The month of May is coming to a close, and with the end of Mental Health Awareness month comes one of the most difficult topics of discussion among the cannabis industry: Does cannabis improve mental health, or make it worse? Many dedicated consumers and patients would be quick to tell you that the plant has had a profoundly positive influence on their lives. And yet, emerging science on the topic has revealed that cannabis and mental health have a much more complicated relationship than ever predicted.

What is Mental Health?

Before diving into the ways in which cannabis affects mental health, it’s useful to paint a picture of what mental health actually means. For most, mental health means being free from depression, free from psychiatric illness, and perhaps even blissfully happy. Unfortunately, while more people are aware of mental and emotional health than ever before, the concept is still far too often boiled down to either a means of coping with severe mental disorders or as a reinforcement of the idea that you should strive to be happy all of the time.

Both of these popular beliefs are a myth — most people must learn how to develop mental health skills at some point in their lives, and, although it is difficult to admit, being happy all of the time is a scientific anomaly. Contented and peaceful, sure, but moments of blissfulness and pure happiness wax and wane for just about everyone. Of course, this is not to discount the lives or experiences of the many who struggle with severe mental health concerns, such as post-traumatic stress, severe depression, and other psychiatric ailments.

For Marsha Linehan, the founder of Dialectical Behavioral Therapy and a world-renowned psychologist, mental health can be broken down into four primary components: mindfulness skills, interpersonal effectiveness, emotional regulation, and distress tolerance. While the names may seem like a mouthful, Linehan believes that each building block is essential for being able to both tolerate and relate to the world in a healthy way.

First, mindfulness is the ability to observe what is happening in the present moment without judgment. Secondly, interpersonal effectiveness relates to your ability to ask respectfully for what you want while setting clear boundaries and saying no what you don’t want. Emotional regulation refers to the ability to feel your emotions without clinging to them or letting them get the better of you. Finally, distress tolerance is the ability to tolerate daily stresses and bounce back from stressful situations.

For Linehan, mental health means practising and maintaining fitness in all four of these skills. Even those with a diagnosed psychiatric disease can still practice these skills to improve their mental health. The therapy was initially designed for those with Borderline Personality Disorder, but the concepts have taken root in the world of psychology and are often readily applied to individuals experiencing all sorts of mental health concerns — from addiction to depression to schizophrenia to struggling with an unexpected life transition.

The Complex Relationship Between Cannabis and Mental Health

So, why bring up Linehan? The definitions of mental health are perhaps as vast as the types of therapies available. As such, there are numerous ways to approach the broad topic of mental health. Most psychiatrists offer a mixture of skill-building and medications in order to treat their patients. Is cannabis a worthwhile therapy for mental health? Well, if early research is any indication, it appears that it would depend on how you use it.

Cannabis for Mental Health: The Pros

For many, cannabis is a go-to remedy for mental health concerns. Whether that means popping a CBD capsule to get through a stressful day or if that means developing a treatment plan to keep symptoms of traumatic stress at bay, cannabis is oft touted as an effective way to improve your state of mind. Cannabis has a long-held reputation as a mood-lifter, inspiring laughing fits, improving sleep, and promoting all-around feelings of well-being.

In patients with serious diseases like cancer, the plant has been proven to reduce pain and improve quality of life, factors which have a profound influence on mental health. There is some early evidence that specific cannabis compounds may be helpful for reducing psychosis related to advanced diseases like Parkinson’s Disease.

Similarly, early experiments suggest that isolated cannabis extracts may reduce agitation associated with dementia. In early clinical trials, CBD treatment has even improved the lives of patients living with treatment-resistant schizophrenia. In the area of post-traumatic stress, cannabis compounds are being studied as uniquely viable treatments for the condition. Amazingly, research suggests that chemicals in the cannabis plant may be able to address possible neurotransmitter deficiencies in PTSD patients.

Further research still explores the ability of low to moderate doses of cannabis medicines to reduce symptoms of depression and anxiety, perhaps offering patients an alternative to medicines like benzodiazepines, which come with a greater addiction potential and a host of severe side effects. Cannabis, in contrast, has been dubbed as well-tolerated with limited side effects in most of the mental health trials conducted so far.

The Risks of Cannabis For Mental Health

But, is cannabis a cure or a crutch? While a body of positive research on cannabis as a mental health aid exists, the plant cannot simply be lumped into a category as either good or bad. Instead, research seems to indicate that cannabis may be beneficial in some circumstances, but it may also worsen overall mental health in others. In high doses, for example, the primary psychoactive component in cannabis, tetrahydrocannabinol (THC), may increase anxiety and cause panic attacks.

Further, professionals also have concerns about the chronic consumption of high-potency cannabis. Several epidemiological studies have suggested that long-term cannabis consumption, especially of the high potency variety, is correlated with increased rates of depression, anxiety, and poor mental health. While correlation does not always indicate causation, researchers have found that the younger you are when you pick up a regular cannabis habit, the more likely you are to experience negative mental health outcomes.

And then, of course, is the argument that cannabis can cause psychosis in some people. This is not exactly the same Reefer Madness argument that has dominated since the late 1930s. Instead, modern genetic research suggests that cannabis consumption may contribute to psychiatric illness in those with a genetic predisposition, especially in those that heavily consume the plant. In teens and adolescents, regular cannabis consumption was correlated to an earlier onset of psychotic symptoms in those with a predisposition to this type of mental health trouble.

Finally, both cannabidiol (CBD) and medical cannabis consumption show potential in treating some forms of addiction, including alcohol, nicotine, and opioid addiction. Regular cannabis consumers, however, can also develop a dependency on the herb. For some, this dependency can cause symptoms of withdrawal after stopping the herb. For this reason, many health professionals are reluctant to offer cannabis as a mental health treatment.

Everything in Moderation

What Linehan describes in her Dialectical Model of Behavioral Therapy are a series of skills that an individual must learn in order to developmental and emotional resilience. While progressive mental health and medical professionals see cannabis medicines as tools that better enable patients to focus on these skills, the plant itself is not a cure-all for mental health problems. In fact, in some cases, overreliance on the herb may lead to greater problems, such as dependence on the plant in order to cope with stressful situations.

And yet, it is almost impossible to evaluate the subjective benefits of the herb. When consumed in moderation, the cannabis plant has a knack for providing sudden shifts in perspective and for opening mental doors that once seemed impossible. After a stressful day, a little cannabis may feel like a nudge in the right direction — a glimpse into another way of thinking that was suffocated by a sour mood. A time-out from a stagnate way of thinking can be an invaluable source of healing and self-compassion.

Scientists and medical professionals have yet to decide whether or not chronic and continuous cannabis consumption is an effective treatment for mental health issues. When consumed in moderation, with mindfulness, and with proper support, however, it’s difficult to deny that the plant holds real value and has the ability to affect lives in a positive way.

Ultimately, it’s up to the patient and their trusted medical professional to decide when the plant is helpful and when it has become an unhealthy diversion.

If you or someone you know needs help with mental health issues, please reach out to Mental Health America or your local helpline.