Depression is a widespread mental health condition that affects approximately 16.2 million adults within the United States. In Europe, approximately 25% of the population suffers from depression or anxiety. In some people, depression can come and go. In others, the condition is a permanent companion that can significantly reduce one's quality of life. Depression draws billions of euros from the economy each year and robs individuals of their potential happiness. Conventional treatments for the condition include a range of medications that work in some cases, yet make things worse in others. Interestingly, many people who experience depression turn to cannabis in an act of self-medication. Science has shown that the herb can be useful for an array of health conditions, but can it help with depression?

WHAT IS DEPRESSION AND WHAT CAUSES IT?

We all get a little sad from time to time. Stress, anxiety, and emotional life events can leave us feeling down in the dumps. Eventually, this sadness lifts and enables us to continue living our lives undisturbed. But depression is more than sadness. It’s a chronic mental health condition that can linger for months or years on end. Sufferers aren't able to simply “snap out of it”.

POTENTIAL TRIGGERS FOR DEPRESSION

The cause(s) of depression is a complex subject. The condition can stem from a distressing life event such as the death of a loved one, a severe illness, or giving birth to a child. For others, it might be the accumulation of minor events that sends them on a downward spiral. The risk of depression is enhanced if people take to hard drugs and alcohol in an attempt to self-medicate.

In other cases, depression can come about for no apparent reason at all. Genetic factors and personality type can play a role. One explanation for depression is a lack of neurotransmitters such as serotonin. Research has also discovered that the hippocampus—an area of the brain involved in learning and memory—is smaller in some depressed people. This could be down to stress suppressing the production of new neurons.

COMMON SYMPTOMS OF DEPRESSION

Depression can manifest in many different ways. Sometimes the signs can be mild, and other times quite severe. Common symptoms of depression include:

• Continuous low mood or sadness
• Lack of motivation and apathy
• Low self-esteem
Insomnia
• Restlessness
• Difficulty concentrating
Overeating or appetite loss
• Persistent aches and pains
• Feelings of hopelessness
• Feeling tearful and crying often
• Feeling irritable and intolerant
• No enjoyment of life
• Suicidal thoughts

COMMON SYMPTOMS OF DEPRESSION

TRADITIONAL TREATMENT FOR DEPRESSION

Multiple traditional treatment options exist for depression. Each one is recommended based on the severity of the condition. Doctors may prescribe conservative treatments in cases of mild to moderate depression, suggesting things like exercise to boost mood. Interestingly, aerobic exercise may increase internal cannabinoids that are responsible for the so-called “runner’s high”[1]. Many depressed individuals also participate in cognitive behavioural therapy (CBT) to change patterns of thought and behaviour.

Doctors often prescribe antidepressants in cases of moderate to severe depression. There are over 30 different types of antidepressants available, including selective serotonin reuptake inhibitors (SSRIs).

SSRIs increase circulating levels of the neurotransmitter serotonin. They limit the reabsorption of serotonin into the presynaptic cell, making more serotonin available. These medications are effective at stabilising mood in some patients, however, they are associated with a long list of side effects including nausea, vomiting, nervousness, dizziness, sexual problems, agitation, and confusion.

These options help some people deal with and even overcome depression. In others, they fail to offer relief. Today, many people are turning to other options, including cannabis.

CANNABIS, DEPRESSION, AND THE ENDOCANNABINOID SYSTEM

If you smoke weed, you’re probably familiar with how good it can make you feel. There are times when hitting a bong can elevate your mood and initiate giggle fits. Some strains induce a state of euphoria that lasts for hours. Other strains have more of a relaxing effect that helps you to unwind and de-stress. However, there’s probably been other times when smoking weed has caused you to experience feelings of anxiety or even panic.

Because cannabis can have very different effects on different people, it’s not guaranteed to improve a person’s mood. For this reason, it won’t help everybody who’s stuck in the rut of depression.

Research has explored the effect cannabis has on depression. Before we delve into the findings, it’s important to make a few distinctions. Cannabis has a varying impact on depression. The plant itself doesn’t activate receptors in the nervous system, but many of the hu ndreds of chemicals it produces do.

To make things more complicated, different strains have wildly fluctuating levels of these chemicals. Some varieties are high in the psychotropic cannabinoid THC, whereas others are high in the non-psychotropic cannabinoid CBD. Furthermore, there are over 100 cannabinoids and 100 terpenes that produce their own effects. Therefore, “Does cannabis impact depression?” can be regarded as a poor and inadequate question. It’s more a case of discovering the impact of individual molecules and how they work in synergy.

