How to use CBD for anxiety
A pounding heart, sweaty palms, racing thoughts: For those living with an anxiety disorder, these unwelcome symptoms can make everyday life feel debilitating.
One in 13 people around the world live with an anxiety disorder, making them the most common mental health disorder worldwide, according to the World Health Organization (WHO). For those living with anxiety, finding a safe method for managing symptoms is a critical concern.
Quick-acting anti-anxiety medication, such as Xanax and Valium, may offer instant relief but can become addictive. Long-range anxiety medications, such as Prozac, may help reduce symptoms over time, but don’t work for everyone.
Enter cannabidiol, better known as CBD. CBD has recently captured the spotlight as an alternative or complementary treatment for anxiety.
CBD: Snake oil or powerful anxiety treatment?
Clinical research on CBD as a treatment for anxiety disorders has proliferated in recent years with accumulating evidence pointing to its therapeutic potential .
Although most studies on CBD are preclinical and use animal models, clinical studies using human participants are now emerging.
1 in 13 people around the world live with an anxiety disorder, making them the most common mental health disorder worldwide.
In a double-blind study from 2019, 37 Japanese teenagers with social anxiety disorder (SAD) received 300 mg of CBD oil or a placebo every day for four weeks. The teens were assessed with surveys used to diagnose and measure SAD symptoms. The anti-anxiety properties of CBD reduced symptoms aligned with the disorder, providing relief comparable to Paroxetine, a drug commonly used to treat the condition.
A 2019 retrospective case study reviewed outpatients at a mental health clinic in Fort Collins, Colorado. Forty-seven of the patients sampled had expressed concerns about anxiety. Over three months, the majority of patients were given 25 mg of CBD daily in addition to treatment.
After the first monthly assessment, 79.2% of patients experienced an improvement in anxiety. After two months, 78.1% of patients reported a further improvement compared with the previous month.
However, there were also patients who reported that the symptoms of their anxiety worsened after taking CBD—15.3% felt their anxiety had become exacerbated after the first month and 19.5% felt their anxiety had worsened further after the second month.
Another study , done in 2018, also suggests that CBD may heighten anxiety. It included a small sample of individuals with paranoid traits and found that CBD exacerbated anxiety among some of the participants. Anxiety was measured through symptoms such as cortisol concentration, heart rate, and systolic blood pressure.
These contradictory findings may be due to factors such as small sample sizes and variations in dosing. CBD is a bidirectional medicine, which means it can cause opposing responses at different doses. We’ll delve deeper into this below.
How should I consume CBD for anxiety?
If you’re curious about using CBD oil as a tool to help manage your anxiety, education is critical. Understanding the pros and cons of the various ingestion methods can help you determine which form of consumption best suits your needs.
Tinctures and oils
CBD tinctures and oils represent a quick, easy, and accurate way to consume CBD. Most tinctures contain CBD in an alcohol base. CBD oils contain CBD extracts infused into a carrier oil, such as coconut or hemp seed oil.
Tinctures and oils are taken using a dropper, which allows you to easily measure intake. The cannabinoid rapidly enters the bloodstream when taken sublingually—results can kick in as quickly as ten minutes and last up to three to four hours.
CBD vape oils
CBD can be vaped using a special pen that vaporizes the oil. At present, the safety of vaping has come under intense scrutiny. A serious lung condition known as VAPI, or EVALI, has hospitalized more than 2,000 people and led to the deaths of 42. The federal Centers for Disease Control has found that most cases have been linked to the use of illicit-market THC vape cartridges tainted with vitamin E oil (tocopheryl-acetate).
CBD vape cartridges purchased in legal state-licensed cannabis stores are highly regulated, while CBD cartridges purchased from other sources are completely unregulated. Proceed with caution when considering any vaping product in an unregulated environment.
CBD can be added to almost every food under the sun. While super easy to consume in this form—and often delicious, particularly as gummies—it may take an hour or more before results are felt.
What’s more, the oral bioavailability of CBD can hinder CBD absorption—when you consume CBD orally, it has to pass through your gastrointestinal tract before it is metabolized by the liver. As a result, a limited quantity of CBD makes it into the circulatory system.
It’s important to also note that the FDA has recently deemed food containing CBD illegal . You’ll have to get CBD edibles in state-licensed adult-use markets.
