‘Without our health, we are nothing’, people often say. But without mental well-being, we can’t even enjoy the physical health we have been blessed with. And with current statistics estimating 1 in 4 people will be affected by a mental health issue at some point in their life, it is more important than ever to find new treatments that care for our mental wellness. That’s why there’s much excitement in the research community as scientists make new discoveries about the therapeutic uses of CBD for mental health conditions as varied as depression, anxiety, psychosis, and PTSD.
What is CBD?
CBD, or Cannabidiol, is a type of compound known as a cannabinoid found only in the cannabis plant. While many people will have heard of THC - the cannabinoid that causes the stoned or high feeling - CBD is getting global column inches due to its non-psychoactive nature and reported therapeutic benefits. Right now, there are 70 studies on humans investigating CBD as a potential drug for conditions as varied as epilepsy, inflammatory bowel disease, fatty liver disease, and even as a treatment for substance abuse. Amongst this research, mental health conditions like anxiety, depression, PTSD, and addiction feature highly.
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Why does CBD help our mental health?
Compared to its cannabinoid cousin THC, research into CBD is in its infancy. In the past, due to CBD’s lack of psychoactivity, scientists thought it rather benign and lacking in therapeutic potential. This was also partly because there was no obvious interaction between CBD and the body’s endocannabinoid system, our own innate network of cannabinoid receptors and cannabis-like chemicals called endocannabinoids.
THC causes its psychoactive effect by activating the endocannabinoid receptors, in particular those found in the central nervous system and brain. But CBD, despite being a cannabinoid, doesn’t activate our endocannabinoid receptors. However, that doesn’t mean it has no effect on our bodies. Anecdotal evidence and scientific research have found that CBD causes an anti-anxiety effect in both animals and humans. They have also observed that the cannabinoid activates the 5-HT1A serotonin receptor, which is involved with regulating mood and anxiety levels - the conclusion being that the anti-anxiety effect and 5-HT1A activation are directly linked.
Scientists have also noted in experiments on rodents that CBD administration creates neurogenesis - the birth of new brain cells in the hippocampus region of the brain, which is key to mental well-being.
That is not to say that CBD’s mood balancing effect has nothing to do with our endocannabinoid system. It was while studying CBD’s effect on psychosis that scientists noted a link between CBD administration, an improvement in the subjects’ symptoms and higher levels of anandamide in their spinal fluid.
Anandamide, a type of endocannabinoid, is intrinsically linked to feelings of happiness. In fact, scientists took inspiration for its name from the Sanskrit word Ananda, which means joy or bliss.
The study’s researchers asked themselves, if CBD doesn’t activate the endocannabinoid receptors, how come there were higher levels of anandamide after it was given to patients? They realised that CBD inhibits the production of an enzyme called Fatty Acid Amide Hydrolase (FAAH), which breaks down anandamide in the body. So in effect, by blocking FAAH, CBD allows for anandamide to last longer, which in turn strengthens our endocannabinoid system.
And why might a strong endocannabinoid system be so important to our mental health? That’s because increasingly, scientists are seeing a link between mental disorders, such as depression, and dysregulated endocannabinoid signalling. Many believe that finding pharmacological ways to balance the endocannabinoid system could provide a novel therapeutic approach for the future.
So let’s take a look at the current areas of mental health research where CBD is being explored.
1. CBD for Anxiety
Stress and anxiety are intrinsically linked. Most would agree that our modern way of life, whereby we work and play hard and are constantly striving towards unattainable goals, is creating anxiety at almost epidemic levels.
Not only is anxiety unpleasant to experience, but it also has knock on effects on our health, such as high blood pressure, migraines, digestive issues, and sleep disorders. While no simple pill or potion is the answer and anyone suffering from anxiety should try and get some professional, psychological support, CBD is showing promise at easing symptoms of anxiety, such as shortness of breath, racing thoughts, and sweaty palms.
Most research has been conducted on subjects suffering from social anxiety, one of the most common anxiety conditions. In one study, CBD was given before a simulated public speaking test with the subjects noting reduced anxiety, better cognitive function and less discomfort compared to the placebo group.
With CBD showing such promising results for anxiety sufferers, it’s surprising that it has taken so long for further clinical trials to take place. However, a two stage clinical trial is in its initial pre-recruitment stage at Mclean Hospital in Massachusetts, testing the efficacy of a high CBD oil (22:1 CBD: THC) on patients with anxiety.
