Can a daily dose of CBD help with depression?
- Because of its antidepressant and anxiolytic (anxiety-reducing) properties, CBD might help improve various conditions related to mental health(1), including major depressive disorder.
- The 2018 study published in the journal Frontiers in Immunology concluded that CBD may also treat other psychiatric conditions. These include various anxiety disorders, epilepsy, schizophrenia, Parkinson’s disease, and sleep disorders(2).
- Studies reveal that CBD helps manage depression because it activates 5-HT1A receptors(3) and facilitates the formation of new neurons in the hippocampus(4).
- However, further study is needed to conclude that CBD alone can treat these psychiatric disorders, especially more severe conditions like extreme depression.
- Compared to antidepressants, CBD has minimal side effects and no adverse reactions. Patients who want to include CBD oils in their medication regimen should consult with their doctor first.
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Why People are Turning to CBD for Depression
CBD is known to help treat various ailments, including psychiatric conditions. Several studies have shown that CBD relieves the clinical signs of depression.
Anxiety is a significant symptom of depression, and several studies conclude that CBD helps alleviate anxiety.
In a 2011 study, patients with Social Anxiety Disorder (SAD) were subjected to a simulation public speaking test. Those who were pretreated with CBD significantly improved(5).
Their anxiety markedly reduced, along with cognitive impairment and discomfort in performing their speech.
Another study has found that CBD may help alleviate the symptoms of neuropsychiatric disorders like epilepsy and schizophrenia. Researchers have observed CBD’s calming effect in the central nervous system(6).
A study in 2015 supports this. The study has also observed CBD’s therapeutic effects on generalized anxiety disorder, social anxiety disorder, panic disorder, and even obsessive-compulsive disorder and post-traumatic stress disorder (7).
A study published in the journal CNS & Neurological Disorders Drug Targets outlines the benefits of CBD. The research highlighted CBD not only as an anxiolytic treatment but also as an antidepressant that treats the symptoms of depression (8).
Another set of researchers supports CBD’s use because of its antipsychotic and anxiety-reducing properties. CBD also has neuroprotective effects. The study concludes CBD’s may be useful in treating depression, epilepsy, schizophrenia, substance abuse and dependence, social phobia, bipolar disorder, post-traumatic stress, Parkinson’s disease, and sleep disorders (9).
A journal outlines the case of an adolescent who has multiple substance use disorder. He also has severe depression, social phobia, and narcissistic personality disorder. In the study, the researchers administered CBD capsules in various dosages for eight weeks (10).
The 16-year old male’s treatment with antidepressants has proven unsuccessful, so he sought help from a public clinic in 2018.
The patient’s simple phobias and symptoms of depression, anxiety, paranoia, and dissociation improved. Without withdrawal symptoms, the patient also quit taking illegal drugs like cannabis, cocaine, and ecstasy.
It is the first report on CBD’s positive effects on patients with multiple substance use disorders.
A study published in the Journal of Cannabis Research was conducted to review the therapeutic benefits of CBD and CBD-containing compounds like nabiximols in treating a variety of psychiatric disorders and cannabis dependence (11).
Nabiximols is an extract from Cannabis Sativa that has been purified into a 1:1 ratio of CBD and THC. Sativex is a famous brand of nabiximols.
In the research, CBD was given to the test subjects in various ways, including oral ingestion, inhalation spray, and sublingual administration (under the tongue). The study revealed that compared to oral administration, inhalation of CBD had higher bioavailability (11-43%).
Bioavailability is the fraction of the drug that reaches the blood.
CBD and nabiximols were most effective in treating cannabis use-related disorders. They also proved promising in treating other psychiatric disorders because of their antipsychotic properties. Their anxiolytic and neuroprotective effects also contributed to the treatment.
In schizophrenia and psychosis cases, high doses of CBD (above 1200 mg daily) showed potential therapeutic benefits, especially in patients with Parkinson’s disease.
The study also supported CBD use in treating anxiety disorders like post-traumatic stress disorders and social performance-related anxiety. Patients with autism spectrum disorder who were administered CBD also exhibited reduced hyperactivity as well as self-injurious behaviors, insomnia, and anxiety.
