Finding the right treatment for obsessive-compulsive disorder can be extremely difficult. Often given antidepressants and anti-anxiety medications as the only treatment options, it’s no wonder why so many with the condition are interested in medical cannabis. Yet, does the herb worsen symptoms or improve them? This segment of our All In The Mind series focuses on one crucial question: Does Cannabis Help OCD? The answer might surprise you.
What is Obsessive Compulsive Disorder?
People use the term OCD lightly these days, but this disorder is far from a laughing matter. OCD stands for obsessive-compulsive disorder. Those with this condition experience an array of symptoms, including obsession, compulsions, and intense anxiety. Obsessions are continuous ruminations on a thought or an idea. These ruminations are main players in the anxiety that goes hand-in-hand with OCD.
These obsessions then lead to compulsions. Compulsions are a series of repetitive behaviors that are a response or coping mechanism to the obsessions. Fear has a big influence over both obsessions and compulsions. For example, an intense fear of germs or disease might make someone with OCD too afraid to touch door knobs with their bare hands.
Another person may have a fear of causing harm to others or acting inappropriately, so that person may obsessively think about those kinds of behaviors. Of course, this is just a very small sampling of the ways in which OCD might express in certain individuals.
Acting out compulsions are not often pleasurable to those with OCD. Rather, these actions might cause a brief escape from the anxiety caused by obsessive thinking. OCD is often treated with a combination of psychotherapy and medication. Anti-depressants and anti-anxiety medications are the most common treatments for this condition.
Does cannabis help OCD?
OCD takes on different personas in different people. Depending on your unique quirks, you might fight cannabis helpful or you might not. Some people with OCD struggle with feeling like they’re not in complete control when they take cannabis. Yet, many others have found much-needed moments of peace with the herb. Take young Ryan Mendoza as an example.
In 2010, Ryan’s mother Judy Mendoza went on national television explaining that medical cannabis is the only thing that helps her son with OCD. Ryan had to be pulled from school. He is pathologically afraid of the number 6 and the wind. She explains her thoughts the moment she decided to give Ryan medical cannabis:
My first response was oh my God, that seems really drastic. But, I don’t want to do all of these antipsychotic medications anymore. They don’t seem to be helping. And I thought to myself, ‘What do I really have to lose?’ -Mendoza
Cannabis did not make Ryan’s OCD go away. But, Mendoza says that Ryan’s ability to cope with the condition changes. While Ryan was a pre-teen when he first began getting cannabis treatment, many older patients have also found relief with the herb. One user explains on Reddit:
I recently started smoking – despite not being a weed person, historically – because I have anxiety and avoidance problems and wanted to see if it would help. (I also live in an area where it has now been effectively decriminalized, so the cost/benefit ratio looked good.)
The effect on attention span, in particular, seems to help jog me out of thought spirals. It’s easier to “start” a thought but harder to sustain it – my thought process reboots more frequently. – Propyl_People_Ether
However, when it comes to cannabis and OCD, there’s a bit of a trick to getting the most out of your medicine. Finding the right strain and the right combination of THC and CBD will make a huge difference in how well the herb manages your symptoms.
How can I make cannabis more effective for OCD?
First off, we are not doctors. As with all psychiatric medications, it’s important to work with a trusted medical professional when you make any changes in treatment. However, there are a few things you should know before you dive into medical cannabis.
To start, strains are important. The world of medical cannabis is very broad, and there are a lot of different options out there. While one person might find success with a THC-dominant strain, another may find the experience very uncomfortable. This is true with almost everyone who tries cannabis, but it is especially true in those with OCD.
Indica vs. sativa
The anxiety caused by OCD can be absolutely devastating. It interferes with your life in ways that you could never predict and often continues to get worse over time. Many people have found relief with cannabis. If you’re interested in trying cannabis as a treatment, it may be best to start with a cannabis indica strain over a cannabis sativa.
Why? Sativa strains produce strong cerebral, brain-focused effects. They tend to be more anxiety-provoking and often cause paranoia. Sativa strains tend to be very stimulating, like drinking a strong cup of coffee. This stimulating effect is why they’re not often recommended for those with serious issues with anxiety.
Indicas, on the other hand, have very different effects. A true indica will slow you down, and the effects are felt mostly in the body. If you’re looking for an all-around mellow time, indicas are the choice for you. The one downfall is that many people find that this form of cannabis zaps their motivation. It may provide several hours of relief from anxiety symptoms, but you also might not appreciate the sleepiness that makes indicas so popular among insomnia sufferers.
