CBD as Anxiety Treatment
Recently, I had a task to write a small description for a category of CBD products aimed at anxiety treatment. (Which was still undone by the time this material was finished.) After starting my research, I discovered tons of all possible materials describing the ailment and cannabidiol as a magic cure for it. The unknown world consumed me for almost two days. I decided to find out how things were going in real life. And to get the facts straight, I wrote this article. Below, you will find information on what anxiety is, how it forms and works, and how to treat the ailment. Of course, CBD as a cure for anxiety has a separate chapter.
The definition of anxiety
My first source of the anxiety definition was Wikipedia. The popular website characterises the ailment as an unpleasant emotion backed by a state of inner turmoil and accompanied by nervous behaviour. So, it completely unclear what anxiety is even if we assume that the latter is characterised by pacing back and forth, somatic complaints, and rumination. You may experience similar states several times a day. Does it mean that you have anxiety and need treatment?
Of course, no! The Wiki article also claims that anxiety is a subjectively unpleasant feeling that always consists of the dread over anticipated events. Now, things become more transparent, but only if you are already familiar with the subject. The fear of a future problem is the critical characteristic that separates anxiety from similar states. At the moment of reading, I didn’t have any idea on what exact state the author was talking about. As an example, the article notes the feeling of imminent death. Although there is such disease as death anxiety, it is still necessary to add numerous details and explanations to help figure out what the ailment actually is.
At this point, I decided to surf other sources to get an answer to my question. That’s what I dug.
In my opinion, a perfect explanation of what anxiety is belongs to Nick Wignall — a clinical psychologist who runs his own blog in spare time.
Although he also characterises the ailment as an emotion, the author highlights slightly different aspects that make his explanation more precise. According to Nick, anxiety is related to fear; however, it has three key characteristics:
- The fear is future-oriented (dread over anticipated events from the Wiki article);
- The fear is prolonged (nothing similar in our initial expression);
- The fear is fundamentally irrational (the fear of death mentioned above may be rational).
Let’s combine what we already know about anxiety to create a more information-bearing explanation.
Anxiety is an unpleasant emotion which originates in fear, is always future-oriented, extended in time, and often completely irrational, as well as accompanied by nervous behaviour. You may feel something like that before an exam, stage, or interview. Does it mean that you have anxiety and need hospitalisation?
Of course, no! Feeling anxious is not an issue at all. Anxiety should persist for an extended period to reach a clinical level and turn into a disorder. If it significantly impairs your functioning, you need treatment. If you are just anxious before an important event, calm down — everything will be alright! You need to distinguish anxiety from other similar states: various cognitive activities, including worry or rumination, or different physical sensations, such as chest tightness or lightheadedness. All of them can be experienced with anxiety. However, they may only be the symptoms of the ailment.
Understanding anxiety through different levels of experience
To solve the issue of anxiety definition, Nick proposes to describe it via three levels of experience: physical, cognitive, and emotional.
When it comes to physical experiences, we should talk about body sensations: you stay under the sun and feel hot, you jump into the water and experience coolness. Dry, spicy, painful, tight, pleasant are other physical experiences.
As for cognitive experiences, they combine a broad range of intellectual (mental) phenomena concerning thoughts and can be either verbal or visual. You can say something within your head or recollect a particular image while thinking.
Emotional experiences combine the previous two levels. When you are in a panic, you think about how to save yourself or prevent a specific situation — a cognitive experience; at the same time, you may experience tension and restlessness — a physical experience.
The main difference between the last category and the remaining two is that we cannot initiate emotional experiences. They are strictly events or states triggered by something. For instance, you can experience delight learning about you’ve been promoted.
As for physical and cognitive experiences they can either happen to us — you feel hunger and an idea about a lunch appears in your head — or we can initiate them — you start thinking about where to get lunch, get it and experience satiation.
So, the main conclusion (regarding the three levels of experience) that helps us understand anxiety is that emotions cannot be controlled. Technically, you can initiate a specific emotional reaction to a trigger. However, you cannot roll back the state or delay it. Let’s explore an example.
You suffer from a bad head of heights, so it is enough to get to the rooftop to experience fear. So, you initiate this state. But you cannot stay there and reduce or delay it. It is only possible to get to a “safe place” to calm down. Thus, when a trigger is nearby, an emotion turns on automatically and controlling it is barely possible.
