Medical Cannabis and Anxiety

Everyone has anxiety to one degree or another.  It’s a normal part of life.  Sometimes, though, anxiety can become disruptive and interfere with daily activities such as work, school, or sleep.  It can disrupt relationships and can even lead to health concerns.

According to the National Institute of Mental Health, about 30% of U.S. adults will be diagnosed with an anxiety disorder sometime in their lives.  22.8% of these cases (or 4.1% of the U.S. adult population) are classified as “severe.”  Women are 60% more likely than men to experience an anxiety disorder over their lifetime.  Peak incidence occurs between the ages of 30-44.

Types of Anxiety Disorders

Following are some of the different types of anxiety disorders:

  • Generalized anxiety disorder
  • Post-traumatic stress disorder
  • Panic attacks and panic disorder
  • Adjustment disorders
  • Social anxiety disorder (social phobia)
  • Phobias
  • Obsessive-compulsive disorder
  • Separation anxiety

While the exact cause of anxiety disorders is not fully understood, anxiety is believed to involve an imbalance of naturally occurring brain chemicals (neurotransmitters) such as serotonin, dopamine and norepinephrine.  Heredity is a factor in anxiety, as are life experiences such as exposure to traumatic events.

Anxiety is also commonly linked to underlying health issues, and the presence of anxiety may serve as a warning sign.  For this reason, it is important to be evaluated by your doctor if you begin experiencing symptoms of anxiety in order to determine if a diagnosable mental health condition is present and to identify any associated physical problems.

Left untreated, anxiety may lead to, or worsen, other mental and physical health conditions, including depression, digestive problems, insomnia, headaches, teeth grinding (bruxism) and substance abuse.  Anxiety has been linked to heart disease, diabetes, thyroid problems, muscle cramps/spasms and asthma.

Conventional Treatments

Anxiety is commonly treated with psychological counseling (psychotherapy) such as cognitive behavioral therapy.  It is also commonly treated with a variety of medications including antidepressants [eg,  fluoxetine (Prozac), paroxetine (Paxil), escitalopram (Lexapro), sertraline (Zoloft), venlafaxine (Effexor), and imipramine (Tofranil)], buspirone (Buspar), and benzodiazepines [eg, clonazepam (Klonipin), lorazepam (Ativan), diazepam (Valium), chlordiazepoxide (Librium) and aprazolam (Xanax)].

These medications are commonly associated with a number of serious side effects including drowsiness, reduced coordination, problems with balance and memory, headaches, and addiction.  Taken in very high doses, some may even be fatal.

Many patients prefer more natural approaches to treat anxiety.  Strategies include learning about your illness, seeking support, establishing a treatment plan, developing coping skills, and taking steps to reduce the impact of symptoms if you’re anxious.


Lifestyle and Home Remedies

  • Exercise regularly
  • Eat right – including foods rich in omega-3 fatty acids and B vitamins.  Avoid fatty, sugary and processed foods.
  • Avoid alcohol and other sedatives
  • Relaxation techniques such as yoga, meditation, and visualization
  • Get a good night’s sleep

Supplements and Herbal Medicine Options

  • Kava – provides relaxation without sedation (you should not use Kava if you have a liver condition or drink alcohol daily)
  • Valerian – sedative effect, commonly used as a sleep aid
  • B vitamins – may relieve anxiety by affecting neurotransmitter production

Medical Cannabis

Many patients also report that medical cannabis is very effective in treating their anxiety disorders.  Patients commonly say that medical cannabis relieves their anxiety symptoms better than pharmaceutical medications with fewer side effects.  Medical cannabis is reported to be very effective in treating symptoms of PTSD.

Scientifically, there is basis for the use of cannabis in the treatment of anxiety.  One of cannabis’ key medicinal ingredients, cannabidiol (CBD), has been well documented to have anxiety-relieving properties in both animals and humans.  In some patients, tetrahydrocannabinol (THC) may cause symptoms of anxiety.  CBD provides an anti-anxiety balancing effect.

Highlights from the Scientific Literature

Berchamaschi MM, et al (2011).  Cannabidiol Reduces the Anxiety Induced by Simulated Public Speaking in Treatment-Naïve Social Phobia Patients.

  • Results:  CBD significantly reduced anxiety, cognitive impairment, discomfort, and alert levels when compared with the control group.

Crippa JA, et al (2011). Neural Basis of Anxiolytic Effects of Cannabidiol in Generalized Social Anxiety Disorder: A Preliminary Report.

  • Results:  Relative to placebo, CBD was associated with significantly decreased subjective anxiety, reduced ECD (a brain scan tracer) uptake in the left parahippocampal gyrus, hippocampus and inferior temporal gyrus, and increased uptake in the right posterior cingulated gyrus.  These results suggest that CBD reduces anxiety in social anxiety disorder (SAD) and that this is related to its effects on activity in limbic and paralimbic brain regions.

Medical Marijuana Patient Information

Besides smoking, delivery methods for the use of medical cannabis include vaporization, tinctures, teas, and edible products.  Most commonly reported side effects from the use of medical cannabis include dry mouth, red eyes, increased appetite, and tiredness.   There has never been a death attributable to a medical cannabis overdose.  Medical cannabis should be used in consultation with a physician who specializes in cannabinoid medicine.

References and Resources

Bergamaschi MM, et al. Cannabidiol Reduces the Anxiety Induced by Simulated Public Speaking in Treatment-Naïve Social Phobia Patients. Neuropsychopharmacology. 2011; 36:1219-1226.  http://www.ncbi.nlm.nih.gov/pubmed/21307846

Crippa JA, et al. Neural basis of anxiolytic effects of cannabidiol in generalized social anxiety disorder: a preliminary report. Journal of Psychopharmacology. 2011; 25(1): 121-130.  http://www.ncbi.nlm.nih.gov/pubmed/20829306

Mayo Clinic Health Information.  Anxiety.  http://www.mayoclinic.com/health/anxiety/DS01187

National Institute of Mental Health. Health Topics. Statistics. http://www.nimh.nih.gov/statistics/1ANYANX_ADULT.shtml

Project CBD.   http://projectcbd.com/

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About markrabe

Mark L. Rabe, MD, ABIHM Integrative Holistic Medicine Centric Wellness 2308 6th Avenue San Diego, CA 92101 Telephone: (619) 546-0420 Fax: (619) 615-2346 E-Mail: info@CentricWellness.com

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