Stress & Anxiety – How CBD Can Help

It’s natural to feel anxious before a big life events, public speaking or a big job interview, but some people battle anxiety constantly, every day in the form of either some kind of phobia (fear) or a form of an anxiety disorder.  Luckily, modern research is showing that Cannabidiol, or CBD, may prove to be a safe and effective tool for combating common forms of anxiety.

Generally, everyone wrestles with anxiety at different times of their lives, regardless of whether they are anxiety prone or not.  It’s natural to feel anxious before a big life event, public speaking or a big job interview, but some people battle anxiety constantly, every day in the form of either some kind of phobia (fear) or a form of an anxiety disorder.  The Mayo Clinic characterizes anxiety disorders as conditions where someone experiences “intense, excessive and persistent worry and fear about everyday situations”¹. 

There are various kinds of anxiety disorders which can be caused by different things, making the task of treating anxiety particularly difficult.  Traditional medications for anxiety include things like beta blockers, antidepressants, and tranquilizers².  Unfortunately, people living with anxiety disorders often find that taking these drugs long-term can result in tolerance, addiction, and a host of side effects.  It is because of these issues that medical researchers are searching for alternative anxiety treatments that are safer and more effective.  And lately, some researchers have their eye on the Cannabis plant.  Based on pre-clinical and limited clinical research, Cannabidiol (CBD) may prove to be a therapy worth considering.

What does the research say?

Unlike many other medical conditions, CBD for the treatment of anxiety has actually been studied in humans.  A 2019 study reported that when 18-19 year old teens with social anxiety disorder were given CBD – “CBD significantly decreased anxiety measured”³.  In a study examining the anti-anxiety effects of CBD for public speaking related anxiety, researchers found that CBD reduced anxiety in healthy male and female subjects aged 18 – 35⁴.  Another similar study examining how CBD affects anxiety related to public speaking in patients with social phobia found that CBD was effective at reducing anxiety compared to placebo⁵.  A study that looked at anxiety more generally, rather than social anxiety, found that nearly 80% of patients in the study reported improved anxiety symptoms when given CBD once in the morning after breakfast⁶. 

So how does CBD affect anxiety?

Some of the primary ways that CBD might be able to affect anxiety, that we know of so far, are through several mechanisms:

1. Inhibiting FAAH and increasing Anandamide (improving the endocannabinoid system)
2. Modulating excitatory signaling (affecting the “volume” of brain signaling)
3. Manipulating Serotonin receptors (affecting mood directly)

Balancing the ECS

Cannabinoid receptors, like CB1 receptors, are located all throughout the brain and are involved in many different processes, including modulating mood.  Anxiety disorders are associated with a decrease of CB1 receptors in the brain, as well as an increase in the production of an enzyme fatty acid amide hydrolase (FAAH), that is responsible for breaking down the endocannabinoid Anandamide.  To put it another way – in the brain of an anxious person, there tend to be less CB1 receptors, and less endocannabinoids being produced to interact with those receptors that would normally help modulate mood.  Interestingly enough, these activities are related.  Anandamide typically stimulates CB1 receptors.  If a chemical receptor is not stimulated much (or, alternatively if it is stimulated too much) the receptor can sometimes be down-regulated by the body, which means the body decides to produce less of those receptors and sometimes marks some of the receptors that do exist for destruction and elimination.

The good news is that CBD can help correct this problem.  While CBD does not stimulate CB1 receptors directly, it does have the ability to stimulate the production of Anandamide while also potentially inhibiting the activity of FAAH.  What this means is that more Anandamide is able to do work in your body for longer before it gets broken down by FAAH.  This allows that extra Anandamide to stimulate CB1 receptors, tell your body to produce more of them, and begin to restore balance to the endocannabinoid system.

Turning Down the Volume!

But the story does not stop here.  That CB1 receptor activity is also associated with the activity of neurotransmitters in the brain that are responsible for excitatory and inhibitory signaling.  In a sense, these neurotransmitters affect the “volume” of signals in the brain.  So as CBD changes the endocannabinoid system to produce more Anandamide, which goes on to stimulate CB1 receptors, it initiates a cascade of effects leading to the modulation of the neurotransmitters GABA and glutamate⁷.  GABA is generally thought of as an inhibitory chemical, that tells things in the brain to be quiet, whereas glutamate is a stimulatory compounds that tells things in the brain to get active.  By decreasing glutamate and increasing GABA activity, excitatory signals in the body can be “turned down.”  Already researchers are focusing on GABA and glutamate modulators as potential new anxiety drugs⁸.  Could CBD be another?

Rubbing Shoulders with Serotonin

Finally, CBD targets another chemical system in the body related to anxiety – the serotonergic system.  Serotonin has been a target of anxiety and depression medications for many years now, with selective serotonin reuptake inhibitors, or SSRIs, being a commonly prescribed class of medications for anxiety disorders.  What SSRIs do in the body is prevent the body from breaking down Serotonin so that it will stimulate serotonin receptors more.  This is a very similar concept to the issue brought up earlier in this article regarding FAAH and Anandamide.  SSRI’s basically do what CBD does for Anandamide, FAAH, and CB1 receptor signaling.

Well it turns out that among the many different types of chemical receptors in the body that CBD displays affinity for, Serotonin receptors are one of them!  Specifically, CBD is active at 5HT1A receptors, and less so at 5HT2A receptors⁹ ¹⁰ ¹¹.  This activity at 5HT1A serotonin receptors is interesting because there are anxiety medications that specifically target 5-HT1A, like buspirone¹².

Reducing Blood Pressure

Anxiety is associated with elevated blood pressure.  As the body prepares for its “fight or flight” response, it tends to increase blood pressure and blood flow to send more oxygen and other nutrients to different parts of the brain and body.  There is research that indicates that single doses of CBD may be effective at lowering blood pressure¹³, which could in turn help relieve feelings of anxiety. 

In Summary

CBD has been demonstrated as an effective treatment for certain forms of anxiety in humans.  Additionally, CBD demonstrates several key mechanisms which could be responsible for the reduction in anxiety.  CBD stimulates the production of Anandamide, an endocannabinoid produced by the body that interacts with CB1 receptors.  Additionally, CBD inhibits an enzyme that would normally break Anandamide down, allowing it to linger in the body longer.  As Anandamide stimulates CB1 receptors, it causes changes to a series of neurotransmitters called GABA and glutamate which also influence anxiety. 

CBD also directly interacts with certain serotonin receptors that are thought to be involved in anxiety and depression.  Finally, CBD exhibits blood pressure lowering effects which can result in reduced feelings of fear and anxiety.  With the research available, it is encouraging to see CBD as a useful tool for treating anxiety.

Please use this as a guide and not medical advice.  Written in collaboration with Jason Wilson, MS – a science educator, natural products researcher, an expert on cannabis and cannabinoid science, and creator of the Curious About Cannabis Podcast.