How CBD works in treating anxiety

Although we don’t usually think of stress as desirable, it is in fact a critical adaptive response that can help us deal with threats to our safety and well-being (our own or our loved ones’). These answers help us to identify and prevent potential threats. They can also help us to take action to improve our situation (work harder, pay the bills, improve relationships, etc.). However, when we do not deal effectively with these physical reactions, they can have a profound effect on our lives and relationships. This can lead to clinically diagnostic anxiety-related disorders. We’ve all heard the saying, “stress kills.”

Anxiety-related disorders affect a huge segment of our population – 40 million adults (18%) in the United States aged 18 years and older. In response to these rates, Big Pharma has developed numerous drugs to treat anxiety-related disorders, from selective serotonin reuptake inhibitors (SSRIs), such as Prozac and Zoloft, to sedatives (the most popular class being benzodiazepines such as Valium and Xanax).

While these drugs may be effective for many patients, some do not respond favourably. Some patients do not see much improvement or cannot tolerate the side effects. In addition, sedatives such as Valium and Xanax can be highly addictive. Clearly, alternative treatments are warranted. Can cannabidiol (CBD), the most prominent non-intoxicating component of cannabis, be a viable alternative to currently available anxiety medications? Quite possibly!

In recent years, CBD has generated a huge amount of interest among consumers, clinicians and scientists. Not only does the data show that the CBD counteracts many of the adverse effects of THC, but many animal studies and accumulated evidence from human experimental, clinical and epidemiological studies suggests that the CBD has powerful anti-anxiety properties. It appears safe, well tolerated and may be beneficial for treating certain anxiety-related disorders such as:

  • Panic disorder
  • Obsessive-compulsive disorder (OCD)
  • Social phobia
  • Post-traumatic stress disorder (PTSD)
  • Generalized anxiety disorder (GAD)
  • Mild to moderate depression
How does CBD work?

CBD exerts several actions on the brain that explain why it can be effective in treating anxiety. Before we delve deeper, it’s important to note that most of the research describing how CBD works is preclinical and based on animal studies. As the saying goes, “mice are not people” – and the results of animal studies do not always translate regularly into human treatments. However, preclinical studies provide information that moves us in the right direction:

5-HT1A: 5-HT1A is a subtype of the serotonin receptor, which is important because anxiety and depression can sometimes be treated with drugs that target the serotonin system. This is why pharmaceutical companies developed selective serotonin reuptake inhibitors (SSRIs) such as Prozac and Zoloft. SSRIs act by blocking the reabsorption of serotonin in the brain, which increases the availability of serotonin in the synaptic space. This helps brain cells to transmit more serotonin signals, which can reduce anxiety and boost mood in some cases (although the full biological basis for this is more complicated and not fully understood).

Similar to SSRIs, CBD can enhance signalling through serotonin receptors. In an animal study, Spanish researchers found that CBD enhances 5-HT1A transmission and can affect serotonin faster than SSRIs. The researchers noted:

“The rapid onset of CBD’s antidepressant effect and the concomitant anxiolytic (anti-anxiety) effect will solve some of the main limitations of current antidepressant treatments.”

The neurogenesis of the hippocampus: The hippocampus is a major region of the brain and plays a critical role in a variety of brain functions. It is most famous for its role in shaping and cognitive memory. Brain scans of patients suffering from depression or anxiety often show a smaller hippocampus, and successful treatment of depression is associated with the birth of new neurons (neurogenesis) in the hippocampus.

In a study using mice as guinea pigs it was found that repeated administration of CBD can help the hippocampus regenerate neurons , which may be useful for treating anxiety or depression. Research shows that both SSRIs and CBD can promote neurogenesis. This is important because evidence suggests that severe disruption of neural plasticity can affect suicidal behaviour. Future research comparing the effect of CBD and SSRIs on neurogenesis could open up promising new avenues for understanding depression and how to treat it more effectively.

How can CBD help anxiety?

Building on the foundation of animal studies, human studies are beginning to provide evidence that CBD can improve many commonly reported symptoms of anxiety disorder, such as acute anxiety and stress.

Human studies show how CBD reduces stress
Brazilian researchers conducted a small double-blind study of patients suffering from generalized social anxiety. After consuming CBD, participants reported a significant reduction in anxiety. The researchers validated patients’ subjective reports by conducting brain scans that showed brain blood flow patterns consistent with an anti-anxiety effect.

In another small study, researchers had patients suffering from Social Anxiety Disorder performing a simulated public speaking task. Participants reported significantly less stress, findings supported by objective indicators of stress such as heart rate and blood pressure.

The researchers concluded that [CBD] significantly reduced anxiety, cognitive impairment and annoyance in their speech performance,” while the placebo group showed “higher anxiety, cognitive dysfunction and discomfort.”

Final thoughts

Data from animal studies are beginning to characterize the details of how CBD acts on the brain, and human studies with patients without anxiety disorders are beginning to validate the effectiveness of CBD as an anti-anxiety treatment. Given the enormous social and economic costs of anxiety disorders in the U.S., CBD has the potential to play an important role in treating myriad anxiety-related disorders.

While research, including large randomized control trials (RCTs), is clearly warranted to examine the long-term effects and potential of CBD, its proven efficacy and highly favourable safety profile (particularly compared to currently available drugs) make it an alternative or complementary alternative to currently available drugs.

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