How Effective Is CBD For Anxiety Relief?
This guide provides insight into CBD’s benefits for specific types of anxiety. In this guide, you’ll find the results of the most recent medical studies investigating CBD effects on:
- Social Anxiety
- Generalized Anxiety
- Panic Attacks
- Public Speaking
You’ll also learn the CBD dosage being studied for anxiety and whether or not that relatively high CBD dosage has any adverse effects.
If you don’t find an answer you’re looking for in this guide, leave a comment below. We’ll search the published studies to see if an answer exists and get back to you.
Let’s get started.
CBD Effects On Mood, Anxiety, And Depression
This 2018 medical study published in the journal Frontiers in Molecular Neuroscience is a scientific deep dive into the effects the endocannabinoid system has on emotional wellness, anxiety, and depression.
The endocannabinoid system (ECS) is the part of the body that CBD affects most directly. The ECS is the chief regulator of many smaller more specialized systems within your body. The job of those subsystems under the ECS is to keep your body in chemical balance. The ECS coordinates that duty by telling those subsystems when to turn on and off depending on how your body is falling out of chemical balance. CBD acts as a signaling agent or ‘neurotransmitter’ to help the ECS complete its task of keeping your body in chemical balance or homeostasis.
As part of CBD’s interaction with the ECS, CBD sends on/off signals to specialized regulatory subsystems throughout your body. According to new science published in this research, some of those subsystems chemically affect our emotional states in complex ways we’re just starting to discover.
So, through CBD’s interaction with your ECS, you may be able to chemically affect how you feel in complex ways—including emotionally.
- “Emotional homeostasis is crucially modulated by the activity of the ECS.”
- “Cannabis-based compounds could exert antidepressant effects through complex influences on different behavioral responses, such as those associated to reward, stress and inflammation, also depending on the individual psychosocial context,” according to the 2018 medical study we’re discussing.
The ECS regulates a wide range of complex functions in your body. Those functions include mood, anxiety, and depression. When CBD is consumed, it directly affects the operations of the ECS. The interaction of CBD and ECS may even affect your thinking about significant subjects in your life like reward, stress, fear, and how you process the things that are going on around you in your life.
And that makes sense, right? To say CBD has a ‘relaxing effect’ sounds simple but on the level of chemical interactions, there must really be some complex science going on. If CBD really is having a relaxing effect on you—or really is relieving anxiety symptoms in a significant way that isn’t simply a form of sedation—then something really interesting and multifaceted must be going on within your brain and nervous system—the areas where the ECS resides.
- “The endocannabinoid system (ECS) has been recently recognized as a prominent promoter of emotional homeostasis, mediating the effects of different environmental signals including rewarding and stressing stimuli. The ECS modulates the rewarding effects of environmental stimuli, influencing synaptic transmission in the dopaminergic projections to the limbic system, and mediates the neurophysiological and behavioral consequences of stress.”
For example, you may have a rushed and high-pressure day that would normally make you feel stressed out. That’s what’s going on around you in your environment. But, that doesn’t have to be what’s going on inside you emotionally. Just because you’re having a day filled with stressful stimulation doesn’t’ necessarily mean that you have to internalize that stress in a way that leaves you feeling stressed out yourself.
- “Experimental data suggest that the ECS could be crucially involved in mediating the neurophysiological and behavioral consequences of stress.”
OK. We’ve established that the process of how you internalize stimulation from your environment is mediated or controlled by your ECS which is a chemical regulatory system built into your brain. So, then that would mean the goal of taking CBD would be to provide you—the conscious you that can think and make decisions to take care of yourself —with the ability to affect that regulatory system to make yourself feel better. By affecting your ECS with cannabinoids like CBD, you’ll hopefully gain the ability to chemically mediate how you internalize environmental stimuli in a way that feels good and is healthy for your life. That may come in the specific form of relieving anxiety, stress, or depression in your life.
Can that be done with CBD? Can you effectively care for your mental health with CBD? Does taking CBD lead to a more balanced internal chemical state? Are already doing that every time they take CBD and the science is way behind how people are already effectively caring for themselves?
For its part, science doesn’t have the definitive answers yet but it’s trying to get there. In part, that’s what this 2018 study is aiming to flesh out.
- “The complex influences of the ECS on both the environmental and internal stimuli processing, make the cannabinoid-based drugs an appealing option to treat different psychiatric conditions.”
