Does weed treat anxiety and stress?
As more states legalize marijuana, both for medicinal and recreational use, more and more people are turning to cannabis in hopes of managing anxiety or generalized anxiety disorder (GAD). Although scientific research in this area is still sparse, there are anecdotal and new scientific reports of marijuana creating a calming experience that temporarily relieves symptoms of anxiety for many people.
Anxiety is both an emotional and a physiological reaction to perceived danger. It’s characterized by a continuum of feelings from general unease to panic, as well as a continuum of physical responses from increased heart rate to running from a threat. Anxiety is considered pathological when the emotional response is disproportionate in duration, frequency, or intensity to the cause and interferes with a person’s ability to live a normal life.2 The ICD-10 definition of generalized anxiety disorder (GAD) (code F41.1) begins with “a condition marked by excessive worry and feelings of fear, dread, and uneasiness that last six months or longer.”3 However, talk to anyone experiencing anxiety and they will tell you it’s not that simple. Anxiety symptoms vary from person to person and can be episodic or chronic. If left untreated, anxiety can interrupt daily life with physical illness symptoms such as abdominal pain and headaches, as well as emotional responses such as not being able to get out of bed in the morning or limiting social interactions.
Anxiety disorders fall into a number of diagnostic categories: GAD, panic disorder, social anxiety disorder (SAD), specific phobias, obsessive-compulsive disorder, posttraumatic stress disorder (PTSD), major depressive disorder, and persistent depressive disorder. Regardless of the specific diagnosis, the mental and physical symptoms are similar, yet they vary vastly in intensity and duration and can involve every system in the body.
Nervous System: When the brain perceives a threat, however minor, the brain releases adrenaline, cortisol, and other neurotransmitters to help the body respond. Constant exposure to these chemicals can cause a sense of unease or doom, difficulty concentrating, and panic attacks. Long-term exposure to these hormones and neurotransmitters due to anxious feelings is linked to other physical health problems such as weight gain, depression, and suicide.
Respiratory System: Hormones released into the body due to anxiety can cause rapid, shallow breathing, especially during a panic attack.
Circulatory System: Heart palpitations are often associated with panic attacks but can also occur with general anxiety and may feel more like a vibration in the chest. Blood pressure may increase when anxiety flares up. If not treated, it can result in hypertension.
Immune System: The constant release of stress hormones into the body can weaken the immune system, which increases the risk for viral and bacterial infections and may result in frequent illnesses.
Gastrointestinal System: The role of the brain-gut connection is very apparent in anxiety disorders, as stomach pains, nausea, and diarrhea are often the first signs of long-term generalized anxiety. While historically it was thought that irritable bowel syndrome (IBS) was a symptom of anxiety, experts now agree that IBS has pathophysiology of its own; however, people with IBS frequently suffer from anxiety, which worsens gut symptoms.
Musculoskeletal System: Anxiety may be linked to otherwise unexplainable aches and pains in muscles and joints.
If left untreated, anxiety can disrupt daily life by making it difficult to concentrate, fulfill job or school responsibilities, complete daily tasks, and establish or maintain personal relationships. For some people, anxiety may make it difficult to leave home or get out of bed. Untreated anxiety has also been linked to more severe conditions such as depression, suicide, and substance abuse and may manifest as physical illness.
There are a range of treatment options for anxiety disorders that may be chosen based on symptoms and severity. The most standard approaches that have proved effective are medication (discussed in-depth below), therapy, complementary and alternative medicine, and transcranial magnetic stimulation (TMS). While therapy is considered the most effective treatment for anxiety disorders, doctors often prescribe antidepressants or antianxiety medications in conjunction with therapy or other complementary treatment. When determining a treatment plan, it’s important to consider all available modalities, including cannabis.
Complementary & Alternative Medicine
There’s growing scientific evidence that complementary and alternative medicine approaches may be useful in the treatment of anxiety symptoms.4 Some examples of these methods include meditation, yoga, and acupuncture.
TMS (also called repetitive TMS or rTMS) may be a safe, effective, and noninvasive option for people who have depression that has not improved with medication and other treatments. TMS creates a magnetic field to induce a small electric current in a specific part of the brain; the current comes from the magnetic field created by an electromagnetic coil that delivers pulses through the scalp. TMS is an FDA-approved treatment.1
Facts v. Fiction: What the research says
- What is cannabis (marijuana)?
- What are common misconceptions?
- Yes – cannabis can be an effective anxiety treatment – but the opposite is also true
- Participate in a clinical trial about cannabis
- Proceed “with caution” and keep these considerations in mind
With the growing legalization of medical cannabis throughout the United States, researchers are often tasked with answering the question of whether cannabis can be useful in alleviating conditions like anxiety-related disorders. Typically, cannabis use will likely worsen anxiety symptoms and interfere with evidence-based treatments, such as exposure therapy. However, preliminary research may suggest some positive benefits. For novice users looking to medical cannabis as an alternative method for anxiety reduction, using CBD is often a recommended starting point, so long as it is managed under the care of both a medical provider and mental health professional.
