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Depression and Mood Disorders

Clinical depression is a serious mood disorder characterized by persistent sadness and loss of interest, sometimes leading to decreased appetite and energy and suicidal thoughts. Commonly used pharmaceuticals for depression often target serotonin, a chemical messenger that is believed to act as a mood stabilizer. The neural network of the endocannabinoid system works similarly to the way that serotonin, dopamine, and other systems do, and, according to some research, cannabinoids have an effect on serotonin levels. Whereas a low dose of THC increases serotonin, high doses cause a decrease that could worsen the condition.[312] In 2009 researchers concluded that there was substantial evidence pointing to endocannabinoid signaling as a target for the pharmacotherapy of depression.[313] Authors of a 2016 study wrote that “CBD could represent a novel fast antidepressant drug, via enhancing both serotonergic and glutamate cortical signaling through a 5-HT1A receptor-dependent mechanism.”[314]

CBD might especially be effective for depression related to chronic stress, which has been shown to cause a decrease in endocannabinoid levels.[315,316]

How to Take the Medicine: Dosage and Delivery

It is suggested that patients work with a health care practitioner experienced in recommending cannabidiol or medicinal cannabis so that dosage and delivery methods can be developed and fine-tuned on an individual basis. At the same time, educated and aware patients can be their own highly informed health consultants.

CBD products with a ratio of 20:1 or higher are recommended and administered as drops, capsules, or edibles. Specifically, products made with Valentine X or Electra 4 are more energizing, helping relieve depression. When low energy is an issue, sativa or other stimulating strains can be helpful for improving energy and focus when THC can be tolerated. Varieties that are high in the terpene limonene are recommended for mood elevation.

Always start with the micro dose to test sensitivity and go up as needed within the dosing range before going to the next, until symptoms subside. The micro to standard dose is usually recommended to treat depression. Vaporized or smoked cannabis is recommended for relief of immediate symptoms, or a boost in dosage, and it can also be useful for sleep issues. Sublingual sprays or tinctures taken as liquid drops take effect quickly and last longer than inhaled products.

Effectiveness: Current Science—CBD Benefits for Depression

The Cannabis Health Index (CHI) is an evidence-based scoring system for cannabis (in general, not just CBD effects) and its effectiveness on various health issues based on currently available research data. Refer to cannabishealthindex.com for updated information. Using this rubric and based on twenty-one studies, cannabis rated in the possible-to-probable range of efficacy for treatment of depression.

Research in 2005 called for clinical trials to look into the effectiveness of cannabinoids for bipolar disorder (manic depression).[317] In 2010, a study suggested that CBD was not useful for the manic episodes associated with bipolar disorder.[318] However, for depressive episodes, the evidence points to greater potential for effectiveness.[319]

Authors of a 2013 review of animal studies wrote that CBD showed antianxiety and antidepressant effects in several models and suggested that the compound worked by interacting with the 5-HT1A neuroreceptor.[320]

“It is important to remember that CBD benefits and improves the activity in the endocannabinoid system by increasing the time anandamide works on the CB1 and CB2 receptors,” writes Dr. Michael Moskowitz. “Anandamide works on the serotonin, norepinephrine, and dopamine systems. It also works on the GABA-glutamate system and the hypothalamic-pituitary-adrenal axis. Its main role is restoring balance through inhibition when levels are too high and enhancement when they are too low. This is the most likely reason phytocannabinoids in general and CBD specifically are able to regulate depression and anxiety.”[321]