Have you seen contradicting messages about cannabis use and anxiety? Learn whether cannabis causes or lowers anxiety. Dr James Connell explains. Read Now. Yes, full-spectrum CBD products can cause or worsen anxiety in some people. Here’s why it affects anxiety differently and what you can do about it.
Does Cannabis Cause Anxiety?
When researching cannabis and anxiety, you often find opposing statements. We’re warned that those with anxiety or depressions shouldn’t use cannabis. At the same time, cannabis is prescribed for anxiety and depression. Learn about why this contradiction exists and whether cannabis causes or lowers anxiety.
Dr James Connell
- Cannabis is prescribed for anxiety, depression and other mental health issues.
- CBD is the main cannabinoid prescribed for anxiety and has very limited side effects. It’s quite safe.
- THC can also be prescribed for anxiety however requires more vigilance and caution when taken with anxiety or other mental health conditions.
In this video, Dr Jim explains why there’s a contradiction around whether cannabis can be used to help with anxiety or whether people with anxiety and other mental health concerns shouldn’t use cannabis.
In this article, we answer a question that was asked by a honahlee community member named Chloe. Here’s Chloe’s question
“I’ve been reading through the info on your website (which has been extremely helpful by the way – so thank you so much for it). However, I’ve come across a discrepancy I would like some further info on.
Mainly on the use of cannabis for anxiety, it says on your Medical Conditions Treated by Cannabis (And Side Effects) that the TGA has approved use of medical cannabis for anxiety (and anxiety disorders) in the past. But then further down in the next subheading (Who should not be using cannabis) it states that people with anxiety disorders shouldn’t be using it.
Basically I’m just looking for clarification on whether it is advised to use medical cannabis for anxiety and anxiety disorders. I have found this same conflicting information on a few different sites, while also hearing anecdotal evidence that it has helped alleviate anxiety symptoms for individuals. Any information you could provide to me would be greatly appreciated.”
Cannabis causes and relieves anxiety – a contradiction
Mental health is one of the most commonly TGA approved areas for medical cannabis. These conditions include:
To understand if it’s safe to use cannabis for anxiety, you need to understand cannabis and the chemical compounds CBD and THC, a bit more deeply. Once you understand CBD and THC at a high level, (no pun intended), and the concept of a ‘therapeutic window’, you’ll see how cannabinoids, one’s therapeutic window and dosing all work together.
Without an understanding of these three concepts, it’s easy to understand why these contradictory statements are often made.
CBD is useful and ‘safer’
There are multiple types of medical cannabis products prescribed for anxiety. Cannabidiol (CBD) predominant treatments are very safe and quite effective for anxiety. And, it’s rare that CBD actually induces any further anxiety in patients. Occasionally at very high doses, it can cause irritability and hyperactivity. But, this is more common with CBD isolates.
So, when we talk about cannabis medicine and anxiety, CBD isn’t something that you generally need to worry about.
THC is useful but needs more vigilance
THC is also prescribed to help with anxiety disorders. It can help with relaxation, sleep, and it can help with traumatic memories and changing the nature of the way that we remember certain events. THC can also provide an alternative perspective on certain situations and helps distance people from the stress of their situations.
But THC is something that directly stimulates the cannabinoid receptors and the endocannabinoid system (ECS). It has a stronger impact on parts of the system that regulate anxiety. In some cases, more often than CBD, too high a dose of THC may provoke cannabis-induced anxiety.
The ECS’s purpose is to maintain homeostasis and balance within systems around the body. This means that the endocannabinoid system needs to be able to upregulate and downregulate certain neurotransmitters within the systems that are being activated. Because the goal of cannabinoid medicine is to help the body find and maintain homeostasis again, when THC is used in too high a dose, it can actually start inducing the symptoms that you’re trying to alleviate.
The therapeutic window
A therapeutic window is the drug dose needed to maintain the benefits and exposure of the medicine that’s effective but avoids any adverse events (AEs). In this case, an AE would be increasing anxiety rather than lowering it.
Everyone has their own therapeutic window where THC is effective. Some people have a very narrow therapeutic window and this means that they’re more prone to getting unwanted side effects with a lower dosage. Some people have a really large therapeutic window. So this means that they could use higher doses of THC and not get an increase in paranoia or any anxiety.
Dosages and your therapeutic window
Even if you have a narrow therapeutic window, THC may still be beneficial in treating your mental health related condition or their anxiety. It just means that when initiating treatment with a THC formulation, you need to start at extremely small. Dr. Jim says:
“We need to start extremely small, pretty much micro doses. And, the treatment needs to be done in a very intentional sort of manner. So people need to be very aware of how the THC is making them feel.
