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Calming the Anxiety: Can CBD Help?

Some stressors are completely healthy to experience, like the nervous feeling that might come over you while preparing to take an exam or giddiness before going into an interview. But when feelings of stress and uneasiness become debilitating for everyday life, you may want to start looking for a healthy way to tackle this anxiety.

You feel it in your chest first. A tightening that makes it hard to breathe as worst-case scenarios run through your head. You try to remind yourself that everything is fine, that you’re fine, but as your heart beats faster and a feeling of sickness takes over, it becomes harder to believe you’re not in grave danger. The seconds tick by, and it is more and more difficult for logic to prevail over your chaotic emotions.

What you’re experiencing is anxiety. And whether you’ve suffered from it before (like roughly 31 percent of the American population) or this is all new as a result of 2020 (a year in which anti-anxiety prescriptions have spiked), you’ve likely found yourself wondering whether or not CBD oil for anxiety could help 1,2 MacCallum, C. A., & Russo,Any Anxiety Disorder. (n.d.). National Institute of Mental Health. Retrieved September 30, 2020, from https://www.nimh.nih.gov/health/statistics/any-anxiety-disorder.shtml .

You wouldn’t be alone in asking that question.

What is Anxiety?

There are a variety of anxiety disorders that all share a few commonalities, including uncontrollable and intense feelings of fear, worry, and often panic. It’s when these feelings begin to interfere with a person’s daily life that an anxiety disorder may be present 3 Mental Health Conditions: Depression and Anxiety. (2020, August 06). Centers for Disease Control. Retrieved September 30, 2020, from https://www.cdc.gov/tobacco/campaign/tips/diseases/depression-anxiety.html .

Approximately 19.1 percent of U.S. adults will struggle with an anxiety disorder in any given year. Women have a higher rate of anxiety than men, with 23.4 percent being diagnosed with an anxiety disorder as compared to 14.3 percent of men 3 Mental Health Conditions: Depression and Anxiety. (2020, August 06). Centers for Disease Control. Retrieved September 30, 2020, from https://www.cdc.gov/tobacco/campaign/tips/diseases/depression-anxiety.html .

The U.S. Department of Health and Human Services identifies five main types of anxiety disorders 4 (DCD), D. (2015, August 21). What are the five major types of anxiety disorders? U.S. Department of Health and Human Services. Retrieved September 30, 2020, from https://www.hhs.gov/answers/mental-health-and-substance-abuse/what-are-the-five-major-types-of-anxiety-disorders/index.html .

Main Types of Anxiety Disorders

1. Generalized Anxiety Disorder

Otherwise known as GAD, generalized anxiety disorder is diagnosed when a person experiences chronic anxiety, consistently being plagued by intense worry and fear, even when there is very little happening to provoke those feelings. To be diagnosed with GAD, a person must experience excessive anxiety or worry most days for at least six months. Symptoms can include restlessness, fatigue, irritability, muscle tension, and sleep difficulties.

2. Obsessive-Compulsive Disorder

People with obsessive-compulsive disorder (also known as OCD) experience intrusive thoughts and obsessions they can’t control or stop. They may engage in repetitive behaviors, known as compulsions and/or rituals, due to these thoughts. This might involve a need to wash their hands five times after going to the bathroom or feeling compelled to repeatedly verify the front and back doors to their house are locked before being able to drive away. Giving in to these compulsions happens with the hope that doing so may provide temporary relief. Failing to perform these rituals often increases the patient’s anxiety, sometimes to the point that the missed ritual becomes all they can think about and focus on.

3. Panic Disorder

As the name suggests, panic disorder (PD) is characterized by recurrent episodes of extreme fear. These episodes are often unexpected and unwarranted when compared to the situation at hand. People with panic disorder experience physical symptoms, known as panic attacks, including excessive sweating, chest pains, trembling, heartbeat irregularities, trouble breathing, dizziness, and abdominal distress. Those who experience panic attacks often work hard to prevent future attacks, trying to avoid people, situations, and places they associate with panic attacks they’ve had in the past. This can result in increased anxiety and isolation as the list of things they are trying to avoid grows with each new panic attack.

4. Post-Traumatic Stress Disorder

Otherwise known as PTSD, post-traumatic stress disorder typically develops after a person has experienced a traumatic event. This may include having their own life threatened or the life of someone they know and love. While most people associate PTSD with veterans coming home from combat, victims of domestic violence, natural disasters, life-threatening medical conditions, and many other traumatic experiences can also develop PTSD as a result. The only truly unifying component between these cases is trauma.

