Endocannabinoid Tone and Anxiety

Anxiety is a natural response that has developed in humans to help us respond to threats and keep us safe.

However, if we experience feelings of anxiety that are particularly strong or last for a long time, they may be caused by an anxiety disorder.

In the UK, it's estimated that more than 12% of the population has a diagnosis of some form of anxiety disorder. How the anxiety presents and what causes it can vary from person to person.

However, there are five main types of anxiety disorder generally recognised today:

• Generalised Anxiety Disorder
• Obsessive Compulsive Disorder
• Panic Disorder
• Post Traumatic Stress Disorder
• Social Anxiety Disorder

OCD and PTSD are no longer classified as anxiety disorders, but anxiety is a key element part of both, so they're still worth including in this list.

Current NHS treatment for anxiety can involve a psychological approach such as cognitive behavioural therapy or a range of medications.

What is CBD?

CBD is a beneficial cannabinoid that is commonly consumed in oils, capsules, e-liquids or gummies as a natural health supplement.

When it enters your cells and tissues, it interacts with a broad range of chemical messenger molecules, enzymes and receptors.

These interactions support your body's ability to restore your body's bio-systems to a state of healthy balance.

Learn more about CBD with our guide: CBD 101 – Everything you need to know

CBD and Your Endocannabinoid Tone 

One of the most common ways that CBD restores balance in your body is by interacting with your endocannabinoid system and improving your endocannabinoid tone.

Endocannabinoid tone refers to the level of potential endocannabinoid activity in your body and the ability of your endocannabinoid system to respond to any problems.

This can be affected by a range of factors, including genetics, diet, stress and disease.

If your endocannabinoid tone is low, your endocannabinoid system is unlikely to be able to restore your body systems to a state of healthy balance. As a result, you may feel unwell, or experience symptoms related to anxiety.

Regular consumption of CBD can stimulate the action of your endocannabinoid system (ECS) and raise your tone. 

To learn more about your endocannabinoid tone, you can read our article: Endocannabinoid Tone and CBD. 

Generalised Anxiety Disorder and your Endocannabinoid Tone

Generalised Anxiety Disorder (GAD) occurs when someone experiences excessive fear, anxiety and worry.

Most people who have a diagnosis of GAD will experience it on most days for at least six months. It can be a continuous struggle that many people face every day of their lives.

Common symptoms of GAD can include:

• Feeling restless or uneasy
• Struggling to concentrate
• Feeling tired throughout the day
• Tense muscles
• Irritability
• Being irritable
• Excessive worrying
• Lack of sleep

On a neurological level, generalised anxiety disorder involves disrupted activity in the brain's emotional centres.

This disruption results in natural fear responses being triggered for situations that can be viewed as low threat or even for no reason at all. 

Recent studies have looked in detail at the behaviour of the endocannabinoid system in the brain and how it behaves when anxiety and fear responses have been triggered. Some conclude that the endocannabinoid tone is crucial to the regulation of these responses.

CB1 receptors are endocannabinoid receptors present in the brain and central nervous system.

When endocannabinoids like anandamide or 2-AG bind to CB1 receptors, they alter the release of GABA and glutamate from neurons.

Scientists have reported they have observed this producing two different opposing effects.

Sometimes it promotes the release of neurotransmitters allowing the brain to reduce anxiety, and at other times it inhibits neurotransmitters and produces effects that promote anxiety.

While there is not yet a concrete answer as to why endocannabinoids can apparently produce two different results from the same receptor, there are some theories.

Most studies suggest that it depends on how many endocannabinoids are available and what other receptors have also been activated:

• Whether CB1 activation reduces or increases anxiety is influenced by the activation of other receptors. 5-HT1A serotonin receptors and TRPV1 receptors can also be activated by endocannabinoids and plant cannabinoids. If your endocannabinoid tone is balanced or high, these receptors are likely activated simultaneously; the combined result is the stimulation of neurotransmitters that increase interbrain signalling and calm anxiety.
• When the endocannabinoid tone is raised very quickly, as experienced when using large amounts of cannabis, the effect of CB1 activation is to stop neurotransmitter release. This can create increased levels of anxiety and paranoia.

As well as its effect on the fear response via neurotransmitter release, endocannabinoid tone also supports anxiety reduction by influencing the emotional response.

Most anxiety and fear responses are acquired by attaching certain emotions to memories.

In this manner, the brain recalls which experiences should have a fear response attached to them, producing a feeling of anxiety when something triggers that memory.

A 2012 study found that CB1 receptors are particularly abundant in the areas of the brain responsible for combining emotions and memories (fear conditioning).

In the brain of someone suffering from general anxiety disorder, these anxious memories remain for a long time.

However, in the brain of someone with a medium to high endocannabinoid tone, those memories are forgotten quicker.

Also, in those fear-related memories, the learned fear response is significantly reduced when the endocannabinoid tone is higher.

As a result, some scientists describe the endocannabinoid system as an effective 'regulatory buffer' for emotional response.

OCD and your Endocannabinoid Tone

Obsessive compulsive disorder (OCD) is a mental health condition that involves obsessive thoughts and compulsive behaviours. 

Obsessive thoughts: These are unpleasant thoughts, images or urges that appear in your mind continuously or repeatedly. It may cause anxiety or disgust. For example, intruders in the house or causing harm to a family member.

Compulsive behaviours: These are behaviours that someone with OCD feels compelled to do to relieve the discomfort produced by the obsessive thoughts. For example, routine activities like going up or downstairs or body movements like tapping, touching or blinking.

In most cases, the behaviours don't reduce the discomfort, but the compulsion remains, so they may be repeated many times, causing increasing distress.

To learn more about OCD, check out this guide from UK mental health charity Mind.

