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Bipolar Disorder & CBD Oil: Potential to Help with Depressive Episodes

Awareness surrounding mental health conditions like bipolar disorder is on the rise but even with this increase in knowledge and understanding, finding suitable treatments can be elusive. While more widely known for its pain relieving, anti-inflammatory properties, CBD oil is now being studied for its potential benefits in treating mood disorders.

Categorized by cyclical peaks and troughs of extreme moods referred to as manic and depressive episodes, bipolar disorder will affect 4.4% of people within their lifetimes. While manic episodes can result in inappropriate behaviors, impulsivity, and insomnia, depressive episodes render the patient feeling hopeless, worthless, and even suicidal.

The most common bipolar treatments involve pharmaceuticals, but using CBD oil for bipolar disorder may be an option worth exploring.

Effectiveness of CBD Oil for Bipolar Disorder

 

While no clinical trials on the links between bipolar disorder and the use of cannabinoids currently exist, a review on the topic has suggested that based on what we do know, “cannabidiol (CBD) may exert sedative, hypnotic, anxiolytic, antidepressant, antipsychotic and anticonvulsant effects.”

Already known to improve mood and reduce depression, CBD oil may also be used to control the presentation of bipolar disorder through its effects on the endocannabinoid system. Phytocannabinoids like tetrahydrocannabinol (THC) and cannabidiol (CBD), are the plant equivalent of the endocannabinoids naturally produced by your body’s endocannabinoid system. Cannabinoids, whether produced by cannabis or your body, act on CB1 and CB2 receptors both directly and indirectly.

Multiple studies have linked irregularities in the endocannabinoid system with mental illness, suggesting that CBD oil may help. One such study conducted in Italy looked at the CB1 receptor in patients who had major depression or bipolar disorder, and compared its levels to those in a healthy test group. While the results were not significant enough to draw a definitive conclusion, the report stated that differences in the endocannabinoid system “may contribute to the susceptibility to mood disorders.” CBD works to elevate endocannabinoid levels in the system to reach optimal homeostasis levels, which could lead to a healthier mental state.

Studies in animals have linked a dysfunctional endocannabinoid system to lower serotonin levels, and low serotonin levels may be linked to bipolar disorder. CBD can elevate serotonin levels in the brain by acting on the 5-HT1A serotonin receptor. As such, CBD oil could be useful for treating certain mood disorders by helping balance the endocannabinoid system to help reduce the depressive symptoms of bipolar disorder. 

Another animal study reported that CBD can trigger quick and sustained antidepressant-like effects by increasing expression of proteins such as Brain-derived neurotrophic factor (BDNF), PSD95 and synaptophysin, which are involved in building neural connections (synapses), in the brains of rodent models (rats and mice) of depression.

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Unfortunately, CBD has not shown the same promising impact on manic episodes.

In one review, researchers examined the effects of CBD in 2 patients with bipolar affective disorder. Both patients were given a placebo for the first 5 days of study and CBD for days 6-30. On days 6-20, the first patient was also given a dose of olanzapine. On day 31, CBD was discontinued and both were given a placebo for 5 more days. The first patient, who was also administered olanzapine, showed improvement in her symptoms while taking both medicines together and experienced no improvement during the placebo and CBD trials. The second patient experienced no improvements in symptoms.

Based on these studies, it appears CBD oil may hold the most potential for treating the depressive side of manic depressive swings.

Benefits of Using CBD Oil for Bipolar Disorder

 

Unfortunately, most treatments for bipolar disorder are not totally effective. While prescription drugs in combination with psychotherapy are able to help a large number of people, there are many others who find that their condition is resistant to treatment.

While CBD oil is gaining traction in medical circles for its use in treating mental illness, the most common medications prescribed to patients with bipolar disorder are still antidepressants, mood stabilizers, and antimanic drugs.

