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Social anxiety disorder (SAD) is a mental health condition characterized by intense fear of social situations and persistent worries about being judged, embarrassed, or humiliated in public. These fears lead a person to avoid situations like being in public or interacting with others, which can cause significant distress and impair daily functioning. SAD affects around 7% of the US population every year, and treatment typically includes interventions such as psychotherapy (particularly cognitive-behavioral therapy (CBT)) or antidepressant medications like selective serotonin reuptake inhibitors (SSRIs).
Medicinal cannabis products also offer potential relief for SAD. Growing interest in alternative approaches to mental health treatment has illuminated the potential for cannabis compounds, particularly cannabidiol (CBD), to alleviate the symptoms of various mental health conditions.
In regards to anxiety, there is increasing evidence that therapeutic use of CBD and now possibly CBG can have significant impacts on lessening symptoms. This means that CBD or CBG may be helpful treatment options for people experiencing the impairments created by SAD.
CBD: How It Works
CBD is one of over 100 cannabinoid compounds found in the Cannabis sativa plant. These compounds interact with the body’s endocannabinoid system (ECS)—a complex network of cannabinoids and receptors found throughout the bodies of humans and other animals. Since the ECS regulates mood, appetite, pain, and sleep, therapeutically administered cannabinoids that act upon this system can improve the functioning of this essential regulatory network to alleviate a variety of symptoms.
The psychoactive cannabinoid tetrahydrocannabinol (THC) is the most well-known cannabinoid produced by the cannabis plant, but CBD differs from THC in significant ways. Most notably, CBD does not cause the intoxication or anxiety that THC triggers, which leads to euphoric and psychoactive experiences commonly known as the “high.”
Excess THC can lead to a temporary increase in anxiety and panic symptoms, at least until it wears off. CBD is known to counter THC’s psychotropic effects and anxious side effects.
The exact mechanisms by which CBD helps with anxiety are not fully understood, but existing research has produced some possible explanations for how it works. There are two main types of receptors found in the ECS: CB1 receptors, primarily located in the brain and central nervous system, and CB2 receptors, found mostly in peripheral organs and immune cells. Although CBD cannot activate or bind to these receptors, it may indirectly influence them by increasing levels of certain endocannabinoids, which are the body’s natural, internally manufactured cannabinoids.
CBD may also work on the systems that modulate serotonin and adenosine receptors and levels, which contribute to the cannabinoid’s therapeutic effects on mood and anxiety. One hypothesis regarding how CBD reduces anxiety is that CBD interacts with particular serotonin receptors to increase the availability of serotonin, the neurotransmitter associated with mood and anxiety regulation.
Another possible way CBD may impact the brain is through its stress response. CBD potentially alters cerebral blood flow in regions of the brain associated with anxiety, such as the amygdala and the anterior cingulate cortex. These brain areas are involved in the processing of fear and emotional responses. By affecting the activity in these regions, CBD could alter feelings of emotional distress and produce calming effects.
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CBD and Social Anxiety
Well-documented and repeated studies suggest that CBD may be an effective treatment for anxiety symptoms. As a result, this makes CBD a promising candidate to help with social anxiety and SAD. There are many preclinical and clinical studies indicating the potential benefits of using CBD in the treatment of anxiety disorders, with some results specifically addressing CBD’s effects on social anxiety.
Multiple studies have produced evidence for CBD’s potential role in mitigating symptoms of social anxiety caused by public speaking tasks. For example, in one 2019 study, researchers gave healthy participants doses of 150 mg, 300 mg, or 600 mg of CBD before a public speaking task. The group with the 300 mg dose of CBD reported reduced levels of anxiety while performing the stressful task than the group treated with the placebo. These findings suggest that CBD can help reduce symptoms of social anxiety at certain mid-range doses, and it may even be particularly useful for handling situations where social anxiety is more present.
Another 2019 study investigated the anxiety-reducing effects of repeated daily administration of 300 mg doses of CBD versus placebos in teenagers with SAD. Throughout the one-month intervention, the CBD group demonstrated significant symptom reduction across the intervention period. These findings not only confirm that CBD can have a positive effect in alleviating anxiety symptoms among healthy individuals in anxiety-producing situations, but CBD can also be particularly valuable for those suffering from the challenges that come with SAD.
Considerations and Cautions
While the research on CBD and social anxiety is promising, it is important to acknowledge that the studies conducted so far have been relatively small. Plus, the studies often involve single doses of CBD in controlled settings, and they do not represent how CBD’s effects on social anxiety might turn out in the longer term (more than 1 month).
When deciding on whether to pursue CBD as a treatment option for anxiety, keep in mind that there is still little information about the long-term effects of CBD, optimal dosing amounts, and CBD’s potential interactions with other medications or treatments for anxiety.
However, consider that social anxiety relief is one of the best-supported use cases of CBD in the literature overall. And that CBG is a promising newcomer in this regard as well.
Moreover, the regulation of CBD products varies widely across the country, which results in inconsistencies in product quality and labeling. As of today, the only FDA-approved CBD-based treatment is the seizure medication Epidiolex. So, when considering CBD as a treatment option, consumers should seek personalized medical advice first, and then consider products from reputable sources and ideally obtain a certificate of analysis (COA) verifying the safety, dosing, and purity of the CBD product.
CBD appears to have promising potential to treat symptoms for those experiencing social anxiety or SAD. Although researchers need to further investigate the mechanisms, benefits, and long-term effects of CBD, current evidence shows that CBD can provide significant short-term anxiety relief.
As always, we recommend that people interested in trying CBD as an alternative treatment for anxiety consult with a healthcare provider to ensure this treatment approach is appropriate for their needs and circumstances.
Sheldon Sommer is a Southern Californian philosopher with a lifelong interest in the biological world. She is enthusiastic to contribute her fascination with philosophy, natural history, psychology, botany, biochemistry and other related topics to providing cannabis education for the similarly curious. Outside of writing, she enjoys painting, singing opera and Taylor Swift songs, as well as spending quality time with a certain beloved orange kitty cat.
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