Smoking provides an almost instantaneous method for enjoying the effects of CBD. Smoking sends the cannabinoid directly to the alveoli of the lungs, and from there, CBD molecules enter the bloodstream for rapid absorption. However, measuring your CBD intake can be tricky when you smoke, and the act of smoking itself can cause lung inflammation.
Dosing CBD for anxiety
If you read the studies cited above, you’ll notice that the dosing varied significantly between them. The teens in the Japanese study were provided with 300 mg of CBD daily, while the outpatients in the Colorado study received 25 mg. Why such a large discrepancy in dose?
As most scientists and clinicians will readily admit, there is no universally recommended dosage for CBD, and, to date, there haven’t been any large-scale clinical trials to inform dosage guidelines. In addition, the FDA is still learning about CBD —such as its cumulative effects on the body—before it decides on how to regulate it.
This doesn’t necessarily mean CBD is unsafe. Existing research already suggests that it appears to be a safe, well-tolerated treatment. If you’re interested in experimenting with CBD to manage your anxiety symptoms, aim for an informed, cautious approach to dosing (which is always a good idea). Below are some dosing considerations.
General dosing tips
Some basic factors that you should consider when devising a CBD dose include:
- Body weight
- Concentration of CBD
- Severity of your anxiety
The concentration of CBD varies between products, and is generally expressed as milligrams (mg) per container.
Your unique body chemistry affects how you respond to CBD.
Once you know the potency of the CBD product you hold, you can use a dosage calculator or an app such as Accugentix to help settle on your perfect dose. Dosage calculators can provide a recommended dose in milligrams based on your body weight and the severity of your symptoms.
Your unique body chemistry also affects how you respond to CBD. Some individuals metabolize medicine faster than others, which can be attributed to genes or lifestyle. If you know that you metabolize medication quickly, it’s possible that you may benefit from a higher dose.
CBD may do different things at different doses, a phenomenon known as bidirectional effects. Overstimulation of the body’s endocannabinoid system may exacerbate symptoms instead of alleviating them.
Additionally, high levels of CBD, such as 300 mg, have been known to promote sleepiness and relaxation. Conversely, low levels of CBD may create an elevating response, inciting wakefulness and alertness. The best way to avoid unwanted bidirectional effects is to follow the adage: start low, go slow.
Start low, go slow
Titration refers to the process of adjusting the dosage of a medication to get its maximum benefits without adverse effects. CBD has been shown to be safe even when taken in high doses (300-600 mg), nonetheless, it’s advisable and more cost-effective to start with a low dose and increase it incrementally, observing how you feel as you go.
This method forces you to pay attention to subtle changes in your body as it responds to the medication. Everyone’s optimal dosage and tolerance is unique, and this process allows you to get acquainted with yours.
Dr. Dustin Sulak, a cannabis medicine expert at Healer.com , offers educational resources for novice and seasoned cannabis users alike to find their optimal dosage.
Talk to an expert on medical cannabis
If you’re still feeling unsure and you live in a state where you can safely converse with a health professional about CBD, consider scheduling a consultation. Some cannabis dispensaries also have medical experts on hand who can provide you with sound advice and dosage recommendations.
Anxiety disorders are the most common mental health disorders worldwide. Enter CBD, which has potential as a treatment for anxiety.
What Dosage of CBD Should You Take?
Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital.
Iryna Veklich / Getty Images
CBD is available in a number of different formulations including creams, tablets, oils, and gummies. These can vary in terms of their ingredients as well as dosages, and there is not a great deal of research available on what dose might be beneficial or safe to treat certain conditions.
Cannabidiol (CBD) is the second most abundant cannabinoid found in marijuana. Unlike tetrahydrocannabinol (THC), CBD does not have psychoactive effects. Interest in the use of CBD for health purposes has grown tremendously in the last few years.
CBD is believed to have a range of positive physical and mental health effects. Because of this, it has become increasingly popular as a way to alleviate everything from anxiety to sleep disorders.
In order to determine if CBD is right for you, it is important to consider its potential benefits, side effects, and available research on safe dosages.
CBD is just one of hundreds of different compounds found in the cannabis plant. While cannabis has been used in holistic medicine for many years, only recently have researchers begun to explore some of the medicinal purposes for CBD and other cannabinoids.
