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How to Handle a Cannabis-Induced Panic Attack

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Cannabis doesn’t affect everyone in the same way, and even if you’re a seasoned consumer, you might not have the same reaction every time you use it.

Sometimes it might work exactly as you intended, whether you’re using it to ease mental health symptoms or stimulate your appetite. But other times, it may increase feelings of stress and anxiety, especially if you’re using a product high in tetrahydrocannabinol (THC)

Cannabis-induced anxiety might show up as a panic attack in some cases, which can result in:

  • sweating or shaking
  • a sudden feeling of doom you can’t explain
  • worries about others watching or judging you
  • racing heartbeat
  • trouble breathing
  • intense feelings of fear
  • chest pain or choking sensations
  • stomach pain or nausea
  • dizziness
  • numbness, tingling, or chills
  • a sense of detachment from reality or your body

It’s also common to worry about dying or losing control. Though these feelings can be frightening, they’re pretty normal with panic attacks.

The good news is, panic attacks don’t pose any significant danger. They also go away on their own, usually within 10 minutes or so. Of course, those 10 minutes might feel like an eternity when panic has you in its grip.

Here are some ways to find relief in the meantime.

Panic attacks can feel different for everyone, but it’s not unusual to wonder if you’re experiencing something serious, such as a heart attack or overdose, especially if you’ve never had a panic attack before.

The fear that happens with a panic attack is perfectly real. The threat, however, isn’t, and reminding yourself that the panic will pass can help you start to calm down.

You might certainly experience some unpleasant symptoms after ingesting too much cannabis, but this scenario isn’t life threatening (even if it feels that way).

Calming exercise

  • Sit down somewhere comfortable — the sofa, the floor, your favorite chair.
  • Close your eyes and take a deep breath.
  • Say, “I’m safe. I’m having a panic attack. I’ll feel better soon.”
  • Repeat this mantra, breathing slowly and naturally, until the feelings of panic begin to life.

Using cannabis on an empty stomach can intensify the effects of THC, leading to a more serious high than you expected.

There’s an easy fix, though: Grab a snack. Even if you weren’t all that hungry to begin with, a light meal can help counteract the effects of cannabis and soothe the panic.

Some evidence also suggests terpenes like limonene, found in lemons, can help ease the effects of THC. So if you have lemons on hand, zest and squeeze one into a glass of water. Add sugar or honey if you’re not a fan of the sour pucker.

If you don’t have lemons, check your cabinets. Another common source of terpenes is black pepper.

If you have whole peppercorns, chew on a couple. If you have a pepper shaker on hand, give it a careful whiff. Just make sure you don’t actually inhale it, as that will create an entirely different set of unwanted symptoms.

Hyperventilation, or very rapid breathing, often happens during a panic attack.

Breathing too quickly can prevent you from getting enough carbon dioxide, which can cause tingling in your extremities and make you feel dizzy or faint. These symptoms can alarm you and end up making the panic attack worse.

Slowing down your breathing can sometimes help you begin feeling better right away. If you have a go-to technique, it can’t hurt to give it a try.

If not, try the breathing exercises below to help yourself relax.

Simple deep breathing exercise

You’ll breathe with your mouth for this technique:

  • Get comfortable. It may help to sit or stand with your back against something supportive.
  • Slowly inhale for 3 to 4 seconds, paying attention to the sensation of your breath filling your lungs. Some people find it helpful to place a hand on their stomach and feel it expand with each breath.
  • Hold the breath for a second or two.
  • Slowly exhale for 3 to 4 seconds.
  • Continue until the lightheaded feeling passes and you can breathe more naturally on your own.

Alternate nostril breathing

This technique uses your nose, so you’ll want to keep your mouth closed:

  • Close one nostril.
  • Breathe in slowly through the other nostril for 2 to 4 seconds.
  • Hold that breath for 1 to 2 seconds, then slowly exhale. Do this twice.
  • Close the other nostril and repeat the process.
  • Continue switching sides and breathing through one nostril at a time until your breathing slows and you feel calmer.

OK, so you’re pretty sure you’re having a panic attack, but that knowledge doesn’t calm you down automatically. Your thoughts are spinning, your heart is racing, and you can’t catch your breath. You know you’re not dying, but you still feel awful.

While it’s sometimes a little challenging to stay present through overwhelming anxiety and panic, grounding techniques can help you step back from waves of fear and anchor yourself.

Here are a few exercises to get you started:

  • Run your hands under cold or warm water.
  • Touch or pick up the first three objects you see, one at a time. Your favorite blanket, a book, the TV remote — anything works. Run your fingers over the contours of the object and focus on its colors and sensations. Even simply holding something can offer a point of connection with reality.
  • Cuddle or stroke your pet.
  • Use the 5-4-3-2-1 technique to identify and list things around you: five sounds, four textures, three visible objects, two different scents, and one taste.

Cannabis is usually linked to feelings of relaxation, and things can sometimes backfire for a range of reasons. Here’s how to deal.

Marijuana and Anxiety: It’s Complicated

If you live with anxiety, you’ve probably come across some of the many claims surrounding the use of marijuana for anxiety symptoms.

Plenty of people consider marijuana helpful for anxiety. A 2017 national survey of more than 9,000 Americans found that 81 percent believed marijuana had one or more health benefits. Nearly half of these respondents listed “anxiety, stress, and depression relief” as one of these potential benefits.

But there also seems to be just as many people who say marijuana makes their anxiety worse.

