Category: Education

June is Men’s Health Month. A time for acknowledging that men’s health issues are often overlooked and encouraging society to destigmatize men seeking help for mental health conditions.

 

Although no individual is free from exposure to stress, a published study showed that hormonal differences may alter how individuals manage stress. When stressed, hormones cortisol and epinephrine are released into the bloodstream. These are responsible for elevating blood pressure, blood sugar levels, and decreasing the effectiveness of the immune system. Oxytocin is another released hormone, which promotes nurturing and relaxing emotions. The study showed that women may release higher levels of oxytocin, therefore they are more likely to nurture themselves when under stress. Men, however, produced lower levels of oxytocin, which may result in suppressing stress or seeking avenues to escape the problem altogether. 

 

Hormonal results of stress may lead to chronic health problems, especially when early symptoms are ignored and not enough emphasis is placed on managing the contributing factors to stress. While acute stress may improve functioning and immune health, chronic or repeated stress can lead to exacerbating mental illnesses and/or suppressing the immune response to bacterial and viral infections, vaccinations, and cancer. 

 

Finding stress-relieving activities may be beneficial. However, lifestyle changes that promote uninterrupted sleep, healthy eating and digestion as well as reduce pain, anxiety, and depression may be keys to preventing chronic stress and the ailments that follow. 

 

The endocannabinoid system (ECS) is a key regulator of stress response, critical to assist our bodies in returning to a non-stressed state. The ECS limits the magnitude of the stress response, helps to return the HPA axis to non-stressed levels, and facilitates habituation of the stress response where repeated or ongoing.The interaction of plant-based cannabinoids and our ECS makes cannabis a likely candidate for alleviating the symptoms of many health conditions, to include stress. In fact, cannabis has been used medicinally for thousands of years in various societies around the world to reduce the physiological and psychological consequences of stress and fear. 

 

Cannabidiol (CBD) and Stress

 

The first clinical evidence that CBD reduces the stress response was from the studies of CBD’s ability to reduce the adverse effects of THC in healthy volunteers. 

 

In 2021, a study reviewed eight clinical trials (seven controlled and one partially controlled) of CBD for stress. The eight trials had a combined total of 352 participants. All showed that CBD was highly effective in significantly reducing the stress response and was non-inferior to pharmaceuticals, when used for comparison. 

 

CBD works with cannabinoid and non-cannabinoid receptors. For example, even at low doses, CBD has been shown to block stress-induced changes in the 5-HT1A receptor gene expression that reduced anxiety associated with the stress-response. 

 

CBD, as well as additional cannabinoids, may be a large influence to major hormones that may affect our stress levels, including epinephrine and cortisol. 

 

Epinephrine

 

Epinephrine, also known as adrenaline, is released during periods of sudden or chronic stress that leads to “fight or flight” actions. While epinephrine is important for sending more blood to our brain and muscles, making us more alert and providing energy, too much can put us at risk for anxiety, depression, and heart complications. Therefore, finding ways to naturally control the overproduction of epinephrine is essential. 

 

In 2001, researchers sought to understand the effects of cannabinoids on adrenaline secretion. It is well known that cannabinoids may promote cardiovascular homeostasis, so they carried out a study with rabbits to look more closely at how and why. It was found that due to the interaction of cannabinoids with the CB1 receptor, the cannabinoids used were able to lower the electrically evoked adrenaline release in the adrenal glands of the rabbits. 

 

While this study did not look at commercially available products for adrenaline control, findings were important to support involvement of specific cannabinoid receptors in the decrease in plasma adrenaline concentration.

 

Cortisol

 

Along with releasing epinephrine during times of stress, cortisol also releases from the adrenal glands to keep us on high alert, further contributing to “fight or flight”. Cortisol also triggers the release of glucose from the liver for increased energy. While research on CBD and cortisol is its infancy, there have been several clinical trials and one partially controlled trial looking at CBD for stress. All showed that CBD was effective in significantly reducing the stress response and comparable to pharmaceuticals where included. 

 

Not only may CBD be helpful in reducing stress-associated anxiety, but it may normalize abnormal stress responses. One study, looking to understand the effects of CBD on participants at high risk of developing psychosis who are found to have decreased levels of cortisol as a stress-response. The CBD treatment adjusted the abnormal cortisol response as well as reduced stress-associated increase in anxiety. 

