Anxiety occurs on a spectrum. In some forms it is relatively mild; in others, it makes life feel almost unbearable. Finding the right solution for your particular level of anxiety can be a challenge — the “Goldilocks zone” is elusive, and it varies from person to person. However, a growing body of research suggests that CBD may be a versatile way to treat for many different types (and severities) of the condition.
The most severe types of anxiety are known as anxiety disorders, which are a major problem throughout the world. By some estimates (Dialogues in Clinical Neuroscience), approximately one-third of people will experience an anxiety disorder over the course of their lifetimes. These disorders affect people from all walks of life, regardless of race, gender, socioeconomic status, or even age. A study published in the Journal of Developmental & Behavioral Pediatrics last year found that as many as 2.6 million children and adolescents in the United States were suffering from at least one anxiety disorder in 2011-12.
However, anxiety by itself is not a disorder. “As unpleasant as it can be, anxiety is typically a natural response to environmental stresses,” Dr. Samoon Ahmad of the Integrative Center for Wellness said. Dr. Ahmad, who is also a unit chief of inpatient psychiatric care at Bellevue Hospital in New York City, elaborated: “Anxiety heightens our senses when we feel we are in danger, often awakening the primal urge of what is known as the ‘fight or flight’ mechanism.” This does not only arise when one is in a life-threatening situation, of course. “It can also arise because of an uncomfortable social situation or when we anticipate having to be in an uncomfortable social situation,” he added.
Anxiety disorders are different. Those who suffer from such disorders feel the discomfort of anxiety, but they either experience discomfort at elevated levels that are considered beyond normal given the circumstances (separation anxiety, for example), or they find it difficult to pinpoint a specific cause for their anxiety. In the latter case, there is just an ominous presence that stubbornly refuses to go away.
The unrelenting sensation of impending danger is more than just distressing. It can also have significant impacts on a person’s life. “Those with even mild phobias, for example, may develop social inhibitions or become extremely withdrawn, which can adversely affect their academic performance or career. Those with more severe social phobias, such as agoraphobia, may find it impossible to even leave their homes,” Dr. Samoon said.
Other studies have found that anxiety disorders are associated with increased “suicidality” and chronic unemployment (particularly with men), and that anxiety disorders can often feed a cycle of alcohol abuse.
Anxiety disorders can be triggered by a variety of genetic, biological, or environmental influences. Researchers have found many factors that contribute to symptoms of anxiety — or that correlate strongly with the increased prevalence rates — but they are still striving to understand the exact physiological mechanisms that cause anxiety disorders in the first place. The neural circuitry responsible for alarm reactions (i.e. fight or flight responses) is a vast, complicated web, and there does not seem to be a gene directly responsible for the development of anxiety disorders. Similarly, there does not there appear to be an anxiety gene (though research strongly suggests that anxiety disorders are passed down genetically).
Just as there is no one physiological culprit for anxiety disorders, there does not appear to be just one environmental factor, either. A study published in the British Medical Journal, for example, found that significantly higher rates of anxiety symptoms correlated with increased exposure to certain forms of air pollution. Meanwhile, at least one study, reported in Smithsonian Mag, has found that diet and the health of one’s gut biome can play a role in many anxiety disorders — specifically, that increasing the amount of fermented vegetablesone eats could ease some symptoms of anxiety disorders.
While there is a significant body of evidence showing that a healthy gut is beneficial to one’s overall health, far more research needs to be conducted before it’s safe to conclude that anxiety can be allayed by snacking on pickles and sauerkraut.
Pickles may not be the only alternative medicine that can help with anxiety — medical cannabis may be able to treat it, as well.
At first glance, this may seem counterintuitive. Some of the most common negative side effects of cannabis use are paranoia and extreme levels of anxiety. Furthermore, there is no shortage of stories about the dangers of biting off more than one can chew floating around on the internet — the experience of the New York Times’ Maureen Dowd being perhaps the most infamous.
However, this one-dimensional understanding of cannabis oversimplifies things. There are hundreds of compounds found within cannabis plants. Some of these compounds are known as cannabinoids. The most prevalent cannabinoids are tetrahydrocannabinol (THC) and cannabidiol (CBD). Both have been shown to have therapeutic qualities, but only THC produces an intoxicating effect for those who consume it. On top of producing the high for which cannabis is known, strains of cannabis that are high in THC have been known to cause anxiety and paranoia.
CBD, on the other hand, is non-intoxicating and its use is not associated with a heightened sense of anxiety. In fact, studies have shown that CBD — on top of being an effective analgesic and anti-epileptic — can mitigate THC-induced anxiety and help with some anxiety disorders. A medical review on the subject from 2015 noted, “Current evidence indicates CBD has considerable potential as a treatment for multiple anxiety disorders, with need for further study of chronic and therapeutic effects in relevant clinical populations.”
Yet another review, this one from 2017 and published in Neuropsychopharmacology, also said that CBD holds promise as a treatment for anxiety disorders. However, the supporting evidence that would come from a robust set of clinical trials is wanting.
Like so many aspects of cannabis, researchers are unwilling to make definitive claims about its efficacy because there simply isn’t enough evidence. We are only now emerging from the proverbial dark as the restrictions that have historically impeded cannabis research are starting to be lifted.
However, two clinical trials show that CBD can reduce symptoms of anxiety. In one, subjects with generalized social anxiety disorder were given either a 600 mg dose of CBD or a placebo. They were then asked to rate their anxiety using a 100-point scale. Those who took the CBD reported declines in feelings of anxiety (16.52 points), while those who took the placebo reported almost no change in their level of anxiety.
The other clinical trial, which was published in January 2019, used a significantly smaller dosage of CBD (either 25 mg or 75 mg per day for all subjects except for one who was given 175 mg per day). Subjects in this trial also reported significant improvements in anxiety levels. After one month, 79.2 percent of subjects reported that their anxiety had become less severe. After two months, the results were relatively the same: 78.1 percent of subjects reported improvements in their conditions. While the doctors who conducted the trial noted the limitations of their study and cautioned against jumping to conclusions about CBD’s potential as an anti-anxiety treatment, they concluded that, “CBD displays promise as a tool for reducing anxiety.”
Though more evidence is needed to definitively prove that CBD or other cannabis products are a medical treatment that can reduce symptoms of anxiety, anecdotal evidence and clinical trials clearly indicate that many patients have found relief by using CBD oil for anxiety. It is likely that additional evidence will continue to emerge to buttress these claims.
Before using any kind of medication, however, you should first consult with a medical professional to ensure proper dosage and to avoid any possibility of the CBD interacting poorly with other medications you may be taking.