Do CBD Gummies Help With Depression

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CBD gummies are known for their stress-relieving properties. Studies suggest that CBD can be used to assist in the treatment of anxiety disorders and depression. What are the best CBD gummies to maximize the effects of such treatment? Let’s take a look! Cannabidiol (CBD) is a cannabis compound that has generated interest for the relief of symptoms of depression. Learn how it's used and if it works. Cannabidiol (CBD) in the Self-Treatment of Depression-Exploratory Study and a New Phenomenon of Concern for Psychiatrists This is an open-access article distributed under the terms of the

Best CBD Gummies for Anxiety & Depression of 2022

CBD is gaining popularity across America because of its anxiolytic (anti-anxiety) properties. The effects of CBD oil on the human brain are yet to be fully understood, but current research shows promising results when it comes to using such products to manage anxiety and depression.

People choose CBD over conventional anxiety medications because they don’t give them enough relief or have horrible side effects with long-term use.

CBD gummies are one of the most popular forms of cannabidiol. Unlike oils, they don’t have that strong hempy aftertaste when swallowed, making them more enjoyable overall.

But do they provide the same benefits as CBD oils and vapes for anxiety and depression?

It turns out they do. After all, the main ingredient remains the same despite a different form.

In this guide, we review the best CBD gummies for sleep and anxiety from reputable brands. After spending several months researching popular vendors in the CBD space, we’ve narrowed our options to 10 companies that offer remarkable formulas to assist with the above health concerns.

We also gathered the most frequently asked questions regarding the use of CBD for anxiety and depression.

Best CBD Gummies for Anxiety and Depression

  1. Royal CBD – Editor’s Pick
  2. Gold Bee – Best Organic Formula
  3. Green Roads – Runner Up
  4. Tasty Hemp Gummies – Best Flavor
  5. CBDfx – Best Variety
  6. cbdMD – Good Value
  7. Charlotte’s Web – Most Popular Brand
  8. PlusCBD Gummies – Largest Size
  9. Medterra – Best for Daytime Use
  10. Joy Organics – Best Customer Service

1. Royal CBD

Get 15% off all Royal CBD products. Use code “CFAH” at checkout.

Royal CBD offers premium CBD gummies from organic hemp and is gently extracted with supercritical CO2 to ensure consistent potency and high purity. These little dots and drops are tested in third-party laboratories for quality and safety to ensure that you’re getting the top-shelf ingredients.

The best part about Royal CBD gummies is that they only contain 3 grams of sugar per container. That’s because they don’t have added sugar; the sweetness has been achieved with fruit juices, so it’s actually a guilt-free treat.

Royal CBD gummies contain 99.9% pure CBD isolate, so there’s no hempy aftertaste when you eat them. Instead, you can easily pick out delicious grape, orange, and strawberry flavors.

You can choose from two strengths: 10 mg and 25 mg. The first option is better if you suffer from mild stress and generally improve your resilience, while the latter is better suited for severe symptoms and users who weigh more than 200 lbs.

Royal CBD uses all-natural ingredients that come from organic sources. As such, they are priced a little bit higher than competitor brands, but the overall experience is worth it.

2. Gold Bee

Gold Bee is another premium company established in California. The brand was founded by a group of friends who are both cannabis aficionados and experts in the superfood niche.

The Gold Bee CBD gummies feature a broad-spectrum extract so that you can benefit from other cannabinoids and terpenes. However, there’s no THC in them, so you can even give them to children when they’re going through episodes of anxiety. Similar to Royal CBD, Gold Bee infuses their gummies with 25 mg of CBD per piece. They offer an assortment of three flavors: apple, berry, orange, and pumpkin.

These gummies are also gluten-free and vegan, making them suitable for people with certain food restrictions. Gold Bee tests all its products for potency and safety in a third-party laboratory. You can reach out to them for Certificates of Analysis (CoA).

3. Green Roads

According to a report from the Brightfield Research Group, green Roads is one of the industry’s pioneers and the biggest private-owned CBD company. They offer a wide range of pharmaceutical-grade CBD extracts, including oils, capsules, edibles, topicals, and pet products.

If you want to add a burst of flavor to your CBD supplementation, Green Roads offers some of the most delicious CBD gummies out there. Their flavor is natural, thanks to the use of natural plant extracts and fruit concentrates. The company has two versions of gummies: 10 mg and 25 mg. The extra-strength version may be more beneficial for heavyweight users and those who experience severe stress throughout the day.

There are 5ct and 30ct containers available, although the potency remains the same. If you’re looking for a better product choice, we recommend opting for Royal CBD or Gold Bee.

4. Tasty Hemp Gummies

Tasty Hemp CBD gummies contain all-natural, organic ingredients, including organic corn syrup, fruit juices, and natural flavorings and colorings. They come in three assorted flavors: cherry, lemon, and orange.

Offering 25 mg of CBD per gummy, these treats are very affordable, considering that most CBD gummies in this price range contain 15 mg of CBD at best. That being said, Tasty Hemp doesn’t provide the lab reports for contaminants such as solvents, pesticides, and heavy metals; they only show the product’s potency and THC content.

5. CBDfx

CBDfx offers a wide range of CBD gummies, each with its own benefits for different users. The best formula for anxiety and depression includes CBD mixed with melatonin. Each gummy contains 25 mg of broad-spectrum CBD and 5 mg of melatonin, so it’s also a decent sleep aid.

Unfortunately, these gummies also contain more sugar than the other products we’ve mentioned in our ranking. This is understandable considering they offer a full-spectrum extract, but on the other hand, they won’t be a good fit if you need to control your sugar levels for health reasons.

6. cbdMD

cbdMD is a hemp manufacturer that offers CBD gummies made from organic, US-grown hemp. The gummies contain broad-spectrum CBD to save some of the entourage effects without adding any THC to the formula.

There are three strengths you can choose from 10 mg, 25 mg, and 50 mg. The last variant is a good choice for people experiencing strong bouts of anxiety during stressful situations.

cbdMD contains a mix of tropical, strawberry, raspberry, and orange flavors, although they are far from the best-tasting gummies. If you don’t like their taste, cbdMD has a 60-day return policy, under which you can get a full refund for the returned product.

