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CBD and Mental Health

There has been a growing popularity and interest in using CBD oil to treat a variety of mental health concerns. As is the case with most new research there is a lot of hype and misunderstanding. CBD oil is being hailed as some kind of panacea to treat all aliments, which should cause warning sounds to most informed consumers. I frequently have clients asking me about it telling me that they heard it is everything from a cure to schizophrenia or just some hype people are using to rationalize their cannabis intake. The aim of this article is to break down what the actual scientific literature says about the benefits and detriments of using CBD oil for mental health reasons

Background Let’s start with CBD. What is it? CBD is shorthand for Cannadidol. It is one of the major active compounds in marijuana or cannabis. Cannadidol is also found in hemp. The hemp plant is similar to marijuana but not contain THC. THC (tetrahydrocannabinol) is the chemical most responsible for the psychological effects (the high) from marijuana. CBD is one of the hundreds of components of marijuana. CBD is thought to bind to the CBD1 and CBD2 receptors in our nervous system. Exactly how CBD affects these receptors is not fully understood but it is thought that it may interact with serotonin signaling. CBD itself does not cause a high. As a recent report from the World Health Organization stated “In humans, CBD exhibits no effects indicative of any abuse or dependence potential…. To date, there is no evidence of public health related problems associated with the use of pure CBD.” In 2015 the FDA eased regulations to allow medical researchers to conduct CBD trails. However, federally, the legality of CBD is somewhat confusing and rapidly changing. For the most part there is a bipartisan consensus in the house of representatives to make hemp and therefore most CBD legal. The federal laws depend on if the CBD that is being sold derives from the hemp plant or the cannabis plant. All 50 states have laws that make CBD legal (with various restrictions). In Texas a law was passed in June 2019 that solidified the legal status of CBD and hemp products. ​

Literature on CBD and Mental Health To date, there have not been many randomized controlled trails of CBD in humans, and even less of those trails focused on a mental health issues. None the less here is a brief review of the literature.

CBD and Anxiety One 1990 study found that CBD was effective in reducing behavioral and psychological symptoms of stress and anxiety in rats (Guimarães et al., 1990). This study was replicated more recently and elaborated on the possible neurological mechanisms that are activated by CBD (Fogaça et al., 2018). A promising study showed CBD might help ease public speaking anxiety in people who have been diagnosed with social phobia (social anxiety). Just one dose of CBD before a simulated public speaking task “significantly reduced anxiety, cognitive impairment and discomfort in their speech performance” (Bergamaschi et al., 2011). Other studies have found CBD effective in reducing public speaking anxiety in “healthy subjects” who did not have mental health diagnosis(Linares et al., 2019). Overall it seems like CBD could be helpful for a range of anxiety disorders. A review of the literature summarized the findings about CBD and anxiety by stating “We found that existing preclinical evidence strongly supports CBD as a treatment for generalized anxiety disorder, panic disorder, social anxiety disorder, obsessive-compulsive disorder, and post-traumatic stress disorder when administered acutely; however, few studies have investigated chronic CBD dosing” (Blessing et al., 2015). Another study which tracked over 100 subjects from previous studies found that “Cannabidiol may hold benefit for anxiety-related disorders” and some benefit for insomnia (Shannon et al., 2019). It also cautioned that more controlled clinical studies are needed.

CBD and Psychosis To be clear, marijuana can produce a psychotic state. Additionally it is well documented that marijuana use is linked to increase frequency and severity of psychotic episodes for people with psychotic disorders like schizophrenia (Hamilton, 2017; Nordentoft, 2006; Ortiz-Medina et al., 2018). It is unclear what aspects of marijuana are responsible for that effect. However, there have been a several studies with animals that show CBD can have antipsychotic properties. A clinical trial with humans found CBD in conjunction with traditional antipsychotic medication was effective at reducing psychotic symptoms and could represent a new class of antipsychotic drugs (McGuire et al., 2018). Another small scale placebo controlled study found a three week treatment with CBD was effective at lowering anxiety and reducing psychotic symptoms in patients with schizophrenia (Bhattacharyya, 2018). A larger scale study examined a 6-week treatment of CBD on schizophrenia found no significant effects and no improvement of psychotic symptoms (Boggs et al., 2018). A small scale study found that CBD alone (not in conjecture with traditional antipsychotics) is not effective at reducing symptoms of schizophrenia (A. W. Zuardi et al., 2006). In summary, CBD might have antipsychotic effects but more studies are needed to better understand if and how it can be effective for people.

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