World Panic Day: medical cannabis for anxiety

Anxiety. For many, it is simply part of the human condition.

Modern-day life is full of stress, uncertainty, and pressure, which can easily lead to feelings of anxiety. But when that anxiety takes over and becomes overwhelming, it can significantly impact your quality of life. Long periods of heavy anxiety can lead to conditions such as generalised anxiety disorder, panic attacks, and social anxiety disorder.

Anxiety disorders are actually among the most commonly diagnosed mental health issues, both here in the UK and globally. Yet, despite its prevalence, there is still a high level of stigma surrounding anxiety, with many patients struggling to find effective treatment options and relief.

Today is 'World Panic Day', a day to raise awareness not only about anxiety and its impact on sufferers, their loved ones, and society as a whole - but also the emerging treatment options, including plant-based treatments and medical cannabis.

A spotlight on World Panic Day

With roots stretching back more than two decades, World Panic Day was created to bring attention to the alarming rise in anxiety disorders and the need for improved understanding, support, and treatment. It is a day to educate others about the realities of living with anxiety, to dispel myths and misconceptions, and to promote acceptance.

And with the rates of anxiety disorders rising every year, it is more important than ever to continue the conversation and advocate for those struggling with this often-debilitating condition.

Understanding anxiety and panic disorders

We all feel the apprehension of anxiety and the pang of panic from time to time.

These uneasy, stressful, and sometimes overwhelming feelings are a natural response to stress, danger, or uncertainty and have been instrumental in our evolution and survival. But when these feelings become constant, excessive, uncontrollable, or chronic, they can significantly affect our mental and physical well-being.

Common signs and symptoms of an emerging or existing anxiety disorder

• Restlessness and agitation
• Persistent worry or fear
• Difficulty concentrating and making decisions
• Sleeping issues, including falling and staying asleep
• A sensation of 'pins and needles' in the arms or legs
• Gastrointestinal upset
• Unexplained muscle tension or aches
• Increased heart rate
• Irritability and mood swings
• Panic attacks, including shortness of breath, racing heartbeat, chest pain, dizziness, and nausea.
• An overarching feeling of 'impending doom' that lasts for days or weeks

The spectrum of anxiety and panic disorders

The full range of panic and anxiety issues now recognised medically is vast, and not everyone experiences the same symptoms. However, some of the most commonly recognised anxiety disorders include:

• Generalized Anxiety Disorder (GAD) - A general feeling of worry or anxiety most of the time.
• Panic Disorder - panic attacks occur for no apparent reason
• Social Anxiety Disorder (SAD) - difficulty dealing with social situations, to the extent that it significantly interferes with daily life.
• Post-Traumatic Stress Disorder (PTSD) - A severe psychological response to trauma, causing acute anxiety.
• Obsessive-Compulsive Disorder (OCD) - uncontrollable and recurring thoughts that create intense stress or worry, sometimes leading to repetitive behaviours or unwanted thought patterns

Conventional treatments for anxiety in the UK

The idea of there being a universal or standard approach to treating anxiety is wrong. No two sufferers will experience anxiety in the same way, even if they are diagnosed with the exact same anxiety or panic condition. 

That's not to say that there isn't a 'conventional' approach to treating anxiety disorders, just that this approach may not be effective for everyone.

If you think you are suffering from a panic or anxiety disorder, the first step is to reach out to your GP. They will provide you with advice on the best treatment options and will be able to refer you on to a specialist where necessary.

NHS protocols and treatments for anxiety

The NHS website offers a comprehensive range of information regarding anxiety and its treatments - including information, resources, and advice to support those experiencing anxiety.

However, the NHS's primary approach to treating anxiety is usually medication-based (serotonin reuptake inhibitors (SSRIs) and benzodiazepines) with a mix of psychological therapies such as cognitive behavioural therapy (CBT) or counselling.

While these treatments can be highly effective, they may not work for everyone and can have some heavy potential side effects. This is where alternative or complementary treatments such as medical cannabis come into play.

