Guide to Treating Obsessive Compulsive Disorder (OCD) with Cannabis
Obsessive compulsive disorder (OCD) is a serious mental illness. We often hear the word OCD thrown around casually, or even used as a pejorative. But claiming to have OCD tendencies, or accusing someone else of OCD behaviours, is making light of a condition that individuals have real and significant struggles with. So, let’s talk about what OCD really is and how we are treating OCD with cannabis.
What is Obsessive compulsive disorder (OCD)?
Obsessive-compulsive disorder (OCD) is an anxiety disorder in which people have recurring, unwanted thoughts, ideas or sensations (obsessions) that make them feel driven to do something repetitively (compulsions). The repetitive behaviours, such as hand washing, checking on things or cleaning, can significantly interfere with a person’s daily activities and social interactions. (source) Many people diagnosed with OCD know their obsessions aren’t true. Despite this they still have a hard time keeping their minds off the obsessions or stopping the compulsive actions.
To be diagnosed with OCD, a person must experience the presence of obsession and/or compulsions that are time-consuming (more than one hour a day), cause major distress, and impair work, social or other important function.
Traditional Treatment for OCD
The most effective treatments for OCD are cognitive behavioural therapy (CBT), particularly exposure and response prevention, as well as medication (typically SSRIs).
SSRIs are serotonin reuptake inhibitors and affect the amount of serotonin in our brains. Such medications are typically used for treating depression, and sometimes anxiety. Though they appear to also help with OCD symptoms, doctors are unsure as to why. This improve may be a result of the fact that people often experience symptoms of depression alongside OCD.
As is the case with all medications, there is a list of side effects though we are seeing significant promise in treating OCD with cannabis.
Cannabis and OCD
Cannabis is not a replacement for mental health support. But there is evidence to suggest it can help manage or alleviate symptoms associated with OCD due to the endocannabinoid systems ability to regulate particular areas of the brain.
Though using cannabis to treat symptoms associated with anxiety can be challenging as cannabis (particularly THC) at higher doses can increase a person’s anxiety.
What the research says
CB1 receptors, which are a fundamental component of the endocannabinoid system, are found in high densities in regions of the brain that are believed to be implicated in OCD. Including the prefrontal cortex, basal ganglia, hippocampus, and amygdala. This connection suggests that the careful activation of CB1 receptors may help ease specific symptoms associated with OCD. Though the research is still in the preliminary stages.
This research is broken down into studies that look at specific areas of functioning. The areas that are important to address in relation to OCD are; stress response, fear and repetitive behaviours. This is because the obsessions manifest as a result of stress or conditioned fear and they influence a compulsion. Again, compulsions are repetitive behaviours.
Studies on rodents have shown that the endocannabinoid system influences the body’s response to stress. The body’s own endocannabinoids promote adaptation to prolonged stress, while THC and other cannabinoids can decrease the stress response when given at low doses.
Fear, or more specifically, conditioned fear, is a fundamental component of OCD. The fear network of the brain pairs an aversive thought with a neutral trigger, sending a signal that something is wrong and it needs to be addressed immediately. For example, a person could have the fear that someone is going to break in to their house and feel to compulsion to check the door multiple times to ensure it’s locked.
Studies have noted that individuals living with OCD have an impaired ability to extinguish fear and that disordered neural pathways are responsible.
Cannabis appears to have the ability to help people with the extinction of conditioned fear. Preclinical studies with mice suggest that the endocannabinoid system is critical to helping snuff out fear memories in the amygdala.
In another study on healthy individuals, dronabinol (a synthetic form of CBD) reduced the response to stimuli that induced fear. Additionally, CBD has been shown to decrease anxiety and help diminish conditioned fear memories in healthy adults.
Rodent studies have connected the endocannabinoid system to learning habits and repetitive behavior. Research has found that both THC and CBD can reduce repetitive behaviours in mice. Research on CBD was found to have persistent results on repetitive behaviour when administered daily over a week. In contrast, diazepam, a common anti-anxiety medication, showed decreasing efficacy over time.
In a study of people with Tourette Syndrome, smoking cannabis was associated with fewer tics and urges to perform compulsive behaviour.
Treating OCD with Cannabis – THC or CBD? And Dosage
As mentioned previously, there is a delicate balance when it comes to using cannabis to treat symptoms associated with anxiety. Some individuals report experiencing increased anxiety with cannabis use. Does this mean CBD is a better choice for treating OCD than THC?
There is a different therapeutic effect on anxiety between THC and CBD cannabis products. Both interact with the amygdala in the brain which affects a person’s stress response, but CBD more reliably decreases this response. While THC can have the same, or similar effects, studies suggest there may be a ‘tipping point’ for THC and too much may increase anxiety in some people (source)(source). Therefore, CBD is likely a good place to start when it comes to treating OCD with cannabis.
Dosage for Treating OCD with Cannabis
Unfortunately there is no accepted dosage for CBD or THC when treating OCD. Many factors may influence the most effective dose for any particular individual. So, we always recommend starting with a low dose and increasing slowly until you experience the desired effects.
In this process it’s important to record your experience. Ensure to not only record the dose, but the time as well as the symptoms you’re experiencing before and after.
If you don’t experience the symptom relief you’re looking for with CBD alone, considering adding THC. CBD and THC interact with the brain in a slightly different manner and can work together to have an increased impact. Note that CBD helps to tone down the psychoactive high that you experience with THC.
When considering treating OCD with cannabis, there are many things to think about. Preliminary research suggests cannabis can help with symptoms associated with OCD due to its ability to influence our stress response and fear conditioning. Although many are seeing results when treating OCD with cannabis, others report experiencing an increase anxiety. Therefore it’s important to pay close attention to your dose.
Research will continue to develop in areas such as treating OCD with cannabis. Dr. Reilly Kayser is currently investigating the effects of cannabinoid use in people with OCD through the New York State Psychiatric Institute. In September 2019, Dr. Kayser also spoke with TreatMyOCD about cannabis and OCD. So, if you want to learn more about the effects of cannabis on OCD he’s the one to watch.
If you’ve been diagnosed with OCD and have used cannabis to help manage your symptoms let us know in the comments. Part of what makes the cannabis community so great is the sharing of knowledge. Let us know what’s worked for you.