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Can You Use CBD for OCD?

Obsessive-compulsive disorder (OCD) is the fourth most common mental health condition affecting people in the United States. It most commonly affects women. Although the exact causes of OCD have not been identified, symptoms of fear, worry, and anxiety underpin this condition.

Addressing this condition is not always easy, as it often requires both therapy and prescription medication. More and more, however, people are looking to natural approaches to help alleviate their symptoms—and many of them are asking if they can use CBD for OCD.

Can You Use CBD for OCD? Just the Facts

Obsessive Compulsive Disorder, more commonly known as OCD, involves intrusive obsessive thoughts followed by compulsive behaviors. Unfortunately, there have not been many studies on using CBD for OCD, or many mental health and mood disorders at all. But there is some promising research that shows CBD oil may help some people with obsessive-compulsive disorder.

What is Obsessive Compulsive Disorder?

Obsessive compulsive disorder is a mental condition in which a person experiences obsessive thoughts which cause anxiety, as well as compulsions to perform a certain behavior.

Here is an example: After a person leaves the house, they begin having a persistent, intrusive thought that the door is not locked, even knowing they double- or triple-checked it. This is the obsessive thought. Next, that person returns home to check that the door is locked. This is the compulsion. In some cases, this cycle of obsessive thoughts and compulsive behaviors repeats several times.

OCD used to be classified as an anxiety disorder, but the Diagnostic and Statistical Manual (DSM-5), which is the main reference for all mental health disorders, no longer views it in the anxiety category. However, one of the main components of OCD is anxiety, so most people still see OCD as an anxiety-related disorder.

Common Obsessive Thoughts

Each person has different types of obsessive thoughts. However, most of the time, they fall into one of several categories. Examples include:

  • Fear of germs, viruses, or contamination
  • Harmful thoughts toward yourself
  • Harmful thoughts toward others or animals
  • Having things organized in a particular order
  • Fear of harming someone because of something you did or did not do (i.e. worrying the shoes you left out could cause a person to trip and fall)
  • Unwanted thoughts that are sexual in nature
  • Fear of forgetting about an important date
  • Obsession with certain colors or numbers being good or bad
  • Inability to make decisions

Compulsive Behaviors

A person uses compulsive behaviors in an attempt to reduce the anxiety they feel from their obsessive thoughts. Often, a person will repeat these behaviors over and over—which may reduce their anxiety level, but only temporarily. Common compulsive behaviors include:

  • Excessive hand washing or bathing
  • Excessive cleaning
  • Continually checking that things are done (i.e. the door is locked)
  • Compulsive counting
  • Repeating certain words or phrases
  • Repeating actives (i,e. going up and down stairs or turning light switches on and off)

The Impact of Having OCD

As previously mentioned, obsessive thoughts cause great anxiety to people affected by OCD. The severity of OCD ranges from mild to severe. However, in all cases, OCD causes distress to a person, affects their quality of life, and can even overtake their life.

In some instances, people don’t realize that what they’re doing is out of the ordinary—but friends, family, or teachers (in the case of children) notice. In other cases, a person knows that their thoughts or behaviors are not rational, but they cannot control them.

Risk Factors of OCD

We do not yet completely understand what causes OCD or all of its risk factors. We do know that there may be a genetic link, as OCD is more common in people who have a first-degree relative with the disorder.

Also, a history of sexual trauma or abuse in childhood increases the likelihood of developing OCD.

Conventional Treatment of OCD

Before looking at whether CBD for OCD is effective, let’s look at some of the conventional treatments available to those with OCD. People with OCD may try to avoid situations where they know their thoughts or actions may be be triggered. In addition, unfortunately, some may turn to drugs or alcohol in an attempt to self-treat.

The most common treatment for OCD is cognitive behavioral therapy, which helps people uncover their underlying thoughts and fears as well as address them.