In the study, however, CBD was ineffective in treating bipolar disorder. The study also emphasized that further research on the use of CBD alone to treat the disorders mentioned above is needed. Dosing may be the reason that it did not show efficacy in bipolar.
The researchers recognize CBD and CBD compounds’ therapeutic potential in relieving symptoms of psychosis and improving cognitive impairment due to various conditions.
Another study published in the journal Molecular Neurobiology demonstrated that compared to some antidepressants, CBD takes effect faster. Depression medications have a “substantial time lag” before taking effect in the body (12).
How CBD Oil Works to Alleviate Symptoms of Depression
Researchers have found that CBD interacts with 5-HT1A receptors (13). This produces anxiolytic and antidepressant effects in the dorsolateral periaqueductal gray (dlPAG) of the brain.
dlPAG is the region of the brain that mediates aversive emotional experiences.
A 5-HT1A receptor is a serotonin receptor subtype that can be found in the brain. When this receptor is activated, it helps in the mechanism of action of antidepressant, anxiolytic, and antipsychotic drugs (14).
Postsynaptic 5-HT1A receptors are located in the areas of the brain responsible for the control of mood, cognition, and memory. Therefore, these serotonin receptors can help in the treatment of neuropsychiatric disorders (15).
5-HT1A receptors are essential in curbing depression. For instance, antidepressants increase postsynaptic 5-HT1A signaling (16).
Suicide patients were also observed to have reduced numbers of the receptor. Researchers have also concluded that the dysfunction of 5-HT1A receptors could result in depressive disorders (17).
A study in 2010 conducted in rodents has proven that CBD activates 5-HT1A receptors, producing anxiolytic effects in the test subjects (18).
As a substance with antidepressant-like effects, CBD also aids in increasing the expression of the brain-derived neurotrophic factor (BDNF). Depressed animals and humans exhibit decreased levels of BDNF (19).
BDNF is a protein that is essential in the growth and survival of neurons (20).
A 2018 study outlines that CBD increases the release of BDNF, which helps in brain neuroplasticity, particularly new synaptic formation and cell proliferation (21). Neuroplasticity is required to achieve antidepressant effects in the test subject.
As an antidepressant, CBD also contributes to hippocampal neurogenesis. It is the production of new neurons in the hippocampus.
A study conducted in mice has shown that the production of neurons in the hippocampus attenuates depression-related behaviors (22).
Research published in the journal Current Neuropharmacology investigates the link between the endocannabinoid system (ECS), the formation of neurons, and antidepressants (23).
The ECS regulates several functions like mood, appetite, sleep, memory, fertility, and reproduction. The study says that when CB1 and CB2 are manipulated, they can contribute to the formation of neurons in the hippocampus.
CB1 and CB2 are cannabinoid receptors.
Three types of cannabinoids interact with the ECS, namely endocannabinoids, phytocannabinoids, and lab-derived cannabinoids.
The body produces endocannabinoids. Phytocannabinoids, meanwhile, are derived from the cannabis or marijuana plant. Tetrahydrocannabinol (THC) and CBD are the most notable phytocannabinoids. THC is the psychoactive ingredient of cannabis plants.
A study in 2018 was conducted on cannabis users. According to the research, prolonged use of cannabis can have detrimental effects on the hippocampus, primarily due to the THC component (24).
The study revealed that CBD has neuroprotective properties that could reverse these effects. It also concluded that CBD helps in hippocampal neurogenesis. Researchers discovered that CBD’s proneurogenic action has anxiolytic effects.
The 2018 study recommended that CBD can be used in treating cannabis dependence and several psychiatric disorders involving hippocampal pathologies. These disorders include schizophrenia, Alzheimer’s, and major depressive disorder.
The Pros and Cons of CBD Oil for Depression
- Human and animal studies have revealed CBD’s therapeutic effects on the symptoms of psychiatric conditions like depression.
- Antidepressants have several side effects like insomnia, headaches, chronic pain in the joints and muscles, skin rashes, stomach upset, diarrhea, and nausea (25). The most adverse effect is reduced blood clotting, but that is rare. CBD, meanwhile, has minimal side effects. The most common are tiredness, diarrhea, and changes in appetite or weight (26).
