Many people with bipolar disorder use marijuana, but it’s not clear whether it is helpful or harmful.
Marijuana can help with many health conditions ranging from depression to multiple sclerosis, but can it help treat bipolar disorder too?
Like many areas of cannabis research, there is little hard data available. Right now, the scientific body of opinion goes both ways.
Some studies have shown that marijuana can worsen manic and depressive symptoms. Studies also suggest that using marijuana may cause bipolar disorder to develop earlier in life.
But there are also anecdotal reports of people with bipolar disorder using marijuana to help manage their symptoms, especially when standard medications don’t work.
Let’s take a deeper dive into the relationship between marijuana and bipolar disorder.
What is Bipolar Disorder?
Bipolar disorder is a mental illness where the sufferer experiences rapid and dramatic shifts in mood, which can significantly impact their everyday lives. The disorder is characterized by these manic and depressive mood episodes.
During manic episodes, people with bipolar disorder have high energy levels. They become very active, excited, and emotional. Someone in a manic state might talk fast and seem agitated or irritable. People in a manic state are also more prone to risky and reckless behaviour.
During depressive episodes, people with bipolar disorder show the opposite behaviour — hence the term “bipolar.” In a depressive state, patients feel hopeless and lost. They become lethargic, unable to concentrate, and lack motivation. At its worst, a depressive episode can drive a person to suicide.
Scientists still aren’t sure what causes bipolar disorder, but genetics and environmental factors both play a part.
The standard treatment for bipolar disorder involves psychiatric medications such as mood stabilizers, antipsychotics, and antidepressants, as well as counselling therapy.
Studies on Marijuana and Bipolar Disorder
Cannabis use is far more common among people with bipolar disorder than the general population.
But marijuana’s effects on bipolar disorder are not heavily studied, so hard data is limited. The current evidence consists mainly of anecdotal reports and clinical studies with small sample sizes.
There is reason to believe that marijuana may have therapeutic use for some bipolar patients, but there is equal reason to believe that marijuana could exacerbate manic or depressive symptoms and make the illness worse.
Many people self-medicate with marijuana to keep their mood swings under control. This may explain why cannabis use is so common in people with bipolar disorder — they may be using it to manage their symptoms.
The cannabinoids in marijuana, THC and CBD, may help patients to manage their mood states. However, there is a chance that those cannabinoids could also exacerbate bipolar symptoms.
In 1996, Gruber et al. described five patient cases where marijuana produced an antidepressant effect. Four of those five people said that marijuana worked better than standard medications, and three of them had a diagnosis of bipolar disorder.
In 2003, two medical surveys in California about cannabis use found that 15-27% of respondents were prescribed cannabis for mood disorders, including depression and bipolar disorder.
Can Marijuana Make Bipolar Disorder Worse?
Marijuana seems to be a double-edged sword when it comes to treating bipolar disorder. While it may help manic-depressive symptoms in some circumstances, it might also worsen them by heightening existing moods and taking them to extremes.
In 2015, the journal PLOS One published a review of studies on the relationship between cannabis use and bipolar disorder. It found that cannabis often caused more frequent and severe mood episodes.
According to the data, people with bipolar disorder who reported using marijuana also developed the illness at a younger age. This suggests that marijuana could play a role in developing the illness.
A different study, published in Psychiatry Research in 2013, found that marijuana use increases the risk of manic symptoms in patients with bipolar. However, the authors suggested that manic symptoms were likely a result of long-term exposure to marijuana, in other words, heavy usage.
Cannabis users also developed bipolar disorder at a younger age than non-users, and the average number of manic and depressive episodes they experienced each year was higher as well.
Another study, published in the Journal of Nervous and Mental Disease in 2009, found that cannabis use interfered with the regular treatment of bipolar disorder.
Over a 12-month period, the cannabis-using bipolar patients showed less compliance with their treatment programs and more severe mania, depression, and psychosis than the subjects in the study that did not use marijuana.
The cannabis users also experienced less satisfaction with life in general, and had fewer positive social relationships than patients who did not use marijuana.
Can Marijuana Help Bipolar Disorder?
The current evidence for marijuana helping with bipolar disorder is not strong. But there are many anecdotal reports of people successfully using marijuana to manage their bipolar disorder. While anecdotal reports are a far cry from clinical data, they still carry some weight.
A study published in 1998 by Harvard professors Dr. Lester Grinspoon and James B. Bakalar documented five cases in which patients obtained significant relief from their bipolar-related symptoms through the use of medical marijuana.
One of these patients, a 47-year-old woman, found cannabis to be more effective than other drugs in controlling her manic episodes.
“Suppose I am in a fit of manic rage — the most destructive behavior of all. A few puffs of this herb and I can be calm. My husband and I have both noticed this; it is quite dramatic. One minute out of control in a mad rage over a meaningless detail, seemingly in need of a strait jacket and somewhere, deep in my mind, asking myself why this is happening and why I can’t get a handle on my own emotions. Then, within a few minutes, the time it takes to smoke a few pinches — why, I could even, after a round of apologies, laugh at myself.”
In another case, the husband of a bipolar sufferer told of numerous ways that cannabis seemed to help his wife in dealing with the disorder.
“My wife functions much better when she uses marijuana. When she is hypomanic, it relaxes her, helps her sleep, and slows her speech down. When she is depressed and would otherwise lie in bed all day, the marijuana makes her more active… Lithium is also effective, but it doesn’t always keep her in control.”
In 1996 the journal Depression published a study that looked at five cases where patients with depression reported using cannabis to relieve their symptoms. Three of these patients had bipolar disorder.
All of the patients reported that marijuana was more effective than standard medications. Some of them also said that their moods worsened when they were no longer able to use marijuana, and that they immediately improved when they resumed taking it.
Besides anecdotal evidence, there is some science to back up these claims. According to a review published in 2005, THC and CBD may have mood-stabilizing properties that could be beneficial for patients with bipolar disorder.
THC is known to have anti-anxiety, hypnotic, and antidepressant effects, which could result in improvements in mood and overall well-being. CBD seems to counter the psychoactive effects produced by high doses of THC and may also possess anti-anxiety, hypnotic, and anticonvulsant properties of its own.
These properties suggest potential for marijuana as a treatment for bipolar disorder. For patients who have had little success with standard medications, medical cannabis may be the answer they’re looking for.
Some studies suggest that marijuana may worsen bipolar disorder, while others suggest it may help with managing symptoms. Bipolar patients frequently use marijuana, and many find that it helps them cope with their illness.
It’s important to note that none of the studies considered dosage or strain type, which are important factors to take into account when studying marijuana. With the immense variety of strains available, there are many possibilities for bipolar patients seeking relief.
If you have bipolar disorder and are thinking about marijuana as a treatment option, speak to your physician first. Some people may find success self-medicating with marijuana, but you should always seek the opinion of a medical professional before trying a new treatment.