Marijuana Use and Social Anxiety Disorder
Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital.
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Marijuana use for social anxiety disorder is a controversial topic. While marijuana is slowly moving in the direction toward legalization in several countries and has been approved for medical use in Canada, as well as medical and recreational use in certain U.S. states, there is still a lot of confusion about its use in the treatment of anxiety.
While some research supports the use of marijuana (also known as cannabis) in treating social anxiety disorder (SAD), long-term studies on effectiveness still need to be conducted. If you live with social anxiety disorder and are considering medical marijuana as a treatment option, you might feel confused about whether or not it can help.
In addition, if you’ve been a recreational marijuana user, you might feel afraid to talk with your doctor about your use of the drug and its relation to your social anxiety. The following article provides some basic information to help you make an informed decision about whether marijuana might be helpful to you, and the best routes to obtain the best effect.
Components of Marijuana
Understanding the components of marijuana is helpful in learning whether it is effective for social anxiety disorder. First, it’s important to know that there are two main categories of chemicals present in marijuana and that they may have different effects on your social anxiety.
Tetrahydrocannabinol (THC) is the psychoactive part of marijuana, which means it is the part that gives the feeling of being high. Cannabidiol (CBD) is an active part of marijuana that contributes to its pharmacological actions without being involved in the high.
While recreational users are in search of the high that comes from THC, people with anxiety may benefit more from the non-psychoactive component of the drug.
Marijuana for Treating Social Anxiety
In a 2015 review, cannabidiol (CBD) was supported as a treatment for social anxiety disorder (among other anxiety disorders) when administered acutely (over a short period). However, we don’t know what the effects are of long-term use of marijuana.
In addition, THC, CBD, and THC-CBD combinations have been shown to improve sleep quality and duration in anxiety disorders. These findings tell us that marijuana may help reduce social anxiety in the short term and may help you sleep better.
Can Marijuana Use Cause Social Anxiety or Make It Worse?
A 2009 review study found that frequent cannabis users consistently had a high prevalence of anxiety disorders and patients with anxiety disorders had a relatively high rate of cannabis use. However, it was not determined if cannabis use increased the risk of developing long-term anxiety disorders.
This means that we know there may be a relationship between using marijuana and having social anxiety; however, it is not clear which comes first. It could be that people who already have social anxiety are more likely to use marijuana (see the next section on marijuana and avoidance). It could also be that using marijuana frequently leads to a greater likelihood of being diagnosed with an anxiety disorder.
How CBD May Reduce Social Anxiety
Although this is an area of great complexity and the neuroscience is still being worked out, CBD has been shown to work as an anxiolytic, or anxiety-reducing drug. Individuals suffering from social anxiety who were given CBD were found to have increased blood flow in the cingulate cortex, which plays a role in interpreting the reactions of others.
They also experienced decreased blood flow to the hippocampus and parahippocampal gyrus, which are key in forming and recalling memories, and also the inferior temporal gyrus, which helps you perceive faces. In studies with rats, CBD has been shown to reduce aversion to stressful situations.
CBD is thought to inhibit the uptake of anandamide in the PAG. Substances that inhibit the uptake of anandamide have been shown to prevent anxiety. In addition, all of the brain areas involved in anxiety, including the prefrontal cortex, amygdala, hippocampus, hypothalamus, and PAG contain CB1 receptors, which are indirectly involved in the effect of CBD.
As a whole, we still don’t know exactly how CBD has its effect. However, it seems that when using this substance, you may be better able to suppress unpleasant memories of anxiety or embarrassment, and also have a better ability to perceive the reactions of others.
Are People With Social Anxiety More Likely to Use Marijuana?
A 2012 questionnaire study showed that people with clinically meaningful social anxiety were more likely to use marijuana to cope with social situations and to avoid social situations if they could not use marijuana. In addition, a 2011 study found that social avoidance was related to marijuana problems and that men with greater social avoidance showed the most severe in terms of marijuana-related problems.
These findings suggest that as a recreational user, you may be more likely to use marijuana if you live with social anxiety, particularly if you are male and tend to avoid social situations. You might find yourself needing to use marijuana before a social event in order to get through it, or may avoid events where you know that you won’t be able to get high to cope with your anxiety.
Medical marijuana is prescribed by a doctor to help with various medical conditions such as chronic pain, cancer, and even anxiety. In Canada, this is regulated by the Access to Cannabis for Medical Purposes Regulations (ACMPR), which came into effect on August 24, 2016.
As for the United States, as of 2019, use of cannabis for medical purposes was legal in 33 U.S. states, the District of Columbia, as well as the territories of Guam, U.S. Virgin Islands, and Puerto Rico.
For some people, daily marijuana use may be related to negative consequences. Marijuana has the potential to intensify existing feelings, so the risk for negative effects may be greater if you use it in an unfamiliar or stressful setting, if you are already depressed, or if you’ve never used marijuana before (such that there is a fear factor involved).
In addition, people who use marijuana have been shown to perform more poorly in terms of information-processing speed, working memory, executive functioning, and visual and spatial perception. Long-term effects may include neurocognitive deficits, psychosis, respiratory ailments, and possibly cancer.
