BY JESSICA CASTILLO
Photo courtesy of Getty Images
If you’ve been anxious, stressed out, or depressed lately, you’re not alone — an estimated 40 million people in the United States navigate some form of anxiety disorder each year. And so many people experience anxiety in different ways: You might experience a tight chest, difficulty breathing, insomnia, or other symptoms of an anxiety disorder. So while it’s understandable and entirely common that you might try to seek relief with therapy or medication, what works for your best friend might not work exactly the same for you.
You’ve likely heard plenty of stories about cannabis helping someone with their anxiety — maybe it was the aforementioned best friend, or perhaps even your therapist suggested looking into a calming CBD product or cannabis for therapeutic use. As with any treatment, however, it’s crucial you know what you’re getting into and how to monitor yourself before you try something new. With that in mind, Dr. Ryan Vandrey, professor of psychiatry and behavioral sciences at Johns Hopkins University School of Medicine offers some expert guidance on the topic. Here’s what you need to know about lighting up to calm yourself down.
Does cannabis really cure anxiety?
While there is no hard and fast cure for anxiety, plenty of people are hopeful that cannabis can help. Sure, the plant is known to cause paranoia in some people, but if you start slow and take the correct dose for you, there are hopeful signs that cannabis can actually help ease your worries.
“Right now the broad view is that there is tremendous promise in cannabinoids as therapeutics and there's a lot of excitement and ongoing research,” Dr. Vandrey told Ember. “Currently, with the exception of FDA-approved products, you need to treat cannabis as a novel therapeutic that does not yet have demonstrated safety and efficacy.”
“There is some initial clinical data that suggest that specific cannabinoids like cannabidiol (CBD), and cannabis, generally speaking, can be helpful for anxiety disorders,” he adds. Because the majority of studies are laboratory studies that focus on short-term exposure rather than large clinical trials of individuals with diagnosed anxiety disorders, “we have to understand that the needed clinical evidence to support particular cannabinoids as a treatment for an anxiety disorder just isn't there,” he added. That means we would need more solid research to say definitively that cannabis can help your anxiety, and to identify the best dose, route of administration, and formulation to maximize benefit and minimize side effects.
Is indica or sativa better for helping anxiety?
While there’s plenty of anecdotal evidence for the ways different strains can influence whether you experience a head high or a body high, there isn’t enough research to say definitively whether one strain is your best bet for anxiety relief — or how different combinations of cannabinoids and terpenes affect your body.
“I've yet to see anything that convinces me that there is an important chemical or pharmacological difference between indica and sativa,” Dr. Vandrey said. “So in my mind, those categorizations of cannabis only describe the physical attributes of the plant.”
The cannabinoids known as tetrahydrocannabinol (THC) and cannabidiol (CBD) affect receptors in the body in different ways, and that matters when you’re trying to ease your anxiety. Some users believe that strains with higher concentrations of THC or CBD can provide different effects — otherwise known as head and body highs. Many people find that body highs help them feel more relaxed, while others might recommend you avoid strains that promise to give you head highs if you’re trying to decompress. The worst thing for an anxiety attack? Feeling even more anxious.
Because THC and CBD affect different receptors in the body, and the physiology of each person varies, cannabis and individual cannabinoids can have different effects on different people. There’s also the matter of the so-called “entourage” effect, in which the relative concentration of various cannabinoids and terpenes (types of chemical components of cannabis) mix together to determine the type of effects you end up feeling. And you shouldn’t discount the power of the expectancy effect, either: If you believe your strain of cannabis will help ease your anxiety, there’s a chance it just might.
Why do people think cannabis makes you more anxious?
The easiest answer is that those people have likely experienced highs that left them feeling anxious or jittery, turning them off from cannabis as a potential therapeutic. Because THC binds directly to CB1 and CB2 receptors, it has a different effect on your body than CBD, which has different properties and effects.
