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Allan Schwartz, Ph.D.Allan Schwartz, Ph.D.
Dr. Schwartz's Weblog

Marijuana Makes it Worse, Revisited

Allan Schwartz, LCSW, Ph.D. Updated: Jan 7th 2010

Marijuana Makes it Worse, RevisitedThere is a perception out there that Marijuana is a harmless drug that can be used liesurely and without worry about side effects. The E. Mail below says other wise as well as some recent research.

This is a recently received E. Mail sent to me from a mother who has a son with Bipolar Disorder and a marijuana smoker.

"Dear Dr. Schwartz,
 
I recently found your article dated November 1, 2008.  I have a son diagnosed with Bipolar Disorder who regularly uses marijuana. I used to believe that the marijuana eased his symptoms, but I now believe that it has made his situation worse. He has been hospitalized at least 6-7 times in the past year and a half, including a 30 day hospitalization in a dual treatment center. The past five years or so with him has been an emotional roller coaster. He has been banned from one mental health facility because of his abusive treatment of the staff. I believe you pegged it when you say that the marijuana contributes toward an endless cycle of relapses."

The original article can be found at this URL:

/poc/view_doc.php?type=doc&id=28964

More recent research lends increasing credibility to the assertions, made by many mental health experts, that the long term effects of marijuana are not known and that there is a lot that is still not known about this drug.

For example, recent studies completed in places such as Australia and Canada, reveal the fact that daily use of marijuana by teenagers who continue to use into their adulthood, alters the structure and chemistry of their brains. Daily usage was defined as smoking five or more joints each day. One study clearly showed that this amount of cannabis usage lowered the amount of the neurotransmitter in the brain called serotonin. Decreased amounts of serotonin cause such problems as increased vulnerability to stress and depression.

Another study showed that daily usage of cannabis actually decreased the size of the Hippocampus. This is an important part of the brain the regulates emotions and memory. A reduced Hippocampus has a negative effect on memory, the ability to verbalize and regulate emotions.

Those who protest that none of this is true based on their own experiences with cannabis overlook the fact that, while the immediate reaction to the drug is to feel good, the negative results take time to develop. In other words, there appear to be long range dangers associated with daily marijuana usage.

It is important to remember that marijuana is being legalized as a prescription medication in many states. However, those who insist on the notion that this is a harmless substance that can be helpful, seem to fail to take into consideration the fact that marijuana used as a prescription has many of its useless properties removed. This substance, when purchased illegally, is unregulated. This means that there is wide variability with regard to its purity and strength when purchased from illegal providers.

We know that cannabis can have hallucinogenic effects and can be the catalyst for a psychotic reaction in those with the physical potential for a psychotic illness. The same can be said for depression. This is not meant to imply that marijuana causes mental illnesses but that it can hasten its appearance in those with that type of vulnerability.

A Final Note:

I want to emphasize two main ideas that I happen to believe:

1. In my opinion, marijuana should be legalized and its manufacture regulated so that consumers get only the best quality product. This would take the drug out of the hands of criminals and better protect the health of the public.

2. Taking this stance against marijuana does not mean that, ipso facto, alcohol is safe. In my view, they are both dangerous drugs that should be handled with care.

3. The public must begin to understand that, just like all drugs, marijuana is not a benign substance that can be used without caution.

The E. Mail cited by the worried mother above, really says it all.  Marijuana can and does worsen symptoms in the mentally ill and can alter ones memory and ability to regulate their emotions, as a result of daily and long term use.

As always, your opinions and experiences are welcome.

Allan N. Schwartz, PhD
 


 
 

Allan Schwartz, LCSW, Ph.D.

Readers who live in the Boulder, Colorado metro area, or in Southwest Florida may contact Dr. Schwartz for face-to-face consultation. He is also available for psychotherapy through Skype video for those who are not in Florida or Colorado. He can be reached via email at dransphd@aol.com for details.

Reader Comments
Discuss this issue below or in our forums.

Understanding Medical Ignorance - Andrew Kauffman - Apr 14th 2012

Okay, I have a lot to say and trust me you might want to read this…

First of all, most doctors have prescription bias. They make most of their money by prescribing medications; this isn’t beneficial to the patient. Drug reps are constantly at their door pushing new drugs on the doctors. These drugs were tested under the ‘FDA’ but funded by the pharmaceutical companies. So in reality they weren’t properly tested by unbiased third-party research facilities in the first place.