In the early phase of using a THC formulation, it’s really beneficial to do a sensitization protocol. This sensitization protocol involves using very small, barely perceptible doses for the first four days. What this often does is, instead of overwhelming the endocannabinoid system, it stimulates the endocannabinoid system and it often broadens the therapeutic window for that person.
The result is that the individual may have a broader range of dosing where THC and cannabis medicines are effective for treating their conditions.”
Without taking a low and slow approach in the early stages of treatment with cannabis medicines, you may get a worsening of symptoms. Too high a dose can cause paranoia, agitation, restlessness, and actually make you feel a lot worse. This can and does put people off using cannabis medicines. This can also happen with other medications, however formalised dosages make it less likely to happen.
Dr. Jim also makes the important observation that, “It’s important to have proper guidance when using such a powerful medicine because of the potential for it to have such wide-ranging effects, and because it’s tapping into a really powerful system within the body that is so important for maintaining balance and homeostasis. Cannabis can affect a lot of different body systems.”
So, does medical cannabis cause anxiety?
Medical cannabis may cause anxiety if not administered properly. Cannabidiol (CBD) is relatively safe for anxiety, however, at very high doses it may increase anxiety.
Tetrahydrocannabinol (THC) is more likely to give you anxiety at a lower dosage and therefore must be monitored very carefully when first starting treatment. Microdosing and a low and slow approach reduce the likelihood of increased anxiety from cannabis medicines.
CBD is a very safe and potentially effective cannabinoid for anxiety. THC can also be used by people with anxiety and it can improve symptoms.
THC however, needs to be used with a lot of caution. It needs to be done in a very intentional, individualised and slow titration to get to that right dose. Otherwise, cannabis can increase anxiety rather than lower it.
CBD oil and all other forms of cannabis are only legal with a prescription in Australia. If you’re interested in buying cannabis for anxiety speak to your GP or a cannabis specialist.
We hope you found this helpful. If you have cannabis questions, please don’t hesitate to ask us a question. If you know someone that this might help, please feel free to share this article. Thanks to Dr. Jim for taking the time to share his wealth of knowledge with the honahlee community.
Can Full-Spectrum CBD Cause Anxiety?
In short: yes, full-spectrum CBD can cause anxiety in some susceptible individuals. Although research has shown that pure cannabidiol (CBD) can relieve anxiety, this isn’t necessarily true for full-spectrum CBD.
If you’re sensitive to THC due to certain risk factors, you can get more anxiety or even a panic attack from taking a large enough dose of a full-spectrum CBD product.
Read on to learn how full-spectrum CBD can cause anxiety and what you can do about it.
Table of Contents
Research on CBD and Anxiety
Unlike its cousin THC, CBD can’t cause anxiety or any other mind-altering effects. On the contrary, multiple human studies have demonstrated that pure CBD can relieve various types of anxiety:
- In a 2011 Brazilian study, CBD capsules improved anxiety caused by public speaking in people with social anxiety disorder (SAD) (1)
- In a similar 2019 Japanese study, pure CBD oil improved anxiety in teenagers with SAD and avoidant personality disorder (2)
- In another 2019 study done in Colorado, CBD capsules improved anxiety scores in almost 80% of the study participants (3)
- The researchers of a 2020 review paper concluded that “CBD has a promising role as alternative therapy in the management of anxiety disorders” which include generalized anxiety disorder (GAD), SAD, and post-traumatic stress disorder (PTSD) (4)
Why Full-Spectrum CBD Can Cause Anxiety
If pure CBD has been shown to relieve anxiety, then why is full-spectrum CBD different?
It’s because full-spectrum CBD is a whole-plant hemp extract. Since hemp is a variety of cannabis that contains small amounts (0.3% or less) of THC, this means full-spectrum CBD can have THC.
THC is the main compound responsible for the cannabis high. Its potential side effects include increased anxiety, paranoia, and panic attacks.
There’s some evidence that THC has a biphasic effect on anxiety, meaning that low doses can reduce anxiety, while higher ones can make it worse (5). On top of that, multiple factors can influence how you respond to THC.
According to research, some people have a higher chance of getting anxiety from THC due to: (6)
- Personality traits
- Infrequent use
- History of previous anxiety reactions
- Presence of anxiety disorders or symptoms
- Basal anxiety levels
- Being female
- The environment and the context in which the THC is consumed
This means that for a minority of people, ingesting even small amounts of THC — such as the kind found in full-spectrum CBD products — can actually cause anxiety, panic attacks, and related side effects.
How Much THC is in Full-Spectrum CBD Products?
