on X.

Mangione was valedictorian of his 2016 class at the Gilman School in Baltimore, where tuition is $40,000 a year. He then graduated cum laude from Ivy League school the University of Pennsylvania.

One colleague told CNN they were ‘flabbergasted’ by news of his arrest.

‘I never got the impression he would self-destruct,’ the person told the network. 

Another friend of Mangione, Boston-based designer Daniel Collins, took to X in recent months in a last-ditch attempt to contact him, saying that ‘nobody has heard from you in months.’

‘Hey man I need you to call me,’ Collins wrote to Mangione on September 7 this year. ‘I don’t know if you are okay or just in a super isolated place and have no service. But I haven’t heard from you in months.

‘Your made commitments to me for my wedding and if you can’t honor them I need to know so I can plan accordingly.’

On October 30, another friend with the X username TheRealMandusa wrote: ‘Hey, are you ok? Nobody has heard from you in months, and apparently your family is looking for you.’

On November 26, a third X user with the name P. wrote: ‘Thinking of you and prayers everyday in your name. Know you are missed and loved.’

The reported claims from school friends of a back injury tally with the trail Mangione left on social media.

One friend, Carolina Leon, tagged Mangione in an Instagram post about her birthday trip to Hawaii in December 2022. Another, Stephen Rasinar, tagged Mangione in a post about a two-week trip to the Pacific archipelago – suggesting he was there with friends in recent years.

His profile picture on X includes an apparent x-ray of metal pins in a spine.

Emergency physician Dr. Kashif Pirzada wrote on X that the picture ‘Looks like a lumbar spinal fusion surgery’.

Mangione had an account on book review site Goodreads.com, and listed books on back pain management.

One is titled ‘Back in Control: A Spinal Surgeon’s Roadmap Out of Chronic Pain’. Another is ‘Crooked: Outwitting the Back Pain Industry and Getting on the Road to Recovery’.

But the most intriguing is a review he wrote of the Unabomber Theodore Kaczynski’s manifesto.

‘He was a violent individual – rightfully imprisoned – who maimed innocent people,’ Mangione wrote. ‘While these actions tend to be characterized as those of a crazy luddite, however, they are more accurately seen as those of an extreme political revolutionary.’

‘When all other forms of communication fail, violence is necessary to survive,’ he added.