First you must consider terpene profiles, then cannabinoid ratios.
A recent survey published in Behavioral Medicine (2019), delved into how cannabis can treat individuals with chronic health symptoms. The intention of the work was to understand how cannabis may improve health-related quality of life (HRQoL). As highlighted in the study, the following conditions seem to feed off one another: pain, anxiety, insomnia and depression. However, cannabis may help. These conditions can be co-morbid and it can be difficult to determine where to start with treatment. Patients may have better health outcomes from sourcing the best strains for anxiety or depression.
Will Cannabis Improve Quality of Life?
The results of the survey shows that cannabis could indeed alleviate concurrent symptoms which will improve quality of life. A significant percentage of patients reported relief from all of the indicated conditions. Of course, the caveat is that this is a self-reported survey rather than a controlled study.
Cannabinoids and Terpenes Combine for Healing
The bigger picture is that there is definitely no one-size-fits-all when it comes to improving HRQoL scores with cannabis. Everyone’s body is unique, as are symptoms. It’s often necessary to try out a few different strains to find out which works best for the individual. But, the starting point in this sea of cannabis choices is to understand the benefits of specific cannabinoids and terpenes.
Managing Chronic Pain
When treating pain, both THC and CBD may be effective. Patients with neuropathy tend to have success with strains higher in THC and those with inflammatory conditions, such as arthritis, gravitate to CBD-rich chemovars. When first starting out, it is recommended that patients start with 1:1 ratio CBD:THC and then increase the major cannabinoid most recommended for their condition.
Terpenes will be the next important consideration. These molecules work with cannabinoids to enhance the medicinal benefits of cannabis. This is called the entourage effect. The terpenes that patients need to look for in dealing with chronic pain are: linalool, beta-caryophyllene, and myrcene.
Anxiety and Depression Benefit from Cannabinoids and Terpenes
Dealing with mood and mental health disorders can be trickier. The best strains for anxiety and depression will include a balance of cannabinoids plus terpenes, such as limonene and myrcene. The cross over in treating co-morbid conditions that negatively impact quality of life, can be seen in terpenes. These have efficacy in treating pain and anxiety.
A note of caution is that the best strains for anxiety and depression would also be lower in THC. This is because a high THC potency has been shown to have the potential to contribute to psychosis. This is especially true for patients that have low GABA. THC can lead to increased heart rate and paranoia, which are enough to tip an anxious patient into a panic attack.
A study published in the Alcohol and Drug Abuse Institute (2019), found that “THC appears to decrease anxiety at lower doses and increase anxiety at higher doses.” However, CBD decreased anxiety at all dosage levels. This is consistent with other studies that have found that CBD is an effective anti-psychotic.
Does it Matter if it’s Indica or Sativa?
There is more to consider when treating HRQoL symptoms with cannabis. Choosing the right chemovar now has nothing to do with indica and sativa. In the past, anxious patients were advised to steer clear of sativa as it was thought to bump energy and potentially activate ‘bad nerves.’
Today, there is a better comprehension of how cannabinoids and terpenes interact and patients need only focus on this aspect. Further, growers will argue that there is really no access to a true indica or a true sativa. These ‘land race’ varieties have become a rarity as genetic manipulation in breeding has tended toward valuing high THC potency.
Still, this is the language patients and dispensaries are most familiar with and we will address that right now. The strains traditionally considered “indica or indica-dominant” are often consumed as pain-killers and relaxers and sleep aids. But there is no cookie-cutter solution here. For example, a strong indica can send a consumer deep inside their mind. For some people suffering from anxiety, that’s not a good thing.
On the other end of the spectrum are that sativa-dominant that tend to be more cerebral and energize patients, while lifting mood. This may also help with symptoms of depression.
Patients, however, will have so much more success finding the best strains for anxiety and depression when they dispense with this old school thinking and investigate terpenes.
Which Chemovars are the Best Strains for Anxiety and Depression?
A strain containing caryophyllene and a balanced ratio of THC and CBD, Harlequin is known for improving moods and motivating the body. This strain is best consumed in the daytime, since it has an energetic effect.
Another strain containing caryophyllene and one that is high in CBD. Cannatonic aids in maintaining motivation, a happier mood and a clear mind. The high CBD content keeps anxiety at bay, and gets the body moving — which is helpful for treating depression. Some patients, conversely, use cannatonic as a sleep aid.
Be aware that this strain is potent in THC, but it also contains limonene, a terpene well-known for keeping anxiety in check. This strain is popular for its creative high, and it’s a sativa, so it should help combat depression as well. Even with the high THC, the terpene profile makes it worth a consideration for patients with anxiety.
This strain is a kush variety and is high in linalool. This same terpene is found in the lavender and valued as a relaxing agent, but it also may have mood-improving qualities. A study published in Life Sciences (2017), found that linalool acts as an anti-depressant. And, as evident in another study published in Frontiers in Neuroscience (2018), kush varieties could be helpful in treating anxiety.
What to Remember When Choosing the Best Strain for Anxiety and Depression
It’s important to keep in mind that humans each have unique physiology as well as individual variation in the endocannabinoid system. What might work for one person may not be effective for the next. This means that some experimentation will follow patient research.
There are still no dosing recommendations and patients even will find inconsistency in strains from grower to grower. This is because the end cannabinoid and terpene content is dependent on grow, cure, and storage condition just as much as genetics.
Don’t be afraid to tinker with different chemovars. Remember the golden rule for cannabis patients: start low and go slow. May you find the right chemovar for you!