What You Need to Know About PTSD and Cannabis

PTSD and what you need to know about cannabis treatment

Image Credit: By wickerwood on Shutterstock

We all will experience trauma to some degree at some point in our lives. It doesn’t mean we have go through combat or be a victim of assault to have it deeply affect us. To experience something traumatic simply means that something shocking and frightening has happened, and your mind needs some time to get over the experience. With most people, coping with trauma is something that can be naturally done in a timely manner without disrupting their lives in an in a long-term way. However, with post-traumatic stress disorder (PTSD), the mind may have a harder time coping with the trauma experienced. Trauma of any kind can be a mountain to get over for anyone. It’s when your mind simply refuses to go near the proverbial mountain that you could have a problem. Those with PTSD often avoid situations that will remind them in any way of the trauma they went through. Even thinking about the event could put the person in a panic. Often times, with PTSD, the mind has a hard time combating feelings of fear when in situations that may bring back memories of the event. This disorder can be debilitating, and life-changing in a lot of ways. Seeking treatment for PTSD is essential for managing the disorder. There are a variety of treatments out there for PTSD. Most are therapy based treatments, however, per the request of veterans of war, many states have approved cannabis as a treatment for PTSD, opening up yet another avenue for relief. If given the chance, cannabis could be one of the safest and most effective treatments for PTSD.

Trauma and Post Traumatic Stress

While trauma and PTSD go together, they have a few important differences. Experiencing trauma does not necessarily mean that you will develop PTSD, or that a more severe traumatic experience will trigger PTSD. PTSD doesn’t have to even originate from a life-threatening or dangerous event. It could even develop from witnessing a traumatic event or having a friend or family member die. The difference is the severity of the symptoms and the length of time in which they last. When someone experiences trauma, they will often have the normal side effects of bad dreams or anxiety. It’s hard to get a shocking experience out of your head. However, if these symptoms persist without getting better, there is a likelihood that you could have PTSD.

Varying events can cause PTSD, however, some common causes include:

  • Car accidents
  • Violent assaults such as sexual assault or robbery
  • Ongoing sexual abuse, violence or neglect
  • Witnessing a death
  • Military combat
  • Natural disasters
  • Unexpected severe injury or death of a loved one
  • Being diagnosed with a serious illness such as Multiple Sclerosis

The most common traumas that cause PTSD for women are physical assault and rape. For men, military combat is the most common stressor. These events don’t necessarily mean that you will develop PTSD. Your response to trauma is different depending on who you are and how your mind copes with stress. PTSD isn’t the only mental disorder that could develop after trauma. Acute stress disorder is also associated with going through a traumatic event. This term is used when symptoms develop within the first month of the trauma. After this time the term PTSD with delayed onset is used.

Though it’s not completely clear why some people are more susceptible to developing PTSD, a few factors could be:

  • Genetics
  • Personality and temperament
  • Lifetime experience of other traumas
  • Current support system (having loved ones around for support)
  • If you’ve had depression or anxiety in the past

Young adults are the most susceptible to developing PTSD. This could have to do with the fact that they are exposed to more situations that may cause PTSD. Also, those who are poor, unmarried and are not socially active are at a higher risk for developing PTSD. This could be due to having a weaker support system to help them cope with their trauma.

Other mental disorders such as anxiety and depression may encourage PTSD, and at the same time, PTSD can encourage other mental health problems as well. These issues include:

  • Drug addictions and alcoholism
  • Eating disorders
  • Suicidal thoughts or attempts
  • Anxiety
  • Depression

A natural reaction to trauma can be mistaken for PTSD, however, the differences lie in the symptoms and the length of time they last.

How Do You Know If You Have PTSD?

