Weed and Bipolar Disorder: A Possible Treatment?

Bipolar disorder, a mental health condition affecting around 4.4% of U.S. adults, is known for its extreme mood swings, from the highs of mania to the lows of depression. These shifts can severely disrupt daily life, making effective management crucial for those affected. In the search for better treatment options, cannabis has sparked interest for its potential therapeutic benefits, such as pain and anxiety relief. However, the relationship between weed and bipolar disorder management is complex and nuanced.

What is Bipolar Disorder?

Bipolar disorder, formerly called manic depression or manic-depressive illness, is a mental health condition that leads to unusual shifts in mood, energy, activity levels, and concentration. This makes daily tasks challenging.

These shifts manifest in three primary forms: 

• Bipolar I disorder is characterized by severe manic episodes often requiring immediate medical care 
• Bipolar II disorder is marked by a pattern of depressive and hypomanic episodes less intense than bipolar I 
• Cyclothymic disorder or cyclothymia is defined by milder symptoms of hypomania and depression.

Symptoms of bipolar disorder include a wide range of emotional states, from feeling overly elated and energized during manic episodes to experiencing deep sadness or hopelessness during depressive episodes. Both states can feature bipolar rage, an intense anger that adds to the distress and challenges. These episodes can severely impact an individual's behavior and functionality, often without their awareness of the potential harmful effects.

The causes of bipolar disorder are multifaceted, involving a combination of genetic, environmental, and neurological factors. Studies suggest that the brain’s function and structure in people with bipolar disorder may differ from those without the condition, potentially influencing the effectiveness of treatments. Additionally, genetics play a significant role, with a family history of bipolar disorder significantly elevating the risk of its onset.

Treatment for bipolar disorder is lifelong and typically involves a combination of medication and psychotherapy. Medications like atypical antipsychotics and mood stabilizers are commonly prescribed to manage symptoms. 

Psychotherapies, such as family-focused therapy and cognitive behavioral therapy (CBT), provide further support and education for managing the condition.

In some cases, other treatment options like electroconvulsive therapy (ECT) or light therapy may be considered, especially for severe symptoms or seasonal affective disorder (SAD).

Living with bipolar disorder requires careful and continuous management of symptoms. A structured routine, regular exercise, and ongoing treatment adherence are crucial for maintaining stability. Support from healthcare providers, friends, and family plays an integral part in the effective management of bipolar disorder, helping individuals lead healthy and active lives.

Why Patients Choose Cannabis for Bipolar Disorder

Cannabis is being increasingly considered by some as a potential aid in treating bipolar disorder, yet its effectiveness varies across individual experiences. Given the limited scientific data, many individuals often turn to experiences shared within their community to understand how cannabis might impact their condition.

Anecdotal reports from individuals with bipolar disorder suggest that cannabis may offer some symptomatic relief, particularly in terms of mood regulation and anxiety reduction. Some patients report a subjective sense of well-being and a decrease in the acute symptoms associated with manic and depressive episodes. 

Some reports indicate that cannabis use might act as an antimanic and antidepressant, helping to reduce both mania and depression symptoms. There is even a possibility of reducing the side effects associated with traditional medications like lithium.¹

However, these anecdotal experiences are not entirely supported by scientific research. The effectiveness of cannabis use for bipolar disorder remains a subject of ongoing research. 

Notably, some studies have raised concerns about cannabis interfering with treatment compliance, particularly among patients receiving conventional medications, such as anticonvulsants, antipsychotics, and lithium.

The potential for cannabis to complement traditional treatment methods is exciting, but the evidence is still in the early stages. Theories, such as the selective activation of CB2 receptors, point to promising areas for future research. This specific theory offers potential mood stabilization that is similar to existing mood stabilizers.

While individual reports suggest some people with bipolar disorder find cannabis helpful, this is not universally supported by scientific evidence. It's important for patients and healthcare professionals to discuss the potential role of cannabis in treatment carefully.

