Does CBD Oil Actually Work for Anxiety? The Answer is Complicated
Three experts weigh in.
Updated Sep 29, 2021 6:38 AM
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In less than five years, CBD has become the poster child of the wellness world. Once eclipsed by the psychoactive cannabinoid THC, this subtle compound has infiltrated our cultural lexicon and emerged as marijuana’s unsung hero ingredient.
Now, there’s seemingly nothing CBD can’t fix. Not unlike Gus Portokalos’s relationship to Windex in My Big Fat Greek Wedding, our society seems to view CBD as a band-aid for virtually any ailment, mental or physical. Anxious? CBD. Acne or aging skin? CBD. Muscle soreness? CBD. Migraine? CBD. Insomnia? CBD.
Unsurprisingly, the internet is peppered with anecdotal accounts of CBD’s miracle properties. But, while CBD is steeped in far more science and history than say, Gwyneth Paltrow’s infamous jade egg, it’s fair to feel skeptical about anything that’s this ubiquitous (especially in the largely unregulated wellness world). There’s a major question to be considered: Does CBD oil for anxiety actually have an effect or is it all just one big placebo?
According to three different experts, it’s less of a question of efficacy than it is quality and education. Without question, CBD and cannabis, in general, have scientific and medicinal merit, but one could argue that the enormous profit opportunity in CBD, coupled with a lack of government regulation, has allowed it to be exploited. The challenge is in navigating this evolving industry to find a high-quality product that works for you. Keep reading to see what two CBD experts and a medical cannabis consultant have to say about the CBD craze, plus how to safely and effectively use CBD oil for anxiety.
The hard science behind CBD is promising
Yes, CBD does work to treat anxiety—at least on a physiological level. “There’s definite science that demonstrates, unequivocally, how CBD works to treat anxiety,” said Martin Lee, director of Project CBD and author of Smoke Signals. He points to two anxiety-related receptors in the brain that are affected by CBD: the serotonin 5HT1A receptor and the GABA receptor.
Studies have shown that CBD is a “powerful activator” of the serotonin 5HT1A receptor, which effectively “regulates the experience of anxiety,” Lee explains. The GABA receptor, on the other hand, is activated by drugs like Valium, Xanax, and alcohol. Unlike these substances, CBD doesn’t activate the GABA receptor to produce a sedating effect—it merely “changes the shape of the receptor” and “makes the receptor function more potently.” In other words, the science says that CBD can help you relax.
Take it from Dr. Frank Lucido, a Berkley, California–based family medicine doctor and medical cannabis consultant who has been recommending different cannabis treatments to interested patients for over 20 years. According to his practice surveys, “anxiety is among the top six reasons for using cannabis,” he explains, referring to both CBD-based products and CBD-THC products. “Chronic pain seems to be number one,” followed by “depression, anxiety, insomnia, gastrointestinal issues, and headaches.”
But there’s still research to be done
With that being said, most of what we know about CBD is based on pre-clinical research, or “research with animals, test tubes, petri dishes, and so forth,” says Lee. “It’s very interesting [work] and it underscores a lot of potential, but there’s a big missing area concerning clinical studies of CBD,” which refers to testing on humans.
Aside from a promising study out of Brazil, which found that a dose of single-molecule CBD mitigated social anxiety in people who were about to give a speech, most of the significant clinical research is still in the works. For example, The Realm of Caring, an independent, high-impact 501(c)(3) nonprofit located in Colorado Springs, has been collaborating with Johns Hopkins University on the largest observational cannabis study in the United States since 2016. “We’ll be publishing data soon in regard to mood, anxiety, and depression that shows CBD having a positive effect on our participants,” said The Realm of Caring founder and CEO Heather Jackson. “This is not a wellness fad but a plant-based dietary option that I think will prove to be a safe and effective therapeutic approach.”
Medical cannabis also has history on its side. “We have very compelling historical data going back thousands of years [showing that] CBD or CBD-rich cannabis was used to treat many diseases and conditions,” adds Lee. According to Project CBD, the earliest reference to the therapeutic use of cannabis dates back to 2700 B.C. in ancient China, while the US Dispensatory first recommended cannabis tinctures for pathologies such as depression, neuralgia, chronic pain, muscle spasms, and hemorrhages back in 1854.
CBD education is key—until regulations step up
So if the science is there, why are the results so lackluster for some? To put it simply, it all boils down to limited access to high-quality products and a lack of education.
“The explosive interest in CBD has led to easy access but poor quality,” explains Lee. Because CBD isn’t properly regulated, pretty much anyone can link up with a supplier, produce CBD products, and cash in on the trend. “There are all sorts of ways in which the whole regulatory apparatus is driving things the wrong way in terms of CBD,” he adds. “The policies should be [geared] toward easy access, good quality products, and education, and that’s not what we’re seeing generally.”
Dr. Lucido echos that sentiment. “We’re seeing a lot of people marketing CBD in just about everything,” he said. “I think it really should be treated as a medicine. Not everybody needs CBD sprinkled in everything, any more than we need vitamin C sprinkled in everything. I think it’s overhyped, but for those who it’s useful for, it can be very useful.”
