It's a common question...CBD versus CBT (cognitive behavior therapy).
Once you see the research below, you'll understand that it's not "versus" but "and".
There's a very powerful pathway that both influence and share at the heart of mental illness, behavior, and addiction.
It's the basis behind how SSRIs (antidepressants) actually work (till tolerance builds up).
It underlies the powerful effects of psilocybin (see psilocybin and mental health).
- Exercise's effect on the brain? Yes.
- Mindful meditation and Yoga? Sure.
All one pathway and after 1 million+ words of research on our site, it's probably the biggest takeaway on all things mental health.
CBT fits neatly into this discussion as well.
We'll cover these topics:
- A quick intro to neurogenesis and BDNF (the biggest secret in mental health and addiction research)
- How CBT works with neurogenesis and BDNF
- How CBD works for brain pathways tied to BDNF and neurogenesis
- Can CBD help Cognitive behavior therapy training?
- How much CBD to use with CBT
- What's the best CBD to use with CBT
Let's get started...we have brain pathways to reroute.
A quick intro to neurogenesis and BDNF (the biggest secret in mental health research)
We've covered in detail across many reviews...it tends to pop up everywhere.
Let's set the stage first.
In our brains, we have competing forces battling over real estate (literally) and the function of our brains.
On one hand, we have many things that can damage the delicate tissue crammed within our enclosed skulls...the "insults" as it were:
- Chronic stress
- Trauma
- Infection
- Hyperactive immune response (can be primed even from in utero)
- Drugs and alcohol
- Oxidative stress from energy production
- Hyperactive glutamate (our brain's "gas pedal")
- Medications
The net effect of this activity is a constant damaging and withering of brain matter.
Left unchecked, you would see a range of mental health issues and even cognitive decline.
Before then, depression, anxiety, and more show signs of distress.
What counters all this damage to the brain (and nervous system)?
Neurotrophins...the primary one being BDNF.
BDNF is short for brain-derived neurotrophic factors.
Essentially, it's the brain's fertilizer!
BDNF is the key factor for repairing, rebuilding and re-directing brain pathways.
Simply put:
Brain-derived neurotrophic factor (BDNF), one of the major neurotrophic factors, plays an important role in the maintenance and survival of neurons and in synaptic plasticity.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2732010/
So it keeps a brain dynamic and changeable! (hmm hmm...CBT cough cough).
Why is this important for mental health and addiction?
Pick a mental health issue...let's go right down the list.
Anxiety and BDNF:
In summary, an impaired BDNF system is a vulnerability factor for anxiety disorders and affects normal hippocampal function.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4513557/
Especially in the hippocampus, a key regulator of mood and also a brain area very susceptible to damage since it's so plastic (changeable).
It's also the seat of memory which makes it very plastic (changeable) but this is also a key weakness against the insults above.
Almost every mental health issue has a tie to hippocampus dysfunction and literally shrinkage.
What about depression?
It turns out that the SSRIs like Lexapro, Prozac, and Effexor boost serotonin but the real mover and shaker is BDNF downstream.
In fact, when they block the conversion of BDNF, SSRIs lose their neurogenesis and antidepressant effects.
See our review of how SSRIs really work.
It even goes down to genetics:
Recent genetic studies also support a link of BDNF to depression/suicidal behavior.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2732010/
This is true for anxiety as well as any mental health issue...if our gene for BDNF is not running at full pace, mental health is almost inevitable.
This speaks to the power of BDNF.
Let's go a little more out of the common.
BDNF appears to be involved in numerous neuronal processes known to be associated with schizophrenia.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6007539/
We dove deep at our CBD and schizophrenia review.
Then, there's addiction.
From our monster review of CBD and addiction, you can see that most addiction starts due to a deficiency in a key pathway.
Dopamine (our reward circuit) and tolerance quickly "lock" this pattern directly into the brain.
In fact, addiction is a form of learning in terms of how the brain sees it.
Learning takes BDNF. Unlearning? BDNF.
Most interestingly, many of the addictive drugs are able to directly dampen BDNF expression which is why it can be so hard to "unlearn" a habit.
For example with cocaine:
In general, cocaine decreased HCal neurogenesis in both groups but at different control points.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4037740/
Neurogenesis is brain growth and rewiring...the net effect of BDNF.
Look what happens when BDNF is added back in with cocaine:
BDNF infusion into the dorsomedial prefrontal cortex immediately following a final session of cocaine self-administration attenuates relapse to cocaine seeking after abstinence, as well as cue- and cocaine prime-induced reinstatement of cocaine-seeking following extinction.