Weed and Bipolar Disorder: Are There Any Risks?

When using weed for bipolar disorder, patients should be aware of the potential risks. Research shows that the relationship between weed and bipolar disorder is complex, requiring careful consideration.

One of the main concerns is how cannabis might change the way bipolar disorder affects a person. Some wonder, “Can weed cause bipolar disorder or worsen the condition?”

While cannabis does not cause bipolar disorder, it can complicate the management of the condition.

Some people might experience more severe mood swings, including intense episodes that mix features of both mania and depression and potentially lead to bipolar rage. 

This leads to questions like, “Can weed make you angry?” when the answer can be complex. While not directly causing anger, cannabis can exacerbate symptoms like irritability and aggression in some individuals with bipolar disorder. 

There's also evidence that people who use cannabis might start showing symptoms of bipolar disorder earlier in life. This could occur up to nine years sooner, especially if there is an above-average use of cannabis.

Cannabis use might also lead to more frequent and severe manic episodes, with symptoms like hallucinations and delusions becoming more common. Over time, this can make bipolar disorder harder to manage and lead to a more challenging course of the illness, impacting a person's ability to function day-to-day and increasing the risk of serious outcomes, such as suicide.²

Additionally, research indicates that cannabis use may reduce treatment compliance among bipolar disorder patients who are taking anticonvulsants, antipsychotics, and/or lithium. This reduction in compliance can undermine the effectiveness of these crucial medications, potentially exacerbating the condition and complicating treatment efforts.¹

It's also worth noting that our understanding of these risks comes from studies that might not capture the whole picture—primarily other risks like environment and childhood trauma. A lot of the research also relies on people remembering and reporting their cannabis use, which can be unreliable. These studies also don't consider the specific types or amounts of cannabis used, which can vary widely among consumers.

Due to these factors, anyone with bipolar disorder thinking about using cannabis should talk to their healthcare provider. This conversation can help ensure that any decisions about using cannabis are made with a complete understanding of the current scientific research, along with a person’s medical history.

Weed as a Treatment for Bipolar Disorder

Current research into cannabis as a potential adjunct or alternative treatment for bipolar disorder is complex. Studies suggest that cannabis may have varying effects on individuals with bipolar disorder. 

Some research indicates that cannabis use might interfere with the effectiveness of conventional bipolar medications over time, such as anticonvulsants, antipsychotics, and lithium. This is particularly noted among patients experiencing acute manic episodes.

In contrast, anecdotal evidence and qualitative studies suggest that some individuals with bipolar disorder find cannabis helpful in alleviating symptoms of both mania and depression.

These reports also hint at cannabis's potential to reduce the side effects associated with lithium treatment, pointing towards a self-medication trend among certain patients. This notion is supported by earlier suggestions that cannabinoids, like THC and CBD, may play beneficial roles in managing anxiety, depression, and psychotic-like behaviors.²

However, it is crucial to highlight that the therapeutic potential of cannabis in bipolar disorder management, especially regarding mood stabilization, remains underexplored in scientific studies. 

While some individuals report positive effects from using cannabis, current research does not support it as a replacement for conventional bipolar disorder treatments.

The existing research indicates that selective activation of cannabinoid receptors might mimic the action of traditional mood stabilizers by influencing certain biochemical pathways.

Given the mixed findings and the lack of substantial clinical evidence, individuals with bipolar disorder considering cannabis as part of their treatment regimen are strongly advised to discuss its use with healthcare professionals. This ensures that health decisions are based on a comprehensive understanding of personal health needs and the current state of research.

Tips for Using Weed for Bipolar Disorder

Considering cannabis as part of bipolar disorder treatment requires careful planning and open communication with healthcare professionals. It's particularly important for patients on specific treatments, such as those using lamotrigine (a common medication for bipolar disorder), to discuss potential interactions between their medication and cannabis.

