Marijuana Addiction & Mental Health Problems

Marie Monroe Doutaz, M.A., LPAT, CADC Updated Mar 25, 2019
  1. Marijuana and the Brain
  2. Mood Disorders
  3. Can Using Marijuana Cause Anxiety?
  4. Marijuana and Psychosis
  5. Marijuana and Dual Disorders
  6. Marijuana Addiction in Teens
  7. Sources

What is a Dual Diagnosis?

The co-occurrence of marijuana use disorder and mental illness is commonly referred to as a dual diagnosis.

  • Marijuana use is prevalent and has the potential for causing both physical and psychological dependence.
  • In 2013, approximately 20 million people over the age of 12 used marijuana in the U.S.

Thus, many individuals with a mental health disorder might also be using marijuana.

What is a Dual Diagnosis?

Marijuana and the Brain

In the short-term, the 'high' or intoxication effects of marijuana is the result of alterations in brain chemistry.

Marijuana acts primarily on cannabinoid receptors in the brain.

  • We naturally produce substances that bind to these receptors, called endocannabinoids.
  • Marijuana contains a chemical called tetrahydrocannabinol (THC) which exogenously (i.e., from the "outside") binds with cannabinoid receptors.
  • This leads to the psychological experience of being "high," along with the drug's action on other mood-regulating neurotransmitters, like dopamine.

Those who are sensitive to higher levels of the neurotransmitter dopamine, or already have higher levels, can experience:

  • Aggression.
  • Physical agitation.
  • Anxiety.
  • Panic.
  • Some types of depression, mania, delusions, hallucinations and/or paranoia.

Brain Structure

  • The brain changes caused by intoxication are often mistakenly thought to be only temporary and only chemical in nature.

    Research indicates, however, that marijuana use also negatively alters brain structure.

  • For example, marijuana used once per week has been associated with altered size and shape of brain structures, specifically, the nucleus accumbens and amygdala; responsible for regulating motivation and emotion.
  • Another brain structure important in learning and memory--the hippocampus--also appears to be vulnerable to structural alterations as a result of marijuana use.

It is not known if any of these effects upon brain structure can be reversed.

Marijuana's stimulation of dopamine release in the brain can increase these already troublesome symptoms or cause the dormant vulnerability to them to awaken. If you are suffering from an addiction to marijuana, you may have developed mental health problems that require treatment. Please call 1-888-993-3112Who Answers? to get treatment today.

Mood Disorders

There are strong links between mood disorders (such as Depression or Bipolar Disorder) and marijuana use. Research shows that marijuana use may increase depressive symptoms in users; however, it is unclear to what degree social and contextual factors play a role.

Possible scenarios that link the two may include:

  • Marijuana-induces mood problems.
  • Self-medication with marijuana for already existing mood problems.
  • Genetic mood vulnerabilities are activated by marijuana use.
  • Freestanding mood problems are worsened by marijuana use.

  • There is strong evidence that depression is more prevalent among marijuana users than the general population. People who use marijuana have been found to be up to 4 times more likely to have depressive thoughts and impaired ability to experience pleasure than people who do not use it.

Associated Problems

Marijuana dependence and concurrent depression can be a debilitating combination with many negative consequences. Problematic symptoms include:

  • Low self-esteem.
  • Feelings of hopelessness and helplessness.
  • Poor concentration.
  • Withdrawal and isolation.
  • Low energy.
  • Low motivation.
  • Poor self-concept.
  • Feelings of poor self-worth.
  • Lack of pleasure.
  • Lack of participation in relationships and life activities.

Consequently, problems develop in social functioning as poor communication, decreased drive and overall apathy influence social interactions.

Clinical Issues

Treatment of co-occurring marijuana use and mood problems can be challenging.

  • Research shows that both need to be addressed at the same time. Otherwise, the unresolved problem is likely to trigger the other repeatedly, causing frequent relapses.
  • Consequently, best treatment practices recommend treatment with providers specially trained in dual diagnosis intervention.
  • Such professionals understand the interaction of marijuana use and mood problems. They can provide treatment that addresses these interactions so that both can be managed in a sustainable recovery.

