Can CBD Help with Anxiety?
Learn how medical cannabis can help calm the body and manage the symptoms of anxiety.
What does CBD do?
Short for cannabidiol, CBD is one of two major cannabis plant compounds called cannabinoids. The other major cannabinoid is THC, or tetrahydrocannabinol, which is known for causing feelings of euphoria, or a “high”. Both CBD and THC activate specialized receptors found throughout the body that make up a vast internal network called the endocannabinoid system, or ECS. The function of the ECS is to regulate states such as sleep cycles, mood and emotion, muscle motor function, pain perception, and inflammation. CBD’s unique molecular shape and structure can activate receptors within the ECS because it mimics a chemical the body itself produces: an endocannabinoid called 2-AG. It’s presumed that by stimulating these bodily receptors, CBD sends the ECS into action, which then addresses physical or neurological imbalances.
CBD versus THC
CBD has a different chemical shape and structure than THC and therefore activates different receptors in the body. While THC stimulates the receptors responsible for feelings of euphoria, CBD does not and is thus considered non-intoxicating. However, CBD does have an effect on the brain, and some consumers use it to manage the symptoms of a wide range of conditions including inflammation, seizures, migraines, and anxiety.
What is anxiety?
Anxiety is a natural response to danger, or the threat of danger, and is felt by everyone from time to time. When a potential threat is picked up, often without conscious thought, a signal is sent to the amygdala, the part of the brain that controls emotions. If the perceived danger is imminent, the amygdala sends distress signals to the hypothalamus, which is also called the brain’s command centre. The hypothalamus then tells the nervous system that it’s time to fight, or flee. Sensations that accompany anxiety can include:
Shaking or trembling
Shortness of breath
Chills or hot flashes
Fear of dying
While this rapid response system can be helpful when there is imminent danger, an estimated one in 10 Canadians experience fear and anxiety that is out of proportion to a given situation or perceived situation (e.g. feeling trapped in a long lineup). This enlarged sense of fear, especially when it impacts how one thinks, feels, and acts on a regular basis, is called an anxiety disorder.
How do I know if I have an anxiety disorder?
If you feel like your anxiety is affecting your everyday life, speak to a healthcare provider or we can help connect you with one. Make a note of your symptoms, when they happen, how intense the physical or cognitive sensations become, and how these symptoms affect your daily life, i.e. your work, studies, social life, and managing daily tasks, such as groceries or laundry.
How can CBD ease symptoms of anxiety?
There is a dense collection of cannabinoid receptors in the amygdala, hippocampus, and anterior cingulate—another part of the brain responsible for emotion and impulse control. When a threat message is received in the brain and the hypothalamus takes control, it specifically activates the sympathetic nervous system—a fast-acting cascade of responses that trigger fight-or-flight reactions. The parasympathetic nervous system, on the other hand, acts as a brake pedal once a perceived threat has passed by slowing down our body’s threat response. CBD stimulates cannabinoid receptors that in turn help to activate the parasympathetic nervous system, reducing the flight-or-fight response while under stress and maintaining a state of calm under less stressful conditions.
Can CBD manage anxiety attacks?
Anxiety attacks, also called panic attacks, are sudden, intense episodes of anxiety and its related symptoms. Anxiety attacks can happen without warning and without an apparent cause. CBD activates the parasympathetic nervous system, which helps to slow down the body’s stress response. As such, there is some early evidence that it may help manage the symptoms of intense, in-the-moment anxiety.
What is the right CBD dosage?
The right amount of CBD for you depends on the symptoms you’re trying to manage, combined with your body’s unique needs. Sometimes, but not always, high-CBD cannabis medicine can include a small amount of THC. The entourage effect is a theory that suggests cannabis works better as a whole with all its cannabinoids intact, rather than just one chemical compound in isolation. In other words, CBD works better when THC is present, in addition to other chemical compounds such as terpenes and even flavonoids. Interestingly, CBD can also block THC at the receptor site, inhibiting feelings of euphoria or a “high”. For this reason, a small ratio of THC is often well tolerated without uncomfortable side effects. Depending on your needs, your healthcare provider may even suggest CBD medicine with a higher ratio of THC to aid in sleep, or for pain management.
It’s worth noting that cannabis medicine has a biphasic or bidirectional effect, which means a high dose isn’t necessarily better at easing symptoms than a low dose. In fact, a higher dose of cannabis may even have the opposite effect of a lower dose. Speak to a healthcare provider to find the right amount of CBD to manage your health.
Doesn’t THC make anxiety worse?
It can, depending on how your body reacts to THC, especially at higher doses. However, healthcare professionals will help you avoid potential negative side-effects from THC with the correct products, dosing and titration schedules to manage your symptoms.
How will I feel after taking CBD?
Feelings of euphoria do not accompany CBD, although there is an effect felt in the body. Sometimes called a “body high”, the feeling can be overall relaxation, improved mood, and a calm mind. Most people can still work and be functional throughout the day, although driving or operating machinery should be avoided.
How do I consume CBD?
There are multiple CBD delivery methods to choose from:
Inhalation: Dried flower heated in a vaporizer, or a vape extract pen, delivers CBD directly into the lungs where it then enters the bloodstream. CBD circulates the body within minutes, and is metabolized within a few hours. In other words, inhalation acts quickly.
