Marijuana and Anxiety: The Chicken or The Egg?

Marijuana has long been linked to higher levels of social anxiety. Some argue that marijuana itself is the cause of social anxiety, while many users would argue marijuana is most often used to cope with pre-existing anxious conditions. In fact, many users in states that allow medical marijuana are prescribed marijuana as treatment for Post-Traumatic Stress Disorder, a particularly severe form of anxiety. Does marijuana cause anxiety, and how do rapidly changing marijuana laws impact the country’s general mental health outlook?

In general, the medical consensus is that while there is certainly a strong link between marijuana and anxiety, there is little evidence to infer causation from correlation. Although, according to a 2002 study, marijuana withdrawal causes several physical and mental health side-effects, notably irritability and anxiety. If a user experiences anxiety while abstaining from marijuana, they may be more likely to continue to smoke marijuana, thus creating a cycle of anxiety-avoidance. In this circumstance, it could reasonably be said that marijuana has caused anxiety.

Research has found that problematic marijuana use, heavy use that interferes with daily activity and responsibility, is typically a reliable indicator of social anxiety. However, the study concluded that when marijuana was strictly used socially or for entertainment purposes, lower levels of anxiety were reported among users. This result was replicated in a 2008 study, in which coping motives for marijuana were examined. This research suggests that motivations for marijuana use, rather than frequency, could be more predictive of mental health disorders. This information could be critical for therapists as they seek to understand their clients’ motivation for marijuana use.

Understanding this information is critical for marijuana users suffering from generalized or social anxiety disorder. If you suffer from anxiety and use marijuana, it is important to ask yourself several questions about your use to develop a better understanding. First, when do you smoke marijuana? If your use occurs in social situations, or to enhance your leisure activities, your use is likely not problematic. If you find you are using marijuana to avoid negative mood states, if you feel uncomfortable in social situations without marijuana, and if you tend to avoid social situations without marijuana, your use is likely problematic. Be sure to share this information with your therapist or psychiatrist, and together you can work on more productive coping mechanisms.

For mental health care providers, this information illustrates the importance of better understanding your clients’ marijuana use. As recent research suggests, motivation for use is typically a more important factor than rate of use, so be sure you fully understand your clients’ motivations for using marijuana. If providers continue to prioritize prevalence of use over motivation for use, positive mental health outcomes may become harder to achieve.

As more states have voted to legalize marijuana use, both for recreational and medicinal purposes, research will likely expand in the coming years. It will be critical to continue expanding knowledge on how marijuana use relates to heightened anxiety. Future research should account for motivations for marijuana use, the relative mood states of recreational and medical users, as well as the method of ingestion, as states such as Washington and Colorado offer marijuana in edible, vapor, and oil forms. A better understanding of the relationship between marijuana and anxiety will be crucial as the country moves into the “post-prohibition” era.