As it stands now, people have to be very conscious consumers and do their research before buying a CBD product, especially if you live in a state where medical cannabis isn’t legalized. “If you’re in a state that has a medical marijuana program like the one we have in California, then you’re in good shape,” explains Lee. “You can walk into a store on the corner and buy a product that’s been tested for pesticide residues, and what’s printed on the label actually matches what’s in the bottle.” If you buy an inexpensive CBD product offline from an unverified retailer, for example, it will most likely be a waste of money. “There are a lot of crops that are basically just garbage out there,” says Lee. “They’re using CBD to sell a product.”
A lack of education around CBD and medical cannabis, in general, is another issue. “People don’t know what to do or how much to take or what to take,” he explains. “We hope that people [don’t] get discouraged because they buy something that doesn’t work and they think something’s wrong with them because it seems to work for everybody else,” he adds. “It’s just not fair to people because there really is something very valuable with CBD and cannabis therapeutics but not as the big commodity that everybody’s jumping on.”
Don’t set your expectations too high, though
Because CBD is technically a form of medical marijuana (though one that does not have psychoactive effects), people tend to anticipate a powerful effect. But contrary to popular belief, CBD isn’t “nature’s Xanax”—it doesn’t always work instantly, it doesn’t make you feel “high” in any way, and it’s not sedating. I’d argue that educating yourself and reframing your expectations prior to trying CBD can drastically change your experience.
“There’s a misperception that CBD is sedating,” says Lee. “CBD in small doses actually tends to be stimulating. It’s very similar to caffeine in a way; it acts in the same pathways.” He describes the feeling as being subtly alert but not speedy. “If you’re having a good day, it’s probably working,” he adds. In Heather Jackson’s opinion, CBD can make you “more resilient to everyday stressors” and provides an “overall sense of calm.”
Users should also reframe their expectations around timing; it can take some experimentation and patience. “Everybody responds to CBD oil differently,” explains Jackson. “Some individuals only need a few drops to find symptom relief, whereas others may need a lot more.” As a general rule of thumb when using CBD oil for anxiety, start with a low dose of a high-quality product, increase it slowly over time, and pay close attention to how you’re feeling. “We’ve had some accounts where people take a very small amount of CBD and have the best day they’ve had in years,” explains Lee. “Other people are at it over and over, and they just never find it; everyone’s different. Don’t be discouraged—there’s real value—just do your research.” Price point is also important. If you want to find a CBD oil that actually works, be prepared to shell out $100 or more.
Finally, don’t expect CBD to be an anxiety cure-all. Depending on the individual, it may not even serve as a viable replacement for prescription anti-anxiety or antidepressant medications. “CBD is merely one tool in your toolkit,” says Heather. “Individuals should consider diet, exercise, meditation, and the like. CBD alone is not a silver bullet, but when used in conjunction with other holistic lifestyle choices, it can be very beneficial.”
Follow these steps before trying CBD
There’s a right and wrong way to do CBD. Because of the explosive popularity of the compound and the lack of regulation surrounding it, the medical cannabis industry is basically the Wild West. To Lee’s earlier point, finding a safe, high-quality, and effective CBD oil shouldn’t be this complicated, but right now, it is. To safeguard yourself against useless, gimmicky CBD products and increase your chances of having a positive experience, consider the following:
Talk to your doctor before starting something new
Jackson and The Realm of Caring team recommend checking with your healthcare provider when treating medical symptoms and conditions with CBD. Of course, there are special considerations, like women who are pregnant and breastfeeding, individuals with psychotic conditions, and some autoimmune disorders. Finally, using pharmaceutical medication doesn’t disqualify you from using CBD, but it’s important to reduce the likelihood of drug interactions by spacing their medications from CBD.
Find a high-quality product
This is arguably the most important bit. According to Project CBD, you should look for products with clear labels showing the quantity and ratio of CBD and THC per dose, a manufacturing date, and a batch number. Avoid ingredients like corn syrup, trans fats, GMOs, artificial additives, thinning agents, or preservatives. CBD-rich products should be lab-tested for consistency and verified as being free of mold, bacteria, pesticides, and solvent residues. Avoid products extracted with solvents like BHO, propane, hexane, or other hydrocarbons. Safer extraction methods include supercritical CO2 or food-grade ethanol. If you live in a state where medical marijuana is legal and available, look for CBD products made from high-resin cannabis (rather than low-resin industrial hemp) that are sold in state-licensed dispensaries. Do your research—read online reviews and ask your friends what’s worked for them.
Dose low and slow
Don’t rush the process with an overly high dosage, specially when using CBD oil for a mental health condition like anxiety. Remember that every individual is different. As Project CBD reports, an effective dose can range from a few milligrams of CBD oil to a gram or more. Take a few small doses over the course of one day rather than one big dose and stick to the same dose for several days. From there, observe the effects and adjust the dose if necessary. While CBD has no adverse side effects, an excessive amount could be less therapeutically effective than a moderate dose. Generally speaking, less is more.