Marijuana has been tested by all walks of life for thousands of years. Only recently has it not been used for medicine. The only reason it was banned IMO was because pharmaceutical companies in the early 20th century realized we could grow it very easily on our own. They also realized it could treat any number of medical/psychological disorders with little to no side effects. They saw it would take away, dramatically, from their profits. Since America is capitalist and everything revolves around money, they couldn’t keep letting Marijuana be legal and also maximize profits. Today, America is literally run by these pharmaceutical companies. They account for more GPD than any other industry.

Also one of the biggest factors pertaining to our health is nutrition. Makes sense, we are literally what we eat. Everyone knows America’s diet is among the worst in the world. Pharmaceutical companies know that if we diet properly our need for prescription medications would decrease exponentially, as would their profits. So they fight and lobby against vitamin supplements and proper diet. When you go to the doctor what you eat is rarely part of the conversation. The sad truth is the programs doctors go through in med school do not normally include nutrition programs. At best they may attend one nutrition class, the same one mandatory for graduates of any degree. This is deliberate IMO; they know that if we were eating unprocessed, natural and organic foods, we would need them much less. We would live longer and be much healthier; mind and body.  Again, we are a capitalist society and profits are always put above the general populations well being. I mean seriously, how is tobacco legal? How is alcohol legal? The consequences and side effects of these two substances are some of the worst known to mankind. There continued use often resulting in death. Regular people operate machinery high on marijuana on a daily basis with virtually zero related incidents. Yet, everyday someone dies from an alcohol fueled car accident. Again, all for the sake of profits, tobacco and alcohol companies lobby constantly backed by billions of dollars to keep legislation from imposing laws against the sales of their products. They also lobby against marijuana realizing its legality would push customers to something less lethal and more desired. This is all at the expense of the public, who doesn’t have billions of dollars to fight for what they really want.

Basically, today’s medical society works the same way as manufacturing companies. They use intrinsic obsolescence; all products are built to last only a certain amount of time to ensure you have to buy a new one some day and they can stay in business. Today’s medicine doesn’t want to prevent or extinguish disease, only temporarily treat, to ensure you need them in the future. The sicker we are; the more money they make. So why would they want us to be healthy? The simple answer, they don’t.

With my personal marijuana experience, even early on it has helped dramatically. When I was a kid, doctors diagnosed me with ADHD and as usual wanted me on Ritalin. My parents, being the smart ones, said no. My grades in school were reflected by my ADHD. It was always hard to focus on teachers and school work.  Since I had my first website at 11 years old, I ignorantly felt that what I was learning on my own was much more important than school work. So even though I had above average intelligence, my grades stuck around C’s and D’s, I only did what was necessary to pass. Because my grades were low I didn’t think I was book smart. Went to a tech college for medical assisting and did a little better as learning was hands on and partially kept my attention. About two quarters in I started smoking marijuana on a regular basis; from then on I was making mostly straight A’s with a few B’s here and there. All the sudden my reading comprehension was back. I wouldn’t get distracted away from homework and my papers were always compelling and deep. My ADHD seemed to completely go away when I was high. At the same time, I was going through relationship problems and had moderate depression. Marijuana helped ease my sadness and anxiety.

 

More recently I’ve gotten married and have a newborn son. From the beginning our marriage has been bumpy at times. She warned me she has bi-polar and depression but we were smoking marijuana so it was unnoticeable. I started to recognize that when she isn’t high she would have manic episodes. She was diagnosed with bi-polar as a teenager. They prescribed her medication that she says made her someone else entirely. If I had to guess, I would say lithium. It wasn’t until she got to college and started smoking marijuana before she got any relief.

Marijuana has been a tremendous benefit to my marriage. The alone time is much more pleasurable and longer lasting when we are high. That one effect from marijuana by itself makes our marriage stronger. Still, it’s the bi-polar that seems to have the biggest negative impact. Often when she is not high we are at each others throat, as if she is off her meds. This isn’t withdrawal, from what I’ve been told there is no proven physical addiction to marijuana. Plus, there are times we go without and everything is fine. If we were addicted then every time we don’t have it there would be noticeable differences. Unlike alcohol, heroin and crack addictions, we can still function. It’s my ADHD and her bi-polar that cause problems and are only present when we are off marijuana.

