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CBD And Anxiety

What is Anxiety?

Anxiety is the most common mental disorder in the U.S. and although about one in five adults will suffer from anxiety, only a third of adults will seek treatment for it. Major anxiety disorders are also more prevalent in women than in men[1]. As someone who has experienced anxiety first hand, as well as advised many clients in using cannabidiol (CBD) and tetrahydrocannabinol (THC) to treat it, I truly empathize with those who suffer from this difficult ailment. Anxiety is treatable, but it is much different than a physical ailment that one can have bandaged up by a doctor. Anxiety affects the very workings of our mind. Thus, it is important for patients and practitioners alike to understand that the identity and decision making of a person is affected when he or she experiences anxiety. It is not so easy to go see a doctor for treatment when you are worried about leaving the house, paying the bills, keeping safe, or confronting many of the scenarios which will exacerbate your anxiety if you do seek treatment. For my clients who have learned how to use CBD correctly to combat anxiety, they have accessed the agency and control over their health (and life) that anxiety has taken away.

THC vs CBD for Anxiety?

        Anxiety occurs when we experience emotional, mental, or physical stress. The stress sets off a chain reaction in our cell behavior starting at the Amygdala- the fight or flight part of the brain. When our Amygdala is activated, we feel like we are fighting for our lives even if it’s our job, spouse, or a memory that is merely triggering the amygdala to respond with anxiety. We also have neurotransmitters (chemical compounds) in the Amygdala and all over the brain called GABA receptors. These control anxiety (feeling revved up) and depression (the post-revved up crash) and therefore, being able to help control the action of GABA is a common target for anxiolytic drugs.[2] Both CBD and THC cannabinoids (neurotransmitter mimicking compounds) interact with GABA[3]. They are interesting compounds because THC can both cause and alleviate anxiety. CBD on the other hand is safer as it rarely increases anxiety and tends instead to correct it. Unlike THC, it is not directly affecting cell behavior. CBD is like a social worker, entering the brain and nerve sites to encourage balance and correct the anxious or depressive action of our brain’s cells. CBD is referred to as a “toner” to the system. Its action is toning the nervous system to respond to stress healthily- not reactively as the amygdala does. It’s important to note that we don’t fully understand the action of CBD on the endocannabinoid system, but the data I have collected from hundreds of clients who consult with me confirms for me that CBD can having a gentle, toning effect on the system. It is important to note that drugs such as gabapentin and benzodiazepines also act on the ubiquitous GABA receptor. Although I have observed successful symptom reduction from CBD in clients who have been affected negatively by benzodiazapines, I do recommend they talk with their doctor before taking CBD.

Experiencing Anxiety

       My personal experience with anxiety is that it most debilitating in the morning when cortisol levels are higher and the day’s to-do list is looming ahead. First it starts off as tightness in my chest and begins to spread outward toward my limbs. It’s as if the nerves are all telling each other in a telephone game how bad the day is going to be. By the time my limbs are buzzing, with anxious nerves firing away, the mind kicks in and gets very creative about what to worry about. When my physical and mental anxiety heightens, my body begins to heat up and sweat. Sometimes, when it gets this bad, my mind begins to worry that my anxiety will cause permanent damage to my body and mind. It’s as if the overload to my nerves will start to wear them out, causing them to get stuck in a permanent state of fear and stress. Stress can then make us vulnerable to sickness and our immune system can kick in as well, creating inflammation in the body. I empathize with anyone who has ever experienced anxiety or panic in this way. It is not fun.

        But when I compare my personal experience with anxiety to that of many of my clients, my symptoms are mild. Severe anxiety can be extremely debilitating and sometimes my clients have been so chewed up and spit out by the medical establishment, pills, and various treatments that they are anxious to try anything new, let alone a drug made from marijuana. (Hemp and marijuana are two varieties of the same species, Cannabis sativa, and both contain CBD). People who are caught in the vicious cycle of anxiety have every right to be worried about medical cannabis and what it may do to their symptoms. THC, the psychoactive constituent in cannabis, can cause or exacerbate anxiety in users[4]. In fact, I’ve found many marijuana users who consume marijuana to ease their anxiety may actually be stuck in a medicated loop. They find the drug mitigates anxiety temporarily, and then causes it to increase again as the high wears off and leaves the nerves ‘wired and tired.’ Although this is not life-threatening, being dependent on an anti-anxiety drug that exacerbates anxiety is demoralizing at the very least.

