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panic attack from marijuana

Using Marijuana for Treating Anxiety

Daniel B. Block, MD, is an award-winning, board-certified psychiatrist who operates a private practice in Pennsylvania.

Verywell / Cindy Chung

As more states legalize marijuana, both for medicinal and recreational use, more and more people are turning to cannabis in hopes of managing anxiety or generalized anxiety disorder (GAD). Although scientific research in this area is still sparse, there are anecdotal and new scientific reports of marijuana creating a calming experience that temporarily relieves symptoms of anxiety for many people.

Marijuana as Self-Medication

Anytime you take it upon yourself to use a substance to treat or cope with a medical problem or symptom, it is referred to as self-medicating. Often, self-medicating produces an immediate relief of the uncomfortable symptoms, thereby reinforcing its use.

The problem with self-medication is that even though the use of marijuana is becoming more acceptable, not enough is known about the efficacy of the drug for particular medical conditions as well as its long-term consequences.

Potential Benefits and Risks

May reduce depression in the short term

May relieve anxiety temporarily

May reduce stress

Higher levels of psychiatric disorders

Can create psychological dependence

Long-term memory loss may occur

Symptoms may increase

May develop cannabis hyperemesis syndrome

Can create increased tolerance and need

Benefits

The scientific community has recently started examining the effect of cannabis on anxiety, and the verdict is that short-term benefits do exist.

Scientists at Washington State University published a study in the Journal of Affective Disorders that found that smoking cannabis can significantly reduce self-reported levels of depression, anxiety, and stress in the short term. However, repeated use doesn’t seem to lead to any long-term reduction of symptoms and in some individuals may increase depression over time.

Risks

Marijuana can affect your body in many ways beyond just getting you high. The high feeling you may experience after smoking or ingesting marijuana is due to tetrahydrocannabinol (THC), the chemical compound that gives marijuana its psychoactive effects.

The effects of THC do not come without risks, and long-term or frequent use has been associated several potential side effects.  

Higher Levels of Psychiatric Disorders

It is possible that people who use marijuana for an extended period of time have higher levels and symptoms of depression, despite any improvements they may have seen in this regard with short-term use.

Some research has also shown that heavy use of marijuana in adolescence (particularly in teenage girls) can be a predictor of depression and anxiety later on in a person’s life. Certain susceptible individuals are also at risk for the development of psychosis with the use of cannabis.

Psychological Dependence

The central problem with using marijuana as an anxiety coping tool is that it can create a psychological dependence on the substance.

Since the effects of marijuana are fast acting, long-term behavior-based coping strategies may seem less helpful at first and may be less likely to be developed.

Long-Term Memory Loss

Several studies have found that long-term marijuana use can cause memory loss. Memory impairment occurs because THC alters one of the areas of the brain, the hippocampus, responsible for memory formation. It also can have negative consequences on the brain’s motivation system.

Increase in Symptoms

THC can raise your heart rate, which, if you have anxiety, may make you feel even more anxious. Using too much marijuana can also make you feel scared or paranoid.

In some cases, marijuana can also induce orthostatic hypotension, a sudden drop in blood pressure when standing, which can cause lightheadedness or feeling faint. Cannabis can also cause feelings of dizziness, nausea, confusion, and blurred vision, which can contribute to anxiety.

Cannabis Hyperemesis Syndrome

A rare consequence of frequent marijuana use, particularly with today’s more potent strains, is cannabis hyperemesis syndrome (CHS). This involves cyclical nausea and vomiting.

This is paradoxical and can be difficult to diagnose, as marijuana has been used to decrease nausea and vomiting in cancer treatment. Sufferers sometimes find relief in hot baths and showers, but ultimately, abstinence from marijuana is necessary for long-term improvement.

Escalating Need

You can develop a tolerance to marijuana. This means that the more you use it, the more you will eventually need to get the same “high” as earlier experiences.

Alternatives to Marijuana

Remember that some level of anxiety is normal and even helpful when you are confronted with something that feels threatening to you. However, when feeling anxious becomes pervasive and difficult to control, it is time to seek professional help to discuss other forms of anxiety management.

Therapy

Proactive coping strategies, learned through counseling, support groups, as well as self-help books and educational websites, can create lasting change without the negative components of extended marijuana use.

Cognitive behavioral therapy (CBT) and other forms of therapy can help you determine the underlying cause of your anxiety and manage it more effectively.   Work with your doctor to develop a treatment plan that is right for you.

Working with a psychotherapist to manage your anxiety will give you a better handle on your condition in the long run.

Medication

The use of certain prescription medications such as the selective serotonin reuptake inhibitors (SSRIs) have been firmly established as safe and effective treatment for anxiety disorders.  

Prescription medication is also preferable to marijuana since the long-term risks have been better studied and are potentially less significant compared to long-term marijuana use. Some anti-anxiety medications are taken daily, while others are taken episodically during periods of extreme anxiety or a panic attack.

A psychiatrist or your primary care doctor can prescribe you an anti-anxiety medication, should you need one.

Cannabidiol (CBD) Oil

CBD oil, a marijuana extract that is often dispersed under the tongue with a dropper, doesn’t contain THC, so it won’t give you the same mind-altering effects as marijuana. There is some beginning evidence to suggest that CBD could be helpful in the treatment of anxiety and addiction, but more clinical trials and research are needed in this area.  

A Word From Verywell

Symptoms of anxiety are treatable. Studies show that psychotherapy and medication are effective for most individuals, whereas the long-term effects of self-medicating with marijuana have yet to be clearly established. If you’ve recently started experimenting with marijuana use to treat your anxiety, be sure to tell your doctor.

If you or a loved one are struggling with anxiety, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area.

For more mental health resources, see our National Helpline Database.

