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Marijuana and Anxiety: It’s Complicated

If you live with anxiety, you’ve probably come across some of the many claims surrounding the use of marijuana for anxiety symptoms.

Plenty of people consider marijuana helpful for anxiety. A 2017 national survey of more than 9,000 Americans found that 81 percent believed marijuana had one or more health benefits. Nearly half of these respondents listed “anxiety, stress, and depression relief” as one of these potential benefits.

But there also seems to be just as many people who say marijuana makes their anxiety worse.

So, what’s the truth? Is marijuana good or bad for anxiety? We’ve rounded up the research and talked to some therapists to get some answers.

Before getting into the ins and outs of marijuana and anxiety, it’s important to understand that marijuana contains two main active ingredients, THC and CBD.

  • THC is the psychoactive compound responsible for the “high” associated with marijuana.
  • CBD is the nonpsychoactive compound that’s used for a range of potential therapeutic purposes.

There’s no question that many people use marijuana for anxiety.

“Many clients I’ve worked with have reported using cannabis, including THC, CBD, or both, to reduce anxiety,” says Sarah Peace, a licensed counselor in Olympia, Washington.

Commonly reported benefits of marijuana use include:

  • increased sense of calm
  • improved relaxation
  • better sleep

Peace says her clients have reported these benefits along with others, including greater peace of mind and a reduction in symptoms they found unbearable.

Peace explains her clients have reported that marijuana in particular helps relieve symptoms of:

  • agoraphobia
  • social anxiety
  • post-traumatic stress disorder (PTSD), including flashbacks or trauma responses
  • panic disorder
  • phobias
  • sleep disruptions related to anxiety

What Peace sees in her practice is on par with most of the existing research around marijuana and anxiety.

A 2015 review supports CBD as a potentially helpful treatment for anxiety, particularly social anxiety. And there’s some evidence that THC may also help in low doses.

It’s not a full cure, though. Instead, most people report it helps reduce their overall distress.

“For example, someone might only have one panic attack a day instead of several. Or maybe they can go grocery shopping with high but manageable levels of anxiety, when before they couldn’t leave the house,” Peace explains.

While marijuana appears to help some people with anxiety, it has the opposite effect for others. Some simply don’t notice any effect, while others experience worsening symptoms.

What’s behind this discrepancy?

THC, the psychoactive compound in marijuana, seems to be a big factor. High levels of THC have been associated with increased anxiety symptoms, such as increased heart rate and racing thoughts.

In addition, marijuana doesn’t appear to offer the same long-term effects as other anxiety treatments, including psychotherapy or medication. Using marijuana may offer some much-needed temporary relief, but it’s not a long-term treatment option.

“I think, like any medicine, cannabis can provide support,” Peace says. “But without lifestyle changes or internal work on mental health, if your stressors or anxiety triggers remain, your anxiety will likely remain in some form.”

While marijuana might seem like a way to avoid the potential side effects associated with prescription medication, there are still some downsides to consider.

Negative side effects

  • increased heart rate
  • increased sweatiness
  • racing or looping thoughts
  • problems with concentration or short-term memory
  • irritability or other changes in mood
  • paranoia
  • hallucinations and other symptoms of psychosis
  • confusion, brain fog, or a “numb” state
  • decreased motivation
  • difficulty sleeping

Smoking risks

Smoking and vaping marijuana can lead to lung irritation and breathing problems in addition to increasing your risk for certain types of cancer.

Plus, vaping is linked to a recent increase in potentially life threatening lung injuries.

Dependence and addiction

Contrary to popular belief, both addiction and dependence are possible with marijuana.

Peace shares that some of her clients have a hard time finding a line between medical use and misuse with daily or regular cannabis use.

“Those who use it frequently to numb themselves or keep from caring about the things causing them stress also often report feeling like they are addicted to cannabis,” Peace says.

Legal status

When using marijuana, you’ll also need to consider the laws in your state. Marijuana is only currently legal for recreational use in 11 states as well as the District of Columbia. Many other states allow use of medical marijuana, but only in certain forms.