 

Frontline healthcare workers were looked to in the height of the COVID-19 pandemic to investigate the safety and efficacy of CBD therapy in reducing emotional exhaustion and burnout. By day 14 of treatment, emotional exhaustion and symptoms of burnout were significantly reduced among the majority.

 

Studies confirm that a misalignment of the sleep-wake cycle has a negative impact on the stress system. There are a few discrepancies in studies when it comes to the relationship of sleep and cortisol, however unbalanced cortisol levels have been observed in individuals with obstructive sleep apnea (OSA) and many studies have shown increase in cortisol levels throughout a night of sleep deprivation and in the prolonged wakefulness of the following day.

 

Cannabis and Sleep

 

Needless to say, along with stress comes disrupted sleep. Cannabis Sativa is often used for improved sleep and relaxation, attributed to Indian hemp in the nineteenth century. 

 

For starters, hemp seeds contain a vitamin B6 content that can trigger the conversion of our body’s tryptophan into serotonin, which can then be converted to melatonin. 

 

CBD has been researched for its therapeutic potential for sleep disorders through limiting symptoms that may keep us awake at night but also may contribute to an increase in sleep duration and depth, as well as decrease in the anxiety responses induced by sleep disturbance. 

 

In comparison to CBD, delta-9-tetrahydrocannabinol (THC) has shown in studies as having an effect on mental and physical sedation, even in low amounts. THC also has positive therapeutic benefits that may lead to better sleep.

 

Cannabinoids CBD, THC, and cannabinol (CBN) have been lightly studied for their effects in balancing melatonin production. Cannabinoids are also being studied to better understand the complementary relationship they have with melatonin. Data published in 2022 suggest that a CBD-melatonin formula could be competitive with synthetic-hypnotic drugs (i.e. Ambien, Unisom). The antioxidant activity of melatonin that benefits the brain network coupled with the pain reduction and anti-anxiety effects of CBD promoted a balanced sensation of wellbeing during sleep. 

 

Overall, Assessed data from a 2020 published observational study looking at various quality of life measures showed that adult cannabis users had greater sleep quality, shorter sleep latency, longer sleep duration, fewer sleep disturbances, and a significantly better sleep score compared with the control group.

 

Finding Support for Cannabinoid Therapy

 

As with any therapy, effective dosing varies widely by individual and condition. When looking to cannabis for medical conditions, we always recommend speaking with a healthcare professional. However, if you are in need of support while on your journey, the care team at Realm of Caring is here to help! Send an email to info@realmofcaring.org, call at 719-347-5400 or chat at realmcaring.org.

Cannabidiol (CBD) has been researched for its benefits across multiple conditions. Some may choose to take it for general wellness while others depend on it for the ability to live a life of quality. While it has become federally legal in recent years, there is still uncertainty when it comes to where and how you can take your therapy with you when traveling. If you are considering flying this summer (or anytime in the near future) below are where you may safely travel with your CBD and where you might be better off leaving it at home. 

 

Background knowledge before we begin: What’s the difference between full spectrum, broad spectrum, and isolate?

 

Full spectrum: Full spectrum considers the whole plant when it comes to CBD. When processing, nothing is deliberately removed to include cannabinoids, terpenes, flavonoids, or any other active compounds that naturally occur in the plant. This means that THC may be found in trace amounts, which may offer additional therapeutic benefits but is non-intoxicating. 

 

Broad spectrum: In a broad spectrum product, all of the naturally occurring compounds of the plant are included with the exception of THC, which is removed in the extraction process. While the idea is to remove all traces of THC, there is always the possibility that some may be in the finished product. You might think of a broad spectrum like decaf coffee, where trace amounts of caffeine may still be present.  

 

Isolate: A CBD isolate will only contain the CBD compound from the plant. 

 

In tincture or oil form, all three CBD types will have a carrier oil such as MCT, Coconut, Olive, or Macadamia Nut.

 

Flying from state to state

 

When traveling state to state, only CBD products that fit the 2018 Farm bill definition of containing no more than 0.3 percent THC on a dry weight basis, are legally able to go through security at the airport. This can be in either a checked or carry-on bag. There should not be a cause for concern when flying within the United States with any of the three variations of CBD listed above. 

