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CBD Guides: Can CBD help with generalised anxiety disorder?

We examine the science behind taking CBD for anxiety to see if it could help with the symptoms

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Anxiety is one of the most common mental health conditions in the UK and it can have a debilitating effect on a person’s daily life. Could CBD help to ease the symptoms?

Anxiety is a natural reaction to stress creating fear or apprehensive feeling about what will happen. While anxiety can happen to everyone from time to time, there are some people who struggle with strong feelings of anxiety every day. These feelings of anxiety can be a symptom of post-traumatic stress disorder (PTSD), generalised anxiety disorder (GAD) or social anxiety disorder.

GAD is a life-long condition that can leave people feeling anxious most days or struggling to relax. The NHS estimates that it can affect up to 5 per cent of the population. It is also thought to affect more women than men.

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What are the symptoms of generalised anxiety disorder?

The psychological symptoms of generalised anxiety disorder can be restlessness, a feeling of dread, feeling on edge, difficulty concentrating and irritability. Patients with GAD may remove themselves from situations where they feel these emotions most such as social situations or work.

It can also cause physical feelings such as dizziness, fast or irregular heartbeat, dry mouth, shortness of breath, stomach aches or excessive sweating. All of which can be exhausting.

What is CBD?

CBD is a cannabinoid found in the cannabis plant. It is non-toxic unlike the cannabinoid tetrahydrocannabinol (THC).

We have different receptors throughout our bodies. It is thought that CBD interacts with these receptors by giving them signals. In particular, it may interact with the receptors, CB1 and CB2 which are found in the immune and nervous systems.

How does CBD work for anxiety?

CBD is thought to interact with the receptors in the brain potentially sending signals to the neurotransmitter, serotonin. There is still a lot of research needed in this area to understand how the two interact.

Serotonin is the neurotransmitter responsible for your mental health and lower levels are sometimes associated with depression or anxiety. This is why the prescription treatment for anxiety is usually selective serotonin reuptake inhibitors (SSRI).

Reducing anxiety in SAD

A study examining the effect of CBD on people with Social Anxiety Disorder (SAD) found that it may help to reduce anxiety.
SAD is a social disorder where people can feel panic at the thought of social settings or speaking to groups of people. Participants in this study were given 400 mg of CBD or a placebo. The researchers reported that those in the group given the CBD recorded lower levels of anxiety.

Improving sleep quality

Another study examined if CBD could help to improve sleep quality while reducing anxiety. The study involved 72 participants with 47 experiencing anxiety of which a further 25 had poor quality sleep. Each participant was given a daily dose of 25mg of CBD then asked to self-report how they felt afterwards. The researchers recorded that 79.2 per cent recorded reduced anxiety while 66.7 per cent said their sleep had improved after the first month.

How do I take CBD for anxiety?

There is no right or wrong way to take CBD for anxiety. It comes down to lifestyle, personal preference and availability.

Here are three of the most popular ways to take CBD
Edibles

Edibles are great if you aren’t a fan of the hemp taste that some oils may have. They are available in many different versions from brownies to gummy bears. It’s also a discreet way to have a dose of CBD without anyone knowing.

However, there are some downsides to edibles

They can often be found in sugary sweets which can be difficult if someone is following a particular diet or reducing their sugar intake. Edibles can take longer to work so if you need a quick dose of CBD then this isn’t the method for you.

A large percentage of CBD can be lost in the digestion process meaning that you may absorb less than the amount you had intended.

Patches

Patches are a good choice if you often forget to take oils or capsules on a regular basis.

They can be applied to the skin easily and left for a day or two depending on the brand. They are designed to be discreet and forgotten about. The CBD in the patch is absorbed through the skin and into the system.

Oil or tincture

Oils and tinctures are the popular way of taking CBD.

There isn’t much difference between the two as they are both ingested through the mouth. To take, pop a small drop of oil or tinctures under the tongue allowing it to absorb for a few minutes before swallowing.

The main difference between tinctures and oils is the carrier. Tinctures use alcohol whereas oil is, well, oil. Oils normally use a carrier such as hemp, rapeseed or flaxseed. Tinctures will usually have a sweetener or flavouring added to mask the bitterness of the alcohol.

Anxiety: A variety of different ways to take CBD including capsules, skincare, oil, sprays and pwoders

What is the best CBD for anxiety?

There isn’t one particular method or type of CBD that works for anxiety. It comes down to personal preference and lifestyle. If the above methods don’t appeal then there are loads of other ways to take it including bath bombs, skincare, massage oil or even capsules.

There is bound to be a method for everyone.

How quickly does CBD work for anxiety?

While it does depend on different factors, some are faster than others.

If you vape or use oil then it will be faster acting than edibles. It is also worth noting that weight may also play a part in how quickly a dose affects you. It’s best to start with a low dose letting it build up over time. A lot of people when new to CBD expect it to work instantly as if it was the same as paracetamol. CBD takes time to build up in the system.

Keeping a record of the different effects you feel can help you to determine future doses, what brands work for you and what methods you prefer.

Would CBD help with depression and anxiety?

CBD is also thought to help with depression as well as anxiety. The two conditions are usually closely linked.

