Cannabidiol (CBD)-what we know and what we don’t
Cannabidiol (CBD) is often covered in the media, and you may see it touted as an add-in booster to your post-workout smoothie or morning coffee. You can even buy a CBD-infused sports bra. But what exactly is CBD? And why is it so popular?
How is cannabidiol different from marijuana, cannabis and hemp?
CBD, or cannabidiol, is the second most prevalent active ingredient in cannabis (marijuana). While CBD is an essential component of medical marijuana, it is derived directly from the hemp plant, a cousin of marijuana, or manufactured in a laboratory. One of hundreds of components in marijuana, CBD does not cause a “high” by itself. According to a report from the World Health Organization, “In humans, CBD exhibits no effects indicative of any abuse or dependence potential…. To date, there is no evidence of public health related problems associated with the use of pure CBD.”
Is cannabidiol legal?
CBD is readily obtainable in most parts of the United States, though its exact legal status has been in flux. All 50 states have laws legalizing CBD with varying degrees of restriction. In December 2015, the FDA eased the regulatory requirements to allow researchers to conduct CBD trials. In 2018, the Farm Bill made hemp legal in the United States, making it virtually impossible to keep CBD illegal – that would be like making oranges legal, but keeping orange juice illegal.
The Farm Bill removed all hemp-derived products, including CBD, from the Controlled Substances Act, which criminalizes the possession of drugs. In essence, this means that CBD is legal if it comes from hemp, but not if it comes from cannabis (marijuana) – even though it is the exact same molecule. Currently, many people obtain CBD online without a medical marijuana license, which is legal in most states.
The evidence for cannabidiol health benefits
CBD has been touted for a wide variety of health issues, but the strongest scientific evidence is for its effectiveness in treating some of the cruelest childhood epilepsy syndromes, such as Dravet syndrome and Lennox-Gastaut syndrome (LGS), which typically don’t respond to antiseizure medications. In numerous studies, CBD was able to reduce the number of seizures, and, in some cases, stop them altogether. Epidiolex, which contains CBD, is the first cannabis-derived medicine approved by the FDA for these conditions.
Animal studies, and self-reports or research in humans, suggest CBD may also help with:
Studies and clinical trials are exploring the common report that CBD can reduce anxiety.
- Insomnia. Studies suggest that CBD may help with both falling asleep and staying asleep.
- Chronic pain. Further human studies are needed to substantiate claims that CBD helps control pain. One animal study from the European Journal of Pain suggests CBD could help lower pain and inflammation due to arthritis when applied to skin. Other research identifies how CBD may inhibit inflammatory and neuropathic pain, which are difficult treat.
- Addiction. CBD can help lower cravings for tobacco and heroin under certain conditions, according to some research in humans. Animal models of addiction suggest it may also help lessen cravings for alcohol, cannabis, opiates, and stimulants.
Is CBD safe?
Side effects of CBD include nausea, fatigue and irritability. CBD can increase the level of blood thinning and other medicines in your blood by competing for the liver enzymes that break down these drugs. Grapefruit has a similar effect with certain medicines.
People taking high doses of CBD may show abnormalities in liver related blood tests. Many non-prescription drugs, such as acetaminophen (Tylenol), have this same effect. So, you should let your doctor know if you are regularly using CBD.
A significant safety concern with CBD is that it is primarily marketed and sold as a supplement, not a medication. Currently, the FDA does not regulate the safety and purity of dietary supplements. So, you cannot be sure that the product you buy has active ingredients at the dose listed on the label. In addition, the product may contain other unknown elements. We also don’t know the most effective therapeutic dose of CBD for any particular medical condition.
How can CBD be taken?
CBD comes in many forms, including oils, extracts, capsules, patches, vapes, and topical preparations for use on skin. If you’re hoping to reduce inflammation and relieve muscle and joint pain, a topical CBD-infused oil, lotion or cream – or even a bath bomb — may be the best option. Alternatively, a CBC patch or a tincture or spray designed to be placed under the tongue allows CBD to directly enter the bloodstream.