To initiate an emotion, you need to pass an interpretation of a trigger — something that happens to you and causes it. Thus, having it is impossible without taking a cognitive action (a reaction to a trigger). So a possible path to treating your anxiety is based on learning these actions and managing them accordingly.
Although you cannot change emotions themselves, your possible reactions to triggers that launch them are quite flexible. It is possible to recreate even the most longstanding habits, obtaining new cognitive tendencies that lead to entirely different reactions.
The problem is that all these reactions form subconsciously as a result of your physical and cognitive experiences gained from early childhood. However, in your early days (and years), you don’t understand how things work, but your brain needs to interpret the surrounding world to create defence mechanisms to let you survive. As a result, everyone gets a unique system of triggers and related reactions (fears) that are often irrational. We no longer inhabit the wilderness, but our brain was formed there, so it acts like we are still in a forest, providing lots of unnecessary reactions, which we crucial for our survival in ancient times. However, everyone gets a unique bunch of atavisms. So while someone is afraid of swimming in a river (this fear can become anxiety), many people cannot imagine their summer rest without it. But what about our a better management of cognitive reactions? How can we recreate them?
Being a child, I wasn’t afraid of dogs at all. They seemed amiable creatures that would never harm. But at the age of four, I got bitten by a feral dog in the yard. After that incident, I started to experience panic when these creatures appeared within my eyeshot. I even felt anxious thinking about routes where feral dogs could walk. Lately, I understood that such reactions were irrational for a teenager who could easily protect himself. However, they were uncontrollable until my mid-twenties when I purchased a bike.
When you ride a bicycle, dogs usually start barking at you or even try to bite. Thus, I occasionally recreated my childhood experience. Feral dogs were trying to catch me, but they never succeeded. By informing my brain that these street inhabitants are no longer constitute a danger, I rebuilt my reaction to the trigger and eliminated the anxious state regarding the threat. I got rid of a longstanding habit that was for almost twenty years with me, and dogs turned to best friends and good boys again. That’s how everyone can change reactions to triggers to take control over emotions and various related states. And anxiety is not an exception. Since it exists on the level of emotional experiences, you can apply the same algorithm to take control over it.
Anxiety mechanism
Anxiety is about avoidance. Even though different anxiety disorders may look and feel differently, the mechanism behind them is always the same.
When it comes to a common state, everyone may have experienced hundreds of times, the thought about doing something or being in a specific condition makes us anxious. We try to avoid the emotional and physical state associated with an unpleasant experience. As a result, we try to evade the experience itself.
As for anxiety disorders, they occur when people have accidentally trained themselves to be afraid of experiences associated with anxiety. They try to avoid triggers, counterintuitively making it worse and accelerating the dynamics of the ailment.
All the processes liable for that take place in the amygdala — one of two almond-shaped clusters of nuclei located in the brain. Being responsible for keeping us safe from physical threats, it continuously scans the surrounding environment for potential dangers. If something is recognised as such, the amygdala launches the alarm: it makes the human body able to run away or defend its place in the food chain. The so-called “fight or flight” response turns on. You experience increased heart and breath rate: blood flows faster, providing muscles with more oxygen. As a result, you become more agile and hardy.
People experience this state multiple times, so you know what I’m talking about. Being entirely uncontrollable, it often happens when there are no real dangers around. The amygdala fails to recognise threats. Instead of it, it spots things that maybe look or feel like ones that can be potentially harmful but aren’t capable of hurting anyone. What happens next?
The alarm turns on so you can either avoid a supposed danger or try to defend yourself. Depending on a chosen behaviour, you program further reactions to the trigger. It is possible to launch either ‘fear learning’ — you avoid a trigger informing your amygdala about insecurity, or ‘safety learning’ — you try to defend your place in the food chain but discover that there is no danger in the supposed threat. Since everything is secure, the amygdala turns on its correction mechanism, changing your further reactions to that particular trigger.
Now, let’s look at everything from the perspective of anxiety. In the short term, avoidance brings relief, and you feel comfortable again. Unfortunately, this mechanism is very mean. Your brain recognises such behaviour as a positive reaction, so you try to avoid a trigger on autopilot every time you see it. However, in the long term, this behaviour reinforces unrealistic beliefs leading to persistent anxiety.
Therefore, you have to overcome yourself and face the discomfort of observing a possible threat to get the information necessary for your amygdala to break the vicious circle. It gets more experienced and smarter while you get less anxious. Otherwise, it associates something harmless with possible dangers and programs protective response. The protective reaction turns into anxiety when you face this object, think about it and try to avoid once again.
