There is growing evidence that cannabidiol (also called CBD) is effective for many individuals suffering from anxiety and sleep issues.
A case study published in 2016, Effectiveness of Cannabidiol Oil for Pediatric Anxiety and Insomnia as Part of Posttraumatic Stress Disorder, reports that cannabidiol oil was effective for reducing the anxiety and improving the sleep of a young girl who was experiencing these problems due to posttraumatic stress disorder (PTSD).
She had been sexually abused at the age of three and the medication (Clonidine) had not helped and had caused side major effects (hallucinations).
In the discussion the authors state the following:
Cannabidiol oil, an increasingly popular treatment of anxiety and sleep issues, has been documented as being an effective alternative to pharmaceutical medications.
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.
Prior to the prescribing of the CBD a functional medicine workup included ruling out thyroid dysfunction and low levels of iron and vitamin D deficiency. The following helped initially but were not sufficient to reduce all her symptoms: 1 -5mg/night of melatonin, 3g inositol 3 times a day, 500 mg/day of fish oil/EPA, 300mg magnesium/day. She also had psychotherapy sessions for 3 years.
Once it was decided to trial CBD she was given 25 mg at bedtime, and 6-12 mg of CBD sublingual spray during the day as needed for her anxiety: A gradual increase in sleep quality and quantity and a decrease in her anxiety were noted. After 5 months, the patient was sleeping in her own room most nights and handling the new school year with no difficulties. No side effects were observed from taking the CBD oil.
In this case study, the CBD was from industrial hemp, providing the medicinal benefits of CBD without the “high” of the THC.
I am very much in favor of CBD rather than THC because of the high risk of psychosis, schizophrenia and increased anxiety with THC. Dr. Hyla Cass and I share our concerns in this Anxiety Summit interview: Marijuana and anxiety: Panacea or Pandora’s Box?
The authors of this case report provide a very thorough overview of the mechanism of action of CBD via the two cannabinoid receptors in the body, CB1 and CB2:
- CBD has an indirect effect on the CB1 receptors by stopping the enzymatic breakdown of anandamide, allowing it to stay in the system longer and provide medical benefits. The CB1 receptors are located mainly in the brain and modulate neurotransmitter release in a manner that prevents excessive neuronal activity (thus calming and decreasing anxiety), as well as reduces pain, reduces inflammation, regulates movement and posture control, and regulates sensory perception, memory, and cognitive function.
- CBD has a mild effect on the CB2 receptors, which are located in the periphery in lymphoid tissue. CBD helps to mediate the release of cytokines from the immune cells in a manner that helps to reduce inflammation and pain
They explain other mechanisms that include “stimulation of vanilloid pain receptors (TRPV-1 receptor)”, “activating adenosine receptors” to reduce anxiety, “a potentially new third cannabinoid receptor GPR55”, and “directly activating the 5-HT1A serotonin receptor.”
I find the latter mechanism very interesting – activation of the serotonin receptor – given the work I do with supporting my clients who have low serotonin and do well with targeted supplementation with tryptophan and 5-HTP. As well as anxiety and insomnia, this young girl was also impulsive and disobedient, had aggressive outbursts at school and was self-destructive, and had low self-esteem and suicidal ideation. These symptoms are all classic signs of low serotonin.
I’d have loved to see how she would have done on a trial of tryptophan instead of 25mg of diphenhydramine (Benadryl), which acts in a similar way to SSRI antidepressants. Interestingly, diphenhydramine was the medication that led to the development of fluoxetine (Prozac) and high doses can mimic serotonin syndrome. Diphenhydramine also has side-effects that include “drowsiness, dizziness, constipation, stomach upset, blurred vision, or dry mouth/nose/throat.”
Based on my experience with tryptophan and 5-HTP – and all her low serotonin symptoms, I’d definitely consider this a better choice for a young girl like this, especially because we see results so quickly, often within a week and sometimes up to 2 or 3 weeks rather than the 5 months it took to completely resolve her sleep issues and anxiety.
Since low GABA can also lead to physical anxiety and insomnia, and with new research suggesting CBD also acts on GABAA receptors a trial of GABA may also have led to quicker results.
Aimée Gould Shunney, ND, summarizes this perfectly in the module on “Stress, Adrenal Health, and Cannabidiol: The ECS-HPA Connection” in the Integrative Cannabis course
CBD impacts the serotonin receptors, in particular the 5-HT1A receptors which has a lot to do with depression [and anxiety]. It impacts the GABA receptors, the dopamine receptors, the glutamine receptors. It also impacts different receptors that effect the inflammatory environment in the body like TRPV-1 and PPAR. There are so many different ways both within the ECS [endocannabinoid system] at the cannabinoid receptors and outside at these other receptors that CBD can help create balance and calm within the HPA axis. In short, CBD balances the system that keeps you balanced.
In summary, doing trials of tryptophan (or 5-HTP) and GABA, together with CBD oil, seems like an ideal approach to consider. I recommend doing this together with dietary changes that support serotonin production, like real whole quality food, quality protein, healthy fats, fermented foods, foods high in zinc, exercise, time in nature etc. so long-term use isn’t needed – for the CBD oil and the amino acids.
I’m excited about this emerging use of CBD oil, all the recent research, and using it in conjunction with dietary and lifestyle changes, and the amino acids and other nutritional approaches.
You can read more about the GABA and tryptophan products I use with clients here.
The two CBD products I’ve had the best results with are Elixinol (read here on using Elixinol for benzodiazepine tapers) and CV Sciences +CBD Oil.
Please share if you’ve used CBD oil or CBD supplements with good results.
We’d also love to hear if using CBD in conjunction with tryptophan (or 5-HTP) and GABA has improved your symptoms even more than just using the amino acids alone, or if the amino acids alone provided relief.