5 Mental Health Uses for CBD
Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital.
The cannabis plant has been utilized for medicinal purposes for thousands of years. The plant contains more than 80 different compounds, which are known as cannabinoids. While tetrahydrocannabinol (THC) is the most abundant and is well-known for its psychoactive properties, the second-most found compound, cannabidiol (CBD) does not have psychoactive effects.
There has been a growing interest in the potential mental health benefits of CBD in recent years. A 2019 research letter published by JAMA Network Open reported a significant increase in Internet searches for CBD in the United States. While search rates remained steady between 2004 and 2014, there was a 125.9% increase between 2016 and 2017. In April 2019 alone, there were 6.4 million Google searches for CBD information.
While there have been a number of studies suggesting that CBD might mental health benefits, a recent comprehensive review found that support for this use was scant and that further investigation is needed to substantiate the purported benefits.
There are a number of conditions that CBD is purported to help, although more research is needed to determine the potential effects and benefits of CBD. Some of the existing studies suggest that CBD holds promise in the treatment of a number of conditions including depression, anxiety, epilepsy, and sleep issues, among other things.
CBD appears to have a range of benefits for neurologic disorders, including decreasing the frequency and severity of seizures. Some of these conditions, such as Dravet syndrome and Lennox-Gastaut syndrome (LGS), may not respond well to anti-seizure medications. Viral clips of CBD treatments effectively alleviating seizures were shared widely in social media in recent years, and research has supported the effectiveness of these treatments.
A large-scale study on the use of CBD in the treatment of pediatric epilepsy found that CBD reduced the frequency of seizures by more than 50% in 43% of the patients with Dravet syndrome. The Food and Drug Administration (FDA) recently approved a cannabis-derived medication containing CBD, Epidiolex, to treat certain childhood seizure disorders.
Anxiety is a common problem for many people. Anxiety disorders affect an estimated 19.1% of U.S. adults each year. Some studies suggest that CBD may help alleviate symptoms of anxiety. One study look at the possible neural basis for CBD reducing symptoms of social anxiety disorder.
A 2015 study published in the journal Neurotherapeutics analyzed the existing preclinical studies on the use of CBD for anxiety and found that CBD was effective for a number of anxiety conditions including:
- Generalized anxiety disorder
- Obsessive-compulsive disorder (OCD)
- Panic disorder
- Social anxiety disorder
- Post-traumatic stress disorder (PTSD)
However, the authors of the study note that while the substance has considerable potential, further research is needed to better determine the therapeutic benefits and long-term effects.
According to the National Institute of Mental Health, depression is one of the most common mental disorders in the U.S., affecting an estimated 17.3 million adults each year. Effective treatments are available, which include psychotherapy and medication, although interest in complementary and alternative treatments has also grown in recent years.
CBD has been investigated for having potential antidepressant effects. Some antidepressants work by acting on serotonin receptors in the brain. Low serotonin levels may play a role in the development of depression, and animal studies suggest that CBD might have an impact on these receptors which may produce antidepressant effects.
A 2018 study found that the antidepressant-like effects that CBD produces depend upon the serotonin levels in the brain. Cannabidiol does not appear to increase serotonin levels but instead affects how the brain responds to serotonin that is already present in your body.
Because CBD may have a calming effect, it may also hold promise in treating sleeping difficulties. Sleep is a critical component of mental health and well-being, yet the Centers for Disease Control and Prevention (CDC) reports that a third of U.S. adults do not get the recommended amount of sleep each night. This is problematic since not getting enough sleep is linked to health conditions such as depression, type 2 diabetes, obesity, and heart disease.
One study conducted with adults who had symptoms of anxiety and poor sleep found that 65% experienced improvements in sleep quality scores after a month of taking an average of 25mg of CBD daily, although those scores fluctuated over time. Further research is needed to determine the possible effects of CBD on sleep.
Post-Traumatic Stress Disorder (PTSD)
PTSD affects approximately 6.1% of U.S. adults. It is characterized by symptoms including re-experiencing traumatic events, intrusive thoughts, nightmares, and avoidance of things that may trigger memories of the trauma.