 

Per the TSA’s website, TSA security officers do not search for “marijuana or other illegal drugs, but if any illegal substance is discovered during security screening, TSA will refer the matter to a law enforcement officer”. 

 

If you decide to leave your CBD at home and purchase it once you are at your destination (or run out while away from home), be aware that although legal at the federal level, CBD laws may be more restrictive in specific states. Some states may require an age verification of 21+ to purchase CBD products while others may prohibit the sale of full-spectrum CBD completely. Before you travel, it might be helpful to check in advance so you can be sure you won’t run out while on the road. 

 

Flying from country to country

 

Flying internationally gets a bit more tricky, as laws for definitions of hemp/CBD and THC allowances will vary from country to country. The rule of thumb is to be as cautious as possible and if you are unclear as to whether or not it will be legal in the country you are flying to, it may be best to leave it at home. 

 

The bottom line

 

Laws and regulations surrounding CBD and cannabis are not only varied but change quickly. It is important to research the latest restrictions before you travel. It is also important to ensure the product you are currently using, or intend to use, are following appropriate regulations. If you have any questions about the quality or safety of your product, a Realm of Caring Care Specialist is here to help. Reach out by emailing info@realmofcaring.org, calling 1-888-210-3772, or scheduling an appointment. 

A lack of motivation can happen to anyone, in fact most people will experience it in one way or another in their lifetime. While a lack of motivation may be common, understanding the underlying causes and solutions for coping are not as commonly discussed. 

 

Choosing Therapy lists the ten potential reasons for a lack of motivation as the result of:

 

• A stress-related condition, such as adjustment disorder
• Chronic stresses that one cannot escape (toxic stress)
• Feeling overwhelmed
• Lacking activities that one enjoys
• Putting the care of others before yourself
• Burn out
• Inflexibility 
• Life-changing events such as death or the loss of a relationship
• Anxiety or self-doubt in reaching a goal 
• Depression or depressive episode

 

Avolition is defined as a lack of interest or engagement in goal-directed behavior. It is often an associated symptom of schizophrenia. Researchers continue to understand how motivation affects adults and investigate beneficial interventions. What has been found to date is that lack of motivation is greater among those with unmet needs regarding daytime activities, psychotic symptoms, behavioral problems, and addiction problems. 

 

There is a common belief that increased cannabis use leads to a lack of motivation. However few studies have come to this conclusion, especially where individuals are dosing their cannabis therapeutically to alleviate symptoms across a myriad of disorders. 

 

Researchers in 2006 found that daily cannabis users did not differ in their level of global motivation compared to those who abstained. In 2016 researchers found that lower self-efficacy over time predicted higher cannabis use, however the study did not observe the opposite direction to understand if higher cannabis use led to lower self-efficacy. A 2018 published study observed college students using cannabis to test the amotivational syndrome. They found that cannabis use lowered initiative and persistence scores but raised effort scores. While understanding how general self-efficacy may be impacted by cannabis use is important, researchers noted that it is not specific to a target behavior and further research is needed.  

 

In 2022, a study was published to understand more about the association between cannabis use and amotivation, given past mixed findings and lack of specific reward sub-processes. Results suggest that cannabis use at a frequency of 3-4 days per week is not associated with apathy, effort-based decision making for reward, reward wanting, or reward liking in adults or adolescents. A qualitative analysis published in 2022 paid close attention to the notable quality of life improvements attributed to medicinal cannabis use. The two overarching categories were “enhanced well-being” and “improved daily functioning”. Enhanced well-being includes feelings such as regaining a sense of hope, enjoying family life, and laughing more often. An adult from the study with Lyme Disease was quoted saying, “People such as myself are able to become productive and valued members of society again when we can have the quality of life improved so simply.” 

 

Despite research to support significant quality of life improvements from therapeutic dosing of cannabis, it is still often stigmatized as the cause for lack of motivation among individuals. For these stigma’s to truly be challenged, we must look to existing scientific research to value the medicinal benefits and place emphasis on the importance of a dose-outcome relationship. 

