Tag Archives: anxiety

Emerging research on the mental health risks associated with cannabis consumption

Rates of cannabis usage have more than doubled in the past decade. Medical marijuana is now legal in half of the United States and is increasing in accessibility to current and future users. Cannabis is now the most widely used illicit substance in the US, more popular than alcohol and cigarettes. Frequent use of cannabis is now twice as common among young people in the 16-24 year old age range. In spite of government and media warnings about health risks, many people believe cannabis to be a harmless substance that helps people to relax and, unlike, alcohol and cigarettes, might even be good for you. Although it is controversial, I believe cannabis should be avoided by the mental health patient and anyone who wants to prevent possible brain dysfunction that can significantly impact basic functioning.

Here are some facts to consider before reaching for cannabis:

What is the chemical makeup of cannabis?  

There are about 400 chemical compounds in an average cannabis plant. The four main ones are delta-9 tetrahydrocannabinol (delta-9-THC), cannabidiol (CBD), delta-8-tetrahydrocannabinol and cannabinol. All but the CBD are psychoactive (known to affect brain function).

What about stronger varieties?

In herbal cannabis, the concentration of the main psychoactive ingredient, THC, varies hugely — from 1% to 15%. The newer strains can have up to 20%. The newer varieties on the whole are 2-3 times stronger than those available 30 years ago.  Some users may even use these stronger varieties as substitutes for Ecstasy or LSD.

Immediate pleasant effects:

A “high” — a sense of relaxation, happiness, sleepiness. Colors appear more intense, music sounds better.

Unpleasant effects:

Even though THC can produce relaxation in many people, that isn’t the case with all people, particularly those who have a family history of mental illness.  In some people, it can have the opposite effect and may cause unpleasant experiences including confusion, hallucinations, anxiety, and paranoia, depending on mood and circumstances. Some people may experience psychotic symptoms with hallucinations and delusions lasting a few hours. Even though these unpleasant effects typically don’t last long, the drug can stay in the system for weeks and have longer lasting effects than users realize. In some genetically predisposed people, it may trigger the onset of Schizophrenia or Bipolar Disorder. This is a bigger risk for people who started using cannabis in childhood or adolescence and into the mid twenties, critical brain development stages.

Long term risks:

Over time, cannabis can have a depressant effect and reduce motivation and the abilities to concentrate, organize information, and use information. A recent review of the literature on cannabis’s effect on pilots showed that those who used cannabis made far more mistakes, both major and minor. The worst were in the first four hours after use, though mistakes persisted for at least 24 hours when the pilot had no sense of “feeling high.”  Recent research published in the Journal of Alzheimer’s Disease found that cannabis users have noticeable deficiencies of blood flow in the brain. Notably, the research showed diminished blood flow in the right hippocampus, the area of the brain that helps with memory formation and learning. This is the area severely affected in those that have Alzheimer’s Disease. Other smaller studies of perfusion imaging in marijuana users show lower amounts of frontal, temporal, and occipital lobe blood flow.

Is cannabis addictive?

Yes, it can be. Current evidence now suggests that it can be, particularly if used regularly. Cannabis has the same features of other addictive drugs, such as the development of:

Tolerance: Tolerance means having to take more and more to get the same effect. Heavy users can experience withdrawal symptoms such as anxiety, cravings, decreased appetite, sleep difficulty, weight loss, aggression, irritability, restlessness, and strange dreams. For regular long-term users, 3 out of 4 experience cravings, half become irritable, and 7 out of 10 switch to tobacco in an attempt to stay off cannabis.  The irritability, anxiety, and insomnia usually appear 10 hours after the last joint and peak around one week after last usage.

Compulsive use: Eventually, many regular users become more compulsive in their usage. The user feels they have to have it and spends much of their life seeking, buying, and using cannabis. They cannot stop even when other important parts of their life such as family, friends, school, and work suffer.

