18 Things Doctors Wish You Knew About CBD for Anxiety

You can find CBD oil in lip balm and shampoo, pain relief products and pet treats: Most tout CBD's supposed anxiety-beating benefits. Learn the 18 things doctors wish you knew about CBD for anxiety before you dive in.

CBD oil is everywhere you look today, with proponents claiming that it has benefits for a host of diseases and conditions—particularly anxiety. But just how much do we really know about CBD and its effect on stress and worry? Here are the 18 things doctors wish you knew about CBD for anxiety.

It probably won’t get you high

cbdKevin McGovern/ Shutterstock

What exactly is CBD oil? It’s the substance cannabidiol and it’s derived from cannabigerol (CBG) in cannabis or marijuana, but unlike other components in this plant, CBD is not psychoactive. Put another way: it won’t get you high. That honor is primarily reserved for the mind-altering tetrahydrocannabinol (THC), according to Harvard Medical School. (Here’s more about the differences between CBD and THC.)

Just because everyone is doing is it doesn’t mean you should

cbd tincture oil stress anxietyelizabethmphl/ Shutterstock

More than 60 percent of people who use CBD oil do so to help with their anxiety, according to a survey from the Brightfield Group, a cannabis research firm. Despite lots of claims and testimonials, CBD oil is not an approved treatment for anxiety, says Smita Das, MD, PhD, an addiction psychiatrist at Stanford University School of Medicine Stanford and the Medical Director of Psychiatry at Lyra Health in Burlingame, California.

“There are a lot of claims that it is useful for anxiety, but they have not been substantiated in large enough studies for recommending it routinely in practice.” Watch for the 9 signs that you may have anxiety.

The FDA is watching

The US Food and Drug Administration sent warning letters to CBD companies that make claims about treating anxiety and other conditions because there is no proof that they do.

There is one FDA-approved CBD product

The FDA has not approved any CBD products except for one prescription drug to treat rare, severe forms of seizure disorders in children.

CBD oil is no substitute for therapy or prescription medications

One big concern, Dr. Das says, is that people may use CBD oil in place of evidence-based treatments such as cognitive behavior therapy, a time-limited form of therapy that aims to change how your body reacts to stressors or prescription anti-anxiety medications. “They may rely on what feels like a quick fix and not get the treatment that they need.” Here are some top tips for therapists on how to deal with your anxiety.

You may not be getting what you think you are

The supplement industry is not regulated by the FDA. “There is always the risk of other chemical contaminants in CBD oil,” Dr. Das warns. The product may also not contain the amount of CBD stated on the label. Also, when third-party organizations test CBD products, there have been cases of finding THC. Here are some other secrets that vitamin manufacturers don’t want you to know.

You get what you pay for

One possible way to assure that you are getting authentic CBD products may be to pay up, Dr. Das says. “Some people may start using a product that is expensive and then in an attempt to get the same product at a lower price, they may go to less reputable market,” she says. Because there are few regulations on the market, the lower-priced products may skimp on the potency.

You may increase your risk for marijuana abuse and addiction

This is a possible scenario, Dr. Das states “Some may learn that cannabis is less expensive than CBD oil and go ahead and use the cannabis instead, placing themselves at risk for cannabis-use disorder.”

CBD oil may interact with your anti-anxiety meds

CBD oil may work on the serotonin system just as many anti-anxiety drugs do, explains Yasmin Hurd, MD, director of the Center for Addictive Disorders at Mount Sinai Behavioral Health System in New York City. Serotonin is a brain chemical that plays a role in mood. “CBD oil and taking anti-anxiety medication can interact in a dangerous way,” she warns. This is why you need to talk to your doctor before you start taking any supplement.

Choose wisely

If you want to try CBD oil, look for a product that has a third-party seal of approval attesting to its quality, Dr. Hurd says. This does not guarantee that it is everything that it claims to be, but it is a vote of confidence. Consumerlab’s CBD & Hemp Extract Supplements, Lotions, and Balms Review is a good place to start.

Start slowly

If you choose to take CBD oil, start with low doses, Dr. Hurd suggests. “Work your way up with doses as too much can make you sleepy,” she says. “It’s not a benign substance and dose matters.”

CBD may help treat PTSD

Many veterans and others experience post-traumatic stress disorder (PTSD). This one thing can put you at high risk for PTSD. Psychoactive compounds, such as marijuana and alcohol, may increase the risk of developing PTSD. But a small, but growing body of evidence suggests that CBD oil may break this cycle early and permanently.”In animal studies we have found that high doses of CBD help break the association between fear and fear response,” says Mallory Loflin, PhD, an assistant professor of psychiatry within the University of California, San Diego (UCSD) School of Medicine. In contrast, other drugs being studied for PTSD work by dampening fear in the moment. Larger studies in vets are now underway. Stay tuned.

