cbd oil not working for anxiety

8 Reasons CBD Might Not Be Working for Your Arthritis (and What to Do About It)

Cannabidiol, known as CBD, is a type of chemical called a cannabinoid that is found in the cannabis plant. It’s not intoxicating like THC, a different kind of cannabinoid that causes the “high” you get from using pot. Chances are you’ve heard of CBD. It’s one of the fastest-growing supplements in the U.S. and has become a popular topic among arthritis patients, from online support groups to clinical conversations in doctors’ offices.

Unlike many alternative arthritis treatments that get touted online, CBD does appear to have some positive effects, says Elyse Rubenstein, MD, a rheumatologist at Providence Saint John’s Health Center in Santa Monica, California. “There really aren’t yet any good studies to show that it works for arthritis but I’ve had patients who have found using CBD very helpful,” she says. “I haven’t seen any harm from it so it may be worth trying.”

However, for every CBD success story there are plenty of people who see little or no effects from using CBD. The first time Chris G., 37, of Denver, Colorado, tried a CBD oil tincture she felt nothing. “I might as well have been drinking straight coconut oil,” she says. Her friend had given her a bottle to help with rheumatoid arthritis pain and told her to just try it. Using CBD didn’t help the second time either. Or the third. Or the fourth. “I finished the whole bottle and never saw any difference,” she says. “I hear others talking about it and wonder why it didn’t work for me.”

Then there are the people who feel an effect — but not a good one. “It was like being drunk, but not in a fun way,” says Jason J., 46, of Minneapolis, Minnesota. The father of two tried it to treat his chronic pain from reactive arthritis as well as anxiety. He started with pure CBD oil and felt nothing so then he moved up to a CBD oil with a small amount of THC. The results were not great. While it did lessen his pain, he says it also made him feel nauseous and dizzy. He tried it a second time, this time spacing the doses further apart, but had similar results. He didn’t like the feeling and as a father was hesitant to do anything that might make him impaired while caring for his kids. “I wish it worked for me, but it did more harm than good,” he says.

If either of these experiences sound familiar, don’t give up yet. There may be good reasons CBD has not helped you — yet — and ways to make using CBD more effective for you.

1. Your CBD isn’t actually CBD

Just because cannabis products are becoming legal in certain parts of the U.S. doesn’t mean they are regulated. CBD is the wild west these days: There are a lot of “CBD” products with little or no actual cannabidiol in them, says McKenzie Mann, product development manager for Blue Forest Farms, a farm that grows high-CBD hemp and sells CBD products. The FDA doesn’t regulate CBD products and there aren’t universal quality standards, so unless you have a basement lab and chemistry degree, it’s near impossible to know exactly what you’re getting.

The fix: Look for brands that have their products independently tested (they should be able to provide you with test results), shop only at places you trust (preferably in person, not online), and when you find a brand that works for you, stick with it, says April Olshavsky, founder of Herbal Risings, a company that educates people on the proper use of CBD products.

2. You may benefit from a different strain

Not all cannabis plants are the same, which means the chemical makeup of your CBD product can differ widely. For one thing, CBD is one of many dozens of types of cannabinoids found in cannabis plants. Just as when you eat different berries (blueberries versus raspberries versus strawberries) you’re exposed to different antioxidants and plant chemicals, different cannabis plants have various amounts and types of cannabinoids and other compounds such as terpenes, which also have anti-inflammatory properties independent of the CBD.

The fix: Unfortunately, there’s no such thing as a specific strain being good for a specific disease or symptoms, says Bridget Seritt, co-founder of the Canna-Patient Resource Connection, a Colorado-based organization that is working to protect patient rights and end stigma against those who choose cannabis as medicine. A good CBD supplier should be able to show you third-party tests that include both the terpene and the cannabinoid profile. “There are hundreds of products with different formulations of each component, so knowing what goes into your products is essential. Keep a journal so you know which products worked and which did not. You can use the profile information to find similar products,” Seritt advises.

