Medically reviewed by Mary Lucas, RN
Written by Our Editorial Team
Last updated 10/23/2020
If you’ve searched for information about treating anxiety, you’ve no doubt come across mentions of cannabidiol, or as it’s more commonly known, CBD.
Cannabidiol, or CBD, is one of more than 100 naturally-occurring cannabinoids that are found in the cannabis plant. In recent years, it has grown in popularity, transforming from a niche natural health product into a widely promoted natural treatment for, well, just about everything.
If you’re familiar with CBD, you’ve probably seen it promoted as a natural treatment for chronic pain, for acne or even for certain side effects of other medical treatments.
One of the common uses for CBD is as a natural remedy for anxiety. Some CBD users state that CBD makes them feel less anxious without any of the side effects that can occur with other anti-anxiety medications.
These claims sound encouraging, but are they backed up by any real evidence?
Below, we’ve looked at what CBD is and how it works, as well as the current scientific evidence to support its use as a natural treatment for certain forms of anxiety.
We’ve also examined several of the most common anxiety-related claims about CBD and how they stack up next to the evidence.
CBD is a naturally-occurring chemical compound that’s found in the cannabis plant. It’s referred to as a cannabinoid — a type of chemical compound that acts on the cannabinoid receptors found throughout your body’s endocannabinoid system.
People tend to associate cannabis with tetrahydrocannabinol, or THC — the cannabinoid that makes you feel high.
Although THC and CBD are nearly similar from a chemical structure perspective, they have totally different effects on your body.
THC binds to receptors in your brain, affecting everything from your mood and thoughts to other bodily processes. It’s the cannabinoid that triggers cannabis’s psychoactive effects.
CBD, on the other hand, doesn’t cause you to feel high. Instead, it’s linked to a range of effects, from increased feelings of relaxation and improvements in sleep to reductions in certain forms of chronic pain.
Today, CBD is available in a large variety of forms. It’s most commonly sold as CBD oil, although it’s also easy to find in capsules, teas and other products.
Laws regarding CBD products can vary between states, meaning you’ll need to check your local laws before purchasing anything that contains CBD. You can find a list of states in which CBD is legal in our guide to where you can legally buy CBD.
Although researchers aren’t completely sure about how CBD works in the body, research tends to show that CBD interacts with the body’s cannabinoid type 1 (CB1) and type 2 (CB2) receptors.
These receptors, which are part of the body’s endocannabinoid system, may alter the neurotransmitter signals released by your nervous system.
Right now, the FDA has not approved CBD as a medicine for treating anxiety. In fact, the only FDA-approved medicinal use of CBD is as a treatment for several epilepsy syndromes, under the brand name Epidiolex®.
However, CBD is widely sold and used as a supplement, with many users claiming that it can help treat and manage the symptoms of anxiety.
Although most research into the relationship between CBD and anxiety symptoms is still in its early stages, there’s some evidence that CBD might be helpful in managing certain symptoms of anxiety.
Most of this comes from animal studies, of which there are several exploring the connections between CBD and anxiety. However, there are also several studies of CBD’s effects on some forms of anxiety involving humans.
In a 2010 study, researchers examined the effects of CBD on human pathological anxiety and its underlying brain mechanisms. Over two sessions, the researchers provided 10 people with generalized social anxiety disorder (SAD) either 400mg of CBD or a non-therapeutic placebo.
In the second session, the drugs used were reversed, with those who received the placebo in the first session this time receiving the CBD, and vice-versa.
The researchers found that, relative to placebo, CBD was linked to a “significantly decreased” level of subjective anxiety. The study concluded that CBD reduces anxiety in people with SAD and that this reduction is related to its activity in the limbic and paralimbic areas of the brain.
A second study involving people with general social anxiety disorder and CBD, this time from 2011, produced similar results.
In this study, a total of 24 patients with SAD were divided into two groups, with one receiving a 600mg dose of CBD and the other a non-therapeutic placebo. The patients were then asked to undergo a simulation public speaking test (SPST).
As part of the test, the researchers looked at both the patients’ self-reported data and several physiological measures of anxiety, such as heart rate and blood pressure.
The researchers found that pretreatment using CBD “significantly reduced anxiety, cognitive impairment and discomfort in ... speech performance” in people with SAD. The patients that received CBD also had significantly decreased alert before undergoing the speaking test.
The patients that received the non-therapeutic placebo, on the other hand, displayed higher levels of anxiety, cognitive impairment, alert and discomfort.
Another study from 2019 looked at the relationship between CBD and improvements in sleep and anxiety.
In this study, 72 adults with concerns of anxiety or poor sleep received treatment with CBD from a Colorado mental health clinic. Almost all of the patients were given a dose of 25mg of CBD per day in capsule form, although some patients received doses of 50mg to 175mg.