Symptoms of post traumatic stress disorder could show up within a month of the trauma happening, or could not appear until years after the event. Symptoms can be severe and cause problems in work and social situations. They can also keep you from doing day to day activities, making you a slave to the disorder. Symptoms are not always the same with everyone, but they generally include four types:

Intrusive memories: Memories of the event could creep in when you simply don’t want to remember them. Having flashbacks of the event can also cause you to relive it over and over again. These memories can also lead to nightmares or disturbing dreams. Even extreme emotional distress or physical reactions (such as lashing out) could occur if something reminds you of the event. This reminder could be something as mild as a news broadcast or hearing a certain song on the radio.

Avoidance: Thinking about the trauma we’ve been through isn’t exactly a day at the park, but most of us do it and eventually get used our memories being there. They simply become part of us. With PTSD, avoiding anything that could remind them of the event becomes a habit. Certain places, people, and activities may be completely avoided for fear of reminding them of the event. This may go so far as avoiding even thinking or talking about what happened.

Negative changes in thinking and altered mood: Having PTSD could mean allowing the event to take over not just what you do, but who you are as a person. You could be a positive person, normally, but begin to change into someone who just can’t seem to be happy. This could mean looking at others and yourself in a more negative way. It could mean seeing the world as a darker place, rather than beautiful and full of opportunities. Relationships may be neglected and a feeling of detachment from friends and family can slowly take over. Not only may you lose interest in the people around you, but you may stop desiring to do activities that you once enjoyed.

Changes in how you react to certain things: When a traumatic event takes over in the form of PTSD, it literally seems to become your life. This could mean that you are always on guard for it to happen again. You could be easily startled or frightened and have trouble sleeping and concentrating. Depending on what the event is, you may feel overwhelming guilt. Many soldiers who are suffering from PTSD will suffer from survivors guilt, where they feel ashamed or guilty for being the one who survived as opposed to the others who didn’t make it home. Irritability and angry outbursts are common as well. Aggressive behavior that is uncharacteristic is something to look out for when you feel as if you may have PTSD. Being careful not to hurt yourself or others is important.

The intensity of these symptoms can vary over time. In particularly stressful times, you may have a harder time dealing with PTSD. Being able to control your everyday stress can help you to cope with reminders of the traumatic event.

If you feel like your symptoms are overwhelming and have been you have experienced them for over a month, it’s a good idea to see a doctor as soon as possible. The sooner the disorder is addressed, the sooner you can learn how to treat it and get your life back. Treatments vary from person to person, but your doctors can help you determine what treatments are right for you.

What Are Common Treatments For PTSD?

Talking with your doctors can help you to address whether or not you have PTSD. Seeking help is crucial when dealing with these symptoms, as treatment can help you get back on track and feeling better. During your appointment, your doctors will most likely do a few different things. A physical exam is necessary to rule out whether your symptoms may be caused by any underlying medical problems. A psychological evaluation can help your doctor to better understand when the symptoms started and the trauma that led up to them. This may include talking about the event, which is extremely difficult for PTSD sufferers. However, the more your doctor knows about your situation the more he or she can help you overcome it. By using the Diagnostic and Statistical Manual of Mental Health Disorders (DSM-5) he or she can better diagnose your illness.

Once your doctor determines that you have PTSD, treatment options will most likely be discussed.

The most common treatment for PTSD is psychotherapy. However, medications may be taken along with this therapy. These treatments can help you by:

  • Helping you to gain confidence in yourself and others
  • Teaching you ways to better cope with your symptoms
  • Learning skills to better identify and deal with your symptoms
  • Identifying and treating other problems that may be present such as drug and alcohol abuse, depression or anxiety
  • Helping you to create a support system so that you don’t have to deal with your symptoms alone

There are several types of psychotherapy that you and your doctor may consider. Some the therapies include:

