Cannabis and Anxiety

I was initially going to post some thoughts I have concerning Cannabis causing psychosis, but decided not to because in summary, I believe the data for this is at best weak.

Of much more general interest is the relationship between Cannabis and anxiety. There are hundreds of articles/blogs claiming that either Cannabis causes anxiety or that it helps anxiety. I believe this is primarily strain related and will address this further, but wanted to first comment that many, many medications I have prescribed in the past have been for anxiety. However, in a certain percentage of patients, these pharmaceuticals would at times increase anxiety. So, this is certainly not rare and should not be a reason to dismiss the patients for whom Cannabis works well for anxiety.

So, back to the strains. In general those patients, who become agitated, paranoid or even perhaps borderline psychotic, have been using sedating strains of Indica. These strains tend to worsen our ability to focus and this results in calmness and sleep for most of us. However, for some patients with anxiety, this loss of focus triggers a loss of connection to their environment and paranoia may creep in. On the other hand, low doses of more activating strains of Cannabis very rarely, if ever, cause these symptoms.

In my personal clinical experience, the patients who seem to become increasingly anxious from Indicas, do very well on Sativa strains.