Cannabis and Bipolar Disorder
How Cannabis affects those with Bipolar Disorder
Researchers and studies are showing conflicted relationship
between cannabis and bipolar disorder. Some studies show that cannabis can
induce the psychotic disease. Patients who are bipolar sear that cannabis helps
them to manage their disorder. So, who is right? Well after doing much research
I would have to believe they both are right! While some of the population of
those with bipolar disorder may be consuming small amounts of cannabis daily
(micro-dosing), have found this herb to be therapeutic in helping with their
anxiety, and depression, others in the bipolar population are finding that the THC
found in cannabis is causing them to have psychotic episodes. They find that it
either increases their episodes of mania or they may feel depressed for days
after consuming cannabis. So is cannabis a good therapeutic treatment for
people with bipolar disorder, or will it do more harm than good? I guess that
depends on each individual patient and how much, or how often, they are
consuming THC.
“Recent advances in cannabinoid receptors and endogenous
ligands have renewed interest in the mechanisms by which cannabis can cause
major psychiatric disorders. It is now recognized that the endocannabinoid
system represents a new signaling process in the nervous system that regulates
neurotransmitter systems, energy metabolism, and immune function. Researchers
now believe that cannabis consumption during critical phases of brain
development can lead to a strong disturbance of the endocannabinoid system and
ultimately cause an inappropriate hardwiring of the brain. Cannabis may play a
role in the complex interactions involving dopamine, gamma aminobutyric acid
(GABA), and glutamate transmission or other factors that cause psychotic
disorders. However, the question remains as to why, in a general population of
cannabis abusers, do only a small population exposed develop a psychiatric
illness.” - Masood A. Khan, MD and
Sailaja Akella, OMS-IV.
There is much more research that needs to be done in order
for us to understand how cannabis affects people differently. This post may
seem conflicting, it is not For nor Against cannabis use in people with
bipolar, but more like trying to pin-point the cause and effect of cannabinoids
in the brain. Also, not all brains and endocannabinoid systems are alike.
Cannabis affects each individual differently. For those with bipolar, it may or
may not help.
The best thing to do is some research and to find a trusted
medical professional to talk to who can evaluate each individual’s reaction to
certain cannabinoids such as THC and CBD. Cannabis is not for everyone, and it
may not be right for you if you are experiencing major psychotic episodes while
consuming a high amount of THC. Some Doctors have suggested taking a
combination of CBD and THC and taking several small doses throughout the day. However,
since each individual is different in their experience, it is best to seek
consultation with a trusted medical professional.
In this post we’ll pull up some research, videos, and find
some groups to connect with. Talking to other people who also have bipolar can
help in trying to find relief from this disorder. All references and links are
posted at the bottom of this page. If you are looking for more information,
feel free to browse those links.
Studies show the effects Cannabis has on those with Bipolar Disorder
Cannabinoids in bipolar affective disorder: a review and
discussion of their therapeutic potential.
“Bipolar affective disorder is often poorly controlled by
prescribed drugs. Cannabis use is common in patients with this disorder and
anecdotal reports suggest that some patients take it to alleviate symptoms of
both mania and depression. We undertook a literature review of cannabis use by
patients with bipolar disorder and of the neuropharmacological properties of
cannabinoids suggesting possible therapeutic effects in this condition. No
systematic studies of cannabinoids in bipolar disorder were found to exist,
although some patients claim that cannabis relieves symptoms of mania and/or
depression. The cannabinoids Delta(9)-tetrahydrocannabinol (THC) and
cannabidiol (CBD) may exert sedative, hypnotic, anxiolytic, antidepressant,
antipsychotic and anticonvulsant effects. Pure synthetic cannabinoids, such as
dronabinol and nabilone and specific plant extracts containing THC, CBD, or a
mixture of the two in known concentrations, are available and can be delivered
sublingually. Controlled trials of these cannabinoids as adjunctive medication
in bipolar disorder are now indicated.”
Cannabidiol was ineffective for manic episode of bipolar
affective disorder.
“The pharmacological profile of cannabidiol (CBD) has
several characteristics in common with drugs known to benefit bipolar affective
disorder (BAD), leading to the hypothesis that CBD may have therapeutic
properties in BAD. Therefore, the aim of the present report was to directly
investigate for the first time the efficacy and safety of CBD in two patients
with BAD. Both patients met DSM IV criteria for bipolar I disorder experiencing
a manic episode without comorbid conditions. This was an inpatient study, and
the efficacy, tolerability and side effects were assessed. Both patients
received placebo for the initial 5 days and CBD from the 6th to 30th day
(initial oral dose of 600 mg reaching 1200 mg/ day). From the 6th to the 20th
day, the first patient (a 34-year-old woman) received adjunctive olanzapine
(oral dose of 10-15 mg). On day 31, CBD treatment was discontinued and replaced
by placebo for 5 days. The first patient showed symptoms improvement while on
olanzapine plus CBD, but showed no additional improvement during CBD
monotherapy. The second patient (a 36-year-old woman) had no symptoms
improvement with any dose of CBD during the trial. Both patients tolerated CBD
very well and no side-effects were reported. These preliminary data suggest
that CBD may not be effective for the manic episode of BAD.”
