Cannabinoids are the active compounds found in cannabis; these active compounds interact with cannabinoid receptors found throughout the body. The endocannabinoid system helps the body maintain homeostasis, especially in response to change. When changes occur to the brain or central nervous system — often leading to anxiety or mood disorders — the use of cannabidiol (CBD) may help restore balance and reduce symptoms of pain, nausea, insomnia, seizures, depression, and anxiety.
What Is Anxiety?
Anxiety, along with fear, is part of an adaptive response the body uses to cope with threats to survival. However, excessive anxiety stems from structural and chemical changes in the brain. Anxiety is one of the most common mental disorders and is associated with a number of symptoms that are a function of chemical or neurotransmitter imbalances.
Neurotransmitters are chemical messengers that either excite or inhibit certain processes, and CBD mimics their structure to target neurotransmitter receptors and moderate response activation. Used therapeutically, CBD can help restore balance, alleviating the symptoms inspired by neurotransmitter imbalances and associated with anxiety, such as hypervigilance or paranoia, feelings of fear, irritability, restlessness, muscle tension, high blood pressure, insomnia, and more.
How Can CBD Improve Anxiety?
CBD has broad therapeutic properties that work by mediating diverse central nervous system activity. In particular, CBD interacts with cannabinoid receptors in different areas of the brain as well as with other receptors, such as those that regulate serotonin and norepinephrine. Anxiety is associated with low levels of serotonin, and one way in which CBD works is by binding and activating serotonin receptors, increasing the overall availability of serotonin.
Another way in which CBD improves anxiety is by modulating certain physiological symptoms, such as preventing an increased heart rate in response to stress. CBD is also said to help with insomnia related to anxiety by moderating the sleep/wake cycle and can benefit other forms of anxiety such as PTSD. In the latter, CBD specifically diminishes areas in the brain responsible for intrusive memories, hypervigilance, and hyperarousal as well as the brain’s fear center.
What Evidence Supports CBD for Anxiety?
While there are limited studies available on CBD, the evidence available supports the clinical potential of CBD for anxiety. In a randomized study of people who were prescribed 600 mg of CBD isolate or equivalent placebo, the intervention group reported significantly less social anxiety vs the placebo group. Even at a smaller dose of 300mg, CBD was still effective at reducing anxiety levels.
The first study to describe CBD’s anti-anxiety effect was actually in the context of reversing the anxiogenic effects of THC. In studies that induced fear or anxiety, such as simulating public speaking events, CBD significantly reduced that anxiety and fear. As demonstrated in neuroimaging studies, CBD also has a mediating effect on cerebral blood flow: CBD reduced flow to areas correlated with anxiogenic effects and increased flow to areas with anti-anxiety effects.
How to Use CBD for Anxiety?
It’s important to note that CBD does not have the psychoactive effects of other well-known cannabinoids such as tetrahydrocannabinol (THC). In fact, CBD works to counteract the “high” a person gets from THC. This is an important benefit for individuals with anxiety or mood disorders, in whom THC may exacerbate certain neuropsychologic symptoms. Many wellness companies today are able to isolate CBD and, although limited, the evidence that CBD can treat certain medical conditions is growing.
CBD comes in different formulations including oral modalities (tinctures, capsules, sprays, and oils), which can be taken as is or prepared in smoothies or coffee. There are also edible CBD products, which come infused in drinks and foods like gummies, and inhalation modalities, which offer the quickest path to relief but have long-term safety concerns that are still being studied. Topical modalities are available as well but are typically used to relieve joint pain or muscle spasms and are not applicable for mental health use.