CBD Oil for PTSD

Post Traumatic Stress Disorder (PTSD) is far more common than people realize. Approximately 8% of American adults have PTSD during any given year, and about 4% of children under age 18 develop PTSD (Anxiety and Depression Association of America, 2018) (Stanford Children’s Health, 2018). That’s about 25 million Americans, but it is most likely underestimated because many people live with PTSD symptoms without ever seeking help or being diagnosed. When people work in high risk professions, the prevalence of PTSD is much higher, and symptoms are often much worse. We are going to briefly review current treatments, and then discuss the evidence for cannabidiol (CBD) and how scientists think it works to treat and even prevent PTSD.

Current treatments: Are PTSD patients getting the care they really need?

Current treatments for PTSD include cognitive behavioral therapy (CBT, also called talk therapy) and/or anti-anxiety medications, antidepressants, and high blood pressure medications (Mayo Clinic, 2018). It is worth noting that most of the drugs used for PTSD are used off-label, only two antidepressants are approved by the FDA for PTSD, and even when medications are prescribed, only about 20% of patients achieve remission. That’s not very effective. If I had PTSD, I wouldn’t be very happy with those odds when swallowing a pill riddled with side effects that might actually make matters worse.

For most pharmacological therapies, there is inadequate evidence regarding efficacy for PTSD. Cognitive behavioral therapy is a widely accepted method of treatment for PTSD, but there is clearly an urgent need to identify more effective pharmacological approaches for the management of symptoms. – Reisman, M., Pharmacy and Therapeutics Journal, 2016.

Will cognitive therapy work for you? Maybe–but its a coin toss. According to Kar (2011), nonresponse to CBT by PTSD patients is as high as 50%. Further, according to Holmes and Maron (2015) the stress symptoms of PTSD actually reduce the effectiveness of cognitive behavioral therapy, and ultimately, a more effective approach might be the targeted erasure of traumatic memories. Is talking about the traumatic experience really the best way to heal from the trauma? I don’t believe so. I believe it is better to help people find a way to forget about it, and move on with their lives.

The endocannabinoid system in PTSD: an overview

There is good news here. There is a lot of evidence that taking CBD oil provides an effective way to manage it.

The endocannabinoid system plays a significant role in PTSD for two major reasons: memory consolidation and emotional regulation (especially in response to stress). The two endocannabinoids (the ones we produce on our own) are anandamide and 2-arachidonoyl glycerol (2-AG). Cannabinoids bind to CB1 and CB2 receptors. CB1 receptors are found in the brain and central nervous system; whereas CB2 receptors are found primarily in the peripheral nervous system and immune cells.

Memory consolidation is the process that takes place in our brain after something happens (such as a traumatic event), and a stable memory “trace” is made. The effectiveness of this process during a stressful event relies heavily on the presence of cannabinoids that can bind to CB1 receptors.  This image explains how we remember a traumatic event within different parts of our brain. You can click here to enlarge it.

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CB1 receptors are densely located in almost every single part of the brain that plays a role in short and long term memory (Alger, 2013). The process of extinguishing (forgetting) an aversive memory (like the memory of a trauma) requires the participation of CB1 receptors and therefore it is not at all surprising that CBD can facilitate the extinction of aversive memories. CBD helps you forget traumatic or noxious memories.

Additionally, studies have also shown that [long term] CBD treatment may facilitate neurogenesis in the hippocampus of the brain, a structure well known for its important role in processing memories, and that is found to be smaller in patients with PTSD – Bitencourt & Takahashi, Frontiers in Neuroscience, 2018

In animal studies, cannabinoids administered shortly after exposure to a traumatic event were found to prevent the development of PTSD (Akirav et al, 2016), and therefore a state of endocannabinoid deficiency could potentially predispose a person to the development of PTSD (Campolongo, et al., 2018). These are immensely promising findings. It is possible that in the future, cannabidiol can be given to people immediately after a trauma to prevent the development of PTSD and help them to appropriately process the memory of the experience. Additional studies in humans are necessary, because obviously we aren’t rats, and animal studies only go so far. Still, so far it seems that on the topic of CBD, the results from animal studies lead to new hypothesis for humans which are later tested and proven in human studies. Of course that is not always the case for many other substances.

