Cannabis has been used to treat anxiety disorder as far back as 2000 BCE where it appears in the Vedic text (1), and anxiety happens to be one of the most common reasons people use the plant across a variety of cultures. Although one of the psychoactive side effects of THC can actually increase anxiety in some people, but can lower it in others. On the other hand, CBD has consistently been shown to reduce anxiety when high-CBD strains of cannabis are used. CBD on its own has been seen to lessen the effects of anxiety in a number of both human and animal studies. CBD has a stress-reducing effect which seems to be related to activity in the paralimbic and limbic brain areas.
Anxiety affects roughly 20 percent of people living in western countries and is considered highly treatable, yet only 36 percent of those suffering receive treatment. Those suffering are three to five times more likely to go to the doctor, and six times more likely to be hospitalized for psychiatric disorders than those who do not suffer from anxiety disorders. Both anxiety and depression can develop from a complex set of risk factors, including genetics, personality, brain chemistry, and life events, which can lead to more serious mental health conditions such as post traumatic stress disorder (affecting 3.5 percent of the US population), or panic disorder (affecting 2.5 percent of the US population). The effects of CBD on mental health, chronic pain, and blood pressure are quite well studied, but the mechanisms behind how full spectrum CBD or other forms of CBD oils work are not quite as well understood.
Full Spectrum Hemp Extracts
There are a variety of hemp derived cannabidiol (CBD) products available, though, not all are produced with a full spectrum of cannabinoids. Some are CBD extracts containing only one of the 120+ cannabinoids present in the cannabis plant, cannabidiol, whereas others utilize a full spectrum of cannabinoids, terpenes, phytosterols, and flavanols from the hemp plant to provide what scientists call the "entourage effect". Which is a term used for the synergy that is created between the various plant compounds when consumed together as a whole, as opposed to an extract containing just one single cannabinoid (CBD). In fact, a class of compounds called "terpenes", when combined with a cannabinoid such as CBG or CBD, actually double the potency and effectiveness than if the terpene wasn't present otherwise.
Best CBD for Anxiety
A 2012 review of the available literature found that CBD has consistently been shown to help reduce anxiety, especially social anxiety, in multiple studies and there was a call for additional clinical trials. (2) Two years later, researchers in an animal study related to the endocannabinoid system (ECS) and stress wrote that assisting in support of the ECS may be a helpful strategy to balance behavioral and physical consequences of stress. (3)
“These findings appear to support that the anxiolytic effect of chronic CBD administration in stressed mice depends on its proneurogenic action in the adult hippocampus by facilitating endocannabinoid-mediated signaling.”
It's hard to pinpoint which is the best CBD oil for anxiety, because there are a number of options available world-wide, but what we do know is that when a full spectrum of cannabinoids are utilized in a hemp product, the effects are considerably more potent than their single extract counterparts, such as in the case with a CBD oil, which is an isolated compound. High quality anxiety CBD hemp extract products should be produced with this in mind, taking great care to keep as many plant compounds intact so they can work synergistically inside the body.
CBD Dosage for Anxiety
When it comes to medical cannabis it’s a recommendation that one works with a doctor who’s comfortable and experienced in working with CBD or medicinal marijuana so that the treatment can be customized based on the individual. On the same line, people who have taken the time to educate themselves to become aware of what they are doing, can become their own highly informed health consultants.
High-CBD products with a ratio of 20:1 or higher are generally the recommendation, and the dose can be taken as capsules, edibles or drops sublingually (under the tongue). Cannabinoids like CBD can be very effective in assisting with reducing chronic anxiety, helping with temporary stressful situations, and protecting the body from the physiological stress of both. High-CBD cannabis products high in the terpene lavender, are considered to be effective for bringing relief to anxiety. Some specialists have found the cannabis strain AC/DC to be very effective.
As always with cannabis use, start low and titrate your way up slowly until symptoms subside. The micro to standard dose is the usual recommendation for anxiety and stress.
If an immediate symptom requires cannabis use, such as in the case of an anxiety or panic attack, smoking or vaporizing work well by getting cannabinoids into the system almost instantaneously. Medicinal cannabis use lasts for between one to three hours, whereas if an ingestible product is used, it would take at least thirty to sixty minutes before taking effect, but would last for longer, about approximately six to eight hours. Vaporizers that utilize a cartridge filled with the CO2 concentrate are highly effective, and these are available to purchase in various ratios of CBD to THC. Herbal vaporizers that utilize the entire plant are also another effective delivery method. Sprays or sublingual tinctures taken as liquid drops can take effect rapidly and last a lot longer than inhaled products.
CBD side effects
Compared to commonly prescribed drugs for the same conditions, CBD is extraordinarily well-tolerated by most people. When seldom side-effects do occur, they're occasionally accompanied with one or any of the following; reduced appetite, drowsiness, fatigue, diarrhea, or dry mouth. CBD interacts with the same medications that contraindicate with grapefruit, so its best to check with your doctor prior to using CBD if you're taking a pharmaceutical drug.
Pros and Cons of CBD Oil for Anxiety
The Cannabis Health Index (CHI) is a system that scores cannabis based on the current available evidence in the medical literature. Based on eleven studies, medicinal cannabis and cannabinoids like CBD rate in the possible-to-probably range of efficacy for treatment of anxiety.
