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CBD and Anxiety: Current Research & Understanding

Anxiety is a common disorder causing excessive mental stimulation and feelings of fear and worry. It can become debilitating when it interferes with daily activities. CBD offers a number of benefits for anxiety — here’s how it works.

Article By
Justin Cooke , posted 1 month ago

Stress is a natural process designed to keep us safe and give us the best chances of survival when faced with a dangerous scenario. In many people, this natural stress response becomes hyperactive — interfering with their ability to perform normal daily activities.

Anxiety belongs to a spectrum of different medical disorders involving a dysfunctional stress response. The reaction to stress may be excessive, too frequent, or last for too long.

In recent years, CBD — one of the active, non-psychoactive compounds in the cannabis plant — has been shown to offer widespread benefits toward symptoms of anxiety. It’s used to manage common side-effects such as insomnia and muscle tension and even offers benefits to the underlying causes of anxiety itself.

Here, we’ll discuss why CBD is gaining popularity as a natural treatment option for anxiety, and how you can start using it to alleviate your most concerning symptoms.

  • Table of Contents

Summary: Using CBD for Anxiety

There are many different causes for anxiety — and the best way to eliminate it is to address the problem at its source. This may be nutritional deficiencies, unresolved traumas from the past, or medication/drug use.

CBD is also beneficial on top of other treatments thanks to its powerful array of anxiolytic benefits.

Benefits of CBD for Anxiety

  • Reduces muscle tension
  • Stimulates the relaxing neurotransmitter — GABA
  • Modulates the immune function
  • Alleviates common side-effects of anxiety such as insomnia or digestive issues
  • Exerts a regulatory effect on the hypothalamus — responsible for regulating anxiety

Tips for Maximizing the Effects of CBD on Anxiety

  1. Don’t use CBD alone — combine it with other anti-anxiety treatment options for the best effects
  2. Be cautious about THC content — some CBD products contain THC, which can cause anxiety for some people
  3. Search for high-quality CBD products only — poor-quality CBD products often contain contaminants that can make anxiety symptoms worse
  4. Start with a low dose and increase slowly over time — always start low when using CBD for anxiety to avoid making symptoms worse

What is Anxiety?

Anxiety is a normal — even healthy — emotion, but it can get out of control and become damaging to our health.

“Healthy” anxiety is designed to protect the body from danger. We might feel anxious when standing high up on a ledge. The nervousness and unease are meant to keep us attentive so we don’t slip and fall off. Additionally, we may experience anxiety when we come face to face with a hungry animal — the anxiety helps us fight or run away.

However, disproportionately high levels of anxiety can begin to cause serious problems for some people.

As a medical disorder, anxiety is characterized by feelings of excessive nervousness, fear, and worry. Physical symptoms such as heart palpitations, high blood pressure, a fast heart rate, muscle twitches, and shallow breathing are also common during anxiety “attacks.”

Unhealthy anxiety forms as an overreaction to normal stresses in our environment. Things such as going to public events, looming deadlines, or financial instability are common causes of clinical anxiety. Our standard stress response is amplified — causing widespread negative side-effects that do nothing to help the situation.

A key element in treating anxiety is to improve the way our brain reacts and responds to stress.

Types of Anxiety Disorders

  • Generalized anxiety disorder (GAD)
  • Panic disorder
  • Specific phobias
  • Social anxiety disorder (SAD)
  • Selective mutism
  • Separation anxiety disorder

A Primer on the Stress Response

Stress is a crucial element of anxiety. When something threatens us, a particular region in the brain known as the hypothalamus steps into action. The goal of the hypothalamus is to react to stress appropriately so we can manage the situation.

The hypothalamus controls the intensity of stress by stimulating the release of hormones such as cortisol and norepinephrine that cause physical changes to the body. The hypothalamus is responsible for controlling the intensity of the stress response so that it best matches the level of danger we’re facing.