3. You need a different type of extract

There are different types of CBD extracts, and it’s important — from both a health and legal perspective — to understand their differences:

Full spectrum: This oil is how it comes raw from the plant and contains a full spectrum of compounds, including CBD, THC, terpenes, chlorophyll, minerals, and other parts of the hemp plant. “This is usually the best for most people and what we recommend — it’s the ‘entourage effect.’ All the compounds in the plant work best when they are together,” Mann explains. “Like most plants, it’s healthier to use it whole.”

Broad spectrum: This oil is similar to a full-spectrum product but with THC removed. In states where CBD is legal, laws can vary as to how much THC is permissible in CBD products in order for them to be legally sold. Many states in which certain CBD products are legal require them to contain less than 0.3 percent THC. A higher amount of THC in the product may make it more effective for certain conditions, Mann says, but this is a good option for people who live in states with THC restrictions.

CBD isolate: This oil is 99 percent straight CBD. While this might look like what you want — especially as it’s often labeled “pure CBD” — it’s the least effective form, Mann says.

The fix: Opt for a full-spectrum product if it’s legal to use where you live.

4. You didn’t wait long enough to see results

Many people do not see a difference after one or two doses of CBD. “CBD works on the endocannabinoid system in the brain and everyone’s is a little bit different,” Mann says. “One person may feel a difference within 20 minutes but others it may take several days to build up enough to where you feel it.” It can take up to eight weeks of regular use to feel an impact, says Seritt.

The fix: Give your CBD time to take effect. Try a product for at least two weeks before deciding that it’s not working for you.

5. You’re not consistent

“The biggest mistake people make with CBD is failing to follow a regular routine. You need to have patience to see the full effects,” Olshavsky says. This is especially true for people dealing with chronic pain from arthritis and other illnesses, she adds.

The fix: Do at least one dose once a day for at least two weeks to give the product time to build up in your system, Mann says.

6. You need a different method of delivery

Oral tinctures — drops that you place under your tongue — are the most popular way to use CBD but there are plenty of other options. You can also inhale it with vape pens, rub it on topically with a lotion, take it orally with capsules, or eat CBD-infused foods. Different delivery methods may be better for certain health conditions or personal preference.

For those using CBD primarily for targeted joint pain, a CBD lotion may be the best option. If you need CBD to take effect quickly for intense pain, vaping will work the fastest. Worried about prying questions? Capsules are simple and discreet to use. And for people who don’t like pills, edibles such as candy, gum, or other CBD foods are a fun way to ingest it. (However, Mann cautions that some of the potency is lost when CBD goes through your digestive tract, so capsules and edibles aren’t his top choice for efficacy.)

The fix: Talk to a reputable company about which form of CBD will work best for your specific needs.

7. You need a higher dose of CBD

People are often hesitant to take CBD because they equate it with recreational marijuana, which can lead them to under-dose, Olshavsky says. Or your dose may be sufficient but you’re not taking it often enough. What works for your friend may not be the right amount for you.

The fix: Between dosages, routine, and application method, it can take some trial and error to find the right product and regimen for you, Olshavsky says. “The best thing you can do is to keep a journal and record your symptoms and results.”

8. You may benefit from some THC

For many people, CBD works better with some THC in it. The compounds work together, with THC providing pain relief and the CBD helping to manage any negative side effects of THC, Mann explains. Many people who complain about their CBD not working are often using one of the types that has no THC in it, he adds. Even a CBD oil with just 0.3 percent THC may be more effective for you than one without any.

The fix: Consider trying something other than the “pure” isolate version of CBD (though you need to research whether or not these products are legal where you live). If you live in a place where marijuana is legal, consider a CBD oil with a ratio of 3:1 or even 5:1 of CBD to THC, Mann says.

Let's Talk About CBD for Anxiety & Depression

In the world of herbal remedies CBD, short for cannabidiol, is like the second coming among enthusiasts. Praised for its healing prowess—for everything from pain and insomnia to gastrointestinal issues and inflammation—the cannabis-born compound is fast developing cult-like status. Not only are physical health benefits reported, but more and more people are turning to CBD to help with mental health conditions—particularly anxiety and depression. And the research is promising. A review in Frontiers in Immunology found that CBD creates a calm in the brain that’s visible on scans—doctors can actually see the angst dissipate. There’s still a lot to learn about CBD’s impact on mood, but we’ve got all the intel to help you weed through the field.

