Will pot soothe my feelings of depression and anxiety?

Dear Alice,

I really want to try pot because I am SICK of being uptight and careful all the time. I have been depressed and anxious for several years and I just want to feel SOMETHING different. But I've had a couple of panic attacks (both related to medication) and they were the most frightening things I've ever experienced. I'm scared that pot would do the same thing to me. What do you think? I know you can't encourage me to smoke pot but I would very much appreciate an honest answer, which I know you always give. (I know that smoking pot is not the best thing to do when you have depression and anxiety, but it would only be once, and I would be with friends. By the way, I'm not currently on medication as I find it useless. But I'm not trying to self-medicate. I just want to remember what it's like to experience an emotion that is not depression or anxiety). Thank you very much.

Answer

Dear Reader,

It can be extremely difficult to feel anxious, depressed, and seemingly unable to make yourself feel better. Your desire to find a solution is a great first step. Currently, the results are mixed on whether smoking marijuana (also commonly called pot or weed) can help with feelings of depression and anxiety. For instance, some research shows benefits of using marijuana to ease social anxiety, while other studies indicate that it may worsen panic disorders and potentially be correlated with depression. Given this, you may want to consider speaking with a health care provider or mental health professional to discuss alternative ways to address you anxiety and depression.

To determine how smoking pot may affect your feelings of anxiety and depression, it may be helpful to take a deeper look at the research. In some studies, individuals who use pot frequently report lower life satisfaction and poorer mental and physical health. However, the evidence isn’t clear on whether smoking pot is the cause of these issues, but it's key to recognize the potential correlation. It's also helpful to note that using it even once could potentially increase anxiety levels and that there's research associating marijuana use with increased panic attacks.

Your idea to try pot once may not produce any negative effects, but tolerance can develop after only a few days of regular use meaning that any benefit or relief you feel from smoking pot may worsen if smoking is discontinued. For example, multiple studies have shown that there may be anti-anxiety effects of medical marijuana, but once the marijuana was no longer used, study participants indicated that feelings of anxiety returned. Still, some health care providers may prescribe marijuana to help with symptoms of anxiety — though as with any treatment, it may not work for everyone. In addition, repeated use of marijuana can lead to the development of substance use disorder (SUD). Research suggests between 9 to 30 percent of those who use marijuana may develop marijuana SUD and people who begin using before age 18 are four to seven times more likely to develop SUD than those who start later. So while you're deciding whether to take a puff with friends, it's key to note that the benefits may only be temporary and there's potential for feeling worse later.

Shifting the focus, it may be helpful to consider exploring some alternatives to smoking pot if looking for relief from anxiety and depression. You may also want to look into mind-body practices such as yoga, tai-chi, or meditation. Additionally, incorporating physical activity into your routine (if you haven't done so already) may be beneficial. Research shows that regular activity may help decrease feelings of anxiety and depression.

Further, you mentioned that the medication you’ve tried in the past has had some undesirable side effects and you aren't currently taking anything. You may find it helpful to revisit the conversation with your health care provider if the current medications aren't working for you. Sometimes trial and error is required to find the appropriate type of medication and dosage for you. They may be able to prescribe alternative medications that may have fewer side effects and help you to feel better. Additionally, you may want to seek support from a mental health professional to help you cope with your feelings of depression and anxiety. They may have different strategies to help you feel more emotions again and to manage panic attacks if they occur. It’s also possible they'll have insights into the use of marijuana to help with your symptoms.

Whatever you decide to do, it's helpful to know that support is out there is you need it.

Best of luck as you work through this experience,

Originally Published
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Summary of informative links

RELATED Q&A’S

  • Friends are double dosing: Marijuana and Prozac
    • This question comes from a reader who is concerned about their friends and wondering if their friends’ behavior is a result of mixing marijuana and Prozac. The answer indicates that marijuana potentially reduces the efficacy of Prozac. This question is directly related to the present question because it discusses depression and marijuana.
  • Will anti-anxiety meds make me a zombie? 
    • This question is on the effects of anti-anxiety medication. While marijuana is not formally an anti-anxiety medication, it’s relevant to the present question since the present question asks if marijuana could be used for anxiety. The reader in the present question also mentions that they did not have good experiences with medication, and this question can provide more information on that.
  • Marijuana – Does it produce serotonin? 
    • This question is particularly relevant to the present question because it also talks about marijuana’s effects on anxiety and depression, specifically with more emphasis on depression. I think these questions could even be combined.