Some research suggests that CBD may be helpful in reducing the symptoms of this condition. In one study published in the Journal of Alternative and Complementary Medicine, researchers found that an oral dose of CBD in addition to routine psychiatric treatment for PTSD was associated with a reduction in symptoms.
Should You Try CBD?
While CBD holds promise, a recent comprehensive review of the research suggests that support for the mental health uses of CBD remains insufficient. This 2019 study was published in The Lancet Psychiatry and looked at 83 studies on the use of CBD to treat mental illness.
The researchers looked specifically at six different disorders: depressive disorders, anxiety disorders, attention-deficit hyperactivity disorder, Tourette syndrome, post-traumatic stress disorder, and psychosis. The review examined previous studies dating from 1980 through 2018.
The review concluded that there is not enough evidence to support the use of CBD in the treatment of mental health conditions.
The study did find that pharmaceutical TCH (either with or without CBD) was linked to small improvements in symptoms of anxiety among people with other medical conditions such as chronic pain and MS, although this evidence was considered low-quality.
This does not mean that CBD isn’t necessarily effective; of the studies reviewed, most only included a small number of participants, followed participants for a short period of time, and less than half were randomized controlled trials.
Instead, this study suggests that there simply isn’t yet enough high-quality evidence to support the use of CBD to treat mental conditions. This may change in the future as more research is carried out.
Many experts remain optimistic that CBD may prove useful for a range of mental health conditions. “CBD has shown therapeutic efficacy in a range of animal models of anxiety and stress, reducing both behavioral and physiological (e.g., heart rate) measures of stress and anxiety,” suggested Nora D. Volkow, the Director of the National Institute of Drug Abuse in testimony presented to the Senate Caucus on International Narcotics Control.
CBD is available in a number of different forms and products. Cannabidiol can be extracted from both hemp and marijuana plants, which differ in terms of how much CBD and THC can be extracted.
CBD from hemp plants contains only small amounts of THC that are not sufficient to produce subjective psychoactive effects. CBD produced from marijuana plants, however, may contain varying amounts of THC which can produce unwanted effects.
There are also three main types of CBD available.
- Isolate contains only CBD
- Full-spectrum contains other compounds found in the cannabis plant, including THC
- Broad-spectrum contains other compounds from the cannabis plant but not THC
People may choose to take a full-spectrum product because research has shown that when cannabinoids including THC and CBD are taken together, it magnifies the therapeutic impact, a phenomenon known as the entourage effect. Research also suggests that CBD can actually counteract the negative effects caused by THC.
Like full-spectrum CBD, products labeled as broad-spectrum contain multiple cannabinoids, which are purported to provide the therapeutic benefits of the entourage effect without the psychoactive effects of THC.
Some of the ways that CBD can be used include:
- Oral: This includes oils (which are made by infusing cannabidiol with a carrier oil), oil tinctures (which are produced by combining CBD with alcohol or water), sprays, and capsules.
- Topical: This includes salves or lotions that are applied to the skin
- Edibles: This can include candies, gummies, and beverages.
- Inhaled: Some CBD oils are specially formulated to be used as vaping oil, although there has been an increase in concern about the health dangers posed by vaping.
Topical solutions may produce localized effects, but only those taken by mouth are likely to produce any mental health effects. It is important to note that while there is a wide variety of these products available on the market, the FDA has not approved any over-the-counter (OTC) CBD product. Many of these products may vary in terms of what they contain, their potency, and their effectiveness.
It is also important to note that while hemp-derived CBD that contains less than 0.3% THC is legal by federal law, it is still illegal in some states. You should always check your state laws before purchasing a CBD product.
Possible Side Effects
While CBD may have some benefits, it is also important to consider some of the possible risks. Research suggests that CBD appears to be well-tolerated at doses up to 600mg.
