How CBD Helps With PTSD
By Yes.Life | 27 December 2019 | 6 min read
What is PTSD?
Post-Traumatic Stress Disorder (PTSD) is a disorder that tends to occur in people who have experienced traumatic events, either directly or even indirectly (such as from learning the details of a horrible trauma). Affecting an estimated 3.5% of United States adults at any given time, PTSD is also believed to affect 1 in every 11 persons at some point in life. PTSD is common among soldiers – those who have witnessed some of the worst atrocities imaginable – but can extend to ordinary civilians as well.
PTSD is mostly characterized by its symptoms. A person afflicted with PTSD tends to have intrusive thoughts of the incident; they might try to avoid reminders of the incident (including people, places, and activities that can trigger their memory), experience negative thoughts and feelings about themselves or the world around them in general, and they might be easily aroused by and reactive to what may seem like small, unrelated events or gestures such as being touched on the shoulder. PTSD is more involved than the above points suggest, but they are a good place to start. If you are interested in learning more about PTSD, further information about it can be learned here.
How Does CBD Affect PTSD?
Cannabidiol – or “CBD” – has been growing in popularity since its federal legalization in 2017. Recent studies and scientific research have found a surprisingly high number of benefits to CBD, and with very few side-effects as well.1 So what can CBD do for those specifically suffering PTSD?
CBD blocks aversive memory consolidation.2 Whenever we remember something, “replay” a memory in our heads, that memory is open to being rewritten – that is, reconsolidated. CBD has demonstrated the ability to block this reconsolidation for memories that are charged with strong emotions, especially negative ones.
Studies were first performed in rats, where conditioned responses were lost after the rats were given CBD. A “conditioned response” refers to one event – usually something painful like an electric shock, or something pleasurable like food – being paired with some other neutral event, like the sound of a whistle. In this experiment, the conditioned response that was lost after CBD administration was for an electric shock – the painful memory of being shocked was lost.2 The results were so positive that human trials were quickly performed, and sure enough, CBD helped in blocking aversive memories from being reformed.3
Memory & Reconsolidation: What is it?
What exactly is memory reconsolidation, and how does it work? To understand this, we’re going to dive into a little bit of how the brain itself works, specifically how it handles memories.
The brain is constantly perceiving the world around it. What amounts to our perception is a combination of neurons (brain cells) firing in our brain, simultaneously and in sequences. Different areas of the brain are specialized for different tasks and processes – one area is concerned with comprehending speech, while another is integral to us perceiving our bodies as our own. Every unique combination of our neurons firing gives us our unique perceptions of what’s going on. But this isn’t just how we perceive things happening right now: it’s how we perceive our memories of them later on.
When the brain “remembers” specific events, the very same neural pathways that fired during the original event fire again. Interestingly, while these pathways fire, they can make mistakes! Where these mistakes stem from could vary greatly, but the fact is that you aren’t guaranteed a perfect recreation of the event in your brain – your memory is fallible.
When you remember things, the memory is pulled out of long-term storage, played for you again amidst whatever else is going on, and then put back into long-term storage however it just finished playing. Whatever is going on while you remember has a chance of tainting the memory.4 5 If you – for example – think of a pink bunny while remembering how you changed your tire a few days ago, the memory could be rewritten involving a pink bunny. You won’t notice differences like these – they become as real as everything else.
In this way, fake memories can actually be imprinted onto people over time. By making people remember things again and again – while suggesting things that didn’t happen at the same time – the brain can mistakenly reconsolidate the real memory with those events that never occurred. A very famous case of this involving a psychiatrist convincing a woman that her father sexually abused her is just one example of this phenomenon.6
An important thing to note is that this process isn’t easy. In fact, it is usually a very slow process that goes under the radar (the example mentioned above took weeks upon weeks of the psychiatrist strongly pushing that her patient was abused). However, by taking advantage of brain chemistry and using certain drugs, the process can be quickened, and even guided. CBD can specifically help negative memories – traumatic ones – because it targets the emotional response associated with the memory. It helps lower the feelings of stress and anxiety so that the memory can be reconsolidated without those factors.
How does CBD Block Aversive Memory Reconsolidation?
The mechanisms of how CBD helps block aversive memories are still not fully understood, although several theories exist. The first involves a basic function of CBD – its ability to boost the body’s own natural amounts of cannabinoid. The cannabinoid anandamide – produced after running or during meditation – is believed to play a role in blocking aversive memories. Anandamide is most active in the brain, where it modulates a great deal of activity via the CB1 cell receptor. It has been found that individuals with a less active endocannabinoid system (less CB1 and/or anandamide) generally have higher stress responses.2
Another proposed way CBD aids in PTSD may be via interactions with serotonin transmission in the brain. One particular receptor CBD may interact with is 5-HT1A. Studies suggested that CBD’s interaction with this receptor reduced general stress and anxiety, while also “reducing the expression of contextual fear conditioning.”7 In layman’s terms, this means the emotional part of the memory was suppressed – and if it is suppressed while the memory is actively engaged, the brain can rewrite things without the intense emotion.
