Can CBD Really Help With Anxiety?

CBD is touted as a miracle for many issues. Many studies touch upon anxiety, in particular. But, despite all the hype, can CBD really help with anxiety? This is one question that begs an answer. 

A lot is written about CBD constantly, and while CBD is genuinely effective in many cases, some companies tend to exaggerate the benefits. For instance, CBD bath bombs may sound enticing, but what benefits can you possibly expect with 5 mg CBD washed down the drain?

Almost every store, regardless of whether they deal with medicinal products, is now stocking CBD. And, it's not just the oil anymore. Stores stock CBD Face masks, CBD coffee, CBD bath bombs, etc. You name it, and they got it. Since it's considered a food supplement, one can't expect strict regulations that otherwise apply to medicines in general.

In this article, we will set aside exacerbated theories and focus on just the facts. There's no doubt that CBD is effective, but we must rely on research to find answers.  

Hopefully, it will help you make the right decision rather than purchasing something just for the hype.

What is Cannabidiol?

Cannabidiol (CBD) is one of the hundreds of cannabinoids found in the cannabis plant. While tetrahydrocannabinol (THC) is the dominant cannabinoid, CBD comes second and is also found in large amounts in cannabis plants.

THC produces a narcotic high in high doses, whereas CBD isn't psychoactive. Therefore, most products contain CBD derived from hemp plants. If you're wondering about the difference between hemp and marijuana plants, note that any cannabis plant containing less than 0.3% THC is considered hemp.

Although there are many studies conducted on CBD, THC, and many other cannabinoids, there's only one FDA-approved CBD medication called Epidiolex [1] as of now. A lot more medications could be approved in the future, considering how researchers have a green signal to conduct tests without worrying about the legality, but only time will tell.

Epidiolex is used to treat severe epilepsy in children. Thanks to definitive studies [2] showcasing CBD's anti-epileptic characteristics when it binds to the GABA receptors, Epidiolex works effectively. Therefore, you can be sure that CBD has a vital role in managing seizures, but does it really help anxiety? To understand that, let's get to how CBD works. 

How Does CBD Work?

The cannabinoids found in the cannabis plant react with the receptors present in the endocannabinoid system (ECS). ECS contains a network of receptors, otherwise known as chemical structures attached to cells. Simply put, these receptors communicate through signals. 

Not every cannabinoid reacts with the receptors in the same fashion. For instance, THC binds with the CB1 receptors found in the nervous system and brain, whereas CBD influences how other cannabinoids react to the receptors. This means that CBD relies on THC to bind to the receptors, but it also negates the psychoactive effects to a certain extent [3]. 

According to research, CBD interacts with serotonin hormones [4] that are responsible for managing your mood. Serotonin is a neurotransmitter and plays a crucial role in managing mental health, including aggression, appetite, learning, consciousness, and sleep. Most medications prescribed for mental health issues serve to boost serotonin levels. 

These medicines are known as SSRIs or Selective Serotonin Reuptake Inhibitors that inhibit the absorption of serotonin by the neurons, so there's more serotonin available. Lower serotonin levels [5] can affect how you feel, which is why physicians prescribe medications such as Zoloft to treat anxiety. 

Furthermore, it's believed that serotonin may manage depression. The symptoms are common regardless of why one suffers from depression, including a reduced desire to participate in any activity, sadness, fluctuations in appetite, energy loss, insomnia, and difficulty focusing. Like anxiety, lower levels of serotonin can cause depression. 

Can CBD Help You Manage Anxiety?

Serotonin gives us hope, but scientists haven't precisely confirmed if it is directly responsible for causing anxiety. Some even go on to call it a “marketing myth” [6] to boost sales of medications like Prozac. That said, some users report that serotonin helps to overcome anxiety. In addition, research by Harvard also supports the theory of serotonin inhibiting anxiety. 

Keeping these contradictions in mind, it's difficult to pinpoint serotonin's role in managing depression and anxiety. However, most medications prescribed to reduce anxiety are SSRIs. 

Coming back to CBD, it also interacts with the serotonin 5-HT1A [7] receptor that invariably reduces the neurons' ability to intake serotonin. This action aids the brain in communicating more effectively to alleviate symptoms of anxiety. So, in simple terms, CBD functions like an SSRI or the medicines used to treat anxiety. 

Interestingly, CBD may also facilitate the growth of an individual's hippocampus to create new neurons [8]. Known as neurogenesis, it may work to reduce depression and anxiety to a great extent. 

Further evidence suggests that CBD reacts with other receptors, including adenosine and glycine, which may help manage anxiety [9]. 

Perhaps the most exciting study [10] that came very close to proving how CBD helped anxiety was conducted in 2019. The scientists used high doses of CBD along with placebos on 57 subjects. They also alternated the doses from 150 to 600 mg of CBD to study the reactions. At the end of the trial, the researchers concluded that CBD reduced anxiety significantly during a public speech. 

Furthermore, the scientists went on to conclude that CBD possesses anxiolytic properties. Any drug that reduces anxiety is considered anxiolytic, so it's safe to say that CBD behaves like medicine used to treat anxiety. 

Now, most people will argue that it's impossible to conclude anything definitively since they tested it only on 57 subjects. Agreed, 57 is not a considerable number; however, note that hemp was legalized recently in 2018, so it will take time for scientists to come up with more extensive trials suggesting hardcore evidence. 

In addition, all studies are not created equally, so there will be differences. For example, many studies are conducted on mice with positive outcomes, but you simply cannot assume that the same is true for humans. 

What To Do If You Have Anxiety?