5. Social Phobia

Also referred to as Social Anxiety Disorder (SAD), this is anxiety that arises in response to social interactions. It presents as overwhelming worries and self-consciousness at the thought of talking to and interacting with other people. Some social anxiety disorder patients may be fine socializing with close friends, only struggling in group settings. Others may suffer from symptoms of anxiety any time they have to interact socially at all. This can develop into agoraphobia, where a person’s excessive fear of social interactions leads to the avoidance of public transportation, crowded spaces, and even leaving their own home.

There are several phobia-related anxiety disorders, as well. These are linked to extreme fears or aversions to certain people, places, things, and experiences. While phobias often involve irrational fears, they can control a person’s entire life, where avoidance of what they are afraid of becomes a driving factor in every decision they make. People with true phobias may also have an extreme response when confronted with their fear 5 Anxiety Disorders. (n.d.). National Institute of Mental Health. Retrieved September 30, 2020, from https://www.nimh.nih.gov/health/topics/anxiety-disorders/index.shtml .

There are countless phobias a person might have, with two common ones being aviophobia (a fear of flying) and arachnophobia (a fear of spiders).

Anxiety Disorders: Contributing Factors

The National Institute of Mental Health identifies the following as potential contributing factors to the development of an anxiety disorder:

  • Childhood traits such as shyness and behavioral inhibition
  • Childhood exposure to stressful or traumatic events
  • A family history of anxiety or other mental illnesses
  • Thyroid issues or heart arrhythmias
  • Substance abuse

Each of the above is considered anxiety disorder risk factors, but it is important to remember that anxiety disorders do not discriminate 5 Anxiety Disorders. (n.d.). National Institute of Mental Health. Retrieved September 30, 2020, from https://www.nimh.nih.gov/health/topics/anxiety-disorders/index.shtml . If you are experiencing excessive worries or fears, especially if those feelings don’t seem to line up with your current circumstances, it’s a good idea to talk to your doctor about whether or not anxiety may be to blame.

Standard Treatment of Anxiety Disorders

People experience varying levels of anxiety all the time. It’s only when that anxiety makes it difficult for a person to navigate their daily lives or is becoming a constant reality that they can’t escape that treatment is typically warranted 6 Bandelow, B., Michaelis, S., & Wedekind, D. (2017). Treatment of anxiety disorders. Dialogues in clinical neuroscience, 19(2), 93–107. .

Cognitive-behavioral therapy is generally regarded as the most effective method of treatment for anxiety disorders. This type of talk therapy involves teaching patients to recognize their distorted thinking patterns and reframe them in a more realistic light. Coping and problem-solving skills are also taught, with the goal of improving a patient’s confidence levels and belief in their own abilities 7 What Is Cognitive Behavioral Therapy? (n.d.). American Psychological Association. Retrieved September 30, 2020, from https://www.apa.org/ptsd-guideline/patients-and-families/cognitive-behavioral .

Medications are also available, and some cases warrant combining both medication and therapy. Unfortunately, not everyone has access to mental health care, and even with insurance, expensive deductibles can often keep those suffering from anxiety from accessing the services that might help. There is also limited research into drug treatments for phobias, and there are side effects to consider even when medication is indicated 6 Bandelow, B., Michaelis, S., & Wedekind, D. (2017). Treatment of anxiety disorders. Dialogues in clinical neuroscience, 19(2), 93–107. .

While not all patients will experience side effects on anti-anxiety meds, some report:

  • Nausea
  • Restlessness
  • Headaches
  • Fatigue
  • Increased or decreased appetite
  • Shakiness
  • Weight gain or loss
  • Excessive sweating
  • Abdominal Distress
  • Sexual dysfunction

There are also individuals who experience treatment resistance, where medications are prescribed and taken, but anxiety persists 8 Roy-Byrne P. (2015). Treatment-refractory anxiety; definition, risk factors, and treatment challenges. Dialogues in clinical neuroscience, 17(2), 191–206. .

CBD oil for anxiety may be the answer for those patients who can’t access therapy or who experience undesirable side effects or treatment resistance to medications.

CBD for Anxiety—How Does it Work?

As one of the two primarily researched cannabinoids in the cannabis plant, CBD (otherwise referred to as cannabidiol) interacts with the body’s endocannabinoid system (ECS) when consumed.

The ECS functions through a complex system of cannabinoid receptors throughout the body, with CBD mirroring some of the cannabinoids the body naturally produces. When CBD is consumed, it binds to those cannabinoid receptors and prevents the body’s naturally occurring cannabinoids from doing so, temporarily interfering with the ECS and the natural production of cannabinoids 9 Alger B. E. (2013). Getting high on the endocannabinoid system. Cerebrum : the Dana forum on brain science, 2013, 14. .