Unfortunately for us, the one thing that helps in almost every area (Bi-polar, ADHD, Depression, anxiety, stress, insomnia, etc.) is illegal. Very recently, I decided I was going to surprise my wife with a $20 bag of marijuana, knowing it always helps her feel better and herself. Our normal connection wasn’t available so I had to go with someone I barely knew but had bought from before a half dozen times. When I get there he has to have me drive him to get more. We go and get it and on our way back we get pulled over. Cops find a loaded gun in his pants and warn me I could have been robbed or killed. The ounce he had just purchased, he put under the passenger seat without my knowledge. I tell the cops from square one I was trying to buy a 20 bag and that he had the marijuana in his pocket. Well, because he stashed it in my car, I go down for felony possession. I also had a bowl in my pocket that earned me a misdemeanor. He denies it’s his marijuana and completely lies to the cops, gets away with just a $1000 bond for the handgun. He wasn’t charged at all for it being concealed. I get a $1500 bond for the bowl and $3500 for the felony possession of 28.5 grams. Tell me how that makes any sense. This guy has tattoos all over his face, is obviously a gang banger, yet I’m the one taken off the streets? So they seized my car and put me in jail. I have two degrees, a job and a family. He has no job, didn’t graduate high school and is carrying a loaded gun, but some how I’m the bad guy. Point is if marijuana was legal I wouldn’t have to risk my life and freedom. Both my wife and I use it for medicinal purposes with virtually no side effects without hurting anyone. The only real side effects of marijuana are that it is illegal and subsequently dangerous to buy.

To sum it up, marijuana can help save my marriage by keeping my wife’s bi-polar in check. If it helps me and my family this much without hurting anyone why can’t we buy or grow it and be left alone? Who are they to tell me what’s good for my family. After thousands of years of successful medical and mental marijuana treatments it’s ignorant and foolish to say it’s harmful.

Bipolar Disorder and Drug Use - - Jan 23rd 2012

Although I can't provide any scientific backings to my claim I can provide everyone with some personal experience. I'm Bipolar and used marijuana to self-medicate. At first it kept me calm and relaxed, helped keep me at an in between state between highs and lows. Unfortunately self medicating eventually stoped working for me. That calm relaxing high turned into panic attacks associated with an increase in my racing thoughts - it honestly felt as if someone opened a floodgate in my mind. After a few weeks of these awful highs I stopped smoking completely. What followed was rapid cycling and an increase in my passive suicidal ideations which eventually became active. Luckily I was able to recognize the change between the two and admitted myself to a treatment facility. I'm definitely not insinuating that my experience is the norm for other sufferers of Bipolar Disorder but I am saying that it could be the case for a few. I honestly think reactions caused by the drug depends on the person and what type of Bipolar Disorder they're suffering from.

Evidence for increase the clinical research - Joël - May 16th 2011

Sorry for my English, I'm french...

Maybe you should tell her to use only cannabis indica or hachish from the northern part of the world.

And to lower a bit her medication. Sometimes it's hard to smoke with the medication. But tell her if she stops pot, she won't be able to handle her problems anymore.

So she should smoke but only in case of she realy need it. Every think is on the amount taken and on the quality of the product! Be carefool and if you are bipolar, do not smoke pot from street dealer!!! This is highly dangerous.

Those strains of indicas are less psycholike or hallucinogenic because there is a composant call CBD (cannabidiol) who can act like an antipsychotic when she is in manic state.

Cannabis sativa higher the state of mind and tends to be a good choice for depression.

There is a study who has collected report cases :

http://rxmarijuana.com/mood_stablizer.htm

See you

Use and bi-polar did not work for long - sc - Apr 23rd 2011

 My wife started to use after her cancer treatments to calm her stomach. She surrived thank God. She started to use more afterwards and was having a hard time making sound jugements on day today choices. She used to be a great mother and super lady. She no longer cares about her family and well being. We have been seperated for 8 months now.I cannot tell you how much this has disrupted our lives. Please ask a sober freind. One that doesn't smoke or use anything, Am I doing O.K.? Have I been making good judgements? Don't ask your using freinds because they always tell you what you want to hear. I wish you all well on your treatments.My wife was fine for a year at first but now has turned 180. Don't be fooled. Time will show you how this medical majiwanna heals. It did not in my wives case. Wish you all well on your road to better living.