There are several ways to avoid non-threats. The first one is behavioural avoidance. You see a trigger, and you run away from it. Everything is quite clear. However, the second way is a little bit more sophisticated. It is associated with cognitive processes and seems to be more dangerous from the perspective of anxiety.
Such mechanisms as worry represent cognitive avoidance. It helps your mind stay away from the unpleasant feelings of anxiety by thinking about the perceived problem. The more you do so, the more proofs the amygdala gets to consider these feelings dangerous. You know what it means in the long term.
Anxiety treatment
Now, when you know what anxiety is and how it forms, let’s take a look at how to treat it. Here is the good news! Anxiety disorders hols a leading position among the most treatable mental health conditions! There are two different ways to eliminate the problem: via various techniques of behavioural therapy or with the help of medication. However, a more efficient approach is the first one. It happens because the psychological processes behind the ailment are relatively well understood. You can leverage one of the following techniques:
- Exposure Therapy — you deliberately expose yourself to a trigger to learn that the feared outcome won’t take place (it is what happened to dogs and me);
- Cognitive Restructuring — you learn how to identify and dispute irrational thoughts and take control over them;
- Mindfulness — you also learn how to control your thoughts by switching from absurd future threats to something that happens right now. Looks like a cognitive practice based on meditation and other similar methods;
- Relaxation Training — you eliminate the symptoms of anxiety via different relaxation techniques: progressive muscle relaxation or diaphragmatic breathing.
As for the medication-based approach, it is a second-line treatment. Furthermore, it may only reduce the symptoms of the ailment, saving you in the short term. To eliminate anxiety, you have to rely on cognitive and behavioural practices.
The problem is that medication does not change the already existing defence mechanisms that create a background for anxiety. However, it may be beneficial as an additional pillar. But most sorts of medication aimed at anxiety treatment are highly addictive. They may provide a rapid and robust impact, but patients face the possibility of substance abuse related to each particular drug. But there is a new trendy way to fight the symptoms — CBD. Yes, we can finally proceed to the last chapter of this article — CBD as an anxiety treatment.
CBD as anxiety treatment
Unfortunately, we still need more scientific evidence of successful anxiety treatment with the help of CBD. Nobody can prove or deny cannabidiol effectiveness. Except, of course, numerous users who write about absolutely different experiences on the Internet.
But, as I’ve mentioned above, the best way to treat anxiety is to use various cognitive and behavioural techniques. Why do we need CBD in this situation? If it works, it may be considered a healthier alternative to traditional drugs due to the following reason:
- It is natural and doesn’t do any harm even in significant amounts;
- You cannot be addicted to CBD, while drugs like Xanax can develop a strong addiction. Furthermore, CBD may also act as a substance for substance abuse treatment;
- You don’t need a prescription to get CBD. However, I strictly do not recommend you to treat your anxiety without a doctor. When delivered by a competent specialist, treatment can be rapid.
So, it means that cannabidiol may be a less harmful second-line treatment that reduces the symptoms of anxiety. But how does it work?
Although research is still very preliminary, CBD is thought to stimulate the body to process serotonin. This hormone plays a role in regulating emotions and, as a result, provides impacts on anxiety. If the serotonin level is enough, you are above par. If it is low, you may more likely experience the symptoms of the ailment.
It is thought that CBD acts similar to serotonin reuptake inhibitors — anxiety and depression medications. CBD targets a 5-HT1A serotonin receptor which results in the increase of the serotonin availability in the brain. Your mood gets better, and you no longer feel anxious. However, you still have to change the way your amygdala interprets threats and non-threats to heal yourself from the ailment. But if you decide to try cannabidiol to test its antianxiety properties, choose one of the following ways to consume the compound:
CBD vaping against anxiety
You can inhale vaporised CBD oil through a vaping pen. A part of it enters the bloodstream through mouth tissues while the most amount gets into the lungs and enters bloodstream there. Next, the compound is spread all over the body, providing relief. It is held that vaping is the fastest way to feel the CBD benefit. This trait is crucial when it comes to an acute anxiety situation. However, you cannot control the amount of compound being consumed. At the same time, the safety of vaping itself is still under question due to various chemicals found in vaping liquid. And don’t forget that both smoking and vaping provide relief even without additional compounds, such as CBD. But the positive impact can be experienced in the short term. When taken as a whole, the process only increases anxiety.