Using marijuana can provide short-term symptom relief for anxiety, but there are risks to consider. Learn more about this and longer-term options.

Cannabis-Induced Anxiety Attacks

Home / Blog / Cannabis-Induced Anxiety Attacks

Cannabis-Induced Anxiety Attacks

Posted by Marijuana Doctors on 11/20/2018 in Medical Marijuana

Updated on August 26, 2020. Medical content reviewed by Dr. Joseph Rosado, MD, M.B.A, Chief Medical Officer

Anxiety is a well-known side effect of marijuana medicine. Some detractors even mention it to try to delegitimize cannabis’ overall safety and medical benefits. Cannabis can cause anxiety and panic attacks, but it works just like any medication’s side effect. When you take your medicine the way your doctor recommends, you can reduce or eliminate any anxiety symptoms. Let’s talk about the facts surrounding cannabis and anxiety attacks.

Why Does Marijuana Make Some People Anxious?

Marijuana consists of multiple compounds called cannabinoids. Tetrahydrocannabinol (THC), the main psychoactive cannabinoid, makes you high when you use cannabis because it attaches to receptors in your brain. However, this phenomenon can also cause the THC to affect your amygdala, the part of the brain that controls fear, stress and other emotions.

When the amygdala is overstimulated, it makes you feel paranoid, anxious and scared. This effect on your brain does not cause harm, but it can certainly feel unpleasant.

Certain risk factors increase a patient’s chance of feeling anxious when they take medical cannabis, like:

  • Tolerance: Everyone reacts to THC differently. The same amount could cause a severe panic attack in one person while another person barely notices it. Your body gets more used to THC as you take it.
  • Administration: The way you take your medicine impacts how quickly it takes effect. Edibles are notorious for side effects because you can underestimate how long it takes for them to kick in. Many new users accidentally take too much and experience intense effects.
  • Amount of THC: Higher doses of THC have a bigger risk of overstimulating your amygdala.
  • Other Sources of Anxiety: If something else is making you feel anxious, THC could make it worse. For example, you might have an existing anxiety disorder or feel nervous about taking your medicine in a new setting.

Doesn’t Cannabis Reduce Anxiety?

If you like to follow our content, you may know we often talk about marijuana’s anxiety-relieving benefits. So, why do we also mention that it can cause panic attacks? The answer lies in marijuana’s nature as a medicine. Many prescription medications have just one or two compounds in them. Meanwhile, cannabis has more than 85 cannabinoids, in addition to other components. Instead of working like a single medicine, marijuana acts like an entire medicine cabinet full of remedies. That’s why it can relieve so many conditions!

But, just like your medicine cabinet, every component in cannabis has its own benefits and side effects. THC can cause anxiety in some people, especially when they take it in large amounts. Imagine taking your pills for the day and having too much of a medication that can make you anxious. Sometimes, a patient takes medicine with too much THC in it, and it causes a feeling of panic. In this scenario, they need to try another kind of marijuana medication.

What Does a Cannabis-Related Anxiety Attack Look Like?

The symptoms of a cannabis-induced panic attack vary from person to person, but they can include:

  • Increased heartbeat
  • Chest pain
  • Feeling dizzy or weak
  • Difficulty breathing
  • Sweating or chills
  • A feeling of doom and unease

If you already know what happens during a regular panic attack, a cannabis-induced anxiety attack has the same symptoms. Sometimes it causes mild problems, while in other cases the patient can feel like they will die.

In most cases, a panic attack will cause no danger to the person experiencing it. However, if you have a history of heart or lung problems, you may want to get medical attention. Your symptoms could indicate another problem.

How Should a Patient Handle Marijuana-Induced Anxiety?

Marijuana-related anxiety often happens because the patient took too much THC for their tolerance. To relieve the stress, you need to let the THC metabolize and calm down as best you can. You may feel like you need to go to the ER because you have a heart attack or breathing issue. But, unless you have existing problems, you don’t need medical help.

Try these strategies if you start to panic after medicating:

  • Relax: If you have a go-to way to relax, do that activity. You can also lie down for a bit, watch your favorite movie or take a bath.
  • Distract Your Mind: Take your mind off your anxiety while your body processes the THC. Distract yourself by taking a walk or talking to a friend.
  • Breathe: Focus on breathing in and out slowly, especially if the panic attack causes you to breathe too quickly. You will find your mind clearing up in no time.

What Can I Do to Reduce My Risk of Getting a Cannabis-Related Panic Attack?

If you get an anxiety attack after taking marijuana medicine, you don’t have to stop taking it for good. Instead, you just need to change the way you medicate. These approaches can help:

  • Take a Lower Dose: In some cases, a smaller amount of THC will provide relief with little to no psychoactive side effects. Only take a little THC at a time and listen to your doctor’s recommendations. You can always take another small dose if you don’t feel enough of an effect.
  • Use a Different Strain: Some varieties of the marijuana plant cause a stronger high than others. Ask your budtender about strains and products that have fewer psychoactive effects.
  • Increase Your CBD Dosage: Cannabidiol (CBD), the other main cannabinoid in marijuana, counteracts THC’s effects. Look for medicine that balances THC out with CBD. As a bonus, you get to benefit from CBD’s symptom relief and the positive effects of THC.

Who Can Help Me Minimize the Risk of Panic Attacks?

Professionals in the medical marijuana industry understand how THC interacts with your body. If you have a sensitivity to THC or want advice, we recommend getting their help. Even in states with legal recreational marijuana, cannabis-positive doctors can help you plan your treatment. Also, the staff members at medical dispensaries are excellent and helping patients find a treatment that works for them. Feel free to use our resources to find the perfect solution for your treatment plan.

While Cannabis can be a useful tool to alleviate anxiety, it also can exacerbate symptoms of anxiety particularly in patients prone to anxiety attacks.