- The World Health Organization reveals that CBD does not develop physical dependence in humans (27). Hence, it is not a potential substance that can be abused.
- Prescription is not needed in purchasing CBD products as long as CBD use is legal in the region.
- More studies need to be conducted to determine if CBD can be used in treating psychiatric disorders, especially the more serious ones.
- The United States (US) Food and Drug Administration has not approved the use of CBD for conditions other than epilepsy. Hence, there is no standard dosage for treating anxiety and depression with CBD.
- There are possible drug interactions between CBD and antidepressants. Cytochrome P450 metabolizes antidepressants. CBD may inhibit these enzymes, thereby reducing the antidepressants’ efficacy (28).
- Because CBD is not FDA-approved, products are not regulated. Discrepancies have been found on some CBD product labels and the amount of CBD they contain (29).
Depression vs. Anxiety
Anxiety and depression are detrimental to those who have them. These disorders significantly affect not only their health and well-being but also their social life and productivity.
These disorders are closely linked, but they are still different from each other. Depression is a more severe condition. Anxiety disorders could also trigger depression.
According to the Mental Health Foundation in the United Kingdom, there are different types of anxiety. These include:
- Generalized anxiety disorder
- Panic disorder
- Post-traumatic stress disorder
- Social anxiety disorder
- Obsessive-compulsive disorder
- Specific phobias
A panic disorder is a sudden attack of panic or fear. Phobias meanwhile vary per person. They could range from an overwhelming fear of enclosed spaces to fear of specific objects, situations, and even feelings.
They may have different treatments, but they generally share the same symptoms like restlessness, a feeling of dread or being “on-edge,” irritability, and difficulty concentrating and sleeping (30).
The causes of anxiety vary, but it is usually caused by biological factors like genetics or chronic physical ailments and injuries. Psychological or social factors also contribute to anxiety. These include experiences of poverty, childhood trauma, employment status, living or work environments, and family and personal relationships.
Depression meanwhile could vary in people, from mild to severe. The symptoms are also different, but depressed people, in general, feel an encompassing sadness or hopelessness (31).
Other symptoms include tiredness and loss of energy, difficulty sleeping or waking up earlier than usual, loss of confidence and self-esteem, difficulty concentrating, perennial anxiety, avoidance of people, difficulty in functioning, intense feelings of guilt or worthlessness, sexual dysfunction, physical aches and pains, difficulty functioning in the daily such as in work or school, and constant thoughts about self-harm and suicide (32).
Depression and anxiety share similar causes, but depression is a more complicated condition. Aside from the causes of anxiety that were already mentioned, depression is also caused by sudden life-changing events. These include pregnancies, life-threatening diseases like cancer, heart disease, back pain, and diabetes.
How CBD Oil Compares to Alternative Treatments for Depression
Psychiatric disorders like depression should not be left untreated as they can worsen. Selective Serotonin Reuptake Inhibitors (SSRIs) or antidepressants are usually used for these.
SSRIs are prescription drugs and cannot be bought over the counter. They are also used as anxiety medications.
Examples of these antidepressant medications include Citalopram (Celexa), Escitalopram (Lexapro), Fluoxetine (Prozac), Paroxetine (Paxil, Pexeva), and Sertraline (Zoloft).
While these medications treat depression, it takes a while before the drugs take effect on the body. These medications also have side effects that can be adverse to the body.
More people are turning to natural alternatives like herbal supplements and even lifestyle changes like more frequent exercise to help treat depression.
Most people go to psychological therapies and support groups. They employ self-help and self-management approaches to treat their major depressive disorder.
Some people also take natural supplements like St. John’s wort. The herb reduces levels of cortisol, a stress-related hormone. It also increases neurotransmitters’ levels of serotonin, norepinephrine, and dopamine (33).
According to Harvard Medical School, however, using St. John’s wort was not as effective as prescription medications like antidepressants. It also causes similar side effects (34).
