There are many Food and Drug Administration (FDA)–approved prescription drug treatments for anxiety. However, some people find the potential of a natural alternative an attractive option.

Some studies have shown that about 25% of people with mood or anxiety disorders have tried cannabis (also referred to as marijuana) to treat symptoms of anxiety.

Questions persist surrounding how the primary compounds in cannabis, CBD (cannabidiol) and THC (delta9-tetrahydrocannabinol), differ from one another, as well as what role each plays in creating therapeutic effects related to anxiety relief.

This article will discuss the use of CBD vs. THC for anxiety relief.

CBD vs. THC: What’s the Difference?

Cannabis, with CBD and THC as its primary compounds, comes from the Cannabis sativa plant, which contains over 400 components.²

CBD

CBD comes from both hemp and non-hemp plants and traditionally contain 0.0% to 0.3% THC.

CBD does not have a mind-altering effect.

It is a compound found in cannabis but does not cause the “high” that is commonly associated with using the drug.

CBD can be taken in various ways as an independent product, such as by mouth (liquids, capsules) or applied topically (lotions, creams).³

THC

THC, a psychoactive compound, is believed to be responsible for producing the mind-altering effect of cannabis.

Notably, if someone consumes THC, they are consuming cannabis. There is no way to take THC as an individual compound.⁴

What Is CBD (Cannabidiol)?

By itself, people use CBD to help with various conditions, such as:⁵

• Insomnia
• Depression
• Anxiety
• Post-traumatic stress disorder (PTSD)
• Pain
• Addiction, otherwise known as substance use disorder (SUD)

You can buy CBD products (containing 0.3% THC or less) within the United States at different locations, including pharmacies and dispensaries (stores that sell cannabis).⁵

However, state laws can differ, so it’s best to check your state laws for more information.⁶

CBD In Prescription Drugs

CBD is also available in a prescription drug called Epidiolex (cannabidiol), which is an oral liquid medication that can be used to treat certain types of seizures.

However, Epidiolex is not FDA-approved for any other conditions, such as insomnia or anxiety.⁷

Administering CBD

CBD is available in multiple forms to suit individual preferences and conditions. For example, if you have muscle pain, you may opt for a topical cream applied to one body part.

Examples of CBD products include:⁸

• Oils
• Oral liquids
• Spray that is administered under the tongue
• Oral capsules
• Patches that are applied to the skin
• Vape
• Topical products like creams and lotions

What Is THC (Delta-9-Tetrahydrocannabinol)?

Popular uses for cannabis, by which individuals consume the combination of effects of THC and CBD, include, but are not limited to:⁹

• Inflammatory bowel disease (IBD), including Crohn’s disease
• Epilepsy
• Multiple sclerosis (MS)

Purchasing Cannabis

The best place to purchase cannabis is at a state-licensed dispensary. You may have heard the terms recreational (adult-use) cannabis and medical (or medicinal) cannabis.

While the products are the same and contain similar amounts of THC, the difference is in how they are sold, such as:¹⁰

• Anyone 21 years and older can purchase recreational cannabis in a state where it is legal.
• To purchase medical cannabis through a state’s medical program, an individual must have a qualifying condition that is approved by the state (approved conditions vary by state) and a healthcare provider’s authorization.

Administering THC

Notable ways people consume cannabis include:¹¹

• Smoking in hand-rolled cigarettes called joints
• Smoking in pipes called bongs
• Smoking in blunts (cigars that have been emptied and filled with cannabis)
• Vaping
• Through edibles (mixed into brownies, cookies, or candy)
• Brewed as a tea
• Dabbing (smoking or eating THC-rich resins extracted from the cannabis plant)

CBD vs. THC for Anxiety

Regarding their effects in alleviating symptoms of anxiety, studies show that CBD may reduce anxiety, while THC may help anxiety at low doses but not higher ones.

Clinical studies have found the following:

• In one older (2011) small study, a group of people were given either CBD or a placebo before a public speaking event. The participants who took CBD had less anxiety than those who took the placebo.¹²
• A 2021 study found that CBD helped people with moderate to severe anxiety but did not help those with mild anxiety.¹³
• A review of studies by Drexel University’s Medical Cannabis Research Center found that lower doses of THC help anxiety symptoms, but higher doses of THC may increase anxiety. The researchers also noted that CBD tends to decrease anxiety, regardless of the dose. The study also noted that CBD or THC should be used in addition to, not in place of, talk therapy (psychotherapy).¹⁴
• A 2022 study found that using cannabis to treat certain conditions (pain, anxiety, or depression) did not improve symptoms and also doubled the risk of developing cannabis use disorder (CUD). People with CUD build up a tolerance to THC and need to use more cannabis as a result. They may also continue to use cannabis despite its causing physical or psychological issues. People using cannabis for anxiety and depression had the highest risk of CUD.¹⁵

Dosing Guidelines for Anxiety

Check with a healthcare provider before trying CBD or THC to make sure they are safe for you.

