CBD Mood Disorders

Hey there everybody, and welcome to this presentation on cannabinoids in mood disorders and the impact of CBD. I'm your host, Dr. Donnellice Snipes. Let's first talk about mood disorders and what happens that may trigger a mood disorder. So when you're under stress, your body releases cortisol, which is a hormone that is a steroid. It tends to be anti inflammatory in nature and it suppresses your immune system. This makes sense when you are trying to fight or flee. When there's a threat, you need to not be in pain. You need to be able to do what you need to do to get out of the situation. So makes sense that your body is going to reduce, release something that is an anti inflammatory and immune suppressive. It doesn't want your immune system causing inflammation. It also releases norepinephrine, dopamine, adrenaline glutamate and tsh, which is thyroid stimulating hormone, which causes the release of thyroxin, which is another stimulating hormone. This produces an increase in blood sugar and fatty acids throughout the body. So all of this causes your body to dump energy so you can fight or flee. Okay, A again, the system still makes sense. It also leads to an alteration in gonadal hormone levels. Your testosterone levels, your estrogen levels, your progesterone levels, all are altered when you're under stress, as is our serotonin and GABA levels. Serotonin tends to be a modulating neurotransmitter and GABA is one that helps you relax. Well, if it's time to fight or flee, it is not time to relax. So it makes sense. All of this culminates in the fight or flee reaction or the stress reaction. When the threat is passed, the body responds basically in reverse and it produces more serotonin, increases GABA and the body sends out inflammatory cytokines. So these are kind of like janitors that go through the body and try to find anywhere where there's damage and clean it up. So the inflammatory cytokines are going through the body and causing a little bit of inflammation. So you can imagine if you're under chronic stress that there may be a breakdown in this system. Because what happens when there's never a break for the body to, you know, clean, clean up all the damage? Chronic stress leads to something called excitotoxicity. All of those chemicals that are released during the stress response, norepinephrine, adrenaline, glutamate, thyroxine, create an environment that is very hot, if you want to think of it that way, which ends up Causing the death of neurons. Additionally, when the body is constantly bombarded by cortisol and it recognizes it can't keep going, it can't run that hot for an extended period of time, so it starts becoming tolerant or resistant to the effects of the cortisol. So cortisol quits having an anti inflammatory impact. So when cortisol is released, you don't have that anti inflammatory effect, you just end up having inflammatory all the time and the body starts having difficulty resetting itself. This can also lead to insulin resistance. When the body is regularly bombarded with high levels of blood sugar, the tissues again will become resistant to that insulin, which can lead to insulin resistance and high A1C levels. Chronic stress underlies a lot of different physical and mental health issues, including anxiety and depression. Symptoms of mood disorders, and I'm just going to go through them really quick because you can probably name them yourself, but apathy, anxiety, difficulty concentrating, slowing or restlessness, reduced energy, changes in sleeping and appetite, changes in pain tolerance, and excessive guilt and potentially suicidal ideation. Now if you are having suicidal thoughts, that's a medical emergency and you need to call 911 right now. Symptoms can be caused. All of these symptoms can be caused by chronic stress and anxiety and dysfunction of that HPA axis. It can be caused by hormone imbalances that are caused by dysfunction of that HPA axis, or simply hormone imbalances that are caused by something else, like aging. As we age, we reduce the amount of our main gonadal hormone that we produce. So men tend to make less testosterone, women tend to make less estrogen. Symptoms can also be caused by inflammation and pain. And when you have inflammation, that means that the body is perceiving a threat. It's seeing you as more vulnerable. So that HPA axis is kicked off, but it's also sending those inflammatory cytokines to that area to try to heal it. Unfortunately, it starts a cascade effect where that HPA axis is chronically activated and you end up with high levels of inflammatory cytokines circulating through your system. They found in this particular study that I highlighted that there were 13 inflammatory markers that tended to be elevated in people with mood disorders. Circadian rhythm dysregulation can also cause a variety of mood and health disorders. Circadian rhythms are more than just sleep. Circadian rhythms regulate your gonadal hormones, your testosterone and your estrogen. It impacts your thyroid hormones and it impacts your hunger and satiation hormones. It impacts your mood, your inflammation, your immune system. It just, wow, it impacts a lot of stuff. If you Want to learn more about your circadian rhythms? There's another video on the YouTube channel you can