Can CBD Help With Teen Anxiety
This hits a little close to home.
One of our founders was wholloped by anxiety as a result of perimenopause and a severe drop in hormones.
That story is here.
Simultaneously, her oldest son started to experience some pretty severe anxiety.
He's not alone in this.
Anxiety is the epidemic among teens with the numbers steadily going up.
A recent study showed that this demographic had the greatest jump in anxiety of any age group.
In fact, 70% of teenagers today now view mental health issues as the biggest challenge they face:
That's a Feb 2019 survey.
In 2012, the percentage of teenagers with anxiety was 1 in 20 or 5%
It sure has gone up since then when looking at the survey above.
In 2007, it was 1 in 28 or 3.5%.
So in 5 years, it jumped over 40%!
That time just happens to coincide with the great recession!
We just wrote an entire article on Social Anxiety and CBD here which is very relevant to teenagers.
We'll look at why this may be, how puberty affects anxiety, and what research is showing for CBD.
There's tremendous research for CBD and anxiety here but we need to obviously consider safety with teenagers.
We'll cover these topics along the way:
- What drives teenage anxiety in the brain
- How hormones and puberty affect teenage anxiety
- Social anxiety for teenagers
- THC's effect on the teenage brain with anxiety
- The endocannabinoid system and the teenage brain
- What research shows for CBD and teenage anxiety
- How much CBD to take for teenage anxiety
- What's the best CBD for teenage anxiety
Let's get started.
As a parent of a teenager who experienced intense anxiety, I can tell you that this article is written with the upmost diligence and delicacy with a focus on safety.
We suffer almost as much as they do.
Let's educate ourselves to make the best decision.
What drives teenage anxiety in the brain
We have very in-depth reviews of the mechanics of anxiety at our CBD and anxiety page.
We also further explored more fascinating detail in our CBD versus anxiety medication page.
There's 10K+ words of thorough investigation with dozens of NIH studies there for a general background of what's going on with anxiety.
There's a good general explanation of teenage anxiety here including symptoms, signs, etc:
No one is debating whether teenagers today have more stress than ever.
- The racheting up of academic workload and expectations
- The increased social scrutiny and online presense
- Self-medicating with substances that can actually increase anxiety long-term
- Constant barage of media focus on physical attractiveness (especially for girls)
- Growing up in the shadow of the great Recession of 2008.
Take your pick or better yet, add them all up cumulatively.
That being said, some teenagers experience ongoing anxiety while others don't.
What's THAT difference?
It's not a character flaw or function of personality...it's chemistry, brain and gut function.
Even increasingly immune response!
We'll look at all of it!
Let's first talk about the gorilla in the room.
Keep in mind that a study showed that 31% of teens would experience an anxiety event from age 13-18 and those were 2014 numbers!
Puberty is a massive state of flux and even the best teenage years are fraught with anxious moments.
There's a very disruptive (but needed) "remodeling" of the brain during puberty.
Two players central to anxiety are in total disrepair:
- Amydala - your emotional center with control over fear, fight or flight response, and more
- Prefrontal Cortex - your rational brain which acts to balance the initial fear response of the Amygdala
Basically, there's a shift of power from the Amygdala (which actually thins out during puberty) to the prefrontal cortex.
During this process, the prefrontal cortex (right behind your forehead) gets "shut down" for remodeling.
Hence, all the risky and emotional responses during teenage years!
There's a spurt of growth right before puberty and then a pruning back of this entire system during puberty.
Remember that the prefrontal cortex is our brake for the Amygdala's fear response.
Now it's being pruned back for remodeling (which will eventually make it more efficient if we survive our teenage years!)
As we look at in CBD for anxiety and CBD for social anxiety, overactive Amygdala signalling is a hallmark of anxiety itself!
It's also critical to the whole puberty process in the brain!
Increasing sensitivity to emotional and social cues coincides with changes in neural structures, particularly the amygdala
Since puberty is a giant flux in hormones (which we'll touch on below), how do they figure into this process?
Indeed, the amygdala is one of the few regions of the brain that contains both estrogen and androgen receptors [16-18], indicating that its function may be directly influenced by hormonal changes during puberty.
Great...so hormones directly impact amygdala function.
Do they drive anxiety-type responses though?
Recent studies have demonstrated that directly administering sex hormones can increase amygdala response to emotional faces
So hormones in flux during puberty drive activity in our emotional (including fear and fight/flight) center of the brain based on social cues (faces).
Our reaction to faces (neutral or emotional) is a great proxy for social development during puberty.