How CBD Helps Anxiety?

        Enter CBD, the second most prominent constituent of cannabis. By properly advising in CBD dosage and administration method, I have helped many patients who tried conventional anxiolytic drugs but found them to be either lacking in effectiveness, or worse, dangerous to their health. Because we are addressing the neuro-chemistry of the brain, it is my opinion that utilizing a non-toxic, whole-plant product like CBD is a more conservative place to start than many pharmaceuticals. Because I have my patients’ health and my community in mind, I also do not believe CBD is a miracle cure capable of relieving everyone’s anxiety. If one tries it and it doesn’t work, or just doesn’t feel right, then he or she can move on to conventional treatments that follow the Federal Drug Administration model. Drugs approved by the FDA have to have precise, measurable molecules creating reproducible actions on the body. Because this precision is necessary in the scientific method, some pharmaceuticals can target receptors in the brain aggressively. Pharmaceuticals are designed to decrease symptoms with no prior knowledge of the patient. For some, this model works. For other more sensitive brains, this precision model can have the opposite effect if a patient’s diverse needs and symptoms are unknown or not addressed. Many people do just fine on the myriad drugs created by pharmaceutical companies to treat anxiety. But not all anxiety drugs work well for patients. That is why there are so many different types. CBD merely provides another option for treatment. Thus, approaching anxiety holistically, as I do with my patients, is in line with the less aggressive action of CBD.

        When assessing a client’s needs I take into account client attitude, past health issues, family history, etc. in order to frame the root of anxiety and experience of the client. They may be better off with an herbal compound such as CBD, but if health insurance pays for the pills then so be it. Or, some people will find that the relief from their anxiety is too deeply buried under the feedback between nervous system and the mind for pills or CBD to work. I cannot imagine what it would be like to live in an anxious state all day every day, but I have worked with people who do. My heart goes out to them.

CBD is not just an herb, it is a proven anti-anxiety compound.[5] Scientists are still working out the biochemistry behind this effect, but because our body has literally billions of cell receptors that respond to the regulating effects of CBD, it’s not surprising that the body feels regulated after ingesting CBD. Imagine how I felt when I discovered that CBD could interfere with the “anxiety telephone game” my body experienced during my anxious moments. The CBD enters the bloodstream and interacts with receptor sites in cells as a regulator. Picture a social worker or coach interacting with a group of stressed out individuals. The CBD guides, tones, and seemingly trains the group to respond more rationally to stressful stimuli. A refrain I hear from patients is this; “Well I don’t necessarily feel the CBD in my body, but I feel better. I can tell that my nerves are a little less reactive. My mood is less volatile. It was hard to tell at first but my anxiety is better on the CBD.” As a cannabis consultant, I want to hear that my clients are having symptom reduction without unwanted side effects. This is why CBD is gaining popularity with cannabis users who find that THC helps calm them but who do not want the psychoactivity or “high” associated with THC. They are also wary of the anxiety-provoking action of too much THC. For this reason, CBD is a much milder and effective anti-anxiety agent.

The Best CBD Products for Anxiety

        Now, if you experience anxiety, and you are interested in trying CBD to help reduce its debilitating effects, while it tones your own system to respond more effectively to stress, then where do you start? What CBD is best for anxiety? What is the proper CBD dose for anxiety? And what is the best method to take CBD for anxiety relief?