Fear extinction: Putting out the fight or flight response fire

The endocannabinoid system helps us deal with traumatic life experiences as a part of a normal coping mechanism—to forget it and leave the past behind . . . Failure to extinguish learned fearful responses may underlie posttraumatic stress syndrome. -Alger, Cerebrum: The Dana Forum on Brain Science, 2013

CBD stimulates the endocannabinoid system and decreases the fear response (Bitencourt & Takahashi, 2018). Click here for a longer explanation of fear extinction if you want to look into it further. For our purposes, just know that impaired fear extinction is implicated in PTSD, and it is likely that anandamide deficiency is what impairs it.

Why do PTSD patients have more CB1 receptors than people without PTSD?

Research has consistently demonstrated that the human endocannabinoid system plays a significant role in PTSD. People with PTSD have greater availability of cannabinoid type 1 (CB1) receptors. – U.S. Department of Veterans Affairs, 2017

Research indicates that PTSD afflicted brains compensate for low anandamide levels by upregulating the CB1 receptors (Bailey et al., 2013). Essentially, the PTSD brain is seeking anandamide by increasing the number of receptors to which anandamide can bind. So where is the anandamide? Why are they deficient? Chronic stress depletes the endocannabinoid system. Not surprisingly, people who are exposed to chronic life stressors prior to the traumatic event have substantially increased risk for PTSD (Sareen, 2016). Life stressors can be anything from financial problems to marital issues… the standard adult stressors. And who is more chronically stressed than our military, police, firefighters, paramedics, and nurses–all of which have a substantially increased risk for PTSD than the average population.

Under conditions of chronic stress, the endocannabinoid system appears to “collapse.”     . . . [Cannabinoids] are a critical component of stress resilience and impairments in this system may result in an increased vulnerability to the adverse effects of stress and, potentially, may be a biological substrate related to the development of stress-related psychiatric illnesses. – Hill and Lee, Biological Psychiatry, 2016

Why medical marijuana / self medicating with marijuana is not the answer

Medical cannabis and the form that is smoked or found in edibles contains another cannabinoid called tetrahydrocannabinol (THC). THC is psychoactive, and provides the “high” from cannabis. THC has various medicinal properties as well, but perhaps not the kind that will help PTSD patients long term. I think the problem lies in the fact that THC can actually reduce the number of CB1 receptors that are available. This is why PTSD patients may find relief from their symptoms when the smoke marijuana. However, I mentioned before, they need those CB1 receptors so that cannabinoids can aid in the processing and extinction of unpleasant trauma memories. Indeed it is well known that many PTSD patients resort to cannabis use for relief of symptoms. But the relief is temporary and the symptoms seem to return soon after it wears off. This leads me to believe that the THC may actually interfering with beneficial actions of CBD. You can develop tolerance to THC, but CBD dosing does not cause tolerance. Smoking marijuana–in my opinion–is simply a crude way to reap its medicinal benefits, not to mention that it remains illegal in most states. Why take that risk at this time?

Indeed administering THC on a chronic basis reduces the number of available cannabinoid receptors by 20%–60%, which effectively leaves the body’s natural endocannabinoids with fewer sites to activate, which may reduce their overall impact. Yarell, The Primary Care Companion for CNS Disorders, 2015

To me, it is glaringly clear that supplementing with cannabidiol (CBD) is the most logical, evidence based treatment choice for PTSD sufferers. Fortunately, CBD oil is quite easy to obtain.

One brand that I personally trust is MedTerra as their CBD oil is CO2 extracted and has zero THC.  If you buy from them, be sure to use my code to get 15% off:

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Oh, and just a heads up: Amazon does not sell any CBD oil whatsoever. The hemp oil being sold by many companies on Amazon is not CBD oil. For more information on CBD oil and what to consider before you make your first CBD oil purchase, click here.

I will be posting in the future about the enzymes that degrade our endocannabinoids, and what we can do to inhibit them. I will also be posting about amino acid supplementation which may also help with PTSD symptoms.

