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Depression

Question
Posted by: | 2020/08/11

Q.

Cannabis and depression

Good Morning Doc I am a male diagnosed with bipolar II and am currently on Lexamil, Dopaquel and Epitec. During the lockdown I struggle to keep my mood stable, with episodes of depression lasting a couple of days. I was wondering what the research say about cannabis and bipolar depression? I tried to do some research myself but get conflicting information. Many thanks

Expert's Reply

A.

Depression expert
- 2020/08/13

Good day,
This is an interesting question. As you will have noticed,  so long as any substance like Cannabis is illegal or even just surrounded by complex controls, it is hard for anyone to conduct proper research to settle significant questions we may have about it.  And the more important it is to have such good quality research in order to answer questions about it.  
From my own experience, with patients, colleagues and others, and from keeping a watching eye on research and other serious publications on these issues, I have not beccome aware of any convincing research or life experience to suggest that cannabis is of value in managing significant mental disorders, and quite a bit of research to suggest that it can be really unhelpful.  Using cannabis may be of some comfort to some people in distress, ( as can gin and tonic ) though comfort is not always helpful.  
There's also the complication that while most medicinal drugs contain one single active chemical ingredient, making it easier to measure their effects and to be sure effects noticed are due to that particular chemical ; cannabis is a highly complex item, containing many different chemicals in varying concentrations, and with really wide variation between different samples as to what they really do contain.  
My impression is that it can be especially unhelpful when a person really needs mental stability and consistently clear thinking.  So I do not recommend it to someone with Bipolar DIsorder or psychotic illnesses.  Remember also that the effects of cannabis will differ in particular individuals, and at difference ages or stages of life.  For instance, it does indeed seem to be associated with an increased risk of psychotic disorders like schizophrenia, and may cause most problems in a  adolescent still growing and developing brain,  than later in life.
I also don't favour trying to manage complex psych disorder wholly with chemical / drug treatments.  For instance, with depression, a skilled psychologist using methods like CBT (Cognitive-Behaviour Therapy) can help one gain useful control in a range of disorders, including recognizing psycho-social triggers and learning how to avoid or manage them better.

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