Cannabidiol (CBD) oil is produced by the dilution of CBD extracts with carrier oils such as hemp seed oil.
CBD is a phytocannabinoid obtained from the hemp plant, Cannabis sativa, and has the ability to moderate a variety of physiological responses by binding to specific receptors of the endocannabinoid system (ECS).
CBD is not psychoactive and has been proven to confer several health benefits.
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Overview of Anxiety
Anxiety is simply an emotion marked by a state of internal turmoil which is usually accompanied by nervous behaviour and overthinking.
It is often just an overwhelming feeling of dread over the perceived outcome of anticipated events.
While the emotion itself is quite common and can be appropriate, however, the anxious state becomes consistent, the individual might suffer from a more serious form of anxiety disorder.
Benefits of CBD in Anxiety
The major benefits of CBD in treating anxiety disorders are linked with its nature as a phytocannabinoid which can modulate neurotransmitter activity. CBD has an overall anxiolytic effect and can, therefore, manage and lower the symptoms of generalized anxiety disorder as well as improve public interactions in individuals with social anxieties.
CBD also helps in fear memory extinction which plays a key role in treating symptoms in people suffering from PTSD. The relaxing effect also lowers the compulsive behaviours and obsessive thoughts in people with OCD. CBD also promotes peaceful sleep in individuals suffering from anxiety.
1. CBD Reduces Generalized Anxiety Disorder (GAD)
Generalized anxiety disorder (GAD) refers to an anxiety disorder marked by uncontrollable, recurrent, and often baseless worry in anticipation of certain events or situations.
Such excessive worrying often affects daily life, because people suffering from GAD always expect the worst-case scenarios.
Individuals often experience a wide range of physical symptoms such as fidgeting, numbness in hands and feet, difficulty in swallowing, trembling, shortness of breath, sleep disturbances, and even vomiting.
In order to be diagnosed with GAD, these symptoms need to be consistent for a period of at least 6 months.
People with a family history of GAD or a genetic predisposition for it are more likely to develop the issue, particularly as a response to a life stressor.
Excessive use of medication like benzodiazepines can also lead to anxiety. Similarly, alcohol abuse has also been linked with the development of GAD.
The onset of GAD has been associated with a malfunctioning of the brain’s amygdala which is involved in the processing of fear and anxiety.
The basolateral complex and the adjacent central nucleus of the amygdala are involved in processing fear-specific sensory information and controlling specific fear-responses in the connections to separate areas of the brain.
In GAD, such connections lose their functional integrities and become less distinct. This results in abnormal fear processing and leads to the development of excess anxiety.
As a result, mental disorders are difficult to prevent however, several techniques can be used to manage and relieve anxiety.
CBD and other cannabis-derived compounds have shown great potential in reducing GAD.
A 2015 review by the New York University School of Medicine has shown that, as a phytocannabinoid, CBD helps in lowering generalized anxiety as it stimulates neurotransmitter activity.
By stimulating the activity of neurotransmitters, CBD helps in lowering and managing GAD.
2. CBD Lowers Social Anxiety Disorder
Social anxiety disorder, also known as social phobia, currently ranks as the third largest mental health issue across the globe.
It denotes a fear of social situations which involves interaction with other people, particularly strangers.
It might stem from the notion of being unfairly judged and evaluated by other people and results in anxiety that can affect the quality of life.
People suffering from social anxiety often come across as shy, quiet, withdrawn, inhibited, nervous, aloof, or even unfriendly.
However, that might not be the case as several surveys have shown that such individuals often want to make friends, be engaged in social activities, and be involved in groups. Yet, paradoxically, their anxiety prevents them from being sociable.
Individuals with social anxiety usually are aware of the fact that their anxieties and fears are irrational and baseless, in most of the cases.
Nevertheless, this insight does not help in suppressing the anxious thoughts as the disorder often becomes chronic leading to extreme difficulties in dealing with social situations.
The feelings that are characteristic of social anxiety include high levels of fear, severe anxiousness, and negative emotions.
Physical symptoms include increased heartbeat, palpitations, blushing, unnatural sweating, dryness of mouth and throat, and muscle twitching. Individuals may also suffer from dysmorphia wherein they perceive themselves negatively.
Cognitive-behavioural therapy is one of the best ways to treat such an issue. CBT has proven to be successful in lowering social phobias in people.
Medications are also used, less frequently, to lower the complications related to social anxiety. Furthermore, cannabis-derived products have been proven to be beneficial in lowering fear and anxiety in social situations.
A 2011 placebo-controlled study by the University of São Paulo observed the role of cannabidiol on social anxiety in public speakers.
It was established that pre-treatment with CBD reduced anxiety and discomfort during the speech as compared to the placebo group.
The anxiolytic effect of CBD was attributed to its ability to mediate the endocannabinoid system (ECS).
CBD helps in lowering anxiety and discomfort in people suffering from social anxiety disorder and improves their interactions in public.
3. CBD Reduces Post-Traumatic Stress Disorder (PTSD)
Post-traumatic stress disorder, commonly referred to as PTSD, is a condition that usually develops in some people after they have gone through a shocking and traumatic event.
