What We Know About Cannabis and Depression
Depression is one of the most common mental health problems , and cannabis is the most commonly used federally illegal drug in the United States. People use cannabis to self-medicate for many things, including mood disorders, usually based on anecdotal evidence and sometimes research. But the lack of clear pharmaceutical guidelines for these uses means it can be hard to know if cannabis is helping the problem, or perhaps even making it worse.
Whenever cannabis is mentioned in a medical context, it should be noted how little is known about how the drug works, in part because the history of its prohibition has made it difficult to study. We are at an impasse when exact science is limited by federal policy.
When it comes to treating depression with cannabis, the lack of hard data does a disservice to those who could potentially benefit from it. How much is too much? Which cannabinoids are ideal for treatment and which exacerbate symptoms? What do the latest research tell us? (But first, it’s important to note that if you’re considering treating depression with cannabis, it’s important to consider other treatments or therapies as well, especially if your symptoms are severe.)
What research can tell us
Depression is hardly a specific condition. There are several types with different symptoms; depression can manifest itself even in people with chronic pain. There are too many factors to recommend a one-size-fits-all treatment option. (Seasonal depression is very different from the low mood swings of bipolar disorder, and treatment for each follows suit.)
The same applies to cannabis. When we talk about a plant with thousands of varieties and chemical variations based on growing and processing conditions, there are no one-size-fits-all solutions. These unknowns would make research difficult even if legality weren’t an issue, which is why science is now divided on the use of cannabis to treat depression and a host of other medical problems.
As Leafly ‘s Emma Stone recently noted , “to date, no clinical trials have focused on cannabis as a treatment for depression, so it is difficult at this time to draw definitive conclusions about whether the herb is good or bad for people with depression.”
Indeed, a 2020 study found: “There is… evidence that cannabis use can lead to depression; however, strong evidence points to an inverse relationship; i.e. that depression can lead to initiation or increased frequency of cannabis use.”
Another analysis of several years of research showed the promising idea that, under controlled production conditions, cannabis can be fine-tuned to treat specific diseases. “Currently, there is encouraging, though rudimentary, evidence for the use of medical marijuana in the treatment of a range of psychiatric disorders,” the analysis notes. “Confirmatory results are emerging for some key isolates, however, clinicians should be aware of a number of prescriptive and occupational safety considerations, especially when using formulas with higher doses of THC.”
In the absence of research, anecdotal evidence
Some practitioners are more optimistic. Eileen Konecny, author of CBD Healing: How Cannabidiol Can Change Your Health Without Getting High , is a registered nurse and certified patient advocate who has been providing cannabis-based treatment advice to her patients since around 2008. the plant as a whole poses no risk when used carefully, but it should be remembered that this is not a panacea and is not suitable for treating all conditions.
She believes that people want to understand the potential of cannabis as a treatment for mental disorders for the simple reason that many people experience depression, but there are no answers yet. “Patients deserve an understanding of how a drug can affect them in order to weigh the benefits or limitations they may face,” she said. “Having a clear answer would help everyone involved. Unfortunately, there is little clinical evidence to support the use of cannabis for depression.”
Much of the evidence we must rely on is anecdotal, although some of it has at least been studied. Konieczny cited a 2018 study of patient data from Strainprint, an app that allows users to track cannabis use by variety/grade and symptom, noting: “89.3% of tracked sessions out of 3,000 contacts with depression symptoms reported a reduction in symptoms; those who used low-THC/high-CBD cannabis strains experienced greater reduction in symptoms than those who used THC-dominant strains.”
However, there was a catch: “When observed over time, these same people noted relapses of depression the longer and more often they used cannabis. This may suggest that cannabis use for depression may be effective in the short term, and may exacerbate the underlying depression in the long term.”
Before we can really understand how cannabis and depression are related, we need to learn more about how the drug affects the body’s endocannabinoid system, as well as the entourage effect, or how cannabis signals this system.
People who work with cannabis as creatives or practical service providers have provided their own anecdotal evidence that cannabis can be used to treat depression. Jordana Wright, photographer and author of Cannabis for Creatives , said she has been on antidepressants for most of her adult life and sometimes supplements her treatment with cannabis, with results varying.
“There are times when it relieves me of acute attacks in a painless and predictable way,” she said. “There are also times when it has the same effect as listening to a sad song when you’re unhappy — it reinforces things in the wrong direction. It all depends on the situation, time, tension, dosage and your point of view.
Of course, no single antidepressant—even those that have been extensively researched—works the same for all patients; some people try several of them before finding the one that seems to work best for their mental health issues without causing too many unwanted side effects. But Wright believes that the stigma surrounding cannabis means that most people refrain from thinking about cannabis as a medicine at all. “I once got rid of the stigma of marijuana in my mind and life. I was able to see it as a positive tool for improving mental health,” she said. “If you work with a psychologist or psychiatrist, be honest about your cannabis use. If you know it’s something that works for you, it’s important to have a doctor who supports cannabis, or at least is open to it.”
In Wright’s experience, the key was finding the right treatment. “I’m lucky to have found an antidepressant and a dosage that still allows me to experience a range of emotions, but when my symptoms flare up, I prefer cannabis to something like Xanax. Sweat takes the edge off [my] obsessive thoughts and painful emotions so [I] can think about problems and be more proactive in finding healthy behaviors and solutions.”
Daniel Olivares, founder of Highlites , a platform to de-stigmatize cannabis use for well-being, is also an advocate for moderation and mindfulness. quickly become a form of self-harm, and this self-awareness helps me stay honest and willful.”
In the absence of sound scientific research, people who seek cannabis for depression must do so alone, but Olivares believes they can do so responsibly. “I truly believe in the ability of cannabinoids to help manage symptoms of depression…when used intentionally and knowingly,” she said.