The physiological changes of stress include:

  • A heightened level of awareness
  • Increased blood sugar levels (to supply more energy to the muscles)
  • Decreased digestive and immune function (to conserve energy for the brain and muscles)
  • Decreased pain sensation

For minor concerns (such as getting caught in a traffic jam), the appropriate response would be only a small amount of stress. We don’t need to shut down our immune system and digestive function to handle this kind of stress.

For larger concerns (such as being held at gunpoint), the appropriate response is far more intense. In this case, it would be beneficial for us to maximize our chances of getting out alive by supplying the muscles with more energy (increased blood sugar) and heightening our level of awareness by releasing stimulating compounds in the brain such as orexin, histamine, and norepinephrine.

In many people suffering from anxiety, the hypothalamus overreacts to the situation. Minor stress — attending a public event, for instance — results in a full-scale stress response, producing what we characterize as anxiety.

The Stages of Anxiety

Anxiety can vary from one person to the next but tends to follow the following general stages.

Stage 1: Stress Trigger

The first stage of anxiety is the trigger — this is the event or thought that causes the stress response. There are many different triggers, and everybody has their unique triggers.

Common anxiety triggers:

  • Financial concerns
  • Upcoming social events
  • Loss of a loved one
  • Medication side-effects
  • Looming work deadlines
  • Exams

Some people’s anxiety is triggered by irrational fears, called phobias. There are many reasons why someone might have these fears, but the most common is a past traumatic event involving the specific trigger.

Examples of common phobias:

  • Acrophobia fear of heights
  • Arachnophobia fear of spiders
  • Ophidiophobia fear of snakes
  • Agoraphobia fear of having a panic attack in public
  • Mysophobia fear of germs
  • Algophobia fear of pain

The first step toward treating anxiety is to identify your triggers. It helps to keep track of when your anxiety appears and what events or thoughts may have led to that reaction.

Stage 2: The Hypothalamus Responds

No matter what the trigger for the anxiety, the next stage involves the response from the hypothalamus.

The hypothalamus can be thought of as the “master controller.” It reacts to stress by delegating other organs to take action.

When it perceives stress, it sends hormones to the adrenal glands to start releasing the primary stress hormones — cortisol, epinephrine, and norepinephrine. These hormones tell the nervous system how to respond (stage 3).

How CBD May Help

In many people with anxiety, the source of the problem arises in the hypothalamus itself. It responds to small stresses as if they were significant and life-threatening. CBD is exceptionally helpful in this case because it acts on the hypothalamus directly, making it less sensitive to minor stresses (more on how this works below).

Stage 3: Sympathetic Nervous System (SNS) Activation

There are two sides to our nervous system — the sympathetic nervous system and the parasympathetic nervous system.

The sympathetic nervous system (SNS) is the part of the nervous system responsible for what we experience as stress. It’s activated by cortisol and norepinephrine.

The parasympathetic nervous system (PNS) is the opposite — it’s responsible for inducing relaxation and recovery once the stress is over.

These two sides of the nervous system work opposite to each other — like yin and yang. When one side is active, the other is suppressed.

During a stress response or anxiety attack, the SNS becomes activated— resulting in most of the changes experienced during a stress reaction, including:

  • Stimulating neurotransmitters are released in the brain to heighten awareness
  • The immune system is inhibited
  • The digestive system is inhibited
  • Heart rate is increased
  • The bronchi leading to the lungs dilate to let more air through
  • The liver dumps glucose into the bloodstream to provide a boost in energy levels

How CBD May Help

In some people, the SNS activation is exaggerated — causing significant changes to the body with even just a small change in SNS/PNS balance. CBD can support this through its ability to increase the PNS directly (through GABA and related neurotransmitters).

Stage 4: Recovery

Once the stress is over, the body then needs to recover. This is when the hypothalamus stops secreting hormones and cortisol is eventually broken down by the liver.

As this happens, the shift in the balance between the SNS and PNS begins to change.

We become more relaxed, brain activity slows, the immune and digestive systems are stimulated, and blood glucose levels begin to drop back down to normal levels.

