A Growing Body of Research Shows How and Why CBD Works for Treating Anxiety
Anxiety disorders are more common than any other mental health disorder in the world. One in every 13 people lives with some form of anxiety disorder. Living with unmanaged anxiety can drastically lower a person’s quality of life.
As such, it is imperative to have an effective treatment to deal with the symptoms, which include a pounding heart, racing and unwanted thoughts, inability to concentrate, sweating, restlessness, irritability, and hyper-vigilance. The pharmaceutical treatments that are currently used lack in safety and effectiveness.
This has led researchers to look into cannabidiol, or CBD, as a potential alternative treatment for anxiety disorders. CBD is a derivative of the cannabis plant. It is what one of more than 100 cannabinoids found in cannabis. The most abundant and famous cannabinoid in cannabis is THC, known for its psychoactive effects that cause users to feel “high.”
On the other hand, CBD is non-intoxicating, and mounting research indicates that it could have numerous therapeutic benefits, including providing significant relief for anxiety disorders.
Scientific data shows that CBD works for treating anxiety
In the last 10 years, research into the therapeutic potential of CBD has exploded, and a good amount of that research is about treating anxiety disorders. The studies began using preclinical animal models, but more recently, clinical, human studies are in the works. They have started to provide the evidence needed to move CBD from and alternative medicine to something prescribed by doctors.
Neuropharmacology published a double-blind, placebo-controlled study in 2011 found that the anxiolytic effects on participants with generalized social anxiety disorder (SAD) were significant. A single dosage of 600 mg of CBD given to participants in a capsule was able to provide rapid-onset therapeutic effects to relieve symptoms of anxiety.
In addition, a 2019 double-blind, randomized, placebo-controlled study on 37 Japanese teenagers suffering from SAD gave them 300 mg of CBD oil or placebo daily for four weeks. Symptoms were measured throughout the study using surveys. The results showed that CBD was effective, reducing SAD symptoms similarly to the pharmaceutical anti-anxiety drug Paroxetine.
When following up with the teenagers from the study, researchers found that nine of the seventeen who had received CBD ended up seeking out treatment for their condition. This is notable because it is not common for teens with SAD to seek help due to the stigma of having this mental health condition, suggesting that the CBD also positively affected their attitudes toward seeking treatment.
A retrospective case study from 2019 assessed outpatients in Fort Collins, Colorado, many of whom mentioned they were concerned about anxiety. For three months, most patients took a daily dose of 25 mg of CBD. The results showed that 79.2 percent of patients saw their anxiety improve in the first month. Then in the second month, 78.1 reported further anxiety relief than the previous month. However, a small percentage found their anxiety to worsen after taking CBD.
In 2020, a randomized, double-blinded, placebo-controlled, crossover clinical trial was conducted on 24 patients with Parkinson’s disease the analyze the effects of public-speaking-induced anxiety and tremors. The 300 mg dose of CBD was found to decrease participants’ anxiety and amplitude of tremors related to the anxiogenic situation (public speaking).
A 2020 observational study of 397 CBD users from New Zealand found that those who used CBD for anxiety or depression reported improvements in their symptoms and ability to perform daily functions after three weeks of treatment. Seventy percent of the study participants as a whole were satisfied with CBD treatment.
A 2018 review analyzed evidence from both animal and human trials regarding the use of CBD for PTSD symptoms. It found evidence that CBD provided therapeutic benefits, reducing the symptoms of people suffering from PTSD. This means CBD for veterans and others who have experienced trauma might be underway.
More research is needed to confirm these results, and while it is coming along, it’s serious investigation is often stalled because of the legal status of cannabis. Orrin Devinsky, the director of the NYU Langone Comprehensive Epilepsy Center in New York City, says, “In New York City, you can go to a latte shop and get a CBD product, but if I want to do a clinical trial, I’ve got to get a 2,000-pound safe and go through six months of paperwork and licensing.”
How CBD works on the body to improve anxiety
The way CBD works on the body is still not entirely clear. Here’s what is known. Anytime we put a substance into the body, a physiological response happens by way of that substance interacting with various bodily receptors. CBD acts on the body’s cannabinoid receptors within its greater endocannabinoid system (ECS), which has been connected to self-regulation, relaxation, and mood.
There are two known cannabinoid receptors: CB1 and CB2. CB1 receptors are mostly found in the central nervous system. CB2 receptors are found throughout the peripheral nervous system and other regions of the body as well. CBD doesn’t usually bind directly to CB1 and CB2, but it does have indirect effects on them. However, CBD does seem to target more than 65 areas of the body, and a lot of its mechanisms overlap. For this reason, it has been hard to track exactly what CBD is doing and how it works.
Studies have shown that CBD might have an effect on serotonin signals in the body. Serotonin is a neurotransmitter that is linked to mental health, playing a role in the regulation of mood. Low levels of serotonin have long been associated with anxiety and depression.
CBD also appears to interact with the body’s GABA receptors, which reduce the activity of other neurons when binding to them. Many researchers think that GABA receptors also play a role in anxiety, as they can control neuronal over-excitement that causes a fear response.
CBD’s anxiolytic effects may also come from how it indirectly interacts with CB1 receptors in the brain. Joseph Maroon, M.D., the vice-chairman of neurosurgery and a clinical professor at the University of Pittsburgh has some insight about this. CBD is an exogenous cannabinoid, produced outside of the body, but the body also produces cannabinoids, called endogenous cannabinoids.
Maroon’s theory is that because CBD prevents the body’s endogenous cannabinoids from breaking down, the overall result is that “it appears to ease anxiety and pain.” This result comes from the body being given the chance to maximize its endogenous cannabinoids, avoiding the overstimulation of CB1 receptors.
