Despite being previously misunderstood and stigmatised, depression and anxiety disorders are becoming far more normalised in modern society as awareness of these issues grows and people begin speaking out about their personal experiences with the disorders. With mindfulness, meditation and wellness crazes springing from this new awareness and openness around mental health, it might be easy to think that our society’s stress disorders are on the decrease as a result.
However, an awareness of these illnesses and their symptoms does not necessarily correlate with a decrease in their prevalence. In fact, quite the opposite seems to be the case. A recent YouGov survey indicates that the number of young people experiencing anxiety and depression may be on the rise, with 18% of young people in the U.K who were surveyed now disagreeing with the statement “life is really worth living”. This is an astonishing 50% increase in the number of young people disagreeing with this statement when compared to the results obtained in 2009. However, this is not just an issue with young people, as generally, 1 in 5 individuals suffers from depression throughout their lives.
Despite the hugely common prevalence of such disorders, treatment remains a challenge, as often the commonplace pre-existing approaches to treating anxiety are not enough to make large scale differences to many individuals still suffering with the disorders. As such, many are left questioning what alternate approaches we can take to treat an increasingly anxious world.
To understand how cannabis might help treat anxiety disorders we first need to fully understand what it is.
What is anxiety?
Looking at anxiety from an evidence-based, integrative medicine point of view, the group of disorders is viewed as a problem related to the central nervous system’s regulation which involves many neurotransmitter systems and coexisting biological factors. Many psychosocial and even environmental influences are also involved.
With such mental health conditions, like with depressive disorders, central nervous system dysfunction often increases, which is frequently accompanied by hyperarousal and disrupted or non-restful sleep. On the other end of the spectrum, oversleeping can also occur. With these symptoms occurring long-term, disruption to the neuroplasticity of the brain makes it harder to change entrenched patterns of behaviour despite the individual’s desire to. The ultimate result to the body is the alteration of multiple neurotransmitter pathways, changes to the neurotransmitter levels themselves (for neurotransmitters like serotonin, dopamine and cortisol) and also changes to neurotransmitter receptors.
Non cannabis-based treatments
While established pharmacological and psychiatric therapies are already used to treat these conditions, the efficacy of such approaches is varied. In many cases, a combination of different types of therapies tailored to suit the patient’s needs yields the most effective results and remission rates.
Popular non-drug therapies include:
- Cognitive behavioural therapy (CBT)
- Psychodynamic psychotherapy
- Interpersonal therapy (IPT)
Frequently prescribed pharmacological treatments include:
- Selective serotonin reuptake inhibitors (SSRIs)
- Atypical antidepressants
- Serotonin and norepinephrine reuptake inhibitors (SNRIs)
- Tricyclics and tricyclic-related drugs
- Monoamine oxidase inhibitors (MAOIs)
- Pregabalin, gabapentin and amitriptyline
Alternate lifestyle-based therapies for treating anxiety and depression may include:
- Art/Music therapies
- Herbal medicines such as St. John’s Wort
Can cannabis help?
We know that the endocannabinoid system interacts with the neurotransmitter systems affected by anxiety, where it can play a role in resetting hypervigilance and decreasing the fear response experienced by sufferers. The endocannabinoid system also has a role to play in reducing perceived and physiological stress symptoms and helping to restore peaceful sleep.
These bodily effects related to the endocannabinoid system help to explain why cannabis based medicinal products appear to help with a variety of mental health conditions, as the system seems to help restore the brain’s ability to self-regulate.
However, it should be realised that, as effective as these medicines can be in helping with the treatment of multiple symptoms, these medicines alone do not seem to offer a definitive cure for anxiety and depressive disorders.
Possible cannabis-based treatments
We know that in recreational cannabis products with high THC content, particularly where there is little CBD to counteract THC’s psychoactive effects, smoking cannabis can in fact lead to anxiety. In extreme cases with products with a very high THC to CBD ratio, paranoia and panic attacks can also be experienced.
However, medical cannabis is not comparable to recreational cannabis and its effects. When medical cannabis is used to treat anxiety, with products containing lower doses of THC and exhibiting generally higher CBD contents, anxiolytic and antidepressant effects can be observed in patients with very few (if any) side effects.
If medical cannabis is regulated and prescribed according to the specific patient’s needs under the careful direction of a trained doctor, there may be many potential benefits for patients who have experienced little success with other drug and lifestyle-oriented therapies. If the doctor also proceeds to track the progress of the patient in the context of a wider mental health treatment plan, using cannabis medicinally for mental health issues could be a highly safe and effective form of treatment.
Further investigation and research into medicinal cannabis and alternative medical options is thoroughly encouraged by The Academy, particularly through the use of our own online courses, evidence base and whitepapers.
The rest of our resources are available on our website. We urge anyone considering use of medical cannabis products to consult with a trained medical professional prior to beginning use.