Why Does Cannabis Cause Paranoia in Some But Helps Anxiety in Others?

Paradoxically, others use cannabis as a tried-and-true way to annihilate their anxiety. Even PTSD patients are using medical marijuana to treat stress and panic symptoms with remarkable rates of success.

Why does marijuana have such a polarizing effects on fear and anxiety?

Cannabis and Brain Chemistry

When it comes to cannabis and paranoia, it’s literally all in your head. Cannabinoids (such as THC) bind to receptors throughout the brain, many of which are focused in the amygdala. The amygdala is involved in emotional processing, governing responses such as fear, stress, and paranoia. When THC acts upon the amygdala, it modifies the neural communication for better or for worse.

THC can overexcite the neural pathways and lead to anxiety and paranoia, especially in individuals who are new or unaccustomed to cannabis. The mechanisms by which this happens are still unclear to researchers, but the body’s endocannabinoid system seems to be full of hints.

Put simply, our body contains receptor sites that are not only filled by marijuana’s cannabinoids, but also by naturally-produced compounds called endocannabinoids that act a lot like those compounds found in cannabis. Shortages of these endocannabinoids have been observed in brains that have been exposed to excessive stress and trauma, which could explain why THC has a relaxing, anti-anxiety effect in some people. In theory, cannabinoids from marijuana replenish these regulatory compounds, resulting in a therapeutic effect. This connection has been pertinent in PTSD studies and could hold promising implications for other mood disorders as well.

Pre-Existing Anxiety Affects Your Cannabis Experience

A 2009 review of anxiety and cannabis studies concluded that “frequent cannabis users appear to have higher levels of anxiety than non-users,” and that “a considerable number of subjects developed anxiety disorders before the first symptoms of cannabis dependence.” That led researchers to believe that anxiety-prone people tend to use cannabis as a self-prescribed anxiety medicine, opposing the idea that cannabis is what’s causing the anxiety.

While these cannabis use trends are helpful in understanding broad behavioral tendencies, researchers acknowledge that anxiety is highly individualized based on a number of risk factors:

• Genetic vulnerability
• Personality
• Gender
• History of paranoid episodes
• Presence of anxiety disorder
• Basal anxiety levels
• Abstinence states

And when you throw cannabis into the mix, a few other risk factors emerge:

• Frequency of use
• Dose
• Cannabinoids
• Set and setting

While anxiety is no doubt unique and nuanced in every individual, researchers noted that regular users tend to see a decrease in anxiety whereas occasional and new users were more likely to experience heightened paranoia. Anxiety was also more likely to occur in high doses of THC.

It’s impossible to say how cannabis will affect you personally unless you’ve already tried it for yourself, but understanding what biological and environmental factors are at play can certainly help guide you to a better experience.

How to Avoid Cannabis-Induced Anxiety and Paranoia

If you’re susceptible to or worried about cannabis-induced paranoia, fear not – there are ways to prevent, even counter, that anxiety. Here are just a few tips:

• Try a low-THC and/or high-CBD strain. CBD is a non-psychoactive compound that combats anxiety and counteracts THC’s psychoactive effects, resulting in a calmer and more clear-headed experience.
• Go easy on the dose. Smoking and vaporizing offer better dose control than oils and edibles, so consider starting there if you’re worried about getting too high.
• Find a comfortable place. Set and setting is pivotal to the experience, so get to a happy place to reduce panic and paranoia.
• Partner up with the right strain. Every strain has something different to offer on a chemical level, so keep track of which ones worked for you. Sativa strains tend to deliver racier, high-energy effects while indicas tend to be more relaxing.