How can CBD be used to improve mental health?

Cannabidiol, commonly known as CBD, is a naturally occurring compound discovered in the cannabis plant. It is one of over a hundred different phytocannabinoids (cannabinoids from plants) present in cannabis.1 CBD has gained significant attention in recent years due to its potential therapeutic properties and non-intoxicating nature, meaning it doesn’t produce the “high” typically associated with another significant cannabinoid, tetrahydrocannabinol (THC). Cannabis has been used for thousands of years for various purposes, including medicinal, recreational, and industrial uses. Unfortunately, THC is so tightly associated with the cannabis plant that when hemp or cannabis is mentioned, everyone thinks about THC.
Let’s think of THC and CBD as siblings, they both have the same parents and were born in the same household but are different individuals with different personalities. CBD is the older, mature sibling; the over-achiever; while THC is the younger, very popular, wild child who loves a good party. Even though CBD has many significant achievements; his younger brother always gets all the attention.
Today we will direct our attention to CBD, the sibling who deserves it.

Figure 1: This diagram shows the difference between the molecular structures of THC and CBD.2
CBD is a phytocannabinoid and can bind to the endocannabinoid receptors in our body which are part of the human endocannabinoid system (ECS). If you are wondering what the ECS is, read our previous article explaining it in detail.
Several animal studies have been done, which have shown that CBD has anti-anxiety, antidepressant, antipsychotic, antiepileptic, and neuroprotective properties. All these properties suggest potential therapeutic uses for several psychiatric, neurological, and drug-use disorders.3
What mechanisms do CBD influence to improve mental health?
The CB1 receptor is part of the ECS; the ECS controls the synaptic transmission of neurotransmitters such as acetylcholine, dopamine, glutamate, opiate peptide, and Gamma-Aminobutyric Acid (GABA). The CB1 receptor is very densely populated in the brain; in areas such as the amygdala, hippocampus, and orbitofrontal cortex. These are all parts of the brain that control emotions and behaviours.4
CBD has an indirect activity on the ECS by inhibiting the endocannabinoid, anandamide. Anandamide (AEA) normally binds to and activates the CB1 receptor which mediates natural rewards such as social interaction, sexual intercourse, delicious food, and drug rewards (desirable effects). The CB1 receptor also results in anxiolytic effects and plays a role in regulating fear and chronic stress.4
CBD increases CB1 and CB2 signalling by increasing human AEA levels by competitively inhibiting the Fatty-Acid Amide Hydrolase (FAAH) enzyme. As the FAAH enzyme breaks down AEA when CBD inhibits the FAAH enzyme, the level of AEA in the body is kept higher than normal. This results in the CB1 receptor being activated more than normal, resulting in beneficial effects that are useful in treating anxiety disorders.5,6
Many of the beneficial effects caused by CBD result from its indirect effect on the CB1 receptor, however, CBD also works on non-endocannabinoid receptors. For example, CBD is a potent agonist at serotoninergic 5-HT1A receptors, which contributes to reducing stress, anxiety, and pain). The anxiolytic and anti-depressant effects of CBD are expected to occur because CBD can elicit responses similar to those of dopamine when binding to the dopamine D2 receptors.7
CBD has been shown to reduce inflammation in the body as well as in the brain. It also reduces the overactivity of neuronal amino acid receptors by stimulating other important receptors which can inhibit the development of mental health disorders.7
Studies that have been down so far
A study was performed in 2011 to investigate the effect of a single dose of CBD on subjects undertaking a simulation public speaking test. There were 24 patients with Social Anxiety Disorder (SAD), who had never been treated before; they all received a single 600 mg dose of CBD 90 minutes before the test. Their speech was improved, and they had a decrease in anxiety, cognitive impairment, and alert anticipatory speech.4
A systematic review was completed using case reports, case series, open-label trials, and non-randomised and randomised controlled trials (RCTs). The review found 23 relevant studies focused on using CBD treatment for a wide range of psychiatric disorders. They found that CBD and CBD-containing compounds helped improve symptoms of schizophrenia, SAD, autism spectrum disorder (ASD), and attention deficit hyperactivity disorder (ADHD).8
A study done to test if CBD can improve the symptoms of individuals with SAD found that those that consumed CBD had a reduction in the anxiety they felt. They found that CBD was associated with areas that have been consistently implicated in the pathophysiology of anxiety.9
Another study was carried out on 72 individuals at a psychiatric clinic to determine whether CBD can improve anxiety and/or sleep. There was a decrease in the anxiety scores within the first month in 57 patients (79.2%) which then remained decreased throughout the duration of the study. The sleep scores improved within the first month in 48 patients (66.7%) however, they continued to fluctuate over time.10
There has been substantial evidence showing that CBD and CBD-containing compounds can be effective in treating mental health conditions such as anxiety, PTSD, SAD, ASD, and depression as well as other psychiatric disorders. However, more studies need to be done, especially large-scale and well-designed RCTs.
So what is the take-home message?
CBD, a naturally occurring compound in the cannabis plant, has garnered attention for its potential therapeutic properties. Specifically, its interaction with the CB1 receptor (a component of the ECS) and how it influences neurotransmitter activity, impacting emotions and behaviours. Systematic reviews and research papers have indicated CBD’s potential efficacy in alleviating symptoms of schizophrenia, social anxiety disorder, autism spectrum disorder, attention deficit hyperactivity disorder, depression, and post-traumatic stress disorder. However, more studies are needed to completely understand the therapeutic potential of CBD for mental health conditions.
M2Bio Sciences
M2Bio Sciences is a bioceutical company focused on alternative plant-based cannabinoids and mental health therapeutic research. M2Bio Science’s mission is to advance botanical-based medicine to the forefront by deploying best-practice science and medicine, clinical research, and emerging technologies. As one of a handful of companies in the world, M2Bio Sciences is actively researching the CBD compound to discover novel indications for different medical conditions.
The company has two consumer-facing brands, Medspresso™ and Liviana™. These brands offer a range of premium CBD-infused foods and beverages. M2Bio Sciences focuses on producing and sourcing the highest-quality ingredients available in the market, from pharmaceutical-grade CBD extract to premium coffees and extra virgin olive oil. All our products are ethically and sustainably produced in South Africa.

