Does Cannabis Work For Anxiety?

Does smoking weed cause social anxiety? Or does it make the condition worse? It depends on who you ask. Cannabis contains hundreds of interesting phytochemicals. Some of these compounds, including THC and CBD, interface with receptors that are, incidentally, targets of numerous anti-anxiety medications. Now, researchers are trying to find out if these plant-based molecules can offer beneficial effects through these mechanisms. Find out everything you need to know about cannabis, CBD, and anxiety below. 

What Is Anxiety?

Defined by feelings of unease, worry, and fear, anxiety can greatly reduce a person’s quality of life. The condition can occur at any time and ranges from mild to severe. Although it has no single cause, researchers believe both genetics and environmental factors play a role in its onset.

As one of the most common forms of anxiety, generalised anxiety disorder (GAD) affects around 6.8 million^[1] adults in the United States alone. The condition can stem from several factors, including:

People diagnosed with GAD often feel restless and worried, have a hard time concentrating, and can even experience dizziness and heart palpitations. GAD can spike during social situations, work, and public gatherings. Ultimately, the condition can rob people of the joy of socialising and enjoying special moments in life. A range of natural lifestyle interventions exist to help tackle the symptoms of GAD, such as:

However, these lifestyle changes don’t work for everybody. Some people have to rely on pharmaceuticals to tackle their feelings of anxiety. Yet, for others, cannabis works as a viable alternative to ease some of the symptoms. Let’s take a look at why cannabis might be a suitable option for some people.

Cannabis For Anxiety: An Overview

The cannabis plant produces a plethora of unique phytochemicals—among these are over 100 cannabinoids and over 200 terpenes. Different strains and extracts contain varying concentrations of these chemicals and therefore produce different effects. Although touted as a “drug”, the complexity of cannabis chemistry eclipses this term. The terpene and cannabinoid profile of one strain can produce psychoactive effects entirely different from another cultivar.

Research in the field has revealed that cannabinoids and terpenes synergise to enhance and modify each other’s effects—a phenomenon known as the entourage effect^[2]. Many of these molecules may affect anxiety symptoms in different ways, and certain strains and extracts might work well for different people.

Let’s take a look at some of the most well-understood cannabinoids and terpenes below to see how they might combat or give rise to anxiety.

THC Underpins The Cannabis High

THC underpins the quintessential psychoactive effect associated with cannabis. It does so by binding to CB1 receptors in the brain, which causes a wave of dopamine to surge. Generally, the more THC a person consumes, the higher they feel. Breeders spent most of the last few decades selectively breeding cultivars to produce high levels of this cannabinoid. Some of the positive effects of THC include:

These effects may help to ease anxiety in some cannabis users. However, new users and those sensitive to THC can experience effects that might increase their anxiety, making it worse in both the short- and long-term. These negative side effects may include:

So, THC can be a double-edged sword. Some users find great peace of mind when using high-THC strains, whereas others may experience worsening symptoms. Moreover, research^[3] shows that low doses of THC can help to quell anxiety, whereas higher doses can cause it to spike. For this reason, it makes sense to use moderate to low-strength strains. Luckily, breeders have started creating cultivars that possess lower levels of THC and higher quantities of non-psychoactive cannabinoids, such as CBD.

THC and the Biphasic Dose Response

New cannabis users have a lot of questions. They often ask, “how many milligrams of THC do you need to feel relaxed?”, or more simply, “how much THC gets you high?”. It turns out the answers to these questions are nuanced and more complex than you might think.

Ongoing trials have thus far found THC to exert a biphasic dose response. Put simply, this means it produces a certain effect at a low dose, and an opposite effect at a high dose.

Research conducted at the University of Illinois in 2017 found that this principle also applies to THC in the context of anxiety^[4]. In order to explore the relationship between cannabis and anxiety, researchers recruited 42 healthy volunteers. Aged 18–40, the participants had some experience with the herb but weren’t regular users.