Unless you find that you tolerate the sleepiness extremely well, opt for indicas in the evening or on days when you don’t have much to do. Otherwise, there is another solution to this side effect that may be more useful for daytime medication.
CBD vs. THC
As a medical cannabis patient, one of the most beneficial things you can do for yourself is to determine whether or not you respond better to CBD dominant or THC dominant strains. When it comes to anxiety disorders, it’s often encouraged to pick up a CBD-dominant strain over a potent THC one. Yet, many anecdotal reports sware by the anxiolytic effects of THC.
Here’s what you should know about the two compounds before you dive into cannabis as a treatment for OCD.
THC is the primary psychoactive in cannabis. It’s what gives you the “high” that has made the herb so famous and controversial. The research on THC and anxiety is hit and miss. Some people seem to respond extremely well to THC, while others find that it only makes their anxiety symptoms worse.
Dr. Daniel Freeman and a team at the University of Oxford in the UK wanted to find out if THC actually triggered anxiety and paranoia symptoms in adults. So, they rounded up 121 individuals between the ages of 21 and 50. Two-thirds of the group were injected with a dose of pure THC equivalent to that of a strong joint. The other third was given a placebo.
50% of those given the THC reported strong feelings of paranoia. The team also noticed that THC seemed to increase symptoms of anxiety, worry, negative self-talk, and low mood. There were some perceptual changes as well, including sensitivity to loud noises and colors seemed to be brighter and more pronounced. Freeman believes that these changes in mood and self-talk contribute to paranoia. He explains:
Freeman believes that these changes in mood and self-talk contribute to paranoia. He explains:
The study identifies a number of highly plausible ways in which our mind promotes paranoid fears. Worry skews our view of the world and makes us focus on perceived threat. Thinking we are inferior means we feel vulnerable to harm. Just small differences in our perception can make us feel that something strange and even frightening is going on. – Freeman
Some counter claims
There are a few caveats to these claims, however. While half of those given THC experienced increased anxiety, the other half did not. So, THC may trigger anxiety in some people, but it won’t in others. It really depends on your unique biology. Further, many experiencing intense anxiety claim that THC actually helps relieve their symptoms and calm them down.
Synthetic THC has also indicated positive results as a potential treatment for OCD. A 2011 study found that a THC-like pharmaceutical was effective at mitigating OCD symptoms in rats. The findings suggested that cannabinoid medicines may help ease compulsive behavior.
Freeman’s study used an injected THC extract. This is not something that you’ll come across in the average dispensary or collective. When you consume cannabis, you’re most definitely not consuming a purified form of THC. Rather, you’re getting THC along with some other cannabinoids and terpenes.
Cannabinoids are the active compounds in the cannabis plant that engage with cell receptors in the body. Terpenes are the flavor and aroma compounds found in cannabis resin. These additional cannabinoids and terpenes have anxiety-fighting properties of their own. Research
Research has shown that the presence of these additional cannabinoids and terpenes actually helps balance out the uncomfortable effects of THC. This may be extremely beneficial for those suffering from OCD and anxiety disorders.
Some mild-mannered THC strains include:
- Dutch Treat
- 3 Kings
- Blackberry Kush
- Critical Kush
If you try THC and it does not work for you, you might just need to go for a CBD-dominant strain. CBD, short for cannabidiol, is a non-psychoactive cannabinoid. It won’t produce a high like THC. Rather, it’s a mild sedative with incredibly potent anxiolytic, and antipsychotic effects. So potent, in fact, that companies like GW Pharmaceuticals are looking into
So potent, in fact, that companies like GW Pharmaceuticals are looking into CBD as a supplemental treatment for those with schizophrenia. Recent research has also pointed to the success of CBD as a treatment for obsessive-compulsive disorder.
A 2014 study hints that CBD is also a potent anti-compulsive. Brazilian researchers put non-psychoactive cannabidiol to the test. They treated mice with a compound known as meta-chloro-phenyl-piperazine (mCPP). MCCP treatment induces obsessive-compulsive behavior in rodents. Mice that were given mCCP began burying things repetitively, an action which is thought to be a good way to test the effectiveness of OCD drugs.
After mCCP treatment, researchers gave the mice CBD. The repetitive burying decreased. The mice showed fewer anxiety symptoms and maintained their energy and activity levels. This led the authors to conclude that CBD demonstrated strong anti-compulsive properties.
