How Does CBD Oil Help With Anxiety?

People today are wondering how does CBD oil help with anxiety? While there’s no magic bullet to banish anxiety for good, managing anxiety symptoms is a commonly stated reason why people take cannabis – medical or otherwise – with CBD showing particular promise in preliminary studies.

Anxiety Disorders.

Anxiety disorders are a collection of mental health conditions characterized by disproportionate worrying about future events that brings about physiological responses in the body such as tightness in the chest, shortness of breath, muscle tension, sleep disturbance, excessive sweating, agitation, restlessness, irritability, and difficulty concentrating.

Avoidance behavior are common strategies among anxiety sufferers. If you’ve had a panic attack crossing a bridge, there’s a fair chance you’ll never make it to the other side of that river again. And for the socially anxious among us, not turning up to that party or after work drinks or a friend’s wedding are tactics regularly employed.

However, the more situations we avoid, the smaller our worlds eventually become, and it’s often at this point when an anxiety disorder is diagnosed. Right now, it’s estimated 260 million people worldwide have some kind of anxiety disorder, with approximately 40 million of them residing in the United States.

Anxiety disorders include generalized anxiety disorder (GAD) when anxiety is felt about a wide range of situations or issues; social anxiety disorder (SAD) – the fear of being negatively judged or rejected in social situations; panic disorder – sudden feelings of terror resulting in panic attacks; obsessive compulsive disorder (OCD) – unwelcomed repetitive thoughts and behavior; phobias – an extreme fear triggered by a situation or object; and post-traumatic stress disorder (PTSD) – anxiety including flashbacks that develop after some kind of traumatic event.

Due to their complex and often individualized nature, there’s no one-size-fits-all approach to treating anxiety disorders. Talking therapies, such as cognitive behavioral therapy (CBT), are often combined with anti-anxiety drugs like SSRI antidepressants or benzodiazepines for a more immediate calming effect. Also known as tranquilizers, benzodiazepines include the likes of Xanax and Valium, and while they may lull patients into a state of anxiety-free calm, taken long term they can result in addiction.

It’s clear, therefore, that a new class of anti-anxiety medication, without risk of abuse or dependence and free from side effects, must be developed. And the big ‘green’ hope is that the cannabis plant might hold the key.

Stress & Anxiety. 

Coping with stress or unwinding from a hectic day, is one of the major reasons millions of people consume cannabis. While your average recreational user isn’t interested in the biological mechanisms behind why they feel more relaxed after smoking a joint, the reason is almost certainly due to the direct activation of their endocannabinoid system (ECS).

The ECS comprises fatty ligands called endocannabinoids which bind to a vast network of cannabinoid receptor sites (CB1 and CB2) throughout the brain, central nervous system, immune system, and organs. Dynamic in nature, it is constantly working to ensure all our physiological systems remain in balance.

Life is filled with external stresses – pollution, poor sleep, that argument with your boss, the 24/7 news reports about the millions of people dying worldwide from the coronavirus. Thankfully the ECS works as a buffer to ensure our organisms don’t develop some kind of illness as a result. It also plays a crucial role in regulating fear, anxiety and how we cope with stress.

Activating CB1 receptors in the brain and central nervous system has been found to calm feelings of anxiety, which explains why consuming cannabis tends to chill people out. However, it’s not a case of the more you smoke, the less anxious you feel as higher doses of THC, the main psychoactive compound in cannabis, can actually be anxiety inducing.

Enhanced signaling between CB1 receptors and the endocannabinoid anandamide in the amygdala, an area of the brain key to processing fear, has been shown to help mice forget frightening experiences. That’s something of clinical interest for the treatment of anxiety disorders where frightening events of the past become indelibly marked in a patient’s memory, fueling future feelings of anxiety.

However, chronic stress itself can eventually impair our endocannabinoid system. Prolonged exposure to stress downregulates CB1 receptor signaling in brain regions involved in emotional processing. Chronic stress also increases levels of fatty acid amide hydrolase (FAAH), the enzyme that breaks anandamide down in the body, resulting in lower concentrations of the feel-good endocannabinoid.

With weakened endocannabinoid signaling, we are more vulnerable to developing anxiety and depression. Indeed, one study showed a clear inverse relationship between anandamide levels and anxiety severity in women with major depression; So in basic terms, the more anandamide deficient we are, the more anxious we may become.

Thus, boosting CB1 signaling could be a potential therapeutic target for both protecting against and treating anxiety disorders – a theory explored in a preclinical study on mice with low anandamide levels caused by stress-induced anxiety. Researchers observed how inhibiting FAAH reversed the animals’ anandamide deficiency, which in turn reduced their anxious behavior.cbd for anxiety

Targeting Many Approachs To Anxiety With CBD.