 

As mentioned above in the top ten potential reasons, a lack of motivation stems from a deeper issue that may be connected to our mental, emotional, and physical well-being. As society moves towards solutions for ailments that are plant-based with reduced side effects and increased efficacy, it is time to change the narrative on cannabis and motivation loss. It may instead serve us better to explore cannabis as a potential benefit to the underlying causes.

 

Cannabis is not a one-size fits all approach, but at Realm of Caring we have a decade of experience helping individuals find success with their therapy across a multitude of conditions. While symptoms such as a lack of motivation may sound minor, it is important to reach out for help if you feel you are beginning to struggle. If you have any questions on how cannabinoid therapy may assist you with your wellness journey, please contact our care team today by calling (719) 347-5400, emailing info@realmofcaring.org, or by scheduling an appointment.

 

Mental Health Awareness Month is recognized throughout the month of May. As the National Alliance on Mental Illness (NAMI) states, “It’s an opportunity for all of us to come together and remember the inherent value we each hold — no matter our diagnosis, appearance, socioeconomic status, background or ability.” Millions of individuals across the globe are affected by a mental illness, and each condition has its own set of symptoms.

 

It is estimated that of mental health conditions, around 29 million Americans will suffer from what is known to be the second most deadliest in their lifetime. More than 10,000 deaths each year in the United States are linked to the direct result of an eating disorder. 

 

There is a lack of effective treatment for eating disorders, such as Anorexia nervosa (AN), bulimia, and binge-eating disorder (BED) however there is extensive evidence that suggests the endocannabinoid system (ECS) plays an essential role in our emotional response to eating as well as the pathophysiology of mental disorders. 

 

Both delta-9-tetrahydrocannabinol (THC) and cannabigerol (CBG) have been looked at for their potential to serve as an appetite stimulant. User anecdotes also suggest that cannabis use will promote appetite. Studies have shown that caloric intake increases among cannabis users when compared with non-users. This leads to the popular belief that cannabis use leads to unintentional weight gain, however many human epidemiological studies show the opposite. As far as appetite is concerned, when provided care and guidance in your approach to dosing, cannabinoids may actually help to promote a healthy weight. 

 

Anorexia nervosa studies

 

A 2013 study observed 25 women with severe, longstanding AN who received 2.5mg of dronabinol twice daily for 4 weeks. A small, but significant weight gain was realized without any significant psychotropic adverse effects. 

 

Taking it a step further, a 2017 study looked at the complex underpinnings of AN, including social, genetic, psychological, and biological predispositions. Among a group of participants receiving low dose THC, their depression rank significantly improved, which had a positive effect on body weight. Participants showed a less restricted attitude towards body feeling and self-esteem, leading to an improved mood. 

 

Recent evidence suggests that exaggerated anxiety and diminished reward or motivation to eat are key roles in triggering AN symptoms. The University of California, San Diego is looking at cannabidiol (CBD) for its potential to reduce anxiety, and to investigate benefits for adults living with AN. Their study to understand CBD’s role in regulating meal time anxiety is currently active. 

 

Cannabinoids as an alternative or complementary therapy

 

When targeting eating disorders with treatment options, Selective serotonin reuptake inhibitors (SSRIs) may be prescribed. This is often counterintuitive as side effects may include short term weight loss or long term weight gain. CBD is more recently being considered as a therapy option for depression and mental illnesses that exhibit symptoms of depression. The serotonergic mechanism of CBD is distinct from commonly used antidepressant medications in that it does not appear to produce symptoms of withdrawal. CBD has also been shown to synergize with other serotonergic medications. Data suggests that CBD could facilitate the antidepressant effect induced by these antidepressant drugs, therefore allowing the SSRIs to be administered at lower doses, resulting in fewer side effects.

 

The importance of a dose-outcome relationship

 

Cannabis is not a one-size fits all approach, and more cannabis does not typically correlate to increased benefit. One-on-one support, taking it slow, and being consistent with your therapy are all key components to finding success. Eating disorders are incredibly complex and more than one therapy may be necessary to alleviate symptoms. Research on cannabis and eating disorders is limited, however if you seek resources for how to talk to your doctor or data-driven answers to your questions about cannabinoid therapy and symptoms of mental health conditions, the Realm of Caring Care Team is here to assist. 