As use and depression progress, there are cumulative effects of such symptoms, like non-achievement across a spectrum of life events that require productivity, motivation, and focus. If you are struggling with marijuana addiction and depression, you need help now. Please call 1-888-993-3112Who Answers? to find a treatment program that can treat both.

Can Using Marijuana Cause Anxiety?

Research has shown that there is a significant relationship between marijuana use and anxiety problems. Anxiety issues have a wide range including: social, performance and generalized anxiety.

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Marijuana use can induce anxiety problems and people with already existing anxiety are prone to self-medicate with marijuana.

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As with other mental health conditions, people who use marijuana and have an anxiety disorder require simultaneous treatment of both issues.

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A dual diagnosis program in which treatment addresses the interactions of marijuana use and anxiety is recommended. If one condition remains unresolved, relapse in both is likely to occur.

Marijuana and Psychosis

Psychosis and schizophrenia have been significantly linked to marijuana use. Studies have shown that there is an increased risk of these conditions in people who have used marijuana. There is also evidence that the risk increases with use of more potent marijuana and with more frequent use.

It is thought that the risk of psychosis or schizophrenia increase three-fold in those who use marijuana. However, a causal relationship has not yet been established.

Associated Problems

Psychosis and schizophrenia can severely impair daily functioning.

  • Substance use of all kinds tends to sabotage management by decreasing medication use and participation in ongoing treatment needed to adequately manage the conditions.
  • Poorly treated symptoms interfere with social interactions, performance of daily tasks and activities and create ongoing emotional and mental distress.
  • Additionally, vulnerabilities to psychosis or schizophrenia are aggravated by marijuana. All of these factors contribute to an overall poor quality of life with psychological distress, social isolation and the likelihood of frequent psychiatric crises involving hospitalization.

Marijuana and Dual Disorders

Marijuana use commonly co-occurs with mental health conditions and the combination can be debilitating. Psychological, social and behavioral problems arise and have negative effects upon daily functioning as well as longer term life outcomes.

  • Marijuana use worsens the symptoms of mental health conditions due to the direct effects of the substance upon the brain.
  • Also, marijuana use tends to coincide with poor illness management behaviors among those who suffer from depression, anxiety, psychosis and schizophrenia.
  • Medication noncompliance and missed mental health appointments are common among those who use marijuana and have a mental illness that requires ongoing management (NAMI).

Consequently, dual diagnosis issues compound and amplify both short-term and long-term negative effects of both marijuana use and a mental illness. If you are suffering under the weight of a mental health problem and marijuana addiction, you need comprehensive treatment. Please call 1-888-993-3112Who Answers? to get connected with the right program today.

These combined factors can create chronic and problematic situations due to persistent symptoms, such as:

  • Lethargy.
  • Impaired memory.
  • Depression.
  • Anxiety.
  • Problems with decision-making, problem-solving and overall cognition are common effects of marijuana use.

These symptoms significantly contribute to poor life outcomes and poor life satisfaction.

  • Negative life outcomes associated with low educational achievement, unemployment, and low incomes have been associated with the chronic use of marijuana.
  • Chronic social problems can be caused by both marijuana use and chronic mental health symptoms.
  • Withdrawal and isolation are common in both conditions as are relationship problems.

Marijuana Addiction in Teens

Teen users of marijuana are at risk for several negative life outcomes. These include:

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Poor educational achievement--teen marijuana use is associated with lower grades and test scores, less likelihood of attending college and higher high school dropout.

Poor peer and partner relationships in later life.

 

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Cognitive impairments--a decline in IQ has been found in chronic users who began use in their teens and continued into adulthood. An average loss of eight IQ points from childhood to midlife has been reported.

 

 

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Addiction--onset of marijuana use in the teens has been linked to later addiction to marijuana and other substances.