review. You'll find that the circadian rhythm is a lot more important than you probably ever thought. But going along with that circadian rhythms do help us get good quality sleep. And when we lack quality sleep, that's another trigger for that HPA axis. It says you're sleepy, so I need to start pumping out all these stimulating neurochemicals to help keep you awake and keep you alert so you're not vulnerable. So what can CBD do? Well, CBD acts on receptors of the cannabinoid system, serotonin, glutamate, dopamine, and opioid systems. So CBD gets in there and starts monkeying with a lot of these different neurotransmitters. CBD binds mostly to CB2 receptors. THC binds mainly to CB1 receptors. So CBD binds mainly to CB2 receptors that are found on cells of the immune system include T and B lymphocytes. The majority of your CB2 receptors are found throughout the body and not in the CNS, which is one of the reasons that CBD is not psychoactive. The activation of CB2 receptors decreases the release of neurotransmitters like glutamate, serotonin, and norepinephrine and provides synaptic control of upstream neurotransmission, which basically means CB2 receptors go in there and start acting as conductors and sending neurotransmitters where they need to be. That it becomes. It takes over control of sending the neurotransmitters where they need to be. CBD also binds with dopamine, specifically the D3 receptors, which can enhance feelings of energy and motivation. Now, dopamine is often misunderstood because dopamine does not produce that euphoria. Dopamine produces a motivation, and it produces energy. It's also involved in schizophrenia, drug addiction, and Parkinson's disease. So dopamine is one of those interesting neurotransmitters. Too much can cause, contribute to hallucinations and delusions and a lot of other issues. And too little, on the other hand, can contributes to fatigue and jerky movements and problems like you would see in Parkinson's disease. So it is important to recognize that you don't want to overload the D3 receptors because they are involved in a lot of things, including muscle movement and contraction, in addition to motivation and energy. In animal studies, it's been found that systemic administration, that means taking it orally generally. So systemic administration of CBD causes a decrease in neurons associated with the fear. Well, I like that. So we don't have as many little neurons out there responding to fear stimuli. And modification of cerebral blood flow in brain areas that play a role in anxiety symptoms. So not only is it reducing the number of neurons looking for fear, but it's also not sending the blood to that area saying, you know what, we're not going to pay attention to that right now. So it reduces cerebral blood flow in the amygdala, hippocampus, hypothalamus, and cingulate cortex. All of those are involved in anxiety. But when that happens, we see a decrease in anxiety related behaviors. One study in humans found that 79.2% of people experienced a reduction in anxiety symptoms when they started taking cbd. Now that's a lot of freaking people. That is much more efficacious than a lot of the pharmacological interventions, the prescription interventions that people take for anxiety. So that's, you know, that's saying something there. We want to take a look at why that's happening. And they still don't completely understand why. CBD stimulates the synaptic plasticity and neurogenesis, which means it enables the synapses, the brain connections, to be more flexible, you know, so they can do workarounds when there's a problem in one area. And neurogenesis is the rebuilding of neurons. Well, that's all good stuff because, remember, when you get too stressed, you lose neurons. So we want neurogenesis, we want these neurons to develop. So this stimulation of synaptic plasticity and neurogenesis also plays a role in the development, well, in the treatment of depression. Lack of synaptic plasticity and loss of neurons plays a part in the development of depression. CBD is also believed to reduce the inflammatory response. Remember we talked about how Most of the CB2 receptors are throughout the body and in the immune system. CBD is believed to reduce the inflammatory response and depression by partially through activation of the A2A adenosine receptor. Now, there's a lot of research out there, and I didn't link to it on this one, but there's a lot of research out there that indicates that there is a very strong correlation between systemic inflammation and depression. When inflammation goes up, depression goes up, and when inflammation goes down, depression tends to go down. So there is a significant, significant connection there. So anything that we can do to reduce systemic inflammation is likely to improve mood, at least some. And CBD does it partly through the adenosine receptor. Now In a lot of my other videos we've talked about adenosine is that chemical that builds up in your brain throughout the day, that contributes to you getting sleepy. It contributes to sleep pressure. And when you're sleeping, when you're in that deep phase of sleep, your brain clears out the adenosine. So when you wake up in the morning, you feel alert and it allows the cortisol to do its job and help you get motivated to