This is called the “rest and digest” response.

How CBD May Help

People with anxiety often have problems with this stage — they become unable to relax fully. Clinically, these people are “SNS-dominant” because the SNS side of the nervous system is active more often than not.

CBD can be used to give the PNS a boost — causing a change in the balance between the SNS and PNS.

Physiological ProcessDuring an Anxiety AttackEffect of CBD
Heart Rate↑↑↑↓↓↓
Blood Pressure↑↑↑↓↓↓
Immune System↓↓↓↑↑↑
Digestive System↓↓↓↑↑↑
Neurostimulation↑↑↑↓↓↓
Blood Glucose Levels↑↑↑↓↓↓

Symptoms of Anxiety Disorders

  • Rapid heartbeat
  • High blood pressure
  • Confusion
  • Dizziness
  • Tinnitus (ringing in the ears)
  • Mood changes
  • Poor concentration
  • Insomnia
  • Digestive disturbances (constipation or diarrhea)
  • Hyperventilation
  • Frequent cold/flu

Causes of Anxiety

  • Alcohol use
  • Caffeine
  • Heart disease
  • Inability to effectively cope with stress
  • Nutritional deficiencies
  • Recreational drug use
  • Side effects of medications
  • Sleep deprivation
  • Smoking
  • Traumatic history

Guide to Using CBD for Anxiety

Let’s go over exactly how you can use CBD for alleviating symptoms of anxiety, how it works, and what dose to take.

Research done in the early 1980s highlighted the difference in effects between the main psychoactive cannabinoid, THC, and the primary non-psychoactive cannabinoid, CBD [1]. Researchers in this study reported that CBD could resist the anxiety-causing effects of THC.

A double-blind clinical trial involving four separate groups of 10 people forced to speak publicly in front of a group of people measured the effects of three anti-anxiety medications. Subjects were given either 300 mg of CBD, 10 mg of diazepam, 5 mg of ipsapirone, or a placebo before the event. This research found that the CBD and ipsapirone group showed the most significant benefit in anxiety symptoms before and immediately after the public-speaking event [2].

Another study used functional neuroimaging to investigate how CBD affects anxiety in the brain [4]. The study found that CBD effectively managed anxiety symptoms in the treatment group. Neuroimaging scans showed decreased blood flow in the parahippocampal and hippocampal regions of the brain — both areas known to be heavily involved during anxiety attacks. Researchers in this study suggested that the mechanism of action for CBD was upregulation of the endocannabinoid system in the brain.

CBD increases GABA activity in the brain [3, 5]. This is the primary neurotransmitter associated with reversing the stress and anxiety response. Many of the primary medications used to treat anxiety use this mechanism as well — including benzodiazepines and barbiturates such as Xanax and Diazepam.

Step 1: Find the Best CBD Oil for Anxiety

There are so many companies in the CBD space at the moment that it can be hard to know which ones to buy. To make matters worse, many of the companies currently on the market are of poor quality. With the recent rise in the public interest for CBD supplements, it’s no wonder why so many companies are manufacturing sub-par products in an attempt to get their piece of the pie, without having to do the rigorous quality control processes necessary to make sure their products are safe and effective.

We’ve taken the liberty of doing these reviews for you — scanning through hundreds of CBD oils, capsules, tinctures, edibles, and vape oils to separate the wheat from the chaff.

When it comes to anxiety, it’s especially important to make sure the products you’re using are of the highest quality possible — with no heavy metal, pesticide, or microbial contaminants. This is because any of these contaminants can cause anxiety. This isn’t something you want from a product used to alleviate symptoms of anxiety.

The only way to confirm none of these contaminants found their way into the final product is to take a look at the company’s third-party-testing reports.

If the company you’re researching can’t provide this — move along to the next one.

Without first confirming the products are safe, you have to assume it’s not. There are too many contaminated CBD products out there to take the gamble.