If you have any questions or comments, or if you feel it is necessary to correct something that you read in my blog, feel free to do so below. I appreciate any and all of your contributions. If you think this post could help a friend, share it. You might change their life.

Legal Disclaimer: The information, including but not limited to, text, graphics, images, website links and other material contained on this website are for informational purposes only. The purpose of this website is to promote broad consumer understanding and knowledge of various health topics, as well as share personal opinions and experiences. It is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition or treatment and before undertaking a new health care regimen, and never disregard professional medical advice or delay in seeking it because of something you have read on this website.

References

Alger, B. (2013). Getting high on the endocannabinoid system. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3997295/

Anxiety and Depression Association of America. (2018). Post traumatic stress disorder. Retrieved from https://adaa.org/understanding-anxiety/posttraumatic-stress-disorder-ptsd

Bailey, C., Carson, R., Corsi-Travali, S., Gujarro-Anton, A., Henry, S., Lin, S., . . . Zheng, M. (2013). Elevated brain cannabinoid CB1 receptor availability in post-traumatic stress disorder: a positron emission tomography study. Retrieved from https://www.nature.com/articles/mp201361

Bitencourt, R. & Takahashi, R. (2018). Cannabidiol as a therapeutic alternative for post-traumatic stress disorder: From bench research to confirmation in human trials. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6066583/

Campolongo, P., Hill, M., Patel, S., & Yehuda R. (2018). Integrating endocannabinoid signaling and cannabinoids into the biology and treatment of posttraumatic stress disorder. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/28745306

Hill, M. & Lee, F. (2016). Endocannabinoids and stress resilience: Is deficiency sufficient to promote vulnerability? Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5086031/

Holmes, A. & Maren, S. (2015). Stress and fear extinction. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4677122/

Kar, N. (2011). Cognitive behavioral therapy for the treatment of post-traumatic stress disorder: a review. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3083990/

Reisman, M. (2016). PTSD treatment for veterans: What’s working, what’s new, and what’s next. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5047000/

Sareen, J. (2016). Posttraumatic Stress Disorder in Adults: Impact, Comorbidity, Risk Factors, and Treatment. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4168808/

Stanford Children’s Health. (2018). Post-traumatic stress disorder in children. Retrieved from https://www.stanfordchildrens.org/en/topic/default?id=post-traumatic-stress-disorder-in-children-90-P02579

U.S. Department of Veterans Affairs. (2017). Marijuana use and PTSD among veterans. Retrieved from https://www.ptsd.va.gov/professional/co-occurring/marijuana_use_ptsd_veterans.asp

Yarnell, S. (2015). The use of medicinal marijuana for posttraumatic stress disorder: A review of the current literature. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4578915/

CBD Oil for Anxiety

Anxiety disorders afflict 40 million people in the United States with 8% of them being children and teens (Anxiety and Depression Association of America [ADAA], 2018). If you are one of them, you are clearly not alone; and there are a variety of natural ways to manage it. It is worth noting that anxiety is a normal experience for most people, but having an anxiety disorder means that your stress response is abnormally high or that you are experiencing anxiousness about unsubstantiated worries. If you are not sure about what you are experiencing, here is a cool infographic from ADAA to clarify:

If you have been diagnosed with an anxiety disorder, or think you may have one, or have a loved one who suffers with anxiety, this post is for you. Here we will be reviewing one of the most effective natural therapies available–cannabidiol (CBD) oil. Rather than defining CBD oil, we will be focusing on how it helps anxiety disorders. You may want to also read What is CBD Oil?.

“We found that existing preclinical evidence strongly supports CBD as a treatment for generalized anxiety disorder, panic disorder, social anxiety disorder, obsessive–compulsive disorder, and post-traumatic stress disorder” – American Society for Experimental Neurotherapeutics (ASENT), 2015.