get out of bed. So when people take cbd, adenosine levels are increased. Adenosine is reduced significantly during chronic stress. So when people are chronically stressed, they tend to be more hypervigilant. The body says this is not the time to relax. So adenosine goes out the door. They are hyper stimulated. They've got that glutamate, norepinephrine, and, you know, probably caffeine going through their system. Adenosine regulates serotonin levels and has sedative properties. Now you remember that serotonin is broken down to make melatonin, which also helps you get sleepy. So when you don't have enough, enough adenosine, when stress is causing you not to have enough adenosine, then you're not going to probably have the right levels of serotonin. When you don't have the right levels of serotonin, it's going to probably impact your sleep, which is also going to impact that HPA axis. So everything that happens in your body is interrelated and often creates a cascade effect. It can be a positive cascade when you're doing positive things or a negative cascade. Sedative, anxiolytic and anticonvulsant drugs. So anxiolytic or your antianxiety medications, all of these. And opioids can inhibit adenosine uptake. So CBD inhibits adenosine uptake. So CBD is supposed to, to help you feel, you know, calmer and it counter counterbalances the effects of THC as we've talked about. But it's important to remember that when you have drugs that do the same thing, a lot of time, they have exponentially additive effects. So if you're taking cbd, which increases adenosine, and you're taking another medication that increases adenosine, you could very quickly get to too much adenosine and cause yourself too much sedation. Other research findings. CBD is thought to improve sleep in 66.7% of respondents. And it was also found to help regulate circadian rhythms. CBD impacts 5ht1a receptors or serotonin receptors, which is a key target involved in anxiety and depression. So not only does CBD help with inflammation, but it also increases serotonin levels, which can help people feel better. CBD at 300 milligrams in this study was found to have anti anxiety effects with a dose dependent bell shaped curve at 100, 300 and 900 milligrams for social anxiety disorder, comparable to other medications that are, you know, FDA controlled, which is interesting. So a bell shaped curve means the 100 really didn't do much. The 300 had the highest amount of effect and the 900 actually didn't do much. So it's, it's interesting to hypothesize what happens when you get high levels of cbd. What else happens that keeps it from being as effective? So too much of a good thing is actually a bad thing. CBD at 600mg in another study reduced anxiety by modulating the patterns of brain activity, altering prefrontal subcortical connectivity via the amygdala and the anterior cingulate. So it kept the prefrontal cortex, which is where we do a lot of our higher order thinking, our impulse control, executive functioning, planning, all that stuff up here, it kept it from connecting as effectively with the amygdala. So it said, you know what, we're not going to talk with that fear aspect of the brain. That's the one that always makes us freak out. So we're just going to break that connection for a while. CBD, 400mg in another study was able to reduce subjective measures of anxiety through reduced activity in the hippocampus without inducing sedation. So 400 milligrams, 300, 400 milligrams in these studies seems to be the sweet spot. There is currently an ongoing double blind, randomized placebo controlled clinical trial and I think everybody knows what that is now, thanks to Dr. Fauci that is evaluating the effects of CBD at 150 to 300 milligrams per day for 12 weeks to reduce anxiety and depression and in people with bipolar disorder. So we're just now barely starting to learn more about what CBD can do and how the cannabinoid system is actually involved in mood disorders as well as a host of other issues. It'll be interesting to learn more as the research comes out. Unfortunately, right now when you go to PubMed, which is where you're going to find most of the peer reviewed research, the majority of the studies are using what's called nabixmos which are a one to one combination of THC and cbd. And that's not really what we're talking about here in these videos. In these videos we're talking about almost pure cbd. We don't want to look at anything that has THC in it because THC is not legal in a lot of places. We want to look at, you know, what is available that people can access right now and start kind of ferreting it out. Another interesting thing, and I have a video about it on the YouTube channel already, is to look at the terpenes. And those are the aromatic oils that are found in the cannabis plant. And those terpenes are not psychoactive, but they can contribute to, to or help with enhancing some of the effects of cbd, such as anti inflammatory properties. So, you know, if you're struggling with inflammation, for example, it might be worth looking at that video as well and seeing if there are potentially some things that you might be able to talk over with your doctor in order to help control your pain a little bit better. Until the next time, I'm your host, Dr. Donnelly Snipes.