Outside of the US, the prescription drug Sativex, which uses CBD as an active ingredient, is approved for muscle spasticity associated with multiple sclerosis and for cancer pain. Within the US, Epidiolex is approved for certain types of epilepsy and tuberous sclerosis.
The bottom line on cannabidiol
Some CBD manufacturers have come under government scrutiny for wild, indefensible claims, such that CBD is a cure-all for cancer or COVID-19, which it is not. We need more research but CBD may prove to be a helpful, relatively non-toxic option for managing anxiety, insomnia, and chronic pain. Without sufficient high-quality evidence in human studies, we can’t pinpoint effective doses, and because CBD currently is typically available as an unregulated supplement, it’s hard to know exactly what you are getting.
If you decide to try CBD, make sure you are getting it from a reputable source. And talk with your doctor to make sure that it won’t affect any other medicines you take.
How To Use CBD To Help Alleviate Anxiety
Dr. Bindiya Gandhi is an integrative medicine physician with expertise in functional and holistic medicine based in Atlanta, Georgia.
Commissions we earn from partner links on this page do not affect our opinions or evaluations. Our editorial content is based on thorough research and guidance from the Forbes Health Advisory Board.
Table of Contents
- CBD for Anxiety
- How to Use CBD for Anxiety
- CBD Dosage for Anxiety
- Potential Risks and Side Effects
While delta-9-tetrahydrocannabinol (THC) can have a bad rap for being intoxicating and anxiety-inducing, cannabidiol (CBD) can actually be used to relieve anxiety. Research supports this benefit, with several studies reinforcing the positive effects CBD can have on various anxiety conditions. In fact, 51% of U.S. adults who use CBD do so to help alleviate their anxiety, according to a recent Forbes Health survey of 2,000 U.S. adults conducted by OnePoll.
CBD isn’t yet legally cleared as an anxiolytic, or anxiety relief medication. Therefore, it’s up to you—and, ideally, a doctor who specializes in cannabis administration—to determine whether CBD is a safe treatment for your anxiety.
Here’s what the science says regarding CBD’s anxiolytic properties, along with experts’ dosage guidelines and advice on how to take CBD safely.
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CBD for Anxiety
The Food and Drug Administration (FDA) has yet to approve any CBD-based medications for anxiety. However, many studies indicate the substance can be an effective anxiolytic.
CBD for Generalized Anxiety
In 2011, a small trial-tested CBD on participants with generalized social anxiety disorder (SAD) and healthy control patients undergoing a simulated public speaking test (SPST), which is a common anxiety testing method  Bergamaschi MM, Queiroz RH, Chagas MH, et al. Cannabidiol reduces the anxiety induced by simulated public speaking in treatment-naïve social phobia patients. Neuropsychopharmacology. 2011;36(6):1219-1226. . Compared to a placebo, CBD significantly reduced anxiety and discomfort in the participants with SAD. In fact, their reduced anxiety levels were comparable to those of the control participants.
Eight years later, a 2019 test compared the efficacy of three CBD doses (150 milligrams, 300 milligrams and 600 milligrams) and a placebo in men taking an SPST  Linares IM, Zuardi AW, Pereira LC, et al. Cannabidiol presents an inverted U-shaped dose-response curve in a simulated public speaking test. Revista brasileira de psiquiatria (Sao Paulo, Brazil : 1999). 2019;41(1):9-14. . Compared to a placebo, 300 milligrams of CBD significantly reduced participants’ anxiety during the speech, but the 150-milligram and 600-milligram doses did not. These results highlight how dosage can be highly variable and that more CBD isn’t necessarily more effective.
