Project CBD’s Top Article On Depression by Stacey Kerr
DEPRESSION AND CANNABIS
Depressed? Could cannabis help? These two questions lead to many more, none of them easy to answer in today’s era of limited science on the topic. Some say cannabis helps pull them out of depression, and a few admit that they feel a bit more depressed if they use it. What is the real story of cannabis and depression?
BY STACEY KERR, M.D. ON JUNE 05, 2018
• Many patients claim that medical marijuana is an effective anti-depressant.
• Those who use cannabis recreationally often use it for mood enhancement, effectively avoiding major depression and the need for pharmaceutical intervention.
• A dysregulated endocannabinoid system is implicated in clinical depression.
• Both THC and CBD have been shown to be beneficial in animal models of depression, but clinical research thus far has been lacking.
• In states with robust medical marijuana programs, the legalization of cannabis for therapeutic use is associated with a five percent decrease in total suicide rate and a greater decrease in the suicide rate of young men in their 20’s and 30’s.
Depressed? Could cannabis help?
THE ENDOCANNABINOID SYSTEM AND MOOD
Our moods are affected by our environment, life situations, genetics, and brain activity. Some individuals are simply happier than others, and research on CB1 (cannabinoid) receptor genes gives us some clues to why that happens.  However, even though some are seemingy genetically destined to find and maintain happiness easier, other variables in life cannot be minimized.
Endocannabinoid system (ECS) activity in the brain affects feelings of anxiety and depression. This connection was all too obvious when the medication rimonabant, a CB1 antagonist, was released as a treatment for obesity. Rimonabant was quickly withdrawn from the market because of undesirable psychiatric side effects such as anxiety, depression and thoughts of suicide.
This definitively showed that blocking the brain’s CB1 receptors had unexpected severe consequences, and also showed the need for more research on the relationship between the ECS and mood.
WHAT IS DEPRESSION?
The DSM major depressive disorder (MDD) diagnostic criteria require the occurrence of one or more major depressive episodes.
Symptoms include the following:
- Depressed mood
- Diminished loss of interest or pleasure in almost all activities
- Significant weight or appetite disturbance
- Sleep disturbance
- Speeding or slowing of muscle movement
- Loss of energy or fatigue
- Feelings of worthlessness – low self-esteem
- Diminished ability to think, concentrate and make decisions
- Recurrent thoughts of death, dying or suicide
- Longstanding interpersonal rejection ideation (ie. others would be better off without me); specific suicide plan; suicide attempt
Additional DSM Major Depressive Disorder Criteria:
In MDD, either a depressed mood or anhedonia (inability to feel pleasure) must be present.
In addition to the criteria for a major depressive episode, the episode must:
- Be at least two weeks long
- Cause significant distress or severely impact social, occupational or other important life areas
- Not be precipitated by drug use
- Not meet the criteria for another mental disorder like schizophrenia or bipolar disorder
- Not be better explained by bereavement such as the loss experienced after a death