While CBD appears to be well-tolerated, that does not mean that it is without side effects. While these may vary depending on the individual, some reported side effects include:
- Mood changes
- Appetite changes
However, understanding the potential side effects is difficult because of the absence of regulation and manufacturing guidelines, which means that there is a lack of consistency in terms of purity and labeling. In other words, it is difficult to determine if the side effects are the same across different products, formulations, and dosages because it is often difficult to determine exactly what is in the products that are currently on the market.
It is important to talk to your doctor if you are thinking about taking CBD products. This is particularly true if you have an existing medical or psychiatric condition, or if you are currently taking any medications or supplements.
CBD may potentially have an effect on your condition or may interact with a medication that you are taking. For example, CBD can sometimes worsen symptoms of anxiety. CBD can also interfere with the metabolism of certain medications, which may change how your medications affect your body.
Some other concerns to consider before taking CBD:
- Drug testing: There have been reports of people failing drug tests after using CBD products that are labeled as containing no THC. While most CBD products contain only trace amounts of THC, there is still the possibility that these products may produce a positive result on a drug test. It is also important to remember that full-spectrum CBD products do contain varying amounts of THC.
- Mislabeling: Labeling accuracy also appears to be a common problem. One study found that almost 70% of CBD products sold online were mislabeled and contained significant amounts of THC. This can be problematic if you are taking CBD to address a mental health condition such as anxiety, since THC may have unwanted psychoactive effects. Mislabeling may also lead to positive drug test results, especially if the product contains more THC than it claims.
- Other possible risks: Finally, it is important to remember that researchers still do not know all the possible risks or benefits of taking CBD. More research is needed to learn about the mental and physical long-term effects of CBD, so you should always use caution and consult your doctor before using it.
A Word From Verywell
If you are experiencing the symptoms of a mental health condition, you should talk to a doctor or mental health professional. Self-medicating with CBD or other supplements can lead to delays in treatment, which may cause your symptoms to worsen. CBD also has the potential to aggravate some symptoms such as anxiety, sleep problems, and psychosis.
If you are still interested in trying CBD as an addition to your regular treatment, work with a healthcare provider who can help monitor your symptoms. Your doctor may recommend a product and dosage that is appropriate based on your symptoms and any medications you are taking. Always be sure to watch out for any potential negative side effects and be sure to talk to your doctor before you stop taking CBD.
Interest in the use of CBD to for mental health issues such as anxiety and depression has grown in recent years. Explore mental health uses for CBD.
Does CBD Oil Help With Schizophrenia?
Editor’s note: This article was updated on 1/5/2021.
Many people say CBD helps them manage health issues like pain, anxiety, sleep trouble, and PTSD. CBD is short for cannabidiol, a natural compound in cannabis (also known as marijuana) and hemp plants. It has the same chemical makeup as cannabis but doesnвЂ™t cause a high.
In 2018, the FDA approved a form of CBD to treat seizures in children. Scientists are also studying CBD oil — the most concentrated form — for dozens of other health conditions, including schizophrenia.
What the Experts Say
Joseph Pierre, MD, a psychiatrist and professor at the University of California, Los Angeles, says CBDвЂ™s potential role in schizophrenia treatment starts with tetrahydrocannabinol (THC), the compound in cannabis that causes a high. THC can cause psychotic symptoms in some people, he says. And long-time cannabis users, especially those who start when theyвЂ™re young, may be more likely to get a disorder like schizophrenia.
вЂњSince CBD opposes some of the effects of THC in the brain, it makes sense it could be useful in treating psychotic disorders,вЂќ Pierre says. вЂњThereвЂ™s also some evidence that CBD has properties similar to antipsychotic drugs.вЂќ
But Pierre says people with schizophrenia shouldnвЂ™t try CBD on their own. The risks and benefits arenвЂ™t clear, and products sold without a prescription donвЂ™t always contain what they claim.
He also notes that the FDA doesnвЂ™t regulate CBD products.
