Mood disorders such as depression and bipolar disorder affect millions of people of all ages, even children. Prescription medications designed to target neurotransmitters in the brain that produce emotional responses like sadness, anger or happiness are usually what’s prescribed to treat these conditions.
But recent research reveals that imbalances in the body’s endocannabinoid system (ECS) could play a major role in developing mood disorders—and that the cannabis compound cannabidiol (CBD) may be as effective as pharmaceuticals are for treating some kinds of mood dysfunctions.
Mood disorders are a group of mental health conditions that are characterized by emotional states not consistent with current circumstances. They can result in persistent feelings of sadness, irritability or a sudden swing into manic euphoria.
This group includes all types of depressive disorders, such as:
But another kind of mood disorder also includes periods of extreme euphoria and hyperactivity. For those with bipolar disorder, or a similar condition called cyclothymia, depression alternates with periods of excessive energy, feelings of extreme self-confidence and racing thoughts.
Both major depression and bipolar disorder can have mixed features, too. What this means is that a person with depression can also experience some aspects of mania, while a person with bipolar disorder can have some ongoing symptoms of depression.
Many factors contribute to the development of mood disorders, including genetics, trauma and even environmental conditions, such as in seasonal affective disorder. But in all of these disorders, brain chemistry plays a key role.
Depressive states are associated with low levels of the feel-good chemicals serotonin and dopamine. Meanwhile, the manic states of bipolar and cyclothymic disorder can be linked to excessive amounts of serotonin and the excitatory neurotransmitter norepinephrine.
Medications aimed at restoring balance in the brain’s signaling systems are what’s generally prescribed for mood disorders. Several types of antidepressant medications target serotonin and norepinephrine. These include:
Many of the medications used to treat mood disorders work, because they target the production and uptake of serotonin, noradrenaline and dopamine. But CBD also affects the signaling of those chemicals in some surprising ways. And this is why a growing body of research now suggests that it can help people with depressive mood disorders to reduce their intake of prescription medications or even stop taking them altogether.
Humans and other mammals have an extensive network of ECS receptors that respond both to cannabinoid-like chemicals produced by the body itself and to cannabinoids from other sources, mainly from the cannabis plant.
So far, scientists have discovered two ECS receptors, which are found throughout the body and brain. They’re triggered by two natural cannabinoids, which produce feelings of calm and relaxation:
But the body also responds to the two most abundant cannabinoids in the cannabis plant: CBD and tetrahydrocannabinol (THC).
THC, which is responsible for the psychoactive high loved by many marijuana consumers, directly activates cannabinoid receptors in the brain.
But [CBD works in very different ways](https://www.projectcbd.org/science/cannabis-pharmacology/how-cbd-work\). This cannabinoid acts on multiple pathways in the brain to affect the activity of the essential mood-regulating chemicals, serotonin and norepinephrine.
The serotonin receptor 5HT1A is one of a family of 5HT receptors that affect a long list of processes including:
Serotonin activates this receptor. And so does CBD, thereby producing the same effects. In this way, CBD can supplement the brain’s own production of serotonin and encourage the calming, mood-lifting effects of this feel-good chemical.
Gamma-aminobutyric acid (GABA) is the brain’s main inhibitory neurotransmitter. This means that it can damp down the effects of excitatory chemicals like norepinephrine and cortisol to produce a calming effect. CBD is a positive modulator for GABA, so that it supports the production and expression of GABA in the brain.
Anandamide is a natural cannabinoid that promotes feelings of well-being and calm. And researchers now believe it may be partly responsible for the runner’s high that comes from exercise. But its presence in the brain is usually short-lived, because it’s broken down quickly by another chemical called FAAH.
CBD inhibits the action of FAAH, so that anandamide is broken down more slowly and remains available in the brain for a longer time.
Because CBD so strongly supports the production of mood-boosting neurotransmitters, particularly serotonin, research suggests that for some people with depressive mood disorders, it can be as effective as prescription medications are.
But HelloMD’s Dr. Richard Kim cautions that for those very reasons, CBD isn’t appropriate for people whose mood disorders include manic episodes.
“CBD mimics serotonin,” says Dr. Kim, “and elevated serotonin is associated with triggering or worsening a manic episode. Bipolar depression, cyclothymia, major depressive disorder with mixed features or any condition that involves mania or hypomania should not be treated with CBD.”
But folks with mood disorders that don’t have a manic component can safely take CBD in any form—smoking, vaping, sublingually or with edibles. Since cannabis can affect people in different ways at different dosages, you may need to experiment a bit to find the dosage that works for you. It’s wise to start small and observe the point at which your symptoms improve.
Some people prefer to take CBD alongside their prescription medications as a way to reduce their consumption of those drugs as well as reduce their side effects and risks. According to Dr. Kim, CBD is safe to take with most antidepressants, but the dose depends on the class of drugs you’re taking.
About 20 mg of CBD three times a day can work well with drugs from the SSRI and SNRI classes. But if you’re taking tricyclic antidepressants or MAOIs, Dr. Kim recommends smaller and more frequent doses of CBD, such as 5 mg three or four times a day. As always, it may take some time to find the right combination that works for you.
Mood disorders can have many causes, but research reveals that typical symptoms such as sadness, loss of interest in life and low energy arise from imbalances in the brain’s handling of serotonin and other mood-related chemicals.
Because CBD supports the activity of these mood-boosting chemicals, it has the power to ease the symptoms of many different kinds of mood disorders.
Photo credit: Brunel Johnson