SUMMARY

SOURCE 1: Marijuana

  • This source gives a basic run down of marijuana, from its short/long-term effects as well as other physical and mental health effects.
  • This source confirms multiple statements from the original answer (see below in “ORIGINAL ANSWER” section).
  • Potential long term effects: if use begins in teenage years, may impair thinking, memory, and learning functions, and affect how the brain builds connections b/t the areas necessary for these functions
    • Study in New Zealand conducted by Duke University, people who started smoking heavily in their teens AND had ongoing marijuana use disorder lost an average of 8 IQ points b/t ages 13 and 38
      • Even in those who quit as adults, lost mental abilities were not recovered
      • Those who started smoking as adults did not show notable IQ declines
    • Additional recent study results indicate that decline in knowledge/verbal ability may be due to other factors rather than marijuana use

SOURCE 2: Risky Business: Marijuana Use

  • This source provides some basic statistics and facts about marijuana, but is most relevant in its section on marijuana used to treat mental illnesses. According to this source, research that supports marijuana as treatment is based on anecdotal evidence or experiments with rats.
  • Marijuana use can cause symptoms like anxiety, depression, and sleep disorders, but these effects generally wear off after the drug wears off as well.
  • Marijuana is prescribed in some states to reduce symptoms of PTSD or stimulate appetite in anorexic patients. Some doctors prescribe marijuana for anxiety if usual methods were unsuccessful.
  • 20 states have legalized marijuana for medical use, while 8 states and the District of Columbia have legalized marijuana for medical AND recreational use.

SOURCE 3: Marijuana and depression: What’s the link?

  • This source is a Mayo Clinic Q&A. The question asks if marijuana can cause depression, and in short, the answer is we don’t know. While there is a correlation between marijuana use and depression, there is no established causal effect.
  • This source confirms that while marijuana use does not seem to directly cause depression, it may worsen symptoms of psychosis.

SOURCE 4: Marijuana as Medicine

  • Medical marijuana is legal in a number of states, but this legalization is fairly recent, so there has not been enough research on marijuana’s effects on people with health- and age-related problems.
  • The FDA-approved medications with marijuana are used to treat nausea and boost appetite, neither of which are for depression or anxiety. Research is being done to see if marijuana can be helpful in other illnesses such as depression/anxiety, but also in physical illnesses like cancer, HIV/AIDS, multiple sclerosis (MS), and more.

SOURCE 5: Effects of Marijuana on Mental Health: Anxiety Disorders

  • This source is probably the most relevant source to this question, as it directly deals with the effect of marijuana on anxiety.
  • Marijuana consists of over 500 chemical substances including THC (delta-9-tetrahydrocannabinol. Other compounds chemically related to THC are called cannabinoids. The most studied cannabinoid besides THC is cannabidiol (CBD). These different compounds produce different results.
    • Research shows that asides from these other factors, THC decreases anxiety at lower doses and increases anxiety at higher doses. In experimental studies, CBD seems to (regardless of dose) decrease anxiety especially with social anxiety disorder. However, for some individuals without anxiety disorders, CBD induced anxiety.
  • This source provides a list of factors that could lead to an individual experiencing anxiety from marijuana use: individual/genetic vulnerability, personality traits, female gender, infrequent use, high dose, high THC/low CBD varieties, history of previous anxiety reaction, presence of anxiety disorder/symptoms, basal anxiety state, abstinence states, and environment/context of use.
  • This source mentions that tolerance to certain effects can develop even only after a few days of regular use, meaning that any mental health benefit from marijuana use could lead to stronger symptoms after marijuana is no longer being used.
  • In California, 13% of patients with medical marijuana IDs were given those IDs by physicians who cited anxiety/depression as the reason, demonstrating that some physicians do recommend marijuana to treat those symptoms. However, medical marijuana for mental illnesses is generally associated with treating anxiety, not depression.
  • A 2016 literature review concluded that there are anti-anxiety effects of medical marijuana. However, those symptoms returned when medical marijuana was no longer used. There are temporary benefits, but no sustained benefits.
  • There doesn’t appear to be a causal relationship between marijuana use and anxiety disorders. However, there is a correlation between marijuana use and substance use disorders.
  • Marijuana use is not the same across all anxiety disorders. While those with social anxiety disorder report higher frequency of marijuana use, individuals with panic disorder have reported avoiding marijuana to avoid potential panic attacks.

ORIGINAL ANSWER

I either confirmed or disconfirmed all the facts stated in the original answer (italicized).

