Cannabis and Bipolar

Over the past few years, cannabis has become legal for medical and recreational use in several US states. If you’re someone who has bipolar disorder, perhaps you’ve wondered, is it safe? Could it be a potential treatment option? Among patients with bipolar 1 disorder, cannabis is the most commonly used illicit substance. If you’ve looked into it, you’ve probably come across conflicting research regarding bipolar disorder and cannabis use. Maybe you even have a friend who claims it helps them better than prescription medication and another friend who won’t go near it. So, what do we actually know about the effects of cannabis on bipolar disorder?

Cannabis is made up of over 80 different cannabinoids. Of these 80, the two that have been most researched are tetrahydrocannabinol (THC) and cannabidiol (CBD). In short, THC makes you feel high while CBD makes you feel calm. CBD has anxiety reducing effects which some believe could help improve the moods of people with bipolar disorder. In 2016, a study was done on the effects of cannabis on the moods and cognitive functions of people with bipolar disorder. The researchers tested a group of bipolar patients who regularly smoked cannabis and found that the patients reported short-term relief from their symptoms after use. This could indicate potential mood-stabilizing properties of cannabis. The ratio of CBD to THC varies from strain to strain, and when it comes to bipolar, this can make all the difference. While THC can induce psychotic reactions, CBD has been found to have antipsychotic effects. The two mitigate each other. There is some suggestion that cannabis strains with higher levels of THC could make things worse for patients with bipolar, while strains higher in CBD might offer some relief. 

It’s important to keep in mind that cannabis affects everyone differently. While it may provide relief for some, it has the potential to induce psychosis in others. Genetics play a role in determining this outcome. According to the National Institute on Drug Abuse, individuals who carry a specific variant of the AKT1 gene have an increased risk for developing psychosis when using cannabis. The risk was found to be seven times higher for those with this variant who used cannabis daily than those who used it infrequently or not at all. At eMoods, we are not doctors and cannot offer medical advice, but if you have bipolar disorder and are interested in using cannabis, it’s a good idea to talk with your doctor about testing for this variant.

Although certain research suggests cannabis may help some individuals with bipolar, there is no guarantee that it will benefit everyone. In fact, there is even some evidence showing that using cannabis makes it more difficult to treat bipolar disorder. In one twelve month study, cannabis users who were being treated for bipolar were found to be less compliant with treatment. They also experienced overall illness severity including mania, psychosis and less life satisfaction compared to those who did not use cannabis. Among all mental disorders, bipolar is responsible for the highest rate of suicide, 20 to 30 times higher than that of the general population. In one study done in 2019, researchers found that cannabis users were generally younger when their bipolar symptoms first appeared compared to non-users. This study also found that cannabis may increase the risk of suicide and manic episodes in bipolar patients. 

There is more research to be done on cannabis and bipolar disorder. At this time, little is known about the long-term effects of prolonged use. Cannabis is still a federally illegal substance and we are not suggesting you use it. While it has provided some bipolar patients with relief from their symptoms, others have had negative, worsening effects. If you are considering using cannabis, it’s important to have a conversation with your doctor first.  


This post was written by Jack Pombriant, a contributor to eMoods.  Jack Pombriant is a freelance writer, radio producer and musician.  His website is located at jackpombriant.com.

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