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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.

CBD Hemp Oil for Anxiety and Stress

Preliminary studies support the use of CBD hemp oil for anxiety and stress. However, research has not yet proven it to be an effective and safe long-term treatment for the condition.

In this article we discuss full spectrum hemp oil, its therapeutic constituents, and the scientific research that helps explain how it may help anxiety.

Research and evidence

A study of healthy individuals showed that CBD doses of 300 mg significantly decreased plasma levels of the stress hormone cortisol and that doses of 600 mg were associated with even greater cortisol decreases.

Higher levels of cortisol in the bloodstream have been associated with a variety of negative health effects including anxiety. By lowering cortisol levels, CBD may help alleviate anxious feelings and other negative consequences.

Functional neuroimaging research shows that CBD significantly decreases subjective anxiety and increases mental sedation by changing the neural activity of brain regions like the limbic and paralimbic areas which normally mediate anxiety.

How Hemp Oil Affects Anxiety

Studies have shown that cannabinoids such as CBD and THC as well as other phytochemicals found in hemp oil such as terpenes and flavonoids play an assortment of therapeutic roles, including as anxiolytic, analgesic, antidepressant, antipsychotic, neuroprotective, neurogenic, anticonvulsant, antiemetic, antioxidant, anti-inflammatory, antiarthritic, and antineoplastic or antitumor agents.

Evidence from both human and animal studies suggests that CBD and the other phytochemicals in hemp oil exert anxiolytic effects via an extensive pharmacological profile that includes interactions with several molecular targets known to regulate fear and anxiety-related behaviors.

CBD alone has been shown to interact with at least 76 different molecular targets. Studies suggest that one way by which CBD may benefit anxiety is through its effects on the body’s endocannabinoid system (ECS).

Specifically, CBD has been shown to inhibit the breakdown of the body made cannabinoid, a.k.a. endocannabinoid, anandamide.

Anandamide is known as the body’s bliss molecule and evidence shows that anandamide produces anxiolytic-like effects by activating CB1 receptors and TRPV1 channels.

In addition to their positive effects on anandamide levels, CBD and THC mimic anandamide by activating TRPV1 channels.

Various studies suggest that CBD interacts with the 5-HT serotonin receptor system, which plays a significant role in anxiety.

In fact, anxiety disorders are most often treated using pharmaceuticals known as selective serotonin reuptake inhibitors and serotonin-norepinephrine reuptake inhibitors.

The hundreds of different phytochemicals found in full spectrum hemp oil each have their own mechanisms of action and unique effects.

Together they affect key brain pathways related to stress, defensive responses, memories, and hormonal balance, CBD products may be able to mitigate the negative effects of stress and chronic anxiety.

How anxiety works

Like most things in life anxiety, or the feeling of unease we experience when confronted with chronic or acute stressors, has a dual role. Both an instinct that allows us to survive, and a bane that torments us unnecessarily, it can range from mildly uncomfortable to completely debilitating.

Understanding why and how our bodies experience anxiety is key to understanding full spectrum hemp oil’s role in alleviating it.

At its most basic, anxiety is a survival instinct and our body’s natural reaction to acute stress. As an adaptive response, it helps us act when we feel threatened.

An approaching grizzly bear, for instance, will trigger the “fight-or-flight” response. This results in an elevated heart rate and increased alertness, which will hopefully lead our bodies and minds to act quickly and either run away from or slay the bear.

Any acute or chronic stressor can trigger anxiety. Even things we normally love, like puppies who escape your clutches and bound towards a busy street. Pleasant situations can go from calm to stressful in the blink of an eye.

When anxiety occurs in the context of life or death situations, like those involving puppies and oncoming traffic, the neurochemical processes set off by its experience are not only normal but potentially necessary for survival.

Not every situation in which we experience anxiety is life or death, however. While there are a variety of totally normal reasons behind why we feel anxious on a daily basis, they most often do not involve a legitimate survival threat that requires our initiation of the fight or flight response. Things like worrying about leaving our dog at home or feeling stressed at work before a big presentation can make us feel overwhelmed, and uncomfortable.

Just because feelings seem like a natural response to outside stimuli, however, does not mean that experiencing them is conducive to our health. In fact, the chronic experience of anxiety, even when it’s generally mild, can be devastating to our minds and bodies.

Anxiety goes from helpful to pathological when it doesn’t aid us in survival. Once used to remain alive during saber-toothed tiger encounters, anxiety has evolved into our country’s most common group of mental illnesses.

As civilization progressed from living in caves to living in homes, many of our lives became safe, sedentary, and decidedly boring when compared to those of our ancestors who expended their anxious energy by clubbing down rivals and teetering on the brink of death.