7. Charlotte’s Web

Charlotte’s Web is one of the oldest companies in the CBD space. The brand turned into a true CBD powerhouse after helping the late Charlotte Figi with a rare form of treatment-resistant epilepsy (Dravet Syndrome). Since then, they have added plenty of different CBD products to their lineup, including a reformulated version of CBD gummies.

Charlotte’s Web CBD Calm gummies are formulated for people looking to address anxiety and depression. Each gummy contains 10 or 25 mg of CBD (depending on the selected variant) and has a lime flavor thanks to the use of natural terpenes and lemon balm, which are known for their stress-relieving properties.

Recently, Charlotte’s Web has received a few warning letters from the FDA for inappropriate health claims on its products, but it’s still one of the most reputable companies in the US despite these setbacks.

8. Plus CBD Gummies

PlusCBD oil offers full-spectrum CBD gummies in four versions: regular, extra-strength, calm, and sleep. The calm variant caters to people suffering from stress and anxiety. You can choose between the fruit punch or cherry mango flavor, both of which do a great job of masking the strong taste of full-spectrum CBD.

At 10 mg of CBD per gummy, they are better suited for lightweight users or people who use CBD to enhance their response to daily stressors. The calm version is also infused with L-theanine and 5-HTP, a precursor of serotonin, which controls our mood stability and emotional well-being.

Unfortunately, PlusCBD doesn’t stock any high-strength gummies, which can be cost-prohibitive for those who weigh more than 150 pounds or struggle with severe anxiety.

9. Medterra

This crafting company from California specializes in hemp extract from organically grown hemp. The gummies are among their best products — especially the Keep Calm option that contains 25 mg of CBD infused into a delicious gummy base chock-full of tropical flavors. These gummies are also vegan and non-GMO, so you can eat them even if your diet doesn’t include wheat and animal-based products.

The gummies are sold in paper bags, each containing 25 mg of broad-spectrum CBD per gummy. Despite a reasonable price, Medterra doesn’t offer any discounts on their products, making them a less affordable company than other manufacturers on this list.

10. Joy Organics

Joy Organics is a family-owned business. The company was founded by Joy Smith, a mother, and grandmother who has been using CBD to help with sleep issues and chronic pain. After failing with several CBD brands, she has decided to launch her own company to ensure her products are crafted to the best standards.

Joy Organics CBD gummies contain CBD isolate, meaning you won’t benefit from other cannabinoids and terpenes. But if you’re interested only in the benefits of CBD and you don’t like the hempy taste of whole-plant extracts, they should be a good fit for you.

The gummies are available in two flavors: green apple and strawberry lemonade, both flavored with fruit concentrates. They’re also gluten-free, vegan, and contain 10 mg of CBD per piece. You can buy them in jars of 30.

However, despite the top-notch quality and simple formula, these gummies may not be affordable in the long run if you’re a heavyweight user or have more stress to deal with in your life.

How We Selected the Best CBD Gummies for Anxiety and Depression

The 2018 Farm Bill legalized hemp on a federal level and paved the way for a new industry — or resurrected once slain giant, to be more accurate.

Every company with a budget big enough to afford a patch of land, an extraction facility, and a web designer, started growing hemp and making CBD products.

But not every manufacturer knows how to do it properly — hence the emergence of poor-quality CBD products on the market.

To understand more about CBD gummies, read our comprehensive guide.

Although the CBD space has matured over the years, there are still many fly-by-night vendors due to the lack of regulations. This article provides you with an all-around buyer’s guide for new consumers who are overwhelmed by the abundance of different CBD gummies.

To prepare our ranking, we’ve:

  • Surveyed over 10 000 readers through emails, scoring a response rate of 64%.
  • Analyzed customer reviews sections of 30 popular CBD companies to get a bigger picture of their products.
  • Tested the gummies ourselves, thinning down our list to the top 10 CBD gummies for anxiety and depression.

Here are the points you need to tick off if you want to make a well-informed decision.

Hemp Source

Organically grown hemp sourced from local US farms is more reliable as the farmers need to abide by certain quality standards. The hemp extracts are clean and contain legal limits of THC. They’re also GMO-free.

Type of CBD

Hemp extracts come in three variants: full-spectrum, broad-spectrum, and isolates.

Full-spectrum CBD contains all plant nutrients and minerals, including trace amounts of THC (less than 0.3%). These products are the most valuable from the therapeutic point of view because they leverage the entourage effect. It’s a concept where all cannabis compounds work synergistically to provide better effects than each of them alone.

Broad-spectrum CBD is very similar to its full-spectrum counterpart, except for the THC content. THC is removed from the extract after initial extraction. Such products evoke some of the entourage effects, but not to their full potential.

Isolates — true to their name — contain just pure CBD. These products boast the highest concentration of CBD per serving and don’t contain any odor and flavor. Since they’re THC-free, they are a better fit for athletes and professionals regularly tested for drugs. On the other hand, there’s no entourage effect because isolates are devoid of other cannabinoids and terpenes.

Formula

CBD has a plethora of health benefits on its own, but you can also use other ingredients to enhance or complement its stress-relieving properties. For example, some CBD gummies for anxiety and depression contain natural relaxants, such as chamomile, L-theanine, lemon balm, 5-HTP, or ashwagandha. Such products are known for producing a calmer effect on the user.

Potency

The amount of CBD present in your gummies defines the strength of their effects. In higher doses, CBD acts as a sedative because it temporarily lowers blood pressure. It can also calm your nervous system and help achieve a more stable mood. Furthermore, the higher the CBD content of a product, the more efficient it is.

Quality of Ingredients

It’s one thing if the CBD comes from organic hemp, but does the manufacturer include other organic ingredients — or do they cut corners on their quality? The ingredients list should contain organic fruit juices, concentrates, flavorings, and colorings on top of the gummy base, generally made of gelatin or fruit pectin (vegan gummies). It’s also important that the gummies are free of any ingredients you wouldn’t use at home. Some companies use preservatives and stabilizers to reduce production costs — but this negatively impacts the overall quality of the product.

Flavors

Although this isn’t the primary issue, the flavor of CBD gummies can make or break your experience. Since they’re edibles, the flavor is essential; if the product tastes good, you will enjoy each serving. When it comes to problems like anxiety, a bad taste can only deteriorate things. Many people can’t stand the hempy flavor of full-spectrum CBD. That’s why flavors are added to gummies, chews, and candies. But then again, these flavorings should be derived from natural ingredients to provide a better experience.

