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Sadness is an inevitable part of life. The death of a family member, a wrenching break up with a long-time boyfriend or girlfriend, perhaps a bad grade or a missed-out promotion -- these are just some of the things that can trigger sadness and all the other feelings related to this emotion.
There are times, however, when these episodes of sadness and feelings of depression persist and cause problems in relationships or hinder day-to-day activities. This is what is called clinical depression, also known as major depression or major depressive disorder.
Among the major signs and symptoms of clinical depression include: feelings of sadness, emptiness, and/or hopelessness; feelings of worthlessness or guilt, even from past failures; irritability or frustration, even on trivial matters; extreme tiredness and lack of energy; sleeping too little or too much; anxiety and agitation; and frequent thoughts of and about death and suicide, and suicide attempts (whether or not successful).
The exact cause of depression has yet to be identified. However, as with other mental disorders, a variety of factors such as biological and chemical differences in the brain, hormonal imbalances (such as that with postpartum depression), and genetics may be involved.
There are also some risk factors that increase the risk of developing or triggering depression. These include traits like low self-esteem or being too self-critical or pessimistic; traumatic or stressful events like sexual abuse or financial difficulties; substance abuse; being lesbian, gay, bisexual, transgender, or intersex in unsupportive, even hostile, situations; and having relatives with a history of depression, bipolar disorder, and alcoholism.
What makes depression a little harder to spot is that the symptoms vary depending on the patient. In fact, once a person is determined to have depression, their doctor may add one or more specifiers to their condition for a clearer diagnosis and better treatment. Some of the “features” of depression are anxious distress, catatonia, peripartum onset, melancholic features, and psychotic features, among others.
Clinical depression is more than just a case of “the blues” and patients don’t simply “snap out of it”. In fact, depression may require long-term treatment with medications or psychotherapy (or both) or, in more severe cases, a prolonged stay in a hospital or a mental care facility.
The most common treatment for depression is antidepressant medications, the most popular of which are SSRIs or selective serotonin reuptake inhibitors (SSRIs). Doctors usually start patients off on SSRIs, as these drugs are considered safer and cause fewer side effects compared to other antidepressants. Popular SSRIs include citalopram (Celexa), fluoxetine (Prozac), and sertraline (Zoloft).
Other common medications include serotonin-norepinephrine reuptake inhibitors (SNRIs) like duloxetine (Cymbalta) and levomilnacipran (Fetzima); tricyclic antidepressants like imipramine (Tofranil) and protriptyline (Vivactil); and monoamine oxidase inhibitors (MAOIs) like tranylcypromine (Parnate) and phenelzine (Nardil). It should be noted that tricyclic antidepressants and MAOIs cause more severe side effects compared to SSRIs. MAOIs in particular may cause dangerous interactions with specific foods such as certain cheeses and wines, and thus require a strict diet.
On the other hand, psychotherapy, sometimes called talk therapy or psychological therapy, can be effective in treating depression in that it can help a depressed person learn how to deal with a crisis, find better ways to cope with and solve problems, and learn to set realistic goals, among others. Psychotherapy may also help the patient regain a sense of satisfaction and the feeling that they are in control of their lives. Different types of psychotherapy include cognitive analytic therapy, cognitive behavioral therapy, interpersonal therapy, and even arts or artistic therapy.
There are also alternative treatments for depression, among them electroconvulsive therapy (ECT) and transcranial magnetic stimulation (TMS). ECT is where electrical currents are passed through the brain to affect the function and action of neurotransmitters in the brain. TMS, meanwhile, uses magnetic pulses to stimulate the nerve cells in the brain that are involved in regulating a person’s mood. These treatments are usually used for people who don’t get the desired effects with medications or can’t take such medications due to underlying health reasons.
Another popular alternative treatment, though quite controversial, is cannabis. In particular, the cannabinoid CBD or cannabidiol, which is more predominant in Cannabis sativa strains, has long been associated with a boost in creativity due to the mental clarity it brings, together with a happy, energetic effect.