Meanwhile, another 2019 study tested CBD in much lower doses than most other clinical studies—some participants consumed 25 milligrams a day while others consumed 50 milligrams or 75 milligrams a day  Shannon S, Lewis N, Lee H, Hughes S. Cannabidiol in Anxiety and Sleep: A Large Case Series. Perm J. 2019;23:18-041. . Researchers thought higher doses might be too expensive for participants to maintain in their normal lives and that low doses would still prove effective. Indeed, anxiety decreased within the first month for most participants and remained low. Sleep quality also improved, although it fluctuated more than anxiety. Only three patients reported side effects.
CBD for Anxiety and Depression
In 2020, researchers tested the effects of CBD oil at varying doses across 397 patients with a variety of ailments  Gulbransen G, Xu W, Arroll B. Cannabidiol prescription in clinical practice: an audit on the first 400 patients in New Zealand. BJGP Open. 2020;4(1):bjgpopen20X101010. . Participants with non-cancer pain or mental health-related symptoms experienced significant improvement in anxiety and depression, as well as in their abilities to complete their usual activities. The use of CBD oil suggested significant pain relief in these groups as well.
CBD for PTSD and Phobia Therapy
A small 2019 study of 11 patients found that, when consumed orally and administered alongside routine psychiatric care, CBD decreased patients’ posttraumatic stress disorder (PTSD) symptom severity  Elms L, Shannon S, Hughes S, Lewis N. Cannabidiol in the Treatment of Post-Traumatic Stress Disorder: A Case Series. J Altern Complement Med. 2019;25(4):392-397. .
Other studies suggest CBD can reduce PTSD symptoms when consumed with THC  Bitencourt RM, Takahashi RN. Cannabidiol as a Therapeutic Alternative for Post-traumatic Stress Disorder: From Bench Research to Confirmation in Human Trials. Front Neurosci. 2018;12:502. . When taken together, the two compounds create what’s known as the “entourage effect,” where THC enhances the effects of CBD as CBD tempers the effects of THC, resulting in a more well-rounded experience  Ferber SG, Namdar D, Hen-Shoval D, et al. The “Entourage Effect”. Terpenes Coupled with Cannabinoids for the Treatment of Mood Disorders and Anxiety Disorders. Curr Neuropharmacol. 2020;18(2):87-96. .
Some studies also suggest CBD can enhance the effects of exposure therapy—which assists patients in dissociating certain cues with a fear response—and cognitive behavioral therapy  Das RK, Kamboj SK, Ramadas M, et al. Cannabidiol enhances consolidation of explicit fear extinction in humans. Psychopharmacology (Berl). 2013;226(4):781-792.  Blessing EM, Steenkamp MM, Manzanares J, Marmar CR. Cannabidiol as a Potential Treatment for Anxiety Disorders. Neurotherapeutics. 2015;12(4):825-836. .
How to Use CBD for Anxiety
Without clear FDA guidance, optimal CBD use for anxiety varies from person to person. You may find one method works better for you over another. You can consume CBD in the following forms:
- Oils and tinctures, which come in dropper bottles and are consumed by mouth
- Gummies, which are chewable, sweet and often fruit-flavored
- Sprays, which come in bottles with a nozzle to be sprayed in the mouth
- Capsules, softgels or tablets, which are taken individually by mouth like a pill
- Vapes, which heat CBD oil without igniting it, resulting in an inhalable vapor
- Flowers, which are dried hemp plants that are typically ignited and smoked
- Creams and gels, which introduce CBD topically (through the skin) as a more localized treatment
You may have to try different forms to determine what works best in addressing your anxiety. For instance, when it comes to the absorption of CBD in your bloodstream, vaping and smoking are more effective than edibles like gummies.
CBD Dosage for Anxiety
You also have to find the right CBD dosage for your anxiety. Experts suggest starting small and working your way up depending on how your body reacts.
Many clinical trials jump right to testing high doses. Successful doses evaluated for anxiety relief specifically include:
- 600 milligrams in patients with SAD in a speech simulation  Bergamaschi MM, Queiroz RH, Chagas MH, et al. Cannabidiol reduces the anxiety induced by simulated public speaking in treatment-naïve social phobia patients. Neuropsychopharmacology. 2011;36(6):1219-1226.