They randomly divided the subjects into three groups. The low-dose group received 7.5mg of THC, the moderate-dose group received 12.5mg of THC, and the placebo group received no THC. The double-blind nature of the study ensured that both the participants and the researchers remained unaware of who received what dose.

During the experiment, the researchers measured their blood pressure, heart rate, and cortisol levels. Interestingly, the participants who received the lower dose experienced less tension, and their tension levels dissipated faster. In contrast, the moderate-dose group experienced a negative mood before and during the programmed tasks.

These results suggest that THC causes a biphasic dose response in terms of anxiety. Lower doses appear relaxing, whereas higher doses seem to cause more tension. However, THC affects people differently, and our unique endocannabinoid tone and genetic expression mean we all experience the herb in our own ways. Moreover, this study focused on isolated THC. Cannabis flowers contain other phytochemicals that synergise with the molecule, potentially making it possible for people to tolerate higher doses of THC.

Does Weed Cause or Alleviate Social Anxiety?

Cannabis has a complex effect on the human brain. Every time you hit a blunt, bong, or joint, you’re inhaling an array of compounds that light up different binding sites, including cannabinoid, GABA, and serotonin receptors. Several cannabinoids and terpenes in the plant also interact with enzymes and pathways that influence mood and memory.

There are hundreds of cannabis chemovars available, all of which offer varying levels of different phytochemicals. Each person also has a unique physiology, which means all of these chemovars will affect each person slightly differently. Both the chemical complexity of the cannabis plant and the physiological diversity of people mean many variables are at play when considering the relationship between weed and social anxiety.

After hitting a joint, some people are left asking, “Why does smoking weed make me socially anxious, nervous, and awkward?”. In contrast, some people become considerably more chatty and sociable after using cannabis. Let’s take a deeper look at what could be behind this.

Social Anxiety vs Anxiety: How Are They Different?

Social anxiety disorder falls under the umbrella term of “anxiety”; however, it differs from other forms in that it involves a specific overwhelming fear of social situations. While most people get slightly nervous before public speaking or meeting a date for the first time, those with social anxiety disorder experience intense fears of daily social interactions.

People with social anxiety disorder experience emotional and behavioural symptoms including:

• Fear of embarrassment
• Intense fear of interacting with strangers
• Avoidance of speaking in public
• Fear of others perceiving symptoms of anxiety
• Expectations of the worst outcomes in social situations

As well as emotional symptoms, people with social anxiety also experience physical symptoms such as:

• Elevated heart rate
• Blushing
• Sweating
• Trembling
• Muscle tension

Several factors are thought to contribute toward social anxiety disorder, including:

• Genetics: Inherited traits may predispose some people to the condition.

• Brain structure: People with an overactive amygdala (a region involved in the fear response) may experience increased anxiety in social settings.

• Environment: Some people may develop social anxiety disorder following a distressing social event, such as extreme embarrassment during childhood.

Current Treatment for Social Anxiety

There is a range of treatment options available for people experiencing social anxiety disorder, including pharmaceutical and non-pharmaceutical routes. These include:

• Cognitive behavioural therapy (CBT): This form of therapy helps people to identify and change negative thought patterns.
• Antidepressant medications: Selective serotonin reuptake inhibitors (SSRIs), such as escitalopram, are prescribed to improve mood.
• Anti-anxiety medications: Benzodiazepines can help to reduce levels of anxiety.
• Beta blockers: These drugs reduce adrenaline production and minimise symptoms such as shaking and sweating.

Does Cannabis Cause Social Anxiety Disorder?

Can weed cause social anxiety? Some people report experiencing symptoms of the condition after using cannabis, both acutely and chronically. THC, the main psychoactive component of cannabis, binds to a site in the central nervous system called CB1. Through this mechanism, cannabis might stimulate or exacerbate social anxiety. Let's take a deeper look at how exactly this might occur.