Our Pro Panel

We went to some of the nation’s top experts in CBD to bring you the most up-to-date information possible.

Junella Chin, M.D.

Chief Medical Officer at Yesterday Wellness and Integrative Medical Cannabis Physician; co-author of Cannabis and CBD for Health and Wellness; Board Member of American Academy of Cannabinoid Medicine

Matthew Mintz, M.D.

Author of Medical Cannabis and CBD: A Physician’s Guide for Patients; Internal Medicine and Primary Care Doctor

April Hatch, R.N.

Member of the American Cannabis Nurses Association; co-founder of Cannabis Care Team

Experts believe careful CBD dosing may help temper the anxiety-induced racing thoughts that can cause disrupted sleep as well as panicked awakenings during the night. While CBD may not help someone with depression directly, it may benefit in other ways that can improve their mood or their ability to manage the condition overall. For example, sleep disruption and depression are closely linked. More than 90% of depressed patients complain about difficulties falling asleep, sleep disruption, or early morning awakenings. CBD can also be used to treat parasomnias, sleep disorders like jaw grinding, sleepwalking, or nightmares, and it cuts the time it takes to fall asleep.

This is one of the great mysteries; the optimal CBD dose is not an exact science. Doctors say there isn’t one universal dosage of CBD because different people (and different animals, for that matter) respond to different dosages of CBD. What experts also agree on, however, is that CBD works best when taken on a regular basis (daily). And the best way to know what works for you is to start on a low dose and titrate up if needed. It may not take as long as for someone with mild symptoms to feel the effects as someone who is dealing with more severe anxiety or depression. The goal is to find the lowest, most effective dose, so work with your doctor and give yourself time to figure it out.

Generally, it takes about 20 minutes for CBD to make its way to the bloodstream (though every person will react a little differently due to their individual biology, metabolism, and DNA, natch).

Experts believe the most effective form of CBD is an oil or tincture (alcohol-based solution) used sublingually (placed under the tongue). A sublingual preparation ensures the cannabinoids get distributed throughout the body. For patients who are feeling all kinds of jittery and need more immediate relief, some experts recommend vaping CBD through a dry-herb vaporizer, which heats up dried CBD flowers. These are relatively safe because they avoid the by-products produced from burning plant material and can be set to a desired temperature that allows you to get the most benefit from CBD you are consuming.

What Is CBD Again?

Maybe you’re already an expert on CBD, so feel free to skip to the section below; if you need a crash course, follow right along. CBD is one of two primary chemical entities (cannabinoids) found in the cannabis plant (the other one is tetrahydrocannabinol, THC). Unlike THC, which is what causes you to get high, CBD has no psychoactive effects (one reason why so many people are trying it). CBD derived from hemp differs from marijuana by its THC content. Hemp has less than the legal limit of 0.3% THC, while marijuana contains more than 0.3% THC.

To complicate matters, CBD is only FDA-approved for use in one medication, Epidiolex, which is used to treats the seizures associated with two rare forms of epilepsy. Because it’s largely unregulated, navigating the world of CBD can feel like a long, strange trip. And since you can’t be sure exactly what you’re getting, word to the wise: Consume with caution and always consult with your doctor.

How Does CBD Impact the Brain?

Understanding how CBD affects the brain starts with a lesson about the endocannabinoid system (ECS), basically the biggest system in the body that you’ve never heard of. It controls just about every internal function we have. Movement, pain sensation, immune responses, temperature, mental functioning like perception, mood, and memory—you name it.

The ECS is like Big Brother, constantly keeping an eye on things so when something’s not working right, it can take action. For example, let’s say your body generates a whole lot of heat after a workout. In this case, endocannabinoids bind to receptors, which then alert the ECS that it’s time to get your body to cool down by producing sweat.

Now, here’s how CBD comes into play. When you take CBD, you’re basically supporting the work the ECS is already doing to help your body function on the regular. Researchers believe CBD works to alleviate symptoms of anxiety and depression by binding to one of the main receptors within the ECS, the CB1 receptor.