According to Dr. Vandrey, research shows that THC can both help and exacerbate someone’s anxiety. “Controlled laboratory studies that we've done show that low doses of THC tend to produce positive drug effects and can have a nice relaxing effect on individuals,” he said. “But if you bought that dosage a little bit higher, it can have an anxiogenic effect,” meaning it will exacerbate your anxiety levels, and perhaps even make you feel paranoid.
Some experts recommend microdosing as a way to manage those adverse effects, which means starting with very small amounts of cannabis and seeing how you react. You can try to use pre-measured vape pens, effects-based products, or edibles with strict dosage amounts per piece. Knowing exactly how much you’re consuming can give you peace of mind, help you sleep better, and rest easier knowing you won’t accidentally get too high.
Dr. Vandrey also stresses the need for product regulation so that people trust the products they’re trying. “It's important to establish a defined product and to evaluate the dosing of that product within the context of treatment of a particular health condition,” he said.
Does that mean CBD is safer for treating anxiety?
It’s hard to say — again, because most of the products on the market have different formulas, and even different sources for their ingredients. The best way to make sure your CBD products are reputable is to know exactly what’s in them, and you’re more likely to find that info from a licensed seller than a company with slick marketing.
“Even though there's hundreds of products out there that have CBD, they have different concentrations of CBD,” Dr. Vandrey pointed out. The way CBD is introduced into your system — whether by tincture, brownie, gummy bear, soak, or anything else — can also impact the cannabinoid’s effect on your body.
Taking the extra step to ensure your products are vetted might seem like a hassle at first, but it can drastically impact your experience with a product. “Drug development and clinical efficacy and safety needs to be determined on a product by product basis, not just on whether it contains CBD,” Dr. Vandrey said. “And CBD product testing studies have continuously demonstrated that there's problems with label accuracy and contamination in those products. It is still a ‘buyer beware’ market in that not all CBD oils are the same.”
Can I stop seeing my therapist if cannabis helps my anxiety?
Whether you’re safe to suspend or graduate from therapy sessions is a decision you should make with your therapist and only your therapist (so you won’t find a yes or no answer here!) Plenty of research shows that therapy is even beneficial to people who feel healthy and happy.
You should always talk to your therapist or doctor before using cannabis as a therapeutic for your anxiety, because the outcome can be impacted by other changes in your life — and it’s helpful if you keep them updated on how cannabis affects you so you can tweak the dosage, create plans for adverse effects, and more.
For his part, Dr. Vandrey is cautiously optimistic that the research needed to understand how cannabis affects anxiety is on the way. “In the meantime, there needs to be a risk-benefit analysis on an individual basis, between the patient and provider, about whether cannabis is an appropriate treatment option for those who live in areas where the medicinal use of cannabis has been legalized,” he stressed. It is also important to monitor progress and symptoms over time. Like many other medications, tolerance may develop and efficacy could be lost with long-term, daily use.
The more open you are with your therapist, the better you’ll be able to work together to determine if cannabis is the right choice for you.
Curious about microdosing? Here are some recommendations from MedMen experts:
Kikoko Little Helpers Calm Mints: Featuring 2.5 mg of THC and 5mg of CBD per serving, these mints are a great intro to microdosing. Like its name implies, it might be just the thing to chill you out in the evening.
Satori 1:1 Blueberries: If you like to end the night with a sweet treat, these dark chocolate covered blueberries feature 2mg of THC and 2mg of CBD.
dosist Calm 100 Dose Pen: Don’t want to wait on an edible? This vape pen offers up 2.5mg of THC per timed inhale and normally kicks in within an hour so you can have a predictable experience.
WYLD Peach 2:1 CBD Gummies: These fan favorite edibles have 10mg of CBD and 5mg of THC so they’re slightly stronger than the rest of the list. If you’re new and prefer to start slow, you can always halve them at first.
[statemade] ebb drops: Edibles not for you and neither are vapes? Try something sublingual (aka absorbed under the tongue) like this tincture that has 4.5mg of THC per dose.
Pure Tonic CabTabs 1:1: Not all edibles have to be sugary snacks. Each of these tablets have 5mg THC and 5mg of CBD and can be taken with water.