When using CBD for anxiety, you usually start with a low dose and gradually increase the dose to 300–400 milligrams (mg) per day.¹⁶

Different formulations have different dosing, so ask your pharmacist or healthcare provider about dosing with your chosen product.

With THC, lower doses (7.5 mg or less) are more effective for anxiety, per past research.

However, the benefits may be temporary, and using cannabis regularly tends to increase the risk of tolerance to its effects, which could lead to cannabis dependence.¹⁷

If you opt for THC, go to a state-licensed dispensary and consult the pharmacist (if there is one on staff) or a “budtender” (a dispensary staff member who can answer questions and offer suggestions) to learn more about the products and how to start with a very low dose.

When to Avoid CBD or THC

Before you use either CBD or THC, check with your healthcare provider to make sure it is safe for you to use.

Inform your provider of your medical history and current and prior conditions, as well as all of the medications you take, including:

• Prescription drugs
• Over-the-counter (OTC) medicines
• Vitamins
• Supplements

If you have ever had an allergic reaction to CBD, THC, or any cannabis product, you should avoid these products.

Use During Pregnancy or Breastfeeding

You should not take CBD or THC if you are pregnant or breastfeeding.

The FDA strongly advises against using any CBD or THC if you are pregnant or breastfeeding.¹⁸

Use in Younger and Older Populations

Children and teenagers should not use CBD or THC unless under the supervision and recommendation of a healthcare provider.¹⁹

Older adults should also check with a healthcare provider before using CBD or THC.⁵

Potential for Interaction

Using CBD or cannabis alongside the following may result in adverse effects:⁸²⁰

• Caffeine
• Alcohol
• Drugs used for the treatment of bipolar disorder, such as lithium
• Drugs used for the treatment of major depressive disorder (MDD), such as Prozac (fluoxetine)
• Drugs that slow down the central nervous system (CNS), such as certain anxiety or sleeping medications

Side Effects of CBD vs. THC

CBD and THC carry the potential for side effects of varying severity.

However, know that CBD- and THC-related side effects may be determined by various factors, including the product strength and purity, quantity used, how it was used (for example, topical or oral), and other medications used.

The following outlines potential side effects associated with CBD vs. THC.

Common Side Effects of CBD

Common side effects associated with the use of CBD include:⁸²¹

• Drowsiness
• Dizziness
• Light-headedness
• Dry mouth
• Agitation
• Decreased appetite
• Diarrhea
• Liver problems

Common Side Effects of THC

Common side effects associated with the use of THC include:¹¹

• A “high”
• Altered senses (such as seeing brighter colors) or sense of time
• Mood changes
• Impaired body movement
• Problems with memory, thinking, and problem-solving
• Hallucinations and delusions (with high doses of cannabis)
• Psychosis (more likely when regularly using high-potency cannabis)

Long-Term Side Effects of THC

Long-term side effects associated with the use of THC (marijuana) include:¹¹

• Breathing problems
• Problems with brain development (impaired thinking, memory, and learning)
• Worsening of symptoms in people with schizophrenia

Federal and State Guidelines: CBD vs. THC

As highlighted above, CBD is federally legal (legal throughout the United States) as long as it contains 0.3% or less THC.⁵

However, foods and beverages that contain CBD are not technically considered legal on a federal scale. Every state has different laws surrounding CBD and THC.

For example, in some states, such as Connecticut, Colorado, and New Jersey, all cannabis products, including CBD and THC, are legal.

Other states have certain limitations.⁶

Alternative Treatment Options for Anxiety

Beyond CBD or THC, if you are interested in treatment for anxiety, there are many options, including prescription medications, therapy, and non-medicinal measures such as:²²

• Writing thoughts in a journal
• Eating a healthy diet (including reducing or eliminating caffeine and alcohol)
• Exercising (especially outdoors)
• Using mindfulness techniques like deep breathing, meditation, yoga
• Stopping smoking
• Getting enough quality sleep
• Using a weighted blanket
• Sticking to a routine
• Joining a support group

You can also ask your healthcare provider for other recommendations on how to treat your anxiety symptoms.

Summary

CBD (cannabidiol) is derived from hemp or non-hemp plants and contains 0.3% THC (the mind-altering component of cannabis) or less.

CBD alone does not have a mind-altering effect, while THC is believed to be responsible for producing the mind-altering effect of cannabis.³

THC is the component of cannabis that gives the “high” effect.¹¹

Both CBD and THC are used for a variety of conditions, such as sleep and anxiety.¹³

Before using CBD or THC, you should consult your healthcare provider to ensure that it is safe and appropriate for you to use.