If you experience persistent and overwhelming feelings of sadness and guilt, then cannabis might be an option for you. Read on to find out about cannabis' link with depression and how it can affect mood.
We note that the subject contained in this article represents illegal activity in certain jurisdictions. Whilst we do not condone any acts which are contrary to any such laws, we understand that readers in those jurisdictions which have decriminalised cannabis may find this article of interest.
With its heavy burden, miserable symptoms and high risk of relapse, depression is a major health concern worldwide. In 2004, the World Health Organisation predicted that by 2020 depression would be second only to heart disease in terms of the world's largest health problem. Well, currently it is 2020 and depression has been identified as the leading cause of disability worldwide, affecting more than 350 million people. With the current state of the world, this number could increase dramatically.
Although research on depression is extensive and awareness is increasing, it is still a poorly understood condition. On top of this, many evidence-based treatments have not been approved for clinical use, resulting in inadequate care for those who need it. Due to the reach and impact that depression has, the need for treatments that are effective and safe remains at an all-time high.
Cannabis is well-known for its multi-faceted therapeutic effects and the conditions that it can treat such as chronic pain, inflammation and epilepsy. It is also popular with some consumers due to the euphoric high that it has become famous for. These mood-lifting effects are utilised by consumers to manage symptoms of sadness, anxiety or stress. But can cannabis help with depression?
What is depression?
To answer that question, let's first take a look at depression and how it can manifest. Depression is primarily classified as a mood disorder but this can be misleading, as it can also affect behaviour and thinking. It can be further sub-classified into a range of different clinical disorders such as major depressive disorder (constant depression for 6 or more months), dysthymia (two or more years of mild depression), seasonal affective disorder aka SAD (depression triggered by seasonal changes) and bipolar disorder.
Depression has a constellation of symptoms that mostly reflect sadness. It is characterised by a significantly lowered mood and a loss of interest or pleasure in activities that are normally enjoyable. Other symptoms include insomnia, fatigue, loss of energy, feelings of worthlessness, excessive guilt, inability to concentrate and recurrent thoughts of death.
Although many theories exist, there is no single causal explanation for the onset of depression as many different factors can affect mental health. An accumulation of these factors can result in the onset of depression. The more risk factors present, the higher the chance of developing a depressive disorder. These risk factors belong to three major categories: internal factors, family or environmental factors and specific life events.
In regards to internal factors, people with certain personality traits or temperaments such as low self-esteem and introversion are deemed to be more at risk than others. Family and environmental risk factors can include family conflict or violence, financial difficulties and discrimination, amongst others. Lastly, traumatic and distressing events, such as the death of a family member, loss of friendship or moving countries can contribute to the onset of depression.
Cannabis as a treatment
As there are many different factors that can lead to depression, there is no all-encompassing treatment or cure. Outside of maintaining a healthy lifestyle, two of the major options for managing depression are therapy and medication.
Therapy is the recommended option for those looking to treat their depression at a psychological level. Psychotherapy can be utilised to help recognise and express emotions healthily while learning skills that are helpful in coping with adversity, trauma and loss. Some forms of psychotherapy include cognitive behavioural therapy (CBT), family-focus therapy and interpersonal therapy.
Though for some individuals, therapy is not feasible. They may find the whole process confronting or sometimes the therapy just isn't working. Medication is another option, which is helpful in managing the symptoms of depression, rather than the underlying causes.
Medication is often utilised for more severe cases of depression, rather than the milder ones. Antidepressants all have different mechanisms of action, but a similar end result – improving mood. Some examples of antidepressants include tricyclic antidepressants, MAO inhibitors and selective serotonin reuptake inhibitors (SSRIs).
Antidepressants aren't perfect either. They alone don't treat depression and some can take several weeks before effects are felt. There are even some nasty potential side-effects from these types of medication including, dizziness, nausea, insomnia and weight gain. For these reasons, cannabis looms as an intriguing alternative.