Found mostly in the brain, the CB1 receptor is thought to tame central nervous system inflammation and help modulate the effects of serotonin, a neurotransmitter that oversees mood. In fact, the way many antidepressants work is by increasing serotonin in the brain.

Additionally, anxiety and stress inhibit GABA, a naturally occurring brain chemical that directs neurons to slow down or stop firing. This neurotransmitter essentially tells the body to chill out by helping to induce sleep, relax muscles, and create a sense of calm. Some scientists believe CBD can help modulate GABA so the body returns to its regularly scheduled programming.

How Effective Is CBD for Anxiety & Depression?

While there’s a solid amount of scientific research that shows CBD can be effective for anxiety in animals, as well as anecdotal evidence and case reports that show it may be beneficial for alleviating anxiety in humans, there is less data on the effectiveness of CBD for depression, though there have been some promising animal studies. For example, a 2018 study on rats published in NeuroscienceNews showed that just a single dose of CBD helped to reduce symptoms of depression for up to one week. Researchers believe CBD helps repair neural circuitry in the prefrontal cortex and hippocampus, which get damaged as a result of depression.

Also keep in mind, anxiety and depression have a complicated relationship. Both are conditions related to poor sleep, pain, and mood regulation. When we experience more anxiety, we experience more pain, and when we are feeling more depressed, we feel more anxious. It’s a chicken/ egg-like scenario. Here’s where CBD may fit in:

CBD is thought to positively influence the processes that regulate our mood, sleep, and pain perception, among others. These processes need to function properly, so we feel better, sleep more soundly, and experience less pain. Anxiety and depression are conditions related to poor sleep, pain, and poor mood regulation because the endocannabinoid system isn’t working to the best of its ability.

Experts believe careful CBD dosing may help temper anxiety-induced racing thoughts that can cause disrupted sleep as well as panicked awakenings during the night. (In some people, though, too much can make anxiety worse, so be sure to dose slowly and carefully).

Sleep disruption and depression are also closely linked. More than 90% of depressed patients complain about difficulties falling asleep, sleep disruption, or early morning awakenings. CBD may improve their mood or their ability to manage the condition overall. CBD can also be used to treat parasomnias, sleep disorders like jaw grinding, sleepwalking, or nightmares, and it also cuts the time it takes to fall asleep.

CBD may also have a positive interaction with serotonin receptors in the brain. In a study on mice published in CNS & Neurological Disorders, researchers found that when depressed rodents were given CBD, it impacted the way their brains’ chemical receptors responded to serotonin, producing an antidepressant effect.

Additionally, CBD can have benefits in social settings. Researchers found CBD decreased anxiety in patients with social phobia by lowering activity in the amygdala and increasing prefrontal cortex activation, the two areas of the brain involved with regulating anxiety. And, it may also help reduce major angst before a stressful event, such as public speaking. Studies, including one published in Neuropsychopharmacology, have shown that CBD administered before a public speech significantly reduced overall anxiety, cognitive impairment, and performance anxiety.

While the research and anecdotal evidence is promising, because CBD is unregulated, it’s difficult to study, and any given sample can differ from the next, which means it’s also tricky to determine just how effective it is. Factors like the severity of depression and anxiety, as well as genetics play a role. And the benefits aren’t universal either.

CBD can be very effective for some people and not make a dent in others. Though it shouldn’t be a stand-alone treatment, it may be a beneficial co-pilot to other anti-anxiety meds or antidepressants, particularly in the time before the effects of antidepressants start to kick in.

Who Should Consider CBD for Anxiety & Depression (and Who Shouldn’t)?

If you’re considering CBD, before you make a move, talk with your primary care physician or mental health provider. Remember, CBD is not a substitute for talk therapy or medication. It’s also not a magic cure-all and may work better for some people than for others.

What Forms of CBD Are Most Effective?

Oils or Tinctures: Keep in mind, not all CBD plant extracts and formulations are created equal (blame it on the wild west unregulated substances create). However, experts believe the most effective form of CBD is an oil or tincture (alcohol-based solution) that’s placed under the tongue. These sublingual preparations ensure the cannabinoids get distributed throughout the body. This method bypasses the gut, which is why experts often prefer it to edibles, most of which get destroyed by the gastrointestinal system. Every person will react a little differently due to their individual biology, metabolism, and DNA, natch.