Cannabis-Induced
Bipolar Disorder with Psychotic Features
“There has been considerable debate regarding the causal
relationship between chronic cannabis abuse and psychiatric disorders.
Clinicians agree that cannabis use can cause acute adverse mental effects that
mimic psychiatric disorders, such as schizophrenia and bipolar disorder.
Although there is good evidence to support this, the connections are complex
and not fully understood.
As the research in the endocannabinoid system is emerging,
the neurobiological effects of cannabis are being evaluated in the development
of psychiatric illness for those individuals who may be genetically vulnerable.
Here we present a case of a college student who initially suffered from an
acute psychotic breakdown secondary to cannabis abuse that manifested into
bipolar disorder with psychosis.
Epidemiological studies have shown that as the frequency of
cannabis abuse increases, so does the risk for a psychotic disorder such as
schizophrenia.1
Studies have also shown that cannabis is the most commonly abused drug among
those diagnosed with bipolar disorder. Looking at the pharmacokinetics of the
psychoactive agent ∆9-tetrahydrocannabinol (∆9-THC), its effects are
perceptible within minutes. ∆9-THC is extremely lipid soluble and can
accumulate in fatty tissues reaching peak concentrations in 4 to 5 days. It is
then slowly released back into the body, including the brain, reaching high
concentrations in the neocortical, limbic, sensory, and motor areas. The tissue
elimination half-life of ∆9-THC is about seven days, and absolute elimination
of a single dose may take up to 30 days. Interestingly enough, the plasma
levels of ∆9-THC poorly correlate with urine levels, making the urine
toxicology screen a wholly unspecific test.
Cannabis intoxication can lead to acute psychosis in many
individuals and can produce short-term exacerbations of pre-existing psychotic
diseases. Cannabis use also causes symptoms of depersonalization, fear of
dying, irrational panic, and paranoid ideas, which coincide with acute
intoxication and remitted quickly. In one survey, it was reported that 15
percent of cannabis users identified psychotic-like symptoms, the most common
being hearing voices or having unwarranted feelings of persecution. What
research has failed to show is if cannabis use is a consequence or cause of
psychiatric disorders. Based on research reviews, looking at the connection
between cannabis and psychosis, two hypotheses have been developed. The first
hypothesis is that cannabis use causes psychotic symptoms in an otherwise
healthy individual that would not have occurred with abstinence. The second
hypothesis is that cannabis use may precipitate psychosis in individuals who
are predisposed to acquiring a psychotic disorder. Only two case studies have
reported prolonged depersonalization after cessation of cannabis use. Symptoms
experienced during drug-free periods are rarely reported.7
The role of cannabis in causing bipolar disorder is not well
documented. Epidemiological studies have shown that bipolar disorder has the
highest rate of substance abuse comorbidity of any axis I disorder. The
Epidemiologic Catchment Area (ECA) study found that 41 percent of patients with
bipolar disorder had a comorbid substance use with cannabis being the most
frequently abused. Cannabis abuse prior to development of bipolar disorder has
a significant effect on first-episode mania and on the course of the disease.
Another study reported that using cannabis at baseline can significantly
increase the risk for manic symptoms during follow up.”
To follow the study click on this link: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2811144/
How Cannabis Use affects people with Bipolar Disorder
Around 2% of the UK population has Bipolar Disorder, with up
to 60% using cannabis at some point in their lives, but research in this area
is limited and reasons for high levels of use are unclear.
Dr. Elizabeth Tyler of the Spectrum Centre for Mental Health
Research at Lancaster University led the study published in PLOS ONE with
Professor Steven Jones and colleagues from the University of Manchester,
Professor Christine Barrowclough, Nancy Black and Lesley-Anne Carter.
She said: "One theory that is used to explain high
levels of drug use is that people use cannabis to self-medicate their symptoms
of bipolar disorder. " The study looked at people diagnosed with bipolar
disorder but who were not experiencing a depressive or manic episode during the
six days the research was carried out.
Each participant completed a paper diary about their
emotional state and drug use at several random points daily over a period of
week. This enabled people to log their daily experiences in the moment before
they forgot how they were feeling.
An individual with experience of bipolar disorder and
cannabis use commented: "I do smoke a small amount to lift my mood and
make myself slightly manic but it also lifts my mood and switches me into a
different mind-set."
"I do not use weed to manage depression as it can make
it worse, making me anxious and paranoid."
"I have found though that if I have smoked more
excessively it can make me feel depressed for days afterwards."
The study found that the odds of using cannabis increased
when individuals were in a good mood. Cannabis use was also associated with an
increase in positive mood, manic symptoms and paradoxically an increase in
depressive symptoms, but not in the same individuals.
