Research reveals one-third of medical cannabis patients use the drug for depression. Alongside this, people who cite stress, anxiety, or insomnia as main reasons for using medical cannabis, usually identify depression as a secondary reason.
Recent research is beginning to emerge supporting the use of hemp or CBD for major depressive disorder (MDD), or depressed mood (DM), while observational data to support its effectiveness is very strong. In a study of 364 young cannabis users,  87 percent stated that they used it to alleviate a depressed mood. Currently, it is unwise to treat MDD solely with medical cannabis. The typical conventional antidepressants are known to be effective, and MDD is a very serious and potentially debilitating problem. Caution must be used when cannabis products are involved in treating depression, because cannabis medicines high in THC are biphasic: At higher doses THC correlates with depression, but at lower doses it correlates with reduced depression. 
The generally accepted definitions used by scientists are defined in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) ; and a diagnosis of MDD is very different from DM, which is considered part of the normal ups and downs of emotional states. Almost all the scientific literature is about MDD. Mood elevation and relief from anxiety using hemp can be very helpful for those suffering from serious mental or physical illnesses where patients who may understandably be depressed from a diagnosis and the complications of its treatment. Loss of independence, hair loss, weakness, fatigue, mental fog, loss of vocation, insomnia, isolation, and, in some cases, poverty and fear of death or disability, can have serious impacts on quality of life (QOL).
Compelling human studies on cannabinoids and depression came about through failed clinical trials of the synthetic cannabinoid rimonabant, a CB1 inverse agonist/antagonist. Because CB1 agonists increase appetite, it was considered that an antagonist might help weight loss. The people receiving rimonabant were 2.5 times more likely to discontinue the drug because of depressed mood, and alarmingly, almost twice as likely to commit suicide. This study showed that CB1 plays a role in depression. Tetrahydrocannabinol in cannabis activates CB1, while rimonabant blocks it. 
The pathophysiology of depression is considered to be linked to hippocampal and prefrontocortical neural degeneration neuroendocrine disturbances of the hypothalamic-pituitary-adrenal axis, and neurochemical deficits.  Although there are multiple neurotransmitters and receptors involved, ultimately all antidepressants work by enhancing 5-HT neurotransmission, primarily in the hippocampus. The terpene limonene is a known anxiolytic and increases levels of dopamine via this mechanism.  When neurons associated with dopamine fire, this controls the social defeat stress mechanism,  a significant feature of depression. Limonene also seems to target the 5-HT1 receptor to increase the levels of serotonin in the prefrontal brain cortex.  Amazingly, limonene enabled discontinuation of antidepressants for 9 of 12 patients in a human trial with hospitalized, clinically depressed patients in Japan.  Linalool is also known for antidepressant and calming effects.   For more information, read our Ultimate Guide to Terpenes.
There are two clearly defined summaries about the interactions of antidepressants with the endocannabinoid system (ECS) in animal studies.   ECS activity parallels the currently accepted mechanisms for antidepressant efficacy, by boosting noradrenergic and serotonergic signaling, dampening the hypothalamic-pituitary-adrenal-axis, and increasing neurogenesis and cellular resilience in the hippocampus.  Depressed patients tend to have low anandamide and 2-AG blood levels and both are involved in ECS signaling.  The strongest scientific support for the use of cannabinoids to treat depression comes from many rodent models, which demonstrate that CBD and tetrahydrocannabinol consistently give the same results as common antidepressants.     For more information, read The Endocannabinoid System Explained.
The information contained in this article is for informational purposes only and does not constitute medical advice. Prior to making changes to your lifestyle or treatment plan, always consult with your doctor.
A 2.5 mg dose of THC (just over the threshold of psychoactivity), and up to 5 mg, inhaled or taken sublingually, may be of value in shifting mood. Light doses of CBD (5 to 10 mg) are ideal for anxiety accompanying depression. CBD products with a 20:1 ratio of CBD to THC or higher are generally more ideal for mood and mental health related conditions.
An important note: based on observational reports from PTSD sufferers, avoid hemp strains that are rich in the terpene, pinene (which could interfere with memory remodeling and fear extinction; the ability to dissolve traumatic or disturbing memories), along with avoiding myrcene during the day, which could be contraindicated in cases of suicidal ideation associated with PTSD.
Cannabidiol (CBD) products can be utilized without any psychoactive effects if taken as an isolate. If the strain is in a ratio of 10:1 or higher, taken sublingually, or in a spray, in doses of 5 mg CBD in the morning and mid-afternoon. It can be utilized throughout the day, as needed, but it is advised that the last dose of the day occurs before 5pm, as CBD can be wake-promoting. Light doses of THC (2.5 mg), taken sublingually, has relatively clear, functional effects and can be of value in shifting or elevating mood. The dose can be increased to 5 mg, if needed. If insomnia is present, 2.5 up to 7.5 mg can be taken orally, one hour before bedtime. Vaping or smoking for mild depression or depressed mood can be of value, since the user can learn to titrate the proper dose.
Start with a micro dose to test for sensitivity, ideally of cannabis flowers, typically a matchstick-head-sized piece. Both inhaled CBD and THC can be of value in elevating mood and relieving rumination or negative “self-talk.”
Strains with the terpene, linalool, with its known calming, sedative, and antidepressant effects   (also found in lavender) or limonene (the terpene responsible for the clear, clean note in citrus peels), and known for their antidepressant effects  are preferred. The strain Tangerine Dream is high in limonene, while Bubba Kush is high in linalool. Another strain called Zeta, is a superb strain for improving mood and stimulating motivation while soothing anxiety. It is, however, very potent, so a matchstick-head-sized piece will suffice for daytime use. For more information, read our Ultimate Guide to Terpenes.
CBD can help with anxiety in some people especially strains that are in a 10:1 ratio or higher of CBD to THC. For those wishing to completely avoid THC, CBD products derived from hemp or CBD isolates can be of great benefit. For more information, see our article on CBD for Anxiety.
For more information, see our other article on CBD for Depression, including side effects.
Visit our blog for the latest evidence based news for health conditions that can have the potential to benefit from plant based CBD oil. CBD's effects for relieving symptoms including various treatment options for social anxiety, mood swings, depression and more.
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