Anxiety has morphed from a survival driven adaptation to a life-draining stressor and rather than helping us stay alive, chronic anxiety has been linked to negative health effects such as heart problems, skin problems, digestive issues, pain, and an increased risk for chronic illnesses.

In the modern world, anxiety tends to pop up under mundane circumstances, such as at networking at events full of strangers. While one might argue that stranger danger is a real threat, fight or flight induced sweating won’t help you survive a meet and greet.

When anxiety begins to limit our ability to feel good, be productive, and function at peak capacity in our everyday lives, it may be time for an intervention.

That’s where CBD rich hemp oil may help.

What is the Difference Between Hemp Seed Oil and CBD hemp oil?

Hemp oil and hemp seed oil are both extracted from the hemp variety of the Cannabis sativa plant. Despite their common origin, the two types of oil are very different and only one contains cannabidiol (CBD).

Hemp seed oil is made by cold pressing hemp seeds and does not contain cannabinoids such as CBD, which studies suggest may exhibit anxiolytic or anxiety reducing effects.

CBD or full spectrum hemp oil, on the other hand, is extracted from hemp flowers and contains significant amounts of CBD.

In addition to CBD, hemp flowers produce hundreds of different therapeutic phytochemicals including various cannabinoids, terpenes, flavonoids, and others.

Hemp oils like Ned’s that retain the maximum number all of these active phytochemicals are known as full spectrum extracts.

These whole-plant extracts differ from CBD isolates, which only contain CBD and nothing else.

Full spectrum hemp oil is rich in cannabinoid and non-cannabinoid phytochemicals with stress-reducing and sedative properties. Research regarding the ability of phytochemicals such as CBD and others to help relieve anxiety is promising.

CBD, the main cannabinoid produced by hemp flowers, is one of over 480 therapeutic phytochemicals found in cannabis. Studies show that when these phytochemicals are consumed together, they act synergistically to enhance each other’s desired effects.

This synergism between hemp phytochemicals is known as the entourage effect. The abundance, variety and synergism of phytochemicals are why full spectrum hemp extract is the best type of CBD oil for anxiety.

Side Effects

Unlike its sister cannabinoid tetrahydrocannabinol (THC), the main compound in marijuana, CBD does not produce the high you feel when eating or smoking marijuana. In fact, in humans, the administration of CBD appears to counteract the anxiety, panic, muscle tension, and paranoia experienced with too much THC.

Full spectrum CBD oil has the potential to interact with other drugs. Therefore, it’s important to consult your doctor if you’re adding CBD to an existing medicinal repertoire.

Dosage

As long as it does not interact poorly with your existing medications, the CBD dosage for anxiety can be flexible and based on your needs.

A review of potential side effects in humans found that orally administered CBD was well tolerated at doses of up to 1500 mg/day, with no reported negative mood effects, vital sign abnormalities, or psychomotor slowing.

While more research is necessary to learn the pathways of CBD action, it is clear that in a time when there is no shortage of natural remedies for anxiety, full spectrum hemp oil holds significant potential in the treatment of anxiety disorders.

Are CBD products right for you?

In one study, CBD decreased defensive behaviors evoked by predator exposure in mice. So, if you’re walking down dark alleys at night or hiking through Glacier National Park where predator threats have real potential, it may be wise to lay off the hemp oil.

In these cases, anxiety might be the tipping point between stopping in your tracks and walking into the path of two charging grizzlies. So, keep your wits about you, your bear spray on hand, and your fight or flight response geared up.

If, on the other hand, you’re feeling unnecessarily hyped up and nervous at your office job, you can likely enjoy the benefits of CBD without any negative consequences.

A great natural alternative to Xanax smoothies, full spectrum hemp oil is a research-backed herbal cure that has been shown to help calm the jitters, improve mood, and lead to homeostasis in our bodies.

Despite the impressive number of studies published in the past several years, there is still a lot we don’t know about CBD’s mechanisms of action and how much of it we need to feel anxiolytic effects.

For instance, I weigh 100lbs and have a quick metabolism. I find that 15 mg doses help me feel awake and motivated when I’m working, while higher doses of 30 mg or more help alleviate my anxiety.

Since, my day to day experience of anxiety isn’t chronic, but rather set off randomly by mundane thoughts like remembering that I need to pack the house I sold to move to Montana, I take a dose of CBD whenever invasive thoughts begin to raise my heart rate and discomfort. Whether its placebo or the real thing I cannot say. However, I find relief soon after consuming 30-45 mg of Ned’s full-spectrum CBD oil gel caps.

Whether or not CBD is right for you and how much of it you need to consume to feel its positive effects without feeling sleepy and lethargic largely depends on your unique biological composition. Everyone is different and only by experimenting can you really know if hemp oil will help alleviate your symptoms.

Luckily, you have very little to lose and everything to gain by trying hemp as a means of anxiety relief.