I self medicate - Joël - Apr 21st 2011

I agree. I've been diagnosed with a bipolar disorder before begining to smoke. Now I self medicate : cannabis indica (CBD++) for manic states. It helps me calm down and is antipsychotic. Strains as Northern Lights are good one.

Cannabis sativa (CBN++) is highly antidepressant

Peace

Huh? - Allan N. Schwartz, PhD - Feb 12th 2011

Hello Guy Dudebro,

This blog on marijuana and mental health stirs lots of controversy. That is fine. What is NOT FINE is rudeness and your comments are rude as well as wrong. What concerns me, more than the facts are your hostile attitudes as expressed in your comment. I have no idea why you seem to need to be nasty but there is no question that is what you are doing.

Facts: Among the 400 other chemicals in marijuana is THC. THC is a mild hallucinogenic drug.

There is ever increasing research showing that there is a direct relatioship between such mental illnesses as depression and schizophrenia. This is research that meets all the criteria for it to be valid and is printed in medical and psychiatric journals.

As yet, there is no marijuana medication produced with its unnecessary properties removed. That is something that some medical researchers are working on now. At present, "medical marijuana" is nothing but marijuana.

Read more carefully and check on your facts before you jump to conclusions and put a stop to the angry tones with which you write.

Dr. Schwartz

Huh? - guy dudebro - Feb 11th 2011

There are so many factual errors and logical leaps of faith in this article that I'm embarrassed to have wasted my time reading it.

A: Medical Marijuana is not regulated in any way. There is no quality control on it the same way that there is no quality control on street weed. You know why? Because they're selling you a plant. You cannot judge potency of the plant the same way you can judge the potency of a pill. It's impossible. In fact, this is one of the main arguments against legalization. You never know your dosage.

B: You say that, "marijuana used as a prescription has many of its useless properties removed." This is patently untrue. They sell you weed. Ganja. Pot. Smokabowls. You know, the same stuff you get on the street. Heck, I know a few people who used to sell weed illegally who now just sell it to clinics. There is no difference between street weed and clinic weed, nor is there any reason to believe that there would be.

C: "We know that cannabis can have hallucinogenic effects." Who is this we? Is it the same magical "we" that thinks you can tell the potency of a plant just because you buy it in a store that also allegedly cleans it of "useless properties?" Where are you getting this stuff, Reefer Madness? Mary-J doesn't make you hallucinate, nor is it a disassociative, as most so-called hallucinogens actually are.

D: Actually, you know what? Let's just go over this whole paragraph here -- "We know that cannabis can have hallucinogenic effects and can be the catalyst for a psychotic reaction in those with the physical potential for a psychotic illness. The same can be said for depression. This is not meant to imply that marijuana causes mental illnesses but that it can hasten its appearance in those with that type of vulnerability."

Your first sentence groups together two completely unrelated ideas. And not only are they unrelated, they're also untrue. As I said above, Cannabis is not a hallucinogen and even if it were, your juxtaposition of it as a cause for mental problems would still be a totally unrelated idea. Furthermore, at the time you published this webpost there were exactly ZERO peer reviewed medical journal studies about weed in relation to the onset of mental illness. There was one published this week, but since you didn't publish this after February 9, 2011, you were just making things up.

This article shows brazen disregard for the scientific method, logical analysis, and shows little understanding of the concept of correlation without causation. I strongly encourage you to hold yourself to a higher standard of ethics and logic if you wish to continue to give medical advice on a forum such as this.

pot use - corey - Jan 4th 2011

Im 22 years old and have had bipolar disorder for years. I have made the mistakes of over useing pain killers/alchol. But even on the meds the hospital gave me after i got locked up the frist time i was still finding it hard to quit the pills and the drinking. So i started smoking pot again and it helped me quit the pills and drinking. I also have noticed that i don't think of death as much. It didn't fix the problems by no means but it helps with them.

My experience witgh marijuana - Michael - Jul 15th 2010

Well I do not suffer from bipolar disorder or psychosis, so let me state that straight up. I have observed people with psychosis and mania use the drug, but unfortunately I was not able to form a definite conclusion. I have seen people manic while smoking pot, indeed when they are manic perhaps they are more attracted to pot, but I am not sure whether the pot caused or aggrivated their mania, but it certainly did not cure it. I've seen people go in for shock therapy, come out later and smoke more pot, and then the next day go in for more shock therapy. In this case I told the doctors the person was consuming pot.

