PTSD is a debilitating psychiatric disorder that affects between 5-10% of the population. For people like combat veterans who were exposed to trauma on a regular basis, the rates of PTSD can be as high as 20 or 30%. Despite the obvious need, there are currently no medications on the market that specifically treat PTSD.
In the past several years, CBD has entered the spotlight. That’s because of its remarkable ability to treat a wide variety of ailments without the intoxicating high that we usually associate with cannabis.
Can CBD also offer relief for PTSD? Let’s take a look at what causes PTSD and why CBD represents a promising treatment.
What is Post Traumatic Stress Disorder?
Post Traumatic Stress Disorder or PTSD is a very common psychiatric disorder. PTSD develops in certain people who have experienced or witnessed a traumatic life event.
It’s normal for someone who has been through a trauma like abuse or assault to experience a difficult period of adjustment. But given enough time to cope and process the event, most people are able to move on and recover.
PTSD arises when symptoms fail to improve, last for months or even years, and interfere with your daily life. About 8% of all adults in the United States will experience PTSD at one point in their lives.
Causes and Risk Factors
Dangerous and terrifying events trigger PTSD. These can include war combat, violence, abuse, and sudden mass casualty events like natural disasters or terrorist attacks.
But everyone is different. Two people can experience the same traumatic event and one of them may develop PTSD and the other may not.
Different factors influence whether or not someone will develop this disorder. Your genes play a key role. Genetics can influence your personality, your brain chemistry, and your susceptibility to anxiety and depression, all of which can make you more or less likely to develop PTSD.
Symptoms of PTSD will usually appear within 3 months of a traumatic event, but they can sometimes surface years later. To be diagnosed with PTSD, your symptoms must last more than a month and be severe enough to interfere with your day-to-day life and relationships.
Signs and symptoms of PTSD can include:
- Re-experiencing symptoms: flashbacks, nightmares, and intrusive memories and thoughts of the traumatic event
- Arousal and reactivity symptoms: trouble sleeping, being easily startled, angry outbursts, and feeling on edge
- Cognition and mood symptoms: negative feelings about life or yourself, feelings of guilt and blame, the inability to enjoy your favorite activities
- Avoidance symptoms: avoiding places, people, thoughts, and feelings that are related to the traumatic event
Current Medications Don’t Work
8 million Americans will suffer from PTSD this year, including nearly 20% of the men and women who served in Iraq and Afghanistan. Despite the obvious need for an effective treatment, there isn’t a single medication on the market that specifically targets PTSD and its symptoms.
Talk therapy is an important component of PTSD recovery. Therapists can help their patients identify triggers and build the skills to manage their symptoms over time. But effective medication can help patients take back control of their lives by bringing more immediate relief.
Unfortunately, the medications that doctors currently prescribe to treat PTSD aren’t very effective. These include antidepressants and anti-anxiety medications. While these medications may help some symptoms, they don’t address the root cause of PTSD—unwanted fixation on the memories of a traumatic event.
Moreover, these medications can also cause negative side effects like sexual dysfunction and even an increased risk of suicidal thoughts and behaviors. As a result, patients are less likely to stick to these types of meds.
So there’s a clear need to develop more evidence-based and targeted medications for PTSD. Could CBD be the answer? Let’s take a look at the evidence that makes CBD a promising treatment for PTSD.
CBD: A Promising Treatment for PTSD
What is CBD?
Cannabidiol or CBD is one of the many chemical compounds found naturally in the cannabis plant. Cannabis is one of the oldest plants cultivated by humans. This miraculous plant has exceptional versatility as a food, fuel, fiber, and medicine.
The great potential of cannabis as a medicine comes from its unique chemical makeup. The plant produces over 100 different cannabinoid compounds, including CBD and tetrahydrocannabinol (THC).
THC usually gets most of the attention. It’s THC that’s mainly responsible for the “high” or intoxication that you feel after consuming cannabis.
