The cannabis plant has been utilized for medicinal purposes for thousands of years. The plant contains more than 80 different compounds, which are known as cannabinoids. While tetrahydrocannabinol (THC) is the most abundant and is well-known for its psychoactive properties, the second-most found compound, cannabidiol (CBD) does not have psychoactive effects.
There has been a growing interest in the potential mental health benefits of CBD in recent years. A 2019 research letter published by JAMA Network Open reported a significant increase in Internet searches for CBD in the United States. While search rates remained steady between 2004 and 2014, there was a 125.9% increase between 2016 and 2017. In April 2019 alone, there were 6.4 million Google searches for CBD information.
While there have been a number of studies suggesting that CBD might mental health benefits, a recent comprehensive review found that support for this use was scant and that further investigation is needed to substantiate the purported benefits.
There are a number of conditions that CBD is purported to help, although more research is needed to determine the potential effects and benefits of CBD. Some of the existing studies suggest that CBD holds promise in the treatment of a number of conditions including depression, anxiety, epilepsy, and sleep issues, among other things.
CBD appears to have a range of benefits for neurologic disorders, including decreasing the frequency and severity of seizures. Some of these conditions, such as Dravet syndrome and Lennox-Gastaut syndrome (LGS), may not respond well to anti-seizure medications. Viral clips of CBD treatments effectively alleviating seizures were shared widely in social media in recent years, and research has supported the effectiveness of these treatments.
A large-scale study on the use of CBD in the treatment of pediatric epilepsy found that CBD reduced the frequency of seizures by more than 50% in 43% of the patients with Dravet syndrome. The Food and Drug Administration (FDA) recently approved a cannabis-derived medication containing CBD, Epidiolex, to treat certain childhood seizure disorders.
Anxiety is a common problem for many people. Anxiety disorders affect an estimated 19.1% of U.S. adults each year. Some studies suggest that CBD may help alleviate symptoms of anxiety. One study look at the possible neural basis for CBD reducing symptoms of social anxiety disorder.
A 2015 study published in the journal Neurotherapeutics analyzed the existing preclinical studies on the use of CBD for anxiety and found that CBD was effective for a number of anxiety conditions including:
However, the authors of the study note that while the substance has considerable potential, further research is needed to better determine the therapeutic benefits and long-term effects.
According to the National Institute of Mental Health, depression is one of the most common mental disorders in the U.S., affecting an estimated 17.3 million adults each year. Effective treatments are available, which include psychotherapy and medication, although interest in complementary and alternative treatments has also grown in recent years.
CBD has been investigated for having potential antidepressant effects. Some antidepressants work by acting on serotonin receptors in the brain. Low serotonin levels may play a role in the development of depression, and animal studies suggest that CBD might have an impact on these receptors which may produce antidepressant effects.
A 2018 study found that the antidepressant-like effects that CBD produces depend upon the serotonin levels in the brain. Cannabidiol does not appear to increase serotonin levels but instead affects how the brain responds to serotonin that is already present in your body.
Because CBD may have a calming effect, it may also hold promise in treating sleeping difficulties. Sleep is a critical component of mental health and well-being, yet the Centers for Disease Control and Prevention (CDC) reports that a third of U.S. adults do not get the recommended amount of sleep each night. This is problematic since not getting enough sleep is linked to health conditions such as depression, type 2 diabetes, obesity, and heart disease.
One study conducted with adults who had symptoms of anxiety and poor sleep found that 65% experienced improvements in sleep quality scores after a month of taking an average of 25mg of CBD daily, although those scores fluctuated over time. Further research is needed to determine the possible effects of CBD on sleep.
Post-Traumatic Stress Disorder (PTSD)
PTSD affects approximately 6.1% of U.S. adults. It is characterized by symptoms including re-experiencing traumatic events, intrusive thoughts, nightmares, and avoidance of things that may trigger memories of the trauma.
Some research suggests that CBD may be helpful in reducing the symptoms of this condition. In one study published in the Journal of Alternative and Complementary Medicine, researchers found that an oral dose of CBD in addition to routine psychiatric treatment for PTSD was associated with a reduction in symptoms.
Should You Try CBD?
While CBD holds promise, a recent comprehensive review of the research suggests that support for the mental health uses of CBD remains insufficient. This 2019 study was published in The Lancet Psychiatry and looked at 83 studies on the use of CBD to treat mental illness.
The researchers looked specifically at six different disorders: depressive disorders, anxiety disorders, attention-deficit hyperactivity disorder, Tourette syndrome, post-traumatic stress disorder, and psychosis. The review examined previous studies dating from 1980 through 2018.
The review concluded that there is not enough evidence to support the use of CBD in the treatment of mental health conditions.
The study did find that pharmaceutical TCH (either with or without CBD) was linked to small improvements in symptoms of anxiety among people with other medical conditions such as chronic pain and MS, although this evidence was considered low-quality.
This does not mean that CBD isn’t necessarily effective; of the studies reviewed, most only included a small number of participants, followed participants for a short period of time, and less than half were randomized controlled trials.
