Can Marijuana Help Your Bipolar Disorder?
Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital.
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Award-winning mental health journalist and author, John McManamy, wrote a thoughtful blog about the implications of medical marijuana as a treatment for bipolar. It’s reasonable to think that the risks outweigh any possible benefits, but the topic is certainly worth discussing.
Since both bipolar depression and mania can have psychotic features, there is some evidence that even medical marijuana use might have negative effects in people with bipolar disorder.
Studies Show Links to Worse Outcomes
Medical research shows that cannabis use in people with psychosis is associated with an earlier age of their first psychotic episode. It’s also associated with manic symptoms and problems thinking.
In one study, patients who quit using marijuana or reduced its use following their first psychotic episode had the greatest improvement in symptoms at the one-year mark, compared both to continuing cannabis users and people who had never used cannabis. Long-term cannabis use may have a negative effect on long-term clinical outcomes for those with bipolar spectrum disorders, as well.
A 2015 study found lower bipolar disorder remission rates for current regular cannabis users (those who used it three times a week or more often) and those who regularly smoke tobacco when compared to people who don’t use either substance. That study, which lasted two years, concluded that regular marijuana users who also have bipolar didn’t do as well long-term as people who didn’t use the drug.
Another study looked at the short-term effects of cannabis use in people with bipolar disorder and concluded that the drug was associated with both manic and depressive symptoms. However, that study couldn’t find evidence that people with bipolar were using cannabis to self-medicate on a regular basis.
Now, none of these studies prove that cannabis is actually causing these problems in people with bipolar—they just show an association between marijuana use and problems. But you should factor this information into your thinking when deciding whether or not to use cannabis.
Substance Abuse Risk With Marijuana
All drugs have risks and side effects, and cannabis is no exception.
Substance abuse can be quite prevalent among those with bipolar disorder. People have used alcohol and drugs to try to control their systems in great numbers and may reduce their likelihood of successful treatment of their bipolar as a result.
By using marijuana to self-medicate for bipolar disorder, you run the risk of gaining a second diagnosis in addition to your bipolar diagnosis: substance abuse (Substance use disorder).
There's some interest in using marijuana to treat symptoms of bipolar disorder but the risks may outweigh any benefits.
Can Marijuana Treat Bipolar Disorder? Here’s What We Know
Created for Greatist by the experts at Healthline. Read more
If you have bipolar disorder (BD) or know someone who does, you’re probably familiar with the big highs and lows that go along with the condition. It can be challenging, but there are several strategies for managing BD — and continuing to be your amazing self. For some people, that includes cannabis (aka marijuana).
To receive a diagnosis of bipolar I, a person must have at least one manic episode — an intense exclamation point of high energy and sometimes out-of-character behavior. (Despite the condition’s name, these highs may not be accompanied by similarly intense lows.)
In bipolar II, the highs, known as hypomania, are less extreme but can be followed by equally challenging periods of depression. And with the third type, cyclothymia, both the highs and the lows are milder, though they can still complicate your everyday life. Lastly, type four: simply called “other,” it covers people who experience highs and lows that don’t quite fit into the other three types (more on the types of bipolar here!).
During an episode of mania, you may feel irritable, impulsive, energetic, and voracious for food and sex, and you may think and talk faster than usual. You might feel super productive and creative at some times and unfocused and scattered at others.
The flip side — depression — can bring on exhaustion, sadness or despair, the inability to focus or do creative work, and the sinking feeling that you’ll never be inspired again. Though it doesn’t last forever, depression can cause you to temporarily lose your mojo for fun stuff like food, sex, and your favorite things.
Medication and therapy are the most well-researched and reliable methods of treating BD. But some people also find that cannabis helps them manage their symptoms. A lot more research is needed, but here’s what we currently know.
The answer here is a big ol’ maybe, because:
Some say yes
Medical case studies dating back to the ’90s highlight people whose BD symptoms were improved by using cannabis. Today, plenty of “weed feeds” on social media reflect the same idea: Cannabis helps (some people, at least) balance out the highs and lows of mania and depression. But that’s all anecdotal.
A 2015 study found that marijuana use resulted in improved mood for people with BD without downgrading their mental functioning. Sounds like a win, but the sample size of this study was pretty small, including only 12 people with BD who also used cannabis.
Another small(ish) study from the same year found that cannabis use in people with BD was associated with positive mood. But this study also found that people experienced more manic and depressive symptoms after smoking marijuana.
Confused? Us too.
The authors of the latter study suggest that because marijuana contains cannabinoids like THC and CBD along with many other compounds, it’s difficult to predict its effects — particularly in people with underlying conditions like BD.
Cannabis is sometimes called “biphasic” or “bidirectional,” meaning it can bring on intensely positive feelings and sensations or downright lousy ones, depending on the dose, the setting, the user’s personality, and whether the user smoked, ate, or vaped the marijuana.
Which leads us to the other side of the coin…
Some say no
A 2015 review of six studies on cannabis and BD found that smoking weed might worsen, or even bring on, BD symptoms. Another study found that people with BD who smoked marijuana were about six times more likely to develop cannabis use disorder than the general population.
It’s also possible that using cannabis at a younger age could bring on BD symptoms earlier in life and increase the chance of suicide.
Medication and therapy, the traditional routes to treating bipolar disorder, are the most well-researched and reliable methods. But some people with bipolar disorder also find that cannabis helps them manage their symptoms. A lot more research is needed, but here’s what we currently know.