According to numbers released by the National Institute of Mental Health, approximately seven percent of American adults experienced social anxiety in the last year. This prevalence increases slightly among young Americans, as well as among women. Considering the many day-to-day ramifications of social anxiety, finding relief is paramount.
Cannabis, long marketed as an anti-stress and chill-out option, could hold the answers. But, as anyone familiar with the intoxicating effects of the plant will know, it’s not as simple as a blanket medical marijuana prescription.
There are hundreds of different, potentially therapeutic compounds in cannabis. Depending on the cannabinoid profile and perhaps even the patient, the effects can range from calming and anxiolytic to paranoid and anxiety-ridden.
With social stigma and anti-drug laws dissolving across the country, research is now underway to explore these nuances. Of particular interest are studies looking at cannabidiol (CBD) for social anxiety.
Research investigating CBD for Social Anxiety
There are already a substantial number of peer-reviewed studies examining the therapeutic value of CBD for anxiety and related conditions like social anxiety, panic disorder, and post-traumatic stress disorder (PTSD). Although CBD is not yet approved by the Food and Drug Administration (FDA) for use for any mental health condition, this area of research is already well underway.
Social Anxiety Related to Public Speaking
One of the most famous studies into CBD’s anxiolytic properties was published in 2011: “Cannabidiol Reduces the Anxiety Induced by Simulated Public Speaking in Treatment-Naïve Social Phobia Patients.”
In this Brazil-based, placebo-controlled study, researchers worked with 24 patients with social anxiety disorder. Twelve received a placebo, while the other 12 received a relatively large dose of CBD (600 mg). Then, both groups were asked to perform a public speech, all the while undergoing a battery of tests for heart rate, blood pressure, and several subjective assessments.
The authors determined that a single dose of CBD “significantly reduced anxiety, cognitive impairment, and discomfort in their speech performance […] and significantly decreased alertness in their anticipatory speech […].” Considering public speaking is one of the most common activities affected by this condition, CBD provided scientifically relevant relief.
Effects Backed up by Neuroimaging
Another study, also from 2011, used neuroimaging after CBD administration among a group of male participants with generalized social anxiety disorder. In this double-blind, placebo-controlled experiment, participants received 400 mg of CBD.
The results following imaging of resting regional cerebral blood flow showed activity changes in limbic and paralimbic brain areas. Combined with self-subjective assessment results, the authors determined, “Relative to placebo, CBD was associated with significantly decreased subjective anxiety.”
Social Anxiety Among Adolescents
In 2019, the results of a Japanese study were published in Frontiers in Psychology, indicating that ongoing treatment with CBD could be helpful for adolescent social anxiety.
In this research, 37 Japanese students aged 18 to 19 with social anxiety and avoidant personality disorder participated. The CBD group received 300 mg per day, while the control group took a placebo. The researchers assessed their anxiety levels using two tools (Fear of Negative Evaluation Questionnaire and the Liebowitz Social Anxiety Scales), once at the beginning and again at the end.
According to this small-scale study, “CBD significantly decreased anxiety measured by both scales,” and the evidence was strong enough to conclude, “The results indicate that CBD could be a useful option to treat social anxiety.”
THC Complicates Cannabis’ Anti-anxiety Effects
But of course, cannabis is much more complex than the effects of any particular cannabinoid. The latest numbers suggest the plant produces well over 100 different cannabinoids, even more terpenes, and a host of other compounds.
Just because CBD is proving valuable for reducing anxiety symptoms doesn’t mean we can make the blanket statement that “cannabis is good for social anxiety.”
As many patients and recreational users are aware, one cannabinoid in particular can trigger the opposite effect to those detailed from CBD. Tetrahydrocannabinol, or THC, is the most infamous cannabinoid and often much more prevalent in commercially available products.
This cannabinoid is almost exclusively responsible for the intoxicating high. It has a biphasic effect (like many cannabinoids), but this variability creates effects ranging from relaxation to stress. High levels of THC can trigger challenging side effects, including paranoia and anxiogenic experiences.
Sessions logged within the RYAH Data Ecosystem demonstrate the highly variable nature of these effects. Between January 1st, 2018, and December 31st, 2021, users logged more than 22,200 sessions specifically targeting social anxiety disorder. Super Lemon Haze, a strain containing substantial levels of THC, was the highest-ranked strain among this demographic. It even ranked above other top CBD-rich contenders like Cannatonic and Harlequin.
Still, within this same ecosystem of session reports, a small portion of Super Lemon Haze consumers reported that it did indeed trigger anxiety. This indicates some degree of variability within the same plant.
CBD is Better Suited for Anxiety Relief
When it comes to THC, dose size and perhaps even patient history could play a role in the anxiety or anti-anxiety effects produced. But it’s a much different story for the anti-anxiety benefits of CBD.
The current research, much of it placebo-controlled and double-blinded, tells us that this calming cannabinoid has measurable and immediate effects on social anxiety, both when applied in acute cases, as triggered through a public speaking test, and chronic cases dosed over several weeks.
More research is needed to help evolve CBD from an interesting experimental cannabinoid to one approved for use to treat social anxiety.