Anti-depressant medications such as selective serotonin reuptake inhibitors (SSRIs) are also prescribed for OCD. However, about 50% of people do not response to SSRIs. The next line of medications (for those who do not respond to SSRIs) is anti-psychotics. Research shows mixed results for both SSRIs and anti-psychotic medications in OCD treatment. In addition, both have numerous adverse side effects.

Can You Use Medical Cannabis and CBD Oil for OCD?

Many people do not find relief from their OCD symptoms with the current medication treatments that are available. Because of this, OCD patients are experimenting with alternative approaches, including using medical cannabis and CBD for their OCD symptoms.

People report using medical cannabis as well as CBD products to help with anxiety and depression. Many report that these products have helped with their depression, anxiety, and stress-related symptoms.

Medical Marijuana vs CBD Products

People report using both medical marijuana and CBD to manage their anxiety. There are, however, significant differences to consider. CBD products are derived from the hemp plant and contain cannabinoids such as cannabidiol. Medical marijuana also contains cannabinoids, but it also contains tetrahydrocannabinol (THC), which has psychoactive properties. In addition, research shows that THC may worsen anxiety.

What the Research Says

Unfortunately, there have not been any human studies to determine whether CBD oil can help with obsessive compulsive disorder directly. However, there has been research conducted on CBD for other anxiety-related mental health issues such as generalized anxiety disorder and post-traumatic stress disorder (PTSD). A large component of OCD is constant anxiety. Therefore, if CBD is effective in managing anxiety symptoms, it could be useful as an adjunct treatment for those suffering with OCD.

The Endocannabinoid System and Anxiety

CB1 Receptors

CB1 receptors are found throughout the brain in the areas involved in emotional and behavioral reactions, learning, memory, and decision making.

CB2 Receptors

CB2 receptors are heavily involved with pain and inflammation of the body. However, research is beginning to discover their role in emotions and mood regulation as well. In addition, inflammation itself is a factor in mood disorders such as depression.

CBD and the Endocannabinoid System

CBD contains cannabinoids—anandamide, in particular—which stimulate CB1 and CB2 receptors within the endocannabinoid system.

Studies have found a relationship between lower levels of anandamide in people with PTSD. PTSD, is another mental health condition that’s characterized by panic attacks and, much like OCD, high anxiety levels. This means it is possible that there is less stimulation of their endocannabinoid systems, which could be contributing to their high anxiety levels.

Studies have also found that activation of CB1 receptors has resulted in lower levels of fear, anxiety, and compulsion.

5-HT Receptors and Anxiety

Another component involved in anxiety is 5-HT receptors. These are affected by the drug Buspirone, which is one of the most common anxiety medications. Cannabinoids are also shown to stimulate these receptors. Therefore, CBD products may help to alleviate anxiety symptoms through this mechanism. And, as such, CBD oil may be able to help people with obsessive compulsive disorder.

CBD and the Brain

Very preliminary evidence has found that CBD oil affects certain structures of the brain that are involved in mood and emotions, such as the amygdala. This study found that CBD works to reduce amygdala activation—which, in turn, lowers the fear, compulsion, and anxiety response.

Animal Studies

A recent animal study assessing the use of CBD oil for OCD in mice found that was effective at reducing obsessive-compulsive behaviors. Although this is a step in the right direction, it’s important to keep in mind that animal studies do not necessarily represent the effect that a substance will have in humans.

A Summary of What the Research Says

Currently, there are no human studies regarding the use of CBD oil for OCD directly. However, there are positive human studies on CBD products and anxiety, which is a large aspect of OCD.

Reasearch shows that CBD affects several mechanisms of the brain involved in anxiety, including the endocannabinoid system, 5-HT receptors, and brain structures.

In general, research studies have found that at low doses, CBD is an anxiolytic, and at high doses, it does not improve anxiety or can worsen it.

Animal studies have found that CBD improves OCD symptoms in mice.

