Can you use CBD for anxiety?
CBD use is widespread and its implementation as a daily ritual is only growing. Many users anecdotally report using CBD for anxiety.
But, what does the research say?
In this article, we will discuss the proposed mechanisms behind CBD for anxiety, emerging anxiety theories, and precautions to take!
How Does CBD Work?
CBD is a cannabinoid concentrated in the hemp plant along with various other cannabinoids.
When these cannabinoids and the other beneficial compounds of the hemp plant are extracted, the produce a CBD-rich, full-spectrum extract sans THC.
These cannabinoids interact with a natural system found in every human body: the endocannabinoid system (ECS).
The ECS is comprised of a group of receptors. The most universally known receptors are the CB1 and CB2 receptors. However, TRPV receptors (the group of receptors that respond to spicy foods) and PPAR receptors (receptors involved in various cellular processes) have also recently been included as part of the ECS.
These receptors govern different parts of the body. CB1 receptors interact with the central nervous system (CNS) to influence neurotransmitter transmission and nerve function. CB2 receptors influence the immune system by impacting the way immune cells function and, thus, inflammation levels.
There are natural cannabinoids present in our body called endocannabinoids. These, along with cannabinoids in hemp, also bind to and affect the activity of ECS receptors.
Researchers believe that CBD could benefit anxiety sufferers by influencing the activity of the ECS.
What Causes Anxiety?
Anxiety is a broad term used to describe various anxiety disorders like post-traumatic stress disorder (PTSD), generalized anxiety disorder (GAD), social anxiety, and specific phobias (1). Broadly, anxiety is a condition characterized by exaggerated fear responses to certain triggers.
Women are 1.5 times more likely to develop anxiety disorders than men.
While we don’t know all the ins-and-outs of anxiety, there are a few theories that can help explain how anxiety happens.
The Neurotransmitter Imbalance Theory
By far, the most widely accepted and current model of anxiety is the neurotransmitter imbalance theory (2).
In our brain, many different neurotransmitters impact our mood and cognition. They work together synergistically to modulate the activity of different parts of the brain.
The brain region implicated in anxiety is called the amygdala. Neuroimaging studies show that electrical activation of this part of the brain leads to anxious behavior.
The neurotransmitter GABA plays a distinct role in the function of the amygdala. Studies using GABA agonists, or substances that activate GABA receptors, decrease anxiety measurements. On the other hand, GABA antagonists, or substances that reduce the activity of GABA receptors, enhance anxiety.
The Neurotransmitter Imbalance model suggests that impaired GABA activity results in anxiety. Although, the exact cause of GABA imbalance is not known. This is one of the major flaws of the Neurotransmitter Imbalance model.
As a result, most of the pharmacological approaches to treating anxiety are centered around restoring GABA transmission. However, this doesn’t address the root cause of GABA dysfunction.
Another aspect of this theory includes serotonin, another neurotransmitter responsible for a myriad of functions in the body. Serotonin receptors agonists are known to have anti-anxiety properties (3).
Collectively, an imbalance of these neurotransmitters can result in mood imbalances.
The Neurogenesis Theory
The Neurogenesis Theory of Anxiety is a fairly new approach to understanding anxiety (4). Neurogenesis is essentially the growth of new neurons.
In studies of depression and anxiety, decreased neurogenesis is directly linked to these disorders. Other studies also point out that antidepressants and anti-anxiety medications depend on the stimulation of neurogenesis to be effective.
However, the body of research is conflicting. One of the major issues that present with this theory is that when neurogenesis is decreased in animals in a normal state, they don’t necessarily develop depression and anxiety.
This has led to a reformation of this theory. Current research is now suggesting that neurogenesis may increase stress resilience, which may prevent triggering factors that can lead to depression and anxiety.
So, while decreased neurogenesis may not necessarily cause depression, increasing neurogenesis may, in theory, be useful for preventing it.
The Inflammation and Oxidative Stress Theory
Various studies have reported that inflammation is associated with anxiety (5). Inflammation is measured by the production of pro-inflammatory molecules. But, the exact relationship between the two is unclear.
There are a few possible links:
- Psychological stress increases pro-inflammatory molecule production.
- Genetic mutations that increase pro-inflammatory molecule production predispose subjects to anxiety disorders.
- Dysregulation of inflammation prolongs and enhances the severity of anxiety.
As it relates to stress, one take on the theory explains that chronic stress leads to an ability of the anti-inflammatory stress hormone, cortisol, to regulate inflammation. As a result, prolonged inflammation may influence neurotransmitter function, according to this theory.
In animal studies, injections of pro-inflammatory molecules into the brain lead to enhance glutamate activity. Glutamate is an excitatory or stimulating neurotransmitter that can result in excitotoxicity. Prolonged exposure to glutamate can lead to neuron death (6).
Glutamate and GABA directly regulate each other, with GABA reducing the excitatory effects of glutamate. GABA also possesses potent anti-inflammatory properties (7). It isn’t clear, though, if inflammation is the cart or the horse in anxiety’s impaired GABA activity.
There are some definite missing pieces to this theory and researchers suggest further studies examining whether the theory holds up or not.
Exploring the Research: Can You Use CBD For Anxiety?
Considering the theories of anxiety, CBD and the other hemp cannabinoids may be beneficial for anxiety in a variety of ways.
