Is Pot Safe for Depression?
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Plamen Petkov/Stockhouse Emma took her first hit of pot when she was 14, though you’d never call the 22-year-old college student a stoner. Like many young women, she occasionally smokes with friends. It wasn’t until last year, when she had her first panic attack, that she began to look at the drug differently. “I was stressed about school and work,” Emma says. She was also having trouble focusing and even getting out of bed: “That wasn’t like me.” She tried eight prescriptions for anxiety and depression. “One made me unable to orgasm; another put me in a daze,” she recalls.
What did help: lighting up. &ldq uo;After I smoke pot, I feel calmer and think more clearly. It helps me accomplish tasks that would usually make me anxious, like writing papers,” she says. She was so struck by weed’s effects that she relayed her symptoms to her doctor and got herself a medical marijuana card which, in her home state of Massachusetts, lets her carry 60 days’ worth of cannabis for personal medical use without any legal ramifications. “It brings instant relief for my anxiety and makes me a happier, more pleasant person,” she says.
Like Emma, a growing number of the 40 million-plus Americans who suffer from anxiety and depression will likely be experimenting with weed to ease their symptoms. After all, medical marijuana is now legal in 20 states (with recreational use allowed in Washington and Colorado). But does reefer work for anything other than inducing a fit of giggles—or an irresistible craving for Ben & Jerry’s? And can the substance a ctually negatively affect anxious or depressed users? The answers are far from clear.
A Kinder, Gentler Form of Pot
Cannabis has been used to treat various maladies for thousands of years. Every hemp plant contains more than 80 cannabinoids, including THC (the compound that makes you high) and cannabidiol (or CBD). Though most of us have heard of THC, it’s CBD, first isolated by scientists in 1940, that may be responsible for Mary Jane’s more medicinal effects. These include quelling the kind of anxiety that Emma feels; alleviating pain and side effects from chemotherapy; easing symptoms from neurological disorders such as multiple sclerosis and epilepsy; and combatting insomnia.
“Pot has tremendous medical potential, but there’s a lot we don’t know—research is still be ing hampered in this country,” says Julie Holland, M.D., a psychopharmacologist in New York City and editor of The Pot Book. CBD, for instance, was initially thought to be inactive, since, when ingested on its own, it didn’t induce any wobbly, euphoric feelings. But a number of more recent studies, mostly done in Canada, Europe and Israel, suggest that CBD has potent medicinal power. A 2011 report found that CBD even eased the terror of public speaking in people with social anxiety disorder. Because of its supposed effects, CBD is being utilized in products beyond plain old pot—such as capsules, body balms and even chewing gum.
When it comes to exploring the possible medical benefits of marijuana in the U.S., however, doctors are forced to take more of a DIY approach. “I knew cannabis eased certain neurological disorders, but I wanted to see what else it could do,” says Stacey Kerr, M.D., a retired family physician in Santa Rosa, Calif., who’s researching pot’s potential to help people with mood disorders. “I had a patient with metastatic cancer who was experiencing a lot of anxiety,” Kerr recalls. “She she was skeptical about pot. She told me, ‘I don’t want the woozies.’” The patient was willing to try a tincture of CBD blended into honey butter in lieu of the antianxiety drugs her doctor had recommended. Says Kerr: “Afterward, she called me in tears, saying that it worked better and faster on her anxiety than any prescription.”
Holland also hears cannabis testimonies from patients: “They tell me it’s great for helping them calm down, shift gears and get to sleep.” That’s not surprising, given the drug’s reputation for inducing a mellow state of mind. But in the same way that the buzz from one or two drinks wears off in an hour or tw o, marijuana’s effects on emotions tend to be fleeting. “The difference between prescription antidepressants and pot or alcohol is that the former can help rebalance mood-regulating neurotransmitters in the brain; the latter just numbs you temporarily,” says Marc Fishman, M.D., assistant professor of psychiatry at Johns Hopkins University in Baltimore. “Pot or booze don’t fix the underlying problem, but rather give you an artificial rush of happiness. Over time, neither one is a sustainable way to get relief.”