After two months of treatment, 78.1 percent of the patients given CBD reported an improvement in anxiety, with 56.1 percent reporting improvements in sleep.
While the results of this study are promising, it’s important to put them in context. This was a naturalistic study without a comparison group. As part of routine clinical care, some patients also received other psychiatric medications throughout the study period.
As such, it’s difficult to conclude that CBD on its own was responsible for the improvement in anxiety symptoms that many patients experienced.
There are also several noteworthy studies related to CBD’s potential effects as a treatment for different types of anxiety, as well as conditions that can potentially cause anxiety.
In a 2013 study, researchers found that CBD can improve extinction learning — a behavioral phenomenon in which a non-reinforced conditioned response, such as fear that’s related to a specific event or experience, fades away over time.
In a study from 2019, researchers found that use of CBD was associated with a reduction in post-traumatic stress disorder (PTSD) symptoms, including relief from nightmares caused by PTSD.
On the whole, the scientific evidence in favor of CBD as a treatment for anxiety is extremely promising. Most studies of CBD and anxiety appear to show that it can improve a variety of anxiety symptoms, although these studies are often limited in scope.
However, it’s important to remember that there isn’t yet any comprehensive evidence showing that CBD can effectively treat anxiety, or that it’s an effective option for everyone.
As such, it’s best to view CBD as a “maybe,” at least when it comes to anxiety.
While the data that’s available right now is promising and certainly demonstrates its potential, we need more data from the experts before it’s okay to put CBD in the “definitely” category as a treatment for anxiety.
Just like other common supplements and medications, the effects of CBD can vary based on the dosage you use.
Because CBD isn’t regulated by the FDA, there’s no specific dosage that’s recommended for people with anxiety. Instead, most people who use CBD work out their dosage using several factors, from body weight and previous use of CBD to the severity of their symptoms.
The specific type of CBD product you’re using — for example, CBD oil, gummies, capsules or tea — can also affect the dosage that’s optimal for you.
In general, the best approach is to follow the dosage instructions provided with the CBD oil or other CBD product you’ve purchased. Often, the packaging will specify a recommended dose, or provide a suggested dosage range.
Depending on your anxiety symptoms, your body weight and your tolerance to CBD’s effects, it may take several days or weeks before you find the CBD dose that works best for you.
Most studies of CBD have shown that it’s safe to use and well tolerated. However, several side effects associated with CBD have been recorded. These include fatigue, diarrhea, changes in appetite and changes in weight.
Because research into CBD is still in the early stages, there’s limited data on how common side effects are amongst CBD users. In a clinical review of CBD, researchers noted that 21 percent of CBD users reported tiredness, 17 percent diarrhea and 16 percent a reduction in appetite.
It’s worth noting that this data comes from studies of people with epilepsy who used Epidiolex, a CBD-based medication, for treatment.
As for CBD’s safety, several reviews have concluded that CBD generally has a favorable safety profile. In a 2011 review, researchers reported in some studies that even when used in extremely high doses of up to 1,500mg per day, CBD appeared to be well tolerated.
Further research carried out in 2017 found that CBD has, based on current data, a better side effect profile than other drugs used to treat epilepsy and psychotic disorders.
With this said, it’s important to remember that CBD hasn’t yet undergone the extensive safety testing that medications face before being approved by the FDA. As such, there could be side effects to CBD use that we don’t yet know about due to research limitations.
It’s also important to note that many CBD products, despite ostensibly being safe, may contain ingredients that aren’t listed on the label. The FDA recently warned consumers about this issue after testing CBD products and finding that many did not contain accurate levels of CBD.
In some cases, this can have severe consequences. For example, in 2017, 52 people in Utah experienced vomiting, nausea, shaking, seizures and an altered mental state after ingesting a CBD product that contained the synthetic cannabinoid 4-cyano CUMYL-BUTINACA (4-CCB) but no CBD.
Because of this, if you’re considering CBD as a natural option for treating anxiety, it’s important to choose a reputable CBD product from a trustworthy company.
It’s also important to talk to your doctor before using CBD, especially if you’re prescribed other medications. Although CBD is generally safe, it does have the potential to interact with certain medications, including some antidepressants, beta blockers and calcium channel blockers.
Although research is still in its early stages, existing studies appear to show that CBD has the potential to reduce the symptoms of certain forms of anxiety. There’s also some evidence that CBD may be able to improve sleep quality in people who experience difficulty sleeping.
However, these studies are by no means conclusive, and CBD isn’t approved by the FDA as a treatment for any forms of anxiety. Because research is still ongoing, we can’t yet say that CBD is definitely an effective treatment for anxiety.
If you have anxiety, it’s best to talk to a doctor about the best treatment options. Depending on your symptoms, your doctor may recommend a range of different treatment options that could potentially include CBD.
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