Dry-herb Vaporizing: For patients who are feeling all kinds of jittery and need more immediate relief, some experts recommend vaping CBD through a dry-herb vaporizer, which heats up dried CBD flowers (unlike traditional vape pens which require oil-based cartridges). These are relatively safe because they avoid the by-products produced from burning plant material and can be set to a desired temperature that allows you to get the most benefit from the CBD you are consuming.

How Much CBD Should I Take?

That’s one of the great mysteries; the optimal CBD dose is not an exact science. And doctors agree there isn’t one universal dosage of CBD because different people (and different animals, for that matter) respond to different dosages of CBD.

What experts also agree on is that CBD works best when taken on a regular basis—daily, often two-to-three times a day—because the effects can take time to build—sometimes even months (though, some people report feeling less angsty right away).

And, the best way to know what works for you is to start on a low dose and titrate up if needed (follow the recommended dosage instructions on the bottle and talk to your doctor). It may not take as long as for someone with mild symptoms to feel the effects as someone who is dealing with more severe anxiety or depression. Ultimately, the goal is to find the lowest, most effective dose. Work with your doctor and give yourself time to figure it all out.

What Are the Potential Risks and Side Effects of Using CBD?

CBD is thought to be relatively safe—a position that’s backed by the World Health Organization—but there can be some mild side effects including:

changes in appetite

There is one major caveat: CBD may cause interactions with certain other drugs, including those for heartburn, migraine, and hypertension—both by enhancing their effects or negating them. This is because medications and natural plant supplements are metabolized by the same liver pathways, and they affect the same serotonin receptors in the brain, so it’s a complex interplay. The bottom line: Talk to your doctor to be sure you're not overconsuming one or the other.

How Do I Find a Doctor Who’s Trained/Familiar With Using CBD?

CBD and cannabis-related curriculum is not (yet) taught in medical schools, so it can be a challenge to find a doctor who’s knowledgeable about the landscape. Most physicians don’t know much about the science behind medical cannabis and how to integrate it within a patient’s treatment plan.

So, you’ll need to do a bit research. Look for integrative and holistic physicians who understand how to support and educate you in the use of phytomedicines.

The Society of Cannabis Clinicians has a provider finder on their website where you can look for health-care professionals in your area who are well-versed in CBD. The Association of Cannabis Specialists is another great resource for researching cannabis clinicians near you. Another option: Hit up your local CBD dispensary. Oftentimes, they may be able to tell you which physicians are sending their patients in to buy CBD.

  • CBD & Social Anxiety:Journal of Psychopharmacology. (2010). “Neural basis of anxiolytic effects of cannabidiol (CBD) in generalized social anxiety disorder: a preliminary report.” journals.sagepub.com/doi/abs/10.1177/0269881110379283
  • The Benefits of CBD:Frontiers in Immunology. (2018). “Translational Investigation of the Therapeutic Potential of Cannabidiol (CBD): Toward a New Age.” ncbi.nlm.nih.gov/pmc/articles/PMC6161644/
  • Therapeutic Effects of CBD for Anxiety:Neurotherapeutics. (2015). “Cannabidiol as a Potential Treatment for Anxiety Disorders.” ncbi.nlm.nih.gov/pmc/articles/PMC4604171/
  • The Benefits of CBD for Public Speaking:Neuropsychopharmacology. (2011). “Cannabidiol Reduces the Anxiety Induced by Simulated Public Speaking in Treatment-Naïve Social Phobia Patients.” ncbi.nlm.nih.gov/pmc/articles/PMC3079847/
  • CBD Effects on Sleep & Anxiety:The Permanente Journal. (2019). “Cannabidiol in Anxiety and Sleep: A Large Case Series.” thepermanentejournal.org/issues/2019/winter/6960-cannabis.html

Jennifer Tzeses is a writer and content strategist specializing in health, beauty, psychology and lifestyle. She’s written for The Wall Street Journal, Mind Body Green, CNN, Architectural Digest, Barron’s, Cosmopolitan, Harper’s Bazaar, Psycom, Elle, Marie Claire, and more. Follow her on Instagram @jtzeses.