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Is Marijuana the Answer to Anxiety Problems?

Recent research reviews the pros and cons of cannabis for anxiety.

Sherry Young/Adobe Stock
Source: Sherry Young/Adobe Stock

As more and more states legalize marijuana use, an increasing number of people are turning to it as a way to manage overwhelming anxiety. Marijuana is well-known to have a calming effect for many people, so it’s not surprising that it’s often used in this way.

However, there is scant research on the safety and effectiveness of cannabis for anxiety, as a recent review concluded. (Please note that I’ll be focusing on the psychoactive form of marijuana, not cannabidiol or CBD.)

Some studies have found that THC (the chemical in marijuana that’s primarily responsible for the “high”) does lower anxiety, while others have found that it increases anxiety. This finding isn’t surprising given that many individuals I’ve spoken with have had a panic attack after using marijuana, often because of the strange physical sensations they experienced.

There are also side effects to consider, such as orthostatic hypotension—a drop in blood pressure when transitioning from sitting or lying to standing which causes dizziness and lightheadedness. Existing studies have tended to use a single dose of marijuana, as well, so it’s unclear what the longer-term effects might be.

I recently spoke about using marijuana to deal with anxiety with Dr. Joel Minden, a clinical psychologist who specializes in the treatment of anxiety. Minden is a fellow blogger on Psychology Today, and he happens to work in California, a state where marijuana is legal for medical and recreational use.

Minden noted that many people tend to use substances like alcohol or marijuana to try to relax when they’re feeling really anxious. “Some say that marijuana helps them unwind after work or fall asleep at night. I think it’s important to be nonjudgmental,” he said, “because it’s really not up to me to decide whether someone should or shouldn’t use it. Some people say, ‘I smoke pot, and I get my stuff done, and I feel pretty good about the way I handle things,’ and I look at it like, Who am I to say, ‘Stop doing that?'”

However, Minden pointed out the potential downsides of using marijuana to cope with anxiety. “When people are struggling with anxiety, and they believe marijuana helps them, they’re often focusing more on the short-term benefits of smoking pot. But if they look at some of the long-term issues—like not being very productive in other areas of life, or avoiding social activities or other challenges—it’s important to consider how marijuana use might impact those things.”

Minden’s remarks offer a broader perspective on the question of whether it’s a good idea to use marijuana to treat anxiety. It’s hard to find any substance that eliminates anxiety—whether marijuana, alcohol, or prescription medication—that doesn’t also reduce engagement in life.

It’s also important to consider the opportunity cost of using a substance like marijuana to manage anxiety. When we rely routinely on chemicals to regulate our emotions, we don’t learn to practice other ways of coping. According to Minden, “It’s important to be able to work through challenges rather than avoiding them,” or relying on marijuana “to feel better when things seem overwhelming. That might work in the short term, but in the long term, it’s not a very effective strategy.”

There seems to be a general rule that a substance which provides acute symptom relief does so at the expense of functioning, as is often the case for prescription medications. Most psychiatrists prefer to prescribe sedating medications like alprazolam (Xanax, a benzodiazepine) only as a short-term strategy for treating anxiety. Benzodiazepines act on the same neurotransmitter system as alcohol and other depressants and have a quick calming effect.

However, sustained benzodiazepine use is associated with risks like physical dependence, memory impairment, and falls. In the long term, many psychiatrists prefer to prescribe medications like the selective serotonin reuptake inhibitors (SSRIs), which don’t produce the same immediate relief, but also don’t have the same risks as benzodiazepines.

So what are some alternatives to marijuana use for dealing with distressing emotions like anxiety?

  • Exercise, which may reduce anxiety in the short term, and also has longer-term, cumulative benefits.
  • Tending our thoughts, especially the “anxious fictions” about things we’re worried might happen
  • Gradual exposure to our fears, which not only reduces our anxiety over time, but also strengthens our feelings of strength and trust in ourselves
  • Meditation and other mindfulness practices, which can pull us away from our preoccupation with a feared future
  • Eating a healthful diet, like the Mediterranean-style diet, low in processed foods and high in foods like fruits and vegetables, nuts, legumes, fish, whole grains, and healthy fats like olive oil
  • Meaningful engagement in life, which is consistently linked to lower levels of anxiety

How we deal with life’s difficulties, whether stress, anxiety, trauma, irritating family members and exes, or anything else, is a very personal decision. We might decide to anesthetize ourselves, whether through marijuana or entertainment or anything else. At other times we may choose to rely on and develop our own internal resources, like when we face our fears directly and strengthen our ability to tolerate discomfort. Each of us will decide for ourselves where the balance lies.

My full discussion with Joel Minden is available here.

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Turna, J., Patterson, B., & Van Ameringen, M. (2017). Is cannabis treatment for anxiety, mood, and related disorders ready for prime time? Depression and Anxiety, 34, 1006-1017.

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