Cannabis + PTSD
May is Mental Health Awareness Month and as May comes to a close, we’d be remiss to say goodbye without taking a moment to discuss the relationship between cannabis and our most vital organ, our brain. Commonly, we hear warnings that excess cannabis use can lead to worsening mental health if one is already dealing with symptoms of mental illness, or worse, that over reliance on the plant can lead to worse consequences like psychosis, substance use disorders like Cannabis Use Disorder (CUD), or addiction. Conversely, patients are being granted medical marijuana cards for conditions like PTSD, generalized anxiety disorder (GAD), ADHD, anorexia nervosa, autism spectrum disorders, and depression. In this blog, we’ll explore the connections between cannabis and mental health, specifically through the lens of PTSD, as well as break down the ways in which cannabis can improve one’s mood and sense of regulation.
Note: I am not a mental health professional. This blog is based on articles accessible through internet search engines and anecdotal evidence. If you have a known mental health condition and have any questions about whether or not cannabis would be beneficial to incorporate into your lifestyle, please consult with your doctor or care provider. We are merely seeking to raise awareness, and introduce readers to new ideas about the potential of cannabis.
PTSD is the most common mental health condition individuals are granted medical marijuana cards for in the state of Illinois. According to the IDPH’s 2023 Annual Cannabis Report, “As of June 30, 2023, MCPP was serving a total of 138,471 active patients… Chronic pain accounted for 31.1% of all diagnoses, PTSD for 16.4%, Migraines, 10.4%, and Osteoarthritis 10.0%.” If that statistic isn’t insightful enough, according to the VA, “About 6 out of every 100 people (or 6% of the U.S. population) will have PTSD at some point in their lives. Many people who have PTSD will recover and no longer meet diagnostic criteria for PTSD after treatment. So, this number counts people who have PTSD at any point in their life, even if their symptoms go away.” It is important to note that most people who experience a traumatic event will not develop PTSD after the event.
For context, PTSD is a psychiatric disorder that may develop in people who have witnessed or experienced a traumatic event, series of events, or set of circumstances. These events may be physically or emotionally harmful and may affect one’s overall well-being. Examples include surviving natural disasters, domestic abuse, terrorist acts, and all forms of assault. Women are twice as likely as men to develop PTSD, and U.S. Latino, African American, and Native Americans are disproportionately affected by circumstances and are three times as likely to develop PTSD than non-latino Whites.
If someone has experienced prolonged, repeated trauma, they may instead be diagnosed with Complex PTSD (C-PTSD). This diagnosis encompasses the symptoms that result from severe psychological damage due to the duration of the traumatic circumstances. During long-term traumas, victims are typically in a controlled, dangerous environment that they cannot get away from. Examples of such traumatic situations include: concentration camps, Prisoner of War camps, prostitution brothels, long-term domestic violence, long-term child physical abuse, long-term child sexual abuse, and organized child exploitation rings.
PTSD typically manifests with the following symptom categories (though one’s symptoms may be any combination of the below; list from psychiatry.org):
- 1. Intrusion: Intrusive thoughts such as repeated, involuntary memories; distressing dreams; or flashbacks of the traumatic event. Flashbacks may be so vivid that people feel they are reliving the traumatic experience or seeing it before their eyes.
- 2. Avoidance: Avoiding reminders of the traumatic event may include avoiding people, places, activities, objects and situations that may trigger distressing memories. People may try to avoid remembering or thinking about the traumatic event. They may resist talking about what happened or how they feel about it.
3. Alterations in cognition and mood: Inability to remember important aspects of the traumatic event, negative thoughts and feelings leading to ongoing and distorted beliefs about oneself or others (e.g., “I am bad,” “No one can be trusted”); distorted thoughts about the cause or consequences of the event leading to wrongly blaming self or other; ongoing fear, horror, anger, guilt or shame; much less interest in activities previously enjoyed; feeling detached or estranged from others; or being unable to experience positive emotions (a void of happiness or satisfaction).
4. Alterations in arousal and reactivity: Arousal and reactive symptoms may include being irritable and having angry outbursts; behaving recklessly or in a self-destructive way; being overly watchful of one’s surroundings in a suspecting way; being easily startled; or having problems concentrating or sleeping.
So how does cannabis become a good alternative to traditional medication for someone dealing with these symptoms or something similar? The power lies in terpenes and cannabinoids.