Research has shown that antidepressants can actually increase the likelihood of mania and/or rapid cycling, which is why mood stabilizers are often prescribed in conjunction with these medicines. This cocktail of medications, while effective for some, leaves others with a host of additional side effects to contend with on top of their condition, as outlined in the chart below.

If you’re considering adding CBD oil to your bipolar treatment regimen, it’s extremely important that you talk to your doctor and consider the potential drug interactions outlined in the chart below.

Commonly Prescribed Medication for Bipolar Disorder Potential Side Effects Potential Side Effects of Combining CBD Oil + Medication for Bipolar Disorder
Lithium (Lithobid) Dizziness; drowsiness; dry mouth; tremors in the hands; blurred vision; nausea; vomiting; upset stomach; difficulty walking. Using CBD Oil with lithium may increase the likelihood of experiencing dizziness; drowsiness; confusion.  Always consult your doctor before using CBD oil.
Olanzapine (Zyprexa) Weight gain; dizziness; high cholesterol; weakness; dry mouth; muscle spasms. Using CBD Oil with Olanzapine may increase the likelihood of experiencing dizziness; drowsiness; confusion.  Always consult your doctor before using CBD oil.
Risperidone (Risperdal) Dizziness; drowsiness; fatigue; fever; weight gain; muscle spasms; feeling hot or cold. Using CBD Oil with Risperidone may increase the likelihood of experiencing dizziness; drowsiness; confusion.  Always consult your doctor before using CBD oil.
Quetiapine (Seroquel) Dizziness; drowsiness; constipation; low blood pressure upon standing; dry mouth; weakness; headache. Using CBD Oil with Quetiapine may increase the likelihood of experiencing dizziness; drowsiness; confusion.  Always consult your doctor before using CBD oil.
Aripiprazole (Abilify) Tardive dyskinesia; muscle spasms; tremors; fainting; trouble swallowing; mood changes; restlessness. Using CBD Oil with Aripiprazole may increase the likelihood of experiencing dizziness; drowsiness; confusion.   Always consult your doctor before using CBD oil.
Ziprasidone (Geodon) Dizziness; drowsiness; nausea; upset stomach; diarrhea; constipation; tremors; rash; runny nose; new or worsening cough. Using CBD Oil with Ziprasidone may increase the likelihood of experiencing dizziness; drowsiness; confusion.   Always consult your doctor before using CBD oil.
Lurasidone (Latuda) Dizziness; drowsiness; weight gain; difficulty moving; sleepiness; tardive dyskinesia. Using CBD Oil with Lurasidone may increase the likelihood of experiencing dizziness; drowsiness; confusion.   Always consult your doctor before using CBD oil.
Symbyax Dizziness; drowsiness; diarrhea; constipation; dry mouth; weight gain; increased appetite. Using CBD Oil with Symbyax may increase the likelihood of experiencing dizziness; drowsiness; confusion.   Always consult your doctor before using CBD oil.
Valproic acid (Depakene) Confusing; tiredness; cold feeling; vomiting; change in mental state; unusual bleeding (nose; mouth; gums); easy bruising. Using CBD Oil with Valproic acid may increase the risk of liver damage.   Always consult your doctor before using CBD oil.

How to Take CBD Oil for Bipolar Disorder

 

If you’re unhappy with the way your bipolar disorder is currently being treated, it is worth speaking to a medical professional to see if CBD oil could help.

While it is generally well tolerated, CBD oil can interact with some medications, including antidepressants, so it’s imperative that you seek medical advice first.

CBD Oil Dosage for Bipolar Disorder

There is no one size fits all solution when it comes to CBD oil dosages. What works for one person will not be what works for another. It is recommended that you begin with the lowest recommended dose for any CBD oil product and slowly increase the dosage if needed.

If you’re looking for a starting point of reference, and your CBD oil product does not have a recommended dosage, we have come up with the following serving suggestion after reviewing hundreds of CBD products:

The CBD Oil Review Serving Standard is 25 mg of CBD, taken twice daily.

