Anxiety

Anxiety is the most common mental disorder in the United States, affecting approximately forty million adults nationwide. This number reflects about eighteen percent of our nation’s population.

Anxiety is a relatively treatable condition; however, only around thirty-seven percent of patients seek treatment. Anxiety disorders, including social phobia, stem from inherited traits, brain structures that affect the fear response, life events, and environmental factors.

Types of Anxiety Disorders 

Five main types of anxiety include:

• Generalized Anxiety Disorder is characterized by chronic stress, tension, and worry when there is little or nothing to provoke it.
• Obsessive-Compulsive Disorder is characterized by recurrent and unwanted thoughts or obsessions and repetitive behaviors or compulsions.
• Panic Disorder is caused by unexpected or repeated episodes of intense fear and other physical symptoms, such as chest tightness, racing heart rate, or gastrointestinal issues.
• Post-Traumatic Stress Disorder occurs after someone is exposed to a traumatic event in which physical or emotional harm occurred or was threatened. This includes sexual assault, military combat, and vehicle accidents.
• Social anxiety disorder, or social phobia, causes an intense fear that one is being evaluated or judged by others when in social settings. This persistent fear can affect daily life, including work, school, friends, family, errands, doctor visits, and more. Although it can feel beyond one’s control, social anxiety and other anxiety disorders are treatable. It is the most common type of anxiety disorder. If treatment isn’t pursued, it could lead to disruptions in everyday life and, in severe cases, result in alcohol and cannabis dependence as a coping mechanism.

Anxiety symptoms

There are many anxiety disorder symptoms, and the frequency of their occurrence depends upon the person and whether they have attempted a potential treatment option. The symptoms of social anxiety can be broken down into three categories: physical, cognitive, and behavioral effects.

Below, we provide examples of the signs and symptoms of Social Anxiety Disorder:

Physical effects– nausea, rapid heartbeat, sweating, flushing, shaky, dizzy, light-headed, chronic pain

Cognitive effects include feeling out of control, high stress, self-consciousness, paranoia, and feeling unsettled or overwhelmed.

Behavioral effects include:

• Difficulty managing pressure.
• Avoiding eye contact.
• Fear of social interaction with strangers or any other unknown social situations.
• Making impulsive or irrational decisions.
• Anxiety-induced panic disorder and subsequent panic attacks.
• Freezing during public speaking.

Daily effects of social anxiety

The intensity of an anxiety disorder varies greatly depending on the individual and their environment.

Social Anxiety patients may experience emotional stress during ordinary activities or anticipatory anxiety before certain events such as:

• Social encounters or introductions with strangers
• Speaking with a boss or leader
• Visiting someone’s home
• Shopping, completing transactions
• Running errands
• Doctor visits
• If they become the center of attention
• Formal or Public speaking
• If they are teased, bullied, or harassed
• During romantic situations
• When trying to make friends

Conventional Treatments

The cognitive-behavioral, group, and exposure therapy, along with an oral dose of prescription medication, are two treatment options proven to affect the symptoms of social anxiety disorder significantly.

The different types of therapy for social anxiety disorder include:

• Group therapy allows a person with an anxiety disorder to learn social skills from others that may be going through similar situations in a safe space. Participating in group activities with other people with anxiety, obsessive-compulsive disorder, or other mental disorder can make one feel less alone and more understood.
• Cognitive behavioral therapy, or talk therapy, is the most common type for those with anxiety disorders. During talk therapy, the patient with a social anxiety disorder will meet regularly with a therapist to self-report measures of behaviors, emotions, and thoughts during everyday life.
• This will encourage and assist the individual in recognizing and addressing intrusive, harmful, or false ideas. Cognitive behavior therapy can change thought patterns and help the patient see things more positively.
• Exposure therapy involves easing a patient with social anxiety disorder into social settings a little bit at a time. The individual may start small and chat regularly with a therapist while emerging into society at a comfortable pace. This category includes yoga, meditation, exercise, and acupuncture. These holistic therapies are popular for people looking to increase blood flow, change their lifestyles and build healthier habits. For some, they can assist in coping with mental disorders. Some alternative solutions combined with medication or meeting with a therapist could successfully result in a significant decrease in anxiety and build a healthy, happy, and productive lifestyle.