вЂњWe have many FDA-approved medications from plant sources,вЂќ Pierre says. вЂњFor example, the heart medication digoxin is derived from the foxglove plant. But if someone needs digoxin, I wouldnвЂ™t recommend they go pick some foxglove, bake it into a brownie, and eat it.вЂќ
Peter Bongiorno, ND, a naturopath and acupuncturist in New York, recommends CBD for some people as part of an approach that includes lifestyle changes, balanced hormones, and lower levels of inflammation. He urges those who take other medicines or who have mental health conditions to вЂњwork with someone who has experience with CBD.вЂќ
What to Know About CBD and Schizophrenia
If you have schizophrenia but antipsychotic medications donвЂ™t work for you or have serious side effects, you might be tempted to give CBD oil a try. But there are some important things to keep in mind.
Because of its link to schizophrenia or psychotic episodes, THC is strictly off-limits if you have schizophrenia or if it runs in your family. So itвЂ™s crucial to know what youвЂ™re getting. ThatвЂ™s not easy, because the market is flooded with products. Many donвЂ™t contain what the label claims, and the terms may be confusing.
- Full-spectrum CBD oil comes from the whole hemp plant. It contains all the compounds called cannabinoids, including traces of THC (0.3% or less). ItвЂ™s a small amount, but you should still skip this one.
- Broad-spectrum CBD oil doesnвЂ™t contain THC but has all the other cannabinoids. Bongiorno says they may help CBD work better.
- Pure CBD oil means 100% CBD. вЂњPure CBD products are supposed to only have CBD, but unfortunately, even those sold in dispensaries sometimes contain THC or donвЂ™t contain any CBD at all,вЂќ Pierre says.В
- Hempseed oil is tricky. To avoid legal trouble, some manufacturers label CBD oil as hemp oil. Hempseed oil is made from hemp seeds and contains no CBD.
Do your research
Find out how the company grows, tests, and processes its CBD products.
- Check the certificate of analysis, or COA. This shows that each batch is tested by an independent lab. It should say exactly whatвЂ™s in the product and what isnвЂ™t, like toxic metals and pesticides. You can find the CoA online, by email, or with the product. If not, steer clear.
- Ask about sources. The best CBD usually comes from organic plants grown on small farms in the U.S. and Canada.
How much to take
вЂњIf youвЂ™re going to use CBD for mental health, ask your practitioner for a high-quality version,вЂќ Bongiorno says. The amount you take can vary. вЂњThe studies tend to use pure CBD, which requires a higher dose. I use CBD with other cannabinoids at lower doses.вЂќВ
CBD is normally very safe but can have side effects in some people. The most common are dry mouth, feeling dizzy or irritable, anxiety, diarrhea, and nausea. ThereвЂ™s a chance of liver damage at very high doses.В
CBD can affect how your body handles other medicines. This means you may have higher or lower amounts in your blood than you should. Penn State University researchers found 60 drugs that interact with CBD or cannabis. Be extra careful if you take blood thinners, heart medicine, or drugs that weaken your immune system after transplant surgery. Pierre says that even some psychiatric medicines, including antipsychotics, could interact with CBD. If you take any prescription meds, ask your doctor if CBD is safe to use.
Gallup.com: вЂњ14% of Americans Say They Use CBD Products.вЂќ
Joseph Pierre, MD, acting chief of Community Care Systems at the VA West Los Angeles Healthcare Center and clinical professor in the Department of Psychiatry and Behavioral Sciences, UCLA.
National Center for Complementary and Integrative Health: вЂњCannabis (Marijuana) and Cannabinoids: What You Need to Know.вЂќ
Kendra Mark, founder 2Rise Naturals.
Peter Bongiorno, ND, naturopath and acupuncturist, InnerSource Natural Health and Acupuncture, New York City and Long Island.
Epidiolex.com: вЂњEpidiolex: A treatment innovation.вЂќ
Journal of Clinical Medicine Research: вЂњDosage, Efficacy and Safety of Cannabidiol Administration in Adults: A Systematic Review of Human Trials.вЂќ
Pennsylvania State University, College of Medicine, Department of Pharmacology: вЂњNTI Meds to be Closely Monitored when Co-administered with Cannabinoids.вЂќ
Scientists are studying CBD oil for schizophrenia and dozens of other health conditions. HereвЂ™s what to know if you have schizophrenia and are thinking of trying CBD.