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CBD for PTSD

Remembering scary situations can be an evolutionary asset when it helps us avoid future danger. But for those with PTSD, frightening memories have become a joy-killing obstacle to living a full life.

Does CBD for PTSD work?

While the research on CBD for PTSD is still in the early stages, there is evidence that CBD may have potential benefits for those suffering from the disorder.

Because PTSD is such a complex condition, any successful treatment has to address multiple symptoms. While it may not be a silver bullet cure, CBD does interact with our endocannabinoid system, creating various interrelated benefits, from stabilized sleep cycles to lowered anxiety.

But perhaps the most promising research on CBD for PTSD points to its apparent ability to help extinguish fear memories.

What is PTSD?

PTSD is a mental health problem that some people develop after experiencing or witnessing a life-threatening event 1 What is Posttraumatic Stress Disorder? (2020). American Psychiatric Association. https://www.psychiatry.org/patients-families/ptsd/what-is-ptsd .

While we most often associate it with combat veterans, PTSD can happen to anyone. It’s particularly common among those who experience or witness traumatic events as part of their jobs, but survivors of all kinds of violence may experience PTSD.

Possible causes of PTSD

We don’t know why only some people develop PTSD after experiencing a traumatic event, but scientists think that it may stem from multiple causes 2 Causes: Post-traumatic Stress Disorder. (2018). National Health Service. https://www.nhs.uk/conditions/post-traumatic-stress-disorder-ptsd/causes/ :

Survival mechanism

Some experts theorize that PTSD may be an instinctive mechanism meant to help you avoid or survive future trauma. This is an example of a helpful tool becoming “maladaptive” once it prevents you from moving on from the trauma.

High adrenaline levels

There is evidence that many people with PTSD have abnormal levels of stress hormones, which produce the “fight or flight” response in a crisis. When those stress hormones remain at high levels, people become locked in a state of hyperarousal and fear.

Changes in the brain

Other studies have shown that people with PTSD may have a smaller hippocampus. The hippocampus is the part of the brain responsible for emotional and memory processing. If the hippocampus malfunctions, memories and emotions are not easily worked through.

What studies exist to support the use of CBD for PTSD?

Research on CBD for PTSD has been ongoing for almost a decade, with many more clinical studies in the works. Here are some highlights:

2013 Clinical Study

Building on animal research, which showed that CBD helps with fear extinction, this early clinical study put 48 participants through a Pavlovian fear-conditioning process 3 Das, R.K., Kamboj, S.K., Ramadas, M., Yogan, K., Gupta., V., Redman, E., Curran, V.C., Morgan, C.J.A. (2013).Cannabidiol enhances consolidation of explicit fear extinction in humans. Psychopharmacology, 226(4): 781-92. https://pubmed.ncbi.nlm.nih.gov/23307069/ . (They were conditioned via electric shocks to experience a fear response in connection to a colored box.)

Researchers found that CBD helped participants in the process of fear extinction – in which they were “unconditioned” to experience fear in relation to those sinister colored boxes.

This was, in the words of the researchers, “the first evidence that CBD can enhance consolidation of extinction learning in humans.” They further suggested that  CBD may be a helpful add-on to extinction-based therapies for anxiety disorders like PTSD.

2016 Case Report

This study details the treatment of PTSD in a 10-year-old girl who was the victim of sexual abuse and parental neglect 4 Shannon, S., & Opila-Lehman, J. (2016). Effectiveness of Cannabidiol Oil for Pediatric Anxiety and Insomnia as Part of Posttraumatic Stress Disorder: A Case Report. The Permanente journal, 20(4), 16-005. https://doi.org/10.7812/TPP/16-005 . While many treatments had proved to be mostly ineffective, CBD seemed to be the key to helping her both sleep better and deal with anxiety during the day.

According to the authors, “The main finding from this case study is that CBD oil can be an effective compound to reduce anxiety and insomnia secondary to PTSD.”

The authors theorize that “CBD may block anxiety-induced [rapid eye movement] sleep alteration via its anxiolytic effect on the brain.”

2018 Literature Review

A 2018 review of the research to date on CBD for PTSD took a deep dive into the possible mechanisms by which CBD works 5 Bitencourt, R. M., & Takahashi, R. N. (2018). Cannabidiol as a Therapeutic Alternative for Post-traumatic Stress Disorder: From Bench Research to Confirmation in Human Trials. Frontiers in neuroscience, 12, 502. https://doi.org/10.3389/fnins.2018.00502 .

The authors of the review note that anti-depressants and anti-anxiety medications, which are often prescribed for PTSD, do not target the memory process at all. This may account for their low rate of success for those suffering from frightening memories.

CBD, on the other hand, does help extinguish the fear response associated with traumatic memories.

Of particular note to the authors was CBD’s action in blocking the endocannabinoid system’s CB1 receptor. This receptor has been shown to play a crucial role in the extinction of fear memories. Multiple studies (cited in this review)  have shown that CBD helps with the extinction of fear memories by activating the endocannabinoid system.

Additionally, the authors note that “chronic CBD treatment may facilitate neurogenesis (the creation of new cells) in the hippocampus, a structure well known for its important role in processing memories.”

