CBD and mental health: what does research say?

Mental health complaints are something many people encounter in their lives. Online you regularly see articles suggesting that CBD can play a role in anxiety, ADHD or other subjects around mental health. In this article, a careful and honest overview of what research says so far about CBD and the endocannabinoid system, and why CBD is not a replacement for regular mental health care.

Important first. Do you have persistent complaints such as anxiety, low mood, sleep problems or other mental health complaints? It is wise to discuss this with your GP. They can think along with you and refer you to the right care if needed. At the bottom of this article you will find a number of helplines.

The endocannabinoid system in brief

The endocannabinoid system (ECS) is a system of the body’s own that was discovered in 1992 and has been researched worldwide ever since. It consists of receptors (CB1 and CB2) spread throughout the body, and of signalling compounds the body makes itself. The system plays a role in processes such as immune regulation, the experience of pain, sleep, appetite and mood.

CB1 receptors are relatively common in parts of the brain involved in reward, memory and the stress response. That is one of the reasons researchers study the relationship between the ECS and various aspects of mental health. Cannabinoids from the hemp plant, including CBD, can act on this system. Exactly how and with what effect is the subject of active scientific research. Much of that is still at an early stage.

What does research say about CBD and mental health?

Clinical research exists into CBD around various mental health themes. The state of play in broad terms:

Anxiety. A number of small clinical studies have looked at acute effects of CBD on anxiety responses. Results are mixed, with sometimes positive effects on short-term social anxiety tests, but also studies where no effect or even worsening was reported. The doses used vary a great deal, often hundreds of mg per dose. CBD is not a recognised treatment for anxiety disorders.
Sleep. Some studies suggest that CBD can influence sleep quality, particularly in people who also experience anxiety. Research is inconsistent and still methodologically limited.
ADHD. Clinical research in ADHD is very limited. One small study in adults found limited improvements on a few endpoints, other studies found no effect. No practitioner advises CBD as ADHD medication.
Autism spectrum (ASD). Research is mainly being done in children and adolescents with ASD, generally with cannabidiol-rich preparations in high doses under medical supervision. Results are cautiously positive on specific behavioural endpoints, but these are always medical trials, not daily use of food supplements.
PTSD. Pre-clinical research points to effects on fear conditioning, but controlled clinical trials in PTSD are scarce.

Important: in virtually all these studies, doses were used that are far above what is found in over-the-counter food supplements, often hundreds to a thousand mg a day under medical supervision. The results cannot simply be translated to daily use of a few drops of CBD oil.

The conclusion from science so far

No Dutch professional body for psychiatry or psychology recommends CBD as a treatment for mental health complaints. Research is ongoing, but is at present far too limited to position CBD as an alternative or addition to recognised care. With persistent complaints, a GP or a psychologist/psychiatrist is the right route.

Particular attention: children, young people and vulnerable situations

In children and young people the use of CBD supplements is not advised. The developing brain responds differently from that of adults, and research is insufficient.
When using psychiatric medication (such as SSRIs, antipsychotics, anti-epileptics): always discuss CBD use with your practitioner beforehand. CBD can influence how the body breaks down certain medicines.
In an acute crisis or with suicidal thoughts, CBD is not relevant. Call your GP, 113 (suicide prevention) or the out-of-hours GP service.

Frequently asked questions

What does research say about CBD and anxiety complaints?

Clinical research is mixed and still methodologically limited. CBD is not a recognised treatment for anxiety disorders. With persistent anxiety, a GP or psychologist is the right first step.

Can I give CBD to a child with ADHD or autism?

No, that is not advised. Research in children is limited and always concerns medical trials under supervision, not daily supplement use. For concerns about a child, go to your GP or a paediatrician.

May I combine CBD with antidepressants?

Always discuss that with your treating doctor or pharmacist first. CBD can influence how certain psychiatric medicines work.

What does research say about CBD and sleep?

Research is mixed. For sleep problems there are proven routes through a GP: lifestyle advice, sleep hygiene, sometimes temporary use of medication under supervision. CBD is not a replacement.

Where can I turn with mental health complaints?

First step: your GP. For anonymous conversations you can turn to MIND Korrelatie. In an acute crisis or with suicidal thoughts: 113 (113.nl, telephone 0800-0113) or the out-of-hours GP service.

Sources and helplines

In an acute crisis: 113 Suicide Prevention: 113.nl or call 0800-0113
MIND Korrelatie (anonymous conversations): mindkorrelatie.nl
Thuisarts.nl on anxiety: thuisarts.nl/angst
Thuisarts.nl on sleeping badly: thuisarts.nl/slecht-slapen
MIND for general mental health information: wijzijnmind.nl

This article is informative and not medical advice. For questions about your mental health, a GP or mental health care is the right route. CBD is a food supplement and not a treatment for psychological complaints.

CBD and mental health: what research says about the endocannabinoid system