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Comment by edgyquant | Hacker News Reader

Yeah this pretty obvious to anyone with an anxiety disorder who tries pot as a solution. It gets recommended by users, who think it’s a cure because their anxiety is due to THc withdrawals. But if you aren’t a user and try it it explodes your anxiety and is just the worst.

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It’s interesting how on HN whenever a topic related to cannabis comes up so many people jump in to say they have anxiety, and that weed makes it worse, and that it must be the same for everyone. Does HN have a higher than normal percentage of highly anxious people? Or is it just the threads attract the kind of people who are likely to be anxious and jumpy around the topic? It’s a really interesting phenomenon. In real life, people may like it or not, may still use it or not, but the discussion seems way more casual and nowhere near as singularly anxiety fixated as when the topic comes up here.

I’m not judging, I’ve been treated for anxiety myself. Just quite curious about how different the conversations are.

A thread about anxiety does seem like it would attract people with anxiety who want to talk about anxiety.

Sure, but the phenomenon exists across all the threads about cannabis.

I think it's a recently developed pushback to the widespread love cannabis has received online for a long time. For a long time, it has been either heralded as a gateway drug or a magical cure all that could do no wrong.

Now that it is much more widely available and many more people have actually tried it for extended periods of time, the narrative has shifted.

How does saying you have anxiety when you smoke weed push back against people who were overly positive about it though?

To provide a counterpoint to the, "Weed is good. Weed can do no wrong." view that many have had about it.

If youre willing to accommodate a highly opinionated take from experience:

Intelligence itself seems to correlate with anxiety, i.e. being able to construct and focus on abstractions, as opposed to your immediate environment, on demand increases likelihood of fixation on abstractions.

Combine that with a lack of forced grounding in computer-based professions, i.e. little human interaction, and you're a heck of a lot more likely to be in your own head, then add weed on top and you're even more likely.

Makes sense! That would align pretty well with my personal experience too.

there's also the possibility there is some correlation between autism spectrum and weed anxiety, and that HN naturally attracts nerds who tend to be (mildly) on the spectrum.

there's no particularly major evidence that it's highly correlated but I've heard anecdotal theories along the line before.

Interesting, do you have a reference for the autism to weed anxiety link?

> In real life, people may like it or not, may still use it or not, but the discussion seems way more casual and nowhere near as singularly anxiety fixated as when the topic comes up here.

It’s been common in my circles as we have aged. In our now mid 30s most have ceased its usage other for that reason other than myself who took it up following a spinal cord injury. For what it’s worth, it did seem to give me anxiety at first but time (and mixing with a cbd strain) seems to have solved that.

edit

We do all work in IT for the most part so…maybe that is something.

I began to notice this phenomenon on internet discussions/forums tied to mental health, physical health, and drugs (illiegal and legal). The discussions themselves attract anxious people who are using the internet to validate and reassure themselves. And I know I used to be the same before I found my own effective treatment for anxiety.

That has also been my experience. I’ve had anxiety since I was a child and was diagnosed with generalized anxiety disorder. Back in 2014 or so, I was at my wits end and wanted to try medical marijuana since it was touted as a solution to my anxiety. I went to see a doctor, who doubled down on this being a good thing to try. So, I got my card, and went to a dispensary where I bought whatever they recommended for anxiety.

Two hours later, I was having my biggest panic attack in years. If I didn’t grow up having panic attacks all my life, I would probably have called 911 or got someone to drive me to the ER.

If there’s an easy fix for anxiety out there, I’d love to know about it. I’ve been fighting this for decades and it doesn’t get better as I get older. What kind of helps in the meantime is therapy, slow exposure to stressors (being careful to prevent flooding), and mindfulness meditation. None of this fixes my anxiety, but it makes it a little bit more manageable.

> I’ve been fighting this for decades and it doesn’t get better as I get older.

As someone younger than you quite possibly suffering with the same thing, that’s saddening to hear. Is there anything you did that you wish you’d done sooner? Have you tried any (pharmaceutical) medication?

See here: https://news.ycombinator.com/item?id=39278214

I do take Clonazepam when I get severe panic attacks or right before something I know usually triggers a panic attack, but nothing on a day-to-day basis. Clonazepam does seem to help with my symptoms, though it just makes me feel euphoric (which, I guess, is better than feeling like I'm dying). I take a tiny dose, but it seems to help a lot.