Although the NHS does recognise medical cannabis as an effective treatment option for certain health issues, anxiety and panic disorders are not included. At the time of writing (and for the past 6 years), the NHS will only offer medical cannabis treatment options for two specific types of rare epilepsy, muscle spasticity caused by MS, and nausea relating to cancer treatment.

If you are suffering from any condition or disorder that is not included in the above list, you will need to reach out to a private cannabis clinic to receive a prescription.

Medical cannabis for anxiety and panic disorders - a growing body of evidence

Despite more than a century of stigmatisation and prohibition, the global tide has truly begun to turn in terms of medical cannabis legalisation. Research surrounding the application of medical cannabis is rapidly expanding, and the results are promising. Medical cannabis should never be seen or advertised as a 'magic cure-all', but the potential presented by this plant and its derivatives could revolutionise mental health treatment.

The endocannabinoid system (ECS) and anxiety

The body's physiological response to internal and external stressors is managed by a few different systems, including the endocannabinoid system (ECS). The ECS plays a vital role in regulating stress, anxiety, and panic responses.

The ECS is made up of:

• Endocannabinoids (cannabinoids produced inside the body and brain)
• Cannabinoid receptors (CB1 and CB2)
• Metabolic enzymes (enzymes responsible for breaking down endocannabinoids)

This system has been shown to play a crucial role in regulating emotions, behaviour, and responses to stress and fear. As such, it's no surprise that medical researchers have begun looking into the potential of phytocannabinoids (the cannabinoid compounds found in cannabis plants - THC, CBD, etc.) as a plant-based, natural therapeutic option in the fight against anxiety and panic disorders.

CBD and THC - the two most studied cannabinoids for anxiety and panic

While there are hundreds of different cannabinoid compounds produced by the cannabis sativa L. genus, there are two that stand above the pack in terms of relevance to anxiety and panic disorders: cannabidiol (CBD) and delta-9 tetrahydrocannabinol (THC).

Both THC and CBD have been shown to interact with the ECS, but through totally different mechanisms, which results in varying effects and outcomes. THC has psychoactive properties, meaning it can produce a 'high' or euphoria when consumed, but it has also shown medical relevance. Meanwhile, CBD is not psychoactive, although it can induce feelings of relaxation and calm.

So, which is best for anxiety and panic disorders?

There is still much research to be done before any concrete conclusion can be made, but at this point in time, it seems like both THC and CBD could have a place in treating anxiety and panic disorders.

CBD has been shown to interact with us in a couple of fundamental ways that may help reduce feelings of anxiety and panic. First up, it reduces the rate at which our bodies metabolise anandamide (also referred to as the 'bliss molecule'), the endocannabinoid responsible for regulating stress and fear. This results in increased levels of calmness and a drop in feelings related to anxiety.

On top of this, CBD has shown potential in reducing anxiety through its interaction with the serotonin 1A (5-HT1A) receptor. Serotonin is a particularly important neurotransmitter and plays a vital role in regulating our mood. CBD has been shown to have the ability to boost serotonin production, which researchers believe could contribute to its potential anti-anxiety effects.

When it comes to THC, the results are a little less clear.

THC has been shown to decrease levels of anxiety when taken at low doses, but at higher levels, it can have the opposite effect. One systematic review from 2019, that looked at eight small studies involving the use of both CBD and THC for anxiety control found that:

"Daily THC (up to 3 mg per day) for DSM-II anxiety disorder reduced anxiety symptoms, but symptoms were very low throughout the study", and that "One crossover trial involving 10 patients with PTSD showed that THC added to standard pharmacotherapy reduced self-reported nightmares".

But the same study also concluded that there is simply not enough evidence at this time to promote the application of THC for anxiety issues, and that larger scale studies are needed. There have been more studies published in the meantime, with the results looking promising, especially for CBD.

One interesting study, also from 2019, found that CBD can reduce intense experiences of anxiety or psychosis-like effects of THC and blunted some of the impairments on emotion. Another, from 2022, looked at both the reduction of anxiety and improvement in sleep scores through CBD administration. It concludes that:

"Anxiety scores decreased within the first month in 57 patients (79.2%) and remained decreased during the study duration. Sleep scores improved within the first month in 48 patients (66.7%) but fluctuated over time."

