Feeding the Beast

Is cannabis treating or accelerating my anxiety?
Beast
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I’ve got some bad news. I fear the vibes are still off. 

No—I’m not talking about the sensationalized news reports about “high-dose THC” or other types of pop culture urban legend claiming weed makes you all sorts of crazy. 

I’m talking about unprecedented levels of anxiety, depression, and likely other more severe mood and personality disorders that are going unchecked due to economic uncertainty (and, in some cases, calamity), skeptical attitudes toward mainstream medical practices, a lack of understanding regarding how cannabis can help or hurt mental health, and, if I had to guess, a healthy dose of the internet, too. Pop onto any cannabis meme page, cruise through a selection of growers’ accounts, or read any Telegram chat and it’s clear: people be fighting. And while macro factors are to blame, I’m also pretty sure the prevalence of intoxicating substances and a lack of formal mental health oversight probably isn’t helping, either. Add to that the promise of a flashy, fun, and seemingly cool budding industry that has had its wings clipped off? It’s the perfect recipe for a mental health crisis.

I don’t say this critically nor lightly nor absolve myself from evaluation. Cannabis users have been marginalized and played with by various factions and forces since the beginning of time, and I’m not interested in perpetuating stigma that cannabis is overly harmful. But I do believe that overuse can become a mask for mental health ailments if one isn’t tuned into oneself properly. I started looking at my own cannabis use and mental health while I was taking an extended T-Break while pregnant. As my dreams came back but my anxiety did not subside, it was clear I had other issues that weren’t necessarily related to my cannabis use. 

But after I gave birth, weaned off breastfeeding, and started to consume cannabis again, I wanted to approach this “new me” with a healthy dose of skepticism and wonder. Was I using too much cannabis before I got pregnant? I wrote about that while I was pregnant, wondering aloud, and got an incredible response. It turns out, many in the cannabis world were also wondering the same thing, including some big names that would shock people. 

But is there such a thing as using too much cannabis? I know that THC is biphasic for anxiety, specifically, which is my main issue. This means that, at certain doses, specifically low ones, THC can help alleviate anxiety, but it’s different for every person. At higher doses, which, again, are different per person, it actually stokes anxiety and makes it worse. I started to wonder, and still do, if I am unintentionally overmedicating, and, therefore, hurting myself. It’s very common to seek THC for anxiety support—This study claims 50% of medical marijuana patients use cannabis for anxiety. Interestingly, CBD at all doses is shown to be anxiolytic, which means it alleviates anxiety regardless of amount.

Years ago, I interviewed cannabis research scientist Emma Chasen. She had this to say about why people feel anxious when using cannabis:

“A few things happen physiologically that cause us to feel anxious when smoking weed. They’re all seemingly caused by THC,” Chasen says, referring to the compound in cannabis that gets people high.

This anxiety response is related to THC use, though it is largely dose-dependent and it doesn’t necessarily happen in all people. “THC interacts with areas of our brains that are responsible for both euphoria and anxiety. When we consume too much THC,” Chasen says, noting that the dose at which this occurs will be different for everyone, “the brain quickly switches from happy-go-lucky to imminent threat level danger.”

I have also had several medical doctors and researchers tell me that it’s also possible that feelings of mental discomfort come from THC-induced changes in perception, not necessarily inherent anxiety. For example, some people feel a loss of control, which they perceive as negative or dangerous. Their heart rate increases, breathing patterns change, maybe there’s a sense of dread or doom.

In other words, a lot of this anxiety has to do with physical changes caused by THC intake and the brain’s sometimes confused and hyperactive responses to them. THC is a vasodilator, which means it opens up blood vessels and allows blood to move throughout the body more quickly, increasing the heart rate. This increased heart rate, alone, can lead some to feel like they’re losing control, heightening the mind-body connection.

After the brain determines a threat via the amygdala, that signal gets sent to the hippocampus and the prefrontal cortex. The hippocampus gives context to anxiety and the prefrontal cortex will decide what to do about it.

