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The connection between marijuana and mental illness is complicated and controversial. There’s no doubt that puffing on a joint or two will lift your spirits in the short term, but can it really have an impact on your mental health? Everyone has a unique body chemistry. Some people will have very strong reactions to cannabis, and others will not. 

Why Is Studying Cannabis and Mental Health So Difficult?

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Marijuana has a very intricate relationship with mood. Mood is a complicated thing in general, and psychiatric illnesses have baffled scientists for years. Cannabinoid receptors are abundant in areas of the brain that control mood, behavior, and cognitive thought. When you smoke a joint or consume weed in any way, you’re taking in compounds that alter the delicate balance in those areas. So there’s no doubt that marijuana has an immediate impact on your mood, which is why puffing on some weed after a stressful day feels so relaxing. But, research on just how compounds in marijuana impact these regions is far from complete.

Much of the scientific debate surrounds whether or not marijuana causes long-term changes in the brain and whether or not it can make some psychiatric conditions worse. The good news is that recent research has found that marijuana use doesn’t seem to be linked to the development of disorders like depression and anxiety. A study published this month surveyed around 35,000 people and checked back in three years later. They found that marijuana use did not correlate with the development of mood disorders, depression, and anxiety.

The bad news? A wealth of other research suggests that cannabis may still cause some people to have a bad time. It depends on your individual biochemistry and genetics.

What Is Mood?

If you want to truly understand how marijuana may impact your mental health, you have to learn a little bit about mood. In our everyday lives, we experience mood as our overall level of energy, fervor, and vitality. If we’re in a “good mood”, we tend to experience emotions like happiness and excitement. We’ll also have high levels of energy and feel motivated. In contrast, a “bad mood” is associated with emotions like anger or apathy. You might feel fatigued and have little motivation. A low mood can indicate depression and anxiety.

We experience mood as general, internal, sensations. But, ultimately, it’s chemicals in the brain are the culprits behind these feelings. Here are a couple of key compounds:

Serotonin

Serotonin is a neurotransmitter that makes you feel happy and gives you a sense of wellbeing. When you have low levels of serotonin, you feel fatigued and depressed. This is the chemical that antidepressant drugs target. Prescription medications like Prozac and Zoloft are known as Selective Serotonin Reuptake Inhibitors (SSRIs), and they work by creating surplusses of serotonin in your brain. Serotonin also helps modulate body temperature, plays a role in pain perception, and is linked to migraines.

Dopamine

This neurotransmitter is another pleasure-inducing chemical. It’s dopamine that helps determine our fight-or-flight response and leads to the creation of adrenaline in our bodies. Imbalances in dopamine levels are associated with major mental health issues like schizophrenia, addiction, bipolar disorder, ADHD, and depression. Further, extreme rushes of dopamine can trigger psychotic episodes.

GABA

GABA is an amino acid that functions as a neurotransmitter. This molecule’s long form name is gamma-amino butyric acid, and it is responsible for quieting excessive neuron activity in the brain. GABA is a depressant, and it works to calm over-stimulation. People experiencing extreme agitation and anxiety often have low levels of this compound. Some forms of epilepsy are also caused by sudden drops of GABA.

When any of these chemicals are out of balance, you can experience some serious mental health consequences. Different types of imbalances in these compounds also imply different mental illnesses.

How Does Weed Affect These Neurotransmitters?

Cannabinoids, the compounds found in the cannabis plant, impact all of these neurotransmitters. In fact, this is why there is so much back and forth about whether or not marijuana can cause or worsen some mental health problems. Any time you take a substance that impacts your body’s production of these neurotransmitters, you’re cutting in and changing your brain chemistry. This is as true with weed as it is with alcohol, prescription drugs, and even poor diet. Of course, all of these items impact these neurotransmitters in very different ways.

Different molecules in marijuana play unique roles once they’re inside your body. This makes strain selection incredibly important if you’re concerned about mental health. While some cannabis products may work well for specific types of mental illnesses (ex: moderately high THC strains for people with PTSD), others may end up making some mental health issues worse.

Here’s the scoop on what does what:

THC

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When you hear that marijuana is harmful to mental health, more often than not the argument is referring to psychoactive THC. In small doses, THC is a potent antidepressant. But, in large doses, THC has been shown to have the opposite effect.

Back in 2007, researchers from McGill University tested the antidepressant effects of synthetic THC in rats. They found that the cannabinoid stimulated serotonin-producing cells in the brain when given in small doses. When given larger doses, however, serotonin levels actually dropped. Study author Dr. Gabriella Gobbi tells Science Daily:

Low doses had a potent anti-depressant effect, but when we increased the dose, the serotonin in the rats’ brains actually dropped below the level of those in the control group. So we actually demonstrated a double effect: At low doses it increases serotonin, but at higher doses the effect is devastating, completely reversed.

