CBD for Anxiety: Your Guide for 2021 [New Research]

by Nathaniel Spock January 30, 2021

What is CBD?

Cannabidiol, also known as CBD, is one of the more highly produced phytocannabinoids within the cannabis plant (especially in hemp) and has been shown to have the potential to address many different health conditions.

Cannabinoids such as CBD interact with your endocannabinoid system, which produces endogenous cannabinoids designed to help your body maintain a state of balance or homeostasis. The endocannabinoid system is the largest known system of receptors in the human body. Cannabinoid receptors CB1 and CB2 are found in almost every organ of the body including the brain. They signal and regulate pain, inflammation, body temperature, stress levels, sleep patterns, etc. For more information on the endocannabinoid system, check out our Complete Guide to CBD.

Unlike THC, CBD isn’t intoxicating, meaning you won’t experience the feeling of being “high” as is the case with traditional marijuana. Instead, it has a range of health applications, such as the ability to reduce seizures in people with rare forms of epilepsy as well as help alleviate inflammation and pain associated with a number of different conditions.

In recent years, CBD has been marketed as a treatment for a number of medical conditions, including:

However, the FDA has only approved one CBD medication, Epidiolex, for the treatment of 2 severe forms of epilepsy: Lennox-Gastaut Syndrome and Dravet Syndrome.

Can CBD help anxiety?

At this time, it’s not fully clear how CBD treats anxiety. Some research has shown that it may work by affecting serotonin levels in the brain. Serotonin is a chemical in your body that plays a role in your mood, sleep, digestion, and behavior. Research suggests that serotonin levels can help treat anxiety and depression. Certain medications, such as antidepressants, work by regulating serotonin levels.

Studies on CBD and anxiety

A very recent study published in 2019 looked at whether CBD could improve sleep and or reduce anxiety. The study involved 72 subjects, with 47 experiencing anxiety and 25 experiencing poor sleep. The subjects were each given 25 milligrams (mg) of CBD in capsule form each day. In the first month, 79.2 percent of the patients reported lower anxiety levels and 66.7 percent reported better sleep.

Another study simulated a public speaking exercise in patients with social anxiety disorder. Patients were given up to 600 mg of CBD prior to their public speaking exercise and were asked to rate their levels of anxiety with and without CBD. Pretreatment with CBD significantly reduced anxiety, cognitive impairment and discomfort in their speech performance, and significantly decreased fear in their anticipatory speech. The placebo group presented higher anxiety, cognitive impairment, discomfort, and fear levels when compared with the control group as assessed with the VAMS (Visual Analogue Mood Scale).

CBD can also counteract the intoxicating effects of THC. For many, overconsumption of cannabis products high in THC can cause anxiety and paranoia. Famed cannabis researcher Dr. Ethan Russo has long talked about CBD’s unique ability to counteract anxiety and paranoia in his Research Paper “Taming THC”.

Another study looked at multiple anxiety disorders to see if CBD could be a treatment option. The study concluded that CBD has considerable potential as a treatment for multiple anxiety disorders, with need for further study of chronic and therapeutic effects in relevant clinical populations.

What doses of CBD are effective for anxiety?

There is no known effective dose for anxiety due to a lack of clinical trials that have been conducted. However, leveraging 4 or 5 preliminary studies as guidance, we can provide some recommendations:

Severe Anxiety Conditions:

Studies run on social anxiety disorder suggest the 30 mg per day dose that many CBD companies tend to recommend most likely won’t be enough to make a major impact on your anxiety symptoms. We recommend consuming between 100 to 200 mg per day if you have a severe anxiety condition. It’s best to start at a lower dose and work your way up to ensure minimal side effects. You can take more than 200 mg per day if needed, but we recommend you do not exceed 1500mg per day.

Moderate Anxiety:

If your anxiety condition is serious but not debilitating, you probably don’t need to consume as much as someone with severe symptoms. We recommend consuming between 75 to 150 mg per day. Again start at a lower dose and work your way up to ensure minimal side effects.

Mild Anxiety:

For less serious anxiety symptoms we recommend 30 to 100 mg per day.

What impacts my dose?

Your body weight
Your gender - Some studies suggest women are ~30% more sensitive to cannabinoids than men.
Additional terpenes present with the CBD - terpenes like Linalool and Limonene will synergistically work with CBD to provide a calming effect.
How you take your CBD - The recommendations above are based on tincture products where the user holds under the tongue for 1-2 minutes before swallowing. Products like capsules may need a higher dose due to lower bioavailability (the amount of CBD that makes it to the bloodstream). Vaporizers may not require as high of a dose due to higher bioavailability of CBD being inhaled into the lung capillaries.