“These areas of the brain often act as safeguards against THC-related anxiety because they can logically assess that there is no real threat and therefore suppress the anxiety. However, at some dose of THC, the hippocampus and prefrontal cortex will decide that there is danger and start panicking. This is most likely due to the suppression of GABA, a neurotransmitter in the brain. And this is when you will start to feel anxious,” Chasen explains.

Additionally, cannabis does not appear to offer the same longer-term effects as other anxiety treatments do, which means its more of a band-aid or immediate-term relief strategy. That doesn’t make it unimportant, but it means that its likely better utilized as part of a larger toolkit for longer-term symptom management. To me, that also means its effectiveness is extremely subjective.

Knowing this, I’m not 100% sure where my use fits in. I know for certain that I use cannabis with the intention of managing daily anxiety symptoms, but I’m not sure if I’m feeding the beast or helping my nerves in the end. So-called “self-medicating” is tricky that way, in that sometimes the immediate relief offered by something can reinforce its use, even if underneath it’s actually exacerbating long-term symptoms. That’s why I’m (surprise, surprise) worried, and I suspect this problem is affecting many other chronic cannabis users, and anxiety sufferers, too.

Another thing I started wondering: What if weed isn’t making me less anxious, it’s just making me too distracted and tired to care? One 2017 study found “blunt stress reactivity in chronic cannabis users.” (I assume no puns intended but, come on, blunt stress reactivity in chronic cannabis users?) Another 2017 study found that higher doses of THC typically resulted in increased negative moods. This study noted that “epidemiological studies tend to support an anxiolytic effect from the consumption of either  CBD or THC, as well as whole plant cannabis. Conversely, the available human clinical studies demonstrate a common anxiogenic response to THC (especially at higher doses).” And, of course, there are a variety of hotly debated studies showing that THC use increases the likelihood of developing anxiety and depression, especially in the adolescent brain. (Though, this teen study said there was “no evidence of an amplified vulnerability to cannabis-related increases in subclinical depression, anxiety or psychotic-like symptoms in adolescence” with serious cannabis use.)

For me, the solution is to engage in talk and somatic therapy, monitor my cannabis use, and make sure I have plenty of somatic interventions to snap me out of an anxious moment. Water, being outside, and cold are all physical tools I have to interrupt my brain, and they work. So does cannabis, and so does the low does of Lexapro I was put on for perinatal anxiety and depression, the pill I credit with helping me and my son have an incredibly beautiful and bonded postpartum period. If anyone is feeling the same way I have been feeling, I encourage them to seek out formal mental health treatment from a licensed professional. There are many who will accept cannabis as a tool in your kit, I promise.

Another macro solution to ease tensions in the industry overall? Legalize it all. Remove it from oversight, period, and let the people have the herb they want and deserve (and that the government has already admitted has medical benefits and is not overly harmful). Removing the commercialization from cannabis will also remove many bad actors, and provide one less incentive for people to spin out over the plant. Maybe this combined with better, more holistic health interventions could help people feel a little better, overall.

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  1. EXCELLENT SUMMARY
    I thought it might be worth adding that multiple studies in rats being given THC have clearly shown exactly the same biphasic effect on anxiety as in humans; that is, a minimal/low dose of THC clearly lowers their anxiety level (measured via behaviour & physiological responses, since you can’t ask them how they’re feeling), while larger doses of THC make them more anxious.

    This inverted bell curve response means that there’s probably an optimum THC dose for everyone which makes them feel better than they did before taking it.

    I also think it’s worth noting that if part of the anxiogenic response to THC is as a result of lowered GABA activity, then it may well explain why a lot of people love to consume another even more popular drug, Alcohol, with their weed. Alcohol as well as benzodiazepines (Valium, Xanax etc) act predominantly as GABA agonists (GABAergic) and this is precisely why the benzo’s are specifically prescribed to suppress anxiety.

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