Anxiety is a natural response to external threats—it exists to put the body into a heightened state of awareness so that we can avoid potential danger. But for an estimated 40 million people in the United States, anxiety is a problem even if there is no present danger. There are several different anxiety disorders, including post-traumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD), panic disorder (PD) generalized anxiety disorder (GAD), and social anxiety disorder (aka “social phobia”). It’s of worthy distinction to note that stress is not the same thing as anxiety, though both evoke the same “fight-or-flight” response within the body. Stress tends to come from external sources, like an argument, or the death of a loved one, or even positive experiences, while anxiety generally is more of an internal response, and usually carries with it feelings of fear or dread. Both stress and anxiety release stress hormones in the body, which are meant to enhance the ability to react.

Brief anxiety is completely normal in response to stressors or emotional difficulties. But an anxiety disorder carries on for long periods of time, even when there is no clear reason or discernible threat. The exact causes of most anxiety disorders are still being studied, but it’s thought that these are influenced by a combination of genetics and environment/upbringing. It is said that people who grow up in an environment where there are regular physical or emotional threats can become “wired” for anxiety. This is a debilitating condition because oftentimes people with anxiety disorders are so used to feeling as they do that they don’t realize it’s a problem and suffer in silence. As anxiety disorders continue and intensify, people can become more socially isolated, and the oversaturation of stress hormones can lead to physical symptoms and depression. Anxiety-related disorders are linked to higher rates of unemployment, relationship problems, and suicide risk.

Anxiety disorders seem to result from a disruption of the balance in the emotional centers of the brain, as opposed to the areas governing higher cognition. These emotional centers have long been referred to as the limbic system, and include several distinct structures within the brain. The limbic cortex, hippocampus, thalamus, hypothalamus, and amygdala (which is sometimes casually referred to as the “lizard brain”) all play an important part in the way that anxiety works, with the amygdala being implicated as the area that is most influential when it comes to the expression of fear and aggression, and the formation of emotional and fear-related memories.

Anxiety disorders can be difficult to treat. For one thing, it’s estimated that only a third of those afflicted seek out treatment to improve their condition. And for the ones who do look for help, it’s usually given in the form of pharmaceutical drugs, many of which can make these problems even worse due to side effects. Common anxiolytic drugs are benzodiazepines like Ativan, Xanax, and Valium. These drugs boost the activity of a neurotransmitter called gamma-aminobutyric acid (GABA), which in turn activates dopamine, the so-called gratification hormone, in the brain. Other drugs like Prozac and Zoloft are selective serotonin reuptake inhibitors (SSRIs), and target the serotonin system. The withdrawal symptoms from these types of medications often include extreme anxiety, ironically, returning patients to the state they were in before they began the medication, or worse.

CBD’s anxiolytic (anti-anxiety) properties have been the subject of numerous studies. CBD as a potential therapy for anxiety-related issues can in fact be traced back to the early studies of THC. A study from 1982, published in Psychopharmacology, detailed CBD’s effects as a sort of “antidote” to the anxiogenic effects of THC. THC is commonly associated with the euphoria that comes with smoking marijuana, but it has other effects as well, one of them being that it can induce anxiety and psychotic symptoms. Because CBD works on the ECS receptors in a different way than THC, it actually was shown to block THC’s anxiogenic effects. This study of CBD against THC gave us the first hints that CBD could be an effective anxiolytic. Later studies confirmed this, and in the 2000s, studies were conducted specifically around CBD and its effect on a variety of anxiety issues. For example, a study published in Neuropsychopharmacology in 2011 showed that CBD reduced anxiety brought on by simulated public speaking in treatment-naïve social phobia patients. CBD also works on non-cannabinoid receptor systems, and can directly interact with opioid receptors, dopamine receptors, and serotonin receptors, the latter two of which play a major role when it comes to the anxiety-related spectrum of disorders and mental health in general.

A major study in 2015 published in Neurotherapeutics reviewed preclinical and clinical evaluations of CBD as a potential therapy for anxiety disorders and reflects positive findings. CBD is shown to work as an anxiolytic, panicolytic, and anticompulsive, to decrease autonomic arousal and fear expression, and to prevent the long-term anxiogenic effects of stress. CBD shows great potential for PTSD specifically, as it helps to enhance “extinction” and block reconsolidation of fear-based memories. Neuroimaging of the brain revealed that CBD might target and affect amygdala activation and its communication with other parts of the limbic system, down-regulating the unnatural fight-or-flight response. In healthy control subjects where anxiety was experimentally induced, 300-600 mg of oral CBD was shown to reduce anxiety in patients with social anxiety disorder, too.

The efficacy of CBD on the spectrum of anxiety disorders has been demonstrated repeatedly. CBD for anxiety has the upside of minimal if any side effects compared with most commonly prescribed courses of treatment. Further clinical study is necessary as much of the literature comes from studies done on animal subjects, but CBD shows great promise in the fight against anxiety and related disorders and has the potential to revolutionize the treatment of mental-health issues in the not-so-distant future.

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