Recently, the importance of mental health has hit high on the agenda, as more people talk about the issues they have beyond the surface and the stigma of maintaining your mental wellbeing has reduced through increased awareness.
One of the most severe forms of anxiety disorders is PTSD, and it’s estimated that around 3% of people will experience it at some point during their life.
While there is a bank of growing evidence of people using marijuana to improve their mental health, this has focused on the benefits of THC.
Historically, academic research in cannabis has focused on deciphering the potential benefits along with misgivings of THC – the compound found in marijuana responsible for the cannabis high.
It’s now becoming more evident that cannabis contains non-intoxicating compounds which are of potential therapeutic interest for both academics and consumers.
One of these is cannabidiol, also known as CBD. It’s a non-intoxicating compound found in the cannabis family of plants and is the main constituent of CBD oils.
Scientific interest in the use of CBD for PTSD anxiety is an area currently under exploration, and while it’s early, there are some compelling pre-clinical results to discuss.
But before we proceed, you might have one question on your mind:
What is PTSD?
Post Traumatic Stress Disorder (PTSD) is an anxiety disorder caused by extremely distressing, frightening or stressful events which significantly impact an individual’s mental health. It can even occur from learning that the trauma happened to someone else.
After an individual goes through a distressing event, it’s normal to feel anxious and experience thoughts of negativity. It’s only if after an extended period these symptoms worsen and compounds it turns into PTSD.
The condition can lead to changes in mental health, including flashbacks, nightmares, mood/sleep pattern changes and emotional withdrawal. Further to this, complex PTSD can develop years after the event, leading to confusion and a lack of self-belief behind the trigger.
While PTSD is mostly associated with war veterans and military personnel, the disorder can affect anyone who has gone through or learned of a significant amount of trauma, either physical or psychological.
Traumatic events may include serious road traffic accidents, domestic abuse, memories of war, physical or sexual assault, but it can be anything which someone finds highly traumatic.
Statistically, some people are significantly more at risk of experiencing PTSD in their life, including:
- Those who are pre-disposed to mental illness due to another underlying condition
- Genetic factors account for between 5 to 20% of PTSD risk following a traumatic event
- Going through a traumatic experience in the past
- Working in settings with repeated traumatic exposures
Does CBD help with PTSD
University College London recently conducted a systematic review of the use of cannabinoids in the treatment of PTSD, using participant notes about the use of cannabis (derived from previous studies).
The review consisted of previous 10 studies, and while the analysis didn’t look at the cannabinoids individually, they concluded that more research is needed as the evidence presented showed promise. Still, it wasn’t clinical or of high quality.
Other studies have explicitly focused on the use of Cannabidiol and PTSD:
- In 2012 a pre-clinical study of rodents published in The Journal of Psychiatric Research suggested that CBD affects predatory stress, hypothesised to be via the interaction of the compound with 5HT1A receptors found in our brain which affect memory. CBD may also enhance anandamide (an endogenous endocannabinoid) signalling, thereby inducing aversive memory extinction and preventing reconsolidation.
- A 2019 study published in The Journal of Alternative and Complementary Medicine consisted of 11 adult participants from an outpatients psychiatry clinic. These patients were given (a flexible and varying dose of) CBD along with traditional psychiatric care across 8 weeks. Finding 91% of participants experienced a decrease in the severity of PTSD symptoms. However, there was no control or placebo group for comparison. The dosing, methods, and quality of the CBD oil was not standardized.
While both of the previously mentioned PTSD studies fall short of a double-blind clinical analysis, and there is a lot of work to do, they do suggest there is a need to further explore the use of CBD oil for post-traumatic stress disorder.
Fortunately, there are currently two human-based trials already underway which examine the use of CBD along with THC for PTSD.
This includes a triple-blind clinical trial of 42 participants using high THC marijuana as a treatment for PTSD, in addition to another similar clinical trial of 80 war veterans, using varying strengths of cannabis to ease the symptoms of PTSD, including high CBD cannabis.
These PTSD trials are expected to be published in 2022. They are what’s needed to move the needle forward to come to a research conclusion for the use of cannabidiol for PTSD outside of anecdotal evidence.
Additionally, as PTSD is classed as a severe anxiety disorder in the UK, other more complex research grants issued in 2019 to explore the broader use of CBD for anxiety could provide beneficial background information. The results of these types of studies are expected to be published sometime in 2020 or 2021.
How CBD affects the symptoms of PTSD
Cannabinoids such as CBD are processed through our endocannabinoid system (ECS), by interacting with two cannabinoid receptors called CB1 and CB2.
Research indicates these interactions with these receptors is partially responsible for emotional memory processing, which is associated with the problems suffers of PTSD can have with negative memories.
Scientists believe that by blocking the back to back retrieval of these memories, the endocannabinoid system is thought to help with both the emotional and cognitive issues associated with PTSD by reducing anxiety in line with suppression of the traumatic event triggering the PTSD.
Broader research on the uses of CBD aligns with this hypothesis, with multiple studies suggesting the compound has potential anxiolytic effects. It’s also thought that as a direct consequence of reducing anxiety, it’s expected those suffering from poor mental health would sleep better and feel less distressed.
Can CBD be used with other forms of treatment?
Current treatments for PTSD consist of psychological therapies, including:
- Cognitive behavioural therapy (CBT): A type of therapy which challenges the way a person thinks and acts, talking through the trauma and associated stress.
- Group therapy: Talking through the trigger with others who also have a similar trigger for PTSD. This method is used with a variety of charities including rape crisis, combat stress and victim support.
- Eye movement desensitisation and reprocessing (EMDR): Involves making eye movements from side to side following a therapists finger while talking through the traumatic event. While this is a recent addition to the other two types of therapy and it is unknown how exactly it works, it’s a new innovative type of psychotherapy.
The most common first line therapies also include psychiatric medications and antidepressants such as sertraline, paroxetine, SSRI’s, and mirtazepine. Nightmares are targeted using prazosin or topiramate to improve sleep. Benzodiazepines are generally avoided given the elevated risk of substance dependence.
Overall, CBD products are considered safe, but they do have a minor likelihood for drug interactions (in line with the grapefruit warning you see on some medications). So if you do use medication which has the grapefruit warning, it’s something to be indeed aware of and keep note. This may include common but important medications like blood thinners and blood pressure medications.
Nonetheless, it is important to always talk to your doctor for medical advice and to inform them of any changes you intend on making, including adding new supplements like CBD to your diet. If you have a pre-existing liver condition, your doctor may need to recheck liver enzymes.
Will CBD completely cure PTSD?
No, CBD is a supplement to be added to your diet to boost your endocannabinoid system.
Nature & Bloom CBD is not a medicine and cannot treat, cure or prevent any disease.
Instead, look at CBD for PTSD as a daily vitamin you take to help regulate your ECS and keep all of your other systems in balance.
It’s clear more robust research is needed, and with larger sample sets to further understand how CBD interacts with the symptoms of PTSD.
The larger bank of evidence being compiled through studies like these will prove fruitful in furthering our understanding of CBD and other cannabinoids.
Either way, if you have or think you may have PTSD ensure you talk to a health professional to gain medical advice to obtain the most appropriate level of input.