At this point, it’s hard to question the validity of weed’s medical use. With 33 states acknowledging its medicinal applications and legalizing its use in that area, the need is clear. Health benefits of the plant range from seizure regulation to glaucoma treatment to – the highest reported reason for medical marijuana use – chronic pain relief. So why is there still so little information on cannabis as potential treatment for mental illnesses?
Federally, marijuana is considered a Schedule I substance – a drug with no accepted medical use. This classification has limited research on medical marijuana for years. However, weed’s shifting social acceptance and the growing understanding of its interaction with our central nervous system has allowed us to learn more about marijuana’s effects on mental illnesses than we ever have before.
Marijuana’s Effects on Anxiety Disorders
After pain, anxiety’s the second most reported reason for medicinal marijuana use. Generalized anxiety is a state of extreme unease and apprehension – usually paired with physical symptoms like rapid heartbeat, increased sweating or rapid breathing. Aside from general anxiety disorder, cannabis has been used to treat many specified afflictions across the spectrum, such as panic attacks, social anxiety, obsessive compulsive disorder and more.
While cannabis has been utilized to quell symptoms of these disorders for centuries, it’d be wise to proceed with caution when approaching treatment. While THC – the main psychoactive compound in cannabis – seems to reduce anxiety at lower doses, there’s evidence that it does the opposite when high doses are consumed. Understanding the variables that cause cannabis to reduce or increase anxiety is key during treatment. These variables can range from the chemistry and dose, the setting where it’s ingested, or the user’s overall headspace – they all contribute to the end result when using THC.
However, when CBD is used, with or without THC, it often quells any nervousness related to THC’s use and reduces the risk of anxiety overall. The endocannabinoid system (ECS), the system that tetrahydrocannabinol (THC) and cannabidiol (CBD) interact with directly, is thought to regulate anxiety. The ECS exists throughout the central nervous system, particularly in the amygdala and hippocampus – areas of the brain tied directly to anxiety. Terpenes found in cannabis have also been known to boost levels of serotonin and dopamine in these areas of the brain, acting as an antidepressant and calming agent.
To use cannabis to get effective relief from symptoms of general anxiety, it’s best to either ingest low doses of THC (1-3 mg) or more middling doses of CBD (4-10 mg). And while higher amounts of THC can lead to more intense psychoactivity, CBD is well tolerated without symptoms in even high doses. For different areas of anxiety disorders, there are different approaches and suggestions for treatment.
Weed’s Effects on Social Anxiety
Similar to general anxiety, low doses of CBD or THC have been beneficial in relieving symptoms of social anxiety disorder. Proper cannabis treatment has allowed patients to enjoy social interactions and engage with others without fear or self-consciousness. Untreated, that fear and self-consciousness has been known to cause personal distress to the point of being unable to function in certain settings.
Studies have shown that pretreatment with CBD can reduce that anxiety and prevent those types of impairments. Going further, CBD has shown to reduce learned fear responses and affect the processing of fear-related memories that lead to social anxiety in the first place.
Weed’s Effects on PTSD
Research suggests that there’s a link between the endocannabinoid system and how the brain processes traumatic memories. This, of course, opens the door between post-traumatic stress disorder and cannabis treatment.
The classic depiction of PTSD is the war-torn veteran, suffering through the painful memories of combat. The U.S. Department of Federal Affairs National Center for PTSD has even discussed how many veterans will use cannabis to treat symptoms, and many states approve of that treatment. However, they also shed doubt on the effectiveness of medical marijuana – claiming that there isn’t proper research evaluating the safety and potency of the treatment.
On the other end of the discussion, there are medical reviews as recent as 2017 citing evidence for cannabis use in treating PTSD symptoms like insomnia, frustration, flashbacks and anxiety. Depending on dosage, cannabinoids may even prevent the development of PTSD if they’re administered close enough to the traumatic incident.
