Last week, our Live with psychiatrist Rafael Baquit raised interesting questions about cannabis and depression. Let’s tell you a little more about it!

Sadness that doesn’t go away, anguish, lack of interest in activities that were once so loved – all of these can be the faces of depression. We know how difficult it is to talk about it openly: family members, loved ones and even our closest friends may not understand what is going on, which can further increase that feeling of isolation. Of being lonely. But you’re not, and that’s why we decided to open this conversation here.

The stigma on this mysterious subject is huge, but the need to work on the taboo and talk about it in a much more open way is even greater. Unlike the mood swings and sadnesses that we all experience in life (yes, this is normal), depression is cruel – and its crises are hardly resolved without proper treatment. In this case, self-medication, whether with antidepressants or cannabis, is not the best way out.

To talk to us, we called the psychiatrist and harm reduction doctor Rafael Baquit. In a live, we chatted about this issue, its relationship with cannabis, and also about anxiety – a disorder closely related to both themes.

What’s up? Do you want to embark on this journey with us?

Anxiety, depression and concepts

Before treating anxiety and depression, you need to know them. According to Baquit, these diseases do not have a hard concept, as they do not happen in just one way. The two things can also start from normal states, inherent to the human being.

“In part, anxiety is normal and necessary; it is our state of alert, of anticipating. It is important even for our survival”. According to the doctor, some physical symptoms, which come from the summation of this feeling, are:

• Excessive fear for no specific reason, such as phobia;
• Obsessive symptoms;
• Tremor;
• Shortness of breath;
• Bellyache.

Anxiety, in our modern society, also has a lot to do with the context in which individuals live, with structural issues, conflicts, traumas, the environment and its social determinants.

Depression is a serious and little recognized subject: categorized as one of the evils of the century, it is estimated that more than 300 million people, of all ages, suffer from this disorder, according to data from the World Health Organization (WHO). Also according to the agency, the disorder is the main cause of disability on the planet, and contributes significantly to the global burden of disease. Women are more affected than men and, in the worst case, depression can still lead to suicide.

The disorder also has a parallel of what is normal pain and what is the disease itself. For Rafael, one of the situations that we live that can resemble the state of depression is mourning, caused by the loss of something or someone very important – and it may have to do with a real or even a symbolic loss. It can range from physical symptoms, such as changes in appetite and sleep, and can be so severe and debilitating that the affected person cannot get out of bed. But understanding when it can be a symptom of deeper suffering can be super challenging …

Psychic suffering can happen in several ways, which is why it doesn’t make sense to just talk about depression and anxiety.

What point is the limit?

“Suffering is inevitable. We are attached beings, so we suffer. Everyone suffers, and we keep finding ways to deal with our suffering. […] But suffering is one thing, and getting sick is another”.

The psychiatrist’s view is that a great point of alert is when our suffering starts to harm us, moving away from activities that we like, and even from daily habits. When our sadness puts us at risk, we may be experiencing a depressive episode.

For him, an interesting view in psychiatry is to bring the individual’s experience and his experience closer, instead of bringing a closed diagnosis, based only on isolated symptoms. This conversation would help to create a narrative and elaborate this pain, to understand it, understand its triggers, and not just suppress it with the use of medication – although it is still a very important step, especially in severe cases .

Neither depression or anxiety are “silliness” 

There are many people who still have a more closed mind, who do not accept depression as a real disorder. But let’s remember that:

• Depression is not laziness;
• Depression is not a lack of God or religion;
• Anyone can develop depression at any stage of life;
• Depression deserves (and needs) to be treated.

The treatments for depression are not unique, but sets of therapies and experiences that can be beneficial to the body. Several practices have already proved effective to help during episodes of crisis or in cases if a situation of more chronic depression: physical exercises, care with food, specific medications, psychotherapy and medical monitoring are some of the main indications. As we said at the beginning of the post, self-medication is something we have to be careful about, it is always good to be accompanied by a doctor in this process of ingesting substances that have intense effects on our body!

Cannabis as a therapeutic tool

“The medical community has never known anything at this level. The point is that we have a plant with hundreds of substances, which are not only psychoactive, and we have the endocannabinoid system, which regulates all the functions of the body – homeostasis. They touch the root, balance the body.”