It's also a faithful signal for anxiety in teenagers:
Specifically, symptoms of social anxiety increase during adolescence for girls [2,35]—and anxiety in general has been shown to impact amygdala response to facial stimuli
Some of this rectifies as the brain matures through puberty (which lasts up to age 25 generally).
So the amygdala is very active in teenage anxiety as expected.
There's a great synopsis of the transition of the teenage brain here:
The net net is this…
Emotional parts of the brain run rampant while the impulse control area is under remodeling till about age 17.
This makes teenagers especially susceptible to anxiety since the Amygdala (fear center) if off the leash!
Combine this with areas of the brain which turn on for abstract thought (that's why you can't teach Algebra before certain modules in the brain turn on).
Now, teenagers can estimate how they are viewed from other peers!
Outside of getting good grades, all the other stressors for teenagers are peer related (how I look, how I fit in, etc).
Let's look at the big disrupters during puberty...hormones!
How hormones and puberty affect teenage anxiety
Estrogen and Testosterone are in full effect.
They literally transform the teenage body and brain into adult versions!
Both are highly correlated with mood instability (see CBD and PMS as an example, testosterone for men is no slouch in that department either).
It goes beyond that.
One example is an interesting switch in brain circuitry involving allopregnanolone.
This is a master hormone that gets turned into (metabolized) other hormones such as progesterone.
Progesterone is a powerful inhibitory hormone in the brain which works with GABA to calm things down.
It has a known anti-anxiety effect.
GABA is the root chemical for anti-anxiety effects in the brain. And drowsiness!
In adults, release of this allopregnanolone calms the circuits down.
This circuit is completely switched in the teenage brain where it actually revs things up!
It's a fascinating read and helps to explain why girls have twice the probability of anxiety during puberty (progesterone is primarily a female hormone although men do have it).
Consequently, is also why women entering perimenopause suddenly start to experience anxiety and other issues.
Check those progesterone levels ladies!
This research points to looking at hormone levels during puberty to help with anxiety.
It also points to the common anxiety/depression spikes after delivery, during the monthly cycle, and during perimenopause/menopause but we digress.
That's a very specific example of how hormones can affect teenage anxiety directly.
Let's keep going or we'll never get to CBD.
Social anxiety for teenagers
We've written extensively on social anxiety and CBD here.
The same usual suspects crop up with the Amygdala and Prefrontal Cortex at play.
We get into the neurotransmitters such as:
- GABA - calming chemical (key to benzo's effect)
- Glutamate - excitatory chemical in the brain
- Histamine - immune excitatory chemical in the brain
We also look at the new theory or inflammation with anxiety and depression and how to correct its effect via neurogenesis.
For teenagers, there are really two common root drivers of anxiety.
- Genetic or past experience driver of general anxiety (systemic)
- Social anxiety as a result of brain remodeling from above (situational)
Meaning, we may have a general tendency towards anxiety which the stress of puberty exacerbates.
The sudden awareness of the social world via brain changes is anxiety causing.
Either way, the mechanics are pretty similar in terms of how the brain and body express anxiety.
The latter will likely rectify after puberty is done.
The first one may continue and require more effort.
A quick synopsis from our Social Anxiety and CBD article.
The circuit between the Amygdala and Prefrontal cortex is still front and center.
There's also some interplay with the pregenual anterior cingulate cortex.
Before your eyes gloss over, this is part of the connector between the two other sections and it's pretty interesting.
It's just the seat of:
- Social rejection
There are studies showing how CBD can affect a person's self-analysis which is critical for social anxiety.
Again, check out the full article here.
For many teenagers, anxiety IS social anxiety.
This makes sense if you read the study above on teenage brain circuit being reversed due to hormones.
The sudden ability to see how others might see you (abstract thought) is a frightening new superpower!
Let's look at important new research on THC and the teenage brain.
THC's effect on the teenage brain with anxiety
THC is CBD's chemical cousin in the cannabis plant but they're very different.
In many ways, they're actually polar opposite.
CBD has been shown to offset negatives of THC.
See their full relationship in our CBD versus THC article.
Here's the deal.
Cannabis is increasingly becoming legal across the US and as the parent of a high schooler, I can tell you that it's EVERYWHERE at that level.
The athletes are using it. The 4.0 AP students are using it. Everywhere.
As my son said during his sophomore year, "I can count on 2 hands the people who haven't tried it and it's shrinking all the time".
First, let's be honest about the situation.
It's in the music. It's in movies. It's all over the internet as being healthy.
We're not anti-pot but THC has some issues.
Especially for the teenage, developing brain.
We're only starting to get good research since it's been a schedule 1 drug for so long.
A recent report showed that 1-2 uses at age 14/15 has an immediate impact on thickening the Amygdala.
