Anxiety is not literally my middle name (itâ€™s Alexandra) but it could be. Like my name, anxiety has been with me always. And until I had kids, everyone â€” including me â€” thought that I was simply a really good planner, a hyper-conscientious worker, and one of those 10-steps-ahead people who wards off problems before they occur.
When my twins came along 16 years ago, however, my constant mind-grind became a liability â€” it was hard to simply enjoy their adorableness, because I was so distracted by the next thing I urgently needed to make happen or that could go horribly, catastrophically wrong. And then, three years ago, my unquiet mind â€” which I had learned to manage fairly well through exercise, meditation, an antidepressant, and therapy â€” really turned up the volume.
Whatâ€™s going on in the news, especially politics, can send me into a state, and all the #MeToo stories roused some sleeping PTSD around events that Iâ€™d shoved into the recesses of my brain. Poor sleep kept me on edge during the day. My doctor prescribed lorazepam, the generic form of the anti-anxiety drug Ativan, and that helps in a pinch, but it also makes me spacey. So I asked her what she knew about cannabidiol (CBD), one of hundreds of compounds found in the cannabis plant.
My doctor knew a fair amount about marijuana and said that her patients have either found that it helped their anxiety â€” allowing them to relax and sleep better â€” or made it much, much worse. I already knew, having tried it decades ago, that I fell into the latter category. Weed turned me into a giant, Oreo-sucking slug who worried I’d drown by my own saliva if I didn’t swallow it faster. So fun.
THC, short for tetrahydrocannabinol, is the best-known compound in cannabis â€” the one that makes you high. But straight CBD oil, Iâ€™d read, does not. It’s said to provide only the chill factor, with none of the panic-inducing disorientation.
So I did some research. I called a friend of a friend, Lynn Parodneck, MD, a former OB/GYN in Bedford, New York, who now exclusively treats medical marijuana patients for things like chronic pain, Parkinson’s, and PTSD. She explained that CBD is found in both marijuana (illegal under Federal law, but legal in some states) and hemp (now legal under Federal law, thanks to the 2018 Farm Bill; but there are some grey areas, which I’ll explain in a sec).
Whichever type of cannabis plant it comes from, “in general, if it has less than 0.3% THC, itâ€™s considered pure CBD, and can be sold over the counter,” Dr. Parodneck says. It can also be shipped to all 50 states if ordered online. There are a few caveats, however: In some areas, local laws have yet to catch up with the Federal laws, and folks have occasionally been busted for having CBD products, either because it comes from a species of the cannabis plant, which remains illegal in some places, or because even the tiniest amounts of THC are entirely illegal â€” so check the rules where you live and travel. (Aaaannnd… as if that’s not complicated enough, now that the FDA has approved the first CBD-based prescription medication for rare forms of epilepsy, CBD is considered a drug and â€” guess what? â€” it’s illegal to sell food products containing drugs, such as CBD-infused coffee or juice shots. How strictly that’s enforced can also be wonky, depending on where you live.)
In any case, the main difference between CBD derived from weed and CBD derived from hemp is that there are still other compounds in marijuana-derived CBD that are thought to enhance the effectiveness of the CBD, something known as “the entourage effect.” But CBD from hemp can also be effective, says Dr. Parodneck.
(Oh, and you should know that it’s possible for CBD to show up on drug tests for up to 30 days, because even if it says “pure CBD” on the label, it may still contain a teensy-tiny bit of THC, says Dr. Parodneck.)
Research into CBD is just cranking up, but it does seem to help with pain and certain neurological conditions. Most of the research into whether CBD helps anxiety specifically has been done on critters, so it’s super preliminary and needs to be conducted in actual humans. But it does show promise, and one itty bitty study involving people asked to speak in public found that CBD significantly reduced anxiety, compared to folks given a placebo.