Final Thoughts

OCD is a distressing mental health condition that can be difficult to successfully treat. Cognitive behavioral therapy is generally useful for this condition, but 50% of people do not respond to the standard current medications. Overall, preliminary research strongly supports the use of CBD oil as a treatment for anxiety disorders.

CBD has shown to influence several aspects of OCD, including anxiety, fear, panic, and compulsion. Given that anxiety is one of the central symptoms in OCD, anxiety-reducing therapies are of great use for symptoms of this condition. Therefore, it is likely that using CBD for OCD may be able to help.

If you suffer from OCD and are interested in using CBD products to help with your obsessive compulsive disorder, speak with your doctor first. Keep in mind that CBD products are not regulated by the United States Food and Drug Administration (FDA). Therefore, make sure any CBD products you purchase are from a reputable source who uses third-party testing. This helps to ensure both the quality and safety of the products.

Can you use CBD for OCD? We take a look at whether or not CBD may be helpful for people with Obsessive Compulsive Disorder.

How do CBD and marijuana affect OCD?

Disclaimer: This post is an examination of research on marijuana and CBD usage among people with OCD and other mental health conditions. NOCD does not endorse any study or its results, or recommend the use of marijuana, CBD, or any psychoactive drug.

In 2015, the National Survey on Drug Use and Health revealed that 22.2 million people had used marijuana in the past month—7% of the population. This made it the most commonly used drug in the United States, and usage was trending upward. As states continue to battle over medical and recreational legalization, marijuana is becoming an increasingly typical part of life in the United States. So far, recreational use has been legalized in ten states and in Washington D.C. Medical use, restricted to those with certain conditions, is now partially or completely legal in 36 states.

These statistics vary drastically around the world, for many reasons. But in the US, at least, widespread and growing use points to a reality in which cannabis products ought to be part of any discussion about mental health. It also points to a need for these discussions to be based in evidence, not alarmism or anecdote.

The short-term effects of cannabis can interact with mental health conditions in complex ways—exacerbating anxiety or encouraging mania, for example. And the long-term effects of these substances are the subject of never-ending, often aggressive debate. A few years ago, the National Academies of Sciences, Engineering, and Medicine convened an expert committee to take a thorough look at huge amounts of research. Their fascinating 2017 report draws over 100 conclusions, among them:

  • “There is substantial evidence of a statistical association between cannabis use and the development of schizophrenia or other psychoses”
  • “There is moderate evidence of a statistical association between cannabis use and… a small increased risk for the development of depressive disorders; increased incidence of suicidal ideation, attempts, completion; increased incidence of social anxiety disorder”
  • “There is limited evidence that cannabis or cannabinoids are effective for… improving symptoms of Tourette syndrome; improving anxiety symptoms in individuals with social anxiety disorder; improving symptoms of PTSD”

Another substance to worry about?

The term cannabinoids encompasses marijuana and other substances that work on the same receptors in our brain. In the past few years, a different kind of cannabis product has grown explosively in popularity. Cannabidiol, or CBD, is the second most abundant chemical compound in marijuana. But when extracted from hemp—a cousin of the marijuana plant—CBD is isolated from THC, the compound in marijuana that causes a high and other psychoactive effects. However, many CBD products actually do contain some proportion of THC.

Subject to claims of effectiveness for all kinds of conditions, CBD is being marketed far more quickly than it can be researched. Due to its trendiness and a shaky but largely unenforced legal status, US sales grew from $108.1 million in 2014 to an estimated $813.2 million in 2019. By 2022 CBD sales are projected to approach $2 billion. Walgreens sells CBD products in nine states, CVS in eight. A staggering 14% of American adults say they use CBD, primarily for pain, anxiety, and insomnia.

People say all kinds of things about marijuana and CBD. They range from potentially true to probably nonsensical, and the longtime illegality of cannabinoid products has only made it harder to get any research done. Everyone is confused—especially those with mental health conditions, who might have the same desire to try these substances but a reduced ability to tolerate their effects.

On the other hand, countless people with or without psychiatric disorders say that marijuana and/or CBD help them feel better. Much research, though in its early form, supports the effectiveness of both medical marijuana and CBD for specific conditions. But, as stated in the National Academies report, there’s only limited evidence for a small number of conditions.

Very little or no research has been conducted on most mental health conditions in relation to the effects of cannabis products. Confusion is the status quo with both substances, although the fact that CBD typically has milder effects and isn’t exactly illegal in most places has allowed manufacturers to shape public opinion significantly.

People with mental health conditions, prone to distress, are often in search of relief. Whether illegally or legally, in moderation or excess, they’re more likely to use substances than the general population. Studies have found that 27-39% of people with obsessive-compulsive disorder met lifetime criteria for substance use disorder (involving any substance), and general usage rates are certainly higher. So, how do the most prevalent illicit drug and its nonintoxicating counterpart affect people with OCD?

Cannabis products and OCD

Although 2-3% of the population has OCD, it doesn’t get enough attention from researchers around the world. This is reflected in the fact that no new medication for OCD has been developed since 1997. Research gravitates toward conditions that are more prominent in our media, already receive better funding, and are at least a bit better understood—think depression and PTSD. There is always remarkable research emerging on OCD, but typically not on the same scale.

Unfortunately, this lack of research carries over to substance use as it relates to OCD. As Dr. Jamie Feusner, MD, Professor of Psychiatry at UCLA and NOCD Chief Medical Officer, put it: “There is very little known about marijuana or CBD use in people with OCD, and no clinical studies of these substances in people with OCD have been published.”

A 2017 study at Washington State University showed that OCD are “was positively associated with cannabis misuse, but not frequency of cannabis use or quantity.” But, as with other studies along the same lines, the researchers didn’t look at the effects of marijuana on their subjects.

Meanwhile, a 2017 clinical trial at the New York State Psychiatric Institute called “Effects of Marijuana on Symptoms of OCD,” has yet to post results. If results do emerge, they’ll come from only 14 participants—a great start, but hardly conclusive. That marijuana remains illegal and stigmatized in so many places limits sample sizes and therefore study progress, and researchers must do what they can with a limited patient population.

Researchers have conducted a few animal studies with cannabinoids, yielding mixed results. Two studies, from 2010 and 2013, linked CBD with a reduction in compulsive-like marble-burying behavior among mice. However, as Dr. Feusner notes, the observed mouse behaviors like marble-burying or pathological grooming aren’t necessarily complete models for OCD in humans.

A 2016 study sheds additional light on the possible neurobiology of these effects. When CB1 receptors—which are blocked indirectly by CBD—were deleted in specific neurons, mice were not able to shift from “goal-directed” to “habitual” behavior (possibly an analogue to compulsions in humans). Those researchers concluded that mice were switching between goal-directed and habitual behaviors based on activity in their CB1 receptors.

Clearly, research efforts have not been extensive enough to determine whether marijuana and CBD might be helpful or harmful for people with OCD. There’s still a lot of energy around this topic, though, and a few researchers plan to conduct larger-scale surveys of people with OCD—perhaps in preparation for research studies. (For more on these, stay tuned to the NOCD blog.)

For the time being, it’s advisable to stay away from psychoactive substances, particularly if one has a mental health condition. The reality is that we still know very little about what happens to the human brain on marijuana and CBD. And with psychiatric conditions already complicating things, there’s good reason to wait for further research to emerge.

If you’re age 18 or older and have been diagnosed with OCD, you can help make this research happen. Take this brief survey from McMaster University.

Disclaimer: This post is an examination of research on marijuana and CBD usage among people with OCD and other mental health conditions. NOCD does not endorse any study or its results, or recommend the use of marijuana, CBD, or any psychoactive drug.

Both CBD and marijuana are widely used by people with OCD. But so far the research hasn't been very clear about their effects. Read our blog to know whether it helps or not.