The ECS was discovered in the 1990s, and research into its purpose in the body is ongoing. The studies we do have, however, have found the ECS to be linked to managing both anxiety and fear 10, 11 Ruehle, S., Rey, A. A., Remmers, F., & Lutz, B. (2012). The endocannabinoid system in anxiety, fear memory and habituation. Journal of psychopharmacology (Oxford, England), 26(1), 23–39. https://doi.org/10.1177/0269881111408958 .

This understanding of the ECS has led to further research into how CBD oil for anxiety may work.

How to Use CBD Oil for Anxiety

When it comes to studying CBD’s potential benefits, there is perhaps more research surrounding CBD oil for anxiety than any other ailment or condition. And the news we have so far is good!

While most researchers agree there is still room for further studies on the potential of CBD oil for anxiety, CBD has been identified as having considerable potential as a treatment for multiple anxiety disorders 12 Blessing, E. M., Steenkamp, M. M., Manzanares, J., & Marmar, C. R. (2015). Cannabidiol as a Potential Treatment for Anxiety Disorders. Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics, 12(4), 825–836. https://doi.org/10.1007/s13311-015-0387-1 .

For PTSD, CBD has shown promise as a treatment option at various stages of the treatment process, helping ease the intensity of traumatic memories and carrying far fewer side effects than the pharmaceuticals typically prescribed to treat this condition 13 Bitencourt RM, Takahashi RN. Cannabidiol as a Therapeutic Alternative for Post-traumatic Stress Disorder: From Bench Research to Confirmation in Human Trials. Front Neurosci. 2018 Jul 24;12:502. doi: 10.3389/fnins.2018.00502. PMID: 30087591; PMCID: PMC6066583. .

Research has found CBD to provide a statistically significant anxiety reduction compared to placebo for social anxiety disorder. Researchers concluded this might be due to CBD’s effects on the limbic and paralimbic parts of the brain 14 Crippa, J. A. S., Derenusson, G. N., Ferrari, T. B., Wichert-Ana, L., Duran, F. L., Martin-Santos, R., Simões, M. V., Bhattacharyya, S., Fusar-Poli, P., Atakan, Z., Filho, A. S., Freitas-Ferrari, M. C., McGuire, P. K., Zuardi, A. W., Busatto, G. F., & Hallak, J. E. C. (2011). Neural basis of anxiolytic effects of cannabidiol (CBD) in generalized social anxiety disorder: a preliminary report. Journal of Psychopharmacology, 25(1), 121–130. https://doi.org/10.1177/0269881110379283 CBD has also significantly reduced anxiety for research participants assigned to give a public speech compared to placebo 15 Linares, Ila M., Zuardi, Antonio W., Pereira, Luis C., Queiroz, Regina H., Mechoulam, Raphael, Guimarães, Francisco S., & Crippa, José A.. (2019). Cannabidiol presents an inverted U-shaped dose-response curve in a simulated public speaking test. Brazilian Journal of Psychiatry, 41(1), 9-14. Epub October 11, 2018. https://dx.doi.org/10.1590/1516-4446-2017-0015 .

Research into CBDs effectiveness in treating multiple anxiety disorders has shown it to be beneficial to those with PTSD, GAD, PD, OCD, and SAD 12 Blessing, E. M., Steenkamp, M. M., Manzanares, J., & Marmar, C. R. (2015). Cannabidiol as a Potential Treatment for Anxiety Disorders. Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics, 12(4), 825–836. https://doi.org/10.1007/s13311-015-0387-1 CBD has also been shown to improve sleep for those struggling with anxiety 16 Shannon, S., Lewis, N., Lee, H., & Hughes, S. (2019). Cannabidiol in Anxiety and Sleep: A Large Case Series. The Permanente journal, 23, 18–041. https://doi.org/10.7812/TPP/18-041 This matters because getting sufficient sleep has been linked to reduced levels of anxiety 17 Ben Simon, E., Rossi, A., Harvey, A.G. et al. Overanxious and underslept. Nat Hum Behav 4, 100–110 (2020). https://doi.org/10.1038/s41562-019-0754-8 .

Due to all this research, even the National Institute on Drug Abuse (NIH) has acknowledged the therapeutic efficacy of CBD in treating anxiety disorders 18 The Biology and Potential Therapeutic Effects of Cannabidiol. (2015, June 24). National Institute On Drug Abuse. Retrieved September 30, 2020, from https://archives.drugabuse.gov/testimonies/2015/biology-potential-therapeutic-effects-cannabidiol .