When taken alongside antidepressants, St. John’s wort may cause serotonin syndrome. This potentially fatal disorder happens when excess serotonin builds up in the body.
Exercise is also useful in treating several health conditions, including depression. It gives the body feel-good chemicals called endorphins and aids in nerve cell growth in the hippocampus (35).
According to a study, exercise increases BDNF levels in the brain, thereby contributing to the improvement of depression (36).
CBD could supplement self-help activities like exercise.
CBD for Better Sleep
Those with depression have trouble with sleep. Studies showed that CBD vastly improved sleep (37) and increased its duration (38).
CBD may reduce insomnia, too (39).
CBD for Stress Reduction
According to the National Institute on Drug Abuse (40), CBD may reduce the behavioral and physiological signs of stress and anxiety. Heart rate, for instance, normalizes when CBD is administered.
CBD for Mood Stabilization
Another study has found that CBD has mood-stabilizing effects (41). Clinical trials have shown that CBD is well-tolerated and effective in patients with psychosis.
The study also highlights the promise of further research on CBD treatment and CBD’s antipsychotic properties.
CBD for Brain Function
CBD may also help improve cognition. Test subjects in a 2018 study (42) have shown improvements in memory, verbal learning, and attentional switching.
How to Choose the Right CBD for Depression
There are three types of CBD oils patients with depression can choose from, which are full-spectrum CBD oil, broad-spectrum, and isolates.
Full-spectrum CBD oil utilizes all the components of a cannabis plant, including trace amounts of tetrahydrocannabinol (THC), terpenes, flavonoids, fatty acids, and essential oils. This type of CBD is found to be the most effective because all the active ingredients of the plant synergize for maximum therapeutic effect, known as the entourage effect.
THC, however, may cause mild psychoactive effects in people and can be detected via drug tests. For those who want to avoid these risks, using broad-spectrum CBD may prove useful.
Broad-spectrum CBD oils contain all the components of full-spectrum oils sans the THC. Those who solely want to use CBD in its purest form or are allergic to other components of the hemp plant may purchase CBD isolates. They are pure CBD, as they only have isolated cannabidiol.
CBD oil is different from hemp oil and hemp seed oil, because CBD comes from the flowers, stalks, and leaves of a hemp plant and contains higher levels of CBD than hemp oil. Hemp seed oil, meanwhile, is an oil extracted from raw hemp seeds. Hence, there are only trace amounts of CBD or none at all.
Full-spectrum hemp extract is also available in the market.
It is also essential to ensure that patients with depression only purchase CBD of the highest quality. CBD buyers should consider the following before making a purchase:
- Check the state laws where the CBD products are bought and administered.
- Ensure that the brand carrying the CBD products are legitimate. Products of high quality are non-GMO and certified organic hemp-derived.
- If the purchase is made online, read up on the CBD brand. Look for reviews first and double-check if the store has been authorized by the government to sell CBD. Some brands even have money-back guarantee policies to assure buyers that their products are of high quality.
- Research on the extraction process of the CBD oil before purchasing. It has different extraction methods like solvent or ethanol extraction. A study reports that the US FDA in pharmaceutical manufacturing recognizes CO2 extraction as a safe process (43). It has also started to become an industry standard. Some of the most natural carrier oils used in the extraction methods include MCT oil (medium-chain triglycerides from coconut oil), extra-virgin olive oil, and hemp seed oil.
- Check if the product has accessible batch testing reports. These are lab analyses from third-party labs that certify the quality and ingredients of the CBD product. A study in 2018 has employed third-party lab testing in 84 products that have been bought online (44). Researchers have discovered that of the 84 CBD products, 26% contained less CBD than labeled. 43% had more CBD than what the label declared, while 21% had THC concentrations that were enough to get children high.
- Consult with a doctor first before buying a CBD product.
CBD Dosage For Depression
Because the US FDA has not approved CBD use, there is no standard dosage chart for patients who want to take CBD. It is advised that they should consult with a doctor first as a medical professional would give the dosage that is most apt for the patient.
A 2019 study was conducted on males that were given different doses of CBD (150 mg, 300 mg, 600 mg, and placebo) (45). The test subjects exhibited varying results when it comes to reducing their anxiety before giving a speech.