The most commonly prescribed medications for anxiety disorders are anti-anxiety drugs (benzodiazepines), antidepressants like selective serotonin reuptake inhibitors (SSRIs), and beta-blockers (off label use as beta blockers are normally for high blood pressure and heart problems). These have many undesirable side effects, some of which can be life-threatening adverse events. Benzodiazepines (benzos) can lead to dependence and addiction, while both antidepressants and benzos often lead to tolerance and the need to increase the dosage to achieve the desired effect. Benzos and SSRIs are known to have a negative impact on the normal sleep cycle resulting in poor quality sleep that is not restorative. Even worse is long term use of benzos can lead to cognitive dysfunction even after they are discontinued. That all sounds pretty terrifying, but for some people anxiety is so debilitating that they are willing to take the hit because they just need to function. Fortunately, CBD oil provides a viable alternative.

How does CBD oil measure up in comparison to commonly prescribed drugs?

“CBD oil is safe and well-tolerated via the oral route (up to 1,500 mg/day). Moreover, because this compound does not induce dependence, tolerance and abstinence symptoms, it can be, in the future, a good alternative as a substitute for high potency benzodiazepines and antidepressant drugs” – Campos & Soares, Current Neuropharmacology, 2017

But how does CBD work? The mechanisms are not fully known and the ones we know about are not fully understood, but here is what we know it does do (and this is not an all inclusive list):

  • It is neuroprotective, which means it reduces damage to your brain and nervous system (Blessing et al., 2015).
  • It stimulates neurogenesis, which means it encourages new nerve growth and development (Campos & Soares, 2017)
  • It is a powerful antioxidant and free radical scavenger–even more powerful than vitamins C and E (Grotenherman & Iffland, 2017).
  • It activates 5HT1A (serotonin) receptors which is believed to be a major part of why it alleviates anxiety (Blessing et al., 2015).
  • It increases anandamide levels in the brain (Campos & Soares, 2017). Anandamide is an endogenous cannabinoid that our body produces on its own, and is also known as the “bliss molecule.”

And here is what we know it doesn’t do:

  • It does not have any psychotropic effects (no “high”)
  • It does not have any residual effect on cognitive or psychomotor functions (for example it does not cause drowsiness that makes it dangerous to drive) (Crippa et al., 2018).
  • It does not interfere with the normal sleep cycle (Crippa et al., 2018)
  • It does not have any known negative side effects even at doses as high as 1500 mg per day (Grotenherman & Iffland, 2017).

Most likely, there are a plethora of other ways CBD oil relieves anxiety, scientists just haven’t been able to identify them yet. Is it risky to take CBD oil when we aren’t exactly sure how it alleviates anxiety? Well, consider this: we have cannabinoid receptors which are biologically designed to bind to cannabinoids, we make our own cannabinoids even when we aren’t taking any, CBD oil has been proven safe and effective as a treatment for anxiety in many human and animal studies, and it is essentially devoid of any negative side effects.

If I were choosing between CBD oil and what pharmaceuticals had to offer for anxiety disorders, I think I’d take my chances.

If you have any questions or comments, or if you feel it is necessary to correct something that you read in my blog, feel free to do so below. I appreciate any and all of your contributions. If you think this post could help a friend, share it. You might change their life.

Legal Disclaimer: The information, including but not limited to, text, graphics, images, website links and other material contained on this website are for informational purposes only. The purpose of this website is to promote broad consumer understanding and knowledge of various health topics, as well as share personal opinions and experiences. It is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified health care provider with any questions you may have regarding a medical condition or treatment and before undertaking a new health care regimen, and never disregard professional medical advice or delay in seeking it because of something you have read on this website.

References

Anxiety and Depression Association of America. (2018). Understanding the facts of anxiety disorders. Retrieved from https://adaa.org/understanding-anxiety

Blessing, E., Steenkamp, M., Manzanares, J., & Marmar, C. (2015). Cannabidiol as a potential treatment for anxiety disorders. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6066583/

Campos, V. & Soares, A. (2017). Evidences for the anti-panic actions of cannabidiol. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5412699/

Crippa, A., Crippa, J., Eckeli, A., Guimaraes, F., Hallack, J., Linares,… Zuardi, A. (2018). No acute effects of cannabidiol on the sleep-wake cycle of healthy subjects: A randomized, double-blind, placebo-controlled, crossover study. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5895650/

Groterherman, F. & Iffland, K. (2017) An update on safety and side effects of cannabidiol: A review of clinical data and relevant animal studies. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5569602/