Cannabis is the most widely used illicit substance globally, and anxiety is the most prevalent mental health condition. But does weed help with anxiety? We’ll help you understand what the research says to make the most informed decisions about your mental health.
Does marijuana help with anxiety?
Many people report using marijuana as a way to manage anxiety, but does it actually work?
Studies show that frequent cannabis users have higher rates of anxiety than non-users. But researchers are struggling to figure out which came first.
Are people with high levels of anxiety drawn to marijuana because it helps relax them and reduce their tension? Or does it create or worsen the symptoms of anxiety over the long term?
The answer isn’t so clear-cut.
People surveyed report that cannabis decreases anxiety symptoms—and a reduction in anxiety is a common reason people seek medical marijuana. Yet research also shows that marijuana can also increase symptoms of anxiety, especially in high doses.
Let’s dig into the opposing perspectives on cannabis and anxiety to understand better how they may impact you.
Cannabis, CBD, THC, & marijuana
People often assume that cannabis, hemp, CBD (cannabidiol), THC (tetrahydrocannabinol), and marijuana are the same. But when it comes to determining their impact on anxiety, the differences really matter.
Here’s the takeaway:
- Cannabis is an umbrella term.
- Marijuana is a commonly used, non-scientific term.
- THC and CBD are 2 active chemicals, also known as cannabinoids, present in cannabis. They’re primarily responsible for the impact cannabis has on mood, stress, and anxiety.
Below are some more detailed explanations of each term.
Describes a group of plants that includes 3 species: Cannabis sativa, Cannabis indica, and Cannabis ruderalis. Marijuana is a sub-type of cannabis. THC and CBD are components of cannabis.
Refers to any parts of the plant Cannabis sativa that are high in tetrahydrocannabinol (THC).
Stands for tetrahydrocannabinol. It’s the substance within cannabis that’s primarily responsible for the feeling “high” or altered.
Stands for cannabidiol. It’s an active yet non-intoxicating, derivative of cannabis.
What’s responsible for how marijuana affects you?
Researchers find that the way marijuana influences anxiety depends on the 4 D’s, a group of factors that help us understand why marijuana impacts people in different ways.
- Dose: THC seems to decrease anxiety at lower doses and increase anxiety at higher doses.
- Duration: Those new to cannabis use are more likely to experience paranoia as a side effect. Longer-term users seem to show increased anxiety over time.
- Difference: A host of individual factors influences the impact, including baseline anxiety levels and genetics.
- Dependence: One of the most significant risk factors of marijuana use is the possibility of dependence on substances in general. Ongoing substance abuse or addiction increases anxiety and all-around psychological distress.
These 4 factors are essential because they help explain some of the apparently contradictory findings. For example, one study might show the beneficial impact of THC, while another shows a strong negative impact. The factor of influence here could be dose or duration.
Anxiety, marijuana, and the brain
When we look at the impact marijuana has on our brains, the findings are nuanced and depend heavily on the dosage.
Between 1995 and 2015, the THC content in the marijuana flower increased 212%. This is important to note because studies suggest that the impact of THC on the brain is very different when looking at high and low doses.
Here’s an example. You may already know that many studies show that marijuana use worsens short-term memory in humans. But recent studies done on animals show that very low doses of THC do something very different.
Though more research is needed, THC has the potential to promote positive development in the brain and reduce cognitive decline.
That being said, these are limited studies performed on mice and shouldn’t be used to make decisions about how you use marijuana. Instead, this example gives a glimpse into just how nuanced the findings are, how far we still have to go with the research, and how much factors like dose impact the results.
Another example has to do with the way THC and CBD, the two main cannabinoids in cannabis, impact the brain differently.
Studies indicate that THC, especially at higher doses, seems to increase anxiety, while CBD appears to decrease it. CBD may also counteract some of the anxiety-promoting impacts of THC.
It seems that the difference lies in how these two substances interact with our endocannabinoid system (ECS), which plays a vital role in modulating our response to stress and reward.
There are several reasons people with anxiety symptoms might benefit from using cannabis in the short term.
1. Short-term relief
The two most common reasons people use cannabis, which are also the two most common short-term benefits, are relaxation and tension relief.
Other reported short-term benefits include
- A feeling of euphoria
- Increased sociability
- Decreased social nervousness
- Reduced physical pain
Studies suggest that medical marijuana generally seems to have an anxiety-reducing impact. However, it’s essential to understand that the anxiety is likely to return upon discontinued use.
2. Temporary reduction of symptoms
Common symptoms of anxiety include
Cannabis can alleviate tension and social nervousness and induce feelings of relaxation. That’s one reason cannabis may relieve some of the more salient anxiety symptoms, at least in the short term.
3. Help with sleep
Some evidence shows that cannabis can lead to improved sleep in those with co-occurring health conditions such as anxiety and chronic pain. It’s not clear if cannabis directly impacts sleep issues or reduces symptoms like physical pain makes it easier to rest. Cannabis may also be helpful for those experiencing anxiety as a result of insomnia.
