Can CBD Be Used for PTSD in Veterans?
Sadly, many people go through traumatic experiences in life – accidents, abuse, natural disaster and even more “minor” experiences like bullying or medical procedures that can register to the body as traumatic. It is estimated that as a result, 6.8% of adults will develop PTSD in their lifetime, with women twice as likely (10.4%) as men (5%). For veterans, these figures are far higher – 30.9% for men and 26.9% for women. War is obviously a very difficult experience, and even vets who aren’t diagnosed can still suffer mental health problems after. In fact, what we now call PTSD was originally termed “shell shock” during World War I.
What is PTSD, exactly?
The human body has natural defense mechanisms designed to help us get through difficult experiences. Most of us have heard of “fight, flight and freeze” – these are some of the body’s in-born responses to threatening experiences. Imagine living in prehistoric times, taking a nice walk in the woods, and coming upon a tiger. Your body would react FAR SOONER than your brain could come up with a good solution. In most cases, you would probably try to run, or perhaps freeze in hopes the tiger would not notice you. After all, its unlikely any of us would win fighting a tiger, but if the tiger pounced, it’s a good thing your body has that defense mechanism ready and waiting too!
The problem is that, as trauma therapist Dr. Peter Levine describes in his book, Waking the Tiger: Healing Trauma, too often these defense mechanisms switch ON but do not turn OFF. Even after the tiger has left, someone who develops PTSD will start seeing tigers everywhere! The body still believes it is under threat, and LOTS of super uncomfortable symptoms start to take over a person’s life. These can include intrusive memories (“flashbacks”), avoidance, depression and hopelessness, hyper vigilance (feeling “on guard”), emotional reactivity and/or numbness. It is not surprising, therefore, that substance abuse is common among veterans. The U.S. Department of Veteran’s Affairs estimates 20% of vets with PTSD also have problems with drugs or alcohol in attempt to deal with their symptoms. In extreme cases, some may act out with violence, like one man who shot and killed his wife after serving in Iraq.
Why might CBD help?
Many researchers think CBD has great potential to help people suffering from PTSD. While there’s not enough research to make CBD a definite “go to” for psychiatrists and psychologists treating veterans with PTSD, there’s a lot of reasons it may one day become a standard treatment.
The endocannabnoid system is highly involved in the body’s stress response, as well as emotional memories and brain processes to reduce the effects of the type of fearful memories that give rise to PTSD. Endocannabinoids appear to be involved in hyperarousal and poor sleep. Researchers have specifically studied veterans with PTSD and found they have lower levels of endocannabinoids than healthy individuals. Since the endocannbinoid system is so deeply involved in processes related to PTSD, it makes sense that CBD might be an attractive solution.
One way researchers study PTSD is by using animals. To create PTSD-like symptoms, researchers will expose animals to mildly traumatic experiences, like a minor foot shock, at the same time as a neutral (or “conditioned”) stimulus. After several rounds the animal comes to associate the conditioned stimulus with the shock, and starts to respond negatively to the stimulus itself. Sort of like if you were in an airplane crash, merely the thought of going on a plane again may be enough to set off a panic attack, without even leaving your house for the airport!
Through experiments like this, researchers have used CBD to reverse this process, that they call “aversive conditioning.” This process has multiple stages, and thus far CBD has helped most every step of the way for our lab rat friends. CBD has been found to reduce responses in the cardiovascular system and anxiety caused by traumatic stress. There’s evidence from studies on humans, too. One experiment shows participants pictures of people who have “fearful faces,” that is, who look afraid! Because we’re social creatures, even the look on another person’s face is enough to get our own body responding without our conscious awareness. When participants took CBD before doing the fearful faces experiment, they had lower levels of anxiety and response in the amygdala, the part of the brain on the lookout for signs of threat. In contrast, participants who took THC had increased anxiety!
What do research studies show?
What’s really cool about cannabidiol PTSD research is that there’s been a wave of studies in animals, that have led to further studies in humans, with many more on the way! While many of the mental and physical health conditions people experiment with CBD for do not have much research to back up, there’s definitely a growing body of findings with positive outcomes for CBD and PTSD thus far. There are currently randomized, placebo-controlled trials using CBD in humans to treat PTSD – so within a few years or so, we’ll have much more hard data.
In humans, several published case studies hint at some exciting possibilities for CBD and PTSD. One looked at 11 patients who cook CBD oral capsules or used an oral spray for 8 weeks. The average starting dose was 33.18mg at the start of the study, and 48.64mg at end. 10 out of 11 patients, or 91%, had a reduction in their PTSD symptoms. The average symptom score was reduced by 28%.
Another case study involved a 10 year-old girl who developed PTSD due to neglect and sexual abuse. Her caretakers had tried many different solutions, both “natural” and pharmaceutical yet she still struggled with terrible insomnia and anxiety. Once they introduced oral capsules and sublingual CBD spray into her routine, she was able to regularly sleep through the night and had a huge reduction in her anxiety. (Note: This was under the direction of her doctor, and should not be construed as medical advice, especially for children!)
Finally, in another case study, a 19 year-old man had severe PTSD that included intense flashbacks, panic attacks and self-harming behaviors. He began smoking cannabis resin that contained a roughly equal amount of THC and CBD, and was relieved to find his symptoms dramatically reduced. There are no studies on war veterans specifically – YET – but there is one currently underway!
Should vets give CBD a try?
If it sounds appealing, talk to your doctor! Over the next few years it is likely we will have even more information to guide decision-making, but if your symptoms are distressing NOW that might seem too long down the road. At the same time, PTSD has many serious symptoms, so its best to work with a medical professional for your own health and safety.
Sarah has a Ph.D in Sociology with a minor in Women’s Studies from the University of Arizona. Her current research spans the fields of trauma, psychology, neurobiology and sociology.