Lab Reports

Always check the lab reports of your CBD gummies. Brands that respect their customers test their products in third-party labs because they know how important transparency is. A third-party laboratory isn’t affiliated with the manufacturer in any way. The lab report gives the user an idea of what the product really contains. CBD gummies should contain less than 0.3% of THC and be free of contaminants and solvents. You’ll find these parameters in the certificate of analysis attached to the product.

Transparency

Decent transparency is a surefire way to win customers’ trust. Companies that openly speak about their practices — farming, extraction methods, lab tests, etc. — are more reliable. Transparency also determines the responsibility of a company. Responsible brands care about their customers from more than just a business perspective.

Reputation

A brand’s reputation depends on the satisfaction of its customers. The better the customer experience, the more positive the reviews. Just make sure to check if your vendor uses certified review services that are posted by verified users. This will give you a better feel about the brand’s quality, both in terms of their products and customer service.

See also  Eden's Herbals CBD Oil Reviews

Customer Experience

A brand’s responsibility to its customers reaches beyond the end of a purchase. This is actually where it begins. The quality of customer service is paramount for their reputation. This increases customer retention and ensures loyalty. If brands value their customers and offer them 5-star services, new people are sure to come.

How CBD Affects the Mood

When you take CBD — be it through inhalation, oral consumption, or topical application — it interacts with your nervous system through signaling the endocannabinoid system (ECS) and several other systems in the body.

CBD indirectly engages with the cannabinoid receptors of the ECS, as well as with receptor-independent pathways. This leads to certain responses of the nervous system that ultimately influence your mood and behavior.

What does Science Say About Using CBD for Anxiety?

According to several clinical trials and preclinical studies, CBD can be an effective remedy for anxiety disorders. If you’re not sure about CBD’s effectiveness on anxiety problems, the following studies shed more light on their relationship:

  • A 2015 study published in the Neurotherapeutics Journal highlighted CBD as a potential treatment option for anxiety. The study concluded its evidence from several human experimental, epidemiological, preclinical, and clinical studies — finding strong evidence supporting CBD’s ability to treat post-traumatic stress disorder, obsessive-compulsive disorder, and panic disorder (1).
  • In a 2019 study posted by the Permanente Journal, the authors reviewed several clinical trials to evaluate CBD’s efficacy in neuropsychiatric disorders, including anxiety, epilepsy, and schizophrenia. The evidence supports CBD’s calming effects on the central nervous system without altering one’s consciousness. The study suggests CBD may be a promising tool for managing anxious episodes in clinical populations (2).
  • A 2020 study from the Cannabis and Cannabinoid Research journal analyzed the influence of CBD on anxiety behaviors of animal models. The researchers found significant evidence of CBD’s potential as an anxiolytic compound (3).

Wondering if CBD-infused gummies can help with other common issues? Don’t worry, we got you covered.

How to Use CBD Gummies

Eating CBD gummies is as simple as munching on any tasty snack to relax. Not only does the very act of chewing the nerves calmly, but the CBD oil, along with delicious flavors, provides a tranquil state of mind and a better stress response.

CBD gummies mentioned on this list contain all-natural and organic ingredients. Since CBD is non-intoxicating, so it won’t get you baked from eating these gummy bears.

There is no specific dose of CBD for a particular ailment, physical or mental issue. In general, it is recommended to start with a very small dose, somewhere between 2.5 and 5 mg of CBD. From there, you can adjust the dosage to your needs, and once you’ve figured out the best dosage, lock that in and stick to that amount.

If you’re wondering why you choose CBD gummies over CBD oil, we would say the ease of use, convenience, discreteness, and taste makes them worth the try. Although CBD has many forms, gummies are the most enjoyable method for those who don’t like smoking or vaping.

How Many CBD Gummies Should You Take for Anxiety and Depression?

As mentioned, there is no one-size-fits-all dosage of CBD for anxiety and depression. The effective dosage may vary between individuals; several factors are involved in determining the right amount of CBD, such as age, body weight, metabolism, tolerance, gender, and the severity of the condition.

Gummies are sold in a range of concentrations, from 5 mg to as much as 50 mg of CBD per piece. They usually come in 30- or 60-count bottles.

If you have 10 mg gummies, you can start with one gummy, and if you don’t feel any change in your mood, you can add another gummy or two and reassess the effects. Just don’t rush another dose too fast; gummies need to pass through your digestive system to produce their effects, which takes longer than sublingual administration. Oral products such as CBD gummies usually kick in after 40 to 90 minutes.

Safety and Side Effects of CBD Gummies

CBD is well-tolerated by humans. Even doses as high as 1500 mg daily are safe and don’t have any harmful side effects. In normal doses, even the minor side effects are nearly nonexistent.

Nevertheless, this doesn’t mean that CBD isn’t capable of triggering an unwanted reaction. If you take too many CBD gummies at a time, you may experience:

  • Dry mouth
  • Lethargy
  • Dizziness
  • Irritation
  • Appetite fluctuation
  • Diarrhea

CBD is also known to interact with many pharmaceutical medications, so if you take any medication, consult the use of CBD with your doctor. Doing so will help you find the right dosage and establish a proper routine to avoid negative interactions.

Final Thoughts: Should You Try CBD Gummies for Anxiety and Depression?

Our review outlined and discussed the top 10 brands that make high-quality CBD gummies for anxiety and depression. We hope it will help you make a well-informed decision based on what you feel is the best for your needs.

Every user has a different opinion on CBD products because of the differences in taste, preferences, and dosage needs. You know yourself better than anyone else, so it’s important to map out your priorities first. Once you know your goals with CBD, find the right potency and formula to address your anxiety issues.

Just keep in mind that while some effects can be noticed right away, sometimes, CBD may need more time to level the deficiencies in your endogenous cannabinoids. In other words, you may need to give it more time — for example, a week or two.

CBD gummies are available in different cannabinoid spectra, all of which can affect your experience. Some people draw more benefits from pure CBD, while others prefer full-spectrum or broad-spectrum products.

Whichever option you choose, always make sure to follow the steps from our guide. Researching your vendors is essential if you want to avoid scammers and companies with no idea how to make CBD gummies.

