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It may seem counterintuitive that a compound found in the cannabis plant (Cannabidiol or CBD) can reduce anxiety when an almost identical compound found in the same plant (Tetrahydrocannabinol or THC) can increase it. The evidence base is building for CBD as an effective anxiolytic (i.e. anxiety reducing agent), with some promising findings in both animal and human studies. For those seeking a natural alternative to pharmaceutical approaches to anxiety, CBD may just hold the answer. For a full list of the medical conditions for which CBD may be useful, please consult our research page.
What we know about CBD & anxiety
Cannabidiol’s anxiety reducing effects are likely due to its interactions with the human endocannabinoid system (the ECS), and other physiological systems within the body. (Learn more about the endocannabinoid system). The endocannabinoid system is, in part, responsible for regulation of our overall response to stress, including fear and anxiety. Unlike THC, which fits like a key into a lock that is a cannabinoid receptor, CBD does not open the lock or activate cannabinoid receptors in the central nervous system. Instead, CBD enhances the effects of our own internally produced cannabinoids (i.e. endocannabinoids). And, it interacts with other non-cannabinoid receptors, including GABA, adenosine and serotonin receptors, all of which are implicated in anxiety.1-3 (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4303399/, https://www.ncbi.nlm.nih.gov/pubmed/19423077, https://www.ncbi.nlm.nih.gov/pubmed/18508500)
In a research review published in 2017, Brazilian researchers concluded that, “Studies using animal models of anxiety…clearly suggest an anxiolytic-like effect of CBD.” (REFERENCE) Human studies have also found benefit. Surveys of CBD users, for example, have found anxiety to be one of the most common reasons people use CBD.4 (https://www.ncbi.nlm.nih.gov/pubmed/30014038) Clinical trials have also shown benefit. For example, in a 2011 clinical trial of individuals with Social Anxiety Disorder (SAD) pre-treatment with CBD was found to reduce self-reported and measurable indicators of anxiety provoked by a simulated public speaking test. In another 2011 clinical trial, also conducted in individuals with SAD, CBD decreased subjectively reported anxiety. Functional neuroimaging demonstrated that the reduction in anxiety was associated with changes in activity in limbic and paralimbic brain areas – regions of the brain thought to be associated with emotions, specifically anxiety.5 (https://www.ncbi.nlm.nih.gov/pubmed/20829306) CBD has also been shown to reduce the anxiety provoking effects of THC, when administered concurrently.6 (https://www.ncbi.nlm.nih.gov/pubmed/6285406)
The anxiety reducing effects of CBD are continuing to be explored in scientific experiments involving both animals and humans. Randomized controlled trials in humans – the “Gold Standard” for clinical research – have been implemented and show promising results.
Research Studies on the effects of Cannabis to treat Anxiety:
Below is a list of available studies concerning the use of CBD, and other phytocannabinoids, in treating anxiety.
- CBDas an anxiolytic drug
- Antidepressant-Like and Anxiolytic-Like Effects of Cannabidiol: A Chemical Compound of Cannabis Sativa
- CBDreduces the anxiety induced by simulated public speaking in treatment-naïve social phobia patients
- Neural basis of anxiolytic effects of CBDin generalized social anxiety disorder
- Central anandamide deficiency predicts stress-induced anxiety: behavioral reversal through endocannabinoid augmentation
- Effects of CBDon regional cerebral blood flow
- The anxiolytic-like effects of cannabidiol injected into the bed nucleus of the stria terminalis are mediated by 5-HT1Areceptors
- The anxiolytic effect of CBDon chronically stressed mice depends on hippocampal neurogenesis: involvement of the endocannabinoid system
- Plant-based medicines for anxiety disorders, part 2
- A systematic review of plant-derived natural compounds for anxiety disorders
- The Endocannabinoid System and Anxiety
- CBDregulation of emotion and emotional memory processing: relevance for treating anxiety-related and substance abuse disorders
- Effect of prior foot shock stress and Δ9-tetrahydrocannabinol, cannabidiolic acid, and cannabidiol on anxiety-like responding in the light-dark emergence test in rats
- How do I find the right dosage of CBD for anxiety-related disorders?
- What is CBD and how does it work?
- What is the endocannabinoid system and why it matters to your health?
What is Anxiety?
