THC, CBD, & Psychiatric Effects

High Court,

Do you recommend I try an indica or a sativa? I have had two recent bad experiences with smoking. I have smoked before and been very chill, but the last couple of times, I had a bad experience. I experienced paranoia and even felt as though I was hallucinating. I’d like to continue enjoying cannabis, but I don’t want to have a bad experience or embarrass myself again.


High Court cannablog cannabis advice column

High Jasmine,

I’m sorry you had a bad experience with cannabis. Most of us who consume regularly have been there before, and it’s no cause for embarrassment. (Good luck telling that to your anxiety, though.)

It probably doesn’t matter if you choose an indica or a sativa, because I expect the answer lies in THC content. The legal cannabis market has led to more and more potent strains with THC that can sometimes top 30%! A lot of people find relief or enjoyment from the high doses of THC, but not everyone.

According to psychology professor Rebecca Craft, who conducted one of the first studies showing how cannabis affects women differently from men, this is due to the elevated potency of modern cannabis. “We’re more likely to see negative side effects today like anxiety, confusion, panic attacks, hallucinations or extreme paranoia,” she said. “And women are at higher risk.”

The good news is that you don’t have to give up cannabis altogether. CBD can counteract the psychiatric effects of THC, including paranoia and anxiety. In 2019, researchers from the University of Western Ontario were able to study and show the molecular mechanisms by which, “CBD blocks the ability of THC to overstimulate the ERK pathway in the hippocampus and thus prevent its negative side-effects.”

To avoid experiencing psychiatric effects, look for a strain that is low in THC and contains CBD as well. A 1:1 THC to CBD would be ideal, to start.

If you don’t live in a location where recreational or medical cannabis is legal, this may be hard to find… I remember well the days of living under prohibition: you take what you can find. Even in fully legal markets, most growers have bred out the CBD that would have been common in the strains years ago.

If you don’t have access to a high variety of strains to select from, you can achieve this balance with edibles. Start with 5mg of a THC edible and 5mg of a CBD edible, taken together. If that’s comfortable, you might try a little more THC the next time, but you don’t have to. The goal is the “very chill” experiences you used to have, not increasing the THC. Please let me know how it goes!


High Court, Jasmine here again.

I thought I should let you know that I have ADD. Could that be the problem? Do you recommend against using cannabis again?

High Jasmine,

Most of the literature that I found reviewed using THC to treat ADD. I’m glad that’s not what you’re asking because there isn’t adequate scientific or medical research to answer that question (yet). I couldn’t find any literature about THC causing greater anxiety in patients with ADD, but again, there’s a general lack of research at play. In the absence of a secondary connection, and since you had good experiences in the past, I don’t want to blame the psychiatric effects of highly potent cannabis on ADD.

If you are not enjoying cannabis, then definitely consider not using it again. Cannabis is not enjoyable for everyone. There is also nothing wrong with experimenting with THC plus CBD to see if you can achieve the desired chill. Listen to your body, and don’t try to force any particular outcome.