 

At Realm of Caring, we are not medical professionals nor clinically trained to advise one through their mental health illness. However, we care. We are here to help you find resources. We are also here to support you if you are utilizing cannabinoid therapy to bring symptomatic relief, whether that relief is needed psychologically or physically. Those of us who suffer are well aware, mental health illnesses go far beyond affecting mood, physical symptoms may also be witnessed. 

 

Reach the care team by calling (719) 347-5400, emailing info@realmofcaring.org, or by scheduling an appointment.

 

Additional Resources:

 

• Help for Mental Illnesses
• Looking after you Mental Health
• Find a Therapist who specializes in anxiety, depression, OCD, PTSD, and related disorders.
• A step-by-step guide to finding a mental health professional who you feel comfortable working with
• Fitness 4Mind4Body: Diet and Nutrition
• The Exercise Effect
• A Comprehensive List of Digital Resources for Mental Health

 

In 2022 Colorado gathered experts across the state to convene in a task force to study intoxicating hemp products and make legislative and rule recommendations. The task force, of which Realm of Caring was a member of, met over the course of six months, collectively committing to thousands of hours. The final report was submitted to the General Assembly on January 3rd, 2023.

 

Before the bill was introduced to the Senate Finance Committee on April 18th, 2023, those findings and recommendations were dismissed. Over the course of the last three weeks of session, through the Senate and House, amendments were further added going well beyond the scope and intent of the bill.

 

The intoxicating products the task force were intended to discuss were synthetically derived and synthetic cannabinoids available in the market. The focus quickly transferred from those products to non-intoxicating, hemp-derived CBD products that have been available for purchase globally for more than a decade. Instead of focusing on the crux of the issue, which are intoxicating products, the amendments sought to further regulate those that are compliant with safety data to prove that they do not produce adverse effects. These products that are being threatened are utilized for an array of healthcare conditions, offering a life-saving therapy for infants, children, adults, and animals. Sacrificing access to these products is to sacrifice a life.

 

To pass this bill with the amendments would impose age restrictions for a subset of the non-intoxicating products now available. Parents are being put into a situation where in order to give their child their medicine, they must verify their age as 21+ for purchasing. Not at a dispensary in Colorado, but at grocery stores, supplement and vitamin shops, and any other retail location where compliant hemp products were once sold without restriction.

 

There is scientific data available to show that in a CBD to THC ratio product made from hemp, THC levels are non-intoxicating up to 3.7mg per serving. Amendments set forth bring that serving limit down to 1.25mg per serving. The task force gathered to make legislative and rule recommendations based in science, which they did. This new serving limit of 1.25mg is arbitrary, not based in science, and will quickly cause Colorado to lose status as a leader in the hemp industry.

 

The rhetoric and reasoning behind these amendments are based in fear from a lengthy war on drugs as well as greed from the marijuana industry. Special interest groups took advantage of the opportunity to regulate intoxicating products with an attempt to instead regulate non-intoxicating products.

 

We cannot risk access to the most vulnerable across our state and nation who purchase from Colorado manufacturers. We have fought too long and too hard to be right back where we were a decade ago. The only difference between then and where we are today, is that we now have a decade of data from our own constituents to support that these products are safe and non-intoxicating.

 

At Realm of Caring, we support a veto to SB23-271. There is still a concern regarding intoxicating, synthetic and synthetically derived products and this bill does not solve that. A veto here would allow stakeholders to come back next year with reasonable solutions that do not impact access to quality and compliant hemp products.

 

For additional viewpoints on the process and outcomes of SB23-271, check out the following resources:

 

Commentary: Is Full Spectrum Hemp a Thing of the Past in Colorado?

 

Colorado Intoxicating Cannabinoid Legislation Threatens an Industry, Fails to Protect Patients and Endangers America’s Children

 

Hemp Rising Podcast

 

There is considerable evidence to suggest that the endocannabinoid system (ECS) is involved in the pathophysiology of depression. 

 

Endocannabinoids and CB1 receptors are widely distributed in the brain areas that are often related to mood disorders and their expression is regulated by antidepressants. Enhancement of endocannabinoid activity at various receptor sites appears to exert antidepressant-like effects. The 5-HT1A receptor is a serotonin receptor that is located in presynaptic and postsynaptic regions. Activating these receptors have been involved in the mechanism of action of anti-anxiety, antidepressant, and antipsychotic medications. 