Let’s take a look at the study’s findings.
CBD has a complex relationship with your endocannabinoid system—the system that helps to maintain emotional balance (1).
How The Endocannabinoid System Works
The endocannabinoid system helps to maintain emotional balance by regulating natural reward processes and moderating your natural response to stress (2).
- “Indeed, a number of emotions and behaviors, such as fear, anxiety, depression, stress-coping and reward-driven behaviors are critically modulated by the ECS.”
This study is a review of cannabinoid effects on emotions and the importance of the endocannabinoid system in mental health.
- “The ECS [has] a prominent role in maintaining emotional homeostasis, mediating the effects of different environmental signals, including rewarding and stressing stimuli.”
According to this research, the endocannabinoid system (ECS) helps to balance emotional responses to rewarding and stressful events.
- “The ECS regulates a number of physiological functions and mediates the crosstalk between different neurotransmitter systems, therefore representing a key player in the control of behavioral responses.”
The ECS helps to regulate rewarding stimuli and moderate the physiological consequences of stress (3).
This review confirms cannabidiol is a promising compound to help with anxiety and depression but is not regularly used in psychiatry because of a lack of clinical data and CBD dosage information (4).
Interested in learning more about CBD and its interaction with the endocannabinoid system? Check out this guide to CBD based on the latest medical studies.
Video: Endocannabinoid System Explained
CBD Benefits For Teens With Social Anxiety
This 2019 medical study published in the journal Frontiers in Psychology determined that CBD reversed anxiety-like behavior in late teens with Social Anxiety Disorder and avoidant personality disorder.
- a double-blinded, placebo-controlled trial
- 37 teens, age 18-19 years old
- 300 mg CBD oil daily for 4 weeks period
Daily 300 mg dose of oral CBD oil significantly reduced symptoms of social anxiety and avoidant personality disorder on the Fear of Negative Evaluation Questionnaire and Liebowitz Social Anxiety Scale (1).
- Social anxiety symptoms were measured at the beginning of the trial period and at the end of the trial.
- There was a 21.7% average decrease over 4 weeks in the CBG group as measured on the Fear Of Negative Evaluation Questionnaire. The placebo group showed an average decline of 0.8% on the same scale (4).
- The results were similar for the Liebowitz Social Anxiety Scale after 4 weeks of treatment with CBD. The average score of the CBD group improved by 16.3% while the placebo group (no CBD) reported improvements of only 4.6% (5).
- This study’s results “are consistent with those obtained by the previous research and indicate that intervention with CBD for a 4-week period reduced the level of symptoms in teenagers with SAD, as measured by the [Fear of Negative Evaluation Questionnaire] and [Liebowitz Social Anxiety Scale].”
Late teens with Social Anxiety Disorder (SAD) and avoidant personality disorder (2).
- all participants were 18-19 years old
- 26 males, 11 females
- none had taken cannabinoids in the past
- diagnosed with by psychiatrists with SAD and avoidant personality disorder prior to study
- all from the Osaka Prefecture, Japan
Interested in how cannabis terpenes affect anxiety? Check out this terpene guide
Medical Cannabis Benefits For Anxiety
Medical cannabis has significant effects on anxiety. It may have either anxiety-relieving (anxiolytic) benefits or anxiety-causing (anxiogenic) effects depending on the cannabinoid and terpene profiles present in a specific cannabis variety.
- Cannabis varieties high in CBD and low in THC are more likely to have anxiety reducing effects
- The opposite is true of cannabis variety with high THC content and low CBD content.
- Some cannabis varieties contain terpenes that are statistically associated with anxiety-causing effects.
The following study was conducted by surveying patients of a single medical marijuana dispensary in Canada.
- Patients were asked to rate the effectiveness of specific cannabis varieties for treating their anxiety symptoms.
- Patients identified which strains they experienced as least effective and most effective at relieving their anxiety.
- Statistical analysis was conducted to determine which cannabinoids and terpenes may be associated with anxiety-relieving or anxiety-causing effects.
442 medical marijuana patients were surveyed in total. They created cannabis an average score of 8.03 on a scale of 0-10 (10 being extremely effective at relieving anxiety symptoms and zero being not effective). (1).