When taken orally â€” either as a tincture, in a capsule or vaped â€” some find that it can alleviate anxiety and depression by working on a system in our bodies called the endocannabinoid system, which plays a role in self-regulation, mood, and relaxation. Our bodies produce their own cannabinoids, explains Dr. Parodneck, which bind to receptors all over our bodies. Itâ€™s thought that people who donâ€™t produce enough cannabinoids can benefit from exogenous phytocannabinoids â€” i.e., taking CBD from plants orally in some form â€” which then bind to those receptors. Another theory is that taking CBD allows our own naturally produced cannabinoids to stick around in our bodies longer, prolonging the calming effect.
While CBD is well tolerated by most people, Dr. Parodneck advised me to “start low and go slow.” “Everybody is different and what kind of effects theyâ€™ll see depends on what their underlying condition is, as well as their tolerance,” she says.
If you have a long history of smoking marijuana, some strains of which are relatively high in CBD, she says, you may have resistance. “When the body gets used to CBD, it makes fewer endogenous cannabinoids,” so you may need more CBD to feel anything. Too much, however, can give you stomach upset or make you tired.
For me, a non-pothead, and for most adults, “10 milligrams is fine to start,” says Dr. Parodneck. If that amount doesnâ€™t help, she advised me, I was to increase my dose in a week. “If itâ€™s too much, youâ€™ll feel sleepy or have diarrhea, which means you should go back to where you were the week before.” Dr. Parodneck recommended I write down what I took when and how I felt, to see if it was working and what my ideal dosage is.
I took 10mg of a CBD tincture at around 11 a.m., held it under my tongue for a minute, and then waited to feel like the secretly chill person I know I am deep down inside. Nada. I did this every day at around the same time, like I would with any medicine.
The next week I tried the same thing, but also bit off half a 10mg CBD gummy, bringing my dosage up to 15mg. I thought maybe I felt a bit calmer maybe an hour or two after taking it â€¦ but I couldnâ€™t be sure.
Then one day the following week, another friend gave me a hit from a CBD oil vape cartridge at a moment when I was starting to panic about being late to the movie we were trying to make. Within less than a minute, I felt a de-escalation, and after a few minutes I felt noticeably, appreciably calmer. I reported back to Dr. Parodneck. “That makes sense,” she said. “When you vape, 50% of the product gets utilized. With edibles, itâ€™s between 10 and 20%, and it takes longer to kick in [because you must metabolize it].”
Since then, Iâ€™ve been vaping one to three times each morning, which helps me feel subtly but noticeably calmer as I organize and set out for my day. I also keep my vape pen on-hand for emergencies. If something happens that amplifies my panic, I step outside and take a hit. The CBD also seems to help me with the dramatic, intrusive thoughts that are one of the many gifts of PTSD, and lets me be more in-the-moment, because Iâ€™m not constantly anticipating the worst possible outcome.
Hereâ€™s the thing: Itâ€™s not for everyone (some people feel nothing) nor are all CBD products created equal â€” not by a long shot. A 2017 Journal of the American Medical Association study found 43% of the CBD products that the researchers ordered online had more CBD than indicated, while 26% had less. Some even had more than trace amounts of THC.
I get my vape cartridges from a small vendor Dr. Parodneck recommended, but she cautions that because CBD quality varies wildly depending on the manufacturer, itâ€™s buyer beware.
The wisest thing to do is to buy CBD made from American-grown hemp, ideally from a state such as California or Colorado (Dr. Parodneck likes this one) where both recreational marijuana use is legalâ€”that means there is some oversight for products sold in dispensaries in those states.
In no way would a few hits of CBD from my vape pen be enough to manage my world-class worrying on its own, but I’m grateful to have another figurative chill pill in my figurative medicine cabinet. I’m still a little self-conscious about taking a toke in front of other people â€” I’m a health editor and don’t want anyone to think I vape anything harmful! â€” so I step outside my office and skulk in the doorway feeling like a sneaky teenager. At some point, however, I predict that CBD-using anxious puppies like yours truly will be able to live out loud and proud.