Yes, medical marijuana can help with your anxiety. In fact, anxiety and anxiety-related disorders are some of the most common conditions cannabis and a medical marijuana card are recommended for. Why? Well, there’s various reasons, and we’ll get onto the science in a bit, but the main two are because there are all sorts of other conditions that can cause anxiety and because it’s quite a common condition. After all, it isn’t surprising if someone who’s in constant physical pain from battling cancer, epilepsy, multiple sclerosis (MS) or any number of conditions feels anxious as well!
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So, with that out of the way, onto the science …
What is Anxiety?
When most people think of anxiety, they’re usually thinking of generalized anxiety disorder (GAD), the most common form of anxiety. Symptoms of GAD include irritability, chronic apprehension and a phobic-like avoidance of situations that could cause a panic attack. Selective serotonin uptake inhibitors (SSRIs), buspirone and benzodiazepines are commonly prescribed for GAD. There are other subsections of anxiety as well, including:
- Social anxiety disorder, aka social phobia – Extreme agitation when in social situations, and/or avoidance of social situations almost entirely. Sometimes shortened to “SAD”, but often not it’s also an acronym for “Seasonal Affective Disorder”.
- Obsessive-compulsive disorder (OCD) – Anxious thoughts about a particular situation leading to obsessive behavior, leading to stereotyped compulsive behavior aimed at resolving the situation in order to ease stress. One popular example is a person suffering from OCD absolutely needing to clean a dirty room, even if the room belongs to someone else, and even if the room might be clean according to everyone else! SSRIs like fluoxetine (Prozac) and tricyclic antidepressants like clomipramine (Anafranil) are often prescribed to those with OCD.
- Panic disorder – Brief spells of overwhelming anxiety or fear, usually lasting between 2 – 10 minutes. SSRIs, monoamine oxidase inhibitors (MAOIs), tricyclic antidepressants and high-potency benzodiazepines are often prescribed to those suffering from panic disorder.
- Post-traumatic stress disorder (PTSD) – Experiencing an intense trauma (e.g. assault, warfare, traffic accidents), which results in long-lasting anxious responses. Disturbed sleep & nightmares, flashbacks, avoidance of certain social situations that may lead to re-experiencing the traumatic event/s and emotional numbing. PTSD is no longer under anxiety-related disorders in the DSM-5, and is now under the new section ‘Trauma- and Stressor- Related Disorders’. SSRIs, low-dose antipsychotic medications and benzodiazepines are often prescribed to those suffering from PTSD.
Anxiety disorders are often comorbid with depressive disorders like dysthymia and major depressive disorder (MDD), body image disorders (e.g. bulimia nervosa) and attention deficit hyperactivity disorder (ADHD). Anxiety-related disorders are often comorbid with depression in particular.
How Does Medical Marijuana Help with Anxiety? It’s Our Good Friend, the ECS
That’s the endocannabinoid system (ECS), for those of you who aren’t regulars to this blog. There is evidence that cannabis has an effect on emotional regulation, and can be used to help mediate symptoms for those suffering from PTSD. So, why does medical marijuana help for PTSD sufferers?
Well, the main reason given is because PTSD sufferers have a lack of the endocannabinoid anandamide – the “pleasure” neurotransmitter thought to be responsible for the “runner’s high”. Anandamide can reduce anxiety by activating CB1 receptors in the brain. Tetrahydrocannabinol (THC) is the phytocannabinoid analogous to anandamide. Though PTSD is no longer an anxiety-related disorder according to the DSM, it has been shown that anandamide deficiency predicts stress-induced anxiety. There are also other cannabinoids – namely, cannabigerol (CBG) – that have significant anxiolytic and antidepressive effects.
So I Need a Strain High in THC?
This is where things get a little difficult. Yes, a good amount of THC is best for anxiety of all types. However, many people report negative effects when using high-THC strains for their anxiety, as THC can induce paranoia. This suggests that, although medical marijuana can be great for anxiety, it can also be detrimental, depending upon the strain. Microdosing THC is ideal in order to prevent anxiety – too much can promote anxiety. THC has biphasic effects, meaning it can beat anxiety in low doses but cause anxiety in larger doses.
So Which Strain, Then? Is There a Best Strain for Anxiety?
Well, this is a difficult one, especially as different types of anxiety might require different strains. However, a strain with high THC and a good amount of CBD to “tone down” the THC’s effects whilst still giving that euphoric effect. For beginners (and even many experts), it is perhaps best to try a 1:1 THC:CBD strain or tincture, such as Cannatonic and ACDC – both indica-sativa hybrids.
Many also swear by blue dream, a cross between blueberry and super silver haze. Indicas like northern lights and granddaddy purple (GDP) are also popular. Overly strong sativas should perhaps be given a miss, although strawberry cough has had its praises sung for its usefulness in battling social anxiety. We can imagine it’s because there’s enough indica in strawberry cough to “smooth out” the overwhelming effects of THC. Strains like GDP, gorilla glue and blueberry-based indicas also tend to have terpenes like humulene, linalool and alpha-pinene, which have anxiety-busting and relaxing effects. They can also combat some of the negative side-effects of THC.
As for strains you may want to avoid, anything high in tetrahydrocannabivarin (THCV) could be best given a miss, as these equatorial sativa strains (generally hailing from Africa) are renowned for their “speedy”, heart-racing effects, which can induce anxiety in some. However, low doses of THCV actually has anti-psychoactive effects (the biphasic effects of cannabinoids), so a small amount of THCV can create a “ceiling” for THC. Some people prefer delta-8 THC for this reason. This includes strains like Durban poison, green crack, trainwreck and AK-47. There are two particular sativas that have mixed reviews: Jack Herer (mostly haze parentage) and girl scout cookies (Durban poison is one parent). Both of these varietals have a significant amount of indica in them, but their phenotype variation means you could end up with a very energetic strain that’s associated woth sativas. This means that such varieties (or “strains” as they’re often called) can be used to both combat and induce anxiety! Thi is why a plant’s growth pattern shouldn’t be used to determine what sorts of effects they can have.
However, we don’t have a definitive “strain science” as of yet, as so much about marijuana’s medical properties and cannabinoid-terpenoid interactions needs to be studied in far more depth than we have so far. For some people, one strain might work, whereas for others it might have a neutral or even negative effect. The boundaries between sativa and indica are fuzzy at best. The only way to find out if medical marijuana will help beat your anxiety is by getting yourself a MMJ card, going to a dispensary and testing out various strains. Sure, use the above as a guide, but not as a manual.
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