Can cannabis defeat anxiety? The herb’s impact on anxiety disorders has been a topic of debate for several years now. Fortunately, we now know a lot more about how cannabis interacts with the brain. This segment of our All In The Mind series will go over how cannabis might be affecting your anxiety and what types of cannabis are most successful in treating anxiety disorders.
Note: Please keep in mind that we are not doctors and this article is for general information purposes only. The information given here is not a treatment recommendation. Always work with a trusted medical provider when making any changes to your treatment plan.
What is an anxiety disorder?
Anxiety disorders are on the rise. Perhaps we can thank the business of modern life, our diets, or environmental stressors for the epidemic. Whatever the reason might be, pretty much everyone has experienced anxiety at some point in their life.
Everyday anxieties transform into a disorder when they’re persistent and cause significant disruptions in daily life. Disorders can manifest themselves in a variety of different ways, but they fit into a few broad categories.
Generalized anxiety disorder
Those with generalized anxiety disorder (GAD) worry about everything all of the time. Did I leave the oven on? Did I forget to lock the doors? Is there going to be a long line at Starbucks? What if I loose my wallet today? What if I’m late?
Extreme worrying almost every day for six months is a common sign of GAD. Those with GAD worry about several different aspects of life. Finances, work, and relationships are common targets for those with GAD.
Social anxiety disorder
People with social anxiety disorder (SAD) have an extreme fear of being judged by others. You might be too afraid of to use public transportation. You might have trouble walking around in places with lots of people.
When you start to avoid social situations because of your anxiety, that’s when it has begun to impact everyday life.
Panic disorder is characterized by recurrent panic attacks. During a panic attack, you might feel an extreme tightness in your chest. Your breathing will become fast and shallow. You are suddenly overcome by an intense, crippling sensation of anxiety. You might feel nauseated, shaky, or suddenly begin to sweat.
Just because you have a panic attack does not mean that you have panic disorder. Panic disorder is characterized by frequent panic attacks, often brought on by the fear of having another panic attack. For example, if you start to notice the physical sensation of your heart racing, you may quickly become anxious that you are having a panic attack. This inevitably triggers a panic attack.
Post-traumatic stress disorder and obsessive-compulsive disorder are also associated with anxiety disorders. For more information on those conditions, check out the articles:
- Marijuana & PTSD #1: Coping With Symptoms
- Marijuana & PTSD #2: The Science Of Your Brain
- All In The Mind #2: Does Cannabis Help OCD?
Can cannabis defeat anxiety?
The relationship between cannabis and anxiety is controversial and complicated. In some cases, the herb makes anxiety a lot worse. In others, it gives you a much-needed moment of calm. The trick is learning what type of cannabis works best for you, when to use it, and how often.
Every person has unique biochemistry. Different people will respond in completely distinct ways to various strains and cannabinoids.
Cannabinoids are the active compounds in cannabis that interact with the body. Psychoactive THC and non-psychoactive CBD are two of the most common cannabinoids found in the herb. Both of them have potent anxiolytic properties. However, proper dosage is extremely important for effective anxiety relief.
Endocannabinoids and anxiety
THC and CBD work differently in the body. THC directly binds to a certain cell site called the CB1 receptor. This receptor is found in various regions of the brain. Turns out, the CB1 receptor plays an important role in our fear response.
Research has shown that there are CB1 receptors on the amygdala, a primal part of the brain that controls our fight-or-flight reaction and manages stress.
The brain engages this region through a network of endocannabinoids, our body’s own THC. Back in 2001, a team from the Vanderbelt University Medical Center wanted to see how endocannabinoids affected fear and stress response.
Using mice, they discovered that when our own endocannabinoids were present in the amygdala, the region became less excitable. This means that the cannabinoids had a dampening effect.
This suggests that plant cannabinoids might have a similar calming effect on our fear response.
New vs. regular users
Those new to cannabis might have a problem with THC. High doses of THC have been correlated with panic attack-like symptoms, though they are only temporary. As the effects of the herb begin to wear off, so does the intensity of the panic attack.