Firstly, the ECS is believed to play a role in mood balance (8). Because CB1 receptors can facilitate neurotransmitter release, modulation of these receptors by hemp cannabinoids may influence mood. Studies in this field indicate that reduced endocannabinoid signaling, either through decreased receptor expression or availability of cannabinoids (both endocannabinoids and hemp cannabinoids), results in anxious and depressive behaviors.
Authors of one review conclude: “Collectively, both clinical and preclinical data argue that cannabinoid receptor signaling may be a realistic target in the development of a novel class of agent for the pharmacotherapy of mood and anxiety disorders.” Thus, hemp cannabinoids may provide a way to modulate neurotransmitter function.
Beyond the ECS, CBD is also believed to facilitate serotonin signaling, possibly influencing mood(3). One study also suggests that a 600mg dose of CBD enhances GABA transmission in healthy subjects (9).
Additionally, chronic use of CBD has demonstrated an ability to promote adult human neurogenesis through CB1 receptors (10). Increasing neurogenesis via CBD may help increase stress resilience.
The anti-inflammatory properties of CBD may also have implications in anxiety. Hemp cannabinoids work synergistically to lower inflammation in a pleiotropic manner, meaning through various molecular mechanisms. Considering inflammatory molecules may play a certain role in anxiety, CBD may be beneficial.
But, has this been proven clinically? Can you use CBD for anxiety?
In one study of 72 adult anxiety patients, 57 patients had decreased anxiety scores within the first month of use (11). However, there was no control group to compare it against, making it hard to truly assess the effectiveness of CBD for anxiety.
A review that summarized the human clinical studies available suggests that CBD reduces and prevents anxiety in experimental models of anxiety as well as some anxiety patients (3). They conclude that CBD potentially has clinical relevance for anxiety.
Although, research is still considered preliminary. More controlled clinical trials are needed to assess the exact benefits of CBD for anxiety.
Nonetheless, CBD is considered to have a remarkable safety profile (3).
The Issue with Marijuana
Marijuana users frequently report using marijuana to improve their anxiety.
Unlike industrial hemp from which CBD products are made, marijuana contains high levels of the psychoactive, “high-inducing” cannabinoid tetrahydrocannabinol (THC). THC has been deemed anxiogenic or anxiety-promoting according to a robust body of literature (12).
So, while some may attribute their reduction in anxiety to marijuana use, research certainly doesn’t support the use of high THC marijuana use.
A Word of Precaution
Although CBD holds properties that may support a healthy mood balance, research is still investigational. However, many users of CBD have reported a reduction in anxiety following its use.
If you’re wondering if you can use CBD for anxiety, you should always discuss with your doctor first. They can advise you on possible interactions with other medicines and the safety profile for your individual physiology.
Choosing the Best CBD Oil: Full Spectrum Hemp Extracts
If you do choose to implement CBD oil into your daily routine, you should always opt for a high-quality, full-spectrum hemp extract.
As with all herbal extracts, hemp is most effective when its nutrient profile matches the composition of its natural state. The hemp plant contains beneficial compounds like additional cannabinoids (CBN, CBV, CBG, CBC), flavonoids, lipids, sterols, and more that are stripped in CBD isolate products. These compounds work synergistically to produce a phenomenon known as The Entourage Effect, where all the compounds work synergistically to promote an overall more beneficial effect than the isolated compounds alone.
As a result, CBD isolates demonstrate to be less effective than extracts which match the hemp plant’s natural composition (13). Thus, full-spectrum hemp extracts provide a more bioactive product than CBD isolates.
To further ensure the benefits of CBD full-spectrum hemp oils, you’ll want to avoid products that are contaminated with toxic residues like pesticides and solvents. So, you’ll want to look for organically-grown hemp and extracts processed using supercritical CO2 processing.
Organic hemp doesn’t retain toxic pesticides while supercritical CO2 processing avoids the use of harmful solvents. Moreover, supercritical CO2 extraction maintains the integrity of the fatty compounds in the extracts.
On another note, while THC is relatively nonexistent in industrial hemp plants, an extra effort to remove THC through chromatography is also important.
The Verdict: CBD for Anxiety
So, can you use CBD for anxiety?
There are many possible routes by which anxiety develops. Through CBD’s anti-inflammatory, neurotransmitter-facilitating, and neurogenesis-stimulating properties, it may have a positive impact on these mechanisms of anxiety development, in theory.
However, clinical trials are still considered to be in their infancy. More controlled studies are needed to assess exactly how CBD benefits anxiety patients. Nonetheless, CBD is considered to be remarkably safe.
When considering CBD use, it’s essential that you discuss its implementation with your doctor. They can give you individualized advice on whether or not CBD is right for you.
If you and your doctor decide CBD is safe for you, you’ll want to opt for organically-grown, supercritical CO2-extracted, THC-free, full-spectrum hemp extracts. This will ensure you are making the most of your investment in your CBD products.
At Phytologica, we take the utmost care in processing our full-spectrum hemp products. Our products are free of pesticides and contaminants, processed using supercritical CO2 and cold purification, and THC-free. Shop our various topical, softgel, and tincture products by visiting our Shop page.
*These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease. FDA has not evaluated this product for safety or efficacy.