Instead, this study suggests that there simply isn’t yet enough high-quality evidence to support the use of CBD to treat mental conditions. This may change in the future as more research is carried out.
Many experts remain optimistic that CBD may prove useful for a range of mental health conditions. “CBD has shown therapeutic efficacy in a range of animal models of anxiety and stress, reducing both behavioral and physiological (e.g., heart rate) measures of stress and anxiety,” suggested Nora D. Volkow, the Director of the National Institute of Drug Abuse in testimony presented to the Senate Caucus on International Narcotics Control.
CBD is available in a number of different forms and products. Cannabidiol can be extracted from both hemp and marijuana plants, which differ in terms of how much CBD and THC can be extracted.
CBD from hemp plants contains only small amounts of THC that are not sufficient to produce subjective psychoactive effects. CBD produced from marijuana plants, however, may contain varying amounts of THC which can produce unwanted effects.
There are also three main types of CBD available.
- Isolate contains only CBD
- Full-spectrum contains other compounds found in the cannabis plant, including THC
- Broad-spectrum contains other compounds from the cannabis plant but not THC
People may choose to take a full-spectrum product because research has shown that when cannabinoids including THC and CBD are taken together, it magnifies the therapeutic impact, a phenomenon known as the entourage effect. Research also suggests that CBD can actually counteract the negative effects caused by THC.
Like full-spectrum CBD, products labeled as broad-spectrum contain multiple cannabinoids, which are purported to provide the therapeutic benefits of the entourage effect without the psychoactive effects of THC.
Some of the ways that CBD can be used include:
- Oral: This includes oils (which are made by infusing cannabidiol with a carrier oil), oil tinctures (which are produced by combining CBD with alcohol or water), sprays, and capsules.
- Topical: This includes salves or lotions that are applied to the skin
- Edibles: This can include candies, gummies, and beverages.
- Inhaled: Some CBD oils are specially formulated to be used as vaping oil, although there has been an increase in concern about the health dangers posed by vaping.
Topical solutions may produce localized effects, but only those taken by mouth are likely to produce any mental health effects. It is important to note that while there is a wide variety of these products available on the market, the FDA has not approved any over-the-counter (OTC) CBD product. Many of these products may vary in terms of what they contain, their potency, and their effectiveness.
It is also important to note that while hemp-derived CBD that contains less than 0.3% THC is legal by federal law, it is still illegal in some states. You should always check your state laws before purchasing a CBD product.
Possible Side Effects
While CBD may have some benefits, it is also important to consider some of the possible risks. Research suggests that CBD appears to be well-tolerated at doses up to 600mg.
While CBD appears to be well-tolerated, that does not mean that it is without side effects. While these may vary depending on the individual, some reported side effects include:
- Mood changes
- Appetite changes
However, understanding the potential side effects is difficult because of the absence of regulation and manufacturing guidelines, which means that there is a lack of consistency in terms of purity and labeling. In other words, it is difficult to determine if the side effects are the same across different products, formulations, and dosages because it is often difficult to determine exactly what is in the products that are currently on the market.
It is important to talk to your doctor if you are thinking about taking CBD products. This is particularly true if you have an existing medical or psychiatric condition, or if you are currently taking any medications or supplements.
CBD may potentially have an effect on your condition or may interact with a medication that you are taking. For example, CBD can sometimes worsen symptoms of anxiety. CBD can also interfere with the metabolism of certain medications, which may change how your medications affect your body.
Some other concerns to consider before taking CBD:
- Drug testing: There have been reports of people failing drug tests after using CBD products that are labeled as containing no THC. While most CBD products contain only trace amounts of THC, there is still the possibility that these products may produce a positive result on a drug test. It is also important to remember that full-spectrum CBD products do contain varying amounts of THC.
- Mislabeling: Labeling accuracy also appears to be a common problem. One study found that almost 70% of CBD products sold online were mislabeled and contained significant amounts of THC. This can be problematic if you are taking CBD to address a mental health condition such as anxiety, since THC may have unwanted psychoactive effects. Mislabeling may also lead to positive drug test results, especially if the product contains more THC than it claims.
- Other possible risks: Finally, it is important to remember that researchers still do not know all the possible risks or benefits of taking CBD. More research is needed to learn about the mental and physical long-term effects of CBD, so you should always use caution and consult your doctor before using it.
A Word From Verywell
If you are experiencing the symptoms of a mental health condition, you should talk to a doctor or mental health professional. Self-medicating with CBD or other supplements can lead to delays in treatment, which may cause your symptoms to worsen. CBD also has the potential to aggravate some symptoms such as anxiety, sleep problems, and psychosis.
If you are still interested in trying CBD as an addition to your regular treatment, work with a healthcare provider who can help monitor your symptoms. Your doctor may recommend a product and dosage that is appropriate based on your symptoms and any medications you are taking. Always be sure to watch out for any potential negative side effects and be sure to talk to your doctor before you stop taking CBD.