But researchers and consumers are starting to aim their attention at CBD. This cannabinoid has some unique medical properties. But unlike THC, it doesn’t cause a high. Researchers have shown that CBD has the potential to treat a wide variety of illnesses, diseases, and disorders including:
- Alcohol Abuse
- Epilepsy and Seizure Disorders
- Irritable Bowel Syndrome
- Multiple Sclerosis
How does CBD work?
CBD interacts with the body’s endocannabinoid system. This is a biological system that’s present all over the body, from our brains to our guts.
The endocannabinoid system is made up of molecules called endocannabinoids—the body’s native cannabinoid compounds—and endocannabinoid receptors. Endocannabinoids fit into certain endocannabinoid receptors like a key into a lock. These interactions help the body maintain a sense of balance by regulating our mood, appetite, temperature, immune system, sleep, and much more.
When we consume CBD, it takes effect by entering the bloodstream and the brain and interacting with our endocannabinoid system.
CBD is Safer than Current PTSD Treatments
More and more researchers are devoting their time and energy to studying CBD. As more data emerges, one thing is becoming clear—CBD is a well-tolerated, generally safe treatment. It’s even safer than many common over the counter medications like ibuprofen.
We’ve covered studies looking at the safety of CBD here on CannaHealth before, but let’s do a quick recap. In one rigorous study, healthy adults tolerated CBD very well. The most commonly reported negative side effects were diarrhea, headache, and drowsiness. It’s important to note that these symptoms occurred with relatively high doses of CBD (between 1500 mg and 6000 mg).
As a testament to its safety and effectiveness, countries around the world have approved CBD as an ingredient in prescription medications. The FDA in the United States approved the CBD-containing Epidiolex in June 2018. The United Kingdom, Canada, and more than 20 other countries have approved Sativex, a formulation of CBD and THC, to treat the symptoms of Multiple Sclerosis.
On the other hand, PTSD is most commonly treated with antidepressant medications, such as Zoloft and Paxil. These drugs can have much more extensive negative side effects—including weight gain and sexual dysfunction—that can interfere with a person’s day-to-day life.
The Relationship Between Fear, Memory, and the Endocannabinoid System
To understand how CBD can help, we need to know a little bit more about what’s going on in the brain of someone with PTSD. Researchers still aren’t sure exactly what causes PTSD, but they’re starting to scratch the surface. Here’s what we know so far.
Forgetting to Forget Bad Memories: The Cause of PTSD
At its core, PTSD is caused by an uncontrollable state of fear. We’ve all experienced fear. It’s a physical feeling as much as an emotional one. Your heart rate increases, your pupils dilate, and your breathing intensifies.
These reactions are known as the fear or stress response and they can be quite unpleasant. But it’s a necessary part of survival. When we feel threatened, we need that boost of adrenaline to kick us into action and get ourselves out of danger.
But with PTSD, the fear never ends. Even things that were never stressful in the past, like a crowd of people or the sound of a car engine starting, can throw someone with PTSD into a state of terror that’s debilitating. For those afflicted with PTSD, this chronic state of fear is incredibly difficult to cope with.
So why does this happen?
Researchers now think PTSD may be caused by impaired memory pathways in the brain. To put it simply, people with PTSD ‘over-remember’ their trauma. Their brains won’t allow these bad memories to fade with time. They dwell on the memories of traumatic events. Traumatic memories can even become distorted and intensified as time goes on.
The Endocannabinoid System Regulates Memory
Interestingly, the endocannabinoid system is involved in memory. The endocannabinoid system plays an important role in the extinction or fading of aversive memories. CB1—the major endocannabinoid receptor found in the brain—is most likely responsible for helping aversive memories fade with time.
CBD doesn’t bind and activate CB1 very well. But it does help stimulate the endocannabinoid system indirectly by increasing the availability of anandamide—one of our native endocannabinoids—in the brain.