While drug companies around the world are experimenting with synthetic FAAH inhibitors, hoping they’ll become the next big thing in anti-anxiety medication, cannabidiol (CBD), the non-intoxicating compound found in cannabis, has been shown to inhibit anandamide reuptake and delay its metabolism by FAAH. Several studies confirm that administering CBD enhances CB1 signaling, in turn promoting the creation of new neurons in the hippocampus, which scientists believe further contributes towards the compound’s anxiolytic effect.

However, CBD’s anti-anxiety action extends beyond increasing endocannabinoid signaling. Animal studies show how CBD interacts with serotonin 5-HT1A receptors in the brain, which are tried and tested targets for anti-anxiety medication.

In one study, administering CBD to rats submitted to 60 minutes of enforced restraint not only lowered their heart rate and mean arterial pressure, but also reduced anxiety levels. However, these results were not replicated when the rats were given a 5-HT1A antagonist, which blocked CBD from interacting with the serotonin receptors, What remains unclear is whether CBD elicits this effect by directly binding with 5-HT1A receptors or by indirectly facilitating 5-HT1A serotonin signaling.

Neuroimaging in healthy subjects given 400mg of a CBD isolate suggested that the relaxation they reportedly experienced may have been caused by activity in the limbic and paralimbic brain system, areas of the brain associated with emotional processing, memory, and cognitive processes.

Evidence With Limitations.

Thousands of glowing anecdotal accounts are one thing, but without some randomized clinical trials, mainstream medical institutions will never take CBD seriously as an anti-anxiety treatment. Unfortunately, as with most areas of cannabinoid research, clinical research into CBD for anxiety still falls rather short.

Because anxiety is such a broad term, most research conducted so far has concentrated on just one type of anxiety disorder, namely social anxiety disorder. A well-established protocol for measuring the effectiveness of an anti-anxiety drug is its administration to socially anxious individuals before they take part in a public speaking test.

In one study, healthy and socially anxious subjects were both asked to perform a simulated public speaking test. Those with social anxiety disorder were either given a one-off dose of 600mg pure CBD or a placebo. The healthy subjects performed the test without any medication.

This hefty dose of CBD allowed the socially anxious participants to perform the task with “significantly reduced anxiety, cognitive impairment and discomfort in their speech performance,” as well as reducing their stress levels prior to the test. In comparison, the placebo group fared less well experiencing high levels of anxiety. No difference in anxiety or performance was noted between the CBD group and the healthy subjects, suggesting a one-off, high dose of CBD before public speaking may allow the socially anxious to perform just as well as someone without social anxiety disorder.

However, giving a single 600mg dose of purified CBD does not reflect the clinical experiences of doctors recommending medical cannabis to patients with anxiety or that of the millions of people around the world taking hemp-based CBD oils for anxiety-related conditions.

Purified Versus Whole Plant CBD.

With a race on to find a new anti-anxiety drug potentially worth billions of dollars, there’s little financial gain to be enjoyed from developing medication based on whole plant cannabis. But purified CBD, while potentially more lucrative and easier to study in clinical trials, has its own therapeutic drawbacks that aren’t present in full spectrum CBD-rich cannabis extracts.

Anyone who’s tried a CBD isolate will vouch for the fact that a high dose is generally needed to get any therapeutic effect. This common experience was confirmed in a meta-analysis comparing CBD-rich products with purified CBD in patients with epilepsy. The study found much lower doses of CBD-rich cannabis were taken by patients to successfully control their seizures compared to the high amounts of purified CBD used in Epidiolex clinical trials.

Boosting CB1 signaling could be a potential therapeutic target for both protecting against and treating anxiety disorders.

Not only that, animal studies demonstrate how purified CBD has a ‘bell shaped dose-response’, whereby it only shows significant therapeutic benefit at a substantial dose, with little efficacy at lower or higher doses.

This inverted bell shaped dose-response was confirmed in the context of social anxiety when healthy volunteers undertaking a simulated public speaking test only experienced a reduction in anxiety when given 300mg of CBD, but no change with either 150mg or 600mg, suggesting a narrower therapeutic window compared to CBD-rich cannabis.

Until recently, there’s been little evidence from human studies about the anti-anxiety effects of taking CBD over a prolonged period. However, just last year, a randomized placebo study was published in which Japanese teenagers with social anxiety and avoidant personality disorder were given 300mg of pure CBD or a placebo daily over four weeks. Not only did CBD significantly decrease their anxiety, but half of the participants given CBD expressed a wish to seek therapy or further treatment at the end of the study, while none of the placebo group mentioned such a desire.