PARAGRAPH 2

  • Daily marijuana use is correlated w/ sig. higher levels of depression and anxiety
    • Increase in suicidal thoughts
      • Source 1: Study findings have been mixed about increased suicidal thoughts
    • Greater risk for schizophrenia later in life 
      • Source 1: can worsen symptoms in patients who HAVE schizophrenia (symptoms such as hallucinations, paranoia, disorganized thinking)
        • Source 3 confirms this as well
      • Source 2: can increase risk of developing schizophrenia and worsen symptoms in those with psychosis
    • Source 3: Yes, daily marijuana use is correlated with higher levels of depression, but no clear evidence that marijuana directly causes depression
  • Repeated use has potential to make your symptoms worse
    • Source 1: repeated use can induce temporary paranoia
    • Source 1: frequent users report lower life satisfaction, poorer mental health, poorer physical health, more relationship problems, less academic/career success, higher likelihood of dropping out of school, more job absences/accidents/injuries
    • Source 5: because of tolerance build up, repeated use could lead to worsening of symptoms after marijuana is no longer being used
  • Repeated use can possibly lead to substance misuse or dependence
    • Source 1: repeated use can lead to development of substance use disorder
      • Research suggests between 9-30% of those who use marijuana may develop some degree of marijuana substance use disorder
      • People who begin using before age 18 are 4-7x more likely than adults to develop the SUD

PARAGRAPH 3

  • Single use can elevate one’s anxiety level esp. during the high 
    • Risk is greater in unfamiliar/stressful environment OR
      • Source 5 confirms this as a factor in elevated anxiety after marijuana use
    • Risk is greater when you’re in a not-so-good mood 
      • Source 5: Not necessarily ‘not-so-good mood’ but “basal anxiety state” is one of the factors that determine if anxiety is elevated after marijuana use
        • See list of factors in source summary
    • Risk is greater if it’s your first time 
      • Source 5 does not directly confirm this, but among the list of aforementioned factors are “basal anxiety state”. Perhaps someone could be more anxious because it is their first time. Also, tolerance can build in a matter of days, but first-time users do not have tolerance, so perhaps they feel the substance’s effects more strongly.
    • Source 1: yes,  a single use can potentially elevate one’s anxiety level
  • 22% of marijuana users reported panic attacks
    • This statistic was not repeated in updated literature reviews on marijuana use.
    • Women were 2x as likely as men to report panic attacks 
      • Source 5: Women are not necessarily more likely to report panic attacks but more are likely than men to respond anxiously to marijuana
  • Marijuana amplifies whatever pre-existing feelings you have 
    • Source 1: marijuana can CHANGE your mood, but will not necessarily amplify your mood
  • Marijuana is not a long-term solution to anxiety 
    • Source 2: Some doctors prescribe marijuana to treat anxiety if other methods have not worked before
    • Source 5: At the same time, marijuana has not been shown to be a long-term treatment. In fact, for some, symptoms return after marijuana use is stopped.
  • Marijuana can worsen anxiety over time 
    • Source 5: No evidence suggests that anxiety will worsen over time, but marijuana will not cure anxiety. Also, anxiety symptoms may be stronger during the days right after cessation of marijuana use.

PARAGRAPH 5

  • There is little evidence that marijuana use helps with depression/anxiety  
    • Source 2: Some doctors prescribe marijuana to treat anxiety if other methods have not worked before, and research indicates positive results for some populations.

OVERALL CONCLUSIONS

The reader is interested in trying marijuana but worried about marijuana causing panic attacks for them. Research shows that individuals with social anxiety disorder report using marijuana to ease their social anxiety, while individuals with panic disorder report avoiding marijuana out of fear of experiencing a panic attack because of marijuana (5). How the reader reacts to marijuana may depend on whether they have social anxiety disorder, panic disorder, both, or neither.

In terms of the potential outcomes of marijuana use for an individual who has depression and anxiety symptoms, results are mixed. It appears that individual factors play a bigger determining factor (of whether or not an individual will experience anxiety from using marijuana) than simply having anxiety and/or depression. (A list of these factors can be found in source 5). If the reader fits several of those factors, perhaps they will have a higher likelihood of having an anxious reaction to marijuana.

However, research does not indicate that marijuana will cause anxiety. Marijuana is not associated with higher rates of anxiety disorders. Marijuana IS associated with more prevalent psychosis symptoms in those with schizophrenia (1) and higher rates of substance use disorder (5).

Ultimately, marijuana’s anxiolytic effects are largely reported from anecdotal evidence or rat studies (2). In states where medical marijuana is legalized, doctors do sometimes suggest marijuana for anxiety, especially for patients who have not responded to other methods of treatment (2). The medicinal effects of marijuana strongly supported by research are for PTSD, anorexia, and other physical illnesses, not anxiety and depression (4).

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