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Cannabis: Is it Good for Treating Anxiety?

It’s a normal part of life to experience feeling anxious from time to time, especially in stressful situations. Perhaps you’re worried about an upcoming job interview, or a loved one is undergoing a critical medical procedure. However, if you’re experiencing an overwhelming feeling of anxiety that already interferes with your daily activities, you may have an anxiety disorder.

What is Anxiety?

Anxiety disorders involve feeling excessive and persistent fear or worry about everyday situations. These feelings are difficult to control, last for a long time, and often out of proportion to the actual situation of concern. Anxiety disorders also usually come with repeated episodes of a panic attack – a sudden, heightened feeling of terror. While there are simple ways to reduce its occurrence, like avoiding certain places or activities that caused it before, a panic attack can also be triggered by any situation that makes a person feel helpless and unable to escape.

A person can also experience more than one anxiety disorder at a time, and can also be a symptom of another medical condition. Different types of anxiety disorders include generalized anxiety disorder or GAD, social anxiety disorder or SAD, agoraphobia, selective mutism, separation anxiety, and phobias.

How is Anxiety Treated

Initial treatments for anxiety include psychotherapy or psychological counseling. This simply involves working with a therapist to reduce anxiety symptoms. There are different forms of psychotherapy, though the most effective seems to be CBT or cognitive behavioral therapy. CBT involves exposure therapy, in which a person is gradually re-introduced to the objects, activities, or places that trigger the anxiety and slowly build confidence to manage both the situation and the resulting symptoms. Therapists who prescribe CBT also teach their patients to practice specific skills to alleviate symptoms like learning how to recognize that you’re feeling anxious, and challenging negative thoughts and replacing them with positive ones.

Anxiety can also be treated using several types of medicines. Depending on the type of anxiety disorder you have, you can be prescribed with certain anti-depressants, anti-anxiety medications, and even sedatives for short-term relief of symptoms. While intended to help, these prescription drugs often come with many unwanted effects, such as drowsiness, dizziness, difficulty in coordination, even headaches and muscle and joint pains. Sometimes, these effects can be persistent enough to negatively affect the person’s quality of life.

On the other hand, herbal medicines and dietary supplements have been studied for years as alternative treatments for anxiety. These include kava, valerian root, passionflower, the amino acid theanine, and the highly controversial cannabis.

Cannabis for Anxiety

Some people, even before medical marijuana has been legalized or even considered as a viable alternative, have already been self-medicating with cannabis to treat anxiety, depression, and sleeplessness. In fact, a study from NYU reported that there was a 50% decrease in the frequency of seizures in epilepsy patients who were using CBD or cannabidiol. This is one of close to a hundred cannabinoids – natural compounds found in the cannabis plant – that does not exhibit psychoactive properties.

One research that focuses on the overall therapeutic effects of cannabis states that inhaled or intravenous CBD can inhibit the effects of THC or tetrahydrocannabinol, a psychoactive cannabinoid. However, the CBD dosage should be considerably higher than that of THC. Careful dosing should be practiced – while 150–600 mg/d dosage of oral may be able to exert a therapeutic effect for social anxiety disorder, insomnia, and epilepsy, 400–700 mg of the same can cause mental sedation or even aggravate cognitive deficits in schizophrenia.

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Managing Anxiety Symptoms

Successfully managing emotions and other anxiety-related factors is also an important part of treatment. One study that looked into the effect of CBD to social phobia patients found out that cerebral bloodflow after CBD treatment exhibited an anti-anxiety effect in the limbic and paralimbic brain areas – the sections of the brain that manages emotions. In the same study, CBD also significantly decreased anxiety, cognitive impairment, and discomfort in the subjects before they gave a public speech (albeit a simulated one), an activity that may trigger anxiety attacks. Meanwhile, in a double blind study, CBD was associated with significantly decreased subjective anxiety compared to those who received placebo, suggesting that that CBD can reduce anxiety in social anxiety disorder sufferers through affecting brain activity in the limbic and paralimbic areas.

On the other hand, using marijuana more regularly might contribute to better stress management, which is an important factor in treating anxiety disorders. A recent study focused on the effectiveness of marijuana in reducing stress response in both regular users and non-users of the drug. The subjects were monitored for their levels of cortisol – the stress hormone – after undergoing both physiological and psychosocial stress. The regular users reported blunted response to acute stress, as they showed no increase in cortisol throughout the stress manipulation; they also did not experience any adverse effects related to cravings or withdrawal symptoms.

One research also studied the effects of CBD to the body’s level of GABA neurotransmitters. GABA (or gamma-aminobutyric acid) plays a role in anxiety response – it counteracts the effects of brain chemicals that influence anxiety. CBD enhances this capability of GABA; and while this effect is also seen in other anti-anxiety treatments like benzodiazepines (Xanax, Klonopin, and Valium, among others), tolerance builds up quickly in these drugs, which can lead to eventual dependency. With medical marijuana, there are fewer side effects and less potential for overdose and addiction.

