Cannabis and Mental Health: Explained

On one hand, some people report that cannabis helps relieve symptoms of:

• Anxiety
• Depression
• PTSD
• And more

There's a reason it's called "medical marijuana" in many places. However, research paints a more complicated picture when it comes to cannabis and mental health.

Some studies suggest CBD, a non-intoxicating compound in cannabis, with its many consumption methods, such as smoking and vaping, may have anxiolytic and antidepressant properties. A 2017 report from the National Academies of Sciences, Engineering, and Medicine found moderate evidence that cannabis or cannabinoids can help with sleep disturbances associated with various conditions.

For those struggling with chronic pain, cannabis may offer some relief. Pain and mental health are closely linked, so managing pain could potentially improve mood and quality of life for some patients.

However, the same report also found substantial evidence linking cannabis use to an increased risk of developing schizophrenia and other psychoses. The risk appears to be dose-dependent, with more frequent use associated with greater risk.

A 2018 study using Mendelian randomization techniques provided further evidence for a causal link between cannabis use and schizophrenia risk. This research suggests that cannabis use isn't just correlated with psychosis - it may actually contribute to its development in vulnerable individuals.

Depression and anxiety present another paradox. While some users report short-term relief, long-term heavy use has been associated with increased risk of mood disorders. A 2018 study found that individuals with major depressive disorder who used cannabis frequently had more severe symptoms compared to non-users.

Let's take a closer look at how cannabis interacts with specific mental health conditions:

The link between cannabis use and psychotic disorders is one of the most well-established in the literature. A landmark Swedish study following over 50,000 participants found that heavy cannabis users were six times more likely to develop schizophrenia compared to non-users.

More recent research has shed light on potential mechanisms. THC, the main psychoactive component in cannabis, can induce temporary psychotic-like symptoms even in healthy individuals. For those with a genetic predisposition to schizophrenia, regular cannabis use may act as an environmental trigger, potentially hastening the onset of the disorder.

Interestingly, Cannabidiol (CBD) shows promise as a potential treatment for psychosis. A few small clinical trials have found that CBD may reduce psychotic symptoms and improve cognitive function in patients with schizophrenia. However, larger studies are needed to confirm these findings.

The relationship between cannabis and mood disorders is complex. Some users report that cannabis helps alleviate depressive symptoms in the short term. However, long-term studies paint a different picture.

A 2018 study found that cannabis use was associated with a higher incidence of depression and suicidal ideation, particularly among adolescents. The exact nature of this relationship isn't clear - does cannabis use lead to depression, or are depressed individuals more likely to use cannabis?

For those with bipolar disorder, cannabis use has been associated with more frequent manic episodes and faster cycling between mood states. While some patients report using cannabis to manage symptoms, the overall evidence suggests it may worsen the course of the illness for many.

Anxiety is another area where the effects of cannabis appear to be dose-dependent. Low doses of tetrahydrocannabinol (THC) may reduce anxiety for some users, but higher doses can actually increase anxiety and paranoia.

CBD, on the other hand, has shown more consistent anxiolytic effects in both animal and human studies. However, most of these studies have been short-term, and we still need more research on the long-term effects of CBD for anxiety disorders.

Some veterans and PTSD sufferers report that cannabis products help manage their symptoms, particularly nightmares and insomnia. However, the research in this area is still in its early stages. While some small studies have shown promising results, we need larger, well-controlled trials to fully understand the potential benefits and risks of cannabis for PTSD.

It's important to note that the effects of cannabis on mental health can vary widely between individuals. Genetic factors play a significant role in determining how someone responds to cannabis.

For example, a 2018 study found that a specific variant of the COMT gene interacted with cannabis use to influence the risk of psychosis. This highlights the complex interplay between genetics, cannabis use, and mental health outcomes. Environmental factors also play a crucial role. Early onset of cannabis use, especially during adolescence when the brain is still developing, appears to carry greater risks for long-term mental health problems.

If you're considering using cannabis, especially if you have a history of mental health issues, here are some important points to keep in mind:

Despite the growing body of research on cannabis and mental health, many questions remain unanswered. The illegal status of cannabis in many countries has historically made it difficult to conduct large-scale, high-quality studies. As more regions legalize cannabis, we have an opportunity to better understand its effects.

Several ongoing clinical trials are exploring the potential of CBD for various mental health conditions. For example, there are active trials investigating CBD for acute schizophrenia and early psychosis.

We also need more research on the long-term effects of cannabis use, particularly in vulnerable populations like adolescents and those with a family history of mental illness. As cannabis becomes more widely available, understanding these risks becomes increasingly important for public health.