Extensive research has been done, and is in fact still being conducted, on how cannabis can treat PTSD and the findings are quite incredible. According to one study, “It is speculated that active ingredients in cannabis, such as THC and CBD, potentiate the memory processing and endocannabinoid systems in the brain and thus, reduce sleep impairment, nightmares [53], and overall PTSD symptoms. Patients with reduced PTSD symptoms and emotional numbing may experience better quality of life, psychosocial functioning, and working ability.” Due to cannabis’ ability to reduce activity in the amygdala and therefore reduce one’s sense of fear or being threatened. Additionally, there’s evidence out there that suggests that cannabinoids can play a role in extinguishing traumatic memories but more research must be done to definitively say they’re related.
Sounds helpful, right? So, where does the potential for harm come in? Cannabis use in the general population has increased in the last few years, but for those whom cannabis provides quick and effective relief, the potential for misuse has also grown with improved access to cannabis due to changes in legalization. According to research, PTSD is the most common co-occurring psychiatric condition with CUD. One study states that, “CUD diagnosis at PTSD treatment intake was predictive of lower levels of change in avoidance and numbing (Cluster C), and hyperarousal (Cluster D) symptom severity over the course of PTSD treatment. Hyperarousal symptoms in conjunction with elevated state anxiety were also prospectively associated with a greater likelihood of cannabis use in an EMA study with community-recruited cannabis users.” While cannabis can be massively helpful for those with PTSD due to its relieving properties, the potential for overuse and in turn an increase in negative symptoms which then turns into increased cannabis use, is quite high.
Balance is everything, and that is why it is important to consult with your mental health providers about your cannabis use if you are diagnosed with PTSD or a similar condition. This is coming from someone who got their medical card here in Illinois as a minor for their C-PTSD!
Now, let’s get into the ways cannabis can help:
Terpenes are the compounds within cannabis that provide each strain’s unique smell and flavor. They also play a role in determining the direction of a strain’s effects.
Limonene in particular is a wonderful terpene that can improve mood, and when paired with linalool, can significantly reduce anxiety while keeping one feeling upbeat and motivated. Linalool itself is immensely relaxing and can even be quite sedating at higher doses. Myrcene, the most common terpene, is generally useful for combatting mental health symptoms as it can offer relief from pain, stress and insomnia. Caryophyllene is particularly useful for reducing inflammation in the body which tends to be high in those that are chronically stressed. Caryophyllene also has some anti-anxiety components. Personally, I seek strains with high levels of terpinolene, as I find terpinolene provides a rush of euphoria I often need when my mood crashes throughout the day, or high levels of ocimene, as I find ocimene to be incredibly restorative for my nervous system. Ocimene provides a clear-headed effect for me that provides relief from a busy mind full of intrusive thoughts. Finally, Pinene can be particularly useful for those struggling with memory, lack of focus or brain fog. Pinene has personally helped me remember (positive!) memories I thought were long gone, while also improving my short-term memory.
Strain recommendations for PTSD:
- 1. Jack Herer – a sativa that is beyond uplifting!
- 2. Blue Dream – restorative, creative, and relaxing.
- 3. OG Kush – deeply relaxing and great for physical and emotional relief
- 4. Pineapple Express – a reliable strain for energy and euphoria
The benefits of cannabinoids tend to vary person to person, but largely, evidence suggests that ideal doses of THC are optional for anxiety, pain and stress relief, however consistently taking “hero” doses or consuming cannabis in larger quantities than necessary may lead to increased feelings of paranoia or anxiety in the long-term. CBD can be a helpful tool for those who are tolerant to CBD’s effects, as CBD acts as a regulatory agent for the endocannabinoid system. CBN can be a helpful addition for those looking for increased physical relief or assistance sleeping, and I find CBG to be quite restorative mentally and systematically. CBG can provide benefits in the realm of focus, GI regulation, and the reduction or elimination of brain fog.
Do you experience mental health symptoms that cannabis improves or otherwise impacts? What’s your experience with using cannabis for mood regulation or pain relief? We’d love to hear more about your experience in the comments below!
Sources:
https://dph.illinois.gov/content/dam/soi/en/web/idph/publications/idph/topics-and-services/prevention-wellness/medical-cannabis/cannabis-report_2023.pdf
https://www.ptsd.va.gov/understand/common/common_adults.asp
https://www.psychiatry.org/patients-families/ptsd/what-is-ptsd
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8222769/
https://www.forbes.com/sites/emilyearlenbaugh/2020/09/17/new-research-reveals-why-cannabis-helps-ptsd-sufferers/?sh=5fa9dc01179a
https://www.ptsd.va.gov/professional/treat/cooccurring/marijuana_ptsd_vets.asp
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9882422/
https://herb.co/learn/best-strains-for-ptsd