Reference links:

  1. Blessing, E. M., Steenkamp, M. M., Manzanares, J., & Marmar, C. R. (2015). Cannabidiol as a Potential Treatment for Anxiety Disorders. Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics, 12(4), 825–836. https://doi.org/10.1007/s13311-015-0387-1
  2. Shannon, S., Lewis, N., Lee, H., & Hughes, S. (2019). Cannabidiol in Anxiety and Sleep: A Large Case Series. The Permanente journal, 23, 18–041. https://doi.org/10.7812/TPP/18-041
  3. Wright, M., Di Ciano, P., & Brands, B. (2020). Use of Cannabidiol for the Treatment of Anxiety: A Short Synthesis of Pre-Clinical and Clinical Evidence. Cannabis and cannabinoid research, 5(3), 191–196. https://doi.org/10.1089/can.2019.0052
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Nina created CFAH.org following the birth of her second child. She was a science and math teacher for 6 years prior to becoming a parent — teaching in schools in White Plains, New York and later in Paterson, New Jersey.

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Can CBD Help With Depression?

Kendra Cherry, MS, is an author and educational consultant focused on helping students learn about psychology.

Verywell Mind articles are reviewed by board-certified physicians and mental healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more.

Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital.

Interest in the potential mental health uses of cannabidiol (CBD) has grown tremendously in recent years, including the use of CBD for depression. CBD is a chemical compound found in the Cannabis sativa plant, also known as marijuana or hemp.

Cannabis contains more than 80 compounds, known as cannabinoids. The main cannabinoid that most people are more familiar with is tetrahydrocannabinol (THC), which is the psychoactive substance that produces the “high” characteristic of marijuana.

CBD, on the other hand, is purported to have a wide range of health benefits without these psychoactive effects. Some research suggests that CBD has antidepressant-like effects, which means it may hold promise in alleviating symptoms of depression.

Benefits

Despite claims about CBD’s purported mental health benefits, it is important to understand that the research on its use is still limited. There have been studies done, but many of these have limitations and further research is needed in order to fully understand CBD’s therapeutic potential.

Research suggests that CBD has antidepressant effects, although it is important to note that many of these are animal studies.  

Other studies suggest that CBD may help alleviate symptoms of depression by interacting with serotonin receptors in the brain. Serotonin is a neurotransmitter that plays a role in a range of functions in the body including the regulation of mood. It may help contribute to feelings of happiness and well-being. It is also often implicated in the onset of depression and many types of antidepressant drugs work by increasing serotonin levels in the brain.

One study published in 2018 suggested that cannabidiol does not increase serotonin levels; rather, it appears to work by influencing how the brain responds to serotonin that is already there.  

Another study found that CBD had a “clear anti-stress effect,” which might play a role in reducing stress levels that contribute to feelings of anxiety and depression.  

How It’s Taken

Cannabidiol is available in several different forms, although only those that are ingested are likely to produce any antidepressant-like effects or other mental health benefits. It may be taken orally as an oil, spray, or capsule. CBD may also be added to edible products including beverages, candies, or chewable gummies.

CBD can also be used topically in creams, salves, lotions, and balms, although it is likely to only produce localized effects in this form. E-liquids that are inhaled via vaping are also available, though vaping comes with its own risks.

It is also important to note that CBD is available in isolate (only CBD), broad-spectrum (contains other cannabinoids but not THC), and full-spectrum (contains other cannabinoids, including THC).

Possible Side Effects

Most of the available research suggests that CBD is generally well-tolerated and produces few side effects. However, this does not mean that people may not experience any unwanted side effects, which may include:

  • Appetite changes
  • Mood changes
  • Diarrhea
  • Anxiety
  • Drowsiness
  • Nausea
  • Dizziness
  • Elevated liver enzymes  

Safety

According to the World Health Organization, the available evidence suggests that CBD is relatively safe. However, the long-term effects are not entirely clear.

One of the biggest concerns that consumers face when purchasing CBD products is the lack of FDA regulation.

CBD products are not subject to regulation because they are marketed as supplements, which means that you don’t know if you are really getting what is described on the label. Because these products are not regulated, you have no way of knowing for sure what you are getting in terms of purity, safety, and dosage.

  • One study found that a whopping 70% of CBD products sold online were mislabeled, with many containing much more THC than the packaging claimed.   So while many CBD products are labeled as not containing THC, many do contain significant amounts. This could potentially result in a positive result on a drug test. This is a major concern, particularly if you want to avoid the psychoactive effects of THC.
  • Another study found that CBD products may also contain potentially dangerous chemicals and medications, including synthetic cannabinoids and cough medicine.   Such contamination could lead to health problems including allergic reactions or drug interactions.

CBD vs. Antidepressants

So how does CBD compare to traditional antidepressants? True comparisons of the effects are not yet possible simply because there is not enough research on CBD’s effects.

However, one animal study suggests that CBD might have some possible benefits by comparison:

  • A 2018 study published in Molecular Neurobiology concluded that CBD had promise as a fast-acting antidepressant drug. While traditional antidepressant drugs typically take some time to begin working, research on rodents found that CBD showed rapid and sustained antidepressant-like effects.  
  • CBD also appears to have relatively few side effects. Antidepressant drugs may sometimes cause things such as appetite changes and sexual side effects.

CBD holds promise, but that does not mean that you should turn to cannabidiol products over traditional treatments for depression.

A Word From Verywell

The bottom line when it comes to CBD’s potential as a treatment for depression is that more research is needed. Most of the evidence supporting CBD’s antidepressant effects comes from animal studies or small trials, and one of the largest reviews of the research found that the available evidence is not strong enough to recommend CBD as a treatment for depression.  

If you are experiencing symptoms of depression, it is important to talk to a doctor or mental health professional. Depression may worsen over time if left untreated, but there are effective treatments available including psychotherapy and medications.

If you are interested in using CBD to alleviate symptoms of depression in conjunction with other treatments, always talk to your doctor first about how to use it and about any possible medication interactions.

If you or a loved one are struggling with depression, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area.

For more mental health resources, see our National Helpline Database.