 

Research has just begun to take place to understand if the ability of cannabis to regulate these receptors, support that cannabinoids, such as cannabidiol (CBD) can have anti-anxiety, antidepressant, and antipsychotic effects.

 

Notable quality of life improvements with CBD

 

Data indicate that repeated administration of CBD may produce an effect that is consistent with results from studies testing traditional anti-anxiety and antidepressant medications. These are known to be clinically relevant findings as CBD is known to benefit while exhibiting few side effects, supporting the initiation of clinical trials testing the efficacy of CBD-based compounds for the treatment of mood disorders. 

 

The serotonergic mechanism of CBD is distinct from commonly used antidepressant medications in that it does not appear to produce symptoms of withdrawal. CBD has also been shown to synergize with other serotonergic medications. Data suggests that CBD could facilitate the antidepressant effect induced by these antidepressant drugs, therefore allowing the SSRIs to be administered at lower doses, resulting in fewer side effects. 

 

In a recently published observational study, it was found that medicinal cannabis use was associated with lower self-reported depression. Initiation of medicinal cannabis during the follow-up period was associated with significantly decreased anxiety and depressive symptoms, an effect that was not observed in Controls who had not initiated cannabis use. 

 

A qualitative analysis published in 2022 paid close attention to the notable quality of life improvements attributed to medicinal cannabis use. The two overarching categories were “enhanced well-being” and “improved daily functioning”. Enhanced well-being includes feelings such as regaining a sense of hope, enjoying family life, and laughing more often. A woman from the study with Lyme Disease was quoted saying, “People such as myself are able to become productive and valued members of society again when we can have the quality of life improved so simply.” 

 

Benefits reported through RoC research

 

The goal of the third published paper by Realm of Caring (RoC) was to provide insight into the effects of medicinal cannabis use for symptoms of anxiety and depression.

 

​​The participants involved were those who were at least 18 years old and reported having anxiety and/or depression without a specific endorsement, as well as specific endorsements, including: major depressive disorder, postpartum depression, dysthymia, premenstrual dysphoric disorder, seasonal affective disorder, generalized anxiety disorder, panic disorder, social anxiety disorder, and agoraphobia. 

 

Of the 538 participants, 368 reported current use of medicinal cannabis products at the baseline. The other 170 participants, who were considering use but had not yet initiated, served as controls. Of the participants who completed the baseline survey, 211 completed at least one follow-up assessment (145 Cannabis Users and 66 Controls). 

 

Cannabis Users reported lower baseline depression, significantly better past-month sleep quality, a higher overall quality of life, and lower past-month average pain compared to Controls.

 

Cannabis Users did not report lower baseline anxiety, however baseline Controls who had initiated cannabis use reported a significant reduction in both mean anxiety and depression scores from baseline to follow-up surveys [evaluated using the Hospital Anxiety and Depression Scale (HADS)]. This observation was not realized among non-initiators throughout the study. A similar effect was observed among participants who sustained medicinal cannabis use throughout the study, suggesting an improvement in symptoms of anxiety and depression with both the onset of cannabis use and with extended use.

 

Limiting stress to limit depression

 

Depression itself is considered a chronic stressor, as too much stress may lead to major depression. CBD has shown to reduce the cardiovascular response to models of stress. Stress can spike blood pressure, heart rate, and stroke volume. In studies done with healthy volunteers exposed to stress; it has been found that CBD may maintain cardiac output by lowering blood pressure, increasing heart rate, and decreasing stroke volume – which are inversely related actions to balance that cardiac output.

 

Call for future research and finding support

 

Though antidepressant effects of CBD are consistently reported in preclinical observations, further studies are necessary to confirm best dosing practices to achieve antidepressant effects.

 

Getting started with cannabinoid therapy can be overwhelming. If you are seeking data-driven answers to your questions about cannabinoid therapy and depression, the RoC Care Team is here to assist. They care a lot about helping you to find success. Reach them by calling (719) 347-5400, emailing info@realmofcaring.org, or by scheduling an appointment.