Marijuana’s Effects on Depression
More than 260 million people suffer from depression worldwide, so it’s not surprising that it’s also cited as a major contributing factor to medical marijuana use. In surveys, one-third of patients listed depression as their reason for using cannabis, despite the overall lack of clinical data to support cannabis as a treatment.
Still, marijuana has the known advantages of mood elevation and anxiety relief, which could be very beneficial in dealing with depression. Elements within cannabis are also known antidepressants, increasing levels of dopamine in the brain. This may help thwart many significant aspects of depression. Still, caution should be used when using medical marijuana as treatment.
As discussed with other conditions, cannabis products high in THC are biphasic – meaning they reduce symptoms in low doses and could agitate symptoms in high doses. Despite there being no clear evidence that marijuana causes depression, some claim there is a link between heavy users and higher depression diagnoses. This, like marijuana’s link to other mental illnesses, is largely unsubstantiated.
Due to the lack of evidence in support of treating depression with cannabis, it’s considered unwise to use it as a sole remedy. Antidepressants that are currently available are thought to be more effective, and the severity of depression certainly isn’t something to overlook. Still, if you’re looking for an effective way to pair cannabis with your treatment, 2.5 to 5 mg of THC can be ingested to help shift your mood. Additionally, 5 to 10 mg of CBD can help curb the anxiety accompanying the depressive feelings.
Marijuana’s Effects on Schizophrenia & Psychosis
Schizophrenia is a severe mental disorder in which patients interpret reality abnormally, often leading to cognitive problems and erratic behaviors and emotions. Though it’s likely a complex mix of genetics, environment, and altered brain chemistry, the exact cause of the disorder is unknown. There’s a storied history of studies and claims linking marijuana use to schizophrenia. Recent research has even suggested that smoking high-THC marijuana on a daily basis could increase chances of developing a form of psychosis. While this association is not in major doubt, none of this evidence applies to high-CBD cannabis.
A recent review has shown that CBD effectively counters psychoactive effects caused by THC, and those benefits weren’t just limited to preventing THC-related psychosis. In small-scale trials, patients showing signs of psychosis were treated with CBD, and results showed that CBD is a very safe and consistent antipsychotic. In any case, the risk of cannabis-related psychosis is minimal unless those tendencies are pre-existing. Many medical professionals overseeing patients suffering from severe social anxiety, ADHD, PTSD, etc. believe that the benefits cannabis provides outweigh the small chance of THC-related psychosis.
Marijuana’s Effects on Autism
Evidence supporting medical marijuana for autism treatment is practically nonexistent. State restrictions for the use of medicinal cannabis by children have been tightened in the past due to growing trends of parents using marijuana to treat their autistic children. New research into the endocannabinoid system’s involvement in the development of autism has only recently paved the way for future studies.
Despite the lack of a formal trial, recent preclinical work suggests that cannabis use with patients on the autism spectrum can better support mental processes disrupted in autism. This is in addition to a synthetic THC being a part of a recent open-label study for treating self-harming behavior in autistic adolescence. As new information sways scientific opinion on the matter, there are also continuing discussions on CBD’s place and if it could be effective in treating the symptoms of some spectrum disorders.
Marijuana’s Effects on ADHD
Attention deficit hyperactivity disorder is one of the most frequent neurodevelopmental disorders among children. However, like with autism and schizophrenia, the idea of cannabis as treatment for ADHD has been a controversial one. Due to its perceived negative effects on the developing brain, cannabis being used to combat a developmental issue can seem counterproductive.
But once again, marijuana has shown to be helpful in treating symptoms when taken in small doses. Health and wellness forums are filled with individual reports claiming cannabis use has been helpful with their ADHD treatment. While this by no means acts a substitute for clinical testing, people have claimed small doses of THC encourages short-term hyperfocus and CBD can help handle severe symptoms like irritability and agitation.
Still, though cannabis may be somewhat effective in treating symptoms of ADHD, most medical professionals conclude that prescription options prove to be more successful.