Finding the Right CBD Dosage For Anxiety

Defining the best CBD dose for anxiety is difficult, if only because the right dosage can vary a lot from person to person. Everything from your height and weight to your age and gender can impact your individual body processes and utilizes CBD. The severity of anxiety you experience may also have an impact on how much CBD you need in order to feel a difference.

We always recommend starting low and working your way up, but we also have some suggestions for where to start when choosing your initial CBD dosage for anxiety. Our suggestions are based on weight and the strength of CBD you are hoping for, but remember: there are other factors that may impact your personal experience. For this reason, it’s a good idea to start with a low strength dosage and work your way up.

It’s only through experimentation and paying attention to your body’s response that you’ll be able to answer the question you came here wondering: is CBD oil for anxiety helpful? For countless anxiety sufferers, CBD has proven to be a beneficial addition to their treatment plans. Hopefully, the same will be true for you.

CBD Oil for Anxiety FAQs

Does CBD Really Work for Anxiety?

At this point in time, the research we have has shown promising benefits for CBD in the treatment of anxiety disorders. But most researchers agree there is still a need for additional studies to pinpoint why this is, what the proper dosing may be, and who CBD for anxiety may best be used for. Until that research is complete, the only way you can know for sure if CBD will help with your anxiety is by trying it for yourself. The good news is CBD has a relatively high safety profile, with few risks associated with adding it to your routine 20 Iffland, K., & Grotenhermen, F. (2017). An Update on Safety and Side Effects of Cannabidiol: A Review of Clinical Data and Relevant Animal Studies. Cannabis and cannabinoid research, 2(1), 139–154. https://doi.org/10.1089/can.2016.0034 . CBD may also work well in combination with non-pharmacological anxiety management, like meditation practices. Still: It’s always a good idea to talk to your doctor first before trying any new treatment option.

How Much CBD Oil Should You Take For Anxiety?

Finding the right CBD oil dosage for anxiety is often a matter of trial and error. We recommend starting low and slow, working your dosage up until you experience a therapeutic benefit. You can also talk to your doctor about how to use CBD oil for anxiety and about what dosage might be best for your body and anxiety symptoms. We have some basic recommendations about where you may want to start. To start off, try one of the low-dose CBD teas we recommend, including relaxing blends with ingredients like chamomile and lavender, which also come in decaffeinated options.

What is the Best THC to CBD Ratio for Anxiety?

There is currently no research into the best THC to CBD ratio, and not all anxiety patients will want to add THC (and the psychoactive effects that are associated with THC) to their anxiety treatment regimen. That said, research has shown therapeutic benefits to combining THC and CBD for a variety of conditions, including anxiety 21 Russo E. B. (2011). Taming THC: potential cannabis synergy and phytocannabinoid-terpenoid entourage effects. British journal of pharmacology, 163(7), 1344–1364. https://doi.org/10.1111/j.1476-5381.2011.01238.x . If this is a combination you would like to try for yourself, you may want to start with a lower dose of THC compared to CBD as you evaluate how your body responds to the effects of THC. If you find you like the combination and are comfortable with the effects, you may want to slowly work your way up to a 50/50 split. Familiarize yourself with the types of CBD so you can identify products that will provide the benefits of CBD on its own or in combination with other cannabinoids and cannabis compounds.

