Everything you need to know about Cannabis and Anxiety
Anxiety affects a staggering number of South Africans of all ages and from all walks of life.
A 2014 Sunday Times article reported that a third of South Africans suffer from mental illness. The report went on to say “More than 17-million people in South Africa are dealing with depression, substance abuse, anxiety, bipolar disorder and schizophrenia”. SADAG – The South African Depression and Anxiety Group states that 1 in 6 South Africans suffer from anxiety.
The number of South Africans who are being diagnosed as having an anxiety disorder is growing at an alarming rate, and the numbers have been increasing for some time now. In response to the alarming growth in anxiety disorders, pharmaceutical companies developed numerous drugs to try and treat anxiety disorders, from SSRIs to benzodiazepines.
While the above mentioned drugs can be effective for some patients in helping alleviate anxiety, some sufferers don’t have such a good experience. Certain anxiety sufferers don’t see much of an improvement at all, or they may have experienced some of the many side effects that these medications can dish out. Additionally, benzos like Diazepam and Xanax can be highly addictive.
Whether you just received a diagnosis or have grappled with it for years, anxiety can be very difficult to deal with. Regardless of the severity of your case, an anxiety disorder makes usually simple activities feel like insurmountable tasks.
Some patients have difficulty finding the right treatment for their anxiety. Since we all have unique brain chemistry and react differently to anxiety meds, the same treatment won’t affect every patient in the same way. In addition to this, finding the right therapist adds another layer to the confusion.
Anxiety disorders include a wide range of mental illnesses such as:
- Generalized anxiety disorder (GAD) – People with GAD experience frequent and excessive nervousness about many facets of everyday life and have a hard time controlling these worries. Even when they know they’re experiencing more anxiety than is warranted for a situation, they can’t stop feeling concerned.
- Obsessive-compulsive disorder (OCD) – While most people think of OCD as being overly neat or organized, it causes as much distress as other anxiety disorders. OCD causes intrusive thoughts – or obsessions – that compel the patient to conduct repeated actions – or compulsions – to calm down.
- Social anxiety disorder – Another misunderstood form of anxiety, social anxiety disorder, goes far beyond shyness. In reality, it makes the patient feel severe anxiety about social interaction. They often worry about judgment from others when in social situations.
- Panic disorder – Patients with panic disorder get sudden, unpredicted panic attacks that cause a racing heartbeat, hyperventilation and other intense symptoms. They often worry about getting panic attacks, which compounds the issue.
- Post-traumatic stress disorder (PTSD) – Patients who have gone through a traumatic event, such as war, disasters, abuse, tragedy or other life-changing or life-threatening occurrences, can develop PTSD. This illness causes the patient to have intense flashbacks about the event, avoid trauma reminders and constantly feel on edge.
- Specific phobias – We all have our fears, but patients with phobias have an extreme fear reaction to the thing they are afraid of. Even though they know they have an irrational fear, they have difficulty controlling it.
Like other mental illness patients, people with anxiety disorders are often dismissed as overreacting. Sometimes, people will tell them just to calm down. But people with anxiety have a much harder time calming down than someone without it.
The relationship between Cannabis and anxiety is incredibly complex. One the one hand, cannabis is often used to calm the mind and body. It’s a natural painkiller, and one that people use often to self-medicate. On the other hand, studies have linked Cannabis to problems with anxiety – both causing anxiety on its own, and making anxiety worse.
With that in mind, another truth about marijuana use is that the drug can cause different reactions in different people. One person might experience relaxation effect, while others may experience an intense and frightening hallucination.
Dosing affects this, but so does a person’s expectations, and this is a key problem with those living with anxiety – often those living with anxiety unintentionally assume a negative reaction (even if they don’t expect it). This, in turn, causes a more anxious reaction.
So those that have anxiety that causes negative thinking (like most people with generalized anxiety disorder), this can be a problem, because marijuana’s effects will conform to those thoughts, and a negative reaction becomes more likely.
Another serious issue can occur in people with anxiety attacks/panic attacks. Panic attacks are technically an anxiety disorder, but they are also a reaction to physical sensations. A person feels something in their body, and suddenly they get this rush of intense anxiety along with genuine physical symptoms as a result of that stress.
Many of these panic disorder triggers are the same as some of the effects of Cannabis:
- Increased heart rate.
- Poor coordination.
- Trouble breathing.
While some of these may be the result of the THC’s relaxation properties, someone living with panic attacks is less likely to respond to the experience with relaxation, and many instead respond with a panic attack or rush of anxiety.