It is most commonly reported in war veterans and sexual assault survivors.
Surveys have shown that most people who have experienced some form of trauma will not develop PTSD. The onset of this disorder often rests on the nature of the traumatic incident.
It has been established that people have gone through interpersonal trauma such as rape or child abuse are more likely to experience PTSD.
While it is quite natural to feel frightened during and after a threatening situation, the condition becomes problematic when the fear grows into a persistent state of mind.
Generally, fear stimulates a wide variety of physiological responses that help in overcoming the stressful situation.
This is known as the ‘fight-or-flight’ response and is usually meant to protect the individual from any harm.
Fear memories often trigger the development of PTSD in people already suffering from anxiety.
Such memories lead to the formation of vivid mental imageries or flashbacks that prevent the patients from getting on with their daily lives. Many people with PTSD report the re-experiencing of trauma in the form of nightmares or uncontrollable thoughts.
Usually, patients may try to block trauma-related thoughts and prevent discussions on the topic. They might also experience a defence mechanism in the form of partial amnesia regarding the event.
However, the traumatic incident is often relieved by the individual by means of intrusive thoughts, persistent recollections, and dissociative episodes wherein the trauma is re-experienced as flashbacks.
PTSD can be prevented by targeting therapy towards individuals with early symptoms but it is often not effective in case of all individuals as people may respond to therapy differently, depending upon the nature of the trauma.
The major treatments include counseling or medication.
Selective serotonin reuptake inhibitors or SSRIs are the principal medications for therapy and often benefit about 50% of the sufferers.
However, these medications are not as effective as cognitive therapies which provide respite from PTSD attacks in the long run and promote normalization of the people’s lives. Medications like benzodiazepines may worsen the condition and hence are not administered.
Cannabinoids like CBD have become popular in combating anxiety in the past decade and effectively reduce the debilitating effects of such attacks.
CBD calms the mind and relaxes the senses, thereby prevents the individual from reliving the traumatic experience that increases mental and emotional stress.
A 2016 review by the University of Haifa assessed the role of CBD in managing anxiety related with PTSD.
It established that several animal models have been used to prove that CBD can prevent the effect of stress on emotional function and can also aid in fear memory extinction.
This phytocannabinoid also reduces the frequency of nightmares and can hence reduce anxiety caused by PTSD.
CBD can help in managing the symptoms of PTSD by reducing emotional stress and helping in fear memory extinction. As a result, it helps in lowering anxiety.
4. CBD Relieves Obsessive-Compulsive Disorder
Obsessive-Compulsive Disorder (OCD), also resulting in anxiety and stress, is a common, long-lasting disorder in which the patient has a series of uncontrollable, recurring thoughts or obsessions and reacts to them via a particular type of behaviour known as compulsions.
They usually feel the urge to repeat these compulsions over and over again.
People suffering from OCD may exhibit symptoms of obsessions, compulsions, or in severe cases, both.
These symptoms generally affect several aspects of life including work, academic life, and even interpersonal relationships.
Obsessions commonly denote recurrent thoughts, mental images, or simply urges that initiate anxiety.
The common symptoms include fear of germs, taboo thoughts involving self-harm or injury, aggressive and violent thoughts concerning others or oneself, or simply being overly particular about having things in a perfect order.
Compulsions typically denote the range of behaviours that are the outcomes of harbouring such obsessions.
They can be manifested as excessive cleaning, arranging things in a precise way, repeatedly checking on certain things, or even compulsive counting and fact-checking.
OCD is associated with anxiety disorders as the compulsive behaviour is a direct outcome of constantly worrying about certain things.
These obsessions and compulsions offer no respite to the individual and often cause a great deal of anxiety and stress as they negatively affect the quality of life.
Tic disorders can also be experienced by people suffering from OCD. Motor tics refer to sudden spells of repetitive movements, such as rapid eye blinking, facial grimacing, as well as shoulder shrugging and jerking.
Vocal tics are also observed and these include repetitive throat-clearing, sniffing, or blurting out taboo phrases.
As a result, OCD often makes life unbearable and increases suicidal tendencies. The reason behind the onset of this disorder is still unclear. Studies have implicated a genetic component behind OCD as identical twins are both affected more often than both fraternal twins.
The major risk factors include childhood trauma or other stress-inducing events.
Therapeutic measures often involve counselling, such as cognitive behavioural therapy (CBT).
Antidepressants such as selective serotonin reuptake inhibitors (SSRIs) have also been prescribed. CBT for treating OCD often involves exposing the patient to the major cause of stress without allowing the manifestation of the compulsive behaviours.
Medication therapies often have adverse side effects and hence are often used as a second line of treatment. Nowadays, CBD has come to the forefront in the treatment of anxiety and related disorders, primarily due to its ability to exert an overall calming effect on the person. It has also shown potential in the treatment of tic disorders.
A 2012 review by the Universidade Federal de Minas Gerais assessed the role of CBD in the treatment of anxiety disorders like OCD.
