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Why More College Students Are Calming Anxiety With Medical Cannabis

July 24, 2018
Brianna is a model of academic excellence. Not only is she about to graduate from college, she’s already working for a women-owned engineering firm. She’s outgoing and social, and comes from a close-knit family. Despite what appears to be a charmed life, though, Brianna was recently diagnosed with anxiety disorder, and prescribed an antidepressant.

The medication is helping, she says, “but not nearly as much as cannabis and CBD. Indica to accept the things I cannot change, sativa to change the things I cannot accept.”

1 in 4 college students take antidepressants, but students who use medical cannabis often report that their clinicians disapprove.

Sarah, a 25-year-old nursing student and mother of two, finds herself in a similar situation. She’s currently transitioning from a selective serotonin reuptake inhibitor (SSRI) to CBD to treat her anxiety. Cannabis, she says, “calms me down and helps me get through most of my day without having a breakdown. I have several panic attacks daily if I don’t use [it].” When she does, she reports, “I might only have one a day.”

In my work as a mental-health speaker, I primarily give presentations at colleges and universities. I always ask my audiences which mental illnesses are most prevalent among themselves and their peers. Overwhelmingly, their answer is anxiety.

A New Openness on Campus

The National Alliance on Mental Illness (NAMI) reports that one in four young adults between the ages of 18 and 24 have a diagnosable mental health disorder, with anxiety and depression being the most common.

Students now speak much more openly about their mental-health issues than they did when I was in college in the 1990s. Back then, I was afraid someone I knew would see me going into the university psych center. I scheduled my appointments for as late in the afternoon as possible so there would be fewer students on campus.

Today, clinicians at college counseling centers tell me they’re overwhelmed with students seeking help. And yet a certain amount of stigma still remains. In this article, for example, I’m not using the last names of a number of patients in order to protect their identities. That probably wouldn’t be the case were they suffering from, say, a common physical disorder.

According to the American Psychological Association, 25 percent of college students take psychiatric medications such as antidepressants and mood stabilizers—but students who use medical cannabis often report that their clinicians disapprove.


The best cannabis strains for anxiety

Physicians Don’t Want to Discuss It

Physicians and therapists tend to be averse to any discussion of medical cannabis. They may have reasons based in law (cannabis remains a federally illegal substance), or in their own self interest (those who have a DEA license to prescribe drugs don’t want to put it at risk). Most are aware of the studies that indicate young people with a family history of schizophrenia may be at greater risk of experiencing a psychotic break triggered by cannabis.

But that resistance to discussing the use of medical cannabis is itself a problem.

'My therapist is highly against smoking marijuana. She says that it contributes to my problems, but she has no idea how much I used to suffer before.'
Lindy, art student

It causes some students to drop out of therapy, or to avoid seeking it in the first place. Avoidance comes at great cost: Chadron State College in Nebraska reports that 64 percent of American students who drop out of college do so because of declining mental health. The most common diagnoses among those who drop out are depression, bipolar disorder, and PTSD.

Art student Lindy suffers from the latter, but she’s one of the fortunate ones. She’s still in school, and she credits cannabis for her ability to stay there. Lindy has a diagnosis of borderline personality disorder, and has tried psychotropic medication to help with her symptoms. The negative side effects, however, made them extremely difficult to take. “The last meds that were prescribed to me caused permanent nerve damage to my foot,” she told me. Lindy’s therapist, she says, is “highly against smoking marijuana; she says that it contributes to my problems, but she has no idea how much I used to suffer before.”

Stigma, Not Cannabis, Is the Problem

As more states legalize the medical use of cannabis, and some allow the regulated use of adult-use marijuana, the attitude among some mental health clinicians is finally starting to change. Some are beginning to embrace cannabis use because they recognize that the stigma may be inhibiting access to effective treatment.

Barbara Blaser is a registered psychiatric nurse who worked for the Illinois Department of Mental Health and Developmental Disabilities for 30 years before moving to the Bay Area to be closer to her family. Her daughter, Debby Goldsberry, is the executive director of Magnolia Wellness in Oakland, one of the city’s foundational cannabis dispensaries.

When Blaser suffered a serious illness in 2014, Goldsberry convinced her to try cannabis. After experiencing for herself the relief it can bring, she began working at Magnolia herself. Today she’s the company’s Director of Clinical Services, a role that enables her to counsel patients seeking medical marijuana. “I believe that cannabis offers hope for people living with a mental illness,” she says. “I think, in particular, people with anxiety disorders can be helped.”

Mental Health Team Medicine

When patients walk into Magnolia seeking cannabis for mental-health issues, Blaser first refers them back to their mental health treatment team to get a HIPPA waiver, which allows her to talk to their providers. “I am comfortable working with a patient who wants to wean off Trazodone,” an antidepressant often used to treat sleeplessness, “but if they have been on a treatment regime, I want their team involved,” she says. “Mental health treatment is more than just medication.” Blaser can’t recommend specific strains for specific diagnoses without putting her license at risk, but she can suggest strains known to help relieve certain symptoms.

