Can CBD oil help anxiety?
Anxiety is something most of us will experience at some point in our lives, but when it becomes prolonged, persistent or out of proportion it can be extremely debilitating.
Anxiety is also one of the most common conditions for which CBD is taken – second only to pain – and there is a good deal of research supporting the idea that CBD can help with a variety of anxiety disorders.
CBD, or cannabidiol, is an extract of the hemp plant used by millions of people worldwide as a natural remedy for a wide range of ailments. It is taken either as an oil, dropped directly into the mouth or added to food and drink, or in capsules, chewable ‘gummies’, vaping liquids or topical creams.
CBD does not have the psychoactive properties associated with THC, the most common compound in cannabis, so won’t get you high. It’s also known for its relatively low level of serious side-effects, making it an attractive option for anxiety sufferers who have experienced the adverse effects and limited efficacy of some traditional anti-anxiety treatments.
What is anxiety?
Fear and anxiety are naturally evolved mechanisms that elicit physiological reactions, such as increased breathing and heart rate, designed to prepare us for intense situations. But when these reactions become persistent, excessive or associated with everyday situations they can be extremely difficult to live with and can even increase the risk of developing depression.
There are several recognised anxiety disorders:
- General Anxiety Disorder (GAD) – persistent and prolonged worrying about a range of subjects – or a generalised sense of panic – that can lead to a variety of chronic physical and mental symptoms
- Social Anxiety Disorder (SAD) – paralysing fear of social situations and judgement by others, including performance anxiety focused on areas such as public speaking
- Panic Disorder (PD) – characterised by panic attacks involving heart palpitations and difficulty breathing, as well as spontaneous feelings of fear or impending doom
- Post-Traumatic Stress Disorder (PTSD) – the result of a traumatic event. PTSD symptoms can begin immediately afterwards or only emerge years later
- Obsessive-Compulsive Disorder (OCD) – sufferers can experience a compulsion to perform repetitive rituals, such as hand-washing or counting, or can be plagued by the intrusion of unwanted and inappropriate thoughts
PTSD and OCD are no longer always classified as anxiety disorders but excessive anxiety is a central symptom of both. Phobias – fears of specific situations such as enclosed spaces or heights – are also a form of anxiety.
Evidence that CBD can help with anxiety
There is a large amount of research suggesting that CBD can help with a variety of anxiety disorders.
A 2015 review of 49 studies into the effectiveness of CBD in treating anxiety found that the combined evidence “strongly supports CBD as a treatment for generalized anxiety disorder, panic disorder, social anxiety disorder, obsessive-compulsive disorder, and post-traumatic stress disorder”.
Another review published in 2019 backed this up, concluding that “CBD has a promising role as alternative therapy in the management of anxiety disorders”. Meanwhile, a retrospective study of 72 psychiatric patients given CBD to treat anxiety and sleep disorders, found that anxiety symptoms decreased in almost 80% of subjects during the first month of usage.
Other studies have looked more closely at CBD’s impact on specific types of anxiety.
Social Anxiety Disorder (SAD)
Research conducted in Brazil treated patients suffering from Social Anxiety Disorder with 400mg of CBD. The subjects reported significant reductions in their anxiety levels. After using computer imagining techniques to examine changes in the patients’ brains, the researchers concluded that the results were related to CBD’s influence on the limbic and paralimbic systems, neural areas that deal with emotion and behaviour.
Studies have also suggested that CBD may help reduce anxiety related to stressful situations. In one experiment, nine subjects were asked to perform a simulated public speaking test. The study found that a 600mg dose of CBD helped reduce a stress-related increase in blood-pressure and concluded that the results may demonstrate the anti-anxiety effects of CBD. Another study of four groups of ten subjects undertaking a similar public speaking test also found that CBD decreased anxiety.
An assessment of a range of both human and animal studies on the effects of CBD on PTSD concluded that CBD “could offer therapeutic benefits for disorders related to inappropriate responses to traumatic memories”. It also noted that CBD’s relatively low level of serious side-effects compared with existing pharmacological treatments provided an added incentive for further research.
How does CBD oil work on anxiety?
One way in which CBD may work to reduce anxiety is via its relationship with the Endocannabinoid System (ECS). The ECS consists of two molecule types called endocannabinoids – andamide (AEA) and 2-arachidonoylglyerol (2-AG) – and two receptors, CB1 and CB2. When endocannabinoids bind with CB receptors, they send signals around the body that regulate a wide range of internal functions including mood and stress.
CBD is one of a number of chemical compounds, known as cannabinoids, found in cannabis and hemp plants. Cannabinoids are not the same as endocannabinoids, which are produced within the body, but they do interact with the Endocannabinoid System. It is thought that CBD may slow the breakdown of endocannabinoids that bind to the CB1 receptor, thereby prolonging their effect. This may explain some of the beneficial impacts CBD appears to have on conditions such as anxiety.
CBD also interacts with another receptor, 5-HT1. 5-HT1 is involved in the production of serotonin, a neurotransmitter known to help stabilise mood and maintain a sense of wellbeing, and has been identified in some studies as contributing to the anti-anxiety effects of CBD.