The anxiolytic effect of CBD was only observed on those that were administered with 300 mg of CBD.
How to Take CBD Oil for Depression
There are several ways to take CBD. It all depends on which form would suit the lifestyle of the patient best.
CBD products can be taken sublingually (under the tongue), swallowed, or vaped. They come in different formulations, like CBD oil, sprays, CBD oil tinctures (drops), soft gels, or capsules. These may be consumed directly or, if they are unflavored, combined with food or beverages.
The upside of getting CBD capsules is that they can be conveniently brought anywhere. CBD tinctures and CBD oil meanwhile allow patients to adjust the dosage of the product quickly.
Tinctures may be taken sublingually by using the dropper to apply CBD oil under the tongue for around 60 to 90 seconds before swallowing.
CBD oil for depression treatment can also be used during massages. There are peppermint-infused oils that could be therapeutic, especially to patients who need to be relieved of stress.
CBD is also available as edibles such as gummies. Some brands offer gummies that are vegan and gluten-free.
There is also a market for people who prefer their CBD in vape form. It is a popular method because users ingest the substance in an instant, thereby giving the quickest results.
A 2020 study states the bioavailability of CBD is higher when it is inhaled (11 to 43%) compared to when it is orally ingested (11 to 13%) (46).
Though the effects are instantaneous because CBD enters the bloodstream via the lungs and not the digestive system, vaping can lead to throat irritation or coughing.
Another downside when using CBD vape or vape pens is that the amount of CBD taken in each draw cannot be determined. The results also last for 30 minutes to an hour or two at most.
Studies need to be done on whether vaping can cause lung problems, so it is recommended to proceed with caution before deciding to inhale CBD via vape pens.
CBD is also available in topical forms like creams and lotions. Topical CBD products are usually used for pain and inflammation management, but seldom for treating depression.
Topical CBD has limited absorption. It is best to purchase products that indicate the use of nanotechnology, encapsulation, or CBD micellization. These mean the CBD can be transmitted through dermal layers instead of only staying on the skin.
Several studies show the health benefits of CBD in managing the symptoms of depression. However, research on whether CBD alone can suffice in treating the said psychiatric disorders is still lacking.
CBD has anxiolytic, antipsychotic, and antidepressant properties. It activates 5-HT1A receptors, resulting in the reduction of depression.
CBD also increases brain-derived neurotrophic factor, which has low levels in depressed animals and humans.
Part of CBD’s antidepressant properties is its ability to facilitate the formation of neurons in the hippocampus. Hippocampal neurogenesis enhances the mood of those who take CBD.
CBD can also help improve sleep, reduce stress, enhance cognitive function, and stabilize mood, thereby making it useful in managing symptoms of depression.
Despite these developments, more research still needs to be done. However, it should be recognized that CBD has much potential in treating depression, especially since it has minimal side effects compared to SSRIs.
Before administering CBD to patients with depression, it is best to consult with a medical professional first.
- Crippa, José A et al. “Translational Investigation of the Therapeutic Potential of Cannabidiol (CBD): Toward a New Age.” Frontiers in immunology vol. 9 2009. 21 Sep. 2018, doi:10.3389/fimmu.2018.02009
- de Mello Schier, Alexandre R et al. “Antidepressant-like and anxiolytic-like effects of cannabidiol: a chemical compound of Cannabis sativa.” CNS & neurological disorders drug targets vol. 13,6 (2014): 953-60. doi:10.2174/1871527313666140612114838
- Beale, Camilla et al. “Prolonged Cannabidiol Treatment Effects on Hippocampal Subfield Volumes in Current Cannabis Users.” Cannabis and cannabinoid research vol. 3,1 94-107. 1 Apr. 2018, doi:10.1089/can.2017.0047
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- Shannon, Scott et al. “Cannabidiol in Anxiety and Sleep: A Large Case Series.” The Permanente journal vol. 23 (2019): 18-041. doi:10.7812/TPP/18-041
- Blessing, Esther M et al. “Cannabidiol as a Potential Treatment for Anxiety Disorders.” Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics vol. 12,4 (2015): 825-36. doi:10.1007/s13311-015-0387-1
- de Mello Schier, A. 2014. op. cit.