- “Over half of the total respondents(n=266/442, 60%) reported anxiety as a symptom for which they use medical cannabis.”
- “A smaller portion—15% of the participants—reported being diagnosed with a specific anxiety disorder.”
- “When asked about side effects [of medical cannabis], 14% of participants reported anxiety as an adverse reaction [to marijuana consumption].”
- “Of the major terpenes only trans-nerolidol displayed a significant correlation with [causing decreased feelings of anxiety].”
Anxiety Causing Terpenes
Terpenes connected to an increase in anxiety were:
- sabinene hydrate
- “Some terpenes with negative coefficients may still be [anxiety relieving], but certain terpenes with high negative coefficients, such as terpinolene or guaiol may be [anxiety causing]. Guaiol was the only major terpene with a “perfect” correlation [to anxiety-causing effects].”
While survey results are a less reliable form of evidence, the ability to gather user reports on a wide range of cannabis varieties is valuable information. This type of information may prove helpful for individuals interested in avoiding medical marijuana varieties with anxiety-causing effects. Cannabis terpene and cannabinoid profiles vary widely from chemovar (cannabis variety) to chemovar making it difficult to provide practical information to consumers.
- “Potency data, including the values of THC, CBD, CBG, and CBC (given as total potential to include both acidic and neutral forms), along with 29 terpenes were collected from the last three production lots of each strain identified in the survey.”
Further research is needed to clearly explain “the entourage effects” that contribute to the anti-anxiety effects of specific varieties of medical marijuana and hemp (5).
- “Cannabis can be used as an effective [anxiety relieving] agent, but further investigations are required to find which chemotype or doses are anxiolytic, and which are [anxiety causing].”
Interested in learning about CBD for PTSD? Check out this guide based on a 2019 study that found 91% of PTSD patients benefited from CBD.
CBD Effects On Social Anxiety Disorder, Psychosis, And Tobacco Use
CBD may have significant benefits for specific types of anxiety and tobacco withdrawal symptoms according to a 2018 review of several medical studies published in the journal Epidemiology And Psychiatric Sciences.
- CBD may have antipsychotic effects in schizophrenia
- CBD may have a fast-acting ability to reduce anxiety symptoms of Social Anxiety Disorder (SAD)
- CBD may reduce nicotine withdrawal symptoms
- This study focuses a critical eye on overall CBD benefits for anxiety and psychological disorders
CBD appears to have promising effects on a wide range of psychiatric conditions including generalized social anxiety and schizophrenia but its exact mechanism of action is still not fully determined. (1)
- “The so far investigated mechanisms of action of CBD may likely explain the preliminary evidences of efficacy in the treatment of psychiatric disorders, especially in psychotic, anxiety and substance-induced disorders.”
Some limitation in the medical studies reviewed limit the author’s ability to definitively state CBD is a treatment for anxiety.
- few placebo-controlled studies
- the small sample size of the studies that do exist
- CBD was administered in an inconsistent manner with regard to dosage, formulation and timing
- biological variance in the participants of the study was not adequately recorded or accounted for
Summary Of Findings
This new CBD study is a selection of the current medical literature available on CBD and its effects on anxiety symptoms (2).
- 8 studies were reviewed in total
- 5 studies found beneficial effects in reducing psychotic symptoms in schizophrenia.
- 3 found mild improvement or no improvement in psychotic symptoms.
CBD may have a fast-acting anti-anxiety effect in patients with Social Anxiety Disorder (SAD).
- “In conclusion, these findings suggest that, in patients with [Social Anxiety Disorder], CBD may exert an acute [anti-anxiety] effect when administered in a single high dose.”
- “Remarkably, this [anti-anxiety effect] may be mainly related to the capacity of CBD to suddenly modify cerebral blood flow in limbic and paralimbic areas (Crippa et al. 2011) and to [interact with serotonin receptors in the brain] (Bergamaschi et al. 2011).”
CBD may reduce tobacco withdrawal symptoms. (4)
- The results of one double-blind randomized controlled clinical trial showed that CBD decreased the number of cigarettes smoked in the CBD group compared to the control group who did not receive CBD.
- The mechanism of action for this effect was not made clear by the study.
- “Additionally, the [interaction between CBD and the serotonin receptors in the brain] may also contribute to the anti-craving effect of CBD and to reduce the relapses of substance abuse by regulating drug reward system, anxiety symptoms and stress management (Prud’Homme et al. 2015). “
- CBD needs to be studied further to confirm its effects in larger randomized clinical studies (5).