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

De mello schier AR, De oliveira ribeiro NP, Coutinho DS, et al. Antidepressant-like and anxiolytic-like effects of cannabidiol: a chemical compound of Cannabis sativa. CNS Neurol Disord Drug Targets. 2014;13(6):953-60. doi:10.2174/1871527313666140612114838

Sales AJ, Crestani CC, Guimarães FS, Joca SRL. Antidepressant-like effect induced by Cannabidiol is dependent on brain serotonin levels. Prog Neuropsychopharmacol Biol Psychiatry. 2018;86:255‐261. doi:10.1016/j.pnpbp.2018.06.002

World Health Organization. Cannabidiol (CBD).

Bonn-miller MO, Loflin MJE, Thomas BF, Marcu JP, Hyke T, Vandrey R. Labeling accuracy of cannabidiol extracts sold online. JAMA. 2017;318(17):1708-1709. doi:10.1001/jama.2017.11909

Black N, Stockings E, Campbell G, Tran LT, Zagic D, Hall WD, et al. Cannabinoids for the treatment of mental disorders and symptoms of mental disorders: a systematic review and meta-analysis. The Lancet Psychiatry. 2019;6(112):P995-1010. doi:10.1016/S2215-0366(19)30401-8

Cannabidiol (CBD) in the Self-Treatment of Depression-Exploratory Study and a New Phenomenon of Concern for Psychiatrists

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The raw data supporting the conclusions of this article will be made available by the authors, without undue reservation.

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Abstract

Cannabis sativa, whose flowers are also known as marijuana or marihuana, is a recreational plant that contains many chemicals that are constantly being studied by scientists around the world. One of these substances is cannabidiol (CBD), which has gained widespread popularity on the internet as a cure for mental health problems, leading many people to use CBD to self-treat depression and anxiety. This article presents an exploratory cohort study (n = 90) of a group of people aged 16–69 using CBD to self-heal depression symptoms. The survey included basic sociodemographic questionnaire and validated Hospital Depression and Anxiety Scale. And was distributed via the Internet. The results were statistically analyzed. High school degree was the most commonly held education (46%), large city was the most popular place of living (33%) and majority of the respondents have a full-time job (53%). Only 19% of the respondents consult their doctor or pharmacists about taking CBD. On the group of psychiatric patients, only 49% of respondents tell their psychiatrist about using the compound. Psychiatrists should be aware of CBD use in their patients during their daily practice, as CBD use can be found within people from all walks of life, and due to public interest, there is a need for education and research on the efficacy and safety of CBD use for mental disorders.

Introduction

Cannabis sativa, commonly known as marijuana or marihuana, is a plant with psychoactive properties used primarily for recreational purposes. However, in recent years, numerous studies have been conducted that have found its beneficial effects in the treatment of many diseases (1). Marijuana-derived compounds, known for their antioxidant, anti-inflammatory, and antinecrotic properties, are considered promising agents that are increasingly used in research related to Parkinson’s disease, epilepsy, depression, anxiety disorders, and schizophrenia, as well as in the treatment of chronic pain (2–4). The substances contained in marijuana are called cannabinoid com-pounds. The most potent constituent of cannabis is natural tetrahydrocannabinol (THC), which is responsible for the psychoactive properties of marijuana (1). Among other compounds, one is especially notable–cannabidiol (CBD), a non-psychoactive compound which could be useful in depression treatment, as the studies have demon-strated the activity of CBD as a partial agonist of 5HT1a serotonin receptors, which could be beneficial in the treatment of depression and anxiety by using this substance, but this still requires extensive research (5).

CBD appears to be relatively safe substance in preliminary studies, but there are several side effects that should be mentioned. CBD is one of the better tolerated substances compared to THC, mainly due to its lower addictive potential (6). In the available literature, the adverse effects described mainly refer to studies in animal models and depend on the dose taken and the duration of use. The use of CBD in animals resulted in the development of drug toxicity, increased fetal mortality, liver cell damage, inhibition of spermatogenesis, and hypotension, but it should be mentioned that the doses used in animals were above the recommended amounts for humans (7). The most common side effects reported in studies of cannabinoid use for epilepsy or psychotic disorders were fatigue, diarrhea, and appetite disturbances (8). Other side effects reported after CBD use included vomiting, insomnia, and hepatologic disorders. Nonetheless, in certain conditions CBD could be dangerous, as it is metabolized in the liver with the involvement of CYP3A4, which affects its interactions with many drugs that are also processed with the involvement of this enzyme system (including anti-fungals, clarithromycin, or rifampicin) (7).

The public is very interested in natural methods to treat depression. Scientists are focusing on the study of dimethyltryptamine (DMT), a psychedelic substance found in many plants, and psilocybin, a psychedelic that occurs naturally in mushrooms such as psilocybin cubensis (9). The popularity of CBD in the treatment of depression is as great in society as the popularity of the use of DMT or psilocybin-on October 15, 2021, the Google search engine returns 6,370,000 results for the term “CBD depression treatment,” and information on this topic can be found on such well-known websites as the New York Times or Forbes (10, 11). Despite the great popularity that the use of CBD for depression enjoys on the Internet, in our opinion, the scientific data on the efficacy and safety of this substance in the treatment of depression remain sparse. It is not difficult to find groups on social media (e.g., Facebook) where experiences are shared about the use of CBD for self-care for mental health and where people (often without medical training) recommend certain products from the Internet along with dosage. Self-care for mental health has its limits, and that is when patients turn to supplements and products purchased online without the knowledge of their doctor, as this is potentially dangerous. There are documented over-the-counter uses of St. John’s wort in combination with serotonin reuptake inhibitors that resulted in the development of serotonin syndrome (12). Because we do not know much about CBD, we believe that people who use CBD to self-medicate should be closely monitored. We were unable to find appropriate studies describing this phenomenon in any disease, although previous literature suggests that self-medication with CBD exists for chronic pain, anxiety, and depression (13). In our opinion, the availability of CBD on the retail market is disproportionate to the number of scientific reports on the efficacy and safety of CBD, because in many European countries such as Austria, Spain, Sweden, Germany or France you can easily buy CBD legally (14). This situation is potentially dangerous from a medical perspective for both patients and medical staff, as people risk potentially treacherous intoxication by searching social media for unverified data on the ingestion of rather unknown substances. Therefore, as a group of psychiatrists, we decided to investigate the problematic phenomenon of using CBD to self-treat depressive symptoms, as it is important to learn more about the people who choose to do so. We aimed to explore the basic demographic and epidemiological characteristics of people who use CBD to self-treat their depressive disorders and to demonstrate the fact that this phenomenon exists. The study was exploratory in nature, therefore we did not rise any particular research questions.