Importantly, CBD’s use in aiding PTSD was done in controlled experiments using professionals. Because the possible method of aiding PTSD focused on herein involves recalling the difficult memories, it is strongly advised that the use of CBD in this way is done only under the care of mental health professionals. Speak to such a professional and inquire if they would be open to your use of CBD during sessions. If your mental health professional is concerned about the use of chemicals like THC, consider using THC-free “Broad Spectrum” CBD products. Do not attempt to face painful or traumatic memories alone, nor without the guidance and care of a health professional present. People are there to help, and things can get better.
Other Benefits of CBD for PTSD
PTSD involves numerous symptoms that CBD can possibly help. Anti-anxiety and anti-depressant qualities are two of CBD’s most touted benefits.8 9 10 While these effects don’t necessarily get to the heart of what’s causing the PTSD, they can still help alleviate some of the difficulty associated with it.
CBD performs its anti-anxiety and anti-depressant effects indirectly, via the boost in your body’s natural anandamide levels.11 Previously, it was believed that endorphins brought about the famous “runner’s high,” but in fact, it is anandamide that does it.12 Anandamide acts in the brain by modulating and stabilizing certain messages between neurons. Specifically, anandamide suppresses the amounts of GABA and glutamate between your brain cells, which is strongly implicated in emotional wellbeing.13 14 It may even be part of CBD’s anti-convulsant effect – it’s the ability to stop seizures.15
Safety of CBD for Soldiers and Veterans
CBD is commonly associated with marijuana, which is strictly forbidden under federal law. So, just how safe is it to use CBD as a soldier or even a veteran? This can vary.
First and foremost, the official stance of the Department of Veteran’s Affairs states that the VA clinicians are only allowed to provide drugs for medical use which have been approved by the FDA.16 CBD and THC have not been approved, nor have any other general cannabinoids. Do not expect the VA to provide support for CBD use.
What about the actual safety of CBD for drug-testing? Many CBD products are “Full Spectrum,” meaning they contain up to 0.3% THC by dry weight.17 According to an FAQ provided by the navy, all military drug testing is subjected to THC-detection, but not general cannabinoid detection.18 This means that while a Full Spectrum CBD product is not safe for military personnel, a Broad Spectrum – which has all THC filtered out – is.
To be extra safe, always contact the manufacturer to make sure that the product you have is in fact free of THC. While federal law allows hemp products to legally contain up to 0.3%, the lack of FDA regulation has led to many manufacturer’s falsely labeling a Full Spectrum product as “THC-Free,” despite the presence of up to 0.3% THC.
Also, keep in mind that THC can remain inside the body for up to 25 days. [19] Even if you are using a Broad Spectrum CBD, any previous THC use can be detected in military drug tests, and cause a positive result to come back. Don’t mistakenly blame a Broad Spectrum CBD product if you have used THC sometime before in the last three months!
Further Resources for PTSD
For you or a loved one suffering from PTSD, CBD isn’t the only answer. There are plenty of other resources out there to be used to help cope with and treat PTSD. Some of these involve therapy while others involve medication. If you or your loved one wants to find additional help, check with your local V.A. for further support. Here are just a few ways you might consider moving forward.
Trauma-Focused Psychotherapies come in a variety of forms. Cognitive Processing Therapy (CPT) involves confronting the traumas associated with PTSD while cognitive techniques are employed to helped change the way the brain is processing and thinking about the traumatic memories.20 Prolonged Exposure therapy is a form of CPT geared towards helping patients gradually confront their traumas both in the safety of the therapist’s room and outside therapy.21 Finally, there is Eye Movement Desensitization and Reprocessing (EMDR) therapy, which is similar in principle to what is described in the article for aiming at reshaping the memories associated with trauma by targeting elements like the emotions that come with the memories.22 If you are interested in these treatments, check with your local V.A. to find a professional now.
There are also two types of drugs that are commonly used to help combat the symptoms of PTSD: SSRIs and SNRIs. While the V.A. does not consider these drugs to work as well as therapy treatment, they can help combat certain elements of PTSD by putting brain messenger chemicals – called “neurotransmitter” – back in balance.23 These drugs act as anti-depressants, and will require a prescription to access. If you are interested, talk to your health or mental health professional about getting ahold of some.
Despite how lonely PTSD can be, there are many people who want to help, and treatments exist. CBD does provide some interesting potential as a means of treating PTSD, but only in the right circumstances. Whether you choose to acquire CBD or not, psychotherapies can certainly provide relief for PTSD symptoms and ultimately help treat it. If you are interested in trying CBD, find a mental health professional who is open to the idea, and give it a shot.
References:
1 Iffland, Kerstin, and Franjo Grotenhermen. “An Update on Safety and Side Effects of Cannabidiol: A Review of Clinical Data and Relevant Animal Studies.” Cannabis and Cannabinoid Research 2, no. 1 (2017): 139–54. https://doi.org/10.1089/can.2016.0034.https://doi.org/10.2174/1871527313666140612114838.