THC also causes spikes of dopamine in your system. Dopamine is a stimulant. It eventually signals the release of other stimulating chemicals like norepinephrine and adrenaline. While these compounds cause a pleasure rush, they also prime your body for a fight-or-flight situation. This can cause fear or paranoia, and can increase anxiety.

Now let’s say you have a disorder like schizophrenia, bipolar disorder, or are prone to psychosis. In schizophrenia and during psychosis or the manic phase of bipolar disorder, dopamine and norepinephrine levels may already be elevated without the help of THC. This means that your body and mind are prone to overstimulation prior to adding in anything that increases dopamine. Consuming a cannabis product that is really high in THC may push dopamine levels over the edge just a little too much, exacerbating any mania, psychosis, or anxious moods. One study suggests that a “high dose” is anything above 15% THC.

Non-Psychoactive Cannabinoids:

A lot of recreational cannabis products are grown for maximum THC output. For folks that suffer from extreme anxiety and psychotic disorders, this is not the best news. BUT, one of the most interesting things about cannabis is that cannabinoids actually work in harmony with each other to balance out the overall effects of the herb.

This phenomenon is known as the “entourage effect”. For example, we all know that THC is a psychoactive substance. However, CBD, the second most abundant cannabinoid, is a powerful antipsychotic. So, on one hand, the cannabis plant can increase psychoactivity in the brain. On the other, that same plant can also mitigate psychoactive stimulation.

CBD isn’t the only cannabinoid that can halt some of the psychoactivity of THC. Research published this year found that THCv (tetrahydrocannabivarin) lessened the psychoactive effects of THC in a small study. 10 healthy adult participants were given THCv coupled with THC or THC and a placebo. 9 out of 10 reported that the psychoactive effects of THC were reduced with THCv.

What’s the point in saying all of this? When it comes to marijuana and mental health, picking a balanced strain helps.

Something like an 80% THC dab might not be the best choice for someone who has a personal or family history of psychotic disorders. But, there is promising new research indicating that other cannabinoids may be potential treatments for a variety of mental illnesses. In fact, GW Pharmaceuticals, the manufacturer of Multiple Sclerosis drug Sativex, currently has open patent applications for the use of cannabinoids in conjunction with antipsychotics. They also have applied for patents to use cannabinoids as potential treatments for mood disorders.

CBD:

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When it comes to protecting your mental health, CBD (cannabidiol) is a must-have component in cannabis strains. Not only is CBD a powerful antipsychotic on its own, but it also helps protect against psychosis that’s related to cannabis use. Further, like small doses of THC, this cannabinoid has potent antidepressant effects. Unlike THC, however, studies have not indicated that CBD loses efficacy as you increase the dose. CBD is also great for anxiety relief.

CBG:

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Also known as cannabigerol, CBG has gained a lot of interest lately for it’s antidepressant and potential tranquilizing properties. Back in 2006, GW Pharmaceuticals even applied for a patent on the cannabinoid specifically for the development of drugs for mood disorders like Unipolar and Bipolar Depression. Pre-patent research suggested that CBG may be a strong antidepressant when coupled with CBD. Other research has shown that CBG may modulate neurotransmitter GABA better than THC or CBD.

Specific Illnesses:

Here’s how cannabis may help (or hurt) specific mental health issues.

PTSD:

Post Traumatic Stress Disorder is quite a bit different from the psychotic disorders medical professionals are often so concerned about. Because PTSD is linked to a traumatic event, marijuana provides relief in a few unique ways. First, THC helps eliminate bad memories. THC takes the place of an endocannabinoid known as anandamide in our bodies. What’s unique about anandamide? It’s literally a molecule that helps us forget. As Michael Pollan explains in The Botany of Desire:

… It didn’t seem adaptive to me to have a drug for forgetting. Memory we understand has great survival utility. You learn that that’s a poisonous mushroom or that that’s a dangerous animal, you stay away and you remember that. But why would forgetting be adaptive? And I asked Mechoulam [the man who discovered THC] this question. And he said: ‘Well, tell me. Do you really want to remember all of the faces you saw on the subway this morning?’

Secondly, it gets rid of bad dreams. Dreams occur during the phase of our sleep cycle known as Rapid Eye Movement (REM). Cannabis shortens the amount of time a person spends in REM sleep and extends the time you spend in deep sleep. This is especially important for people with PTSD, who often experience nightmares. One 2009 study found that 72% PTSD patients treated with a synthetic cannabinoid found nightmare relief.

Anxiety:

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Too much THC can be anxiety provoking. In fact, a review of clinical literature published in 2009 found that rates of anxiety disorders are extremely high in cannabis users. The reverse is also true; people with anxiety disorders tend to self-medicate with marijuana. Which is causing which? It’s a little unclear. But, the good news is that strains that are high in CBD tend to work wonders on anxiety.

