OCD, or obsessive-compulsive disorder, is a mental illness that causes the repetition of unwanted thoughts or sensations, or the urge to do something over and over again. Making light of OCD or claiming to have OCD tendencies is rather common, but in reality, about 1 in 40 adults suffer from the condition while 1 in 100 children do as well. Living with the disorder can often be a distressing and debilitating experience, and finding methods to manage the treatment of OCD can pose a serious challenge to many.
A growing body of research is uncovering the role our endocannabinoid system plays in our management of fear, anxiety, and repetitive behaviors. As a result, scientists specializing in the treatment of OCD have begun examining cannabinoids in greater detail to determine if these natural compounds can play a role in the management or alleviation of OCD symptoms.
Can cannabis play a pivotal role in the management of OCD? Can it lessen the symptoms to help those that suffer? Let’s take a closer look to find out.
What is OCD?
Before we jump into this demanding topic, let’s take a moment to examine OCD in greater detail.
Truth be told, we all experience worries, doubts, and fears at one time or another. From getting a good score on an upcoming exam to paying the bills on time, it’s normal to encounter these uncomfortable emotions in everyday life. As common as these experiences maybe, they’re not what healthcare professionals would define as OCD.
Instead, OCD is diagnosed based on a specific set of circumstances. This happens when compulsions or obsessions consume excessive amounts of time, cause significant distress, and interfere with daily functions at home, work, school, or in relationships.
Characterized by obsessive thoughts, impulses, or images and compulsions, OCD is difficult to suppress and it takes a lot of time and energy to overcome. Like most mental health conditions, OCD affects everyone differently and in a spectrum of ways: some individuals may find themselves fixated on cleaning, while others may find an urge to align objects in a symmetrical or specific pattern. Others may experience body-centered compulsions such as skin picking or hair pulling.
Every person’s experience with OCD is specific to them, but people with OCD share the common experience of obsessions or persistent, uncontrollable thoughts, or impulses that are distracting and disturbing. These obsessions can cause an individual with OCD to feel anxiety and perform regular repetitive actions, known as rituals, to control and disperse the anxiety.
How Might Cannabis Help?
A 2019 study published in Cannabis and Cannabinoid Research provides evidence for the treatment of OCD via the body’s endocannabinoid system, or ECS. Because OCD affects the parts of the brain associated with anxiety, stress, fear, and habitual behaviors, the ECS can be utilized to control these behavioral patterns and emotional responses.
CB1 receptors—a fundamental component of the ECS—are found in dense pockets of the brain that many believe are associated with OCD, including the prefrontal cortex, basal ganglia, amygdala, and hippocampus. This connection suggests that activation of the CB1 receptors may help ease specific symptoms associated with OCD. Read on as we examine these different symptoms of OCD, and the role cannabis may play in helping alleviate them.
OCD is characterized by repetitive, habitual behaviors that provide a sense of structure and potential relief from the otherwise ongoing anxiety. Believe it not, connections can be found between these habit-specific locations in the brain and the ECS.
For example, rodent studies have shown that both THC and CBD can influence or even reduce repetitive behaviors in mice. A 2010 study on CBD found that administering the natural compound over the course of a week was effective in manipulating repetitive behaviors. Meanwhile, common anti-anxiety medications like diazepam showed a decrease in efficiency over time.
In a 2017 study that examined individuals suffering from Tourette’s Syndrome, smoking cannabis resulted in fewer tics and urges to perform compulsive behavior. Other research showed a reduction in hair-pulling behavior amongst women that took dronabinol, a synthetic form of cannabis, over the course of 12 weeks. Based on the results of these studies and others of a similar nature, researchers have demonstrated that cannabis directly impacts regions of the brain associated with repetitive, habitual thoughts or actions, thus setting the stage for potential relief from the symptoms of OCD.
Anxiety and Stress
Anxiety and stress are some of the defining symptoms of obsessive-compulsive disorder that can erode one’s sense of self over time. Considerable evidence already suggests cannabis can help regulate anxiety and stress when delivered in the proper doses.
CB1 receptors, a component of the ECS, help fine-tune the brain when it fires up neurons, or inhibits their actions. Agonists are substances that bind to CB1 receptors and help alleviate or build up their potential. How agonists interact with the CB1 receptor depends on the dosage, the way the substance has been administered, and the sensitivity of the receptor itself.
THC is a perfect example of one of these agonists. When THC binds with CB1 receptors at low doses, it can produce calming and sedative effects. At higher doses, it tends to elevate anxiety and produce greater amounts of energy.
More research has shown that when CB1 receptors are blocked, anxiety tends to amplify. Meanwhile, studies on rodents have found that the ECS also influences the body’s responses to stress. Our body’s endocannabinoids promote adaptation to prolonged periods of stress, while THC and other cannabinoids may decrease stress when administered at lower doses.
To properly manage anxiety and stress through the use of THC, it would seem that proper dosage is necessary. Too much or too little will influence mental outcomes.
Conditioned fear is a fundamental component of OCD. This is because the fear-based regions of our brain will pair an aversive or intrusive thought with a neutral trigger, sending a signal to the brain that something is wrong and it needs to be addressed immediately.
For instance, a flickering light may induce fear in the mind of an OCD sufferer, even though such a stimulus would pose as nothing more than an annoyance to you or I. Studies have shown that individuals living with OCD have an impaired ability to remove themselves from fear due to disordered neural pathways.
The ability to extinguish conditioned fear is a major strength for cannabis. In fact, studies of mice have found that the ECS and CB1 receptors are critical when snuffing out fear within the amygdala.
Meanwhile, other clinical literature suggests CBD and dronabinol can also help extinguish fear. In a 2013 study of healthy individuals, dronabinol reduced response time to stimuli that induced fear. Additional research has shown that CBD can decrease anxiety and help reduce fear memories in healthy adults.
The Future of Cannabis and OCD
As is often the case with cannabis and research-related topics, we simply don’t have enough information to determine if cannabis can help treat OCD. At present, only three case studies have specifically explored the effects of cannabinoids on OCD. In each study, participants responded poorly to traditional medications and cognitive-behavioral therapies, but they reported improvements in quality of life with a reduction in OCD symptoms after taking dronabinol.
Cannabis may help some individuals find relief from OCD symptoms, but it may instead produce no effect or negative effects in others. Various factors can contribute to these conflicting experiences, such as dosage, whether or not someone is new to cannabis, and concentrations of THC. Only time and further research will determine the effect cannabinoids have on the treatment of this condition. If you suffer from OCD and find yourself looking to cannabis as a form of treatment, talk with your healthcare provider before doing so.