Anxiety


BACKGROUND:

Fear and anxiety are part of life. One may feel anxious before taking a test or walking down a dark street. This kind of anxiety is useful - it can make you more alert or careful. It usually ends soon after you are out of the situation that caused it. But for millions of people in the United States, the anxiety does not go away, and actually gets worse over time. People may experience chest pain or nightmares. They may even be afraid to leave home. These people have anxiety disorders. There are different types of anxiety disorders which may include:      

  • Panic disorder
  • Obsessive-compulsive disorder
  • Post-traumatic stress disorder
  • Phobias
  • Generalized anxiety disorder

Anxiety disorders are a group of related conditions, and each with its unique symptoms. However, all anxiety disorders have one thing in common: persistent, excessive fear or worry in situations that are not threatening. People may experience one or more of the following symptoms:

Emotional symptoms:        

  • Feelings of apprehension or dread
  • Feeling tense and jumpy
  • Restlessness or irritability
  • Anticipating the worst and being watchful for signs of danger

Physical symptoms:

  • Pounding or racing heart and shortness of breath
  • Upset stomach
  • Sweating, tremors and twitches
  • Headaches, fatigue and insomnia
  • Upset stomach, frequent urination or diarrhea
  • Loss of balance

The most common mechanisms involved in anxiety are: over activation of brain neurotransmission and neuronal firing, and excess stimulatory neurotransmitters like Glutamate. Glutamate is an excitatory amino acid transmitter that is involved in excitatory neurotransmission and is activated by stress.        

Anxiety is also related to deficiency of the inhibitory neurotransmitter GABA. GABA is used by the body to create relaxation and sedation.

The role of other neurotransmitters:

Norepinephrine: Activates certain parts of the brain to create fear and anxiety. Excess amounts are released during stress.

Serotonin: Helps relieve anxiety through the stimulation of 5HT2 and 5HT3 receptors

The amygdala is central to the processing of fear and anxiety, and its function may be disrupted in anxiety disorders.

Cannabinoid receptors are present within areas of the brain known to control emotional behavior, mood, sleep, stress, irritability, fear and even the sensation of “craving.” Activation of these receptors within the brain lowers heart rate and blood pressure responses to stress and reduces panic and anxious behavior.

CBD (Canabidiol) administration appears to attenuate the well-known “fight or flight” phenomenon to physical and mental stress. As well as decreasing fear-avoidant and conditioned responses to pain or punishment.

TREATMENT USING CANNABIS:         

Effects of CBD and THC on anxiety:

The use of cannabis in the treatment of anxiety disorders was first described by ancient Indian medical literature, which said that cannabis helped its user to be “delivered from all worries and care.” Several herbal remedies have been reported as helpful including lemon balm which is one of the terpenoids found in marijuana. An Israeli study published last year suggests that “Cannabinoid system activation could represent a novel approach to the treatment of cognitive deficits that accompany a variety of stress-related neuropsychiatric disorders.”

Studies have now shown that the endocannabinoid system – the body’s natural cannabinoid system – plays a major role in regulating anxiety. Cannabinoid receptors – the binding sites of cannabinoids – are highly concentrated in parts of the brain that are responsible for anxiety, including parts of the limbic system. The limbic system supports a variety of functions including emotion, behavior, motivation, long-term memory, and olfaction. Emotional life is largely housed in the limbic system, and it has a great deal to do with the formation of memories.

Research has also linked the endocannabinoid system to the extinction of bad memories – supporting its potential role in treating post-traumatic stress disorder – as well as the growth of new brain cells (neurogenesis), which is believed to improve anxiety levels. It was previously thought that neurogenesis did not occur and that drugs such as alcohol, cocaine, LSD destroyed neurons in the limbic system.

Studies have shown that Cannabidiol (CBD):

  • Has an anxiolytic (anxiety reducing) effect in both animal and human trials.
  • Can significantly reduce anxiety, cognitive impairment and discomfort in social phobia patients.
  • Has an anxiolytic effect on individuals submitted to a simulated public speaking test.
  • Reverses stress-induced anxiety by inhibiting the enzyme that deactivates the body’s own   cannabinoid (Anandamide).
  • Provides an anxiolytic effect in stressed mice.
  • CBD’s activation of Serotonin receptors causes an anxiolytic-like effect.
  • Action on limbic and paralimbic brain areas were shown to be responsible for its anxiolytic properties.
  • The Vanderbilt medical research team in conjunction with the Institute of Medicine explains that their findings “strongly support the utility of Anandamide augmentation as a therapeutic approach for stress-related affective and anxiety disorders.”
  • CBD inhibits the degradation of Anandamide and Tetrahydrocannabinol (THC) and can mimic their effects.
  • Brain scans show the CBD – compared to placebo – was able to significantly decrease subjective anxiety measures as well as decrease activity in certain parts of the brain normally associated with anxiety.

STUDIES:

The first study to investigate its therapeutic role in patients with anxiety disorders was published in 2011 by researchers at the University of Sao Paulo in Brazil. The study involved giving a 400mg dose of CBD to 10 patients diagnosed with social anxiety disorder, who then underwent a brain scan. The results showed that CBD – compared to placebo – was able to significantly decrease subjective anxiety measures as well as activity in certain parts of the brain normally associated with anxiety.

Studies conducted on both animals and humans have revealed a surprising effect of THC on anxiety. That is, THC seems to have opposite effects on anxiety levels depending on the dosage. THC acts to decrease anxiety at lower doses but can increase anxiety at higher doses.

While THC acts primarily on the CB1 receptors that are found in high concentrations throughout the brain, CBD seems to have little to no effect on CB1 receptors. Still, studies have found CBD to play a major role in regulating anxiety and have even suggested that it may be a more effective treatment than THC for anxiety disorders.

One can reasonably infer that cannabis-based therapies may help counter stress-induced anxiety