Here’s What You Need to Know About Cannabis & Anxiety

Anxiety affects 40 million adults in the United States, or around 18.1% of the population. In fact, anxiety disorders are the most prevalent mental health issue in our country. It has been associated with several other conditions including depression, panic disorder, obsessive compulsive disorder, PTSD, insomnia, generalized and/or social anxiety disorder, phobias, eating disorders, and several types of headaches . (1) Discuss your health conditions, including anxiety, with one of our Florida Medical Marijuana Doctors to see what strain, route, and dose would be most effective for you. To find out if you pre-qualify to become a medical cannabis patient, take our 5-minute eligibility survey. 

Anxiety can pose a real problem that interferes with our physical health and mental well-being. It is characterized by feelings of fear, worry or uneasiness; restlessness; difficulty sleeping; an increased heart rate; rapid breathing; and difficulty concentrating.  Over time, these feelings can interfere with normal functioning and even complicate or intensify other health conditions. Current mainstream medical treatment for anxiety includes therapy and pharmaceutical drugs, many of which can have negative side effects. (2) In contrast, in writings dated around 600BC cannabis was recognized for, among other things, its ability to induce sleep; 1621 The Anatomy of Melancholy suggested cannabis as a treatment for depression; as early as 1799 it was used as a sedative by the French. (3)   Medical cannabis presents a viable alternative for people who choose not to use medications such as antidepressants and sedatives. Used properly, cannabis can ease many of the symptoms associated with anxiety without negative side effects like lack of motivation, fatigue, weight gain, insomnia, nausea, diarrhea, dizziness, headache, and a decreased sex drive. (4)

In 2014 students at Vanderbilt University discovered cannabinoid receptors in the amygdala; this part of the brain is instrumental in processing emotion. Chronic stress and anxiety can cause a decrease in both endocannabinoids and the responsiveness of their receptors, which further increases anxiety. Cannabis increases the levels of cannabinoids in the system, thereby helping lower agitation and leading to a sense of calm. (5) A study done in 2008 also showed that stimulating CB1 receptors in this area of the brain by administering low doses of THC reduces the reactivity of the amygdala in response to a perceived threat. In addition, people who regularly use cannabis report feelings of calmness as well as decreased anxiety levels. (6) 

There are some important things to remember when choosing a strain of cannabis to use for anxiety. While each individual may respond differently based on their unique chemistry, it is generally accepted that low to moderate levels of THC in the bloodstream will help ease the symptoms associated with anxiety by acting as a mood booster, strains with higher amounts of THC can actually make it worse by increasing your heart rate and causing your thoughts to race. This is where CBD comes in handy, because it helps moderate the activity of THC while causing no psychoactive effects. In addition, CBD increases serotonin levels in the blood; this can help people with panic disorder and social anxiety. There seems to be a general consensus that strains with a THC:CBD ratio of 1:1 or 2:1 are most helpful for lifting mood and lowering anxiety levels. (7) It is recommended that patients start with a small dose, and build up over time to an amount that works best for them.

 Cannabis strains shown to be effective in relieving anxiety include:

• Granddaddy Purple – Indica
• Harlequin – Sativa
• Skywalker OG Kush – Hybrid
• Amnesia Haze – Hybrid
• Girl Scout Cookies – Hybrid
• Northern Lights – Indica
• Chocolate Chunk – Indica
• Bubba Kush – Indica
• Blueberry Lambsbread – Hybrid (8,9)

Certain terpenes have been found to be helpful in reducing anxiety. 

• Limonene, with its citrusy smell, increases dopamine and serotonin levels in key levels of the brain. It also decreases OCD-related behaviors, normalizes stress hormone levels and improves immune function. (10)
• Linalool, most commonly associated with lavender, was shown to decrease anxiety, increase social activity and lessen the incidence of aggressive behavior. (11)
• Beta-caryophyllene, the peppery-smelling terpene that acts like a cannabinoid, helps regulate emotional behavior. It has noted antidepressant and anti-anxiety properties. (12)
• Alpha-pinene, with a smell like a pine tree, is thought to help inhibit anxiety when inhaled. It works by binding to the GABAA receptor in the limbic system, which includes the amygdala. (13)

For patients concerned about the psychoactive effects of THC, CBD can be an effective substitute for SSRI or SNRI drugs such as Prozac, Zoloft, Lexapro, Effexor and Cymbalta. CBD has been shown to reduce stress and lower the signs of anxiety such as increased heart rate, agitation, and insomnia. It can also help lessen the frequency and intensity of nightmares as well as repeated negative memory recall in patients with PTSD. It is important to discuss CBD use with your physician if you are taking drugs such as anticoagulants and others that carry a warning to avoid grapefruit because it can interfere with cytochrome P450, which helps break down these medications; as a result, you may experience an increase in the drug’s side effects. (14,15) 

In addition to the use of medical cannabis, there are other natural ways to help relieve the symptoms of anxiety. 

