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How to.use cbd oil for ptsd depression and anxiety

How To Use CBD To Help Alleviate Anxiety

Dr. Bindiya Gandhi is an integrative medicine physician with expertise in functional and holistic medicine based in Atlanta, Georgia.

Commissions we earn from partner links on this page do not affect our opinions or evaluations. Our editorial content is based on thorough research and guidance from the Forbes Health Advisory Board.

Table of Contents

  • CBD for Anxiety
  • How to Use CBD for Anxiety
  • CBD Dosage for Anxiety
  • Potential Risks and Side Effects

While delta-9-tetrahydrocannabinol (THC) can have a bad rap for being intoxicating and anxiety-inducing, cannabidiol (CBD) can actually be used to relieve anxiety. Research supports this benefit, with several studies reinforcing the positive effects CBD can have on various anxiety conditions. In fact, 51% of U.S. adults who use CBD do so to help alleviate their anxiety, according to a recent Forbes Health survey of 2,000 U.S. adults conducted by OnePoll.

CBD isn’t yet legally cleared as an anxiolytic, or anxiety relief medication. Therefore, it’s up to you—and, ideally, a doctor who specializes in cannabis administration—to determine whether CBD is a safe treatment for your anxiety.

Here’s what the science says regarding CBD’s anxiolytic properties, along with experts’ dosage guidelines and advice on how to take CBD safely.

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CBD for Anxiety

The Food and Drug Administration (FDA) has yet to approve any CBD-based medications for anxiety. However, many studies indicate the substance can be an effective anxiolytic.

CBD for Generalized Anxiety

In 2011, a small trial-tested CBD on participants with generalized social anxiety disorder (SAD) and healthy control patients undergoing a simulated public speaking test (SPST), which is a common anxiety testing method [1] Bergamaschi MM, Queiroz RH, Chagas MH, et al. Cannabidiol reduces the anxiety induced by simulated public speaking in treatment-naïve social phobia patients. Neuropsychopharmacology. 2011;36(6):1219-1226. . Compared to a placebo, CBD significantly reduced anxiety and discomfort in the participants with SAD. In fact, their reduced anxiety levels were comparable to those of the control participants.

Eight years later, a 2019 test compared the efficacy of three CBD doses (150 milligrams, 300 milligrams and 600 milligrams) and a placebo in men taking an SPST [2] Linares IM, Zuardi AW, Pereira LC, et al. Cannabidiol presents an inverted U-shaped dose-response curve in a simulated public speaking test. Revista brasileira de psiquiatria (Sao Paulo, Brazil : 1999). 2019;41(1):9-14. . Compared to a placebo, 300 milligrams of CBD significantly reduced participants’ anxiety during the speech, but the 150-milligram and 600-milligram doses did not. These results highlight how dosage can be highly variable and that more CBD isn’t necessarily more effective.

Meanwhile, another 2019 study tested CBD in much lower doses than most other clinical studies—some participants consumed 25 milligrams a day while others consumed 50 milligrams or 75 milligrams a day [3] Shannon S, Lewis N, Lee H, Hughes S. Cannabidiol in Anxiety and Sleep: A Large Case Series. Perm J. 2019;23:18-041. . Researchers thought higher doses might be too expensive for participants to maintain in their normal lives and that low doses would still prove effective. Indeed, anxiety decreased within the first month for most participants and remained low. Sleep quality also improved, although it fluctuated more than anxiety. Only three patients reported side effects.

CBD for Anxiety and Depression

In 2020, researchers tested the effects of CBD oil at varying doses across 397 patients with a variety of ailments [4] Gulbransen G, Xu W, Arroll B. Cannabidiol prescription in clinical practice: an audit on the first 400 patients in New Zealand. BJGP Open. 2020;4(1):bjgpopen20X101010. . Participants with non-cancer pain or mental health-related symptoms experienced significant improvement in anxiety and depression, as well as in their abilities to complete their usual activities. The use of CBD oil suggested significant pain relief in these groups as well.

CBD for PTSD and Phobia Therapy

A small 2019 study of 11 patients found that, when consumed orally and administered alongside routine psychiatric care, CBD decreased patients’ posttraumatic stress disorder (PTSD) symptom severity [5] Elms L, Shannon S, Hughes S, Lewis N. Cannabidiol in the Treatment of Post-Traumatic Stress Disorder: A Case Series. J Altern Complement Med. 2019;25(4):392-397. .

