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Mother Knows Best: Is Cannabis Causing My Paranoia, or Is It Something Else?

What to do when smoking marijuana sparks some unwanted side effects.

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Dear Mother,

I know sativa strains can increase paranoia and marijuana use can exacerbate schizophrenia, but I've been smoking for 10-plus years and never had this issue. I'm on probation and quit smoking for about nine months before picking back up. Now, after about two months of smoking again, my paranoia is at an all-time high. When I smoke it helps at first, but then I start to freak out. I think it's because of probation being on my case, but then also I'm thinking maybe weed is affecting me differently now. Does this have to do with the weed I’m smoking, or something else entirely?

— DV

Hi DV,

Thanks for writing in. Paranoia is no joke, so I'm glad you realize that this is something serious that you'd like to fix. The first thing I want to remind you, however, is that I'm not a doctor, but I’ll still do my best to offer up some ideas and suggestions.

My first suggestion would be: Go see a doctor!! Health providers don't need to know you're on probation, and unless you're hurting yourself or others, they will not report your cannabis activity to anyone. Please, if you go to a doctor or psychiatrist, let them know you've been smoking cannabis. They will need all the information possible to help you out with this.

You mentioned knowing that sativa strains might increase a person's anxiety or paranoia, and that's definitely a possibility. Sativa strains are known for their high cerebral and energizing effects which can cause anxiety to flare; a sativa strain's effects can even mimic a panic attack in some people. Indica strains, on the other hand, offer powerful body highs which can help combat a lot of anxiety's physical symptoms. I know that as someone with a diagnosed anxiety disorder, I stay away from sativa strains and even sativa-dominant hybrids for that very reason. High CBD and/or indica and indica-dominant strains help calm me down the most. If you're able to, try to steer away from potent sativa strains for a while and stick to indica ones if you can.

While I can't say that your paranoia is a direct result of your long term cannabis use based on just an email, what I can tell you is that there is some research that shows a connection between cannabis and paranoia. For a long time there were two main questions folks tried to answer: "Is cannabis causing these mental health issues?" and "Do people predisposed to mental health issues tend to unknowingly self-medicate with cannabis until it's not enough?" Unfortunately, there really aren't any easy answers.

A few years ago, scientists at Vanderbilt University released a study which detailed that cannabinoid receptors are present in the amygdala, the part of the brain that regulates anxiety and fear. Researchers found that cannabis does indeed impact the "fight or flight" response in our brains. But, the impact is not uniform among cannabis users, and the report noted that the plant can have different effects on different people. In other words, just because one person feels less anxious after smoking cannabis, another marijuana user may experience the exact opposite. The study did not clarify why people’s experiences with cannabis differ, and the reason is still unknown.

In 2011, another study was published in the Journal of Neuroscience that illustrated something similar. After experimenting on rats, researchers at the University of Western Ontario in Canada found that cannabis has the potential to enhance fear-based behavior responses and learning processes. As a reporter for TIME put it, the study demonstrated how cannabis can lead “brain to jump to conclusions about mild experiences involving particular places or things, and to perceive them as scarier and more strongly connected than they are.”

Are you over 18?

DV, you explain that while you smoked for a quite a while, you took an almost year-long break from cannabis. That time could have been enough to help repair any desensitized cannabinoid receptors in the brain. Instead of the relaxing experiences you may have had in the past, your "newbie" brain might be reacting differently this time around.

At the same time, your marijuana use over the past decade could be viewed as self-medication to alleviate symptoms of mental illness you might have been experiencing, perhaps unknowingly. When you took the mandated break, that gave your brain enough time to wave a bunch of red flags (i.e. your paranoia) to alert you to an issue that was no longer being treated by cannabis. Your brain might be saying to you, "Hey! I'm not functioning the right way without that marijuana! These symptoms of x are no longer being helped!”

As you can see, the answer isn't really clear, even after looking at the research out there. Again, I’d suggest reaching out to a professional who can screen you for mental health issues, as well as talk to you about other ways to help combat your paranoia. Hopefully they’re able to reach the root of the issue, and you can once again use marijuana without any negative side-effects.

— Mother


Are you over 18?