Is Smoking Weed Reducing or Increasing My Social Anxiety?
A veteran journalist ponders marijuana and anxiety's complicated relationship
April 10, 2020
I can rationalize smoking marijuana in many ways. It helps with writer’s block, boosts my libido, settles my stomach, and helps curb my boozing. But there is only one way I can justify smoking it before, say, walking into my 3-year-old’s playdate or ballet class: Weed helps with my (self-diagnosed) social anxiety disorder—or so I tell myself.
There are other signs that I smoke marijuana to deal with social anxiety: I have smoked right before my evening “beer league” hockey games, despite the often deleterious effects on my performance. Then there’s the smoking before funerals, before my graduate school classes, before work at the office and even before job interviews—all of which can seem, well, not particularly appropriate.
Does marijuana actually help me feel less anxious? In the short-term, yes. Perhaps the simplest way to put it is that: Before smoking, I really don’t want to go to social event X. I’m bad at chitchat. I think to myself, I’m not particularly interesting or witty. Also I have performance anxiety. I fear being put on the spot. It’s a fear of choking that leads to choking. With ice hockey, I would be stressing about my pending performance so much that I didn’t really want to play. After smoking, ironically, I could play worse and yet it didn’t seem to be as big of a deal. The high puts me into an excited state that makes me less self-conscious. It gets me through the awkward opening phase of a party. But it also leads to varying degrees of stupidity, paranoia and lethargy. And it can lead to stressing out about smoking itself, if and when to smoke, and about my lifestyle choices. Confusion over whether it’s helping or hurting is probably adding to my stress.
The marijuana plant and anxiety—social anxiety in particular—have a complicated and often paradoxical relationship. Social anxiety disorder (SAD) is defined by the Anxiety and Depression Association of America as “intense anxiety or fear of being judged, negatively evaluated, or rejected in a social or performance situation.” People with social anxiety disorder may worry about acting or appearing visibly anxious (e.g., blushing, stumbling over words), or being viewed as stupid, awkward, or boring.” SAD is one of the most commonly cited health reasons for which people say they smoke marijuana. But according to a 2017 report from University of Washington’s Alcohol and Drug Abuse Institute, anxiety is also one of the most common side effects of marijuana use. THC, the active ingredient, can reduce anxiety at low doses but tends to increase anxiety at high doses.
Due to marijuana’s range and potency, its effects are difficult to generalize or predict. One major issue? There are more than 100 cannabinoids in the average leaf. Says Dr. Susan Stoner, primary author of the above report: “We don’t even know what cannabinoids and other compounds in the cannabis plant are psychoactive.” These compounds, like terpenes, can lead to an “entourage effect” that complicates things further. Stoner notes that “even if you buy the same strain from the same source, the cannabinoid content can vary widely.”
Vice magazine interviewed several scholarly researchers in 2018 who agreed that nothing had been scientifically confirmed on marijuana and anxiety, and more research is needed. As someone familiar with the academic literature, Stoner still hasn’t come across any randomized controlled trials that show sustained benefits of cannabis in the treatment of anxiety disorders. Personally, I certainly have not felt “sustained benefits” after years of use, and instead feel anxious about what smoking pot for so long has wrought on my innards. But in the short term, Stoner says, successful management of symptoms can give users the illusion of having found a cure.
SAD is the anxiety disorder most associated with the development of a cannabis use disorder, according to Stoner’s report. She has a theory on the interplay of weed’s heady effects and sociocultural settings: “The social relaxation that comes from the combined effects of the drug itself, the trust that people share when they use it together, and the sense that use is normative can create powerful associations between marijuana and social anxiety reduction.” This seems like a logical hypothesis about why pot smokers claim weed helps with social anxiety. I would know: It sounds like me twenty-odd years ago, taking bong hits at my fraternity house if for no other reason than everyone else seemed to want to. And they seemed to want me to join them. Smoking pot was simply a social act, an event in itself that often had no other performance-enhancing or social-anxiety-reducing purpose. The only benefit it had, in my view at the time, was the potential to initiate or build friendships. In college, smoking weed permeated the culture. I went to a big state school in southeast Ohio, which has the best growing conditions in the state. I even sold drugs (I couldn’t afford to do them otherwise) in what I would later understand as a desperate attempt to feel less inhibited and more accepted.
Whether marijuana reduces, masks or prolongs SAD is a question intertwined with so many other questions, not only on the scientific level but also on the personal level. I have journals from junior high through my mid-twenties showing that I’ve always had a bit of social insecurity and probably full-fledged social anxiety disorder. I can feel residual anxiety when I read them. I wanted to hang with the popular kids, but I was an introvert, a “writer.” I knew too well that I lacked a quick wit. I was tongue-tied with girls. And then there were the times I couldn’t get it up sexually. I chronicled both my fear of rejection and my performance anxiety.
In my twenties, after a move to New York City to work in magazines, it was cocaine and ecstasy that allowed me to fit in and feel more socially confident, while weed was an afterthought. This fit with the new culture: Working long hours in the celebrity gossip trade and going to drug-den dance clubs like Twilo and Tunnel till dawn. Yes, I romanticized and imitated Bright Lights Big City and Bret Easton Ellis books.