• Exercise — Regular mild to moderate exercise is a great way to burn off the extra energy caused by anxiety.

• Prayer or Meditation – Focusing on something calming can help slow racing thoughts and lower stress.

• Time management – Having a plan may help you be able to focus on one thing at a time and feel less stressed because you know what comes next.  

• Relaxation exercises – Tensing and then relaxing different muscle groups can help ease overall body tension. Progressive relaxation, working your way up from your toes to your head, is a good way to help battle the muscle tightness caused by anxiety. 

• Writing – Whether using a pen and paper, doing an online blog, or engaging in creative writing exercises, expressing your thoughts this way can help you cope with anxiety more effectively and even make it feel more manageable.

• Aromatherapy – Experiment with different aromas to find ones that soothe you. Aromatherapy can also decrease your heart rate and help you sleep better. 

• Herbal Supplements – While these can bring calm and a sense of peace, make sure to talk to your doctor before trying a new supplement if you are taking any other kind of medication to prevent negative reactions. 

• Herbal Teas – The act of making tea can be soothing in and of itself. Chamomile tea as well as some others can help you relax and sleep better.

• Spend Time with Animals – Pets offer support, companionship, and unconditional love. Just having them around can decrease stress levels, reduce the stress associated with trauma, and improve psychological health. (16)

Cannabis can be an important part of not only treating anxiety, but preventing it. Using a multi-faceted approach including regular dosing with medical cannabis may offer relief from stress and anxiety, improving your health as well as your quality of life. 

1. https://adaa.org/about-adaa/press-room/facts-statistics
2. https://www.healthline.com/health/anxiety
3. https://medicalmarijuana.procon.org/historical-timeline/
4. https://www.everydayhealth.com/anxiety/guide/medications/
5. http://news.vumc.org/2014/03/06/discovery-sheds-new-light-on-marijuana-anxiety-relief-effects/
6. https://www.jneurosci.org/content/28/10/2313
7. https://greatist.com/live/cannabis-and-anxiety#Cannabis-101:-CBD-vs.-THC
8. https://medmardispensary.com/best-cannabis-strains-help-ease-anxiety/
9. https://www.leafly.com/news/science-tech/got-anxiety-study-finds-cannabis-strains-to-try-or-avoid
10. https://www.leafly.com/news/strains-products/cannabis-strains-high-limonene-anxiety-stress-depression
11. https://www.sciencedirect.com/science/article/abs/pii/S0944711309002578
12. https://www.royalqueenseeds.com/blog-beta-caryophyllene-a-terpene-against-anxiety-and-depression-n702
13. https://www.sundialcannabis.com/discover-cannabis/how-terpenes-work-with-cbd-to-relieve-anxiety
14. https://www.healthline.com/health/cbd-for-anxiety
15. https://www.healthline.com/nutrition/grapefruit-and-medications
16. https://www.medicalnewstoday.com/articles/322396.php

Dr. Ross Glider

Dr. Glider is a board certified Internal Medicine Specialist.  He received his Florida Medical Marijuana Physicians Certification in 2017 and was one of the first recommending physicians with DocMJ. In addition to medical marijuana recommendations, Dr. Glider continues to practice Internal and Geriatric Medicine in private practice. Additionally, he serves as Medical Director for a home health company, supervising and educating staff, as well as supervising an advanced Registered Nurse Practitioners for a transitional care program.

Dr. Glider graduated from the College of Osteopathic Medicine & Surgery in Des Moines, IA and completed his residency at Saddlebrook General Hospital in Saddlebrook, NJ. He has received several honors and awards throughout his professional career, including a City of Des Moines Merit Award and a Chamber of Commerce Award (Port St. Lucie, FL).  Dr. Glider is an experienced and caring physician who is loved and respected by his peers and his patients.