Everyone feels anxious or stressed from time-to-time. It’s a natural response to real or perceived threats to our safety or wellbeing.
But a significant proportion of the population experiences chronic anxiety, which can seriously undermine their quality of life.
It’s estimated that 1 in 4 New Zealanders are living with an anxiety disorder, or related condition, at any one time — that’s close to a million people.
And in our hyper-connected modern world, anxiety seems to be more widespread, particularly among younger people.
The most commonly prescribed medications for anxiety disorders include selective serotonin re-uptake inhibitors (SSRIs) such as Prozac; benzodiazepines; antidepressants; beta blockers; and monoamine oxidase inhibitors (MAOIs).
All of these can be effective treatments for anxiety, but some people experience adverse effects.
Patients who don’t respond well to common pharmaceutical medications or would prefer more natural alternatives may be interested in exploring medicinal cannabis to help manage their anxiety.
Cannabis and anxiety: Is it good or bad?
The relationship between cannabis and anxiety is a complicated one.
Cannabis use has been associated with inducing feelings of anxiety, depression, panic, and paranoia.
So it might come as a surprise that studies are finding cannabis — particularly CBD — has considerable potential as a treatment for anxiety disorders.
CBD may help to ease excessive worrying, panic attacks, and feelings of agitation, restlessness, fatigue, and social anxiety.
That’s not to say it’s safe to smoke cannabis anytime you feel anxious. In fact, doing that without knowing the dose and blend could make your anxiety worse.
Medicinal cannabis products are much safer as the cannabinoid dose and quality are carefully controlled.
CBD has been found to have the most potential in treating anxiety, while high-dose THC can have undesirable effects.
It’s important to talk to your doctor about which medical cannabis product is best suited to treating your anxiety.
We recommend doing your own research into cannabis and anxiety before scheduling your doctor’s appointment.
To help you prepare, let’s look at how cannabis works to relieve symptoms of anxiety and what the research says.
Go deeper into the research with Ora Support, our medicinal cannabis education platform for patients and caregivers.
How it works
Scientists think CBD (and to a lesser extent, THC) helps to relieve anxiety and stress by interacting with the endocannabinoid system (ECS).
The ECS contains CB1 and CB2 cannabinoid receptors.
There is a high density of CB1 cannabinoid receptors in the parts of the brain associated with anxiety processing.
Ora Pharm medical and research officer Dr Roger Negrete says CBD reduces anxiety by activating serotonin receptors in the brain.
Serotonin is a neurotransmitter that has many important functions, including modulating mood.
CBD and THC may also influence the presence of anandamide, known as “the bliss molecule”, which helps with emotional balance.
Studies have also found that cannabis-derived terpenes, such as limonene and linalool, may produce anti-anxiety effects and help to reduce stress.
CBD for treating anxiety: What the research says
The research into medical cannabis as a treatment for anxiety and stress is limited, but promising.
The first New Zealand study
A study of 253 patients in New Zealand, published in 2020, found that CBD oil helped to relieve symptoms of anxiety.
Patients completed a questionnaire at baseline before taking CBD and again after at least three weeks of using the medicine.
The questionnaire measured mobility, self-care, usual activities, pain or discomfort, and anxiety or depression, each with five levels of severity.
“Overall, current evidence indicates CBD has considerable potential as a treatment for multiple anxiety disorders.”
There were a wide range of doses used in the study, but this wasn’t monitored and reporting was inconsistent.
Overall, the study found that self-reported levels of anxiety decreased after using CBD oil and there were no major adverse effects.
However, the authors say the results should be interpreted with caution due to the limitations of the study.
The public speaking test
Everyone knows how nerve-wracking public speaking can be.
A 2011 double-blind randomised study looked at how CBD influenced anxiety during a simulated public speaking exercise.
The study compared a healthy control group with a group of people with social anxiety disorder, half of which received a single dose of CBD, taken orally, or a placebo before the speaking test.
Subjects were required to rate their mood and self-evaluate their performance, and their blood pressure, heart rate and skin conductance were measured six times during the test.
The group treated with CBD experienced “significantly reduced anxiety, cognitive impairment, and discomfort in their speech performance”. They were also less worried about having to speak.
Whereas, the placebo group presented higher anxiety, cognitive impairment, discomfort, and alert levels.
This study is a promising indication of the rapid onset of CBD’s therapeutic effects in people with social anxiety disorder.
A review of the research
A 2020 review of 35 “significant” animal, human and epidemiological studies concluded that whole cannabis and CBD “may have a beneficial role in anxiety disorders”.
“Based on current data, cannabinoid therapies (containing primarily CBD) may provide a more suitable treatment for people with pre-existing anxiety or as a potential adjunctive role in managing anxiety or stress-related disorders.”
However, isolated THC may have anxiety-causing effects in humans.
Further research is needed to establish consistency in the results and determine therapeutic thresholds and dosage.
A double-edged sword
It’s easy to read that cannabis can help with anxiety and think, “Great, I’ll start using it then”.
But it’s important to note that cannabis has been found to both treat anxiety, and contribute to it.
Therefore, you should be careful about which cannabis products you use.
CBD is showing the greatest potential as an anti-anxiety medicine in studies with humans, but it’s possible that low-THC, high-CBD varieties can also be effective.
If you’re experiencing prolonged symptoms of anxiety or you’re not happy with your current medication, you can talk with your doctor about trying CBD.