The rise of medical cannabis in the United States has left many wondering whether jumping on the cannabis bandwagon is right for them. Often portrayed as a user-friendly substance that can help “mellow out” our responses to everyday life stressors, using medical cannabis for anxiety symptoms and disorders has been of interest to those seeking alternative treatment methods. Considering its controversial history, inconsistent research findings, and the current federal regulations around cannabis in the United States, answering the question, “will medical cannabis treat my anxiety?” is not so simple. Let’s explore the science behind cannabis, cannabis use, and the legal ramifications to getting a bit closer to answering the question “should I start using cannabis?
What is cannabis?
Cannabis, sometimes referred to as “marijuana,” is made up cannabinoids, which are naturally occurring compounds found in the Cannabis sativa plant. Cannabinoids act on cannabinoid receptors in the brain that make up the endocannabinoid system, which plays an important role in a host of bodily processes, including memory, perception of pain, mood, and appetite1. The two most commonly known and studied cannabinoids are tetrahydrocannabinol (THC) and cannabidiol (CBD), with the former being the principal psychoactive component of cannabis and the latter being a non-intoxicating compound2,3.
As a plant, cannabis can be manipulated to exhibit certain characteristics in the form of varying “strains”, including the two most polarized: sativa and indica. Sativa strains of cannabis have higher levels of psychoactive THC and lower levels of non-intoxicating CBD, while indica strains are the more “mellow” of the two with lower levels of THC and higher levels of CBD. However, strains are often blended to allow for more varied cannabis effects, while ingestion types and dosage also vary, making the consumption of cannabis a multifaceted practice4.
Cannabis – Fact v. Fiction
Given its tumultuous history and inaccurate and exaggerated portrayals in films and media, particularly as a result of the ongoing “War on Drugs” implemented by former president Richard Nixon in the 1970s, many misunderstandings, misinterpretations, and misrepresentations exist around cannabis and its effects. Some of the more common being:
- Cannabis is a harmful drug that can lead to significant memory loss, lung disease, psychosis and/or death
- Cannabis is a “gateway” drug and leads to more severe substance use
- Cannabis is a highly addictive drug that is abused by many
In contrast, it is not uncommon for the benefits of cannabis use to be overstated by supporters, which can be misleading to those looking for alternative methods to alleviate difficulties with mood and anxiety. Recent surveys of the general population show that anxiety management is the second most endorsed reason for medical cannabis use5. Reports such as these suggest that those struggling with anxiety may be reaching for cannabis to treat their symptoms, which underscores the importance of reviewing the objective findings available on this topic. Common misconceptions among those in favor of cannabis use include:
- There is conclusive evidence that cannabis can treat anxiety
- There are minimal negative side effects of cannabis
- Cannabis is safe for long-term use
Marijuana as Self-Medication
Anytime you take it upon yourself to use a substance to treat or cope with a medical problem or symptom, it is referred to as self-medicating. Often, self-medicating produces an immediate relief of the uncomfortable symptoms, thereby reinforcing its use.
The problem with self-medication is that even though the use of marijuana is becoming more acceptable, not enough is known about the efficacy of the drug for particular medical conditions as well as its long-term consequences.
Potential Benefits and Risks
The scientific community has recently started examining the effect of cannabis on anxiety, and the verdict is that short-term benefits do exist.
Scientists at Washington State University published a study in the Journal of Affective Disorders that found that smoking cannabis can significantly reduce self-reported levels of depression, anxiety, and stress in the short term. However, repeated use doesn’t seem to lead to any long-term reduction of symptoms and in some individuals may increase depression over time.
Marijuana can affect your body in many ways beyond just getting you high. The high feeling you may experience after smoking or ingesting marijuana is due to tetrahydrocannabinol (THC), the chemical compound that gives marijuana its psychoactive effects.
The effects of THC do not come without risks, and long-term or frequent use has been associated several potential side effects.
It is possible that people who use marijuana for an extended period of time have higher levels and symptoms of depression, despite any improvements they may have seen in this regard with short-term use.
Some research has also shown that heavy use of marijuana in adolescence (particularly in teenage girls) can be a predictor of depression and anxiety later on in a person’s life. Certain susceptible individuals are also at risk for the development of psychosis with the use of cannabis.
The central problem with using marijuana as an anxiety coping tool is that it can create a psychological dependence on the substance.
Since the effects of marijuana are fast acting, long-term behavior-based coping strategies may seem less helpful at first and may be less likely to be developed.
Long-Term Memory Loss
Several studies have found that long-term marijuana use can cause memory loss. Memory impairment occurs because THC alters one of the areas of the brain, the hippocampus, responsible for memory formation. It also can have negative consequences on the brain’s motivation system.
Increase in Symptoms
THC can raise your heart rate, which, if you have anxiety, may make you feel even more anxious. Using too much marijuana can also make you feel scared or paranoid.
In some cases, marijuana can also induce orthostatic hypotension, a sudden drop in blood pressure when standing, which can cause lightheadedness or feeling faint. Cannabis can also cause feelings of dizziness, nausea, confusion, and blurred vision, which can contribute to anxiety.
