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Cannabis's Role in Treating Bipolar Disorder

A few years back, reality star Kylie Jenner caused quite an uproar online when she said that she was “so bipolar” after saying that she missed her jet-black hair soon after dyeing it blond, then blue. The then-16-year-old received comments such as “indecisive”, “moron”, and “insensitive”. One concerned Twitter user even said that Jenner’s post was the “dumbest and most ignorant use of the word bipolar”.

But more than just a lesson for Jenner to not use bipolar and other mental health terms in such a throwaway manner, the incident also shows a need for stronger efforts in educating everyone about mental illnesses. This is especially important not only because mental illnesses may begin to manifest as early as age 14, but also because of the misrepresentation of these conditions in the media and the social stigma, no matter how unfounded, associated with them.

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What is Bipolar Disorder?

Bipolar disorder, also previously known as manic depressive illness or manic depression, is a mental health condition that causes unusual and often extreme shifts in mood, energy levels, and emotions, More than just being simple “mood swings”, however, episodes of bipolar disorder can disrupt sleep, interfere with the ability to perform day-to-day tasks, and affect judgment and behavior.

There are four types of bipolar disorders, all of which involve distinct changes in mood and energy that range from the extremely “up”, characterized by elation, euphoria, and highly energized behavior (manic episodes); to the extremely “down”, with accompanying feelings of hopelessness, loss of interest or pleasure in any kind of activity, and decreased ability to concentrate (depressive episodes).

Bipolar I disorder is defined by manic episodes that may last at least seven days, that may either be preceded or followed by hypomanic (less severe cases of manic episodes) or depressive episodes that typically last for two weeks. In some cases, the manic episodes may trigger psychosis. Bipolar II disorder has a similar pattern to bipolar I, although without the full-blown manic episodes and with significantly longer depressive episodes.

Cyclothymic disorder or cyclothymia is characterized by several periods of both hypomanic symptoms and depressive symptoms in a span of two years (one year in children and teenagers). However, the indications are not enough to be diagnosed completely as hypomanic and depressive episodes. Finally, there are other types of bipolar disorders and other related illnesses that are defined by bipolar disorder symptoms but do not match the other three categories. These may be induced by certain drugs or brought about by a medical condition such as Cushing’s disease.

Diagnosing and Treating Bipolar Disorder

Much like any other mental illness, the exact cause of bipolar disorder has yet to be fully determined. However, key factors like biological and physiological differences (especially in the brain), and genetics are believed to be at play here. In fact, having a first-degree relative such as a sibling or a parent with bipolar disorder increases one’s risk of having it as well. Periods of high stress and other traumatic events, as well as drug and/or alcohol abuse may also increase the risk of developing bipolar disorder.

And perhaps because of the exaggerated or distorted characterization of people with bipolar disorder in the movies or on TV, some may not recognize that the extreme mood swings they are experiencing are, in fact, already symptomatic of the condition. This, among other things, prevents patients from getting the treatment that they need.

There are even some cases when the patient rather enjoys the feeling of extreme elation and productivity that comes with the manic episodes that they choose to forgo treatment. However, the lack of treatment not only leaves the person physically and emotionally worn out, they may also find themselves in legal and financial troubles.

This is why consulting with a mental health professional is important when you experience any symptoms of mania and/or depression. Bipolar disorder may be tricky to diagnose and doesn’t get better on its own. It may even be accompanied by other health conditions like anxiety or eating disorders that can worsen manic and/or depressive symptoms.

Treatments for bipolar disorder include several types of psychotherapy, including interpersonal and social rhythm therapy (IPSRT), cognitive behavioral therapy (CBT), psychoeducation, and family-focused therapy. These therapy sessions can be provided in individual or group settings, which can help ease a reluctant patient into attending these meetings.

Electroconvulsive therapy or ECT may also be a viable treatment option for bipolar disorder, especially for those who can’t take medications due to health reasons such as pregnancy or those at high risk of suicide. This procedure is said to cause changes in the brain chemistry that may reverse symptoms of mental illnesses.

Meanwhile, there are a number of medications used to treat bipolar disorder, which are prescribed depending on the patient’s symptoms. These include antipsychotics like risperidone (Risperdal), quetiapine (Seroquel), and lurasidone (Latuda); antidepressants like fluoxetine (Prozac) and escitalopram (Lexapro), which are both SSRIs, and duloxetine (Cymbalta) and levomilnacipran (Fetzima), which are SNRIs; antidepressant-antipsychotic medications like Symbyax; anxiolytics like benzodiazepine; and mood stabilizers like lithium (Lithobid), carbamazepine (Tegretol), and valproic acid (Depakene).

Research And Studies Show That Cannabis May Be Able To Help With Bipolar Disorder.

Can Cannabis Work for Bipolar Disorder?

Since managing one’s mood swings is one of the key aspects of treating bipolar disorder, it’s not a big surprise that cannabis has been floated as a possible treatment, with the herb’s mood-enhancing properties. Indeed, a study as early as 1998 already has patients reporting that cannabis works better than conventional drugs in alleviating symptoms of mania and depression. One research also found that cannabis use is more common in people with bipolar disorder, with anecdotal reports suggesting that some patients indeed take cannabis to manage both their manic and depressive episodes. And while research results in the effects of cannabis remain mixed, there is also strong evidence that cannabidiol (CBD), one of the primary cannabinoids present in marijuana, possesses antipsychotic, anticonvulsant, and antidepressant properties -- all valuable elements in treating bipolar disorder and its symptoms.

