Cannabis can help fight chronic anxiety!

It is normal to feel anxiety and stress. What is not normal is for anxiety to be chronic or long lasting, nor for stress to be excessive. Among the beneficial properties of cannabis are mood regulation, anxiety reduction and even the possibility of treating disorders such as post-traumatic stress. To learn more, read on!

This article was written to inform the general public about medical cannabis, so we have tried to keep the language simple.

Health professionals who wish to read a more technical version can click here.

Fear and anxiety are normal responses to cope with dangers in order to survive, but when stress and anxiety become chronic or persistent it can lead to psychiatric disorders such as generalized anxiety disorder, panic disorder, anxiety disorder or social phobia, post-traumatic stress disorder (PTSD) and obsessive-compulsive disorder.

The latter two are no longer classified as anxiety disorders, but one of their main components is chronic anxiety. [3] Anxiety disorders result in a decreased sense of well-being, increased unemployment, relationship problems, and an elevated risk of suicide. [4]

In the United States, these disorders have a prevalence of 29%, higher than any other mental disorder. [3] Mexico is not far behind: a 2014 study reports that nearly 70% of Mexicans have experienced traumatic events that trigger chronic anxiety and post-traumatic stress. [4]

Only 4 out of 10 Mexicans affected by PTSD received medical or professional care and treatment. [7]

Anxiety

Anxiety is an altered and excessive emotional state that leads to lasting emotional disturbances and a sense of constant apprehension and worry about the future. [8] Anxiety is a normal reaction that can alert us to dangers and to pay more attention to our environment. Anxiety disorders is not just feeling nervous, but involves excessive emotions and chronic anxiety. [1]

According to studies by the Ministry of Health in Mexico, cases of anxiety increased by 75% between 2013 and 2018. Additionally, according to data from the National Survey of Psychiatric Epidemiology in the country, almost 30% of adults will suffer from some mental disorder in their lifetime. [5]

Post-traumatic stress disorder

According to the American Psychiatric Association, post-traumatic stress disorder (PTSD) is a disorder that can occur in people who have experienced or witnessed a traumatic event, or have been victims of violence or crime. [2,6] PTSD is also known by its acronym PTSD or Post-Traumatic Stress Disorder.

People with PTSD 'relive the trauma' for a long time and with various symptoms: with flashbacks or nightmares, feeling anxiety, sadness, fear, anger; and even loneliness or isolation.

They tend to avoid people, places, or situations that remind them of the traumatic event, and seizures can be triggered by common things such as loud noises or physical contact. [2,6]

Unfortunately, in Mexico it is "extremely common" to experience traumatic events due to the levels of violence and the degree of social inequality that exists in the country. A 2013 study indicates that 28% of Mexican youth between 10 and 25 years old have experienced two or three traumatic events, and 13% have witnessed four or more. [4] 

Conventional drug treatment

Currently available treatments for these conditions include psychiatric medications such as antidepressants (SSRIs, SNRIs, MAOIs, TCAs) and benzodiazepines. Anticonvulsants and atypical antipsychotics are also used to treat PTSD. [3]

These medications do not always help and often have side effects, particularly in PTSD. The limitations of current treatments expose the importance of developing new treatments that are more effective and have side effects that are not disabling. [3]

Anxiolytic properties of cannabis

The endocannabinoid system or ECS is found in various organs and tissues, including in the limbic brain, known as the 'emotional brain'. CB1 receptors are found mainly in the brain and balance the excessive activity of neurons: they increase feelings of calm, decrease anxiety, reduce pain and inflammation, regulate movement, the five senses, memory and cognitive function. [10] Different studies suggest that cannabinoids may help modulate anxiety and depression. [9]

Studies conducted in 2008 and 2013 showed that a single dose of THC reduced the intensity of reactions to threat cues. THC has also been shown to modulate anxiety (depending on the dose) and decrease fear. However, THC at high doses can exacerbate anxiety, so a physician's prescription and advice on its use is essential. [12]

CBD can exert its anti-anxiety effect by activating receptors that regulate the heart and blood pressure, as well as having a broad anti-inflammatory effect throughout the body. At high concentrations, CBD directly activates serotonin receptors in the brain, which provides antidepressant effects. [10]

A recently published study (May 2020) administered marijuana to patients with PTSD; patients reported a 50% decrease in symptoms immediately after treatment administration. [11]

CBD and THC as treatment

CBD oil can be effective in reducing anxiety as well as insomnia caused by anxiety. Animal studies support this use and report that CBD can correct sleep disturbances caused by chronic anxiety. [10] More research is still lacking, but preliminary data suggest that CBD may help individuals with PTSD to treat psychopathology related to stress, anxiety, and trauma. [13]

These findings add to the growing evidence that cannabis helps with pharmacological modulation of the endocannabinoid system and may be a promising approach to treat anxiety- and stress-related psychopathologies. [13]

But do not forget that the diagnosis and dosage of cannabis, CBD or other cannabinoids should always be carried out by a medical specialist or psychiatrist in the case of humans and a veterinarian specializing in ethology in the case of animals.

References

[1] American Psychiatric Association. (2017). What Are Anxiety Disorders? Recuperado de <Sitio web>, última consulta 23 junio 2020.

[2] American Psychiatric Association. (2020). What Is Posttraumatic Stress Disorder? Recuperado de <Sitio web>, última consulta 23 junio 2020.

[3] 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. doi:10.1007/s13311-015-0387-1.

[4] Flores, S. (2017). Traumas. Nexos. Recuperado de <Sitio web>, ultima consulta 23 junio 2020.

[5] Gudiño, A. (2018). Ansiedad aumenta 75% en los últimos cinco años en México. Recuperado de <Sitio web>, ultima consulta 23 junio 2020.

[6] National Institute of Mental Health. (2019). Post-Traumatic Stress Disorder. Recuperado de <Sitio web>, ultima consulta 18 junio 2020.

[7] Norris, F. H., Murphy, A.D., Baker, C.K., Perilla, J.L. (2003). Epidemiology of trauma and post-traumatic stress disorder in Mexico. Journal of Abnormal Psychology, 112(4), pp. 646-656.

[8] Tambaro, S., and Bortolato, M. (2012). Cannabinoid-related Agents in the Treatment of Anxiety Disorders: Current Knowledge and Future Perspectives. Recent Patents on CNS Drug Discovery, 7(1), 25-40.doi:10.2174/157488912798842269

[9] Kendall, Dave and Alexander, Stephen (2009). Behavioral Neurobiology of the Endocannabinoid System. 10.1007/978-3-540-88955-7.

[10] 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.

[11] LaFrance, E. M., Glodosky, N. C., Bonn-Miller, M.,& Cuttler, C. (2020). Short- and Long-Term Effects of Cannabis on Symptoms of Post-Traumatic Stress Disorder. Journal of affective disorders. 274, 298-304. Advance online publication. https://doi.org/10.1016/j.jad.2020.05.132

[12] Hindocha C., Cousijn, J., Rall, M., & Bloomfield, M. A. P. (2019). The Effectiveness of Cannabinoids in the Treatment of Posttraumatic Stress Disorder (PTSD): A Systematic Review. Journal of Dual Diagnosis, DOI: 10.1080/15504263.2019.1652380.

[13] Rabinak, C. A., Blanchette, A., Zabik, N. L., Peters, C., Marusak, H. A., Iadipaolo, A., & Elrahal, F. (2020). Cannabinoid modulation of corticolimbic activation to threat in trauma-exposed adults: a preliminary study. Psychopharmacology. doi:10.1007/s00213-020-05499-8

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