That brain area (seat of emotional response and fear) should be recognizable to you by now.
It's all over teenage anxiety!
Here's the issue….the Amygdala should be thinning out at this point.
Not getting thicker!
Think of brain area mass as signal strength.
The net effect of a thicker amygdala is more risk for anxiety in the future.
The problem is that we're literally building brain during this time!
Yes, the body can continue to remodel as we get older but it's much harder.
Kinda like how it's harder to pick up a language or musical instrument for adults.
If you're a teenager, wait.
Let your brain finish cooking!
If you're a parent...keep up the dialog and let them know about this study so they can make a better decision.
Otherwise, all they hear online is that everything is fine.
As for CBD…
- It's not psychoactive
- It's not habit forming
- It offsets the negatives of THC
Learn all about CBD offsets the effects of THC here.
If anything, use it to counter the negatives.
Just a side note...THC has been shown in studies to increase or cause anxiety!
The original meaning of the "entourage effect" everyone uses to sell full spectrum CBD (more on that below) was to offset this anxiety effect via CBD's powerful effect.
THC is not good for brain remodeling in teenagers and can increase anxiety.
Learn about that here.
Finally...we're getting there. One last stop before CBD for teenage anxiety.
The endocannabinoid system and the teenage brain
They may not want to admit it, but even teenagers share an endocannabinoid system with adults!
It's roughly 600 million years old and is tasked with key systems:
- Nervous system - home to the Amygdala, prefrontal cortex, GABA, Glutamate and more
- Endocrine system - home to hormones like Estrogen, Progesterone, Testosterones and drivers of puberty
- Immune system - inflammatory response due to stress and also histamine!
- Serotonin signaling
- GABA signalling and balance with Glutamate
- Histamine response
- Hippocampus neurogenesis
- Reducing neuroinflammation
- Balancing brain activity (see research on CBD and psychosis)
That all stands true for teenagers but let's look at the ECS (endocannabinoid system) and puberty.
Is it involved in that process within the brain?
Emerging evidence suggests that during adolescence, changes in eCB signaling contribute to the maturation of local and corticolimbic circuit populations of neurons, such as mediating the balance between excitatory and inhibitory neurotransmission within the prefrontal cortex.
Let's translate this please.
"Corticolimbic" speaks to the old part of our brain that contains the hippocampus and Amygdala, both key to fear responce processing.
The "corti" part is interesting as well.
It's the connector between the emotional processing area (hippocampus and Amygdala) and prefrontal cortex (our rational brain).
It includes areas such as the Anterior Cingulate Cortex which pops up prominently with social anxiety (let's face it...that's teenage anxiety as this circuit comes online during puberty).
This is THE circuit for teenage anxiety.
Continuining with the summary statement from the research…
"Mediating balance between excitatory and inhibitory neurotransmission".
Too much activity in the Amygala (fear and emotional response) and not enough rational braking of this response.
This is at the heart of what research is finding out about the ECS.
It's role appears to find balance in other key systems.
In another animal study, they showed how endocannabinoids like Anandamide appear to help govern the hormonal transition during puberty:
There's a great deal of research on cannabis by itself (including THC) which is not positive for the teenage developing brain in terms of the critical endocannabinoid system.
Teenagers must try to avoid THC and cannabis as much as possible so that their neural circuits can form correctly.
It's akin to building a house in the rain.
Build the house first and then it can withstand the rain better.
See more below in the safety area.
Let's move onto CBD.
Again, there's lots of information on anxiety specifically here:
What research shows for CBD and teenage anxiety
At those links above, you can see how CBD directly interacts with the contributors of anxiety.
CBD's antianxiety effect might be it's most pronounced (outside of brain area normalization for psychosis and epilepsy).
Quick bullet points before we look at teenagers specifically based on research:
- CBD helps to boost GABA (our calming neurotransmitter)
- CBD helps to balance Glutamate signalling (our excitatory neurotransmitter)
- CBD helps to stimulate neuron growth in the hippocampus
- CBD is a powerful anti-neuroinflammatory
- CBD helps to normalize signalling between the Amgydala and Prefrontal Cortex
- CBD calms the histamine response (excitatory in the brain)
On to the teenage brain.
Let's look at specific studies which are in short supply.
The one specific to teenage anxiety involved a 10 year old girl who had intense anxiety and insomnia as a result of pretty horrific abuse.
The standard anxiety meds were not helping her or had terrible side effects (see CBD versus anxiety meds here).
Her chief issues included anxiety, insomnia, outbursts at school, suicidal ideation, and self-destructive behaviors.
Again, other medical interventions did not work and her symptoms deteriorated.
CBD (cannabidiol) was a last-ditch effort for both her anxiety and insomnia.
