Millions of people across the globe suffer from depression, with little relief from conventional medicine and big pharma. Many are turning to cannabis to treat their condition and regain a sense of normalcy in their lives.

Depression affects nearly 16 million people in the United States alone. Although the emotional reasons will be different for each person, from a chemical standpoint, the root cause of depression is an endocannabinoid deficiency that effects the 5-HT1A receptors and causes low levels of serotonin.  Low levels of serotonin also cause the limbic system to shrink.

The limbic system controls various emotions including fear, pleasure, hunger, anger, and sex drive. This is the reason why people who suffer from depression often describe the feeling as “flat” or just “blah”, because it simply sadness they are feeling, but a general disinterest in things that once made them happy and loss of enjoyment in life.

To add to the distress, pharmaceutical medications have a reputation for not always being effective, and in some cases, causing more harm than good. What is the role of cannabis in the treatment of depression? Is it the silver lining therapy that many people are yearning for?  

What is Depression?                                 

Depression is an incredibly complex mood disorder that ranges in severity and type. Several forms of depression exist such as major depression, dysthymia, bipolar disorder, and seasonal. Regardless of the type, depression can have a major impact on a person’s quality of life and ability to complete day-to-day tasks. Some sufferers of depression lose the ability to feel joy or pleasure at all – and all these feelings last for an extended period of time.  

The World Health Organization estimates that around 350 million are living with depression worldwide It affects people of all ages and races, and those of differing socio-economic status. Although symptoms vary widely from person to person, in general, symptoms include feelings of hopelessness, lethargy, low self-esteem, guild, shame, and anxiety.

Again, these symptoms will manifest differently in each person as well, but it’s common for sufferers to feel tired and unable to focus, they can experience negative/intrusive thoughts, issues sleeping and eating, problems with memory, difficulty making decisions, and many will be irritable and short-tempered.

Depression can lead to dangerous and reckless behavior, substance abuse for example, and life-changing decisions that cause additional stress and increased feelings of depression. Depression can also lead to self-harm as well as suicidal thoughts and attempts, and according to the Centers for Disease Control and Prevention (CDC), suicide is the tenth leading cause of death in the United States. On average, the CDC records upwards of 48,000 suicides each year – that’s one life every 12 minutes. And the numbers continue to rise with seemingly no solution in sight.

How Cannabis Can Help

For centuries cannabis has been a natural remedy for depression. It wasn’t until the 1900s that in started to become widely politicized and prohibited. Back in the early 1600s, English clergyman Robert Burton discussed the use of medicinal cannabis in his book The Anatomy of Melancholy, published in 1621. During that same time period, doctors in India were regularly using cannabis to treat depression and anxiety in their patients. Around the world, cannabis is a renowned ancient therapy.

The reason it works is because cannabinoids stimulate our endocannabinoid systems (ECS). The ECS is a network of receptors found throughout the bodies of all animals (except insects), and the naturally produced endocannabinoids that bind to them. This is why cannabinoids have such wide-ranging effects on human health, able to treat everything from depression, to physical pain, to epilepsy and more.

Cannabis is a natural, much safer alternative to pharmaceutical antidepressants, which are known to have worrisome side effects including nausea, blurred vision, aches and pains, and oddly enough, they can increase the risk of suicidal tendencies in some rare circumstances. Talk about counter intuitive.

Cannabis is faster-acting, and there are quite a few natural compounds in the plant that work synergistically to fight depression. Both THC (tetrahydrocannabinol) and CBD (cannabidiol) have their place in the treatment of mental health disorders; and terpenes, which are found in all plants not just cannabis, can also be beneficial for this purpose.

According to researchers from McGill University in Montreal, Canada, who conducted a study on this subject in 2006, “This natural remedy offers patients peace of mind and battles stress by enhancing mood, providing energy and focus, relieving anxiety, inducing hunger, and combating insomnia. Occasional or daily cannabis consumers have lower levels of depressive symptoms than non-users.”

The University Medical Center Utrecht, in the Netherlands, also touted cannabis as a promising treatment option for depression and other mental illnesses. Numerous studies have linked moderate but regular cannabis use to mood stabilization and stress relief.

Samir Haj-Dahmane, a senior research scientist at the University of Buffalo’s Research Institute on Addictions who studies chronic stress and depression, mentions this: “Chronic stress is one of the major causes of depression. Using compounds derived from cannabis — marijuana — to restore normal endocannabinoid function could potentially help stabilize moods and ease depression.”

When to Abstain from Cannabis Use

It’s important to keep in mind that cannabis won’t work for everyone, and while there is scientific literature showing that low to moderate doses can be helpful, too much THC can actually do the opposite in some people. High doses of THC can induce anxiety and panic attacks. Studies found that CBD can counteract the effects of THC, so if you’re feeling anxious or paranoid after smoking it might be time to switch to a different strain, maybe something with a 1:1 ratio of CBD:THC.

There is also the issue of human error, and evidence suggest that many patients misuse their cannabis, using either too much or too little depending on their current mood, when in reality, a consistent regimen might be better. It’s also more likely for patients to stop using any conventional treatments in lieu of medical cannabis, although they might not be ready to make the full transition yet.

“I was, at times, able to get patients to agree to stop their marijuana use for a few weeks just so they could determine whether there was or was not an improvement in mood,” says Allan Schwartz, LCSW, PhD, a psychotherapist and licensed clinical social worker in Colorado and New York. “These individuals were surprised, but were willing to admit that they felt real improvement in mood and functioning.

“I have directly witnessed the tragedy of patients going off of their medications for bipolar disorder, using marijuana and ending up re-hospitalized in worse shape than any time prior to the relapse,” Schwartz added. “In fact, it has been my experience that many of these unfortunate patients experienced multiple relapses and were caught in an endless cycle of hospitalizations marked by periods of instability in between.”

Possible Interactions with Pharmaceuticals

Researchers from the Division of Child and Adolescent Psychiatry at the University of Connecticut Health Center conducted an extensive review of the research available, albeit limited, to determine if there are any interactions between cannabis and pharmaceutical anti-depressants. Their report, titled Psychotropic Medications and Substances of Abuse Interactions in Youth, they specified how minimal the risk is.

“It’s possible adverse events are ‘relatively rare’ or ‘do not happen.’ Moreover, ‘newer psychotropic medications have a relatively high therapeutic index’—as a class of drugs, they are less likely to produce adverse interactions.” Patients who consume cannabis along with antidepressants are advised to “be cautious” and “talk with [their] health provider” before making any changes to their treatment plans.

Final Thoughts

Cannabis isn’t for everyone, but it does seem to work well for the overwhelming majority of people who struggle with symptoms of depression. There is no standardization when it comes to medical cannabis, so how it’s used will depend on many factors including the individual’s current health, weight, cannabinoid tolerance, and more. Speak to your physician or a healthcare provider you trust before stopping any of your medications.