Another literature review published in 2012 found that CBD was successful at relieving social anxiety and had strong anxiolytic effects. A more recent study from 2014 found a connection between levels of anandamide and stress. When the body is under stress, anandamide levels decrease. When researchers blocked the enzyme (FAAH) that breaks down anandamide in our bodies, they found that negative stress behaviors decreased. CBD deactivates FAAH, meaning that it could be a potential treatment for stress-related psychiatric disorders.

Depression (unipolar depression, major depression):

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The discussion around depression and marijuana use is a huge one. Back in 2006, researchers from the University of Cologne performed autopsies on former patients with schizophrenia, bipolar disorder, and major depression. Patients with schizophrenia and bipolar disorder did not show any decreases in CB1 receptors in the brain, but patients with major depression did. The CB1 receptor is a part of the endocannabinoid system and is the binding site for anandamide and THC.

Research from the University of Buffalo published last year also found links between depression and the endocannabinoid system. In animal models, levels of endocannabinoids dropped during periods of chronic stress. This lead to symptoms that resembled melancholic depression.

Several marijuana-derived cannabinoids express potent antidepressant effects. Low doses of THC coupled with cannabinoids like CBD, CBC, CBN, and CBC may increase the mood-lifting ability of weed.

Bipolar Disorder (manic depression, BD):

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In 2011, the Bipolar Gnome Study looked at cannabis use in 471 BD patients and 1761 controls. Those with BD were 6.8 times more likely to use cannabis. The same study also found that around 30% of those with BD were dependent on cannabis, and rates of suicide attempts were far higher in those people. Marijuana use has been linked to increased time in mixed or manic episodes.

But, is cannabis use the cause or the effect? As with other studies, it’s difficult to tell. Another 2011 study published in Acta Psychiatrica Scandinavica suggests that imbalances in the endocannabinoid system may play a role in the development of mood disorders. Thus, clinical research of cannabinoid medicines is needed. They conclude:

Anandamide, tetrahydrocannabinol (THC) and cannabidiol (CBD) variously combine antidepressant, antipsychotic, anxiolytic, analgesic, anticonvulsant actions, suggesting a therapeutic potential in mood and related disorders.

This call for more research is backed up by an older paper published in 2005, which highlighted the polypharmacological nature of manic depression. Further, as previously stated, GW Pharmaceuticals is currently researching cannabis-based drugs for depression and bipolar disorder.

Schizophrenia:

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As mentioned earlier, high doses of THC may not be the best choice for those with schizophrenia. But, cannabinoid medicines can still offer quite a bit of hope. In findings published last year, GW Pharmaceuticals added CBD to the treatment plans of 88 patients with schizophrenia. The results were overwhelmingly positive. While the patients had been only partially responsive to their current medications, supplementing treatment with CBD greatly increased cognitive function and decreased symptom severity.

These findings corroborate with research published in 2012 which found that CBD eased psychotic symptoms in those with schizophrenia. The same research also targeted the endocannabinoid system as a new approach to treating the disorder. Though cannabis use among patients with schizophrenia has been a topic of hot debate for quite some time, current research on nonpsychoactive cannabis medicines actually looks extremely promising.

Cannabis-Induced Psychosis:

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Medical researchers have been debating over whether or not marijuana is linked to psychotic behavior for years. In an NPR interview last year, National Institute of Drug Addiction director Dr. Nora Valkow states: “You can have a psychotic episode from the use of marijuana without it turning into schizophrenia,” Volkow says. “It’s very distressing, but you’ll get out of it.”

As with other forms of mental illness, however, research publicized just this week found a genetic marker for cannabis-induced psychosis. Yes, that’s right. You can be genetically pre-disposed to having a psychotic experience while high.

Now identified as the AKT1 gene, researchers in the UK were the first to stumble across this anomaly in healthy people. Those who have the gene are more likely to develop paranoia, visual distortions, and other psychotic-like hallucinations. Since this was just announced to the public this month, more research is needed to explain just what happens in the brain during these episodes.

Warning Signs:

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All too often patients with mental illnesses are misdiagnosed or diagnosed too late. Contact a medical professional right away if you experience any of the following symptoms after consuming cannabis:

  • Suicidal thoughts
  • Excessive, fast-paced, uninterrupted talking
  • Unwarranted or excessive agitation
  • Rushed, fragmented thoughts that seem incomplete, jumbled or disconnected
  • Hallucinations
  • Panic attacks
  • Excessive paranoia or delusions

This article is far from a complete synopsis on how cannabis can affect your mental health. When it comes to the way marijuana affects the brain, your individual biochemistry and genetics play major roles in how you’ll react to the plant. The truth is, many people with mental illnesses use marijuana to help cope and provide relief. But, if you know that you are predisposed to mental health issues, make sure what you’re smoking is helping rather than hurting.

Have you or a loved one used cannabis to cope with mental illness? Do you prefer high THC or CBD? Let us know! Share your thoughts with us on social media or in the comments section below.

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Delilah Butterfield

Delilah Butterfield is a Pacific Northwest native with a passion for cannabis and natural health. Contact her on Twitter @delilahbfield.
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