What is anxiety?
Anxiety, at its core, is the body’s physical reaction to threat. It is important to note – that everyone feels anxious at times and certain levels of anxiety in particular situations can be considered normal, and usually subside once the stressful situation has passed. However, anxiety can become a concern when the feelings of pressure, stress and anxiety itself persist – for seemingly no plausible reason, and when the anxiety begins to negatively impact an individual’s everyday life. It is estimated that 14.4% (2.3 million) of Australians suffer from anxiety. Can CBD be used for anxiety?
What are the symptoms of anxiety?
Anxiety is more than just feeling worried or stressed, and individuals who suffer from an anxiety disorder may experience a number of different symptoms. Different types of anxiety disorders have different symptoms and range from physiological, psychological to behavioural. The most general and common symptoms include:
- Sweating and/or shaking
- Feeling weak
- A racing heart and/or sensation of a tight chest
- Rapid breathing/trouble with breathing
- Obsessive and excessive thoughts that instil fear
- A sense of impending doom or danger
- Hot and cold flushes
- Troubled sleep
- Stomach pains and/or digestion issues
- Feeling tense and wound up
- Avoiding situations that make you feel anxious
What causes anxiety?
In order to treat anxiety disorders effectively, medical professionals should understand how these conditions emerge and what factors are involved in maintaining them. Unfortunately, it is often difficult to understand the underlying causes of an anxiety disorder – as it is usually developed by a number of factors that range in ambiguity. Ultimately, the exact cause of anxiety disorders is unknown, though according to the National Institute of Mental Health, researchers believe that a combination of genetic and environmental factors may play a role as well as brain chemistry. Currently, the most common known causes of anxiety include a history of family mental illness, various personality factors, ongoing stress, physical health problems, substance use and other mental health conditions.
Traditional treatments for anxiety
Numerous neurotransmitters play a role in normal states and anxiety states, which is why anxiety disorders can be treated with psychopharmacological and cognitive–behavioural interventions. Current pharmacological treatments for anxiety disorder include; Selective Serotonin Reuptake Inhibitors (SSRI’s), Serotonin–Norepinephrine Reuptake Inhibitors (SNRI’s), Benzodiazepines, Antiseizure Medications, Tricyclic Antidepressants and additional medications such as Hydroxyzine (Atarax, Pfizer), mirtazapine (Remeron, Organon) and nefazodone (Bristol-Myers Squibb.)
Many of these pharmacological treatments can incur undesirable side effects. Benzodiazepines have been known to cause dependency, overdoses (when mixed with alcohol or opioids), impaired cognition and coordination, memory loss and even potential fatalities among withdrawal. More general side effects of most anxiety medication can include weight loss or gain, fatigue, constipation, headaches and sexual problems.
It often takes some time before patients are matched with suitable and effective medication and in some cases, anxiety disorders can be treatment-resistant. This has prompted new developments in the field of alternative strategies for managing anxiety.
Medicinal CBD for anxiety
Cannabis has been used throughout history as a treatment for anxiety, and its use for this issue can be traced back to 2000 BCE, where it was employed as Ayurvedic medicine in India. When administered, Cannabinoids interact with the numerous and diverse receptors that regulate feelings of fear and anxiety in the human body. CBD works by interacting and stimulating the endocannabinoid system – a central regulatory system that helps the body maintain homeostasis and affects a wide range of biological processes. As the endocannabinoid system is involved in regulating moods and emotions, it can be assumed that CBD plays a role in the alleviation of anxiety.
Recently, medicinal CBD has received increased research attention due to relaxation of regulations around the world. It is currently used to treat a number of physical conditions – yet its potential in the field of psychiatry, though seemingly promising – is under-researched. A study published by NCBI explored Cannabidiol as a Potential Treatment for Anxiety Disorders with the purpose of assessing evidence from existing preclinical, clinical and ‘epidemiological studies pertaining to the potential risks and benefits of CBD as a treatment for anxiety disorders.’ The study assessed 49 existing preclinical, clinical and epidemiological studies along with neuroimaging studies that documented results from anxiety-related tasks or resting neural activity. Epidemiological or clinical studies were included that assessed CBD’s effects on anxiety symptoms or the possible protective effects of CBD in regards to anxiety. The study found that found the existing preclinical evidence strongly suggested CBD as a treatment for generalised anxiety disorder, social anxiety disorder, obsessive-compulsive disorder, post-traumatic stress disorder and panic disorder when administered acutely. Overall the study was able to emphasise the potential value and necessity for further study of medicinal CBD as a treatment for anxiety.
There are several studies that echo this same conclusion – including The Social Science & Medical Journal’s systematic review and analysis with patients who self-reported to use medicinal cannabis for various kinds of health issues. The study found that out of those who participated, 50% claimed to use medicinal CBD for anxiety. Individuals who participated in the study reported that their anxiety symptoms were reduced when they treated themselves with medicinal CBD. Thus the findings suggest that medicinal cannabis is effective. Though once again, highlighted that future research is needed urgently to move the field forward.
Despite the lack of contemporary research, there is certainly some promising evidence that medicinal CBD may be an effective treatment in reducing anxiety symptoms. BMC Psychiatry located 13 existing studies human studies in order to research the potential of medicinal CBD for treating mental health symptoms. Out of those 13 existing studies, one included the effects of medicinal cannabis on those who suffer from Social Anxiety Disorder. The research involved administering an acute dose of CBD (600mg) or matching placebo, an hour and a half before a simulated public speaking test. The findings strongly suggested that ‘pre-treatment with CBD significantly reduced anxiety, cognitive impairment and discomfort in the social anxiety group’s speech performance, and significantly decreased hyper-alertness in their anticipatory speech compared to the placebo group (which presented higher anxiety, cognitive impairment, discomfort, and higher alertness levels).’ In addition to this, neuroimaging research has also revealed that for patients diagnosed with social anxiety ‘cerebral blood flow may be altered via CBD.’ This particular neuroimaging research involved administering 400 mg of oral CBD or matching placebo to 10 patients and concluded that; 400 mg of CBD was associated ‘with significantly decreased subjective anxiety, with blood flow being modulated in the left parahippocampal gyrus, hippocampus, and inferior temporal gyrus, and the right posterior cingulate gyrus.’ Though it must be noted that due to the small sample size, the above data should be considered with caution.
Does CBD help with anxiety?
Various studies have shown that medicinal CBD may reduce anxiety symptoms across stress-induced anxiety, PD and compulsive behaviour and most notably, contextual fear conditioning. CBD has been shown to enhance the extinction of contextually conditioned fear responses. This means that a situation that once bought an individual an immense amount of anxiety no longer does, or that the anxiety felt is dramatically reduced.
Most research conducted that explores medicinal CBD as a treatment for anxiety is based on existing research. Though this does not take much value away from the findings. In fact, it appears to highlight the neglect of necessary research needed to further understand the connection between medicinal CBD and the evident reduction in anxiety.
Due to the lack of up-to-date, objective and clinical research involving CBD and anxiety, in conjunction with the ambiguity and variations of anxiety disorders themselves, it is hard to conclude if medicinal cannabis definitively remedies anxiety. However, preclinical research and personal advocacy definitely indicate that the benefits of CBD oil lead a strong treatment for anxiety disorders. Despite the fact that the way CBD works to treat anxiety is not comprehensively understood, it has not deterred millions of people from trying it. It is reported that 14% of Americans use CBD, and 37% of CBD users use it as a treatment for anxiety.