Earlier studies on CBD and OCD reached similar conclusions. Back in 2012, a research team from Aberdeen, UK found that CBD decreased obsessive-compulsive behavior in rats. Other studies have suggested that CBD may help improve the effectiveness of psychological treatments like therapy if it is taken prior to the session.
CBD treatment has also been shown to reduce the anxiety associated with stressful events like public speaking if taken before the event takes place. This is good information to have handy when you know that you’re about to do something that may aggravate your anxious, obsessive, or compulsive tendencies.
Some high CBD strains include:
- Charlotte’s Web
- One to One
The endocannabinoid system and anxiety
Not a whole lot of research has been done on cannabis and obsessive-compulsive disorder specifically. But, a ton of research has been done on cannabis and anxiety. Turns out, there’s a reason why cannabis has been so instrumental to anxiety sufferers throughout the ages.
When you’re in an anxiety state, under stress, or experience a traumatic event, levels of endocannabinoids decrease in the body. Endocannabinoids are like our body’s own THC. They interact with a larger network known as the endocannabinoid system (ECS). The ECS is responsible for all kinds of things, like mood, fear response, sex drive, appetite, and sleep rhythms.
Sachin Patel, M.D., Ph.D., professor of Psychiatry and of Molecular Physiology and Biophysics, wanted to study just how cannabis and the endocannabinoid system interact in those with anxiety. Patel and a team of researchers from Vanderbilt University decided to do some research back in 2014. In their study, they managed to find out that the endocannabinoid system regulates anxiety. Patel explains:
Chronic stress or acute, severe emotional trauma can cause a reduction in both the production of endocannabinoids and the responsiveness of the receptors. – Patel
When you consume cannabis in an anxious or stressed state, you’re essentially replacing the missing endocannabinoids with a plant-based version. This causes a near-immediate relief of anxiety symptoms.
Additional research has discovered that cannabinoid receptors actually exist in the amygdala. The amygdala is the fear center of the brain. Our natural endocannabinoids work to regulate the fear response in the amygdala. When these endocannabinoids are in short supply, expect fear, worry, and anxiety galore.
Opt for low doses
If you’re new to cannabis or just starting to pay more attention to how the herb impacts your OCD, it’s best to start out with a low dose at first. Patel’s research team showed that low doses of THC are extremely anxiolytic. As the dose increases, however, the cannabinoid can actually have the opposite effect. Chronic use of THC is thought to desensitize cannabinoid receptors, meaning that they are less responsive to the quieting effects of THC or our own endocannabinoids.
As the dose increases, however, the cannabinoid can actually have the opposite effect. Chronic use of THC is thought to desensitize cannabinoid receptors, meaning that they are less responsive to the quieting effects of THC or our own endocannabinoids.
Choosing an edible over smoked cannabis can help lengthen the time between medication sessions. When you smoke/ vape, the effects of cannabis usually wear off within about three hours. When you eat an edible, the effects of a similar dose can be felt for around five hours. This helps combat the need to light up repeatedly throughout the day, which can more quickly lead to increased anxiety symptoms with THC. CBD is not associated with the same increase in anxiety symptoms.
This helps combat the need to light up repeatedly throughout the day, which can more quickly lead to increased anxiety symptoms with THC. CBD is not associated with the same increase in anxiety symptoms.
OCD will not go away on its own. Even if you have found wild success with cannabis, the most effective treatments include a mix of psychotherapy, medication, and a healthy lifestyle.
Cognitive behavioral therapy
Cognitive behavioral therapy (CBT) is a form of psychotherapy that teaches you how to cope with your condition. Its focus is on problem-solving rather than analysis. So, rather than focusing on the cause of your OCD, you focus on learning how to better live with the disorder.
Though this probably sounds like the most terrifying possible method for getting a handle on OCD, exposure therapy is highly effective. As the name suggests, exposure therapy forces you to come face to face with situations you fear or causes anxiety. Exposure therapy is actually a form of CBT, so the two go together quite nicely.
As with all mental health issues, it’s key to find the right therapeutic approach for you as an individual. Cannabis may or may not be the most effective way to manage your condition. Only you really know how you feel when you take the herb. There is strong evidence that cannabis can help a variety of anxiety disorders, and OCD is one of them.
Starting with low doses and perhaps opting for CBD is probably the safest route when first beginning cannabis treatment. But, as mentioned earlier, we aren’t medical experts. Always work with a doctor when trying a new psychiatric treatment.
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