• Amygdala overstimulation: Under normal conditions, endocannabinoids bind to CB1 receptors in the brain. Ingesting cannabis causes THC to activate these sites much more intensely than normal. This can overstimulate receptors located on amygdala cells, resulting in paranoia and subsequent social anxiety.

• Dopamine blunting: Acutely, THC causes a rise in dopamine and sensations of euphoria in many cannabis users. However, over time, the molecule can lower levels of dopamine^[5] in the brain. Social phobia may arise from a reduction^[6] in dopamine receptor binding.

Does Cannabis Help Social Anxiety Disorder?

While some people are fraught with anxiety after hitting a joint, others find themselves much more social and less nervous. But why does this happen? Researchers are still looking into it, but it could involve the following:

• The biphasic dose response: While high levels of THC can stoke anxiety, lower doses are thought to create the opposite response^[7].
• CB1 receptor activation: Anti-anxiety medications produce some of their effects through interactions with the CB1 receptor^[8]. THC likely helps some people feel less nervous through this pathway.
• CBD: Many modern chemovars contain higher levels of CBD, a non-psychotropic cannabinoid that researchers are pitting against anxiety^[9] in human studies.
• Terpenes: Cannabis also contains aromatic molecules known as terpenes. Scientists are working to find out if they synergise with cannabinoids to impact mood and anxiety^[10].

The relationship between cannabidiol and anxiety

A lack of studies means that scientists can't make any conclusions just yet. But many interesting investigations are underway that will hopefully clear up the relationship between CBD and anxiety. Some of the most important ongoing studies include:

• How CBD affects ECS enzymes: Researchers are testing CBD for its ability to inhibit an ECS enzyme^[5] known as fatty acid amide hydrolase (FAAH). This protein breaks down the endocannabinoid known as anandamide, which plays an important role in mood. If CBD helps prevent FAAH from breaking it down, it could have a knock-on effect on mental state.
• The link between CBD and GABA: Ongoing studies are also looking into how CBD affects GABA levels^[11] in the brain. Also known as gamma-aminobutyric acid, this inhibitory neurotransmitter works to dampen brain activity, which helps to turn things down a notch in the anxious brain.
• Testing CBD against social anxiety: Researchers are now conducting human experiments to see how CBD influences certain outcome measures. For example, a paper published in the journal Neuropsychopharmacology administered CBD to patients with generalised anxiety disorder before engaging in a simulated public speaking event^[12]. The researchers looked to measure factors such as cognitive impairment, discomfort, and levels of alertness.
• CBD and blood flow to the brain: Some human studies are taking things a step further and looking to see if CBD alters blood flow to regions of the brain associated with anxiety. Using arterial spin labelling (an MRI technique that measures changes in blood oxygen levels), a team of University College London set out to see if CBD changes blood flow to the hippocampus^[13]—a brain region associated with the modulation of anxiety.

Does CBD Produce Anxiety?

CBD produces side effects in some users, including nausea, fatigue, and irritability. The cannabinoid can also interact with a long list of prescribed medications. However, the cannabinoid isn't known to induce anxiety at this time.

Using THC And CBD Together

CBD produces a clear-headed and relaxing sensation without any psychoactive effects. This makes the cannabinoid more of a feasible option than THC for many anxiety sufferers. However, people can benefit from both cannabinoids at the same time.

Some strains contain varying ratios of the two chemicals. CBD:THC ratios of 1:1 provide a balanced effect, whereas ratios of 8:1 or higher provide almost no psychoactive effects at all. Interestingly, CBD appears to block THC at the CB1 receptor^[15], meaning it might help to reduce the intensity of THC. These findings suggest that those sensitive to THC might experience its benefits when using CBD at the same time.

