How Can CBD Help Manage Anxiety?

How Can CBD Help Manage Anxiety?

Published on October 9, 2021 by Kristina Willis

We all experience some degree of anxiety when faced with uncomfortable or daunting situations. For some people, it becomes a persistent state of being. Whether your fear involves driving on the freeway or dreaded social interactions, you would probably jump at the chance to alleviate some of the associated anxiety. Considering the recent hype around cannabidiol’s (CBD) therapeutic properties, it is only natural to ask, can CBD help?

Available research strongly indicates that CBD can be used to help manage anxiety, including debilitating disorders. The evidence from anecdotal accounts, preclinical trials, animal studies, and randomized controlled trials (RCT) paints a sincerely hopeful picture. Though further placebo-based human studies are needed to determine specifics, we can confidently say that acute doses of CBD act on serotonin receptors to produce an anxiolytic effect.

49% of American CBD users take it to address anxiety and stress despite the lack of official support. As the second most common reason for using CBD, there is little doubt that anxiety treatments hold the public’s interest.

In this article, we detail the most up-to-date and accurate information regarding the use of CBD for managing anxiety.

Can CBD Treat Anxiety?

For many years, information regarding cannabis and anxiety was conflicting. Some studies found that cannabis reduced anxiety levels, while others reported the opposite. Research has since brought to light that the difference in response likely has to do with what specific cannabinoids are present.

Tetrahydrocannabinol (THC), which is responsible for the psychoactive effects of marijuana, can be anxiogenic, particularly in high doses. CBD, on the other hand, exhibits anxiolytic properties. When taken together, CBD may even counteract the adverse side effects of THC, including paranoia and anxiety.

Self-reports corroborate CBD’s efficacy, with 86.5% of respondents reporting decreased anxiety symptoms. As an aside, 92.2% of respondents using CBD for perceived stress noted reduced stressed levels. Though further research is needed to fully understand CBD’s effect on the body and brain, the available evidence supports the use of CBD to manage and decrease anxiety.

Recent studies supporting CBD’s anxiolytic effects:

► A New Zealand audit for cannabidiol prescriptions found that patients with mental-health-related symptoms experienced improvements to anxiety. (2020)

► A double-blind study of Japanese teenagers with social anxiety disorder (SAD) and avoidant personality disorder concluded that a daily intervention of 300 mg of CBD over a 4-week period reduced symptoms measured by standard evaluation systems (FNE and LSAS). (2019)

► CBD may potentially attenuate anxiety related to opioid cravings, according to a double-blind, randomized, placebo-controlled trial. (2019)

► A study on anxiety and sleep indicated that CBD administration reduced anxiety within the first month for 79.2% of patients and persisted throughout the study’s duration. (2019)

► A low dose of cannabidiol decreased anxiety behavior and normalized 5-HT activity in a study on pain in rats. (2019)

► Using public speaking as a stressor, researchers confirmed that acute administration of CBD induced anxiolytic effects following a dose-dependent inverted U-shaped curve. (2017)

► A study focusing on generalized social anxiety disorder (SAD) found that acute administration of CBD reduced subjective anxiety, specifically affecting the functional activity of brain areas implicated in processing anxiety. (2010)

Excerpt from Cannabidiol as a Potential Treatment for Anxiety Disorders (2015):

“We found that existing preclinical evidence strongly supports CBD as a treatment for generalized anxiety disorder, panic disorder, social anxiety disorder, obsessive–compulsive disorder, and post-traumatic stress disorder when administered acutely; however, few studies have investigated chronic CBD dosing.

Likewise, evidence from human studies supports an anxiolytic role of CBD, but is currently limited to acute dosing, also with few studies in clinical populations.

Overall, current evidence indicates CBD has considerable potential as a treatment for multiple anxiety disorders, with need for further study of chronic and therapeutic effects in relevant clinical populations.”

How Does CBD Regulate the Anxiety Response?

CBD’s anxiolytic effects are not entirely understood, though recent studies have sought to illuminate the underlying mechanisms and affected brain regions. For instance, CBD’s role as a CB1 agonist is thought to play a prominent role in counteracting THC hyperactivity and inflammatory actions.

At a fundamental level, CBD interacts with receptors that regulate fear and anxiety in the central and peripheral nervous systems. Regarding brain activity, CBD targets areas associated with emotional information, such as the right posterior cingulated cortex.

Key anxiety systems affected by CBD:

► Serotonin type 1A receptors (5-HT1A)
► Vanilloid receptors (TRPV1)
► Cannabinoid receptors (CB1 & CB2)
► Anandamide production
► Hypothalamic-pituitary-adrenal axis (HPA axis)

Serotonin 1A (5-HT1A) receptor

While numerous components are involved in anxiolytic action, serotonin 1A receptors (5-HT1A) seem to be the most involved. This is not particularly surprising, as serotonin receptors are widely distributed in areas related to stress and anxiety, including the prefrontal cortex, hippocampus, and amygdala.

To elicit acute anxiolytic effects, low and intermediate doses of CBD activate 5-HT1A receptors. Due to its complex interactions with the endocannabinoid system, the effects of CBD often vary depending on circumstances and control factors. Results from rodent studies suggest that dose, strain, cadence, and delivery all play a role in how CBD dosing is received.

The (Growing) Problem with Anxiety

As an integral part of our “fight or flight” response, anxiety is a perfectly natural human reaction. However, persistent or excessive anxiety can cause unwarranted physical and emotional distress. Worst case scenario? It leads to a potentially debilitating disorder that can permeate all aspects of your life.

As the most common mental illness in the United States, more than 40 million adults suffer from an anxiety disorder every year. Moreover, recent surveys suggest that anxiety is a growing epidemic, with 1 in 5 people feeling anxious nearly all the time or a lot of the time. Many of these cases severely impact quality of life—yet less than 40% receive treatment.

While reasoning may vary—including lack of availability and social stigma—one primary contributing factor is that current treatments for anxiety disorders are far from optimal. Pharmacological options show limited efficacy and produce adverse side effects. While behavioral therapies (particularly cognitive behavioral therapy) are effective, they are also time-consuming and rarely provoke immediate results.

Many people are hesitant to commit to such treatments when the benefits are delayed. Thus, they turn to self-prescribed medications such as cannabis. Unfortunately, conflicting information and the circulation of unregulated products make it challenging for consumers to control or optimize their intake for maximum results.

Should You Use CBD to Help Manage Your Anxiety?

In all likelihood, CBD can be used to effectively manage anxiety with minimal effort required. Most importantly, it has a good safety profile and a low risk of abuse. If anxiety is affecting your life to the point where you feel like you are being held back or are frequently unable to enjoy activities you want or need to partake in, then CBD is a valid consideration.

Fortunately, CBD is easy to obtain. Hemp-derived CBD products with less than 0.3% THC are legal in every state and can be acquired from dispensaries, retail stores, or online. However, be wary of less-reputable brands as misinformation and inaccurate labeling are common due to a lack of regulation.

Keep in mind that everyone reacts differently to cannabis products, and tolerance can vary drastically. Thus, it is essential to find a dose and strain that work for you. The best cannabis strains for anxiety and stress tend to be low in THC and high in CBD. When possible, consult with a cannabis-aware physician to determine a safe and optimal dosage as well as monitor your health.