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Cannabis for People with Anxiety

Anxiety and anxiety disorders affect more than 40 million adults in the U.S. Cannabis may help quell anxious thoughts and feelings for some cannabis consumers. The relationship between cannabis and anxiety is one still being studied by researchers, but there are some clear links between the two that have already been observed in human studies. This guide details the ins and outs of cannabis and anxiety.

What is anxiety?

Anxiety is one of your body’s reactions to stressful situations. In small, manageable amounts, anxiety can be a great motivator to address the problems and challenges we encounter every day. When anxiety never goes away, however, it becomes an unhealthy and interruptive force in our daily routines. 

There are many anxiety related disorders. Some prominent examples include:

  • Generalized anxiety disorder (GAD): GAD is characterized by excessive and persistent worrying, as well as an impending sense of doom. GAD affects 6.8 million adults per year, which is 3.1% of the U.S. population1.

  • Panic disorder: Panic disorder is characterized by sudden, unanticipated panic attacks. These panic attacks are often difficult to predict. It is estimated that 2% to 3% of Americans per year experience a panic disorder2.
  • Social anxiety disorder: Social anxiety disorder is characterized by an intense fear of rejection or judgment in social situations or performance. It is thought to affect 15 million American adults every year and is the second most common anxiety disorder diagnosed, second only to specific phobias3

Anxiety is not always a disorder in itself. It’s often related to other conditions or disorders, of which anxious behavior and ideation are a symptom. Some examples include:

  • Obsessive-compulsive disorder (OCD): OCD is characterized by obsessions – intrusive distressing thoughts – and compulsions, which are behaviors a person feels compelled to engage in to ease their anxiety or distress. OCD affects about 1.2% of American adults per year4.

  • Post-traumatic stress disorder (PTSD): PTSD is linked to traumatic events and is characterized by flashbacks, vivid nightmares, and intrusive memories. There are currently about 8 million people in the U.S. living with PTSD5.

How does cannabis impact anxiety?

Anxiety manifests in many ways and is a relatively common phenomenon. In fact, one of the most commonly cited reasons people turn to medical cannabis is in hopes that it could have a positive impact on their anxiety6. While the reported effects of cannabis may cause anxiety in some patients, it may also relieve anxiety in others.

The connection between cannabis and anxiety – and understanding how to reduce anxiety with cannabis – starts with examining the body’s endogenous cannabinoid system, also called the endocannabinoid system or the ECS. The ECS is made up of a series of cannabinoid receptors found throughout your body, including large amounts in your mid-brain, which is largely responsible for regulating and processing emotions and memory. 

Chemicals your body produces called endocannabinoids bind to the ECS to regulate many everyday functions across your central nervous system and immune system. Interestingly, the phytocannabinoids found in cannabis, like Tetrahydrocannabinol (THC) and Cannabidiol (CBD), mimic the structure and behavior of endocannabinoids and can influence the ECS in a similar way. When you consume cannabis, the phytocannabinoids interact with the receptors of the ECS to produce wide-ranging effects that researchers are still actively working to better understand.

In the brain, endocannabinoids modulate neurotransmission associated with anxiety. Phytocannabinoid interactions with CB1 receptors in this region of the brain are thought to amplify and supplement the influence on anxiety endocannabinoids already have7.

For example, THC is thought to influence anxiety responses because it activates the CB1 receptor. This could aggravate anxiety or quiet it down. CBD is also believed to modulate the effect THC has on your brain, as CBD can reduce anxiety rather than cause it8. In more balanced strains of cannabis, where the THC to CBD ratio is more even, anxiety responses are less common. As a result, THC:CBD ratio has become an important factor in determining if a certain strain will be helpful for reducing anxiety. 

What does the research say about cannabis and anxiety?

While research is still ongoing, it is clear the CB1 receptor — and the agonists and antagonists which act upon it — is linked to anxiety responses. 

Several human studies regarding the potential anti-anxiety effects of cannabis demonstrate a clear link between the ECS and anxiety responses9. However, it is less clear as to how cannabis influences anxiety responses. As more is uncovered, researchers hope to determine precisely how phytocannabinoids can help regulate anxiety responses, potentially unlocking new cannabis-based therapies for anxiety responses and anxiety disorders. 

Here’s a closer look at some of the studies regarding the ECS, cannabinoids, and anxiety:

  • A 1976 study found that subjects placed under simulated harassment by experimenters after cannabis consumption were more likely to experience anxiety than subjects who consumed in a neutral environment. This study demonstrated the important role environmental context plays in post-consumption anxiety responses10.

  • Subjects of a 2008 study were given rimonabant, a medication investigated for the treatment of obesity and diabetes and a CB1 receptor antagonist. Subjects given rimonabant exhibited significantly more anxiety responses than those taking a placebo. This study demonstrated the relationship between the CB1 receptor and anxiety responses11.

  • Another 2008 study demonstrated that an increase in endocannabinoids in women with depression served to reduce anxiety. In this study, researchers concluded that some of the physical responses related to anxiety could be associated with reduced function of the ECS12

How may cannabis help with anxiety?

If you’re considering trying a cannabis-based therapy for anxiety or an anxiety-related disorder, work closely with your healthcare professionals to determine the safest path forward. Keep in mind:

  • Anxiety responses are highly personalized and can vary on a case by case basis. Pay close attention to how and when cannabis is consumed, as well as where you were, your state of mind, and who you were with when it was consumed, to help determine the best environment for cannabis consumption.

  • Start with a small amount. Cannabis consumption should be gradual and measured to determine the right amount for you.

  • Keep a journal of how you feel before, during, and after consumption. Track how these feelings change over time. 

Explore cannabis for anxiety with Ethos

Cannabis-based therapy for anxiety and anxiety-related disorders is a developing field of study. While researchers have identified processes within the ECS responsible for regulating anxiety and stress, it’s not fully clear how phytocannabinoids influence these processes. 

At Ethos, we understand that your cannabis journey is also a learning experience. Cannabis is a complex plant, but we are your partners in ongoing education. Whatever your goals or questions, our staff is here to help you make the best decisions for your needs.

Sources

  1. https://adaa.org/understanding-anxiety/generalized-anxiety-disorder-gad
  2. https://adaa.org/understanding-anxiety/panic-disorder
  3. https://adaa.org/understanding-anxiety/social-anxiety-disorder
  4. https://adaa.org/understanding-anxiety/obsessive-compulsive-disorder-ocd
  5. https://adaa.org/understanding-anxiety/posttraumatic-stress-disorder-ptsd
  6. https://adai.uw.edu/pubs/pdf/2017mjanxiety.pdf
  7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3808114/pdf/nihms518943.pdf
  8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3691841/pdf/nihms-482368.pdf
  9. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3808114/pdf/nihms518943.pdf
  10. https://pubmed.ncbi.nlm.nih.gov/1062533/
  11. https://pubmed.ncbi.nlm.nih.gov/17098084/
  12. https://pubmed.ncbi.nlm.nih.gov/17391861/
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