4. Reducing harm
Harm reduction is an approach that seeks to minimize the negative consequences of substance use. A review analyzing 60 studies focused on medical cannabis—cannabis prescribed by a medical practitioner in states where it’s legal—found that cannabis can sometimes be successfully used as a substitute for higher-risk substances.
Risk of increased anxiety symptoms
So, is weed good for anxiety? That is to say, is it an effective treatment for anxiety? Although many people use marijuana to cope with anxiety, research indicates that, broadly speaking, it has the opposite effect over the long haul.
There is no evidence to date that cannabis supports sustainable, long-term reductions in the symptoms of anxiety. Some of the ways cannabis can increase symptoms of anxiety include:
1. Acute anxiety
20-30% of users show a brief anxiety reaction to smoking marijuana. Most often, this kind of anxiety is triggered for people who have not previously used the substance, are ingesting high doses of THC, or are in a new or stressful setting.
Unfamiliar or stressful settings increase the risk of marijuana anxiety—the panic-like experience that can come from using. This experience can feel similar to an anxiety attack or panic.
2. Re-emerging symptoms
For some with pre-existing anxiety, cannabis can exacerbate those symptoms or trigger a recurrence of acute anxiety or panic.
3. Dulling the effects of medication
Cannabis can reduce the effectiveness of anti-anxiety medications.
4. Increasing symptoms over the long-term
One study looking at Italians drafted into the army found that anxiety symptoms increased with extended use.
When someone becomes reliant on marijuana to cope with anxiety, it’s described as anxiety dependence. This is most prevalent for individuals with social anxiety disorder.
We don’t know precisely why cannabis reduces anxiety in some and not others. But according to a review lead by Jose Alexandre Crippa at the University of Sao Paulo, these are some of the factors at play:
- Individual and genetic vulnerability
- Personality traits
- Frequency of use
- Dose and quantity consumed
- Proportions and concentration of cannabinoids
- History of a previous episode
- Presence of anxiety disorders/ symptoms
- Baseline anxiety levels
- Abstinence states
- Environment and context of the use
Marijuana use certainly has some short-term benefits but can pose mental health risks over the long term.
1. Memory loss
2. Addiction & dependence
Marijuana is associated with an increased risk of substance use disorders, particularly for adolescents or anyone with social anxiety disorder.
It probably comes as no surprise that cannabis dependence is associated with higher levels of psychological distress and anxiety.
3. Legal issues
Marijuana remains illegal in many states and countries. In others, medical authorization is required.
4. Not a long-term solution
Using marijuana to cope with anxiety can prevent you from learning other strategies like physically relaxing exercises or calming techniques. Marijuana may have some short-term benefits, but the gains are not long-lasting.
Marijuana use seems to be higher among people diagnosed with schizophrenia than the average population. But it’s difficult to determine whether cannabis actually contributes to this mental health condition. If you know you’re prone to psychosis, researchers recommend caution and careful monitoring when using cannabis.
- Marijuana offers short-term relaxation but can increase anxiety over the long haul.
- THC may decrease anxiety in small doses but increase it in large doses.
- CBD appears to decrease anxiety at all doses tested.
- You’re more likely to experience marijuana anxiety or THC anxiety when first using it or using it in an unfamiliar setting.
- Medical marijuana for anxiety provides better outcomes than marijuana obtained in other ways.
- The American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596
- Budney (2007). Marijuana dependence and its treatment. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2797098/
- Calabrese et al. (2018). Biphasic effects of THC in memory and cognition. https://onlinelibrary.wiley.com/doi/full/10.1111/eci.12920
- Crippa et al. (2009). Cannabis and anxiety: a critical review of the evidence. https://onlinelibrary.wiley.com/doi/abs/10.1002/hup.1048
- Grinspoon (2018). Cannabidiol (CBD) — what we know and what we don’t. https://www.health.harvard.edu/blog/cannabidiol-cbd-what-we-know-and-what-we-dont-2018082414476
- Hall & Degenhardt (2008). Cannabis use and the risk of developing a psychotic disorder. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2424288/
- Iversen (2003). Cannabis and the brain. https://academic.oup.com/brain/article/126/6/1252/330602
- The National Institute of Health. (2019). Cannabis (Marijuana) and Cannabinoids: What You Need To Know. https://www.nccih.nih.gov/health/cannabis-marijuana-and-cannabinoids-what-you-need-to-know
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- Stoner (2017). Effects of Marijuana on Mental Health: Anxiety Disorders. http://adai.uw.edu/pubs/pdf/2017mjanxiety.pdf.
- Walsh et al. (2017). Medical cannabis and mental health: A guided systematic review.https://www.sciencedirect.com/science/article/abs/pii/S0272735816300939