2019 Case Series

The most recent of the published research on CBD for PTSD is an open-label case series, which looked at the effects of CBD on 11 adult patients in an outpatient clinic 6 Elms, L., Shannon, S., Hughes, S., & Lewis, N. (2019). Cannabidiol in the Treatment of Post-Traumatic Stress Disorder: A Case Series. Journal of alternative and complementary medicine (New York, N.Y.), 25(4), 392–397. https://doi.org/10.1089/acm.2018.0437 . The patients (who were diagnosed with PTSD) took CBD for eight weeks along with psychiatric care.

As a result of the treatment, ten of the eleven patients experienced a decrease in PTSD symptom severity – and several noted a reduction in nightmares and sleep disturbance.

There are certainly some clear limitations to the study since it was a small, open-label review that did not include a placebo or control group. However, it represents the first case series examining the effect of CBD on symptoms of PTSD in humans.

Of particular interest to the researchers was the effect of CBD in increasing the amount of anandamide, the body’s own endogenous cannabinoid. Anandamide, which is known as the “bliss molecule,” has known anti-anxiety effects and has been shown to decrease fear in otherwise stressful situations.

How to use CBD for PTSD

If you want to try CBD for PTSD, the most important thing is to use a method that will reliably deliver it to your bloodstream. For that reason, topicals aren’t the best way to go. These are best for targeted pain relief. But there are lots of options out there that work well for systemic benefits.

No matter how many novel CBD products hit the market, tinctures remain the staple of the CBD industry. They are convenient, relatively fast-acting, and offer high bioavailability  (meaning your body will absorb more of the CBD).

When it comes to full-spectrum tinctures, you can’t go wrong with a company like Nuleaf Naturals. The owners are industry pioneers that have consistently emphasized quality over the bells and whistles.

Joy Organics is a great option for those looking to avoid even trace amounts of THC (which can be problematic for some with PTSD). Excellent customer service and a high level of transparency are hallmarks of the family company. Plus, they offer products like gummies and capsules if you prefer that method of dosing.

If you’re open to inhaling CBD, then concentrates like CBD wax offer unsurpassed bioavailability as well as fast-acting effects. The downside is that it’s harder to know precisely how much CBD you’re getting (if exact dosing is important to you).

For specific advice on getting started with CBD, check out our CBD Dosage Chart, which walks you through the process of finding your optimal dose.

Cautions about taking CBD for PTSD

According to the World Health Organization, CBD has a good safety profile . 7 Cannabidiol (CBD) Critical Review Report Expert Committee on Drug Dependence Fortieth Meeting Geneva, 4-7 June 2018. https://www.who.int/medicines/access/controlled-substances/CannabidiolCriticalReview.pdf However, there are a couple of things to be aware of.

First, if you are taking other medications to treat your symptoms, it’s imperative that you consult your physician before experimenting with CBD. CBD can interfere with drugs that are metabolized by the liver, resulting in reduced efficacy or increased side effects.

Also, if you suffer from panic attacks, you might want to consider using a CBD product that doesn’t contain any THC, which can worsen panic or paranoia. Broad-spectrum or isolate- based CBD products are a good alternative.

Summary

PTSD is a debilitating disorder, and promising treatments are often elusive. For some people with PTSD, CBD seems to exert powerful benefits, but we also know it’s not enough for many people on its own. It may be that CBD works best as one component in a many-layered strategy targeting the various symptoms of PTSD.

Either way, the multiple clinical studies in the works will soon help expand our understanding of CBD’s benefits for PTSD.

Sources
  1. What is Posttraumatic Stress Disorder? (2020). American Psychiatric Association. https://www.psychiatry.org/patients-families/ptsd/what-is-ptsd
  2. Causes: Post-traumatic Stress Disorder. (2018). National Health Service. https://www.nhs.uk/conditions/post-traumatic-stress-disorder-ptsd/causes/
  3. Das, R.K., Kamboj, S.K., Ramadas, M., Yogan, K., Gupta., V., Redman, E., Curran, V.C., Morgan, C.J.A. (2013).Cannabidiol enhances consolidation of explicit fear extinction in humans. Psychopharmacology, 226(4): 781-92. https://pubmed.ncbi.nlm.nih.gov/23307069/
  4. Shannon, S., & Opila-Lehman, J. (2016). Effectiveness of Cannabidiol Oil for Pediatric Anxiety and Insomnia as Part of Posttraumatic Stress Disorder: A Case Report. The Permanente journal, 20(4), 16-005. https://doi.org/10.7812/TPP/16-005
  5. Bitencourt, R. M., & Takahashi, R. N. (2018). Cannabidiol as a Therapeutic Alternative for Post-traumatic Stress Disorder: From Bench Research to Confirmation in Human Trials. Frontiers in neuroscience, 12, 502. https://doi.org/10.3389/fnins.2018.00502
  6. Elms, L., Shannon, S., Hughes, S., & Lewis, N. (2019). Cannabidiol in the Treatment of Post-Traumatic Stress Disorder: A Case Series. Journal of alternative and complementary medicine (New York, N.Y.), 25(4), 392–397. https://doi.org/10.1089/acm.2018.0437
  7. Cannabidiol (CBD) Critical Review Report Expert Committee on Drug Dependence Fortieth Meeting Geneva, 4-7 June 2018. https://www.who.int/medicines/access/controlled-substances/CannabidiolCriticalReview.pdf

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