Let's translate that because it's so important.
When BDNF was added to the brain, relapse, cravings, and the whole initial "surge" that leads to relapse all dropped!
Just think about the implications of that.
See why we get so excited about BDNF and neurogenesis!
Check out CBD and brain repair or CBD and neurogenesis to learn more.
What does any of this have to do with CBT?
Let's go there.
How CBT works with neurogenesis and BDNF
Cognitive behavior therapy has shown great promise for a range of mental health and addiction issues.
In fact, for many issues, it's the only thing that really bears out long-term effectiveness.
So...what is CBT or cognitive behavior therapy.
It's a slow way to get the neurogenesis we discussed by practice!
Similar to mindful meditation.
Essentially, a person is re-wiring their brain to respond differently from stimulus received by activity forcing new thoughts and behaviors.
If you do this over and over again, the brain will literally rewire to strengthen this connection.
Think of running water.
At first, it's just a stream. Eventually, entire rivers can occur and actually carve rock out of mountains.
This is the issue with addiction. Additive drugs spike dopamine, our reward circuit, which has a critical piece in this re-wiring process.
It's a damn break!
Dopamine is thought of as the pleasure neurotransmitter but there's no actual pleasure associated with its release.
Technically, it's more of a "do that again" messenger.
It goes back to ancient needs such as food, water, and sex. We've since extrapolated that out to job promotions, good grades, and being asked out.
Habits and patterns (anxiety, anger, etc) actually get wired directly into the architecture of the brain which is why they seem to operate under their own control!
CBD works, by brute force and contraction, to unwire those connections with practice, though, and action.
Again, very akin to mindful meditation.
The key takeaway is this...CBT relies on neurogenesis (brain change):
After just nine weeks of internet-delivered cognitive behavioral therapy, the brain of patients suffering from social anxiety disorder changes in volume. Anxiety is reduced, and parts of the patients' brains decrease in both volume and activity.
https://www.sciencedaily.com/releases/2016/02/160202185552.htm
See CBD and anxiety circuits to learn more.
As we know by now, neurogenesis relies on BDNF so the questions remains…
Is CBT results affected?
Look at this result from panic attacks and CBT:
The serum BDNF levels of the patients with poor response (25.9 ng/ml [S.D. 8.7]) were significantly lower than those of the patients with good response (33.7 ng/ml [S.D. 7.5]).
https://pubmed.ncbi.nlm.nih.gov/15905010/
Goodness...CBT requires BDNF to function.
This all makes sense after everything we've read.
So...this brings us to the question of CBD.
How CBD works for brain pathways tied to BDNF and neurogenesis
CBD works as a feedback mechanism within a system called the endocannabinoid system.
This system dates back about 600 million years and it's tasked with balancing other key systems including…
Neurotransmitters!
The start of the BDNF chain is serotonin so what's CBD's role there?
Technically, it's called an allosteric modulator which means that it supports when needed but not when high.
Here's one example (see CBD and serotonin for more) after injury exhausts serotonin function:
repeated treatment with low-dose CBD induces analgesia predominantly through TRPV1 activation, reduces anxiety through 5-HT1A receptor activation, and rescues impaired 5-HT neurotransmission under neuropathic pain conditions.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6319597/
5HT is short for serotonin.
The most important word here is "rescue". CBD supported serotonin when it was down due to injury.
Keep in mind that other things can draw down serotonin:
- Stress
- Trauma
- Infection
- Sleep issues
Any of those ring a bell with mental health?
They all do! Remember, they are the enemy of the brain that BDNF fights against.
So..we know that serotonin drives BDNF from above. What about CBD and BDNF directly?
Let's look at a very important part of the brain tied to many mental health issues (depression, anxiety, schizophrenia, etc).
The prefrontal cortex...the seat of what makes humans, human.
It's also the adult in the brain room keeping our more primitive brain areas like the amygdala (emotional response including fear, anger, etc) under control.
When it's under assault (the same culprits above), depression, anxiety, and much worse can result.
This area is deeply tied to depression (see CBD and depression).
So...why all this brain science when talking about CBD and BDNF?
Goodness…
Cannabidiol Induces Rapid and Sustained Antidepressant-Like Effects Through Increased BDNF Signaling and Synaptogenesis in the Prefrontal Cortex
https://pubmed.ncbi.nlm.nih.gov/29869197/
Let's translate, please.