How to know if you have a dependency and/or addiction:

Cannabis can become a significant problem for some people. Marijuana-anonymous.org says people have realized they have an addiction when “cannabis controls our lives and our thinking, and … our desires center around marijuana — scoring it, dealing it, and finding ways to stay high so that we lose interest in all else.”

Cannabis is similar to alcohol addiction.  Here are some questions to ask oneself to see if cannabis is a problem. Yes to any of these questions indicates a problem:

  1. Has smoking pot stopped being fun?
  2. Do you ever get high alone?
  3. Is it hard to imagine a life without marijuana?
  4. Do you choose or lose friends based on your marijuana usage?
  5. Do you smoke marijuana to avoid dealing with your problems?
  6. Do you smoke pot to cope with your feelings?
  7. Does your marijuana use let you live in a privately defined world?
  8. Have you ever failed to keep promises you made about cutting back or controlling your pot smoking?
  9. Has marijuana caused problems with memory, concentration, or motivation?
  10. When your stash is nearly empty, do you feel anxious or worried about how to get more?
  11. Do you plan your life around your marijuana use?
  12. Have friends or relatives ever complained that your pot smoking is damaging your relationship with them?

Other reasons not to use cannabis (even if you are not addicted):

Besides the reasons mentioned above, street cannabis may be laced with other more dangerous drugs that could be deadly.  Additionally, there are drug-drug interactions that may make  it unsafe to use with other types of medications. As cannabis over time tends to have a depressant effect and may even increase anxiety, it can counteract any medication your provider prescribes for you. Your provider may ask or even require that you drastically cut down or discontinue your pot use (along with other drugs and alcohol).  Additionally, as it affects motivation, it interferes with the ability to eat healthy, exercise, do psychotherapy, and practice other healthy habits that contribute to mental health.

In conclusion, although cannabis may show short-term alleviation of anxiety symptoms, I believe in the long run it has more risks than benefits and do not recommend mental health patients use cannabis or medical marijuana.

Satu Woodland is owner and clinician of Mental Health Solutions, an integrative mental health practice located at Bown Crossing in Boise, Idaho. She sees children, adolescents, and adults. Information in this blog is not intended as medical advice. Please consult your health care provider about decisions regarding your health.

Both obese and anorexic women short on “feel-good” chemical

If you’re anorexic or obese, there’s a good chance you’re depressed, too. More than 50 percent of anorexic women and 43 percent of obese people suffer from depression.

Surprisingly, a new study shows the biochemistry contributing to depression and anxiety in those two opposite physical conditions appears to be the same. Both obese and anorexic women have low levels (50 percent of normal or less) of allopregnanolone, a steroid that enhances the signal produced when the neurotransmitter GABA binds to its receptors, resulting in a general feeling of well being. Women in either weight category with low levels of allo were more likely to suffer from depression or anxiety.

Several previous studies have connected low allo levels with depression in the past, but its levels have never before been linked to anorexia or obesity.

Meds that increase the body’s ability to convert progesterone into allo could be helpful for treating depression and anxiety in these women who are outside normal body weights. We need more research before going that route, though. Scientists are working on that.

If your weight is at either end of the spectrum and you’re feeling depressed, come on in. We can talk about how to successfully modify your behavior to get you to a healthier weight along with what medications might help.

Satu Woodland is owner and clinician of Mental Health Solutions, an integrative mental health practice located at Bown Crossing in Boise, Idaho. She sees children, adolescents, and adults. Information in this blog is not intended as medical advice. Please consult your health care provider about decisions regarding your health.

Probiotics to treat depression?

It’s not official yet, but a new study suggests taking probiotics could relieve symptoms of depression.

Remember several months ago, when I wrote about the relationship between your gut and your mental health? I recommended changing what you eat to develop a healthier gut. Well, this new study is along those same lines: Taking a probiotic to treat irritable bowel syndrome (IBS–a gut affliction) can also treat depression and anxiety.