Full-spectrum CBD products can legally contain up to 0.3% THC, so roughly speaking, a full-spectrum CBD oil can contain as much as 3 milligrams (mg) of THC per one milliliter (ml) of liquid.
For example, here’s a third-party lab report of a high-quality full-spectrum CBD oil showing that the THC content is about 1.6 mg/ml of oil or about 0.17% (a bit below the 0.3% legal cutoff for hemp).
With this in mind, we can estimate that 1 ml (one full dropper in most cases) of your average full-spectrum CBD oil will contain 1-3 mg of THC. Even if you were to take two full droppers, this would only add up to 2-6 mg. This doesn’t seem like much, and for most people, it isn’t.
But for individuals who are highly sensitive to THC due to the risk factors we discussed earlier, this can be enough to cause or worsen anxiety.
My Experience With Anxiety From Full-Spectrum CBD
I’ve personally experienced an uncomfortable high and anxiety that lasted for 3 hours after taking roughly 80 mg of full-spectrum CBD oil. If I had to estimate, it contained about 3-4 mg of THC.
At first, I was surprised because full-spectrum CBD products had always relieved anxiety for me.
But after doing some research, it made total sense. I’ve smoked cannabis in the past and stopped using it after I began to get anxiety even from a few puffs. I also found many other reports of people who experienced anxiety and even panic attacks from full-spectrum CBD products.
Like other susceptible individuals, I’m so sensitive to THC that even the small amount present in full-spectrum CBD can make me feel anxious.
Using Full-Spectrum CBD for the First Time? Start Low
If you plan on using a full-spectrum CBD product and think it might make you anxious (especially if you have existing anxiety issues), be sure to follow the “start low and go slow” approach to cannabinoids recommended by clinical researchers (7).
Start with a small 5-10 mg dose of CBD and wait for two hours to see the effects. If you don’t notice anything, you can try a higher dose, again stopping for two hours to see if you notice any difference.
Use this method to find the full-spectrum CBD dose that provides you with anxiety relief or whichever benefit you’re looking for.
Alternatives to Full-Spectrum CBD
If you’ve already experienced anxiety from full-spectrum CBD products, you have four options.
First, you can simply lower your dose. In my case, I found that as long as I kept my full-spectrum CBD oil doses below about 70 mg, I still got the calming effects and none of the anxiety.
Another option is to switch to a different brand. After trying various full-spectrum CBD oils I’ve noticed more pronounced THC-related effects from certain brands.
These two choices are ideal because full-spectrum CBD provides the greatest benefits thanks to the “entourage effect” produced by all of the cannabinoids, terpenes, and other active compounds working in synergy (8). So even though THC is the issue, it’s nice to have a little bit for that extra boost to the entourage effect.
But if you want to play things safe, you can also go with broad-spectrum CBD products. This type of extract contains the same ingredients as full-spectrum CBD but removes THC (undetectable traces might remain). This way, you can maximize the entourage effect while avoiding THC.
The last option is to use CBD isolate products, which contain only pure CBD and nothing else. But this isn’t ideal since you won’t be getting the synergistic benefits of all the other cannabinoids and terpenes found in full and broad-spectrum CBD.
Pure CBD can’t cause anxiety because it’s a non-intoxicating compound that has anxiety-relieving effects. However, full-spectrum CBD can potentially cause or worsen anxiety symptoms, depending on your sensitivity to THC.
While most people will be fine, some are so sensitive to THC that even a small amount is enough to trigger anxiety.
That’s why you should always check the third-party lab test reports (called Certificates of Analysis) to see the precise levels of THC in your product.
Keep in mind that although THC comes in two forms, delta-9 and delta-8, we’re mostly concerned about delta-9 because delta-8 is less psychoactive and naturally found in much smaller quantities (unless you’re using delta-8 products).
An example of a third-party Certificate of Analysis (CoA) showing that a full-spectrum CBD oil contains 1.6 mg of THC per ml.
There’s little regulation in the CBD industry, so it’s common for products to contain more or less CBD, THC, and other cannabinoids than advertised on the label.
You should never buy CBD from companies that fail to provide third-party test reports since they help you confirm that the CBD and THC levels are accurate and you’re getting your money’s worth.
Besides, these tests can also verify that there are no contaminants such as pesticides and heavy metals.
Gleb is a freelance writer from Vancouver, Canada specializing in CBD and cannabis. He’s read thousands of studies on CBD and other supplements, helping him translate complex science into plain language. Gleb has tried and reviewed dozens of CBD brands and products, written third-party testing reports, and knows the CBD industry inside and out. When not writing, he likes to kickbox, travel, and tell everyone how awesome intermittent fasting is.