Could Habits to Improve Mental Health Include Cannabis Consumption?

Could habits to improve mental health include cannabis consumption? 

To begin with, researchers investigating the association between mental health conditions and a dysfunctional endocannabinoid system would tend to agree. Researchers have uncovered that the endocannabinoid system is critical in the regulation of emotion and stress. Further, there is an association between certain mental health conditions and sub-optimal levels of endocannabinoids.^[1]Marco, E. M., & Viveros, M. P. (2009). The critical role of the endocannabinoid system in emotional homeostasis: avoiding excess and deficiencies. Mini Reviews in Medicinal Chemistry, 9(12), … Continue reading This lends to the idea that consuming cannabis to bring the endocannabinoid system back to homeostasis may be an effective solution. Habits to improve mental health could then include cannabis consumption. However, the research is still ongoing.

Further, the preliminary research suggests that a well-regulated endocannabinoid system is important for mental health. Many people have heard of a link between mental health disorders and chemical imbalances in the brain. This hypothesis has been referred to as the chemical imbalance theory (or chemical imbalance hypothesis). Although refuted by some health professionals due to the oversimplification of the problem, there is no doubt that chemical imbalances play a major role.

Endocannabinoid System Deficiencies in Mental Health Conditions

There are three main components to the endocannabinoid system: endocannabinoids, cannabinoid receptors, and metabolizing cannabinoid enzymes. Each of these components are critical to the overall functioning of the endocannabinoid system. Too much production, and conversely, a lack of degradation, can throw the endocannabinoid system out of balance and lead to undesirable physiological effects. In a recent review published in Biochemical Pharmacology (2018), the researchers reviewed studies that examined alterations to these critical endocannabinoid system components across major mental health disorders. Specifically, they focussed on depression, anxiety, and schizophrenia. Their findings highlight that each of these major mental health disorders is in some way connected to endocannabinoid dysregulation.^[2]Ibarra-Lecue, I., Pilar-Cuéllar, F., Muguruza, C., Florensa-Zanuy, E., Díaz, Á., Urigüen, L., … & Callado, L. F. (2018). The endocannabinoid system in mental disorders: Evidence from … Continue reading

Endocannabinoid Levels and Depression

In a study published in Pharmacopsychiatry (2008), the researchers examined the levels of anandamide and 2-AG in serum from medication-free female patients diagnosed with major or minor depression.  Next, they looked at control participants matched for demographic statistics. The researchers found that 2-AG concentrations were significantly lower in patients with major depression. Moreover, they also negatively correlated with the duration of the depressive episode. For those subjects with minor depression, anandamide levels were significantly elevated, and 2-AG demonstrated a similar pattern.^[3]Hill, M. N., Miller, G. E., Ho, W. S., Gorzalka, B. B., & Hillard, C. J. (2008). Serum endocannabinoid content is altered in females with depressive disorders: a preliminary report. … Continue reading

Similar findings were found in a study published in Neuropsychoendocrinology (2009). In this case, the researchers found that in women with major depression, serum concentrations of anandamide and 2-AG were significantly reduced when compared to matched controls.^[4]Hill, M. N., Miller, G. E., Carrier, E. J., Gorzalka, B. B., & Hillard, C. J. (2009). Circulating endocannabinoids and N-acyl ethanolamines are differentially regulated in major depression and … Continue reading

Metabolizing Endocannabinoid Enzymes and Anxiety 

In this case study published in European Neuropsychopharmacology (2016), the researchers explored the effect of genetically reduced fatty acid amide hydrolase (FAAH) on the development of anxiety and depression. They looked at participants who experienced repeat childhood trauma. FAAH is an enzyme responsible for breaking down anandamide. With reduced FAAH levels, there will be an abundance of anandamide in the system. They realized that this may lead to desensitization of the CB1 receptor, and increased neural signaling.^[5]Lazary, J., Eszlari, N., Juhasz, G., & Bagdy, G. (2016). Genetically reduced FAAH activity may be a risk for the development of anxiety and depression in persons with repetitive childhood trauma. … Continue reading

Subsequently, the researchers concluded that genetically reduced FAAH activity and repeated stress in the developing years could lead to a higher risk of anxiety and depression later in life. Elevated anandamide combined with early life stress could cause a dysfunctional stress response through CB1 receptor downregulation during neurodevelopment in the brain. This is just one example of how the endocannabinoid commonly referred to as the ‘bliss’ molecule can actually have negative effects on the body when it is not properly controlling production and degradation.

Cannabinoid Receptors and Schizophrenia

Two studies, one published in 2010, and the other in 2013, and both in Neuroimage, found that there is a generalized increase in CB1 receptor density (binding potential) in the majority of brain regions when comparing schizophrenia patients to healthy controls.^[6]Wong, D. F., Kuwabara, H., Horti, A. G., Raymont, V., Brasic, J., Guevara, M., … & Rahmim, A. (2010). Quantification of cerebral cannabinoid receptors subtype 1 (CB1) in healthy subjects … Continue reading ^[7]Ceccarini, J., De Hert, M., Van Winkel, R., Peuskens, J., Bormans, G., Kranaster, L., … & Van Laere, K. (2013). Increased ventral striatal CB1 receptor binding is related to negative … Continue reading

Additionally, CB1 receptor binding in some brain regions correlated with the severity of positive symptoms and inversely correlated with the severity of negative symptoms. However, another study published in Biological Psychiatry (2016), reported opposite findings. These researchers found a significant decrease in CB1 receptor availability when comparing schizophrenia patients to healthy controls.^[8]Ranganathan, M., Skosnik, P. D., & D’Souza, D. C. (2016). Marijuana and madness: associations between cannabinoids and psychosis. Biological Psychiatry, 79(7), 511-513.

Cannabis and Mental Health – Evidence of Effectiveness

The previously mentioned scientific studies highlight the many moving parts of the endocannabinoid system, and the associations between it and the development of mental health disorders. So, what does it all mean? Can we treat these mental health conditions with some sort of cannabinoid therapy? Although undoubtedly many people would say that they are currently managing a mental health disorder with cannabis, there are a limited number of studies demonstrating a positive effect.

At the same time, a recent systematic review included only six randomized controlled trials investigating the effect of CBD on anxiety, a hot topic in current cannabis trends. Although the authors found a consistently positive effect across studies, each study included a small number of participants, ranging from ten to fifty-nine.^[9]Skelley, J. W., Deas, C. M., Curren, Z., & Ennis, J. (2019). Use of cannabidiol in anxiety and anxiety-related disorders. Journal of the American Pharmacists Association.

Further, there are reports of links between cannabis consumption and worsening symptoms of depression and schizophrenia. The available evidence suggests that restoring balance to the endocannabinoid system in mental health sufferers could be important, but important details like dosages, routes of administration, and how to select the correct cannabinoid profile, remain unclear. Larger and longer randomized controlled trials are the only way to get the answers.

Can Personal Habits to Improve Mental Health Include Cannabis Consumption?

To sum up, those people who are currently consuming cannabis to manage a mental health disorder should feel comfortable continuing to do so. Cannabis maintained its attractive safety profile during these tests. However, the consultation of a health professional should accompany all decisions regarding mental health treatment. Consequently, personal habits to improve mental health can include cannabis consumption. However, cannabis should not be used independent of other mental health coping strategies, such as exercise or a healthy diet.