Marijuana’s Effects on Alzheimer’s
Alzheimer’s Disease (AD) is an irreversible mental disorder where memory and thinking deteriorate and dementia symptoms grow worse over time. Some of the most debilitating symptoms of AD include pain, lack of appetite, weight loss, anxiety, and sleep problems – all of which are seemingly treatable with medical marijuana. Though these symptoms have been reduced in other disorders, there seems to be conflicting studies on marijuana’s effects on dementia symptoms.
A study at Radboud University Medical Center in the Netherlands surveyed a group of 50 patients, split into two groups. One group received a daily medical marijuana treatment, the other receiving a placebo. After three weeks, they found there wasn’t a substantial difference between the two groups. A conflicting open-label study in The Journal of Alzheimer’s Disease followed the effects of cannabis on 10 subjects over the course of 4 weeks. Their research went on to conclude that cannabis oil was a safe and promising treatment option, with delusions, agitation, irritability, apathy and sleep all improving.
In addition, preclinical work has suggested that compounds found in cannabis – including THC – might slow the production of proteins central to the progression of Alzheimer’s overall. Inflammation of the brain and the killing of nerve cells is a major contributor to Alzheimer’s damage. If THC-like compounds are slowing this process and protecting the brain, who’s to say what evidence and useful treatment might be found in a clinical trial?
Marijuana’s Effects on Drug Addiction
There’s been a lot of discussion on marijuana’s potential to curb the opioid epidemic. Solid research shows that the endocannabinoid system regulates many processes underscoring addiction, and evidence suggests compounds in cannabis could be useful in treating opioid dependency.
However, conflicting reports from the National Institute on Drug Abuse show no evidence that laws allowing marijuana use are linked with changes in opioid overdose mortality rates. Some researchers argue that medical providers should emphasize other methods of treatment over cannabis, such as cognitive-behavioral and physical therapy. They argue that chronic use of cannabis can lead to dependency, but CBD – which arguably plays a larger role in fighting opioid addiction – doesn’t carry the same psychoactive qualities.
Non-intoxicating cannabinoids like CBD interfere with the central aspects of addiction. Studies have shown that CBD suppresses behavior cues related to drug use. That’s been followed by
reports of CBD’s positive outcomes across major phases of addiction – intoxication, withdrawal and relapse. Still, disputers argue that medical marijuana is a companion drug rather than a substitution drug, and there isn’t sufficient evidence to show it can curb an addiction epidemic.
Prohibition-era propaganda portrays marijuana as a highly-addictive drug that pushes users to commit violent crime and perform lewd sex acts. Though that reputation has lingered for quite a while, it turns out that it isn’t completely accurate.
Out of the 50+ million self-identifying cannabis users in the U.S. about 4% have been dependent on marijuana at some time in their lives. While the some of the qualifying criteria has been debated, cannabis dependency is exhibited by:
- Excessive and daily use of cannabis
- Compulsion to use cannabis whenever available
- Excessive time spent on the possession and intake of cannabis
- Withdrawal symptoms after quitting use of cannabis
Cannabis withdrawal is not at all common and is generally mild, with symptoms such as irritability, reduced appetite, moodiness, insomnia and mild depression. These symptoms rarely last longer than two weeks, but if treatment is needed, stress management and temporary medicinal solutions for the appetite and insomnia can help. Due to CBD’s promise in addiction treatment, it could be useful in helping with any withdrawal symptoms.
In Conclusion: Mental Illnesses and Marijuana
Like any medicine, the value and success of medical marijuana is wholly dependent on the circumstances surrounding its use. What is it supposed to be treating? What dosage is administered? What is the method of ingestion?
Every treatment – plant-based, lab grown or otherwise – is going to have a set of variables that need to be monitored and changed depending on the patient’s needs. And while cannabis products aren’t currently as measured and regulated as pharmaceuticals, research is expanding everyday. The progress that has been made already with how little we know is incredible, and it’ll be exciting to see what innovations can be made in cannabis treatments for mental illness patients in the future.
If you’d like to learn more about weed’s impact on mental illnesses, check out these other articles from the Weed Blog: