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CBD and Anxiety

CBD and Anxiety: a possible natural remedy?

Accumulating evidence indicates that cannabidiol (CBD), a non-psychotropic and non-addictive main component of the cannabis sativa plant, reverses anxiety-like behaviour. 

Having to deal with an important and/or new situation, facing a critical day at work, struggling to get through university exams, taking care of your home and family, going on a date, going through a break-up, meeting your manager or going to a job interview, dealing with situations that have caused stress in the past....

When people find themselves in these circumstances, It is common to begin to feel fear, an overwhelming sensation, shortness of breath, nausea, and stomach pain. These discomforts may be linked to excessive stress that leads to symptoms of anxiety. According to preclinical trials, CBD has potential as a natural remedy to reduce such symptoms.

What is anxiety? 

The term anxiety can refer not only to a more chronic disorder but also to its symptoms that can appear acutely. It is a natural adaptive mechanism that puts us on alert in compromising situations, being suitable to prevent dangerous situations and to keep us focused in circumstances where we have to give 100%.

Problems arise when there is an excess of stress and there are not enough tools to handle it, so people can feel overwhelmed and with a sense of resignation in a situation that exceeds their own capabilities.

All this can be worsened in people who have lived through traumatic experiences of different degrees. The symptoms may be associated with similar experiences or simply with stimuli that are associated with those memories, which can provoke panic attacks that often represent another traumatic event, thus extending the cycle and leading the person into an incapacitating situation.

The person suffering from anxiety may feel particularly vulnerable or helpless and there may be a deterioration in psychosocial and physiological functioning.

Symptoms related to episodes of anxiety are:

  1. Palpitations or tachycardia
  2. Shortness of breath and a feeling of being out of breath, with rapid breathing
  3. Feeling of tightness in the chest
  4. Fear or panic; Literally, feeling in danger
  5. Sweating or shivering
  6. Trembling
  7. Nausea or abdominal discomfort
  8. Dizziness or even fainting

If anxiety is persistent and intense, it can prevent the person experiencing it from carrying out a normal day-to-day life.

How can CBD help you treat anxiety? 

What is CBD? Properties and benefits of CBD.

CBD (Cannabidiol) is the second most abundant cannabinoid among the phytocannabinoids found in Cannabis Sativa L. plants. Unlike many other cannabinoids, CBD is non-psychotropic and has a different beneficial and therapeutic profile than other psychoactive cannabinoids, recognised by the World Health Organization (WHO).

Why is CBD good for anxiety?

One of the properties of CBD is that it is anxiolytic. It acts in our body through the receptors of the endocannabinoid system, regulating the activity of the amygdala and the insula, whose activities are related to the emotions and symptoms linked to anxiety disorders and stress, such as fear, disgust or sadness, but also to love and happiness. Its role as a regulator and modulator of the activities of these brain structures is therefore significant.

Stress by definition is not always negative, as it produces hormones such as adrenaline, dopamine, or serotonin, which influence the energy of a person, increasing their vigor and confidence to face a problem. However, when stress is continuous or unmanageable, the body generates different hormones such as cortisol, which produces feelings of exhaustion and irritability or even lack of motivation. CBD stimulates specific receptors capable of modulating serotonergic and dopaminergic activity to promote a physiological balance whose effect on the psychological level is anxiolytic and antidepressant.

Evidence for the benefits of CBD for anxiety

Existing preclinical evidence strongly supports CBD's potential as a treatment for anxiety disorders. This is because CBD exhibits a range of effective properties for some symptoms, including anxiolytic, antipsychotic, panicolytic and anti-compulsive actions, a decrease in fear, and prevention of long-term anxiogenic effects due to stress.

These preclinical studies have shown that CBD interacts with receptors that regulate fear and anxiety-related behaviours, specifically the cannabinoid receptor type 1 (CB1), the serotonin receptor 5-HT1A and the transient receptor potential (TRP) vanilloid type 1 (TRPV1).

CBD, administered consistently on a regular basis, reduced acute stress-induced increases in heart rate and blood pressure, as well as the delayed anxiogenic effects of stress (those occurring within 24 h of the stress-inducing event). CBD has also been shown to enhance the extinction of fear responses in addition to blocking the reconsolidation of adverse memories.

In summary, it can be seen that CBD is a complete and integral therapeutic tool, capable of acting on a physical, psychological and emotional level, while representing one of the most suitable treatments for anxiety and stress disorders.

How to use CBD to treat anxiety

CBD, unlike other substances that have a more direct impact (stimulating or inhibiting), is able to indirectly modulate and enhance the endocannabinoid system, so that all the physiological processes necessary to re-establish the homeostasis (balance) of the body are set in motion.

Every person has a different body that is characterised by a unique and personal balance. Therefore, each person will have their own specific ways of coping with different problematic situations such as anxiety, thus requiring the most personalised treatment possible.

For these reasons, it is difficult to establish an effective amount of CBD for anxiety in general, as it is necessary to find the most appropriate dosage for each person. In addition, anxiety can be triggered for highly personal reasons and each individual often resorts to very different therapies and tools, making each therapeutic journey very specific.

This is why the various clinical studies that have been conducted (2)(7) and are being conducted (8) tend to use a dosage that can vary from 30 mg (9)(10) to 800 mg daily(11), as well as using different routes of administration.

Routes of administration

Inhaled route: the effect is immediate and maximum from the beginning, so the inhaled form can help to alleviate acute episodes of anxiety and/or panic or feelings of anguish.

