CBD and Its Role in Calming Stress

Fear, stress, and anxiety are normal responses triggered when the body perceives threats to survival. However, in modern times, we encounter situations such as deadlines at work, unemployment, financial challenges, caring for our elderly relatives, and many other situations that cause our body to get stuck in stress mode. This leads to excessive and ongoing fear, stress, and anxiety. A number of mental disorders are also associated with excessive fear and anxiety, including  generalized anxiety disorder (GAD), panic disorder (PD), post-traumatic stress disorder (PTSD), social anxiety disorder (SAD), and obsessive-compulsive disorder (OCD).

CBD can soothe mild stress and anxiety by virtue of its effects on the central nervous system.^1,2

CBD interacts with several receptors that regulate fear and anxiety-related behaviors such as the cannabinoid receptor CB₁, the serotonin 5-HT_1A receptor, and the transient receptor potential (TRP) vanilloid type 1 (TRPV1) receptor.³ I discussed these receptors in detail in chapter 1. Remember that CBD works through the endocannabinoid system. And the endocannabinoid system plays an important role in reducing stress and anxiety.

Your Body’s Own Stress-Reduction Mechanism

The endocannabinoid system regulates emotional behavior. It determines how you respond to unpleasant events and leads to an appropriate response to stress.^4-6 As I talked about in previous chapters, endocannabinoids that are part of the endocannabinoid system activate CB₁ receptors. These endocannabinoids act like locks that fit into the receptor “key.” Activation of CB₁ receptors regulates anxiety and fear.⁶ In animal research, CB₁ receptor activation led to an improved response to bad memories.⁷

When you’re under stress, your body is tasked with sending you back into your non-stress state of peaceful balance. In order to accomplish this, it performs what’s called a negative feedback loop. The loop begins when stress activates the hypothalamic-pituitary-adrenal (HPA) axis and the sympathetic nervous system (SNS). This leads to a stress response or stress cascade, as it’s sometimes called. This stress cascade helps the body make the necessary changes required to cope with stress. When the body is knocked out of balance by a stressor it triggers the release of corticotropin-releasing hormone (CRH) from the brain region known as the hypothalamus. This in turn leads to the release of adrenocortiotropin hormone (ACTH) into the circulation. This is a signal for the adrenal cortex to release glucocorticoids into the blood. In an effort to restore your body back into the pre-stress state, the glucocorticoids stop the release of CRH, shutting down the stress response.⁸

The activation of CB₁ receptors also play a critical role in this negative feedback loop that occurs as your body deals with stress. CRH release can lead to anxiety. CRH increases the production of the enzyme fatty acid amide hydrolase (FAAH), which reduces the endocannabinoid anandamide (AEA) within the amygdala of the brain. By activating the CB₁ receptor, CRH release is cut off and AEA levels increase, which can have a calming effect.⁹ On the other hand, chronic, unpredictable stress can throw off the endocannabinoid system in the hippocampus and amygdala of the brain, leading to anxiety.¹⁰

CBD works through the endocannabinoid system to soothe stressful feelings.¹¹ Although CBD doesn’t act directly on the CB₁ receptor, it can act indirectly.¹¹ It also blocks the actions of FAAH and in doing so increases levels of AEA.¹¹ It may counteract the FAAH-raising effects of CRH.¹¹ CBD can also work through the serotonin receptor.¹² Serotonin is a “feel-good” hormone that contributes to feelings of calm and relaxation.

CBD can also modify blood flow in brain areas that are involved in anxiety, such as the amygdala, hippocampus, hypothalamus, and cingulate cortex.¹³ This is another way in which CBD can produce feelings of calm and relaxation.

CBD and the Stress of Public Speaking

To test whether CBD can relax people who are under stress, scientists undertook several studies of CBD’s effect on people giving public speeches. In one of those studies, researchers caused anxiety in a group of 57 healthy male subjects by having them perform a simulated public speaking test.¹⁴ In this double-blind study, the participants were given different doses of CBD (150 mg, 300 mg, 600 mg) or a placebo. CBD (300 mg) significantly reduced anxiety during the speech.

