When I first began using cannabis almost a decade ago, I found it worked wonders for my anxiety. Back then, it didn’t really matter which strain I was smoking—cannabis almost always helped regardless of set, setting, dose, or strain.
But as I got older, things got more complicated. I began to notice that certain strains made me more anxious than others. High doses made me paranoid. Using cannabis with unfamiliar people or in unfamiliar places almost always made me hypervigilant, self-conscious, and on edge.
Instead of taking multiple bong rips of potent strains like Original Glue and GSC, I moved toward strains with equal levels of THC and CBD—and taking just a few hits off a bubbler. I’ve found 5mg THC edibles to be a far better experience than one with 10-20mg THC. And instead of wake-and-baking with high-THC flower, I start my day with a CBD tincture.
Anxiety evolves and changes, and so might how you treat it.
Cannabis is complicated, and so is anxiety. Your ideal strain, product, dose, and regimen may not look like mine, and you should expect your relationship with cannabis as an anti-anxiety medicine to shift over the years. Anxiety evolves and changes, and so might how you treat it. There are also many different types of anxiety, and cannabis may affect each differently.
This guide is meant to help you understand your options. Finding the perfect product and routine for you will ultimately require personal experimentation, and we’ll walk you through all the first steps to get started.
Research on marijuana and anxiety
Cannabis is relaxing. Well, it should be, but if you’ve ever smoked a little too much or underestimated an infused edible, you know quite well that THC can sometimes turn on this reputation.
When it comes to high-THC cannabis and anxiety, there’s one thing to keep in mind based on research: At lower doses, cannabis seems to help anxiety; at higher doses, it seems to worsen it. So if opting for a high-THC variety, be sure to pay close attention to your dose (more on that below). However, high doses of CBD appear to reduce anxiety.
So why does cannabis soothe anxiety at some doses and exacerbate at others? Answering that requires a closer look at the biological system cannabis primarily interacts with: the endocannabinoid system (ECS).
The ECS is a vast system of receptors found throughout each of our bodies: in our brains, organs, guts, skin—these cannabinoid receptors are widespread and play an important role in ensuring that the body is operating in healthy balance. Our bodies naturally produce cannabis-like compounds—called endocannabinoids—that act similarly to cannabis compounds and also interact with the ECS, but sometimes their production goes awry. That’s where cannabis comes in as a potential therapy.
Studies show that the endocannabinoid system plays an important role in regulating anxiety, fear, and stress responses by regulating our behavioral response to stressful stimuli. Notably, cannabinoid receptors are abundant in areas of the brain involved in anxiety processing such as the hippocampus, prefrontal cortex, and areas of the amygdala. These studies also explain how THC can have opposing effects on anxiety as dosage affects neuron activity differently via cannabinoid type 1 receptors
Another study published in Jan. 2020 showed that the endocannabinoid 2-AG (which activates the same receptors as THC) reduced anxiety-inducing connections between the amygdala and frontal cortex, suggesting another mechanism by which cannabis relieves anxiety in certain doses.
Cannabis terpenes are another area of interest when it comes to unveiling answers around the plant’s anti-anxiety effects. Terpenes are fragrant oils produced by the plant that make up its aroma, and researchers are exploring to what degree they provide additional therapeutic benefits. For example, the terpene limonene has been studied for its anti-anxiety benefits. Further research is needed to understand how individual terpenes impact the overall therapeutic experience of cannabis.
Does marijuana interact with anti-anxiety medication?
When it comes to mixing cannabis with other anxiety drugs, there are a few things to consider.
There hasn’t been much research investigating the interplay of cannabis and anxiety medications, but based on available studies and patient reports, we have a sense for which medications are riskier than others when it comes to mixing. Due to the lack of extensive research, it is advisable to first consult your doctor before combining cannabis and other medications.
SSRIs (selective serotonin reuptake inhibitors)—like Prozac, Paxil, Celexa, Zoloft, and Lexapro—are among the most common prescriptions for anxiety. Very few adverse interactions between cannabis and SSRIs have been reported by patients. This also seems to be the case with NDRIs (norepinephrine and dopamine reuptake inhibitors) like Wellbutrin, Aplenzin, and Forfivo.
Other medications call for greater caution as cannabis could amplify adverse side effects such as increased heart rate and blood pressure. These higher-risk combinations include:
- Sedatives (e.g., Xanax, Klonopin, Ambien)
- Tricyclic antidepressants (e.g., imipramine/Tofranil, amitriptyline, doxepin, trimipramine/Surmontil)
- MAOIs (e.g. tranylcypromine/Parnate, phenelzine/Nardil, isocarboxazid/Marplan)
Another consideration is how cannabis may complicate symptom tracking. If you’ve just started taking anti-anxiety medication, you may want to hold on using cannabis so you can clearly see whether your anti-anxiety medication is working on its own.
How to choose the right strain for anxiety
Although research shows that certain types of cannabis seem to generally work better than others for anxiety, we’re all different. Finding the strain that knocks out your anxiety will require a bit of exploration, which is made easier by Leafly’s Cannabis Guide.
Leafly’s Cannabis Guide is a visual system that helps us better predict the potential effects of a strain using shapes and colors. By noting which shapes and colors made you feel better (or worse), you can easily shop for similar varieties on your next dispensary visit.
Here are a few strains that are generally rated well for anxiety that you might consider trying.
Cannabinoid profile: Balanced CBD/THC
Terpenes: Myrcene, pinene, caryophyllene
Harlequin is a commonly found balanced 1:1 CBD/THC strain, but there are many other varieties out there that look a lot like this one. With a lower dose of THC and a moderate dose of CBD, Harlequin’s cannabinoid profile is well-suited for anxiety fighters who don’t mind gentle euphoria. Its most abundant terpene is myrcene, which is believed to have a relaxing effect and has been used throughout history as a sleep aid.
Cannabinoid profile: CBD-dominant
Terpenes: Myrcene, pinene, caryophyllene
Looking for a safe first step into the world of cannabis? A CBD-dominant strain like ACDC can offer anxiety benefits without the buzz. Containing only trace levels of THC, ACDC uses the force of CBD and terpenes like myrcene to invoke a clear, calm state of mind. If you’re new to cannabis and leery of feeling high, ACDC or a strain with a similar chemical profile is the ticket.
Cannabinoid profile: THC-dominant
Terpenes: Caryophyllene, limonene, myrcene
This should be prefaced with one big caveat: When it comes to THC-dominant strains, there is a lot of variation in the types of strains consumers prefer. If you take a look at Leafly’s strain database sorted by strains highly rated for anxiety relief, you’ll see many different terpenes (colors), indicating that consumers may not agree on the “best” strain for anxiety. Imagine that.
But many experienced consumers would recommend something like Bubba Kush. This strain is known for its calming, blissful high that helps you sink deeply into your relaxation routine, whatever that may be. With warm flavors of earthy coffee and black pepper, Bubba Kush brings a sense of coziness to mind and body for those accustomed to a fairly strong THC high.
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