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As I sit here writing this, the COVID-19 pandemic is challenging individuals around the world to question their values, traditions, and beliefs in the face of fear and massive, unprecedented social upheaval. If you suffer from a clinical anxiety disorder, this pervasive uncertainty about the future is probably not making your symptoms any better. The good news is, you are not alone; it is estimated that as many as 30% of Americans have been diagnosed with some type of clinical anxiety disorder.(1)

There are multiple types of anxiety disorders, including Generalized Anxiety Disorder, Panic Disorder, phobia-related disorders, and Obsessive Compulsive Disorder. Despite their differences, anxiety disorders overlap in their causes, symptoms and treatments.(2) Fortunately, there is clinical evidence to suggest that cannabis, in combination with traditional anxiety-management techniques, can be used to help manage symptoms and improve quality of life over the long-term. But before delving into the research behind cannabis and anxiety, it is important to first gain a basic understanding of what anxiety is and how it works.

What Causes Anxiety?

Anxiety is a sensation we experience as a result of the evolutionary mechanism known as the fight-or-flight response. When we encounter a threat—such as being faced alone in the woods with a Grizzly bear—our bodies respond physically to prepare us to either run away or attack in self-defense. Our cortisol levels spike; our muscles tense; our hearts race.(3) When the threat has dissipated, our bodies return to normal, completing the stress response cycle.

What happens, though, when we can neither run away nor fight back? We become locked in a permanent state of fight-or-flight mode.(4) Inability to complete the stress response cycle is a feature of anxiety disorders and can result from socialization, exposure to traumatic incidents, genetics, or various combinations of the three. Symptoms often include persistent worrying, restlessness, muscle tension, inability to concentrate, insomnia, panic attacks, and more—any of which can interfere significantly with daily activities and impair quality of life.(5)

Science-Backed Strategies for Reducing Anxiety—and How Cannabis Helps

There are a number of different strategies for reducing and managing anxiety, and most of them come down to setting and following routines that rewire existing thought patterns. By practicing science-backed stress reduction techniques, it is possible to reshape your ways of thinking so that the cognitive pathways contributing to your anxiety are replaced by those contributing to your well-being instead.

One of the best ways to change thought patterns, according to research, is by immersing oneself in a state of flow. Think about a time when you became so absorbed in an activity that you lost track of time; you became fully concentrated on the task at hand so that all other thoughts and worries evaporated. Dr. Csikszentmihalyi defines flow as a state that results from engaging in an activity that challenges the individual to cultivate a skill, making it intrinsically rewarding. Flow allows the individual to transcend self-consciousness and performance anxiety.(6) In other words, flow is living fully in the moment.

Medication, too, can be tremendously helpful for some individuals with anxiety, particularly if the biological structure of the brain is preventing them from putting in the work necessary to change their thought patterns.(7) That being said, you should always consult with a doctor before combining cannabis with other medications. While cannabis is not a cure for anxiety, it can work synergistically with proven stress-management techniques to heighten their overall impact.

If you are a runner, you are all too familiar with the runner’s high, or the warm, fuzzy feeling that causes you to forget the pain you have just endured and lace up again tomorrow. Exercise-induced euphoria is a classic example of flow. In addition to aerobic activity, other activities conducive to flow include mindfulness practice (meditation, yoga, grounding), creating art or music, having sex or sharing affection, and practicing bodily self-care (e.g., getting a massage). (8) (9) (10)

Interestingly, the biological state of flow is characterized by the release of anandamide, the body’s internally-produced equivalent to THC (tetrahydrocannabinol).(11) THC is a compound found in cannabis and, when consumed, is responsible for producing the mind-altering effects commonly associated with use of the plant. THC, CBD (cannabidiol), and hundreds of other cannabis compounds known as cannabinoids work synergistically with the stress-regulating systems of the body, suggesting that—with practice—cannabis may facilitate the formation of habits that are helpful for reducing the amount of anxiety in your life.

When using cannabis to manage anxiety, it is important to incorporate both THC and CBD into one’s regimen. Like THC, CBD is a cannabinoid, though it does not produce a high. Whereas THC mimics anandamide in its ability to induce flow, CBD has the unique ability to increase the amount of anandamide in the body, compounding its anxiety-reducing effects. (12) CBD also reduces cortisol levels, which are responsible for activation of the fight-or-flight stress response cycle. (13)

One similarity between THC and CBD is that both cannabinoids are linked to fear memory extinction,(14) meaning that exposure to situations linked with traumatic or stressful experiences do not invoke as intense of a reaction. For individuals dealing with panic disorders, the ability to reduce the intensity of a situation can sometimes be enough to allow you to stop, take a deep breath, and curb the cyclical thought storm that ultimately culminates into a full-blown panic attack. Cannabis reduces anxiety through a variety of mechanisms—many of which we have yet to understand—underscoring the importance of incorporating a full spectrum of naturally-occurring cannabis compounds (or at the very least, THC and CBD) in order to achieve the maximum therapeutic impact afforded by the plant.