  • Cognitive therapy: Thoughts of self-doubt and blame will oftentimes muddle the truth. You may also feel as if the world is dangerous, which can hold you back from doing many of the things you enjoy. This therapy teaches you how to deal with these thoughts productively. Your therapist can help you to examine whether or not there is a basis for these thoughts, or if they are just fears. From here you can decide how to act or not act on these feelings. This treatment isn’t easy, as talking about the traumatic events can be painful. The long-term benefits, however, will make up for the brief discomfort. The actual therapy typically lasts around 3 months and is composed of 60-90 minute sessions.
  • Exposure therapy: This therapy is used to help with phobias as well as PTSD. It is designed to help a patient face his or her fears, and gain control over them. This must be done delicately as to not re-traumatize the patient. In some cases, a doctor may decide that the patient would benefit in facing these fears all at once. In other cases, it must be taken in steps. This is never done by force, and a good therapist will make sure that their patient is comfortable with all therapy techniques. Self-treating is not recommended for this type of treatment as there is potential for more harm to be done. A professional therapist is needed to properly administer exposure therapy.
  • Eye movement desensitization and reprocessing (EMDR): This is a fairly new therapy that is gaining popularity with those who have PTSD. This differs from other therapies as there is no talk or medications involved. With this therapy the therapist instead uses the patient’s rapid, rhythmic eye movements to lessen the effect of past traumatic memories. These sessions typically last around 90 minutes. In the session the therapist will move his or her fingers in a back and forth motion in front of your face. While the therapist is doing this he or she will have you remember the traumatic event, including how you were feeling at the time. After this the therapist will tell you to begin to move your thoughts to more positive memories. At times these sessions may also include music or tapping. Before beginning therapy the therapist will ask you to rate your distress and will do the same after the therapy session is over. This is a way for the therapist to establish a baseline of distress to know whether the therapy is working.

Therapy is often couple with medications to help manage symptoms. Common medications for PTSD include:

  • Anti-anxiety medications: These drugs can help to manage anxiety. However, it is important to note that some medications for anxiety have a high risk for abuse; so, often these drugs are used only for a short time and with caution.
  • Antidepressants: These drugs can help with depression and anxiety, but also may help with sleep. Zoloft and Paxil are two serotonin reuptake inhibitors that have been approved by the FDA to treat PTSD.
  • Prazosin: This drug is often prescribed for treating insomnia and nightmares. It hasn’t been approved by the FDA to treat PTSD, but it may help with sleep problems in those with post traumatic stress disorder.

Finding a treatment that is right for you can help you take control of your life. However, oftentimes psychotherapies can be hard in the beginning and may take a bit of gritting your teeth to get through. This is why many choose to couple those therapies with medications as well. The downside is that these medications can come with side effects that just replace PTSD symptoms with other problematic effects. Anti-anxiety drugs such as benzodiazepines are highly addictive and typically lose their therapeutic effects after 4 to 6 months of use. This means that you could become dependent on a medication that only helps temporarily. In many cases coming off of these anti-anxiety medications can include some serious withdrawal symptoms. To make it worse, once off the medications many times patients will have rebounding anxiety that can be worse than it was before.

Antidepressants also have a long list of potential side effects that include:

  • Suicidal behavior
  • Heart disorders
  • Birth defects
  • Liver problems
  • Aggression
  • Hallucinations
  • Seizures
  • Withdrawal reactions
  • High or low blood pressure

This is just to name a few possible effects. But if some patients need a little boost when starting therapy, what is the alternative to potentially dangerous pharmaceuticals?

The answer many may lie in the cannabis plant.

Could Cannabis Be A Viable Treatment Option?

Understanding how our body reacts to ingesting cannabis is important when studying its medicinal effects.

