Can Marijuana Help Your Bipolar Disorder?
Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital.
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Award-winning mental health journalist and author, John McManamy, wrote a thoughtful blog about the implications of medical marijuana as a treatment for bipolar. It’s reasonable to think that the risks outweigh any possible benefits, but the topic is certainly worth discussing.
Since both bipolar depression and mania can have psychotic features, there is some evidence that even medical marijuana use might have negative effects in people with bipolar disorder.
Studies Show Links to Worse Outcomes
Medical research shows that cannabis use in people with psychosis is associated with an earlier age of their first psychotic episode. It’s also associated with manic symptoms and problems thinking.
In one study, patients who quit using marijuana or reduced its use following their first psychotic episode had the greatest improvement in symptoms at the one-year mark, compared both to continuing cannabis users and people who had never used cannabis. Long-term cannabis use may have a negative effect on long-term clinical outcomes for those with bipolar spectrum disorders, as well.
A 2015 study found lower bipolar disorder remission rates for current regular cannabis users (those who used it three times a week or more often) and those who regularly smoke tobacco when compared to people who don’t use either substance. That study, which lasted two years, concluded that regular marijuana users who also have bipolar didn’t do as well long-term as people who didn’t use the drug.
Another study looked at the short-term effects of cannabis use in people with bipolar disorder and concluded that the drug was associated with both manic and depressive symptoms. However, that study couldn’t find evidence that people with bipolar were using cannabis to self-medicate on a regular basis.
Now, none of these studies prove that cannabis is actually causing these problems in people with bipolar—they just show an association between marijuana use and problems. But you should factor this information into your thinking when deciding whether or not to use cannabis.
Substance Abuse Risk With Marijuana
All drugs have risks and side effects, and cannabis is no exception.
Substance abuse can be quite prevalent among those with bipolar disorder. People have used alcohol and drugs to try to control their systems in great numbers and may reduce their likelihood of successful treatment of their bipolar as a result.
By using marijuana to self-medicate for bipolar disorder, you run the risk of gaining a second diagnosis in addition to your bipolar diagnosis: substance abuse (Substance use disorder).
There's some interest in using marijuana to treat symptoms of bipolar disorder but the risks may outweigh any benefits.
Updated on April 13, 2020. Medical content reviewed by Dr. Joseph Rosado, MD, M.B.A, Chief Medical Officer
From multiple sclerosis to depression to cancer, medical marijuana is helping people deal with an array of health conditions and their treatment. Now bipolar disorder patients can turn to medical marijuana for addressing their bipolar disorder, too.
How and Why Marijuana Can Be an Effective Treatment for Bipolar Disorder
Some research has linked cannabis use with a psychotic threshold decrease where you transition into active psychotic symptoms. Your symptoms may get worse. However, cannabis use can lower the age where you start experiencing bipolar disorder symptoms.
But, the relationship between bipolar disorder and marijuana is up for debate since some studies have shown cannabinoids may provide therapeutic applications in bipolar disorder and anecdotal evidence supporting this claim.
Bipolar Disorder and Medical Marijuana
Research has shown some mood disorders, such as Bipolar Disorder, can run in families, with the potential to skip a generation of diagnosed cases. Beyond the known causes of chemical imbalances in the brain and the chemical transmitters not working properly between the cells of the brain, it isn’t certain why some people are predisposed to bipolar disorder, and others are not. Bipolar refers to the two poles of mood, similar to a battery. One is for the “positive” effects of mood and the other “negative.”
Usually, the person with bipolar disorder has rapid swings in mood, cycling from high energy and inflated sense of self and even elation to severe depression and exhaustion leaving them unwilling to crawl out of bed on any given day. The more rapid the cycle, the more dangerous the situations for the patient with bipolar disorder as both extremes can result in death from suicides, accidents or carelessness because they think they can fly, run faster than a train, etc.
These mood cycles over the last fifty years were controlled with some powerful drugs and even treated with electroshock therapy. “One Flew Over The Cuckoo’s Nest” is all about mood disorders and bipolar treatments. Half the characters in the story suffer from a mood disorder. These barbaric treatments leaving patients overmedicated and over-treated led the revolution to find “safer” drugs to treat these disorders.