Edibles: Commonly available in candies, chocolates, teas, and dissolvable powders, CBD edibles pass through the intestinal tract and are metabolized in the liver before entering the bloodstream. It takes one to two hours for CBD to be metabolized, but then it stays in the body about six to nine hours.
Oils: Easy to incorporate with food or ingest on their own, CBD oils are made from cannabis extracts that are blended with plant-based or vegetable-based oils such as olive, grape seed, or MCT (medium-chain triglyceride) oil derived from coconut, palm, or a combination of the two. You can simply swallow CBD oil, which will pass through the intestinal tract like an edible, or the oil can also be held under the tongue for a minute where mucous membranes may absorb some of the CBD into sublingual blood vessels. CBD oil sprays are also intended to target mucous membranes within the mouth to absorb CBD directly before it reaches the digestive tract. Oral absorption can take anywhere from 15 minutes to over an hour, but it remains in the bloodstream like an edible, six to nine hours.
Softgels: Also called capsules or pills, softgels are a convenient way to consume CBD and they help you know exactly how much you’re ingesting. They’re made from CBD extract housed within a soft gel or hardened shell, just like other prescription or over-the-counter pills. CBD softgels also remain in the bloodstream six to nine hours.
Topicals: Available in products such as creams or transdermal patches, topical cannabis is typically used to help with localized joint, muscle, or skin conditions. When cannabinoid receptors in the skin are activated by topicals, they work to desensitize tissue injury or inflammation and reduce inflammation. CBD crosses the skin barrier more efficiently than THC, meaning the body will naturally absorb more CBD in a product containing both cannabinoids. Topical creams are considered non-intoxicating, however, transdermal patches may enter the bloodstream.
How is CBD oil extracted?
Cannabis oil is made from extracting CBD from the leaves and flowers of the cannabis plant and turning it into a concentrated form. CBD can be extracted a few different ways, although the type of extraction method can produce variations in terpenes and cannabinoids. Here are the most commonly used methods:
Supercritical CO2 extraction: This method is used in many food applications, such as removing caffeine from coffee beans. A specialized machine places carbon dioxide under extreme pressure until it reaches a “supercritical” stage, forming a liquid-like state. This liquid is then used to extract cannabinoids and other cannabis compounds, such as terpenes, at temperatures low enough to keep these delicate components activated. This process leaves behind a clean end product without any harmful solvents. Some manufacturers further refine the extract to remove things like plant waxes that can separate in the end product. Because supercritical CO2 is non-combustible it’s considered the safest way to make extracts. Add to that a clean end product with no toxic substances, and the ability to fine-tune this method to capture specific cannabinoids and terpenes, supercritical CO2 extraction is thought to be the optimal method overall.
Hydrocarbon extraction: This method uses butane or a butane-propane blend to remove cannabinoids from cannabis. Similar to CO2 extraction, butane gas is changed into a liquid before it’s used to extract cannabis compounds from the plant. This method also uses very low temperatures which keep cannabinoids and terpenes intact; however, it does require extra steps to remove residual solvents. Butane is also highly flammable, posing a risk to manufacturers and processors. However, this method is said to solubilize a wide spectrum of cannabinoids and even the most delicate terpenes, resulting in an extract that’s very close to the original cannabis flower, minus the chlorophyll.
Ethanol extraction: A relatively low-tech method, ethanol (an alcohol made from corn or wheat) is mixed with cannabis then stored in a cool, dark place for several weeks. Some methods freeze the mixture to extract specific terpenes and cannabinoids, which also helps remove waxes and fats that can separate in the finished CBD oil product and end up in the bottom of a bottle. The mixture is then strained of plant materials before the remaining infused alcohol is placed under low-pressure evaporation. The result is pure cannabis oil. Unlike the above methods that produce a clear oil, this process keeps chlorophyll intact which gives the end product a dark green colour. While not all terpenes are lost in the evaporation process, the consensus is that ethanol extraction strips the end product of most of these delicate compounds.
Is hemp-seed oil the same as CBD oil?
Hemp-seed oil is not the same as cannabis oil. It’s made from pressing the grains of hemp plants. It does not contain CBD extract. Hemp-seed oil falls under the same classification as any commercial oil, such as canola, and is used in products such as food or cosmetics.
What are the side effects of CBD?
Although considered non-intoxicating, CBD does affect the body and brain. Side effects noted with CBD use include nausea, fatigue, and irritability. It can also interact with some medications, particularly blood thinners and also some antidepressants and pain medications. Always consult with a healthcare provider before starting any cannabis medicine.
How can I get a CBD prescription?
You can obtain a cannabis prescription, called a medical document, from any licensed physician or nurse practitioner in Canada. The first step is a meeting with a healthcare practitioner, either in-person or online, to determine if cannabis is right for you. The physician or nurse practitioner then signs a document to authorize the patient to purchase cannabis, much like a prescription. This document grants patients access to medical cannabis products from Licensed Producers, and from us. Learn how we can help you get a medical document to start your cannabis therapy, or call our Shoppers Cannabis Care team at 1-844-633-2627 Monday to Friday 9 a.m. to 9 p.m. EST, or Sunday 9 a.m. to 5 p.m. EST.