This is a very tricky question b/c people’s reactions to cannabinoids are very unique. The first question to answer is this: Is Med Cann going to help or hurt the patient? If pts come to me with complaints of depressed mood or mood swings, a couple of major questions come up: Has the patient seen a mental health professional? Has the patient a heavy user of cannabis &/or other substances? Other MD’s here might not have seen first hand but I’ve seen cann. used heavily precipitate violent mood swings and even frank psychosis. This is the reason I’m so careful about recommending cannabis with mental health issues. However, here are some key points I like to follow:
- If there is any recent hint of suicidal ideation or self harm, I am very wary to
write a recommendation. If you as a patient are feeling any of these, getting a cannabis recc is not nearly as important as GETTING HELP FiRST
- Especially w/ Depression & Mood lability, I tell patients to keep things "low and slow" with the cannabis. Try not to use daily unless you are using it to help you sleep and calm down (and even then, continuous daily use for extended periods of time sets you at risk for tolerance and psych dependency)
- Be aware of potential side effects, even subtle ones; in the literature I’ve read 2 big signs that there might be too much cannabis in the pt’s system is irritability or paranoia. If pt’s feel these they should probably give themselves a short break from med cann
- The best place to start in my experience is 2:1 CBD:THC (or 1:1 CBD:THC) but pts will have to determine for themselves what they are comfortable with. In any case, I tell pts to SAFELY experiment with diff cannabinoid ratios
As for specific strains? I tell pts that what’s on the label in terms of cannabinoid dosages and ratios is more important than the strain name (this allows pts to find other strains that have similar cannabinoid profiles if there dispensary doesn’t have the strains they want).
The other very important non-cannabis tips for mood mgmt? Well, you’ll have to come over to HelloMD and talk to me or another one of our outstanding MD’s and NP’s to find out. I don’t want to give away ALL our trade secrets!