It was just a small study with 44 participants. Each had both IBS and mild to moderate anxiety or depression. Half the participants took a probiotic (Bifidobacterium longum NCC3001, to be specific), while half took a placebo.

In the end, 14 of the 22 probiotic takers reported improvement in their depression symptoms, compared to half that number in the placebo group.

The researchers took it further and scanned the participants’ brains: Those whose depression symptoms had improved also showed changes in areas of the brain associated with mood control.

We need to see a larger version of this study before we start jumping on board, but given the established connection between the gut and the brain, I think it’s a promising area of research.

Satu Woodland is owner and clinician of Mental Health Solutions, an integrative mental health practice located at Bown Crossing in Boise, Idaho. She sees children, adolescents, and adults. Information in this blog is not intended as medical advice. Please consult your health care provider about decisions regarding your health.

Poor sleep? It could be affecting your negative thoughts

Ever heard of cognitive reappraisal? It’s where you take a negative thought or experience and recast it in a positive light. (Failed a test? At first maybe you dwell on your shortcomings, but then you “reappraise” and think of it as a chance to see where you can improve.)

A new study shows people with sleep problems have a harder time doing that than do their well-rested counterparts.

All participants in the study had a depression and/or anxiety disorder, which already puts them at a disadvantage for seeing the positive side of things. Researchers wanted to see if lack of sleep made that worse.

First, the scientists gave participants sleep trackers. After measuring how well they slept for six nights, they hooked the subjects up to an MRI and watched brain activity while the participants completed an emotional regulation task: They had to look at disturbing images and reappraise them in a more positive light. (For example, a subject might look at a picture of a battered woman and imagine her as a model wearing make-up instead of as a victim of violence.)

The region of the brain known to be involved in regulating emotions is called the dorsal anterior cingulate cortex (DACC), and it springs into action when you’re engaging in cognitive reappraisal.

Here’s what the scientists found: During the reappraisal task, people who had sleep problems had more activity in the DACC than did people who slept well. Researchers interpreted those findings to mean the sleep-deprived brains had to work harder to come up with a positive spin on images.

If you’re depressed or anxious, let’s talk about your sleep. If we can get you sleeping better, you could find it easier to see the world in a more positive way.

Satu Woodland is owner and clinician of Mental Health Solutions, an integrative mental health practice located at Bown Crossing in Boise, Idaho. She sees children, adolescents, and adults. Information in this blog is not intended as medical advice. Please consult your health care provider about decisions regarding your health.

“Forest bathing” for your health

There’s a video going around social media about the Japanese practice of “forest bathing,” and it’s a concept I believe in and love.

What is Japanese “forest bathing” and how can it improve your …

Need a boost? This is the power of a walk among the trees. Read more: http://wef.ch/2nWtXUR

Posted by World Economic Forum on Tuesday, April 4, 2017


The Japanese phrase for “forest bathing” — or taking in the forest atmosphere — is “shinrin-yoku,” and the government has been promoting it since the 1980s.

Japanese researchers have spent a lot of time studying the effects of shinrin-yoku. They’ve found that time spent in forest environments reduces feelings of stress, anxiety, and anger and improves energy. On the physiological front, it promotes lower levels of stress hormone, lower pulse, and lower blood pressure. Researchers have even found that forest bathing increases the activity of “natural killer” cells in the immune system. These cells respond to viruses and tumors. The scientists attribute the change to phytoncides, or the oils trees emit to protect themselves from germs and insects. As forest bathers inhale them, they’re inhaling better immune system health.

The concept behind forest bathing is one of the reasons I offer walking therapy sessions on the Boise greenbelt. Getting out in nature is good for the soul, and there’s science to prove it.

Satu Woodland is owner and clinician of Mental Health Solutions, an integrative mental health practice located at Bown Crossing in Boise, Idaho. She sees children, adolescents, and adults. Information in this blog is not intended as medical advice. Please consult your health care provider about decisions regarding your health.


Newborn brain scans predict depression

Does depression change the brain, or are brain abnormalities the cause of depression?