In the last thirty years, lithium, the very dangerous substance used to charge batteries, became available in pill form to treat bipolar disorder. Its promising effects kept it on the market, and it’s still in use today despite the fact studies have revealed the long-term use of lithium damages the speech and thought processes of the brain. Patients who regularly take lithium have to have regular blood draws to check for toxic levels of the drug in their livers/systems.
Researchers engaged in a literature review of marijuana for bipolar disorder in one study and of cannabinoids neuropharmacological properties and found some patients with bipolar disorder use cannabis to ease their depression and mania symptoms. This suggests marijuana may have potential therapeutic effects in bipolar disorder.
This study showed THC and CBD might distribute specific effects, such as:
You may use nabilone and dronabinol, pure synthetic cannabinoids, and specific plant extracts containing CBD, THC or both in known concentrations sublingually. We’ve now seen controlled trials of the two cannabinoids as a secondary medicine in bipolar disorder.
What Side Effects and Symptoms of Bipolar Disorder Can Medical Marijuana Treat?
Bipolar can bring on a whole range of symptoms medical cannabis can treat, such as:
- Sleeping problems
- Changes in energy levels — too little or too much
Bipolar Disorder and Medical Marijuana Treatments
But these patients don’t have to start lithium, ever. The two main strains of medical marijuana, indica, and sativa, can be used together or separately to treat the symptoms as the patient starts to cycle.
Indica is often used to calm, alleviate anxiety, and relieve insomnia, which could be used when the patient is experiencing a high cycle and can’t be bothered to come down to sleep, eat, or focus. Sativa elevates mood and acts as a stimulant. It’s most effective for the lows in the person with bipolar disorder. So much relief could be gained and without any harm to the body’s organs or long-term damage to the brain and liver through the use of medical marijuana.
So why aren’t more people with mood disorders like bipolar disorder being treated with medical marijuana? It’s simple really. Either they don’t live in a state legalized its use (like Wisconsin, where depression is rampant due to less sun all year round) or lack of information and informed choice in the states where it is legal.
MarijuanaDoctors.com makes it a point of our website to get the word out on the benefits medical marijuana has for so many people. We can and will help anyone find a qualified doctor in the right state get the prescription they need for medical marijuana control in a more natural and healthy way their bipolar or mood disorder. That’s a guarantee.
There is anecdotal evidence supporting the promise medical cannabis for bipolar disorder can help you manage your depressive or manic episode symptoms with the right treatment plan. According to one man, his wife functions better after marijuana and bipolar disorder treatment. It helps her sleep, relaxes her when she’s hypomanic and slows down her speech. Medical cannabis keeps her more active when she would otherwise lie in bed in a depressive state. While lithium also helps, it isn’t always effective keeping her in control.
Best Strains of Marijuana to Use for Bipolar Disorder Symptoms and Treatment Side Effects
None of the studies conducted considered strain or dosage type, and these are two essential factors to consider when studying cannabis. With so many different types of strains available, bipolar patients have many possibilities to find relief.
Depending on what type of marijuana is used, studies may misrepresent consistency. For example, patients with bipolar disorder who smoke high THC marijuana concentrates may be more likely to have a negative mood response whereas those who smoke strains rich in CBD directly from the cannabis flower may find more positive mood responses.
Indica strains reduce anxiety and have a calming effect. Sativa strains stimulate and elevate the mood. And doctors may prescribe cannabis and bipolar disorder treatment as part of your overall treatment strategy for your BP. Some good strains to try include:
- Blue Dream (Hybrid): Searching for a strain to invigorate the mind and body, many bipolar patients turn to Blue Dream. It works well for addressing anxiety, depression, and headaches.
- White Widow (Hybrid): You’ll benefit from this strain’s ability to knock out stress, pain, and depression while it also helps you sleep well at night. Many BP patients say this strain helps enhance their creative and artistic pursuits too. It also makes a healthy and great way to distract yourself, particularly if you’re struggling with a severe BP episode.
- Sour Diesel (Sativa): A strain developed to deliver a dreamy and energizing cerebral effect, making it a powerful strain for providing long-lasting pain, depression, and stress relief. It’s a good choice for patients looking to medicate during the day so they can stay productive and focus on their tasks.
