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8 min read
Lydia Kariuki
Anxiety and depression are the leading mental health disorders in the UK. In 2017, 17% of adults (above 16 years) in the UK exhibited symptoms of depression or anxiety. At the same time, the prevalence of mental health problems among children and young people is becoming an increasingly concerning issue. In 2017, close to 12.8% of children in the UK (aged between 5 to 16) were diagnosed with a mental health disorder; with emotional disorders being the most common mental disorder affecting children.
Suicide rates have also been on the rise. According to the Office for National Statistics (ONS), the suicide rate in the UK in 2020 stood at 11 deaths per 100,000 population. Even though suicide is a complex matter that is influenced by various factors, mental health disorders are a significant contributor to suicidal tendencies and suicide.
Over the last couple of years, there has been a growing demand for mental health services in the country. In England alone, mental health services in England received a record 4.6 million referrals during 2022. Despite some progress made in recent times, there remains a significant stigma associated with mental health. This has made it difficult for patients to seek help. And for the few patients that seek treatment in the form of antipsychotics, the associated side effects are often dispiriting.
Mental health disorders are complex in nature because the causes are multifactorial. This calls for a multimodal approach to treatment that may include a combination of interventions such as psychotherapy, pharmacotherapy, and even diet management combined with other general lifestyle changes.
For example, a patient may be referred by the NHS for cognitive behaviour therapy (CBT) which is really a kind of “talking therapy.” CBT is a short-term treatment that helps to identify the root cause of the mental disorder. It works well for acute cases and helps the patient develop coping mechanisms. This kind of treatment may be offered together with pharmacotherapy.
Many patients with mental health disorders end up taking antipsychotic medication. Antipsychotic medications, also known as neuroleptics, are the mainstay of pharmacotherapy for mental health disorders. First-generation antipsychotics include fluphenazine. Second-generation antipsychotics include drugs such as clozapine, olanzapine, aripiprazole, and risperidone among others. Antipsychotics work by modifying the activity of certain neurotransmitters in the brain to alleviate symptoms. They are primarily administered to treat conditions such as schizophrenia, bipolar disorder, and other psychotic disorders.
It's worth noting that antipsychotics can have side effects that can be uncomfortable or undesirable. These side effects will vary depending on the specific medication, dosage, frequency of adminisitratio, and individual factors. First-generation antipsychotics, for example, can cause what is known as extrapyramidal side effects when taken for extended durations.
Extrapyramidal side effects include dyskinesias and akathisias (erratic movements) which can greatly diminish one’s quality of life. Other side effects of antipsychotics include drowsiness, weight gain, movement disorders, and metabolic changes. Neuroleptic malignant syndrome is a rare life-threatening side effect of antipsychotics.
While antipsychotics are not addictive, they can cause physical dependence if used over an extended period. This occurs when one abruptly stops the medication or reduces the dosage too quickly, leading to withdrawal symptoms or a return of the underlying symptoms being treated.
It is therefore advisable to consult with your health care provider to assess the potential benefits versus risks before commencing treatment with antipsychotics. Other than antipsychotics, sleeping pills and mood stabilisers such as lithium may also be used to manage mental health disorders.
Mental health disorders are complex and multifaceted conditions. They stem from a combination of physiological, psychological, and social factors, and scientists are only beginning to understand the underlying causes and mechanisms. The complexity of these disorders makes it difficult to develop universal treatment approaches that work effectively for everyone. At the same time, mental health treatment often requires active participation and collaboration from individuals seeking help. Unfortunately, factors such as low motivation, limited insight into their condition, or possible cognitive impairment due to the disease can make it difficult for some individuals to engage in treatment and adhere to prescribed interventions.
As mentioned previously, the stigma surrounding mental health due to social, cultural, or personal factors is a barrier to mental health treatment. Comorbidities, such as substance abuse, physical health problems, or additional mental health disorders, further complicate the treatment of mental health disorders.
