Article by Jonathan N. Stea, Psychology Today
The relationship between cannabis and mental health is complicated. I’ve written about it here. What follows is the transcript of an interview exchange with a reporter who was interested in understanding the relationship between cannabis and depression in a bit more depth.
Reporter: For cannabis consumers who have depression, what is the most important thing they should keep in mind?
Dr. Stea: If a person thinks that they are experiencing depression, then it is most important to reach out for help by seeking a referral to a mental health professional for an assessment.
Depressive symptoms can arise for many reasons and it’s therefore important to get an accurate diagnosis to inform the treatment plan. Sometimes frequent cannabis use itself can induce depressive symptoms, and so it’s possible that a period of abstinence will be required to better assess a person’s mental health.
Reporter: What are the potential benefits and adverse effects of cannabis as it relates to depressive symptoms?
Dr. Stea: While cannabis users commonly report that they use cannabis to help manage symptoms of depression, there are no randomized controlled trials to date that have evaluated the cannabis plant or particular cannabinoids for the treatment of major depressive disorder. And for the data that we do have that addresses whether or not cannabis helps or hinders depression, the evidence is mixed, and tilted towards the idea that cannabis likely leads to the development or worsening of depressive symptoms.
Clinically, there is evidence that people with depression who continue to use cannabis throughout treatment make less improvement on their mental health symptoms than people with depression who do not use cannabis during treatment.
Reporter: What is the nature of the relationship between the endocannabinoid system and depression?
Dr. Stea: We know that the endocannabinoid system is involved in mood regulation. For example, there’s some evidence that CB1 receptor antagonism can produce depressive symptoms, and that CB1 agonism might increase serotonin-related neural activity. And so in this vein, there is theoretical reason to be optimistic about the potential to develop cannabinoid-based medicines for depression—but from an evidence-based practice perspective, we are not yet even close to having the data to support or recommend the use of cannabis for the treatment of depressive symptoms.
Reporter: What advice would you give to a consumer or patient for monitoring or tracking their mental well-being in relation to cannabis use and other medical treatment such as therapy and medication?
Dr. Stea: If a person is a regular cannabis user and experiencing depressive symptoms, then it is important to first seek help from a mental health professional. Depression is a serious condition and not to be taken lightly. Given the reinforcing properties of cannabis, it is no wonder that one population particularly at risk for developing cannabis addiction is those who experience mental disorders. Cannabis users with mental disorders are approximately twice as likely as cannabis users without mental disorders to have or develop cannabis addiction.