For decades, scientists have tried to find a way to treat the effects of or even cure post-traumatic stress disorder (PTSD), but research has shown that an effective treatment may have been available all along: CBD.
In the past decade, CBD, or cannabinol, has become a popular way to treat a myriad of illnesses, including PTSD.
Part of the reason more and more PTSD sufferers are looking towards CBD instead of prescription medications is the many side effects that the prescriptions come with.
Typical and Off-Label PTSD Treatments
As of 2019, the United States Food and Drug Administration has only approved 2 drugs for the treatment of PTSD. These drugs are part of the Selective Serotonin Reuptake Inhibitors (SSRI) family of medications.
The 2 drugs are sertraline (known under the brand name Zoloft) and paroxetine (known under the brand name Paxil). In addition to these a third SSRI, fluoxetine (under the brand name Prozac), is prescribed as an off-label medication.
The exact way SSRIs work is unknown. Scientists hypothesize that SSRIs increase the serotonin levels in the brain by limiting or preventing the reabsorption of serotonin into certain brain cells allowing a “pool” of serotonin to accumulate and increase so the serotonin can form bonds with neurotransmitter receptors to help regulate neural and central nervous system activities.
Serotonin-Norepinephrine Reuptake Inhibitors (SNRI) are also prescribed as an off label medication for PTSD. The most common SNRI that’s prescribed for PTSD is venlafaxine (marketed under the brand name Effexor). SNRIs work in the same fashion as SSRIs where serotonin reabsorption is restricted. But with an SNRI, the reabsorption of norepinephrine is also inhibited to allow it to pool and bond with neurotransmitters.
Another class of drugs used to treat PTSD is Monoamine Oxidase Inhibitors (MAOI). MAOIs prevent the removal of norepinephrine, serotonin, and dopamine from the brain. The only MAOI that’s currently recommended (although still an off-label prescription) for PTSD is phenelzine (marketed under the brand name Nardil). This drug is usually tried after several other options have failed as it has side effects that could be fatal. If the user has a history of high blood pressure or consumes alcohol or illicit narcotics heavily, then doctors usually won’t prescribe phenelzine or any other MAOI.
A less common option, but certainly not unheard of option for PTSD is the class of drugs known as benzodiazepines (commonly referred to as “benzos”). These drugs are never used as a long term solution as they’re not only highly addictive but can hinder a therapist’s ability to effectively treat a patient as they can create a sort of brain fog that prevents the patient from recalling the trauma.
Benzodiazepines are generally used when a patient is suffering from an acute attack that lasts for several hours or days to relax the patient. The drugs act on a neurotransmitter which slows down and calms the central nervous system and dulls the symptoms of the attack.
Among the most commonly prescribed benzodiazepines are:
- Clonazepam (marketed under the brand name Klonopin)
- Lorazepam (marketed under the brand name Ativan)
- Diazepam (marketed under the brand name Valium)
- Alprazolam (marketed under the brand name Xanax)
Anyone that’s put on these medications needs to be closely monitored for the improvement of symptoms as well as to make sure that the user doesn’t become addicted.
Since the short-term goal of PTSD is to relax the patient, another medication that’s prescribed off-label is propranolol. Propranolol is a type of beta blocker. Beta blockers work by blocking norepinephrine at and adrenaline from entering the central nervous system as well as organs such as the muscles and the heart. Despite the off-label use for PTSD, beta blockers have been found to help reduce anger, surprise from being startled, vivid flashbacks, and nightmares.
One of the major symptoms of PTSD is nightmares. Some physicians will prescribe prazosin (marketed under the brand name Minipress) to combat the nightmares. While it is effective for that specific purpose, there’s little evidence to suggest that it helps with any of the other symptoms of PTSD and isn’t generally recommended. https://www.sidran.org/resources/clinicians-guide-to-medications-for-ptsd/
What Causes PTSD?