Other studies suggest CBD can reduce PTSD symptoms when consumed with THC [6] Bitencourt RM, Takahashi RN. Cannabidiol as a Therapeutic Alternative for Post-traumatic Stress Disorder: From Bench Research to Confirmation in Human Trials. Front Neurosci. 2018;12:502. . When taken together, the two compounds create what’s known as the “entourage effect,” where THC enhances the effects of CBD as CBD tempers the effects of THC, resulting in a more well-rounded experience [7] Ferber SG, Namdar D, Hen-Shoval D, et al. The “Entourage Effect”. Terpenes Coupled with Cannabinoids for the Treatment of Mood Disorders and Anxiety Disorders. Curr Neuropharmacol. 2020;18(2):87-96. .

Some studies also suggest CBD can enhance the effects of exposure therapy—which assists patients in dissociating certain cues with a fear response—and cognitive behavioral therapy [8] Das RK, Kamboj SK, Ramadas M, et al. Cannabidiol enhances consolidation of explicit fear extinction in humans. Psychopharmacology (Berl). 2013;226(4):781-792. [9] Blessing EM, Steenkamp MM, Manzanares J, Marmar CR. Cannabidiol as a Potential Treatment for Anxiety Disorders. Neurotherapeutics. 2015;12(4):825-836. .

How to Use CBD for Anxiety

Without clear FDA guidance, optimal CBD use for anxiety varies from person to person. You may find one method works better for you over another. You can consume CBD in the following forms:

  • Oils and tinctures, which come in dropper bottles and are consumed by mouth
  • Gummies, which are chewable, sweet and often fruit-flavored
  • Sprays, which come in bottles with a nozzle to be sprayed in the mouth
  • Capsules, softgels or tablets, which are taken individually by mouth like a pill
  • Vapes, which heat CBD oil without igniting it, resulting in an inhalable vapor
  • Flowers, which are dried hemp plants that are typically ignited and smoked
  • Creams and gels, which introduce CBD topically (through the skin) as a more localized treatment

You may have to try different forms to determine what works best in addressing your anxiety. For instance, when it comes to the absorption of CBD in your bloodstream, vaping and smoking are more effective than edibles like gummies.

CBD Dosage for Anxiety

You also have to find the right CBD dosage for your anxiety. Experts suggest starting small and working your way up depending on how your body reacts.

Many clinical trials jump right to testing high doses. Successful doses evaluated for anxiety relief specifically include:

  • 600 milligrams in patients with SAD in a speech simulation [10] Bergamaschi MM, Queiroz RH, Chagas MH, et al. Cannabidiol reduces the anxiety induced by simulated public speaking in treatment-naïve social phobia patients. Neuropsychopharmacology. 2011;36(6):1219-1226.
  • 300 milligrams in male patients in a speech simulation [11] Linares IM, Zuardi AW, Pereira LC, et al. Cannabidiol presents an inverted U-shaped dose-response curve in a simulated public speaking test. Revista brasileira de psiquiatria (Sao Paulo, Brazil : 1999). 2019;41(1):9-14.

However, other trials suggest much lower doses are also quite effective in treating anxiety.

  • 25 to 75 milligrams for generalized anxiety and/or sleep problems [12] Shannon S, Lewis N, Lee H, Hughes S. Cannabidiol in Anxiety and Sleep: A Large Case Series. Perm J. 2019;23:18-041.
  • 33 to 49 milligrams a day for PTSD, in addition to routine psychiatric treatment [13] Elms L, Shannon S, Hughes S, Lewis N. Cannabidiol in the Treatment of Post-Traumatic Stress Disorder: A Case Series. J Altern Complement Med. 2019;25(4):392-397.

Another study involving hundreds of patients noted success with doses from 40 milligrams to 300 milligrams a day, further supporting the idea that CBD dosage varies significantly, depending on a person’s symptoms and physiology.

Potential Risks and Side Effects

The World Health Organization deems CBD a safe and generally well-tolerated substance. Studies report very few adverse effects, if any.

However, taking CBD while on other medications may pose a risk, as these substances may interact and cause unwanted effects, such as weight gain, drowsiness, upset stomach and change in appetite.

Cheryl Bugailiskis, M.D., a cannabis specialist at Heally, a telehealth platform for alternative medicine, also warns people with preexisting liver injuries and people taking medications that can cause liver injuries should practice caution when using CBD.

How Does CBD Oil Help PTSD?

Cannabidiol, or CBD, is a powerful chemical compound found in the cannabis plant, and a recent superstar when it comes to treating a wide variety of medical issues ranging from anxiety to epilepsy. While research of this particular cannabinoid remains in its early stages, existing research and anecdotal evidence point to exciting potential for CBD to help patients with a vast number of medical conditions, including Posttraumatic Stress Disorder.

