The Yin and Yang of Cannabis and Psychosis
The ancient oriental concept of yin and yang describes how all things in nature exist in a state of perfect balance and harmony. Yin and yang are complementary opposites. They represent night and day, cold and warmth, water and fire, female and male. Furthermore, yin and yang are not seen as two separate entities, but two halves of one whole. Nothing can ever be entirely yin or entirely yang.
Yin and yang exist within the human body as well as in the natural world. The sympathetic nervous system can be considered yang. It is responsible for our ‘fight or flight’ reaction and allows us to launch into action in the face of either perceived or real danger. The parasympathetic nervous system can be considered more yin. It is responsible for our ‘rest and digest’ function and allows our bodies to recover and repair themselves after a stressful day.
When yin and yang are perfectly in balance, your body and mind will be healthy and free from disease. But when these powerful forces fall into disarray, illness will soon occur.
Oriental medicine practitioners often strive to understand modern diseases in terms of yin and yang. One interesting example is how cannabis is related to psychosis . On the one hand, the herb has frequently been linked to the development of psychosis. On the other, new research suggests that one of its components, CBD, could actually help in the treatment of this serious psychiatric disease.
Marijuana and Psychosis
There is plenty of scientific evidence linking cannabis use to psychosis. Statistics suggest that it is involved in as many as 50% of cases of psychosis , schizophrenia, and schizophreniform psychosis. The risk is especially high in people who start using marijuana in their teens as their brains are still developing, and people whose mothers use cannabis during pregnancy are also at higher risk.
The exact cause-effect relationship between cannabis and psychosis has still not been fully established. However, there are several theories as to why it occurs. It is thought that, in certain genetically susceptible individuals, THC (the psychoactive compound in marijuana) can trigger the onset of psychosis. One survey of high risk and recent-onset patients with psychosis found that in 37% of cases, symptoms first appeared during cannabis use.
Scientists believe that THC can cause neurological dysfunction by altering the effects of neurotransmitters such as dopamine. Neurotransmitters are chemicals which influence our mood and thought processes, amongst many other things. When healthy individuals use cannabis, it is these changes that produce the sensation of being high; altered mood, perception, attention, and memory. However, in people who are susceptible to psychosis, these changes could be enough to trigger a complete break with reality which may last long after the initial effects of cannabis wear off.
It is unclear exactly why THC affects certain people in this way and not others, although researchers are getting increasingly closer to finding the answer. It appears that people who develop psychosis or schizophrenia may have an imbalance in their endocannabinoid systems .
The endocannabinoid system consists of CB1 receptors, found mainly in the brain and nervous system, and CB2 receptors found throughout the rest of the body. These receptors bind with endocannabinoids, molecules produced by the body which work similarly to plant cannabinoids like THC.
One 1999 study found that schizophrenic patients had elevated levels of anandamide and palmitylethanolamide, two of the body’s natural endocannabinoids, in their cerebrospinal fluid. Another study from 2001 found that schizophrenic patients have increased numbers of CB1 receptors in their brains. Although we still do not have the whole picture, this goes some way towards explaining why cannabis and psychosis often go hand in hand.
The Yin and Yang of Cannabinoids
The component of cannabis that is associated with psychosis is THC, but the cannabis plant contains a myriad of other active compounds including CBD, CBG, CBN, terpenes, and many more. All of these compounds affect the body in a slightly different way. In this article, we will look at the two major cannabinoids, THC and CBD, and terpenes, the aromatic oils that give marijuana its distinctive smell.
As we have already mentioned, THC is the compound that gives marijuana its psychoactive properties and in some people, may trigger psychosis. The effects of THC can be euphoric, inducing a sense of relaxation and general well-being. However, it can also cause less pleasant side effects such as anxiety, paranoia, suspicion, and fragmented thoughts. Some people may even feel disconnected from reality or experience sensory changes or hallucinations. In most people, these effects last just a few hours, but for those prone to psychosis, they can be far more persistent.
However, CBD appears to have the opposite effect. A study on the effects of THC and CBD on emotional processing confirm this theory. Fifteen healthy volunteers were given either THC, CBD, or a placebo, and then were exposed to images of fearful faces while undergoing MRI imaging. The results showed that while THC increased anxiety levels during the study, CBD had a much more calming effect.
The dangers of using THC alone have been highlighted by the advent of synthetic cannabinoids such as Spice and K2. The negative effects of these narcotics have been well publicized, with some even nicknaming users as ‘Spice Zombies’ due to the powerful mind-altering actions of these drugs. The results of a 2015 study by Di Forti et al. published in the Lancet also suggest that the risk of cannabis-induced psychosis rises with the use of more potent forms of the drug.
It is widely believed that CBD goes some way to balancing out the effects of THC and preventing a high from becoming too much to handle. Could CBD be the yin to THC’s yang? Perhaps, but it is not quite so simple.
As well as THC and CBD, the cannabis plant contains many different chemicals which work together in a complementary fashion. Terpenes are another essential constituent of cannabis which are thought to have a wide range of physiological effects. There are two particular terpenes which are of interest here. One is limonene, which is also found in lemons and other citrus fruit. The other is linalool which is also found in lavender. Both of these terpenes are known to reduce anxiety and may play a vital role in rounding out the THC high.
Although terpenes are a relatively new discovery, humans have known about their effects for many centuries. One text from 10th-century Persia suggests eating “acid fruits” to combat the harms of marijuana. This recommendation was repeated in 19th-century literature which states that lemonade can “cure” the intoxicating effects of the herb. Various other foods with high terpene contents have also been recommended as antidotes throughout history including calamus, pine nuts, and black pepper.