For more than a decade, I did a lot of harmful drugs and drank too much because this made it easier for me—for both self-esteem and social reasons—to fit in. (It’s important to mention that my white middle-class privilege kept the consequences of this to a minimum.) But by my mid-thirties, I had a wife, a decent career and was working on a master’s degree. Hangovers were no longer tolerable—I had dropped the hard liquor and hard drugs. Weed was healthier and cheaper, and my dealers had gotten much more sophisticated, offering a wider array of THC-filled items and shooting me special offers over text. I now smoke alone mostly, it would seem, to enhance my performance. Not to fit in, per se, but to feel more chatty, and as a result more interesting and less insecure.
With more than a decade of learning how high-quality marijuana affects me, and now with the benefit of spreading legalization and cultural acceptance, I justify my habit with little difficulty. I consider myself a mature, discerning and generally high-functioning marijuana user, who only spends about $100 a month, and who, by the way, no longer gets drunk. I’m a “hands-on” dad with a full-time job and a side hustle who loves spending time with his two objectively cute toddlers—sometimes while high. I know my strains and dosages, and I feel like marijuana makes a hectic or stressful life, as well as more mundane tasks, more manageable.
Still I have a sneaking suspicion that getting high, for all the good I tell myself it does, is not really some social-anxiety salve. First of all, there are the awkward social scenarios—overdoing it can make you a bit stupid. I have trouble remembering people’s names and occupations when I see them again and forget whole conversations. The high makes me garrulous and energized, but it also exacerbates one of my most frustrating paradoxes by making me temporarily desire the same kind of social life that has always left me unsatisfied. It can exaggerate FOMO and the loathing I can feel for my introverted leanings. But a bigger concern has been the comedown, which often leads to mild paranoia, overthinking and lethargy—problems real and imagined can start to loom larger. Instead of making me more careless or more risk-prone with my daughters, as one might assume, it has been the opposite. I was sometimes too scared or hesitant to take them to the playground on my own, a fear maybe backed up with a little laziness. Then I would ruminate on being a bad father and not being more productive—and feel anxious.
Is weed really reducing or exacerbating my overall anxiety? The answer is, of course, both. Dr. Stoner broke it down for me in a simple way: “When considering whether a drug helps a condition, it’s important to keep in mind whether we are talking about symptom management or cure and understand the natural course of the condition without any treatment” [Emphasis mine]. Does the drug eradicate the malady or inadvertently prolong it? According to Dr. Stoner, anti-anxiety drugs, including cannabis, can be very effective at symptom management. “They often enable a person to decrease or stop avoidance of feared situations.” However, users are likely to become reliant on the drug to deal with anxiety-provoking situations, which can lead to the problem of “developing anxiety about not having the drug, in which case the reliance on the drug becomes a psychological dependence, and can develop further into a substance use disorder.” She asks me to consider: Having relied on marijuana to cope with social situations, are you more anxious about facing social situations without marijuana than you were about facing social situations before you started using marijuana?
Indeed, there is a better way to treat social anxiety—one that can lead to cessation of the disorder, which Dr. Stoner defines as a self-perpetuating condition. “When people have social anxiety, they avoid social situations, so they miss out on opportunities to develop comfort and competence in those situations.” The best way to cure social anxiety, as with all anxiety, is “exposure to the feared situations or stimuli and the development of a sense of mastery.”
The general takeaway is that marijuana is a risky anti-anxiety drug. And so considering her statements and imparted knowledge, it’s clear that weed is not helping me to “develop any sense of self-efficacy for feeling comfortable in future social situations without using marijuana.” It is not leading to a cure. I am using the plant as a crutch with no real plans to stop.
Thus the question I should be asking is, Am I ready to do the practice of reducing my social anxiety—possibly a combo of therapies, maybe meds, and cutting way back on smoking—and to develop the necessary skills, or do I want to manage the symptoms of my (self-diagnosed) social anxiety and continue to be dependent on marijuana?
While I ponder that, there is something that could potentially help with anxiety, and assist me in cutting back on marijuana by giving me a healthier habitual ritual. What Dr. Stoner is excited about is the scientific progress of cannabidiol or CBD, often rendered as an oil. Stoner notes that cannabis and related compounds are garnering more research interest, both in academic and industry settings, and there are some “intriguing findings.” By “intriguing findings,” she means the continued good news about CBD, which she says has been proven to help with anxiety. She points to this paper, which concludes: “Cannabidiol may hold benefit for anxiety-related disorders. Controlled clinical studies are needed.” She also notes a small randomized controlled trial of CBD in Japanese teenagers with social anxiety disorder that showed a benefit.
The only problem with CBD for me, is that it doesn’t get you high.
This site is for educational purposes and not a substitute for professional medical care by a doctor or otherwise qualified medical professional. The information provided by Outlier Magazine is on the understanding that it does not constitute medical or other professional advice or services.