Dr. Tyler said: "The findings suggest that cannabis is
not being used to self-medicate small changes in symptoms within the context of
daily life. However, cannabis use itself may be associated with both positive
and negative emotional states. We need to find out whether these relationships
play out in the longer term as this may have an impact on a person's course of
bipolar disorder."
Lancaster
University. "How cannabis use affects people with Bipolar Disorder."
ScienceDaily. ScienceDaily, 13 March 2015.
<www.sciencedaily.com/releases/2015/03/150313130855.htm>.
Cannabis Dosing Guidelines
Dosing guidelines should be done by a trusted medical doctor
who understands bipolar disorder and how cannabis helps. A high CBD product is likely the safest to experiment with to balance mood. It may be more
beneficial to find a cannabis medicine tincture that has a heavier CBD amount and a light THC amount,
such as something with a combination of CBD and THC of 1:1 or less, a 10:1
meaning 10x the amount of CBD-THC. CBD dosage for anxiety ranges between 2.5 and 10 mg. CBD has been tolerated very well in high doses. It’s possible high amounts of THC, as well as synthetic cannabinoids, can cause psychotic-like
symptoms.
Some may find CBD alone to be more beneficial. Orally taking
a few drops of oil under the tongue, when needed, may be the best route. But
again, TALK TO A TRUSTED MEDICAL PROFESSIONAL! Find the dosing that works best
for you and once you found it don’t change it. Cannabis is not for everyone, it
may not be right for you to help with extreme episodes of mania or depression.
It’s best to weigh the side effects and benefits from cannabis use. Do the
benefits outweigh the side effects?
Videos about Cannabis and Bipolar Disorder
Paul Bregman, MD – Bipolar Cannabis Patient https://www.youtube.com/watch?v=6hRNVwUI7t8
Dr. Bregman talks about how marijuana helps his bipolar
depression type 2.
Cannabis and Bipolar Disorder: What do we need to know? What
do we still need to learn?
How to treat bipolar disorder & manic depression
naturally https://www.youtube.com/watch?v=pZhLPOxtnzQ
John Gray talks in this video about other natural ways to
help your bipolar disorder.
He doesn’t talk about cannabis, usually I wouldn’t mention
this information outside of the subject of cannabis and bipolar, but I feel
there isn’t enough evidence for cannabis and bipolar, so I am deciding to add
this one… or two…
I am no longer bipolar and I solved my own issues without
medication
Pam Wright is so funny, and she brings up good points, if
your interested in watching this 5 minute one.
Find Help and Connect with Others
You can find others who are struggling with Bipolar Disorder
and how cannabis has affected them. Some groups worth looking are:
I am a personal fan of Julie A. Fast and what she is
contributing to the Bipolar Community. She offers workshops, as well as one-on-one
help. She understands cannabis and bipolar, if you are considering that option
I highly recommend you connect with her.
Julie Fast is a world leading mental health expert on
Bipolar, depression and mood disorders. Find more information, management plan,
books, family coaching and workshops: http://www.bipolarhappens.com/bipolar_cannabis_workshop/
Check out this 4 minute video about her class. https://www.youtube.com/watch?v=rAqHHqSKGKs
If you want to try cannabis but do not have a trusted doctor
to talk to, reach out to Julie Fast, mentioned above. Reach out to one of the FaceBook
pages and find other patients who can recommend talking to someone they like. Try
doing an online search to find a trusted medical professional who can evaluate
you.
There is too much research showing that cannabis may worsen
the episodes caused by bipolar. There are too many studies showing that
cannabis use may be the cause of psychotic episodes when younger people with
developing brains are using, or abusing, cannabis at an early age. However, at
the same time there are tons of people coming out and saying they use cannabis
to treat their bipolar disorder and it is working for them. I also believe
there is a huge difference between younger adults using cannabis versus older
adults using cannabis.
I hope any information found on this page as well as the
links can help you to understand the role of cannabis, and the endocannabinoid
systems in the brain of someone with bipolar disorder. I regret that I cannot
find helpful information with cannabis use, but these posts are about bringing
to the people the research.
If you have bipolar or know someone who does, feel free to
leave a comment letting us know specifically how you use cannabis to help you,
and how you take it. Also, if you know of more useful information regarding
cannabis and bipolar disorder, feel free to leave that info in the comments
section as well.
One last thing, if trying cannabis for the first time, take
EXTREME CAUTION when combining it with anti-psychotic drugs and/or alcohol!
Resources:
https://www.youtube.com/watch?v=6hRNVwUI7t8
https://www.healthline.com/health/bipolar-disorder/marijuana-and-bipolar#symptoms
The book CANNABIS PHARMACY, The Practical Guide to Medical Marijuana. By Michael Backes, Foreword by Andrew Weil, M.D., and Jack D. McCue, M.D.
https://www.healthline.com/health/bipolar-disorder/marijuana-and-bipolar#symptoms
The book CANNABIS PHARMACY, The Practical Guide to Medical Marijuana. By Michael Backes, Foreword by Andrew Weil, M.D., and Jack D. McCue, M.D.