- CBD had antidepressant effects
- CBD boosted BDNF in the prefrontal cortex
- CBD boosted new brain connections in this area (the rewiring we talked about).
What about that very vulnerable area...the mood controller called the hippocampus?
The acute antidepressant effects (30 min) were associated with increased expression of synaptophysin and PSD95 in the medial prefrontal cortex (mPFC) and elevated BDNF levels in both mPFC and hippocampus (HPC)
We look closely at the hippocampus in our CBD, meditation, and exercise review.
Again...BDNF is the magic bean so to speak.
You can learn all about it at CBD and BDNF or CBD and brain repair.
So...back to the question of CBD versus CBT.
Can CBD help Cognitive behavior therapy training?
The main issue with CBT is that it's slow and takes lots of effort.
Many people stop as they don't see results right away or can't be regimented.
Asking someone in the middle of a mental health crisis to focus on willpower is tough.
That being said, CBT can be very successful IF people stay with it.
Really, neurogenesis is at the heart of all healthy brain change.
Combining CBD and CBT appears to be perfect cohorts.
There are finally studies such as one on phobias to compare CBD+CBT versus just CBT.
We look forward to those results and expect a pretty robust effect.
One note...the research above is on CBD by itself.
THC has issues long term as it builds tolerance which takes away from any benefits we would hope to gain.
After all, neurogenesis is a long-term game. This is why SSRIs take 2 weeks to even show any benefits (until they build tolerance as well).
CBD has been shown in research to not be additive or cause tolerance!
This is probably its greatest benefit as tolerance is the curse of modern medicine (see CBD versus benzos or CBD versus SSRIs).
This brings us to some practical questions.
How much CBD to use with CBT
We actually have some really good data on this front and it stems from neurogenesis itself.
Studies have found that peak neurogenesis occurs around 300 mgs daily.
Beyond that, other pathways kick in and neurogenesis starts to decrease.
We find this number over and over again across multiple issues and studies.
The only time we see higher amounts is for very acute (right now!) issues:
- Psychosis (see CBD and psychosis)
- Public Speaking (see CBD and public speaking phobia)
- Stroke (see CBD and brain damage)
- Initial drug withdrawals (first 10 days generally). (see CBD and addiction)
Periods of serious harm or imbalance.
Otherwise, the 300 mg daily appears to be the magic number for neurogenesis and long-term brain change.
This would be ideal with CBT which goes about this process by sheer effort.
What about the type of CBD to use with cognitive behavioral therapy?
What's the best CBD to use with CBT
Here are the essential requirements that many CBD brands do not meet:
- Organically grown at US farms registered with the FDA
- CO2 processed
- 3rd party tested
- No THC (more on this below)
- No heavy metals
- No solvents
- No pesticides
- No bacteria
- No mold
Our 3rd party testing is available at the top of each page.
What about the THC question?
First, a study on BDNF:
Findings suggest that when marijuana use escalates, the BDNF pathway becomes more deregulated.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6433615/
THC in itself is not bad. It mimics anandamide, our primary endocannabinoid naturally occurring in the brain.
It lingers too long and at too high a level (hence the high effect) so the brain panics and will actually start to downregulate this pathway to compensate.
It's the whole basis for tolerance.
You're left worse off than where you started in the whole pathway you're trying to boost!
Again, this is longer-term use.
The second question is full-spectrum CBD versus CBD isolate.
All the research is on CBD isolate (CBD by itself). Everything else is just marketing until we see actual research.
We've looked at CBD isolate versus full spectrum in detail but the part that everyone's missing is...histamine.
40-60% of the population has histamine (chemical behind allergies) issues.
That number goes up as we get older and for women (thanks for leaving, progesterone!)
The reason so many people have a bad response to "CBD" is because of the full spectrum issue or just bad product.
We see that all go away with CBD isolate which is how we found it to begin with after having bad responses to 3-4 of the biggest CBD brands (full spectrum).
Then, there's cost.
300 mg daily matches the research but it definitely doesn't match what's on the market or general cost.
There are lots of ripoff products out there.
The key is the cost per mg of CBD.
We price our 6000 mg bottles (about 200 mg per dropper) at 2-3 cents before discounts up to 50% on purpose.
We found CBD as the result of a brutal perimenopause (that story is here) and we've seen firsthand how it can help with mental health issues.
Be well. Take care of each other. Take care of yourself.
Always work with a doctor or naturopath with any supplement!
The information provided here is not intended to treat an illness or substitute for professional medical advice, diagnosis, or treatment from a qualified healthcare provider.