In an earlier study, researchers compared the effects of the anti-anxiety drugs ipsapirone (5 mg) or diazepam (10 mg) with CBD (300 mg) or placebo in 40 healthy volunteers during a simulated public speaking test.¹⁵ Compared to the placebo, CBD or ipsapirone were each effective at reducing the anxiety caused by public speaking.

CBD produced the same effects in people with generalized social anxiety disorder (SAD).¹⁶ Because a pronounced fear of public speaking is one hallmark of this disorder, researchers had 24 patients with SAD and 12 healthy controls perform a public speaking test.¹⁶ In this double-blind, randomized study, 12 of the SAD subjects took 600 mg of CBD 1½ hours before public speaking, while 12 SAD patients received a placebo. The healthy controls didn’t receive any treatment.

The study authors used three methods of determining anxiety levels in the participants. The scientists looked at ratings on the Visual Analogue Mood Scale (VAMS), which allows study subjects to rate their level of anxiety, cognitive impairment, and sedation,  and the Negative Self-Statement Scale (SSPS-N), which is based upon theories that social anxiety is the result of thinking poorly of yourself and believing others also think poorly of you. The researchers also measured blood pressure, heart rate, skin conductance, and physical reactions to stress at six different points during the public speaking test. Compared with the placebo group, SAD patients taking the CBD experienced significantly less anxiety, cognitive impairment, and emotional discomfort during their speech. The CBD-group also was more relaxed when they were anticipating giving the speech. The SAD patients taking the placebo experienced increases on the Negative Self-Statement Scale. Patients in the CBD group experienced almost no increase in negative self-statements. The responses of the SAD patients given CBD were similar to healthy controls, meaning the CBD led to a more normal stress response in regards to public speaking.

CBD and Blood Pressure Spikes Caused by Stress

Long-term stress is associated with the development of cardiovascular disease.¹⁷ Social isolation, depression, not having enough money, stressful family life, and problems at work are linked to both an increased risk of cardiovascular disease and worsening of already existing cardiovascular conditions.¹⁸  Evidence from animal studies and some recent interesting human studies suggest that CBD may regulate the body’s cardiovascular response to stress. Restraining rats is a way that researchers cause stress in the animals. In one study, CBD injections reduced the cardiovascular response to restraint stress and the typical stressed out behavior of the animals when restrained.¹⁹

Blood pressure rises when a person is under stress. Two human studies have found that CBD may support healthy blood pressure when we’re feeling anxious about a situation or under physical stress. In one of the randomized, placebo-controlled, double-blind studies, researchers gave 26 healthy males 600 mg of oral CBD or a placebo for a week.²⁰ The men participated in isometric exercise and their blood pressure was measured both during rest and during exercise. In response to stress, participants in the CBD group had lower systolic blood pressure both after the initial dose and after repeated seven days of  use. After a week on CBD, the men’s carotid artery widened and the arteries became more flexible. According to the researchers, “CBD reduces BP at rest after a single dose but the effect is lost after seven days of treatment (tolerance); however, BP reduction during stress persists.”

In the other randomized, placebo-controlled, crossover study, nine healthy male subjects were given 600 mg of CBD or a placebo.¹⁸ A crossover study is where scientists place the subjects on one protocol (in this case CBD supplementation) for a specific time and then switch the subjects to the placebo for another period of time. The researchers caused stress in the subjects by exposing them to cold and exercise and giving them a test designed to produce mental stress. Diastolic and systolic blood pressure were significantly lower immediately following the stress test in men who had taken CBD. After exposure to cold, men taking the CBD experienced a significant drop in systolic blood pressure and mean arterial pressure. The researchers also found that diastolic blood pressure was significantly less in the men given CBD during cold stress. During exercise stress, CBD lowered systolic blood pressure and mean arterial pressure.

Researchers believe CBD’s ability to lower blood pressure during stress may be an added benefit of its calming properties.¹⁸ By relaxing the mind, it may relax the body and the cardiovascular system, too.

