Mental Health IS Health
As Indian psychiatrist Vikram Patel says, “there is no health without mental health”. While it’s important to keep our bodies in good shape, it doesn’t matter much if we are suffering in the mind and with our emotions! Anxiety affects 40 million adults in the United States every year, and approximately 17.3 million adults have had at least one significant episode of depression. It has been estimated that 1 in 6 Americans take psychiatric drugs, while many others try “alternative” or “complementary” approaches like yoga, meditation, nutrition, acupuncture, mindfulness and other techniques.
Considering all of the treatment possibilities that exist, does CBD help with anxiety and depression? And, if so, how?
CBD For Stress
The Endocannabinoid System and Mental Health
Why should we consider CBD for stress relief? First, let’s take a step back and look at the endocannabinoid system (ECS). The ECS is a really important system that plays a role in many physical and mental health processes. For instance, the ECS is related to our conscious awareness and sense of self (Murillo-Rodriguez et al. 2017). It plays a significant role in the way we process emotions, how we learn and also our sleep patterns.
The ECS can also modulate the hypothalamic‐pituitary‐adrenal (HPA) axis, the hormonal system meant to keep us balanced under stress. Whether you’ve got an irritating boss, are struggling in your marriage or have to deal with a 2-hour drive through traffic to get to work every day – we all experience stress, so the HPA helps keep us in check. But stress is meant to be temporary – and unfortunately in modern society our stress response tends to turn “on” very quickly, and many of us lack the opportunity or skills to help turn it “off” more easily. When we’re in stress overdrive, excessive activation of the HPA system increases risk of both mental and physical health problems.
Keeping the ECS in working order may help alleviate some of the problems that arise from excess stress and emotional issues. There is a lot of evidence that a deficient endocannabinoid signaling may be related to depression and anxiety. CBD is known to affect this system, and may be one method individuals suffering from mental health challenges can be helped.
CBD Effects on Anxiety: What Does Research Show?
CBD effects on anxiety were first discovered in 1974. Researchers found that while high doses of THC can cause anxiety and paranoia, except when also given CBD simultaneously. Some researchers call this the “protective effect” of CBD against the negative effects of THC.
There are many studies in animals that show an “anxiolytic” (anti-anxiety) effect of CBD. Since it’s not really possible to sit a rat down on a couch and ask about its feelings, studies use different behavioral tests to see how animals respond to different scenarios. Since they understand how rats behave under normal, healthy circumstances, certain changes in behavior can show researchers rats are feeling anxious. We’re actually not all that different – if a friend walked in on us crying while binge-watching Netflix and gorging on Oreos, they’d (hopefully!) ask if we’re doing alright.
There are limited studies in humans, but they point to a potential benefit of CBD. One study involved patients with social anxiety disorder who had never received treatment before. The group of 24 patients was split in half, where 12 received 600mg of CBD and the other 12 got a placebo. Then, both groups performed a public speaking exercise – an activity that even worries people without social anxiety! Those who had CBD experienced less anxiety, discomfort and mental impairment, while those with the placebo had much higher scores. The researchers took multiple measures of anxiety – both subjective, where they asked participants using surveys how they felt, and physiological, measuring blood pressure, heart rate and skin conductance – all elements that typically increase when one is feeling anxious. What is interesting is that there were no significant differences in physical measures between groups, but their subjective experience was still different.
Obviously, more research is needed to better understand how CBD affects the human body and anxiety, but these results point to exciting possibilities for worry warts everywhere.
CBD Effects on Depression: What Does Research Show?
The endocannabinoid system contains a number of different receptors located throughout the body. One set of receptors, called 5hT1A receptors, seem to play an important role in depression in particular. These receptors are targeted by SSRI antidepressants like Prozac, and a number of studies have found CBD also affects these receptors too.
Most research on CBD and depression is focused on animals at this point. Animals are obviously different from humans in many ways, and just because something works in mice does not always mean it will work the same way in humans. That said, animal studies are important for researchers to begin to understand potential mechanisms they can later take to a human population.
A recent study on rats explored the effects of CBD on two different “models” or types of rat depression, and subjected the rats to two tests. In the “forced swim test,” the rats were placed in a Plexiglass cylinder filled with water for 5 minutes, essentially being forced to swim. That doesn’t sound fun, does it? They look at whether the animals actually swim, struggle or become immobile. The idea is that immobility in particular is a sign of helplessness, a feeling people can also experience when depressed. Then the researchers did what’s called a “Saccharin Preference Test,” where an artificial sweetener was placed in one water bottle, while another contained plain water. After the swim test, the rats should theoretically be hungry, right? (I know I would be!) This test is known to assess what’s called “anhedonia,” which basically means a lowered ability to feel pleasure – something many people struggle with when depressed. Researchers measured to see how much they consumed of each liquid. Turns out, the rats given CBD had less immobility (i.e., less helplessness) and consumed more saccharine solution (i.e., increased pleasure). Studies like this are obviously quite a bit removed from the person who has trouble getting out of bed in the morning because they are so depressed, but are really helpful in understanding specific ways CBD can help. One important limitation is that CBD was only given to the rats at one time, while most people’s depression is ongoing rather than limited to single laboratory tests – so there’s plenty to be learned about CBD and depression in humans!
Is CBD Good For Anxiety and Depression?
Should you try CBD for your anxiety and depression? It will probably be years before scientists know exactly how CBD works for human mental health in enough detail to recommend, but plenty of people are experimenting on their own. That said, if you’re already taking medications for anxiety and/or depression, definitely talk with your doctor first. Like over 60% of pharmaceuticals, CBD is processed by what are called cytochrome p450 enzymes. SSRIs, tricyclic antidepressants and some anti-anxiety medications are also processed by the same enzymes. While there are no known serious interactions with CBD and pharmaceuticals, it also hasn’t been studied systematically so a “better safe than sorry” approach is a good idea. As with any health measure, starting “low and slow” is a good idea to see how you respond to CBD. Every body is different, so if you’re interested and feel safe trying, CBD may be beneficial to add to your health – and mental health! – regimen.
References:
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3975269/
- https://adaa.org/about-adaa/press-room/facts-statistics
- https://www.nimh.nih.gov/health/statistics/major-depression.shtml
- https://www.scientificamerican.com/article/1-in-6-americans-takes-a-psychiatric-drug/
- https://cpr.bu.edu/wp-content/uploads/2020/01/4.-Alternative-Approaches-TEXT-version.pdf
- https://www.ncbi.nlm.nih.gov/pubmed/21693551
- https://onlinelibrary.wiley.com/doi/full/10.1111/j.1365-2826.2008.01673.x
- https://www.ncbi.nlm.nih.gov/pubmed/19839936
- https://www.ncbi.nlm.nih.gov/pubmed/18833429
- https://www.frontiersin.org/articles/10.3389/fpsyt.2013.00130/full
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4604171/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3079847/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3267552/
- https://www.ncbi.nlm.nih.gov/pubmed/30571957
- https://www.frontiersin.org/articles/10.3389/fneur.2018.00183/full
- https://doh.dc.gov/sites/default/files/dc/sites/doh/publication/attachments/Medical%20Cannabis%20Adverse%20Effects%20