It was established that cannabidiol alleviates such disorders by stimulating 5-HT1A(hydroxytryptamine)-mediated neurotransmission.
As CBD has the ability to stimulate neurotransmission, it can easily help in improving the quality of lives of people suffering from OCD.
5. CBD Oil Promotes Sound Sleep
A majority of the patients suffering from anxiety disorders often have issues with sleep and have reported substantial difficulties in initiating and successfully maintain a period of uninterrupted, sound sleep.
This is because anxiety functions as an internal alarm which warns of imminent danger and frequent false alarms, as seen in anxiety disorders, can lead to chronic sleep-wake difficulties.
In fact, surveys of the general population have shown that people suffering from sleep disturbances often develop anxiety disorders and vice versa.
Around 24-36% of people with insomnia exhibited anxiety whereas the prevalence of anxiety amongst people with hypersomnia was around 27-42%.
Several polysomnographic studies have shown that patients with panic disorders display longer sleep latency (transition from wakefulness to sleep), increase in wakefulness, and diminished sleep efficiency.
In cases of generalized anxiety disorders, polysomnographic studies have revealed that patients exhibit increased sleep latency which means that the transition from complete wakefulness to sleep is hindered and takes up longer periods of time.
The studies also reported decreased continuity of sleep.
60-70% of anxiety patients complain of experiencing troubled sleep but detailed research has shown that REM (Rapid Eye Movement) sleep patterns remain unaffected.
However, many patients suffering from panic disorder or generalized anxiety disorder have complained of insomnia as well as the disturbance of sleep due to nightmares that usually trigger night-time panic attacks.
Cases regarding such patients are aplenty but the REM phase manages to remain unaffected by anxiety. However, this scenario changes in case of patients with obsessive-compulsive disorders (OCD) and post-traumatic stress disorder (PTSD).
Claims have been made about increased REM-sleep latency which needs to be aptly studied.
A dysfunction in the control system associated with maintaining REM sleep has been recorded in patients suffering from PTSD.
While OCD patients have also shown problems pertaining to the REM phase, yet the claim has not been sufficiently addressed and replicated in laboratory studies.
As the entire spectrum of anxiety disorders have varying effects on sleep, it is very difficult to prescribe a generalized therapeutic measure for all the conditions.
Benzodiazepines are usually administered to treat severe anxiety and insomnia but they come at a cost of dependence liability as well as withdrawal symptoms.
Recently, cannabinoids like CBD have become quite popular in the treatment of anxiety and mood disorders as cannabidiol exerts an anxiolytic effect.
A 2017 study by the National Center for PTSD has shown that cannabinoids can help in improving sleep, particularly in patients with PTSD as they help in reducing nightmares.
As CBD exerts an anti-anxiety effect, it helps in calming patients and improving sleep in people suffering from anxiety disorders.
It is prudent to consult a health care provider before consuming medications containing THC (tetrahydrocannabinol). The dosage depends on the mode of delivery as the CBD products can be orally ingested or inhaled by a vaporizer.
There is no prescribed dosage for using CBD oil to lower anxiety.
However, to provide symptomatic relief, small doses of 50-60mg should be consumed, initially, and the optimum dose should be decided as per the individual’s tolerance level.
Vaporizers containing CBD oil can be used to relieve severe anxiety attacks. 6-8mg should be inhaled.
The plant-derived cannabinoid, CBD, has very few side-effects. In fact, daily oral doses of up to 500mg can be had for up to 6 months.
Even high doses of 1500mg can be tolerated per day for a period of up to 3 months without producing any unwanted complications.
CBD products usually contain variable amounts of the psychotropic agent, tetrahydrocannabinol (THC), which is mostly responsible for the side-effects.
While the quantity of THC permitted in medicinal products is quite insufficient but sensitive individuals might still experience some form of cognitive impairment.
CBD inhibits the activity of cytochrome p450, a class of liver enzymes responsible for metabolizing drugs and therefore, CBD usage might reduce the efficacies of certain types of medications. Medicines containing an excess of THC might cause confusion, dizziness, disorientation, nausea, fatigue, impaired balance, hallucinations, and paranoia.
They might also cause tachycardia, a condition wherein the heart rate gets rapidly raised for a short duration. Cannabis products which have a moderate amount of THC should not be accompanied by alcohol.
Pregnant and lactating women should consult a gynaecologist before consuming CBD-containing medicines.
Caution should also be maintained while administering THC-containing products to children and adolescents as it might affect their CNS differently.
To summarize, it can be said that, CBD provides many benefits to people suffering from anxiety disorders.
Its anxiolytic effect helps in lowering generalized anxiety disorder by reducing the severity of the symptoms.
CBD also improves social interactions and public speaking in individuals suffering from severe social phobias.
CBD also helps people with PTSD by aiding fear memory extinction and lowering anxiety in case of any flashbacks or nightmares.
It also helps in preventing the development of obsessions and compulsive behaviours in people with OCD.
Finally, it promotes sound sleep in people with anxieties and improves their mental and emotional health.