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This Is Why Weed Makes Some People Anxious

As a type A person—a generous understatement—I used to have high hopes that weed could give me that elusive experience known as chilling out. But each of the five times that I tried it in high school and college, it did nothing. Then, when I was 24, a friend and I took a walk through San Francisco and saw a huge cloud of smoke rising from Golden Gate Park. That’s when we realized we’d arrived at around 4:20 on 4/20. Eager to take advantage of the coincidence, I bought a weed-laced Rice Krispies Treat from a guy in the park and downed a third of it. What followed was one of the most stressful afternoons of my life.

As my brain seemed to become progressively slower and more ineffective over the course of the next hour, I worried I wouldn’t remember how to get home. What if I walked in front of a car and died? Then, I got a text from a colleague who needed me to share a Google doc with her. I panicked as I realized that simple task eluded me. I spent ten minutes trying to figure it out, convinced she’d somehow know why I was taking so long and think less of my adulting abilities.

Reeling from that ordeal, I had my friend walk me home. Two ice cream cones later, I lay down in my bed, where I realized my eyes rolled back when I closed them. I opened them in panic, convinced they’d get stuck in the back of my head. Thankfully, after several minutes of debating whether it was safe to close my eyes, the drug’s sedative effects seemed to override the anxiety and paranoia, and I fell asleep. Needless to say, I gave away the other two-thirds of that Rice Krispies Treat.

It seemed unfair that the substance many swore by for anxiety reduction had only made me more anxious. But it turns out my reaction wasn’t that unusual. “[Weed] made me feel overly aware of everything that was going on around me and paranoid that anyone in the same room was watching and judging me,” says Kim, a 26-year-old teacher in New Orleans who declined to share her last name for her career’s sake. “I would eventually just freeze wherever I was so that I wouldn’t do anything ‘wrong’ but still be anxiously spiraling inside my head.”

Weed similarly has given Alaina Leary, a 24-year-old editor in Boston, a flood of worries like: “Does my girlfriend actually love me? Is what I just said really stupid and are my friends going to abandon me now? What if we split up while walking and I get lost forever?”

These reactions aren’t typical, but they’re not uncommon either, says James Giordano, professor of neurology and biochemistry at Georgetown University Medical Center. They’re especially common for people who are new to weed and unfamiliar with the feeling of being high. “The disorientation can be very anxiety provoking,” he explains, as can the loss of control that comes with compromised mental capacities.

However, there’s another reason why people might feel anxious while stoned, even long after their first time. THC binds to the brain’s cannabinoid receptors, releasing the neurotransmitters dopamine, serotonin, and GABA, a neurotransmitter that stops neurons from firing, Giordano explains. Increased GABA and serotonin activity inhibits norepinephrine—a neurotransmitter involved in alertness and anxiety—which calms most people down.

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But for some people, reduced norepinephrine has a rebound effect, stimulating activity in the brainstem’s locus ceruleus and limbic forebrain, which are involved in arousal and excitation, Giordano says. This activity in turn sends the sympathetic nervous system into overdrive, leading to a rise in heart rate and release of cortisol, which we tend to perceive as anxiety.

Paranoia is a separate but often co-occurring side effect of weed, typically caused by an increase in dopamine primarily in the limbic forebrain, Giordano says. This change in dopamine activity can make some people feel anxious and think others are out to get them or judging them.

It’s a cruel irony that the very people who could benefit from weed’s relaxing effects are often the ones who don’t feel them. While some neurotic or hypervigilant people get relief while they’re stoned, others’ fears are exacerbated. “What pot tends to do is augment aspects of one’s personality,” Giordano tells me. “If you tend to be a jovial person, if you’re smoking weed, those personality traits tend to be disinhibited and you become more of that. Individuals who have anxious traits or those with paranoid traits might need a bit of caution.”

People’s reactions to weed tend to be fairly consistent, so if it’s made you anxious once, it might be first-time anxiety, but anything more than that probably means that’s just how your brain responds to the drug, Giordano says. People who have paranoid or anxious reactions to weed should be especially careful about edibles, since those highs tend to last longer. So, maybe stay away from the special Rice Krispies Treats.

If someone around you is having an unpleasant experience on weed, Giordano suggests comforting them and letting them know they’re in a supportive environment. Make sure not to joke about it because that could add to their social anxiety. He adds that if you find yourself in the middle of weed-induced anxiety, getting fresh air and moving around might help you metabolize the drug. Some also find that relaxation techniques like deep breathing and meditation help.

Most importantly, let someone know you’re having a hard time, even if it feels like you’re killing the mood because everyone else is blissed out. People who get anxious when they’re stoned “should be very forthright about what they’re experiencing, particularly if it’s not pleasant,” Giordano says. “You don’t want to suffer through this by yourself. It can be a scary experience.”

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It’s a cruel irony that the very people who could benefit from weed’s relaxing effects are often the ones who don’t feel them.

Marijuana and Anxiety: It’s Complicated

If you live with anxiety, you’ve probably come across some of the many claims surrounding the use of marijuana for anxiety symptoms.

Plenty of people consider marijuana helpful for anxiety. A 2017 national survey of more than 9,000 Americans found that 81 percent believed marijuana had one or more health benefits. Nearly half of these respondents listed “anxiety, stress, and depression relief” as one of these potential benefits.

But there also seems to be just as many people who say marijuana makes their anxiety worse.

So, what’s the truth? Is marijuana good or bad for anxiety? We’ve rounded up the research and talked to some therapists to get some answers.

