Today’s TRUCE Medical Minute is written by TRUCE Volunteer and Medical Cannabis Advocate Dr. Russell Cashin.
Dr. Cashin teaches an Intro to Medical Cannabis Course through Dixie State University’s Continuing Education program. We are thrilled to have a mental health provider contribute to the TMM, and welcome additional opinions or requests for topics. If you are a medical professional and would like to write a Sunday column please reach out. We love the idea of our community educating each other!
Cannabis and Your Mood
Of the few conditions for which a patient may obtain a medical Cannabis recommendation in Utah, when it comes to our psychological health only PTSD is specifically covered. Conditions such as anxiety and depression or other related mood disorders are not on Utah’s “Qualifying Conditions” list.
Additionally, those seeking to use Cannabis for PTSD have an added burden in that they are required to be “treated and monitored by a mental health therapist” and “diagnosed by a health care provider” when seeking a recommendation (Utah Department of Health, 2019).
A historical foundation as well as recent clinical reporting indicate that Cannabis helps with stress and anxiety as well as other mood-related symptoms. Historians report that Cannabis was widely used in India some 3000 years ago, where it was celebrated as one of “five kingdoms of herbs … which release us from anxiety.”
It is important to understand the impact this plant has on mood, especially given the high comorbidity (where two or more diseases exist simultaneously) with affective disorders that often occur in patients that have long-term pain, cancer, seizures, or other medical conditions.
What this means for those patients who are using Cannabis for any covered condition who also experience stress, anxiety or other mood-related conditions, is that attention needs to be given to the type of plant profile one chooses to treat the primary condition. While each cultivar (“strain”) has differing amounts of the various cannabinoids and terpenes, it is easiest to just refer to the main subspecies of Sativa, Indica or Hybrid when determining which to use.
Sativa is known for its energizing effects, which often include a cerebral “high” if the THC is ingested in a sufficient dose. For example, this may be helpful with those who need the medicinal benefit of the plant for pain, but who also suffer from low-mood or energy and require help to get their day started. However, if you have anxiety in addition to pain then Sativa, due to its energizing properties, is probably not for you.
Indica is primarily known for its relaxing and even sedating effects.
Indica is considered helpful for those who have a covered condition that also adversely effects sleep by either helping them get to sleep or stay asleep. However, Indica may be too sedating during the day and therefore best taken in the evening.
Hybrids are a variety of Cannabis that are crossbred cultivars of Sativa and Indica, which offer the dominant characteristic of either the energizing Sativa or relaxing Indica, but also offer some benefits of both. In other words, an Indica dominant hybrid will be less sedating than a pure Indica, which is helpful for those wanting to relieve pain during the day, but also suffer from stress or anxiety and need to decrease the unpleasant feelings without being overly sedated.
Therefore, when considering which plant or extract to use, be aware of the mood-altering effects of the source plant’s profile by choosing one that will help with your primary condition AND your mood.
Russell H. Cashin, PhD