There’s a new study out that sheds some light on that question.

A group of scientists took their research all the way back to the beginning of life: They scanned the brains of newborn babies.

Two years later, they evaluated those children for signs of depression and anxiety (sadness, excessive shyness, nervousness, or separation anxiety — all symptoms that have been linked to depression and anxiety disorders in older children and adults).

They found a pattern in the scans. The children who showed signs of depression and anxiety at age two tended to have at birth similar connections between the amygdala (a structure involved in processing emotion) and other brain regions (such as the insula, which is associated with consciousness and emotion, and the medial prefrontal cortex, which is involved in decision making).

The researchers want to stretch the study out further to see if these connectivity patterns really do predict psychiatric disorders later in life, but so far the evidence is interesting. If you’re suffering from depression or anxiety now, it’s likely you were born with the brain connections that helped lead you there.

But no matter when or where you psychiatric distress came from, help is available! Therapy, lifestyle changes, and medication can counteract the tendencies you were born with or developed later in life. Let’s talk about it!

Satu Woodland is owner and clinician of Mental Health Solutions, an integrative mental health practice located at Bown Crossing in Boise, Idaho. She sees children, adolescents, and adults.

Your body under emotional stress: It’s not pretty

Let’s talk about stress. You know it’s bad for you emotionally, but did you know it’s dangerous physically, too?

It’s true. When you’re stressed out and you repress it, the stress can resurface as a physical illness. You may even find yourself in the emergency room with chest pains and shortness of breath — a panic attack masquerading as a  heart attack.

While panic attacks won’t kill you immediately, the long term effects of your anxiety can. We’re talking about blood pressure, heart disease, obesity and diabetes. Stress contributes to each of those.

In the short term, you could experience pain in your head, chest, stomach, or muscles. You might feel fatigued and have trouble sleeping. You could see changes in your sex drive. You might take longer than usual to recover from illness.

You also have to watch out for harmful behavior that could be addictive. Some people self harm or turn to drugs and alcohol to escape their anxiety. Others find an outlet in shopping, gambling, or sexual behavior they later regret.

So you need to find healthy ways to fight your stress. You probably know better than anyone what relaxes you: Is it exercise? Doing art or another hobby? Being with family or friends? Getting a massage? Being in nature? Meditation?

Therapy can be so helpful. Your therapist can help you identify sources of stress and strategies for relieving it. Even just having someone to listen in a non-judgmental way while you talk about your problems can be a big help.

So if you’re stressed, come on in. Let’s talk about it.

Pokemon Go is helping with depression

Here’s the last thing I expected to hear about a popular smart phone game based on Japanese anime characters: It’s lessening players’ depression and anxiety symptoms.

But that’s what users are reporting, and it actually makes sense. Pokemon Go is an augmented reality game–meaning it takes the real world around you and supplements it with virtual content. As you look at a real-life scene through the camera of your smart phone, characters appear. Your job is to catch them. Millions of people are heading outside for hours at a time to go on Pokemon hunts.

The game gets people moving around in nature, and that’s a dynamite combination for mental health. When you’re depressed or anxious, finding the motivation to head outside and exercise and engage socially can be extra difficult, but with the game’s competition and rewards, people are doing it. It’s enough that hundreds have been commenting on social media about feeling better.

It’s the opposite effect from traditional video games, and I’m happy to see it.

Click here to read what people are saying about Pokemon Go and mental health!

Satu Woodland is owner and clinician of Mental Health Solutions, an integrative mental health practice located at Bown Crossing in Boise, Idaho. She sees children, adolescents, and adults.


Mindfulness: It’s good for your heart

Over the years, I’ve seen mindfulness meditation make a big difference for clients dealing with depression and anxiety. But today I learned that mindfulness is good for the heart not just metaphorically, but physically as well. 