- 300 milligrams in male patients in a speech simulation  Linares IM, Zuardi AW, Pereira LC, et al. Cannabidiol presents an inverted U-shaped dose-response curve in a simulated public speaking test. Revista brasileira de psiquiatria (Sao Paulo, Brazil : 1999). 2019;41(1):9-14.
However, other trials suggest much lower doses are also quite effective in treating anxiety.
- 25 to 75 milligrams for generalized anxiety and/or sleep problems  Shannon S, Lewis N, Lee H, Hughes S. Cannabidiol in Anxiety and Sleep: A Large Case Series. Perm J. 2019;23:18-041.
- 33 to 49 milligrams a day for PTSD, in addition to routine psychiatric treatment  Elms L, Shannon S, Hughes S, Lewis N. Cannabidiol in the Treatment of Post-Traumatic Stress Disorder: A Case Series. J Altern Complement Med. 2019;25(4):392-397.
Another study involving hundreds of patients noted success with doses from 40 milligrams to 300 milligrams a day, further supporting the idea that CBD dosage varies significantly, depending on a person’s symptoms and physiology.
Potential Risks and Side Effects
The World Health Organization deems CBD a safe and generally well-tolerated substance. Studies report very few adverse effects, if any.
However, taking CBD while on other medications may pose a risk, as these substances may interact and cause unwanted effects, such as weight gain, drowsiness, upset stomach and change in appetite.
Cheryl Bugailiskis, M.D., a cannabis specialist at Heally, a telehealth platform for alternative medicine, also warns people with preexisting liver injuries and people taking medications that can cause liver injuries should practice caution when using CBD.
I Took CBD Oil Every Day for My Anxiety—Here’s What Went Down
Dana Myers, LCSW is a licensed clinical social worker and life coach based in Philadelphia. She has a special interest in how race, sex, gender, ethnicity, social status and competencies impact those in marginalized communities and aims to help her clients find purpose and peace in life.
Michelle Regalado is a seasoned editor, fact-checker, and content strategist with expertise in women’s lifestyle news.
When I first learned about CBD oil, I’ll admit I was a bit skeptical. My mind immediately turned to weed and the unnerving experiences I’d had with heightened anxiety in college. For me, a person who’s already predisposed to overthinking, marijuana, no matter what the form, would typically put my mind into overdrive and result in a common yet dreaded side effect: Paranoia. But, let’s back up a bit. What even is CBD?
What is CBD?
A bit of online digging led me to realize that the active ingredient in Charlotte’s Web Everyday Plus Hemp Oil, the product I’d been offered to test, was the chemical compound CBD, which stands for cannabidiol. Unlike THC, the other crucial compound in hemp and marijuana plants, CBD (when derived from the hemp plant) does not produce the psychoactive effects that make you feel “high”; instead, emerging science has hinted that CBD may actually ease anxiety, and therefore, makes you less likely to freak out.
For example, one study comparing the effects of THC and CBD found that, while THC increased anxiety by activating the neurotransmitters involved in the “fight or flight” response, CBD actually repressed autonomic arousal—or the nervous system response associated with sudden increases in heart rate or respiration. In other words, CBD may be ideal for people looking to relax and unwind.
While the science behind CBD’s effectiveness for treating anxiety, pain, and insomnia is still in its infancy, Charlotte Figi’s inspiring story sounds promising. Figi, a 6-year-old girl diagnosed with a rare and resistant form of epilepsy known as Dravet syndrome, was placed on hospice care and given a “do not resuscitate” order when her parents, desperate and frustrated with pharmaceutical medication, considered medical marijuana; specifically, a strain low in THC and high in CBD. Charlotte is now nearly seizure-free since she began supplementing with Charlotte Web’s CBD oil, which the brand named after Figi.