- Further study would allow researchers to connect specific CBD effects on patients to chemical reactions in the brain and nervous system (6).
Interested in CBD’s effect on psychosis? Check out this guide to a 2020 medical study about CBD effects on patients at “ultra high risk” for psychosis.
CBD Benefits For Anxiety: Public Speaking
This 2020 study published in the Journal of Psychopharmacology included 24 participants to determine the effects of CBD on anxiety associated with public speaking in individuals with Parkinson’s Disease.
- 300 mg CBD taken orally shortly before speaking in front of a simulated audience
- CBD showed statistically significant benefits for anxiety
- randomized, double-blinded, placebo-controlled, crossover clinical trial
Clinical Trial Results
The results of this placebo-controlled trial report that a dose of 300mg cannabidiol significantly decreased anxiety and tremors during simulated public speaking in patients with Parkinson’s Disease (1).
- “Acute CBD administration at a dose of 300mg decreased anxiety in patients with [Parkinson’s Disease], and there was also decreased tremor amplitude in an [anxiety causing] situation.”
- “There were statistically significant differences in the [Visual Analog Mood Scales] anxiety factor for [CBD].
- “CBD [reduced] the anxiety experimentally induced by the [Simulated Public Speaking Test].”
- Statistical analysis showed a significant effect on tremor amplitude likely because of CBD.
This study was designed to test the effects of CBD on anxiety signs and symptoms in patients with Parkinson’s Disease.
- randomized, double-blinded, placebo-controlled, crossover clinical trial
- 24 patients with Parkinson’s Disease
- conducted over a 15 day period
- 2 sessions of simulated public speaking per patient
- 300mg CBD taken orally prior to the simulated speaking event
- patients evaluated for heart rate, blood pressure, tremor frequency and amplitude
- patients evaluated on a visual mood scale for anxiety
- patients self-evaluated how they felt during the speaking test (2)
Evaluation of CBD Effects
After taking either a placebo or 300mg CBD, study participants underwent a Simulated Public Speaking Test (SPST) used to evaluate anti-anxiety medications. Data were collected during the test for:
- heart rate
- systemic blood pressure
- tremor frequency and amplitude
- Visual Analog Mood Scales (VAMS)
This data was assessed with a type of statistical analysis called repeated-measures analysis of variance (ANOVA) to determine the statistical significance of CBD’s effects on anxiety symptoms within the study.
Interested in how CBG (another powerful cannabinoid) affects anxiety? Check out this guide to CBG anxiety benefits.
CBD Effects On Panic Disorder
This 2017 study published in the journal Current Neuropharmacology is a review of the state of scientific knowledge about CBD’s possible benefits for treating Panic Disorder.
- Panic Disorder definition: Sudden feelings of terror when there is no real danger.
- Panic Disorder affects 5% of the world population.
- SSRIs are the current first-line pharmaceutical treatment however patients often discontinue use because of adverse effects.
- CBD is a promising treatment for Panic Disorder
- More study is needed to fully understand how CBD may benefit Panic Disorder
Published February 2017
After reviewing multiple studies, CBD is clearly a promising treatment for different types of anxiety disorders at a 300-600 mg dosage, possibly including Panic Disorder. (1)
- “Regarding CBD, the work of Zuardi and coworkers  showed that a single dose of CBD (300 mg, p.o.) decreased anxiety after [a simulated publish speaking] test in healthy volunteers.”
- “CBD seems to be a promising drug for the treatment of [Panic Disorder]. However, novel clinical trials involving patients with the [Panic Disorder] diagnosis are clearly needed to clarify [exactly how CBD works for Panic Disorder] and the safe and ideal therapeutic doses of [CBD].” (2)
Panic Disorder Treatment
Panic Disorder affects up to 390 million people worldwide. (3).
- Panic Disorder symptoms and prevalence: “Panic disorder (PD) is a chronic and disabling psychiatric disorder that is characterized by unexpected and recurrent panic attacks and affects approximately 0.8-5% of all people worldwide and may vary according to socio-demographic factors.”
- Common side effects and SSRIs (pharmaceutical drugs for panic disorder) cause many people to stop this course of treatment.