Marijuana may be very attractive in people with mania because marijuana is very good at alleviating jittery feelings from a lack of sleep, it also may tend to give people with bipolar "grandiose ideas". I have noticed some psychotic on pot believe "they have figured everything out". Yet again I am not sure if it was the pot or their illness.

But I suffer from Major Depression and borderline personality disorder. For me marijuana has been a god send.

I used to be a chronic alcoholic, my arms and legs are covered with scars from smashing bottles and hacking myself up. I had to have multiple surgeries and hundreds of stiches. I have had  the swat team out and nearly shoot me, I have vandalized huge amounts of public property, I have nearly been hit by a train, nearly drowned, been taken probably around 50 times by ambulance to hospital. I had over 50 criminal charges. You would find me homeless passed out around the city in random locations. I have honestly seen police officers intimidated by me when I have been screaming and ranting and completely covered in blood and suffering from pronounced blood loss. There is much, much more to the chaos that was my alcohlism. I had HORRIFIC, EVIL hallucinations, it was CHOAS. Nothing can really describe it in words.

Marijuana helped me escape the dark curse that is alcoholism. I'd most likely be dead or in prison if I hadn't stopped drinking.

It helps with my depression quite a lot. However marijuana is a very complex drug.

There is a tolerance wall that most people encounter if they smoke chronically.

The problem is marijuana has mood elevating effects (on many people anyway). Some people suffering from depression etc use it as a crutch, but when something makes their depression worst, they may increase significantly their usage of marijuana.

The problem is over several days a chronic elevation in usage can IMPEDE the mood elevating effects. It seems quite natural if you find marijuana helps your moods, and then say somebody dies or something makes you depressed. Its very easy to start elevating your consumption higher and higher to treat your moods. This is the problem. What can happen is because chronic usage of marijuana WEAKENS the psychoactive effects is that when a person is most depressed, the apparent mood elevating effects of marijuana can collapse. I have had this happen to me once or twice over the years. Marijuana is WEAKER when used chronically. The more you use it, the less it will effect you.

It takes around 5-10 days with significant alteration in consumption behaviour for changes in tolerance to fully express themselves, in some cases it may be even longer.

Marijuana SIGNIFICANTLY helps me. Its not an EITHER/OR scanario. I take medications for depression, I take these with weed. The medications take away my lowest and darkest moods, but marijuana enables me to enjoy things. This is a very big problem for me, my ability to partipate and enjoy things. Marijuana DEFINATELY promotes in me intellectual interest in things.

 

People need to understand marijuana makes me feel really HAPPY and positive. It has in one way or another MOOD ELEVATING effects, you can call this antidepressant if you want because it works for my depression.

Everynight I consume it for 3-4 hours before bed. If you ever catch me, you will find me dancing around to music, laughing, just being talkative and happy and friendly.

My cousin who is BRAINWASHED against marijuana and has never used it (despite getting drunk heavily on a regular basis). He is AGAINST POT, but even he has decided to make an exception to me, because he says I am happier and better to be around these days. Indeed I can honestly say not a single person I know (that is a close friend or relative) has ANY problem with my consumption of pot, all of them are very happy with how much better I am doing these days.

 

Every night when I consume Pot, I plan for the next day. It truly puts me in a positive state of mind, where I feel optimistic and self-empowered. It brings me so much deep happyness. I have the highest affection for pot.

Yet I have never said pot is harmless. I think it is fairly safe for most people (without SEVERE psychiatric problems), and I truly do think it has some place in treating certain types of depression, in conjunction with other treatments.

I personally am not sure about the effect marijuana may have on schitzophrenia, psychosis, and bipolar. Though I probably would avoid marijuana with these conditions.

 

It seems fairly safe for borderline personality disorder, especially in older people with this disoder. Its worth trying for depression, but people should be warned that if they significantly elevate their usage to heavy chronic daily usage, that the mood elevating effects may fail. If your starting to get depressed, marijuana actually seems more useful if you keep your dose the same, or even somewhat reduce your consumption.

you need more facts - - Apr 20th 2010

marijuana has 2 active chemicals thc and cbd. cbd has been proven by Canadian doctors to help mental disorders. thc may or may not help but cbd helps

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