Over the course of a decade, the public perception of cannabis has rapidly swung from negative to positive. What was once a distasteful if not dangerous drug has become nothing less than a cure-all, touted by scientists as the key to managing a multitude of devastating diseases. Already, a pharmaceutical with a cannabis compound as its active ingredient has been approved by the FDA for the treatment of epilepsy, and researchers have strong evidence that a number of other cannabis compounds could be essential in managing conditions like Parkinson’s, Alzheimer’s, MS and even chronic pain.
Yet, some of the most common uses for medical cannabis are in the treatment of mental disorders, particularly anxiety, depression and post-traumatic stress disorder. Is there any evidence that cannabis compounds are effective in managing these disorders, and are there any potential side effects?
CANNABIS AND ANXIETY
Many stoners claim that they enjoy their drug of choice primarily because it helps them control overwhelming feelings of anxiety. Indeed, when one is trapped in an anxiety loop, it might make sense to partake of a psychoactive substance, which can help to interrupt unhelpful thoughts and provide more pleasurable sensory input.
Unfortunately, cannabis doesn’t always provide that useful release. Studies on cannabinoids have found that the drug is equal parts unhelpful and helpful in anxiety reduction. The dominant psychoactive compound in cannabis, THC, often exacerbates anxiety symptoms; in fact, a common symptom of THC use is paranoia or panic, both of which compound existing anxious thoughts. In contrast, the second-most common compound is a non-psychoactive cannabinoid called CBD, which does seem to have a minor anxiety-reduction effect.
Knowing how to deploy cannabinoids properly during anxious episodes is the key to managing anxiety using cannabis. Small doses of CBD throughout the day can keep anxious thoughts in check during times of particularly high stress. However, CBD should not be used constantly in the long-term, and it should not be an anxious person’s only recourse in managing their condition.
Yet it isn’t merely the compounds within cannabis that can affect its efficacy as an anxiety treatment. Using cannabis as a crutch during anxious periods might intensify anxiety, especially if a user is not in a good position to partake — if they are in public or haven’t recently visited a Salem pot shop for supplies. Generally, clinical anxiety that affects daily life is best managed through mental health counseling and drugs developed for anxiety treatment. Cannabis should only be applied in the short-term under the supervision of a mental health professional.
CANNABIS AND DEPRESSION
One is often tempted to rely on substances as a distraction or brief respite from the depths of depression. Marijuana can be particularly enticing because THC provides feelings of euphoria and contentment which are often long missing from a depressed person’s mindset.
Fortunately, research has confirmed that cannabinoids can stimulate feelings of well-being and reduce symptoms of depression. Unfortunately, these feelings are remarkably short-term, lasting only a few hours before the prior depressive state returns. Research has found no evidence that using cannabis will lead to long-term reduction in symptoms; in fact, the opposite seems to be true, with depression worsening the longer cannabis is used as the sole form of treatment. Worse, reliance on cannabis in this way can lead to cannabis use disorder, which requires different methods of treatment to overcome.
As with anxiety, cannabinoids may be useful tools in managing depression — but only when they are deployed alongside other depression-fighting methods. Those suffering from depression should seek help from mental health professionals and utilize more traditional medications, only using cannabis under the direction of their doctors.
CANNABIS AND PTSD
Perhaps surprisingly, PTSD is one of the few mental health conditions that is positively affected and effectively treated by cannabis. This is largely due to the nature of the disease. While PTSD can share lingering symptoms similar to anxiety and depression — like emotional detachment, sadness and difficulty sleeping — the worst symptoms of PTSD are episodes of panic caused by memories of a traumatic event.
Because cannabis is both fast-acting and short-lived, cannabinoids can be deployed during these episodes to interrupt memories and provide a feeling of calm and comfort. By disrupting the pattern of the episode, cannabinoids help to make the memories less powerful and give sufferers a chance to overcome their trauma. This also extends into sleep, as cannabinoids reduce the period of REM during which nightmares might develop.
Research indicates that antidepressants alone are not as effective at PTSD treatment as marijuana. However, as with any mental disorder, those with PTSD should avoid the temptation to self-medicate and instead seek treatment through a mental health professional.
The truth is that we aren’t close to understanding the complexities of mental health, and treating mental health disorders is a complicated and delicate endeavor. Though cannabis could be a crucial element to the management of anxiety, depression and PTSD, it is best used in conjunction with other, better-understood treatment options.