2 Bitencourt, Rafael M., and Reinaldo N. Takahashi. “Cannabidiol as a Therapeutic Alternative for Post-Traumatic Stress Disorder: From Bench Research to Confirmation in Human Trials.” Frontiers in Neuroscience 12 (2018). https://doi.org/10.3389/fnins.2018.00502.
3 Das, Ravi K., et al. “Cannabidiol Enhances Consolidation of Explicit Fear Extinction in Humans.” Psychopharmacology 226, no. 4 (October 2013): 781–92. https://doi.org/10.1007/s00213-012-2955-y.
4 Goldstein, E. Bruce. “Long-Term Memory.” Cognitive Psychology: Connecting Mind, Research, and Everyday Experience, 4th Edition, Cengage Learning, 2015, pp. 198-201.
5 Goldstein, E. Bruce. “Everyday Memory and Memory Errors.” Cognitive Psychology: Connecting Mind, Research, and Everyday Experience, 4th Edition, Cengage Learning, 2015, pp. 227-239.
6 La Ganga, Maria L. “Father Wins Suit in 'False Memory' Case.” Los Angeles Times, 14 May 1994.
7 Gomes, Felipe V, et al. “Cannabidiol Injected into the Bed Nucleus of the Stria Terminalis Reduces the Expression of Contextual Fear Conditioning via 5-HT1Areceptors.” Journal of Psychopharmacology 26, no. 1 (August 2010): 104–13. https://doi.org/10.1177/0269881110389095.
8 Schier, Alexandre, et al. “Antidepressant-Like and Anxiolytic-Like Effects of Cannabidiol: A Chemical Compound of Cannabis Sativa.” CNS & Neurological Disorders - Drug Targets 13, no. 6 (December 2014): 953–60. https://doi.org/10.2174/1871527313666140612114838.
9 Peres, Fernanda F., et al. “Cannabidiol as a Promising Strategy to Treat and Prevent Movement Disorders?” Frontiers in Pharmacology 9 (November 2018). https://doi.org/10.3389/fphar.2018.00482.
10 Nagarkatti, Prakash, et al. “Cannabinoids as Novel Anti-Inflammatory Drugs.” Future Medicinal Chemistry 1, no. 7 (2009) pp. 1333–1349., doi:10.4155/fmc.09.93.
11 Leweke, F M, et al. “Cannabidiol Enhances Anandamide Signaling and Alleviates Psychotic Symptoms of Schizophrenia.” Translational Psychiatry 2, no. 3 (2012). https://doi.org/10.1038/tp.2012.15.
12 Fuss, Johannes, et al. “A Runner’s High Depends on Cannabinoid Receptors in Mice.” Proceedings of the National Academy of Sciences 112, no. 42 (2015) pp. 13105–13108., doi:10.1073/pnas.1514996112.
13 Luscher, B, et al. “The GABAergic Deficit Hypothesis of Major Depressive Disorder.” Molecular Psychiatry 16, no. 4 (2010) pp. 383–406., doi:10.1038/mp.2010.120.
14 Jun, Chansoo, et al. “Disturbance of the Glutamatergic System in Mood Disorders.” Experimental Neurobiology 23, no. 1 (2014) p. 28., doi:10.5607/en.2014.23.1.28.
15 Perucca, Emilio. “Cannabinoids in the Treatment of Epilepsy: Hard Evidence at Last?” Journal of Epilepsy Research 7, no. 2 (2017) pp. 61–76., doi:10.14581/jer.17012.
16 US Department of Veterans Affairs, and Veterans Health Administration. “Public Health.” VA and Marijuana – What Veterans Need to Know - Public Health, 9 Feb. 2017, www.publichealth.va.gov/marijuana.asp.
17 Petrocellis, Luciano De, et al. “Effects of cannabinoids and Cannabinoid-Enriched Cannabis extracts on TRP Channels and endocannabinoid Metabolic Enzymes.” British Journal of Pharmacology 163, no. 7 (2011) pp. 1479–1494., doi:10.1111/j.1476-5381.2010.01166.x.
18 “Drug Testing FAQs.” Navy Medicine, https://www.med.navy.mil/sites/nmcphc/Documents/navy-drug-screening-labs/drug-testing-faqs.doc
19 Sharma, Priyamvada, et al. “Chemistry,Metabolism, and Toxicology of Cannabis: Clinical Implications.” Iranian Journal of Psychiatry, Tehran University of Medical Sciences 2012, www.ncbi.nlm.nih.gov/pmc/articles/PMC3570572/.
20 “Cognitive Processing Therapy (CPT).” American Psychological Association, American Psychological Association, www.apa.org/ptsd-guideline/treatments/cognitive-processing-therapy.
21 “Prolonged Exposure (PE).” American Psychological Association, American Psychological Association, www.apa.org/ptsd-guideline/treatments/prolonged-exposure.
22 “Eye Movement Desensitization and Reprocessing (EMDR) Therapy.” American Psychological Association, American Psychological Association, www.apa.org/ptsd-guideline/treatments/eye-movement-reprocessing.
23 “Mental Health.” PTSD: Treatment - Mental Health, 22 Apr. 2009, www.mentalhealth.va.gov/ptsd/treatment.asp.
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