Sublingual: this is the most recommended form for medium/long-term treatment and to provide relief in more chronic situations such as an ongoing anxious state.

Topical: can provide relief in areas of the body that tend to tense up during episodes of anxiety, such as the cervical and pectoral muscles.

CBD to treat anxiety and insomnia

Anxiety can affect other factors in our lives such as sleep, leading to insomnia. CBD treatment for anxiety is recognised and according to studies, if the dosage is stable over the long term, it has therapeutic potential to improve sleep.

To find out more you can take a look at our article, reviewed by Viola Brugnatelli, on the effects of CBD on sleep.  

Can CBD abuse lead to intoxication? What happens if i take high doses of CBD?

CBD has been found to have a bell-shaped response curve, meaning that higher doses are not necessarily more effective, but rather quite the opposite. It is therefore essential to find the right dose for the individual. To do this, it is recommended to start with a low dose and gradually increase it until the effects appear.

According to the Canna Foundation, the possible adverse effects of CBD are: "tiredness, drowsiness, dry mouth, dizziness and decreased appetite,” which diminish when the dose of CBD is reduced or administration is suspended.

To learn more about the effects, take a look at our article, "What are the side effects of CBD.”

And what about THC?

Due to its psychoactivity, THC can cause an anxiogenic effect (i.e. it produces anxiety), especially in people who are prone to anxiety. Therefore, its use is not recommended for people who suffer from episodes of anxiety.

Has CBD been scientifically proven to help with anxiety and depression?

The simple answer is: No. There are preclinical trials, such as those cited above, that show it to be effective, but more research is needed. The range of conditions for which CBD has been evaluated is diverse, consistent with its neuroprotective, anti-epileptic, anxiolytic, antipsychotic, analgesic, and anti-inflammatory properties.

Much more research and clinical studies are needed to evaluate CBD as a possible treatment for anxiety and depression. This does not mean that it would not help, but properly controlled clinical trials are needed to support the use of CBD to treat anxiety or depression

Thanks to preclinical results and other research around the world, the regulatory and bureaucratic frameworks have increased their acceptance of the use of cannabinoids as a therapeutic alternative. In countries such as the USA, Sweden and Canada, CBD is permitted for ingested use.

Still, much remains to be known about the complex endocannabinoid system and how it interacts with the different cannabinoids. The key to this progress is the destigmatisation of the cannabis plant and the encouragement of clinical trials.

Bibliography:

  1. "Can CBD Help with Anxiety?" American Association of Anxiety. 2019
  2. Esther M. Blessing et al. "Cannabidiol as a Potential Treatment for Anxiety Disorders." 2015
  3. Scott Shannon, MD et al. "Cannabidiol in Anxiety and Sleep: A Large Case Series,"2019
  4. Vanessa P. Soares and Alline C. Campos."Evidences for the Anti-panic Actions of Cannabidiol," 2017
  5. Nobuo Masataka. "Anxiolytic Effects of Repeated Cannabidiol Treatment in Teenagers With Social Anxiety Disorders." Primate Research Institute. Japan. 2019
  6. Peter Grinspoon, MD "Cannabidiol (CBD) — what we know and what we don’t."Hardvard Contributor. 2019
  7. Skelley JW, Deas CM, Curren Z, Ennis J. Use of cannabidiol in anxiety and anxiety-related disorders. J Am Pharm Assoc (2003). 2020.
  8. Salerno, Lindsey et.al. Is Cannabis an effective treatment for anxiety?. Anxiety.org. 2018
  9. Sublingual Cannabidiol for Anxiety. Mclean Hospital. Clinical Trial. 2019.
  10. A Clinical Trial of a Hemp-Derived Cannabidiol Product for Anxiety. Mclean Hospital. Clinical Trial. 2020.
  11. Cannabidiol for the Treatment of Anxiety Disorders: An 8-Week Pilot Study. McMaster University. 2020.
Author information

Neuropsychologist | Specialised in treatments with Medical Cannabis

Tommaso Bruscolini

Tommaso Bruscolini (Rimini, Italy) is a neuropsychologist and phytotherapist based in Barcelona, where he has been running his private practice since 2014, both in person and online, where he formulates and produces different preparations with all kinds of medicinal plants, as well as making personalised recommendations.

A member of the Official College of Psychologists of Catalonia and qualified as a Health Psychologist, he is a specialist in Neuropsychology, the branch that studies the brain and its neurological function. Tommaso complements his training with studies in Phytotherapy and Herbalism at the Guild of Herbalists of Catalonia and two Masters, one in Nutrition and Herbal Dietetics and the other in Mindfulness.

In recent years she has specialised in Medical Cannabis, through private training and collaborations with different entities in the world of Medical Cannabis, coordinating for a year a clinic specialising in cannabinoid medicine, carrying out consultations, writing articles, talks, training courses as well as carrying out consultations and patient follow-up.

He currently collaborates with several entities of the cannabis sector in Spain, among other things he is the coordinator of the therapeutic area of the magazine DolceVita España, consultant in the SmokingMap portal, collaborator of the Unión de Pacientes por la Regulación del Cannabis (UPRC) and Alpha-Cat certified technician to perform cannabinoid analysis.

What fascinates him most about the Cannabis plant is the possibility it has to change the current medicinal and therapeutic paradigm towards a more holistic vision as it acts on our body, mind and mood, in a synergic way.

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