        There are a plethora of CBD companies creating an ever-growing number of CBD products to help patients treat ailments like anxiety. I believe that every CBD product has the potential to provide a patient symptom relief, but I have also found that CBD products can have different effects. They may not get the user “high” exactly, but they are strong alterants—one can feel the CBD sedating and coursing through the body. Others, like the Holland grown CBD I sell to clients, tends to have very little alterants capabilities. Patients instead report that although they don’t feel it physically acting on the body, they do notice symptom relief. One client of mine took what I call a ‘course of CBD’ regiment that I suggested to him over a 3 week period. At the end of the three weeks he stopped using the CBD as he didn’t feel it “working.” But within a few days, his symptoms came back and he realized that it actually had been working to reduce his symptoms. Having reduced symptoms without side-effects is important for many patients. Having tried conventional anxiety medications, I can appreciate a CBD that has very little in the way of altering side-effects. I like my Holland-based CBD for this reason. Some types of CBD, especially if they are taken at higher doses, can be felt by the user quite strongly. If a sensitive patient has anxiety, then taking a cannabis-based compound with strong physical side-effects is not fun. Often, the physical feeling can exacerbate their anxiety, especially if their anxiety comes from feeling physically unsafe. At high doses, even my Holland-based CBD can be “felt” in the body. I tested it at roughly 10 times the suggested dose and found that it had a sedative and melancholy effect for about three days after ingesting the CBD.

Recommended CBD Doses for Anxiety         

To address sensitive anxiety sufferers, I believe a Holland-style CBD is a good place to start. For type and dosage, I would suggest a user try an oil-infused CBD over a period of 2-4 weeks to allow the oils carrying the CBD to penetrate into the lipids (fatty components) of his or her cells. We often dismiss oils as being bad or unhealthy in our culture, but lipids make up the very structure of our cells. CBD, as well as the carrier oil (such as olive), and our cells are all lipids. Therefore, a daily oral dose of CBD oil may bring a more sustained relief to an anxiety sufferer. There is also a CBD formulation I make which is designed to enter the system more rapidly and provide anxiety relief on an as-needed basis. My alcohol/glycerin formula has a sweet taste and the carrier liquids are absorbed more quickly into the body than oils. I tell anxiety clients to keep an oil-based CBD in their medicine cabinet and an alcohol/glycerin formula on their person in case of panic attacks or anxiety flare-ups.

        Although studies point to doses as high as 400mg as anxiety-relieving[6], I would advise a client to start far more conservatively with a 10mg dose. If after 2-4 hours, if no negative effects are felt, then one can initiate what’s called a load-up dose. This is a larger dose which determines how the CBD is felt in the body. A load-up dose of approximately 40-60mg is usually enough to feel the calming effects of CBD. (If one feels groggy or melancholy afterward then the load up dose is indicating that the user can use less to access the anxiety reducing effects.)

        After the load-up dose provides a baseline effect, then the user can settle into a daily maintenance dose which will be enough to feel reduced anxiety, but not enough to make the person feel heavy, groggy, or melancholy. Determining dose requires good note-taking by the patient and his or her caretaker.

        I encourage patients to resist the pharmaceutical model of ‘take X dose and forget about it.’ Instead, users should take a moment to get centered and feel their anxiety level every day before they take CBD. Some days may require a stronger than baseline dose and some days may require less. If patients are tuning into their intuitive sense of their own body in assessing what dose is actually working, then I believe relief will be more accessible. It’s not a magical thing to tune into the body. It is data collection.

        Usually, after two to three weeks of taking their course of CBD, patients will know when to use the CBD for acute anxiety moments, and when to just hold steady with their daily dose. Eventually, as the CBD has a toning effect on the nervous system, a patient may find that less and less CBD is needed to feel relief. Essentially, the CBD begins to feel too strong at the normal dose because the nervous system requires less. With time and a positive attitude, healthy diet, and regular sleep, an anxiety sufferer can ween off the CBD and enter a more anxiety-free life. If issues come up, he or she knows CBD (and my guidance) will be available for symptom relief.

 

[1] https://www.adaa.org/about-adaa/press-room/facts-statistics

[2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4303399/

[3] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3473327/

[4] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4032500/

[5] https://www.ncbi.nlm.nih.gov/pubmed/26341731

[6] https://www.ncbi.nlm.nih.gov/pubmed/20829306

 

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