Studies on terpenes and anxiety

What terpenes have been found to combat anxiety? There are over 200 terpenes that are found in cannabis and over 15,000 found in nature. Since the terpenes found in cannabis can also be found in other plants, we know a lot more about their medicinal effects than cannabinoids since scientists have been able to study them.

Linalool - If you’ve ever experienced the calming properties of lavender, you may have already experienced the benefits of linalool. This terpene has been shown to produce a calming effect and reduce anxiety.
Limonene - Also found in lemon rinds, limonene has been shown to exhibit strong anti-anxiety, antidepressant, and energetic effects.
Beta-Caryophyllene - One of the most promising terpenes due to its interaction with the CB2 receptor in a process called cannabimimetic, where a compound acts as a terpene and a cannabinoid simultaneously. Due to this interaction with the CB2 receptor, Beta-Caryophyllene has been shown to decrease anxiety similar to CBD.
Alpha Pinene - The most common terpene found in nature, alpha pinene is found in pine needles and many conifer trees. Alpha pinene is particularly helpful in memory retention, focus, and reducing anxiety.

Which product types are best to combat anxiety?

It really depends on how fast of an onset you need to combat anxiety. Vaporizers would be best to combat panic attacks as you’ll need the product to work quickly at reducing your symptoms. For reducing anxiety on a daily basis, tinctures seem to be most effective at managing symptoms and providing consistent, measurable doses.

Will CBD make me feel high?

The reason CBD has become somewhat of a phenomenon amongst the public has been due to users self reporting that CBD does not make you feel high and provides numerous health benefits. While some CBD products are full spectrum and can include up to 0.3% THC, the THC is at such a low level you will not feel intoxicated. Additionally, CBD has been shown to tame THC’s potential feeling of being “high”, paranoid or anxious.

Potential side effects of CBD

Compared to pharmaceutical anxiety drugs, the side effect profile of CBD is much less severe.

It’s unfortunate that the only FDA approved CBD drug contains sucralose, an artificial sweetener, to improve the taste of Epidolex, which could contribute to side effects of the drug. Luckily most hemp companies have not followed suit of adding artificial sweeteners to their products. We recommend all natural products to reduce any unwanted side effects.

Studies run of the side effects of CBD reveal its tame side effect profile compared to many other drugs. The most common side effects of CBD use include:

Fatigue
Diarrhea
Changes in appetite or weight

Is CBD Legal?

CBD’s legal status is still evolving, although the Farm Bill federally legalized growing hemp for CBD as long as the grower obtains the proper state licenses.

On the federal level, CBD extracted from hemp plants with less than 0.3% THC is legal, but CBD extracted from marijuana plants is illegal. That’s because it’s illegal under federal law to grow marijuana plants. States have legalized CBD to different degrees, but some still have restrictions on growth, sale, and possession. It’s best to check the laws in your state.

And once again, it’s worth pointing out that with the exception of Epidiolex, CBD products are not regulated by the FDA. That means you can’t be sure that you’re getting what’s on the label. Even if you’re buying the same product, the dose can still vary from batch to batch due to a lack of regulation.

In fact, a study in 2017 found that nearly 70% of CBD products sold online were labeled improperly and contained more or less CBD than advertised. The products also contained more THC than advertised.

It’s important to purchase your CBD from a reputable retailer with high quality and safety standards. You’ll also want to review the lab report of the product to confirm the company does testing and the product has the amount of CBD as marketed.

Review the lab report

Be sure to review the lab report of the CBD product you are purchasing to ensure the proper amount of CBD is present and also helpful terpenes like linalool, limonene, Beta-Caryophyllene, or alpha pinene are dominant within the product profile.

CBD products optimized for a “Calm” effect

Cannabinoids like CBD aren’t the only compounds worth considering in your cannabis product. Terpenes like Linalool, Limonene, and Beta-Caryophyllene may also help you feel more calm. Additionally you want to ensure a full spectrum of potentially helpful cannabinoids like CBG and CBN are also present.

Conclusion:

CBD and certain terpenes may help reduce anxiety
There is no known dose for anxiety although severe anxiety disorders may require a dose up to 200 mg or greater
Review the lab report to ensure helpful terpenes like linalool, limonene and Beta-Caryophyllene are dominant within the profile
If additional cannabinoids like CBG or CBN are present they may also aid in reducing anxiety

Article has been medically reviewed by Third Year PhD Medical Student: Ryan McLoughlin