Social Anxiety & Public Speaking

One of the most ubiquitous fears is that of public speaking, which stems from a fear of being judged.

Interestingly, the fear of public speaking is actually very similar to social anxiety. It is in fact a form of state social anxiety. However, the fundamental difference is that fear typically disappears after being faced with speaking in front of a crowd.

In social anxiety, the fear is pervasive when faced with everyday social situations which most of us would consider normal.

The good news is that CBD is here to help, and has demonstrated some promising evidence for the treatment of social anxiety conditions.

In a double blind protocol, CBD (300mg), ipsapirone (5 mg), diazepam (10 mg), or placebo were administered before a simulated public speaking test. Bar the placebo, all the interventions significantly reduced the anxiety induced by the test. This is encouraging, as CBD demonstrates equal efficacy for alleviating social anxiety, only without the risks and side effects associated with pharmaceuticals such as diazepam.

In another study, participants with Social Anxiety Disorder were given CBD (600mg) or placebo in a double blind, randomised fashion. Again, they were tested using a simulated public speaking test. Healthy participants were also subjected to the same test, only without the use of medication. The Visual Analogue Mood Scale (VAMS) and Negative Self-Statement scale (SSPS-N) were used to assess subjective anxiety, as well as physiological markers of anxiety – blood pressure, heart rate and skin conductance.

Participants treated with CBD significantly reduced anxiety, cognitive impairment and discomfort during their speech. As a result, SAD participants given CBD showed a similar response to public speaking as the healthy controls. This indicates a strong potential for CBD to reduce any excessive fear that would be otherwise considered as an anxiety disorder.

Effects On Mood

Depression is a common passenger that hitches a ride with anxiety. The fact that one experiences anxiety (especially chronically) is enough to produce a bleak outlook on life.

Disturbances in mood and depression are famously associated with serotonin signalling (although more contemporary evidence suggests there is more to it than that). As we have seen above, CBD activates the 5-HT1A receptor, which stimulates serotonergic neurones affecting mood.

Mood disorders are complex, and involve a range of neurotransmitter and signalling pathways. At the root of many signalling pathways are the endocannabinoids. Your endocannabinoid system is a homeostatic regulator of neurotransmitter systems, and just about every other physiologic system in the body.

As we have seen, CBD can influence endocannabinoid signalling and therefore other neurotransmitters, such as glutamate. This is excitatory in nature, and is closely associated with anxiety responses. An indirect inhibition of glutamate signalling (via endocannabinoid activity) might also contribute to the anti-anxiety effects of CBD.

When we talk about neurotransmitters binding receptors, we have to look at a given molecules affinity for that receptor. Take CB receptors for example; CBD is an antagonist of the CB receptors, with a fairly weak affinity. It also influences endocannabinoid biosynthesis and subsequently CB receptor binding. THC however is a partial agonist with strong affinity (its more attracted to that receptor), which may explain some of CBD’s subtle effects on mood when compared to THC, which has full blown psychoactive effects.

Thats why the addition of THC is often synergistic with CBD, as an even more effective means of treating depression and anxiety. In the right ratios, they can be a power couple for altering mood.

Anyway, CBD can actually change the shape of the GABA-A receptor in a way which increases its affinity for its specific target neurotransmitter – GABA. Gamma-Aminobutyric acid is an inhibitory neurotransmitter which produces states of calm and balance throughout the nervous system, and is what accounts for the sedating and relaxing qualities of alcohol. Through a greater affinity for GABA-A receptors, the relaxing qualities of GABA are more pronounced, alleviating anxiety.

In addition, a more recent understanding of mood disorders, such as depression and anxiety has emerged. These share a common underpinning which you may be familiar with – inflammation.

Neuroinflammation (brain) is found in a host of mental illnesses which affect mood, including depression, anxiety and even bi-polar disorder and schizophrenia. This inflammation actually effects a host of communication networks within the brain, messing with mood.

More good news – CBD is a potent anti-inflammatory and has antioxidant properties which make it an effective neuroprotective.