So, what’s the truth? Is marijuana good or bad for anxiety? We’ve rounded up the research and talked to some therapists to get some answers.

Before getting into the ins and outs of marijuana and anxiety, it’s important to understand that marijuana contains two main active ingredients, THC and CBD.

  • THC is the psychoactive compound responsible for the “high” associated with marijuana.
  • CBD is the nonpsychoactive compound that’s used for a range of potential therapeutic purposes.

There’s no question that many people use marijuana for anxiety.

“Many clients I’ve worked with have reported using cannabis, including THC, CBD, or both, to reduce anxiety,” says Sarah Peace, a licensed counselor in Olympia, Washington.

Commonly reported benefits of marijuana use include:

  • increased sense of calm
  • improved relaxation
  • better sleep

Peace says her clients have reported these benefits along with others, including greater peace of mind and a reduction in symptoms they found unbearable.

Peace explains her clients have reported that marijuana in particular helps relieve symptoms of:

  • agoraphobia
  • social anxiety
  • post-traumatic stress disorder (PTSD), including flashbacks or trauma responses
  • panic disorder
  • phobias
  • sleep disruptions related to anxiety

What Peace sees in her practice is on par with most of the existing research around marijuana and anxiety.

A 2015 review supports CBD as a potentially helpful treatment for anxiety, particularly social anxiety. And there’s some evidence that THC may also help in low doses.

It’s not a full cure, though. Instead, most people report it helps reduce their overall distress.

“For example, someone might only have one panic attack a day instead of several. Or maybe they can go grocery shopping with high but manageable levels of anxiety, when before they couldn’t leave the house,” Peace explains.

While marijuana appears to help some people with anxiety, it has the opposite effect for others. Some simply don’t notice any effect, while others experience worsening symptoms.

What’s behind this discrepancy?

THC, the psychoactive compound in marijuana, seems to be a big factor. High levels of THC have been associated with increased anxiety symptoms, such as increased heart rate and racing thoughts.

In addition, marijuana doesn’t appear to offer the same long-term effects as other anxiety treatments, including psychotherapy or medication. Using marijuana may offer some much-needed temporary relief, but it’s not a long-term treatment option.

“I think, like any medicine, cannabis can provide support,” Peace says. “But without lifestyle changes or internal work on mental health, if your stressors or anxiety triggers remain, your anxiety will likely remain in some form.”

While marijuana might seem like a way to avoid the potential side effects associated with prescription medication, there are still some downsides to consider.

Negative side effects

  • increased heart rate
  • increased sweatiness
  • racing or looping thoughts
  • problems with concentration or short-term memory
  • irritability or other changes in mood
  • paranoia
  • hallucinations and other symptoms of psychosis
  • confusion, brain fog, or a “numb” state
  • decreased motivation
  • difficulty sleeping

Smoking risks

Smoking and vaping marijuana can lead to lung irritation and breathing problems in addition to increasing your risk for certain types of cancer.

Plus, vaping is linked to a recent increase in potentially life threatening lung injuries.

Dependence and addiction

Contrary to popular belief, both addiction and dependence are possible with marijuana.

Peace shares that some of her clients have a hard time finding a line between medical use and misuse with daily or regular cannabis use.

“Those who use it frequently to numb themselves or keep from caring about the things causing them stress also often report feeling like they are addicted to cannabis,” Peace says.

Legal status

When using marijuana, you’ll also need to consider the laws in your state. Marijuana is only currently legal for recreational use in 11 states as well as the District of Columbia. Many other states allow use of medical marijuana, but only in certain forms.

If marijuana isn’t legal in your state, you may face legal consequences, even if you’re using it to treat a medical condition, such as anxiety.

If you’re curious about trying marijuana for anxiety, there are a few things you can do to reduce your risk for it worsening your anxiety symptoms.

Consider these tips:

  • Go for CBD over THC. If you’re new to marijuana, start with a product that contains only CBD or a much higher ratio of CBD to THC. Remember, higher levels of THC are what tend to make anxiety symptoms worse.
  • Go slow. Start with a low dose. Give it plenty of time to work before using more.
  • Purchase marijuana from a dispensary. Trained staff can offer guidance based on the symptoms you’re looking to treat and help you find the right type of marijuana for your needs. When you buy from a dispensary, you also know you’re getting a legitimate product.
  • Know about interactions. Marijuana can interact with or reduce the effectiveness of prescription and over-the-counter medications, including vitamins and supplements. It’s best to let your healthcare provider know if you’re using marijuana. If you don’t feel comfortable doing this, you can also talk to a pharmacist.
  • Tell your therapist. If you’re working with a therapist, make sure to loop them in, too. They can help you evaluate how well it’s working for your symptoms and offer additional guidance.

Marijuana, particularly CBD and low levels of THC, shows possible benefit for temporarily reducing anxiety symptoms.

If you decide to try marijuana, keep in mind it does increase anxiety for some people. There’s really no way to know how it will affect you before you try it. It’s best to use it cautiously and stick to smaller doses.

Other nonmedical treatments can also help relieve anxiety symptoms. If you’re looking for alternative approaches to treatment, consider giving other self-care approaches a try, like:

It may take some trial and error, but with time you can find a treatment that works for you.

Crystal Raypole has previously worked as a writer and editor for GoodTherapy. Her fields of interest include Asian languages and literature, Japanese translation, cooking, natural sciences, sex positivity, and mental health. In particular, she’s committed to helping decrease stigma around mental health issues.

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