Occasional anxiety is a normal part of life. You might feel anxious when faced with a problem at work, before taking a test, or making an important decision. Anxiety disorders involve more than temporary worry or fear, however. The anxiety can be persistent and worsen over time. Uncomfortable feelings can interfere with daily activities, such as job performance, school work, and relationships. There are several different types of anxiety disorders. Examples include Generalized Anxiety Disorder, Panic Disorder, and Social Anxiety Disorder.
Signs and Symptoms
Generalized Anxiety Disorder
People with Generalized Anxiety Disorder display excessive anxiety or worry for months and face several anxiety-related symptoms.
Generalized Anxiety Disorder symptoms include:
- Restlessness or feeling wound-up or on edge
- Being easily fatigued
- Difficulty concentrating or having their minds go blank
- Muscle tension
- Difficulty controlling the worry
- Sleep problems (difficulty falling or staying asleep or restless, unsatisfying sleep)
People with Panic Disorder have recurrent unexpected panic attacks, which are sudden periods of intense fear that may include palpitations, pounding heart, or accelerated heart rate; sweating; trembling or shaking; sensations of shortness of breath, smothering, or choking; and feeling of impending doom.
Panic Disorder symptoms include:
- Sudden and repeated attacks of intense fear
- Feelings of being out of control during a panic attack
- Intense worries about when the next attack will happen
- Fear or avoidance of places where panic attacks have occurred in the past
Social Anxiety Disorder
People with Social Anxiety Disorder (sometimes called “social phobia”) have a marked fear of social or performance situations in which they expect to feel embarrassed, judged, rejected, or fearful of offending others.
Social Anxiety Disorder symptoms include:
- Feeling highly anxious about being with other people and having a hard time talking to them
- Feeling very self-conscious in front of other people and worried about feeling humiliated, embarrassed, or rejected, or fearful of offending others
- Being very afraid that other people will judge them
- Worrying for days or weeks before an event where other people will be
- Staying away from places where there are other people
- Having a hard time making friends and keeping friends
- Blushing, sweating, or trembling around other people
- Feeling nauseous or sick to your stomach when other people are around
Evaluation for an anxiety disorder should begin with a visit to your doctor.
1. Nuss P. Anxiety disorders and GABA neurotransmission: a disturbance of modulation. Neuropsychiatr Dis Treat. 2015;11:165-175.
2. Akimova E, Lanzenberger R, Kasper S. The serotonin-1A receptor in anxiety disorders. Biol Psychiatry. 2009;66(7):627-635.
3. Correa M, Font L. Is there a major role for adenosine A2A receptors in anxiety? Front Biosci. 2008;13:4058-4070.
4. Corroon JM, Phillips J. A Cross-Sectional Study of Cannabidiol Users. Cannabis and cannabinoid research. 2018.
5. Crippa JA, Derenusson GN, Ferrari TB, et al. Neural basis of anxiolytic effects of cannabidiol (CBD) in generalized social anxiety disorder: a preliminary report. Journal of psychopharmacology (Oxford, England). 2011;25(1):121-130.
6. Zuardi AW, Shirakawa I, Finkelfarb E, Karniol IG. Action of cannabidiol on the anxiety and other effects produced by delta 9-THC in normal subjects. Psychopharmacology. 1982;76(3):245-250.
Chief Medical Advisor at Green Flower BotanicalsDr. Jamie Corroon, ND, MPH is the founder and Medical Director of the Center for Medical Cannabis Education, and Chief Medical Advisor at Green Flower Botanicals. Dr. Corroon is a licensed Naturopathic Doctor, peer-reviewed clinical researcher and industry consultant with a focus on medical Cannabis. He has completed certification programs from both the Society of Cannabis Clinicians and the American Academy of Cannabinoid Medicine. He is a member of both organizations and serves on the Research committee for the SCC. Dr. Corroon is committed to investigating the important clinical and public health questions resulting from the broadening acceptance of Cannabis in society. He lives in San Diego, California.
Latest posts by Dr. Jamie Corroon, ND, MPH (see all)
This page has been submitted in cooperation with our Medical Advisor, Dr. Jamie Corroon. Dr. Corroon has reviewed and approved the information contained on this page for general accuracy, authenticity, and relevancy of the stated research. While it is our intent to publish the most up-to-date research available, this review is limited to the material submitted on this page and does not take into account research which may currently exist or supersede this content. This review is for informational purposes only and does not constitute the practice of medicine. CBD products are not approved by the FDA for the diagnosis, cure, mitigation, treatment, or prevention of any disease. You should always seek the advice of your physician before adding any supplement to your diet.
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