Cannabis needs to be thought of as a possible supplement, not a remedy. “We have thousands of genetic variations (from cannabis). The problem is when you still don’t know, you don’t know very well, how the combination works best. Little is known, but it is an extraordinary potential.” The doctor makes it evident that it is necessary to think about illness in a critical way. “Treatment is a process, it is a set of things, it cannot be just a plant. Medical cannabis has extraordinary potential, and medicine will study further and discover even more about it”.

There is research in the world that shows the potential of CBD as an agent in the treatment of depression. We observed an increase in clinical interest in cannabis, in a regulated use, as an agent in the treatment of depression, anxiety and several other disorders. But that does not mean that we do not have to take care, nor consume the herb thinking that it can be the solution to our problems!

Anxiety and panic with cannabis

Rafael tells a little about the history of cannabis in Brazil to contextualize the relationship between the substance and anxiety:

“Until the 1980s, we had loose cannabis, from the Cabrobró region. In the 1980s, a whole crackdown began to take place, and in that way our distribution was shrinking, and that’s when the brick weed began to arrive. In the Northeast, they still have it today. And the brick weed is all over the national territory, it is the main cannabis in the country, and we know that it has a strong effect. It is probably a stronger cannabis, with more THC, and damage, who knows the effects of the degradation of everything. The fact is that loose cannabis is low in quantity, and the brick weed has more THC. ”

According to the doctor, the relationship between THC and anxiety is very interesting. As you increase the dose of THC, the possibility of anxiety symptoms appears. The way in which cannabis is used can also be the key in all this: loose cannabis, in bloom, tends to have lower THC levels than the pressed one.

Too much THC creates anxiety. But we need to remember the entourage effect, the entourage effect: your body’s reaction to cannabis occurs according to the relationship between the cannabinoids present in the herb, the terpenes, and other substances. For the doctor, for this reason, it is not so interesting to talk only about CBD or THC, since together they help to suppress each other’s negative effects.

“I think the most important thing is our autonomy, our ability to manage drugs in our lives. That’s what we do with Harm Reduction. ”

Depression symptoms aggravated by cannabis use

“It is common to happen, as a clinical psychiatrist, who accompanies many people who use cannabis, I see that. In fact, cannabis often worsens depressive states. But it also has a lot to do with the ban. Knowing what is in cannabis is the most appropriate, in addition to the way we use it. If it were at the pharmacy, it would be a little different ”.

According to Baquit, not everything is flowers (especially in prohibitionism, where almost everything is literally pressed). In the situation we live in, we have no way of knowing the exact amount of cannabinoids and the profile of what we consume, which makes even cannabis testing difficult. In other countries, where the substance is already legalized, there are many cases of people who treat psychiatric disorders with oils and extracts – with follow-up. But it is very difficult to replicate this model in our reality.

We have research that shows that THC, in small doses, is a great antidepressant – but that in large quantities it can have the reverse effect. In other words: the secret is exactly in the dose. However, how can we have this data in a country whose demand for cannabis is solved almost exclusively by trafficking?

Well, who knows what changes expect us in the near future, right?

Another major problem is compulsiveness. Depression can lead the user to obsessive behavior, in which the individual may use cannabis in a way with less control. According to an American survey, there is evidence that individuals with depression are twice as likely to start using cannabis on a regular basis, ignoring its risks – something that can become harmful.

Cannabis is no different: it is necessary to have control of its use in all situations. According to studies, the acute and chronic use of cannabis can lead to difficulties in adhering to treatments, and lead to a worsening of affective disorders – such as depression and bipolarity.

Invitation to care

Are you smoking too much? Is cannabis the only thing that makes sense? It may be time to ask for help. If this is your case, or the case of a friend, family member or anyone you care about, it is interesting to open this dialogue. Recognizing that there is a problem is the first step to improving – and there are many, many approaches and forms of treatment for depression.

Today, there are many ways to find a professional who can help. In addition to private or covenant therapists, which may be outside the reality of a large part of the population, we have psychosocial care centers through SUS and social assistance for vulnerable patients. Look it up. Inform yourself. What’s not worth is staying like this. We know how difficult it is, but it can always get better!