Cannabis for Depression: A Complicated Relationship
06.02.21 - 4 min read
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Elizabeth Ardillo, PharmD, has seen firsthand how physical and mental pain are connected, in the eyes and the stories of the people she meets. As lead pharmacist for RISE Dispensaries in Pennsylvania, she counsels many patients who have symptoms of depression alongside the condition that brings them in the door.
“A lot of patients with chronic pain and illness also have depression,” Ardillo says. “Often, they’re mentally and physically drained by the time they get to us. Their pain keeps them up at night, they don’t have a good sleep cycle and it affects their mood.”
Of course, you don’t need to have a physical illness to be depressed; it can happen to anyone. In a typical year, more than 7 percent of the U.S. population experiences depression; during the COVID-19 pandemic, the incidence of depression appears to have tripled.
Cannabis has the potential to relieve symptoms of depression and lift mood, but it can also aggravate depression and worsen feelings of sadness, Ardillo says. That’s why it’s important to get expert guidance if you’re interested in using marijuana for depression.
“People need to work with their mental health providers and track how they feel when they use cannabis,” Ardillo says. “That can help us get them to a product that may relieve their symptoms instead of aggravating them.”
The research into cannabis and depression is in its infancy, and so far it’s a mixed bag, Ardillo says. Some studies show cannabis improves symptoms of depression; others have found that it is not useful for improving depression and that it might even be tied to an increased risk of developing depression. One study found that cannabis improved depression symptoms in cancer patients; researchers have considered whether cannabis can ease symptoms of depression caused by chronic stress.
Marijuana contains chemical compounds called cannabinoids, including THC and CBD, that help create its effects on the body and mind. Our bodies have a natural endocannabinoid system that reacts to the cannabinoids in cannabis. When cannabis does improve symptoms of depression, it may be because of the plant’s ability to boost certain endocannabinoids (chemical compounds made by the human body) that help regulate how we feel, Ardillo says. Deficiencies in two of these endocannabinoids, 2-AG and anandamide, may signal depression; cannabis may mimic the effects of these endocannabinoids and lift mood.
Importantly, the effects of cannabis are biphasic, which means high and low doses can create opposite effects, Ardillo says. Typically, a low dose of THC helps relieve symptoms of depression and a higher dose may worsen symptoms of depression, she says.
Maria Caligiuri, 32, is a RISE medical marijuana patient who lives in Pittsburgh. She has multiple sclerosis, chronic knee pain and major depressive disorder, and cannabis has been a helpful part of her treatment plan for all of these conditions, she says. She takes a daily antidepressant, but she also has found that cannabis can be a mood lifter, especially strains that have low doses of THC. For her, using cannabis while she’s feeling depressed has inspired creative pursuits, such as painting, which is a good distraction from ruminating thoughts.
“It enables your mind to hack into your creative space so you see things differently,” she says.
If you think you might be clinically depressed, it’s important to talk to your doctor or a mental health therapist. If you are having suicidal thoughts, please seek emergency help by calling 911 or the National Suicide Prevention Lifeline: 800- 273-8255.
If you have diagnosed depression or you’re struggling with low mood and want to try cannabis, Ardillo offers these tips:
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