What are the low-but-life-changing risks?
Exacerbation (and possibly development) of mental illness like psychosis, bipolar disorder, or schizophrenia is entirely possible.
Along with two other blokes, I got interested in psychedelics in high school. Took one medium high dose and wasn't right for a few months. Never in my life did i ever experienced paranoia, delusions, or hallucinations that are genuinely hard to separate from reality, but I did after that.
Intense psychedelic experiences can fracture what you once knew as "reality" allows all sorts of ideas to float into your mind, with equal possibility. This might be helpful and give you more flexible thinking (helpful for depression) but it also leaves you incredible vulnerable to all sorts of garbage ideas that you never would have considered otherwise. ie conspiracy theories or straight up delusions about the supernatural. Remember: It's not paranoia if you genuinely believe they really are out to get you!
Fighting these garbage ideas is a lot of work once they take hold, but you'll only know too late if you were vulnerable, and worse, if you can successfully align your understanding of reality with most other people.
I got extremely lucky that I stabilized. I'm convinced part of this was only doing it one time. My two co-experimenters took many trips with various doses are still in and out of mental hospitals years later. Psychedelics are incredibly potent and nobody really understands them very well. A lot of what is written on the internet ignores, downplays, or denies the very serious risks to your philosophy of mind and mental function. Its like playing with fire when you don't have heat sensation in your hands.
Several other comments on this page echo these warnings. One even claims there is an 18% chance you could go from depressed to schizophrenic. I have no idea where that figure came from, but the risk is certainly not 0%
HPPD and .. honestly, some people have bad trips, and while it is popular in psychedelic circles to say "There is no such thing as a bad trip just the way you interpret it" that isn't really true. Even Terrence McKenna stopped taking mushrooms for a decade after a bad experience.
That said, I _do_ recommend mushrooms to everyone I know with depression or anger issues.
Some people report personality changes, some as radical as "I found I didn't love my husband anymore."
Basically it hyper-connects your brain. When people talk about seeing shapes, its not that they are hallucinating, its that when they look at the random fuzz pattern on a rug, and pick out the particles of fuzz that make a creature face, its looks like someone purposefully put those pieces there to make that face.
As such, if you are "surfing" thoughts and find an association of something, that association can become very prominent. If you don't have the context to understand why you are making that association, especially after the trip, you can get stuck with beliefs about yourself that could be non optimal.
On the flip side this hyperconnectivity also allows you to see things like a completely different person would see them, which is where the true healing power lies. Its like you can be disugsted with a particular food when you are sober, but on shrooms you can truly feel what it would be like to enjoy that food. Once you have that context, you are able to move forward after the trip into right directions.
This is why set and setting are EXTREMELY important for significant trips. You want to be with someone who a) has done psychedelics, b) is in a very good mental state, and c) has a low ego not to project their own personality onto you. The best trip sitters are those that encourage exploration - they take everything you communicate to them and ask you questions about it without imparting any bias.