While further research is still needed, there is some evidence that CBD may have some beneficial mental health effects. These include:
- Alleviating depression: Some research also indicates that CBD may be useful as a treatment for depression. Studies suggest that the cannabinoid might have an influence on how the brain responds to serotonin, a neurotransmitter that plays a key role in mood. People with depression sometimes have a low level of serotonin, so CBD may help the brain use available serotonin more effectively.
- Improving sleep: While the reasons are not entirely understood and require further research, CBD also appears to have potential as a treatment for sleep problems. For example, one study found that people who took CBD also reported improvements in the quality of their sleep.
- Reducing anxiety: Anxiety is one of the most common types of mental health conditions, affecting almost 20% of American adults each year. Research suggests that CBD may help alleviate acute symptoms of a number of anxiety-related conditions including generalized anxiety disorder, obsessive-compulsive disorder, and social anxiety disorder.
In addition to the mental health benefits, CBD may also have therapeutic benefits for a range of other conditions. The World Health Organization suggests that CBD may have beneficial effects in the treatment of:
- Alzheimer’s disease
- Cardiovascular disease
- Multiple sclerosis
It is important to remember that these benefits have not yet been conclusively proven. More research is needed to determine the role that CBD might play in the treatment of different disorders and health conditions.
There have been a number of studies that suggest that CBD may have a number of different physical and mental health uses. However, more research is still needed to better understand the substance’s potential applications and possible long-term side effects.
A 2019 comprehensive review published in The Lancet Psychiatry looked at previously published studies. The review ultimately concluded that there was little evidence to support the use of CBD for mental health purposes and suggested that more research is needed in order to substantiate its use to treat symptoms of conditions such as anxiety, depression, and insomnia.
It is important to remember that this doesn’t mean that CBD isn’t effective. Many of the studies that were included in the review were small, had few participants, and were not randomized controlled trials.
This suggests that more research involving more participants and well-designed studies is needed in order to better understand if, how, and why CBD works.
While its effectiveness is still up for debate, one 2017 review found that it was a relatively safe option. While it is important to remember that there is still a great deal we don’t yet know about CBD and its effects, it is something that you might opt to try to see if you experience any benefits.
How Much Should You Take?
The dosages used in research studies vary and there is no consensus on how much should be used for specific conditions. If you do decide to try CBD, it is also important to note that there is no universally agreed upon dose. Research also suggests that people may respond differently to various dosages, so the amount that is right for your needs might vary.
Some dosages that have been used in research studies for different conditions include:
- Anxiety: 300 to 600 mg
- Bowel disease: 10 mg per day
- Cancer-related pain: 50 to 600 mg per day
- Parkinson’s disease: 75 to 300 mg per day
- Poor sleep: 25 mg per day
- Psychosis: 600 mg per day
One 2020 review of studies found that participants showed improvements in anxiety levels after single doses of CBD ranging from 300 to 600 mg. Such results indicate that the CBD may hold promise as a treatment to alleviate symptoms of acute anxiety.
It is important to remember that you should always talk to your doctor before using CBD if you have symptoms of a serious mental or physical health condition. CBD could potentially worsen symptoms or interact with other medications you are taking.
Looking at the dosage information for the CBD product that has been FDA approved can also be helpful. For Epidiolex, an FDA-approved cannabis-derived medication used to treat seizures in people with certain types of epilepsy, the starting dosage is 5 milligrams per kilogram of body weight. This dose can later be increased to 5 mg per kilogram of body weight twice a day.
Other CBD products are not FDA regulated and do not have officially recommended dosages. This can make it difficult to determine how much you might need, but there are some things you can consider that might help.
- Assess your sensitivity to CBD: Your individual ability to tolerate CBD can also play a role in determining how much you need. If you are very sensitive to the effects of CBD, you should take a small dose. Some people may find that they are not as affected by the substance, so they may need to take a larger dose to notice any beneficial effects.
- Consider individual factors: When you are trying to decide how much CBD to take, there are a number of factors you should consider. These include the formulation and concentration of the capsule, oil drops, or gummies you are taking, the symptoms you are treating, and your age, sex, weight, and overall health. Generally, people with heavier bodies need to take a little more to achieve the same effects. Men may need a larger dose, while older people may need less.
- Consider the symptoms you’re treating: The symptoms you are trying to alleviate can also play a role in the CBD dosage you need to take to see results. In one study, participants who took 25mg of CBD each day had improved sleep quality, although the results were not consistent. However, you might find that you need a lower or higher dose if you are treating another type of condition.