OCD appears to develop for different reasons, but most professionals agree that it often has a genetic or hereditary component.

Although OCD is no longer classified as an anxiety disorder, anxiety is a central feature of the experience of many patients with OCD.

Some health professionals argue that anxiety is a secondary symptom of OCD, but others report that in some cases, anxiety takes on a more central role in the condition. 

Studies have found that the brains of people with OCD have many alterations to the expected brain activity.

Some of the most notable include alterations in communication between brain areas, a decrease in the brain's outer layer (grey matter) and a reduction in serotonin levels.

Some scientists believe that the areas of the brain affected by OCD are those involved in storing behavioural memory sequences. These are repeated sequences of behaviour called 'structured event complexes' (SEC).

When an SEC is completed, it usually triggers a reward or relieves any associated anxiety.

For people who have OCD, these sequences may not be able to complete correctly, resulting in them getting stuck in loops of anxiety-related behaviour that they can't finish.

The endocannabinoid system is intricately involved with the regulating of the neurotransmitters that control the systems surrounding memory retrieval and their associated emotions.

When the endocannabinoid anandamide binds with the CB1 receptors in the brain, it can either promote or inhibit the release of neurotransmitters.

It also interacts with the 5-HT system, which controls serotonin release.

This means that when the endocannabinoid tone is medium or high, the brain can better regulate the release of neurotransmitters that are essential to the correct functioning of the SEC.

This could mean that a medium to high endocannabinoid tone in someone with OCD might let them end obsessions or compulsions more effectively.

Panic Disorder and your Endocannabinoid Tone

Intense feelings of anxiety can become overwhelming and cause sensations of panic.

Panic disorder is a condition when a person suffers from panic attacks that can last between 5 and 20 minutes.

These attacks may become regular and can come at any time with no obvious cause.

Panic disorder can be caused by a range of things, including:

• A family history of panic attacks 
• Major life stress
• A traumatic event

The symptoms of panic disorder include:

• Shortness of breath
• Feeling faint or dizzy
• An increased heart rate
• Nausea
• Chest pain or chest tightness
• Shaking
• A dry mouth

Despite each panic attack eventually coming to an end, people who have a panic disorder report that it affects their entire life.

At the times when they're not experiencing a panic attack, they may still feel extreme anxiety as they worry when the next one might come.

When a panic attack begins, the parts of the brain involved in the fear response go into overdrive.

The amygdala begins to release the stress hormones cortisol and norepinephrine to get the brain and body ready to respond to a threat. 

Having a medium to high endocannabinoid tone allows for precise regulation of many of the actions involved in anxiety and panic.

With the optimum level of endocannabinoids, receptors and enzymes, neurotransmitters are controlled and provide appropriate responses to stimuli.

This reduces the situations when a normal fear response could become a panic attack.

While having a higher endocannabinoid tone will not remove panic disorder, some of the studies indicate that it may have a moderating effect that allows someone with panic disorder to manage their condition.

Post Traumatic Stress Disorder and your Endocannabinoid Tone

Post-traumatic stress disorder (PTSD) is a condition that can occur when a person experiences a frightening or distressing event. About 1 in 3 people who go through a trauma develop PTSD.

It's not currently understood why some people develop it and some don't.

The cause of PTSD can be anything that a person perceives to be traumatic, including:

• A car accident
• A violent assault
• Abuse
• Bullying
• Health problems
• Childbirth

The symptoms of PTSD can include:

• Nightmares
• Vivid memories
• Guilt
• Insomnia 
• Lack of concentration

Several studies have determined that when a person experiences trauma, it can have a long term effect on their endocannabinoid system.

These changes may affect the person's ability to move on from trauma and could contribute to the symptoms of PTSD.

However, so far, most studies have not been able to determine exactly what the changes to the ECS include. 

Some scientists suggest that this is because the effect of trauma may be different depending on its nature and the age of the person experiencing it.

Some investigations recorded a decrease in endocannabinoid levels, and others found decreases in the number of active CB1 receptors.

There were even some studies that reported increases in endocannabinoids following a trauma. 

This demonstrates the strong links between the brain's fear response and the endocannabinoid system.

As with OCD, PTSD involves the creation of connections between memories and emotions.

A balanced or high endocannabinoid tone has been found to support the proper processing of these memories.

This can result in 'memory extinction' where the memory and corresponding emotion are no longer involved in a sequence of behaviour.

Social Anxiety Disorder and your Endocannabinoid Tone

Social anxiety disorder (SAD) involves regularly feeling excessively anxious in situations involving other people.

This could be performances, meetings or just one to one interactions. It's often linked to a fear that the interaction will cause humiliation or embarrassment.

The causes of SAD can vary from person to person, but some of the most common are:

• Genetic predisposition
• Negative parenting styles
• Bullying
• Conflict
• Abuse

The symptoms of SAD often include:

• Fear of social situations 
• Worries about embarrassing or humiliating yourself
• Fear of talking to strangers
• Going red
• Increased heart rate
• Shaking
• Sweating

12% of people in Europe will likely experience SAD during their lifetime, making it significantly more prevalent than other anxiety disorders.

One of the common features of SAD is that it usually first occurs in childhood or adolescence, and most people who develop it will have done by the time they reach 20.

Because of the prevalence of social anxiety disorder, studies have been conducted to investigate what occurs in the brain and explore a range of treatment methods.

One such study found that higher levels of anandamide and higher endocannabinoid tone correspond with significant improvements in the condition and a reduction in symptoms. 

Scientists suggest that these effects may be a result of the combined activation of CB1 receptors and 5-HT1A receptors.

Together they allow for a series of chemical actions that limit anxiety and give the brain greater control over neurotransmitters in stressful situations.