Thanks to the ongoing pandemic, the prevalence of anxiety is on an upwards trajectory. Months of uncertainty have caused us to stress like never before. A study published in 2020 by the British Journal of Psychiatry revealed that the pandemic has doubled rates of anxiety in the UK, from 13% to 24% of the population.
In recent years, increasingly more people have discovered the therapeutic benefits of CBD. Already showing promise in the treatment of a variety of conditions, CBD has now captured the attention of researchers for its potential to alleviate anxiety.
What is CBD?
Cannabidiol, commonly known as CBD, is an active ingredient in the Cannabis sativa plant. It is one of 113 known cannabinoids in cannabis and has shown promising therapeutic potential in treating numerous mental and physical health conditions.
In the UK, CBD is completely legal- and no, it doesn’t make you high. The psychoactive properties of cannabis come from THC, or tetrahydrocannabinol. For a CBD product to be legally sold it must contain negligible amounts of THC.
How it works
CBD interacts with the endocannabinoid system (ECS). This is a biological system that helps to regulate our mood, appetite, sleep, immune activity, memory, and much more. Effectively, the ECS coordinates the nervous system and the immune system to ensure that our mind and body are working in perfect harmony.
Within the ECS are two major cannabinoid receptors, CB1 and CB2. Through CB1 receptor activity, the ECS helps to signal serotonin in the brain. Serotonin is a neurotransmitter known to stabilise our mood. When there’s not enough of it in the brain, this can be the cause of mental health issues, such as anxiety and depression.
How it helps anxiety
There is a growing body of evidence to support the claim that CBD is anxiolytic, meaning it can reduce symptoms of anxiety.
Anxiety is our body’s response to stress or trauma. It can be hard to pinpoint the direct cause of anxiety, but common triggers include major life changes, traumatic past experiences, physical health conditions, or certain medications.
Although anxiety is recognised as a mental health disorder, its symptoms can be physical as well as psychological. Anxiety manifests itself differently in everyone, but common symptoms include:
- Excessive worrying
- Heart palpitations
- Problems sleeping
Most people experience mild anxiety at some point in their life. This can typically be dealt with using stress-relief techniques. Chronic anxiety is different; your mind is in a constant state of perceived stress, even when there is no immediate threat. It’s a hugely debilitating condition that often requires clinical treatment. CBD may hold promise in the treatment of common anxiety disorders, including:
- Generalised anxiety disorder (GAD)
- Social anxiety disorder (SAD)
- Panic disorder
There have also been numerous studies into the effect of CBD on post-traumatic stress disorder (PTSD) and obsessive-compulsive disorder (OCD). Although these are disorders within their own right, anxiety is a major symptom that CBD may help to relieve.
CBD is thought to alleviate anxiety by activating serotonin receptors, specifically 5-HT1A. This does two things: it increases levels of serotonin, which can subsequently improve our mood. It can also suppress the HPA-axis, which reduces our body’s hormonal response to stress.
Common prescription drugs for anxiety are selective serotonin reuptake inhibitors (SSRIs). Similarly to CBD, SSRIs increase serotonin levels in the brain- but they can have some pretty nasty side effects. Symptoms only begin to improve after about 4-6 weeks of use, and coming off SSRIs can cause uncomfortable withdrawals. So could CBD be a better, natural alternative?
CBD may also reduce anxiety by indirectly increasing CB1 receptor activation. Within the ECS are endogenous cannabinoids- or endocannabinoids- that are naturally produced by the body. CBD has been shown to increase levels of anandamide, a key endocannabinoid, by preventing its breakdown. Researchers have suggested that endocannabinoid signalling is our body’s natural way of reducing stress. If CBD can offer a helping hand with this process, this shows huge promise for the future treatment of anxiety.
What the science says
There’s lots of information out there about how CBD can help anxiety, so we’ve had a look at some of the latest evidence.
In an analysis of recent CBD publications, anxiety was the focus of nearly 40%. Of those studies, 70.6% showed promising results with the use of CBD for treating anxiety.
The most encouraging results have been noted in social anxiety disorder. Some of the earliest evidence we have of this is from 2011. In a double-blind randomised trial, 12 participants were given a single CBD dose or a placebo drug, prior to a public speaking simulation. 600 mg of CBD was able to significantly reduce both physiological and self-reported anxiety.
More recently, these results have been replicated in 18-19-year olds with chronic social anxiety. Participants received a daily 300 mg CBD dose for 4 weeks and demonstrated significantly reduced anxiety levels than those who received the placebo.