Materials and Methods

The study was designed by psychiatrists from the Department of Psychiatry at the Medical University of Silesia in Katowice and was conducted according to the guide-lines of the Declaration of Helsinki and Good Clinical Practice. It included 23 questions in Polish in the areas of: general sociodemographic parameters, general psychiatric interview of patients, questions related to CBD intake: frequency, dosage and form of consumption, improvement of wellbeing after CBD intake and additionally included the Hospital Anxiety and Depression Scale (HADS) questionnaire. The HADS is one of the most widely used self-assessment questionnaires for screening anxiety/depression symptoms and focuses mainly on the cognitive and psychological aspects. It is used in both the general medical population and the healthy population. The HADS consists of a total of 14 items on 2 separate subscales: Anxiety (HADS-A) and Depression (HADS-D), and the total score ranges from 0 to 42 points. Currently, the categorization system includes several groups: 0–7, normal; 8–10, mild; 11–15, moderate; over 16, severe (15). The survey was uploaded to the Internet via Google Forms, Google’s original online survey tool. The form consisted of 5 separate pages-consent to the study, questions about demographic data, questions about previous psychiatric treatment, questions about CBD use, and the HADS questionnaire. Data were collected via Facebook from August 27, 2021 to September 16, 2021. We asked administrators of depression, mental illness, and CBD use groups and websites to help us collect data, and they actively provided a link to the form on their websites, therefore we could not estimate the amount of people who received the link to the survey. Incomplete questionnaires were rejected. To ensure complete anonymity, as marihuana is still generally a taboo subject, no personal or contact information was collected, including email addresses or IP addresses that would identify respondents. For that reason, we had to avoid sampling methods that would be normally used in such study. We had to avoid using data collection enhancement methods, as they would require us to use more complex technical methods that would not allow data anonymization. Participation in the survey was voluntary, respondents were informed of the purpose of the survey and were required to answer in the affirmative to the first question “I use CBD oil to improve symptoms of depression and agree to participate in this anonymous study (or as a minor, I have the consent of my legal guardian to participate),” otherwise they were not given access to the questionnaire. Ninety seven responses were collected, of which 7 subjects, after reading the manual, did not agree to submit their anonymous responses to analysis.

The collected data were analyzed using STATISTICA 13.0 software (StatSoft, Kraków, Poland). Qualitative variables were tested using the chi-square test. The Shapiro-Wilk test was used to check whether quantitative variables conformed to the normal distribution. The test revealed that not all variables conformed to the normal distribution. In case of non-normal distribution, Mann-Whitney U test was used to compare two independent groups, while Kruskal-Wallis test was used to compare multiple independent samples. Spearman’s rank order correlation test was used to test the relationship between the variables. Statistical significance was assumed at p < 0.05.

Results

We collected 90 correctly completed questionnaires from the respondents. The study comprised a group of males and females of comparable size who did not differ significantly in age, education and type of occupation. One person reported being non-binary and was excluded from the statistical analysis. The youngest respondent was 16 years old and the oldest was 69 years old. High school degree was the most commonly held education (46%), large city was the most popular place of living (33%) and majority of the respondents have a full-time job (53%). Majority of the respondents claim that they either trust or probably trust the psychiatrists. The detailed characteristics of the study population are shown in Table 1 . There is no difference in trust in psychiatrists between the groups. Respondents’ place of residence differs between gender groups, but the significance level is borderline, which could be tested if a larger sample of respondents were used.

Table 1

All Male Female
n 90 42 48
% 100% 46,7% 53,3%
Average age 33,7 32,9 34,5
Education High school degree 46% 43% 50%
Vocational school 9% 7% 8%
Higher bachelor’s degree or equivalent 14% 14% 15%
Higher masters or equivalent 30% 33% 27%
Doctorate or higher academic title 1% 2% 0%
Place of living Village 21% 26% 17%
Small town (up to 50,000 inhabitants) 21% 12% 29%
Medium-sized city (from 50,000 to 200,000 inhabitants) 25% 19% 29%
A large city (over 200,000 inhabitants) 33% 43% 25%
Type of work Full-time job 53% 50% 54%
Entrepreneur 15% 21% 10%
Another form of employment 10% 10% 10%
Unemployed 7% 10% 4%
Seasonal job 7% 2% 10%
Student 5% 2% 8%
Pupil 3% 5% 2%
Do you trust psychiatrists? Definitely not 6% 2% 8%
Probably not 29% 36% 23%
Probably yes 44% 43% 46%
Yes 21% 19% 23%

Majority of the respondents were or still are treated by a psychiatrist (55%) and started using CBD for depressed mood (69%). The most commonly consumed other psychoactive substance was caffeine (47%). Only 19% of respondents consulted a doctor or pharmacists about taking CBD, and most respondents (59%) consume CBD daily. Majority of the respondents (57%) are currently under the supervision of a psychiatrist and a little over half (51%) do not tell their psychiatrists about their use of CBD. Majority of respondents said they felt better after CBD treatment (86%). The detailed characteristics of CBD use for self-treatment of mental disorders are shown in Table 2 .

Table 2

CBD consumption characteristics.