Terpenes Matter

If THC and CBD exist in most strains, why do different cultivars produce different effects? Although these cannabinoids largely underpin cannabis’ effects, terpenes add a unique spin that makes each strain different. Just like cannabinoids, terpenes offer their own unique benefits. Check out the terpene profile of a strain before you consume or cultivate it to maximise the outcome. Below are some of the most promising terpenes when it comes to anxiety:

• Myrcene: The most abundant terpene in most cannabis strains, myrcene features an earthy, musky scent. It also heavily contributes to the stoning high of many indica varieties. The terpene exerts sleep-promoting effects that might help to improve sleep quality and relax the body. Via the entourage effect, myrcene may increase the soothing properties^[15] of THC.
• Limonene: This terpene adds a citrusy scent to cannabis flowers. Strains high in limonene literally taste like oranges and lemons! In animal studies^[16], the molecule has demonstrated an ability to boost serotonin and dopamine. Limonene also appears to enhance the anxiolytic action^[17] of CBD.
• Caryophyllene: Both a terpene and a dietary cannabinoid, caryophyllene binds to the CB2 receptor of the endocannabinoid system. Caryophyllene imparts a peppery, spicy taste, and has produced anxiolytic^[18] effects in animal models.
• Pinene: Responsible for the fresh smell of pine, pinene unleashes an earthy and piney aroma. The terpene has demonstrated an anxiolytic effect in animal studies^[19], and it may help to counteract some of the negative side effects of THC, such as short-term memory impairment.

A-Pinene

 

Anti-Inflamatory
Bronchodilator
Aids Memory
Anti-Bacterial

Linalool

 

Anesthetic
Anti-Convulsant
Analgesic
Anti-Anxiety

Beta-CaryophYllene

 

Anti-Inflamatory
Analgesic
Protects Cells Lining The Digestive Tract

Myrcene

 

Contributes To Sedative Effect Of Strong Indicas
Sleep Aid
Muscle Relaxant

Limonene

 

Treats Acid Reflux
Anti-Anxiety
Antidepressant

A-Pinene

  Anti-Inflamatory
Bronchodilator
Aids Memory
Anti-Bacterial

Linalool

  Anesthetic
Anti-Convulsant
Analgesic
Anti-Anxiety

Beta-Caryophillene

  Anti-Inflamatory
Analgesic
Protects Cells Lining The Digestive Tract

Myrcene

  Contributes To Sedative Effect Of Strong Indicas
Sleep Aid
Muscle Relaxant

Limonene

  Treats Acid Reflux
Anti-Anxiety
Antidepressant

Timing Is Important

After deciding which strain and mix of phytochemicals works best for you, it helps to determine the best time to take it. Not much data exists on timing, so you’ll have to find what works best through trial and error.

For some users, taking CBD-rich cannabis in the morning might help keep their anxiety low throughout the day. Others might find it more helpful to take extracts or hit a joint right as their symptoms begin to occur. For those who have trouble sleeping, enjoying an indica strain rich in THC and myrcene before bed may help them wind down.

Remember, different products take effect at different times. Edibles take an hour or more to set in, but the effect lasts longer. Vaping and sublingual administration work much faster, but the effects are more transient.

Many users also find great success with microdosing, which involves taking a sub-perceptual amount of cannabis in order to address symptoms without feeling high.

Cannabis and Psychotherapy: Are They Compatible?

Cannabis may contribute to mental health conditions in susceptible individuals, but some find the herb to actually work alongside psychotherapy.

What Is Psychotherapy?

Psychotherapy is a form of talk therapy. During sessions, psychotherapists help patients to understand their symptoms, feelings, thoughts, and behaviours. Practitioners use a range of techniques to achieve this, including cognitive behavioural therapy (CBT) and dialectical behaviour therapy (DBT). These strategies can help with a range of conditions, including anxiety, obsessive-compulsive disorder (OCD), and post-traumatic stress disorder (PTSD).

Does Cannabis Have a Place in Psychotherapy?

Under certain circumstances, psychotherapy and medications are used to achieve better patient outcomes. But do weed and therapy go hand in hand? No studies have sought to determine how cannabis impacts the success of psychotherapy sessions. However, many people experiencing various health conditions use cannabis to experience the plant’s holistic benefits. Researchers have found that some cannabis users would expect cannabis-assisted psychotherapy^[20] to help them deal with depression. The same expectations could be true for anxiety. In any case, it’s clear that a demand exists for cannabis in psychotherapy.