Legal and Safety Things To Know About CBD
The current CBD industry is like the internet’s early years. the Wild West. Legally, speaking, a Harvard Medical School blog post reads, “All 50 states have laws legalizing CBD with varying degrees of restriction, and while the federal government still considers CBD in the same class as marijuana, it doesn’t habitually enforce against it.” With heightened interest around CBD, it’s important to note that because CBD is currently unregulated, it’s difficult to know what you’re getting (whether that’s a tincture—commonly referred to as CBD oil, which is often combined with a carrier oil like coconut oil—topical products like creams and balms, sprays, or capsules), despite product labels and brand promises, the blog post further reads. It’s also important to note that people experience CBD differently. For the most part, the National Institute of Medicine says that while most people can tolerate CBD, side effects do exist. They might include dry mouth, drowsiness, and reduced appetite, among others.
That said, those interested in exploring the potential benefits of CBD should consult with their doctor (especially if you are pregnant, nursing, or currently taking medication) and be mindful of your dosage, writes Consumer Reports. And before you buy, Megan Villa, co-founder of the hemp-focused website and shop Svn Space, told Shape magazine to seek out a certificate of analysis. “Ask for a COA for the batch number of the product you have, since these products are made in batches,” she said. “You need to match the batch number to the COA that pertains to it.” Then, scan the report for potency (i.e. does the number of milligrams of CBD that the product label touts match the lab report?), contaminants and pesticides, and mold (which should live under the “Microbiological Testing” part of the report). Go a step further and note whether the testing lab is GMP (Good Manufacturing Principles) certified, and whether the lab is registered with the Food and Drug Administration (FDA). Shape magazine also suggests purchasing CBD products made from domestically-grown hemp, and reading up on the difference between full- and broad-spectrum and CBD isolate.
With that, I threw caution to the wind and asked for a sample. Here’s what happened—including what it feels like—when I took one full dropper of Charlotte’s Web’s Everyday Plus Hemp Oil in the mint chocolate flavor every morning for seven days.
My First Impression
It was actually a bad bout of jet lag after a trip to California that inspired me to finally test out the CBD oil (I’ll admit that my weed-based reservations kept me from trying it for the first few months). Knowing that the oil had also helped people with sleep issues, I squeezed one full dropper of the Everyday Plus oil onto my tongue, per the instructions, and waited.
Thirty minutes later, I was surprised by how subtle the effect was. While I expected a hazy nodding-off effect similar to melatonin’s, the oil simply relaxed my body ever so slightly—my heart stopped pounding against my chest, my legs stopped kicking beneath my sheets, my mind stopped racing. I wasn’t sure if it was the oil or the late hour, but eventually, physical relaxation gave way to mental relaxation, and I drifted off to sleep.
Reflecting the next morning, I was most surprised by the fact that I never felt “high” in any way—there was never a moment of It’s kicking in; I can feel it now like with pain medications or even anti-anxiety drugs. Considering it takes time, consistency, and the right dosage to experience the full effect, I continued taking the oil once a day for the next six days. Here’s what went down.
It Made Me Less Anxious and Edgy
Rather than overthinking a sternly worded email or analyzing a social interaction, I found it easier to recognize the irrationality of these thoughts and actually let them go.
While normally I’d be slightly tripped up by little things like an overly crowded subway car or a full inbox at work, the CBD oil seems to have taken the edge off of my anxiety a bit. Rather than overthinking a sternly worded email or analyzing a social interaction, I found it easier to recognize the irrationality of these thoughts and actually let them go. In some ways, I feel more like myself. With that said, I’ve still experienced some social anxiety when meeting new groups of people—I’d be interested to see what taking the full recommended dose would do.
I’m More Focused At Work
I work well under pressure, but being extremely busy at work has almost made me less productive—I’m constantly distracted by email, Slack, and the people around me, to the point where getting my work done becomes difficult. This week, however, I’ve found it easier to put my blinders on, block out all distractions (especially social distractions), and focus on one task at a time. I think this is partly related to the lessened anxiety—I feel more frazzled and off task when my anxiety is running high. It almost feels like a newfound sense of clarity and calm that enables me to focus.