References
- Kilaru A, Chapman Kent D. 2020. The endocannabinoid system. Essays in Biochemistry, 64(3):485-499. Available here.
- Rudd J, editor. CBD vs THC – What are the main differences? [Internet]. 2018 [cited 2023 Aug 10]. Available from here.
- García-Gutiérrez MS, Navarrete F, Gasparyan A, et al. 2020. Cannabidiol: A potential new alternative for the treatment of anxiety, depression, and psychotic disorders. Biomolecules, 10(1575):1-34. Available here.
- Lowe H, Toyang N, Steele B, et al. 2021. The endocannabinoid system: A potential target for the treatment of various diseases. International Journal of Molecular Sciences, 22(17):9472. Available here.
- The endocannabinoid system explained [Internet]. www.youtube.com. [cited 2023 Aug 15]. Available from here.
- Skelley JW, Deas CM, Curren Z, et al. 2020. Use of cannabidiol in anxiety and anxiety-related disorders. Journal of the American Pharmacists Association, 60(1):253–61. Available here.
- Henson JD, Vitetta L, Hall S. 2022. Tetrahydrocannabinol and cannabidiol medicines for chronic pain and mental health conditions. Inflammopharmacology, 30(4):1167–78. Available here.
- Khan R, Naveed S, Mian N, et al. 2020. The therapeutic role of cannabidiol in mental health: a systematic review. Journal of Cannabis Research, 2(2):1-21. Available here.
- Crippa JAS, Derenusson GN, Ferrari TB, et al. 2011. Neural basis of anxiolytic effects of cannabidiol (CBD) in generalized social anxiety disorder: a preliminary report. Journal of Psychopharmacology, 25(1):121–30. Available here.
- Shannon S. 2019. Cannabidiol in anxiety and sleep: A large case series. The Permanente Journal, 23(1):18-041. Available here.