Cannabis Hyperemesis Syndrome
A rare consequence of frequent marijuana use, particularly with today’s more potent strains, is cannabis hyperemesis syndrome (CHS). This involves cyclical nausea and vomiting.
This is paradoxical and can be difficult to diagnose, as marijuana has been used to decrease nausea and vomiting in cancer treatment. Sufferers sometimes find relief in hot baths and showers, but ultimately, abstinence from marijuana is necessary for long-term improvement.
You can develop a tolerance to marijuana. This means that the more you use it, the more you will eventually need to get the same “high” as earlier experiences.
Alternatives to Marijuana
Remember that some level of anxiety is normal and even helpful when you are confronted with something that feels threatening to you. However, when feeling anxious becomes pervasive and difficult to control, it is time to seek professional help to discuss other forms of anxiety management.
Proactive coping strategies, learned through counseling, support groups, as well as self-help books and educational websites, can create lasting change without the negative components of extended marijuana use.
The most common and effective form of therapy for anxiety is cognitive behavioral therapy, which focuses on identifying, understanding, and changing thinking and behavior patterns.1 Therapy of any type requires the patient to be actively involved in learning the skills necessary to control anxiety. While therapy traditionally involves in-person sessions with a therapist, advances in technology allow patients to interact with therapists by phone, video call, or even text message.
Cognitive behavioral therapy (CBT) and other forms of therapy can help you determine the underlying cause of your anxiety and manage it more effectively. Work with your doctor to develop a treatment plan that is right for you.
Working with a psychotherapist to manage your anxiety will give you a better handle on your condition in the long run.
The use of certain prescription medications such as the selective serotonin reuptake inhibitors (SSRIs) have been firmly established as safe and effective treatment for anxiety disorders.
Prescription medication is also preferable to marijuana since the long-term risks have been better studied and are potentially less significant compared to long-term marijuana use. Some anti-anxiety medications are taken daily, while others are taken episodically during periods of extreme anxiety or a panic attack.
A psychiatrist or your primary care doctor can prescribe you an anti-anxiety medication, should you need one.
Cannabidiol (CBD) Oil
CBD oil, a marijuana extract that is often dispersed under the tongue with a dropper, doesn’t contain THC, so it won’t give you the same mind-altering effects as marijuana. There is some beginning evidence to suggest that CBD could be helpful in the treatment of anxiety and addiction, but more clinical trials and research are needed in this area.
The connection between cannabis and anxiety is tricky. Some users experience relief of the symptoms of anxiety, such as stress and panic, while others experience an increase in paranoia. This is a result of the strain’s THC content.
Fortunately, anxiety sufferers can usually find relief in low-THC, high-CBD strains, as well as some high-THC strains that can help.
Find out more about the best cannabis strains for alleviating the symptoms of anxiety and how to treat anxiety with cannabis.
- Granddaddy Purple: This strain is known for inducing a tranquil mindset that relieves stress and tension, which is helpful for anxiety sufferers.
- Jack Herer: This strain is high in THC, but it’s known for its tapering euphoria that brings calming effects, perfect for relieving the symptoms of anxiety.
- Shark Shock: THC-sensitive individuals may benefit from this high-CBD strain. It offers a 1:1 ratio, which can alleviate the symptoms of anxiety that many cannabis users seek to remedy.
Best Cannabis Strains for Post-Traumatic Stress Disorder (PTSD)
- Girl Scout Cookies: This strain has a lot of THC, but studies have shown that PTSD sufferers often have a deficiency of naturally occurring anandamide, which is a compound similar to THC. This strain can replenish this compound for therapeutic effects.
- Painkiller XL: This is a high-CBD strain that promotes clear-headedness, which is perfect for PTSD sufferers. It has a small amount of THC as well, which is balanced by the CBD for relaxation.
Best Cannabis Strains for Social Anxiety
- Strawberry Cough: This strain balances energizing effects with calming effects, giving users a social feeling without paranoia.
- ACDC: This strain is high in CBD, making it a great choice for severe cases of social anxiety. It has minimal psychoactive effects as well, so the result is relaxation, focus, and clear-headedness.
Best Cannabis Strains for Obsessive-Compulsive Disorder (OCD)
- Northern Lights: This is a tranquil strain that’s known to slow the body and mind, promoting a deep state of relaxation. For OCD sufferers, this effect settles nervous compulsions.
- White Sour: This strain has high levels of THC, but it also contains myrcene and limonene. These terpenes promote stress release and relaxation, which eases the compulsions OCD sufferers experience.
Best Cannabis Strains for Insomnia
- MK Ultra: This is an indica strain that has strong sedative effects, making it a good choice for anxiety-induced insomnia.
- Purple Punch: This is another relaxing indica strain that reduces the stress and anxiety that keep anxiety sufferers awake at night.
As more attention is paid to cannabis in the treatment of conditions such as anxiety disorders, it’s imperative that health care professionals learn the basics in order to confidently and accurately answer patient questions. If not, patients will turn to friends, the internet, and budtenders (some of whom may not be adequately educated) for recommendations and validation. Cannabis can be an effective first-line or adjunct treatment if used as part of a personalized care plan.