A new study shows that people who are more mindful — in other words, they are better at focusing on “the now” instead of rehashing the past or worrying about the future — have healthier glucose levels. Two things that might help explain this connection, researchers found, are: 1. Mindful people are less likely to be obese, and 2. Mindful people have a stronger sense of control over their lives — they believe they can make important changes.

This is good news for everyone, not just the mindful among us, because mindfulness is a trait that can be learned and developed. Working with a therapist is helpful, but practicing mindful meditation on your own can be, too. You can even find apps for your smartphone that will walk you through various meditations, helping bring your mind back to what is going on inside and around you.

Eventually, we hope, doing these mindfulness exercises will help you cultivate the everyday mindfulness that will change how you behave and how you respond to stressful situations.

So let’s work to be more aware of the world around us! It’s good for our hearts!

Wondering where you fall on the mindfulness spectrum? Here are some questions to consider:

  • Do you find yourself running on autopilot frequently?
  • Do you forget names soon after you hear them?
  • Do you snack without being aware of what you’re eating?
  • Do you break or spill things out of carelessness?

Go here for the full questionnaire researchers use to measure mindfulness. 

Satu Woodland is owner and clinician of Mental Health Solutions, an integrative mental health practice located at Bown Crossing in Boise, Idaho. She sees children, adolescents, and adults.

Treating mood swings during perimenopause

When you first start having perimenopausal symptoms, you may not put two and two together; after all, you’re too young to be going through menopause. The changes in your body can confuse you and drive you to distraction. It is not uncommon to be confused and for mood swings to occur. If you are experiencing episodes that you don’t understand such as extreme mood swings, there are treatment options.

Mood swings can have many causes. Sleep patterns may be interrupted by night sweats or hot flashes. Studies show that when a person doesn’t get enough sleep each night, episodes of irritability, lack of focus, and extreme stress may occur. Along with these symptoms, your immune system weakens because the body is not getting the downtime it needs to repair and restore from the day’s activities.

Mood swings can be brought on by difficult or changing situation in your life. A normal interaction with a child who asks for something repeatedly can pluck that last nerve and send you screaming out of the room. A cross word can send you into tears. An extra project at work combined with sleep deprivation can lead to poor work performance and/or missed deadlines.

It can seem like everything has gone to hell in a hand basket in no time at all. This slow descent into the abyss we call stress can lead to depression in many perimenopausal women. Not being able to get a handle on the symptoms leaves you in a vulnerable state without your normal coping mechanisms you’ve relied on during all those “normal” years.

Treatment Options

You are not alone in your despair. There are many options for treating this very common part of perimenopause:

• Support – This can be a group sponsored by your doctor, church, hospital, online group, or simply a group of friends who are also going through the same situation. Talking with others about your symptom can ease the burden. Women experiencing the same things may also be able to suggest ways that may help you cope better.
• Meditation – Taking time out in a quiet place to listen to your inner self can help you prepare for the day with a full suit of armor. Yoga is a type of meditation that also involves body stretches which prove to increase your fitness level and that mind-body connection.
• Exercise – There’s a reason exercise keeps coming up. Exercise is great for a variety of ailments. Physical activity increases oxygen levels in the brain and also releases the body’s natural antidepressants; endorphins. You think more clearly, experience greater mobility, and relieve tension and stress with exercise. That is why exercise is mentioned so often.
• Antidepressants – There are many reasons why antidepressants are prescribed; some reasons are obvious, while others, not so much. There are antidepressants which actually have helpful side effects which benefit perimenopausal symptoms; such as sleeplessness. Your doctor or nurse practitioner may prescribe antidepressants for many different reasons, for instance, to help you cope with mental and physical changes that are causing quality of life problems. You don’t have to stay on antidepressants forever. Your provider will help you wean off the antidepressants when you and your doctor feel you are ready.

Mood swings can be managed during perimenopause even though you might not think so right this minute. You do not have to suffer alone. Ask your doctor or nurse practitioner for information regarding the current research on ways to fight mood swings during this stage in your life.