One study from 2019 involving 72 adults, found that anxiety scores decreased by a whopping 80 percent in the first month of medicinal cannabis use, and remained decreased. Sleep scores also happened to increase by 66 percent and fluctuated over the course of the study. The researchers concluded that CBD may hold benefits for anxiety-related disorders and called for more clinical trials to be done. (4)
In 2019, a meta-analysis of the available research was published in the Journal of the American Pharmacists Association with researchers concluding that “CBD has a promising role as alternative therapy in the management of anxiety disorders.” They called for more clinical trials to be completed with an emphasis on determining the appropriate dosing of CBD and its place in therapy.
Another study from 2019 was published in the journal Frontiers in Psychology with a focus on utilizing CBD for teenage social anxiety disorder. Researchers discovered that “CBD significantly decreased anxiety” and that, “CBD could be a useful option to treat social anxiety.” (6)
A 2017 study published in Current Neuropharmacology had researchers find that CBD has “anti-panic” actions for those suffering from a form of panic disorder (PD), which is a disabling psychiatry condition affecting roughly 5 percent of the worldwide population and leads to an increasing number of regular panic attacks. The researchers concluded that, “CBD seems to be a promising drug for the treatment of PD.” (7)
A 2020 study published in the British Journal of General Practice involving 400 people from Auckland, New Zealand, found “marked” improvements of quality of life, and decreased pain and anxiety after using CBD oil. (8)
The Endocannabinoid System
In a 2015 study researchers published a review of the endocannabinoid system on its ability to safeguard against fear, stress, and anxiety, writing that when functioning normally, allows the person to cope with both environmental and internal stressors better, leading to better emotional and behavioral outcomes, known as stress-resilience. Dysfunction of the ECS can lead to psychiatric disorders from chronic, long-term stress, and the inability to adapt to a changing environment. (9)
In other words, the endocannabinoid system assists us mentally, emotionally and physically in being more resilient and adaptable to our ever-changing environment in today’s modern world.
Medicinal cannabis and CBD can work to restore function and balance to the ECS so it can go to work on bringing homeostasis to the brain and body. It is essentially the “missing link” between the mind-body that has gone undiscovered and unnoticed until the mid 1990’s when it was first discovered by researchers in Israel who were studying the effects of THC and CBD.
An analogy for restoring function to the ECS could be this; we eat food to maintain our energy balance (and body weight) so we don’t starve. Phytocannabinoids from the cannabis plant such as CBD, CBG, CBN and CBC are essentially “food” that can nourish an overworked and overtired ECS back to full health.
We take care of the ECS with cannabinoids from the cannabis plant. Cannabis is rich in phytocannabinoids, which when consumed, help “supplement” the cannabinoids our body already makes called “endocannabinoids.” These endocannabinoids are found naturally in mothers' breast milk to support the health and development of the baby, and our own ECS was first seen to develop at eight weeks gestation.
If the endocannabinoid system is the most powerful system of physiology inside the body that brings balance and restores order to all other systems of the body, then does it not make sense to take care of it? We do this with hemp / cannabis.
Ways to Reduce Anxiety Naturally
Some other ways of dealing with anxiety and bringing your stress levels down while you explore the world of medicinal cannabis are;
- Meditation: if you're new to meditation, try free guided meditations on YouTube from channels like Jason Stephenson who regularly produces meditations for relief from anxiety and stress.
- Exercise: regular exercise is good for supporting your emotional and physical health by assisting in releasing feel good hormones like endorphins into your system and getting rid of toxins.
- Nutrition: consume whole-plant nutritious foods and drink plenty of water. Research shows those who eat a whole-food plant-based diet experience less depression and better health outcomes. (10)
- Sleep: go to sleep at a regular time each night, and ensure you slow down an hour before your bedtime by doing something under low light such as reading a book, playing a board game, or listening to some relaxing music. Make sure your room is as dark as possible to aid in the release of melatonin, the sleep hormone.
- Ditch substances: smoking, drinking alcohol, and caffeine can all impair your ability to deal with stress and remain mentally and emotionally balanced. If you must consume coffee, refrain from caffeine six hours before bed time to avoid sleep impairment.
- Therapy: everyone should at some point or another seek the support of an experienced and trained therapist or councilor to help navigate the occassional storms life can bring. Just remember, after the cloudy rain, comes the warm sunshine.
Mental health is an important topic that needs a lot of focus, and from the research we can see that it can decline over time when one experiences chronic long-term stress and anxiety that isn't tended to. In New Zealand, you can call the councilor hotline on "1737" if you "need to talk" to someone. It's free, and can be very helpful. As always, the information contained in this article is for informational purposes only, prior to making any changes to your lifestyle or treatment plan, consult with a licenced medical professional.
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1. http://antiquecannabisbook.com/chap2B/India/OldArticle.htm
2. https://pubmed.ncbi.nlm.nih.gov/22729452/
3. https://pubmed.ncbi.nlm.nih.gov/25004388/
4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6326553/
5. https://pubmed.ncbi.nlm.nih.gov/31866386/
6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6856203/
7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5412699/
8. https://doi.org/10.3399/bjgpopen20X101010
9. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5871913/
10. https://nutritionfacts.org/2018/04/03/the-best-diet-for-depression/