- Jack Herer (Sativa): You can experience a clear-headed, uplifted and blissful high while helping with creative projects with this strain. Many bipolar patients turn to this strain to help them deal with stress, pain, lack of appetite, fatigue, and depression. If your energy is zapped by tiring mood swings, you may want to try this strain out.
Best Methods of Marijuana Treatment to Treat Side Effects and Symptoms of Bipolar Disorder
The stereotypical assumption with medical weed is you have to smoke it. But there are various other interesting ways to use this herb. Trying a different consumption method comes with various practical benefits, too, such as increasing discretion. However, it may also change the effect you get, such as the intensity or duration of a high and other effects. Here are some consumption methods you may want to try:
- Smoking. You tend to feel the effects immediately when you smoke medical pot, and they generally wear off in a couple of hours. Unfortunately, smoking is not the healthiest way of using marijuana.
- Vaporizing. Vaporizing heats the herb to where the cannabinoids like THC turn into vapor you inhale. It’s a healthier option than smoking and a preferred method for many.
- Topicals. Topicals are weed-infused products you apply to your skin and typically come in lotions and oils.
- Tinctures. With tinctures, the doses you get are highly concentrated. You only need one drop under your tongue to get almost instant effects. The effects last for a couple of hours.
- A tasty way of getting your marijuana for bipolar disorder, edibles tend to produce a strong, long-lasting effect of up to eight hours or so. Just cook your marijuana into your favorite foods like cookies, brownies or even pizza.
Let Marijuana Doctors Help You Get Your Bipolar Symptom Relief Through Medical Marijuana
While there are still questions about whether individuals should treat their bipolar disorder with medical cannabis, only you will know if this medicine will help relieve your symptoms. Browse for a medical marijuana dispensary or search for a cannabis-certified doctor so you can sit down and discuss this potent herb’s potential in treating your depressive or manic episodes.
What Is Bipolar Disorder?
Bipolar disorder, previously referred to as manic depression, is a mental health disorder characterized by extreme mood swings alternating between lows — depression — to highs — mania or hypomania.
With depression, you may feel hopeless or sad and lose pleasure or interest in most activities. When your mood shifts into hypomania or mania, you might feel full of energy, euphoric or unusually irritable. These various mood swings can affect your activity, behavior, sleep, judgment, and ability to think clearly.
Mood swing episodes may come on multiple times a year or rarely. Between occurrences, some individuals may experience emotional symptoms, while others might not experience any.
Even though bipolar disorder usually afflicts you for life, a treatment plan can help manage its symptoms and mood swings. Typically, doctors treat the condition with psychotherapy, or psychological counseling, and medication.
Types of Bipolar Disorder
Various bipolar disorder types exist, but all involve episodes of mania and depression to a certain degree. These forms consist of these five:
- Bipolar I disorder. Here you experience severe mood events from depression to mania.
- Bipolar II disorder. This is a milder type of mood elevation and involves milder hypomania episodes, which can switch to periods of severe depression.
- Cyclothymic disorder. You have brief periods of hypomanic symptoms alternating with short depressive symptom periods when you have a cyclothymic disorder. These aren’t as long-lasting or extensive as you would see in full depressive or full hypomanic episodes.
- Mixed features. Here, you’re hypomanic, manic or depressive and experience concurrent opposite mood polarity symptoms.
- Rapid-cycling. This type of bipolar disorder occurs when you have four or more mood events in a year.
History of Bipolar Disorder
In the first century in Greece, Aretaeus of Cappadocia started recording bipolar disorder symptoms in the medical field. For many centuries, his association between depression and mania went unnoticed.
The ancient Romans and Greeks generated the terms “melancholia” and “mania,” which today mean depressive and manic. Even back then, they realized lithium bath salts helped to calm manic individuals down and lift the spirits of individuals who were depressed. Lithium today continues to be a common treatment for patients with bipolar disorder.
Symptoms of Bipolar Disorder
Bipolar disorder patients experience alterations in how they sleep, unusually intense emotion, strange behaviors and changes in their activity levels. These individual episodes are known as “mood episodes.” Individuals with bipolar disorder mood episodes behave much differently than the typical behaviors and moods of an individual. Extreme changes in sleep, energy and activity go hand-in-hand with mood episodes.