Other experts in the field have other guesses about why CBD works for anxiety. Lynn Parodneck, MD is a former OB/GYN who now treats medical marijuana patients only, including for PTSD, hypothesizes that some people do not produce enough endogenous cannabinoids on their own, and they are the ones who benefit most for external cannabinoids like CBD.
Another interesting point on CBD’s therapeutic benefits to the human body is that exogenous cannabinoids like CBD have similarities to the endogenous cannabinoids the body produces. It may be for that reason that we benefit from it.
While all this information remains unconfirmed, it provides a basis for understanding the complex ways CBD functions inside of our bodies to reduce anxiety. With much more research underway and to come, more and more will be understood about CBD and the exact mechanisms that it enacts.
How to use CBD for anxiety
There are a few different methods for consuming CBD, all of which have slight to moderate differences in the results. As such, education is necessary to understand the best way to take CBD specifically for anxiety.
To treat anxiety, CBD can be consumed orally, sublingually, or inhaled. For consuming CBD orally, the base is a pure CBD oil or pure CBD tincture. How to ingest CBD oil depends on your preference.
CBD oil or tincture can be consumed directly by placing it on the tongue and swallowing. It can also be dropped into food and beverages, swallowed in capsules, or eaten as a pre-made edible product (such as CBD gummies or CBD cookies) found wherever CBD products are sold.
All of these oral methods of CBD consumption require it to pass through the digestive system before it reaches the bloodstream. This means you can expect the onset of the effects to take anywhere from 45 minutes to two hours. The effects are longer-lasting than any other method of taking CBD. However, CBD is not as bioavailable when digested, so the body does not use the full amount that has been taken.
Those who live with a mild to moderate yet constant state of anxiety, the duration of the effects of oral CBD use might prove to be the more effective.
CBD oil can also be taken under the tongue, or sublingually. When consumed this way, the CBD enters into the bloodstream directly, allowing for much faster onset, between 15 and 45 minutes. To take CBD oil sublingually, drop the desired amount under the tongue and hold it there for one to two minutes.
Sublingual CBD use has a higher bioavailability but does not last as long as when taking it orally. However, for those who experience sudden onsets of anxiety or panicked feelings, sublingual use could be helpful.
Vaporizing CBD with a device called a vape pen is another option. Vape pens hold CBD oil cartridges, where the oil is heated into vapor then inhaled. Inhaling CBD has a very quick onset; the effects can be felt within minutes. This method of consumption also has the highest bioavailability, meaning that the effects of the CBD per milligram will be highest. Those looking for immediate anxiety relief should consider vaping CBD. Keep in mind that the effects do not last as long as oral and sublingual CBD consumption.
Despite the positive side of inhaling CBD, many opt out of this method due to the fact that inhaling any substance is harmful to the lungs.
The question, “How much CBD should I take” often comes up when considering using CBD for anxiety or any reason. Unfortunately, there is no consensus on this yet. This is partly because of limited research on the subject and also because it varies by the individual. Factors such as weight, body chemistry, and metabolism come into play.
Co-founder of CBD Seniors Dr. Igor Brussel says, “When it comes to dosing, taking 1-20 mg of CBD twice daily can help bring noticeable anxiety relief to many people. Dosing can vary between individuals based on body type and weight and may need to be adjusted. The best way to find the correct dose is to start with a low dose and slowly increase over time as you pay careful attention to the subtle effects on your body.”
Regardless, anyone looking for a calm CBD for anxiety disorders should consult with their doctor before beginning.
Using CBD safely
Research has now indicated that CBD is safe to use, non-habit-forming, and lacking in serious and severe side effects. The side effects that have been noted are diarrhea, and appetite and weight changes, though they are not common. One 2011 review found that even taking as much as 1500 mg of CBD per day is well-tolerated by humans. Another study from 2019 found that taking CBD long-term was also safe.
This is especially good news considering that many of the traditional, pharmaceutical anti-anxiety medications, such as drugs classified benzodiazepines, are not always safe. Benzodiazepines are effective for anxiety relief, but they are also psychoactive and can lead to addiction. CBD seems to be a much more efficacious option for treating anxiety disorders.
Mallory Loflin, a psychologist at the University of California, San Diego, is currently conducting a long-term clinical trial on the use of CBD for treating PTSD. Loflin says, “[Researchers] are really seeing reductions in anxiety only in folks with anxiety pathology. That suggests you’re actually getting a change in the pathological process—not just an overall dampening of the central nervous system, like what you’d see with a benzodiazepine.”
One thing to be aware of in terms of safe CBD use for anxiety is that it can potentially have negative interactions with other medications. The research into drug interactions with CBD is still in its early stages, so nothing is certain. However, findings so far show that it could be dangerous when combined with the benzodiazepine clobazam and blood thinners. Regardless, it is crucial to always let your doctor know if you plan on taking CBD.
Hospitalizations from CBD use have occurred, but only because CBD remains unregulated by the FDA. The result of this is that some CBD manufacturers include unsafe or low-quality additions to the product they sell, and what’s more this information is not usually on the label. Contaminants, pesticides, heavy metals, and other chemical additions have been found in CBD products.
This makes finding a trustworthy CBD brand a necessity. To find a high quality CBD oil to use, consider the transparency of the company. The more you know about them the better. Often, quality CBD companies will include things like the source of the CBD, the extraction method that was used, its purity, and it will be tested by an unbiased third party.
Checking reviews might also provide some insight. The best CBD oil reviews tend to come from medical professionals or other experts in the field.
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Jess Lakritz 