I have a few things I wish I'd done sooner if you'd indulge my ranty and highly personal list:

* Moving out of the city and into the country. I know this one is not feasible for most people, but it helped me to get out of the hustle and bustle and back to an environment similar to where I grew up.

* Reducing caffeine and increasing water intake. I limit myself to one cup of coffee in the morning and no caffeine afterward.

* Quitting my high-stress job in favor of a job at a startup and taking more breaks.

* Daily cardio exercise for at least 30 minutes.

* Talking about how I'm feeling with my partner. It seems simple and silly, but this one is crucial for me. I tend to lock up when I'm feeling crappy and lash out. Overcoming that and talking about how I'm feeling has helped enormously.

* Going to therapy.

These are all helping me cope, so I still have panic attacks, but not as often as a decade or so ago.

> if you'd indulge my ranty and highly personal list

Not ranty at all; very helpful in fact!

It’s interesting you say cutting down on caffeine helped… I feel the opposite would be true for me. For some reason it seems to have a calming effect.

Anyway… good luck to you. I hope it continues to gradually improve.

Propanolol is a fantastic anxiety treatment. In some ways better than xanax, at least for me.

Highly, highly recommend trying it. They say it's for "stage fright", which can be offputting because "stage fright" (at least to me) seems almost wholly unrelated to the type of anxiety I suffer from.

It's a miracle from my perspective. If you suffer from generalized anxiety, please ask your doctor about it.

Just to really hammer this home: I had doctors recommend this drug to me for years, and I always more or less ignored them. I have taken xanax for quite some time, and took this recommendation as them being apprehensive about prescribing it (which i understand, since many people abuse it).

Propanolol seems to have the same type of calming effect, but with none of tired/disassociative feelings that xanax gives (which I don't like). The first time I took it I almost wanted to cry. It really was just like a switch that turned the anxiety off. It does take about 60-90 minutes to fully kick in, though.

Thanks for the suggestion; I appreciate it. Is this something you take daily or as you need it?

As needed, but it's fine to take daily with no negative downsides.

I'll take it before I need to go do something which might have triggered an attack, but the long term benefit here is that doing those activities without getting triggered lessens the sensitivity to the trigger (if that make sense).

So lately I haven't taken any in weeks, but when I was first prescribed it I took it every day.

I feel that propanolol helps with physical effects of anxiety (which are not much of a problem for me), but doesn't affect the mental side of anxiety the same way benzos do. It's much less addictive than benzos of course, and preferable for that reason if it works.

I only get the physical effects, which is why it works so well for me.

I'm a hobbyist musician with IBS-D, which is often triggered by general anxiety. I've been asked to play with the pros several times, and every time I have to say 'no' several hours beforehand b/c I'm chained to the toilet. Do you think that propranolol would negate those issues? I have also tried CBT with a therapist and it was only marginally helpful

I think the drug is often prescribed for this exact scenario (stage fright, essentially).

This is not medical advice. However propranolol is prescribed off label for “performance anxiety” so it may be worth discussing with your PCP. It is not an anxiety medication per se, it is a non selective beta blocker, it blocks some of the effects of (nor)adrenaline. How this can help isn’t entirely understood but part of performance anxiety is a positive feedback cycle where your physical feelings of anxiety provoke more anxiety.

The good thing about propranolol is that since it does not have meaningful addiction or tolerance potential it’s reasonable to take long term. It’s relatively safe in otherwise healthy people, so it’s overall low risk, with depressed heart rate and BP leading to syncope the main one. It historically was a blood pressure medication, but oral beta blockers are poor first line BP meds. Few PCPs have qualms prescribing it if there are no contraindications.

+ 1 for propranolol. Its a beta blocker. It binds to receptor sites for adrenaline so adrenaline doesnt have effect. Usually anxiety attack is a loop where brain panics, triggers body reaction like increased heart rate etc and that causes brain to panic further and this loop escalates. Propranolol blocks this loop in the body, as in, heart rate wont increase.

Personally I found it useful.

It's very likely that you had way too much THC. Especially if you vaped or ingested it.