This is a promising step in understanding the potential of medical cannabis for anxiety treatment and panic disorders. While further research is still needed to fully understand the effects and mechanisms, the recent results have been encouraging, particularly for CBD. With its unique interaction with the ECS and potential to boost serotonin levels, it could prove to be a valuable tool in managing stress and anxiety-related issues.

Patient perspectives

There is an overwhelming amount of anecdotal evidence that points to the positive effects of taking medical cannabis as a treatment for anxiety and panic disorders.

Patient surveys are a great resource, with one study looking at the experiences of 808 patients with anxiety.

"Most participants reported benefits from cannabis use for a variety of conditions where traditional treatments were ineffective or unacceptable. These included physical symptom improvements such as reduced pain (28%), improved sleep (18%), and seizure reduction (18%), and mental health improvements including reduced anxiety (22%) and improved mood (11%)".

Another self-reporting study found that 50% of respondents reported relief from stress and anxiety.

Patient perspectives and real-life experiences are important to consider when looking at the potential of medical cannabis as a treatment. While more research is needed, these surveys are a helpful starting point in understanding the potential benefits and impact on patients' quality of life.

Medical cannabis and anxiety FAQs

What types of anxiety and panic disorders can CBD potentially help with?

CBD is showing enormous potential as a complementary treatment option for a wide range of anxiety. The currently available research suggests that it may be most effective in treating conditions such as generalised anxiety disorder (GAD), social anxiety disorder (SAD), panic disorder, post-traumatic stress disorder (PTSD), and obsessive-compulsive disorder (OCD).

The amount of research currently underway looking into CBD and anxiety is truly exciting, and we're confident that over the coming years, we will have a firmer grasp on its potential.

Does THC offer anxiolytic properties?

Yes, but it is very much dosage-dependent. While some studies have found that low doses of THC can help reduce anxiety, higher doses may actually worsen symptoms. As with CBD, there is much more research needed to understand the effects and mechanisms of THC on anxiety fully, but in the near future, we should have a clearer picture.

For now, CBD is the more promising option for those looking to manage anxiety and panic disorders.

Is medical cannabis an effective long-term solution for managing anxiety?

As with any treatment option, medical cannabis will offer some patients great relief from their anxiety symptoms, while others may find it less effective. Working closely with a specialist doctor is important to find a treatment plan that works for you.

As your body becomes accustomed to cannabinoids, it builds up a tolerance. This means that the dosage size may need to be increased for the same effects to continue to be felt. Regular tolerance breaks are recommended to help reset this build-up, with a break of two to three days every few weeks.

Is medical cannabis a cure for anxiety?

No. Medical cannabis should never be viewed as a straight-out cure for anxiety, but rather as a complementary treatment option that can help manage and reduce symptoms. It has shown to work best when taken in conjunction with other therapy and management techniques such as mindfulness, exercise, and counselling.

Removing the stigma surrounding medical cannabis and promoting mental health

Although the way that mental health issues are viewed, discussed, and treated has come a long way in recent years, there is still a significant stigma surrounding anxiety and panic disorders. This can make it challenging for patients to seek help or discuss their struggles.

Medical cannabis, while gaining more recognition and acceptance in the medical community, also faces its own stigma due to its past associations with recreational use. Thankfully, as the years slowly tick on by, research continues to uncover the vast potential of medical cannabis in treating the symptoms related to anxiety and panic disorders.

We are committed to supporting and promoting open and honest discussions about mental health. By providing clear and honest information on the benefits of medical cannabis, we hope to contribute to removing the stigma surrounding both mental health and medicinal cannabis administration.

Releaf understands that embarking on your medical cannabis journey can be overwhelming, and even slightly intimidating – that's why we offer tailored monthly packages, specialist consultations for medical cannabis, and our unique medical cannabis card to give you the peace of mind that your treatment is protected, all based on your medical cannabis prescription.