CBD, Cannabis, & Anxiety

There’s being anxious and then there is excessive worry that’s ongoing and out of proportion to the situation at hand. Symptoms of anxiety may include trouble falling asleep, muscle tension, irritability, difficulty concentrating, restlessness, shortness of breath, pounding heartbeat, and fatigue.

Panic disorder refers to episodes of intense fear that occur suddenly. They can last for a few minutes or hours and the trigger may or may not be obvious. Associated symptoms include heart racing, chest pain, shortness of breath, a feeling of choking, dizziness, nausea, cramping, sweating, tingling in the hands and feet as well as chills or hot flashes. Medical conditions that are associated with intense anxiety include mitral valve prolapse, cardiac arrhythmias, hyperthyroidism or seizures.

CBD Effect On Depends On The Individual

NOTE FOR FIRST TIME READERS: Cannabinoids–such as THC, CBD–and terpenes are the main medically active components in cannabis (aka marijuana). For more information on these components and much more about the plant, see our section on the Science of Cannabis.

There is a mixed response by doctors for using cannabis for anxiety. A successful treatment seems to be more dependent on the individual than the therapy itself. In fact, some patients report cannabis causing anxiety rather than alleviating it. The response of a patient may depend on the levels of THC and cannabidiol (CBD) or what is called the potency and cannabinoid profile of the plant. Another variable is the dose that the patient takes. And then there’s the patient’s genetic makeup, which is difficult to assess and can dramatically affect their anxiety response. 

CBD Increases Blood Flow In Anxiety Control Center 

In human studies of the brain, it was found that CBD increased blood flow to the areas of the brain that are known to control anxiety. CBD was compared to a placebo and two anti-anxiety medicines for treatment of social anxiety. CBD was found to be as effective as the two known anti-anxiety medicines and was significantly more effective than the placebo.

In a similar study, patients with social anxiety who received CBD had less body symptoms of anxiety and less negativity about public speaking than those who received a placebo. Also, a synthetic cannabinoid was found to reduce anxiety in patients suffering from anxiety disorders after a month of treatment.

THC Is Found To Create Anxiety In Patients

THC, the most prominent medicinal compound in cannabis, is known to cause an anxiety reaction in high doses in some patients. CBD, the second most common compound in cannabis, appears to ease anxiety even if taken in high doses (and has no psychoactive effects). It is now thought that the terpene profile, which determines many strain characteristics, is most important in mood effects, allowing some high THC strains to actually be relaxing.

What Strains Of Cannabis Are Useful For Treating Anxiety

There are many ways to treat anxiety with cannabis. Smoking a relaxing strain, perhaps with the terpene linalool, with the aroma of lavender, is a good choice. This can be a strain that is a THC-CBD hybrid. You can also vaporize such a strain, but it must be done with a vaporizer that uses full flower, to retain the terpene content. Strains that are THC dominant are not recommended since they may make anxiety worse. Alternatively, CBD dominant preparations, even in oil or tincture formulation without terpenes are useful. A dose of 10 mg of CBD, or a CBD/THC mix with a 4:1 ratio is useful. This can usually be found in a tincture. Or, you can vaporize an oil that has this ratio, having one to two puffs every 3-4 hours. And a handy CBD rich mouth spray that can be carried in your pocket is a good choice for immediate rescue for panic episodes.

References  

Bergamaschi M, et al. Cannabidiol reduces the anxiety induced by simulated public speaking in treatment-naïve social phobia patients. Neuropsychopharmacology. 2011, 36: 1219-26.

Campos-Outcalt D, Hamilton P, Rosales C. Medical marijuana for the treatment of generalized anxiety disorder. An evidence review. 2012. http://www.azdhs.gov/documents/licensing/medical-marijuana/debilitating/Debilitating-Conditions-Anxiety.pdf 

Crippa JA, et al. Neural basis of anxiolytic effects of cannabidiol (CBD) in generalized social anxiety disorder: a preliminary report. Journal of  Psychopharmacogyl. 2011, 25(1): 121-30.

Fusar-Poli P, et al. Modulation of effective connectivity during emotional processing by delta-9-tetrahydrocannabinol and cannabidiol.  International Journal of Neuropsychopharmacology. 2009, 24: 1-12.

Zuardi AW, Shirakawa I, Finkelfarb E, Karniol IG. Action of cannabidiol on the anxiety and other effects produced by delta-9-THC in normal subjects. Psychopharmacology. 1982, 76: 245-250.

Zuardi A, et al. Effects of ipsapirone and cannabidiol on human experimental anxiety. Journal of Psychopharmacology. 1993, 7: 82-8.