All Male Female
n 90 42 48
% 100% 46,7% 53,3%
Have you ever been diagnosed / diagnosed or treated / treated by a psychiatrist? Yes 55% 40% 67%
No 45% 60% 33%
Answers only from the group of people who have ever been diagnosed or treated by a psychiatrist (n = 50) Why did you receive psychiatric treatment? Anxiety disorders 76% 94% 66%
Depression 72% 76% 69%
Insomnia 36% 35% 37%
Personality disorder 16% 18% 13%
Addiction 14% 18% 13%
Bipolar affective disorder 4% 0% 6%
Schizophrenia 4% 6% 3%
Does your psychiatrist know you are taking CBD? Yes 49% 47% 50%
No 51% 53% 50%
Are you undergoing psychiatric treatment right now? Yes 57% 41% 66%
No 43% 59% 34%
Why did you start to use CBD? Depressed mood 69% 74% 65%
Anxiety 62% 60% 65%
Insomnia 58% 45% 69%
No motivation 48% 38% 56%
Problems with concentration 40% 33% 46%
Energy drop 37% 26% 46%
What other psychoactive substances are you using? Caffeine 47% 55% 40%
THC 38% 50% 27%
Nicotine 33% 26% 40%
Alcohol 21% 33% 10%
Hallucinogenic substances 7% 7% 6%
Psychostimulants 2% 0% 4%
None 29% 19% 38%
Where did you first heard of CBD? Internet 62% 76% 50%
Friends 29% 17% 40%
Family 8% 5% 10%
Television 1% 2% 0%
Have you consulted CBD consumption with a doctor or a pharmacist? Yes 19% 14% 23%
No 81% 86% 77%
Where do you buy CBD most often? Online shop 66% 67% 65%
Local store 22% 24% 21%
Pharmacy 2% 0% 4%
Friends 10% 10% 10%
What form do you most often consume CBD? CBD oil 73% 62% 83%
Hemp drought 26% 38% 15%
Pure CBD in the form of a spray 1% 0% 2%
How often do you consume CBD? Every day 59% 60% 58%
A few times a week 22% 21% 23%
Several times a month 13% 10% 17%
Several times a year 4% 7% 2%
Less often 1% 2% 0%
Do you usually measure the same doses of CBD? No, I’m not measuring my doses 38% 43% 33%
Yes, 1–50 milligrams a day 39% 33% 44%
Yes, 51 to 100 milligrams a day 9% 10% 8%
Yes, 101 to 150 milligrams a day 9% 10% 8%
Yes, 151 to 200 milligrams a day 3% 5% 2%
More than 200 milligrams a day 2% 0% 4%

Women were more likely to be diagnosed or treated by a psychiatrist compared to men (χ 2 =; 6.19 p = 0.01; chi-square test). Among the psychiatric disorders treated, men were significantly more likely to be diagnosed with anxiety disorders (χ 2 = 4.87; p = 0.027; chi-square test). No significant difference was found between genders for the other disorders. Women were significantly more likely than men to take CBD due to insomnia (χ 2 = 5.07; p = 0.024) and energy depletion (χ 2 = 3.72; p = 0.05 (borderline); chi-square test). Men were significantly more likely than women to use THC (χ 2 = 5; p = 0.025) and alcohol (χ 2 = 7.06; p = 0.008 chi-square test).

Men were significantly more likely than women to learn about CBD from the Internet, while women learned from friends and family (χ 2 = 8.61; p = 0.04 chi-square test). Respondents most frequently purchased CBD from online stores, while the most common form of CBD consumption was CBD oil, which was significantly more frequently consumed by women (χ 2 = 7.12; p = 0.03 chi-square test).

Majority of the respondents (53%) claim that CBD made them feel overall better and 88% of the respondents would more likely take CBD than a prescription drug from a psychiatrist. Table 3 shows detailed psychiatric outcome analysis for respondents using CBD.

Table 3

Assessment of CBD effects on mental health of respondents.

All Male Female
n 90 42,00 48,00
% 100% 46,7% 53,3%
Did CBD make you feel overall better? Definitely not 6% 7% 4%
Probably not 8% 10% 6%
Probably yes 33% 31% 35%
Definitely yes 53% 52% 54%
With your current knowledge, would you be more likely to take CBD or prescription drugs from a psychiatrist? Prescription drugs 12% 64% 36%
CBD 88% 44% 56%
HADS–average result Anxiety 10,43 9,17 11,58
Depression 8,04 8 8,16
HADS categories in anxiety subscale Normal 31% 43% 21%
Mild 20% 19% 21%
Moderate 31% 24% 38%
Severe 18% 14% 21%
HADS categories in depression subscale Normal 53% 52% 54%
Mild 17% 21% 13%
Moderate 26% 21% 29%
Severe 4% 5% 4%
See also  CBD And Fish Oil

Out of respondents who are or were treated by a psychiatrist, the most commonly drugs prescribed were selective serotonin reuptake inhibitors (16%). Table 4 shows which prescription medications were or are being taken by respondents. Greater improvement in wellbeing was reported by younger respondents (r = −0.22; p < 0.02; Spearman's rank-order correlation). There was no correlation between reported improvement in wellbeing after CBD use and: (1) frequency of CBD use, (2) amount of CBD dose taken, or (3) form of CBD use.

Table 4

Psychiatric medications taken by respondents.

Substance n
Medications taken by respondents in the past Selective serotonin reuptake inhibitors 16%
Serotonin and norepinephrine reuptake inhibitors 12%
Trazodone 6%
Opipramol 4%
Alprazolam 3%
Hydroxyzine 3%
Pregabalin 3%
Monoamine oxidase inhibitors 2%
Quetiapine 2%
Aripiprazole 1%
Lamotrigine 1%
Mianserin 1%
Mirtazapine 1%
Olanzapine 1%
Risperidone 1%
I do not remember the names 16%
I have never received any prescription drugs from my psychiatrist 7%
Medications currently taken by respondents Selective serotonin reuptake inhibitors 8%
Serotonin and norepinephrine reuptake inhibitors 8%
Pregabalin 6%
Trazodone 3%
Alprazolam 1%
Aripiprazole 1%
Quetiapine 1%
Lamotrigine 1%
Mirtazapine 1%
Olanzapine 1%
Opipramole 1%
I am currently not using any prescription drugs 38%

Under the HADS Anxiety subscale, 69% of respondents qualified for the group that exceeded the norm criteria (score > 7 points), while in the case of the HADS sub-scale, 47% exceeded this cut-off point.

93% of the respondents did not observe any negative effects of CBD consumption. Two respondents reported the occurrence of anxiety disorders during therapy, while 1 respondent reported the following symptoms: depressed mood, addiction, diarrhea, xerostomia.

Only 17% of respondents reported that they were currently taking psychotropic drugs. This group is too small to perform a statistical analysis using the above statistical tests. 49% of respondents admit to having taken the above drugs in their lifetime. Individuals who admit to taking psychotropic drugs in the past are significantly more likely to trust psychiatrists (p < 0.0001; Mann Whitney U test).