Lastly, each person's experience with a mental health disorder is unique. For example, patients with depression may present with different symptoms, and respond differently to treatments.
Finding the right treatment approach for each individual can be a complex and time-consuming process. To compound the issue, some patients may fail to respond to conventional treatments. They may experience treatment resistance after a while or have limited options due to intolerable side effects of some antipsychotics, or experience poor response to psychotherapy.
Such challenges have compelled patients and caregivers to seek alternative and safer treatment options for managing mental health disorders.
But can CBD really help?
Cannabidiol, aka CBD, is one of the many bioactive molecules that are present in cannabis. CBD has gained increasing popularity in the last couple of years due to its perceived therapeutic potential. CBD is a natural extract that has a high safety threshold, and it is well tolerated by most people, including children.
From what has emerged so far, CBD may be helpful for patients with mental health issues. The section below reviews the science supporting the potential benefits of CBD in managing mental health disorders.
CBD has been studied in both preclinical and clinical studies for its potential anxiolytic (anti-anxiety) properties. For example, in a recent phase 2 clinical trial that was published in 2022, the researchers concluded that “patients quickly achieve and maintain symptom reduction with few side effects.” CBD interacts with serotonin receptors in the brain. These receptors are involved in regulating mood and anxiety. CBD may also influence other brain receptors involved in the stress response.
Depression is a complex disease that is difficult to both diagnose and treat. What has emerged so far is that CBD may help alleviate symptoms of depression due to its interaction with serotonin receptors, but there is no evidence supporting any claims that it can cure depression. Further research is needed to paint a clearer picture of the role that CBD plays in depression.
One study highlighted a “concern” regarding the rampant use of CBD for self-treatment of depression. It is important to note that though CBD may have the potential alleviate some symptoms of depression, it is unwise to start yourself on CBD treatment without first consulting your psychiatrist.
Post-traumatic stress disorder is a mental health condition that can occur after experiencing or witnessing a traumatic event, such as war or a tragic accident.At the time of writing, there is no research showing that CBD can cure PTSD, but there are some interesting studies on the subject.
One study, from 2019, found that “Administration of oral CBD in addition to routine psychiatric care was associated with PTSD symptom reduction in adults with PTSD. CBD also appeared to offer relief in a subset of patients who reported frequent nightmares as a symptom of their PTSD”. Again, this study points out the need for further research.
CBD has been studied for its potential therapeutic benefits in treating substance use disorder (SUD). Preliminary studies have found that CBD may help to reduce cravings for addictive drugs. CBD may also reduce withdrawal symptoms associated with substance use.
While the exact mechanisms are still under investigation, some research suggests that CBD may alter the brain's reward system and therefore reduces the intensity of cravings and withdrawal symptoms. In addition, CBD may weaken the association between cues (that cause the cravings) and the desire to use substances, and in this way reduce the likelihood of a relapse.
It's important to note that CBD should not be considered a standalone treatment for mental health disorders. Mental health requires a holistic approach that considers both physiological and psychological factors, as well as the unique underlying cause or trigger. CBD may not offer a cure for mental health illness, but from what has been illustrated above, it supports patients in achieving milestones in their recovery journey.
CBD shows promise as a potential tool for improving mental health, although more research is necessary to fully understand its effects and establish evidence-based guidelines. So far, science has revealed CBD may have some potential as an anxiolytic, antidepressant, and neuroprotectant.
This means that CBD may help alleviate symptoms of anxiety and depression, reduce stress, and protect the brain from damage caused by various factors. While CBD is safe and effective for most people, bear in mind that CBD may react adversely with other drugs that you might be taking. If you or your loved one suffers from a mental health disorder, it may be helpful to ask your healthcare provider if CBD can be of benefit to you.
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Check your eligibilityLydia Kariuki, a medical nurse and journalist with a diploma in clinical research, specialises in translating complex cannabis research into accessible content, fostering public understanding and awareness.
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