2. CBD and Depression
Like anxiety, depression is mental disorder on the rise. The two often go hand in hand and patients can find themselves on a cocktail of mood-stabilizing, antidepressant drugs.
So far, there are few human trials looking into CBD and depression, although the compound’s activation of the 5-HT1A serotonin receptor makes it a therapeutic target with exciting potential, something that has shown promising results in animal studies. One preclinical trial which examined the effect of CBD on the ability of rats with depression-like symptoms to experience pleasure, found “that CBD may be beneficial for the treatment of clinical depression.” Another study concluded that “CBD could represent a novel fast antidepressant drug, via enhancing both serotonergic and glutamate cortical signalling through a 5-HT1A receptor-dependent mechanism.”
A clinical trial in Brazil testing CBD for depression in bipolar disorder is in the early stages of recruitment.
3. CBD for Psychosis
Psychosis, defined as “a severe mental disorder in which thoughts and emotions are so impaired that contact is lost with external reality,” is experienced in a range of mental disorders including schizophrenia, but also neurological conditions like Alzheimer’s, Parkinson’s and sometimes after brain injury.
Interestingly, psychosis is also linked to cannabis use in young adolescents, but researchers now realise that it is the high levels of THC which can be problematic in young, developing brains.
For many, it is then counterintuitive to think that a cannabis compound could have an antipsychotic effect. But that’s where you’d be wrong.
CBD is currently being investigated as an antipsychotic drug, particularly in schizophrenia. A recent clinical trial, in which subjects were given CBD alongside their existing antipsychotic medicine, found that after six weeks, their psychotic symptoms were lower compared to the placebo group. The subjects given CBD also showed improvements in cognitive and overall functioning.
4. CBD and PTSD
Post Traumatic Stress Disorder (PTSD), a condition in which sufferers relive traumatic events from their past again and again, is another potential therapeutic target for CBD. This makes sense, when we consider how the compound can reduce feelings of anxiety through its 5-HT1A serotonin receptor activation, something confirmed in a study on rats with long term behavioural consequences of predator stress. Scientists have also seen that CBD reduces activity in the amygdala, the area in the brain activated by fearful episodes. In animal studies the compound prevented the consolidation of fearful memories due to its inhibition of the FAAH enzyme and a resultant increase in anandamide levels.
A study on a 10-year-old survivor of sexual abuse found that CBD “resulted in a maintained decrease in anxiety and a steady improvement in the quality and quantity of the patient's sleep.”
A further two clinical trials are in the offing; one studying the effect of CBD on alcohol abuse disorder in patients with PTSD and another on army veterans comparing a high-CBD cannabis strain, a high-THC strain, 1:1 ratio THC/CBD, and a placebo.
6. CBD for OCD
Obsessive compulsive disorder (OCD) is a form of anxiety in which sufferers get caught up in a cycle of obsessions and compulsions, such as repetitive hand washing, constant checking or hoarding.
So far, research into CBD and OCD has only been on rats that show obsessive marble burying traits as a result of being injected with Meta-chlorophenyl-piperazine. Scientists already knew that activating the 5-HT1A serotonin receptor tended to reduce obsessive behaviour, so they decided to observe whether CBD would elicit a similar effect. Their suspicions were confirmed as the rats almost immediately stopped their obsessive burying and resumed normal behaviour.
A pilot research study run by the New York State Psychiatric Institute will compare the effects of high-CBD cannabis, high-THC cannabis and a placebo on subjects with OCD.
7. CBD and Addiction
Many people who have undergone some kind of trauma find themselves numbing the emotional pain through addiction to some kind of substance, such as tobacco, alcohol or drugs like cocaine, heroin or crack. Self-medicating through drugs or alcohol are also common in cases of bipolar disorder.
For many, it’s hard to imagine that a compound found in cannabis might help, but right now, CBD for addiction is a growing area of clinical study. In their research, scientists have found that CBD reduces the craving sensations experienced when someone is trying to come off a drug, such as heroin or tobacco. CBD’s anxiety reducing effect can also make quitting an addiction more manageable.
A clinical trial is currently underway investigating the effects of CBD on cocaine craving and relapse.
But perhaps the most surprising use of CBD for addiction is as a potential therapeutic tool to treat cannabis misuse disorder. Researchers have found that CBD can reduce the ‘wanting’ and ‘liking’ of cannabis-related stimuli, suggesting “that CBD has potential as a treatment for cannabis dependence.”
It seems that according to pending further research, CBD has the potential to treat a wide cross section of mental health disorders ranging from mild anxiety to serious conditions, such as psychosis.