CBD was discovered in the 1960s, but it wasn’t until much more recently that it gained the attention it’s currently enjoying worldwide. While it has many similarities to THC, the biggest difference is its lack of psychoactive properties, making it especially interesting for medicinal benefits. Besides not having any intoxicating effects, it is also non-habit forming, easily tolerated by the human body, and full of potential therapeutic benefits that people with a variety of conditions could potentially enjoy [1]. For these reasons CBD is a great option for clinical trials and exploration, and is why it is currently one of the most studied cannabinoids extracted from the cannabis plant. 

CBD has already been widely studied for its anti-inflammatory and immune boosting properties [2], its anti-psychotic abilities [3], as an analgesic [4], and for its anti-epileptic benefits [5]. Besides the psychotropic differences, CBD is different from THC on a molecular level too. When compared to THC, CBD shows less attraction to the CB1 and CB2 receptors in the endocannabinoid system (ECS), meaning it doesn’t activate the receptor directly but instead alters the effectiveness of anything attached to those receptors. This can range from a stimulation of acidic release process to inhibiting an enzyme from breaking down a specific molecule.  

The ECS

The Endocannabinoid System (ECS) is an important part of human physiology. It’s responsible for maintaining the body’s state of homeostasis. If some sort of disruption is introduced in the body, the ECS will start working to make sure everything in the body remains at a stable and optimal level. This is an important function of the human body. All the internal systems need to be in a state of equilibrium to work effectively.  

There are three primary elements that make up the endocannabinoid system:

  • Endocannabinoids: These are compounds that are naturally produced by the body, but are very similar to the chemical compounds in cannabis, like CBD. The two main endocannabinoids in the ECS are called anandamide and 2-AG.

  • Cannabinoid Receptors: These receptors are found on the surface of cells throughout the body. The endocannabinoids the body produces, and any cannabinoids ingested will bind to these receptors. The action of binding allows them to communicate with different systems in the body, helping the ECS maintain an equilibrium in each of the specific systems. The two main types of cannabinoid receptors are CB1 and CB2.

  • Enzymes: After the endocannabinoids attach themselves to the cannabinoid receptors and the ECS has achieved stabilization in the body, enzymes start breaking down the endocannabinoids to avoid a possible overcorrection. Each type of endocannabinoid has a specific enzyme that works at breaking it down effectively. The two enzyme types are called FAAH and MAGL and each is specific to a particular endocannabinoid. 

The Review

As researchers become more interested in the medicinal possibilities of CBD, more studies on its potential abilities become available. A recent review looked at how CBD could be used to help treat somatic and psychiatric disorders. The review itself consisted of 25 studies, all of which were peer-reviewed and published in full length articles in scientific journals. These studies included 538 men and 389 women. 22 of the review studies were performed as controlled clinical trials and three were observationally designed. The studies came out of five countries.

It should also be noted that formulations, dose, and dosage schedules varied between each study. The dosage rate varied from a single dose all the way to 48 weeks of continued usage. Most studies used the purest form of CBD, with the exception of two that used seed CBD oil and CBD botanical extracts. Most CBD was taken in capsule form, but some were also vaporized or administered as oil droplets under the tongue. Because of the varied doses and formulations, many of these studies must be taken with a moderate level of bias assumed. Without everything being equal, those reviewing the results must be prepared for a margin of error and prejudice present in reviews such as these. 

The Results

Anxiety Disorder

11 of the studies were focused on anxiety disorders, consisting of 358 participants. Most participants were given 150-900 mg of CBD in the form of gelatin capsules. These studies examined different anxiety disorders, including social anxiety disorder (SAD). The studies reported that by giving those suffering from SAD a dose of CBD before public speaking, their anxiety was reduced in preparation and during their speaking engagement [6], allowing them the possibility to be more comfortable and confident during their presentation. There was no effect discovered, however, on physiological measurements like heart rate or blood pressure. Another study showed that CBD decreased anxiety and increased mental sedation in those suffering from chronic anxiety or paranoia disorders [7]. This would indicate a more calm mind in situations that might normally produce increased anxiety levels. Finally, another study came to the conclusion that CBD could be helpful in reactions to negative stimuli, like situations that cause fear. When participants were given CBD they were more likely to take the time to think about an appropriate reaction in the face of fear rather than acting on impulse and instinct alone [8]. Humans, and most other creatures, have a basic level of fight-or-flight that they default to when faced with fear. This study showed that in the moment when fear would normally take over, leaving the participant to rely on their base instincts only, the addition of CBD allowed them to take a moment to survey the situation and make a more informed decision, one not based solely on instinct. 

Psychosis

For CBD’s effect on psychosis, specifically schizophrenia, four studies consisting of 196 participants were analyzed. For these trials, CBD was administered orally using gelatin capsules in the doses of 600-1000 mg. While CBD showed no observable difference in treating cognitive function and psychotic symptoms in these patients, it did show itself to be just as effective as a potent prescription medication commonly used as an antipsychotic for schizophrenia. CBD was also found to be more tolerable and safe than that same prescription medication, and with all the same benefits of improved psychotic symptoms. When used in conjunction with this medication, the results were heightened and the prescription medication was found to have more potency, even in a reduced dosage [9]. 

Substance Use Disorder

When used to help those addicted to smoking, research has found that an inhaled pure dose of CBD over the course of one week did produce positive results in those with nicotine addictions. These results were measured by the number of cigarettes smoked per day by the group of participants who were ready and willing to quit smoking [10]. Studies also found that if administered after an overnight time frame without any nicotine, participants found cigarettes less important and pleasurable than they did without the CBD. This indicates CBD could potentially have an effect on the actual motivation to smoke in nicotine addicts, causing them to look unfavorably at tobacco products, therefore reducing the odds that they would be tempted to reach for one of these products to satisfy a current craving [11]. 

The Conclusion

Most of the studies reviewed showed the best benefits of CBD at the dosage levels ranging from 300-600 mg. Many of the studies were performed on healthy adults, with the exception of the SAD trials which were performed on clinical patients. These studies also used a comparative placebo group to evaluate the effectiveness of the results. 

Research is still ongoing and the exploration of CBD and other cannabinoids will be something scientists study for years to come, but early information is giving those suffering from psychosomatic disorders hope for a treatment plan that has the potential to move away from prescription drugs, or the ability to modify their prescription medication plan with a more therapeutic approach. Just like every person is different, so is every psychosomatic disorder. What works for one person or in one study may not hold true for another person or another research project. After reviewing more than 20 cases, this review holds high hopes for the benefit of CBDs and other cannabinoids in the fight for mental health.