If marijuana isn’t legal in your state, you may face legal consequences, even if you’re using it to treat a medical condition, such as anxiety.

If you’re curious about trying marijuana for anxiety, there are a few things you can do to reduce your risk for it worsening your anxiety symptoms.

Consider these tips:

  • Go for CBD over THC. If you’re new to marijuana, start with a product that contains only CBD or a much higher ratio of CBD to THC. Remember, higher levels of THC are what tend to make anxiety symptoms worse.
  • Go slow. Start with a low dose. Give it plenty of time to work before using more.
  • Purchase marijuana from a dispensary. Trained staff can offer guidance based on the symptoms you’re looking to treat and help you find the right type of marijuana for your needs. When you buy from a dispensary, you also know you’re getting a legitimate product.
  • Know about interactions. Marijuana can interact with or reduce the effectiveness of prescription and over-the-counter medications, including vitamins and supplements. It’s best to let your healthcare provider know if you’re using marijuana. If you don’t feel comfortable doing this, you can also talk to a pharmacist.
  • Tell your therapist. If you’re working with a therapist, make sure to loop them in, too. They can help you evaluate how well it’s working for your symptoms and offer additional guidance.

Marijuana, particularly CBD and low levels of THC, shows possible benefit for temporarily reducing anxiety symptoms.

If you decide to try marijuana, keep in mind it does increase anxiety for some people. There’s really no way to know how it will affect you before you try it. It’s best to use it cautiously and stick to smaller doses.

Other nonmedical treatments can also help relieve anxiety symptoms. If you’re looking for alternative approaches to treatment, consider giving other self-care approaches a try, like:

It may take some trial and error, but with time you can find a treatment that works for you.

Crystal Raypole has previously worked as a writer and editor for GoodTherapy. Her fields of interest include Asian languages and literature, Japanese translation, cooking, natural sciences, sex positivity, and mental health. In particular, she’s committed to helping decrease stigma around mental health issues.

Last medically reviewed on December 16, 2019

Why does marijuana help some people's anxiety symptoms and worsen those of others?

Using Marijuana for Treating Anxiety

Daniel B. Block, MD, is an award-winning, board-certified psychiatrist who operates a private practice in Pennsylvania.

Verywell / Cindy Chung

  • Treatment
  • Symptoms
  • Diagnosis
  • Coping

As more states legalize marijuana, both for medicinal and recreational use, more and more people are turning to cannabis in hopes of managing anxiety or generalized anxiety disorder (GAD). Although scientific research in this area is still sparse, there are anecdotal and new scientific reports of marijuana creating a calming experience that temporarily relieves symptoms of anxiety for many people.

Marijuana as Self-Medication

Anytime you take it upon yourself to use a substance to treat or cope with a medical problem or symptom, it is referred to as self-medicating. Often, self-medicating produces an immediate relief of the uncomfortable symptoms, thereby reinforcing its use.

The problem with self-medication is that even though the use of marijuana is becoming more acceptable, not enough is known about the efficacy of the drug for particular medical conditions as well as its long-term consequences.

Potential Benefits and Risks

May reduce depression in the short term

May relieve anxiety temporarily

May reduce stress

Higher levels of psychiatric disorders

Can create psychological dependence

Long-term memory loss may occur

Symptoms may increase

May develop cannabis hyperemesis syndrome

Can create increased tolerance and need

Benefits

The scientific community has recently started examining the effect of cannabis on anxiety, and the verdict is that short-term benefits do exist.

Scientists at Washington State University published a study in the Journal of Affective Disorders that found that smoking cannabis can significantly reduce self-reported levels of depression, anxiety, and stress in the short term. However, repeated use doesn’t seem to lead to any long-term reduction of symptoms and in some individuals may increase depression over time.

Risks

Marijuana can affect your body in many ways beyond just getting you high. The high feeling you may experience after smoking or ingesting marijuana is due to tetrahydrocannabinol (THC), the chemical compound that gives marijuana its psychoactive effects.