CBD may help alleviate social anxiety

CBD may offer some relief for those of us who have an intense fear of public speaking and other types of social anxiety, but results have been mixed. “One study found that people who took 600 milligrams (mg) of CBD oil daily reduced their anxiety in simulated public speaking exercises, but higher doses did not,” Dr. Loflin says.

You may fail your next drug test

CBD isn’t intoxicating in and of itself, but CBD extract from hemp does contain THC. “It’s usually not enough to get you intoxicated, but over time, you may fail a drug test,” Loflin says. “If the label reads zero THC, it is probably not true as hemp has trace amounts of THC, and if you use it daily, it could lead to a positive drug test.” Her advice? “Buy a commercial dry test to see where you stand.”

It’s important to track your progress

The only way to know if CBD is having an effect on your stress and worry is to keep a symptom diary, says Scott Shannon, MD, an assistant clinical professor in the department of psychiatry at the University of Colorado in Denver. “If you don’t feel better within a month, don’t keep taking it.” It usually starts working within five days if it is going to help. He suggests starting with CBD capsules containing 10-15 mg once or twice a day.

It doesn’t help everyone

Many people respond to CBD oil for anxiety, but a percentage doesn’t. “And there is a small amount who feel worse, and we don’t know how to predict this yet,” says Dr. Shannon.

It seems safe

First, do no harm is one of the basic tenets of medicine. “We haven’t seen anything significant or concerning with CBD oil, just a little fatigue and occasional dry eyes,” Dr. Shannon says. CBD oil’s side effect profile is much better than we see with prescription antidepressants.

More studies are needed

This is the real bottom line, Dr. Shannon says “We need large randomized controlled trials to determine if CBD helps treat anxiety.”

Sources
  • Harvard Medical School: "Cannabidiol (CBD) — what we know and what we don't"
  • Brightfield Group: "Understanding CBD Report"
  • FDA: "Warning Letters and Test Results for Cannabidiol-Related Products"
  • FDA: "FDA approves first drug comprised of an active ingredient derived from marijuana to treat rare, severe forms of epilepsy"
  • Smita Das, MD, PhD, addiction psychiatrist, Stanford University School of Medicine, Stanford, CA; Medical Director of Psychiatry, Lyra Health, Burlingame, California
  • Yasmin Hurd, MD, director, Center for Addictive Disorders, Mount Sinai Behavioral Health System, New York City
  • Consumerlab: "CBD & Hemp Extract Supplements, Lotions, and Balms Review"
  • Mallory Loflin, PhD, assistant professor of psychiatry, University of California, San Diego School of Medicine
  • Neuropsychopharmacology: "Cannabidiol Reduces the Anxiety Induced by Simulated Public Speaking in Treatment-Naïve Social Phobia Patients"
  • Scott Shannon, MD, an assistant clinical professor, Department of Psychiatry, University of Colorado, Denver
Medically reviewed by Ashley Matskevich, MD, on November 16, 2019

Denise Mann, MS
Denise Mann is a freelance health writer whose articles regularly appear in WebMD, HealthDay, and other consumer health portals. She has received numerous awards, including the Arthritis Foundation's Northeast Region Prize for Online Journalism; the Excellence in Women's Health Research Journalism Award; the Journalistic Achievement Award from the American Society for Aesthetic Plastic Surgery; National Newsmaker of the Year by the Community Anti-Drug Coalitions of America; the Gold Award for Best Service Journalism from the Magazine Association of the Southeast; a Bronze Award from The American Society of Healthcare Publication Editors (for a cover story she wrote in Plastic Surgery Practice magazine); and an honorable mention in the International Osteoporosis Foundation Journalism Awards. She was part of the writing team awarded a 2008 Sigma Delta Chi award for her part in a WebMD series on autism. Her first foray into health reporting was with the Medical Tribune News Service, where her articles appeared regularly in such newspapers as the Detroit Free Press, Chicago Sun-Times, Dallas Morning News, and Los Angeles Daily News. Mann received a graduate degree from the Medill School of Journalism at Northwestern University in Evanston, Ill., and her undergraduate degree from Lehigh University in Bethlehem, Pa. She lives in New York with her husband David; sons Teddy and Evan; and their miniature schnauzer, Perri Winkle Blu.