For More Information on Finding the Best CBD Products, Check Out Some of Our Buyer’s Guides:

Step 2: Assess Optimal Starting Dosage

Dosing CBD can be a challenge for first-time users. To make this as simple as possible, we’ve included a basic dosage chart. Taking into account your weight and the desired strength, you can make a rough estimate regarding the amount of CBD needed to get the results you’re looking for.

Recommended strength to treat anxiety: mid to high strength

Daily Doses of CBD by Weight and Strength (in mg)

Weight (lbs)Low StrengthMedium StrengthHigh Strength

100 lbs

10 mg

30 mg

60 mg

125 lbs

13 mg

38 mg

75 mg

150 lbs

15 mg

45 mg

90 mg

175 lbs

17 mg

52 mg

105 mg

200 lbs

20 mg

60 mg

120 mg

225 lbs

22 mg

67 mg

135 mg

250 lbs

25 mg

75 mg

150 mg

Step 3: Monitor the Effects of CBD

As with many mood and neurological disorders, it’s wise to keep track of your symptoms whenever trying a new supplement or medication.

This gives you a starting baseline and helps you track your progress — both good and bad — to see how the new supplement or medication is working.

We recommend spending a few minutes before taking CBD to answer the following questions:

  • How is your mood on a scale of 1–10? (1 being very poor, 10 being very good)
  • How would you rate your quality of sleep on a scale of 1–10?
  • When you experience anxiety attacks, where do they rank in severity on a scale of 1–10?
  • How is your energy on a scale of 1–10?
  • What are some triggers for your anxiety symptoms?
  • How many anxiety attacks do you have per day on average? Per week?
  • What other symptoms are you experiencing along with your anxiety?
  • What makes your symptoms feel better?

After a solid month of use, go back and answer these questions again. Are there any improvements? Is anything worse?

Some of the benefits of CBD supplementation may be noticeable right away, especially those related to insomnia and severity of anxiety attacks. You can expect to see the broader benefits after around a month or two. These may involve a reduction in the frequency of your anxiety attacks and improvements in associated conditions such as depression or fatigue.

When to Avoid CBD for Anxiety

There are plenty of benefits CBD has to offer people who suffer from anxiety — but there are also some situations where CBD use may not be appropriate.

Some examples include:

  • If taking antipsychotic medications
  • If taking blood thinners
  • Anything with more than 0.3% THC, as THC may make anxiety symptoms worse
  • In combination with bipolar disorder or mania unless monitored by a physician

References

  1. Zuardi, A. W., Shirakawa, I., Finkelfarb, E., & Karniol, I. G. (1982). Action of cannabidiol on the anxiety and other effects produced by Δ 9-THC in normal subjects. Psychopharmacology, 76(3), 245-250.
  2. Zuardi, A. W., Cosme, R. A., Graeff, F. G., & Guimarães, F. S. (1993). Effects of ipsapirone and cannabidiol on human experimental anxiety. Journal of psychopharmacology, 7(1_suppl), 82-88.
  3. Banerjee, S. P., Snyder, S. H., & Mechoulam, R. A. P. H. A. E. L. (1975). Cannabinoids: influence on neurotransmitter uptake in rat brain synaptosomes. Journal of Pharmacology and Experimental Therapeutics, 194(1), 74-81.
  4. Crippa, J. A. S., Derenusson, G. N., Ferrari, T. B., Wichert-Ana, L., Duran, F. L., Martin-Santos, R., … & Filho, A. S. (2011). Neural basis of anxiolytic effects of cannabidiol (CBD) in generalized social anxiety disorder: a preliminary report. Journal of Psychopharmacology, 25(1), 121-130.
  5. Bakas, T., Van Nieuwenhuijzen, P. S., Devenish, S. O., McGregor, I. S., Arnold, J. C., & Chebib, M. (2017). The direct actions of cannabidiol and 2-arachidonoyl glycerol at GABAA receptors. Pharmacological research, 119, 358-370.

Conditions that May Respond to Cannabidiol