- Try a dosage calculator: Researchers note that while the variety of dosing strategies and formulations make it difficult to determine efficacy, there are a number of online “dose-calculators” available online (such as mydosage.com) that are designed to help people choose the correct dose. The accuracy of such calculators is difficult to assess, but it may be a good place to start.
Before you try CBD, discuss your plan with your doctor. They may be able to recommend a dose and help you better understand any potential risks, complications, side effects, or interactions you might experience.
Start With a Low Dose
Unless your doctor recommends a specific dose, start by taking 10 to 20 mg a day. Take this for a week to ensure that it is well-tolerated and that you don’t experience any unwanted effects or an allergic reaction.
If this dose does not have the desired effect, try increasing in increments of 5mg each week until the desired amount is reached.
In studies, amounts vary from as low as 20 milligrams per day to up to 1,500 milligrams (mg) per day. The World Health Organization reports that dosages in clinical research studies typically range between 100 and 800 milligrams per day.
Is It Possible to Take Too Much?
So what is the maximum amount of CBD you should take? Researchers have found that 600 mg per day appears to be safe, but one study suggested that doses of up to 1,500 mg a day are safe and tolerated well.
However, it’s important to remember that research is still in its infancy and experts do not yet fully understand the potential long-term impacts of CBD usage. For that reason, you should always discuss your CBD use with your doctor.
Starting at a lower dose and working your way up to the amount you need may be the best ways to avoid taking too much.
How to Take CBD
The amount of CBD found in a product may depend on different factors, including the formulation and method of administration. CBD products are available in a number of different forms including oils, capsules, tablets, nasal sprays, and gummies.
One of the most popular ways to take CBD is as an oil. Such products are made by combining CBD with some type of carrier oil, such as coconut oil. Some more recently developed products include dietary supplements, foods, beverages, lotions, salves, and cosmetics.
The type of CBD product you choose may depend on what you are trying to treat. If you are looking for general mood improvements, a dietary supplement might be a good option.
If you are targeting specific symptoms of a condition, taking an oil, capsule, or gummy might be a better way to obtain a higher, more concentrated dose.
Topical applications may produce localized effects, but they are unlike to have any mental health benefits.
What Kind Should You Take?
It’s also important to remember that many products don’t contain just CBD on its own. There are three types of CBD available:
- Isolate contains CBD and only CBD.
- Broad-spectrum contains CBD and other cannabinoids, but not THC.
- Full-spectrum contains CBD, THC, and other cannabinoids.
It may be helpful to take a broad-spectrum product since research suggests that CBD’s effects may be most beneficial when taken in conjunction with other cannabinoids, a phenomenon known as the entourage effect. CBD may also help mitigate some of the effects of THC.
While CBD is generally well-tolerated, this does not mean that you won’t experience any side effects.
Some of the most common side effects that people experience when taking CBD include:
- Appetite changes
- Stomach upset
- Weight changes
Some recent research has generated concerns over the safety and potential long term effects of CBD. One study involved giving mice an equivalent of the maximum dose of the CBD medication Epidiolex, which is used to treat certain forms of epilepsy. The results indicated an increased risk for liver damage as well as concerns over its interaction with other medications.
It is also important to remember that CBD products are not regulated by the U.S. Food and Drug Administration (FDA). Some manufacturers make unproven claims about the uses and efficacy of their products. There is also concern about the quality and safety of the products themselves.
One report by the Centers for Disease Control and Prevention (CDC) indicated that a number of people experienced negative unwanted side effects due to CBD products that contained synthetic CBD, although the products were not labeled as containing such ingredients.
Mislabeling appears to be a fairly common problem with CBD products. In one study, 70% of the CBD products that were sold online contained significantly more of the psychoactive ingredient THC than the label indicated.
Federal law prohibits the sale of products that contain more than 0.3% THC. States laws also vary, so you should always check with your state before buying CBD products online.
A Word From Verywell
If you do decide to take CBD to alleviate an acute or chronic condition, remember that the amount that you take will depend on a variety of factors. Finding the right dosage often takes some experimentation and adjustments. Starting with a low dose and then gradually increasing the amount you take until you achieve the desired effects is the best approach.
CBD holds promise as a treatment for a range of conditions, but how much should you take? Learn more about CBD dosages for different purposes.