If you’re experiencing a mood episode, you may:
- Have an abundance of energy
- Feel extremely high, up or elated
- Have difficulty sleeping
- Feel wired or jumpy
- Have an increase in activity levels
- Be irritable, agitated or “touchy”
- Become unusually active
- Do risky things like have reckless sex or spend lots of money
- Experience fast thoughts
- Think you can perform many things all at once
If you’re experiencing a depressive episode, you may:
- Have low energy
- Feel very down, sad, hopeless or empty
- Feel empty or worried
- Experience a decrease in activity levels
- Feel you can’t enjoy anything
- Eat too little or too much
- Have difficulty concentrating
- Feel “slowed down” or tired
- Be forgetful
- Have trouble sleeping, either too much or too little
- Think about suicide or death
In some cases, a mood episode will include symptoms of both depressive and manic symptoms, characteristic of mixed features. When you’re experiencing mixed features, you may feel empty, sad or hopeless, but still feel incredibly energized.
Effects of Bipolar Disorder
The longer your bipolar disorder goes untreated, the worse it tends to get. Diagnosis and treatment delays often result in social, personal and financial problems, making your disorder more troubling to handle for both you and those around you.
You are at risk for specific dangers if you leave your bipolar disorder untreated, including:
- Inability to work: Bipolar disorder is among the six top causes of disability
- Broken personal relationships: This can lead to divorce, unemployment and legal issues.
- Substance abuse problems: Individuals with untreated bipolar disorder are more likely to abuse alcohol and drugs. In fact, 44 percent of bipolar patients abuse alcohol while 56 percent abuse drugs.
- Suicide: Out of all individuals with bipolar disorder, 30 percent commit suicide.
Treatment, however, can help those dealing with this life-long illness manage their symptoms and live a normal life.
Bipolar Disorder Statistics
- Around 5.7 million, or 2.6 percent of the population, in the U.S. aged 18 and older are affected by bipolar disorder each year.
- Twenty-five years is the average median age of bipolar disorder onset. However, this disorder can affect people in their 40s and 50s as well as early childhood.
- Over two-thirds of individuals with the disorder have close relatives struggling with it.
Current Treatments Available for Bipolar Disorder and Their Side Effects
Most bipolar patients, even people who have severe forms of the condition, can substantially stabilize their symptoms and mood swings with the right treatment. Since this is a recurrent illness, professionals highly encourage long-term preventative treatment. For optimal management of the disorder long-term, you’ll need a treatment plan of both psychotherapy and medication.
Medications for Bipolar Disorder
Typically, you would begin balancing your mood swings immediately with medication. You can experience side effects with these drugs, depending on the medicine you’re prescribed.
Side Effects if Bipolar Disorder Medication includes:
- Weight gain
- Hair loss
- Reduced sex drive
- Movement problems
- Dry mouth
To relieve these types of symptoms, your doctor may try a different medication or change your dose. You should never change or stop a medication without the guidance of your doctor.
Substance Abuse Treatment for Bipolar Disorder
If your bipolar disorder has led you to abuse drugs or alcohol, you may need substance abuse treatment. Otherwise, you may have a hard time managing your condition.
Day Treatment Programs for Bipolar Disorder
While getting your symptoms under control, your physician or psychiatrist may suggest a day treatment program where you can get counseling and support.
Hospitalization for Bipolar Disorder
If you feel suicidal, are behaving dangerously or are becoming psychotic, or detached from reality, your physician may recommend hospitalization. While at the hospital, you’ll receive psychiatric treatment designed to keep you safe and calm while treatment stabilizes your mood, regardless of if you have a major depressive or manic episode.
Continued Treatment for Bipolar Disorder
As mentioned, bipolar disorder is a lifelong disorder, and treatment for it is as well, even if you’re experiencing times where you’re feeling better. If you skip treatment, you have a significant risk of symptom relapse or having your mild mood changes turn into full-blown depression or mania.
The main bipolar disorder treatments include psychological counseling, or psychotherapy, and medication to control your symptoms. You’ll also have access to support groups and education.
See how medical marijuana could help relieve your bipolar disorder symptoms. Medical marijuana can also help relieve some of the symptoms of bipolar disorders.