Medical

CBD and Anxiety

By David Jenison

Anxiety is a common human emotion that manifests as unease, worry and nervous anticipation triggered by an imminent event or uncertain outcome. While anxiety is a normal emotional expression, neurobiological abnormalities can produce anxiety disorders that manifest as panic attacks, debilitating fear, traumatic flashbacks, insomnia, heart palpitations and muscle tension. Generalized anxiety disorders involve unrealistic and unwarranted worry, but variations of the disorder include social phobia, agoraphobia and post-traumatic stress syndrome (PTSD), among others. An anxiety disorder is, unequivocally, not the result of personal weakness or character deficiencies. Though the exact causes are unknown, clinical studies suggest that severe anxiety can stem from abnormal neurotransmissions, brain circuitry and similar biochemical issues. Environmental factors like trauma and sustained stress often play a role as do hereditary predispositions passed down genetically. Medical professionals often treat anxiety with benzodiazepine-class sedatives (e.g., Xanax, Klonopin, Valium) that involve substantial levels of risk, but clinical studies suggest that cannabis-based cannabidiol (CBD) is a natural anxiolytic that can be safely administered for extended durations.

Cannabis and CBD

The cannabis plant contains at least 100 different phytochemicals known as cannabinoids, and each person has an endocannabinoid system with different types of receptors. The human body produces cannabinoids itself, but the best-known phytocannabinoids are CBD and tetrahydrocannabinol (THC). Unlike the latter, CBD does not have psychoactive properties, and it potentially reduces or delays THC-related euphoria. Generally speaking, THC levels above 20 percent and CBD levels above four percent are considered high, but horticultural techniques help growers produce plants that are naturally high in one cannabinoid or the other. Compared to cannabis sativa, indica plants tend to have more CBD content and natural sedative effects.

A person can experience the benefits of CBD through traditional delivery devices (e.g., pipes, vapes, rolling papers), but non-psychoactive CBD oils are produced using various extraction methods. Oil concentrates can be smoked, ingested and/or topically applied, and they provide low-dose, high-potency, non-psychoactive medicine appropriate for all ages and that will not impair vehicle operation. Some studies do suggest, however, that cannabinoids have mutually enhancing effects that make whole-plant consumption more effective therapeutically.

How CBD Affects Anxiety

A study published in The British Journal of Pharmacology in 2009 looked at the mechanism of action for CBD, which the authors admitted was not fully understood. After running several tests on rodents using varying amounts of CBD, the researchers found that the cannabinoid reduced acute stress response and delayed emotional consequences. Looking at the data and other studies, the researchers suggested two possible mechanism for the anxiolytic effects, which were as follows:

  • CBD increases endocannabinoid levels by blocking the reabsorption of the body’s natural cannabinoids and the enzymes that metabolize them
  • CBD activates 5-HT1A serotonin receptors in the brain that affect blood pressure, heart rate and mood levels

As a binding site for serotonin, the 5-HT1A receptor is typically associated with depression, and its role in anxiety is still debated. However, numerous studies suggest that activating the receptor can protect against stressful emotional change, reduce anxiety-like behavior and improve coping abilities. The receptor is heavily clustered in areas of the brain associated with mood, and a person who lacks receptors and/or sensitivity could have issues with anxiety and depression. Neurotransmission issues (e.g., neurotransmitters failing to reach or activate receptors) can also play a role in anxiety disorders. When CBD molecules bind to 5-HT1A, they activate inhibitory serotonergic effects that slow signaling and promote homeostasis within the body. CBD also activates the TRPV1 (pain, inflammation, body temperature) and adenosine A2A (cardiovascular, respiratory) receptors, the latter of which appears to aid in anxiety management.

Other studies also demonstrate the efficacy of CBD even in high-stress situations. In one of the more fucked-up clinical studies, researchers tested anxiety levels by placing mice (with and without CBD injections) into a space with a wild snake. While the control group demonstrated classic panic-like behavior, the mice pretreated with CBD demonstrated “significant and robust” levels of calm, per the CNS & Neurological Disorders Drug Targets journal in 2014. The researchers also found that CBD did not negatively affect cognitive function or mobility.

Whether anxiety is normal or pathological, cannabis and CBD oils typically provide relief. Individuals with severe anxiety disorders, however, should pursue comprehensive care that includes CBD and therapeutic modalities like Cognitive Behavioral Therapy (CBT).

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