Compared to its psychoactive counterpart THC (or tetrahydrocannabinol), CBD is a relatively recent topic in cannabis research and high-CBD strains only began to achieve mainstream popularity in 2012. However, studies that focus on using cannabis for anxiety and other symptoms of depression have yielded mostly positive results.
Case in point: a 2016 study showed that CBD is able to enhance the transmission of 5-HT1A, a subtype of the serotonin receptor. Low levels of serotonin -- a neurotransmitter that is believed to regulate and affect anxiety, happiness, and mood -- in the brain has been linked to depression and anxiety disorders. By boosting the 5-HT1A transmission, CBD helps increase the available serotonin in the brain and thus helps minimize anxiety. In fact, this same effect can be seen in SSRI medications.
Another way that cannabis helps in managing anxiety -- and therefore depression -- is through enhancing the capabilities of the body’s GABA neurotransmitters. GABA (or gamma-aminobutyric acid) plays a critical role in managing the body’s anxiety response by counteracting the effects of brain chemicals that influence and transmit anxiety “signals”. This is similar to how benzodiazepines, which are the most popular anti-anxiety medications, work in the body. What’s good is that with cannabis, there are fewer side effects and lower potential for overdose.
Researchers also discovered that CBD assists in neurogenesis -- the production of neurons by neural stem cells -- in different parts of the brain, including the hippocampus. The hippocampus is part of the limbic system, the part of the brain that handles memory, emotion, and motivation. The successful treatment of depression and other anxiety disorders have been linked to neurogenesis in this part of the brain. CBD also has neuroprotective abilities that help reduce damage to the brain.
One study also showed the potential of CBD to decrease anxiety and discomfort by simulating anxiety-triggering activities such as giving a public speech. Another study also suggested that CBD can reduce anxiety by influencing brain activity in the limbic and paralimbic systems of the brain.
Finally, CBD has also been shown to stop the body from absorbing anandamide, an endocannabinoid that has anxiolytic and antidepressant properties. The blissful effect of CBD may be attributed to the increased amount of anandamide, sometimes also called the “bliss molecule”, in the bloodstream. The interaction of CBD with both CB1 and CB2 receptors also inhibits the degradation of anandamide by stopping the actions of the fatty acid amide hydrolase. This further reduces a person’s vulnerability to depression and anxiety.
Research And Studies Show That Cannabis May Be Able To Help With Depression.
CBD is the dominant cannabinoid in C. sativa and sativa-dominant hybrids, so if you are considering using cannabis for anxiety and depression, here are some strains you might want to consider.
Unwind After Those Long, Rough Days: This Is RELAX.
There is a lot of work still to be done to conclusively say that cannabis does indeed treat depression. For one, physiological factors remain a barrier -- the results of medical marijuana vary greatly in different patients. Some report that they feel relieved of the symptoms, while others say they feel heightened anxiety after using cannabis. This may be due to the varying levels of THC and CBD, even in well-established strains, pure or hybrid. While most prescription medications also have varying effects in depression sufferers, these drugs aren’t associated with the negative stigma that is attached to cannabis, making them the bottomline for depression medication at the moment.
There is also a lack of research about the effects and the relationship of other cannabinoids, such as cannabigerol and tetrahydrocannabivarin (CBG and THCV), with THC and CBD. New research in this subject may open more doors for cannabis as a viable treatment not only for depression and anxiety, but also for other diseases.
But with the increasing number of success stories from cannabis users, as well as the continuing evolution and gradual acceptance of medical marijuana, it may not take long to finally have indisputable proof of cannabis’s effectiveness in addressing depression and its symptoms.
CrEATe is a direct-to-consumer culinary cannabis subscription that includes world-class educational materials, high-end oils, and exclusive chef-curated recipes. Embark on a transformative culinary journey.
In this eBook, we will be going through everything you need to know about culinary cannabis and how to enjoy this versatile herb responsibly.