If you’re anything like me, the world sure can get you down. A stable middle-class lifestyle with a pension seems impossible for many people. Even the very idea of retirement is starting to seem like a quaint relic of the past. Homelessness and child hunger loom large, with 1 in 6 children in the United States suffering food insecurity. In the United States, there is so much political dysfunction that the two parties regularly resort to threats of government shutdown, with one such shutdown likely looming as of the writing of this article. The young people who will graduate high school this year (2018) were babies when the September 11th terrorist attacks took place, which means there will never again be children in this world who have known what it was like to live in a world without mass surveillance or even the ability to accompany a friend or family member all the way to the airport terminal. The war on terror has claimed over a million lives, and wars in Iraq, Afghanistan, and Syria rage on destroying homes and displacing people, without much of a chance of peace in sight. And climate change will likely displace millions more, disproportionately affecting poor countries.
Our personal relationship with all this news, none of which seems good, is deeply affected by the fact that because our smartphones and other devices are virtually always within arm’s reach. Many of us constantly check and recheck our Twitter, Facebook, Instagram, and Snapchat feeds. We never seem to be able to escape news about the latest world crisis–and now we’re told a lot of our news is fake anyway. With such dire, seemingly unsolvable problems, it’s little wonder so many people are being diagnosed with anxiety, depression, bipolar, and other mood disorders.
Anxiety and depression are mood disorders that affect a significant portion of the world population. Because they are mental illnesses and there are all kinds of stigmas and taboos surrounding mental illnesses in our society, misunderstandings and misinformation abound. The purpose of this article is to clear up some of this misinformation. I will explain anxiety and depression and the relationship between them, then discuss treatment options, including a number of promising studies that are encouraging for patients and advocates who, like me, are open to medical cannabis or cannabis-derived medicine like CBD.
What are mood disorders? Mood disorders are distinct from other mental illnesses but are often present in people who have other mental and physical illnesses. They are caused by a mixture of hereditary and environmental factors and include the following:
Major depressive disorder (MDD), with 20% of the U.S. adult population reporting at least one symptom of depression each month.
Persistent depressive disorder (PDD, also known as dysthymia), a milder form of depression that tends to stick around for long stretches of time.
Seasonal affective disorder (SAD), also known as seasonal depression.
Bipolar disorder (mood swings between depression and mania–euphoria or irrational overconfidence), with 1% of the U.S. population diagnosed but possibly many more living with it undiagnosed because the mania symptoms are often not recognized and therefore not included in diagnosis or treatment.
Cyclothymia: A Milder Form of Bipolar
Anxiety and depression seem to be on the rise among young people. People of color and women are more likely to be diagnosed with depression. With such significant swaths of our population dealing with these problems, it’s worth learning as much as possible about these diseases. You may even save a life.
Anxiety is extreme fear, worry, and nervousness. While it’s normal to feel nervous in certain situations, you may have anxiety if you feel nervous a lot of the time or if you feel nervous about things people don’t normally feel nervous about. Many people who have anxiety are perfectionists and will overdo straightforward tasks such as home chores or assignments for school or work.
A common form is social anxiety disorder. It is important to note that social anxiety disorder is very different from ordinary shyness. People with social anxiety disorder are debilitatingly terrified of embarrassing themselves in social interactions. They worry about being judged or being seen as awkward or boring. Many feel they cannot face their fears and avoid going out altogether. The disorder can have physical symptoms including a high heart rate, nausea, and sweating.
Another common form of anxiety is generalized anxiety disorder (GAD), which affects 3.1% of the U.S. adult population. If you find it difficult to control your feelings of worry more than half the time for six months and you have three or more of the following symptoms, seek help from a counselor or doctor:
Anxiety can be unpredictable and can cause a panic attack, like in panic disorder, another form of anxiety. If you have anxiety, your doctor may refer you to psychological counseling which may include therapies such as cognitive behavioral therapy or dialectical behavioral therapy. These therapies have proven effective for many people with anxiety, depression, and other mental illnesses. A doctor or psychiatrist may prescribe anti-anxiety medicine. Always be open and honest with your doctor and follow his or her advice.
Depression is very common. Odds are, you know someone who struggles with a mood disorder. Your favorite celebrities may have depression. I know a lot of my favorite writers struggled with depression their whole lives, and some of them tragically cut their lives short because of it. I have family members with severe mood disorders, and at one point in college, all three of my roommates were taking antidepressants. So you’re certainly not alone. If you’ve been feeling sad and having negative thoughts for over two weeks, go to the doctor. Many people worry that if they talk to their doctor about depression, they will be prescribed unnecessary medications. While you can always get a second opinion if you feel antidepressants are unnecessary for you, what is sometimes misunderstood is that antidepressants such as SSRIs have been shown again and again to be effective in the overwhelming majority of cases.
Some people worry that if they talk about mood disorders with their doctors, their bosses or coworkers will find out. But medical practitioners take confidentiality very seriously, meaning it would be a serious breach of ethics for them to tell anyone about your issues. Furthermore, if your employer did punish you or lay you off because of a mental illness diagnosis, your employer could be guilty of discrimination and would face serious legal ramifications.
Depression and anxiety can mix in what feels like an unholy amalgam of worry, angst, sadness, negative thoughts, fatigue, self-loathing, and every other nasty feeling imaginable. The two diseases tend to feed off of each other, with anxiety making you depressed and depression making you anxious. But there is hope. CBT, DBT, and other forms of psychotherapy, combined with antidepressants and antianxiety medicine, are immensely helpful in many cases of anxiety/depression. These therapies may lead you to challenge your way of thinking about happiness. Your therapist may help you challenge your depressing and anxious thoughts by confronting them head-on. Or you may thoughtfully create personalized coping strategies that involve meditation, deep breathing, yoga, or even hyperfixation.
And many patients have reported relief of symptoms and improved mood resulting from cannabis-derived treatments such as cannabidiol (CBD) oil, cannabis vape oil, or edibles. If you live in a state where medical marijuana is legal and other treatments have not worked for you, consider asking your doctor about cannabis. The human endocannabinoid system, which interacts with the substances found in marijuana, is emerging as a key player in the treatment of many illnesses including depression and anxiety, and a preliminary review demonstrates that anxiety has been successfully treated using CBD. The “runner’s high” or euphoria from physical activity is actually caused at least in part by the endocannabinoid system being triggered, and phytocannabinoids (substances such as CBD and THC) can have the same effect. In one 2011 study, people with social anxiety who took CBD oil felt less anxious in a public speaking activity than those who did not take CBD.
So while you or I may not be able to solve the world’s problems today, we do have resources to get ourselves healthy enough to approach the issues we care about. In the long run, not even our misguided attorney general can do much to stop the body of evidence in favor of medical marijuana from continuing to grow. Don’t forget: the otherwise generally anti-marijuana National Institute on Drug Abuse admits that medical marijuana may be useful for a number of diseases and predicts that more cannabis-based treatments may be approved in the future. I believe these treatments will help countless people with all kinds of ailments including children, elderly people, and their families and carers. With that optimistic thought in mind, join me in letting 2018 be a great year for mental health. Whatever our struggles, let’s help each other heal and create the best world we can.