Oral CBD as anxiety treatment
Another way to calm down your mind and body during another anxiety peak is to use oral CBD. Unlike vaping, it is considered a more safe way of intake. You can use either CBD oils or CBD oral sprays to consume the compound and feel the CBD benefit. Put it under your tongue and wait one-two minutes before swallowing. As for dosage, you have to discover one that suits you. Since CBD impacts every user individually, start with a small amount and explore the impact. While one manufacturer does not recommend to consume more than 75mg of CBD daily, people on the Internet talk about 75–100mg depending on the anxiety level.
CBD edibles on your way to kill anxiety
CBD-infused food, candies, and beverages introduce another way to consume the compound to treat anxiety. However, CBD edibles are associated with the slowest method to cut off the symptoms of the ailment. You need to wait until cannabidiol gets into bloodstream from your digestive system. Depending on the product, this may require different timestamps.
And don’t forget that food and sweets, in general, may reduce the symptoms. Thus, the only drawback is that your brain thinks that too many candies are never too much, while in the long term it may play a dirty trick on you, especially before the beach season.
Note that it is always better to talk to your doctor to figure out what CBD product to choose and what starting dosage to use.
Research and evidence
According to the nonprofit National Organization for the Reform of Marijuana Laws (NORML), very few products contain enough CBD to replicate the therapeutic effects achieved in clinical trials. But what is the amount scientists used?
In a 2018 study, CBD proved its effectiveness in treating anxiety symptoms for subjects who were undergoing a simulated public speaking test. They received an oral dose of 300 mg of CBD. However, 150mg and 600mg showed little to no results. Do you still remember about the daily limit mentioned above? It is several times smaller than the CBD amount that succeeded in the study. You should also take into account that only 57 subjects participated in the experiment. It is not enough to make any profound conclusions.
Also, note that people who take such a massive amount of CBD may experience such side effects as low blood pressure, lightheadedness, and drowsiness. By interacting with other medications or dietary supplements, the compound may also cause other side actions.
However, some people talk about the cumulative effect of CBD. It means that the compound is stored in the human body and act when the necessary amount is gained. That’s why CBD manufacturers recommend taking it daily.
Let’s take a look at more research. According to this review of pre-clinical and clinical findings, anxiolytic properties of CBD were reported in the Social Anxiety Disorder, but larger, randomised, placebo-controlled trials are needed. Only then, scientists will be able to evaluate the therapeutic potential of CBD. The results of another research show that there is scarce evidence to suggest that cannabinoids improve anxiety disorders.
Conclusion
Once again, I’d like to emphasise the fact that the best anxiety treatment is behavioural and cognitive therapy. All medications, including CBD, may reduce only its symptoms. Of course, this impact on the ailment is often vital, especially considering that behavioural practices require time to fix the problem, but you need to be fully functional right now.
From the perspective of symptom treatment, CBD introduces excellent opportunities since it tends to be harmless, even in large amounts, in comparison to traditional drugs. More common medications are very addictive and often lead to misuse.
However, even CBD has several side effects, including fatigue and lightheadedness. Another problem is that nobody knows the right dosage. And while a small amount may not provide any negative impact, the bigger one may force you to experience all side effects associated with cannabidiol. Or may not. Consult your doctor before starting the therapy. Some manufacturers recommend to begin with a small amount of CBD and gradually increase the dosage.
And don’t forget that there is scarce evidence to suggest that CBD improve anxiety disorders. But the opposite is exact: nobody can prove that it is useless. More research is necessary.
Verified by a Healthcare Professional
Anastasiia Myronenko
Anastasiia Myronenko is a Medical Physicist actively practicing in one of the leading cancer centers in Kyiv, Ukraine. She received her master’s degree in Medical Physics at Karazin Kharkiv National University and completed Biological Physics internship at GSI Helmholtz Centre for Heavy Ion Research, Germany. Anastasiia Myronenko specializes in radiation therapy and is a fellow of Ukrainian Association of Medical Physicists.
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This article is based on the following materials:
- https://nickwignall.com/understanding-anxiety/
- https://www.healthline.com/health/mental-health/how-people-use-cbd-for-anxiety
- https://www.healthline.com/health/cbd-for-anxiety
- https://www.womenshealthmag.com/health/a26826400/cbd-and-anxiety/
- https://www.ncbi.nlm.nih.gov/pubmed/31672337
- https://www.ncbi.nlm.nih.gov/pubmed/31601406
- https://alphagreen.io/