PTSD is caused by a horrific or terrifying event experienced or observed by a person.
In a normal scenario, a person who experienced such an event usually can overcome issues such as fear and anxiety with counseling and medication.
For a person suffering from PTSD, the symptoms remain for months or years. Instead of the symptoms diminishing, they may stay the same or even intensify to the point of interfering with a person’s ability to function normally.
The Fourth Edition of the Diagnostic and Statistical Manual of Mental Disorder (DSM-IV) groups the symptoms of PTSD into 5 “clusters”. If a person has at least 1 symptom from each of the 5 clusters, they are considered to have PTSD.
In order for the diagnosis to be made, these symptoms can’t be associated with drug or alcohol use (although drug or alcohol use can result from the symptoms) and they have to be experienced for at least a month with a lack of ability to function normally in everyday tasks.
- The Stressor Cluster – For this cluster, the patient was exposed to a life-threatening injury or illness that included violence or injury. Symptoms from this cluster include:
- Witnessing a trauma
- Direct exposure to the trauma
- Learning that someone close to you experienced the trauma
- Exposure to trauma by being a first responder
- The Intrusion Cluster – In this cluster, the patient re-lives the trauma. Symptoms for this cluster can include:
- Being physically “triggered” by being exposed to reminders of the event.
- Flashbacks
- Nightmares
- Intense memories of the event
- Mood/Thought Change Cluster – Experiencing sudden mood, thought or behavioral changes when the event is brought up. Symptoms in this cluster can include:
- Feelings of isolation
- Inability to remember the trauma clearly
- Negative feelings about self and the world
- Blaming self or others for the trauma
- Difficulty feeling positive
- Decreased interest in things that were once enjoyable
- Avoidance Cluster – When the patient actively tries to avoid any and all reminders of the traumatic event. Symptoms in this cluster include:
- Avoiding external reminders of what happened
- Avoiding trauma-related thoughts or emotions
- Use of illicit drugs or alcohol to forget about the occurrence
- Reactivity Cluster – When the patient becomes intensely fearful of minor situations that would startle the average person. Symptoms in this cluster include:
- Difficulty sleeping or staying asleep
- Engaging in destructive or risky behavior
- Hyper-awareness
- Difficulty concentrating
- Intensified aggression or irritability
- Heightened startle response
How Can CBD Help Treat PTSD?
It has been known for a long time that CBD has many health benefits. Among these benefits is that CBD has neuroprotective properties.
In the case of PTSD, CBD helps mitigate and in some cases eliminate the symptoms of PTSD by activating receptors in the body’s endocannabinoid system (ECS) and produce chemicals in the brain that quell fear and anxiety and promote memories of pleasure and happiness.
CBD helps prevent the memory retrieval of the traumatic experiences and memories, which stops such issues as flashbacks and nightmares that patients experience.
In 2013, a study was conducted called Elevated brain cannabinoid CB1 receptor availability in post-traumatic stress disorder: a positron emission tomography study, researchers found that PTSD suffers have lower levels of a brain chemical called anandamide, another endocannabinoid. Anandamide much like CBD has neuroprotective properties.
Anandamide acts as a naturally produced antidepressant in the body. A lack of this substance and other endocannabinoids such as CBD can work in the opposite manner, amplifying fear and anxiety.
In the study, the lead researcher discusses the ineffectiveness of synthetic antidepressants and mentions the success that PTSD sufferers have had that use cannabis to treat their symptoms:
“There’s a consensus among clinicians that existing pharmaceutical treatments such as antidepressant simply do not work. In fact, we know very well that people with PTSD who use marijuana — a potent cannabinoid — often experience more relief from their symptoms than they do from antidepressants and other psychiatric medications. Clearly, there’s a very urgent need to develop novel evidence-based treatments for PTSD.” https://www.ncbi.nlm.nih.gov/pubmed/23670490
CBD use can help prevent a major symptom of PTSD: nightmares. Use of CBD helps eliminate the stress that can occur as someone is trying to fall asleep. Many times patients will experience “distorted thoughts” that send the mind racing and make trying to sleep incredibly difficult for the patient.