Sources
  1. MacCallum, C. A., & Russo,Any Anxiety Disorder. (n.d.). National Institute of Mental Health. Retrieved September 30, 2020, from https://www.nimh.nih.gov/health/statistics/any-anxiety-disorder.shtml
  2. America's State of Mind Report. (2020, April 16). Express Scripts. Retrieved September 30, 2020, from https://www.express-scripts.com/corporate/americas-state-of-mind-report
  3. Mental Health Conditions: Depression and Anxiety. (2020, August 06). Centers for Disease Control. Retrieved September 30, 2020, from https://www.cdc.gov/tobacco/campaign/tips/diseases/depression-anxiety.html
  4. (DCD), D. (2015, August 21). What are the five major types of anxiety disorders? U.S. Department of Health and Human Services. Retrieved September 30, 2020, from https://www.hhs.gov/answers/mental-health-and-substance-abuse/what-are-the-five-major-types-of-anxiety-disorders/index.html
  5. Anxiety Disorders. (n.d.). National Institute of Mental Health. Retrieved September 30, 2020, from https://www.nimh.nih.gov/health/topics/anxiety-disorders/index.shtml
  6. Bandelow, B., Michaelis, S., & Wedekind, D. (2017). Treatment of anxiety disorders. Dialogues in clinical neuroscience, 19(2), 93–107.
  7. What Is Cognitive Behavioral Therapy? (n.d.). American Psychological Association. Retrieved September 30, 2020, from https://www.apa.org/ptsd-guideline/patients-and-families/cognitive-behavioral
  8. Roy-Byrne P. (2015). Treatment-refractory anxiety; definition, risk factors, and treatment challenges. Dialogues in clinical neuroscience, 17(2), 191–206.
  9. Alger B. E. (2013). Getting high on the endocannabinoid system. Cerebrum : the Dana forum on brain science, 2013, 14.
  10. Ruehle, S., Rey, A. A., Remmers, F., & Lutz, B. (2012). The endocannabinoid system in anxiety, fear memory and habituation. Journal of psychopharmacology (Oxford, England), 26(1), 23–39. https://doi.org/10.1177/0269881111408958
  11. Lisboa, S. F., Gomes, F. V., Terzian, A. L., Aguiar, D. C., Moreira, F. A., Resstel, L. B., & Guimarães, F. S. (2017). The Endocannabinoid System and Anxiety. Vitamins and hormones, 103, 193–279. https://doi.org/10.1016/bs.vh.2016.09.006
  12. Blessing, E. M., Steenkamp, M. M., Manzanares, J., & Marmar, C. R. (2015). Cannabidiol as a Potential Treatment for Anxiety Disorders. Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics, 12(4), 825–836. https://doi.org/10.1007/s13311-015-0387-1
  13. Bitencourt RM, Takahashi RN. Cannabidiol as a Therapeutic Alternative for Post-traumatic Stress Disorder: From Bench Research to Confirmation in Human Trials. Front Neurosci. 2018 Jul 24;12:502. doi: 10.3389/fnins.2018.00502. PMID: 30087591; PMCID: PMC6066583.
  14. Crippa, J. A. S., Derenusson, G. N., Ferrari, T. B., Wichert-Ana, L., Duran, F. L., Martin-Santos, R., Simões, M. V., Bhattacharyya, S., Fusar-Poli, P., Atakan, Z., Filho, A. S., Freitas-Ferrari, M. C., McGuire, P. K., Zuardi, A. W., Busatto, G. F., & Hallak, J. E. C. (2011). Neural basis of anxiolytic effects of cannabidiol (CBD) in generalized social anxiety disorder: a preliminary report. Journal of Psychopharmacology, 25(1), 121–130. https://doi.org/10.1177/0269881110379283
  15. Linares, Ila M., Zuardi, Antonio W., Pereira, Luis C., Queiroz, Regina H., Mechoulam, Raphael, Guimarães, Francisco S., & Crippa, José A.. (2019). Cannabidiol presents an inverted U-shaped dose-response curve in a simulated public speaking test. Brazilian Journal of Psychiatry, 41(1), 9-14. Epub October 11, 2018. https://dx.doi.org/10.1590/1516-4446-2017-0015
  16. Shannon, S., Lewis, N., Lee, H., & Hughes, S. (2019). Cannabidiol in Anxiety and Sleep: A Large Case Series. The Permanente journal, 23, 18–041. https://doi.org/10.7812/TPP/18-041
  17. Ben Simon, E., Rossi, A., Harvey, A.G. et al. Overanxious and underslept. Nat Hum Behav 4, 100–110 (2020). https://doi.org/10.1038/s41562-019-0754-8
  18. The Biology and Potential Therapeutic Effects of Cannabidiol. (2015, June 24). National Institute On Drug Abuse. Retrieved September 30, 2020, from https://archives.drugabuse.gov/testimonies/2015/biology-potential-therapeutic-effects-cannabidiol
  19. Nepon, J., Belik, S. L., Bolton, J., & Sareen, J. (2010). The relationship between anxiety disorders and suicide attempts: findings from the National Epidemiologic Survey on Alcohol and Related Conditions. Depression and anxiety, 27(9), 791–798. https://doi.org/10.1002/da.20674
  20. Iffland, K., & Grotenhermen, F. (2017). An Update on Safety and Side Effects of Cannabidiol: A Review of Clinical Data and Relevant Animal Studies. Cannabis and cannabinoid research, 2(1), 139–154. https://doi.org/10.1089/can.2016.0034
  21. Russo E. B. (2011). Taming THC: potential cannabis synergy and phytocannabinoid-terpenoid entourage effects. British journal of pharmacology, 163(7), 1344–1364. https://doi.org/10.1111/j.1476-5381.2011.01238.x

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