Now that you're aware of what CBD can do, it's possible to evaluate your options. First, of course, you must discuss everything with your physician. Most doctors prescribe SSRIs to manage anxiety, but adding CBD in your routine to negate any side effects may work in your favor. 

Speaking about side effects, SSRIs can cause blurred vision, nausea, reduced sex drive, appetite loss, lack of basic coordination, dry mouth, etc. Therefore, many users tend to use CBD in combination with SSRIs to reduce side effects. But, again, consult your doctor to see how you can add CBD into your routine. 

How To Use CBD For Anxiety?

CBD aids in managing problems, but it's essential to keep the dosage in mind. Lower doses of CBD may do nothing at all. Based on the 2019 study we discussed earlier, at least 150 to 600 mg CBD was administered to achieve a positive outcome. 

Similarly, you must calculate a proper dosage if you want to get any benefits from the cannabinoid. In addition, the way you administer CBD also matters. It all depends on the bioavailability or the rate at which the human body absorbs the cannabinoids. 

Here are a few ways of using CBD:

Vaping 

Vaping is one of the fastest ways to ingest CBD, so users that vape CBD flowers may experience the effects within 3-10 minutes, depending on the potency. For example, if you vape a less-potent flower, you may not experience desired results. 

Vaping CBD also allows cannabinoids to enter the bloodstream pretty quickly, so you can vape CBD if you want to experience the effects immediately. However, keep in mind that the effects will not last as long as consuming edibles or oils. 

Smoking 

Although smoking is not recommended, it pretty much works like vaping. The cannabinoids enter the bloodstream directly and the users can feel the effects in just a few minutes. But, again, the effects are short-lived. 

Oils and Edibles

Oils, including edibles, take slightly longer to produce effects because the cannabinoids have to pass through the liver before they can be released into the bloodstream. It may take anywhere from 30 minutes to 1.5 hours to feel significant effects. Since the liver also reduces potency greatly, the effects are somewhat lower if you go for less-potent oils and edibles. In contrast, the effects last for a long time compared to smoking and vaping CBD. 

So, what's an appropriate level of dosage? Well, there's no exact science that can tell you how much you're supposed to consume. Some studies [11] suggest that you can even consume up to 1500 mg CBD per day, but regular CBD oils start with 30 mg/ml. Therefore, we can consider Epidiolex since it's an FDA-approved drug. 

Those using Epidiolex may begin with 2.5 mg CBD per kilo at least twice a day. Once the body adjusts to it, the users can double the dosage to 5 ml per kilo, twice a day. This means that an individual can intake up to 10 mg of CBD/kilo per day. Quite a large difference compared to the previous study suggesting 1500 mg, right?

Many studies use more than 800 mg CBD to observe any effects. However, it's best to start with small doses and see how your body reacts to it. This is why it's essential to see a doctor and schedule a dosage rather than trying to calculate it yourself. 

Summary

Can CBD help with anxiety? Yes, many studies suggest it can work to manage depression and anxiety to a certain extent. This is because the cannabinoid serves as a serotonin booster and works similar to SSRIs used to treat anxiety. 

Although there's no fixed dosage, you can speak to your doctor to calculate appropriate amounts. Note that this is very important since lower doses may not work at all. CBD also affects every individual differently, so it's recommended that you start with small doses and then scale it up. 

Resources used in this article 

1. Kaplan, S. (2018). FDA panel recommends approval of cannabis> based drug for epilepsy. The New York Times, The New York Times, 19.

2. Abu-Sawwa, R., Scutt, B., & Park, Y. (2020). Emerging use of epidiolex (cannabidiol) in epilepsy. The Journal of Pediatric Pharmacology and Therapeutics, 25(6), 485-499.

3. Niesink, R. J., & van Laar, M. W. (2013). Does cannabidiol protect against adverse psychological effects of THC?. Frontiers in psychiatry, 4, 130.

4. De Gregorio, D., McLaughlin, R. J., Posa, L., Ochoa-Sanchez, R., Enns, J., Lopez-Canul, M., ... & Gobbi, G. (2019). Cannabidiol modulates serotonergic transmission and reverses both allodynia and anxiety-like behavior in a model of neuropathic pain. Pain, 160(1), 136.

5. Cowen, P. J., & Browning, M. (2015). What has serotonin to do with depression?. World Psychiatry, 14(2), 158.

6. Cowen, P. J. (2008). Serotonin and depression: pathophysiological mechanism or marketing myth?. Trends in Pharmacological Sciences, 29(9), 433-436.

7. Martínez-Aguirre, C., Carmona-Cruz, F., Velasco, A. L., Velasco, F., Aguado-Carrillo, G., Cuéllar-Herrera, M., & Rocha, L. (2020). Cannabidiol acts at 5-HT1A receptors in the human brain: relevance for treating temporal lobe epilepsy. Frontiers in Behavioral Neuroscience, 14.

8. Beale, C., Broyd, S. J., Chye, Y., Suo, C., Schira, M., Galettis, P., ... & Solowij, N. (2018). Prolonged cannabidiol treatment effects on hippocampal subfield volumes in current cannabis users. Cannabis and cannabinoid research, 3(1), 94-107.

9. Blessing, E. M., Steenkamp, M. M., Manzanares, J., & Marmar, C. R. (2015). Cannabidiol as a potential treatment for anxiety disorders. Neurotherapeutics, 12(4), 825-836.

10. Linares, I. M., Zuardi, A. W., Pereira, L. C., Queiroz, R. H., Mechoulam, R., Guimarães, F. S., & Crippa, J. A. (2018). Cannabidiol presents an inverted U-shaped dose-response curve in a simulated public speaking test. Brazilian Journal of Psychiatry, 41, 9-14.

11. 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.