However, since cannabis also contains tetrahydrocannabinol (THC), which is the herb’s principal psychoactive agent, it also has a tendency to worsen mania, depression, and psychosis in persons with bipolar disorder. This makes the careful selection of cannabis strains a particularly important step in using cannabis and its derivatives, like edibles and cannabis oil, in treating this mental health condition.

This makes CBD, which has also been found to counteract the psychoactive effects of THC, far more valuable for bipolar patients, as it induces mental clarity high energy, and overall feelings of happiness. This is primarily due to how CBD interacts with the brain and certain neurotransmitters that work to influence mood and emotion.

For example, CBD has been proven to enhance the capabilities of GABA or gamma-aminobutyric acid. This neurotransmitter counteracts the brain chemicals that transmit anxiety signals, similar to how anti-anxiety medications like benzodiazepines work. Coupled with the uplifting effects of most high-CBD strains, cannabis appears to be a more viable option for bipolar disorder, since there are fewer side effects, lower overdose potential, and limited negative withdrawal symptoms.

CBD also enhances the transmission of 5-HT1A, a subtype of a serotonin receptor. A 2016 study found that by boosting the 5-HT1A transmission, CBD is able to increase the available serotonin -- a neurotransmitter that helps control emotions, reduce depression, and regulate anxiety -- in the synaptic space. This, in turn, helps boost one’s mood and happiness and decrease anxiety and other symptoms of depression. In fact, because serotonin is considered the body’s natural mood stabilizer, the higher level of this neurotransmitter in the brain means it is easier to maintain a rational, stable mood.

The blissful effect of CBD may also be attributed to its capability to stop the body from absorbing anandamide, an endocannabinoid and neurotransmitter that has both anxiolytic and antidepressant properties. The name itself is actually related to feelings of happiness -- “anandamide” is taken from the Sanskrit and Pali word “ananda” which literally means “joy, bliss, delight”. With more anandamide in the bloodstream, a person is more predisposed to feel happier. Furthermore, when CBD interacts with the body’s CB1 and CB2 receptors,it stops the body from breaking down anandamide, further reducing a person’s tendency to suffer from anxiety and depression -- 2 key symptoms of the depressive episode of bipolar disorder.

High-CBD Strains for Managing Bipolar Disorder

Unless you are specifically looking for cannabis that’s high in CBD, you’ll most likely find strains that have high THC content. This is because CBD is a relatively newer discovery, and only in 2012 did high-CBD strains achieve widespread popularity. However, as long as you stick to sativa strains and sativa-dominant hybrids, it’s easy to get high enough amounts of CBD. If you’re concerned about getting an exact dose of CBD, it may be best to use cannabis oil instead. Pay a visit to your local dispensary and ask if they have CBD oil, in particular. You can also find instructions on how to make your own cannabis oil at home through the Internet, although it may take some time before you can actually get the correct dose of CBD you want.

Nonetheless, here are some of the most popular high-CBD strains that you may want to try.

  1. Harlequin. This is a 75:25 sativa-dominant hybrid with an earthy, mango-like flavor. It’s ideal for daytime consumption, as focus and alertness are among its most well-known payoffs. Harlequin also has pain-killing properties, along with its paranoia-countering effects.
  2. Kali Mist. Kali Mist is popular in the creative community, with an energetic, clear-headed effect that shakes one’s imagination loose. It’s also a lightweight, easy-to-use sativa strain that’s beginner-friendly, so if you want to stay focused and productive during the day, Kali Mist is a must-try.
  3. Strawberry Cough. As its name implies, Strawberry Cough has the sweet aroma of fresh strawberries. Coupled with its euphoric, uplifting effects, this strain is ideal for managing stress and social anxieties. Be warned, though! Even long-time marijuana users can’t help but cough after a couple of hits, due to the expanding sensation that this strain is well-known for.
  4. Durban Poison. This is one of the most popular pure sativa strain, originating from the South African port city of the same name. It has a sweet-spicy flavor that brings an energetic, uplifting effect. Durban Poison is also among the few strains with high amounts of THCV or tetrahydrocannabivarin, which provides a brain-stimulating buzz that works wonders for your productivity.
  5. Chocolope. With its sweet, earthy coffee flavor, Chocolope is famous for its strong uplifting, euphoric effect that’s perfect for combating depression and stress. Indeed, some users find that the actual buzz doesn’t last for very long, but the lingering feelings of optimism, happiness, and motivation can stay with you for more than three hours after the mental stimulation dies down.
  6. Jack Herer. Blissfully clear. This is how most users of this 55% sativa hybrid describe its effects. Jack Herer is also an award-winning, high-quality medical strain that leaves the mind focused and the body energetic. And with its spicy, piney aroma, it’s no wonder that Jack Herer is also well known for its positive effects on mood and focus.
  7. ACDC. This sativa-dominant hybrid has a remarkable CBD:THC ratio of 20:1, which helps treat anxiety, panic disorder, and depression without any psychoactive effects. Its high CBD content also makes ACDC an effective, non-drowsy pain killer.
  8. Green Crack. This sativa strain delivers sharp mental focus and uplifting energy, which makes it an ideal daytime medication for those suffering from anxiety, depression, fatigue, and stress. Green Crack also has a fruity flavor that makes it a delight to consume, whether through edibles or smoking.

It may be a long time yet before people, both in and out of the medical profession, can completely understand the way mental illnesses like bipolar disorder work. The same can be said for cannabis and its vast potential as a treatment option for mental disorders and other diseases. However, as more studies look into these two subjects and as more tools become available for advocates to spread awareness, it’s safe to say that the road ahead will be easier to navigate.