Can cannabis improve mental health? We’re not in a position to recommend or endorse cannabis as a therapy for mental health without a psychologist’s or psychiatrist’s diagnosis and prognosis. Despite the disclaimer, there is evidence that cannabis can contribute to mental health care.
The World Health Organization (WHO) says, “Mental health is defined as a state of well-being in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community.” Unfortunately, all aspects and terms of the definition are ambiguous or subjective.
Recognizing the strengths and weaknesses of the WHO definition, World Psychiatry offered an alternative:
Mental health is a dynamic state of internal equilibrium which enables individuals to use their abilities in harmony with universal values of society. Basic cognitive and social skills; ability to recognize, express and modulate one's own emotions, as well as empathize with others; flexibility and ability to cope with adverse life events and function in social roles; and harmonious relationship between body and mind represent important components of mental health which contribute, to varying degrees, to the state of internal equilibrium.
It is a fuller definition but no more concrete than the other. Without clarity, it fails to address points of cause, effect, and symptomology,
Signs of mental health problems
The American Psychiatric Association goes a step further: “Mental illnesses are health conditions involving changes in emotion, thinking or behavior (or a combination of these). Mental illnesses are associated with distress and/or problems functioning in social, work or family activities.”
Symptoms of troubled mental health include feeling sad, down, or suicidal. Thinking may be confused, or concentration disturbed even to the extent of paranoia or hallucinations. Victims detach from reality and/or from social connections with friends and family. They may experience extreme fears, guilt feelings, or major changes in eating or sex drive habits. Unable to relate to situations and people, they may self-medicate with drug or alcohol abuse.
So, what’s a treating psychiatrist, psychologist, or neurologist to do?
Psychiatry remains the “gold standard” in treatment. Mental Health America says, “Psychotherapy is the therapeutic treatment of mental illness provided by a trained mental health professional. Psychotherapy explores thoughts, feelings, and behaviors, and seeks to improve an individual’s well-being. Psychotherapy paired with medication is the most effective way to promote recovery.”
Such care takes a long time and runs up costs. Medications do not cure mental health problems but reduce symptoms to make care more effective. Other treatments include peer support and support groups. Hospitalization is a last resort therapy, but contemporary clinicians are recommending complementary and alternative care. And, this is where cannabis may play a role.
There are pros and cons to cannabis as an alternative therapy for mental health issues.
Cons should make you confer with your physician:
- Ignorance: Practitioners remain in the dark because of a lack of research into the complex chemistry of cannabis. Key issues like the mechanism of action, select dosage, and applicable choice of material have not been settled.
- Quality: Absent universal standards, doctors have no confidence in the quality of cannabis product. With the multitude of strains, they have little confirmation on what strain treats what symptoms. And, recently developed and available strains accent the THC content risking additional health issues.
- People: Patients vary by genetics, age, and brain/body chemistry. This means treatment with cannabis is no surer than treatment with prescription medications. Still, there is mounting cannabis research indicating a more serious impact on adolescents.
- Addiction: With legalization expanding, there has been an increase in Cannabis Use Disorder (CUD). It does not register as chemical addiction, but it does occur in people pre-disposed to dependency. If used as a purposeful means of self-medication, it does not resolve mental illness.
Pros should not counteract your need to confer with your physician:
- Addiction: Research and history do not indicate that cannabis is addictive. CUD aside, cannabis may preferable to known addictive prescription meds.
- Chemistry: The restrictions on research in the U.S. have motivated research elsewhere. In addition to anecdotal history, research has identified key properties in cannabis: anti-anxiolytic, anti-chronic pain, anti-depressant, anti-emetic, anti-inflammatory, anti-spasmatic, and more.
- Cost: The price of cannabis care may be well below that of medications and psychotherapy. However, that money will be better spent when there is tested content, clear labels, and proven appropriate dosage.
- Self-medication: Purposeful self-medication with cannabis can provide an escape from symptoms and contexts that contribute to the problems.
You don’t have to take my word
An occasional hit doesn’t seem to hurt anyone. Even moderate use of cannabis seems relatively safe. Friends and family are positioned to raise the first red flags if it is not working or contributing to the problem.
But it’s not within our expertise to oversimplify this. I will leave it to Scientific American that concludes, “But for those with mental health and addiction concerns, cannabis can be both a friend and enemy. If it is to be used as part of a psychiatric treatment plan, then there is an ethical imperative to develop such a plan in consultation with a treatment team that practices evidence-based medicine. One risk of self-medication with cannabis is that other evidence-based treatments could be disregarded, which could result in a worsening of mental health and addiction symptoms.”