CBD and Anxiety: What You Need To Know

People often experience peace and contentment when consuming cannabis and CBD products. This experience leads many to ask "does CBD really work for anxiety?". At this stage, the studies are still ongoing. While we can't give a clear cut answer to this burning question, it helps to look at the current data to get an idea of where the research around CBD and anxiety is headed. Join us as we cover the intricacies of anxiety, the studies that have pitched CBD against the condition, and how to consume the cannabinoid.

What Is Anxiety?

As a lingering feeling of unease, worry, and fear, anxiety can have varying effects on the quality of life. Whereas some only experience occasional bouts of unpleasant feelings, others are weighed down by constant and crippling feelings of dread. Generalised anxiety disorder (the most common form of anxiety) affects around 5% of the population^[1] in the United Kingdom alone. Unfortunately, cases of anxiety continue to rise^[2] across the world (partly fuelled by the recent pandemic), despite the myriad of treatment options available. A range of factors is responsible for this surge, including stress and trauma during childhood, poor sleeping habits, excess exposure to social media, and even diet.

• Types of Anxiety

There are many different types of anxiety. Each condition affects people in different ways, and some of them require a different approach when it comes to treatment. Some of them are also much more common than others. The most prolific types of anxiety include:

• Generalised anxiety disorder: People with this condition experience constant feelings of anxiety. Several causes underpin the condition, including an imbalance of brain chemicals, painful health conditions, and a history of drug and alcohol misuse.
• Obsessive-compulsive disorder: Severe cases of this chronic disorder significantly impact the quality of life. The signs and symptoms include extreme fear of germs, unpleasant intrusive thoughts, aggression towards self and others, and the need for perfect order.
• Social phobia: A long-term and overwhelming fear of social situations. The condition usually starts in people during their teenage years. The symptoms include worrying about everyday activities, frequently blushing and sweating, and a fear of embarrassment.
• Panic disorder: Characterised by sudden and regular bouts of panic and fear. The causes of this condition include an imbalance of neurotransmitters and stressful life events. The symptoms include but aren't limited to nausea, chest pain, elevated heartbeat, trembling, and hot flushes.
• Post-traumatic stress disorder: Traumatic events trigger this mental health condition. When people struggle to cope after such a situation, they may experience flashbacks, nightmares, and extreme anxiety.

Current Treatments for Anxiety

Fortunately, those with anxiety have various treatment options to choose from, such as medication, therapy, and lifestyle changes. The most common forms of treatment include:

How CBD Is Related to Anxiety

So, does CBD deserve a place on this list? And what's the relationship between CBD and anxiety? At this point, we simply don't know. Decades of prohibition have prevented human clinical trials from taking place in the past, and modern-day restrictions and bureaucratic labyrinths make them difficult to perform. However, ongoing studies are making good ground. Researchers are going to great lengths to pitch CBD against different types of anxiety in humans. Cell and animal studies continue to unveil how cannabinoids like CBD work in the body to make relevant physiological changes. So far, they've figured out that CBD influences the body and brain by binding to specific receptor sites, including serotonin receptors and those that make up the endocannabinoid system (ECS).

• What is the endocannabinoid system and how is it related to anxiety?

Put simply, the ECS helps to govern almost every facet of human physiology by driving homeostasis (a state of biological balance). It shows up everywhere, from neurons and immune cells to bone cells, where it plays the role of the universal regulator^[3]. In the brain, the ECS holds significant sway over neurotransmitter traffic. Signalling molecules within the system (known as endocannabinoids) travel backwards across the synaptic cleft^[4], allowing these brain cells to dictate the volume and type of chemicals that bind to their receptors. Because cannabis-derived cannabinoids either bind to ECS receptors directly or modulate endocannabinoid levels through other means, researchers are keen to find out exactly how they impact anxiety in humans.