TPRV-1 is a receptor which is well associated with pain perception and inflammation. Capsaicin (the pungent principal in chills) actually binds this receptor, and produces the burning sensation associated with the chilli’s ‘heat’. In an opposing manor, CBD may act to desensitise you to pain, and quite possibly exert its anti-inflammatory effects through this receptor (as well as CB2 receptor activity, which ‘talks’ to the immune system).

As you’ve seen above, the limbic system is a key regulator of mood and stress. The hippocampus, as part of this system is also of great interest in anxiety. Conditions of chronic stress can impair the neural plasticity within the hippocampus, and produce symptoms of depression and anxiety. This might explain the co-existence of these two mood disorders, as stress induces depression.

What is neural plasticity?

Its basically the brains ability to adapt to new situations and environments, and respond to injury and disease through the development and maintenance of neural networks.

A key regulator of neural plasticity, Brain Derived Neutropic Factor (BDNF) can be measured as a serum and plasma reading, and is typically found to be reduced in cases of depression. BDNF is a crucial component in the growth and development of new neural networks in the brain – neurogenesis.

I bet your guessing what role Cannabis has to play here, right?

Well, its a corker, Ill tell you that.

Anandamide is actually very closely associated with BDNF. In fact when you exercise you are increasing Anandamide signalling, thereby stimulating BDNF to work its magic on the hippocampus. This is why exercise is such a powerful anti-anxiety therapy.

In a similar way to exercise, CBD prevents the metabolism and re-uptake of Anandamide, allowing increased endocannabinoid signalling and possibly BDNF presence. In this way, neurogenesis can occur in the hippocampus.

In addition, a synthetic cannabinoid which mimicked the action of THC (CB1 activation), when administered chronically showed anxiolytic and antidepressant action likely via hippocampal neurogenesis.

If you think about the similarity between THC and anandamide, they both bind to the CB1 receptor and cue its activation. CBD encourages increased binding of Anandamide to produce this effect, and exercise independently increases Anandamide signalling. Together, these could be powerful anti-anxiety treatments.

CBD has been shown to induce hippocampal neurogenesis in mice.

CBD And Panic Attacks

Anyone who experiences anxiety knows about the incessant background noise that seeks to undo their very being. If that wasn’t enough, sometimes it goes a step further when a tidal wave of anxiety suddenly hits at once.

Coming out of the blue, this rogue wave takes hold and unfolds into full blown panic – unpleasant to say the least. Thankfully, CBD has a helping hand to play in riding this wave out.

Moderated once again through the activation of the 5-HT1A receptor, CBD impairs escape like behaviour, which suggests that it packs an anti-panic punch. This was found by a study conducted on rats subjected to electrical stimulation whilst housed in a circular arena. Panic was defined as the threshold which prompted the rats to run around the arena in an attempt to escape.

When injected with CBD, the rats showed reduced defensive responses (associated with anxiety and panic) when electrical stimulation was administered.

A similar study also showed inhibition of anxiety and panic in mice, whose fear was induced by the presence of a wild snake!

These animal studies are encouraging, and can likely be supported by the anecdotal evidence of human CBD users who experience panic attacks.

Taking This Into Consideration

These studies may have a certain degree of internal validity, but when using CBD oil for yourself, doses and effects may vary. In addition, many studies showing a potentially efficacious effect of CBD are on animals, and may vary for humans.

Due to your highly personalised genetic make – up and biochemical individuality, an effective dose for you may be different from others. In addition, the tone of your endocannabinoid system may vary, which could affect your response to CBD (and cannabinoids in general).

A good starting point is to try low doses of CBD and work your way up. Anywhere from 10mg allows you space to experiment. Doses used in studies (400 & 600mg) are considered fairly high, so before you dive into the unknown or potentially waste your CBD oil (isolated CBD may have a bell shaped curve effect compared to full spectrum extract), dip your toe in.

Here’s a neat summative illustration of everything listed above: