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Using Marijuana for Treating Anxiety

Daniel B. Block, MD, is an award-winning, board-certified psychiatrist who operates a private practice in Pennsylvania.

Verywell / Cindy Chung

As more states legalize marijuana, both for medicinal and recreational use, more and more people are turning to cannabis in hopes of managing anxiety or generalized anxiety disorder (GAD). Although scientific research in this area is still sparse, there are anecdotal and new scientific reports of marijuana creating a calming experience that temporarily relieves symptoms of anxiety for many people.

Marijuana as Self-Medication

Anytime you take it upon yourself to use a substance to treat or cope with a medical problem or symptom, it is referred to as self-medicating. Often, self-medicating produces an immediate relief of the uncomfortable symptoms, thereby reinforcing its use.

The problem with self-medication is that even though the use of marijuana is becoming more acceptable, not enough is known about the efficacy of the drug for particular medical conditions as well as its long-term consequences.

Potential Benefits and Risks

May reduce depression in the short term

May relieve anxiety temporarily

May reduce stress

Higher levels of psychiatric disorders

Can create psychological dependence

Long-term memory loss may occur

Symptoms may increase

May develop cannabis hyperemesis syndrome

Can create increased tolerance and need

Benefits

The scientific community has recently started examining the effect of cannabis on anxiety, and the verdict is that short-term benefits do exist.

Scientists at Washington State University published a study in the Journal of Affective Disorders that found that smoking cannabis can significantly reduce self-reported levels of depression, anxiety, and stress in the short term. However, repeated use doesn’t seem to lead to any long-term reduction of symptoms and in some individuals may increase depression over time.

Risks

Marijuana can affect your body in many ways beyond just getting you high. The high feeling you may experience after smoking or ingesting marijuana is due to tetrahydrocannabinol (THC), the chemical compound that gives marijuana its psychoactive effects.

The effects of THC do not come without risks, and long-term or frequent use has been associated several potential side effects.  

Higher Levels of Psychiatric Disorders

It is possible that people who use marijuana for an extended period of time have higher levels and symptoms of depression, despite any improvements they may have seen in this regard with short-term use.

Some research has also shown that heavy use of marijuana in adolescence (particularly in teenage girls) can be a predictor of depression and anxiety later on in a person’s life. Certain susceptible individuals are also at risk for the development of psychosis with the use of cannabis.

Psychological Dependence

The central problem with using marijuana as an anxiety coping tool is that it can create a psychological dependence on the substance.

Since the effects of marijuana are fast acting, long-term behavior-based coping strategies may seem less helpful at first and may be less likely to be developed.

Long-Term Memory Loss

Several studies have found that long-term marijuana use can cause memory loss. Memory impairment occurs because THC alters one of the areas of the brain, the hippocampus, responsible for memory formation. It also can have negative consequences on the brain’s motivation system.

Increase in Symptoms

THC can raise your heart rate, which, if you have anxiety, may make you feel even more anxious. Using too much marijuana can also make you feel scared or paranoid.

In some cases, marijuana can also induce orthostatic hypotension, a sudden drop in blood pressure when standing, which can cause lightheadedness or feeling faint. Cannabis can also cause feelings of dizziness, nausea, confusion, and blurred vision, which can contribute to anxiety.

Cannabis Hyperemesis Syndrome

A rare consequence of frequent marijuana use, particularly with today’s more potent strains, is cannabis hyperemesis syndrome (CHS). This involves cyclical nausea and vomiting.

This is paradoxical and can be difficult to diagnose, as marijuana has been used to decrease nausea and vomiting in cancer treatment. Sufferers sometimes find relief in hot baths and showers, but ultimately, abstinence from marijuana is necessary for long-term improvement.

Escalating Need

You can develop a tolerance to marijuana. This means that the more you use it, the more you will eventually need to get the same “high” as earlier experiences.

Alternatives to Marijuana

Remember that some level of anxiety is normal and even helpful when you are confronted with something that feels threatening to you. However, when feeling anxious becomes pervasive and difficult to control, it is time to seek professional help to discuss other forms of anxiety management.

Therapy

Proactive coping strategies, learned through counseling, support groups, as well as self-help books and educational websites, can create lasting change without the negative components of extended marijuana use.

Cognitive behavioral therapy (CBT) and other forms of therapy can help you determine the underlying cause of your anxiety and manage it more effectively.   Work with your doctor to develop a treatment plan that is right for you.

Working with a psychotherapist to manage your anxiety will give you a better handle on your condition in the long run.

Medication

The use of certain prescription medications such as the selective serotonin reuptake inhibitors (SSRIs) have been firmly established as safe and effective treatment for anxiety disorders.  

Prescription medication is also preferable to marijuana since the long-term risks have been better studied and are potentially less significant compared to long-term marijuana use. Some anti-anxiety medications are taken daily, while others are taken episodically during periods of extreme anxiety or a panic attack.

A psychiatrist or your primary care doctor can prescribe you an anti-anxiety medication, should you need one.

Cannabidiol (CBD) Oil

CBD oil, a marijuana extract that is often dispersed under the tongue with a dropper, doesn’t contain THC, so it won’t give you the same mind-altering effects as marijuana. There is some beginning evidence to suggest that CBD could be helpful in the treatment of anxiety and addiction, but more clinical trials and research are needed in this area.  

A Word From Verywell

Symptoms of anxiety are treatable. Studies show that psychotherapy and medication are effective for most individuals, whereas the long-term effects of self-medicating with marijuana have yet to be clearly established. If you’ve recently started experimenting with marijuana use to treat your anxiety, be sure to tell your doctor.

If you or a loved one are struggling with anxiety, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area.

For more mental health resources, see our National Helpline Database.

Using marijuana can provide short-term symptom relief for anxiety, but there are risks to consider. Learn more about this and longer-term options.

Marijuana anxiety? Here’s what to do if you have a panic attack while high

While many find weed a relaxing drug, marijuanaВ alsoВ has a direct connectionВ to panic attacks. Even aВ habitual smoker who seems the very definition of “chill” has likely had the experienceВ of being way too high, man. В

In the moment, that can be overwhelming. But it’sВ not the end of the world. Here’s what you need to know aboutВ theВ scary, stressfulВ and sometimes overwhelming problemВ of weed-induced panic.

Can weed causeВ panic attacks?

“It can,” said Ryan Vandrey, whoВ studiesВ the behavioral pharmacology of cannabis useВ atВ Johns Hopkins University School of Medicine,В in a phone interview. “It happens from direct effects of the drug inВ the brain and/or direct effects of the drug on body.”В

“Cannabis can modulate neurotransmitters in parts of the brain that control anxiety and elevateВ yourВ heart rate,” which can in turn create a sense of escalating panic, he explained.

Recognizing the panic attack for what it is

AВ wide variety of physiological effectsВ fall under the umbrella term “panic attack,” though Vandrey cautioned that they’re specific to each person, andВ none can be considered “typical.”

ThereВ “hasn’t been a lot of research focused exclusively” on the signs ofВ weed-related panic, Vandrey said. “The important thing to note is that it’s dose-related. You see greater exacerbation of heart rate at higher doses. And it’s more likely to occur in individuals who already deal with anxiety issues or have a predisposition to or familyВ history ofВ them.”

That said, people whoВ experienceВ panic attacks have reportedВ symptoms including, but by no means restricted to:

• Racing heartbeat

• Tunnel vision

• Sweat or chills

• Chest pains

• Tingling or numbness in the extremitiesВ

• Weakness and dizziness

• Trouble breathing

These areВ someВ potential results of aВ “flight-or-fight” response, which is triggered by the brain’s hypothalamus when you instinctuallyВ detect a threat — either real or imagined. Your wholeВ body is placed on high alert, and fear of impending death or doom is palpable.В

What to do when you know you’re panicking

The key thing to rememberВ is that a panic attack can’t hurt you. Contrary to what some of the above symptoms may suggest, you’re likelyВ not suffering aВ heart attack or obstructed airway.

There’s also zeroВ chance you’veВ “overdosed”В on weed. Remind yourself that this condition is not lasting but temporary. In due course, it will all be over.В

The experienceВ “usually doesn’tВ lastВ that long,” Vandrey said,В perhaps “half hour or an hour, dependingВ on how the cannabisВ was ingested — shorter if inhaled, longer if eaten.”В В

“It all depends on the individual,” he said.В “None of it is applicable to everybody.” В

Take stock of your situation and surroundings

For many, weed-based anxiety involves a hefty dose of paranoia about other people. Because marijuana is a drug enjoyed in social settings, getting too stoned can lead to suspicions that your own friends resent you, or that you’re somehow “ruining” their good time.

“Research has shown that individual responses to a given drug can absolutely be influenced by the situation in which it occurs,” Vandrey said. “If somebody takes a drug that produces anxiety in uncomfortable surroundings, they may heighten their anxiety.В Cannabis is a perfect example.”

If environmental factors are contributing to your fear or stress, removing yourself from that context can help.

Ask for help

Resist the idea that anyone hates you for obscure reasons of your own invention. The truth is that anyoneВ not in the throes ofВ panicВ can assure you that your symptoms are exaggerated, impermanentВ and not life-threatening, which is a huge advantage when your mind is playing tricks on you.

A companion is also handy to haveВ when it comes to limiting environmental stressors, and canВ address any simple and immediate needs.

“There’s no one way to treat this,” Vandrey said. “When it does happen in our lab we respond to the needs of the individual. We encourage people to get comfortable and provide them with whatever they need — whetherВ that’sВ food, or water, or sometimes just to close their eyes, lie down and relax.”

Give yourself a break

As a panic attack releases its grip, you mayВ feel a little sheepish or outright embarrassed about what you did or saidВ whenВ it took hold. “Why did I freak out like that?” you’ll ask yourself.В

Despite popular conceptions of such episodes, Vandrey said they’re “notВ common at all.”В They’reВ especially unusualВ for “frequent, experienced” users:В “It rarely happens, and usually only after very high doses.”В

And while limiting your intake or indulging in a more comfortable environmentВ may prevent a repeat occurrence in the future, the best way to avoid a weed-related panic attack “is is to not use cannabis at all.”В

In other words, this is a risk everyone runs with weed — but, Vandrey said, a “subset of people” are particularly vulnerable to it. So while someВ stoners can laugh about the times they tipped over the edge into full-blown paranoia and horror,В treating it likeВ a rite of passage, others will find that they’re better off not gambling with their neurochemistry this way.В В

In any case, rest assured that a weed-induced panic attack is not going on your permanent record, and will soon be forgotten by whoever happened to witness it. The only judgment you face is your own.

Figure out what went wrong

As we’ve discussed, “situational” factors are important determinants in matters of substance abuse and addiction, and anyone fond ofВ weed will tell you that theВ effectsВ are similarly contingent on your surroundings: Where were you? Who were you with?В

And, maybe above all:В What was your frame ofВ mind?

AnyВ such detailВ could have contributed toВ your panic attack, and after it’s over, it’s worth considering whether they did — particularly if this was an isolated incident. You might choose toВ swear offВ potentВ marijuana strains with high levels of THC, the cannabinoid responsible for weed’s psychoactiveВ “high,” or pick the time and place of your weed use more carefully. Strictly limiting the size of your doses is an even better idea.

But, as Vandrey pointed out, none of thisВ is a guarantee against another panic attack. And if theВ oneВ you hadВ fits into a larger pattern of recurrent behavior, then seeking a doctor’s opinion on the nature of your anxiety is the smart move. Even if you think you’reВ self-medicating yourВ anxiety with marijuana, you could be doing more harm than good.В

“CannabisВ I don’t think is any different thanВ anyВ other drug that can produce anxiety,” Vandrey said — and there are many drugsВ that can. So don’t let weed’s chill reputation fool you:В As with any prescription you pick up at the pharmacy, it’s essential to be informed of possible adverse effects.В

While many find weed a relaxing drug, marijuana also has a direct connection to panic attacks. Even a habitual smoker who seems the very definition of "chill" has likely had the experience of being way too high, man.  In the moment, that can be…