I’m Falling Asleep Faster
I assume this is also a side effect of feeling less anxious, but I seem to fall asleep faster; within the 20-30-minute range rather than my normal 45 minutes to one hour (or longer). Not only do I seem to be skipping or at least shortening the whole tossing-and-turning phase of my sleep cycle, but I’m able to snap out of the overthinking that often keeps me up at night. Of course, there’s no telling whether a big life event would disrupt this newfound bliss, but I’d like to think it’s helped on a day-to-day basis.
My Experience With CBD
Would I say that CBD oil has fundamentally changed my life? No. But per the Charlotte’s Web website, this is the typical first experience. “Anyone who has ever started a new vitamin or supplement routine knows the short answer to how long it takes to kick in is—’it depends.’ For many newcomers, they’re not sure what to imagine, or some anticipate a huge change right away. For most of us, though, dietary supplements take time.”
With that said, I’m definitely intrigued enough by the subtle effects to continue taking the oil and to possibly up the dosage to the recommended two full droppers of the 30mL bottle per day. Plus, I take comfort in knowing that it’s an all-natural product that’s responsibly grown on family farms in Colorado. Something that’s safe, legal, requires no prescription, and makes me less anxious, less scatterbrained, and more focused? I’m definitely on board.
Explore the World of CBD
Looking to learn more about CBD? These are some of my favorite products to help get you started.
For those new to CBD, Charlotte’s Web recommends this hemp oil. Containing 17mg of CBD per 1mL serving, this CBD oil is also U.S. Hemp Authority Certified. Choose from four different flavors including Lemon Twist, Mint Chocolate, Orange Blossom, and Olive Oil.
Go deep on the subject of CBD with this book that includes case studies, interviews with doctors, an overview of the latest cannabis research, and how scientists are exploring cannabis for various medical uses. There is also an explainer about the difference between CBD products made from industrial hemp versus in a lab, and products made from the whole marijuana plant.
Charlotte’s Web inaugural CBD oil product comes in two flavors; Olive Oil and Mint Chocolate. It’s also its most potent. According to its website, its Original Formula Hemp Extract Oil comes with 50mg CBD per mL.
Gretchen Lidicker puts a lifestyle spin on the world of CBD as the author draws on the “knowledge of leaders in the health and wellness world” to explain why CBD has become a top beauty and wellness trend for top athletes and celebrities. The book also includes recipes and recommendations for how to choose a top-quality CBD product.
This travel-friendly roll-on is packed with CBD and fragrant essential oils, including lavender, bergamot, and chamomile, for an easy de-stress quick fix. The result? “That elusive feeling of wakeful calm,” reads the Sagely Naturals website.
With this book, CBD is explained from A to Z and breaks down the good, bad, and ugly of a fledgling industry that is poised for rapid growth. CBD: 101 Things You Need to Know About CBD Oil covers what it is, why people take it, who it’s for (and who it isn’t for), its myriad forms, and more.
Lord Jones’ High CBD Formula Body Oil combines CBD with organic avocado, jojoba and safflower oils for smooth, hydrated skin. Each bottle has 100mg of CBD.
Charlotte’s Web’s Extra Strength Capsules feature 25 mg of CBD per capsule. The website offers capsules as a convenient and precise way to take CBD—on the go, stash them in your gym bag, pocket, etc.
Byrdie takes every opportunity to use high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial guidelines to learn more about how we keep our content accurate, reliable and trustworthy.
Blessing EM, Steenkamp MM, Manzanares J, Marmar CR. Cannabidiol as a potential treatment for anxiety disorders. Neurotherapeutics. 2015;12(4):825-836. doi:10.1007/s13311-015-0387-1
Shannon S, Lewis N, Lee H, Hughes S. Cannabidiol in anxiety and sleep: A large case series. Perm J. 2019;23:18-041. doi:10.7812/TPP/18-041