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.
What is cannabis?
Cannabis sativa is a plant. People use the flower, the leaves, and even the seed oil, for recreational and medicinalTrusted Source purposes.
While cannabis comprises more than 120 active ingredients and compounds, the most abundant are cannabidiol (CBD) and delta-9-tetrahydrocannabinol (THC).
In recreational use, cannabis can trigger the following effects and feelings:
- relaxation
- elation or euphoria
- paranoia
- confusion
- changes perceiving color, taste, sounds, time, or space
- an increased appetite
People who use cannabis can consume it in the following ways:
- smoking or vaping
- drinking it in tea
- consuming it in edibles such as brownies or cakes
- eating it raw
- rubbing a topical preparation on their skin
- consuming capsules or supplements
Aside from the recreational effects, there are several potential health benefits of CBD and THC, including the possible treatment of anxiety.
Symptoms of anxiety
According to the National Institute of Mental Health, an estimated 31.1% of adults in the United States experience an anxiety disorder some time in their lives.
Symptoms of anxiety include:
- feelings of worry
- irritability
- restlessness
- a sense of being on-edge
- difficulty sleeping
- difficulty concentrating
Physical symptoms of anxiety include:
- increased heart rate
- shortness of breath
- nausea
- sweating
- feeling of weakness
- upset stomach
- dizziness
- hot flashes
Can cannabis treat anxiety?
There are limited human clinical trials that look at cannabis to treat anxiety. However, growing evidence, from animal studies to cannabis user surveys, suggests the drug could be effective. This is particularly the case when cannabis is in CBD oil form.
One 2010 study found that CBD oil reduced anxiety symptoms in people with social anxiety disorder. Participants had their brains scanned, revealing that CBD oil triggered changes in blood flow to regions in the brain linked with feelings of anxiety.
These findings suggest CBD oil can help treat anxiety. It also reveals the mechanism of how CBD interacts with the brain to achieve this.
A 2015 reviewTrusted Source analyzed previous research into CBD oil, stating the vast majority of the research used animal models. However, based on these studies, CBD oil could potentially reduce several anxiety disorders.
These included post-traumatic stress disorder, generalized anxiety disorder, obsessive-compulsive disorder, and social anxiety disorder.
Human studies are needed to confirm these findings in animals. Furthermore, this research generally only used acute CBD dosing. Therefore, scientists need to conduct more studies to establish whether chronic dosing has similar effects, sustained effects, or both.
A 2018 survey looked at cannabis use in easing the symptoms of depression and anxiety. It reveals that medical cannabis users reported a 58% reduction in anxiety and stress.
In addition, females reported a larger reduction in anxiety after using medical cannabis than males. It also showed that high THC and high CBD cannabis gave the most effective results in reducing stress.
Does cannabis cause anxiety?
In some cases, cannabis use may trigger anxiety.
A 2014 studyTrusted Source analyzed the effectiveness of medical cannabis in treating neurological conditions. The results show that some people using the drug experienced anxiety as an adverse effect. It also suggests a link between anxiety and higher concentrations of THC.
According to the Substance Abuse and Mental Health Services Administration, there is a link between cannabis abuse and anxiety disorders.
However, experts do not know for sure if cannabis use triggers anxiety, or if people with anxiety disorders tend to use more cannabis.
The Drug Enforcement Administration also state that cannabis use can exacerbate anxiety symptoms.
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
Benefits
- May reduce depression in the short term
- May relieve anxiety temporarily
- May reduce stress
Risks
- Higher levels of psychiatric disorders
- Can create psychological dependence
- Long-term memory loss may occur
- Symptoms may increase
- May develop cannabis hyperemesis syndrome
- Can create increased tolerance and need
Benefits
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.
Risks
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.
The Role of the Endocannabinoid System in Anxiety
The endocannabinoid system is expressed in all brain regions that are important for the processing of anxiety, fear,
and stress and has been identified as playing an important role in these responses.
Recently, the molecular,
cellular, and circuit mechanisms underlying the central role that cannabinoid signaling in the brain and body has in the
control of stress, fear, and anxiety have begun to be elucidated.
Both for anxiety and fear memory processing, the
endocannabinoid system is thought to ensure an appropriate reaction to stressful events and to serve as a regulatory
buffer system for emotional responses.
Endocannabinoids appear to modulate highly interactive stress and reward networks, consisting of the
endocannabinoid system (ECS), dopamine system, and hypothalamo-pituitary-adrenocortical axis. These networks
establish the balance between distress and well-being. Like social interaction and exercise, marijuana intoxication
produces a sought-after state of calmness or contentedness, mediated by interactive anxiolytic effects of increased
cannabinoid and oxytocin receptor activation and rewarding effects of elevated dopamine. Conversely, cannabis
withdrawal is associated with lower ECS tone, partially mediated by release of stress hormones and reduced dopamine
levels.
Marijuana Intoxication and Anxiety
Relaxation or tension reduction is commonly identified as a marijuana use motive or effect expectancy.On the
other hand, anxiety and panic reactions are the most commonly noted negative acute effects of marijuana
intoxication.Crippa et al. reviewed the literature on the relationship between marijuana intoxication and anxiety.
They found the risk of anxiety being induced by marijuana intoxication was associated with the following factors:
individual and genetic vulnerability, personality traits, female gender, infrequent use, high dose, high THC/low CBD
varieties, history of previous anxiety reaction, presence of anxiety disorder/symptoms, basal anxiety state, abstinence
states, and environment and context of use.
All other things being equal, THC appears to decrease anxiety at lower doses and increase anxiety at higher doses.
Such an effect was observed in a recent study in which participants were exposed to a well-validated psychosocial
stress task.A low dose of THC (7.5 mg) reduced the duration of negative emotional responses to the task and posttask appraisals of how threatening and challenging the stressor was. In contrast, a higher dose of THC (12.5 mg)
produced small but significant increases in anxiety, negative mood and subjective distress at baseline before and
during the psychosocial stress task.
CBD, on the other hand, appears to have robust anxiolytic effects without anxiogenic effects at higher doses. In fact,
the anxiolytic effects of CBD in humans were first demonstrated in the context of reversing the anxiogenic effects of
THC.Human studies show that 300-600 mg of oral CBD reduces experimentally induced anxiety in individuals
without anxiety disorders and reduces anxiety in patients with social anxiety disorder. Notably, effects have only
been demonstrated acutely; further studies are needed to establish the efficacy of CBD in reducing anxiety with
chronic dosing.