 

 

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Psychiatric problems-- teen use of marijuana is associated with higher rates of psychosis in adult life.

    • Those who have used by age 18 are 2-4 times more likely to receive a diagnosis of schizophrenia later in life.
    • Also, research shows a correlation between repeated teen use and depression, anxiety, suicidal thoughts and personality disorders.

Sources

  1. Bovasso, G. (2001). Cannabis Abuse as a Risk Factor for Depressive Symptoms. American Journal of Psychiatry, 158, 2033-2037.
  2. Brook, J., Lee, J., Finch, S., Seltzer, N., & Brook, D. (2013). Adult work commitment, financial stability, and social environment as related to trajectories of marijuana use beginning in adolescence. Substance Abuse,34, 298-30.
  3. Bucknera, J., Zvolenskyb, M., & Schmidtc, N. (2012). Cannabis-related impairment and social anxiety: The roles of gender and cannabis use motives. Addictive Behaviors, 37 (11), 1294-1297.
  4. Caspi, A., Moffitt, T., & Cannon, M. (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. Biol Psychiatry, 57(10), 1117-1127.
  5. Cobb-Clark, D., Kassenboehmer, S., Le, T., McVicar, D., & Zhang, R. (2015). 'High'-School: The Relationship between Early Marijuana Use and Educational Outcomes. Economic Record, 91, 247-266.
  6. Gilman, J., Kuster, J., Lee, S., Lee, M., Kim, B., Makris, N., & Kouwe, A. v. (2014). Cannabis Use Is Quantitatively Associated with Nucleus Accumbens and Amygdala Abnormalities in Young Adult Recreational Users. The Journal of Neuroscience, 34(16), 5529-5538.
  7. Grant, B., Stinson, F., Dawson, D., Chou, S., Dufour, M., Compton, W., . . . Kaplan, K. (2004). Prevalence and Co-occurrence of Substance Use Disorders and IndependentMood and Anxiety Disorders. Arch Gen Psychiatry, 61(8), 807-816.
  8. Large, M. (2011). Cannabis Use and Earlier Onset of Psychosis: A systematic meta-analysis. Archives of General Psychiatry, 68(6), 555-561.
  9. Lynskey, M., & Hall, W. (2000). The effects of adolescent cannabis use on educational attainment: a review. . Addiction, 95, 1621-1630.
  10. Makin, S. (2014, August 14). Does Marijuana Harm the Brain? Retrieved from Scientific American: http://www.scientificamerican.com/article/does-marijuana-harm-the-brain/
  11. Meier, M., Caspi, A., Ambler, A., & al., e. (2012). Persistent cannabis users show neuropsychological decline from childhood to midlife. Proceedings of the National Academy of Sciences of the USA, 109, 2657-2664.
  12. Minkoff, K. (2001). Best Practices: Developing Standards of Care for Individuals With Co-occurring Psychiatric and Substance Use Disorders. Psychiatric Services 52:5, 597-599.
  13. Moore, T., & Zammit, S. (2007). Cannabis Use and Risk of Psychotic or Affective Mental Health Outcomes: A Systematic Review. Lancet, 370(9584), 319-28.
  14. NIDA. (2015, September). Is there a link between marijuana use and mental illness? Retrieved from NIDA (National Institute on Drug Abuse: http://www.drugabuse.gov/publications/research-reports/marijuana/there-link-between-marijuana-use-mental-illness
  15. Semple, D., McIntosh, A., & Lawrie, S. (2005). Cannabis as a Risk Factor for Psychosis: Systematic Review. Journal of Psychopharmacology, 19(2), 187-94.
  16. Volkow, N., Baler, R., Compton, W., & Weiss, S. (2014). Adverse health effects of marijuana use. N Engl J Med.370, 2219-2227.
  17. Wynn, S. (2014, November 24). Dual Diagnosis. Retrieved from Journal of Addictive Disorders, 2002: http://www.breining.edu