A study from 2011 examined the effect of CBD on people with SAD. The participants were given either 400 mg of oral CBD or a placebo. Those who were in the CBD group reported feeling less anxiety.

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Mental health

New data supports use of medical cannabis for anxiety and depression 

The study is thought to be the largest to date examining medical cannabis for anxiety and depression

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New data supports use of medical cannabis for anxiety and depression 
The symptom improvements seen were sustained for at least one year.

A Canadian survey has found evidence to suggest that medical cannabis is associated with sustained improvements in anxiety and depression.

In what is thought to be the largest dataset of its kind, Canadian researchers surveyed over 7,000 patients authorised to access medical cannabis products.

According to their findings, published in the journal Psychiatry Research, patients with symptoms of anxiety and/or depression report sustained improvements following the use of cannabis.

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Authors reported “statistically significant improvements” between subjects’ baseline and follow up scores on validated measurements of anxiety and depression. 

Greater improvements were seen in patients who were actively seeking medical cannabis to treat these particular conditions. 

Furthermore, according to the study, the symptom improvements seen were sustained for at least one year.

Building the evidence

The survey is thought to be the largest to date, exploring the effects of medicinal cannabis on anxiety and depression.

Findings from the UK also indicate that patients are finding it helpful for symptoms of these conditions.

The UK Patient Registry, which now includes data from around 2,000 patients, showed statistically significant improvements in anxiety, pain and sleep quality scores following treatment with medical cannabis.

Meanwhile data from the observational study, Project Twenty21, shows cannabis may be more effective at improving mood during the first three months of treatment, than some commonly prescribed antidepressants.

The authors concluded: “To our knowledge, this study is the largest completed to date examining the impact of medical cannabis use on anxiety and depression outcomes utilising longitudinal data and validated questionnaires.

“It provides evidence on the effectiveness of medical cannabis as a treatment for anxiety and depression that otherwise is not currently available, demonstrating that patients who seek treatment with medical cannabis for anxiety and depression can experience clinically significant improvements.”

They added: “This study offers reasonable justification for the completion of large clinical trials to further the understanding of medical cannabis as a treatment for anxiety and depression.”

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The most common reasons Australians are being prescribed medical cannabis

Medical cannabis has been prescribed over 140 conditions since 2016

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The most common reasons cannabis is being prescribed in Australia
248,000 prescriptions have been approved for Australians since 2016

New data from Australia, shows cannabis has been prescribed over 140 conditions since 2016, with anxiety among the most common.

The first in-depth study of Australia’s medicinal cannabis programme, shows the treatment has been prescribed for over 140 different conditions since it began in 2016. 

In total, 248,000 prescriptions have been approved for Australians since the inception of the scheme. 

Researchers at the University of Sydney’s Lambert Initiative for Cannabinoid Therapeutics, analysed data from the Therapeutic Goods Association’s (TGA) medical cannabis dataset  – Australia’s Special Access Scheme B – which is the only one of its kind in the world. 

No other country has monitored prescriptions in this way since launching their own medical cannabis programmes.

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The study found anxiety was among the top three reasons for patients being prescribed cannabis, the other two being pain and sleep disorders.

This reflects similar patterns in the UK, where chronic pain and anxiety are the most frequently prescribed for conditions, according to data from Project Twenty21. 

The team also found that the number of medicinal cannabis prescriptions have increased significantly since 2020 – over 85 percent of total prescriptions to date have been given since January 2020. They are currently unable to say whether the rise was pandemic related.

Lack of clinical evidence 

However, the researchers have warned that there is a limited number of high-quality clinical trials investigating the drug’s efficacy for these conditions.

Senior author Dr Elizabeth Cairns said the current evidence base for medicinal cannabis for anxiety is limited to only a few studies investigating CBD-dominant products, rather than THC-containing products

“Historically, the effects of THC have been described as anxiety-inducing, although this may depend on dose size and other factors.”

The evidence of effectiveness for medicinal cannabis in the treatment of pain is controversial, at least in Australia, where the Australian Faculty of Pain Medicine suggests not to prescribe medicinal cannabis for this purpose. Very few studies have also been done examining cannabis for the treatment of sleep disorders.

Study co-author and medicinal cannabis prescriber in her capacity as a GP, Associate Professor Vicki Kotsirilos AM from Western Sydney University, says the top reasons for prescriptions didn’t surprise her.

“Pain, anxiety and sleep issues are often interconnected – chronic pain can also cause mental health and sleep issues,” she says. 

Associate Professor Kotsirilos, who prescribes medical cannabis for pain, says this should only be done as a last resort, after more evidence based behavioural and drug therapies, such as counselling, exercise and deep breathing for pain, anxiety and/or sleep disorders, have failed or are of limited clinical benefit. 

Other interesting findings

The size of the dataset allowed the researchers to find prescribing patterns in small, but significant, populations that otherwise might have been overlooked.

“Apart from the link between anxiety and flower products, we found other interesting associations, for example, prescriptions of topical CBD for convulsions,” Dr Cairns said.

“This usage has not been extensively explored.”

The authors note, however, that the data doesn’t include patient outcomes.