Research has also shown that it may be safer to ingest marijuana or to use a vaporizer than to smoke it directly. A low dose at the start is also preferred, just as with any other medication for a mental health condition. Marijuana should also not be used for social anxiety if you have existing problems with substance abuse.
The ideal medical marijuana for social anxiety disorder would have a significant quantity of CBD and low levels of THC, which has been shown to induce anxiety and panic. Safe access to marijuana varieties with this combination of concentrations would allow for the beneficial effects without the potential drawbacks.
There are many alternatives to treating anxiety if medical marijuana is not the right option for you. Meditation and mindfulness are two methods for calming the mind and slowing down anxiety. These are also strategies that you can practice on your own. If you are comfortable with mainstream treatment, social anxiety disorder respond well to traditional medication and therapy such as cognitive-behavioral therapy (CBT).
A Word From Verywell
If medical marijuana is available for a prescription where you live, it may be one option to help reduce social anxiety. At the same time, this type of treatment is still in its infancy and more research is needed to confirm marijuana’s effectiveness and safety for this use. If you do find yourself using marijuana to treat your social anxiety, be sure it has a higher proportion of CBD and a lower proportion of THC for maximum benefits. Also be sure to tell your doctor if you are using recreational marijuana to self-medicate, as prescribed medical marijuana may be an option and be more helpful for you.
Learn about the use of medical marijuana to treat social anxiety, including the components of the drug that may be most effective against SAD.
Does marijuana help with anxiety? Maybe, but reports are mixed
Research is scarce about how marijuana can affect anxiety symptoms like irritability, muscle tension, and excessive worrying. For some people, marijuana may even increase anxiety.
Here’s what experts know so far about how chemicals in marijuana affect the brain and why that may help, or enhance anxiety.
The uses of marijuana for anxiety
There are two main chemical compounds in marijuana: tetrahydrocannabinol (THC) and cannabidiol (CBD).
Both attach to specific receptors in the brain, which trigger the various sensations you feel. THC is the chemical that produces the high you experience when you use marijuana, while CBD has a more subtle, non-intoxicating effect.
Though some US states have legalized marijuana, there are still restrictions in place against using marijuana in medical research. Therefore, there’s limited scientific proof that marijuana can alleviate anxiety. But that hasn’t stopped people from using the drug to find relief.
A 2016 survey of medical marijuana users found that 58 percent of users say they use marijuana to treat their anxiety. And in a small 2012 study, two-thirds of college students with high social anxiety reported that they smoke marijuana to help them cope with social situations.
Given the lack of scientific research, it’s unclear what chemical in the marijuana plant may help with anxiety — whether it’s THC, CBD, a combination of both, or something else entirely.
But a 2015 review of 40 preliminary studies on CBD found that this chemical may play a key role. The researchers said they found encouraging, preliminary results that concentrated doses of CBD oil, when taken regularly, could be an effective treatment for a host of anxiety disorders including:
- Generalized anxiety disorder
- Panic disorder
- Social anxiety disorder
- Obsessive-compulsive disorder
- Post-traumatic stress disorder
The drawbacks of marijuana for anxiety
Even if the restrictions on marijuana were lifted, and researchers could use it in their studies, there’s another problem.
Both anxiety disorders and marijuana sensations are individualized. So, marijuana may help one person with their anxiety but not another. Take the following example:
Someone with generalized anxiety disorder symptoms like difficulty sleeping may have a better reaction to marijuana than someone with panic disorder who fears losing control.
Even worse, using marijuana could enhance symptoms of anxiety for some people, says James Giordano, PhD, a professor of neurology and biochemistry at Georgetown University Medical Center.
“Some are overly sensitive to the ‘activating’ effects of THC, and this can induce anxiety, rather than reduce or relieve it,” Giordano says.
Then, there’s the chance that smoking marijuana won’t reduce or enhance anxiety at all. That was the case for college students surveyed in a 2012 study who said they did not see a significant change in their anxiety after smoking.
The risks of using marijuana
Even if marijuana does help with your anxiety symptoms, it comes with risks to your physical health. For example, it can impair motor coordination and control.
“This could be problematic when driving, or engaging in tasks that require fine motor and coordination skills,” Giordano says.
Using marijuana has also been found to cause short-term memory loss in people who start smoking it in their teen years. Though, how it affects long-term memory is unclear.
Lastly, a 2018 review found evidence that smoking marijuana can increase the risk of heart issues like an irregular heartbeat — particularly in older age groups. Though, this may be a consequence of the act of smoking and not related to what is being smoked.
The bottom line
It’s difficult to say whether marijuana can help you, specifically, with anxiety.
If you do decide to try marijuana, it’s important to talk to your doctor about it to get a professional opinion, Giordano says.
If it’s a new experience, it’s best to start with a very small amount and to be in an environment that can give you support and assistance if needed.
Studying marijuana is restricted, but researchers have evidence that the CBD compound in marijuana may help treat many different anxiety disorders.