THC impacts the neural communications between the amygdala and the rest of your brain. This hypes your emotion to a point that’s going to leave you feeling a heightened sentiment. Some individuals understand this sensation and take it in with full affection. Others aren’t so keen on it and find it rather unsettling, especially new users who have little experience with getting high.
Endocannabinoids that your body naturally produces are the chemicals responsible for relieving anxiety. Through research, it has been discovered that people who’ve undergone much stress and/or trauma – such as those affected by PTSD – naturally produce fewer endocannabinoids. And smoking Cannabis helps stimulate the missing chemicals in their brains. This gives us a small insight as to why marijuana helps relieve stress in certain individuals.
One study comparing the effects of THC and CBD even found that, while THC increased anxiety by activating the neurotransmitters involved in the “fight or flight” response, CBD actually repressed autonomic arousal—or the nervous system response associated with sudden increases in heart rate or respiration. In other words, CBD is ideal for people looking to relax and unwind—not get out of their minds.
In recent years, CBD has generated a tremendous amount of interest among consumers, clinicians, and scientists. Why? Not only does evidence suggest CBD counteracts many of THC’s adverse effects, but numerous animal studies and accumulating evidence from human experimental, clinical, and epidemiological studies suggest CBD has powerful anti-anxiety properties. Administered acutely (“as needed”), it appears safe, well-tolerated, and may be beneficial to treat a number of anxiety-related disorders, including:
- Panic disorder
- Obsessive Compulsive Disorder (OCD)
- Social phobia
- Post-Traumatic Stress Disorder (PTSD)
- Generalized Anxiety Disorder (GAD)
- Mild to moderate depression
THE SCIENCE BEHIND CBD & THE BRAIN
CBD can help with anxiety and depression in two noticeable ways:
5-HT1A – CBD works by exerting several actions on the brain. It has been proven effective in boosting signalling via a serotonin receptor 5-HT1A agonist. 5-HT1A is a serotonin receptor subtype that is important because depression and anxiety can be treated with drugs that target the serotonin system. That is why selective serotonin reuptake inhibitors (SSRIs) are often prescribed, they work by blocking serotonin re-absorption in the brain. This, in turn, increases serotonin availability in the synaptic space. Consequently, there is an increase in the signals that are transmitted by the brain cells, thereby boosting mood and reducing anxiety in some cases. CBD works similarly to SSRIs. By boosting signalling via serotonin receptors. Some studies have even shown that CBD can enhance 5HT1A transmission and its effect on serotonin may be faster than that of SSRIs.
Hippocampus – The hippocampus is an area in the brain that plays a significant role in various brain functions. It is particularly known for its role in cognition and memory formation. Scans of anxiety and depression patients actually reveal a smaller hippocampus. And, depression therapeutic aids show regeneration of neurons or neurogenesis in this area. That means these therapeutic aids may help with depression and anxiety. Both CBD and SSRIs have been proven effective in promoting neurogenesis. This is important because evidence shows that when severely impaired, neuronal plasticity can lead to suicidal behaviours.
People interested in managing their anxiety with CBD oil should look exclusively at research on cannabidiol, not generalized studies of medical Cannabis. Although there are fewer studies on cannabidiol specifically, the preliminary research is promising.
A small 2010 study found that cannabidiol could reduce symptoms of social anxiety in people with social anxiety disorder (SAD). Brain scans of participants revealed changes in blood flow to the regions of the brain linked to feelings of anxiety. In this study, cannabidiol not only made participants feel better but also changed the way their brains responded to anxiety. A 2011 study also found that cannabidiol could reduce social anxiety. For that study, researchers looked specifically at cannabidiol to treat anxiety associated with public speaking. Research published in 2014 found that CBD oil had anti-anxiety and antidepressant effects in an animal model. A 2015 analysis of previous studies concluded that CBD oil is a promising treatment for numerous forms of anxiety, including social anxiety disorder, panic disorder, obsessive-compulsive disorder, generalized anxiety disorder, and post-traumatic stress disorder.
Evidence from animal studies have begun to characterize the details of how CBD acts in the brain, and human studies of patients with and without anxiety disorders are starting to validate CBD’s efficacy as an anti-anxiety treatment. Given the huge social and financial costs of anxiety disorders in South Africa, CBD has the potential to play a significant role in treating a myriad of anxiety-related disorders. Therefore, considering the therapeutic aid of an anxiety-related disorder, it may eventually become a highly favourable, safer, and effective therapeutic aid for anxiety compared to the available conventional drugs.
If you need to speak to someone and cannot afford professional help then contact The South African Depression and Anxiety Group, Africa’s largest mental health support and advocacy group. To contact a SADAG counsellor between 8am-8pm Monday to Sunday, Call: 011 234 4837. For a suicidal Emergency contact them on 0800 567 567.