In an open label retrospective study also published in 2019, 72 psychiatric patients with anxiety or sleep disorders were given between 25-175mg of CBD a day, alongside existing psychiatric medications. After two months of treatment, 78.1% of patients reported feeling less anxious and 56.1% experienced improved sleep.cbd oil helps

A Doctor’s Experience.

These encouraging results validate the experiences of clinicians who regularly prescribe medical cannabis to patients with anxiety. “For me, it’s a really good choice for treating anxiety in people,” says Dr. Rebecca Moore, a UK-based consultant psychiatrist who sees patients at The Medical Cannabis Clinics in London.

“I’ve seen some amazingly wonderful results. People who’ve had lifelong anxiety, who are doing all the right things in terms of their diet, their exercise, their supplements, but still have a fairly crippling anxiety, and within a couple of months they don’t have any anxiety at all and can’t quite believe what’s happened to themselves.

“One lady told me that she had been able to pick up a book and read for the first time in 20 years, focus and enjoy it. And another said she was planning her first holiday in 10 years. You know, it’s just life-changing differences for people.”

While there’s no magic bullet to banish anxiety for good, managing anxiety symptoms is a commonly stated reason why people take cannabis – medical or otherwise.

Dr. Moore has found medical cannabis – in particular CBD-rich oil, but also including small amounts of THC – to benefit patients with all types of anxiety disorders. In general, patients need far smaller doses than used in published preliminary studies, with some benefitting from as little as 30mg of CBD a day.

Patients usually arrive at Dr. Moore’s clinic because they find the anti-anxiety drugs they have been prescribed over the years don’t work well, and they struggle with the harsh side effects. “I’ve had people come in,” says Dr Moore, “on four or five different medications, who have managed to stop them all and just be on CBD. People who were on two antidepressants, plus a benzodiazepine, plus a sleeping tablet at night, plus an anti-hypertensive, and they stopped all of them.”

It’s in her treatment of PTSD using cannabinoids where Dr. Moore has seen some of the most fascinating changes in patients: “I think particularly with trauma memories, it’s so interesting the way it seems to impact on people’s recollection of their memory. People talk about feeling like their trauma memories are being deleted. And then I’ve had lots of people say they actually then start to remember positive memories, which they weren’t able to access before.”

Clinical Trials.

Right now, a number of clinical trials to study the effectiveness of CBD for anxiety are in the process of recruiting, including one using 25mg of full spectrum CBD soft gel capsules over a period of twelve weeks; and a phase II clinical trial evaluating the efficacy of CBD for social anxiety, which will also measure changes in endocannabinoid levels. And a Harvard Medical School research project will compare whole-plant and single-extract CBD solutions for anxiety.

Unfortunately, though, with clinical research moving at a slow pace, we’re a long way from official approval of CBD as an anti-anxiety medicine.

In the meantime, in a bid to minimize any damage to our endocannabinoid system caused by current coronavirus stress which may make us more vulnerable to anxiety disorders now and in the future, we could do a lot worse than incorporating high quality, CBD-rich cannabis or a CBD oil into our self-care routine.

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Post Author: Bill

18 Replies to “How Does CBD Oil Help With Anxiety?”

  1. Hello there!

    Your review is very well written and informative. I did not know the types of anxiety,  but thanks for opening my eyes , now I know them. The OCD, GAD, SAD, and the PTSD which were very well explained.

    Now I understand how CBD oil works.

    Thanks for sharing.

    Stephen.

  2. Hi Bill,

    Thanks for the very thorough article.  I have wondered for quite awhile if CBD oil results in a positive drug test (urine, hair, blood) when tested for THC.

    I’m a physician, and I have suffered from anxiety (OCD and GAD) for most of my life.  I was prescribed clonazepam for about 12 years, and now I’m able to manage my anxiety with only SSRI medication (fluvoximine, which is especially helpful for OCD).  The clonazepam was very effective for treating my anxiety; however, I had to take more and more in order to achieve the same effect, and after 12 years, it simply wasn’t doing the job anymore.

    It seems as if CBD oil could potentially be an effective treatment for anxiety, especially since it doesn’t produce a “high” like that associated with THC.  Anxiety, at least for me, is grossly underestimated and can be crippling, and many of the medications in the past (quaaludes, benzodiazepines, barbiturates) have had their share of negative effects.

    Thanks for all of the information in this very thorough review of the types of anxiety and hopefully CBD oil will become more mainstream as a treatment for anxiety with further study.