• The relationship between cannabidiol and anxiety

A lack of studies means that scientists can't make any conclusions just yet. But many interesting investigations are underway that will hopefully clear up the relationship between CBD and anxiety. Some of the most important ongoing studies include:

• How CBD affects ECS enzymes: Researchers are testing CBD for its ability to inhibit an ECS enzyme^[5] known as fatty acid amide hydrolase (FAAH). This protein breaks down the endocannabinoid known as anandamide, which plays an important role in mood. If CBD helps prevent FAAH from breaking it down, it could have a knock-on effect on mental state.
• The link between CBD and GABA: Ongoing studies are also looking into how CBD affects GABA levels^[6] in the brain. Also known as gamma-aminobutyric acid, this inhibitory neurotransmitter works to dampen brain activity, which helps to turn things down a notch in the anxious brain.
• Testing CBD against social anxiety: Researchers are now conducting human experiments to see how CBD influences certain outcome measures. For example, a paper published in the journal Neuropsychopharmacology administered CBD to patients with generalised anxiety disorder before engaging in a simulated public speaking event^[7]. The researchers looked to measure factors such as cognitive impairment, discomfort, and levels of alertness.
• CBD and blood flow to the brain: Some human studies are taking things a step further and looking to see if CBD alters blood flow to regions of the brain associated with anxiety. Using arterial spin labelling (an MRI technique that measures changes in blood oxygen levels), a team of University College London set out to see if CBD changes blood flow to the hippocampus^[8]—a brain region associated with the modulation of anxiety.

How Is CBD Consumed?

There are several different ways to consume CBD. Following its boom in popularity, companies are coming up with new ways to utilise the cannabinoid, from vaping extracts to putting the molecule in bottled water. The most common ways to consume CBD include:

• Inhalation: Smoking and vaping send CBD directly into the bloodstream via the lungs. This method makes for fast onset times (within a few minutes) but comes with obvious health concerns. Products include raw flowers, hash, kief, moonrocks, and shatter and wax.

• Oral: Eating or drinking CBD subjects the molecule to first-pass metabolism. Because it must first pass through the stomach and liver before entering systemic circulation, CBD-infused brownies, cakes, gummies, and sauces take a while longer set in (around 30–60 minutes) However, recent water-soluble products slash this waiting time to around 10–15 minutes.

• Sublingual: Placing CBD oils under the tongue gives the molecule almost instant access to the bloodstream. Sublingual application offers a fast onset without having to inhale vapour or smoke.

• A note on dosing

Although human trials revolving around CBD seem promising, you need to take the dosage into consideration. Some of these studies administer doses as high as 600mg, that's more than the entire volume of CBD within some oil products. Not only is consuming that amount expensive, but it also increases the risk of side effects such as stomach upset and drowsiness.

CBD Isn’t FDA Approved for Anxiety

The Food and Drugs Administration in the United States has not approved CBD as a treatment for anxiety. Why? For one, many CBD products out there aren't accurately dosed and don't contain what they claim. Furthermore, the lack of conclusive human trials means it isn't feasible for the organisation tasked with protecting public health to approve the cannabinoid for this use. Hopefully, developed dosing strategies, increased product purity, and further evidence from human studies will change this stance.

Does CBD Produce Anxiety?

CBD produces side effects in some users, including nausea, fatigue, and irritability. The cannabinoid can also interact with a long list of prescribed medications. However, the cannabinoid isn't known to induce anxiety at this time.

Legality

CBD has legal status in many countries, providing that products abide by the legal THC threshold. For example, CBD oil in the United Kingdom must contain less than 0.2% THC. Only a small group of countries have outlawed CBD, including Albania, Belarus, Bosnia and Herzegovina, and Serbia. Always check your local regulations.

Does CBD Really Work for Anxiety?

Now you're aware of the ongoing studies that are pitching CBD against models of anxiety. You've also discovered the most popular ways of consuming the cannabinoid and why it hasn't won FDA approval. So, can CBD help to treat anxiety? Right now, we don't know. But the amount of research in this field means we'll likely have a solid answer in the near future.