Current Medications

There are five categories of medication used to treat anxiety. They are antidepressants, buspirone, benzodiazepines, hydroxyzine, and beta-blockers. Systematic review proves that each category includes certain drugs with risk factors and potential health benefits administered acutely.

Selective serotonin reuptake inhibitors are commonly prescribed to treat social anxiety disorder. The only SSRIs that are currently FDA-approved for this condition are Zoloft and Paxil. Extended-release venlafaxine is a serotonin and norepinephrine reuptake inhibitor that is also FDA-approved to treat social anxiety disorder.

Patients using SSRIs and SNRIs may experience the following side effects:

• Nausea
• Drowsiness
• Weight gain
• Headache
• Dizziness
• Sleeplessness
• Sexual difficulties

Marijuana as an Alternative Treatment

Medical marijuana for an anxiety disorder typically has a more considerable amount of CBD, and lower levels of THC, depending on the type, can induce anxiety and panic. Safe access to medical marijuana strains with the combination of cannabidiol CBD concentrations could provide health benefits without the risks.

THC and CBD can improve sleep quality and duration in anxiety disorders. Recent clinical trials tell us that medical cannabis may help reduce social anxiety in the short term and help you sleep better. However, before using marijuana to treat anxiety, we recommend speaking with your doctor to be safe. 

Cannabinoids and Anxiety

Delta 9- tetrahydrocannabinol (THC), the component in cannabis responsible for the psychoactive effect, binds more substantially to the CB1 receptor than cannabidiol; however, it has been known to increase anxiety for some people when larger doses are taken. New medical marijuana patients should pick high CBD to low THC ratios or possibly avoid THC altogether to lessen the probability of THC-induced anxiety. CBD has been shown to reduce the short-term stress caused by THC.

Cannabis researchers believe that CBD increases anandamide, which directly increases serotonin activity and helps ease fear and stress. When paired with CBD, it acts similarly to prescription serotonin and norepinephrine reuptake inhibitors (SNRIs) by relieving feelings of anxiety.

Medical Research

An American Psychiatric Press study stated the following in regards to their clinical data on the link between marijuana use disorders and social anxiety disorder:

“Although social anxiety disorder is related to CUD, it has a stronger association with dependence on the cannabis sativa plant than abuse. This link is not better accounted for by other psychopathology in this study. SAD onset before CUD for the majority of CUD-SAD respondents. Importantly, the co-occurrence of these two disorders appears to result in greater impairment and distress than either disorder alone.”

Medically reviewed cannabis research with informed consent from healthy subjects with anxiety and placebo group in Italy suggested that:

The increasing prevalence rate of cannabis consumption and the recent debate on the legal status of marijuana use suggest a careful examination of risk and protective factors for problematic use of cannabis. The present study adds to the current knowledge on this issue, showing that social anxiety symptoms negatively associate with complex cannabis involvement among young adults. Specifically, the findings show that the negative relationship between social anxiety and problematic use of cannabis is fully mediated by negative expectations about the effects of cannabis consumption. “

A study published in 2011 by Neuropsychopharmacology tested the effects of orally ingesting CBD capsules before presenting study participants with a public speaking stress test. Participants received a dose of CBD or placebo before participating in the trial. They participated in a survey analyzing their stress levels and were monitored for changes in blood pressure, heart rate, and skin conductance. The patients treated with CBD had significantly lowered anxiety and cognitive impairment compared to those with the placebo. 

States with Anxiety as a Qualifying Condition

In these five states, patients with generalized social anxiety disorders qualify for a medical marijuana card with a prescription from a licensed physician. However, PTSD is another form of anxiety recognized in most medically legal states. We recommend speaking with your doctor for more information on your specific condition. 

1. Pennsylvania
2. New Jersey
3. Florida
4. North Dakota
5. California

In Conclusion

Anxiety disorder is not a condition to leave untreated. It can be a remarkably debilitating condition that negatively impacts many aspects of life along with your mental health. It’s not uncommon for someone with a generalized anxiety disorder to develop depression due to social withdrawal. In extreme cases, some patients have developed avoidant personality disorder and other severe mood disorders.

Nearly fifty percent of those diagnosed with depression are also diagnosed with an anxiety disorder. This can lead to substance abuse disorders in severe cases without proper treatment. Some marijuana strains may be helpful as an alternative therapy for anxiety.