- “Less than half of the patients who suffer from PD show complete and sustained remission of the symptoms after long-term treatments with the currently available treatments .”
Panic Disorder Symptoms
- Sense of impending doom or danger
- Fear of loss of control or death
- Rapid, pounding heart rate
- Trembling or shaking
- Shortness of breath or tightness in your throat
- Hot flashes
Why CBD For Panic Disorder?
CBD may be a good alternative because it does not have some of the serious—even life-threatening—side effects associated with some potent pharmaceutical drug treatments offered to individuals with Panic Disorder.
- CBD does not have psychoactive effects
- CBD “is safe and well-tolerated via the oral route (up to 1500mg/day)
- Because CBD does not have some of the severe adverse effects of pharmaceutical sedatives, it may be a good future alternative “substitute for high potency benzodiazepines and antidepressant drugs in [Panic Disorder] patients who are resistant to the current treatments.”
After reviewing multiple clinical and preclinical trials, this study concludes that cannabidiol is a promising treatment for Panic Disorder (5).
- “However, it is important to stress that we are just in the first steps in the route to get a possible final approval of CBD for the treatment of [Panic Disorder]. Several clinical trials using CBD alone or in combination with other cannabinoids are under development.”
- Future studies are needed to better understand how CBD helps anxiety and what the proper CBD dosage is for treating panic attacks.
Interested in the possible benefits of CBD for PTSD? Possible CBD benefits for PTSD based on the latest 2019 medical study.
CBG (cannabigerol) Effects On Anxiety
Cannabigerol (CBG) is a lesser-known cannabinoid compound that is the precursor to CBD.
Though the mechanism of action is still poorly understood, several studies have identified specific medicinal properties of CBG.
- CBG is believed to have significant anti-anxiety effects, neuroprotective effects, and pain-relieving benefits.
Let’s take a look.
de Faria SM, de Morais Fabrício D, Tumas V, et al. Effects of acute cannabidiol administration on anxiety and tremors induced by a Simulated Public Speaking Test in patients with Parkinson’s disease. J Psychopharmacol. 2020;34(2):189–196. doi:10.1177/0269881119895536
Masataka N. Anxiolytic Effects of Repeated Cannabidiol Treatment in Teenagers With Social Anxiety Disorders. Front Psychol. 2019;10:2466. Published 2019 Nov 8. doi:10.3389/fpsyg.2019.02466
Kamal BS, Kamal F, Lantela DE. Cannabis and the Anxiety of Fragmentation-A Systems Approach for Finding an Anxiolytic Cannabis Chemotype. Front Neurosci. 2018;12:730. Published 2018 Oct 22. doi:10.3389/fnins.2018.00730
Mandolini GM, Lazzaretti M, Pigoni A, Oldani L, Delvecchio G, Brambilla P. Pharmacological properties of cannabidiol in the treatment of psychiatric disorders: a critical overview. Epidemiol Psychiatr Sci. 2018;27(4):327–335. doi:10.1017/S2045796018000239
Stampanoni Bassi M, Gilio L, Maffei P, et al. Exploiting the Multifaceted Effects of Cannabinoids on Mood to Boost Their Therapeutic Use Against Anxiety and Depression. Front Mol Neurosci. 2018;11:424. Published 2018 Nov 20. doi:10.3389/fnmol.2018.00424
Soares VP, Campos AC. Evidences for the Anti-panic Actions of Cannabidiol. Curr Neuropharmacol. 2017;15(2):291–299. doi:10.2174/1570159×14666160509123955
Blessing EM, Steenkamp MM, Manzanares J, Marmar CR. Cannabidiol as a Potential Treatment for Anxiety Disorders. Neurotherapeutics. 2015;12(4):825–836. doi:10.1007/s13311-015-0387-1
de Mello Schier AR, de Oliveira Ribeiro NP, Coutinho DS, et al. Antidepressant-like and anxiolytic-like effects of cannabidiol: a chemical compound of Cannabis sativa. CNS Neurol Disord Drug Targets. 2014;13(6):953–960. doi:10.2174/1871527313666140612114838
Tambaro S, Bortolato M. Cannabinoid-related agents in the treatment of anxiety disorders: current knowledge and future perspectives. Recent Pat CNS Drug Discov. 2012;7(1):25–40. doi:10.2174/157488912798842269