THC & Anxiety: Yay or Nay?

Key takeaways.

Anxiety is one of the most common reasons people self-medicate with cannabis, a close second to chronic pain. Cannabis is user-friendly, praised as a substance that “mellows you out,” and doesn’t (always) need a doctor’s prescription. So there’s no confusion about why so many people use cannabis to reduce their symptoms of anxiety.

But there’s a little bit more at play here. For example, there’s an influential school of thought  suggesting that cannabis can actually exacerbate symptoms of mental ill-health like anxiety, paranoia, and depression. We could tout this school of thought as “anti-cannabis”, “anti-legalization”, and an attempt to dampen the chances that cannabis will ever be medically recognized. But we won’t — because it’s nuanced. 

Cannabis, just like any other herbal remedy, has side effects, indications (things it’s used for), contraindications (things it should never be used for), and safety guidelines. The factors that contribute to this are cannabinoid content and ratio (i.e. milligrams of THC to CBD — ), terpene content and quality, and the consumption method used. Herein lies the nuance: is THC a good remedy for anxiety? It’s the psychoactive compound that recreational weed users chase, but that doesn’t necessarily make it the best choice for those suffering with anxiety.

In this article, we’re breaking down the THC-anxiety conundrum. Should sufferers of anxiety use THC, and if so, in which ways should they use it? 

THC for anxiety: The research

Let’s start with the elephant in the room: THC and mental illness. There are a lot of medical professionals who believe that THC can actually exacerbate symptoms of mental illness. But this isn’t 100% corroborated by science, and as research emerges, it becomes more of a “chicken and egg” conundrum. What we know is that those in the onset of mental illness such as schizophrenia or anxiety are more likely to use cannabis as a form of self-medication. What emerges in the clinic is a correlation between cannabis use and mental health conditions, but it isn’t clear which one came first: mental illness, or cannabis?

In a 2018 meta-analysis (a study analyzing and combining results from other studies), researchers found a correlation between cannabis use and symptomatic levels of anxiety. Those with PTSD, bipolar disorder, panic disorder, and depressive disorder were included in the sample. Those who had used cannabis recently or frequently showed greater symptoms of anxiety compared with those who didn’t. 

What the research inconveniently leaves out of the question is which cannabinoids were used for these studies. And that’s because in most studies, this nuance isn’t questioned. Cannabis is used in the studies, but the cannabis samples themselves aren’t analysed for cannabinoid content.

In a 2007 study, THC was tested for its anxiolytic (anxiety-reducing) properties in mice. Researchers interestingly found a biphasic effect of THC on anxiety: at low doses, it was anxiolytic, while at high doses it was anxiogenic (induces anxiety). 

The body of research around THC, CBD, and their roles in anxiety continues to mount, and it’s generally accepted that CBD counteracts many of the effects of THC, acting as a buffer.. In this 2010 study, MRI imaging was used to determine the difference between THC and CBD on different brain areas. Researchers were not only able to induce acute anxiety with THC, but they also  observed a decrease in subjective anxiety after administration of CBD. 

When it comes to anxiety, it's all about the THC:CBD ratio

The research says a few things pretty clearly:

1. There are a lot of people who would rather self-medicate with cannabis than seek out pharmaceutical options.
2. A lot of THC might not be a good idea for those with anxiety.
3. CBD helps.

Now, how does that translate into usable, reliable advice for cannabis users with anxiety?

It’s all about getting the THC:CBD ratio correct. There is a lot of anecdotal evidence, and a lot of science to support it, that high doses of THC can exacerbate symptoms of anxiety. So it makes sense to keep dosage low. 

Alongside a lower dose of THC, it’s also recommended that there is a substantial amount of CBD to counteract any symptoms of anxiety that might present. Choosing a strain that has a 1:1 or 2:1 THC:CBD ratio should create a more balanced effect, both subjectively and neurologically. 

We know this because CBD offsets many of the negative side effects of THC on a neurological level. For example, CBD reduces the breakdown of anandamide, an endogenous cannabinoid. Anandamide encourages feelings of relaxation, brings on sleep, increases appetite and creates a sense of overall wellbeing, therefore reducing anxiety. We can then see, at least on a chemical level, how CBD might reduce feelings of anxiety brought on by THC.

How To Safely Use THC To Reduce Symptoms of Anxiety

Cannabis users can absolutely use THC to reduce symptoms of anxiety reliably — and safely. As long as care is taken in choosing a strain and minimizing the THC dose, users can enjoy cannabis without exacerbating their symptoms. 

We already mentioned the importance of cannabinoid ratio. Users should opt for a minimum of 1:1, but can safely use a 2:1 THC:CBD strain. Consumption method also matters, so we’ll lay out the different ways a sufferer of anxiety might want to use CBD.

Vaping

Vaping is arguably the most effective administration route for anxiety. This is because it’s extremely easy to control the dose, and it’s effective immediately. A cartridge packed with the right strain of cannabis allows anxiety sufferers to:

• Carefully control their dose with a puff-by-puff dose regimen.
• Treat acute anxiety pretty much immediately, as via the lungs, cannabinoids take effect instantly.

From the pantry

Edibles

It’s much harder to control dosage when it comes to edibles. But that doesn’t mean it’s impossible. If you have found a candy, gummy, or edible with the perfect amount of THC and CBD, this is also a great way to manage anxiety. The effects of edibles last longer, and therefore require fewer doses. 

The rule of thumb is to start low, and go slow. We recommend starting with microdoses of 5mg - 10mg THC, waiting at least an hour and a half, and gauging the effects. Use precaution when upping your dose. We suggest writing down and tracking the effects and onset times — i.e. how long it takes to feel the full effects of different doses so you can reliably replicate those experiences.

From the pantry

Tincture and oils

Tinctures and oils also offer a great means of treating anxiety. When used under the tongue, effects take hold within 30 minutes and can last for up to 2 hours. So long as the tincture is standardized (it says exactly how many mg of THC and CBD), dosage is also easy in this form. 

From the pantry

The bottle contains 350mg CBD, but also contains trace amounts of THC. CBD reduces anxiety by increasing serum levels of anandamide, and trace levels of THC may also create sensations of euphoria, relaxation, and upliftedness. 

Empowered, not anxious

The research that surrounds THC and mental illness shouldn’t be a reason for cannabis users to fear or feel anxious. In fact, this research should empower cannabis users to understand exactly how they can use cannabinoids to manage anxiety. Like with virtually any other herbal or traditional remedy in the world, there are specific ways to consume and prepare a remedy depending on what it’s being used for. Cannabis is no different. Those with ADHD might thrive under high doses of THC, but the same isn’t true for those with anxiety. 
THC can be anxiolytic in low doses, and so, for those with anxiety, this is how it should be used. So avoid high doses of THC, and remember to balance it out with CBD. And that makes for a perfect anti-anxiety remedy.