It appears that when it comes to creating a balanced and enjoyable high, nature really does know best. The way that the compounds in cannabis work together synergistically to influence the human body has become known as the ‘ entourage effect .’
Can CBD Help with Psychosis?
New research suggests that CBD could actually help with the symptoms of psychosis. Eighty-eight subjects with schizophrenia were given either CBD or a placebo alongside their regular medication for six weeks. At the end of the study, those who received CBD had fewer psychotic symptoms and felt generally less unwell. The treatment was well tolerated, and the rate of adverse effects did not differ significantly from placebo. Although there is no doubt that more research is required to understand the full implications of this, it seems that CBD could potentially help in the treatment of psychosis.
If you or somebody you know has psychosis, this new therapy could be worth a try. CBD is available as an oil, capsules, edibles, e-liquids and in many other forms. There are also now many cannabis strains which boast high CBD levels while still being low in THC. However, we do recommend that you talk to your physician before using any of these products to confirm that they are suitable for you. You should also keep taking any prescribed medication unless your doctor agrees to you stopping, even if you feel much better.
The Yin and Yang of Marijuana and Psychosis: Final Thoughts
The relationship between cannabis and psychosis is a complex one and is still not fully understood. What we do know, however, is that THC can trigger psychosis in susceptible individuals and that CBD could help in the treatment of this condition.
It seems that the delicate balance of cannabinoids and terpenes in cannabis may play a significant role in balancing out the adverse effects of THC, and that, like all things in nature, these chemicals work best when they are in a state of harmony. If we ignore this fact by using synthetic cannabinoids or marijuana strains with too much THC and not enough CBD, we could well be asking for trouble.
We take a detailed look at the complex relationship between cannabis and psychosis, explore how different active compounds work together.
VTCNA Health Tips: Cannabis – A Yin/Yang Understanding
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Cannabis has been a component of Traditional Chinese Medicine for over 2000 years. From an acupuncturist’s perspective, applying a Yin/Yang framework to the therapeutic effects of this ancient herb can provide a deeper understanding of not only the “feeling” associated with the psychoactive effects, but also what symptoms are appropriately treated by a specific variety or strain.
Genetics is a complex field, and cannabis genetics is an ever-growing arena of complicated varieties, cloning, and breeding. Simply naming and breeding a strain doesn’t guarantee the child will have the same genetic structure as the parent, even if it’s similar in appearance. This is significant, because we’re also learning that genetic structures within a specific plant will change and alter over generations.
In addition, conditions, location, and even water sources can influence the expression or repression of certain genes, affecting not only a plant’s appearance but its “strain” and type. In other words, strains associated with being indica can eventually breed to produce sativa-type plants that are indica in appearance but sativa in therapeutic effect.
And, this, of course, is an oversimplification, as many varieties have been bred and cross-bred for years, and resemble nothing of their landrace origins. Comparing wild, or feral, indica and sativa plants with intentionally bred cultivars would be as different as looking for the similarities between tigers and house cats. They’re obviously genetically linked but, express astounding variety.
Lead With Your Nose!
How do we bring this back to Yin and Yang? Keeping it old school, herbalists from every tradition have learned to recognize the effects of herbs by knowing what they look like, but also can anticipate the plant’s therapeutic characteristics by smell. This is an important component in understanding the medicinal effects of cannabis, as well as the way specific psychoactive components will play out in your body.
Yang refers to upward movement, heat, action, fast, drying and outward characteristics while Yin refers to downward, cooling, resting, moistening and inward characteristics. If we apply this to therapeutic effects, we can begin to see that Yang can typify the “high” sensation commonly associated with sativa varieties while Yin can characterize the “stoned” sensation associated with indica varieties.
Of course, just as there are no absolutes in Yin and Yang, the same goes for cannabis. Most varieties will have a combination of both aspects, while others will express genes that breeders may not have intended to highlight. This is why smell matters. Associating certain smells with Yin and Yang characteristics can help the grower, tender, and user select the right flower or bud for their needs.
Lower – or Yin type – aromas will seem heavy, leathery, chocolatey, with the deeper earthy tones of humulene and myrcene terpenoids , and tend to have a sedating effect, which can most likely help with anxiety, insomnia and other “hyper type” imbalances.
Higher – or Yang type – aromas such as cinnamon, fruity and citrus aromas – coming from linalool, geraniol, valencence, and terpineol terpenoids – can have an invigorating effect most likely helpful for low energy, fatigue, foggy brain, and other “hypo type” imbalances.
Of course there are also neutral scents as well. This is a growing area of study, and can only expand the potential for improved outcomes, as well as serve a tool for identifying the presence of mold and other undesirable chemicals.
There are even training courses on “interpening,” designed to teach people to identify the varieties potency and therapeutic effects of cannabis by its scent. This is similar to sommelier training, but for weed!
As an acupuncturist physician, understanding scent allows me to combine cannabis with other herbs for the best therapeutic results – both for medicinal and recreational purposes (which in my humble opinion is also medicinal).
An important takeaway here is that the name of a “strain” does not always mean it will have an effect that the name might indicate. So, be sure to take a whiff of a cannabis you’re contemplating. Pay attention to what you smell, and where you feel the sensations. Are they below your nose into your jaw – indicating a lower or Yin type, or do you feel a heady sensation in the forehead or a tickling, which indicates a Yang type? Know that it’s also possible to feel a combination of sensations.
Remember that your body chemistry will also play a role in how you metabolize the components of cannabis, so your sense of smell can be your best tool in deciding which bud’s for you.
Cannabis has been a component of Traditional Chinese Medicine for over 2000 years. From an acupuncturist's perspective, applying a Yin/Yang framework to the