Some of the correlation may be due to the fact that de- pressed people sometimes turn to cannabis to self-medicate. Certain strains or varietals of the plant can provide mental and physical stimulation and focus, temporarily alleviating feelings of apathy or sadness and allowing the user to function effec- tively in society. Ideally, a patient would discuss their use of marijuana openly with their physician—but a depressed person who has been self-medicating (without a doctor’s certification) may not view their own use as therapeutic, and therefore might not think to include cannabis when asked what drugs they are taking. On the other hand, a patient may recognize that can- nabis is helping their depression, but fear judgment or denial of treatment if they share with a doctor that they are using it. A 2005 survey of 4400 respondents by Denson and Ear- lywine (“Decreased depression in marijuana users,” Addictive Behaviors Vol. 31, Iss. 4, Pages 738-742) revealed interesting conclusions. The research team grouped respondents into those who had never used marijuana, those who used once a week or less, and those who consumed daily. All took The Epidemiologic Studies Depression scale and responded to a series of ques- tions about their marijuana use. The researchers point out that they chose to use an online format in hopes of attracting more- depressed participants, including those whose condition would have made it difficult to go to a public clinic or even to talk on the phone. Those in the once-a-week or less group reported “less de- pressed mood, more positive affect, and fewer somatic com- plaints” than the cannabis-naïve group. Daily users reported less depressed mood and more positive affect than the non-using group. This study also separated out medical and non-medical consumers, and found that the medical users “reported more de- pressed mood and somatic complaints than recreational users.” Researchers at McGill University discovered in 2007 that
low doses of dronabinol function as a potent anti-depressant. Dronabinol (also known as Marinol) is the synthetic form of the THC molecule, which is responsible for the “high” associated with marijuana. However, at higher doses, dronabinol worsened depression. This makes sense—THC is known to cause psycho- active effects and in high doses of whole-plant medicine it can also cause anxiety, agitation, paranoia and floating fear. The McGill findings underscore the need for whole-plant users to consume responsibly, and in moderation. They also implicitly highlight the benefits of using the whole plant. There are dozens of therapeutically valuable compounds in marijuana, including cannabidiol (CBD). Recent research indicates that CBD acts to moderate the psychoactive high of THC. Flavonoids and terpenes in the plant are also thought to have therapeutic efficacy, including soothing and relaxing effects. While Western medicine tends to analyze and break apart the constituent parts of medicinal plants (think willow bark tea vs. aspirin), the active compounds in whole-plant cannabis interact with one another in complex ways to provide relief. And studies have shown that patients prefer whole plant medicine over dronabinol by wide margins.
Cannabis an Empowering, Engaging Treatment Op- tion
In the survey of our members, 72% of respondents reported being more able to work or attend school since starting cannabis therapy. These patients did not all identify as suffering depres- sion, but withdrawal from one’s usual activities is certainly a symptom of depressive disorders. 77% were able to reduce by at least one the number of prescription medications they were taking after starting medi- cal marijuana—and 30% of these prescriptions had been prescribed to alleviate side effects of another prescription medication. Beyond improving mood and social functioning, and re- ducing pharmaceutical intake, there is an often-overlooked benefit to depressed patients who choose therapeutic cannabis: personal empower- ment. Unlike pharmaceuticals, whole-plant cannabis can be self-titrated; the patient deter- mines the optimum amount and frequency of dosing. 80% of our survey respondents were able to identify their optimum dosing in between two and eight weeks of beginning use. The empowerment that comes from identifying and control- ling this aspect of treatment may itself be beneficial to those living with depression.
Here are the current qualifying conditions for the use of
therapeutic cannabis in Maine:
• PTSD • Cancer • Glaucoma
• Chronic pain (that has not responded to traditional treatment for more than 6 months) • HIV+/AIDS • Hepatitis C • ALS/Lou Gehrig’s disease • Crohn’s disease and other chronic digestive disorders
• Agitation of Alzheimer’s • Nail-patella syndrome • Cachexia, severe nausea, seizures, or sever and persistent muscle spasms
Responsible cannabis use can help depressed patients feel more engaged and participate more fully in life, especially in combination with other complementary therapies such as cogni- tive behavioral counseling, or the physical exercise that Burton recommended four centuries ago. Faced with the “Chaos of Melancholy,” contemporary patients, physicians and therapists should communicate openly and objectively about how this traditional therapeutic herb may fit into a successful treatment regime.
Becky DeKeuster, M.Ed is a founder and the current Director of Community & Education of the Wellness Connection of Maine, a not-for-profit mutual benefit corporation which operates four of Maine’s eight state-licensed and regulated medical cannabis dispensaries. For more information, visit
www.mainewellness. org, or email
info@mainewellness.org. See ad on page 21.
www.EssentialLivingMaine.com
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