One student turns to Lemon Haze during panic attacks. 'It allows me to slow down the spiraling thought process, come into focus with the issue, and address it in a more strategic way.'

Indeed, the students I interviewed who lived in legal states had strong strain preferences. Those who suffered from depression preferred sativas, while those with anxiety preferred indicas (but frequently used sativas during the day).

Brianna, who’s transitioning off her SSRI antidepressant under medical supervision, relies on Lemon Haze during panic and anxiety attacks. “It allows me to slow down the spiraling thought process, come into focus with the issue, and address it in a more strategic way.”

DJ, an education major who lives in a legal state, discontinued traditional psych meds when they didn’t adequately treat his symptoms. “Cannabis has played a huge role in treating both my depression and anxiety,” he says. DJ reports that San Fernando Valley OG, NYC Diesel, and Blue Dream are among the strains that provide the most relief. Purple strains, such as Purple Kush and Purple Urkel, don’t work well for him.

Greater Success in Legal States

The students who lived in legal states reported more successful symptom relief, due largely to the ability to choose their strains. Sarah, the nursing student, lives in a state in which cannabis is still illegal, but says her obstetrician suggested it when she could no longer take Xanax to treat her anxiety during pregnancy. “I can’t weigh in on strains, because in an illegal state, you never know what you really get,” she says. “But when I’ve been able to know the strain I was smoking, I did prefer sativas. I felt they helped calm me more than just get me high.”

While the students I interviewed unanimously reported anxiety and depression relief, some research indicates that cannabis may exacerbate the symptoms of psychotic disorders such as schizophrenia and schizoaffective disorder.

Cannabis medicine works in part because it fosters community, both directly and indirectly.

Because first-episode schizophrenia often occurs during the college years—NAMI reports that the average age of onset is 18 in men, and 25 in women—it is crucial that students with psychotic disorders, or a family history of psychotic disorders, disclose this information when seeking medical marijuana recommendations.

More recent research has provided more depth and complexity to the schizophrenia question. A 2018 study published in the American Journal of Psychiatry found that patients given CBD-only cannabis medicine reported lower levels of positive psychotic symptoms, such as hallucinations, delusions, and racing thoughts.


The 10 best CBD cannabis strains according to Leafly users

No Judgment, Just Talk

No matter their diagnosis or symptoms, college students in legal states may find relief in the community services dispensaries offer, regardless of whether they ultimately choose to use cannabis. “I think for some, just knowing that someone like me is available to have a cup of coffee with is welcome,” says Blaser. “We can talk. No judgment. You don’t have to buy anything. We can talk stigma, hygiene, hunger, sleep issues—sometimes that [support] is a missing piece of their lives.”

The importance of community support for those with mental health disorders is the most profound lesson I’ve learned in my seven years of speaking and listening to college students. No psychiatric medication alleviates symptoms in a void. Connection with one’s peers is vital, especially when those peers struggle with the same issues.

Cannabis medicine works in part because it fosters community, both directly and indirectly. Smoking a joint is more enjoyable when you have someone to share it with, but sometimes medicating alone allows you to leave the house and participate in social events. Cannabis can help students with anxiety and depression make the friends who will ultimately keep them alive.

Gaining a Sense of Mastery

To his peers who want to try medical cannabis, DJ offers the best advice: “Cannabis is able to help get symptoms under control without the slew of negative side effects of other meds, but must be treated like medicine. Becoming a burnout is not going to help you feel better, or advance…the repeal of federal prohibition. Know your limit, and only use what you need to get through each situation.”

This is what recovery from mental illness looks like: getting through each situation, one situation at a time, until you build what Marsha Linehan, the creator of Dialectical Behavior Therapy (which, incidentally, saved my life), calls “a sense of mastery.”

For those of us who live with mental illness, the ultimate proof of a drug’s efficacy is that it allows us to live with mental illness. If a medication helps keep you from killing yourself, it’s effective. When therapists who work with college students validate their patients’ use of cannabis as a legitimate medication, they increase the likelihood those patients will return for more sessions. The more students seek help, the more they decrease stigma in their communities.

And the more we reduce stigma, the more people stay alive.

Stacy Pershall's Bio Image

Stacy Pershall

Stacy Pershall is the author of "Loud in the House of Myself: Memoir of a Strange Girl." Based in New York, she is a public speaker and mental health advocate for college-age students.

View Stacy Pershall's articles

  • massman

    Question the medical community continuously. They’ve been brainwashed. Big Pharma has taken over. Cannabis is a safe effective way to replace their poison.