A gradual increase in sleep quality and quantity and a decrease in her anxiety were noted. After 5 months, the patient was sleeping in her own room most nights and handling the new school year with no difficulties. No side effects were observed from taking the CBD oil.
Her results are here:
This is anecdotal and we need more research.
That being said, it's very telling for teenage anxiety and she was very troubled, with an explicit PTSD diagnosis (see CBD and PTSD).
The FDA recently approved CBD for specific types of pediatric epilepsy.
The results were impressive there:
Patients with LGS taking cannabidiol oral solution at 20 mg/kg/day in two clinical trials saw a 42%-44% reduction in drop seizure frequency over a 14-week treatment period
This study gives a good track record for CBD's long term effect during puberty since we now have more data and these kids have gone through puberty using CBD for epilepsy.
We do not see developmental issues as a result in that reserach
Just a side note...research is showing that some stress during puberty actually primes the brain for being better able to handle issues later in life:
In fact, a certain amount of stress exposure or socio-environmental stimulation is probably necessary for normal development and exerts long-term stress-protective, anxiolytic, and antidepressant effects later in life [240, 277, 355, 356]
Let's end where we began.
Remember how we discussed the "fear" and "threat response" circuits of the brain during puberty and teenage years.
It's a tug of war that's temporarily being won by the Amygdala while the prefrontal cortex is closed for remodeling.
What does CBD do here?
CBD is associated with increased resting cerebral regional blood flow (rCBF) in the left parahippocampal gyrus and decreased rCBF in the amygdala-hippocampus complex, including the posterior cingulate cortex
To translate...imaging showed that activity slowed down in the area that's in overdrive for fear and emotional response during teenage years.
This showed especially during a time of highly charged emotional response:
A functional neuroimaging (fMRI) study found evidence for attenuation of the blood-oxygen level dependent (BOLD) signal in the amygdala and the posterior and ACC in response to the presentation of fearful faces, combined with a reduction in subjective anxiety
We talked about fearful faces and the awakening of the teenage brain to social scrutiny above.
Taken together, these results point to both an anxiolytic effect of CBD and a critical modulatory role of the ACC.
Anxiolytic means anti-anxiety.
This is brain science folks (just behind rocket science in some circles).
What's very interesting is that CBD did not interfere with brain activity for other tasks.
This is very important and a big difference with THC which happens to affect other aspects of judgement and task proficiency.
In fact, CBD was shown to help offset these effects of THC on the brain.
We're going to take one more detour that you're probably not going to find anywhere on the map for teenage anxiety.
Like we said...this is personal for us!
It's a part of the brain that's typically tied to reward and motor systems.
It's not usually part of the anxiety discussion.
That's because so much of the anxiety discussion is about adults and it's all treated as one thing.
The teenage brain is not the same!
Why even look at this part of the brain??
the co-occurrence of the adolescent striatal development with the peak vulnerability of adolescents to anxiety disorders might potentially reflect a causal relationship.
The study goes on to show how the striatum function and activity directly mirrors puberty and is tied to the rest of the anxiety 'circuit".
We bring this up as ONE example of a brain area that is "normalized" by CBD.
It actually came out of studies on psychosis (keep your jokes about teenagers to yourself).
CBD was shown to normalize key areas of the brain in pre-pyschotic people via brain scans.
One of the three main areas… the striatium!
Look, teenage years are fraught anxiousness for most teens.
The goal is to address more serious or debilitating levels of it.
Since we're talking about teenagers and developing brains….is CBD safe to use?
Is CBD safe for teenagers with anxiety
This is tricky...not because we see evidence of safety concerns in the 100's of NIH studies on CBD that we've read.
The safety profile is very strong for CBD.
That being said, we have only seen a few studies with adolescents or teenagers specifically.
The FDA approval for pediatric epilepsy does provide a tremendous amount of longer term data as kids go through puberty and that data has been positive in terms of safety profile.
How do we weight the benefits for teenage anxiety with any unknown variables?
It comes down to this…
Check out the comprehensive comparison of CBD and anxiety medications here.
It looks at the safety and effectiveness of CBD and the benzo's or SSRI's (most popular classes of medications for anxiety).
As parents, we actually had to make this decision (klonopin or Xanax versus CBD) ourselves.
That is what prompted us to learn everything we could about both for teenagers.
I spend about 2 hours a day research NIH studies on CBD.
Check out our article are whether there are any reasons NOT to take CBD here.
The safety profile of CBD is here.
The Anxiety meds article goes through safety for the common anxiety meds and our experience with those is what drove us to study and try CBD.
Do the research. Be your own advocate. Make an informed decision.