Similar positive results have been seen across numerous trials in healthy volunteers, particularly in reducing THC-induced anxiety. CBD is also effective in reducing PTSD-related anxiety. CBD can alter fear responses in animal models of PTSD, which shows promise in the treatment of panic disorders and phobias.
Sleep and anxiety are more intertwined than you may think. If we’re anxious, we can’t sleep; if we’re sleep deprived, we’re more prone to stress. In a survey by Anxiety UK, an astonishing 81.8% of people said that anxiety was the main cause of their poor sleep. CBD can improve sleep quality. As SSRIs have been shown to negatively impact sleep, CBD may be the more appropriate treatment for anxiety.
Having reviewed the evidence, it seems as though CBD may be a big help to those with anxiety- and it’s proving hugely popular. In a recent survey of 387 CBD users, the most common reason for using CBD was to reduce anxiety, reported by 42.6% of participants.
Can CBD make anxiety worse?
If you look at the effectiveness of CBD on a graph, it tends to follow a bell-shaped curve. As the dosage increases, as does CBD’s therapeutic benefit. However, once the CBD dosage surpasses optimal levels, it can begin to have the opposite effect. At high doses, CBD has shown to be either anxiety-inducing or have no effect on anxiety.
So how much CBD should you be taking for anxiety? Dosage appears to vary across the research, and there’s not really any evidence to say how much is best. The optimal CBD dosage is different for everyone; it’s largely dependent on your height, weight, and symptom severity. The best advice is to start low and increase your dose if necessary.
CBD is known to be safe and, in most people, it is well-tolerated. Though in rare cases, it can have mild side effects, such as tiredness, diarrhoea or appetite changes.
There have also been reports of CBD interacting with other medications, which could have serious implications for our liver health. More research is needed to assess the safety of CBD use alongside other drugs, so exercise caution before adding it to your routine. If in doubt, ask your doctor.
As CBD is not an addictive substance, it does not cause withdrawals if you stop using it. In a study of 30 healthy volunteers, there was no evidence of withdrawal symptoms after twice-daily CBD use was stopped. So if CBD isn’t working for you there’s no need to gradually wean yourself off it, which can not be said for SSRIs.
Ways of taking CBD for anxiety
The CBD market is booming. There are countless ways in which CBD has been packaged for consumption. These are just some of the most effective ways to take CBD:
Sublingual administration involves dropping CBD oil under the tongue. This allows CBD to get directly into the bloodstream, so it’s an efficient way to get your dose in. It’s the most common method for taking CBD to manage anxiety, but it’s not for everyone. CBD oil has a pretty strong taste!
Oral CBD comes in many forms, the most common being gummies and capsules. It’s a convenient method that gives you a consistent dose, but as the CBD needs to go through the digestion process, it takes between 30 minutes and 2 hours to feel the effects. There’s also an issue with bioavailability. CBD is lipid-soluble; it doesn’t dissolve very easily, so much of it is broken down in the stomach before it is absorbed. Researchers have shown that giving CBD to animals in a fed state increases its bioavailability 3-fold. So taking CBD with a meal rich in healthy fats will get you much more bang for your buck.
Vaping CBD allows it to enter the bloodstream quickly. As it’s easily transportable, a CBD vape can be used on the move for immediate relief. With its rapid onset and impressive bioavailability, a vape might sound like the best option, but there are some concerns. The long-term effects of vaping are not fully understood, so approach this method with caution.
There’s not really any conclusive evidence to say which delivery method is best for anxiety, but there are some interesting trends in the research.
A review published in the Journal of Clinical Medicine Research found that a single dose of CBD tends to have the greatest effect on reducing anxiety. They also noted that chronic administration of CBD is associated with greater side effects than acute use. Although positive results have been seen with both delivery methods, this suggests that taking CBD as-and-when may be better for anxiety than a daily dose.
I think CBD could help me – what next?
Fancy giving CBD a go? Firstly, do your research. There are a lot of products out there and it’s important to make sure you’re buying from a trustworthy brand.
CBD brands must share their lab reports so that you know exactly how much CBD you’re getting. Traceability is also crucial; brands must be transparent about where their plants were grown. If none of this information is easily accessible, it’s time to look elsewhere.
More clinical research must be done before doctors can start prescribing CBD for anxiety. But the testimonial evidence is in abundance; CBD has helped many people with their anxiety. If you’re keen to discover the wonders of cannabinoids for yourself but don’t know where to start, see our beginners guide to CBD.