Many cannabis users claim that marijuana helps them to feel happier, more relaxed and less anxious. On the other hand, some cannabis users report that marijuana increases their anxiety, depression and paranoia. So, which is it — does marijuana use improve or worsen the symptoms of anxiety and depression?
The evidence is conflicting regarding the relationship between marijuana use and mental health disorders such as anxiety and depressive disorders. On one hand, researchers suggest that the chemicals found in marijuana can be effective for treating symptoms of anxiety and depressive disorders, and do not increase the likelihood of developing certain mental health problems. One study found that a synthetic form of THC was effective at low doses for depression, but higher doses of delta-9-tetrahydrocannbinol (THC) worsened depression and other mental health problems (e.g., psychosis).
Another study published in the journal JAMA Psychiatry last month investigated the relationship between marijuana use and the development of mental health problems in nearly 35,000 Americans who participated in the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). The researchers found evidence that adult marijuana use was not associated with anxiety, depression or bipolar disorder, but instead was more closely related to the development of substance use disorders such as alcohol, tobacco and marijuana abuse and dependence.
High doses of THC, on the other hand, are notoriously linked to the development of brief psychotic reactions, even in people who do not have schizophrenia, as well as symptoms of psychosis including depersonalization, fears of dying, irrational panic and paranoid ideas, although these symptoms often quickly abate soon after the effects of marijuana are gone. Adolescent marijuana use is also associated with an increased risk of early onset of psychotic symptoms and psychotic disorders such as schizophrenia, especially among those with a family history of psychotic disorders, a history of abuse or a pre-existing genetic vulnerability.
The double-edged sword: Self-medicating with marijuana
Research links marijuana use to mental health problems — including anxiety, depression, suicidal thoughts, schizophrenia and short-term psychosis. Cannabis use can affect complex mental processes through its effects on neurotransmitters such as dopamine, gamma-aminobutyric acid (GABA) and glutamate transmission — dysregulation in any of these neurotransmitters can underlie the etiology of psychotic disorders.
The body’s natural endocannabinoid system may regulate anxiety and stress by dampening excitatory signals to neurotransmitter glutamate, said Christopher Bergland. Naturally produced endogenous cannabinoid chemicals, called endocannabinoids, target cannabinoid receptors found throughout the body and the brain and, when activated, can make us feel happier and less anxious. Nerve cells in the amygdala create and release their own natural “endocannabinoids” and other substances endogenously, which can be hijacked by exogenous drugs and produce anxiety-relieving effects, according to researchers from Vanderbilt University.
Similarly, THC, the main psychoactive ingredient of marijuana, and other cannabinoid-based compounds, including cannabidiol (CBD), delta-8-tetrahydrocannabinol and cannabinol, can attach to the same cannabinoid receptors and produce the same euphoric and anxiety-relieving effects as these natural chemicals in the brain, said Gary L. Wenk, Ph.D.
People with anxiety disorders who use marijuana may experience relief from anxiety through the endocannabinoid system’s normal coping mechanism — extinction of the conditioned fear response — which may be helpful for forgetting and leaving the past behind. Notably, there are cannabinoid receptors located in the amygdala — one of the main brain regions involved in fight-or-flight responses and anxiety regulation — which may be a major underlying contributor to anxiety-producing and -relieving effects that are produced by marijuana.
Marijuana use in young people with depression and anxiety
Marijuana abuse clearly has numerous risks and consequences, especially for young people whose brains are still developing. A 2013 study conducted by researchers from the Department of Community Health and Epidemiology at Dalhousie University investigated the link between cannabis and other illicit drug use and mental health problems, including depression, suicidal ideation and suicidal attempts, in 976 school students attending four high schools in Canada. The students were surveyed in grade 10 and 12. The researchers found that heavy cannabis use alone predicted depression, but not suicidal ideation or attempts, among high school students.
Another study that followed 1,600 Australian school-aged children for seven years, found that children who regularly used cannabis had a significantly higher risk of depression, but children who had pre-existing depressive disorders were not more likely to use cannabis compared to their peers. Adolescents who used cannabis on a daily basis were five times more likely to develop depression and anxiety later in life.
Negative consequences of marijuana use
Despite the potential benefits of marijuana use for improving mood and relieving anxiety, the chronic use of exogenous cannabinoids (i.e., THC in marijuana) can lead to the down-regulation of cannabinoid receptors, resulting in more anxiety and a depressant effect, said Bergland. Although studies indicate that lower doses of THC are effective for depression and anxiety, the problem is that most cannabis available nowadays contains a high concentration of THC — newer strains are now two to three times stronger than those that were available just 30 years ago.
These highly concentrated THC strains work more quickly and can produce hallucinations with profound relaxation and elation, along with nervousness, anxiety attacks, vomiting and a strong urge to eat. People who self-medicate with marijuana may experience short-term relief from their symptoms and may at first experience pleasant effects (e.g., happiness, sleepiness and relaxation).
Those who use cannabis strains with higher THC concentrations, or chronically use cannabis, may be more vulnerable to experiencing less desirable effects, including confusion, anxiety, depression, suicidal thoughts, forgetfulness, short-term psychosis and psychotic symptoms such as delusions, hallucinations and paranoia. Some studies report that as many as 20 to 30 percent of people who use marijuana experience more intense anxiety and panic attacks. Researchers also suggest that the long-term use of cannabis can lead to irreversible cognitive deficits, which can interfere with a person’s ability to concentrate and make decisions, and contribute to higher impulsivity and hyperactivity.
Dangers of high-potency cannabis strains
Edible marijuana products may be especially dangerous, as these products contain high amounts of THC and take longer to have an effect when ingested. In addition to containing high amounts of THC, edible marijuana products are broken up into several servings that are not intended to be ingested all at once. THC peaks in the blood one to two hours after marijuana is ingested compared to only 5 to 10 minutes after it is smoked, which might prompt someone to ingest dangerous levels of it without feeling the effects immediately.
Although studies continue to find a link between marijuana use and psychiatric conditions such as anxiety and depression, researchers argue that only higher concentrations of marijuana’s main psychoactive ingredient, THC, contribute to mental health problems. Sadly, we hear horror stories of people committing suicide, acting erratically or having serious anxiety attacks following the overconsumption of THC, like the 19-year-old in Colorado who jumped off of the balcony of a four-story building after he ingested six servings of 10 milligrams of THC.
A widely held belief among marijuana users is that marijuana use helps to relieve anxiety and improve depression. Based on the available research, it seems that the euphoric, pleasant and anxiety-relieving effects produced by marijuana are only temporary and can actually contribute to worsening symptoms of depressive and anxiety disorders with higher concentrations of THC and the chronic use of marijuana.
The Sovereign Health Group is a leading provider of addiction treatment, offering evidence-based, individualized behavioral health treatment services to patients with marijuana abuse and dependence. At Sovereign Health of California, we believe in treating patients holistically so they can overcome their addiction and take back control of their lives. To find out more about the behavioral health treatment programs offered at Sovereign Health of California, please contact our 24/7 helpline to speak to a member of our team.
About the author
Amanda Habermann is a writer for the Sovereign Health Group. A graduate of California Lutheran University, she received her M.S. in clinical psychology with an emphasis in psychiatric rehabilitation. She brings to the team her background in research, testing and assessment, diagnosis and recovery techniques. For more information and other inquiries about this article, contact the author at firstname.lastname@example.org.
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