This is one of the most compelling reasons for CBD as a potential PTSD treatment. By stimulating the endocannabinoid system, it might help those suffering from PTSD put to rest their traumatic memories. Unlike antidepressant medications that doctors frequently prescribe for PTSD, CBD potentially addresses the root cause of the disorder.
Why CBD Works: The Evidence
Now let’s take a closer look at how CBD works when it comes to treating PTSD. Here’s some of the most current evidence that supports CBD as a PTSD treatment.
People with PTSD Have an Endocannabinoid Deficiency
At first, the relationship between the endocannabinoid system, memory, and PTSD was all hypothetical. But researchers have proved this link to be the real deal. Several studies have shown that people who suffer from PTSD have lower levels of the endocannabinoid anandamide.
Anandamide binds and activates the CB1 receptor which is important for regulating both memory and anxiety. If anandamide levels are too low, the body compensates by making more CB1 to try and capture more anandamide. One study also showed that PTSD patients have more CB1 receptors in brain regions associated with fear and anxiety.
We know that CBD increases anandamide levels in the brain. This means that CBD could be an effective treatment to target the potential cause of PTSD—long-lasting, fear-based memories.
CBD Helps Bad Memories Fade
We just talked about how CBD may be able to treat PTSD by helping bad memories fade. Well, researchers have put this theory to the test.
In Lab Rats
Nearly ten different studies have looked at the fear response and memory in rodents. Lab rats don’t exactly get PTSD. But researchers can use aversive stimuli like loud noises to reliably create a fear response in rats that they can measure.
All of the studies in rats showed that CBD helped the bad memories fade in some way. In some cases, CBD increased the extinction of the fearful memory. And in other cases, CBD decreased the reconsolidation of the fearful memory. Memory reconsolidation helps maintain memories. It can also strengthen and modify existing memories, something you don’t want with a traumatic memory.
Unfortunately, there’s not as much data with human participants. But the studies that are out there are just as promising.
A 2013 study looked at fear conditioning and memory extinction in healthy adults. The researchers found that CBD significantly increased fearful memory extinction. And a small 2019 study showed that 91% of patients decreased their PTSD symptoms with 8 weeks of CBD treatment.
CBD Fights Anxiety
People diagnosed with PTSD will often suffer from other psychological disorders like anxiety and depression. Researchers still aren’t sure whether PTSD causes anxiety and depression or whether people with PTSD are just more likely to suffer from these other disorders. In either case, CBD can offer relief to both anxiety and depression.
There’s especially a wealth of evidence that shows CBD has a positive effect on anxiety. Several studies show that CBD relieves perceived anxiety in those suffering from anxiety disorders. A 2015 review concluded that, although further studies are needed, CBD has a huge potential for treating a range of anxiety-based disorders.
CBD Will Give You a Good Night’s Sleep
One symptom that makes PTSD particularly debilitating is sleep disturbance. Nightmares of traumatic memories are very common among those suffering from PTSD and obviously disrupt sleep.
But people with PTSD experience a range of sleep problems. These include trouble falling asleep and waking up frequently throughout the night.
Sleep problems are likely caused by the state of hyperarousal often associated with PTSD (see “Symptoms” section above). This means that people with PTSD frequently feel overstimulated, tense, and on edge.
Such a heightened state of arousal makes it difficult to settle down, relax, and fall asleep at night. Moreover, high arousal increases the likelihood that you’ll wake up with even the slightest hint of a nearby sound or movement.
PTSD is a heavy burden to bear. The constant fear and anxiety can make it hard to get through the day and sleep well at night. And unfortunately, there aren’t any medications designed to treat PTSD.
Commonly prescribed antidepressants don’t target the underlying cause of the disorder and have a long list of unwanted side effects. But CBD and cannabis are emerging as effective alternatives. Nearly 30 states specify PTSD as a qualifying condition for medical marijuana.
Moreover, convincing evidence is emerging that CBD can target the root cause of PTSD—recurring, traumatic memories. CBD offers a safe, easily accessible option for treating the symptoms of PTSD.