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CBD isn’t a cure-all or a magic fix, but it might help make things a little more bearable if you’re struggling with anxiety right now.
If you are feeling anxious or on edge about everything going on in the world at the moment, you’re not alone.
CBD isn’t going to magically fix everything, and we’re not here to profess that it will, but it might be a helpful tool to have to hand when it all feels too much.
We’ve put together a definitive guide for anyone thinking about trying CBD to help with their anxiety.
What actually is anxiety?
Anxiety is one of the most common mental health conditions in the UK and it can have debilitating effects on a person’s daily life. It’s a natural reaction to stress that creates fear or an apprehensive feeling about what could go wrong. While anxiety can happen to everyone from time to time, some people struggle more than others.
There are many different forms of anxiety including generalised anxiety disorder (GAD), social anxiety disorder (SAD), panic attacks or post-traumatic stress disorder (PTSD).
Each form of anxiety may have different symptoms but the most common include restlessness, a feeling of dread, difficulty concentrating and irritability. When it comes to panic attacks, a person may feel a sudden increase in cortisol and epinephrine which cause a fight or flight response. PTSD may cause nightmares, flashbacks or feelings of isolation.
People struggling with anxiety may remove themselves from situations where they feel these emotions the most such as social situations or work. It may 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.
How does CBD work?
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).
CBD may work differently for different types of anxiety. SAD is a social disorder where people can feel panic at the thought of social settings or speaking to groups of people.
A study on CBD for patients with SAD found that it may help to reduce symptoms. Participants in this study were given 400mg of CBD or a placebo before being given questionnaires and undergoing functional neuro-imaging to record the differences. The researchers reported that those in the group given the CBD recorded lower levels of anxiety.
Anxiety can also often make it difficult for people to fall asleep, with CBD potentially 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.
Post-traumatic stress disorder (PTSD) can develop after exposure to a traumatic event. This may be different for everyone but the journal, Frontiers in Neuroscience estimates that 10 per cent of the population will develop PTSD in their lifetime. The symptoms can be debilitating, affecting a person’s sleep, wellbeing and relationships.
Some studies show CBD may be effective if taken immediately after the person experiences trauma. It is thought that CBD may make it more difficult for the brain to form negative or frightening memories. The potential of CBD to help PTSD is why many veterans take CBD or cannabis to help their symptoms.
Panic attacks can be another symptom of anxiety. They are a reaction by the body to extremely stressful situations or fear. They can cause a person to experience a racing heartbeat, feeling faint, increased sweating, nausea, ringing in the ears, dry mouth or numbness. Those experiencing panic attacks may avoid situations for fear it may trigger another attack.
There is a desperate need for more studies on humans who experience panic attacks as many existing studies are on animal subjects. One such study from 2012 measured the ‘fight or flight’ reaction of mice who were given CBD then exposed to predators. They reported that the CBD had a potentially anti-adverse effect where the mice were less inclined to attempt escaping.
The escape behaviour mirrored the symptoms of human panic attacks, which suggested that CBD may be helpful.
What is the best CBD for anxiety?
There isn’t one particular product that works on just anxiety. As each person is an individual, different factors may affect how CBD works such as height, weight or metabolism.
The different types of anxiety may mean different methods of CBD work better than others. If someone is experiencing a panic attack, they may prefer to have a faster acting way of absorbing CBD such as oils or vaping. If a person is using CBD for PTSD then they may prefer to take CBD at night to aid in falling asleep. Anxiety experienced throughout the day such as GAD may respond to continuous doses throughout the day. Patches may be a great option for someone who needs a steady amount.
It is worth doing your research when it comes to selecting what CBD you want to take, what brand to buy and when is the best time to take it. Some brands may offer CBD tailored for particular symptoms associated with anxiety conditions.
Terpenes are another consideration as they can offer an extra bit of anxiety relief. Terpenes are the compound found in plants that causes their smell such as limonene in citrus fruits. Some CBD brands have begun to add different terpenes to particular blends aimed at relaxation or sleep. The most notable would be linalool in lavender, pinene in pine needles and myrcene in hops.
After starting CBD for anxiety, you may notice increased effects over time. This is where the saying ‘start low, go slow’ comes from. If you start with a lower percentage, you can build up slowly over time. While some effects can be seen faster than others, CBD works best when it is taken consistently over longer periods of time.
One of the best ways to notice the difference in your anxiety is to record your CBD journey. This means noting down any decreases in your panic attacks, changes to your sleep pattern or even, increased feelings of calm or restfulness.
It can help you to identify when it’s time to change the brand, method or even increase the dose but more than anything, it can be reassuring to see the differences and know that it’s working.
Always talk to your GP before making any changes to your medical care.
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
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.
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.”
The most common reasons Australians are being prescribed medical cannabis
Medical cannabis has been prescribed over 140 conditions 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.
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.”
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.
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.
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’.
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.
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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