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Treating Depression with Cannabis, The Do's & Don'ts

by: Laura Geftman, LCSW

Scientific research is well on its way to proving the medicinal qualities of cannabis. Included in the potential benefits of treating depression. While there is still more to know about cannabis and depression, we've got some basics to know before beginning your journey with treating depression with cannabis.

What is depression?

In this day and age of over-diagnosing and over-medicating everything. It’s important to know what depression really is and looks like.

Depression is a serious mood disorder characterized by persistent sadness, melancholy or gloom, loss of interest, decreased appetite, energy, and sleep. This clinical diagnosis is also associated with feelings of worthlessness, weight loss, agitation, inability to concentrate, and recurrent suicidal ideation.

Depression isn’t just about having a bad day or week, five symptoms must persist for over two weeks. During that time, those struggling with clinical depression tend to experience a disruption in their daily living. That means those struggling with depression experience great difficulty getting out of bed, staying awake, maintaining hygiene, completing tasks, etc… Minor depression shows up as a low mood you can’t shake, inability to enjoy things, etc…

It’s important to look at why someone may be experiencing symptoms. If there’s a primary concern- marital distress, increased use of a substance (alcohol, prescription medication, drugs), body image, loss or grief- the symptoms related to depression may not be the actual concern to best be addressed. Therefore it may be likely that another course of treatment is indicated. Answering the tough questions about the onset of the symptomology need to be answered to determine the best course of treatment.

Here’s how the Diagnostic and Statical Manual of Mental Disorders (DSM) defines Major Depressive Disorder:

Symptoms include the following:

Depressed mood

Diminished loss of interest or pleasure in almost all activities

Significant weight or appetite disturbance

Sleep disturbance

Speeding or slowing of muscle movement

Loss of energy or fatigue

Feelings of worthlessness – low self-esteem

Diminished ability to think, concentrate and make decisions

Recurrent thought of death, dying or suicide

Longstanding interpersonal rejection ideation (other would be better off without me); specific suicide plan; suicide attempt

Additional criteria, the episode must: Be at least two weeks long or more, cause significant distress or severely impact social, occupational, or other important life areas, not to be precipitated by drug use, not meet the criteria for another mental disorder like schizophrenia or bipolar disorder, and not be better explained by bereavement such as the loss experienced after a death

What should people know about treating depression with cannabis?

Like most diagnoses and disorders with cannabis, there currently isn’t any peer-reviewed or significant research on the treatment of depression with cannabis. There is, however, anecdotal information to support this complex relationship.

Furthermore treating depression with cannabis may seem counterintuitive. The stereotypical response of couch-lock may associate with mimicking or increasing depressive symptoms.

However, modern cannabis has introduced many effects with a multitude of strains.  The various combinations of cannabinoids and terpenes offer different effects including increased energy and decreased fatigue. Using strains to fend off lethargy is proving to help those struggling with depression find short-terms ways through their genetic depressive disposition.

Getting a kick from cannabis to get motivated is best. However, cannabis can’t resolve depression alone. Managing depression is about creating coping skills. Combining the use of cannabis with adequate sleep, healthy eating, exercise, mediation, yoga, journaling, therapy, and support from others is ideal. Developing life skills, more structure to your day, and a positive support system very much contribute to managing mood as well.

Managing depression is about creating coping skills. Combining the use of cannabis with adequate sleep, healthy eating, exercise, mediation, yoga, journaling, therapy, and support from others is ideal.

What are some misconceptions about depression and cannabis use?

There is still a great deal of fear and stigma around treating any mental health condition with cannabis. Mental health professionals have been basing their practices and treatments on peer-reviewed evidence-based treatment. models Due to prohibition, that information simply doesn’t yet exist for cannabis and may not for some time due to political regulations. Ultimately the official evaluation of the efficacy of medical cannabis for depression is still in its early stages to properly understand and prescribe the possible benefits of endocannabinoid function and mood stabilization.

However as state legislation continues to change, more and more people are experimenting with cannabis for medicinal healing. So it’s important to understand what we do know about cannabis if you decide to do your own experiment to self-medicate.

Here are a few misconceptions to consider:

• Cannabis will make depression worse

Again there are still many misconceptions about the desired effect of cannabis use. Cannabis naturally produces cannabinoids (chemical compounds) that play a role in motor control, cognition, emotions, and behavior. Introducing cannabis into your system may help restore homeostasis or typical functioning.

It is important to once again point out you need to assess your concern and if depression is actually what you hope to treat. There is research that states cannabis can trigger schizophrenia or psychosis. This research isn’t conclusive but it’s important to recognize your risk factors.

• Cannabis is addictive

This is yet another topic you see widely debated. And again this is due to the legalities of cannabis. The National Institute on Abuse (NIH) has reported that cannabis use if not harmless and nearly six million people experience marijuana use disorder.

Keep in mind this national agency is subject to the same federal laws that continue to list cannabis as a Schedule 1 drug along with heroin, LSD, MDMA, GHB and more.

Unless cannabis is rescheduled, they need to maintain this stance on cannabis.

Other studies that are not regulated by the federal government refute the NIH’s claims. While the NIH reports 16.1 million Americans live with depression, they also report every 19 minutes someone dies from a prescription drug overdose. The reported six million people struggling with marijuana abuse equates to 1.5% of Americans.

So weigh the information and odds. If you have a history or family history of substance abuse or dependence, consider your options carefully and have support in place if you decide to use just in case.

• Cannabis is a magic elixir

I see this notion all the time. I also hear about people chugging a whole bottle of cannabis oil thinking the more you take the quicker it will resolve an issue. There’s no magic here folks. We’re talking about science.

CBD increases our body’s serotonin production and stabilizes its presence. Serotonin, a natural mood stabilizer, is a chemical in our brain that impacts emotions. Low levels of serotonin can lead to depression. THC is thought to be best used in low doses as too high a dose could worsen the condition. Strains high in the terpene Limonene are recommenced for mood elevation.

It will take some experimentation to identify the best cannabis treatment for each individual and therefore it is highly recommended to have support in doing so from a healthcare practitioner.

• I can stop taking my psychotropic medications as soon as I start using cannabis

Nope. No way. Don’t do it. BAD IDEA. Quitting antidepressants “cold turkey” could make you sick, set back your treatment and/or increase your symptoms.

Antidepressant withdrawal is real and cannabis cannot immediately replace any medication. Talk to your prescribing doctor. If they are not supportive of cannabis use, consider getting a second opinion but do not just stop taking your meds!

That said- As always, it best to discuss your treatment with a medical professional. It is, however, worth noting medical schools just started educating about the endocannabinoid system. Many healthcare providers are not well versed in medical cannabis treatment and/or may be associated with corporate systems that will not yet allow them to discuss this as an option. Don’t be afraid to ask if the provider you are scheduling with is knowledgeable and supportive of medicinal cannabis us.

originally published in thecalmcoolandcollected.com
January 2019

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