4 Ways CBD Oil Helps PTSD Symptoms

  • Encourage Better Sleep
  • Decrease Anxiety
  • Ease Symptoms of Depression
  • Decrease Traumatic Memories

Highly touted for its therapeutic effects, CBD oil is federally legal, so long as it contains less than .3 percent THC. THC, or tetrahydrocannabinol, is the chemical compound present in marijuana that causes psychoactive effects—most notably the euphoric feeling of being high. THC remains illegal on the federal level, though it is legal in some states.

Early research has shown a positive connection between treatment with CBD and ADHD , epilepsy, chronic pain and more. But before you embark on using CBD oil, make sure you check your state’s laws regarding its regulation. There are certainly many reasons to be optimistic about the potential of CBD oil to treat stress and symptoms of PTSD, but it’s always important to talk with your doctor before adding any supplement to your PTSD treatment regimen.

It’s also important to note that the U.S. Food and Drug Administration has not approved non-prescription cannabis products, so they are largely unregulated. Make sure you purchase CBD products only from highly respected retailer partners you know and trust—like Farmer & Chemist.

What is Post Traumatic Stress Disorder?

Posttraumatic Stress Disorder, also known as PTSD, is a serious mental health condition that patients often suffer after experiencing a traumatic, high stress, or fearful life event. These events can include anything from a car accident to military combat, and it’s estimated that roughly 10 percent of Americans will experience PTSD at some point in their lives. The condition may be short lived or chronic, depending on the particular patient and the severity and duration of the stress or traumatic experience involved.

Many patients with PTSD report trouble sleeping, struggles with anxiety and depression, and repetitive thoughts that replay the traumatic incident over and over in a loop. In fact, PTSD can be a debilitating mental health condition that can lead to chronic challenges like overwhelming emotions, recurring nightmares, hypervigilance, panic attacks, detachment from others, and even self-destructive behavior. In the very worst cases, severe PTSD symptoms have led some sufferers to die by suicide.

Conventional PTSD Treatments

Most conventional therapies for treating PTSD include cognitive-behavioral therapy—including memory extinction therapy, talk treatment, and psychotherapy, plus several types of prescription medication. These are most commonly antidepressants designed to address the symptoms of stress, anxiety and depression, and sometimes to induce healthy sleep and reduce the incidence and severity of nightmares. The challenge for the health care community is often how to balance a patient’s psychiatric medication to minimize adverse side effects and potential addiction.

Many PTSD patients also see positive results from participating in support groups and by prioritizing some level of moderate physical activity every day—both of which help manage stress and anxiety. Though research is early and sometimes inconclusive , PTSD treatment with CBD oil may represent one more tool in the arsenal for managing PTSD symptoms. And many who deal with managing PTSD continue to report that medical cannabis is helpful for alleviating PTSD symptoms.

CBD Research for PTSD

New research indicates that cannabis can reduce activity in the amygdala, which is the part of the brain that drives our fear responses to threats. Another recent study has suggested that the cannabis sativa plant’s cannabinoids could play a role in eliminating aversive memories. While much of this research centers on the use of THC in helping with PTSD, there is also evidence that CBD can also help alleviate symptoms.

This could be very good news for patients because once the relationship between CBD and PTSD is better understood, CBD oil could become an alternative to prescription drug therapies that often bring unwanted side effects and the potential for addiction. Instead, CBD has been shown to be well tolerated, with very few adverse events reported and zero likelihood of addiction.

In fact, taking anywhere from 10 to 400 milligrams of CBD per day for an extended time period did not produce any toxic effects for patients who participated in one large, retrospective study of CBD’s potential as a therapeutic treatment for anxiety and insomnia. Even higher doses up to 1,500 milligrams of CBD per day have been well-tolerated by research participants .

4 Ways CBD Oil Helps PTSD Symptoms

Now let’s take a closer look at the various ways CBD oil may help certain patients manage symptoms associated with PTSD.

1. Encourage Better Sleep

PTSD patients deal with a wide range of issues that cause insomnia. CBD oil is a popular therapeutic treatment for many sleep problems, including insomnia. Many PTSD patients have reported that they were able to fall asleep easier and stay asleep longer when using CBD oil.

The research supports this idea, too. For example, one study found that, compared to a placebo, a CBD dosage of 160 milligrams was shown to increase participants’ sleep duration.