Discussion

The path to the use of CBD in psychiatry is partially clear, as CBD has been approved by the U.S. Food and Drug Administration as a drug for the treatment of drug-resistant epilepsy, suggesting that the compound has a satisfactory long-term safety profile for this neurological condition (16). Data on the benefits of CBD in reducing the severity of depressive symptoms and anxiety are limited but promising. Some studies show that CBD is useful in treating depression, anxiety, sleep disorders and even problematic cannabis use, as well as in reducing the positive symptoms of schizophrenia, with little to no side effects such as diarrhea, which decreased over time (17, 18). Clinical studies are also encouraged by the authors of publications summarizing the achievements of science in the field of CBD use in psychiatry. They point out that studies in larger groups of people are necessary not only to determine the safety and usefulness of the substances in psychiatric treatment, but also to determine the efficacy of the treatment in the context of differences in symptoms of gender disorders, since most clinical trials have been conducted mainly in men (19, 20). There is still too many question marks to not monitor people who use CBD on their own. The situation in which patients decide to self-medicate their symptoms with a drug for which there is, for the time being, limited evidence of efficacy and safety is potentially dangerous because, apart from the side effects, such actions may worsen their mental state through the natural progression of depressive disorders, especially since some respondents choose to take more than CBD, including THC or hallucinogens, which may not be neutral among respondents.

The survey involved people of different ages (both minors and retirees), with different levels of education, and living in both rural and urban communities, which means that the use of CBD for self-treatment of depression is not limited to certain social groups. This information may be useful in further planning of scientific and educational activities in this area.

When analyzing the above responses, it should first be noted that only 19% of respondents consulted their doctor or pharmacist about taking CBD. At the same time, in the group of psychiatric patients, only 49% of respondents informed their psychiatrist about the use of CBD during psychiatric treatment. This situation is potentially dangerous because when patients buy CBD outside the pharmacy, this sale escapes the control of the pharmaceutical regulatory authority, which may encourage the accidental ingestion of other substances than intended, because when sales are outside the control of pharmaceutical regulators, consumers need to trust the honesty of the sellers. The situation of physicians and pharmacists being informed by the patient of the use of a psychoactive substance that is not an approved drug for the condition being treated is also extremely difficult. Categorical prohibition is unlikely to be effective, but it will limit the patient’s honesty at subsequent visits, and acceptance of this state of affairs means that the patient accepts responsibility-at least in part – for the possible adverse effects of taking a psychoactive substance. The situation of physicians and pharmacists will not improve until they have accurate knowledge of the effects of CBD in various clinical situations and of interactions with the most common psychotropic drugs. There is an urgent need to complete this knowledge.

An important element in the mystery of the CBD phenomenon is the chemical composition of the oil itself or the dried fruit you buy. You should keep in mind that in addition to CBD and other cannabinoids, there are substances from other chemical groups, such as terpenoids, flavonoids, and alkaloids. It is possible that these substances may have an impact on the patient’s wellbeing (21). It is important to know this because a possible complex antidepressant effect of Cannabis sativa- derived substances cannot be excluded. Research suggests that CB1 and CB2 receptors are associated with depression and bipolar disorder, and a single nucleotide polymorphism in the CB1 receptor has been observed in patients with treatment-resistant depression (22). CBD is an agonist of the 5HT-1A receptor, which in combination with its action on cannabinoid receptors may lead to a new unique effect (5).

As mentioned in the introduction, the media is eagerly interested in the topic of using CBD to treat depression, and society is picking up on the topic in social media. In public discourse, healthcare professionals should stick to facts. There is not enough data to conclusively confirm or rule out the claim that CBD is useful in treating mental illness. Given the social aspect of CBD use, further research by interdisciplinary teams made up of psychiatrists and pharmacists seems well warranted.

The responses collected shed light on another aspect. When planning further research on the use of CBD to improve symptoms of depressive disorders, it is important to pay attention to validated instruments that help in the diagnosis of depression. The responses to the question about reasons for starting CBD use may suggest that although we asked about self-treatment of depression, and this was clearly explained in the survey instructions and in the first question, some of the public may not fully understand the nature of this disorder. Patients could be suffering from major depressive disorder or mixed depression-anxiety disorder, and since it makes a difference in terms of the proper medical solutions offered byphysicians, it may not make a difference to patients. They might just call both disorders “depression,” whereas according to our HADS-A and HADS-D results, anxiety is actually more prevalent in our study group. Differentiating the causes of depressive disorders on the basis of the currently used International Statistical Classification of Diseases and Related Health Problems will make it possible to reduce methodological errors, contribute to a more rapid resolution of scientific problems and avoid inaccuracy in providing data to other scientists.

Study Limitations

This study is probably the only study to examine the extent of self-treatment of depression with CBD, but it is not free of limitations. The data was collected during COVID-19 pandemic, which could have an impact on the respondents wellbeing in terms of depressive and anxiety symptoms. Due to anonymity of the study, the study was anonymous and was not prospective, therefore, we could not explain if CBD actually helps people who use the substance. The survey was conducted over the Internet, which limits the ability to rule out respondent error in completing the survey and prevents intentional bias from being ruled out. A small group of respondents does not allow for indepth statistical analysis and it is not necessarily representative for the population; furthermore, the selection of the group depends on activity on the Internet. However, the exploratory nature of this study provides solid justification for further research and analysis in this area.

Conclusions

Psychiatrists should be aware of CBD use in their patients during their daily practice, as CBD use can be found within people from all walks of life for self-treatment of depression due to depressed mood. Due to public interest, there is a need for education and research on the efficacy and safety of CBD use for mental disorders.

Data Availability Statement

The raw data supporting the conclusions of this article will be made available by the authors, without undue reservation.

Ethics Statement

Ethical review and approval was not required for the study on human participants in accordance with the local legislation and institutional requirements. Written informed consent from the participants’ legal guardian/next of kin was not required to participate in this study in accordance with the national legislation and the institutional requirements.

Author Contributions

GW: conceptualization, project administration, and visualization. GW and MS: methodology and software. GW and RP: validation and writing—review and editing. GW, IS, and MS: formal analysis, investigation, and writing—original draft preparation. GW and IS: resources. MS: data curation. PG and RP: supervision. All authors contributed to the article and approved the submitted version.

Conflict of Interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Publisher’s Note

All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.

Acknowledgments

The authors would like to thank Kombinat Konopny, HempNation, Dr. Konopny Siedlce, and Depresja, Stany Lekowe, Ataki Paniki, Fobie. Grupa integracyjna. Facebook group for making their networking channels available so the authors could collect the data.

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