If this amount does not provide the results you need, slowly increase the amount by 25 mg every 3 to 4 weeks until the desired effects are achieved.

To learn more about dosage, read our CBD Oil Dosage Guide or consider speaking to a naturopathic doctor who can provide you with a personalized action plan.

CBD Delivery Format

There are lots of different ways to take CBD oil for bipolar disorder. Most people will choose a format that is comfortable and familiar to them, like vaping CBD or using a CBD oil capsule. Each format has its advantages that must be factored into the decision.

CBD Vape Oil/CBD Flower:  These inhaled delivery formats are fast acting. Because the CBD is absorbed directly through the lungs and does not have to be processed by the liver, you’ll feel the effects immediately. The main downside is that the effects often wear off within an hour. It can also be difficult to gauge dosage because an inhale volume can vary from person to person. Using a CBD oil vape or CBD flower is best for treating the sudden onset of symptoms, like anxiety or depressive thoughts.

CBD Oil Capsules/Edibles:  CBD oil capsules and edibles are an incredibly easy and convenient way to take CBD. CBD capsules provide the same dose every time and can be consumed in a routine and familiar way, with your daily vitamins, for example. Because the CBD has to pass through the digestive system and is then absorbed through the liver, it can take up to an hour for effects to appear. But, these effects can last 4 to 6 hours, making a CBD capsule or edible a perfect “set it and forget it” method for taking your CBD. These delivery formats are great for a regular and consistent supplementation routine.

CBD Oil Tinctures/Drops:  CBD oil drops and tinctures are great for people looking for maximum dose control. They are administered through a dropper making it easy to adjust as needed, down to the very drop! The CBD is absorbed through the skin under the tongue and the effects can be observed within 30 minutes and can last 2 to 4 hours. Tinctures and drops are great for both regular CBD oil supplementation and discreet use for sudden symptoms.

Give yourself some time to experiment with the different delivery formats. You may find one is better for addressing your bipolar symptoms over others. For more, check out our Beginner’s Guide to CBD Oil for an in-depth look at the different types of CBD oil products on the market.

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+ 8 sources

Sources:

  1. Bipolar Disorder - The National Institute of Mental Health https://www.nimh.nih.gov/health/statistics/bipolar-disorder
  2. C H Ashton et al. Cannabinoids in bipolar affective disorder: a review and discussion of their therapeutic potential - National Library of Medicine https://pubmed.ncbi.nlm.nih.gov/15888515/
  3. PalmieroMonteleone et al. (2009) Investigation of CNR1 and FAAH endocannabinoid gene polymorphisms in bipolar disorder and major depression - Elsevier B.V. https://www.sciencedirect.com/science/article/abs/pii/S1043661810000162?via%3Dihub
  4. M. Nakazi et al. (2000) Inhibition of serotonin release in the mouse brain via presynaptic cannabinoid CB1 receptors - Springer Nature Switzerland AG. https://link.springer.com/article/10.1007/s002109900147
  5. T Mahmood et al. Serotonin and bipolar disorder - National Library of Medicine https://pubmed.ncbi.nlm.nih.gov/11532527/
  6. Amanda J Sales et al. (2018) Cannabidiol Induces Rapid and Sustained Antidepressant-Like Effects Through Increased BDNF Signaling and Synaptogenesis in the Prefrontal Cortex - National Library of Medicine https://pubmed.ncbi.nlm.nih.gov/29869197/
  7. Aw Zuardi et al. (2008) Cannabidiol was ineffective for manic episode of bipolar affective disorder - National Library of Medicine https://pubmed.ncbi.nlm.nih.gov/18801823/
  8. Alexander Viktorin et al. The risk of switch to mania in patients with bipolar disorder during treatment with an antidepressant alone and in combination with a mood stabilizer - National Library of Medicine https://pubmed.ncbi.nlm.nih.gov/24935197/

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