Here are some tips for using cannabis safely for those with bipolar disorder: 

• Consultation with Healthcare Professionals: Patients should seek guidance from their healthcare providers to understand the potential benefits and risks associated with cannabis use for bipolar disorder management. 
• Awareness of Medication Interactions: Patients should be aware of the potential interactions between cannabis and existing medication, including mood stabilizers and antipsychotics, to ensure the continued efficacy and safety of their treatment regimen.
• Gradual Introduction: If cannabis use is considered, starting with minimal doses and gradually adjusting based on the individual's response can help in assessing its impact on bipolar disorder symptoms.
• Monitoring and Documentation: Keeping a detailed record of cannabis use and its effects on mood and overall well-being can be valuable for both the patient and the healthcare provider in evaluating the appropriateness of cannabis as an adjunct treatment.
• Exploring CBD-Dominant Cultivars: Opting for cannabis cultivars with a higher ratio of CBD to THC may offer therapeutic benefits while minimizing intoxicating effects, which could be more suitable for individuals with mood disorders. 
• Setting Realistic Expectations: It is important to recognize that cannabis may provide symptomatic relief for some individuals but is not a replacement for a comprehensive bipolar disorder treatment plan.
• Observation of Mood Changes: Patients should remain vigilant for any significant changes in mood or behavior and communicate these changes promptly to their healthcare provider.
• Choosing Reputable Sources: Obtaining cannabis from reputable and legal sources is important for quality assurance and safety. 

Given the complexity of bipolar disorder and the variability in individual responses to cannabis, a cautious and informed approach is recommended.

Ask a Budtender: Which Weed Products do Patients Choose for Bipolar Disorder?

When exploring cannabis for bipolar disorder, it's essential to proceed with caution, as the field relies heavily on patient reports rather than extensive scientific research. 

Many patients with bipolar disorder lean towards strains higher in CBD for their minimal intoxicating effects and potential therapeutic benefits. These strains are often chosen in the hope of avoiding exacerbation of mania or paranoia.

For instance, cultivars such as Diesel and Jack Herer are commonly used by individuals to help relieve symptoms of depression. One can look for cultivars with a balanced THC-to-CBD ratio, which some patients find offers a harmonious effect, aiding in mood stabilization with fewer side effects.

Certain terpenes in these strains, such as caryophyllene and linalool, might contribute to their effectiveness. Researchers recognize these compounds for their potential anti-inflammatory and calming properties, which may contribute to the strain's overall therapeutic potential.

Starting with low doses and gradually adjusting is a common approach among patients to carefully gauge the effect on bipolar symptoms. This method allows for a personalized understanding of how cannabis interacts with their condition.

These insights come from individual experiences and lack scientific confirmation. Therefore, consulting with psychiatrists or healthcare providers before incorporating cannabis into a treatment plan for bipolar disorder is recommended. 

A thorough discussion can help ensure that any cannabis use is thoughtfully considered within the broader context of the patient’s health and treatment goals.

References

1. Arjmand S, Behzadi M, Kohlmeier KA, Mazhari S, Sabahi A, Shabani M. Bipolar disorder and the endocannabinoid system. Acta Neuropsychiatrica. 2019;31(4):193-201. doi:10.1017/neu.2019.21 ↩︎
2. Tourjman SV, Buck G, Jutras-Aswad D, et al. Canadian Network for Mood and Anxiety Treatments (CANMAT) Task Force Report: A Systematic Review and Recommendations of Cannabis use in Bipolar Disorder and Major Depressive Disorder. Can J Psychiatry. 2023;68(5):299-311. doi:10.1177/07067437221099769 ↩︎

The information in this article and any included images or charts are for educational purposes only. This information is neither a substitute for, nor does it replace, professional legal advice or medical advice, diagnosis, or treatment. If you have any concerns or questions about laws, regulations, or your health, you should always consult with an attorney, physician or other licensed professional.