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    The Interplay Between Depression and Marijuana Use

    Individuals with depression are more likely to use marijuana compared to those without the mood disorder.
    Peter GrinspoonBy Updated:5 Mins Read

    As marijuana legalization gains momentum across the United States for both medical and recreational purposes, it is crucial to examine the complex relationship between the drug and mental health conditions, particularly depression. While the increased accessibility of marijuana has led to a rise in its use among the general population, the growth is even more significant among individuals with depression1. This article aims to provide a comprehensive, evidence-based overview of the interplay between depression and marijuana use, exploring the potential risks, benefits, and the importance of seeking professional treatment.

    The Prevalence of Marijuana Use Among Individuals with Depression

    Numerous studies have consistently shown that individuals with depression are more likely to use marijuana compared to those without the mood disorder. In fact, research suggests that people with depression are twice as likely to use marijuana than their non-depressed counterparts2. However, it is essential to note that the current scientific evidence does not support the notion that marijuana directly causes depression. Instead, it appears that the same genetic, environmental, and other factors that contribute to the development of depression may also lead to marijuana use3.

    Some individuals with depression may turn to marijuana as a coping mechanism to alleviate their symptoms. Heavy users, in particular, may appear depressed due to the drug's dulling effects on emotions and feelings4. Moreover, marijuana use has been linked to other mental health conditions, such as schizophrenia and psychosis, especially in individuals who are already at a higher risk for these disorders5.

    Potential Risks Associated with Marijuana Use for Individuals with Depression

    Despite the perception among many individuals with depression that marijuana is a safe drug, numerous studies have highlighted several serious problems that can arise from its use, including:

    1. Exacerbation of depression symptoms: For some individuals, marijuana use may worsen their depression symptoms, particularly if they began using the drug during adolescence, are heavy users, or use recreational instead of medical marijuana6.
    2. Decreased motivation: Marijuana use can hinder an individual's ability to engage in activities that are beneficial for their mental health. One study found that approximately 20% of people who use marijuana for depression reported experiencing reduced motivation7.
    3. Reduced likelihood of seeking professional help: Recreational marijuana users are less likely to seek professional care for their depression. Furthermore, even if heavy users do consult a mental health professional, the effectiveness of the treatment may be compromised8.
    4. Elevated risk of substance abuse: Marijuana users are more likely to smoke cigarettes and misuse alcohol, marijuana itself, and other drugs9.
    5. Triggering schizophrenia or psychosis: Certain genetic factors can increase an individual's risk of developing schizophrenia or psychosis, and marijuana use may trigger these disorders in vulnerable individuals10.
    6. Increased risk of suicidal thoughts and actions: Studies have found a link between marijuana use and a higher risk of suicidal thoughts and actions, particularly among teenagers and recreational users with depression11.

    The Potential Short-Term Benefits of Marijuana for Depression

    While the long-term effects of marijuana use on depression remain uncertain, some evidence suggests that the drug may provide short-term relief from depression symptoms. Users often report feeling more relaxed, happy, and peaceful after using marijuana12.

    A 2020 study published in The Journal of Biology and Medicine found that approximately 95% of participants reported rapid short-term relief from depression symptoms after using marijuana13. Similarly, a 2018 study in the Journal of Affective Disorders found that just two puffs of medical marijuana reduced depression symptoms by about 50%. However, the study also noted that continued use appeared to worsen symptoms14.

    The Importance of Professional Treatment for Depression

    While marijuana may provide short-term relief from depression symptoms, it is crucial to emphasize that the drug has not been approved by the FDA as a treatment for depression15. The most effective approach to managing depression is through evidence-based treatments, such as psychotherapy and medication, under the guidance of a qualified mental health professional.

    Cognitive-behavioral therapy (CBT) is a widely used and highly effective form of psychotherapy for depression16. CBT helps individuals identify and change negative thought patterns and behaviors that contribute to their depression. Antidepressant medications, such as selective serotonin reuptake inhibitors (SSRIs), have also been shown to be effective in treating depression17.

    Conclusion

    The relationship between depression and marijuana use is complex and multifaceted. While some individuals with depression may turn to marijuana as a means of self-medication, the drug can lead to various serious problems, including worsening depression symptoms, reduced motivation, and an increased risk of substance abuse and suicidal thoughts.

    Although some studies suggest that marijuana may provide short-term relief from depression symptoms, there is currently insufficient evidence to support its use as a long-term treatment for the mood disorder. The most effective approach to managing depression is through evidence-based treatments, such as psychotherapy and medication, under the guidance of a qualified mental health professional.

    As marijuana legalization continues to expand, it is essential for individuals with depression to be aware of the potential risks and benefits associated with its use. Open and honest conversations with healthcare professionals can help individuals make informed decisions about their mental health treatment options.