As mentioned earlier, there is lots of research-based evidence for the use of cannabis in treating a wide range of different physiological conditions. Evidence on its ability to treat psychological conditions, such as depression, is more scarce. While further research on cannabis and depression is being conducted, these studies have historically been hampered by cannabis' classification as a prohibited substance.
In spite of this, many cannabis consumers will preach about how effective cannabis has been in treating their depression and anxiety. As the plant continues to de-stigmatise itself through its various medical applications, more doctors and researchers are becoming comfortable with the idea of prescribing cannabis in order to manage mental conditions.
How does it work?
Cannabis is a fast-acting alternative to antidepressants, which works by stimulating the endocannabinoid system. Cannabinoids derived from the plant help restore normal endocannabinoid function (a process called homeostasis) which can potentially stabilise moods and ease depression. Cannabis is also helpful with alleviating stress, a major cause of depression in a lot of individuals.
Cannabinoids such as THC and CBD are well-known for their sedative, antidepressant and antipsychotic effects, but how exactly do they improve mood? It was once thought that the euphoria that accompanies cannabis consumption was caused by THC activating the brain's reward system through cannabinoid receptors. This would result in the brain being flooded by dopamine (known as the pleasure molecule).
However, recent studies have suggested that consuming cannabis only produces a modest amount of dopamine. While other potent drugs such as cocaine and amphetamines do flood the brain with dopamine to make you feel good, the same is not true of cannabis. The mood-lifting effects of cannabis are associated with another neurotransmitter, known as anandamide (aka the 'bliss molecule').
Anandamide not only produces heightened feelings of happiness but it also plays an important role in memory, motivation, movement, pain, appetite and fertility. It has even displayed the potential to inhibit cancer cell proliferation. Anandamide's role in neurogenesis (the creation of new nerves) is primarily responsible for its antidepressant and anxiolytic effects.
Anandamide is also an endocannabinoid, meaning it is a cannabinoid that is naturally produced within the body. THC is a phytocannabinoid (cannabinoid from the plant) twin of anandamide. Both have a strong affinity for the CB1 and CB2 receptors in the endocannabinoid system, but binding to CB1 receptors specifically produces the euphoric effects.
Cannabinoids aren't the only molecule in cannabis that can make you feel good. Limonene is a terpene found in certain cannabis strains that has displayed antidepressant effects. Inhalation of limonene vapour has been shown to increase serotonin and dopamine in key areas of the brain that are associated with anxiety and depression, however, the mechanism of action is still unclear.
Strains that are limonene-dominant such as Wedding Cake and Do-Si-Dos are commonly utilised to combat depressive symptoms. Other terpenes that have displayed antidepressant properties are caryophyllene and linalool.
So what's the verdict?
While cannabis can improve mood, alleviate stress and has shown potential in combatting other depressive symptoms, this only presents one side of the argument. For all the evidence that suggests cannabis is effective in the treatment of depression, there is conflicting research which argues that chronic cannabis use can actually trigger the onset of depression and worsen depression symptoms.
Chronic cannabis use has also been linked to other mental disorders such as schizophrenia and psychosis. This information can also be misleading though, as cannabis use and mental health is a complex issue. Unlike using medicinal cannabis to treat chronic pain, mental disorders have many more additional factors that need to be taken into account.
When investigating cannabis use and depressive symptoms, it may seem like there is a causal relationship a lot of the time. However, a deeper dive into an individual's history, personality traits and temperament may dissolve that relationship and paint more of a picture.
With all the conflicting evidence and complex issues, the impact of cannabis use on depression and vice versa is an area which requires further study. Cannabis isn't for everyone and it may not be right for you, but it presents as a real option to those looking for alternative treatments for combatting depression.
Before resorting to medication, try some strategies which others have found helpful. A good place to start is removing any unnecessary stressors and responsibilities from your everyday life. Adding structure to your day, getting good sleep and discovering new, fun ways to relieve stress are also important. These can be as simple as a daily walk, trying meditation, cooking different dishes or even reading a new series of books.
Always remember to take some time to look after yourself. Nothing is more important than your mental wellbeing.
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