The effects of THC do not come without risks, and long-term or frequent use has been associated several potential side effects.  

Higher Levels of Psychiatric Disorders

It is possible that people who use marijuana for an extended period of time have higher levels and symptoms of depression, despite any improvements they may have seen in this regard with short-term use.

Some research has also shown that heavy use of marijuana in adolescence (particularly in teenage girls) can be a predictor of depression and anxiety later on in a person’s life. Certain susceptible individuals are also at risk for the development of psychosis with the use of cannabis.

Psychological Dependence

The central problem with using marijuana as an anxiety coping tool is that it can create a psychological dependence on the substance.

Since the effects of marijuana are fast acting, long-term behavior-based coping strategies may seem less helpful at first and may be less likely to be developed.

Long-Term Memory Loss

Several studies have found that long-term marijuana use can cause memory loss. Memory impairment occurs because THC alters one of the areas of the brain, the hippocampus, responsible for memory formation. It also can have negative consequences on the brain’s motivation system.

Increase in Symptoms

THC can raise your heart rate, which, if you have anxiety, may make you feel even more anxious. Using too much marijuana can also make you feel scared or paranoid.

In some cases, marijuana can also induce orthostatic hypotension, a sudden drop in blood pressure when standing, which can cause lightheadedness or feeling faint. Cannabis can also cause feelings of dizziness, nausea, confusion, and blurred vision, which can contribute to anxiety.

Cannabis Hyperemesis Syndrome

A rare consequence of frequent marijuana use, particularly with today’s more potent strains, is cannabis hyperemesis syndrome (CHS). This involves cyclical nausea and vomiting.

This is paradoxical and can be difficult to diagnose, as marijuana has been used to decrease nausea and vomiting in cancer treatment. Sufferers sometimes find relief in hot baths and showers, but ultimately, abstinence from marijuana is necessary for long-term improvement.

Escalating Need

You can develop a tolerance to marijuana. This means that the more you use it, the more you will eventually need to get the same “high” as earlier experiences.

Alternatives to Marijuana

Remember that some level of anxiety is normal and even helpful when you are confronted with something that feels threatening to you. However, when feeling anxious becomes pervasive and difficult to control, it is time to seek professional help to discuss other forms of anxiety management.

Therapy

Proactive coping strategies, learned through counseling, support groups, as well as self-help books and educational websites, can create lasting change without the negative components of extended marijuana use.

Cognitive behavioral therapy (CBT) and other forms of therapy can help you determine the underlying cause of your anxiety and manage it more effectively.   Work with your doctor to develop a treatment plan that is right for you.

Working with a psychotherapist to manage your anxiety will give you a better handle on your condition in the long run.

Medication

The use of certain prescription medications such as the selective serotonin reuptake inhibitors (SSRIs) have been firmly established as safe and effective treatment for anxiety disorders.  

Prescription medication is also preferable to marijuana since the long-term risks have been better studied and are potentially less significant compared to long-term marijuana use. Some anti-anxiety medications are taken daily, while others are taken episodically during periods of extreme anxiety or a panic attack.

A psychiatrist or your primary care doctor can prescribe you an anti-anxiety medication, should you need one.

Cannabidiol (CBD) Oil

CBD oil, a marijuana extract that is often dispersed under the tongue with a dropper, doesn’t contain THC, so it won’t give you the same mind-altering effects as marijuana. There is some beginning evidence to suggest that CBD could be helpful in the treatment of anxiety and addiction, but more clinical trials and research are needed in this area.  

A Word From Verywell

Symptoms of anxiety are treatable. Studies show that psychotherapy and medication are effective for most individuals, whereas the long-term effects of self-medicating with marijuana have yet to be clearly established. If you’ve recently started experimenting with marijuana use to treat your anxiety, be sure to tell your doctor.

If you or a loved one are struggling with anxiety, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area.

For more mental health resources, see our National Helpline Database.

Using marijuana can provide short-term symptom relief for anxiety, but there are risks to consider. Learn more about this and longer-term options.