The importance of dosing cannot be stressed enough when it comes to managing anxiety with cannabis. While the therapeutic benefits of THC and CBD are well-documented, these effects vary according to dose. Consuming a large dose of THC, for instance, may elicit an anxiety-producing effect due to its biphasic properties. (15) CBD can also produce different effects at high or low doses, though the threshold can be several times higher than that of THC. (16) Consequently, cannabis products with lower amounts of THC and higher amounts of CBD are typically recommended for those with anxiety. A low or beginner dose of THC typically ranges from one to three milligrams, (17) but every body reacts differently to cannabis; it will take conscious experimentation to find a dose that works best for you. Luckily, a licensed cannabis dispensary will have plenty of products available that meet these standards.

One misconception people have about cannabis is that it can fix all of your problems after one use. This is not true. Just as anxiety management techniques require practice to achieve results, cannabis must be used regularly to experience its long-term benefits. Tinctures are a versatile option for incorporating cannabis into your daily routine. A great product for this is Dr. Raw’s Focus formula tincture. With 20 parts CBD and 1 part THC, one dose does not produce a high, but it does impart the synergistic benefits of both THC and CBD. One of the added benefits of taking a high-CBD product in the morning includes boosting alertness and concentration, (18) allowing you to reach flow more easily and without feeling high. When using tinctures, you can let your dose absorb under your tongue, or put it in your coffee or breakfast.

By now, you probably recognize that simply knowing all of this information is not enough to reduce and manage anxiety. Regular practice is needed to alter thought patterns and yield long-term results. Luckily, cannabis is a wonderful supplement to assist you in taking these steps. In the next blog post on Managing Anxiety with Cannabis, I will discuss more ways of incorporating cannabis into your daily regimen and address how it can be helpful for managing other symptoms of anxiety, including insomnia, muscle tension, and panic attacks. Until then, remember to be kind to yourself, as it is normal to experience anxiety during times like these. At Torrey Holistics, we hope you will take solace in knowing that we will be here to help you every step of the way.

These statements have not been evaluated by the FDA. Nothing said, done, typed, printed or reproduced by Torrey Holistics is intended to diagnose, prescribe, treat or take the place of a licensed physician.

REFERENCES

(1) Kessler RC, McGonagle KA, Zhao S, et al. Lifetime and 12-Month Prevalence of DSM-III-R Psychiatric Disorders in the United States: Results From the National Comorbidity Survey. Arch Gen Psychiatry. 1994;51(1):8–19. doi:10.1001/archpsyc.1994.03950010008002

(2) The National Institute of Mental Health. (2018). Anxiety Disorders. https://www.nimh.nih.gov/health/topics/anxiety-disorders/index.shtml#part_145333. Accessed 20 March 2020.

(3) Harvard Medical School. (2011). Understanding the Stress Response. Harvard Health Publishing, https://www.health.harvard.edu/staying-healthy/understanding-the-stress-response. Accessed 30 March 2020.

(4) Pedersen, T. (2018). New Framework Details Five Fear Responses. Psych Central, https://psychcentral.com/news/2015/06/13/new-framework-details-five-fear-responses/85682.html. Accessed 24 March 2020.

(5) The National Institute of Mental Health. (2018). Anxiety Disorders.

(6) Csikszentmihalyi, Mihaly. Flow: The Psychology of Optimal Experience. New York: Harper & Row, 1990. Cross Ref: http://positivepsychology.org.uk/living-in-flow/. Accessed 30 March 2020.

(7) The National Institute of Mental Health. (2018). Anxiety Disorders.

(8) Harvard Medical School. (2011). Understanding the Stress Response.

(9) Moyer, C. A., Rounds, J., & Hannum, J. W. (2004). A Meta-Analysis of Massage Therapy Research. Psychological Bulletin, 130(1), 3–18. https://doi.org/10.1037/0033-2909.130.1.3

(10) Nagoski, Emily. Come As You Are : the Surprising New Science That Will Transform Your Sex Life. New York :Simon & Schuster Paperbacks, 2015, pp. 120-124.

(11) Fuss, Johannes et al. “A runner’s high depends on cannabinoid receptors in mice.” Proceedings of the National Academy of Sciences of the United States of America vol. 112,42 (2015): 13105-8. doi:10.1073/pnas.1514996112

(12) Maroon, Joseph, and Jeff Bost. “Review of the neurological benefits of phytocannabinoids.” Surgical neurology international vol. 9 91. 26 Apr. 2018, doi:10.4103/sni.sni_45_18

(13) Zuardi, AW, Guimarães, FS, and AC Moreira. “Effect of cannabidiol on plasma prolactin, growth hormone and cortisol in human volunteers.” Surgical neurological international vol. 9 91.
26 Apr. 2018, doi: 10.4103/sni.sni_45_18

(14) Maroon, Joseph, and Jeff Bost. “Review of the neurological benefits of phytocannabinoids.”

(15) Ruehle, S et al. “The endocannabinoid system in anxiety, fear memory and habituation.” Journal of psychopharmacology (Oxford, England) vol. 26,1 (2012): 23-39. doi:10.1177/0269881111408958

(16) Maroon, Joseph, and Jeff Bost. “Review of the neurological benefits of phytocannabinoids.”

(17) MacCallum, C.A., European Journal of Internal Medicine (2018), https://doi.org/10.1016/j.ejim.2018.01.004

(18) Pamplona, Fabricio A et al. “Potential Clinical Benefits of CBD-Rich Cannabis Extracts Over Purified CBD in Treatment-Resistant Epilepsy: Observational Data Meta-analysis.” Frontiers in neurology vol. 9 759. 12 Sep. 2018, doi:10.3389/fneur.2018.00759

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