These distorted thoughts can translate into distressing dreams or even nightmares when the patient finally gets to sleep, causing a PTSD attack.
CBD can help reduce the stage of deep dreaming called REM sleep. REM, or rapid eye movement, is a stage of the sleep cycle where a person falls into a deep sleep and has vivid dreams. It is characterized by the eyes shifting back and forth in a fast manner under the closed eyelids.
While many of the studies conducted with PTSD involving CBD are of the effects of cannabis as a whole, the stigma of THC and its psychoactive properties have been a barrier in the treatment process, with researchers looking more towards synthetics that can be approved versus marijuana which is still classified as a Schedule I drug by the United States Food and Drug Administration (FDA), thus making marijuana or marijuana products nearly impossible as Schedule I drugs by legal definition “have no therapeutic value”.
But with changes that have recently occurred in the law, hemp is no longer banned, making the accessibility of CBD (which can be derived from hemp without any psychoactive substances such as THC) widespread and available for research.
CBD provides a natural, and non-toxic alternative to many anti-depressants. As discussed earlier, some of the antidepressants that are prescribed can have addictive effects and may cause organ damage with prolonged use. Some medications require a patient to have bloodwork and urinalysis done on a monthly basis to make sure that the medications are not affecting the liver or kidneys in negative ways.
In addition, unlike most antidepressants, the patient has a number of methods they can choose to ingest the CBD. The most common method, a tincture, allows a user to put drops of CBD oil under their tongue. But other methods include vaping, edibles, drinks, pill, capsules, gelcaps, gummies, as well as lotions and bath products that can help a PTSD sufferer relax.
Many have found that the use of CBD has taken them from a disabled PTSD sufferer to regaining at least some, if not most of their lives back.
CBD Alone Isn’t the Answer
While CBD can help with the physical effects that PTSD sufferers experience, it will not be effective in the long term if it is used alone. PTSD is psychological trauma. In some cases, the experience for the sufferer has been so horrific that it may take years to overcome.
That’s why a person looking to treat their PTSD with CBD needs to seek help from a therapist, psychologist, or psychiatrist that specializes in PTSD trauma.
Many times a mental health professional will recommend cognitive behavioral therapy (CBT). In traditional therapy, a therapist tries to help the patient find the “root” of the problem, which for some psychological issues may come from childhood. But with cognitive behavioral therapy, the therapist works with the patient to focus on solutions by encouraging them to challenge distorted thoughts and change patterns of behavior that may be causing further exasperation of the condition.
CBT helps patients identify when they have these distorted thoughts and work through them to avoid the patient from acting on them (especially when they’re harmful or dangerous) and find a way to cope with them. In some cases “coping mechanisms” are identified for the patient. For example, a patient may find that writing their feelings in a journal or drawing may help them cope with their situations.
The therapist may also suggest that the patient join a therapy group to help them grow their support network.
When seeking out a mental health professional, it’s important that the patient let the professional know that they wish to uses CBD as part of their treatment plan, as some may not be “on-board” with its use.
Conclusion
PTSD can be debilitating for many and the use of prescription medications may quell the symptoms of the condition, but create new issues with being able to function on a daily basis as well as cause physical medical issues like organ damage.
CBD has proven effective in helping reduce the symptoms of PTSD and is a naturally occurring chemical in the body. The only side effect of CBD is that it can make someone sleepy or a bit lethargic. This can be controlled by altering the dosage.
As a natural substance with only a minor side effect, CBD is becoming a popular choice for PTSD and many other conditions. It may take a few more years to be fully embraced by the medical community due to the stigma that cannabis has had over the last 75 years, but legitimate scientific research is proving that CBD shouldn’t be ignored as a way to help people overcome their conditions.