- Crippa, J. 2018 Sep. 21. op. cit.
- Laczkovics, C., Kothgassner, O.D., Felnhofer, A. et al. Cannabidiol treatment in an adolescent with multiple substance abuse, social anxiety and depression. Neuropsychiatr (2020). https://doi.org/10.1007/s40211-020-00334-0
- Khan, R., Naveed, S., Mian, N. et al. The therapeutic role of Cannabidiol in mental health: a systematic review. J Cannabis Res 2, 2 (2020). https://doi.org/10.1186/s42238-019-0012-y
- Sales, Amanda J et al. “Cannabidiol Induces Rapid and Sustained Antidepressant-Like Effects Through Increased BDNF Signaling and Synaptogenesis in the Prefrontal Cortex.” Molecular neurobiology vol. 56,2 (2019): 1070-1081. doi:10.1007/s12035-018-1143-4
- de Mello Schier, A. 2014. op. cit.
- “5-HT1A Receptors in Psychopharmacology.” Edited by Flavio Guzman, Psychopharmacology Institute, psychopharmacologyinstitute.com/publication/5-ht1a-receptors-in-psychopharmacology-2123.
- Guzman, F. op. cit.
- Zanelati, T V et al. “Antidepressant-like effects of cannabidiol in mice: possible involvement of 5-HT1A receptors.” British journal of pharmacology vol. 159,1 (2010): 122-8. doi:10.1111/j.1476-5381.2009.00521.x
- de Mello Schier, A. 2014. op. cit.
- Bathina, Siresha, and Undurti N Das. “Brain-derived neurotrophic factor and its clinical implications.” Archives of medical science : AMS vol. 11,6 (2015): 1164-78. doi:10.5114/aoms.2015.56342
- Sartim, Ariandra G., et al. “Hippocampal Mammalian Target of Rapamycin Is Implicated in Stress-Coping Behavior Induced by Cannabidiol in the Forced Swim Test.” Journal of Psychopharmacology, vol. 32, no. 8, Aug. 2018, pp. 922–931, doi:10.1177/0269881118784877.
- Hill, Alexis S et al. “Increasing Adult Hippocampal Neurogenesis is Sufficient to Reduce Anxiety and Depression-Like Behaviors.” Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology vol. 40,10 (2015): 2368-78. doi:10.1038/npp.2015.85
- Fogaça, Manoela Viar et al. “Cannabinoids, Neurogenesis and Antidepressant Drugs: Is there a Link?.” Current neuropharmacology vol. 11,3 (2013): 263-75. doi:10.2174/1570159X11311030003
- Beale, C. 2018 Apr. 1. op. cit.
- Health Publishing. “What Are the Real Risks of Antidepressants?” Harvard Health, Mar. 2014, www.health.harvard.edu/mind-and-mood/what-are-the-real-risks-of-antidepressants.
- Iffland, Kerstin, and Franjo Grotenhermen. “An Update on Safety and Side Effects of Cannabidiol: A Review of Clinical Data and Relevant Animal Studies.” Cannabis and cannabinoid research vol. 2,1 139-154. 1 Jun. 2017, doi:10.1089/can.2016.0034
- “CANNABIDIOL (CBD) Critical Review Report.” World Health Organization, 2018.
- Yamaori S, Ebisawa J, Okushima Y, Yamamoto I, Watanabe K. Potent inhibition of human cytochrome P450 3A isoforms by cannabidiol: role of phenolic hydroxyl groups in the resorcinol moiety. Life Sci. 2011 Apr 11;88(15-16):730-6. doi: 10.1016/j.lfs.2011.02.017. Epub 2011 Feb 26.
- Freedman, Daniel A, and Anup D Patel. “Inadequate Regulation Contributes to Mislabeled Online Cannabidiol Products.” Pediatric neurology briefs vol. 32 3. 18 Jun. 2018, doi:10.15844/pedneurbriefs-32-3
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