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WHAT THE RESEARCH SAYS

Unfortunately, comprehensive research in this area is lacking. So far, we have a shallow idea of these complex mechanisms. However, science has developed a greater understanding of how THC and CBD individually might affect mood.

When looking at the effects of these chemicals on the brain, it’s helpful to have an understanding of the endocannabinoid system (ECS). “Endo” means within, and “cannabinoid” refers to chemicals that influence receptors of the ECS. The ECS is made up of a series of receptors found on numerous cell types throughout the body. So far, science has confirmed two of these receptors—CB1 and CB2.

The ECS is also made up of specialised neurotransmitters that bind to these receptor sites and modulate the system. These molecules are known as endocannabinoids, namely anandamide and 2-AG. As it happens, molecules from the cannabis plant can influence the same receptors thanks to their similar shape. Cannabinoids from cannabis—and other plant species—are known as phytocannabinoids.

Both anandamide and 2-AG play a key role in the dopaminergic system, and therefore, in the regulation of mood. Both of these molecules bind to CB1 receptors on certain neurons and stimulate dopamine release.

THC (tetrahydrocannabinol) is one of the main constituents of modern cannabis cultivars. The molecule produces psychotropic effects by binding to CB1 receptors in the central nervous system. The cannabinoid may take the edge off depression in the short-term by increasing dopaminergic cell firing[2]. Consequently, neurons produce and release increased amounts of dopamine. This may result in improved mood and feelings of motivation.

Research published in the _Journal of Affective Disorders_ found that cannabis significantly reduced rates of depression[3], anxiety, and stress. Researchers gathered data from the app Strainprint to examine the effects of certain strains on depression, anxiety, and stress. The data showed that cannabis users perceived a 50% reduction in depression and a 58% reduction in anxiety and stress after using cannabis.

THC isn’t the only cannabinoid that might help with depression. The study found that strains high in CBD and low in THC were more associated with the largest changes in depression ratings. In contrast, strains high in THC and low in CBD produced the largest perceived changes in stress.

This data suggests that CBD might be more effective at treating the symptoms of depression. The antidepressant effects of the cannabinoid may involve serotonin[4], a neurotransmitter that regulates mood. CBD is believed to bind to the 5-HT1A serotonin receptor[5].

WHAT THE RESEARCH SAYS

CBD doesn’t bind to CB1 receptors, and therefore doesn’t affect dopaminergic neurons in the same way as THC. Instead, CBD is known to be an indirect agonist of CB1 receptors. This ultimately means that CBD can increase anandamide levels by inhibiting an enzyme that breaks down the endocannabinoid. Increased levels of anandamide then bind to CB1 receptors and produce effects similar to THC.

The research regarding cannabis and depression is promising. However, the herb has proven to be a double-edged sword.

CANNABIS AND DEPRESSION: A COMPLEX RELATIONSHIP

Although there’s research to suggest that cannabis may help with depression, some data suggests the opposite. Although acute exposure to THC can boost dopamine release, chronic exposure may blunt the dopaminergic system[6]. Long-term cannabis use may decrease the brain's response to dopamine and possibly lead to reduced feelings of reward and motivation.

As stated, cannabis isn't just THC. CBD has displayed positive effects in regards to depression. Plus, researchers have yet to study over 100 other cannabinoids in this domain. The most sensible course of action is to discuss the matter with your healthcare professional. If you feel cannabis could be an appropriate option for you, check out these strains that might soothe some symptoms.

External Resources:
  1. Wired to run: exercise-induced endocannabinoid signaling in humans and cursorial mammals with implications for the ‘runner’s high’ | Journal of Experimental Biology https://jeb.biologists.org
  2. The effects of Δ 9 -tetrahydrocannabinol on the dopamine system | Nature https://www.nature.com
  3. A naturalistic examination of the perceived effects of cannabis on negative affect - ScienceDirect https://www.sciencedirect.com
  4. Antidepressant-like effect induced by Cannabidiol is dependent on brain serotonin levels. - PubMed - NCBI https://www.ncbi.nlm.nih.gov
  5. Agonistic Properties of Cannabidiol at 5-HT1a Receptors | SpringerLink https://link.springer.com
  6. The effects of Δ 9 -tetrahydrocannabinol on the dopamine system | Nature https://www.nature.com
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This content is for educational purposes only. The information provided is derived from research gathered from external sources.

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