One of the things that makes CBD attractive as a natural remedy, and of continued interest to researchers looking for alternatives to some traditional medicines, is it’s relatively low level of serious side-effects. In clinical terms it is considered ‘well tolerated’, meaning that it is rare for research subjects to drop out of a CBD trial due to its side-effects. And one large-scale survey of CBD users in 2018 found that two-thirds reported no adverse effects at all.
However, there are some side-effects experienced by a proportion of CBD users. In the above mentioned survey, dry mouth was the most reported, by 11% of users. Other studies show fatigue or tiredness to be among the most common side-effects, while some sources suggest that CBD oil can sometimes cause nausea, diarrhoea, appetite changes or irritability.
If you are on medication or supplements you should talk to your doctor before taking CBD.
That's because CBD can inhibit enzymes that metabolise some drugs, potentially leading to unsafe levels in your system. One of the enzymes that CBD interacts with is also inhibited by the ingestion of grapefruit and some other citrus fruits, so you should check with your doctor before taking CBD if you use medication that comes with a 'grapefruit warning'. According to the US Food & Drugs Administration, these include some anti-anxiety drugs, including buspirone (brand name Buspar).
However, CBD also inhibits enzymes responsible for the breakdown of drugs that don't carry grapefruit warnings, which is why you should consult your doctor before using CBD if you're on any medication. Don't stop taking medication without your doctor's advice either.
How to use CBD oil for anxiety – products and methods
CBD is most commonly sold as a bottled oil in which the cannabinoid is mixed with a carrier oil such as hemp, olive or coconut. Most good brands have an integrated dropper in the lid so that measured doses of oil can be dropped directly into the mouth or into food or drinks.
The safest and most efficient way to take CBD oil is sublingually. Simply place the required number of drops under the tongue and hold them there for a minute or two before swallowing. This allows the CBD to be absorbed through the permeable membrane there and enter more directly into the bloodstream.
CBD oil can also be dropped straight into the mouth and swallowed, added to drinks such as coffees and smoothies, or drizzled onto food after cooking. However, when you ingest CBD oil there are a number of factors that can influence how much of it is eventually absorbed.
Digestion will always remove some of the CBD before it can reach the bloodstream, but the extent of this varies depending on what you've eaten, with high-fat foods thought to promote greater absorption. Some research also suggests that CBD may degrade in solutions heated to above 71°F, meaning hot drinks could affect how much of it is eventually available to your body.
As well as bottled oil, CBD comes in capsules, soft gels and chewable ‘gummie' sweets, creams that can be rubbed into the skin and e-liquids for use in a vaping device (although the safety of vaping itself is still in question so this may come with inherent dangers). See How long does CBD oil take to work? and What dosage of CBD oil should I take? for further things to consider when it comes to the different methods of taking CBD.
The speed with which CBD oil takes effect varies widely depending on how it is consumed. Inhaling CBD-based e-liquids directly into the lungs using a vaping device is the fastest method and could take just a matter of minutes. However, it may not be the safest.
Taking CBD oil sublingually – holding drops of oil under the tongue – is the next most efficient method, taking advantage of the high concentration of blood vessels and allowing the CBD to penetrate quickly into the bloodstream. It can take around 15 to 25 minutes for effects to be felt.
CBD oil that is swallowed – either as droplets, in food or drink or as capsules – will take longer to work, more likely measured in hours than minutes, but the length of the digestive process will depend on a number of factors including what has been eaten and how long ago. Chewable CBD gummies may allow for a degree of absorption through the mouth before they are swallowed.
There are also a whole range of factors relating to a person’s general body chemistry and current state that could influence how long it takes for them to feel any effects of CBD oil.
Age, weight, metabolism, body chemistry and the condition you want to treat can all have a bearing on what dosage of CBD you should take. And you should give particular consideration to how you take CBD, since different methods can make a huge difference to how much of the CBD is actually absorbed by your body (see How to use CBD oil for anxiety).
The best way to find the right dose for you is to first choose a trustworthy CBD oil – one like Jersey Hemp, whose products are tested by an independent laboratory – so that you can have confidence in how much CBD is actually in the product. Then start with a small dosage and work your way up gradually.
Begin with 5-10mg, try it for a few days and if there are no unwanted side-effects, continue by adding the same amount again. Repeat this process, perhaps keeping a diary to record how you feel each day, until you find the optimum amount for you.
Depending on the condition you are aiming to treat, you might also want to experiment with smaller amounts taken several times a day.
Here's how you can work out how many mg of CBD are in a single drop of oil.
You can use the Jersey Hemp CBD dosage calculator to give you an idea of the dosage that might work for you.
Main image by Free-Photos from Pixabay
The author of this article is not a medical expert and nothing in this article constitutes medical advice or gives rise to a medical practitioner/patient relationship. You should seek specialist medical advice where required. Never disregard professional medical advice or refrain from seeking it because of something you have read here.