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:
- social anxiety
- post-traumatic stress disorder (PTSD), including flashbacks or trauma responses
- panic disorder
- 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
- hallucinations and other symptoms of psychosis
- confusion, brain fog, or a “numb” state
- decreased motivation
- difficulty sleeping
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.
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?
Marijuana anxiety? Here’s what to do if you have a panic attack while high
While many find weed a relaxing drug, marijuanaВ alsoВ has a direct connectionВ to panic attacks. Even aВ habitual smoker who seems the very definition of “chill” has likely had the experienceВ of being way too high, man. В
In the moment, that can be overwhelming. But it’sВ not the end of the world. Here’s what you need to know aboutВ theВ scary, stressfulВ and sometimes overwhelming problemВ of weed-induced panic.
Can weed causeВ panic attacks?
“It can,” said Ryan Vandrey, whoВ studiesВ the behavioral pharmacology of cannabis useВ atВ Johns Hopkins University School of Medicine,В in a phone interview. “It happens from direct effects of the drug inВ the brain and/or direct effects of the drug on body.”В
“Cannabis can modulate neurotransmitters in parts of the brain that control anxiety and elevateВ yourВ heart rate,” which can in turn create a sense of escalating panic, he explained.
Recognizing the panic attack for what it is
AВ wide variety of physiological effectsВ fall under the umbrella term “panic attack,” though Vandrey cautioned that they’re specific to each person, andВ none can be considered “typical.”
ThereВ “hasnвЂ™t been a lot of research focused exclusively” on the signs ofВ weed-related panic, Vandrey said. “The important thing to note is that itвЂ™s dose-related. You see greater exacerbation of heart rate at higher doses. And it’s more likely to occur in individuals who already deal with anxiety issues or have a predisposition to or familyВ history ofВ them.”
That said, people whoВ experienceВ panic attacks have reportedВ symptoms including, but by no means restricted to:
вЂўВ Racing heartbeat
вЂўВ Tunnel vision
вЂў Sweat or chills
вЂў Chest pains
вЂў Tingling or numbness in the extremitiesВ
вЂў WeaknessВ and dizziness
вЂўВ Trouble breathing
These areВ someВ potential results of aВ “flight-or-fight” response, which is triggered by the brain’s hypothalamus when you instinctuallyВ detect a threat вЂ” either real or imagined. Your wholeВ body is placed on high alert, and fear of impending death or doom is palpable.В
What to do when you know you’re panicking
The key thing to rememberВ is that a panic attack can’t hurt you. Contrary to what some of the above symptoms may suggest, you’re likelyВ not suffering aВ heart attack or obstructed airway.
There’s also zeroВ chance you’veВ “overdosed”В on weed. Remind yourself that this condition is not lasting but temporary. In due course, it will all be over.В
The experienceВ “usually doesn’tВ lastВ that long,” Vandrey said,В perhaps “half hour or an hour, dependingВ on how the cannabisВ was ingested вЂ”В shorter if inhaled, longer if eaten.”В В
“It all depends on the individual,” he said.В “None of it is applicable to everybody.” В
Take stock of your situation and surroundings
For many, weed-based anxiety involves a hefty dose of paranoia about other people. Because marijuana is a drug enjoyed in social settings, getting too stoned can lead to suspicions that your own friends resent you, or that you’re somehow “ruining” their good time.
“Research has shown that individual responses to a given drug can absolutely be influenced by the situation in which it occurs,” Vandrey said. “If somebody takes a drug that produces anxiety in uncomfortable surroundings, they may heighten their anxiety.В Cannabis is a perfect example.”
If environmental factors are contributing to your fear or stress, removing yourself from that context can help.
Ask for help
Resist the idea that anyone hates you for obscure reasons of your own invention. The truth is that anyoneВ not in the throes ofВ panicВ can assure you that your symptoms are exaggerated, impermanentВ and not life-threatening, which is a huge advantage when your mind is playing tricks on you.
A companion is also handy to haveВ when it comes to limiting environmental stressors, and canВ address any simple and immediate needs.
“ThereвЂ™s no one way to treat this,” Vandrey said. “When it does happen in our lab we respond to the needs of the individual. We encourage people to get comfortable and provide them with whatever they need вЂ” whetherВ that’sВ food, or water, or sometimes just to close their eyes, lie down and relax.”
Give yourself a break
As a panic attack releases its grip, you mayВ feel a little sheepish or outright embarrassed about what you did or saidВ whenВ it took hold. “Why did I freak out like that?” you’ll ask yourself.В
Despite popular conceptions of such episodes, Vandrey said they’re “notВ common at all.”В They’reВ especially unusualВ for “frequent, experienced” users:В “It rarely happens, and usually only after very high doses.”В
And while limiting your intake or indulging in a more comfortable environmentВ may prevent a repeat occurrence in the future, the best way to avoid a weed-related panic attack “is is to not use cannabis at all.”В
In other words, this is a risk everyone runs with weed вЂ” but, Vandrey said, a “subset of people” are particularly vulnerable to it. So while someВ stoners can laugh about the times they tipped over the edge into full-blown paranoia and horror,В treating it likeВ a rite of passage, others will find that they’re better off not gambling with their neurochemistry this way.В В
In any case, rest assured that a weed-induced panic attack is not going on your permanent record, and will soon be forgotten by whoever happened to witness it. The only judgment you face is your own.
Figure out what went wrong
As we’ve discussed, “situational” factors are important determinants in matters of substance abuse and addiction, and anyone fond ofВ weed will tell you that theВ effectsВ are similarly contingent on your surroundings: Where were you? Who were you with?В
And, maybe above all:В What was your frame ofВ mind?
AnyВ such detailВ could have contributed toВ your panic attack, and after it’s over, it’s worth considering whether they did вЂ” particularly if this was an isolated incident. You might choose toВ swear offВ potentВ marijuana strains with high levels of THC, the cannabinoid responsible for weed’s psychoactiveВ “high,” or pick the time and place of your weed use more carefully. Strictly limiting the size of your doses is an even better idea.
But, as Vandrey pointed out, none of thisВ is a guarantee against another panic attack. And if theВ oneВ you hadВ fits into a larger pattern of recurrent behavior, then seeking a doctor’s opinion on the nature of your anxiety is the smart move. Even if you think you’reВ self-medicating yourВ anxiety with marijuana, you could be doing more harm than good.В
“CannabisВ I donвЂ™t think is any different thanВ anyВ other drug that can produce anxiety,” Vandrey said вЂ” and there are many drugsВ that can. So don’t let weed’s chill reputation fool you:В As with any prescription you pick up at the pharmacy, it’s essential to be informed of possible adverse effects.В
While many find weed a relaxing drug, marijuanaВ alsoВ has a direct connectionВ to panic attacks. Even aВ habitual smoker who seems the very definition of "chill" has likely had the experienceВ of being way too high, man. В In the moment, that can beвЂ¦