Regular users, however, don’t really have this problem. In a review of scientific literature on cannabis and anxiety, a team lead by Jose Alexandre Crippa explain:
About 20-30% of users show brief acute anxiety reactions after smoking the drug. Such symptoms usually occur when the drug is used at high doses and are more common in drug-naıve subjects and in novel or stressful environmental situations. – Crippa and team
Crippa’s team goes on to say that:
Long-term users typically report that cannabis use is associated with a reduction in anxiety. Relaxation and relief from tension remain the most common effects of using cannabis and the most common reasons for using the drug.
Finding the right cannabis type
While THC is associated with increased anxiety in high doses, CBD is not. Studies from 2011 have found that CBD significantly improved social anxiety symptoms, as well as reduced anxiety associated with public speaking in patients with social phobia.
A single-case examination of a 19-year-old woman was given 300mg then 600mg of CBD as a treatment for a medical condition. She did not experience any paranoia, anxiety symptoms, or symptoms of withdrawal after using the herb. So, if you try THC and find that it does not work well for you, CBD might be a better option.
Similarly, many anxiety sufferers find relief with sleepy indicas over energizing sativas. Since the brain tends to be overactive in those with anxiety, sativas might make you feel a little too wired. Indicas, on the other hand, produce a strong body high. This relaxes the muscles and is a powerful sedative.
Best cannabis for anxiety disorders
If you’re looking to get the most out of your medical cannabis treatment, here’s a loose breakdown of what is generally thought to work well for anxiety disorders:
- Panic Disorder: Stay away from high doses of THC, opt for CBD or very low doses of THC
- SAD: Low doses of THC, CBD, or strains with diverse cannabinoid profiles
- GAD: Indicas or indica-dominant hybrids, high CBD strains, low doses of THC
Strains to consider:
- One to One
Products high in CBG (cannabigerol) are also thought to be great for anxiety. However, high-CBG products are not very common. California-based Harborside sells a high-CBG product called Jayden’s Juice, which is said to have 12.5mg of CBG and over 16mg of CBD per milliliter. If you’re able to give this a try, it might be a good option as well.
Does cannabis cause rebound anxiety?
There’s another thing you need to watch out for with cannabis: rebound anxiety. Rebound anxiety occurs once the cannabis has worn off. You may have had some relief to begin with. But, when the effects of that last joint begin to fade away, you begin to feel anxious and irritable.
This same effect happens when you take pretty much any anxiety medication. If you pop a Xanax, for example, it’s not uncommon to notice a low mood or irritability the next day. Fortunately, there are ways to get around this with cannabis. Here are some general guidelines to help with rebound:
The reason for this is simple. The effects of edibles last a whole lot longer than smoked or vaporized cannabis. Your body has to metabolize the infused-food, so the effects tend to come on more slowly and last a few hours longer than a few puffs of the herb. This means that you won’t find yourself starting to feel anxiety effects again two hours after you medicate.
If you’re at work, for example, an edible might be able to get you through the whole day. You won’t experience as many ups and downs while you’re trying to get things done.
To test out how they work for you, always try them on a day when you don’t have anything important to do. If your edibles contain THC, the high might be significantly stronger than you were expecting. Too much THC in an edible can also make you feel extremely paranoid.
Explore the dosage that works best for you. If needed, opt for high-CBD, low-dose THC edibles.
Keep doses as small as is effective
As with any medication, the more you take, the greater the come-down. Start with small doses first and work your way up until you find the dose that you feel is most effective. You build up tolerances to cannabis over time, so if you want to use it as medication, you don’t want to start with a massive dose right off the bat.
Using cannabis only as needed can also help mitigate some of the rebound effects. Just as many doctors prescribe Xanax or Ativan as needed, you can use cannabis in a similar way. If you decide to use it this way, pick strains containing low to moderate THC, or are not associated with paranoia.
Leafly’s Strain Finder is a great tool for weeding out anxiety-provoking strains. You can choose to exclude strains that are known to cause paranoia.
Cannabis vs. benzodiazepines
There has been a five-fold increase in deaths from benzodiazepines between 2001 and 2014. As more and more anti-anxiety medication is being prescribed, more people are being exposed to the drugs’ dangerous side effects.