  • Nice article. Thank you. A few points:

    1) Many physicians are perfectly happy to and capable of addressing this. Find ones who will.

    2) There are several studies that show that college student recreational users do more poorly in school. Cannabis probably shouldn’t be first line treatment for anxiety or depression. In patients which ongoing or poorly controlled symptoms, cannabis can be very helpful. This should not be done on your own. Find a doc who can help.

    3) The differences between strains, and the whole Indica v. Sativa thing is being shown to be fictitious. Low dose cannabis can be helpful the rest of that trope is marketing hype.

    4) Avoid cannabis use during the day – low dose at night is entirely sufficient to be helpful for anxiety and depression.

    5) As mentioned above, there is mounting good evidence that cannabis can be helpful in low dose, but that in higher doses can be counterproductive.

    6) Any clinicians who doesn’t give you information on exactly what to take, when, and how, and inform you of side effects and risks, is committing malpractice.

    • Open Minds

      You made some good points except for the “The differences between strains, and the whole Indica v. Sativa thing is being shown to be fictitious”. The difference between strains is not fictitious. The terpenes of each strain do have an effect. Here is a link to a study done by John McPartland and Ethan Russo. Go to page 7 to read about terpene effects on the body.

      • You are correct, Jordan. There is difference in the terpenes and anyone who has every used cannabis medically will tell you there is a difference between indica and sativa. The word on the street I hear is indica is In The Couch and Sativa is Wake and Bake. In other words, the sativa does not give you the deadened feeling that can come with indica. I treat many people who admit to using it.

      • 360dunk

        I agree and the doctor above probably knows very little about the ‘entourage effect’ of using the entire plant.

    • Scooter Bell

      Good point Dr. Tishler. I think your points on 4 and 5 could be viewed in the same light as alcohol usage. Your physical reaction, your job and or your usage all contribute. So having one hit at lunch might be okay for one person, but not another( same with one beer at lunch ). On item #2, I can relate, having needed help before; I think it’s important to have both medicinal use(cannabis) and counseling(psychologist/psychiatrist).

    • 360dunk

      What is your source to claim recreational users ‘do more poorly’ and that higher doses can be counterproductive? Is this just speculation? Because it all sounds so generalized. In other words, where exactly does a dose level become ‘higher’? As for your last point, thanks to the federal government’s continual rating of marijuana as a Schedule I drug, most physicians don’t have any idea how to explain or prescribe cannabis. They’ve been too programmed to prescribe synthetic painkillers all these years. Reminds me of the ADA, where dentists were told for decades that mercury makes for a good filling.

    • OV

      I was apprehensive at first due to the “stigma” of the government control. Thanks to States Rights, and getting over it, I moved forward. I found that whatever “pain” I was experiencing subsided.

      Soon, I learned how to create my own muffin mix with Canna oil.


      1 box or package of muffin/bread mix
      Replace regular cooking oil with canna oil

      Follow the directions for making muffins

      I started using the Boxed Bread/muffin mix from Trader Joes and I have also used Red Baron muffin mix. Next, I will try a couple of mixes from Big Lots. It’s fun experimenting and It’s far more economical than buying the edibles ready made.

      1 box mix = 18 muffins

      1 dose each evening before bed = 1/2 muffin

      Testimony: Anxiety under control or gone using the muffin dose nightly with a sprinkling of Mindfulness during the day.

  • Jay

    Being able to choose between strains gives users a better chance to find the right strains for different conditions. A strain that works for chronic back pain for me will not have the same affect for someone else…I use a Sativa for during the day to keep me alert and thinking (i.e. I was stoned while doing a City and Guilds in electrical installation and came away with 2 distinctions.) and an Indica for sleep. So the differences in strains is vital…cannabis used correctly is almost a cure all and that’s what big pharma is scared about.

  • Bramael gnome

    I have beef with the dr’s claim in point 3 or anyone’s that dismisses the obvious difference in sativa vs Indica then mentions it to be fictitious without pointing to studies indicating results to any facts. Then in the next statement dismissing anything else as “marketing hype”?

    Low dose is different depending on a person’s tolerance, thus the patient becomes the expert with what is sufficient for their personal eleviation of symptoms.

    A question of point 6. If a doctor “doesn’t give you information on exactly what to take, when, and how, and inform you of side effects and risks, is committing malpractice”, then what does the spreading of misinformation or disinformation result in? We’ve had 80 years of this in prohibition, sorting it all out in a few years isn’t going to happen and the doctor’s role over the years has not been supportive in this or frankly one of trust specifically in this matter.

    There are far more people out there who have much more experience with Cannabis then current doctors maybe they should weigh in.

    That being said I agree with some of the doctor’s “advice”.

    Kudos to those weighed in about the “entourage effect” and agreed.