A Mixed (Dime) Bag
A key difference between a traditional Rx and whatever you nab from your local dealer? Consistency: Street marijuana isn’t regulated in the same way as prescription drugs, which means that you can’t be sure of what’s inside that little baggie. Unless you live in a medical marijuana state and can qualify to buy purer dispensary products, “you just don’t know wh at you’re getting,” cautions Martha Montemayor, owner of Healthy Choices Unlimited, a Colorado clinic that, among other things, performs medical marijuana evaluations.
Another problem with substituting dope for Prozac: CBD-rich bud isn’t easy to get your hands on. For obvious reasons, most pot on the street contains large concentrations of THC, designed to provoke a This is great stuff, man, reaction. “And people who work at dispensaries are often more like bartenders than pharmacists,” Kerr notes. That makes it tricky to be sure that what you’re inhaling will actually calm you down, help you sleep or ease depression. adding to the trouble, THC-rich weed can actually increase anxiety. “If you get too much THC, you can experience rapid heartbeat, paranoia and dizziness,” Montemayor says.
And though the research is mixed, several major studies suggest that chronic pot use can exacerbate depression, a s well as impair cognitive skills and memory—not just while a person is under the influence, but over the long term. A less common, but even more troubling side effect: “If someone is vulnerable to schizophrenia, they may have a psychotic break earlier if they smoke pot,” Holland warns.
Ultimately, though, MJ affects people differently, depending on their emotional makeup—and the blend. “If depression is your issue (although it’s not a qualifying condition for medical marijuana in some states), THC may be more uplifting, and CBD more calming,” Montemayor says. “It’s about finding the right combination.” Unless you have access to a dispensary that offers precise blends of cannabis, that means experimenting with whatever strains your source has available.
That imprecision makes many traditional physicians uncomfortable, to say the least. So does the lack of large, randomly controlled clinical trials— the kind needed to get a substance approved by the FDA. “Any physician who prescribes weed for depression is an idiot,” says Fishman, who is also medical director of Maryland Treatment Centers. “There’s just no clear scientific evidence that it’s helpful for emotional issues.” It’s one thing, he says, to grab the occasional drink or joint to relax. “But it’s unreasonable for a doctor to say, ‘Take three martinis—or tokes—for your depression and call me in the morning.’”
Of course, a raft of widely publicized studies suggest that prescription antidepressants are not necessarily much more effective than placebos, either. But as Fishman points out, when you use marijuana to self-medicate, you tend to need more and more of it to get the same benefit. “Over time, pot and certain other intoxicants hijack the brain’s feel-good dopamine reward pathways, so you have to ingest more to get that surge,” he explains. “That typically doesn’t happen with antidepressants.”
Taking Matters Into Their Own Hands
Kerr agrees that more research is crucial. In a survey by The Society of Cannabis Clinicians, 25 percent of the roughly 400 female respondents gave CBD-rich cannabis a 10 out of 10 for reducing anxiety; 26 percent gave it a 10 for mood improvement. “Many said they’d stopped taking prescription drugs like Paxil or Xanax,” Kerr says.
Not that pot is a panacea. “There’s no question that people can use it compulsively, or as an escape,” Holland says, “but at least it’s less toxic than many other drugs and medications.” Indeed, while you may have a bad reaction to a toke, most experts agree that you won’t die of a pot overdose. “Compare that to the 300 people a year who die from acetaminophen!” Montemayor points out. You most likely wo n’t become an addict, either—only 9 percent of people who ever smoke weed eventually become dependent on it, the same rate as alcohol and lower than the 32 percent who get hooked on tobacco. Bottom line: Like almost any medication, prescription or no, cannabis can give you unasked-for side effects. “But ideally,” Montemayor says, “it should be available as another tool in the doctor’s kit.”
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