Dr Cairns said: “Unfortunately, we just don’t know if these treatments were effective for these patients, but this data highlights where we can focus our attention next – to do focused studies and/or clinical trials.”

“There is a clear, unmet need for effective drug treatments across a variety of conditions that may be being helped with medicinal cannabis. For example, it could be worth conducting high-quality clinical trials on the use of flower products for anxiety, and that is certainly something that the Lambert Initiative and its collaborators may look to do in future.”

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Medical cannabis and neurodivergence – “It helps me tune in to sensory experiences”

Justin Clarke shares how cannabis has helped him find the freedom to enjoy life.

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Medical cannabis and neurodivergence - "It helps tune in to sensory experiences"
Justin says cannabis helps him enjoy sensory experiences such as eating or listening to music.

My quality of life has improved significantly since starting to use medical cannabis, writes Justin Clarke, who is neurodivergent, in that he is autistic and has ADHD.

I consider both my being autistic and ADHD to be linked – this is because both significantly impact my sensory processing. I consider them to be ways to describe differences in the way my mind works to the perceived norm. 

I suffer in terms of mental health from anxiety and depression and I am working through complex trauma in therapy. I attribute many of my mental health struggles to the challenges of living as a neurodivergent person in a world that is frequently invalidating and rarely tries to understand or accommodate without a fight.

I’m now 33, and was officially diagnosed as autistic during my last semester at university at the age of 22, and as being ADHD (Combined Type) just two years ago.

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Autism is a lifelong neurodevelopmental difference, which affects how people communicate and interact, as well as emotional and sensory processing – amongst many other things. 

Autism tends to be described as being like a spectrum and it can affect people in many different ways. I view it as a spectrum of varying colours and shades, with a lot of complexity to it, rather than as a straight line that goes from ‘mild’ to ‘severe’. Things aren’t that simple at all.

Functioning labels such as ‘high functioning’ and ‘low functioning’ are losing favour in recent times, as we begin to recognise and accept that one’s level of “functioning” is not static and can vary significantly from day to day depending on how it is defined and by whom.

I describe the sensory overwhelm I often experience as being like having all of my senses with the sliders turned up on a figurative stereo equaliser, with no ability to turn them down. 

Cannabis makes them easier to control and process.

Meanwhile, ADHD is a neurodivergence that can involve impulsive behaviours and unusual levels of hyperactivity as well as difficulties with motivation and attention span. 

As with autism it is usually diagnosed in childhood and the way it affects people can vary significantly. There are commonly described to be three types; ‘Inattentive’, and ‘Impulsive’, and ‘Combined’.

Justin Clarke, 33.

Discovering cannabis

I was first prescribed medical cannabis for anxiety following the establishment of Project Twenty21 by Drug Science in 2020. 

Anxiety has been a frequent visitor and presenter of challenges to me as a neurodivergent person living in a world designed for the fabled ‘default human’ or neurotypical. 

Sensory and social anxiety are the main forms of anxiety that I find cannabis to be helpful for – the way it helps with these mainly is by allowing me to better filter and modulate my senses.

I am more socially relaxed and can better participate in conversation when I am not experiencing sensory overwhelm. I don’t get overloaded so quickly by lots of sensory info of different kinds coming in at once.

I can better ‘tune in’ to sensory experiences such as eating food and listening to music. I can enjoy these things without cannabis but it helps me to better immerse myself in them and the experience.

With my sensory processing figuratively eased by cannabis, I also find that executive functioning-related challenges such as staying focused and motivated on tasks to become more achievable.

Social situations

My quality of life has improved significantly since starting to use medical cannabis.

Another thing I find cannabis helpful for is social situations and being around people like in crowded places such as music gigs. This again is mainly because of how it enables me to better tolerate sensory discomfort and anxiety. With it’s help I am able to feel more relaxed in crowds and in unfamiliar social situations.

I am also working through some emotional trauma in therapy and have found cannabis to be helpful in enabling me to talk more openly, as well alleviating some of the trauma-related anxiety that has sometimes resulted from my sessions.

A gentler medication 

From 2014 to 2018, I was prescribed sertraline, an antidepressant that belongs to a group of drugs called selective serotonin reuptake inhibitors. I would describe it as having been very emotionally numbing most of the time, although it was helpful in some ways.

Using cannabis for my anxiety and depression has enabled far better quality of life compared with sertraline in hindsight. It has especially been helpful in topically alleviating anhedonia – the loss of the ability to enjoy things.

I’ve also taken prescribed amphetamines to cope with ADHD which have been useful at times depending on the situation, but they kill my appetite and disturb my sleep, so I tend to use cannabis alongside them to calm down and stimulate my appetite.

Both help my concentration and motivation in different ways, however cannabis is far gentler.

Amphetamines are like an on switch, whereas cannabis gives me the freedom to choose to tune in to what I’m doing and often tends to induce a state of calm inquisitiveness in me.

More often than not, I’ve been able to entirely replace my use of amphetamines with medical cannabis. Unfortunately with it only available privately it is significantly more expensive which means replacing the NHS-prescribed stimulants with them entirely isn’t yet really an option.

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