Written by: Dr. Jonny Lisano, Ph.D.
Anxiety, we all experience it and deal with these feelings daily. It doesn’t matter if it’s a big presentation at work, getting ready for a first date, or worrying how others will judge your clothing choices. Stress from anxiety can manifest itself in many forms, but could cannabidiol (CBD) make these feelings more manageable?
Anxiety is a broad term, and many different clinical conditions and everyday feelings can fall under this umbrella. It is defined as an intense, persistent and excessive feeling of worry or fear. These feelings of anxiousness can be evoked by both the fear of past experiences and the fear of new situations. For example, you might be terrified of public speaking because the last time you spoke in front of people you didn’t perform well, or you might be going out on a first date with someone you really like and are nervous about how the date will go. There is no one-way anxiety manifests itself, and it varies from person to person. In our busy, modern-day world, it seems that anxiety is a regular, albeit unwanted, part of life.
When we start to feel anxious this activates our sympathetic nervous system, which you have probably heard it more commonly referred to as the “fight or flight” response. When this system is activated, you have a heightened sense of alertness because your body is under the impression that it is in danger. Even though the stimuli, like public speaking, might not be physically threatening, it can be emotionally threatening, and evokes the same physiological response as being confronted with an angry bear. Normal symptoms of anxiety can manifest as increased heart rate, rapid breathing, sweating, nausea or in severe cases loss of consciousness. These are all common responses to a stress-inducing situation.
A 2018 cross-sectional study of CBD users found that anxiety was the 3rd most common use for CBD, behind chronic pain and joint/arthritis pain (Corroon 2018). Is this because it’s just a common disorder that people are seeking relief from, or is there some scientific merit to seeking cannabinoids to balance our emotional state? Let’s find out!
The Research on CBD
In 2016, a study was published by a research group investigating the effectiveness of orally ingested CBD oil for the treatment of anxiety, related to post-traumatic stress disorder in a 10-year old girl. For this study they had the patient consume 6-12 mg of CBD at a time sublingually (under the tongue) as needed to treat her feelings of anxiety. Within the first 2-months, the patient’s SCARED score (a validated method to assess anxiety disorders in children) decreased from 34 to 24. On this index, a score greater than 25 indicates a high probability of an anxiety disorder. At the end of the treatment period, the participant’s SCARED score was down to 18. She was still taking 6-12 mg of CBD as needed for anxiety but was not having to consume it as often throughout the week as compared to earlier in the study (Shannon 2016). Even though this was a case study observing one single participant, the results are promising, but do these findings still hold true in studies with a larger and more varied population?
Social anxiety disorder, also known as SAD, is a social phobia where the individual suffering from this condition experiences intense feelings from the fear of being judged, seen in a negative light or socially rejected by their peers and the public. A recent publication from Japan explored the effectiveness of CBD oil to treat symptoms of SAD in 37, 18-19-year-old teens living in Japan. They were randomly assigned to either the control group or the experimental group, which received daily doses of 300 mg of CBD for four weeks. Participants were evaluated before and after the 4-week intervention using two separate measures of social anxiety. Compared to the placebo group, the teens that received treatment with CBD had a significant reduction of their scores on both the “Fear of Negative Evaluation Questionnaire” and the “Liebowitz Social Anxiety Scale” (Masataka 2019). These findings indicate that CBD oil significantly decreases feelings of social anxiety and may be an effective alternative option for managing anxiety.
For those who are not familiar with the world of research, the “Gold-Standard” of a designed clinical trial is one that is double-blind, randomized, and crosses-over.
- Double-Blind: Neither the researchers nor the participants are unaware of the treatment they are receiving until the end of the study.
- Randomized: The treatment (in this case, the order of the treatments) subjects receive is randomly assigned.
- Crossover: Participants receive both the experimental (i.e. CBD) and placebo treatments at different time points during the study.
A study using this approach assessed feelings of anxiety in 24 participants that were diagnosed with various stages of Parkinson’s disease. Researchers found that a dose of 300 mg of CBD prior to a Simulated Public Speaking Test significantly decreased feelings of anxiety throughout the assessment (de Faria 2020). In concordance with the previous studies, this again suggested the oral administration of CBD oil could help stabilize the autonomic dysregulation that leads to anxiety. However, the three studies we have discussed to this point all involved clinical populations (PTSD, SAD, and Parkinson’s disease), but what about these effects in a relatively healthy adult population?
A recent study performed in relatively healthy adults that regularly attended a psychiatric clinic looked to further explore the effects of CBD on anxiety. Researchers observed 72 patients over a 3-month period who were administering 25 mg of CBD oil in a capsule in the morning following breakfast (Shannon 2019).
(Why after breakfast you ask? Read here how consuming CBD with a meal can change its absorption and bioavailability!)
Within the first month, nearly 80% of participants reported decreases in measures of anxiety, however, a small portion (15%) of patients did report a worsening in their feelings of anxiety after 1-month. Improvement in feelings of anxiousness persisted throughout the 3-month duration of the study. Leading researchers to conclude that CBD may be beneficial for the treatment of anxiety and anxiety-related disorders, but that more clinical research is needed to validate these effects (Shannon 2019).
Within the context of the studies reviewed in this article, it appears that CBD oil may hold beneficial effects on feelings of anxiety and anxiety-related disorders. Participants in these studies consumed anywhere from 6-300 mg of CBD oil, usually in the morning to help manage their symptoms, but significant results were observed at lower doses of 6-25 mg of CBD per day. The big question though is why? Well, that answer is still unclear, as both the mechanisms underlying anxiety and the physiological actions of CBD on the body are still being understood, but some may suggest that a possible reason for this is CBD’s actions on the serotonin receptor (5-HT1A) and other cannabinoid receptors in the brain and the peripheral tissues of the body (Lee 2017). Serotonin is a chemical that is released throughout the body in response to many different stimuli but is largely associated with mood and a sense of satisfaction or well being. Decreased levels of serotonin have even been associated with symptoms of depression (Dell’Osso 2016 & Kraus 2017). The CBD molecule can mimic the effects of serotonin by binding to the serotonin receptor, thus partially mimicking serotonin’s effects (Lee 2017). Further, the overactivity of neural communication within the brain could result in anxiety as well (Ressler 2011). Within the brain, CBD can act on neural synapses, mimicking the effects of our endogenous cannabinoids, like anandamide, and suppress the frequency of signals that are being sent between neurons, quite literally calming down the brain.
There is preliminary scientific evidence that suggests CBD may naturally support our mental welfare, but before turning to CBD as a more natural alternative to managing your stress, make an appointment with your physician to discuss the transition so they can monitor your unique experience using CBD. There is still a lot we don’t know about CBD regarding potential drug interactions and long term effects, so work with your physician to find out what’s best for your unique needs.
If you feel like you need help with symptoms of anxiety or are having thoughts of suicide please seek help. The National Suicide Prevention Hotline is available 24-hrs a day: 1-800-273-8255
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Disclaimer: Part of our mission is to always present the latest cannabinoid research; however, none of this is intended to represent the safety or efficacy of our products. These statements and our products have not been evaluated by the FDA, and our products are not intended to diagnose, prevent, treat or cure any disease. You should consult your physician or other health care professional before taking CBD to determine if it is right for your needs.