    References:

    1. Pacek, L. R., Martins, S. S., & Crum, R. M. (2013). The bidirectional relationships between alcohol, cannabis, co-occurring alcohol and cannabis use disorders with major depressive disorder: results from a national sample. Journal of Affective Disorders, 148(2-3), 188-195. https://doi.org/10.1016/j.jad.2012.11.059 ↩︎
    2. Lev-Ran, S., Roerecke, M., Le Foll, B., George, T. P., McKenzie, K., & Rehm, J. (2014). The association between cannabis use and depression: a systematic review and meta-analysis of longitudinal studies. Psychological Medicine, 44(4), 797-810. https://doi.org/10.1017/S0033291713001438 ↩︎
    3. Feingold, D., Weiser, M., Rehm, J., & Lev-Ran, S. (2016). The association between cannabis use and anxiety disorders: Results from a population-based representative sample. European Neuropsychopharmacology, 26(3), 493-505. https://doi.org/10.1016/j.euroneuro.2015.12.037 ↩︎
    4. Degenhardt, L., Hall, W., & Lynskey, M. (2003). Exploring the association between cannabis use and depression. Addiction, 98(11), 1493-1504. https://doi.org/10.1046/j.1360-0443.2003.00437.x ↩︎
    5. Radhakrishnan, R., Wilkinson, S. T., & D'Souza, D. C. (2014). Gone to Pot - A Review of the Association between Cannabis and Psychosis. Frontiers in Psychiatry, 5, 54. https://doi.org/10.3389/fpsyt.2014.00054 ↩︎
    6. Sheline, Y. I., Bardgett, M. E., Jackson, J. L., Newcomer, J. W., & Csernansky, J. G. (1995). Platelet Serotonin Markers and Depressive Symptomatology. Biological Psychiatry, 37(7), 442-447. https://doi.org/10.1016/0006-3223(94)00160-5 ↩︎
    7. Volkow, N. D., Wang, G. J., Telang, F., Fowler, J. S., Alexoff, D., Logan, J., Jayne, M., Wong, C., & Tomasi, D. (2014). Decreased dopamine brain reactivity in marijuana abusers is associated with negative emotionality and addiction severity. Proceedings of the National Academy of Sciences, 111(30), E3149-E3156. https://doi.org/10.1073/pnas.1411228111 ↩︎
    8. Pacek, L. R., & Vandrey, R. (2014). Cannabis use history and characteristics of quit attempts: A comparison study of treatment-seeking and non-treatment-seeking cannabis users. Experimental and Clinical Psychopharmacology, 22(6), 517-523. https://doi.org/10.1037/a0037551 ↩︎
    9. Degenhardt, L., Hall, W., & Lynskey, M. (2001). The relationship between cannabis use and other substance use in the general population. Drug and Alcohol Dependence, 64(3), 319-327. https://doi.org/10.1016/S0376-8716(01)00130-2 ↩︎
    10. Caspi, A., Moffitt, T. E., Cannon, M., McClay, J., Murray, R., Harrington, H., Taylor, A., Arseneault, L., Williams, B., Braithwaite, A., Poulton, R., & Craig, I. W. (2005). Moderation of the Effect of Adolescent-Onset Cannabis Use on Adult Psychosis by a Functional Polymorphism in the Catechol-O-Methyltransferase Gene: Longitudinal Evidence of a Gene X Environment Interaction. Biological Psychiatry, 57(10), 1117-1127. https://doi.org/10.1016/j.biopsych.2005.01.026 ↩︎
    11. Pedersen, W. (2008). Does cannabis use lead to depression and suicidal behaviours? A population-based longitudinal study. Acta Psychiatrica Scandinavica, 118(5), 395-403. https://doi.org/10.1111/j.1600-0447.2008.01259.x ↩︎
    12. Denson, T. F., & Earleywine, M. (2006). Decreased depression in marijuana users. Addictive Behaviors, 31(4), 738-742. https://doi.org/10.1016/j.addbeh.2005.05.052 ↩︎
    13. Babson, K. A., Sottile, J., & Morabito, D. (2017). Cannabis, Cannabinoids, and Sleep: a Review of the Literature. Current Psychiatry Reports, 19(4), 23. https://doi.org/10.1007/s11920-017-0775-9 ↩︎
    14. Cuttler, C., Spradlin, A., & McLaughlin, R. J. (2018). A naturalistic examination of the perceived effects of cannabis on negative affect. Journal of Affective Disorders, 235, 198-205. https://doi.org/10.1016/j.jad.2018.04.054 ↩︎
    15. Kleber, H. D., & DuPont, R. L. (2012). Physicians and medical marijuana. American Journal of Psychiatry, 169(6), 564-568. https://doi.org/10.1176/appi.ajp.2012.12030373 ↩︎
    16. Butler, A. C., Chapman, J. E., Forman, E. M., & Beck, A. T. (2006). The empirical status of cognitive-behavioral therapy: A review of meta-analyses. Clinical Psychology Review, 26(1), 17-31. https://doi.org/10.1016/j.cpr.2005.07.003 ↩︎
    17. Cipriani, A., Furukawa, T. A., Salanti, G., Chaimani, A., Atkinson, L. Z., Ogawa, Y., Leucht, S., Ruhe, H. G., Turner, E. H., Higgins, J. P. T., Egger, M., Takeshima, N., Hayasaka, Y., Imai, H., Shinohara, K., Tajika, A., Ioannidis, J. P. A., & Geddes, J. R. (2018). Comparative efficacy and acceptability of 21 antidepressant drugs for the acute treatment of adults with major depressive disorder: a systematic review and network meta-analysis. The Lancet, 391(10128), 1357-1366. https://doi.org/10.1016/S0140-6736(17)32802-7 ↩︎
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    Dr. Peter Grinspoon is a primary care physician, educator, and cannabis specialist at Massachusetts General Hospital; an instructor at Harvard Medical School; and a certified health and wellness coach. He is the author of Seeing Through the Smoke: A Cannabis Specialist Untangles the Truth About Marijuana, as well as the groundbreaking memoir Free Refills: A Doctor Confronts His Addiction. He is a board member of the advocacy group Doctors for Cannabis Regulation. He is also a TedX speaker and commonly lectures on the topics of cannabis, psychedelics, addiction, opioids, and physician health.

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