If you’re struggling with depression, I would recommend being evaluated by a physician who specializes in depression before initiating medical marijuana or increasing the dosage.

We are in a very stressful time in our lives. For those who have a history of anxiety and depression, the current worldly troubles can lead them back into or worsen these ill feelings. For those who have never had anxiety or depression before, this can be the beginning of a difficult time.

It can be overwhelming to think of COVID-19, job insecurity, food and housing insecurity, managing schooling for the kids, racial issues and typical stressors of life for an extended period of time. But unfortunately, this is where we are without a specific timeline as to when it will sort itself out.

Having an open discussion with family, friends or heath care providers about personal mental health issues can be frightening. This is an important topic that needs to be addressed. Without facing the issues, depression and anxiety can worsen. We all know someone who is struggling whether ourselves or others. We need to be aware of symptoms such as pessimism, feelings of hopelessness, decreased energy, sleep disorders, decreased interest in hobbies and activities such as sex, persistent physical symptoms that do not respond to therapy, suicidal thoughts or attempts.

Unfortunately suicide has been the second most common cause of death in people aged 15-29.

When many people hit this wall of distress they begin self-help. When this therapy involves exercise, meditation or talking to friends, it can be very therapeutic. When this involves overuse of alcohol or drugs, it can become dangerous.

So my question is: where does cannabis fit into this picture of therapy for anxiety and depression?

We have many people using medical marijuana for anxiety/depression. There are also many who are self-medicating with recreational marijuana.

Unfortunately, the studies regarding cannabis and depression/anxiety have mixed resultsⁱ. The studies themselves are done with difficulty since cannabis is a Schedule 1 drug. Often the dosage of the drug is incompletely known since the drug is supplied by the patient.

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Insomnia can promote depression or be caused by it. Many people use THC/CBD to help them sleep. In many cases this works well. For others it causes increased anxiety and sleeplessness. It has been reported that the sleep architecture of cannabis induced sleep has a smaller REM componentⁱⁱ. This component of sleep is important for memory and mood.

Does cannabis improve or worsen depression? Some studies have shown that increasing cannabis use is related to increasing depressionⁱⁱⁱ. But the question I would ask is: Does the cannabis cause worsening depression or do people who become more depressed tend to use more cannabis to attempt to alleviate the symptoms?

Other studies have shown improvement in depression with cannabis use^iv. The study from Yale showed that THC was more effective than CBD in improving some depressive symptoms, making 64% of people more relaxed and peaceful, but worsened motivation in 20%^v.

If a person is having difficulties with depression, I would recommend being evaluated by a physician who specializes in depression before initiating medical marijuana or increasing the dosage. It can be a slippery slope to move from a therapeutic dose to a dosage of abuse. Once the decision to use medical marijuana is made, it is beneficial to enlist the help of a budtender for decisions regarding strains.

With regards to depression with oneself or others, this is another case of “If you see something, say something”.

i The Lancet. “Insufficient evidence that medicinal cannabinoids improve mental health.” ScienceDaily. www.sciencedaily.com/releases/2019/10/191028213912.htm

ii Schierenbeck T, Riemann D, Berger M, Hornyak M. Effect of illicit recreational drugs upon sleep: cocaine, ecstasy and marijuana. Sleep Med Rev. 2008 Oct;12(5):381-9. doi: 10.1016/j.smrv.2007.12.004. Epub 2008 Mar 3. PMID: 18313952.

iii Lev-Ran S, Roerecke M, Le Foll B, George TP, McKenzie K, Rehm J. The association between cannabis use and depression: a systematic review and meta-analysis of longitudinal studies. Psychol Med. 2014 Mar;44(4):797-810. doi: 10.1017/S0033291713001438. PMID: 23795762.

iv Yale J Biol Med. 2020 Jun; 93(2): 251–264. Published online 2020 Jun 29. PMCID: PMC7309674 PMID: 32607086

v Li X, Diviant JP, Stith SS, Brockelman F, Keeling K, Hall B, Vigil JM. The Effectiveness of Cannabis Flower for Immediate Relief from Symptoms of Depression. Yale J Biol Med. 2020 Jun 29;93(2):251-264. PMID: 32607086; PMCID: PMC7309674.