The Future of Cannabis-Assisted Psychotherapy

Is there a place for marijuana in psychotherapy? As psychedelic-assisted psychotherapy starts to edge its way into the mainstream, we could see cannabis used in a similar context in the future. Right now, the herb remains understudied. Researchers are just getting to grips with how certain molecules influence human neurochemistry, and how they might synergise. As we continue to uncover the vast chemical complexity of the cannabis plant, we could find more molecules fit for cannabis-assisted therapy.

Cannabis Can Help, But Shouldn’t Be A Crutch

Cannabis can make a big difference in some anxiety sufferers, but it shouldn’t be overused or relied upon. However, it can form part of a wider holistic approach. Diet, meditation, therapy, exercise, and communication all play an important role in such a strategy. Balance is the key.

Which Cannabis Strain To Choose?

The following three strains are three that we think cover most bases when using cannabis as a means of managing anxiety. It is impossible to say how you will react when consuming cannabis but understanding the different effects that can be obtained will help you to make an educated and informed judgement. Finally, starting with a low THC and/or high CBD strain is more than likely the best place for most anxiety sufferers. CBD is a non-psychoactive compound that can help combat anxiety with attributes such as a clearer head and a stronger feeling of calm.

Stress Killer

Kicking things off you couldn't get a more apt name. Whilst primarily a sativa dominant strain, it still possesses a strong indica pairing. Sativa strains typically uplift and energise the user which can be detrimental when trying to calm oneself. Stress Killer mixes the best of both worlds. It has a THC content of 11%, whilst also being high in CBD to provide that clear head high. Bursting with citrusy flavors, this is a surefire strain to kick start your day.

Stress Killer Automatic CBD

Stress Killer Automatic CBD

	Lemon Shining Silver Haze x Juanita la Lagrimosa x Ruderalis
	16 to 19 oz/m²
	3 to 4 feet
	7 - 8 weeks
	THC: 11%

	Sativa 60% Indica 30% Ruderalis 10%
	4 to 5 oz/plant
	5 to 6 feet
	11 - 12 weeks after sprouting
	Clear, Focus

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Royal Jack Automatic

Named after a tireless cannabis activist, Jack Herer. Royal Jack Automatic, whilst still slightly sativa dominant is a more balanced strain. Because of the higher indica DNA, it gives a slightly more body stoned feeling to help when that anxiety starts to build and you need some time to yourself. Despite this, a medium CBD content still helps to keep things clear so you can think with renewed clarity.

Royal Jack Auto

Royal Jack Auto

	Jack Herer x Ruderalis
	12 to 14 oz/m²
	1 to 3 feet
	7 - 8 weeks
	THC: 16%

	Sativa 40% Indica 30% Ruderalis 30%
	2 to 4 oz/plant
	2 to 3 feet
	11 - 12 weeks after sprouting
	Creative, Motivating

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Northern Lights

Being an indica dominant hybrid, this strain is very much an end of the day affair. Boasting some award-winning genetics is provides a strong stone able to couchlock the user whilst they enjoy the high. Perfect for when some contemplation time is needed or for when the days events can become too much. Providing a medium strength of CBD it also has the highest THC content of all three strains.

Northern Light

Northern Light

	Northern Light S1
	18 to 19 oz/m²
	3 to 5 feet
	8 - 9 weeks
	THC: 18%

	Sativa 0% Indica 100%
	20 to 22 oz/plant
	6 to 7 feet
	Late September
	Balanced, Clear, Stoned

Buy Northern Light

Finally, this list is by no means exhaustive. As every person is unique so is your choice in weed, so experiment until you find the right strain for you. The key is to get a feel for the high before you commit to a lengthy session. Typically smoking or vaping allow you to control the high a lot more than dabs or edibles, so these methods of consumption are recommended.