    Ian

    1. Thanks for the comment. Yes, CBD has helped many people and will have a greater future once it is legalized and regulated by the FDA. There is still a lot of misleading information concerning CBD and it is hoped that this will soon change.

  3. Hi Bill,
    Wow…lots of information in this article. I’m very curious to know whether taking CBD oil (in any dose) would cause one to test positive for THC on a basic urine, blood, or hair drug screen.

    I’m a physician, and I have suffered from anxiety for most of my life now. I specifically am affected with OCD and GAD. I was taking clonazepam (benzo) for the past 12 years, and I wouldn’t say that I was addicted to it, but I was definitely physically dependent. Although it was a very effective medication, over time, higher doses were required to achieve the desired effect.

    Over the past decades, several different medications (most having a fairly high potential for abuse) have been effective for anxiety (e.g., quaaludes, benzodiazepines, barbiturates); however, they can be dangerous and addictive.

    As someone who potentially could undergo drug tests at any given time, and a positive test for THC would not be a good thing, I’m never sure if the CBD oil compounds could result in a positive test for THC.

    Thanks for the information; this is a very thorough article. Hopefully, CBD oil can be purified and isolated enough so that it doesn’t result in a positive drug test. It seems that this could be a very promising potential treatment for anxiety.

    Ian

    1. Thanks for the comment. If you are going to take CBD at any time I would let your employer know about it before you take it. It will probably show up on a urine test so you should take this precaution and let your employer know. Better safe than sorry.

  4. I can totally get why people are looking into using CBD oil to combat stress. With the ongoing pandemic and economic impact this has many people have lost their jobs and anxiety has hit new record levels. People naturally looking for a way to deal with this but we must all be very careful with such things that we still don’t know the effects it has. It’s good that you provide so much information on the subject and I hope this will help a little people to get their bearing on the matter.

    1. Thanks for the comment. A person should always consult with a doctor before trying any CBD product just to be on the safe side. We are all different and react differently to treatments for our well being.

  5. What a great post, Bill.

    I have been wanting to learn more about cbd as I know this industry is going to be booming so much over the next few years and I am an advocate for natural healing and cbd is right up there.

    I have a friend who uses cbd products for anxiety and he has found a lot of relief.

    Great post, thank you.

    1. Thanks for the comment. I am glad your friend found relief from CBD. It has helped many people with many ailments,

  6. I have a female friend who have been suffering from difficulty of sleeping. She acquired the problem when her father passed away, her grades in school have dropped so she failed and were not able to graduate in time, then when her boyfriend learned that she’s now having difficulty in sleeping, he broke up with her. 

    Being a friend and an elder to the church which the girl is also a member of, I would like to help. I’ve been looking for a food supplement to share to her, something that would not require a prescription from a physician so if something happens, I would not be liable. 

    After reading this article, I got reminded of the CBD Oil and how it can help with anxiety. I will try refer her to this article and hopefully, the suggestion would be welcome by her.

    1. Thanks for the comment. Your friend has much more to gain than lose. CBD has helped an untold amount of people already and it is increasing daily.

  7. Hello, thank you for sharing this informative post on CBD. Personally, I’ve been using CBD for a while now. Initially, I used it for chronic pain as a Powerlifter. More recently, been using it for my social anxiety.  Though it does not make you high, it does make you feel much more relaxed in your mind and in the muscles. I definitely recommend it for any kind of anxiety!

    Cheers.

    1. Thanks for the comment. Pain and anxiety are just two of the many benefits of CBD. I’m glad that it has helped you.

  8. Yes Bill, you are right. 200 million people worldwide has some kind of anxiety. It is the growing trend of today’s world. The main problem is because of the lifestyle changes. Too much competition, jobless persons and relying on a digital world and less on using our “thinking minds”. All these lead to an unsettling mindset and our way of living a sedentary life makes it worse.
    Yes, I’ve heard about the CBD product which is a trial basis for treatment of anxiety problems. Although we look forward for good medication to relieve ourselves from the pressures of life, I think that we should strive to regain our composure and try to change and introduce a better healthy lifestyle starting from our young generation, so that they don’t have to face the problems millions of people are already experiencing.

    1. Thanks for the comment. Yes, there are many problems worldwide that cause stress and until we can abolish stress and anxiety from this world, CBD is one of the helpful treatments people can now use.

  9. Hello thanks for sharing this wonderful article on how does cbd oil help with anxiety. The truth is whether you suffer from anxiety, depression or stress, consider making cbd a regular part of your health regimen. In fact, the best place to begin your cbd journey is by trying out some products I love because apart from help anxiety it also help with arthritis.

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