When marijuana enters the body’s bloodstream, the plant cannabinoids travel into the body and brain, affecting certain functions. These cannabinoids work within a system of cell receptors called the endocannabinoid system. The two main cannabinoids that have been found to have medicinal properties are tetrahydrocannabinol (THC) and cannabidiol (CBD). THC is the most popular of these cannabinoids as it gets a bad boy reputation from its psychotropic effects. When THC enters the brain it binds with CB1 receptors in the endocannabinoid system, which can produce varying results. Some of these effects can include paranoia, memory loss, heightened mood, increased appetite and in many cases pain relief. CBD has a much gentler approach. Unlike THC, cannabidiol does not have these same psychotropic effects. When CBD enters the brain, it does not actually bind to the CB1 receptors as THC does. CBD does, however, interact with the CB1 receptors by helping to prevent other cannabinoids such a THC from binding to them. Some research shows that because of this, CBD can help reduce the negative psychoactive effects of THC such as paranoia and anxiety. Not only can CBD not get you high, it can also help with existing neurological problems. Cannabidiol interacts with the CB1 receptors, but can also work with other neurotransmitters as well. CBD can directly activate 5-HT1A, which is a serotonin receptor. Lack of serotonin is often linked to anxiety disorders, which means that using CBD can lead to anti-anxiety effects. Serotonin is a G-coupled protein that helps neurological issues such as pain perception, anxiety, addiction, sleep and nausea.

When those suffering from PTSD are prescribed serotonin reuptake inhibitors the goal is the same: to up serotonin levels. The difference between these drugs and CBD is that there is much less risk involved with taking CBD. The health hazard with taking CBD oil simply pale in comparison to antidepressants. The few side effects of CBD that have been reported are dry mouth, lightheadedness, low blood pressure and drowsiness, which are extremely mild compared to that of antidepressant pharmaceuticals.

This makes the investigation into cannabis as treatment to PTSD sufferers, that much more tempting. So far, a specific treatment for PTSD has not been developed. Most of the treatments used can simply treat certain symptoms of PTSD. However, researchers are finding that if they can pinpoint exactly how cannabis works in the endocannabinoid system, this could reveal how cannabis can effectively treat PTSD.

Director of Project CBD, Martin Lee has researched both cannabis and PTSD and found some interesting details. He states:

Researchers found that people with PTSD had lower levels of anandamide, an endogenous cannabinoid compound, compared to those who did not show signs of PTSD. Innate to all mammals, anandamide (our inner cannabis, so to speak) triggers the same receptors that are activated by THC and other components of the marijuana plant

This means that one reason some may have PTSD is due to a lack of endocannabinoids. By taking cannabis, these missing cannabinoids may be replenished which could help to keep a better mental balance.

One study involving individuals with PTSD who witnessed the World Trade Center attacks seems to support this theory. In the study it was found that there were reductions in endocannabinoid levels in these people. This shows that there could be a correlation between anxiety disorders and unbalanced endocannabinoids. Using cannabis could help to regulate these levels.

Veterans have helped to bring attention to the importance of legal medical marijuana for PTSD sufferers.

According to CBS News, a retired Marine staff sergeant, Mark DiPasqual found relief and freedom by taking medical marijuana. DiPasqual was taking 17 opioids, anti-anxiety pills and other drugs to treat his migraines, PTSD and other existing injuries. “I just felt like a zombie, and I wanted to hurt somebody,” says DiPasquale describing his experience with these medications. After getting off of his medications and switching to cannabis he says:

“Do I still have PTSD? Absolutely. But I’m back to my old self. I love people again.”

So far, many seem to agree with DiPasqual. Twenty-eight states along with Washington DC have now legalized marijuana for PTSD treatment.

The United States is slowly, but surely, beginning to comprehend the importance of cannabis in health care. Dispensaries are making marijuana accessible to those with PTSD in over half of the United States. With marijuana laws becoming friendlier to those who can benefit from the marijuana plant, the US is progressively becoming more aware of how its citizens can receive better, safer care.

If you think that you may be suffering from PTSD, please see your doctor for treatment options, and to see if cannabis is right for you. As always, check your state laws before purchasing and consuming cannabis.

If you are a veteran and in need of immediate help or are feeling suicidal, please call 1-800-273-8255 to reach the National Center for PTSD Veterans Crisis Line.

Editorial Staff
Editorial Staff
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