Benzodiazepines are not meant for long-term use. They are meant as a temporary treatment to help you calm down and overcome intense anxiety. Common side effects of benzos include:
- Intense sedation
- Dependence and addiction
- Blurred vision
- Increased depression and anxiety symptoms
Cannabis is also a sedative and can impair memory. However, there has yet to be a single death from a cannabis overdose, and the herb does not create the extreme physical withdrawal symptoms associated with benzos.
Does cannabis help with benzo withdrawal?
Anyone who has experienced benzodiazepine withdrawal knows that it is absolutely awful. You might be awake for two days straight. One day you’ll feel fine, and the next you’re afraid to leave your house and can bearly talk thanks to rebound depression.
Never quit a benzodiazepine cold turkey. If you simply stop taking a benzo, you face serious risk of seizure. Always work with a doctor to come off of the drug. You will have to titrate down little by little until you get down to just a quarter of a dose of medication. This process can take several weeks.
Though scientific literature is lacking, CBD may be extremely helpful during benzo withdrawal. Benzodiazepines artificially prevent your body from being able to burn through a neurotransmitter called gamma-Aminobutyric acid (GABA). GABA is a natural anxiolytic. When you have too little GABA, you feel intense anxiety, restlessness, and are susceptible to seizure.
During withdrawal, you have extremely low GABA. This is why CBD may be able to help. It is a GABA uptake inhibitor, meaning that it increases available concentrations of GABA in your brain. This has a calming, antianxiety effect and theoretically makes you less prone to seizure.
CBD may prove to be an effective tool for benzo withdrawal, but THC is not. High doses of THC suppress GABA . This can increase your anxiety and worsen some of your withdrawal symptoms.
Help! I’m having a cannabis-induced panic attack
Here are three tips to help you calm down when experiencing a cannabis-induced panic attack:
Tip 1: Change your environment
As Crippa and his team mentioned earlier, anxiety symptoms can be exaggerated if you’re in an uncomfortable environment. If you find yourself feeling a little weird at a party, go out for a walk. Duck into the bathroom for a few minutes, or a dark, quiet room. If you can safely get yourself home, even better. You just need some time to chill out.
Tip 2: Take a breath
When you’re in a quiet space, do some deep breathing exercises. Try to really focus on the sensation of the breath, what it feels like to breathe in and out. Concentrating on your breath distracts you from any jumbled, paranoid thoughts you might be having. Remember: you’re feeling paranoia because of how you are currently perceiving the world. Shift your attention to something else to help you look at things a little differently.
Tip 3: Try some CBD
As early as 1982, studies have shown that CBD helps to block some of the anxiety created by THC. This is why opting for a strain that contains CBD is so beneficial in the first place. If you know you’ll be using cannabis later, having a high-CBD strain on hand as a backup might help if you need something to quickly take the edge off.
Those on a whole foods diet are significantly less likely to experience anxiety symptoms. A whole foods diet means eating foods as close to the earth as possible. Avoid processed foods, caffeine, alcohol, sugar, and eat plant-based meals. In women specifically, there is a strong association between a western diet and increased depression and anxiety symptoms.
Cognitive behavioral therapy
Cognitive behavioral therapy (CBT) is a unique kind of psychotherapy that focuses on problem-solving. In CBT, you will learn how to understand your anxiety triggers and learn healthy coping mechanisms to calm yourself down.
For those with social anxiety and panic disorder, exposure therapy helps you face anxiety-provoking situations in a controlled, safe environment. The goal of exposure therapy is exactly what its name suggests. You work with a therapist to expose yourself to your fears in the hopes of learning to better manage them.
Mindfulness therapy teaches you how to accept the present moment in spite of challenges. This type of therapy draws heavily from zen Buddhism but has been adapted for use in western psychotherapy. Mindfulness helps you tolerate uncomfortable situations without acting on the urgent desire to change them.
Cannabis and anxiety have a complicated relationship. So, effectively incorporating cannabis into your treatment plan might seem a little daunting. Fortunately, it’s more or less smooth sailing once you find the strains and products that work best for you.
Always remember that cannabis alone will not cure you of your anxiety. It is simply another medication like Xanax or Ativan, albeit a more natural one. The most effective treatments combine medication, psychotherapy, and lifestyle changes.
How has cannabis improved your anxiety? Share your story with us on social media or in the comments below. We’d love to hear from you!