How Does CBD Work Against Anxiety

Cannabinoids like CBD and THC work by interacting with the body’s cannabinoid receptors – CB1 and CB2 – located throughout the body. CB1 receptors are found in the kidneys, lungs, liver, and reproductive organs, but they are most abundant in the brain and the central nervous system. These are the receptors that interact with THC, producing that euphoric kind of high. Due to their higher concentration in the central nervous system, the interaction of CB1 receptors with cannabinoids are seen to help prevent and treat neurodegenerative diseases like Alzheimer’s and Parkinson’s.

Meanwhile, CB2 receptors are most common in the immune system. When stimulated by cannabinoids, they trigger an anti-inflammatory response, which reduces pain and damage to tissues. This is especially helpful in treating inflammation-related diseases like arthritis and Crohn’s.

When CBD interacts with both CB1 and CB2 receptors, it stops the fatty acid amide hydrolase from degrading the endocannabinoid called anandamide. By helping prevent the degradation of anandamide, which has anti-anxiety and antidepressant properties, CBD helps reduce one’s vulnerability to anxiety and depression.

CBD is also known to enhance the transmission of 5-HT1A, a subtype of the serotonin receptor. Depression and anxiety disorders are linked to low levels of serotonin in the brain; higher serotonin levels, on the other hand, are believed to improve mood. This boost in 5-HT1A transmission and the increase of available serotonin in the synaptic space are also seen among the effects of selective serotonin reuptake inhibitors (SSRIs) like Prozac.

Finally, studies have also shown that CBD helps in neurogenesis, including in the hippocampus. The hippocampus is a major area in the brain that is especially important in the consolidation of information ad memory formation, as well as spatial memory and navigation. Patients with depression or anxiety disorders often have smaller hippocampuses, and the successful treatment of depression and anxiety disorders involves neurogenesis in this region of the brain. Apart from this neurogenerative ability, CBD also exhibits neuroprotective properties – it reduces damage to the brain and nervous system.

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The Future of Medical Marijuana for Anxiety

Marijuana has a rich history being used as a treatment for depression and other health concerns. In India, for example, cannabis has been used to treat depression and stress as recently as 400 years ago. CBD-rich medical marijuana has also been used as a pain reliever across Asia, the Middle East, and Africa. William Brooke O'Shaughnessy, an Irish doctor, is credited to the popularization of medical marijuana in America and England in the 18th century, as he used cannabis to relieve discomforts of nausea caused by rabies, cholera, and tetanus. It has even been said that Queen Victoria used cannabis to help ease the discomfort brought by menstrual cramps.

But because marijuana remains illegal in some states and most countries, further research on the effects of cannabinoids on the brain to influence emotions and behaviors can prove to be a challenge. There is also the concern of the hundreds of different strains of marijuana that contain different levels THC and CBD which can cause concerns especially to recreational users who may not be able to dose correctly. In fact, most marijuana plants are bred to have more levels of THC. Not only is this compound more popular because it provides the euphoric, “floaty” high that recreational users crave, it is also used in treating more popular health conditions like cancer. Only recently has CBD strains emerged in medical usage due to the growing awareness of its benefits for anxiety sufferers.

Because of different physiological factors, the results of medical marijuana to anxiety disorder sufferers also vary – some feel relieved of the symptoms while others feel more anxious after using. Apart from this, there is also a lack of research in the effects of other cannabinoids which all relieve symptoms of illnesses but aren’t explored as thoroughly as THC and CBD.

While it is not discouraged to use cannabis in treating anxiety and its symptoms, it is advisable to do a complete physical and mental evaluation first. A person’s anxiety may sometimes be associated with other conditions, such as depression, alcoholism, and obsessive compulsive disorder, among others. It may be helpful to seek treatment for these conditions first before treating the anxiety disorder.

Even so, there are still numerous studies that claim positive effects of cannabinoids, especially CBD, to anxiety sufferers. However, the scientific community has barely scratched the surface in studying the effects of medical marijuana in treating anxiety and beyond. But with the number of success stories from cannabis and its derivatives, definitive proof of marijuana’s medical benefits and eventual acceptance may not be far behind.

In the meantime, more studies are needed to further clarify the link between the use of medical marijuana products, such as cannabis oil, and anxiety. Future researches, especially those involving human subjects, should also address design problems, such as comparing long-time cannabis users with people who had never used before without accounting for baseline characteristics such as educational attainment and pre-existing conditions.

One thing is clear, however: medical marijuana has a huge potential in treating a host of different ailments, and it would be unwise to dismiss these benefits without enough knowledge about its immediate and long-term effects.