Before getting into the ins and outs of marijuana and anxiety, it’s important to understand that marijuana contains two main active ingredients, THC and CBD.

  • THC is the psychoactive compound responsible for the “high” associated with marijuana.
  • CBD is the nonpsychoactive compound that’s used for a range of potential therapeutic purposes.

There’s no question that many people use marijuana for anxiety.

“Many clients I’ve worked with have reported using cannabis, including THC, CBD, or both, to reduce anxiety,” says Sarah Peace, a licensed counselor in Olympia, Washington.

Commonly reported benefits of marijuana use include:

  • increased sense of calm
  • improved relaxation
  • better sleep

Peace says her clients have reported these benefits along with others, including greater peace of mind and a reduction in symptoms they found unbearable.

Peace explains her clients have reported that marijuana in particular helps relieve symptoms of:

  • agoraphobia
  • social anxiety
  • post-traumatic stress disorder (PTSD), including flashbacks or trauma responses
  • panic disorder
  • phobias
  • sleep disruptions related to anxiety

What Peace sees in her practice is on par with most of the existing research around marijuana and anxiety.

A 2015 review supports CBD as a potentially helpful treatment for anxiety, particularly social anxiety. And there’s some evidence that THC may also help in low doses.

It’s not a full cure, though. Instead, most people report it helps reduce their overall distress.

“For example, someone might only have one panic attack a day instead of several. Or maybe they can go grocery shopping with high but manageable levels of anxiety, when before they couldn’t leave the house,” Peace explains.

While marijuana appears to help some people with anxiety, it has the opposite effect for others. Some simply don’t notice any effect, while others experience worsening symptoms.

What’s behind this discrepancy?

THC, the psychoactive compound in marijuana, seems to be a big factor. High levels of THC have been associated with increased anxiety symptoms, such as increased heart rate and racing thoughts.

In addition, marijuana doesn’t appear to offer the same long-term effects as other anxiety treatments, including psychotherapy or medication. Using marijuana may offer some much-needed temporary relief, but it’s not a long-term treatment option.

“I think, like any medicine, cannabis can provide support,” Peace says. “But without lifestyle changes or internal work on mental health, if your stressors or anxiety triggers remain, your anxiety will likely remain in some form.”

While marijuana might seem like a way to avoid the potential side effects associated with prescription medication, there are still some downsides to consider.

Negative side effects

  • increased heart rate
  • increased sweatiness
  • racing or looping thoughts
  • problems with concentration or short-term memory
  • irritability or other changes in mood
  • paranoia
  • hallucinations and other symptoms of psychosis
  • confusion, brain fog, or a “numb” state
  • decreased motivation
  • difficulty sleeping

Smoking risks

Smoking and vaping marijuana can lead to lung irritation and breathing problems in addition to increasing your risk for certain types of cancer.

Plus, vaping is linked to a recent increase in potentially life threatening lung injuries.

Dependence and addiction

Contrary to popular belief, both addiction and dependence are possible with marijuana.

Peace shares that some of her clients have a hard time finding a line between medical use and misuse with daily or regular cannabis use.

“Those who use it frequently to numb themselves or keep from caring about the things causing them stress also often report feeling like they are addicted to cannabis,” Peace says.

Legal status

When using marijuana, you’ll also need to consider the laws in your state. Marijuana is only currently legal for recreational use in 11 states as well as the District of Columbia. Many other states allow use of medical marijuana, but only in certain forms.

If marijuana isn’t legal in your state, you may face legal consequences, even if you’re using it to treat a medical condition, such as anxiety.

If you’re curious about trying marijuana for anxiety, there are a few things you can do to reduce your risk for it worsening your anxiety symptoms.

Consider these tips:

  • Go for CBD over THC. If you’re new to marijuana, start with a product that contains only CBD or a much higher ratio of CBD to THC. Remember, higher levels of THC are what tend to make anxiety symptoms worse.
  • Go slow. Start with a low dose. Give it plenty of time to work before using more.
  • Purchase marijuana from a dispensary. Trained staff can offer guidance based on the symptoms you’re looking to treat and help you find the right type of marijuana for your needs. When you buy from a dispensary, you also know you’re getting a legitimate product.
  • Know about interactions. Marijuana can interact with or reduce the effectiveness of prescription and over-the-counter medications, including vitamins and supplements. It’s best to let your healthcare provider know if you’re using marijuana. If you don’t feel comfortable doing this, you can also talk to a pharmacist.
  • Tell your therapist. If you’re working with a therapist, make sure to loop them in, too. They can help you evaluate how well it’s working for your symptoms and offer additional guidance.

Marijuana, particularly CBD and low levels of THC, shows possible benefit for temporarily reducing anxiety symptoms.

If you decide to try marijuana, keep in mind it does increase anxiety for some people. There’s really no way to know how it will affect you before you try it. It’s best to use it cautiously and stick to smaller doses.

Other nonmedical treatments can also help relieve anxiety symptoms. If you’re looking for alternative approaches to treatment, consider giving other self-care approaches a try, like:

It may take some trial and error, but with time you can find a treatment that works for you.

Crystal Raypole has previously worked as a writer and editor for GoodTherapy. Her fields of interest include Asian languages and literature, Japanese translation, cooking, natural sciences, sex positivity, and mental health. In particular, she’s committed to helping decrease stigma around mental health issues.

Last medically reviewed on December 16, 2019

Why does marijuana help some people's anxiety symptoms and worsen those of others?