When I first started smoking, 0.01g (yes, one hundredth of a gram - a barely visible layer on top of some tobacco) was enough to get a whole room of students incredibly high for a few hours. I used to buy 0.2g and that lasted 5 people the entire weekend.

And that was before all of this lamp-grown craziness with 10% and more THC content. If you used more than 0.1g of these medical dispensary strains, it's really no wonder you had a crazy panic attack. I'd have too and I'm an experienced smoker.

I know some people using weed to treat anxiety. They smoke so little they don't feel high at all. One gram might last them a month.

I have 2nd this. I've been using weed for a very long time and have seen so many people try to take a lung full of smoke as opposed to a small sip.

I don't do "vapes". That stuff is so highly concentrated that it makes me cough with even a tiny sip. Same with "gummies". I can't really know how the dose will affect me and I don't want to get "stoned".

I do think that if you're wanting weed to help with anxiety you should probably look into CBD too. That probably works better for anxiety.

For the curious reader: that clownshow is at ~30% THC these days.

Anxiety is likely to get worse as you age, unfortunately. If you have it when you're young, the prognosis isn't good.

I'm way less anxious as an adult than I was as a kid. Likely due to various coping strategies that I've ingrained over the years.

I have diagnosed GAD as well. And the first time I smoked marijuana I had an intensely anxious experience. However, i find that small doses of edibles are like magic. I am sensitive to it but the dose makes the poison.

Apart from mindfulness practices (which do help, but slowly), I've found the following to be life-changing regarding my lifelong, debilitating social anxiety:

- psychedelic therapy (1-4 times a year, over 6 years, turned me into a functional person in social contexts)

- strong chammomile flower tea (depresses my nervous system to a normal baseline -- this has been the most dramatic way to ease physiological symptoms of anxiety for me)

I wouldn't say it's this simple—there are lots of different strains out there with wildly different effects due to the cannabinoids they contain. Furthermore, every person's own endocannabinoid system is different, and reacts differently to cannabinoids. For one person, a strain might make them feel relaxed and happy—for another, the same strain might make them simply fall asleep (or extremely anxious, for instance).

There's also the very common issue of people new to cannabis using far, far too much—which generally results in a feeling of intense anxiety. Anyone who hasn't had any cannabis before should be extremely careful and use as little as possible.

Finally, regular users who have developed a tolerance for certain cannabinoids may find it difficult to relax without them. Anyone regularly using a substance like cannabis should be on the lookout for this, and change their behavior accordingly.

I smoked a lot about a decade ago. Anecdotally, I can confirm this as well. I would feel great if I got high when life was stress free but it heightened my anxiety when I was already worried about something. It also generally made me anxious to be around other people.

Can anecdotally confirm that I know lots of nonsmokers (or at least, those who don't regularly smoke) who find their anxiety spiked when they tried weed. Some of that is just because being in an altered state for the first time is fairly anxiety-inducing itself.

I find that even with tons of experience, it's a matter of frequency and habituation. When I was smoking every day, there wasn't any anxiety but after a long break, the next time is like the very first time. Full of anxiety.

It's definitely more than just conflating "treating" THC withdrawal with treating anxiety, at least for me personally. I'll quit for months, have an anxiety attack, and I'm able to interrupt it by using cannabis. It doesn't per say treat my anxiety but can be like a "rescue inhaler" to disrupt repetitive anxious thoughts and snap me out of an anxiety attack. Once they're disrupted, I have a fighting chance to confront my anxiety with other strategies (which are the real long term solutions).

But it does make perfect sense to me that the effects of cannabis on someone who has been a longtime user are quite different and that it isn't great generic advice to tell people to try cannabis for their anxiety. I definitely think this current vogue of trying to apply cannabis to every problem is misguided and an artefact of the commercial environment around cannabis being increasingly legal, not our medical understanding of it.

I'm comfortable recommending broad-spectrum CBD with little or no THC as an anxiety aid.

Not all cannabis has THC, high THC (the anxiety-inducing part, for most).

Nor should it!

I'm aware, but I personally wouldn't recommend any mind altering substance to anyone without a lot of context. When I was a young troublemaker my friends and I fancied ourselves as knowledgeable and made very casual recommendations to people about what substances they should try and what dosages would be appropriate. It became apparent to me that a dosage that has no discernable effect on one person can put another under the table, and I became very, very conservative about such things.