One reason cannabis may help battle insomnia and provide better sleep is that its interaction with the endocannabinoid system can help regulate the body’s cortisol levels. Cortisol, commonly known as the stress hormone, is often higher at night for patients who suffer from insomnia and may be a factor in the patient’s inability to relax and fall asleep. But in one study , patients given 300 to 600 mg of CBD displayed decreased cortisol levels, indicating that CBD may help regulate cortisol production.

Some PTSD patients may also suffer from headaches, which keep them from falling asleep and/or staying asleep. There is also positive early evidence that CBD for headaches can be an effective PTSD treatment that can lead to better sleep.

Though additional research is needed, there is some early evidence, along with anecdotal testimony, pointing to the fact that CBD could be an effective remedy for insomnia that so often plagues those who live with PTSD. If you think cannabinoid could be an effective course of treatment for you or for a loved one, make sure to speak with a doctor about how much CBD oil to take and any potential interactions with other medications.

2. Decrease Anxiety

A key symptom of PTSD is anxiety, which early studies show may be managed using CBD oil. A recent study undertaken by researchers at Wayne State University in Detroit examined how cannabis use might influence the fear response of patients dealing with trauma-related anxiety disorder, such as the type of anxiety associated with PTSD. While previous research has indicated that cannabis has the potential to help reduce anxiety, until this particular study, no research had specifically investigated the fear/anxiety response for adult patients dealing with trauma—which perfectly defines those who deal with PTSD.

A 2011 study exploring effects of CBD treatment for anxiety also reports that a single dose of 600 milligrams of CBD reduced anxiety. And further evidence indicates that treatment with CBD lessens anxiety most effectively in patients who suffered stress or trauma before their CBD treatment—meaning that therapeutic treatment with CBD is ideal for patients who experience anxiety stemming from previous experiences and situations.

Another study has shown that CBD was most effective when helping people deal with immediate traumatic events. Meaning, if CBD is used quickly after a traumatic incident, it has the potential to significantly decrease adverse effects. If and when more research continues to support this theory, it could mean major breakthroughs for the military, first responders, and others who are directly in the path of trauma while doing their life’s work.

3. Ease Symptoms of Depression

Though research into how CBD may treat symptoms of depression is early and limited, the initial results seem promising. For example, one early study into CBD as a treatment for depression indicates that CBD may interact positively with serotonin receptors in the brain. Because serotonin helps regulate the brain’s emotional state and feelings of well-being or happiness, keeping its levels in appropriate and healthy balance can be a key therapy for people suffering from depression. And while it doesn’t seem as though CBD boosts serotonin levels, cannabinoid may influence how the brain’s cannabinoid receptors respond to the serotonin that’s already in someone’s system.

A 2014 study conducted with animals showed that CBD’s effect on the brain’s chemical receptors produced both antidepressant and anti-anxiety effects, while a 2018 review of existing research determined that CBD shows anti-stress effects in study participants, which may help reduce stress-related symptoms of depression.

It’s important to keep in mind that most of the research around CBD’s ability to ease depression symptoms have been carried out exclusively with animals, so CBD’s potential to ease those symptoms for humans remains to thoroughly be researched. However, if you think CBD may help ease PTSD-related depression symptoms, it’s worth a conversation with your doctor about the pros and cons.

4. Decrease Traumatic Memories

One 2016 study found evidence that drugs interacting with the body’s endocannabinoid system may help reduce PTSD symptom severity after memory extinction or prolonged exposure therapy.

In this type of therapy, a PTSD patient encounters similar situations to those associated with the onset of PTSD, without triggering stimuli and under the close observation of a trained therapist. CBD’s success in this case is largely attributed to the fact that the endocannabinoid system, which includes CBD receptors, affects both anxiety and memory, two factors that play a large role in PTSD symptoms.

Additionally, there’s some evidence to show that many patients who suffer from PTSD have an endocannabinoid system that is impaired, so the effect of medicinal cannabis on the endocannabinoid system may help re-establish a healthy balance within the system, helping PTSD sufferers more healthfully replace traumatic memory association with neutral or positive ones.

CBD Can Ease a Multitude of PTSD Symptoms

PTSD is complicated and often relentless in its ability to impair a patient’s everyday life and activities. And while many patients report good results with cognitive behavioral therapy, talk therapy, and prescription drugs; CBD may represent another path. A path that, according to early research, seems safe and effective, without the harmful side effects or possibility for addiction that many current drug treatments bring with them.

If this sounds like a promising path, talk to your doctor about using CBD for PTSD. When you’re ready to purchase CBD oil or other CBD products, shop with a reputable retailer— like FarmerAndChemist.com . Our team of pharmacists and pharmacy technicians stand ready to answer any questions you may have about using CBD for PTSD.