More Restful Sleep

Stress can lead to insomnia and a lack of restorative sleep. CBD’s calming effect can help promote better sleep even during stressful times. CBD may hold promise for REM sleep behavior disorder and excessive daytime sleepiness.²¹ In patients with post-traumatic stress disorder (PTSD), CBD combined with routine psychiatric care has improved the quality of sleep and reduced nightmares.²²

In a case study, researchers investigated the effects of CBD on a ten-year-old girl with PTSD due to sexual abuse and who had little parental supervision when the girl was under the age of five.²³ The girl had tried pharmaceutical medications, but they only provided partial relief and any benefits were only temporary and accompanied by major side effects. On the other hand, CBD oil led to a prolonged decline in anxiety and steadily improved quality and quantity of sleep. The study authors concluded, “This case study provides clinical data that support the use of cannabidiol oil as a safe treatment for reducing anxiety and improving sleep in a young girl with posttraumatic stress disorder.”

Researchers conducted a larger human study of 72 patients whose primary concern was either anxiety or poor sleep.²⁴ The subjects were given CBD along with their usual treatment at a large psychiatric outpatient clinic. CBD supplementation was associated with a significant decline in anxiety in 57 of the patients (79.2%) during the first month of use and the participants continued to feel this increased calmness throughout the study. Sleep improved in 48 of the patients (66.7%) in the first month of CBD supplementation, but these results fluctuated over time, indicating mild improvement. CBD was well tolerated although three of the participants experienced fatigue. The doses used in this study (25 mg/day to 175 mg/day) were much lower compared with other clinical studies that used 300 mg/day to 600 mg/day, which may explain why even though CBD caused a noteworthy decline in anxiety it only resulted in a modest improvement in sleep.

Evidence from rodent studies mirror CBD’s beneficial effects in humans. One group of researchers triggered PTSD-like anxiety in rats by having them navigate a maze.²⁵ CBD blocked the suppression in rapid eye movement (REM) sleep caused by anxiety. Getting enough rapid eye movement sleep, the stage in which most of our dreams occur, is essential to feeling refreshed and energized. It’s also important for learning, memory, and happiness.

Hemp Oil: Teaming Up with Terpenes

Supplementing with hemp oil can provide advantages over CBD alone. As I mentioned in previous chapters, hemp oil contains beneficial compounds known as terpenes, which have their own stress-reducing effects. For example, the terpene d-limonene soothes anxious thoughts by increasing levels of serotonin and dopamine,²⁶ both hormones linked to mood and happiness. Another terpene found in hemp, d-linalool, also promotes relaxation, likely by influencing glutamate and GABA neurotransmitter pathways involved in stress management.²⁷  In mice, d-linalool prevented conflict among the animals.²⁸ Many essential oils known for their stress-relieving properties, such as lavender, contain d-linalool. It’s thought to be the main active component in lavender responsible for the anti-anxiety effects of lavender oil.

A third relaxing terpene in hemp is myrcene. Myrcene calms the mind and promotes sleep.²⁷  Nerolidol and phytol are terpenes that, like their other hemp-derived cousins, promote relaxation.²⁷ Phytol is also found in green tea, and its presence there could explain why green tea is so relaxing even though it contains caffeine.²⁷ Phytol raises levels of the calming neurotransmitter GABA and blocks an enzyme responsible for breaking down GABA.²⁷ In mice, nerolidol increases the animals’ interest in exploring brightly lit open areas, an indication of reduced anxiety.²⁹

Side Benefits of Reducing Stress

By reducing stress, CBD can indirectly enhance a couple other areas of health. First, by promoting feelings of calm under pressure, it can support healthy immunity. Psychological stress is known to reduce immune function.^30-33 I will discuss CBD’s potential role in immune support later in this book. Second, by lowering stress, CBD may also support a healthy inflammatory response. Stress is well known to increase inflammation.³⁴ I’ll talk about this aspect of CBD more in future chapters.

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