Eg, I've seen people smoke large amounts of weed and concentrates and then go off and do something productive, and I've seen people take a single hit or gummy and have a panic attack.

Someone I know tried a CBD product to see if it would help their anxiety (to be clear, they didn't consult with me on this, this was of their own volution). They somehow had gotten the impression that they wouldn't feel high, and were alarmed when they did. In that case, there wasn't any lasting harm, they simply didn't try it again. I know another person who would have a lot of anxiety on CBD gummies. Again, no lasting harm, they just stopped taking them. But I don't believe that there is no cause for caution with CBD products.

I see CBD gummies advertised for just about everything, from helping you sleep to helping you feel awake and helping you feel aroused. These are all plausible effects for someone to experience, but I don't believe we have it down to such a science that these experiences can be bottled and productized. There's clearly a lot of snake oil out there.

To be clear I think it's broadly good that cannabis is being slowly legalized in the US and that people have the opportunity to experiment and see if it's helpful to them. I've just had a respect for mind-altering substances ingrained in me, so I'm not uncomfortable with how casually people sometimes recommend these products.

Indeed, someone who, say, isn't even familiar with the difference between CBD and CBN-containing products probably should not be the person giving out recommendations.

> Indeed, someone who, say, isn't even familiar with the difference between CBD and CBN-containing products probably should not be the person giving out recommendations.

Well, it's disappointing that you are more interested in being snarky than engaging seriously, I just hope you don't hurt anybody. And I hope if you do, you're in a position to know that it happened and to learn from it.

I'd like to leave you with this thought experiment. You probably wouldn't feel comfortable telling a stranger on the Internet they should be taking sertraline, right? Why should you feel more comfortable telling them to take a CBD product? Do you really feel you have the context to prescribe drugs to strangers? Is that a rational belief?

No, I'll leave all of the drug recommending to the knowledgeable folks - like podcasters, and Coca-Cola!

Nobody said anything about making a health recommendation to a stranger - almost always a mistake.¹

I make recommendations to people I have taken time to know well, who are struggling and ask for help. I also tell them I'm not a doctor - and to read!

¹Which is why doctors, with no true context, offering a psychiatric diagnosis (and prescription!) after an 11 minute appointment is often also ridiculous, ineffective - and potentially harmful.

You're injecting a lot of tone into a conversation where we're broadly in agreement. I'd appreciate it if you didn't do that. I'm here for discussion, not arguments.

Where I am, it can unfortunately end up being a pretty serious legal accusation to say someone's making diagnoses, or prescribing medications.

If I say these things "require a lot of context" and you respond with an insult, the natural inference is that you disagree. If it bothers you to be seen as supporting a position you don't agree with and feel may entail legal jeopardy, consider that it is entirely within your power to make a different decision about how to respond.

That's my last word on the matter. Have a good day.

I said nothing nearing an insult, or even personally about you, if one is reading and commenting within the guidelines,

which ask us to assume the most charitable interpretation of what's written.

The day was okay.

"I'm not uncomfortable with how casually people sometimes recommend these products" ≠ these things "require a lot of context"

I am comfortable with how casually people recommend CBD, especially if that replaces any % of the casual Xanax or SSRI recommendations I hear.

Not sure why this is being downvoted, you're completely correct — anxiety and paranoia are well-known effects of being high on weed (depending on the strain ofc), and anxiety and depression are well-known withdrawal symptoms. And it's much worse if you're already prone to anxiety and depression.

It's not obvious to my sibling. They won't confess they have anxiety even though it's hard to have a conversation with them without heading towards the apocalypse--a change concurrent with treating so e physical disorder with edibles and smokables.

> who think it’s a cure because their anxiety is due to THc withdrawals.

You don't have any proof that this is true or not, yet you state it as fact. Lazy thinker.

I wouldn't read too much into this story, as any people who do benefit from THC probably wouldn't be visiting an emergency department for cannabis-related reasons. I'll also say, as someone with an anxiety disorder, that it certainly didn't make it worse. For me, it worked pretty much like Xanax: did wonders for my anxiety, but I couldn't manage to get anything done, so I had to switch back to my usual not-completely-effective meds.

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